WorldWideScience

Sample records for leila sahli smail

  1. İsmail Hikmetî ve Divanı İsmail Hikmetî and His Divan

    Directory of Open Access Journals (Sweden)

    Fatih SONA

    2012-09-01

    Full Text Available The Ottoman Empire started to regress in the 18th century. The Ottoman Empire felt behind the western states in this century. However we cannot say the same thing for culture and literary life. The evolution of literature wasn’t change in this century. The influence of Iran on literary life decreased. A notable example of poets in this century was Ismail Hikmeti. He lived in Edirne and became successor of Ahmed Saki who died in 1741. He wrote his great work Divan and named Tuhfe-i Na-dide. The poet was influenced Ibrahim Sahidi’s Tuhfe. It wasgiven meaning of various Persian word in this Divan. We know there arefour copies of İsmail Hikmeti’s Divan. One of these copies is PrincetonUniversity Library in USA, one of these copies Yapı Kredi Sermet CifterResearching Library, one of these copies is in Istanbul MetropolitanMunicipality Ataturk Library Osman Ergin Manuscripts Departmentand one of these copies is in Suleymaniye Library, Lodge of Ussaki.There are 645 poems in the book consisting of dibace, 131 kaside, 430gazel, 38 murabba, 11 muhammes, 10 museddes, 6 musemmen, 2muasser, 3 kıta, 3 mathnawis, 11 mufred. Religion and sufism coversignificant part in his Divan. The term words and explanations ofsufism are used in his Divan. The poet occasionally wrote human lovein his poetries.He passed away in 1773 in Edirne. In this article, we aim toanalyze his literary pieces and introduce him to literary world. 18. yüzyılda Osmanlı Devleti eski gücünü kaybetmeye başlamıştır. Bu yüzyılda Osmanlı Devleti’nin batılı devletlerden geri kaldığı ortaya çıkmış; ancak kültür ve edebiyat hayatı bu gerilemeden pek etkilenmemiştir. Bu asırda edebiyatın gelişiminde bir değişiklik olmamış, bunun yanında İran tesiri azalmıştır. Bu dönemdeki şairlerden birisi de İsmail Hikmetî’dir. Şair, Edirne’de yaşamıştır. M.1741 yılında Edirne’de vefat eden Ahmed Sâkî’nin halifesi olmuştur. İsmail Hikmet

  2. An Ottoman response to Darwinism: İsmail Fennî on Islam and evolution.

    Science.gov (United States)

    Bilgili, Alper

    2015-12-01

    The Scopes trial (1925) fuelled discussion in the United States on the social and political implications of Darwinism. For the defenders of the 1925 Tennessee law - which prohibited the teaching of Darwinism in schools - Darwinism was, amongst other things, responsible for the German militarism which eventually led to the First World War. This view was supported by İsmail Fennî, a late Ottoman intellectual, who authored a book immediately after the trial which aimed to debunk scientific materialism. In it, he claimed that Darwinism blurred the distinction between man and beast and thus destroyed the foundations of morality. However, despite his anti-Darwinist stance, İsmail Fennî argued against laws forbidding the teaching of Darwinism in schools, and emphasized that even false theories contributed to scientific improvement. Indeed, because of his belief in science he claimed that Muslims should not reject Darwinism if it were supported by future scientific evidence. If this turned out to be the case, then religious interpretations should be revised accordingly. This article contributes to the literature on early Muslim reactions to Darwinism by examining the views of İsmail Fennî, which were notably sophisticated when compared with those of the anti-religious Darwinist and anti-Darwinist religious camps that dominated late Ottoman intellectual life.

  3. 5 küsimust Leila Pärtelpojale / Leila Pärtelpoeg ; interv. Ell-Maaja Randküla

    Index Scriptorium Estoniae

    Pärtelpoeg, Leila, 1927-

    2006-01-01

    Leila Pärtelpojast, talle omistatud aastapreemiad, tema tuntumad tööd ja autorile kõige rohkem huvi pakkunud tööd. Leila Pärtelpoeg pälvis ESL-i 2005. a. publitsistika preemia raamatu "Pööningul. Auf dem Dachboden" eest. Autor raamatust, mille toimetaja on Krista Roosi, kujundaja ja fotograaf Maarja Roosi, ning kollektsionäär Leonhard Venest

  4. 5 küsimust Leila Pärtelpojale / Leila Pärtelpoeg ; interv. Ell-Maaja Randküla

    Index Scriptorium Estoniae

    Pärtelpoeg, Leila, 1927-

    2006-01-01

    Leila Pärtelpojast, talle omistatud aastapreemiad, tema tuntumad tööd ja autorile kõige rohkem huvi pakkunud tööd. Leila Pärtelpoeg pälvis ESL-i 2005. a. publitsistika preemia raamatu "Pööningul. Auf dem Dachboden" eest. Autor raamatust, mille toimetaja on Krista Roosi, kujundaja ja fotograaf Maarja Roosi, ning kollektsionäär Leonhard Venest

  5. Leila Pärtelpoeg and the Soviet antique / Mart Kalm

    Index Scriptorium Estoniae

    Kalm, Mart, 1961-

    2010-01-01

    Sisearhitekt Leila Pärtelpojast, kes 2010. a. pälvis EV kultuuri elutööpreemia. Nõukogude ajal tegeles antiikmööbliga, uuris mööbliajalugu, kogus ajaloolist mööblit. Sisearhitekti tööst Eesti NSV-s, võimalusest kavandada mööblit. L. Pärtelpoja rollist ajalooliste interjööride (Parlamendihoone Toompeal, mõisahooned) restaureerimisel ja sisustamisel. Tallinna raekoja restaureerimisest (1975), ajalugu ja kaasaega sünteesivast terviklikust kujundusest

  6. Isaac D’Israeli’s Mejnoun and Leila

    Directory of Open Access Journals (Sweden)

    Elham Nilchian

    2016-01-01

    Full Text Available This article is a comparative analysis of the eighteenth-century British Orientalist Isaac D’Israeli’s romance Mejnoun and Leila (1797 with its original source Leyli o Majnun (1188 by Nezami of Ganja (1141-1209. Nezami, a twelfth-century Persian poet, is considered the greatest romantic epic poet in Persian literature. The idea of the love of Leyli and Majnun is raised as being primarily an earthly love, yet it is transcended into a divine type of love through suffering and hence loss of self in the Other. The article discusses the extent to which D’Israeli’s treatment of Sufism in his romance is sympathetic with Nezami’s work. Keywords: Isaac D’Israeli, Nezami, Persian Poetry, Sufism, Orientalism, Pre-Romantic Literature

  7. Röa mõisapaviljon = Röa manor pavilion / Leila, Pärtelpoeg ; intervjueerinud Margit Mutso

    Index Scriptorium Estoniae

    Pärtelpoeg, Leila, 1927-

    2011-01-01

    Röa mõisa peahoone taastamisest. Kontseptsiooni autor ja sisearhitekt Leila Pärtelpoeg. Arhitekt Ülar Saar (AB Ruum). Leila Pärtelpoeg pälvis Röa mõisa pargipaviljoni eest EK arhitektuuri sihtkapitali 2010. a. sisearhitektuuripreemia, tellija Jaan Meikup arhitektuuri sihtkapitali tunnustuse

  8. Röa mõisapaviljon = Röa manor pavilion / Leila, Pärtelpoeg ; intervjueerinud Margit Mutso

    Index Scriptorium Estoniae

    Pärtelpoeg, Leila, 1927-

    2011-01-01

    Röa mõisa peahoone taastamisest. Kontseptsiooni autor ja sisearhitekt Leila Pärtelpoeg. Arhitekt Ülar Saar (AB Ruum). Leila Pärtelpoeg pälvis Röa mõisa pargipaviljoni eest EK arhitektuuri sihtkapitali 2010. a. sisearhitektuuripreemia, tellija Jaan Meikup arhitektuuri sihtkapitali tunnustuse

  9. Management of SAH with traditional Chinese medicine in China.

    Science.gov (United States)

    Wang, Chunxue; Zhao, Xingquan; Mao, Shujing; Wang, Yongjun; Cui, Xiangning; Pu, Yuehua

    2006-06-01

    China lacks large scale authorized epidemiological study results in allusion to subarachnoid hemorrhage (SAH) within recent 15 years since MONICA (multinational monitoring of trends and determinants in cardiovascular disease) study revealed SAH situation in China in 2000. The main cause of SAH in China is aneurysm which takes up 30-50%, while over 90% aneurysm locates at Willis circle. Early surgery for SAH after aneurysm rupture is the dominant procedure to deal with SAH in China. Moreover, calcium antagonists rank the absolute leading position for cerebral vascular spasm (CVS) among medication-based treatment options. However, traditional Chinese medicine such as Salvia miltiorrhiza, Acanthopanax senticosus, Ginkgo biloba, Pueraria lobata, Liguisticum chuanxiong, cow bezoar, Diospyros kaki and Gynostemma pentaphyllum have been proven beneficial in CVS prevention and treatment, while Salvia miltiorrhiza and TCM soup have unique effects on bleeding absorption. In addition, aescine and some TCM soup might relieve strong headache after SAH. In general, TCM integrated with western medicine have shown unique advantages in the current treatment of SAH in China. However, it is a pity that China still lacks larger scale randomized controlled trials and research on SAH treatment focusing on TCM and the related mechanism of TCM on SAH still need to be investigated further.

  10. Evaluation of a murine single-blood-injection SAH model.

    Directory of Open Access Journals (Sweden)

    Marcel A Kamp

    Full Text Available The molecular pathways underlying the pathogenesis after subarachnoid haemorrhage (SAH are poorly understood and continue to be a matter of debate. A valid murine SAH injection model is not yet available but would be the prerequisite for further transgenic studies assessing the mechanisms following SAH. Using the murine single injection model, we examined the effects of SAH on regional cerebral blood flow (rCBF in the somatosensory (S1 and cerebellar cortex, neuro-behavioural and morphological integrity and changes in quantitative electrocorticographic and electrocardiographic parameters. Micro CT imaging verified successful blood delivery into the cisterna magna. An acute impairment of rCBF was observed immediately after injection in the SAH and after 6, 12 and 24 hours in the S1 and 6 and 12 hours after SAH in the cerebellum. Injection of blood into the foramen magnum reduced telemetric recorded total ECoG power by an average of 65%. Spectral analysis of ECoGs revealed significantly increased absolute delta power, i.e., slowing, cortical depolarisations and changes in ripples and fast ripple oscillations 12 hours and 24 hours after SAH. Therefore, murine single-blood-injection SAH model is suitable for pathophysiological and further molecular analysis following SAH.

  11. Coiled coils and SAH domains in cytoskeletal molecular motors.

    Science.gov (United States)

    Peckham, Michelle

    2011-10-01

    Cytoskeletal motors include myosins, kinesins and dyneins. Myosins move along tracks of actin filaments, whereas kinesins and dyneins move along microtubules. Many of these motors are involved in trafficking cargo in cells. However, myosins are mostly monomeric, whereas kinesins are mostly dimeric, owing to the presence of a coiled coil. Some myosins (myosins 6, 7 and 10) contain an SAH (single α-helical) domain, which was originally thought to be a coiled coil. These myosins are now known to be monomers, not dimers. The differences between SAH domains and coiled coils are described and the potential roles of SAH domains in molecular motors are discussed.

  12. SLEEP APNEA/HIPOPNEA SYNDROME (SAHS: HOME DIAGNOSIS AND TREATMENT

    Directory of Open Access Journals (Sweden)

    Coma del Corral MJ

    2006-02-01

    Full Text Available SUMMARYRecent studies associate SAHS with higher cardiovascular morbidity-mortality and we know that even today SAHS continues to be under-diagnosed. This under-diagnosis, signifies, on the one hand, a lowering or loss of health, and on the other, an increase in costs, since it has been demonstrated that patients with undiagnosed or untreated SAHS are higher consumers of health service resources and have higher work absenteeism, while these costs are reduced in SAHS patients treated with CPAP. Therefore, we find ourselves faced with the need to diagnose and suitably treat the largest possible number of patients who suffer from SAHS.The diagnostic method of choice continues to be supervised nocturnal PSG in the sleep laboratory, however, the future of SAHS diagnosis is inevitably moving towards the use of simplified systems with a high sensitivity and specificity. In this sense, the Respiratory Polygraphy represents an alternative tool for the diagnosis of SAHS, being able to be carried out in the home of the patient, just like the Auto-CPAP systems. Thus, the current approach to SAHS has changed and therefore, a patient with a high probability of suffering from SAHS, is able to have a RP carried out at home which might diagnose SAHS and later to have the CPAP adjusted to the optimum pressure level, as a recording using Auto-CPAP, could be carried out at home.With this new approach to SAHS, waiting lists could be reduced and thus reduce the under-diagnosis. All this brings about an implicit saving of resources. The place of diagnosis will basically be the home, and in this sense, the development of telematic applications will contribute significantly to the modification of diagnostic strategies.The success of this form of approach to SAHS, will be established with a suitable selection of subsidiary diagnosed patients and adjustment of home treatment, therefore, each sleep unit must set up its own diagnostic-therapeutic strategy which may be more

  13. Minaret di Leila Aboulela: dall’esilio a una nuova casa?

    Directory of Open Access Journals (Sweden)

    Stefania Sterlecchini

    2011-11-01

    Full Text Available Negli ultimi anni, sembra essere emerso un nuovo genere letterario. Si caratterizza per l'inconfondibile voce di scrittori di origine musulmana che affrontano l’esperienza dell’emigrazione e esplorano l’intricata relazione con la cultura britannica. Leila Aboulela, scrittrice sudanese, fa parte di questo nuovo filone letterario. Nel suo secondo romanzo, Minaret (2005, attraverso una narrazione ironica affronta i rapporti che si creano tra la protagonista Najwa e gli altri personaggi, e illustra il complesso ruolo che gioca la città di Londra nell’esperienza della protagonista.

  14. The Image of Veil in Leila Ahmed’s Women and Gender in Islam

    Directory of Open Access Journals (Sweden)

    Asım AYDIN

    2013-07-01

    Full Text Available Most of the time suppressed and disempowered throughout man’s history, the gender of woman has undergone a dissipating process where such an overpowering oscillation between two genders occurs. In spite of the fact that this bias creates a generalization, the position of the ‘womanhood’ wasn’t always under subjugation. As a matter of fact, this essay intends to throw light upon women’s ‘past, present and future’ by relying on mainly Leila Ahmed’s flagship works into by drawing a map showing how the veil plays a critical role in the representation of women.

  15. The Image of Veil in Leila Ahmed’s Women and Gender in Islam

    Directory of Open Access Journals (Sweden)

    Asım AYDIN

    2013-06-01

    Full Text Available Most of the time suppressed and disempowered throughout man’s history, the gender of woman has undergone a dissipating process where such an overpowering oscillation between two genders occurs. In spite of the fact that this bias creates a generalization, the position of the ‘womanhood’ wasn’t always under subjugation. As a matter of fact, this essay intends to throw light upon women’s ‘past, present and future’ by relying on mainly Leila Ahmed’s flagship works into by drawing a map showing how the veil plays a critical role in the representation of women.

  16. SA Virumaa Muuseumid Viru-Nigula pastopraadimuuseum / Fredi-Armand Tomps, Leila Pärtelpoeg, Annes Hermann

    Index Scriptorium Estoniae

    Tomps, Fredi-Armand, 1928

    2008-01-01

    12 ill.; fotod: Sven Arbet, Arvi Kriis; pastoraadimajas on renoveeritud esimesed ruumid, s.h. saal (arhitekt Fredi Tomps, sisearhitekt Leila Pärtelpoeg); sohva koopia on valminud 1990-ndate algul L. Pärtelpoja jooniste järgi Tartu kunstikooli mööbliosakonna õpilaste diplomitööna Annes Hermanni juhendamisel

  17. The pseudo-SAH sign: an imaging pitfall in postmortem computed tomography.

    Science.gov (United States)

    Shirota, Go; Gonoi, Wataru; Ikemura, Masako; Ishida, Masanori; Shintani, Yukako; Abe, Hiroyuki; Fukayama, Masashi; Higashida, Tomohiko; Okuma, Hidemi; Abe, Osamu

    2017-07-20

    Postmortem computed tomography (PMCT) of the brain has an important role in detection of subarachnoid hemorrhage (SAH), which has a high mortality rate. However, a phenomenon known as "pseudo-SAH," or high-attenuation areas along the cisterns mimicking SAH, may be seen on CT. The aim of this study was to evaluate the diagnostic accuracy of brain PMCT for SAH and to identify the characteristics of pseudo-SAH. Findings on PMCT (sulcal effacement, asymmetry, maximum thickness of SAH signs, presence of acute/subacute intraventricular/intraparenchymal hemorrhage) and clinical history (left ventricular assist device [LVAD] implantation, anticoagulation therapy/coagulation disorder, global ischemia) were compared between subjects with true SAH and those with pseudo-SAH. Twenty eight of 128 enrolled subjects had positive signs of SAH on PMCT, 20 (71.4%) had SAH on autopsy, and 8 (28.6%) did not. The sensitivity, specificity, positive predictive value, and negative predictive value of SAH signs seen on PMCT were 95.2, 94.6, 71.4, and 99.3%, respectively. Asymmetry of SAH signs and acute/subacute intraventricular and intraparenchymal hemorrhage were significantly more common in true SAH cases than in pseudo-SAH cases. The maximum thickness of SAH signs was significantly greater in true SAH cases. A history of LVAD implantation, anticoagulation therapy, and/or a coagulation disorder were more common in true SAH cases but not significantly so. A history of global ischemia was significantly more common in pseudo-SAH cases. If signs of SAH are observed on PMCT, it is important to look for other signs on PMCT and carefully review the clinical history to avoid a diagnostic error.

  18. Current management and treatment of cerebral vasospasm complicating SAH.

    Science.gov (United States)

    Kühn, Anna Luisa; Balami, Joyce Saleh; Grunwald, Iris Quasar

    2013-03-01

    Cerebral vasospasm is a common and serious complication of aneurysmal subarachnoid haemorrhage. Despite the improvements in treatment of aneurysmal subarachnoid haemorrhage (aSAH), cerebral vasospasm complicating aSAH has remained the main cause of morbidity and mortality. Subarachnoid haemorrhage (SAH)-induced vasospasm is a complex entity caused by vasculopathy, impaired autoregulation, and hypovolaemia, causing a regional reduction of cerebral brain perfusion which can then induce ischaemia. Cerebral vasospasm can present either asymptomatically detected only radiologically or symptomatically (delayed ischaemic neurologic deficit). The various diagnostic approaches include the use of transcranial doppler, digital subtraction angiography and multimodal computed tomography (CT) and magnetic resonance (MR) techniques. Although digital subtraction angiography is usually the gold standard for the diagnosis of cerebral vasospam, transcranial doppler is commonly the first-screening method for the detection of cerebral vasospam. The treatment of subarachnoid haemorrhage -induced vasospasm include the use of both medical and endovascular therapy. The aim of this review is to discuss the various current therapeutic options and future perspective measures for reducing cerebral vasospasm induced stroke after SAH.

  19. [Simvastatin efficacy in vasospasm treatment in patients after aneurysm SAH].

    Science.gov (United States)

    Shekhtman, O D; Éliava, Sh Sh; Belousova, O B; Tseĭtlin, A M; Okishev, D N; Sarshaev, M A

    2012-01-01

    Number of trials had previously demonstrated cerebroprotective effect of statin therapy in SAH patients. Aim of the current study was to assess effects of simvastatin on vasospasm in clinical practice. The study group comprised 35 patients admitted to Burdenko Neurosurgery Institute with aneurysmal SAH in 2007-2011. All patients were treated with surgery within 14 days post-SAH and received simvastatin 40 mg/day. Mean age was 46,5 (16-69) years, male: female ratio - 20:15, Hunt-Hess scale breakdown: I - 7 (20%), II - 12 (34.3%), III - 11 (31.4%), IV - 4 (11.4%), V - 1 (2.8%). In 31 (88.6%) patients aneurysm was clipped, in 4 (11.4%)--coiled. Outcomes at discharge and at follow-up (modified Rankin scale), vasospasm dynamics, delayed ischemic neurological deficit (DIND), duration of hospital stay and number of home discharged patients were evaluated and analyzed in comparison to control group (n = 30). Statin group did not demonstrated valid difference in immediate and late outcomes (mean 20,5 month), risk of DIND, length of hospital stay and percentage of discharged home patients. Statin group showed significantly lower rates of vasospam progression--42.9% vs. 76.7% in control (chi2-test, p = 0.01). Our evidence corresponds with outcomes of international trials of statin application in SAH patients. As follows from our results and existing randomized and clinical trials data there is no strong evidence nowadays to recommend statin prescription in SAH patients.

  20. Control of methionine metabolism by the SahR transcriptional regulator in Proteobacteria.

    Science.gov (United States)

    Novichkov, Pavel S; Li, Xiaoqing; Kuehl, Jennifer V; Deutschbauer, Adam M; Arkin, Adam P; Price, Morgan N; Rodionov, Dmitry A

    2014-01-01

    Sulphur is an essential element in the metabolism. The sulphur-containing amino acid methionine is a metabolic precursor for S-adenosylmethionine (SAM), which serves as a coenzyme for ubiquitous methyltrtansferases. Recycling of organic sulphur compounds, e.g. via the SAM cycle, is an important metabolic process that needs to be tightly regulated. Knowledge about transcriptional regulation of these processes is still limited for many free-living bacteria. We identified a novel transcription factor SahR from the ArsR family that controls the SAM cycle genes in diverse microorganisms from soil and aquatic ecosystems. By using comparative genomics, we predicted SahR-binding DNA motifs and reconstructed SahR regulons in the genomes of 62 Proteobacteria. The conserved core of SahR regulons includes all enzymes required for the SAM cycle: the SAH hydrolase AhcY, the methionine biosynthesis enzymes MetE/MetH and MetF, and the SAM synthetase MetK. By using a combination of experimental techniques, we validated the SahR regulon in the sulphate-reducing Deltaproteobacterium Desulfovibrio alaskensis. SahR functions as a negative regulator that responds to the S-adenosylhomocysteine (SAH). The elevated SAH level in the cell dissociates SahR from its DNA operators and induces the expression of SAM cycle genes. The effector-sensing domain in SahR is related to SAM-dependent methylases that are able to tightly bind SAH. SahR represents a novel type of transcriptional regulators for the control of sulphur amino acid metabolism.

  1. The Politics of Location and Sexuality in Leila Ahmed’s and Nawal El Saadawi’s Life Narratives

    Directory of Open Access Journals (Sweden)

    Aouadi Leila

    2014-09-01

    Full Text Available This article explores Leila Ahmed’s A Border Passage, and Nawal El Saadawi’s Memoirs from the Women’s Prison, A Daughter of Isis, and Walking Through Fire. It contrasts their works and argues that location and genderawareness play an important role in the writing of autobiographies. The focus is on showing how El Saadawi’s positioning as a feminist activist in Egypt and Ahmed’s location in the USA determine the texts’ themes and shape the construction of the autobiographical “I.”

  2. Pequenas e grandes catástrofes de cada dia: Diários públicos, de Leila Danziger

    Directory of Open Access Journals (Sweden)

    Késia Oliveira

    2014-11-01

    Full Text Available Diários públicos, da artista visual e escritora Leila Danziger, 2001, é uma obra construída a partir de uma coleção de jornais impressos composta por  séries de trabalhos (“Para Irineu Funes”, “Resistir-por-ninguém-e-por-nada”, “Para-ninguém-e-nada-estar”, “O que desaparece, o que resiste”, dentre outras. Nelas a artista se apropria de trechos literários, como versos de Paul Celan, Carlos Drummond de Andrade, Ana Cristina César e Cecília Meireles, por exemplo, reinscrevendo-os sobre páginas de notícias que foram raspadas.

  3. [Being cared for and caring: living with multiple chronic diseases (Leila)-a qualitative study about APN contributions to integrated care].

    Science.gov (United States)

    Müller-Staub, Maria; Zigan, Nicole; Händler-Schuster, Daniela; Probst, Sebastian; Monego, Renate; Imhof, Lorenz

    2015-04-01

    Hintergrund: Das Leben mit mehreren chronischen Krankheiten ist komplex und führt zu einer erhöhten Pflege- und Betreuungsbedürftigkeit. Zur Förderung der integrierten Versorgung wurde ein dreijähriges Projekt namens «Leben mit Langzeiterkrankung» (Leila) initiiert. Ziel: Das Projekt hatte zum Ziel, Leistungen von Pflegeexpertinnen in Advanced Practice Nursing (APN) für chronisch erkrankte Menschen in Zusammenarbeit mit Hausarztpraxen zu entwickeln. Folgende Fragestellungen wurden untersucht: 1. Wie erleben Patient(inn)en, Zuweisende und Pflegeexpertinnen APN das Leila-Dienstleistungsangebot? 2. Wie gestalten sich Zuweisungsprozesse? 3. Wie erleben die Beteiligten die Zusammenarbeit und die APN-Rollenausübung? Methode: Es wurde ein qualitativer Ansatz gemäß Grounded Theory nach Corbin und Strauss gewählt, um Erfahrungen mit Leila und Interaktionen der an Leila beteiligten Personen zu untersuchen. Dabei wurden 38 Interviews mit Patient(inn)en, die mit multiplen chronischen Krankheiten leben, deren betreuende Pflegeexpertinnen APN und zuweisenden Ärzt(inn)en durchgeführt und evaluiert. Ergebnisse: «Umsorgt werden und umsorgen» zeigte sich als zentrale Kategorie. Diese beschreibt wie auf die Patient(inn)en eingegangen wurde, sie einbezogen und ernst genommen wurden. Die Hauptkategorie «Den Alltag gestalten» zeigt, dass die Patient(inn)en lernten, mit den Folgen chronischer Erkrankungen im Alltag umzugehen. «Alle Ressourcen nutzen» legt dar, wie Potenziale und Stärken eingesetzt wurden. Schlussfolgerungen: Die Ergebnisse zu Zuweisungs- und Kooperationsprozessen ergaben, dass die APN-Rollenanerkennung und -ausübung noch ausgehandelt werden muss. Zukünftige APN-Angebote für diese Patient(inn)engruppe sollten nebst Ärztenetzwerken in weitere Dienstleistungen und die Spitex integriert werden.

  4. Burden of disease and costs of aneurysmal subarachnoid haemorrhage (aSAH in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Gray Alastair

    2010-04-01

    Full Text Available Abstract Background To estimate life years and quality-adjusted life years (QALYs lost and the economic burden of aneurysmal subarachnoid haemorrhage (aSAH in the United Kingdom including healthcare and non-healthcare costs from a societal perspective. Methods All UK residents in 2005 with aSAH (International Classification of Diseases 10th revision (ICD-10 code I60. Sex and age-specific abridged life tables were generated for a general population and aSAH cohorts. QALYs in each cohort were calculated adjusting the life tables with health-related quality of life (HRQL data. Healthcare costs included hospital expenditure, cerebrovascular rehabilitation, primary care and community health and social services. Non-healthcare costs included informal care and productivity losses arising from morbidity and premature death. Results A total of 80,356 life years and 74,807 quality-adjusted life years were estimated to be lost due to aSAH in the UK in 2005. aSAH costs the National Health Service (NHS £168.2 million annually with hospital inpatient admissions accounting for 59%, community health and social services for 18%, aSAH-related operations for 15% and cerebrovascular rehabilitation for 6% of the total NHS estimated costs. The average per patient cost for the NHS was estimated to be £23,294. The total economic burden (including informal care and using the human capital method to estimate production losses of a SAH in the United Kingdom was estimated to be £510 million annually. Conclusion The economic and disease burden of aSAH in the United Kingdom is reported in this study. Decision-makers can use these results to complement other information when informing prevention policies in this field and to relate health care expenditures to disease categories.

  5. Molecular mechanisms of Triple H therapy in the treatment of SAH-induced vasospasm

    Institute of Scientific and Technical Information of China (English)

    Masanori Ishiguro; Corey B.Puryear; Erica Bisson; Ryan Jewell; David J. Nathan; Bruce I. Tranmer; George C. Wellman

    2004-01-01

    Objective Cerebral artery vasospasm is a major cause of death and disability in patients experiencing subarachnoid hemorrhage (SAH). Vasospasm typically has been evaluated using angiography to examine narrowing of large diameter (>1 mm) cerebral arteries. Currently, little is known regarding the impact of SAH on small diameter (100~200 μm) cerebral arteries, which play an important role in the autoregulation of cerebral blood flow. The goal of the current study was to examine the influence of SAH on the pressure-diameter relationship of these small diameter blood vessels. Methods Small diameter cerebral arteries were obtained from a rabbit SAH model. Isolated artery segments were canulated and placed in a myograph chamber superfused with warmed, oxygenated, physiological saline solution. Diameter measurements were then recorded to step-wise increases in intravascular pressure. Results Cerebral arteries from SAH animals exhibited a significant increase in pressure-induced constrictions (myogenic tone) at intravascular pressures between 40 mmHg and 120 mmHg. At intravascular pressures above 120 mmHg, myogenic tone began to decrease and was abolished at pressures above 180 mmHg. Conclusion These data suggest that in the days following SAH, myogenic tone is enhanced in small diameter cerebral arteries subjected to physiological levels of intravascular pressure. However, supra-physiological intravascular pressures causes vasodilation, suggesting small diameter cerebral arteries may act as therapeutic targets of hypervolemia, hemodilution, and hypertension "Triple H therapy" used in the treatment of cerebral artery vasospasm.

  6. Enriched environment at work and the incidence of dementia: results of the Leipzig longitudinal study of the aged (LEILA 75+.

    Directory of Open Access Journals (Sweden)

    Francisca S Then

    Full Text Available BACKGROUND: The high incidence of cognitive impairments in the aging population together with the challenges it imposes on health systems raise the question of what effect working life has on cognitive abilities. Animal models have demonstrated that so called enriched environments protect against neurodegenerative diseases, such as dementia. The aim was to investigate the impact of enriched environment at work on the incidence of dementia. METHODS: The Leipzig Longitudinal Study of the Aged (LEILA 75+ is an ongoing representative population cohort study that examines cognitive functioning and dementia in individuals aged 75 years and older. The participants' occupational information was matched to O*NET SOC codes and the relevant job descriptors were used to create occupational context indices describing enriched environment at work. RESULTS: Results of logistic regression modeling suggest that a higher level of the index Executive was associated with a lower risk of incident dementia (odds ratio  = 0.61, 95% confidence interval  = 0.47-0.79, p<0.001. Adjustment for various confounders did not alter the association. The cognitive stimulation indices were only significant in univariate analysis. The Novelty-index remained non-significant. CONCLUSIONS: The results suggest that occupational contexts enriched with independent planning/performance of work tasks might decrease the risk of developing dementia. A protective effect of enriched environment at work in general, namely high cognitive stimulation or confrontation with new tasks, could not be confirmed by the results.

  7. ASPEK PEMIDANAAN HUKUM PERKAWINAN SIRRÎDALAM PERSPEKTIF SIYÂSAH SYAR’IYYAH

    Directory of Open Access Journals (Sweden)

    Khaeron Sirin

    2013-03-01

    Full Text Available Abstrak: Gagasan tentang pemidanaan terhadap kasus perkawinan yang tidak dicatatkan—biasa disebut perkawinan sirrî—yang mencuat di awal 2010 langsung memunculkan polemik. Bagi masyarakat yang mendukung, pemidanaan perkawinan yang tidak dicatatkan akan bisa memperketat prilaku perkawinan yang semena-mena, melindungi hak-hak perempuan dan anak-anak, serta menumbuhkan budaya tertib hukum di masyarakat. Sementara bagi kalangan yang menentang, perkawinan yang tidak dicatatkan adalah tetap sah secara agama (Islam—jika dilakukan sesuai syarat dan rukun nikahnya—dan negara tidak bisa memidanakan pelaku perkawinan yang tidak mencatatkan perkawinannyake instansi pemerintah.Tulisan ini berusaha mengana-lisis polemik tersebut dari sudut pandang siyâsah syar`iyyah, utamanya berkait dengan peluang dimasukkannya aspek hukum pidana dalam penerapan hukum perkawinan di Indonesia. Abstract: The notion of criminalizing on illegal (not legally registered marriage appearing in the early 2010 resulted polemics. Those who support this idea argue that it could tighten an unfair marriage, protect children and women rights, and create law-abiding culture concerning marriage in society. Those who deny the notion claim that an unregistered marriage is consider lawful from the perspective of Islam as long as it fulfils marriage principles and requirements. This article aims to analyze the case of unregistered marriage in Indonesia by siyâsah shar’iyyah perspective. Kata Kunci: Pemidanaan, perkawinansirrî, hukum Islam, siyâsah syar’iyyah

  8. Counter-Orientalism: Retranslating the ‘Invisible Arab’1 in Leila Aboulela’s The Translator and Lyrics Alley2

    Directory of Open Access Journals (Sweden)

    Ahmed Gamal El Din

    2015-02-01

    Full Text Available Retranslation is a foundational postcolonial metaphor that might highlight the new horizons of transcultural and transnational relations and their political backdrop. By the same token, Arab British migrant narratives are of special relevancy to both translation and cultural studies, since migrant identity and writing are closely associated with the politics of translation, rewriting, relocation and cross-cultural pollination. This contribution explores the role of counter-discourses in general and counter-Orientalism in particular in the contemporary fiction of Arab British writers. In particular the paper focuses on the textual representations of invisible Arab men and women and the East-West cultural exchange in the writing of the Sudanese feminist and Scottish immigrant Leila Aboulela (1964-. Drawing on the counter-traditional concept of translation as engagement rather than transfer, this article attempts to spotlight the aesthetic and political parameters of cultural translation in Arab British literature represented by Leila Aboulela’s The Translator (1999 and Lyrics Alley (2010. Many studies have examined the mis/representation of Arabs in Western Orientalist narratives, but very few have probed how Arab émigrés have deftly attempted to engage with Orientalist narratives by restructuring new identities and critically hybridizing unexampled cultural models. In other words, counter-Orientalism implies appropriating Orientalist stereotypes of space, history, identity and gender in counter-narratives that seek to retranslate, demythologize and therefore de-Orientalize Arab subjects.

  9. Fast Construction of SAH BVHs on the Intel Many Integrated Core (MIC) Architecture.

    Science.gov (United States)

    Wald, I

    2012-01-01

    We investigate how to efficiently build bounding volume hierarchies (BVHs) with surface area heuristic (SAH) on the Intel Many Integrated Core (MIC) Architecture. To achieve maximum performance, we use four key concepts: progressive 10-bit quantization to reduce cache footprint with negligible loss in BVH quality; an AoSoA data layout that allows efficient streaming and SIMD processing; high-performance SIMD kernels for binning and partitioning; and a parallelization framework with several build-specific optimizations. The resulting system is more than an order of magnitude faster than today's high-end GPU builders for comparable BVHs; it is usually faster even than spatial median builders; it can build SAH BVHs almost as fast as existing GPUs and CPUs- and CPU-based approaches can build regular grids; and in aggregate "build+render" performance is significantly faster than the best published numbers for either of these systems, be it CPU or GPU, BVH, kd-tree, or grid.

  10. pH-sensitive NMDA inhibitors improve outcome in a murine model of SAH.

    Science.gov (United States)

    Wang, Haichen; James, Michael L; Venkatraman, Talaignair N; Wilson, Lawrence J; Lyuboslavsky, Polina; Myers, Scott J; Lascola, Christopher D; Laskowitz, Daniel T

    2014-02-01

    Despite intensive research, neurological morbidity from delayed cerebral ischemia remains common after aneurysmal subarachnoid hemorrhage (SAH). In the current study, we evaluate the neuroprotective effects of a pH-dependent GluN2B subunit-selective NMDA receptor antagonist in a murine model of SAH. Following induction of SAH, 12 ± 2 week old male C57-BL/6 mice received NP10075, a pH-dependent NMDA receptor antagonist, or vehicle. In a separate series of experiments, NP10075 and the non-pH sensitive NMDA antagonist, NP10191, were administered to normoglycemic and hyperglycemic mice. Both histological (right middle cerebral artery diameter, NeuN, and Fluoro-Jade B staining) and functional endpoints (rotarod latency and neuroseverity score) were evaluated to assess the therapeutic benefit of NP10075. Administration of NP10075 was well tolerated and had minimal hemodynamic effects following SAH. Administration of the pH-sensitive NMDA antagonist NP10075, but not NP10191, was associated with a durable improvement in the functional performance of both normoglycemic and hyperglycemic animals. NP10075 was also associated with a reduction in vasospasm in the middle cerebral artery associated with hemorrhage. There was no significant difference between treatment with nimodipine + NP10075, as compared to NP10075 alone. These data demonstrate that use of a pH-dependent NMDA antagonist has the potential to work selectively in areas of ischemia known to undergo acidic pH shifts, and thus may be associated with selective regional efficacy and fewer behavioral side effects than non-selective NMDA antagonists.

  11. BENTUK-BENTUK DIGITAL SIGNATURE YANG SAH DALAM TRANSAKSI ELEKTRONIK DI INDONESIA

    Directory of Open Access Journals (Sweden)

    I Wayan Ariadi

    2016-05-01

    Full Text Available Teknologi informatika menjadi salah satu isu hukum di Indonesia karena keamanan system informasi mempengaruhi jalannya transaksi elektronik, sehingga perlu untuk menempatkan tanda tangan pada transaksi elektronik unutk memastikan validitas seperti beberapa transaksi secara kertas. Tujuan dari peneletian ini adalah untuk menentukan bentuk tanda tangan digital dalam transaksi elektronik adalah sah. Penelitian jurnal ini dilakukan dengan menggunakan metode normatif. Tanda tangan yang dapat menjamin transaksi elektronik sehingga bias menjadi bukti hukum adalah tanda tangan elektronik atau digital, bentuk tanda tangan elektronik adalah password; scan tanda tangan atau diketik naman; tombol ok atau tombol menerima; biometrik; dan penggunaan tanda tangan elektronik lainnya dari enkripsi berbasis pesan (tanda tangan digital

  12. Automated frequency domain analysis of oxygen saturation as a screening tool for SAHS.

    Science.gov (United States)

    Morillo, Daniel Sánchez; Gross, Nicole; León, Antonio; Crespo, Luis F

    2012-09-01

    Sleep apnea-hypopnea syndrome (SAHS) is significantly underdiagnosed and new screening systems are needed. The analysis of oxygen desaturation has been proposed as a screening method. However, when oxygen saturation (SpO(2)) is used as a standalone single channel device, algorithms working in time domain achieve either a high sensitivity or a high specificity, but not usually both. This limitation arises from the dependence of time-domain analysis on absolute SpO(2) values and the lack of standardized thresholds defined as pathological. The aim of this study is to assess the degree of concordance between SAHS screening using offline frequency domain processing of SpO(2) signals and the apnea-hypopnea index (AHI), and the diagnostic performance of such a new method. SpO(2) signals from 115 subjects were analyzed. Data were divided in a training data set (37) and a test set (78). Power spectral density was calculated and related to the desaturation index scored by physicians. A frequency desaturation index (FDI) was then estimated and its accuracy compared to the classical desaturation index and to the apnea-hypopnea index. The findings point to a high diagnostic agreement: the best sensitivity and specificity values obtained were 83.33% and 80.44%, respectively. Moreover, the proposed method does not rely on absolute SpO(2) values and is highly robust to artifacts.

  13. Serial measurement of regional cerebral blood flow in patients with SAH using 133Xe inhalation and emission computerized tomography

    DEFF Research Database (Denmark)

    Mickey, B; Vorstrup, S; Voldby, Bo

    1984-01-01

    performed on 20 patients in Hunt and Hess' clinical Grades I to III in the first 21 days post SAH. Five patients with normal CBF tomograms on admission developed delayed neurological deficits in the 2nd week after hemorrhage, at which time repeat CBF tomograms in four patients revealed large areas of well...... defined regional flow decrease in the vascular territories of the anterior or middle cerebral arteries. Severe vasospasm was noted in three of these patients in whom arteriography was performed in the 2nd week post SAH. Diffuse bihemispheric CBF decreases were noted later in the course of delayed...

  14. Estratégias de luta das enfermeiras da Maternidade Leila Diniz para implantação de um modelo humanizado de assistência ao parto

    Directory of Open Access Journals (Sweden)

    Ricardo José Oliveira Mouta

    2009-01-01

    Full Text Available Es una investigación cualitativa con abordaje socio-histórico, cuyo objetivo fue identificar las estrategias de la lucha simbólica de las enfermeras de la Maternidad Leila Diniz para la aplicación de un modelo de atención al parto humanizado y analizar los efectos de esa lucha. Se usaron como fuentes primarias los documentos escritos y testimonios orales obtenidos por entrevistas semiestructuradas con los jefes de enfermería y las enfermeras. Las etapas del análisis son: ordenación, clasificación y triangulación de los datos. Se usaron los conceptos de campo, habitus, poder simbólico, y capital, según Pierre Bourdieu. Las estrategias encontradas son las siguientes: la búsqueda de especialización, la implantación del Proyecto de Asistencia al Parto por las Enfermeras Obstétricas, la divulgación de ese capital en el contexto científico, la participación de las enfermeras en el grupo de embarazadas. Se concluye que las estrategias de lucha desarrolladas por esos agentes contribuyen para que las enfermeras obstétricas conquisten una posición jerárquica para el desarrollo de las prácticas obstétricas según el modelo humanizado.

  15. 配合物Ni(DPBP-SAH)2·2CH3CH2OH的合成和晶体结构%Synthesis and Structure of Complex Ni(DPBP-SAH)2·2CH3CH2OH

    Institute of Scientific and Technical Information of China (English)

    张丽; 刘浪; 刘广飞; 贾殿赠; 郁开北

    2005-01-01

    A nickel(Ⅱ)complex Ni(DPBP-SAH)2·2CH3CH2OH, (DPBP-SAH=N-(1,3-diphenyl-4-benzylidene-5-pyrazolone)-salicylidene hydrazone), has been synthesized and characterized by elemental analyses, IR spectra and single crystal X-ray diffraction. It belongs to monoclinic, space group C2/c with a=2.737 9(4) nm, b=1.249 2(2) nm,c=1.760 8(2) nm,β=120.212(9)°, Mr=1065.84, V=5.204(1) nm3, Z=4. The X-ray diffraction reveals that the nickel(Ⅱ) ion in the title complex is in a slightly distorted octahedral arrangement of the ON donor atoms of two DPBPSAH and two O-donor atoms in ethanol. CCDC: 249394.

  16. LA CONSTRUCCIÓN DE LA IMAGEN DE MARCA «ANDALUCÍA» COMO DESTINO TURÍSTICO A TRAVÉS DE LAS CAMPAÑAS PUBLICITARIAS «SMAIL YOU ARE IN ANDALUCÍA» Y «ANDALUCÍA TE QUIERE»

    Directory of Open Access Journals (Sweden)

    Esther Martínez Pastor

    2013-01-01

    Full Text Available Este trabajo analiza la semántica de la marca «Andalucía» en las campañas publicitarias de promoción turística «Smail you are in Andalucía» y «Andalucía te quiere». A través del «análisis de contenido» se ha elaborado un esquema semántico de la marca «Andalucía» que recoge el discurso común presente en las tres campañas. A su vez, se identifican las promesas y significados que actúan de manera singular en cada anuncio como propuestas o valores añadidos según el tipo de consumidor destinatario del mensaje.

  17. Luulõtuisi / Leila Holts

    Index Scriptorium Estoniae

    Holts, Leila

    2006-01-01

    Sisu: "maq elä katõ ilma vaihõl..." ; "tõnõ maa..." ; "mul om kats koto..." ; Kodo perrä hõlahus ; "väläh nii keväjäne valgus..." ;"täämba tunnõ edimäst kõrda keväjät..." ; "ja omgi kevväi..."

  18. CFD Analysis on the Thermal Hydraulic Performance of an SAH Duct with Multi V-Shape Roughened Ribs

    Directory of Open Access Journals (Sweden)

    Anil Kumar

    2016-05-01

    Full Text Available This study presents the heat transfer and fluid flow characteristics in a rib-roughened SAH (solar air heater channel. The artificial roughness of the rectangular channel was in the form of a thin circular wire in discrete multi V-pattern rib geometries. The effect of this geometry on heat transfer, fluid flow, and performance augmentation was investigated using the CFD (computational fluid dynamics. The roughness parameters were a relative discrete distance of 0.69, a relative rib height of 0.043, a relative rib pitch of 10, a relative rib width of 6.0, and a flow-attack-angle of 60°. The discrete width ratios and Reynolds numbers ranged from 0.5 to 2.0 and from 2000 to 20,000, respectively. The CFD results using the renormalization k-epsilon model were in good agreement with the empirical relationship. This model was used to investigate the heat transfer and fluid flow characteristics in the multi V-pattern rib roughened SAH channel. The thermo-hydraulic performance was found to be the best for the discrete width ratio of 1.0. A discrete multi V-pattern rib combined with dimple staggered ribs also had better overall thermal performance compared to other rib shapes.

  19. ACTUACIÓN DOMICILIARIA EN EL SINDROME DE APNEAS/HIPOPNEAS DURANTE EL SUEÑO (SAHS: DIAGNÓSTICO Y TRATAMIENTO

    Directory of Open Access Journals (Sweden)

    Coma del Corral MJ

    2006-02-01

    Full Text Available RESUMEN:Estudios recientes, relacionan el SAHS con mayor morbimortalidad cardiovascular y por otro lado, sabemos que aún hoy en día, el SAHS sigue estando infradiagnosticado. Este infradiagnóstico supone, por un lado, un déficit o perdida de salud y por otro lado, un aumento de costes, ya que está demostrado que los pacientes con SAHS no diagnosticados ni tratados, son mayores consumidores de los servicios de salud y presentan mayor absentismo laboral, mientras que estos costes se reducen en los pacientes con SAHS tratados con CPAP. Por tanto, nos encontramos ante la necesidad de diagnosticar y tratar adecuadamente al mayor número posible de pacientes que padezcan un SAHS.El método diagnóstico de elección, sigue siendo la PSG nocturna vigilada en el laboratorio de sueño, sin embargo, el futuro del diagnóstico del SAHS pasa indefectiblemente por el empleo de sistemas simplificados con alta sensibilidad y especificidad. En este sentido, la Poligrafía Respiratoria, representa una alternativa útil para el diagnóstico del SAHS, pudiendo ser realizada en el domicilio del paciente, al igual que los sistemas Auto-CPAP. De esta forma, el abordaje actual del SAHS ha cambiado y así, un paciente con alta probabilidad de padecer un SAHS, se le puede realizar una PR domiciliaria que diagnostique el SAHS y posteriormente para ajustar el nivel de presión óptima de CPAP, se le podría hacer un registro domiciliario de Auto-CPAP.Con este nuevo abordaje del SAHS, se podrán disminuir las listas de espera y por tanto disminuir el infradiagnóstico. Todo ello conlleva implícitamente un ahorro de recursos. El lugar del diagnóstico, será fundamentalmente el domicilio, y en este sentido, el desarrollo de aplicaciones telemáticas contribuirá de forma importante a la modificación de las estrategias diagnósticas.El éxito de esta forma de abordaje del SAHS, vendrá marcado por una adecuada selección de los pacientes subsidiarios de diagnóstico y

  20. PENANGGULANGAN PENANGKAPAN IKAN SECARA TIDAK SAH (ILLEGAL FISHING OLEH KAPAL IKAN ASING DI ZONA EKONOMI EKSKLUSIF INDONESIA

    Directory of Open Access Journals (Sweden)

    Melly Aida

    2014-03-01

    Full Text Available Penangkapan ikan secara tidak sah ( illegal fishing oleh kapal ikan asing di wilayah Zona Ekonomi Eksklusif Indonesia ( ZEEI semakin tahun semakin meningkat. Seiring dengan kondisi tersebut negara menderita kerugian yang besar dari tindakan ini. Ada anggapan bahwa terjadinya hal tersebut karena kewenangan penegakan hukum oleh negara pantai  ( Indonesia yang terbatas disebabkan  ketentuan yang ada di dalam Konvensi Hukum Laut 1982 ( KHL 1982 . Kemudian jika  dilihat dari segi penegakan hukum oleh pemerintah, penanganan illegal fishing nampaknya masih memprihatinkan. Tulisan ini ingin mengkaji bagaimana kewenangan Indonesia dalam menanggulangi illegal fishing di wilayah ZEEI berdasar KHL 1982. Selain itu dalam tulisan ini juga ingin dikaji bagaimana penanggulangan yang dilakukan oleh pemerintah Indonesia terhadap tindak illegal fishing ini. Data dalam tulisan ini dicari dengan cara melakukan studi kepustakaan, artinya dengan cara mempelajari buku-buku, naskah-naskah yang berkaitan dengan permasalahan yang dibahas. Data yang didapat kemudian dikumpulkan lalu disistematisasi.  Data yang sudah disistematisasi itu kemudian  dijelaskan untuk dapat menjawab permasalahan yang diajukan. Hasil yang didapat dari pembahasan dalam tulisan ini adalah: Indonesia berdasar KHL 1982 mempunyai kewenangan yang tegas dalam menindak pelaku illegal fishing, namun dalam pelaksanaan penanggulangan illegal fishing di wilayah ZEE masih mengalami beberapa hambatan.

  1. 萨本铁的前半生%Peter Pan Tieh Sah's Early Career in China: 1912-1946

    Institute of Scientific and Technical Information of China (English)

    张黎

    2006-01-01

    萨本铁(Peter Pan Tieh Sah,1900-1987),有机化学家、生理学家、药物学家,是20世纪为数不多的享有国际声誉的中国科学家之一.1946年移居美国.其一生中所发表的论文数量,远居同一时代的中国科学家之首,而且有多篇在21世纪初还为人引用.主要依据清华大学和日据北京大学的有关档案资料、辅仁大学校友会的有关资料、萨本铁所发表的学术论文、20世纪20-40年代的相关刊物,以及萨氏后人的访谈及其所提供的资料,首次较为细致地勾勒了萨本铁在清华学堂、美国威斯康星大学求学,以及回国后任教于清华大学、辅仁大学、日据北京大学等的经历,并概述了其移居美国之后的卓越学术贡献.尝试着从社会、个人、家庭等诸多方面的因素,分析萨本铁在人生的若干关键时刻所做出的选择,以此初步地诠释其前半生中性格、信仰以及人生际遇等所发生的复杂变化.

  2. Draft genome sequence of the extremely halophilic Halorubrum sp. SAH-A6 isolated from rock salts of the Danakil depression, Ethiopia

    OpenAIRE

    2016-01-01

    The draft genome sequence of Halorubrum sp. SAH-A6, isolated from commercial rock salts of the Danakil depression, Ethiopia. The genome comprised 3,325,770 bp, with the G + C content of 68.0%. The strain has many genes which are responsible for secondary metabolites biosynthesis, transport and catabolism as compared to other Halorubrum archaea members. Abundant genes responsible for numerous transport systems, solute accumulation, and aromatic/sulfur decomposition were detected. The first gen...

  3. Cloning and expression of sahib gene in Escherichia coli quorum sensing defective strain%大肠杆菌密度感应缺陷株中sahH基因克隆与表达的研究

    Institute of Scientific and Technical Information of China (English)

    王倩; 黄正蔚

    2011-01-01

    目的 利用克隆和表达sahH基因,恢复大肠杆菌密度感应缺陷株的甲基循环通路.方法 通过扩增铜绿假单胞菌sahH基因,克隆到pGEX4T-1载体上,继而转入大肠杆菌密度感应缺陷株.诱导培养后,经考马斯亮蓝染色及蛋白印迹鉴定SahH-GST融合蛋白的表达.结果 成功扩增并克隆了sahH基因,在大肠杆菌密度感应缺陷株中表达出约75 ku大小的蛋白,其大小与SahH-GST蛋白相符.结论 大肠杆菌密度感应缺陷株内可以表达外源基因sahH,恢复了甲基循环的该菌株可进一步应用于密度感应与代谢循环调节作用的实验.%Objective Make use of cloning and expression of sahH gene to recover the activated methyl cycle of Escherichia coli quo rum sensing defective strain. Methods The sahH gene of pseudomonas aeruginosa strain PA01 was amplifided and introduced into pGEX4T-1 vector,and then transformed into E. coli quorum sensing defective strain. After induction and culture, Coomassie brilliant blue and Western blot were performed to identify the expression of SahH-GTS fusion protein. Results The sahH gene was successfully amplified and cloned. The SahH-GTS fusion protein, whose molecular weight was about 75 ku, was expressed in the E. coli quorum sensing defective strain. Conclusions In the quorum sensing defective strain of E. coli, the exogenous gene sahH could be expressed. This E. coli strain, which has recovered activated methyl cycle, can be used to do research in the regulation of quorum sensing and methyl metabolic cycle subsequently.

  4. Manejo del SAHS mediante dispositivos de avance mandibular: Estudio preliminar Sleep apnea-hypopnea syndrome management using a mandibular advancement device: Preliminary study

    Directory of Open Access Journals (Sweden)

    Manuel Sánchez-Moliní

    2010-12-01

    Full Text Available El tratamiento que ha demostrado mayor eficacia en los pacientes con síndrome de apneas-hipopneas del sueño (SAHS es la presión positiva continua de la vía aérea (CPAP. Los mayores inconvenientes son la incomodidad y la sensación de claustrofobia, que en algunos pacientes provoca rechazo o intolerancia. Una alternativa son los dispositivos de avance mandibular (DAM, que insertados en las arcadas dentarias producen el avance de la mandíbula y de la lengua, aumentando el volumen de la vía aérea. Objetivo: Presentar nuestra experiencia en el tratamiento del SAHS mediante dispositivos de avance mandibular tipo Herbst. Metodología: Estudio de seguimiento prospectivo desde junio de 2006 hasta enero de 2009 de 7 pacientes del Área Hospitalaria Virgen Macarena con SAHS que rechazan el tratamiento con CPAP y a los que se ofrece tratamiento con DAM. Las variables analizadas son: índice de apneas-hipopneas por hora, índice de desaturaciones por hora, intensidad subjetiva del ronquido y el test de somnolencia de Epworth, antes del tratamiento y al menos 6 meses después desde el inicio de su uso. Utilizamos el test de Wilcoxon para detectar diferencias estadísticas significativas (pThe most effective treatment in patients with sleep apnea-hypopnea syndrome (SAHS is CPAP (continuous positive airway pressure. The main drawback of CPAP is the discomfort and claustrophobic sensation that it causes, which elicits rejection or intolerance by some patients. A non-surgical alternative to CPAP is the mandibular advancement device (MAD, which consists of a plastic splint inserted between the dental arches to shift the jaw and tongue forward and thus increase airway volume. Objective: Report our experience with the treatment of SAHS using the Herbst mandibular advancement device. Material and method: A prospective follow-up study was carried out from June 2006 until January 2009 at the Virgen Macarena University Hospital with 7 patients with SAHS who

  5. Occurrence of vasospasm and infarction in relation to a focal monitoring sensor in patients after SAH: placing a bet when placing a probe?

    Directory of Open Access Journals (Sweden)

    Christian T Ulrich

    Full Text Available INTRODUCTION: Vasospastic brain infarction is a devastating complication of aneurysmal subarachnoid hemorrhage (SAH. Using a probe for invasive monitoring of brain tissue oxygenation or blood flow is highly focal and may miss the site of cerebral vasospasm (CVS. Probe placement is based on the assumption that the spasm will occur either at the dependent vessel territory of the parent artery of the ruptured aneurysm or at the artery exposed to the focal thick blood clot. We investigated the likelihood of a focal monitoring sensor being placed in vasospasm or infarction territory on a hypothetical basis. METHODS: From our database we retrospectively selected consecutive SAH patients with angiographically proven (day 7-14 severe CVS (narrowing of vessel lumen >50%. Depending on the aneurysm location we applied a standard protocol of probe placement to detect the most probable site of severe CVS or infarction. We analyzed whether the placement was congruent with existing CVS/infarction. RESULTS: We analyzed 100 patients after SAH caused by aneurysms located in the following locations: MCA (n = 14, ICA (n = 30, A1CA (n = 4, AcoA or A2CA (n = 33, and VBA (n = 19. Sensor location corresponded with CVS territory in 93% of MCA, 87% of ICA, 76% of AcoA or A2CA, but only 50% of A1CA and 42% of VBA aneurysms. The focal probe was located inside the infarction territory in 95% of ICA, 89% of MCA, 78% of ACoA or A2CA, 50% of A1CA and 23% of VBA aneurysms. CONCLUSION: The probability that a single focal probe will be situated in the territory of severe CVS and infarction varies. It seems to be reasonably accurate for MCA and ICA aneurysms, but not for ACA or VBA aneurysms.

  6. The quantitative and functional changes of post-operative PB immune cell subsets relate to SAH patients' prognosis: A Preliminary Study.

    Science.gov (United States)

    Jiang, Yugang; Zhou, Yu; Peng, Yong; Zhang, Mingming

    2017-08-30

    It has been suggested that the preoperative (PRE) and postoperative (POST) immune system alteration triggered by aneurysmal subarachnoid hemorrhage (SAH) and surgical treatment itself may affect patients' prognosis and contribute to postoperative complications. The mechanisms maybe attributed to immune-suppression triggered infection or immune-overreaction triggered aseptic inflammation. In this study, we investigated the dynamic changes in peripheral immune cell subsets as well as the alterations of inflammatory cytokines in aneurysmal SAH patients who received craniotomy and clipping surgery. In addition, we studied the association of those changes with postoperative complications and clinical prognosis. We investigated 27 patients who received craniotomy and clipping surgery for the aneurysmal SAH. The operations were all performed within 24h after the occurrence of aneurysm rupture. Detailed immune monitoring (Peripheral blood leukocytes and lymphocyte subsets, inflammatory cytokines) was performed in PRE (on admission), day1, day3 and day 6 after operation. Our data displayed that the percentage of CD3+, CD8+, NKT, CD4+, Tregs cells significantly decreased and the level of IL-4, IFN-γ and IL-2 significantly increased 1 day after surgery as compared to the data in PRE. On the contrary, NK, NKG2D, B cells increased and the level of IL-10 in plasma decreased. In study the relationship between POST fever and the change in immune cell subgroups, it was noted that the fever group had a lower percentage of CD3+, CD4+, NKT, Tregs and B cells in day 1, day 3 and day 6 post surgery as compared to the non-fever patients' , while CD8+, NK, NKG2D subsets showed the opposite trend. Furthermore, we analyzed the association between immune profile changes and the prognosis of those patients. The patients were divided into unfavorable prognosis (n=6) and favorable prognosis (n=21) according to Glasgow score and post-operation (POST) coma. Our results displayed that except for

  7. Intracranial hematoma and SAH: actual aspects in its interpretation with magnetic resonance. Hematoma intracraneal y hemorragia subaracnoidea: aspectos actuales en su interpretacion mediante resonancia magnetica

    Energy Technology Data Exchange (ETDEWEB)

    Muoz Gonzalez, A. (Hospital 12 de Octubre. Servicio de Radiodiagnostico. Madrid (Spain))

    1993-01-01

    A basic understanding of the magnetic properties of Hb degradation products explains the mechanisms and production of the signals occurring at the different stages of the formation and degradation of intracranial hematoma and SAH. Despite the interaction among complex phenomena and the fact that their explanations are not univocal, since many phenomena remain to be understood even in the light of those theories that, at present, most closely agree, the proposed models permit the comprehension and diagnosis of a pathology which, in addition to being common, is diagnostically relevant and serves as paradigm in Radiological research. (Author) 44 refs.

  8. Clinical and diagnostic approach to patients with hypopituitarism due to traumatic brain injury (TBI), subarachnoid hemorrhage (SAH), and ischemic stroke (IS).

    Science.gov (United States)

    Karamouzis, Ioannis; Pagano, Loredana; Prodam, Flavia; Mele, Chiara; Zavattaro, Marco; Busti, Arianna; Marzullo, Paolo; Aimaretti, Gianluca

    2016-06-01

    The hypothalamic-pituitary dysfunction attributable to traumatic brain injury (TBI), aneurysmal subarachnoid hemorrhage (SAH), and ischemic stroke (IS) has been lately highlighted. The diagnosis of TBI-induced-hypopituitarism, defined as a deficient secretion of one or more pituitary hormones, is made similarly to the diagnosis of classical hypopituitarism because of hypothalamic/pituitary diseases. Hypopituitarism is believed to contribute to TBI-associated morbidity and to functional and cognitive final outcome, and quality-of-life impairment. Each pituitary hormone must be tested separately, since there is a variable pattern of hormone deficiency among patients with TBI-induced-hypopituitarism. Similarly, the SAH and IS may lead to pituitary dysfunction although the literature in this field is limited. The drive to diagnose hypopituitarism is the suspect that the secretion of one/more pituitary hormone may be subnormal. This suspicion can be based upon the knowledge that the patient has an appropriate clinical context in which hypopituitarism can be present, or a symptom known as caused by hypopituitarism. Hypopituitarism should be diagnosed as a combination of low peripheral and inappropriately normal/low pituitary hormones although their basal evaluation may be not distinctive due to pulsatile, circadian, or situational secretion of some hormones. Evaluation of the somatotroph and corticotroph axes require dynamic stimulation test (ITT for both axes, GHRH + arginine test for somatotroph axis) in order to clearly separate normal from deficient responses.

  9. Draft genome sequence of the extremely halophilic Halorubrum sp. SAH-A6 isolated from rock salts of the Danakil depression, Ethiopia

    Directory of Open Access Journals (Sweden)

    Ashagrie Gibtan

    2016-12-01

    Full Text Available The draft genome sequence of Halorubrum sp. SAH-A6, isolated from commercial rock salts of the Danakil depression, Ethiopia. The genome comprised 3,325,770 bp, with the G + C content of 68.0%. The strain has many genes which are responsible for secondary metabolites biosynthesis, transport and catabolism as compared to other Halorubrum archaea members. Abundant genes responsible for numerous transport systems, solute accumulation, and aromatic/sulfur decomposition were detected. The first genomic analysis encourages further research on comparative genomics, and biotechnological applications. The NCBI accession number for this genome is SAMN04278861 and ID: 4278861 and strain deposited with accession number KCTC 43215.

  10. Draft genome sequence of the extremely halophilic Halorubrum sp. SAH-A6 isolated from rock salts of the Danakil depression, Ethiopia.

    Science.gov (United States)

    Gibtan, Ashagrie; Woo, Mingyeong; Oh, Dokyung; Park, Kyounghee; Lee, Han-Seung; Sohn, Jae Hak; Lee, Dong-Woo; Shin, Jung-Kue; Lee, Sang-Jae

    2016-12-01

    The draft genome sequence of Halorubrum sp. SAH-A6, isolated from commercial rock salts of the Danakil depression, Ethiopia. The genome comprised 3,325,770 bp, with the G + C content of 68.0%. The strain has many genes which are responsible for secondary metabolites biosynthesis, transport and catabolism as compared to other Halorubrum archaea members. Abundant genes responsible for numerous transport systems, solute accumulation, and aromatic/sulfur decomposition were detected. The first genomic analysis encourages further research on comparative genomics, and biotechnological applications. The NCBI accession number for this genome is SAMN04278861 and ID: 4278861 and strain deposited with accession number KCTC 43215.

  11. Identification of two vicinal operons for the degradation of 2-aminobenzenesulfonate encoded on plasmid pSAH in Alcaligenes sp. strain O-1.

    Science.gov (United States)

    Ruff, Jürgen; Smits, Theo H M; Cook, Alasdair M; Schleheck, David

    2010-05-30

    Alcaligenes sp. strain O-1 inducibly deaminates 2-aminobenzenesulfonate (ABS) via dioxygenation to 3-sulfocatechol, which is desulfonated during meta ring-cleavage to yield 2-hydroxymuconate. This intermediate is transformed through the oxalocrotonate-branch of the sulfocatechol meta-pathway (Scm). The complete pathway is encoded on the 180-kb plasmid pSAH, 20kb of which was sequenced. Twenty open reading frames (ORFs) were detected. Two clusters (abs and scm) with degradative genes were surrounded by several transposon-related ORFs. The six genes of the abs cluster were shown to be co-transcribed, and contained the genes for two characterised subunits of the oxygenase component of the ABS-dioxygenase system, and genes putatively encoding ABS-transport functions with similarities to (a) an ABC-type transporter system and (b) a putative major facilitator superfamily transporter. No gene encoding the reductase for the oxygenase system was present in the abs gene cluster, but a candidate gene was found in the scm cluster. The seven-gene scm cluster was also transcribed as single polycistronic message. Functions could be attributed to the gene products, but one enzyme, which was shown to be present, 2-hydroxymuconate isomerase, was not encoded in the scm cluster. No transcriptional regulator was found. This genetic information on the degradation of ABS in strain O-1 provides another example of both split operons and dispersed pathway genes.

  12. The Inner Centromere Protein (INCENP) Coil Is a Single α-Helix (SAH) Domain That Binds Directly to Microtubules and Is Important for Chromosome Passenger Complex (CPC) Localization and Function in Mitosis.

    Science.gov (United States)

    Samejima, Kumiko; Platani, Melpomeni; Wolny, Marcin; Ogawa, Hiromi; Vargiu, Giulia; Knight, Peter J; Peckham, Michelle; Earnshaw, William C

    2015-08-28

    The chromosome passenger complex (CPC) is a master regulator of mitosis. Inner centromere protein (INCENP) acts as a scaffold regulating CPC localization and activity. During early mitosis, the N-terminal region of INCENP forms a three-helix bundle with Survivin and Borealin, directing the CPC to the inner centromere where it plays essential roles in chromosome alignment and the spindle assembly checkpoint. The C-terminal IN box region of INCENP is responsible for binding and activating Aurora B kinase. The central region of INCENP has been proposed to comprise a coiled coil domain acting as a spacer between the N- and C-terminal domains that is involved in microtubule binding and regulation of the spindle checkpoint. Here we show that the central region (213 residues) of chicken INCENP is not a coiled coil but a ∼ 32-nm-long single α-helix (SAH) domain. The N-terminal half of this domain directly binds to microtubules in vitro. By analogy with previous studies of myosin 10, our data suggest that the INCENP SAH might stretch up to ∼ 80 nm under physiological forces. Thus, the INCENP SAH could act as a flexible "dog leash," allowing Aurora B to phosphorylate dynamic substrates localized in the outer kinetochore while at the same time being stably anchored to the heterochromatin of the inner centromere. Furthermore, by achieving this flexibility via an SAH domain, the CPC avoids a need for dimerization (required for coiled coil formation), which would greatly complicate regulation of the proximity-induced trans-phosphorylation that is critical for Aurora B activation.

  13. 吡哆醇对脑淋巴引流阻滞所致SAH后神经细胞凋亡加重的影响%Cerebral lymphatic blockage aggravates apoptosis of cortical neurons after SAH in rat and pyridoxine has a certain role in the mitigation

    Institute of Scientific and Technical Information of China (English)

    王轩; 陈锋; 高兵; 高向东; 贾丽丽; 杨明峰; 孙保亮

    2010-01-01

    目的 探讨脑淋巴引流阻滞(CLB)对蛛网膜下腔出血(SAH)后神经细胞凋亡的影响和吡哆醇的缓解作用及相关机制.方法 健康成年Wistar大鼠,随机分为正常对照组、SAH组、SAH+CLB组、SAH+CLB+吡哆醇组、SAH+CLB+生理盐水组.采用枕大池2次注血法建立SAH模型.于第2次注血3 d后检测相关指标.SAH+CLB+吡哆醇组于CLB术前30 min按50 mg·kg-1腹腔注射吡哆醇生理盐水溶液,每天以上述半量重复注射2次.采用TUNEL荧光标记法检测原位凋亡情况;免疫组织化学激光共聚焦检测大鼠皮层神经细胞Caspase-3和Bcl-2的蛋白表达.结果 ①与正常对照组比较,其余各组大鼠TUNEL阳性细胞表达均明显升高,而SAH+CLB组和SAH+CLB+生理盐水组又明显高于SAH组(P<0.01),SAH+CLB+吡哆醇组与SAH+CLB组比较表达有所减弱(P<0.01).②与正常对照组比较,其余各组大鼠皮层神经细胞Caspase-3蛋白表达均明显升高,而SAH+CLB组和SAH+CLB+生理盐水组最高,与SAH组比较差异具有显著性(P<0.01),SAH+CLB+吡哆醇组与SAH+CLB组比较表达有所减弱(P<0.01).③与正常对照组比较,其余各组大鼠皮层神经细胞Bcl-2蛋白表达均明显升高,而SAH+CLB组和SAH+CLB+生理盐水组明显低于SAH组(P<0.01),SAH+CLB+吡哆醇组较SAH+CLB组表达增强.结论 脑淋巴引流阻滞可以通过Caspase-3高表达和Bcl-2低表达加重SAH后大鼠皮层神经细胞的凋亡,而吡哆醇具有一定的缓解作用.

  14. Diagnostic Value of 64-slice CTA in Detection of Intracranial Aneurysm in Patients with SAH and Comparison of the CTA Results with 2D-DSA and Intraoperative Findings

    Directory of Open Access Journals (Sweden)

    Elif Ergun

    2011-03-01

    Full Text Available Objective: To prospectively evaluate the diagnostic value of 64-slice CTA in detecting intracranial aneurysms and to compare it with 2D-DSA and/or intra-operative findings.Material and Methods: 37 cases with SAH according to unenhanced cranial CT were included in the study. A 64-slice CTA was performed to all cases immediately after the nonenhanced cranial CT. DSA was performed in 24-48 hours following CTA. CT images were reviewed by two radiologists experienced in CT vascular imaging. The DSA reader was the angiographer who performed the DSA. The results of the CTA were compared with the DSA results and/or intraoperative findings in order to determine the diagnostic efficacy of CTA in detecting intracranial aneurysms. Results: Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CTA in detecting aneurysms were 92.8%, 83.3%, 96.2%, 71.4% and 91.2% respectively. The diagnostic value of CTA in detecting intracranial aneurysms was found to be equal to DSA by Mcnemar test. Conclusion: CTA is invaluable in detecting intracranial aneurysms. It may be used as a first line modality in SAH, and DSA may be reserved for patients with negative or equivocal CTA results.

  15. Perspectivas actuales en el tratamiento del Síndrome de Apneas-Hipopneas del Sueño (SAHS) y dificultades para su implementación en nuestro medio.

    OpenAIRE

    Rey de Castro Mujica, Jorge

    2013-01-01

    El Síndrome de Apneas-Hipopneas del Sueño (SAHS) es un trastorno serio de curso crónico caracterizado por episodios repetidos de colapso parcial o total de la vía aérea superior presentados durante el dormir. La interrupción y fraccionamiento del sueño produce excesiva somnolencia diurna (ESD). La información relacionada a su prevalencia indica que este desorden es común y puede fluctuar entre 2-4 % de los adultos en la edad media de la vida (1-3). Debido a su asociación con alteraciones neur...

  16. Rôle des oiseaux sur la régénération du ligneux Boscia senegalensis (pers.) Lam. en savane sahélienne au Nord Sénégal

    OpenAIRE

    Tréca, Bernard; Tamba, Seynabou

    1997-01-01

    En savane sahélienne, #Boscia senegalensis$ (Pers.) Lam, est l'espèce ligneuse qui se régénère le mieux, surtout sous le couvert des #Acacia$. Les oiseaux, mais pas les mammifères, consomment abondamment ses fruits et, sauf quand ils mangent la pulpe sur place, dispersent les graines soit par transport du fruit dans le bec soit par ingestion. Les graines sont alors régurgitées ou déféquées après digestion de la pulpe, sous le couvert des arbres où perchent les oiseaux, des #Acacia$ dans 2/3 d...

  17. Le petit poids de naissance à terme en milieu rural sahélien: importance, déterminants et conséquences/Low birth weight at term in rural sahelian area: Importances, determinants and consequences.

    OpenAIRE

    Kaboré, Patrick

    2009-01-01

    Du fait de son impact sur la morbidité et la mortalité infantile, ainsi que de ses implications sur la santé à l’âge adulte, le petit poids de naissance constitue un problème majeur de santé publique. Le Burkina Faso, pays sahélien enclavé au cœur de l’Afrique occidentale est classé dans le groupe des pays pauvres très endettés et présente une forte prévalence de petit poids de naissance, imputable dans la majorité des cas au retard de croissance intra-utérine. Le contexte de ce travail, réal...

  18. The relationship between P53 gene expression and cell injury after SAH in rat%大鼠蛛网膜下腔出血后脑组织P53基因表达与细胞损伤

    Institute of Scientific and Technical Information of China (English)

    潘军; 周岱

    1999-01-01

    目的探索防治蛛网膜下腔出血(SAH)引起的脑血管痉挛(CVS)的新途径.方法利用大鼠SAH模型,设立对照组、SAH组、放线菌素酮治疗组(CHX组).经DIG-RT-PCR对不同时间大鼠脑组织P53基因进行检测.结果对照组、CHX组P53基因表达相近,SAH组P53基因表达增高.显微镜下见CHX组病理形态学变化近似正常,SAH组神经细胞损伤严重.结论大鼠SAH后CVS所致的脑缺血,脑组织P53基因表达明显增高.大鼠SAH模型P53基因表达与脑神经元细胞损伤明显相关.放线菌素酮通过抑制P53基因表达从而抑制其诱导的损伤.

  19. Conceptualisation des espaces sahéliens chez les auteurs arabes du Moyen Âge Conceptualization of the Sahelian spaces by the Arab authors in the Middle Ages

    Directory of Open Access Journals (Sweden)

    Jean-Charles Ducène

    2013-05-01

    Full Text Available Si les auteurs arabes médiévaux constituent une source unique pour la connaissance des espaces sahéliens, il n’en reste pas moins que ces observateurs définissent ces régions selon les concepts géographiques ou ethniques du moment (ixe–xe siècle. Les principes directeurs de la géographie de l’époque imposent une définition mathématique et déterminent une ethnographie pour ces contrées, alors que les conditions naturelles semblent légitimer cette vision qui établit une forte différenciation entre les populations du Nord et du Sud du Sahara, ce dernier espace étant plus un lieu de transition qu’une barrière. Ces cadres une fois constitués, les informations recueillies viennent y trouver place sans entraîner une redéfinition de l’ensemble ou en préciser les contours, et ceci malgré la pénétration de l’islam et la densification des relations entre les Arabes et le bilād al-Sūdān, à partir du xiie siècle. Les toponymes se multiplient ainsi que les « observations » culturelles, celles-ci fondées sur le principe que plus le comportement s’éloigne de ce que connaît l’observateur, plus il est remarquable.The medieval Arab authors are an invaluable source for the knowledge of Sahelian spaces. However, these observers defined these lands according to geographical or ethnic concepts, fitting with the spirit of their time (9th-10th centuries. The guidelines of the medieval geography impose a mathematical definition to the space and determine an ethnography for these peoples, while natural conditions seemed to legitimate this vision, that established a huge differentiation between the populations located North and South of the Sahara. This desert was seen as a transitional space rather than a barrier. Once established, this framework didn’t move in spite of the islamization of these lands and the increasing contacts between the Arabs and the bilād al-Sūdān in the 12th century. The toponymy becomes

  20. 克拉玛依市区35岁以上汉、维吾尔族睡眠呼吸暂停低通气综合征人群糖尿病患病率调查%Prevalence study of Han nationality and Uygur nationality of diabetes in SAHS in adults aged over 35 years in Kelamayi city

    Institute of Scientific and Technical Information of China (English)

    何忠明; 韩芳; 宋镇; 李鸿霞; 宋玉玲; 雷清生; 李敏

    2013-01-01

    Objective To study the prevalence of diabetes in SAHS adults aged over 35 years in kelamayi city,and to analyze relationship between sleep apnea and Type 2 diabetes mellitus.Methods 1081 subjects (age≥35) were derived from the population living in three districts in Kelamayi city.All subjects were screened for SAHS using questionnarie,they were asked to answer the questions concerning snoring etc.and meaturing the height,weight,neck circumference,abdominal circumference and blood sugar,include 572 subjects of Han nationality and 509 subjects of Uygur nationality.All subjects have respiration and pulse oximeter testing.Results The body mass index [(24.9 ± 3.2) kg/m2 vs (27.9 ±4.2) kg/m2],neck circumference [(35.3±3.2)cm vs (36.9±3.2) cm],abdominal circumference [(87.6±9.7) cm vs (96.0±11.3) cm],oxygen desaturation over 4% per hour sleep >5 times [(10.8±0.4) times/h vs (7.5±0.4) times/h],the nadir arterial oxygen saturation [(93.2±2.3)% vs (92.7±6.3)%],apnea htpopnen index [(16.2±15.8) times/h vs (11.3± 14.1) times/h] and blood sugar [(6.3±1.7) mmol/L vs (7.0±2.8) mmol/L] were significantly different bettween Han nationality and Uygur nationality groups (P < 0.01),there are significant difference on the prevalence of diabetes between with and without SAHS groups(34.7% vs 9.5%) (P <0.01),and significant difference on the prevalence of diabetes in SAHS between Han nationality and Uygur nationality groups (39.6% vs 28.5 %) (P <<0.05).Conclusions The prevalence of diabetes in SAHS in adults over 35 years old was 44.7% in Kelamayi city,the prevalence of SAHS and Type 2 diabetes mellitus increased with abdominal circumference,the prevalence of Type 2 diabetes in SAHS groups was higher than no SAHS groups,there relationship between sleep apnea and Type 2 diabetes mellitus.%目的 调查克拉玛依市区35岁以上睡眠呼吸暂停低通气综合征(SAHS)患者中2型糖尿病的患病率,探讨睡眠呼吸紊

  1. Método simplificado para el diagnóstico del síndrome de apnea-hipopnea del sueño (SAHS: A propósito de una serie de casos empleando el polígrafo respiratorio BREAS SC-20.

    Directory of Open Access Journals (Sweden)

    Jorge Rey de Castro Mujica

    2007-04-01

    Full Text Available Objetivo: Presentar una serie de casos con diagnóstico de síndrome apnea hipopnea del Sueño (SAHS establecido con un polígrafo respiratorio (PR. Materiales y métodos: Se presentan 53 PRs realizadas entre enero 2005 y octubre 2006 en pacientes con sospecha de trastornos respiratorios del sueño. Se utilizó el polígrafo respiratorio BREAS SC-20 validado por nosotros anteriormente. La prueba fue implementada a lo largo de la noche en el domicilio del paciente y sin supervisión de personal técnico. En 32 (60% casos la PR fue instalada en el consultorio y el resto en el domicilio del paciente. Resultados: Se analizaron 53 PRs, realizadas en el mismo número de pacientes. El equipo falló en seis (11% ocasiones; las seis pruebas fueron repetidas obteniéndose buenos resultados para el análisis. El Tiempo de registro fue 7,7±1,1 [5,5-10,7] horas, índice de apnea-hipopnea 35,5±20 [0-82], tiempo porcentual de registro con SatO2Hb menor de 90% (T90 9,8±15,2 [0-62] % y desaturación máxima de oxígeno (DesMax 73±14,8 [38-91] %. Los principales diagnósticos fueron: SAHS 46 (86%, apnea central con patrón periódico Cheyne Stokes 3 (6%, ronquido primario benigno 2 (4% y prueba normal 2 (4%. El procedimiento fue bien tolerado y no hubo efectos secundarios relacionados. Conclusiones: Con los resultados obtenidos, consideramos que el sistema BREAS SC-20 bajo supervisión de médicos entrenados en los trastornos respiratorios del sueño; es una herramienta útil, práctica y económica para el diagnóstico del SAHS.(Rev Med Hered 2007;18:59-67.

  2. Aquaculture en zone sahélo-soudanienne: diagnostic des ...

    African Journals Online (AJOL)

    SARAH

    30 avr. 2014 ... agricole pratiqué dans toutes les treize régions du pays (Kabré et Zerbo, ... poisson dans les grands centres urbains. Elle s'impose ..... Les canaux primaires d'évacuation (canaux E) conduisent les eaux usées des étangs.

  3. KONSEP SYÛRÂ DALAM PANDANGAN FIQH SIYÂSAH

    Directory of Open Access Journals (Sweden)

    Moh. Zahid

    2013-09-01

    Full Text Available Al-Qur’ân stipulation on syûrâ, as principal law, is exceedinglyshort; the detailed ways to perform it has been absence. TheHoly Qur’ân does not persist whether the social problems mustbe determined on the basis of syûrâ, also on the matter that issyûrâ specifically applicable on government issues? Yet theProphet Muhammad saw. didn’t recommend certain outlines tobe followed. It was reflected on the method of leadersubstitution done by khalîfah after his period of time. Theprocess of substitution was merely different among one toanother. The unspecific explanation on syûrâ, takes it into aflexible, smooth and appropriate to any situation and to thewhole social problems. Consequently, the concept of al-Qur’ânon syûrâ is not identical with democracy, though its idea hashighly appreciated the major opinion as stated in democracythought.

  4. 172 rue de Vanves, Paris XIV / Leila Anupõld, Jüri Hain

    Index Scriptorium Estoniae

    Anupõld, Leila

    1998-01-01

    Kujutava Kunsti Sihtkapitali Valitsuse (KKSKV) poolt alates 1925. a. teisest poolest kunstnikele antud välismaa stipendiumidest. Stipendiaatide (Wiiralt jt.) raskest elust Pariisis. Eesti Vabariigi Prantsusmaa saatkonna abist kunstnike stipendiaatide töö korraldamisel. Sihtkapitali ateljeest, mida 1929-30. aastail lühiajaliselt kasutasid Albert Kesner ja Eduard Wiiralt

  5. Markkinointiviestinnän kehittäminen : Leila's Hyvät Maut

    OpenAIRE

    Ruosteluoma, Jesse

    2016-01-01

    Opinnäytetyön toteutettiin kehittämistyönä paikalliselle lähiruokaa valmistavalle yritykselle Leila’s Hyvät Maut. Opinnäytetyön tarkoituksena oli luoda kehitysideoita markkinointiviestintään yritykselle. Ensimmäisenä tavoitteena oli perehtyä yleisesti markkinointiviestinnän keinoihin ja kanaviin kuluttaja- sekä yritysmarkkinoilla. Opinnäytetyön toisena tavoitteena oli analysoida Leila’s Hyvät Maut -yrityksen markkinointiviestinnän nykytilannetta. Kolmantena tavoitteena oli analysoida kilpaili...

  6. Palmse mõis / Johann Caspar Mohr, Aarne Kann, Leila Pärtelpoeg

    Index Scriptorium Estoniae

    Mohr, Johann Caspar (?-1788)

    1996-01-01

    Esimesed kirjalikud teated mõisa kohta pärinevad 1348. aastast. Omanik von Pahlen. (W. S. Stavenhageni terasegravüür 1866-1867. a.). lk. 74 (Oruveski, postkaart a. 1910), värv., lk. 75 (mõisahoone ja suur kaskaad, postkaardid a. 1910), värv., lk. 76 (mõisahoone pärast restaureerimist 1980-ndatel aastatel), värv., lk. 77 (härrastemaja tagakülg), värv., lk. 78 (park tiigi, paadisilla ja teemajaga), värv., lk. 79 (fragment 1753. a. plaanist ; vaade parki), värv., lk. 80-83 (restaureeritud siseruumid), värv., lk. 84 (park, paviljonid, 'Suur sild'), värv., lk. 85 (kasvuhoone), värv.

  7. 动脉瘤性蛛网膜下腔出血患者行腰大池置管引流治疗发生分流依赖性脑积水的相关因素研究%Study on relevant factors of shunt-dependent hydrocephalus when occurred in aSAH patients given lumbar catheter drainage treat-ment

    Institute of Scientific and Technical Information of China (English)

    侯双兴; 夏峰

    2014-01-01

    Objective To study relevant factors of aneurysmal subarachnoid hemorrhage( aSAH)patients given lumbar catheter drainage treatment when occurring shunt-dependent hydrocephalus. Methods Retrospective analysis May 2010 to August 2013 for treatment of aSAH clinical data of 42 cases. All patients Hunt-Hess grade classification grade Ⅰ ~ Ⅲ,underwent surgery;surgery during or after surgery,1~3 d for all patients with lumbar catheter drainage treatment. According to shunt-dependent hydrocephalus to analysis Hunt-Hess grade,the aver-age number of days of catheterization,acute ventricular dilatation,aneurysm location and surgical approach were observed. Results Seven cases (16. 7%)occurred shunt dependency hydrocephalus in 42 patients. ①which admission Hunt-Hess grade 1 to gradeⅠcases,Ⅱgrade 2 cases,Ⅲ grade 4 patients,Hunt-Hess more likely in patients with high shunt-dependent hydrocephalus. ②occurrence of cerebral shunt-dependent hydrocephalus patients with lumbar puncture tube was significantly longer than the average number of days hydrocephalus patients(14. 7 ± 1. 9 d ratio of 8. 9 ± 1. 8 d)did not occur. ③proportion of patients with acute ventricular dilatation occurs hydrocephalus does not appear significantly higher in patients with acute ventricular dilatation(44. 4% compared with 9. 1%). Communicating artery aneurysm and posterior circulation aneu-rysms after. ④shunt-dependent hydrocephalus highest incidence was 33. 3% in posterior circulation aneurysm;followed by 25. 0% in the poste-rior communicating artery aneurysm. ⑤line treatment of patients with surgical clipping of the emergence of shunt-dependent hydrocephalus ratio endovascular embolization patients(14. 8% compared to 20. 0%)below the line,but the difference was not statistically significant. Conclusion Occurs when treatment aneurysmal subarachnoid hemorrhage patients underwent drainage shunt -dependent hydrocephalus and Hunt -Hess grade level,the position of the aneurysm

  8. The Influence of Good Education on Women-A Case Study Of Leila, the Heroine of A Thousand Splendid Suns

    Institute of Scientific and Technical Information of China (English)

    ZHOU Bi-zheng

    2016-01-01

    With the development of society, people are increasingly aware of the importance of education, especially the good ed-ucation on women. This paper took one of the heroines of a thousand splendid suns—Laila as an example to elaborate clearly the significant influence of good education on women’s body and mentality. In doing so, it made an attempt to achieve the purpose of giving a deeper understanding of the process, the obstacles and the significant meaning of education on women. It was also hoped that this deeper understanding would lead to greater input into women’s education and their more comprehensive involve-ment in social and economic development.

  9. Common cold is the most frequent cause for misdiagnosing aneurysmal SAH

    Directory of Open Access Journals (Sweden)

    Tetsuhisa Yamada, M.D.

    2017-09-01

    Conclusions: Subarachnoid hemorrhage was misdiagnosed as a common cold in younger patients in whom headache suddenly developed at rest, but symptoms were mild, and the patient was brought to a general practitioner at a clinic by means other than an ambulance on the day after onset or subsequently. Misdiagnosis can be prevented by suspecting subarachnoid hemorrhage and performing imaging examinations; obtaining a detailed medical history is therefore essential.

  10. Description du peuplement piscicole du lac sahélien de Higa, un ...

    African Journals Online (AJOL)

    SARAH

    30 nov. 2015 ... Cichlidae had the highest factor condition K: Sarotherodon galilaeus (K = 1.94), Oreochromis niloticus (K = 1.88) .... pêcheurs et 5 femmes transformatrices des produits de ..... Convention sur les zones humides (Ramsar, Iran,.

  11. Omar und Leila : eine romantische Oper in 3 Acten / in Musik gesetzt von F. E. Fesca. [Text] von L. Robert. Vollst. vom Comp. verfertigter Clavierausz.

    OpenAIRE

    Fesca, Friedrich Ernst; Robert, Ludwig

    2009-01-01

    INHALT Atto I Overtura 1. Intr. Rec . ed Aria. lch fürcht' euch nicht, ihr Götter. 2. Rec. Aria e Coro. Genossen der Nacht ! 3. Romanze. Dort in der Laub' am Gitter 4. Terzetto e Coro. Meine Taube ! 5. Duetto . Zerbinchen, Zerbinchen! 6. Finale. Leela, hör' ! Atto II 7. Aria e Coro. Leise von Ort zu Ort 8. Rec. ed Aria. Wär sie am Leben nur 9. Aria. Die Katz' die in die Küche kommt 10. Cavatina. 11. Terzetto e Coro. Herbei, ihr Geister 12. Duetto e Coro. Hört uns da unten! 13. Finale. Nein,ne...

  12. Predictors of nursing home admission of individuals without a dementia diagnosis before admission - results from the Leipzig Longitudinal Study of the Aged (LEILA 75+

    Directory of Open Access Journals (Sweden)

    Matschinger Herbert

    2010-06-01

    Full Text Available Abstract Background In previous decades a substantial number of community-based studies mostly including dementia cases examined predictors of nursing home admission (NHA among elderly people. However, no one study has analysed predictors of NHA for individuals without developing dementia before NHA. Methods Data were derived from the Leipzig Longitudinal Study of the Aged, a population-based study of individuals aged 75 years and older. 1,024 dementia-free older adults were interviewed six times on average every 1.4 years. Socio-demographic, clinical, and psychometric variables were obtained. Kaplan-Meier estimates were used to determine mean time to NHA. Cox proportional hazards regression was used to examine predictors of long-term NHA. Results Of the overall sample, 7.8 percent of the non-demented elderly (n = 59 were admitted to nursing home (NH during the study period. The mean time to NHA in the dementia-free sample was 7.6 years. Characteristics associated with a shorter time to NHA were increased age, living alone, functional and cognitive impairment, major depression, stroke, myocardial infarction, a low number of specialist visits and paid home helper use. Conclusions Severe physical or psychiatric diseases and living alone have a significant effect on NHA for dementia-free individuals. The findings offer potentialities of secondary prevention to avoid or delay NHA for these elderly individuals. Further investigation of predictors of institutionalization is warranted to advance understanding of the process leading to NHA for this important group.

  13. Microgreffage de quatre espèces ligneuses sahéliennes Acacia senegal, Faidherbia albida, Tamarindus indica et Ziziphus mauritiana en vue de leur rajeunissement

    Directory of Open Access Journals (Sweden)

    Danthu, P.

    2001-01-01

    Full Text Available Micrografting of Four Sahelian Trees (Acacia senegal, Faidherbia albida, Tamarindus indica and Ziziphus mauritiana with a View to their Rejuvenation. This paper proposes a protocol of rejuvenation of four Sahelian ligneous species : Acacia senegal, Faidherbia albida, Tamarindus indica and Ziziphus mauritian. It consists in aseptically removing a small scion (5-10 mm in length and in micrografting it on to a seeding grown in vitro used as rootstock. The main elements of success are the age of the rootstock (two to six weeks depending on species, the level of grafting (on hypocotyl instead of epicotyl and the origin of the scion (apex have higher growth after micrografting than axillary buds. The method developed was applied to the restoration of juvenile traits of adult trees. The main criterion is the rooting ability of microcuttings sampled on scions, after micrografting. Rooting competence restoration depends on the species, the nature of the first copy of the donor tree and the number of cycles of micrografting. The rejuvenation was more definite for F. albida, mobilised by root cuttings. In this case, one third of the microcuttings rooted after the first cycle of micrografting and 75 % after the second. For 2. Mauritiana mobilised by horticultural budding, 25 % of microcuttings were rooted after the second successive micrograft. No restoration of rooting competence was obtained with A. senegal and T. indica mobilised by cutting.

  14. Al-Sulṭānah fī Cirebon: Dirāsah Tārīkhīyah wa Thaqāfīyah

    Directory of Open Access Journals (Sweden)

    Uka Tjandrasasmita

    2009-08-01

    Full Text Available This article discusses the Sultanate of Cirebon from two perspectives. First, from its historical standpoints, including its rise, development and fall. Second, from its cultural point of views covering such aspects as architecture, literature, and performing arts, which have become local traditions until nowadays. Geographically, Cirebon is located in Northern part of law coast. Its strategic location, with a number of river mouths, plays an important role for the development of Cirebon to become a harbor city for regional and international sailing and trading nativities. The position of Cirebon as a harbor city has begun since Hindu and Buddhist Kingdom of Sundanese Pajajaran, as can be seen from local archives, such as babad and carita, as well as foreign historical records.Copyright (c 2014 by SDI. All right reserved.DOI: 10.15408/sdi.v16i2.485

  15. Les stratégies d’adaptation des ruraux sahéliens à la variabilité climatique: analyse de la diversité

    DEFF Research Database (Denmark)

    Zorom, Malicki; Barbier, Bruno; Mertz, Ole

    2010-01-01

    Coping strategies are generally based on financial resources, human capital for labour, quality of soils, rainfall and knowledge of the environment, but there is no single model of adaptation. This study develops a typology of adaptation strategies based on economic data collected in five Sahelian...

  16. Intensification agricole en région sahélo-soudanienne. 2. Productivité et risques économiques

    Directory of Open Access Journals (Sweden)

    Abdoulaye Dieng

    1997-01-01

    Full Text Available Intensification of farming in the Sahelian-Sudanese region. 2. Productivity and economic risks.his second part concerns the analysis of land productivity and labour results within a traditional farming system and two improved systems experimented on a site in the center-west part of the Senegalese groundnut basin. Intensified farming systems associate farming and livestock and use motorized or draft cultivation (oxen as means of mechanization. Results show that intensification systematically increases crop yields and gives rise to larger amounts of by-products fitting well for use as animal feed. Furthermore, yields stabilize with soil fertility improvement. The economic risk linked to intensification strongly depends on the climatic context. A 400 mm annual rainfall appears as a threshold to insure a net increase of land and labour productivity, justifying an intensification operation that combines plowing, liming material, organic and minerai fertilizer applications. In the climatic risk zone like that where the experimentation took place, the diversification of farming activity increases and stabilizes income. Therefore, productions as cassava or bissap and the integration of a perennial forage crop offer interesting development perspectives. The constraints limiting the adoption of intensified and diversified farming systems are linked to market conditions, time-labour feasibility, soil fertility management and institutional context. To minimize the risks, tactical adjustments are also analyzed.

  17. Les stratégies d’adaptation des ruraux sahéliens à la variabilité climatique: analyse de la diversité

    DEFF Research Database (Denmark)

    Zorom, Malicki; Barbier, Bruno; Mertz, Ole;

    2010-01-01

    Coping strategies are generally based on financial resources, human capital for labour, quality of soils, rainfall and knowledge of the environment, but there is no single model of adaptation. This study develops a typology of adaptation strategies based on economic data collected in five Sahelia...... for diversified households. The groups have in general not adopted new coping strategies outside of classic strategies: agricultural diversification, migration and breeding. A weak relationship between coping strategies and the north–south rainfall gradient was found....

  18. Martina Läubli, Sabrina Sahli (Hg.: Männlichkeiten denken. Aktuelle Perspektiven der kulturwissenschaftlichen Masculinity Studies. Bielefeld: transcript Verlag 2011.

    Directory of Open Access Journals (Sweden)

    Anna Buschmeyer

    2012-08-01

    Full Text Available Der Sammelband bietet einen guten Überblick über die Vielfalt an Themengebieten, mit denen sich die kulturwissenschaftlichen ‚Masculinity Studies‘ zurzeit beschäftigten. Neben theoretischen Texten finden sich Berichte aus zahlreichen kleineren Studienprojekten, die das Rätsel der Konstruktion von Männlichkeit u. a. durch die Analyse von Geschlechtsdarstellungen in Computerspielen, in der Literaturanalyse, in der Psychoanalyse oder in der Filmrezension zu lösen versuchen. Allen ist gemeinsam, dass sie von einer Fragilität von Männlichkeit ausgehen: Männlichkeit scheint etwas zu sein, dass brüchig wird, sobald es sich von heteronormer Zweigeschlechtlichkeit löst und ‚anders‘ daherkommt, als hegemoniale Vorstellungen dies vorschreiben.This anthology offers a good overview on the variety of subject areas, which the cultural studies field of ‘masculinity studies’ is currently devoted to. In addition to theoretical texts, the reader finds reports from numerous smaller research projects, which try to solve the mystery of the construction of masculinity, among others through the analysis of gender representations in computer games, in literary analysis, in psychoanalysis, or in movie reviews. They all act on the assumption of the fragility of masculinity: masculinity seems to be something that becomes fragile once it is separated from the heteronormative binary conception of gender and appears in a ‘different’ way than hegemonic perceptions prescribe.

  19. Intensification agricole en région sahélo-soudanienne. 1. Itinéraires techniques dans un contexte à risques

    Directory of Open Access Journals (Sweden)

    Abdoulaye Dieng

    1997-01-01

    Full Text Available Intensification of farming in the Sahelian-Sudanese region. 1. Crop management sequence in a risk context.An experimentation carried out in a station during five consecutive years compared the traditional farming system of the Senegalese groundnut basin to two modernized systems, based on a close synergy between agriculture and livestock productions: a system intensified by draught cultivation (oxen and a system using heavy motorization. The experimentation, implemented at a real farm scale, has taken place in pedo-climatic conditions representative of the region. By producing manure and an important work force, livestock strongly contributes to the success of farming activities. Results show that the suggested intensification models have a beneficial effect on the soil fertility. Several technical options are put forward aiming at a reduction of the risks linked to climatic hazards. Among the main adjustments considered in the modernized systems, we can mention: crop diversification, rotation between cereals and short duration crops ("bissap", black-eyed cowpeas, planned minerai fertilizer application and judicious selection of growing season and soil tilling procedures. Results provide interesting technical references for setting up development programs

  20. Valorisation de Cassia obtusifolia L. dans l'alimentation des ovins d'embouche en région sahélienne du Burkina Faso

    Directory of Open Access Journals (Sweden)

    Ouédraogo, T.

    2008-01-01

    Full Text Available Use of Cassia obtusifolia L. as Feed Resource for Ram Fattening in the Sahelian Region of Burkina Faso. The objective of this study was to analyse economic and technical performances of the use of straws from Cassia obtusifolia as substitute feed to soybean straws and cotton seed cake for ram fattening in the Sahelian region of Burkina Faso. Five feed rations were tested with different levels of Cassia obtusifolia in substitution to soybean straws (Vigna unguiculata and cotton cake at rates varying between 0 to 20%. The control ration contained 40% of cotton cake and 20% of soybean straws. The results show that Cassia obtusifolia (CO is an efficient feed resource. The average growth rate varied from 56.6 ± 22.3 g/day/animal in the control group to 105.2 ± 33.7 g/day/animal in the groups fed CO. Economically, rations with 25% and 50% cassia substituted to cotton cake showed low variable costs and high profit. These rations are likely to be accessible to any farmers regardless to their resources. On the other hand, the diet with 50% CO substituted to soybean straws maintained high profits, in spite of high production costs. This ration could only be accessible to farmers owning relatively important resources.

  1. Moodsad ajad vanas majas : Raekoja 1975. aasta sisekujundus = Modern Times at an Old Building : 1975 Interior Design of Tallinn Town Hall / Kai Lobjakas

    Index Scriptorium Estoniae

    Lobjakas, Kai, 1975-

    2004-01-01

    1973. a. Tallinna Raekojale uue sisekujunduslahenduse saamiseks korraldatud kutsutud konkursi võitis töö Annunciation, mille põhiautoriks oli Leila Pärtelpoeg, kaasautoriteks Aate-Heli Õun, Anu Raud, Ilme-Anu Neemre. Tööd jätkas Leila Pärtelpoeg koos Udo Umbergiga. Rippvaipade galerii autor Valve Ilveste

  2. Raamat "Tööraamat" = "A life's work" book

    Index Scriptorium Estoniae

    2012-01-01

    Eesti Sisearhitektide Liidu 2011. aasta publitsistika preemia: Pärtelpoeg, Leila. Tööraamat / koostaja Krista Roosi ; kujundaja Maarja Roosi. [Tartu] : Eesti Sisearhitektide Liit, [2011]. Loetletud Leila Pärtelpoja, Krista Roosi ja Maarja Roosi tehtud töid

  3. Moodsad ajad vanas majas : Raekoja 1975. aasta sisekujundus = Modern Times at an Old Building : 1975 Interior Design of Tallinn Town Hall / Kai Lobjakas

    Index Scriptorium Estoniae

    Lobjakas, Kai, 1975-

    2004-01-01

    1973. a. Tallinna Raekojale uue sisekujunduslahenduse saamiseks korraldatud kutsutud konkursi võitis töö Annunciation, mille põhiautoriks oli Leila Pärtelpoeg, kaasautoriteks Aate-Heli Õun, Anu Raud, Ilme-Anu Neemre. Tööd jätkas Leila Pärtelpoeg koos Udo Umbergiga. Rippvaipade galerii autor Valve Ilveste

  4. Raamat "Tööraamat" = "A life's work" book

    Index Scriptorium Estoniae

    2012-01-01

    Eesti Sisearhitektide Liidu 2011. aasta publitsistika preemia: Pärtelpoeg, Leila. Tööraamat / koostaja Krista Roosi ; kujundaja Maarja Roosi. [Tartu] : Eesti Sisearhitektide Liit, [2011]. Loetletud Leila Pärtelpoja, Krista Roosi ja Maarja Roosi tehtud töid

  5. Optimisation du greffage pour trois espèces fruitières de cueillette des zones sahélo-soudaniennes: Balanites aegyptiaca, Detarium senegalense et Tamarindus indica

    Directory of Open Access Journals (Sweden)

    Soloviev, P.

    2004-01-01

    Full Text Available Optimization of Grafting for three Gathered Fruit Species of Sahelo-Sudanese Areas: Balanites aegyptaica, Detarium senegalense and Tamarindus indica. Balanites aegyptiaca, Detarium senegalense and Tamarindus indica are three forest species producing fruits traditionally picked and much enjoyed by Sahelo-Sudanese populations. They consume the pulp either fresh or transformed into drinks. To struggle against the diminishing resources of gathered fruits as well as the genetic erosion, a domestication program is being carried out in Senegal. It aims at selecting and cloning trees of a superior phenotype before introducing them into local populations. Some tests have been tried out so as to develop and optimise techniques of grafting adapted to theses species. The tested factors have been the age of the source plants, the time for grafting, as well as the type of graft. The best dates to graft have been defined as follows: end of dry season for D. senegalense, during rainy season for B. aegyptiaca, beginning of dry season for T. indica. For these three species the apical grafts (cleft graft and splice graft gave better results than other types. A narrow relationship has been established between the survival percentage of juvenile and mature materials. However, the development of these techniques is not to be taken into consideration without the preliminary application of protocols concerning the rejuvenation of mature material.

  6. Al-Shaykh Aḥmad al-Rifā‘ī wa Siyāqīyat al-Sharī‘ah al-Islamīyah: Dirāsah ‘alá Kitab Takhyirah

    Directory of Open Access Journals (Sweden)

    M. Adib Misbachul Islam

    2012-04-01

    Full Text Available Kitab Takhyirah is a tarjumah book comprises of Kiai Ahmad Rifa'i Kalisalak's thoughts on Islam from its various aspects, such as 'aqidah, shari'ah, and akhlaq. The book consists about ideas that can be considered provocative in the context of Islamic thinking in the nineteenth century especially in Java and generally in Nusantara. Through Takhyirah, Kiai Ahmad Rifa'i has disseminated his notions on the unification of the various doctrinal aspects of Islam. He is different from the general ulama who tend to separate one aspect of Islam with other aspects. For example, Kiai Ahmad Rifa'i argued that Islamic syariah includes usul (akidah aspect, fiqh (Islamic law aspect, and tasawuf (akhlak and spiritual aspect.Copyright (c 2014 by SDI. All right reserved.DOI: 10.15408/sdi.v19i1.372 

  7. Des aménagements hydro-agricoles dans la vallée du fleuve Sénégal ou le risque de maladies hydriques en milieu sahélien

    OpenAIRE

    Handschumacher, Pascal; Hervé, Jean-Pierre; Hébrard, Georges

    1992-01-01

    La vallée du fleuve Sénégal porte les espoirs de développement de toutes les populations implantées sur ses rives. Des aménagements de taille et de portée diverses jalonnent son histoire. Mais la mise en service des deux barrages de Diama et de Manantali constitue sans conteste une accélération de ce processus d'aménagement. Ces nouvelles ambitions font cependant craindre l'apparition ou le développement de maladies liées à l'eau. C'est ce paradoxe du risque des maladies hydriques dans un env...

  8. Vulgarisation de la méthode du triple ensachage pour le stockage amélioré du niébé en zone sahélienne du Nord Cameroun: enjeux et perceptions paysannes

    Directory of Open Access Journals (Sweden)

    Folefack, DP.

    2013-01-01

    Full Text Available Diffusion of the Triple Bagging Method to Improve Cowpea Storage in the Sahelian Zone of North Cameroon: Stakes and Farmer Perceptions. The study reveals the stakes of the triple bagging method, assesses farmer perception about this technology and identifies the factors determining their perception. One of the most limiting factors of cowpea production is the storage. To solve this problem, Purdue University Improved Cowpea Storage Project introduced in 2010 in Cameroon the PICS bag technology without chemical. The survey revealed that pilot farmers were satisfied of the use of this technology. An assessment of econometric model pointed out an evident correlation between socio-economic factors and the level of satisfaction of pilot farmers. Some variables influenced significantly the probability of being satisfied, namely: the farmer experience in cowpea cropping, annual area covered by cowpea crops, the use of PICS bags without chemical, health protection and the potential use of PICS bags to store other crops. Farmers are willing to adopt this technology for the storage of cowpea. A further survey must be done in the future to assess the real adoption rate and the impact of this technology in this zone.

  9. Amélioration des systèmes de production mixtes en Afrique soudano-sahélienne. Rôle de l'espèce Stylosanthes hamata (L. Taub. (synthèse bibliographique

    Directory of Open Access Journals (Sweden)

    Camara, A.

    2015-01-01

    Full Text Available Improvement of mixed farming systems in Sudano-Sahelian Africa. Role of the species Stylosanthes hamata (L. Taub. A review. Introduction. In Sudano-Sahelian Africa, the traditional farming systems are no longer able to meet the food needs of the population. In order to sustainably improve the food security of small family farms, agro-ecological practices are increasingly being promoted by research and development organizations. Literature. Several studies have shown that agricultural productivity can be sustainably improved through a better integration of agriculture and livestock activities. One approach currently being considered is the integration into farming systems of Stylosanthes hamata (L. Taub: a herbaceous annual to short-lived perennial. This plant has the proven potential to enhance the performance of cropping systems in many ways. It also allows for the critical production of a high quality fodder for animal feed, from the second year after planting onwards. However, phytosanitary, technical, environmental and / or socio-economic constraints would need to be lifted to allow a better integration of the crop into farming systems. Conclusions. Integration of S. hamata into the farming systems of the Sudano-Sahelian regions presents potential benefits that merit further investigation, in order to identify the appropriate modalities for this integration.

  10. THE ROLE OF ATATURK REVOLUATION IN TIME OF NADIR SHAH IN AFGHANISTAN’S MODERNIZATION EFFORT / ATATÜRK INKILÂBININ NADIR SAH DÖNEMINDE AFGANISTAN’IN MODERNLESME ÇABASINA ETKISI

    Directory of Open Access Journals (Sweden)

    Dr. Mehmet KÖÇER

    2008-09-01

    Full Text Available Being the leader of Turkish National Struggle and founder ofTurkish Republic, Atatürk proved such an eminent leader that manyother countries, nations and leaders took him as a source ofinspiration, a good model in other words. He showed himself as aleading person in Turkish Nationalist Movement, which started risingafter the 19th century, followed changes and development experiencedin the world closely and most importantly was a very well-educated person. He always adopted a stable and self-consistent policy whileimplementing his revolutions with the public’s support. Nadir Shah,the third leader throning to Afghanistan during Atatürk era, was asoldier like Atatürk. Being aware of importance both Turkey andAtatürk posed for his country, Afghanistan, Nadir Shah likeEmanullah realized crucial role of maintaining friendly relations withnewly-founded Turkish Republic with an eye to contribute toAfghansitan’s welfare and development. Hence, he struggled hard toestablish communication with Atatürk’s Turkey. He showed hisdetermination in this aspect by asking for the Turkish ambassador’sidea while he was being throned to rule. Furthermore, the message hesent to Atatürk to celebrate anniversary of Turkish Republic just afterhe was throned was an obvious sign of this loyality and interest.

  11. DESCRIPCIÓN DEL SÍNDROME DE SOBREPOSICIÓN (APNEA / HIPOPNEA OBSTRUCTIVA DEL SUEÑO -SAHS- Y ENFERMEDAD PULMONAR OBSTRUCTIVA CRÓNICA (EPOC EN UNA POBLACIÓN SELECCIONADA DE PACIENTES A DOS DIFERENTES ALTITUDES

    Directory of Open Access Journals (Sweden)

    Cano DJ

    2015-01-01

    Full Text Available Objective: To describe the architecture of sleep, breathing events and oxygenation in a selected population of patients with chronic obstructive pulmonary disease (COPD and obstructive sleep apnoea-hypopnoea syndrome (OSAHS in Burgos (800 m and Bogota (2640 m. Methodology: Study, retrospective. Patients with a diagnosis of stable COPD who underwent a polysomnography at the Hospital Universitario de Burgos (HUBU or Fundación Neumológica Colombiana (FNC. Databases of patients of both institutions, medical records and the results of baseline polysomnography, spirometry and arterial blood gases were reviewed, collecting variables related to sleep architecture, respiratory events and oxygenation. Results: Patients Burgos: n 17, 94.1% male, age 63.2 ± 8.8 years, BMI 31.28 ± 5.5 kg / m2. Spirometry FVC: 2.84 ± 0.9 liters (64.19 ± 17%, FEV1: 1.86 ± 0.7 liters (57.26 ± 18.2%, FEV1 / FVC 62.8 ± 6.6. Low sleep efficiency. Low percentage of NREM and REM. IAH 33.4 (IQR 16.2 to 65.2. Percentage of time with SpO2 <90%: 52.2 ± 35%. Oxygen desaturation index of 29 ± 19. Bogota patients: n 18, 55.6% male, age 69.1 ± 8.2 years. BMI 28.08 ± 4.1 kg / m2. FVC: 2.23 ± 0.7 liters (71.72 ± 12.1%, FEV1: 1.14 ± 0.49 liters (46.8 ± 13.2%, FEV1 / FVC 50.8 ± 9.9. Low sleep efficiency, low percentage of REM. IAH 19.3 (RIC 13 to 54.9. Percentage of time with SpO2 <90%: 60.8 ± 35.4%. Oxygen desaturation index 50.8 ± 29.1%. Conclusions: Two different groups of patients with overlap syndrome (OSAHS/COPD are presented. Clinical and oxygenation differences generate analysis in the diagnostic approach and evaluate reference values.

  12. Evolution des ressources forestières en Afrique de l’Ouest soudano-sahélienne au cours des 50 dernières années

    OpenAIRE

    Ariori, Serge Léopold; OZER Pierre

    2005-01-01

    On the basis of an exhaustive consultation of the literature describing the temporal evolution of land cover in arid, semiarid and dry subhumid regions of West Africa, this study shows that the deforestation trend has been very important during the second half of the 20th century. This trend to deforestation is globally large (2% per year) and is clearly alarming. Although our results differ from FAO's official data, it is demonstrated that those are questionable. In addition, if dense woody ...

  13. Description du système racinaire de trois espèces fourragères en zone soudano-sahélienne : Andropogon gayanus, Vigna unguiculata et Stylosanthes hamata

    Directory of Open Access Journals (Sweden)

    Koné D.

    1998-01-01

    Full Text Available Description of root systems of three fodder crops in the Soudano-Sahelian area: Andropogon gayanus, Vigna unguiculata and Stylosanthes hamata. Root systems of fodder crops (Andropogon gayanus, Vigna unguiculata and Stylosanthes hamata were studied at two Research Stations in Mali in 1992, using soil monoliths. In this method, roots are studied throughout the soil profile in cubical compartments of 1 dm3. Root biomass production of A. gayanus planted in 1951 was 4 t.ha-1 against 5 t.ha-1 when planted in 1991. Above-ground biomass was 12 and 8 t.ha-1, respectively. The majority (90% of the root biomass was concentrated in the upper 60 cm of the soil profile even if the root depth reached 180 cm. Root biomass decreased with depth following a negative exponential curve, but root length density decreased to a lesser extent, resulting in increasing specific root length (root length per unit of root biomass with depth. Root biomass of V. unguiculata was 1,118 kg.ha-1 without phosphorus fertilization and 2,922 kg.ha-1 with Pfertilization. The effect of Pon above ground biomass was negligible, and no reduction of specific root length with depth was observed. Root biomass production by S. hamata hardly responded to P fertilization: 3,596 kg.ha-1 without P and 4,161 kg.ha-1 with non-limiting P-supply; above-ground biomass was 8,360 and 10,680 kg.ha-1 respectively. Root length density was relatively high for the whole root profile and specific root length increased from 35 m.g-1 for the 0–20 cm layer to 100 m.g-1 for the 130–140 cm layer, allowing S. hamata to use water and nutrients efficiently throughout the whole profile.

  14. Influence d'une infection expérimentale à Trypanosoma congolense sur la fonction sexuelle des béliers Djallonké et Sahéliens en zone subhumide

    Directory of Open Access Journals (Sweden)

    Sangare, M.

    2010-01-01

    Full Text Available Influence of an experimental Trypanosoma congolense infection on the reproductive function of Djallonké and Sahelian rams in subhumid zone. To measure the effect of African animal trypanosomosis (AAT on male reproductive function, eight 18-24 month old Djallonké (ID; 31.2 ± 2.95 kg and Sahelian (IS; 41.7 ± 4.64 kg rams were infected with 104 Trypanosoma congolense. Eight other Djallonké (CD and Sahelian (CS rams with similar bodyweight and ages were used as uninfected controls. Four weeks after infection, ID and IS were treated with a trypanocidal drug, while maintained under observation. The evolution of clinical parameters shows a higher aptitude of Djallonké than Sahelian to control the effects of infection. This interbreed difference in susceptibility to AAT was confirmed by the higher weight losses in IS (-31.3 g when compared to ID (-12.8 g as to CD and CS rams. The effect of a T. congolense infection consisted in a decreased libido in IS (33 s when compared to ID (22.1 s (P > 0.05. The results indicate a significant effect of breed on ejaculate volume (CS: 1.23 ml vs CD: 0.88 ml; P < 0.05. Otherwise, breed did not significantly affect the other spermatic parameters. CD sperm cells concentration (3,293.4 x 106.ml-1, total abnormality rate (15.3%, dead sperm cells rate (13.9%, mobile sperm cells rate (75.5%, individual (3.76 and mass motilities (3.94 did not differ (P > 0.05 from those of CS (respectively 3,481.7 x 106.ml-1; 17.3%; 12.4%; 74.9%; 3.77; 3.36. However, the later produced 26% more total sperm cells than CD (P > 0.05. The infection reduced ejaculate volume by 15.8 and 14.5%, (P > 0.05, production of total sperm cells by 18.2 and 13.3% (P > 0.05 and the rate of mobile sperm cells by 14.2 and 27.9% (P < 0.05 respectively for Djallonké and Sahelian rams. The results show a dysfunctional state of testicles due to the harmful effects of AAT infection, hence the increase in dead sperm cells by 69.8 and 74.3% (P > 0.05 and in the rate of total abnormal sperm cells by 23.6 and 24.1% (P > 0.05 respectively for ID and IS rams when compared respectively to CD and CS animals. Harmful effects often more pronounced in Sahelian breeds during this experiment could indicate a higher susceptibility of this breed to AAT in comparison with Djallonké. One Sahelian ram died two weeks post-infection and azoospermia was observed in another one six weeks after chemotherapy and the disappearance of parasites from the bloodstream.

  15. Tratamiento del síndrome de apneas-hipoapneas del sueño (SAHS con dispositivos mecánicos generadores de presión postiva. CPAP, APAP y ventilación servoasistida

    Directory of Open Access Journals (Sweden)

    Dr., PHD Joaquín Durán-Cantolla

    2013-05-01

    El tratamiento con CPAP, aunque bien aceptado por la mayoría de los pacientes con cumplimientos superiores al 70% no está exento de incomodidades. El 50% de los pacientes presenta algún tipo de efectos secundarios, generalmente leves y transitorios. La utilización de las escuelas de CPAP para el inicio del tratamiento y el seguimiento de los pacientes con CPAP por personal entrenado se ha mostrado muy eficaz. Es imprescindible la formación y la colaboración entre todas las partes implicadas en el proceso. En este sentido, se considera esencial una mayor participación de los médicos de asistencia primaria en el control y seguimiento de los pacientes en tratamiento con CPAP.

  16. Al-Islām wa al-qānūn wa al-dawlah: Dirāsah fī fikri Ki Bagus Hadikusumo wa dawrihi

    Directory of Open Access Journals (Sweden)

    Sudarnoto Abdul Hakim

    2014-07-01

    Full Text Available This article discusses the intellectual and political biography of Ki Bagus Hadikusumo, a prominent Muslim leader in Indonesia. He was born in Yogyakarta where he grew up  in a Muslim priyayi family of Kauman in the city. This study explains that the Sufi tradition of Pesantren Wonokromo in Yogyakarta deeply influenced his religious thoughts. Later, he was noted as one of the first students of K.H. Ahmad Dahlan, the founder of Muhammadiyah. It is clear that he was under a strong intellectual, ideological and religious influence of Dahlan. He published works on Islamic theology, Fiqh, Sufism, and also on Islam and state. During the Japanese occupation, he  became the Chairman of Muhammadiyah organization . Ki Bagus was also known as a prominent leader of political parties, i.e. PII, MIAI, Masyumi and then a prominent member of BPUPKI, an important element of Indonesian independence in 1945. Representing a nationalist-Islamist wing, he greatly contributed to the politics of early modern Indonesia by (1 preparing  the Indonesian constitution, and (2 providing solid arguments for Muslims to accept Pancasila as the nation’s state ideology.Copyright (c 2014 by SDI. All right reserved.DOI: 10.15408/sdi.v21i1.881

  17. Al-Siyāsah al-Qanūnīyah li Ḥizb al-‘Adālah wa al-Rafāhīyah (Partai Keadilan Sejahtera/PKS fi al-Fatrah 1998-2004 al-Mīlādī: Dirāsah li Qaḍīyat Qānūn Idārat al-Zakāh

    Directory of Open Access Journals (Sweden)

    Ismail Marzuki

    2012-12-01

    Full Text Available This article discusses the politics of Islamic law of Partai Keadilan Sejahtera (Prosperity and Justice Party, PKS 1998–2004 by analyzing the formulation of Law No. 38/ 1999 on Zakat Management, and Law No. 23/2011 on Zakat Management. It shows that there has been a shifting ideological expression in the evolution of the PKS that began to appear when this party morphed from Partai Keadilan (Justice Party to PKS in 2002 because it had failed to pass the parliamentary threshold for the 1999 election, and had a practical political agenda for obtaining an increase of electoral votes. The ideological shift, among others, is shown through the process of the formulation of the Zakat Management Law which was influenced by several motives, among others ideological and practical political interests. PKS’s politics on Islamic law show that if its ideological interests contradict with its practical political interests, then the party opts for practical political interests.Copyright (c 2014 by SDI. All right reserved.DOI: 10.15408/sdi.v19i3.357 

  18. Politik, tshinovnik i obshtshestvennõi dejatel stshitajut : roditleskije zarplatõ ustanovlenõ nespravedlivo / Anna Orshanskaja

    Index Scriptorium Estoniae

    Orshanskaja, Anna

    2003-01-01

    Riigikogu liige Mihhail Stalnuhhin hääletas vanemahüvitise seaduse vastu. Narva aselinnapea Reet Välja ja paljulapseliste ühingu "Suur perekond" esimees Leila Kurgjärv peavad seadust ebaõiglaseks

  19. Kunsti-Pegasus / Harry Liivrand

    Index Scriptorium Estoniae

    Liivrand, Harry, 1961-

    2000-01-01

    1963. a. valminud kohvik "Pegasus" interjöörist ja seal toimunud näitustest. Kohviku interjööri autorid olid Allan Murdmaa, Leila Pärtelpoeg ja Vello Tamm, modernistliku alumiiniumskulptuuri autor Edgar Viies

  20. Dvorjanskoje gnezdo : glava iz knigi 'ESTICA : kultura i istorija' / Jüri Kuuskemaa

    Index Scriptorium Estoniae

    Kuuskemaa, Jüri, 1942-

    1998-01-01

    Rägavere mõisa härrastemajast, arvatav arhitekt Johann Schulz. Selle taastamisest kultuurikeskuse tarvis. Sisekujundaja Leila Pärtelpoeg, skulptor Cornelius Tamm. Maali- ja mööblikollektsioonist

  1. Politik, tshinovnik i obshtshestvennõi dejatel stshitajut : roditleskije zarplatõ ustanovlenõ nespravedlivo / Anna Orshanskaja

    Index Scriptorium Estoniae

    Orshanskaja, Anna

    2003-01-01

    Riigikogu liige Mihhail Stalnuhhin hääletas vanemahüvitise seaduse vastu. Narva aselinnapea Reet Välja ja paljulapseliste ühingu "Suur perekond" esimees Leila Kurgjärv peavad seadust ebaõiglaseks

  2. Kunsti-Pegasus / Harry Liivrand

    Index Scriptorium Estoniae

    Liivrand, Harry, 1961-

    2000-01-01

    1963. a. valminud kohvik "Pegasus" interjöörist ja seal toimunud näitustest. Kohviku interjööri autorid olid Allan Murdmaa, Leila Pärtelpoeg ja Vello Tamm, modernistliku alumiiniumskulptuuri autor Edgar Viies

  3. 安哥拉小姐获2011“环球小姐”称号

    Institute of Scientific and Technical Information of China (English)

    孙育红(选注)

    2011-01-01

    Leila Lopes from Angola was crowned Miss Universe on September 12th, 2011, smoothly handling an interview question about what physical trait she would change if she could by stating it was her inner beauty and principles that counted most.

  4. Short-Communication: Revisiting conclusions of the report titled, "The impact of psychological factors on self-reported sleep disturbance among people living in the vicinity of wind turbines," by Leila Jalali, Mohammad-Reza Nezhad-Ahmadi, Mahmood Gohari, Philip Bigelow, & Stephen McColl, published in environmental research, volume 148, July 2016, 401-410.

    Science.gov (United States)

    Palmer, William K G

    2017-05-01

    The research report concluded, "It appears that self-reported sleep reported of participants may be associated to the indirect effects of visual and attitudinal cue and concern about property devaluation rather than distance to the nearest WT's or noise as itself." Careful reading of the report shows that the conclusions presented are not supported by the data provided in the report. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Anisotropic Frequency Response of Critical Density Fluctuations of NIPA Gel under Oscillation Shear

    DEFF Research Database (Denmark)

    Sugiyama, M.; Vigild, Martin Etchells; Fukunaga, Toshiharu

    2006-01-01

    A relation between rheology and structure of high density NIPA gel around criticai point on volume phase transition was studied by a simultaneous rheology and smail-angle neutron scattering measuÆmeiit Just below the critical temperature, the NIPA gel showed softening: G’ and G” get doser (G’> G...

  6. Combinatorial administration of insulin and vitamin C alleviates the cerebral vasospasm after experimental subarachnoid hemorrhage in rabbit

    Science.gov (United States)

    2011-01-01

    Background Cerebral vasospasm (CVS) is a common serious complication after the spontaneous subarachnoid hemorrhage (SAH). Despite recent advances in medical and surgical treatments, the 30-day mortality rate of SAH remains high, and there is lack of especially effective clinical treatment to alleviate and improve CVS. The present study has investigated the therapeutic effect of insulin and vitamin C on CVS after SAH. Results Five days after SAH, there is obvious basilar artery spasm in SAH group, whose average vascular cross-sectional area (233,099 ± 16,750 μm2) is significantly smaller than that in control group (462,128 ± 74,756 μm2), which is also significantly different from those in SAH + insulin group (221,114 ± 43,457 μm2) and SAH + vitamin C group (237,820 ± 21,703 μm2). SAH + insulin + vitamin C group shows no evident vasospasm and maintains a vascular cross-sectional area of 425,530 ± 45,503 μm2, which is significantly different from that in SAH group. Insulin receptor α (InRα) expression is significantly downregulated in the vascular endothelial cells of SAH, SAH + insulin, and SAH + vitamin C groups (P vitamin C group (P > 0.05). Five days after SAH, serum and cerebrospinal fluid NO levels in SAH, SAH + insulin, and SAH + vitamin C groups decrease significantly (P vitamin C group (P > 0.05). Conclusion Combinatorial treatment with insulin and vitamin C has effectively relieved the CVS after SAH in rabbit, possibly through increasing the InRα expression and NO level, whereas treatment with insulin or vitamin C alone fails to do so. PMID:21801458

  7. Long-term reintegration and quality of life in patients with subarachnoid hemorrhage and a good neurological outcome: findings after more than 20 years.

    Science.gov (United States)

    Sonesson, Bengt; Kronvall, Erik; Säveland, Hans; Brandt, Lennart; Nilsson, Ola G

    2017-04-28

    OBJECTIVE The goal of this study was to examine long-term quality of life (QOL) and reintegration in patients with good neurological recovery after aneurysmal subarachnoid hemorrhage (aSAH) and SAH of unknown cause (SAH NUD). METHODS A long-term follow-up was performed in an original cohort of 113 individuals who had suffered SAH (93 with aSAH and 20 with SAH NUD) between 1977 and 1984. Self-reporting assessments, performed > 20 years after the bleeding episode, included the Quality of Life Scale (QOLS), Psychological General Well-Being (PGWB) index, and Reintegration to Normal Living (RNL) index, along with information on sleep disturbances and work status. RESULTS Seventy-one survivors were identified. Questionnaires were returned by 67 individuals who had suffered SAH 20-28 years previously. The QOL was rated in the normal range for both the QOLS score (aSAH 90.3 vs SAH NUD 88.6) and the PGWB index (aSAH 105.9 vs SAH NUD 102.8). Ninety percent of patients had returned to their previous employment. Complete RNL was reported by 40% of patients with aSAH and by 46% of patients with SAH NUD; mild to moderate readjustment difficulties by 55% and 38%, respectively; and severe difficulties by 5% of patients with aSAH and 15% of patients with SAH NUD. Self-rated aspects of cognition, mood, and energy resources in addition resulted in a substantial drop in overall reintegration. Sleep disturbances were reported by 26%. CONCLUSIONS More than half of patients with SAH who had early good neurological recovery experienced reintegration difficulties after > 20 years. However, the general QOL was not adversely affected by this impairment. Inability to return to work after SAH was associated with lower QOLS scores. Sleep disturbances were associated with lower PGWB scores.

  8. [Protective effect of mitochondria-targeted antioxidant SS31 on early brain injury following subarachnoid hemorrhage in rats].

    Science.gov (United States)

    Zhou, Jian; Li, Zhengzheng; Chen, Zhenggang; Yang, Kun

    2017-09-28

    To evaluate protective effects of SS31 on early brain injury (EBI) induced by subarachnoid hemorrhage (SAH) in rats.
 Methods: A total of 96 Sprague-Dawley rats were randomly divided into 4 groups: A sham group, an SAH group, an SAH+vehicle group (SAH+V), and an SAH+SS31 group. The SAH-induced prechiasmatic cistern rat model was established in this study. Neurological deficit scores were evaluated at 24 h after SAH. The SS31 (5 mg/kg) as well as equal volume of vehicle were administrated intraperitoneally at 2 h after SAH. The neurological scores, brain edema, blood-brain barrier (BBB) permeability, apoptosis, malondialdehyde (MDA), glutathione peroxidase (GPx) activity, superoride dismutase (SOD) activity, and the expression of cytosolic cytochrome c (Cyt C) and Bax were analyzed at 24 h after SAH.
 Results: Treatment with SS31 could significantly reduce MDA levels, and restored the activities of GPx and SOD in the cortex following SAH when compared with the SAH+V group. In addition, Bax SS31 trearment increased or decreased the levels of mitochondrial Cyt C or Bax, respectively. Moreover, SS31 treatment ameliorated brain edema and Evans blue dye extravasation, improved neurological deficits, and decreased neuronal apoptosis at 24 h after SAH.
 Conclusion: SS31 could alleviate EBI after SAH through its antioxidant property and ability in inhibition of neuronal apoptosis.

  9. Bayn ma‘had Tebuireng wa Madrasat Manba‘ al-‘Ulūm: Dirāsah tārīkhīyah ‘an nash’at mafhūm “Al-Madrasah fī al-Ma‘had”

    Directory of Open Access Journals (Sweden)

    Toto Suharto

    2014-07-01

    Full Text Available This article discusses the history of modernization in Indonesian Islamic education, and how its traditional education system is open to modernizing forces. By examining Pesantren Tebuireng and Pesantren Mambaul Ulum, Java’s two old Islamic boarding schools  this study explains how the two pesantrens had become the subject of modernization to introduce “madrasah” system. The existing literature in the field suggests that there are two different opinions as to who was the first institution to develop the madrasah model—Pesantren Tebuireng or Pesantren Mambaul Ulum? This study reveals that, historically, Pesantren Tebuireng was the first pesantren that implemented the madrasah model; Pesantren Mambaul Ulum was not, given the fact that the latter is, institutionally, not a boarding school. There are two reasons why Mambaul Ulum is not considered as an Islamic boarding school. Firstly, the main founder of Mambaul Ulum was a King; therefore, intellectually, he did nothave a tradition with the Islamic boarding school system. Secondly, Mambaul Ulum was established with different motives, compared to other Islamic boarding schools established in Java at the time.Copyright (c 2014 by SDI. All right reserved.DOI: 10.15408/sdi.v21i1.882

  10. Al-Ṭaṣawwuf fī Indūnīsīyā: Dirāsah li Nuskhah al-Kitāb Maṭālib al-Sālikīn Ta’līf Yūsuf al-Makāsārī

    Directory of Open Access Journals (Sweden)

    Awis Kami

    2014-03-01

    Full Text Available Muhammad Yusuf al-Makasari (1627-1699 was one of the Muslim thinkers Nusantara (Indonesian who lived around the leading 17th century. The other two are Nuruddin ar-Raniri (d. 1658 and as-Singkili Abdurrauf (1615-1693 derived from the Sultanate of Aceh .Yusuf al-Makasari has devoted his life to the propagation of Islam. He has focused his attention on the study of various fields, especially with respect to kalam (theology, tasawwuf (Sufism, and the shari'ah (Islamic law and write no less than 23 books in Arabic.Matalib al-Salikin (MS is one of the interesting work of Yusuf al-Makasari. Arable field which he wrestled in this book is tasawwuf, with the main thesis of the separation between tawhid impossible (oneness of God , ma'rifah (divine knowledge, and worship (Rite. He maintains the view that if someone lost one of the elements of the integral, then it has fallen on an idolatrous attitude.Copyright (c 2014 by SDI. All right reserved.DOI: 10.15408/sdi.v3i2.810

  11. Al-‘Alaqah bayn al-‘Ulamā’: Dirāsah Ta’ṣīlīyah li al-Thaqāfah al-Islāmīyah fī al-Ma’āhid al-Taqlīdīyah fī Jāwā

    Directory of Open Access Journals (Sweden)

    Muhbib Abdul Wahab

    2014-03-01

    Full Text Available The role of kyai (religious leaders in pesantren (Islamic Boarding School has long been the object of study for many reaserchers. A notable example is the study of Clifford Geertz in which he obseerves the role of kyai as agents pf culture. In this study, Geertz maintains that kyai act as filters in the flow of information tp student (santri, spreading that which the kyai deem useful for the discarding that which may endanger them.Copyright (c 2014 by SDI. All right reserved.DOI: 10.15408/sdi.v8i3.684

  12. THE ROLE OF ATATURK REVOLUATION IN TIME OF NADĐR SHAH IN AFGHANISTAN’S MODERNIZATION EFFORT / ATATÜRK İNKILÂBININ NADİR SAH DÖNEMİNDE AFGANİSTAN’IN MODERNLESME ÇABASINA ETKİSİ

    Directory of Open Access Journals (Sweden)

    Dr. Mehmet KÖÇER

    2008-12-01

    Full Text Available Being the leader of Turkish National Struggle andfounder of Turkish Republic, Atatürk proved such an eminent leader that many other countries, nations andleaders took him as a source of inspiration, a good modelin other words. He showed himself as a leading person inTurkish Nationalist Movement, which started rising afterthe 19th century, followed changes and developmentexperienced in the world closely and most importantlywas a very well-educated person. He always adopted astable and self-consistent policy while implementing hisrevolutions with the public’s support. Nadir Shah, thethird leader throning to Afghanistan during Atatürk era,was a soldier like Atatürk. Being aware of importanceboth Turkey and Atatürk posed for his country,Afghanistan, Nadir Shah like Emanullah realized crucialrole of maintaining friendly relations with newly-foundedTurkish Republic with an eye to contribute toAfghansitan’s welfare and development. Hence, hestruggled hard to establish communication with Atatürk’sTurkey. He showed his determination in this aspect byasking for the Turkish ambassador’s idea while he wasbeing throned to rule. Furthermore, the message he sentto Atatürk to celebrate anniversary of Turkish Republicjust after he was throned was an obvious sign of thisloyality and interest.

  13. Naẓarīyat al-Fanā’ fī al-Turāth al-Ṣūfī al-Indūnīsī: Dirāsah Taḥlīlīyah

    Directory of Open Access Journals (Sweden)

    Masri Elmahsyar Bidin

    2009-08-01

    Full Text Available This article attempts to analyze deeply concept of fana' that expanded by Indonesian Sufis such as Hamzah Fansuri and Muhammad Nat'is aI' Banjari, in relation with other Sufis in the Muslim zeroed such as lbnu 'Arabi, Abi Yazid al-Bustami, and al-Ghazali. Connection with Indian philosophy like Nirvana and Yoga will also be explored. In the courses of its development, the concept of fana' has triggered controversies in intellectual community, and even there it yielded some prejudices among them that this concept was religious deviation in the Muslim world. This can be seen for example in the cases of al-Hallaj as he said "And al-Haq (I am the God, and Siti Jenar as he said "there is no Siti Jenar, there is God".Copyright (c 2014 by SDI. All right reserved.DOI: 10.15408/sdi.v16i2.484

  14. Naẓariyāt fī Takāmul al-‘Ulūm: Dirāsah Naqdīyah wa Ta’sīsīyah fī Thaqāfat al-Minangkabau

    Directory of Open Access Journals (Sweden)

    Eka Putra Wirman

    2016-07-01

    Full Text Available This article aims at identifying various concepts of science at Islamic Universities in Indonesia, especially after the conversion of a number of State Islamic Institute (IAIN into the State Islamic University (UIN. After analyzing the existing concepts and its shortcomings, this study offers a new pespective that is derived from Minangkabau local wisdom as an alternative. The study uses text analysis methods against various science concepts adopted by various state Islamic universities, such as “Web Spiders”; “Tree of Science”, and “Integration of Science” Through a comparative study between various opinions and work around the Minangkabau tradition, it was concluded that the current concepts being applied are mostly based on the dichotomy of science, where a discipline only applies in a particular period, and does not apply at other times. This sort of dichotomy in turn leads to a vacuum and underdevelopment, even shutting down the growth and progress of certain sciences. Therefore, this study offers a new scientific paradigm called “Tali Tigo Sapilin” which is based on local wisdom of Minangkabau culture with its characteristics, such as balance, synergy and collaboration.DOI: 10.15408/sdi.v23i1.2105

  15. POETRY AFTER TANZİMAT AND ISMAİL SAFÂ TANZİMAT SONRASI ŞİİR ANLAYIŞI VE İSMAİL SAFÂ

    Directory of Open Access Journals (Sweden)

    Sefa YÜCE

    2011-06-01

    Full Text Available İsmail Safâ was a poet of a transitional period. He was ipraised by Muallim Naci and he attracted the attention of his peers. In the discussion of antiqutiy-innovation, he took Ekrem’s stand and adopts new approach in poetry. He participated to Servet-i Fünûn (Wealth of Sciences Community. He took Ekrem’s “Talim-i Edebiyat” (Instruction of Literature production as a model. He wrote theoretical productions regarding main problems of literature.İsmail Safâ was a poet who knew poetry well and attracted attention with having command of the language. Also one of his characteristics seperating him from other poets is to put forward the concept of “national language”. Believing that art can not exist without science poet became a model to young poets in this case by defending the vitality of science of literature.In this study, Literature’s theorectical problems are tried to be assessed by addressing from the point of İsmail Safâ’s productions İsmail Safâ, bir geçiş dönemi şairidir. Edebiyatta eskilik-yenilik tartışmalarında Recaizâde Ekrem’in tarafını tutar ve yeni şiir anlayışını benimser. Servet-i Fünûn topluluğuna katılır. Ekrem’in “Talim-i Edebiyat” eserinden etkilenerek edebiyatın temel sorunlarıyla ilgili teorik eserler yazar. İsmail Safâ, şiir ve şiiriyeti iyi bilen, dile hakimiyeti ile dikkat çeken bir şairdir. Ayrıca onu diğer şairlerden ayıran bir niteliği de “millî dil” kavramını öne çıkarmasıdır. İlimsiz sanat olamayacağını düşünen şair, edebiyat ilminin gerekliliğini savunarak bu konuda genç şairlere örnek olur.Bu çalışmada, İsmail Safâ’nın eserlerinden hareketle edebiyatın teorik sorunları ele alınarak değerlendirilmeye çalışılmaktadır.

  16. Life Satisfaction and Return to Work After Aneurysmal Subarachnoid Hemorrhage

    NARCIS (Netherlands)

    Passier, Patricia E. C. A.; Visser-Meily, Johanna M. A. Anne; Rinkel, Gabriel J. E.; Lindeman, Eline; Post, Marcel W. M.

    2011-01-01

    This study was conducted to investigate life satisfaction and employment status after aneurysmal subarachnoid hemorrhage (SAH) and to explain the associations between life satisfaction and demographic, disease-related, psychological, and personality characteristics. Subjects with SAH (n = 141) livin

  17. Hypopituitarism is uncommon after aneurysmal subarachnoid haemorrhage

    DEFF Research Database (Denmark)

    Klose, Marianne; Brennum, Jannick; Poulsgaard, Lars

    2010-01-01

    Aneurysmal subarachnoid haemorrhage (SAH) has recently been reported as a common cause of chronic hypopituitarism, and introduction of routine neuroendocrine screening has been advocated. We aimed at estimating the risk of hypopituitarism after SAH using strict criteria including confirmatory...

  18. Subarachnoid Hemorrhage

    Science.gov (United States)

    ... the control group and espe- cially the SAH group. This is very important because high blood pressure and smoking were more common in the SAH group than the general population. Finally, when looking at ...

  19. Electrocardiographic abnormalities and serum magnesium in patients with subarachnoid hemorrhage

    NARCIS (Netherlands)

    van den Bergh, Walter M; Algra, Ale; Rinkel, Gabriël J E

    2004-01-01

    BACKGROUND AND PURPOSE: ECG abnormalities and hypomagnesemia frequently occur after aneurysmal subarachnoid hemorrhage (SAH). Because hypomagnesemia is associated with several ECG abnormalities, we studied whether hypomagnesemia mediates ECG abnormalities after SAH. METHODS: We prospectively studied

  20. Impaired endothelial function after aneurysmal subarachnoid haemorrhage correlates with arginine:asymmetric dimethylarginine ratio

    DEFF Research Database (Denmark)

    Bergström, A; Staalsø, J M; Romner, B

    2014-01-01

    BACKGROUND: Endothelial dysfunction might be involved in the development of cerebral vasospasm after aneurysmal subarachnoid haemorrhage (SAH). METHODS: This prospective observational study of 48 SAH subjects and 23 control subjects examined associations between reactive hyperaemia index (RHI...

  1. Brain natriuretic peptide concentrations after aneurysmal subarachnoid hemorrhage : relationship with hypovolemia and hyponatremia

    NARCIS (Netherlands)

    Dorhout Mees, Sanne M; Hoff, Reinier G; Rinkel, Gabriel J E; Algra, Ale; van den Bergh, Walter M

    2011-01-01

    BACKGROUND: Hyponatremia and hypovolemia occur often after aneurysmal subarachnoid hemorrhage (SAH) and are associated with poor outcome. The authors investigated whether brain natriuretic peptide (BNP) is related to hypovolemia and hyponatremia after SAH and whether it can differentiate between hyp

  2. Life Satisfaction and Return to Work After Aneurysmal Subarachnoid Hemorrhage

    NARCIS (Netherlands)

    Passier, Patricia E. C. A.; Visser-Meily, Johanna M. A. Anne; Rinkel, Gabriel J. E.; Lindeman, Eline; Post, Marcel W. M.

    2011-01-01

    This study was conducted to investigate life satisfaction and employment status after aneurysmal subarachnoid hemorrhage (SAH) and to explain the associations between life satisfaction and demographic, disease-related, psychological, and personality characteristics. Subjects with SAH (n = 141)

  3. Deficiency of tenascin-C and attenuation of blood-brain barrier disruption following experimental subarachnoid hemorrhage in mice.

    Science.gov (United States)

    Fujimoto, Masashi; Shiba, Masato; Kawakita, Fumihiro; Liu, Lei; Shimojo, Naoshi; Imanaka-Yoshida, Kyoko; Yoshida, Toshimichi; Suzuki, Hidenori

    2016-06-01

    OBJECT Tenascin-C (TNC), a matricellular protein, is induced in the brain following subarachnoid hemorrhage (SAH). The authors investigated if TNC causes brain edema and blood-brain barrier (BBB) disruption following experimental SAH. METHODS C57BL/6 wild-type (WT) or TNC knockout (TNKO) mice were subjected to SAH by endovascular puncture. Ninety-seven mice were randomly allocated to WT sham-operated (n = 16), TNKO sham-operated (n = 16), WT SAH (n = 34), and TNKO SAH (n = 31) groups. Mice were examined by means of neuroscore and brain water content 24-48 hours post-SAH; and Evans blue dye extravasation and Western blotting of TNC, matrix metalloproteinase (MMP)-9, and zona occludens (ZO)-1 at 24 hours post-SAH. As a separate study, 16 mice were randomized to WT sham-operated, TNKO sham-operated, WT SAH, and TNKO SAH groups (n = 4 in each group), and activation of mitogen-activated protein kinases (MAPKs) was immunohistochemically evaluated at 24 hours post-SAH. Moreover, 40 TNKO mice randomly received an intracerebroventricular injection of TNC or phosphate-buffered saline, and effects of exogenous TNC on brain edema and BBB disruption following SAH were studied. RESULTS Deficiency of endogenous TNC prevented neurological impairments, brain edema formation, and BBB disruption following SAH; it was also associated with the inhibition of both MMP-9 induction and ZO-1 degradation. Endogenous TNC deficiency also inhibited post-SAH MAPK activation in brain capillary endothelial cells. Exogenous TNC treatment abolished the neuroprotective effects shown in TNKO mice with SAH. CONCLUSIONS Tenascin-C may be an important mediator in the development of brain edema and BBB disruption following SAH, mechanisms for which may involve MAPK-mediated MMP-9 induction and ZO-1 degradation. TNC could be a molecular target against which to develop new therapies for SAH-induced brain injuries.

  4. Muuga mõis (Münkenhof) / Otto Pius Hippius, A. Brüllow, David Grimm...[jt.

    Index Scriptorium Estoniae

    2002-01-01

    5 fotot, värv.; lossi lasi ehitada Carl Timoleon von Neff, ehituskavandeid täiendasid A. Brüllow, D. Grimm, O. Hippius, joonised tegi L. Bohnstedt; interjöör restaureeriti 1987-1994 - sisearhitekt Leila Pärtelpoeg; 1944. aastast töötab mõisas kool

  5. Maalähedane "Tuuline rand" / Kristiina Davidjants

    Index Scriptorium Estoniae

    Davidjants, Kristiina, 1974-

    2011-01-01

    Režissööride Kaljo Kiisa ja Viktor Sõmeri filmist "Tuuline rand" (1971), kriitikute hinnangust filmile. Osades Heino Raudsik, Antanas Barcas, Leila Säälik, Katrin Välbe, Hugo Laur, Enn Kraam, Rein Aren, Jüri Järvet jt.

  6. Kulka aastapreemiate žürii hinnang = Comments from the panel of judges / Laila Põdra, Eva Hirvesoo, Tiit Sild, Epp Lankots ; intervjueerinud Margit Mutso

    Index Scriptorium Estoniae

    2011-01-01

    Arhitektuuriaastast 2010. Eesti Kultuurkapitali aastapreemia - Maarja Kask, Karli Luik, Ralf Lõoke, Kristiina Arusoo, Margit Argus, Pelle-Sten Viiburg (Sõmeru keskusehoone, maanteemuuseumi välialad). Arhitektuuri sihtkapitali arhitektuuripreemia - Hannes Koppel (Kuressaare rannahoone), Raul Vaiksoo (eramu), restaureerimispreemia - Jaan Jõgi (Laupa mõis), sisearhitektuuri preemia - Leila Pärtelpoeg (Röa mõis), tegevuspreemia - Karin Hallas-Murula, Eesti Arhitektuurikeskus

  7. Modifying Resilience Mechanisms in At-Risk Individuals: A Controlled Study of Mindfulness Training in Marines Preparing for Deployment

    Science.gov (United States)

    2014-01-01

    acknowledge the assistance of Christopher Demuro, Karl Van Orden, Sante Kotturi, Akanksha Shukla , Leila El-kara, John Schaldach, Robert Skidmore, Matt...Potterat EG, Taylor MK , Van Orden KF, Bauman J, Momen N, Padilla GA, Swain JL: A neuroscience approach to optimizing brain resources for human performance

  8. The handling of fruit reefer containers in the Cape Town container terminal

    CSIR Research Space (South Africa)

    Goedhals-Gerber, LL

    2014-10-01

    Full Text Available -SCM2014 XII International Logistics and Supply Chain Congress - "Supply Chains of the Future", Istanbul, Turkey, 30- 31 October 2014 The handling of fruit reefer containers in the Cape Town container terminal Leila L. Goedhals-Gerber1, Christo Stander...

  9. ثنائية الاتساق والانسجام في الخطاب الشعري عند سميح القاسم ليلى العدنية-أنموذجاً

    Directory of Open Access Journals (Sweden)

    فاطمة زياد

    2015-12-01

    Full Text Available The goal of this article is to study cohesion and coherence in the text of the Paltestinian poete Smih El – Kassim « Leila Al- Adania » using several textual linguistic tools such as connexion, thaming and reiteration which contributed to the cohesion of the text.

  10. Linnumustriga laulupeosokkidest on saanud Suva vabriku hitt-toode / Erik Müürsepp

    Index Scriptorium Estoniae

    Müürsepp, Erik

    2009-01-01

    Suurest huvist AS Suva toodetud laulu- ja tantsupeo "ÜhesHingamine" temaatikaga sokkide ja põlvikute vastu. 25. laulu- ja 18. tantsupeo kunstniku Liina Tepandi ja AS Suva disaineri Leila Tamme kujundatud sokkide ja põlvikute mudelite ja värvide valikust

  11. The life of Rabia al-Adawiyya: reflections on feminism and fundamentalism

    NARCIS (Netherlands)

    Vintges, K.; Dubel, I.; Vintges, K.

    2007-01-01

    The life of Rabia al-Adawiyya is the subject of many legends and stories. Rabia was an eighth century mystic who is generally known as one of the founders of Sufism. Her life is still a source of inspiration for many Muslim women. Muslim feminists like Leila Ahmed make references to her, but so do

  12. The life of Rabia al-Adawiyya: reflections on feminism and fundamentalism

    NARCIS (Netherlands)

    Vintges, K.; Dubel, I.; Vintges, K.

    2007-01-01

    The life of Rabia al-Adawiyya is the subject of many legends and stories. Rabia was an eighth century mystic who is generally known as one of the founders of Sufism. Her life is still a source of inspiration for many Muslim women. Muslim feminists like Leila Ahmed make references to her, but so do w

  13. Kulka aastapreemiate žürii hinnang = Comments from the panel of judges / Laila Põdra, Eva Hirvesoo, Tiit Sild, Epp Lankots ; intervjueerinud Margit Mutso

    Index Scriptorium Estoniae

    2011-01-01

    Arhitektuuriaastast 2010. Eesti Kultuurkapitali aastapreemia - Maarja Kask, Karli Luik, Ralf Lõoke, Kristiina Arusoo, Margit Argus, Pelle-Sten Viiburg (Sõmeru keskusehoone, maanteemuuseumi välialad). Arhitektuuri sihtkapitali arhitektuuripreemia - Hannes Koppel (Kuressaare rannahoone), Raul Vaiksoo (eramu), restaureerimispreemia - Jaan Jõgi (Laupa mõis), sisearhitektuuri preemia - Leila Pärtelpoeg (Röa mõis), tegevuspreemia - Karin Hallas-Murula, Eesti Arhitektuurikeskus

  14. Linnumustriga laulupeosokkidest on saanud Suva vabriku hitt-toode / Erik Müürsepp

    Index Scriptorium Estoniae

    Müürsepp, Erik

    2009-01-01

    Suurest huvist AS Suva toodetud laulu- ja tantsupeo "ÜhesHingamine" temaatikaga sokkide ja põlvikute vastu. 25. laulu- ja 18. tantsupeo kunstniku Liina Tepandi ja AS Suva disaineri Leila Tamme kujundatud sokkide ja põlvikute mudelite ja värvide valikust

  15. Partial Support of MAST Academy Outreach Program

    Science.gov (United States)

    1992-07-23

    Peter Swart RSMAS/MGG Gross, Shannon C. Dr. Alina Szmant RSMAS/MBF Gunder, Shawanda L. J. Pfoffenberger SEFC Levy, Wren H. S. Kelly- Fraga SEFC...Martinez, Elias Drs. Clarke/Frazel RSMAS/MBF Rodriguez-Perez, Manuel Dr. Szmant RSMAS/MBF Rolle, Leila A. Librarian NOAA/AOML Simon, Eric J. Drs. Clarke

  16. Arquitectura en Mazatlán : apropiación de su historia y contexto /

    OpenAIRE

    Villarreal Dau, Leila sustentante.

    2009-01-01

     tesis que para obtener el grado de Doctor en Arquitectura, presenta Leila Villarreal Dau ; asesor Luis Arnal Simón. 171 páginas : ilustraciones. Doctorado en Arquitectura UNAM, Facultad de Arquitectura, 2009

  17. Stenbocki maja rekonstrueerimine : Eesti Vabariigi Valitsuse ja Riigikantselei hoone / Peeter Tambu

    Index Scriptorium Estoniae

    Tambu, Peeter

    2000-01-01

    Arhitektuurne projekt: Kalle Rõõmus AB. Arhitekt Ülle Orav. Sisekujundus: Vaikla Stuudio, sisekujundajad Ain Koit, Raja Gonestov, Angeelika Pärna, Peeter Tambu, Argo Vaikla, Katrin Vaikla. Konstruktiivne osa: ESP. Arhitektuuriajaloolised eritingimused Rasmus Kangropool, eksperdid Mart Kalm, Leila Pärtelpoeg. Hoone ajaloost. Arhitektuurne ja sisekujundusprojekt, ehitus 1996-2000, sisustusprojekt 2000. 8 ill

  18. Kaks head naist - üks istub saalis, teine mängib laval / Aime Jõgi

    Index Scriptorium Estoniae

    Jõgi, Aime, 1958-

    2005-01-01

    3. dets. esietendub Ugalas E. Vetemaa "Püha Susanna ehk Meistrite kool", lavastab näitlejanna L. Säälik, peaosalist mängib L. Komissarov. Kommenteerivad ka teatrijuht Peeter Tammearu ja lavastaja Leila Säälik

  19. Muuga mõis (Münkenhof) / Otto Pius Hippius, A. Brüllow, David Grimm...[jt.

    Index Scriptorium Estoniae

    2002-01-01

    5 fotot, värv.; lossi lasi ehitada Carl Timoleon von Neff, ehituskavandeid täiendasid A. Brüllow, D. Grimm, O. Hippius, joonised tegi L. Bohnstedt; interjöör restaureeriti 1987-1994 - sisearhitekt Leila Pärtelpoeg; 1944. aastast töötab mõisas kool

  20. Meremaa võluriga päeva kallastele / Helle Leppik

    Index Scriptorium Estoniae

    Leppik, Helle

    1999-01-01

    29. apr. esietendub Ugalas "Meremaa võlur. Päeva kaldad", lavalugu Ursula K. Le Guini Meremaa-lugude alusel, lavastaja Andres Noormets, kunstnikud Silver Vahtre ja Airi Eras, peaosades Margus Vaher, Martin Algus, Aarne Soro, Leila Säälik, Gert Raudsepp, Silvia Sarrap

  1. America’s Targeted Killing Policy: Is it Right? Is it Working?

    Science.gov (United States)

    2013-03-01

    Georgetown University, April 16, 2010), 48-49. 54 Leila Hudson, Colin S. Owens, and David J. Callen , “Drone Warfare in Yemen: Fostering Emirates Through...and Callen , “Drone Warfare in Yemen.” 76 Miller, “Plan for Hunting Terrorists.” 77 Brennan, “The Efficacy and Ethics.” 78 Klaidman, Kill or Capture

  2. Defeating Stereotypes of Muslim Women

    Science.gov (United States)

    Smith, Susan E.

    2007-01-01

    Dr. Leila Ahmed's memoir, "A Border Passage: From Cairo to America--A Woman's Journey", pulses with a theme of many women's stories: the struggle to define oneself in the face of social restraints. The 1999 book by Ahmed, the first professor of women's studies in religion at Harvard's Divinity School, came long before the recent wave of memoirs…

  3. Cardiac abnormalities after subarachnoid hemorrhage

    NARCIS (Netherlands)

    Bilt, I.A.C. van der

    2016-01-01

    Aneurysmal subarachnoid hemorrhage(aSAH) is a devastating neurological disease. During the course of the aSAH several neurological and medical complications may occur. Cardiac abnormalities after aSAH are observed often and resemble stress cardiomyopathy or Tako-tsubo cardiomyopathy(Broken Heart Syn

  4. CT perfusion in subarachnoid hemorrhage: pieces of a complicated puzzle

    NARCIS (Netherlands)

    Cremers, C.H.P.

    2016-01-01

    Subarachnoid hemorrhage (SAH) accounts for 5% of all strokes and is caused by a ruptured intracranial aneurysm in 85% of the cases. After aneurysmal SAH (aSAH) many complications can occur. A common neurological complication is delayed cerebral ischemia (DCI), which can present as focal neurological

  5. Experiment on prevention of cerebral vasospasm after subarachnoid hemorrhage and progress of Clinical research%蛛网膜下腔出血并发脑血管痉挛预防的实验与临床研究进展

    Institute of Scientific and Technical Information of China (English)

    梁柯

    2007-01-01

    @@ Cerebral vasospasm(CVS),a common complication of subarachnoid hemorrhage(SAH),is caused by many factors and associated with poor prognosis of SAH.CVS generally occurs 3-4 days after the initial SAH and peaks at 5-7 days.

  6. Subarachnoid hemorrhage induces enhanced expression of thromboxane A2 receptors in rat cerebral arteries

    DEFF Research Database (Denmark)

    Ansar, Saema; Larsen, Carl; Maddahi, Aida;

    2010-01-01

    after SAH in cerebral arteries. SAH was induced in rats by injecting 250 microl of blood into the prechiasmatic cistern. Two days after the SAH, cerebral arteries were harvested and contractile responses to the TP receptor agonist U46619 were investigated with myographs. In addition, the contractile...

  7. Cerebrovascular ETB, 5-HT1B, and AT1 receptor upregulation correlates with reduction in regional CBF after subarachnoid hemorrhage

    DEFF Research Database (Denmark)

    Ansar, Saema; Vikman, Petter; Nielsen, Marianne;

    2007-01-01

    with the reduction in regional and global cerebral blood flow (CBF) after subarachnoid hemorrhage (SAH). SAH was induced by injecting 250 microl blood into the prechiasmatic cistern in rats. The cerebral arteries were removed 0, 1, 3, 6, 12, 24, and 48 h after the SAH for functional and molecular studies...

  8. Recovery from a Subarachnoid Hemorrhage: Days 1 through 22

    Science.gov (United States)

    Brice, Alejandro E.; Brice, Roanne G.; Wallace, Sarah E.

    2016-01-01

    Subarachnoid hemorrhages (SAHs) are a serious medical emergency, as 30% to 50% of all SAHs can result in death. Personal accounts and case studies are an important aspect of evidence-based practice. This first article of two presents a review of AB's (patient) condition immediately following an SAH in the intensive care and immediately post…

  9. Genetic Epidemiology of Spontaneous Subarachnoid Hemorrhage

    DEFF Research Database (Denmark)

    Korja, Miikka; Silventoinen, Karri; McCarron, Peter

    2010-01-01

    BACKGROUND AND PURPOSE: It would be essential to clinicians, familial aneurysm study groups, and aneurysm families to understand the genetic basis of subarachnoid hemorrhage (SAH), but there are no large population-based heritability estimates assessing the relative contribution of genetic...... and 1 opposite sex) and 492 discordant twin pairs for SAH. The concordance for SAH in monozygotic twins was 3.1% compared with 0.27% in dizygotic twins, suggesting at most a modest role for genetic factors in the etiology of SAH. The population-based probability estimate for SAH in dizygotic siblings...

  10. [Increased urinary sodium excretion in the early phase of aneurysmal subarachnoid hemorrhage as a predictor of cerebral salt wasting syndrome].

    Science.gov (United States)

    Nakagawa, Ichiro; Kurokawa, Shinichiro; Takayama, Katsutoshi; Wada, Takeshi; Nakase, Hiroyuki

    2009-12-01

    Cerebral salt wasting syndrome (CSWS) in patients with aneurysmal subarachnoid hemorrhage (SAH) is considered to correlate with delayed ischemic neurological deficits (DIND) induced by cerebral vasospasm; however, its exact mechanism is still not well-known. The purpose of the present study is to evaluate the relationship between hyponatremia caused by CSWS and the increase of the urinary sodium excretion in early phase following SAH. Fifty-four patients with SAH were divided into 2 groups, normonatremia group and hyponatremia group which suffered hyponatremia after SAH. The hyponatremia group comprise 14 patients (26%) in whom the hyponatremia developed of the SAH. In this group, the serum level of sodium significantly decreased 7 days after SAH and then gradually normalised. Further, excretion of sodium in the urine tended to increase 3 days after SAH and significantly increased 7 days after SAH. In conclusion, the increased urinary sodium excretion in the early phase of SAH would serve as a predictive factor for CSWS after SAH. We consider that it is important to start sodium and fluid supplementation and inhibit natriuresis by fludrocortisone acetate administration before hyponatremia occurs in order to prevention delayed ischemic neurological deficits in SAH patients.

  11. Structural insights into a secretory abundant heat-soluble protein from an anhydrobiotic tardigrade, Ramazzottius varieornatus.

    Science.gov (United States)

    Fukuda, Yohta; Miura, Yoshimasa; Mizohata, Eiichi; Inoue, Tsuyoshi

    2017-08-01

    Upon stopping metabolic processes, some tardigrades can undergo anhydrobiosis. Secretory abundant heat-soluble (SAHS) proteins have been reported as candidates for anhydrobiosis-related proteins in tardigrades, which seem to protect extracellular components and/or secretory organelles. We determined structures of a SAHS protein from Ramazzottius varieornatus (RvSAHS1), which is one of the toughest tardigrades. RvSAHS1 shows a β-barrel structure similar to fatty acid-binding proteins (FABPs), in which hydrophilic residues form peculiar hydrogen bond networks, which would provide RvSAHS1 with better tolerance against dehydration. We identified two putative ligand-binding sites: one that superimposes on those of some FABPs and the other, unique to and conserved in SAHS proteins. These results indicate that SAHS proteins constitute a new FABP family. © 2017 Federation of European Biochemical Societies.

  12. Alteration of Basilar Artery Rho-Kinase and Soluble Guanylyl Cyclase Protein Expression in a Rat Model of Cerebral Vasospasm following Subarachnoid Hemorrhage

    Directory of Open Access Journals (Sweden)

    Chih-Jen Wang

    2014-01-01

    Full Text Available Background and Purpose. The vasoconstrictor endothelin-1 (ET-1 has been implicated in the pathogenesis of cerebral vasospasm following subarachnoid hemorrhage (SAH. Previous results showed that CGS 26303, an endothelin converting enzyme (ECE inhibitor, effectively prevented and reversed arterial narrowing in animal models of SAH. In the present study, we assessed the effect of CGS 26303 on neurological deficits in SAH rats. The involvement of vasoactive pathways downstream of ET-1 signaling in SAH was also investigated. Methods. Sprague-Dawley rats were divided into five groups (n=6/group: (1 normal control, (2 SAH, (3 SAH+vehicle, (4 SAH+CGS 26303 (prevention, and (5 SAH+CGS 26303 (reversal. SAH was induced by injecting autologous blood into cisterna magna. CGS 26303 (10 mg/kg was injected intravenously at 1 and 24 hr after the initiation of SAH in the prevention and reversal protocols, respectively. Behavioral changes were assessed at 48 hr after SAH. Protein expression was analyzed by Western blots. Results. Deficits in motor function were obvious in the SAH rats, and CGS 26303 significantly improved the rate of paraplegia. Expressions of rho-kinase-II and membrane-bound protein kinase C-δ and rhoA were significantly increased, while those of soluble guanylyl cyclase α1 and β1 as well as protein kinase G were significantly decreased in the basilar artery of SAH rats. Treatment with CGS 26303 nearly normalized these effects. Conclusions. These results demonstrate that the rhoA/rho-kinase and sGC/cGMP/PKG pathways play pivotal roles in cerebral vasospasm after SAH. It also shows that ECE inhibition is an effective strategy for the treatment of this disease.

  13. Tert-butylhydroquinone alleviates early brain injury and cognitive dysfunction after experimental subarachnoid hemorrhage: role of Keap1/Nrf2/ARE pathway.

    Directory of Open Access Journals (Sweden)

    Zhong Wang

    Full Text Available Tert-butylhydroquinone (tBHQ, an Nrf2 activator, has demonstrated neuroprotection against brain trauma and ischemic stroke in vivo. However, little work has been done with respect to its effect on early brain injury (EBI after subarachnoid hemorrhage (SAH. At the same time, as an oral medication, it may have extensive clinical applications for the treatment of SAH-induced cognitive dysfunction. This study was undertaken to evaluate the influence of tBHQ on EBI, secondary deficits of learning and memory, and the Keap1/Nrf2/ARE pathway in a rat SAH model. SD rats were divided into four groups: (1 Control group (n=40; (2 SAH group (n=40; (3 SAH+vehicle group (n=40; and (4 SAH+tBHQ group (n=40. All SAH animals were subjected to injection of autologous blood into the prechiasmatic cistern once in 20 s. In SAH+tBHQ group, tBHQ was administered via oral gavage at a dose of 12.5 mg/kg at 2 h, 12 h, 24 h, and 36 h after SAH. In the first set of experiments, brain samples were extracted and evaluated 48 h after SAH. In the second set of experiments, changes in cognition and memory were investigated in a Morris water maze. Results shows that administration of tBHQ after SAH significantly ameliorated EBI-related problems, such as brain edema, blood-brain barrier (BBB impairment, clinical behavior deficits, cortical apoptosis, and neurodegeneration. Learning deficits induced by SAH was markedly alleviated after tBHQ therapy. Treatment with tBHQ markedly up-regulated the expression of Keap1, Nrf2, HO-1, NQO1, and GSTα1 after SAH. In conclusion, the administration of tBHQ abated the development of EBI and cognitive dysfunction in this SAH model. Its action was probably mediated by activation of the Keap1/Nrf2/ARE pathway.

  14. Elevated serum S-adenosylhomocysteine in cobalamin-deficient megaloblastic anemia.

    Science.gov (United States)

    Guerra-Shinohara, Elvira M; Morita, Olga E; Pagliusi, Regina A; Blaia-d'Avila, Vera L; Allen, Robert H; Stabler, Sally P

    2007-03-01

    Impaired methylation due to accumulation of S-adenosylhomocysteine (SAH) may contribute to the pathophysiology of cobalamin-deficient anemia. We assayed serum S-adenosylmethionine (SAM), SAH, total homocysteine (tHcy), and methylmalonic acid (MMA) in 15 subjects with cobalamin-deficient megaloblastic anemia and compared results with those of 19 subjects with anemia/pancytopenia due to other causes. Cobalamin-deficient subjects had a median hematocrit level of 20% and mean cell volume of 111.7 fL. The median serum cobalamin level was 37 pg/mL, MMA 3030 nmol/L, and tHcy 62.0 micromol/L. SAH was elevated in 13 of 15 subjects (median, 42 nmol/L) and the median SAM value was normal (103 nmol/L), but SAM/SAH ratio was low (2.5). The SAH was higher and SAM/SAH ratio was lower in cobalamin-deficient subjects compared with those with other anemias after excluding 4 patients with renal insufficiency. SAM concentrations were not low in cobalamin deficiency. Cobalamin injections corrected anemia, MMA, tHcy, SAM/SAH ratio, and SAH. Some hematologic variables were inversely correlated with SAH and cobalamin but not tHcy or MMA. In conclusion, serum SAH is elevated in cobalamin-deficient subjects with megaloblastic anemia and corrects with parenteral cobalamin therapy.

  15. Elevated Serum S-Adenosylhomocysteine in Cobalamin Deficient Megaloblastic Anemia

    Science.gov (United States)

    Guerra-Shinohara, Elvira M.; Morita, Olga E.; Pagliusi, Regina A.; Blaia-d’Avila, Vera L.; Allen, Robert H.; Stabler, Sally P.

    2007-01-01

    Impaired methylation due to accumulation of S-adenosylhomocysteine (SAH) may contribute to the pathophysiology of cobalamin deficient anemia. We assayed serum S-adenosylmethionine (SAM), SAH, total homocysteine (tHcy), and methylmalonic acid (MMA) in 15 subjects with cobalamin deficient megaloblastic anemia and compared results to 19 subjects with anemia/pancytopenia due to other causes. Cobalamin deficient subjects had a median hematocrit of 20% and mean cell volume of 111.7 fL. The median serum cobalamin was 37 pg/mL, MMA 3030 nmol/L and tHcy 62.0 umol/L. SAH was elevated in 13 of 15 subjects (median value 42 nmol/L) and the median SAM was normal (103 nmol/L) but SAM/SAH ratio was low, 2.5. The SAH was higher and SAM/SAH ratio lower in cobalamin deficient subjects as compared to those with other anemias after excluding 4 patients with renal insufficiency. SAM concentrations were not low in cobalamin deficiency. Cobalamin injections corrected anemia, MMA, tHcy, SAM/SAH ratio and SAH. Some hematologic variables were inversely correlated with SAH and cobalamin but not tHcy or MMA. In conclusion, serum SAH is elevated in cobalamin deficient subjects with megaloblastic anemia and corrects with parenteral cobalamin therapy. PMID:17292722

  16. Blockage of mitochondrial calcium uniporter prevents iron accumulation in a model of experimental subarachnoid hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Yan, Huiying [Department of Neurosurgery, Jinling Hospital, School of Medicine, Nanjing University, 305 East Zhongshan Road, Nanjing 210002, Jiangsu Province (China); Hao, Shuangying; Sun, Xiaoyan [Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, 22 Hankou Road, Nanjing 210093, Jiangsu Province (China); Zhang, Dingding; Gao, Xin; Yu, Zhuang [Department of Neurosurgery, Jinling Hospital, School of Medicine, Nanjing University, 305 East Zhongshan Road, Nanjing 210002, Jiangsu Province (China); Li, Kuanyu, E-mail: likuanyu@nju.edu.cn [Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, 22 Hankou Road, Nanjing 210093, Jiangsu Province (China); Hang, Chun-Hua, E-mail: hang_neurosurgery@163.com [Department of Neurosurgery, Jinling Hospital, School of Medicine, Nanjing University, 305 East Zhongshan Road, Nanjing 210002, Jiangsu Province (China)

    2015-01-24

    Highlights: • Iron accumulation was involved in the acute phase following SAH. • Blockage of MCU could attenuate cellular iron accumulation following SAH. • Blockage of MCU could decrease ROS generation and improve cell energy supply following SAH. • Blockage of MCU could alleviate apoptosis and brain injury following SAH. - Abstract: Previous studies have shown that iron accumulation is involved in the pathogenesis of brain injury following subarachnoid hemorrhage (SAH) and chelation of iron reduced mortality and oxidative DNA damage. We previously reported that blockage of mitochondrial calcium uniporter (MCU) provided benefit in the early brain injury after experimental SAH. This study was undertaken to identify whether blockage of MCU could ameliorate iron accumulation-associated brain injury following SAH. Therefore, we used two reagents ruthenium red (RR) and spermine (Sper) to inhibit MCU. Sprague–Dawley (SD) rats were randomly divided into four groups including sham, SAH, SAH + RR, and SAH + Sper. Biochemical analysis and histological assays were performed. The results confirmed the iron accumulation in temporal lobe after SAH. Interestingly, blockage of MCU dramatically reduced the iron accumulation in this area. The mechanism was revealed that inhibition of MCU reversed the down-regulation of iron regulatory protein (IRP) 1/2 and increase of ferritin. Iron–sulfur cluster dependent-aconitase activity was partially conserved when MCU was blocked. In consistence with this and previous report, ROS levels were notably reduced and ATP supply was rescued; levels of cleaved caspase-3 dropped; and integrity of neurons in temporal lobe was protected. Taken together, our results indicated that blockage of MCU could alleviate iron accumulation and the associated injury following SAH. These findings suggest that the alteration of calcium and iron homeostasis be coupled and MCU be considered to be a therapeutic target for patients suffering from SAH.

  17. Al-Ta’āruf ‘alā al-Islām al-‘Aqlānī: Dirāsah ‘an al-Maqālāt al-Ṣadirah fī al-Wasā’il al-Maṭbū’ah fī al-Fatrah al-Mumtaddah min 1911-1942

    Directory of Open Access Journals (Sweden)

    Imas Emalia

    2010-04-01

    Full Text Available This article describes the efforts of several Islamic organizations like the Sarekat Islam (1911, Muhammadiyah (1912, and Persjarikatan Oelama (1913 in transforming the Javanese paradigm, particularly of those who were cultured in quackery and mysticism. The analysis in this article relies on news and articles that were published in newspapers and Islamic journals from 1911 to1942. This article also aims to discuss various crucial problems in Javanese society in the twentieth century, ranging from the social, political, economic, and cultural sphere to religious life. Moreover, this article also portrays the development of the press and local mass media in Java and how they carried out their missionary movements by using rational standardsCopyright (c 2014 by SDI. All right reserved.DOI: 10.15408/sdi.v17i1.469

  18. LIVING IN LIMBO: THE BUDDHA OF SUBURBIA AND THE FINAL PASSAGE

    Directory of Open Access Journals (Sweden)

    Jenny M. Djundjung

    2001-01-01

    Full Text Available Karim and Leila live between two cultures that are considered to be in two polar opposites, the cultures of the white and the black. Because of their parentage, they belong to both cultures and yet they do not belong to either one. The white British regards Karim as "the other", but he also regards an India born Indian to be "the other". Whereas Leila, is also regarded as "the other" in the Caribbean village where she grew up and yet, when she has immigrated to London, she regards the other Caribbean immigrant as "the other". This means that both of them have shifted their position from "the other" to "the self" in their attempt to find a place where they belong. The feeling of not belonged, puts them in a state of limbo; a state that is loaded with anxieties, questions and conflicts as they are unable to find an anchor that they can grip on.

  19. The role of the sonic hedgehog signaling pathway in early brain injury after experimental subarachnoid hemorrhage in rats.

    Science.gov (United States)

    Li, Tao; Zhang, Jie; Liu, Rong-Yao; Lian, Zhi-Gang; Chen, Xiao-Lin; Ma, Li; Sun, Hao-Min; Zhao, Yuan-Li

    2013-09-27

    Previous studies have demonstrated that the sonic hedgehog (Shh) pathway plays a neuro-protective role. However, whether the Shh pathway is induced by subarachnoid hemorrhage (SAH) has not been investigated. We sought to investigate Shh activation in the cortex in the early stage of SAH, and assessed the effect of cyclopamine (a specific inhibitor of the Shh pathway) on Shh pathway regulation and evaluated the impact of cyclopamine on SAH. We found that the Shh pathway was up-regulated in the cortex after SAH, and that blocking the Shh pathway increased cell apoptosis. Early brain damages, including brain edema, blood-brain barrier impairment, and cortical apoptosis were significantly aggravated following with cyclopamine treatment compared with vehicle treatment. Our results suggest that the Shh pathway should be activated in the brain after SAH, and plays a beneficial role in SAH development, possibly by inhibiting cerebral oxidative stress through induction of antioxidant and detoxifying enzymes.

  20. Paravascular pathways contribute to vasculitis and neuroinflammation after subarachnoid hemorrhage independently of glymphatic control.

    Science.gov (United States)

    Luo, C; Yao, X; Li, J; He, B; Liu, Q; Ren, H; Liang, F; Li, M; Lin, H; Peng, J; Yuan, T F; Pei, Z; Su, H

    2016-03-31

    Subarachnoid hemorrhage (SAH) is a devastating disease with high mortality. The mechanisms underlying its pathological complications have not been fully identified. Here, we investigate the potential involvement of the glymphatic system in the neuropathology of SAH. We demonstrate that blood components rapidly enter the paravascular space following SAH and penetrate into the perivascular parenchyma throughout the brain, causing disastrous events such as cerebral vasospasm, delayed cerebral ischemia, microcirculation dysfunction and widespread perivascular neuroinflammation. Clearance of the paravascular pathway with tissue-type plasminogen activator ameliorates the behavioral deficits and alleviates histological injury of SAH. Interestingly, AQP4(-/-) mice showed no improvements in neurological deficits and neuroinflammation at day 7 after SAH compared with WT control mice. In conclusion, our study proves that the paravascular pathway dynamically mediates the pathological complications following acute SAH independently of glymphatic control.

  1. Yrityspalveluiden markkinoinnin kehittäminen

    OpenAIRE

    Mahiout, Leila

    2011-01-01

    Laurea-ammattikorkeakoulu Tiivistelmä Laurea Leppävaara Palvelujen tuottaminen ja johtaminen Mahiout, Leila Yrityspalveluiden markkinoinnin kehittäminen Vuosi 2011 Sivumäärä 54 Tämän toimintatutkimuksena tehdyn opinnäytetyön tarkoituksena oli kehittää liikuntapalveluita tarjoavan yritys X:n yrityspalveluiden markkinointia. Pääongelma oli, kuinka yritys X:n yrityksille tarjoamia palveluita voitaisiin kehittää houkuttelevimmiksi potentiaalisten asiakkaiden silmi...

  2. Entomopathogenic organisms: conceptual advances and real-world applications for mosquito biological control

    OpenAIRE

    Samuels, Richard; Paula,Adriano; Carolino,Aline; Gomes,Simone; Paula,Catia; Cypriano,Mariana; Silva, Leila; Ribeiro, Anderson; Bastos,Jonathan; Peres, Carlos

    2016-01-01

    Richard I Samuels,1 Adriano R Paula,1 Aline T Carolino,1 Simone A Gomes,1 Catia OP Morais,1 Mariana BC Cypriano,1 Leila EI Silva,1 Anderson Ribeiro,1 Jonathan WAB Santos,1 Carlos P Silva,21Department of Entomology and Plant Pathology, State University of Norte Fluminense, Campos dos Goytacazes, Rio de Janeiro, 2Department of Biochemistry, Federal University of Santa Catarina, Florianópolis, Brazil Abstract: Recently, advances have been made in the use of entomopathogenic fungi for...

  3. Milline rikkus! / Kaarel Tarand

    Index Scriptorium Estoniae

    Tarand, Kaarel, 1966-

    2010-01-01

    27. jaanuaril avalikustas kultuuriministeerium 2010. a. riiklike kultuuripreemiate määramiseks esitatud kandidaatide nimed. Kümnendi pikaajalise tegevuse preemiate jagunemisest professionaalse kultuuri valdkonniti. Filmikunsti valdkonnas on tänavu elutööpreemiale esitatud režissöörid Andres Sööt ja Heino Pars, kujutava kunsti ja arhitektuuri valdkonnas kunstnik Leonhard Lapin, maalikunstnik Olev Subbi, arhitekt Raine Karp ja sisearhitekt Leila Pärtelpoeg

  4. QTL Analysis and Functional Genomics of Animal Model

    DEFF Research Database (Denmark)

    Farajzadeh, Leila

    In recent years, the use of functional genomics and next-generation sequencing technologies has increased the probability of success in studies of complex properties. The integration of large data sets from association studies, DNA resequencing, gene expression profiles and phenotypic data......, for example, has enabled scientists to examine more complex interactions in connection with studies of properties and diseases. In her PhD project, Leila Farajzadeh integrated different organisational levels in biology, including genotype, phenotype, association studies, transcription profiles and genetic...

  5. Riigi kultuuripreemiad

    Index Scriptorium Estoniae

    2003-01-01

    Riigi kultuuripreemia kandidaatide hulgas olid: pikaajalise väljapaistva loomingulise tegevuse eest: Vello Asi, Leila Pärtelpoeg, Bruno Tomberg, 2002. a. loominguliste saavutuste eest: Andres Alver, Tarmo Laht, Indrek Rünkla, Ulla Mets, Tiit Trummal (Kuressaare Ferrumi ärihoone), Jüri Kermik (raamat "A. M. Luther 1877-1940"), Juhan Maiste (artiklikogumik "Tuldud teed tagasi"), Jüri Okas (Mardi talu Saaremaal)

  6. Aasta parimad interjöörid muutsid vana trendikaks / Piret Tali

    Index Scriptorium Estoniae

    Tali, Piret, 1972-

    2001-01-01

    Eesti Sisearhitektide Liidu aastapreemiad: eramu sisekujunduse preemia - Tüüne-Kristin Vaikla ja Urmas Vaikla, meelelahutusliku interjööri preemia - kohvik "Pegasus" (Gert Sarv, Margus Tammik, Tarvo H. Varres osaühisusest Front Arhitektid), ajaloolise interjööri preemia - Tallinna Reaalkooli renoveerimisprojekt Tiina Lõhmuse juhtimisel, unikaaleseme preemia - Leila Pärtelpoja kujundatud riigikogu esimehe puhkeruumi mööbel Toompeal. Nimetatud žürii koosseis

  7. Tannenrode villa / Kadri Tarbe

    Index Scriptorium Estoniae

    Tarbe, Kadri

    2004-01-01

    Tannenrode suvevilla (1884) restaureerimis-sisekujunduslahendusest. Villa omanikud Margit ja Mart Hirtentreu. Sisekujunduse autorid Leila Pärtelpoeg ja Karl-Erik Tarbe pälvisid villa renoveerimise eest Eesti Sisearhitektide Liidu aastapreemia. Peasaalis on ampiirgarnituur. Söögisaali mööbel on valmistatud Aleksander Umbergi 1934. a. stiilis. Kabineti mööbel kujundati stiliseeritud ampiirstiilis. Kirjutuslaua nahkkatte valmistas Pille Kivihall. 15 ill

  8. High Resolution Melting Analysis for fast and cheap polymorphism screening of marine populations

    OpenAIRE

    sprotocols

    2015-01-01

    Authors: Anne-Leila Meistertzheim, Isabelle Calves, Sébastien Artigaud, Carolyn S. Friedman, Christine Paillard, Jean Laroche & Claude Ferec ### Abstract This protocol permits the mutation scanning of PCR products by high-resolution DNA melting analysis requiring the inclusion of a saturating intercalating dye in the PCR mix without labelled probe. During a scanning process, fluorescent melting curves of PCR amplicons are analyzed. Mutations modifying melting curve shapes, are all...

  9. Une temporalité de Tanger: histoire, mémoire et le temps postcolonial dans l'archive audiovisuelle

    NARCIS (Netherlands)

    Pisters, P.; Kaddouri, A.; van der Poel, I.

    2009-01-01

    Port et ville périphérique par excellence à la frontière de l’Europe et l’Afrique, Tanger est aujourd’hui plutôt connue pour ses immigrés clandestins, voulant traverser ce bras de mer qui les sépare de l’Europe. Le documentaire Tanger, le rêve des brûleurs (Leila Kilani, 2002) présente ce rêve

  10. Postpopi poiss Martin Saar : noor kunst / Riin Kübarsepp

    Index Scriptorium Estoniae

    Kübarsepp, Riin, 1978-

    2007-01-01

    Praegu New Yorgis elava ja töötava kunstniku Martin Saare (sünd. 1980) näitus "80ndad Eestis" ArtDepoos 9.-20. X. 6. XI avatakse kunstniku tööde näitus New Yorgi Leila Taghinia-Milana Helleri galeriis. Sama galerii esindab Martin Saart tema 20 akvarelli, õlimaali ja fotodega 6.-9. XII Miami Art Baselil

  11. Kivinäkkide ja puiesteede Olustvere

    Index Scriptorium Estoniae

    2003-01-01

    Olustvere mõisast. Pargi rekonstrueerimisprojekti tegi 1903. a. Georg Kuphaldt. Omanikest, maakivist ehitistest, kiviraidur Jaan Meisnerist, härrastemajast, kus praegu on turismikeskus, muuseumiväljapanekud jm., hoonete ja pargi korrastamisest, 1978. a. hõbedaleiust, Voldemar Luhti hobusekujukeste väljapanekust, Leonhard Martin Vene (1920-1994) mööblikollektsioonist, mille aitas välja panna Leila Pärtelpoeg

  12. High Resolution Melting Analysis for fast and cheap polymorphism screening of marine populations

    OpenAIRE

    sprotocols

    2015-01-01

    Authors: Anne-Leila Meistertzheim, Isabelle Calves, Sébastien Artigaud, Carolyn S. Friedman, Christine Paillard, Jean Laroche & Claude Ferec ### Abstract This protocol permits the mutation scanning of PCR products by high-resolution DNA melting analysis requiring the inclusion of a saturating intercalating dye in the PCR mix without labelled probe. During a scanning process, fluorescent melting curves of PCR amplicons are analyzed. Mutations modifying melting curve shapes, are all...

  13. 西比灵防治蛛网膜下腔出血后脑血管痉挛的分析%Analysis of the effect of Xibiling in prevention of cerebrovascular spasm after subarachnoid hemorrhage

    Institute of Scientific and Technical Information of China (English)

    崔景修; 李钢; 陈正挪; 李成哲; 史有立

    2002-01-01

    Background:Cerebrovascular disease(CVS)is one of the major complications of subarachnoid hemorrhage(SAH) and the major cause of disability and death in SAH patients.Xibiling is a blocking agent of calcium channel and can prevent the occurrence of CVS.We analyzed the effect of Xibiling in prevention of CVS after SAH in patients from April 1995 to April 2001 in our hospital in this paper.

  14. Apigenin protects blood-brain barrier and ameliorates early brain injury by inhibiting TLR4-mediated inflammatory pathway in subarachnoid hemorrhage rats.

    Science.gov (United States)

    Zhang, Tingting; Su, Jingyuan; Guo, Bingyu; Wang, Kaiwen; Li, Xiaoming; Liang, Guobiao

    2015-09-01

    Early brain injury (EBI) following subarachnoid hemorrhage (SAH) is associated with high morbidity and mortality. Inflammation has been considered as the major contributor to brain damage after SAH. SAH induces a systemic increase in pro-inflammatory cytokines and chemokines. Disruption of blood-brain barrier (BBB) facilitates the influx of inflammatory cells. It has been reported that the activation of toll-like receptor 4 (TLR4)/NF-κB signaling pathway plays a vital role in the central nervous system diseases. Apigenin, a common plant flavonoid, possesses anti-inflammation effect. In this study, we focused on the effects of apigenin on EBI following SAH and its anti-inflammation mechanism. Our results showed that apigenin (20mg/kg) administration significantly attenuated EBI (including brain edema, BBB disruption, neurological deficient, severity of SAH, and cell apoptosis) after SAH in rats by suppressing the expression of TLR4, NF-κB and their downstream pro-inflammatory cytokines in the cortex and by up-regulating the expression of tight junction proteins of BBB. Double immunofluorescence staining demonstrated that TLR4 was activated following SAH in neurons, microglia cells, and endothelial cells but not in astrocytes. Apigenin could suppress the activation of TLR4 induced by SAH and inhibit apoptosis of cells in the cortex. These results suggested that apigenin could attenuate EBI after SAH in rats by suppressing TLR4-mediated inflammation and protecting against BBB disruption. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Subarachnoid Haemorrhage and Sports

    Directory of Open Access Journals (Sweden)

    Liliana Sousa Nanji

    2015-11-01

    Full Text Available Background: Some cases of subarachnoid haemorrhage (SAH have been associated with vigorous physical activity, including sports. Our research aimed to describe the association between SAH and sports and to identify the types of sports that were more frequently found as precipitating factors in a tertiary single-centre SAH register. Methods: We retrieved information from a prospectively collected SAH registry and reviewed discharge notes of acute SAH patients admitted to the Stroke Unit of Hospital de Santa Maria, Lisbon, between 1995 and 2014. Results: Out of 738 patients included in the analysis, 424 (57.5% cases of SAH were preceded by physical activity. Nine cases (1.2% were associated with sports, namely running (2 cases, aerobics (2 cases, cycling, body balance, dance, surf and windsurf. Patients with SAH while practicing sports were younger than controls (average age 43.1 vs. 57.0 years; p = 0.007. In 1 patient, there was a report of trauma to the neck. Patients in the sports group only had Hunt and Hess scale grades 1 (11.1% or 2 (88.9% at admission, while patients in the control group had a wider distribution in severity. Conclusions: Our findings indicate that SAH precipitated by sports is not very frequent and is uncommonly related to trauma. Patients who suffered SAH associated with sports were younger and apparently had a milder clinical presentation.

  16. Regulation of enhanced cerebrovascular expression of proinflammatory mediators in experimental subarachnoid hemorrhage via the mitogen-activated protein kinase kinase/extracellular signal-regulated kinase pathway

    Directory of Open Access Journals (Sweden)

    Maddahi Aida

    2012-12-01

    Full Text Available Abstract Background Subarachnoid hemorrhage (SAH is associated with high morbidity and mortality. It is suggested that the associated inflammation is mediated through activation of the mitogen-activated protein kinase (MAPK pathway which plays a crucial role in the pathogenesis of delayed cerebral ischemia after SAH. The aim of this study was first to investigate the timecourse of altered expression of proinflammatory cytokines and matrix metalloproteinase in the cerebral arteries walls following SAH. Secondly, we investigated whether administration of a specific mitogen-activated protein kinase kinase (MEK1/2 inhibitor, U0126, given at 6 h after SAH prevents activation of the MEK/extracellular signal-regulated kinase 1/2 pathway and the upregulation of cerebrovascular inflammatory mediators and improves neurological function. Methods SAH was induced in rats by injection of 250 μl of autologous blood into basal cisterns. U0126 was given intracisternally using two treatment regimens: (A treatments at 6, 12, 24 and 36 h after SAH and experiments terminated at 48 h after SAH, or (B treatments at 6, 12, and 24 h after SAH and terminated at 72 h after SAH. Cerebral arteries were harvested and interleukin (IL-6, IL-1β, tumor necrosis factor α (TNFα, matrix metalloproteinase (MMP-9 and phosphorylated ERK1/2 (pERK1/2 levels investigated by immunohistochemistry. Early activation of pERK1/2 was measured by western blot. Functional neurological outcome after SAH was also analyzed. Results Expression levels of IL-1β, IL-6, MMP-9 and pERK1/2 proteins were elevated over time with an early increase at around 6 h and a late peak at 48 to 72 h post-SAH in cerebral arteries. Enhanced expression of TNFα in cerebral arteries started at 24 h and increased until 96 h. In addition, SAH induced sensorimotor and spontaneous behavior deficits in the animals. Treatment with U0126 starting at 6 h after SAH prevented activation of MEK-ERK1/2 signaling. Further, U0126

  17. Frequency and appearance of hemosiderin depositions after aneurysmal subarachnoid hemorrhage treated by endovascular therapy

    Energy Technology Data Exchange (ETDEWEB)

    Falter, Bernhard; Wiesmann, Martin; Freiherr, Jessica; Nikoubashman, Omid; Mull, Michael [University Hospital Aachen RWTH, Department of Neuroradiology, Aachen (Germany)

    2015-10-15

    It is still unclear how often subarachnoid hemorrhage (SAH) leads to chronic hemosiderin depositions. In this study, we aimed to determine the frequency of chronic hemosiderin depositions after aneurysmal SAH in patients who did not undergo surgery. Furthermore, we analyzed typical MRI patterns of chronic SAH and sought to obtain information on the temporal course of MRI signal changes. We retrospectively analyzed 90 patients who had undergone endovascular treatment for acute aneurysmal SAH. In all patients, initial CT studies and at least one T2*-weighted MRI obtained 6 months or later after SAH were analyzed for the presence and anatomical distribution of SAH or chronic hemosiderin depositions. In total, 185 T2*-weighted MRI studies obtained between 2 days and 148 months after SAH were evaluated (mean follow-up 30.2 months). On MRI studies obtained later than 6 months after SAH, subpial hemosiderin depositions were found in 50 patients (55.5 %). Most frequent localizations were the parenchyma adjacent to the frontal and parietal sulci and the insular cisterns. While the appearance of hemosiderin depositions was dynamic within the first 3 months, no changes were found during subsequent follow-up. MR signal changes were not only conclusive with subarachnoid hemosiderin depositions but in many cases also resembled those that have been associated with cortical hemosiderosis. T2*-weighted MRI is an effective means of diagnosing prior SAH. Our study suggests that chronic hemosiderin depositions can be found in a considerable number of patients after a single event of subarachnoid hemorrhage. (orig.)

  18. Subarachnoid hemorrhage in pituitary tumor

    Directory of Open Access Journals (Sweden)

    Ashis Patnaik

    2013-01-01

    Full Text Available Subarachnoid hemorrhage (SAH is the bleeding into the subarachnoid space containing cerebrospinal fluid. The most common cause of SAH is trauma. Rupture of aneurysms, vascular anomalies, tumor bleeds and hypertension are other important etiologies. SAH in the setting of pituitary tumor can result from various causes. It can be due to intrinsic tumor related pathology, injury to surrounding the vessel during the operative procedure or due to an associated aneurysm. We discuss the pathological mechanisms and review relevant literature related to this interesting phenomenon. Early and accurate diagnosis of the cause of the SAH in pituitary tumors is important, as this influences the management.

  19. Neurokinin-1 receptor antagonism in a rat model of subarachnoid hemorrhage

    DEFF Research Database (Denmark)

    Ansar, Saema; Svendgaard, Niels-Aage; Edvinsson, Lars

    2007-01-01

    was injected intracisternally 30 minutes and 24 hours after the induction of SAH. Two days after SAH induction, the basilar arteries were harvested, and contractile responses to endothelin-1 (ET-I, an ETA- and ETB-receptor agonist) and 5-carboxamidotryptamine (a 5-hydroxytryptamine- I1 [5-HT1]-receptor agonist......) were investigated using sensitive myographs. To determine whether NKIR inhibition had an influence on local CBF after post-SAH, a quantitative autoradiographic technique was used. After SAH, the vascular receptor phenotype was changed in cerebral arteries through upregulation of contractile ET, and 5...

  20. Melatonin mitigate cerebral vasospasm after experimental subarachnoid hemorrhage: a study of synchrotron radiation angiography

    Science.gov (United States)

    Cai, J.; He, C.; Chen, L.; Han, T.; Huang, S.; Huang, Y.; Bai, Y.; Bao, Y.; Zhang, H.; Ling, F.

    2013-06-01

    Cerebral vasospasm (CV) after subarachnoid hemorrhage (SAH) is a devastating and unsolved clinical issue. In this study, the rat models, which had been induced SAH by prechiasmatic cistern injection, were treated with melatonin. Synchrotron radiation angiography (SRA) was employed to detect and evaluate CV of animal models. Neurological scoring and histological examinations were used to assess the neurological deficits and CV as well. Using SRA techniques and histological analyses, the anterior cerebral artery diameters of SAH rats with melatonin administration were larger than those without melatonin treatment (p melatonin were less than those without melatonin treatment (p melatonin could mitigate CV after experimental SAH.

  1. Role of Mitochondrial Calcium Uniporter in Early Brain Injury After Experimental Subarachnoid Hemorrhage.

    Science.gov (United States)

    Yan, Huiying; Zhang, Dingding; Hao, Shuangying; Li, Kuanyu; Hang, Chun-Hua

    2015-12-01

    Previous studies have shown that mitochondrial Ca(2+) is undertaken by mitochondrial calcium uniporter (MCU), and its accumulation is associated with the development of many diseases. However, little was known about the role of MCU in early brain injury (EBI) after subarachnoid hemorrhage (SAH). MCU can be opened by spermine under a physiological condition and inhibited by ruthenium red (RR). Herein, we investigated the effects of RR and spermine to reveal the role of MCU in SAH animal model. The data obtained with biochemical and histological assays showed that mitochondrial Ca(2+) concentration was significantly increased in the temporal cortex of rats 1, 2, and 3 days after SAH, consistent with constant high levels of cellular Ca(2+) concentration. In agreement with the observation in the acute phase, SAH rats showed an obvious increase of reactive oxygen species (ROS) level and decrease of ATP production. Blockage of MCU prevented Ca(2+) accumulation, abated the level of oxidative stress, and improved the energy supply. Translocation of cytochrome c, increased cleaved caspase-3, and a large amount of apoptotic cells after SAH were reversed by RR administration. Surprisingly, exogenous spermine did not increase cellular Ca(2+) concentration, but lessened the Ca(2+) accumulation after SAH to benefit the rats. Taken together, our results demonstrated that blockage of MCU or prevention of Ca(2+) accumulation after SAH is essential in EBI after SAH. These findings suggest that MCU is considered to be a therapeutic target for patients suffering from SAH.

  2. Blockage of mitochondrial calcium uniporter prevents iron accumulation in a model of experimental subarachnoid hemorrhage.

    Science.gov (United States)

    Yan, Huiying; Hao, Shuangying; Sun, Xiaoyan; Zhang, Dingding; Gao, Xin; Yu, Zhuang; Li, Kuanyu; Hang, Chun-Hua

    2015-01-24

    Previous studies have shown that iron accumulation is involved in the pathogenesis of brain injury following subarachnoid hemorrhage (SAH) and chelation of iron reduced mortality and oxidative DNA damage. We previously reported that blockage of mitochondrial calcium uniporter (MCU) provided benefit in the early brain injury after experimental SAH. This study was undertaken to identify whether blockage of MCU could ameliorate iron accumulation-associated brain injury following SAH. Therefore, we used two reagents ruthenium red (RR) and spermine (Sper) to inhibit MCU. Sprague-Dawley (SD) rats were randomly divided into four groups including sham, SAH, SAH+RR, and SAH+Sper. Biochemical analysis and histological assays were performed. The results confirmed the iron accumulation in temporal lobe after SAH. Interestingly, blockage of MCU dramatically reduced the iron accumulation in this area. The mechanism was revealed that inhibition of MCU reversed the down-regulation of iron regulatory protein (IRP) 1/2 and increase of ferritin. Iron-sulfur cluster dependent-aconitase activity was partially conserved when MCU was blocked. In consistence with this and previous report, ROS levels were notably reduced and ATP supply was rescued; levels of cleaved caspase-3 dropped; and integrity of neurons in temporal lobe was protected. Taken together, our results indicated that blockage of MCU could alleviate iron accumulation and the associated injury following SAH. These findings suggest that the alteration of calcium and iron homeostasis be coupled and MCU be considered to be a therapeutic target for patients suffering from SAH.

  3. Sleep apnea syndrome in endocrine diseases.

    Science.gov (United States)

    Bottini, Paolo; Tantucci, Claudio

    2003-01-01

    It is increasingly recognized that sleep-disordered breathing (SDB) - from snoring to apnea-hypopnea syndrome (SAHS) - can affect patients with various endocrine diseases (ED). Different mechanisms are implied in SDB, promoting either central or, more frequently, obstructive apnea in different ED. In the past, acromegaly and hypothyroidism were first associated with both central and obstructive SAHS. Today, great attention is placed on the complex cause-effect relationship between diabetes mellitus and obstructive SAHS (and vice versa). Symptoms and signs of SAHS may complicate the clinical course of these diseases and should be promptly suspected to detect and possibly treat the accompanying SDB. Copyright 2003 S. Karger AG, Basel

  4. Decision-making deficits persist after aneurysmal subarachnoid hemorrhage.

    Science.gov (United States)

    Al-Khindi, Timour; Macdonald, R Loch; Schweizer, Tom A

    2014-01-01

    Effective decision-making is critical for resuming day-to-day activities after aneurysmal subarachnoid hemorrhage (aSAH). Little is known, however, about how decision-making is affected after aSAH, particularly under ambiguous conditions in which neither the outcome nor the outcome probabilities are known. Here we examined the integrity of decision-making under ambiguity in a cohort of aSAH patients classified as having made a "good outcome" according to the Glasgow Outcome Scale. Thirty aSAH survivors and 33 healthy controls completed the Iowa Gambling Task (IGT) and the Balloon Analogue Risk Task (BART). Mean time of assessment poststroke was 30 months. Although patients and controls had similar decision-making strategies on the IGT, patients made significantly fewer switches between decks, suggesting perseveration and cognitive inflexibility. On the BART, aSAH patients demonstrated significantly enhanced risk-taking behavior relative to controls. Examination of effect sizes revealed cognitive inflexibility in 33% to 35% of aSAH patients and enhanced risk-taking behavior in 35% to 40% of aSAH patients. Approximately one third of "good outcome" aSAH patients experience cognitive inflexibility and enhanced risk-taking behavior over 2 years poststroke, illustrating the persistence of aSAH-associated cognitive impairment.

  5. Inhibition of the Receptor for Advanced Glycation End-Products (RAGE) Attenuates Neuroinflammation While Sensitizing Cortical Neurons Towards Death in Experimental Subarachnoid Hemorrhage.

    Science.gov (United States)

    Li, Hua; Yu, Jia-Sheng; Zhang, Ding-Ding; Yang, Yi-Qing; Huang, Li-Tian; Yu, Zhuang; Chen, Ru-Dong; Yang, Hong-Kuan; Hang, Chun-Hua

    2017-01-01

    Subarachnoid hemorrhage (SAH) is a threatening and devastating neurological insult with high mortality and morbidity rates. Despite considerable efforts, the underlying pathophysiological mechanisms are still poorly understood. The receptor for advanced glycation end products (RAGE) is a multiligand receptor that has been implicated in various pathological conditions. We previously showed that RAGE was upregulated and may be involved in pathophysiology of SAH. In the current study, we investigated its potential role in SAH. We found that the upregulation of RAGE after SAH was NF-κB-dependent positive feedback regulation. Further, pharmacological inhibition of RAGE attenuated neuroinflammation, indicating a possible contributive role of RAGE in inflammation-associated brain injury after SAH. Conversely, however, inhibition of RAGE sensitized neurons, exacerbating cell death, which correlated with augmented apoptosis and diminished autophagy, suggesting that activation of RAGE may protect against SAH-induced neuronal injury. Furthermore, we demonstrate that inhibition of RAGE significantly reduced brain edema and improved neurological function at day 1 but not at day 3 post-SAH. Taken together, these results suggest that RAGE exerts dual role after SAH. Our findings also suggest caution should be exercised in setting RAGE-targeted treatment for SAH.

  6. Comparison of differences in pharyngeal critical pressure between male and female patients with sleep apnea/hypopnea syndrome%男性与女性睡眠呼吸暂停低通气综合征患者临界压的对比研究

    Institute of Scientific and Technical Information of China (English)

    孟小明; 钱桂生; 王惠玉; 陈志勇; 孙汉军

    2004-01-01

    目的用临界压(Pcrit)来提示男性与女性睡眠呼暂停低通气综合症(SAHS)患者发病方式上的差别,进而用于指导临床治疗.方法分别对202名男性、66名女性进行多导睡眠图(PSG)检查;用压力振荡技术(Forced oscillation technique,FOT)在患者平卧位快动眼睡眠Ⅱ期对通气量与压力的关系,用外推法在气流为零时作图解出Pcrit.并对SAHS3组中的男性及女性患者试用持续正压通气(CPAP)治疗.结果pcrit在女性SAHS1组为(0.8±0.7)cmH2O,SAHS2组为(1.4±0.6)cmH2O,SAHS3组为(1.4±1.2)cmH2O,三组间无显著意义;而Pcrit在男性SAHS1组为(1.2±0.6)cmH2O,SAHS2组为(1.7±0.8)cmH2O,SAH3组为(2.4±0.8)cmH2O,三组间比较均有非常显著增高的意义.男性SAH3组患者的Pcrit亦显著地高于女性SAH3组患者;并且Pcrit与男性SAH3组患者的OAI、MAI呈非常显著正相关;而男性患者的OAI、MAI又与BMI均呈非常显著正相关.女性患者pcrit与OAI、MAI及OHI均无相关关系,但女性患者OHI与BMI显著正相关.SAH3组男性及女性患者接受CPAP治疗的顺应性分别为40.6%及10.5%.结论pcrit能从功能上反映男性SAHS患者睡眠时咽部塌陷的程度;女性患者以OH为主,Pcrit较小,咽部塌陷较轻;这对临床治疗有一定的指导意义.%Objective: To elucidate the differences in pharyngeal critical pressure(Pcrit) between male and female patients with sleep apnes/hypopnea syndrome (SAHS). Methods: 202 males and 66 females were checked up by PSG individually, in which 33 males served as normal male control group (N) and 12 females as normal female control group (N). The other 169 male and 54 female patients with SAHS were divided into SAHS1, SAHS2, and SAHS3 groups according to AASM Task Force (1999). Among them, 93 male and 23 female patients with SAHS were checked up by maximal inspiratory flow and pressure using the forced oscillation technique (FOT), then Pcrit was derived from the relationship between the flow and the

  7. History from within? Contextualizing the new neurohistory and seeking its methods.

    Science.gov (United States)

    Burman, Jeremy Trevelyan

    2012-02-01

    "Histories from below" sought to give voice to those ordinary folk whose social position had failed to afford them great power, wealth, or responsibility: the neglected undocumented. Now, Lynn Hunt (2009) calls for a revolution that would task historians with giving voice to feelings--what I will call a "history from within." This is what led her to endorse Daniel Lord Smail's (2008) suggestion that historians appeal to neuroscience and thereby construct a "new neurohistory." The purpose would be to introduce a common factor to all human stories: a tool to think with when describing what it was like (cf. Nagel, 1974). If successful, this would be quite powerful: in Hunt's view, such a project could lead to a universalization of human rights. But the program is not without challenges, one of which is to provide an acceptable explanation for the type of looping causation that applies to bio-cultural kinds. Smail's solution involves an appeal to evolutionary theory, but how this solves the problem of causation is not clear. Here, therefore, an attempt is made to clarify his solution. Smail and Hunt's views on the role of evidence in history are also made plain. The paper then concludes by importing related ideas from the recent history of philosophy. If one is going to have a brain-based view of felt-history, then the neurohistorian's task is to situate historical individuals in contexts of shared experience--to not just read evidence through lenses of intellectual "thought collectives" (generalized from paradeigma), but also through "experiential" or "moral categories" (aisthánomai).

  8. 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.

  9. Protective Effect of Quercetin against Oxidative Stress and Brain Edema in an Experimental Rat Model of Subarachnoid Hemorrhage

    Science.gov (United States)

    Dong, Yu-shu; Wang, Ju-lei; Feng, Da-yun; Qin, Huai-zhou; Wen, Hua; Yin, Zhong-min; Gao, Guo-dong; Li, Chuan

    2014-01-01

    Quercetin has been demonstrated to play an important role in altering the progression of ischemic brain injuries and neurodegenerative diseases by protecting against oxidative stress. The effects of quercetin on brain damage after subarachnoid hemorrhage (SAH), however, have not been investigated. This study was designed to explore the effects of quercetin on oxidative stress and brain edema after experimental SAH using four equal groups (n = 16) of adult male Sprague-Dawley (SD) rats, including a sham group, an SAH + vehicle group, an SAH + quercetin10 group, and an SAH + quercetin50 group. The rat SAH model was induced by injection of 0.3 ml of non-heparinised arterial blood into the prechiasmatic cistern. In the SAH + quercetin10 and SAH + quercetin50 groups, doses of 10 mg/kg and 50 mg/kg quercetin, respectively, were directly administered by intraperitoneal injection at 30 min, 12 h, and 24 h after SAH induction. Cerebral tissue samples were extracted for enzymatic antioxidant determination, lipid peroxidation assay, caspase-3 activity and water content testing 48 h after SAH. Treatment with a high dose (50 mg/kg) of quercetin markedly enhanced the activities of copper/zinc superoxide dismutase (CuZn-SOD) and glutathione peroxidase (GSH-Px), and treatment with this dose significantly reduced the level of malondialdehyde (MDA). Caspase-3 and brain edema was ameliorated and neurobehavioral deficits improved in rats that received the high dose of quercetin. The findings suggest that the early administration of optimal dose of quercetin may ameliorate brain damage and provide neuroprotection in the SAH model, potentially by enhancing the activity of endogenous antioxidant enzymes and inhibiting free radical generation. PMID:24516353

  10. Clinical relevance of negative initial angiogram in spontaneous subarachnoid hemorrhage.

    Science.gov (United States)

    Moscovici, Samuel; Fraifeld, Shifra; Ramirez-de-Noriega, Fernando; Rosenthal, Guy; Leker, Ronen R; Itshayek, Eyal; Cohen, José E

    2013-03-01

    We aimed to compare the presentation, management, and clinical course in patients with perimesencephalic and nonperimesencephalic (aneurysmal) bleeding patterns on noncontrast CT, but negative initial 4-vessel digital subtraction angiography (DSA). We retrospectively reviewed clinical and imaging data for 280 patients presenting with spontaneous SAH admitted between 2005 and 2011. We identified 56 patients (20%) with SAH diagnosed on high resolution head CT performed within 48 hours of admission, and negative initial DSA, and divided them into perimesencephalic and non-perimesencephalic groups based on hemorrhage patterns. Patients with traumatic subarachnoid bleeding and those with initial positive DSA were excluded from this analysis. Perimesencephalic SAH was seen in 25 patients (45%); non-perimesencephalic bleeding patterns were seen in 31 (55%). All patients with perimesencephalic SAH presented with Hunt and Hess (HH) I, versus 45% HH I and 55% HH II-IV in those with non-perimecenphalic SAH. All patients with perimesencephalic SAH achieved modified Rankin score (mRS) 0 at discharge and 6-month follow-up, compared with 45% mRS 0 at discharge and 68% at 6-month follow-up in non-perimesencephalic SAH. Patients with perimesencephalic SAH presented a uniformly uncomplicated clinical course. Among non-perimesencephalic SAH patients there were 19 neurological/neurosurgical and 10 medical complications, two small aneurysms diagnosed at follow-up DSA, and one death. In this series, perimesencephalic SAH was associated with good clinical grades, consistently negative initial and follow-up angiograms, and an excellent prognosis. In contrast, non-perimesencephalic SAH was associated with a worse clinical presentation, higher complication rates, higher rates of true aneurysm detection on follow-up angiogram, and a poorer outcome.

  11. Violencia de los usuarios hacia el personal de enfermería : evaluación del riesgo laboral y análisis de las consecuencias psicológicas

    OpenAIRE

    Galián Muñoz, Inmaculada

    2015-01-01

    La presente tesis doctoral se centra en el estudio de la exposición a la violencia de los usuarios del personal de enfermería de los hospitales públicos de la Región de Murcia, ya que el riesgo de violencia laboral presenta una especial importancia en el ámbito sanitario, siendo el colectivo de enfermería uno de los más afectados tal y como se refleja en distintos estudios (Franz, Zeh, Schablon, Kuhnert y Nienhaus, 2010; Kling, Yassi, Smailes, Lovato y Koehoorn, 2009; Roche, Diers, Duffield y...

  12. Viral erythrocytic necrosis: Chapter 2.2.7

    Science.gov (United States)

    Winton, James R.; Hershberger, Paul K.

    2014-01-01

    Viral erythrocytic necrosis (VEN), originally termed piscine erythrocytic necrosis, is a condition that has been reported to affect the red blood cells (RBCs) of many species of marine and anadromous fishes in both the Atlantic and Pacific Oceans (Nicholson and Reno 1981; Smail 1982; Wolf 1988; Dannevig and Thorud 1999). Fish with VEN may develop a severe anemia that can reduce their stamina, predispose them to other infections or increase the impact of other stressors (MacMillan et al. 1980; Nicholson and Reno 1981; Meyers et al. 1986; Haney et al. 1992) resulting in population-scale impacts in susceptible species (Hershberger et al. 2009).

  13. CT perfusion on admission and cognitive functioning 3 months after aneurysmal subarachnoid haemorrhage

    NARCIS (Netherlands)

    Wajer, Irene M. C. Huenges; Cremers, Charlotte H. P.; van Zandvoort, Martine J. E.; Vergouwen, Mervyn D. I.; van der Schaaf, Irene C.; Velthuis, BK; Dankbaar, Jan Willem; Vos, Pieter C.; Visser-Meily, Johanna M. A.; Rinkel, Gabriel J. E.

    2015-01-01

    Many survivors of aneurysmal subarachnoid haemorrhage (aSAH) have persistent cognitive deficits. Underlying causes of these deficits have not been elucidated. We aimed to investigate if cerebral perfusion in the acute phase after aSAH measured with CT perfusion (CTP) is associated with cognitive out

  14. Relationship between vasospasm, cerebral perfusion, and delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage

    NARCIS (Netherlands)

    Dankbaar, Jan W.; Rijsdijk, Mienke; van der Schaaf, Irene C.; Velthuis, Birgitta K.; Wermer, Marieke J. H.; Rinkel, Gabriel J. E.

    2009-01-01

    Vasospasm after aneurysmal subarachnoid hemorrhage (SAH) is thought to cause ischemia. To evaluate the contribution of vasospasm to delayed cerebral ischemia (DCI), we investigated the effect of vasospasm on cerebral perfusion and the relationship of vasospasm with DCI. We studied 37 consecutive SAH

  15. Brain edema formation correlates with perfusion deficit during the first six hours after experimental subarachnoid hemorrhage in rats

    Directory of Open Access Journals (Sweden)

    Westermaier Thomas

    2012-07-01

    Full Text Available Abstract Background Severe brain edema is observed in a number of patients suffering from subarachnoid hemorrhage (SAH. Little is known about its pathogenesis and time-course in the first hours after SAH. This study was performed to investigate the development of brain edema and its correlation with brain perfusion after experimental SAH. Methods Male Sprague–Dawley rats, randomly assigned to one of six groups (n = 8, were subjected to SAH using the endovascular filament model or underwent a sham operation. Animals were sacrificed 15, 30, 60, 180 or 360 minutes after SAH. Intracranial pressure (ICP, mean arterial blood pressure (MABP, cerebral perfusion pressure (CPP and bilateral local cerebral blood flow (LCBF were continuously measured. Brain water content (BWC was determined by the wet/dry-weight method. Results After SAH, CPP and LCBF rapidly decreased. The decline of LCBF markedly exceeded the decline of CPP and persisted until the end of the observation period. BWC continuously increased. A significant correlation was observed between the BWC and the extent of the perfusion deficit in animals sacrificed after 180 and 360 minutes. Conclusions The significant correlation with the perfusion deficit after SAH suggests that the development of brain edema is related to the extent of ischemia and acute vasoconstriction in the first hours after SAH.

  16. Hypopituitarism after subarachnoid haemorrhage, do we know enough?

    NARCIS (Netherlands)

    L. Khajeh (Ladbon); K. Blijdorp (Karin); S.J.C.M.M. Neggers (Bas); G.M. Ribbers (Gerard); D.W.J. Dippel (Diederik); F. van Kooten (Fop)

    2014-01-01

    textabstractBackground: Fatigue, slowness, apathy and decrease in level of activity are common long-term complaints after a subarachnoid haemorrhage (SAH). They resemble the symptoms frequently found in patients with endocrine dysfunction. Pituitary dysfunction may be the result of SAH or its compli

  17. Interferon-beta attenuates lung inflammation following experimental subarachnoid hemorrhage

    NARCIS (Netherlands)

    Cobelens, P.M.; Tiebosch, I.A.C.W.; Dijkhuizen, R.M.; van der Meide, P.H.; Zwartbol, R.; Heijnen, C.J.; Kesecioglu, J.; van den Bergh, W.M.

    2010-01-01

    Introduction: Aneurysmal subarachnoid hemorrhage (SAH) affects relatively young people and carries a poor prognosis with a case fatality rate of 35%. One of the major systemic complications associated with SAH is acute lung injury (ALI) which occurs in up to one-third of the patients and is associat

  18. The Impact of the Tropical Indian Ocean on South Asian High in Boreal Summer

    Institute of Scientific and Technical Information of China (English)

    HUANG Gang; QU Xia; HU Kaiming

    2011-01-01

    The tropical Indian Ocean (TIO) is warmer than normal during the summer when or after the El Nińo decays. The present study investigates the impact of TIO SST on the South Asian High (SAH) in summer.When the TIO is warmer, the SAH strengthens and its center shifts southward. It is found that the variations in the SAH cannot be accounted for by the precipitation anomaly. A possible mechanism is proposed to explain the connection between the TIO and SAH: warmer SST in the TIO changes the equivalent potential temperature (EPT) in the atmospheric boundary layer (ABL), alters the temperature profile of the moist atmosphere, warms the troposphere, which produces significant positive height anomaly over South Asia and modifies the SAH. An atmospheric general circulation model, ECHAM5, which has a reasonable prediction skill in the TIO and South Asia, was selected to test the effects of TIO SST on the SAH. The experiment with idealized heating over the TIO reproduced the response of the SAH to TIO warming. The results suggest that the TIO-induced EPT change in the ABL can account for the variations in the SAH.

  19. CT perfusion on admission and cognitive functioning 3 months after aneurysmal subarachnoid haemorrhage

    NARCIS (Netherlands)

    Huenges Wajer, Irene M C; Cremers, Charlotte H P; van Zandvoort, Martine J E; Vergouwen, Mervyn D I; van der Schaaf, Irene C.; Velthuis, Birgitta K.; Dankbaar, Jan Willem; Vos, Pieter C.; Visser-Meily, Johanna M A; Rinkel, Gabriel J E

    2015-01-01

    Many survivors of aneurysmal subarachnoid haemorrhage (aSAH) have persistent cognitive deficits. Underlying causes of these deficits have not been elucidated. We aimed to investigate if cerebral perfusion in the acute phase after aSAH measured with CT perfusion (CTP) is associated with cognitive

  20. Loss of Consciousness at Onset of Aneurysmal Subarachnoid Hemorrhage is Associated with Functional Outcomes in Good-Grade Patients

    NARCIS (Netherlands)

    Wang, Justin; Alotaibi, Naif M.; Akbar, Muhammad Ali; Ayling, Oliver G S; Ibrahim, George M.; Macdonald, R. Loch; Noble, Adam; Molyneux, Andrew; Quinn, Audrey; Schatlo, Bawarjan; Lo, Benjamin; Jaja, Blessing N R; Johnston, Clay; Hanggi, Daniel; Hasan, David; Wong, George K C; Lantigua, Hector; Fukuda, Hitoshi; Torner, James; Singh, Jeff; Spears, Julian; Schaller, Karl; Stienen, Martin N.; Vergouwen, Mervyn D I; Cusimano, Michael D.; Todd, Michael; Tseng, Ming; Le Roux, Peter; Macdonald, R. Loch; Yamagata, Sen; Mayer, Stephan; Schenk, Thomas; Schweizer, Tom A.

    2017-01-01

    Background Transient loss of consciousness (LOC) is one of the most common presentations of aneurysmal subarachnoid hemorrhage (SAH) and may be an indicator of early brain injury. In this study, we examined the association of LOC and functional outcomes in patients with good-grade SAH. Methods We

  1. Clinical Trials in Cardiac Arrest and Subarachnoid Hemorrhage: Lessons from the Past and Ideas for the Future

    Directory of Open Access Journals (Sweden)

    Jennifer A. Frontera

    2013-01-01

    Full Text Available Introduction. Elevated intracranial pressure that occurs at the time of cerebral aneurysm rupture can lead to inadequate cerebral blood flow, which may mimic the brain injury cascade that occurs after cardiac arrest. Insights from clinical trials in cardiac arrest may provide direction for future early brain injury research after subarachnoid hemorrhage (SAH. Methods. A search of PubMed from 1980 to 2012 and clinicaltrials.gov was conducted to identify published and ongoing randomized clinical trials in aneurysmal SAH and cardiac arrest patients. Only English, adult, human studies with primary or secondary mortality or neurological outcomes were included. Results. A total of 142 trials (82 SAH, 60 cardiac arrest met the review criteria (103 published, 39 ongoing. The majority of both published and ongoing SAH trials focus on delayed secondary insults after SAH (70%, while 100% of cardiac arrest trials tested interventions within the first few hours of ictus. No SAH trials addressing treatment of early brain injury were identified. Twenty-nine percent of SAH and 13% of cardiac arrest trials showed outcome benefit, though there is no overlap mechanistically. Conclusions. Clinical trials in SAH assessing acute brain injury are warranted and successful interventions identified by the cardiac arrest literature may be reasonable targets of the study.

  2. Appreciation of CT-negative, lumbar puncture-positive subarachnoid haemorrhage : risk factors for presence of aneurysms and diagnostic yield of imaging

    NARCIS (Netherlands)

    Bakker, Nicolaas A.; Groen, Rob J. M.; Foumani, Mahrouz; Uyttenboogaart, Maarten; Eshghi, Omid S.; Metzemaekers, Joannes; Luijckx, Gert Jan; van Dijk, J. Marc C.

    OBJECTIVE: Patients without a subarachnoid haemorrhage (SAH) on brain CT scan (CT-negative), but a lumbar puncture (LP)-proven SAH, are a challenging patient category. The optimal diagnostic approach is still a matter of debate. Also, there is little knowledge on the probability of finding an

  3. Time-dependent test characteristics of neck stiffness in patients suspected of nontraumatic subarachnoid haemorrhage

    NARCIS (Netherlands)

    Backes, Daan; Rinkel, Gabriel J E; Sturkenboom, A. J Martijn; Vergouwen, Mervyn D I

    2015-01-01

    Background: Neck stiffness can be the only diagnostic clue for subarachnoid haemorrhage (SAH) at neurological examination in patients with a clinical suspicion of nontraumatic SAH who present with a normal level of consciousness and no focal neurologic deficits. Since the clinical impression is that

  4. Flexibility in Complex Enterprises: Case Studies from Military Operations and Acquisition

    Science.gov (United States)

    2010-03-04

    on efficiency and minimizing error • Ref: Sah- Stiglitz ; Radner; Ioannides; Ranson, et al.; Volberda – Not as abstraction and complexity management...Ioannides; Sah and Stiglitz – Multi-organizational systems: fully functioning separate organizations that are also part of a larger

  5. Delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage : the role of coagulation and fibrinolysis

    NARCIS (Netherlands)

    M.D.I. Vergouwen

    2009-01-01

    Patients with aneurysmal subarachnoid hemorrhage (SAH) are at risk to develop complications, especially within the first two weeks after the hemorrhage. Delayed cerebral ischemia (DCI) is a complication which occurs in about 30% of SAH patients, leading to symptoms such as aphasia, hemiparesis, or i

  6. Headache in subarachnoid hemorrhage and headache attributed to intracranial endovascular procedures.

    Science.gov (United States)

    Agostoni, E; Zagaria, M; Longoni, M

    2015-05-01

    Headache is a critical problem in the emergency setting. In this paper we briefly review the epidemiological data regarding headache in Subarachnoid Hemorrhage (SAH), considering the role of headache as a warning symptom and the other clinical manifestation of SAH. We have also introduced a recent clinical entity, represented by headache associated to intracranial endovascular procedures (IEPs).

  7. Antithrombotic drugs and subarachnoid haemorrhage risk

    DEFF Research Database (Denmark)

    Pottegård, A; García Rodríguez, L A; Poulsen, F R

    2015-01-01

    The study objective was to investigate the relationship between use of antithrombotic drugs and subarachnoid haemorrhage (SAH). We identified patients discharged from Danish neurosurgery units with a first-ever SAH diagnosis in 2000 to 2012 (n=5,834). For each case, we selected 40 age-, sex...

  8. Magnetic resonance imaging in experimental subarachnoid haemorrhage

    NARCIS (Netherlands)

    van den Bergh, W M; Schepers, J; Veldhuis, W B; Nicolay, K; Tulleken, C A F; Rinkel, G J E

    2005-01-01

    BACKGROUND: We developed an MRI protocol to measure cerebrovascular diameter and blood flow velocity, and if we could detect cerebrovascular alterations after SAH and their impact on cerebral ischaemia. METHOD: SAH was induced in 15 Wistar rats by means of the endovascular filament method; 6 other r

  9. Increased GFAP and S100beta but not NSE serum levels after subarachnoid haemorrhage are associated with clinical severity.

    NARCIS (Netherlands)

    Vos, P.E.; Gils, M. van; Beems, T.; Zimmerman, C.; Verbeek, M.M.

    2006-01-01

    Assessment of initial disease severity after subarachnoid haemorrhage (SAH) remains difficult. The objective of the study is to identify biochemical markers of brain damage in peripheral blood after SAH. Hospital admission S100beta, glial fibrillary acidic protein (GFAP) and neuron-specific enolase

  10. Non-traumatic cortical subarachnoid haemorrhage: diagnostic work-up and aetiological background

    Energy Technology Data Exchange (ETDEWEB)

    Spitzer, C.; Kosinski, C.M. [University Hospital of RWTH Aachen, Department of Neurology, Aachen (Germany); Mull, M. [University Hospital of RWTH Aachen, Department of Neuroradiology, Aachen (Germany); Rohde, V. [University Hospital of RWTH Aachen, Department of Neurosurgery, Aachen (Germany)

    2005-07-01

    Only 15% of all subarachnoid haemorrhages (SAHs) are not of aneurysmal origin. Among those, circumscribed SAHs along the cortical convexity are rare and have only been described in singular case reports so far. Here, we present a collection of 12 cases of SAH along the convexity, of non-traumatic origin. Over a period of 10 years, 12 cases of circumscribed SAH along the convexity were identified at our clinic. The clinical presentations, neuroradiological SAH characteristics, further diagnostic work-up to identify the underlying aetiologies, the therapy and clinical outcome were analysed. The patients' chief complaints were unspecific cephalgia, focal or generalised seizures and focal neurological deficits. Typical signs of basal SAH, such as nuchal rigidity, thunderclap-headache or alteration of consciousness, were rare. Magnetic resonance imaging (MRI) and digital subtraction angiography (DSA) revealed different aetiologies, namely postpartal posterior encephalopathy (three), cerebral vasculitis (two), dural sinus thrombosis (two), cortical venous thrombosis (one), intracerebral abscesses (one) and cerebral cavernoma (one). Two cases remained unresolved. Treatment of the underlying disease and symptomatic medication led to good clinical outcome in almost all cases. On the basis of these findings, we demonstrate that the clinical presentation, localisation and aetiology of cortical SAH differ clearly from other SAHs. A diagnostic work-up with MRI and eventually DSA is essential. Mostly, the causative disease can be identified, and specific treatment allows a favourable outcome. (orig.)

  11. Hyperglycemia in aneurysmal subarachnoid hemorrhage : a potentially modifiable risk factor for poor outcome

    NARCIS (Netherlands)

    Kruyt, Nyika D.; Biessels, Geert Jan; DeVries, J. Hans; Luitse, Merel J. A.; Vermeulen, Marinus; Rinkel, Gabriel J. E.; Vandertop, W. Peter; Roos, Yvo B.

    2010-01-01

    Hyperglycemia after aneurysmal subarachnoid hemorrhage (aSAH) occurs frequently and is associated with delayed cerebral ischemia (DCI) and poor clinical outcome. In this review, we highlight the mechanisms that cause hyperglycemia after aSAH, and we discuss how hyperglycemia may contribute to poor c

  12. Unruptured intracranial aneurysms

    NARCIS (Netherlands)

    Backes, Daan

    2016-01-01

    Rupture of an intracranial aneurysm results in aneurysmal subarachnoid hemorrhage (SAH), a subtype of stroke with an incidence of 9 per 100,000 person-years and a case-fatality around 35%. In order to prevent SAH, patients with unruptured intracranial aneurysms can be treated by neurosurgical or end

  13. Hyponatremia, volume status and blood pressure following aneurysmal subarachnoid hemorrhage

    NARCIS (Netherlands)

    E.F.M. Wijdicks (Eelco)

    1987-01-01

    textabstractPatients who survive an aneurysmal subarachnoid hemorrhage (SAH) are endangered by complications, which especially occur during the first weeks after the hemorrhage. These complications have a high mortality and morbidity, and the outcome of patients with SAH will improve if these compli

  14. Detection of Subarachnoid Hemorrhage at Acute and Subacute/Chronic Stages: Comparison of Four Magnetic Resonance Imaging Pulse Sequences and Computed Tomography

    Directory of Open Access Journals (Sweden)

    Mei-Kang Yuan

    2005-03-01

    Conclusion: FLAIR and GE T2* MRI pulse sequences, and CT scans, are all statistically significant indicators of acute SAH. GE T2*-weighted images are statistically significant indicators of subacute-to-chronic SAH, whereas other MRI pulse sequences, and CT scans, are not.

  15. Considerable delay in diagnosis and acute management of subarachnoid haemorrhage

    DEFF Research Database (Denmark)

    Larsen, Carl Christian; Eskesen, Vagn; Hauerberg, John

    2010-01-01

    Rebleeding from subarachnoid haemorrhage (SAH) usually occurs within the first six hours after the initial bleeding. Rebleeding can be prevented effectively with tranexamic acid (TXA). Although a broad consensus has evolved that SAH should be treated as an emergency, it is likely that delays do...

  16. Long-term mortality and vascular event risk after aneurysmal subarachnoid haemorrhage

    NARCIS (Netherlands)

    Wermer, M. J. H.; Greebe, P.; Algra, A.; Rinkel, G. J. E.

    2009-01-01

    Background: Patients with a history of subarachnoid haemorrhage (SAH) may be at risk for vascular events and excess mortality. Methods: We interviewed 752 patients ( mean age 50 years, 67% women, mean follow-up 8.1 years) clipped between 1985 and 2001 after SAH who had been discharged home or to a r

  17. Aneurysm occlusion in elderly patients with aneurysmal subarachnoid hemorrhage : a cost-utility analysis

    NARCIS (Netherlands)

    Koffijberg, H.; Rinkel, G.J.; Buskens, E.

    2011-01-01

    BACKGROUND: Aneurysm occlusion after subarachnoid hemorrhage (SAH) aims to improve outcome by reducing the rebleeding risk. With increasing age overall prognosis decreases and the complications of aneurysm occlusion increase. The balance of risks for aneurysm occlusion in elderly SAH patients in dif

  18. Aneurysm occlusion in elderly patients with aneurysmal subarachnoid haemorrhage : a cost-utility analysis

    NARCIS (Netherlands)

    Koffijberg, H.; Buskens, E.; Rinkel, G. J. E.

    2011-01-01

    Background Aneurysm occlusion after subarachnoid haemorrhage (SAH) aims to improve outcome by reducing the rebleeding risk. With increasing age, overall prognosis decreases, and the complications of aneurysm occlusion increase. The balance of risks for aneurysm occlusion in elderly SAH patients in d

  19. The neuroprotective effect of dexmedetomidine in the hippocampus of rabbits after subarachnoid hemorrhage.

    Science.gov (United States)

    Cosar, Murat; Eser, Olcay; Fidan, Huseyin; Sahin, Onder; Buyukbas, Sadik; Ela, Yuksel; Yagmurca, Murat; Ozen, Oguz A

    2009-01-01

    Subarachnoid hemorrhage is a serious condition, often accompanied by cerebral vasospasm, which may lead to brain ischemia and neurologic deterioration. We evaluated if dexmedetomidine has neuroprotective effects in the hippocampus of vasospastic SAH rabbits or not. Eighteen New Zealand rabbits were taken. An experimental SAH model was formed by injecting 0.9 mL of autologous arterial blood per 1 kg of body weight to the cisterna magna of 12 rabbits. Craniotomy was performed in the control group (n = 6) except performing experimental SAH. Rabbits in the SAH-alone (n = 6) group were infused with 5 mL.kg(-1).h(-1) 0.9% sodium chloride, and rabbits (n = 6) in the SAH-dexmedetomidine group were infused with 5 microg.kg(-1).h(-1) dexmedetomidine for 2 hours, 48 hours after SAH was established. Rabbits of all groups were sacrificed via penthotal 24 hours after dexmedetomidine administration. Brains were removed immediately, and hippocampal tissues were blocked from the right hemisphere for histopathologic study. In addition to this, hippocampal tissues of left hemispheres were dissected for biochemical analyses to evaluate MDA levels, activity of XO, and SOD. The histopathologic study showed that dexmedetomidine may have a neuroprotective effect in SAH-induced hippocampal injuries. The biochemical parameters support the neuroprotective effect of dexmedetomidine (P < .05). Our study showed that dexmedetomidine may have a neuroprotective effect in the hippocampus of vasospastic SAH rabbits.

  20. Complications of hemorrhagic and ischemic stroke : a CT perfusion evaluation

    NARCIS (Netherlands)

    Dankbaar, J.W.

    2010-01-01

    In this thesis the use of CT-perfusion (CTP) imaging in the evaluation of the most severe complications of subarachnoid hemorrhage (SAH)) and ischemic stroke was explored. These complications are delayed cerebral ischemia (DCI) after SAH and damage to the blood-brain barrier (BBB) after ischemic str

  1. Spinal syringomyelia following subarachnoid hemorrhage.

    Science.gov (United States)

    Nakanishi, Kinya; Uchiyama, Takuya; Nakano, Naoki; Fukawa, Norihito; Yamada, Kimito; Yabuuchi, Tomonari; Kato, Amami

    2012-04-01

    Subarachnoid blood has been reported as a cause of chronic spinal arachnoiditis. Although syringomyelia has been thought to be caused by spinal arachnoiditis, reports of syringomyelia following aneurysmal subarachnoid hemorrhage (SAH) are very rare. We describe two patients with syringomyelia associated with chronic spinal arachnoiditis following SAH. From January 2001 to December 2010, 198 patients with aneurysmal SAH were treated at Kinki University School of Medicine. Two of the 198 patients had syringomyelia following aneurysmal SAH; thus the rate of syringomyelia associated with aneurysmal SAH was 1.0%. Patient 1 was a 54-year-old woman who presented with back pain, back numbness and gait disturbance 20 months after SAH. Her MRI revealed syringomyelia of the spinal cord from C2 to T10. She underwent shunting of the syrinx to the subarachnoid space. Patient 2 was a 49-year-old man, who was admitted to the hospital with headache, diplopia, hoarseness, dysphagia and ataxia five months after SAH. MRI revealed syringomyelia from the medulla oblongata to C6, and an enlargement of the lateral and fourth ventricles. After foramen magnum decompression and C1 laminectomy, a fourth ventricle-subarachnoid shunt was placed by insertion of a catheter. Spinal arachnoiditis and spinal syringomyelia are rare but important chronic complications after SAH.

  2. Subarachnoid hemorrhage enhances endothelin receptor expression and function in rat cerebral arteries

    DEFF Research Database (Denmark)

    Hansen-Schwartz, Jacob; Hoel, Natalie Løvland; Zhou, Mingfang

    2003-01-01

    OBJECTIVE: Inspired by organ culture-induced changes in the vascular endothelin (ET) receptor population, we investigated whether such changes occur in cerebral arteries in a rat subarachnoid hemorrhage (SAH) model. METHODS: SAH was induced with injection of 250 microl of blood into the prechiasm...

  3. Prognostic value of premorbid hypertension and neurological status in aneurysmal subarachnoid hemorrhage : Pooled analyses of individual patient data in the SAHIT repository

    NARCIS (Netherlands)

    Jaja, Blessing N R; Lingsma, Hester; Schweizer, Tom A.; Thorpe, Kevin E.; Steyerberg, Ewout W.; Macdonald, R. Loch; Louffat-Olivares, Ada; Noble, Adam; Molyneux, Andrew; Quinn, Audrey; Lo, Benjamin; Johnston, Clay; Hanggi, Daniel; Hasan, David; Wong, George K C; Torner, James; Singh, Jeff; Spears, Julian; Vergouwen, Mervyn D I; Cusimano, Michael D.; Todd, Michael; Tseng, Ming; Etminan, Nima; Le, Peter; Mayer, Stephan; Schenk, Thomas; Van, William

    2015-01-01

    OBJECT The literature has conflicting reports about the prognostic value of premorbid hypertension and neurological status in aneurysmal subarachnoid hemorrhage (SAH). The aim of this study was to investigate the prognostic value of premorbid hypertension and neurological status in the SAH Internati

  4. Extracellular Mitochondria in Cerebrospinal Fluid and Neurological Recovery After Subarachnoid Hemorrhage.

    Science.gov (United States)

    Chou, Sherry H-Y; Lan, Jing; Esposito, Elga; Ning, MingMing; Balaj, Leonora; Ji, Xunming; Lo, Eng H; Hayakawa, Kazuhide

    2017-08-01

    Recent studies suggest that extracellular mitochondria may be involved in the pathophysiology of stroke. In this study, we assessed the functional relevance of endogenous extracellular mitochondria in cerebrospinal fluid (CSF) in rats and humans after subarachnoid hemorrhage (SAH). A standard rat model of SAH was used, where an intraluminal suture was used to perforate a cerebral artery, thus leading to blood extravasation into subarachnoid space. At 24 and 72 hours after SAH, neurological outcomes were measured, and the standard JC1 (5,5',6,6'-tetrachloro-1,1',3,3'-tetraethyl-benzimidazolylcarbocyanineiodide) assay was used to quantify mitochondrial membrane potentials in the CSF. To further support the rat model experiments, CSF samples were obtained from 41 patients with SAH and 27 control subjects. Mitochondrial membrane potentials were measured with the JC1 assay, and correlations with clinical outcomes were assessed at 3 months. In the standard rat model of SAH, extracellular mitochondria was detected in CSF at 24 and 72 hours after injury. JC1 assays demonstrated that mitochondrial membrane potentials in CSF were decreased after SAH compared with sham-operated controls. In human CSF samples, extracellular mitochondria were also detected, and JC1 levels were also reduced after SAH. Furthermore, higher mitochondrial membrane potentials in the CSF were correlated with good clinical recovery at 3 months after SAH onset. This proof-of-concept study suggests that extracellular mitochondria may provide a biomarker-like glimpse into brain integrity and recovery after injury. © 2017 American Heart Association, Inc.

  5. Consensus meeting on microdialysis in neurointensive care

    DEFF Research Database (Denmark)

    Bellander, Bo-Michael; Cantais, Emmanuel; Enblad, Per;

    2004-01-01

    Microdialysis is used in many European neurointensive care units to monitor brain chemistry in patients suffering subarachnoid hemorrhage (SAH) or traumatic brain injury (TBI).......Microdialysis is used in many European neurointensive care units to monitor brain chemistry in patients suffering subarachnoid hemorrhage (SAH) or traumatic brain injury (TBI)....

  6. Effect of interferon-β on neuroinflammation, brain injury and neurological outcome after experimental subarachnoid hemorrhage

    NARCIS (Netherlands)

    Tiebosch, Ivo A C W; Dijkhuizen, Rick M; Cobelens, Pieter M; Bouts, Mark J R J; Zwartbol, René; van der Meide, Peter H; van den Bergh, Walter M

    2013-01-01

    INTRODUCTION: Aneurysmal subarachnoid hemorrhage (SAH) has a poor outcome, particularly attributed to progressive injury after the initial incident. Several studies suggest a critical role for inflammation in lesion progression after SAH. Our goal was to test whether treatment with anti-inflammatory

  7. Clinical Features and Prognosis of Intracranial Artery Dissection

    NARCIS (Netherlands)

    Sikkema, Tineke; Uyttenboogaart, Maarten; Dijk, van J.M.C.; Groen, Rob J. M.; Metzemaekers, Jan D. M.; Eshghi, Omid; Mazuri, Aryan; Bakker, Nicolaas A.; Luijckx, Gert-Jan

    2015-01-01

    BACKGROUND: Intracranial artery dissections (IADs) are an important cause of stroke or subarachnoid hemorrhage (SAH). Outcome of IAD in the anterior circulation or presentation without SAH is rarely investigated and might be different. OBJECTIVE: To evaluate the clinical features and prognosis of pa

  8. Roles of Pannexin-1 Channels in Inflammatory Response through the TLRs/NF-Kappa B Signaling Pathway Following Experimental Subarachnoid Hemorrhage in Rats

    Directory of Open Access Journals (Sweden)

    Ling-Yun Wu

    2017-06-01

    Full Text Available Background: Accumulating evidence suggests that neuroinflammation plays a critical role in early brain injury after subarachnoid hemorrhage (SAH. Pannexin-1 channels, as a member of gap junction proteins located on the plasma membrane, releases ATP, ions, second messengers, neurotransmitters, and molecules up to 1 kD into the extracellular space, when activated. Previous studies identified that the opening of Pannexin-1 channels is essential for cellular migration, apoptosis and especially inflammation, but its effects on inflammatory response in SAH model have not been explored yet.Methods: Adult male Sprague-Dawley rats were divided into six groups: sham group (n = 20, SAH group (n = 20, SAH + LV-Scramble-ShRNA group (n = 20, SAH + LV-ShRNA-Panx1 group (n = 20, SAH + LV-NC group (n = 20, and SAH + LV-Panx1-EGFP group (n = 20. The rat SAH model was induced by injection of 0.3 ml fresh arterial, non-heparinized blood into the prechiasmatic cistern in 20 s. In SAH + LV-ShRNA-Panx1 group and SAH + LV-Panx1-EGFP group, lentivirus was administered via intracerebroventricular injection (i.c.v. at 72 h before the induction of SAH. The Quantitative real-time polymerase chain reaction, electrophoretic mobility shift assay, enzyme-linked immunosorbent assay, immunofluorescence staining, and western blotting were performed to explore the potential interactive mechanism between Pannexin-1 channels and TLR2/TLR4/NF-κB-mediated signaling pathway. Cognitive and memory changes were investigated by the Morris water maze test.Results: Administration with LV-ShRNA-Panx1 markedly decreased the expression levels of TLR2/4/NF-κB pathway-related agents in the brain cortex and significantly ameliorated neurological cognitive and memory deficits in this SAH model. On the contrary, administration of LV-Panx1-EGFP elevated the expressions of TLR2/4/NF-κB pathway-related agents, which correlated with augmented neuronal apoptosis.Conclusion: Pannexin-1 channels may

  9. 创伤性蛛网膜下腔出血并发脑积水危险因素分析%Risk Factors for Hydrocephalus Following Traumatic Subarachnoid Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    栗向军; 张鹏远; 夏熙双; 褚峥

    2016-01-01

    Objective To analyze the risk factors for hydrocephalus following traumatic subarachnoid hemorrhage (SAH). Methods From January 2013 to February 2015,we enrolled 143 patients with traumatic SAH. Among them,17 patients with hydrocephalus following traumatic SAH were assigned into hydrocephalus group,and the rest patients were assigned into control group. General data and clinical indexes of the two groups were analyzed. Multivariate Logistic regression analyses were conducted to investigate the risk factors for hydrocephalus following SAH. Results The two groups were not significantly different in gender and the site of traumatic SAH( P > 0. 05);the two groups were significantly different in age,history of hypertension,GCS score at admission, decompressive craniectomy, the distribution of traumatic SAH, the thickness of traumatic SAH,lumbar cistern drainage and intraventricular hemorrhage(P 0.05);两组患者年龄、高血压病史、入院格拉斯哥昏迷量表(GCS)评分、去骨瓣减压术、创伤性 SAH 分布、创伤性 SAH 厚度、腰大池引流、脑室内出血发生率比较,差异均有统计学意义(P <0.05)。多因素 Logistic 回归分析结果显示,高龄、行去骨瓣减压术、弥漫创伤性 SAH、创伤性 SAH 厚度≥5 mm、未行腰大池引流、脑室内出血为创伤性 SAH 并发脑积水的危险因素( P <0.05)。结论高龄、行去骨瓣减压术、弥漫创伤性 SAH、创伤性 SAH 厚度≥5 mm、未行腰大池引流、脑室内出血为创伤性 SAH 并发脑积水的危险因素,应对合并高危因素患者采取更加积极治疗方案,从而减少创伤性 SAH 后脑积水的发生。

  10. The link between intracranial haemorrhage and cardiogenic shock: a case of Takotsubo cardiomyopathy.

    Science.gov (United States)

    Caretta, Giorgio; Vizzardi, Enrico; Rovetta, Riccardo; Evaristi, Laura; Quinzani, Filippo; Raddino, Riccardo; Dei Cas, Livio

    2012-06-01

    Myocardial dysfunction occurs frequently during subarachnoid haemorrhage (SAH) and it is often referred to as neurogenic stunned myocardium (NSM). Takotsubo cardiomyopathy (TTC), which can lead to life-threatening acute heart failure, has been considered a possible complication of SAH. Actually, NSM and TTC are believed to share the same pathophysiological mechanisms and are likely a manifestation of the same disease. We report a case of a 64-year-old woman with SAH and cardiogenic shock due to acute left ventricular dysfunction. Echocardiography and ventriculography showed the typical pattern of TTC. Angiography excluded coronary artery disease or coronary spasm. Short-term inotropic support was necessary. Rapid recovery of left ventricular function was observed after 8 days. Acute myocardial dysfunction due to TTC in the setting of SAH may lead to cardiogenic shock which is difficult to treat. Patients with SAH and haemodynamic instability warrant a careful assessment of ventricular function on admission to rule out TTC

  11. Magnetic resonance imaging of aneurysmal subarachnoid hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Ogawa, Toshihide; Shimosegawa, Eku; Inugami, Atsushi; Shishido, Fumio; Fujita, Hideaki; Ito, Hiroshi; Uemura, Kazuo; Yasui, Nobuyuki (Research Inst. of Brain and Blood Vessels, Akita (Japan))

    1991-11-01

    Magnetic resonance imaging of subarachnoid hemorrhage (SAH) due to aneurysm rupture was evaluated in relation to CT findings in nine patients. Six patients were studied within 3 days and the other three patients were studied 4 to 6 days from the ictus of SAH using a 0.5 Tesla superconducting unit. In all of the patients, hematoma in the subarachnoid space and ventricles was demonstrated by the proton density-weighted spin echo sequence, which showed that bloody cerebrospinal fluid (CSF) had a higher signal intensity than brain tissue or normal CSF. Magnetic resonance imaging was more sensitive in detecting SAH and more informative as to the site of the ruptured aneurysm than CT. Despite some limitations in applying it to patients with acute SAH, magnetic resonace imaging has clear advantages in the diagnosis of SAH. (author).

  12. Neuroinflammation responses after subarachnoid hemorrhage: A review.

    Science.gov (United States)

    Zheng, Vera Zhiyuan; Wong, George Kwok Chu

    2017-03-13

    Subarachnoid hemorrhage (SAH) is an important cause of stroke mortality and morbidity, especially in the young stroke population. Recent evidences indicate that neuroinflammation plays a critical role in both early brain injury and the delayed brain deterioration after SAH, including cellular and molecular components. Cerebral vasospasm (CV) can lead to death after SAH and independently correlated with poor outcome. Neuroinflammation is evidenced to contribute to the etiology of vasospasm. Besides, systemic inflammatory response syndrome (SIRS) commonly occurs in the SAH patients, with the presence of non-infectious fever and systematic complications. In this review, we summarize the evidences that indicate the prominent role of inflammation in the pathophysiology of SAH. That may provide the potential implications on diagnostic and therapeutic strategies.

  13. Clinical features of spinal cord hemangioblastoma complicated by hematomyelia and subarachnoid hemorrhage: Description of a clinical case and review of literature

    Directory of Open Access Journals (Sweden)

    G. Yu. Evzikov

    2015-01-01

    Full Text Available The paper describes subarachnoid hemorrhage (SAH and hematomyelia resulting from bleeding from spinal hemangioblastoma. SAH is encountered in spinal pathology extremely rarely and results from bleeding from malformations in most cases. The described case demonstrates that the tumors may also cause spinal SAH even there is no clinical evidence of gradually progressive spinal cord compression in the history. Patients with hemangioblastoma are at the highest risk for clinically relevant massive bleeding in intramedullary tumors. In this case, of special attention is its clinical picture: SAH began with neck and arm pain, rather than headache, which indicates the primarily spinal level of bleeding. Head and arm pains were joined by SAH -typical headache, nausea, and vomiting in only a few minutes, which was associated with retrograde blood flow into the basal cisterns of the brain and the fourth ventricle. Primary MRI of the cervical spine was a more rational diagnostic scheme in this case.

  14. Subtype activation and interaction of protein kinase C and mitogen-activated protein kinase controlling receptor expression in cerebral arteries and microvessels after subarachnoid hemorrhage

    DEFF Research Database (Denmark)

    Ansar, Saema; Edvinsson, Lars

    2008-01-01

    BACKGROUND AND PURPOSE: The pathogenesis of cerebral ischemia associated with subarachnoid hemorrhage (SAH) still remains elusive. The aim of this study was to examine the involvement of mitogen-activated protein kinase (MAPK) and protein kinase C (PKC) subtypes in the pathophysiology of cerebral...... enhanced phosphorylation only at 48 hours after SAH. The pattern was identical in large cerebral arteries and in intracerebral microvessels. Treatment with either the PKC (RO-31-7549) or the raf (SB386023-b) inhibitor prevented the kinase activation. CONCLUSIONS: The results show that specific subtypes...... ischemia after SAH in cerebral arteries and microvessels and to examine temporal activation of the kinases. We hypothesize that treatment with a MAPK or PKC inhibitor will prevent the SAH-induced kinase activation in brain vessels. METHODS: SAH was induced by injecting 250 microL blood...

  15. Depression and Anxiety Following Aneurysmal Subarachnoid Hemorrhage Are Associated With Higher Six-Month Unemployment Rates.

    Science.gov (United States)

    Al Yassin, Altaib; Ouyang, Bichun; Temes, Richard

    2017-01-01

    Although survival has dramatically improved following aneurysmal subarachnoid hemorrhage (aSAH), the reasons for persistent high rates of unemployment in this population remain unknown. Retrospective review for medical records of patients with aSAH admitted to Rush University Medical Center was undertaken. Multivariate logistic regression models were used to test the association of either depression or anxiety with the 6-month employment status. Among the 29 patients who developed depression or anxiety, 86.2% were unemployed at 6 months following their aSAH. After controlling for confounding factors, anxiety and depression were significantly associated with higher 6-month unemployment rates (odds ratio [OR]=0.08, 95% confidence interval [CI]=0.02-0.3, p=0.0002). Depression and anxiety are common following aSAH and are associated with increased unemployment rates 6 months post aSAH.

  16. Structural Basis for Recognition of S-adenosylhomocysteine by Riboswitches

    Energy Technology Data Exchange (ETDEWEB)

    A Edwards; F Reyes; A Heroux; R Batey

    2011-12-31

    S-adenosyl-(L)-homocysteine (SAH) riboswitches are regulatory elements found in bacterial mRNAs that up-regulate genes involved in the S-adenosyl-(L)-methionine (SAM) regeneration cycle. To understand the structural basis of SAH-dependent regulation by RNA, we have solved the structure of its metabolite-binding domain in complex with SAH. This structure reveals an unusual pseudoknot topology that creates a shallow groove on the surface of the RNA that binds SAH primarily through interactions with the adenine ring and methionine main chain atoms and discriminates against SAM through a steric mechanism. Chemical probing and calorimetric analysis indicate that the unliganded RNA can access bound-like conformations that are significantly stabilized by SAH to direct folding of the downstream regulatory switch. Strikingly, we find that metabolites bearing an adenine ring, including ATP, bind this aptamer with sufficiently high affinity such that normal intracellular concentrations of these compounds may influence regulation of the riboswitch.

  17. Structural basis for recognition of S-adenosylhomocysteine by riboswitches

    Energy Technology Data Exchange (ETDEWEB)

    Edwards, A.L.; Heroux, A.; Reyes, F. E.; Batey, R. T.

    2010-11-01

    S-adenosyl-(L)-homocysteine (SAH) riboswitches are regulatory elements found in bacterial mRNAs that up-regulate genes involved in the S-adenosyl-(L)-methionine (SAM) regeneration cycle. To understand the structural basis of SAH-dependent regulation by RNA, we have solved the structure of its metabolite-binding domain in complex with SAH. This structure reveals an unusual pseudoknot topology that creates a shallow groove on the surface of the RNA that binds SAH primarily through interactions with the adenine ring and methionine main chain atoms and discriminates against SAM through a steric mechanism. Chemical probing and calorimetric analysis indicate that the unliganded RNA can access bound-like conformations that are significantly stabilized by SAH to direct folding of the downstream regulatory switch. Strikingly, we find that metabolites bearing an adenine ring, including ATP, bind this aptamer with sufficiently high affinity such that normal intracellular concentrations of these compounds may influence regulation of the riboswitch.

  18. Toward understanding non-coding RNA roles in intracranial aneurysms and subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Huang Fengzhen

    2017-05-01

    Full Text Available Subarachnoid hemorrhage (SAH is a common and frequently life-threatening cerebrovascular disease, which is mostly related with a ruptured intracranial aneurysm. Its complications include rebleeding, early brain injury, cerebral vasospasm, delayed cerebral ischemia, chronic hydrocephalus, and also non neurological problems. Non-coding RNAs (ncRNAs, comprising of microRNAs (miRNAs, small interfering RNAs (siRNAs and long non-coding RNAs (lncRNAs, play an important role in intracranial aneurysms and SAH. Here, we review the non-coding RNAs expression profile and their related mechanisms in intracranial aneurysms and SAH. Moreover, we suggest that these non-coding RNAs function as novel molecular biomarkers to predict intracranial aneurysms and SAH, and may yield new therapies after SAH in the future.

  19. Evaluation of a supplementary retention program for black allied health sciences students.

    Science.gov (United States)

    Hesser, A; Lewis, L; Abbott, B; Vericella, B

    1993-01-01

    The Medical College of Georgia's (MCG's) Minority Academic Advising Program (MAAP), which began in 1984, is a supplementary retention program for Black students. This paper describes an evaluation study of the effectiveness of MAAP within the MCG School of Allied Health Sciences (SAHS). The study sample consisted of 89 Black students who enrolled in the SAHS from fall 1978 to fall 1982 (preMAAP period) plus 129 Black students who entered the SAHS from fall 1984 through fall 1988 (MAAP period). The comparison group consisted of all other students who entered the SAHS (n = 1,884) within those same time periods. Using an evaluation design produced by merging a quasi-experimental and a time-series design, the authors found that the MAAP succeeded in increasing both the Black student retention-to-graduation rate and the time-persisted-in-program, to the extent that Black students achieved parity with other SAHS students.

  20. Blunted serum and enhanced salivary free cortisol concentrations in the chronic phase after aneurysmal subarachnoid haemorrhage--is stress the culprit?

    Science.gov (United States)

    Poll, E M; Gilsbach, J M; Hans, F-J; Kreitschmann-Andermahr, I

    2013-03-01

    Spontaneous aneurysmal subarachnoid haemorrhage (SAH) is a cause of stroke, which constitutes a severe trauma to the brain and may lead to serious long-term medical, psychosocial and endocrinological sequelae. Adrenocorticotrophic hormone deficiency, which is considered to occur in up to 20% of all survivors, is a possible consequence of bleeding. Moreover, preliminary data suggest that a poor psychosocial outcome in SAH survivors is linked to alterations in cortisol secretion. Despite these findings, investigation of diurnal cortisol profiles and the cortisol awakening response (CAR) in chronic SAH patients has not been done so far. In this study, basal serum cortisol and salivary cortisol concentration profiles were investigated in 31 SAH patients more than 1 year after the acute event and in 25 healthy controls. Additionally, low-dose dexamethasone (DEX) suppression tests were conducted, and sensitivity to stress was measured with a psychometric questionnaire (Neuropattern(TM)). Although significantly higher salivary cortisol concentrations were observed on waking in SAH patients (p = 0.013, ANOVA), without a CAR change, total serum cortisol concentrations were blunted, but only in patients with high levels of perceived stress (SAH high stress: 337 nmol/l, SAH low stress: 442 nmol/l, controls: 467 nmol/l; Controls vs. SAH high stress p = 0.018). DEX suppression of cortisol secretion was not significantly different between patients and controls. The results indicate that total (serum) and free (salivary) cortisol concentrations give different information about cortisol availability in patients after aneurysmal SAH. Enhanced free cortisol concentrations may reflect a meaningful biological coping mechanism in SAH patients.

  1. Serum magnesium levels and clinical outcome of aneurysmal subarachnoid hemorrhage: a study in 60 patients

    Directory of Open Access Journals (Sweden)

    Habibi Z

    2008-06-01

    Full Text Available Background: Hypomagnesemia is commonly encountered in patients with a wide variety of diseases including subarachnoid hemorrhage (SAH, cardiovascular emergencies, head trauma, migraine attacks, seizure and preeclampsia. It seems to be associated with a poor clinical outcome. This study considers the prevalence and temporal distribution of hypomagnesemia after aneurysmal SAH and its correlation with the severity of SAH, delayed cerebral ischemia (DCI as well as the neurological outcome after a period of three months.Methods: Between 2003 and 2008, 60 patients were admitted to the emergency ward of Imam Khomeini Hospital with acute SAH. Serum magnesium levels were measured during the first 72 hours, days 4-7, and second and third weeks after SAH. The three-month outcome was assessed according to the Glasgow Outcome Scale (GOS. Clinical SAH grading was performed according to the criteria of the World Federation of Neurological Surgeons (WFNS and the patients were allocated to "Good" (GOS = 4, 5 and "Poor" (GOS= 1-3 outcome groups. The prevalence of hypomagnesemia was assessed in both patient groups. Fisher exact test was used to analyze data.Results: Hypomagnesemia occurred in 22% of patients during the first 72 hours after SAH. It was associated with more prevalent DCI (p<0.05, whereas low serum magnesium levels during days 4-7 17% of patients and the second week (22% of patients after SAH were correlated with poor clinical outcome (p<0.05. No correlation was found between first 72 hour-hypomagnesemia and poor clinical outcome at three months.Conclusion: Hypomagnesemia occurs after aneurysmal SAH and it may predict the occurrence of DCI, while low serum magnesium levels during days 4-7 and within the second week of event predict poor clinical outcome at three months. Treatment of this electrolyte disturbance may have a favourable effect on the clinical outcome of patients with aneurysmal SAH.

  2. The neuro-behavioral profile in rats after subarachnoid hemorrhage.

    Science.gov (United States)

    Boyko, Matthew; Azab, Abed N; Kuts, Ruslan; Gruenbaum, Benjamin Fredrick; Gruenbaum, Shaun Evan; Melamed, Israel; Brotfain, Evgeny; Shapira, Yoram; Cesnulis, Evaldas; Zlotnik, Alexander

    2013-01-23

    Despite significant advancements in the understanding of the pathophysiological mechanisms of subarachnoid hemorrhage (SAH), little is known about the emotional consequences. The primary goal of this study was to describe the locomotor and behavioral patterns in rats following both a single-injection and double-injection model of SAH. In 48 rats, SAH was induced by injecting 0.3 ml of autologous arterial blood into the cisterna magnum (single-hemorrhagic model). In 24 of these rats, post-SAH vasospasm was induced by a repeated injection of blood into the cisterna magnum 24h later (double-hemorrhagic model). In 24 additional rats, 0.3 ml of saline was injected into the cisterna magnum (sham group). Neurological performance was assessed at 24, 48 h, 1, 2 and 3 weeks after SAH. Four behavioral tests were performed for 3 weeks after SAH for the duration of 6 consequent days, in the following order: open field test, sucrose preference test, elevated plus maze test and forced swimming test. Following both, a single and double-hemorrhagic models of SAH, rats were found to have significant behavioral abnormalities on the open field test, sucrose preference test, elevated plus maze test, and forced swimming test. A more prominent disability was found in rats that underwent the double-hemorrhagic model of SAH than rats that underwent the single-hemorrhagic model. Both a single and double injection model of rats SAH are associated with significant behavioral disturbances including locomotor abnormalities, depressive behavior and increased anxiety, even as early as 3 weeks after SAH.

  3. 睡眠呼吸暂停低通气综合征42例漏诊分析%Missed Diagnosis of Sleep Apnea Hypopnea Syndrome:Analysis of 42 Cases and Literature Review

    Institute of Scientific and Technical Information of China (English)

    马小花; 欧阳松云; 孙培宗; 陈瑞英

    2012-01-01

    Objective To analyze the causes of missed diagnosis of sleep apnea hypopnea syndrome (SAHS). Methods 42 missed diagnosed cases with SAHS from May 2009 to May 2011 were retrospectively analyzed and related literatures were reviewed. Results The SAHS patients often visited the doctors for complications of SAHS such as hypertension,diabetes mellitus, metabolic syndrome,etc. Clinical misdiagnosis rate was very high. Lack of specific symptoms during the day, complicated morbidities, and insufficient knowledge of SAHS led to the high misdiagnosis rate and the poor treatment effect of patients with SAHS. Conclusion Strengthening the educational propaganda of SAHS,detail medical history collection, and polysomnography monitoring (PSC) as early as possible can help diagnose SAHS more accurately and reduce missed diagnosis.%目的 探讨睡眠呼吸暂停低通气综合征(SAHS)的漏诊原因.方法 结合文献对郑州大学第一附属医院2009年5月至2011年5月漏诊的42例SAHS患者进行回顾性分析.结果 SAHS常因高血压、糖尿病、代谢综合征等并发症而就诊,临床漏诊率高.常见的漏诊原因是SAHS白天症状缺乏特异性,并发症多且复杂,需要多学科协作诊治等.而人们却对SAHS认识不足,导致漏诊率高,患者治疗效果差.结论 加强SAHS的宣传教育,详细采集病史,尽早行多导睡眠图(PSG)监测,从而正确诊断SAHS,减少漏诊.

  4. Decorin alleviated chronic hydrocephalus via inhibiting TGF-β1/Smad/CTGF pathway after subarachnoid hemorrhage in rats.

    Science.gov (United States)

    Yan, Hui; Chen, Yujie; Li, Lingyong; Jiang, Jiaode; Wu, Guangyong; Zuo, Yuchun; Zhang, John H; Feng, Hua; Yan, Xiaoxin; Liu, Fei

    2016-01-01

    Chronic hydrocephalus is one of the severe complications after subarachnoid hemorrhage (SAH). However, there is no efficient treatment for the prevention of chronic hydrocephalus, partially due to poor understanding of underlying pathogenesis, subarachnoid fibrosis. Transforming growth factor-β1(TGF-β1) is a potent fibrogenic factor implicated in wide range of fibrotic diseases. To investigate whether decorin, a natural antagonist for TGF-β1, protects against subarachnoid fibrosis and chronic hydrocephalus after SAH, two-hemorrhage-injection SAH model was conducted in 6-week-old rats. Recombinant human decorin(rhDecorin) (30ug/2ul) was administered before blood injection and on the 10th day after SAH. TGF-β1, p-Smad2/3, connective tissue growth factor (CTGF), collagen I and pro-collagen I c-terminal propeptide were assessed via western blotting, enzyme-linked immunosorbent assay, radioimmunoassay and immunofluorescence. And neurobehavioral tests and Morris water maze were employed to evaluate long-term neurological functions after SAH. We found that SAH induced heightened activation of TGF-β1/Smad/CTGF axis, presenting as a two peak response of TGF-β1 in cerebrospinal fluid, elevation of TGF-β1, p-Smad2/3, CTGF, collagen I in brain parenchyma and pro-collagen I c-terminal propeptide in cerebrospinal fluid, and increased lateral ventricle index. rhDecorin treatment effectively inhibited up-regulation of TGF-β1, p-Smad2/3, CTGF, collagen I and pro-collagen I c-terminal propeptide after SAH. Moreover, rhDecorin treatment significantly reduced lateral ventricular index and incidence of chronic hydrocephalus after SAH. Importantly, rhDecorin improved neurocognitive deficits after SAH. In conclusion, rhDecorin suppresses extracellular matrix accumulation and following subarachnoid fibrosis via inhibiting TGF-β1/Smad/CTGF pathway, preventing development of hydrocephalus and attenuating long-term neurocognitive defects after SAH.

  5. The Early Endocrine Stress Response in Experimental Subarachnoid Hemorrhage.

    Directory of Open Access Journals (Sweden)

    Christoffer Nyberg

    Full Text Available In patients with severe illness, such as aneurysmal subarachnoid hemorrhage (SAH, a physiologic stress response is triggered. This includes activation of the hypothalamic-pituitary-adrenal (HPA axis and the sympathetic nervous system. The aim of this study was to investigate the very early responses of these systems.A porcine animal model of aneurysmal SAH was used. In this model, blood is injected slowly to the basal cisterns above the anterior skull base until the cerebral perfusion pressure is 0 mm Hg. Sampling was done from blood and urine at -10, +15, +75 and +135 minutes from time of induction of SAH. Analyses of adrenocorticotropic hormone (ACTH, cortisol, aldosterone, catecholamines and chromogranin-A were performed.Plasma ACTH, serum cortisol and plasma aldosterone increased in the samples following induction of SAH, and started to decline after 75 minutes. Urine cortisol also increased after SAH. Urine catecholamines and their metabolites were found to increase after SAH. Many samples were however below detection level, not allowing for statistical analysis. Plasma chromogranin-A peaked at 15 minutes after SAH, and thereafter decreased.The endocrine stress response after aneurysmal SAH was found to start within 15 minutes in the HPA axis with early peak values of ACTH, cortisol and aldosterone. The fact that the concentrations of the HPA axis hormones decreased 135 minutes after SAH may suggest that a similar pattern exists in SAH patients, thus making it difficult to catch these early peak values. There were also indications of early activation of the sympathetic nervous system, but the small number of valid samples made interpretation difficult.

  6. Can mobile phone technology support a rapid sharing of information on novel psychoactive substances among health and other professionals internationally?

    Science.gov (United States)

    Simonato, Pierluigi; Bersani, Francesco S; Santacroce, Rita; Cinosi, Eduardo; Schifano, Fabrizio; Bersani, Giuseppe; Martinotti, Giovanni; Corazza, Ornella

    2017-05-01

    The diffusion of novel psychoactive substances (NPSs), combined with the ability of the Internet to act as an online marketplace, has led to unprecedented challenges for governments, health agencies, and substance misuse services. Despite increasing research, there is a paucity of reliable information available to professionals working in the field. The paper will present the pilot results of the first mobile application (SMAIL) for rapid information sharing on NPSs among health professionals. The development of SMAIL was divided into 2 parts: (a) the creation of the application for registered users, enabling them to send an SMS or email with the name or "street name" of an NPS and receive within seconds emails or SMS with the information, when available and (b) the development of a database to support the incoming requests. One hundred twenty-two professionals based in 22 countries used the service over the pilot period of 16 months (from May 2012 to September 2013). Five hundred fifty-seven enquires were made. Users received rapid information on NPSs, and 61% of them rated the service as excellent. This is the right time to use mobile phone technologies for rapid information sharing and prevention activities on NPSs. Copyright © 2017 John Wiley & Sons, Ltd.

  7. Molecular diagnosis of infectious hematopoietic necrosis and viral hemorrhagic septicemia

    Science.gov (United States)

    Winton, James R.; Einer-Jensen, Katja

    2002-01-01

    The fish rhabdoviruses, infectious hematopoietic necrosis virus (IHNV) and viral hemorrhagic septicemia virus (VHSV), cause extensive losses among salmon and trout in several areas of the world (Bootland and Leong, 1999; Smail, 1999; Wolf, 1988). Historically, IHNV was endemic among wild anadromous salmonids in the western portion of North America, but the virus has spread to stocks of cultured rainbow trout (Oncorhynchus mykiss) in the United States, Asia and Western Europe, probably as a result of the movement of infected fish or eggs (Winton, 1991). Prior to 1989, VHSV was thought to be largely restricted to freshwater fishes in Western Europe (Wolf, 1988); however, in the last decade, VHSV has been isolated from an increasing number of free-living marine fish species in the North Pacific and North Atlantic Oceans (Dixon et al., 1997; Dixon, 1999; Kent et al., 1998; Meyers and Winton, 1995; Meyers et al., 1999; Mortensen et al., 1999; Smail; 2000, Takano et al., 2000). These findings have lead to the conclusion that both viruses are principally endemic among marine or anadromous fish species, but have established themselves in freshwater among cultured salmonids where their effects are most frequently observed.

  8. Purpurogallin, a Natural Phenol, Attenuates High-Mobility Group Box 1 in Subarachnoid Hemorrhage Induced Vasospasm in a Rat Model

    Directory of Open Access Journals (Sweden)

    Chih-Zen Chang

    2014-01-01

    Full Text Available High-mobility group box 1 (HMGB1 was shown to be an important extracellular mediator involved in vascular inflammation of animals following subarachnoid hemorrhage (SAH. This study is of interest to examine the efficacy of purpurogallin, a natural phenol, on the alternation of cytokines and HMGB1 in a SAH model. A rodent double hemorrhage SAH model was employed. Basilar arteries (BAs were harvested to examine HMGB1 mRNA and protein expression (Western blot. CSF samples were to examine IL-1β, IL-6, IL-8, and TNF-α (rt-PCR. Deformed endothelial wall, tortuous elastic lamina, and necrotic smooth muscle were observed in the vessels of SAH groups but were absent in the purpurogallin group. IL-1β, IL-6, and TNF-α in the SAH only and SAH plus vehicle groups were significantly elevated (P<0.01. Purpurgallin dose-dependently reduced HMGB1 protein expression. Likewise, high dose purpurogallin reduced TNF-α and HMGB1 mRNA levels. In conclusion, purpurogallin exerts its neuroinflammation effect through the dual effect of inhibiting IL-6 and TNF-α mRNA expression and reducing HMGB1 protein and mRNA expression. This study supports purpurogallin could attenuate both proinflammatory cytokines and late-onset inflammasome in SAH induced vasospasm.

  9. Lack of global epigenetic methylation defects in CBS deficient mice.

    Science.gov (United States)

    Lee, Hyung-Ok; Wang, Liqun; Kuo, Yin-Ming; Gupta, Sapna; Slifker, Michael J; Li, Yue-Sheng; Andrews, Andrew J; Kruger, Warren D

    2017-01-01

    Cystathionine β-synthase (CBS) deficiency is a recessive inborn error of metabolism in which patients have extremely elevated plasma total homocysteine and have clinical manifestations in the vascular, visual, skeletal, and nervous systems. Homocysteine is an intermediary metabolite produced from the hydrolysis of S-adenosylhomocysteine (SAH), which is a by-product of methylation reactions involving the methyl-donor S-adenosylmethionine (SAM). Here, we have measured SAM, SAH, DNA and histone methylation status in an inducible mouse model of CBS deficiency to test the hypothesis that homocysteine-related phenotypes are caused by inhibition of methylation due to elevated SAH and reduced SAM/SAH ratio. We found that mice lacking CBS have elevated cellular SAH and reduced SAM/SAH ratios in both liver and kidney, but this was not associated with alterations in the level of 5-methylcytosine or various histone modifications. Using methylated DNA immunoprecipitation in combination with microarray, we found that of the 241 most differentially methylated promoter probes, 89 % were actually hypermethylated in CBS deficient mice. In addition, we did not find that changes in DNA methylation correlated well with changes in RNA expression in the livers of induced and uninduced CBS mice. Our data indicates that reduction in the SAM/SAH ratio, due to loss of CBS activity, does not result in overall hypomethylation of either DNA or histones.

  10. Subarachnoid hemorrhage: tests of association with apolipoprotein E and elastin genes

    Directory of Open Access Journals (Sweden)

    Sauerbeck Laura

    2007-07-01

    Full Text Available Abstract Background Apolipoprotein E (APOE and elastin (ELN are plausible candidate genes involved in the pathogenesis of stroke. We tested for association of variants in APOE and ELN with subarachnoid hemorrhage (SAH in a population-based study. We genotyped 12 single nucleotide polymorphisms (SNPs on APOE and 10 SNPs on ELN in a sample of 309 Caucasian individuals, of whom 107 are SAH cases and 202 are age-, race-, and gender-matched controls from the Greater Cincinnati/Northern Kentucky region. Associations were tested at genotype, allele, and haplotype levels. A genomic control analysis was performed to check for spurious associations resulting from population substructure. Results At the APOE locus, no individual SNP was associated with SAH after correction for multiple comparisons. Haplotype analysis revealed significant association of the major haplotype (Hap1 in APOE with SAH (p = 0.001. The association stemmed from both the 5' promoter and the 3' region of the APOE gene. APOE ε2 and ε 4 were not significantly associated with SAH. No association was observed for ELN at genotype, allele, or haplotype level and our study failed to confirm previous reports of ELN association with aneurysmal SAH. Conclusion This study suggests a role of the APOE gene in the etiology of aneurysmal SAH.

  11. Radiological findings in cerebral venous thrombosis presenting as subarachnoid hemorrhage: a series of 22 cases

    Energy Technology Data Exchange (ETDEWEB)

    Boukobza, Monique [APHP - Paris-Diderot University, Department of Neuroradiology and Therapeutic Angiography, Assistance publique - University Hospitals Lariboisiere-St-Louis-Fernand-Widal, Paris (France); Crassard, Isabelle; Bousser, Marie-Germaine [Assistance publique - University Hospitals Lariboisiere-St-Louis-Fernand-Widal, APHP - Paris-Diderot University Paris, France, Department of Neurology, Paris (France); Chabriat, Hugues [Assistance publique - University Hospitals Lariboisiere-St-Louis-Fernand-Widal, APHP - Paris-Diderot University Paris, France, Department of Neurology, Paris (France); INSERM UMR 1161 and DHU NeuroVasc, Paris (France)

    2016-01-15

    The main objectives of the present study are to assess the incidence of cerebral venous thrombosis (CVT) presenting as isolated subarachnoid hemorrhage (SAH) and to determine the occurrence of cortical venous thrombosis (CoVT). Among 332 patients with CVT, investigated with the same CT and MR standardized protocol, 33 (10 %) presented with SAH, associated in 11 cases with hemorrhagic infarct or intracerebral hemorrhage. This study is based on 22 cases of CVT presenting as SAH in the absence of hemorrhagic brain lesion. Diagnosis of sinus thrombosis was established on T2* and magnetic resonance venography and that of CoVT on T2* sequence. Diagnostic of SAH was based on fluid-attenuated inversion recovery (FLAIR) sequence. CVT involved lateral sinus in 18 patients, superior sagittal sinus in 16, and straight sinus in 1. Cortical veins were involved in all patients, in continuity with dural sinus thrombosis when present. SAH was circumscribed to few sulci in all cases and mainly localized at the convexity (21 cases). CoVT implied different areas on the same side in four patients and was bilateral in seven. There was no perimesencephalic or basal cisterns hemorrhage. Cortical swelling was present in 12 cases, associated with localized edema. All patients except one had a favorable outcome. This report shows that the incidence of CVT presenting as isolated SAH is evaluated to 6.4 % and that SAH is, in all cases, in the vicinity of CoVT and when dural thrombosis is present in continuity with it. (orig.)

  12. Detecting subarachnoid hemorrhage: Comparison of combined FLAIR/SWI versus CT

    Energy Technology Data Exchange (ETDEWEB)

    Verma, Rajeev Kumar, E-mail: rajeev.verma@insel.ch [University Institute of Diagnostic and Interventional Neuroradiology, Support Center for Advanced Neuroimaging, University of Bern, Inselspital, Freiburgstrasse 4, 3010 Bern (Switzerland); Kottke, Raimund, E-mail: raimund.kottke@insel.ch [University Institute of Diagnostic and Interventional Neuroradiology, Support Center for Advanced Neuroimaging, University of Bern, Inselspital, Freiburgstrasse 4, 3010 Bern (Switzerland); Andereggen, Lukas, E-mail: lukas.andereggen@insel.ch [Department of Neurosurgery, University of Bern, Inselspital, Freiburgstrasse 4, 3010 Bern (Switzerland); Weisstanner, Christian, E-mail: christian.weisstanner@insel.ch [University Institute of Diagnostic and Interventional Neuroradiology, Support Center for Advanced Neuroimaging, University of Bern, Inselspital, Freiburgstrasse 4, 3010 Bern (Switzerland); Zubler, Christoph, E-mail: christoph.zubler@insel.ch [University Institute of Diagnostic and Interventional Neuroradiology, Support Center for Advanced Neuroimaging, University of Bern, Inselspital, Freiburgstrasse 4, 3010 Bern (Switzerland); Gralla, Jan, E-mail: jan.gralla@insel.ch [University Institute of Diagnostic and Interventional Neuroradiology, Support Center for Advanced Neuroimaging, University of Bern, Inselspital, Freiburgstrasse 4, 3010 Bern (Switzerland); Kiefer, Claus, E-mail: claus.kiefer@insel.ch [University Institute of Diagnostic and Interventional Neuroradiology, Support Center for Advanced Neuroimaging, University of Bern, Inselspital, Freiburgstrasse 4, 3010 Bern (Switzerland); Slotboom, Johannes, E-mail: johannes.slotboom@insel.ch [University Institute of Diagnostic and Interventional Neuroradiology, Support Center for Advanced Neuroimaging, University of Bern, Inselspital, Freiburgstrasse 4, 3010 Bern (Switzerland); and others

    2013-09-15

    Objectives: Aim of this study was to compare the utility of susceptibility weighted imaging (SWI) with the established diagnostic techniques CT and fluid attenuated inversion recovery (FLAIR) in their detecting capacity of subarachnoid hemorrhage (SAH), and further to compare the combined SWI/FLAIR MRI data with CT to evaluate whether MRI is more accurate than CT. Methods: Twenty-five patients with acute SAH underwent CT and MRI within 6 days after symptom onset. Underlying pathology for SAH was head trauma (n = 9), ruptured aneurysm (n = 6), ruptured arteriovenous malformation (n = 2), and spontaneous bleeding (n = 8). SWI, FLAIR, and CT data were analyzed. The anatomical distribution of SAH was subdivided into 8 subarachnoid regions with three peripheral cisterns (frontal-parietal, temporal-occipital, sylvian), two central cisterns and spaces (interhemispheric, intraventricular), and the perimesencephalic, posterior fossa, superior cerebellar cisterns. Results: SAH was detected in a total of 146 subarachnoid regions. CT identified 110 (75.3%), FLAIR 127 (87%), and SWI 129 (88.4%) involved regions. Combined FLAIR and SWI identified all 146 detectable regions (100%). FLAIR was sensitive for frontal-parietal, temporal-occipital and Sylvian cistern SAH, while SWI was particularly sensitive for interhemispheric and intraventricular hemorrhage. Conclusions: By combining SWI and FLAIR, MRI yields a distinctly higher detection rate for SAH than CT alone, particularly due to their complementary detection characteristics in different anatomical regions. Detection strength of SWI is high in central areas, whereas FLAIR shows a better detection rate in peripheral areas.

  13. Reduction of neutrophil activity decreases early microvascular injury after subarachnoid haemorrhage

    Directory of Open Access Journals (Sweden)

    Bi Weina

    2011-08-01

    Full Text Available Abstract Background Subarachnoid haemorrhage (SAH elicits rapid pathological changes in the structure and function of parenchymal vessels (≤ 100 μm. The role of neutrophils in these changes has not been determined. This study investigates the role of neutrophils in early microvascular changes after SAH Method Rats were either untreated, treated with vinblastine or anti-polymorphonuclear (PMN serum, which depletes neutrophils, or treated with pyrrolidine dithiocarbamate (PDTC, which limits neutrophil activity. SAH was induced by endovascular perforation. Neutrophil infiltration and the integrity of vascular endothelium and basement membrane were assessed immunohistochemically. Vascular collagenase activity was assessed by in situ zymography. Results Vinblastine and anti-PMN serum reduced post-SAH accumulation of neutrophils in cerebral vessels and in brain parenchyma. PDTC increased the neutrophil accumulation in cerebral vessels and decreased accumulation in brain parenchyma. In addition, each of the three agents decreased vascular collagenase activity and post-SAH loss of vascular endothelial and basement membrane immunostaining. Conclusions Our results implicate neutrophils in early microvascular injury after SAH and indicate that treatments which reduce neutrophil activity can be beneficial in limiting microvascular injury and increasing survival after SAH.

  14. Troponin elevation in subarachnoid hemorrhage

    Institute of Scientific and Technical Information of China (English)

    Ioannis N Mavridis; Maria Meliou; Efstratios-Stylianos Pyrgelis

    2015-01-01

    Troponin (tr) elevation in aneurysmal subarachnoid hemorrhage (SAH) patients is often difficult to be appropriately assessed by clinicians, causing even disagreements regarding its management between neurosurgeons and cardiologists. The purpose of this article was to review the literature regarding the clinical interpretation of tr elevation in SAH. We searched for articles in PubMed using the key words:“troponin elevation”and“subarachnoid hemorrhage”. All of them, as well as relative neurosurgical books, were used for this review. Some type of cardiovascular abnormality develops in most SAH patients. Neurogenic stunned myocardium is a frequent SAH complication, due to catecholamine surge which induces cardiac injury, as evidenced by increased serum tr levels, electrocardiographic (ECG) changes and cardiac wall motion abnormalities. Tr elevation, usually modest, is an early and specific marker for cardiac involvement after SAH and its levels peak about two days after SAH. Cardiac tr elevation predictors include poor clinical grade, intraventricular hemorrhage, loss of consciousness at ictus, global cerebral edema, female sex, large body surface area, lower systolic blood pressure, higher heart rate and prolonged Q-Tc interval. Elevated tr levels are associated with disability and death (especially tr>1μg/L), worse neurological grade, systolic and diastolic cardiac dysfunction, pulmonary congestion, longer intensive care unit stay and incidence of vasospasm. Tr elevation is a common finding in SAH patients and constitutes a rightful cause of worry about the patients’ cardiac function and prognosis. It should be therefore early detected, carefully monitored and appropriately managed by clinicians.

  15. Effect of subarachnoid hemorrhage on contractile responses and noradrenaline release evoked in cat cerebral arteries by histamine

    Energy Technology Data Exchange (ETDEWEB)

    Lobato, R.D.; Marin, J.; Salaices, M.; Rico, M.L.; Sanchez, C.F.

    1981-10-01

    This study analyzes the changes induced by subarachnoid hemorrhage (SAH) on the contractile responses and the noradrenaline release evoked in cat cerebral arteries by histamine. The dose-dependent vasoconstriction induced by histamine on the cerebral arteries of normal cats was significantly reduced by diphenhydramine and phentolamine. When SAH was produced 3 and 7 days before the experiment, the histamine-induced vasoconstriction also decreased. Thereafter, a tendency to normalization in the contractile vascular responses was observed such that in 15 days after the hemorrhage it was not significantly different from that found in controls animals. The decrease in the contractile responses to histamine provoked by SAH was similar to that seen after pretreatment with intracisternal injections of 6-hydroxydopamine. The amount of radioactivity released by histamine following preincubation with /sup 3/H-noradrenaline from the cerebral arteries of cats exposed to SAH 3, 7, and 15 days before the experiment was significantly reduced when compared with controls. Moreover, the basal level of tritium release and the radioactivity retained at the end of the experiment were also decreased after SAH. Results indicate histamine releases noradrenaline from cat cerebral arteries, and SAH produce a transient denervation of the perivascular adrenergic nerve endings, which explained by the impairment of the indirect adrenergic mechanism involved in the overall contractile response elicited by this amine in cerebral arteries. Histamine does not seem to play a significant role in the production of the cerebral vasospasm occurring after SAH.

  16. Mdivi-1 Alleviates Early Brain Injury After Experimental Subarachnoid Hemorrhage in Rats, Possibly via Inhibition of Drp1-Activated Mitochondrial Fission and Oxidative Stress.

    Science.gov (United States)

    Wu, Pei; Li, Yuchen; Zhu, Shiyi; Wang, Chunlei; Dai, Jiaxing; Zhang, Guang; Zheng, Bingjie; Xu, Shancai; Wang, Ligang; Zhang, Tongyu; Zhou, PeiQuan; Zhang, John H; Shi, Huaizhang

    2017-02-16

    Mdivi-1 is a selective inhibitor of mitochondrial fission protein, Drp1, and can penetrate the blood-brain barrier. Previous studies have shown that Mdivi-1 improves neurological outcomes after ischemia, seizures and trauma but it remains unclear whether Mdivi-1 can attenuate early brain injury after subarachnoid hemorrhage (SAH). We thus investigated the therapeutic effect of Mdivi-1 on early brain injury following SAH. Rats were randomly divided into four groups: sham; SAH; SAH + vehicle; and SAH + Mdivi-1. The SAH model was induced by standard intravascular perforation and all of the rats were subsequently sacrificed 24 h after SAH. Mdivi-1 (1.2 mg/kg) was administered to rats 30 min after SAH. We found that Mdivi-1 markedly improved neurologic deficits, alleviated brain edema and BBB permeability, and attenuated apoptotic cell death. Mdivi-1 also significantly reduced the expression of cleaved caspase-3, Drp1 and p-Drp1((Ser616)), attenuated the release of Cytochrome C from mitochondria, inhibited excessive mitochondrial fission, and restored the ultra-structure of mitochondria. Furthermore, Mdivi-1 reduced levels of MDA, 3-NT, and 8-OHdG, and improved SOD activity. Taken together, our data suggest that Mdivi-1 exerts neuroprotective effects against cell death induced by SAH and the underlying mechanism may be inhibition of Drp1-activated mitochondrial fission and oxidative stress.

  17. Arctigenin, a Potent Ingredient of Arctium lappa L., Induces Endothelial Nitric Oxide Synthase and Attenuates Subarachnoid Hemorrhage-Induced Vasospasm through PI3K/Akt Pathway in a Rat Model

    Directory of Open Access Journals (Sweden)

    Chih-Zen Chang

    2015-01-01

    Full Text Available Upregulation of protein kinase B (PKB, also known as Akt is observed within the cerebral arteries of subarachnoid hemorrhage (SAH animals. This study is of interest to examine Arctigenin, a potent antioxidant, on endothelial nitric oxide synthase (eNOS and Akt pathways in a SAH in vitro study. Basilar arteries (BAs were obtained to examine phosphatidylinositol-3-kinase (PI3K, phospho-PI3K, Akt, phospho-Akt (Western blot and morphological examination. Endothelins (ETs and eNOS evaluation (Western blot and immunostaining were also determined. Arctigenin treatment significantly alleviates disrupted endothelial cells and tortured internal elastic layer observed in the SAH groups (p<0.01. The reduced eNOS protein and phospho-Akt expression in the SAH groups were relieved by the treatment of Arctigenin (p<0.01. This result confirmed that Arctigenin might exert dural effects in preventing SAH-induced vasospasm through upregulating eNOS expression via the PI3K/Akt signaling pathway and attenuate endothelins after SAH. Arctigenin shows therapeutic promise in the treatment of cerebral vasospasm following SAH.

  18. Arctigenin, a Potent Ingredient of Arctium lappa L., Induces Endothelial Nitric Oxide Synthase and Attenuates Subarachnoid Hemorrhage-Induced Vasospasm through PI3K/Akt Pathway in a Rat Model.

    Science.gov (United States)

    Chang, Chih-Zen; Wu, Shu-Chuan; Chang, Chia-Mao; Lin, Chih-Lung; Kwan, Aij-Lie

    2015-01-01

    Upregulation of protein kinase B (PKB, also known as Akt) is observed within the cerebral arteries of subarachnoid hemorrhage (SAH) animals. This study is of interest to examine Arctigenin, a potent antioxidant, on endothelial nitric oxide synthase (eNOS) and Akt pathways in a SAH in vitro study. Basilar arteries (BAs) were obtained to examine phosphatidylinositol-3-kinase (PI3K), phospho-PI3K, Akt, phospho-Akt (Western blot) and morphological examination. Endothelins (ETs) and eNOS evaluation (Western blot and immunostaining) were also determined. Arctigenin treatment significantly alleviates disrupted endothelial cells and tortured internal elastic layer observed in the SAH groups (p < 0.01). The reduced eNOS protein and phospho-Akt expression in the SAH groups were relieved by the treatment of Arctigenin (p < 0.01). This result confirmed that Arctigenin might exert dural effects in preventing SAH-induced vasospasm through upregulating eNOS expression via the PI3K/Akt signaling pathway and attenuate endothelins after SAH. Arctigenin shows therapeutic promise in the treatment of cerebral vasospasm following SAH.

  19. Hydrogen Sulfide Ameliorates Early Brain Injury Following Subarachnoid Hemorrhage in Rats.

    Science.gov (United States)

    Cui, Yonghua; Duan, Xiaochun; Li, Haiying; Dang, Baoqi; Yin, Jia; Wang, Yang; Gao, Anju; Yu, Zhengquan; Chen, Gang

    2016-08-01

    Increasing studies have demonstrated the neuroprotective effect of hydrogen sulfide (H2S) in central nervous system (CNS) diseases. However, the potential application value of H2S in the therapy of subarachnoid hemorrhage (SAH) is still not well known. This study was to investigate the potential effect of H2S on early brain injury (EBI) induced by SAH and explore the underlying mechanisms. The role of sodium hydrosulfide (NaHS), a donor of H2S, in SAH-induced EBI, was investigated in both in vivo and in vitro. A prechiasmatic cistern single injection model was used to produce experimental SAH in vivo. In vitro, cultured primary rat cortical neurons and human umbilical vein endothelial cells (HUVECs) were exposed to OxyHb at concentration of 10 μM to mimic SAH. Endogenous production of H2S in the brain was significantly inhibited by SAH. The protein levels of the predominant H2S-generating enzymes in the brain, including cystathionineb-synthase (CBS) and 3-mercaptopyruvate sulfur transferase (3MST), were also correspondingly reduced by SAH, while treatment with NaHS restored H2S production and the expressions of CBS and 3MST. More importantly, NaHS treatment could significantly attenuate EBI (including brain edema, blood-brain barrier disruption, brain cell apoptosis, inflammatory response, and cerebral vasospasm) after SAH. In vitro, H2S protects neurons and endothelial function by functioning as an antioxidant and antiapoptotic mediator. Our results suggest that NaSH as an exogenous H2S donor could significantly reduce EBI induced by SAH.

  20. Role of S-adenosylhomocysteine in cardiovascular disease and its potential epigenetic mechanism.

    Science.gov (United States)

    Xiao, Yunjun; Su, Xuefen; Huang, Wei; Zhang, Jinzhou; Peng, Chaoqiong; Huang, Haixiong; Wu, Xiaomin; Huang, Haiyan; Xia, Min; Ling, Wenhua

    2015-10-01

    Transmethylation reactions utilize S-adenosylmethionine (SAM) as a methyl donor and are central to the regulation of many biological processes: more than fifty SAM-dependent methyltransferases methylate a broad spectrum of cellular compounds including DNA, histones, phospholipids and other small molecules. Common to all SAM-dependent transmethylation reactions is the release of the potent inhibitor S-adenosylhomocysteine (SAH) as a by-product. SAH is reversibly hydrolyzed to adenosine and homocysteine by SAH hydrolase. Hyperhomocysteinemia is an independent risk factor for cardiovascular disease. However, a major unanswered question is if homocysteine is causally involved in disease pathogenesis or simply a passive and indirect indicator of a more complex mechanism. A chronic elevation in homocysteine levels results in a parallel increase in intracellular or plasma SAH, which is a more sensitive biomarker of cardiovascular disease than homocysteine and suggests that SAH is a critical pathological factor in homocysteine-associated disorders. Previous reports indicate that supplementation with folate and B vitamins efficiently lowers homocysteine levels but not plasma SAH levels, which possibly explains the failure of homocysteine-lowering vitamins to reduce vascular events in several recent clinical intervention studies. Furthermore, more studies are focusing on the role and mechanisms of SAH in different chronic diseases related to hyperhomocysteinemia, such as cardiovascular disease, kidney disease, diabetes, and obesity. This review summarizes the current role of SAH in cardiovascular disease and its effect on several related risk factors. It also explores possible the mechanisms, such as epigenetics and oxidative stress, of SAH. This article is part of a Directed Issue entitled: Epigenetic dynamics in development and disease.

  1. The efficacy and safety of selective H1-antihistamine versus leukotriene receptor antagonist for seasonal allergic rhinitis: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Yu Xu

    Full Text Available Both selective H1-antihistamine (SAH and leukotriene receptor antagonist (LTRA have been shown to be effective in treating patients with seasonal allergic rhinitis (SAR, but it is still uncertain which treatment option is optimal. This meta-analysis was aimed to compare the efficacy and safety of SAH and LTRA for SAR.PubMed, EMBASE and the Cochrane Library were searched for all eligible studies that compared the efficacy and safety of SAH and LTRA for SAR up to September 7, 2014. The pooled mean difference (MD, odd ratios (ORs and 95% confidence intervals (95% CIs were calculated using a fixed- or random-effects model.Nine studies with 5781 SAR patients were included. The results showed that SAH is superior to LTRA in terms of the daytime eye symptoms score (DESS and composite symptoms score (CSS for SAR (MD = 0.06, 95% CI, 0.03 to 0.10, P = 0.000, I2 = 99%; MD = 0.03, 95% CI, 0.01 to 0.05, P = 0.010, I2 = 98%, whereas LTRA overmatched SAH with respect to the night-time symptoms score (NSS (MD = -0.04, 95% CI, -0.05 to -0.02, P = 0.000, I2 = 97%. Additionally, the results of subgroup analysis indicated that the dose, duration and gender of the patients might impact the comparisons of the effects of SAH and LTRA on their efficacy for SAR.This meta-analysis suggested that SAH and LTRA have similar effects and safety for SAR, but SAH is more appropriate for daytime nasal symptoms (congestion, rhinorrhea, pruritus and sneezing, while LTRA is better suited for nighttime symptoms (difficulty going to sleep, nighttime awakenings, and nasal congestion on awakening, respectively. Meanwhile, the dose, duration and gender of patients may influence the anti-SAR effects of SAH and LTRA.

  2. Immune and inflammatory gene signature in rat cerebrum in subarachnoid hemorrhage with microarray analysis.

    Science.gov (United States)

    Lee, Chu-I; Chou, An-Kuo; Lin, Ching-Chih; Chou, Chia-Hua; Loh, Joon-Khim; Lieu, Ann-Shung; Wang, Chih-Jen; Huang, Chi-Ying F; Howng, Shen-Long; Hong, Yi-Ren

    2012-01-01

    Cerebral vasospasm following subarachnoid hemorrhage (SAH) has been studied in terms of a contraction of the major cerebral arteries, but the effect of cerebrum tissue in SAH is not yet well understood. To gain insight into the biology of SAH-expressing cerebrum, we employed oligonucleotide microarrays to characterize the gene expression profiles of cerebrum tissue at the early stage of SAH. Functional gene expression in the cerebrum was analyzed 2 h following stage 1-hemorrhage in Sprague-Dawley rats. mRNA was investigated by performing microarray and quantitative real-time PCR analyses, and protein expression was determined by Western blot analysis. In this study, 18 upregulated and 18 downregulated genes displayed at least a 1.5-fold change. Five genes were verified by real-time PCR, including three upregulated genes [prostaglandin E synthase (PGES), CD14 antigen, and tissue inhibitor of metalloproteinase 1 (TIMP1)] as well as two downregulated genes [KRAB-zinc finger protein-2 (KZF-2) and γ-aminobutyric acid B receptor 1 (GABA B receptor)]. Notably, there were functional implications for the three upregulated genes involved in the inflammatory SAH process. However, the mechanisms leading to decreased KZF-2 and GABA B receptor expression in SAH have never been characterized. We conclude that oligonucleotide microarrays have the potential for use as a method to identify candidate genes associated with SAH and to provide novel investigational targets, including genes involved in the immune and inflammatory response. Furthermore, understanding the regulation of MMP9/TIMP1 during the early stages of SAH may elucidate the pathophysiological mechanisms in SAH rats.

  3. Activation of nuclear factor-κB in the brain after experimental subarachnoid hemorrhage and its potential role in delayed brain injury.

    Directory of Open Access Journals (Sweden)

    Wan-Chun You

    Full Text Available It has been reported that inflammation is involved in brain injury after subarachnoid hemorrhage (SAH. Nuclear factor-κB (NF-κB is a key transcriptional regulator of inflammatory genes. Here, we used pyrrolidine dithiocarbamate(PDTC, an inhibitor of NF-κB, through intracisternal injection to study the role of NF-κB in delayed brain injury after SAH. A total of 55 rabbits were randomly divided into five groups: the control group; the SAH groups including Day-3, 5, and 7 SAH groups (the rabbits in these groups were sacrificed at 3, 5, 7 days after SAH, respectively; and the PDTC group (n = 11 for each group. Electrophoretic mobility shift assay (EMSA was performed to detect NF-κB DNA-binding activity. The mRNA levels of tumor necrosis factor (TNF-α, interleukin (IL-1β, and intercellular adhesion molecule (ICAM-1 were evaluated by RT-PCR analysis. Deoxyribonucleic acid fragmentation was detected by TUNEL and p65 immunoactivity was assessed by immunohistochemistry. Our results showed the activation of NF-κB after SAH, especially at day 3 and 5. The activated p65 was detected in neurons. NF-κB DNA-binding activity was suppressed by intracisternal administration of PDTC. Increased levels of the TNF-α, IL-1β, and ICAM-1 mRNA were found in the brain at day 5 after SAH, and which were suppressed in the PDTC group. The number of TUNEL-positive cells also decreased significantly in the PDTC group compared with that in the Day-5 SAH group. These results demonstrated that the activated NF-κB in neurons after SAH plays an important role in regulating the expressions of inflammatory genes in the brain, and ultimately contributes to delayed brain injury.

  4. Soluble Toll-Like Receptors 2 and 4 in Cerebrospinal Fluid of Patients with Acute Hydrocephalus following Aneurysmal Subarachnoid Haemorrhage.

    Directory of Open Access Journals (Sweden)

    Bartosz Sokół

    Full Text Available Toll-like receptor (TLR signalling begins early in subarachnoid haemorrhage (SAH, and plays a key role in inflammation following cerebral aneurysm rupture. Available studies suggest significance of endogenous first-line blockers of a TLR pathway-soluble TLR2 and 4.Eighteen patients with SAH and acute hydrocephalus underwent endovascular coiling and ventriculostomy; sTLR2 and 4 levels were assayed in cerebrospinal fluid (CSF collected on post-SAH days 0-3, 5, and 10-12. Release kinetics were defined. CSF levels of sTLR2 and 4 were compared with a control group and correlated with the clinical status on admission, the findings on imaging, the degree of systemic inflammation and the outcome following treatment.None of study group showed detectable levels of sTLR2 and 4 on post-SAH day 0-3. 13 patients showed increased levels in subsequent samples. In five SAH patients sTLR2 and 4 levels remained undetectable; no distinctive features of this group were found. On post-SAH day 5 the strongest correlation was found between sTLR2 level and haemoglobin level on admission (cc = -0.498, P = 0.037. On post-SAH day 10-12 the strongest correlation was revealed between sTLR2 and treatment outcome (cc = -0.501, P = 0.076. Remaining correlations with treatment outcome, status at admission, imaging findings and inflammatory markers on post-SAH day 5 and 10-12 were negligible or low (-0.5 ≤ cc ≤ 0.5.In the majority of cases, rupture of a cerebral aneurysm leads to delayed release of soluble TLR forms into CSF. sTLR2 and 4 seem to have minor role in human post-SAH inflammation due to delayed release kinetics and low levels of these protein.

  5. Tamoxifen as an effective neuroprotectant against early brain injury and learning deficits induced by subarachnoid hemorrhage: possible involvement of inflammatory signaling.

    Science.gov (United States)

    Sun, Xuebo; Ji, Chengyuan; Hu, Tong; Wang, Zhong; Chen, Gang

    2013-12-28

    Tamoxifen, a selective estrogen receptor modulator, has successfully been used to treat several animal models of brain injury, but the underlying mechanisms remain unclear. This study was undertaken to evaluate the effect of tamoxifen on the toll-like receptor 4 (TLR4)- and nuclear factor-κB (NF-κB)-related inflammatory signaling pathway and secondary brain injury in rats after subarachnoid hemorrhage (SAH). Adult male Sprague-Dawley rats were divided into four groups: (1) control group (n = 28); (2) SAH group (n = 28); (3) SAH + vehicle group (n = 28); and (4) SAH + tamoxifen group (n = 28). All SAH animals were subjected to injection of autologous blood into the prechiasmatic cistern once on day 0. In SAH + tamoxifen group, tamoxifen was administered intraperitoneally at a dose of 5 mg/kg at 2 h, 12 h, and 36 h after SAH. In the first set of experiments, brain samples were extracted and evaluated at 48 h after SAH. In the second set of experiments, the Morris water maze was used to investigate cognitive and memory changes. We found that treatment with tamoxifen markedly inhibited the protein expressions of TLR4, NF-κB and the downstream inflammatory agents, such as interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and intercellular adhesion molecule-1 (ICAM-1). Administration of tamoxifen following SAH significantly ameliorated the early brain injury (EBI), such as brain edema, blood-brain barrier (BBB) impairment, and clinical behavior scale. Learning deficits induced by SAH were markedly alleviated after tamoxifen treatment. Post-SAH tamoxifen administration may attenuate TLR4/NF-kappaB-mediated inflammatory response in the rat brain and result in abatement of the development of EBI and cognitive dysfunction after SAH.

  6. Eesti Sisearhitektide Liit jagas parimatele aastapreemiaid / Tiina Kolk

    Index Scriptorium Estoniae

    Kolk, Tiina

    2006-01-01

    2005. a. publitsistikapreemia sai Leila Pärtelpoeg raamatu "Pööningul = Auf dem Dachboden" eest, näitusekujunduse preemia Malle Jürgenson, Krista Lepland ja Tea Tammelaan Eesti Maanteemuuseumi näituse "Tee ajalugu" eest, ajaloolise interjööri preemia Juta Lember ja Aulo Padar Rahvusooperi Estonia sisekujunduse eest, ühiskondliku interjööri preemia Katrin Kaevats ja Peeter Pere Pääsküla raamatukogu ruumikujunduse ja Meelis Press AS TTP ärihoone eest

  7. ESL aastapreemia 2005 žürii. ESL aastapreemia 2005 žürii koosoleku protokoll : 8. märts 2006 / Mari Kurismaa

    Index Scriptorium Estoniae

    Kurismaa, Mari, 1956-

    2006-01-01

    2005. a. publitsistikapreemia Leila Pärtelpojale raamatu "Pööningul. Auf dem Dachboden" eest, näitusekujunduse preemia ühendusele Laika, Belka &Strelka Eesti Maanteemuuseumi näituse "Tee ajalugu" eest, ajaloolise interjööri preemia Juta Lemberile Rahvusooper Estonia publikuruumide kujunduse eest, ühiskondliku interjööri preemia Katrin Kaevatsile ja Peeter Perele Pääsküla raamatukogu interjööri eest ning Meelis Pressile TTP ärihoone eest

  8. ‘Writing Now’

    OpenAIRE

    Chambers, Claire; Watkins, Susan

    2015-01-01

    This chapter considers the themes and forms that characterise women’s writing in the new millennium. Post-9/11, self-representation has become a particularly urgent task for Muslim writers such as Monica Ali and Leila Aboulela. A concern with refugees, asylum seekers, and modern forms of slavery becomes increasingly prominent, not only in fiction – for example, Fadia Faqir’s My Name is Salma (2007) and Monica Ali’s In the Kitchen (2009) – but also in the theatre: Kay Adshead’s The Bogus Woman...

  9. From Pain to Healing:Cure for Trauma in Bone by Fae Myenne Ng

    Institute of Scientific and Technical Information of China (English)

    YAO Wei

    2015-01-01

    Fae Myenne Ng, one of dominant writers in American literary circle currently, had been making her efforts in Bone for ten years. In Bone, Ng depicts the trauma Chinese-Americans suffered profoundly while trying to offer therapy to the trauma⁃tized. The narrator, Leila and her stepfather Leon come to terms with trauma by their own ways. What ’s more, Ng records her own life experience in a way to work through trauma and remains her own understanding about the solution to trauma.

  10. Effect of water regime on the growth, flower yield, essential oil and proline contents of Calendula officinalis

    Directory of Open Access Journals (Sweden)

    SAMI ALI METWALLY

    2013-11-01

    Full Text Available Metwally SA,Khalid KA, Abou-Leila BH. 2013. Effect of water regime on the growth, flower yield, essential oil and proline contents of Calendula officinalis. Nusantara Bioscience 5: 63-67. The effects of water regime on the growth, content of essential oil and proline of Calendula officinalis L. plants were investigated. Water regimes of 75% of field water capacity increased certain growth characters [i.e. plant height (cm, leaf area (cm2, flower diameter (cm and spike stem diameter] and vase life (day. Water regime promoted the accumulation of essential oil content and its main components as well as proline contents.

  11. Une temporalité de Tanger: histoire, mémoire et le temps postcolonial dans l'archive audiovisuelle

    NARCIS (Netherlands)

    Pisters, P.; Kaddouri, A.; van der Poel, I.

    2009-01-01

    Port et ville périphérique par excellence à la frontière de l’Europe et l’Afrique, Tanger est aujourd’hui plutôt connue pour ses immigrés clandestins, voulant traverser ce bras de mer qui les sépare de l’Europe. Le documentaire Tanger, le rêve des brûleurs (Leila Kilani, 2002) présente ce rêve d’imm

  12. Värvikas Riigikogu / Lylian Meister

    Index Scriptorium Estoniae

    Meister, Lylian, 1966-

    2007-01-01

    1920-1922 Herbert Johansoni ja Eugen Habermanni projekti järgi ehitatud Riigikogu hoonest. Saaliavade ja aknapõskede kujundamisel oli abiks Jaan Koort. 1935. a. rajati Alar Kotli projekti järgi lossi lõunatiib.Valge saal rekonstrueeriti 1936. a. Artur Perna ja Johann Ostrati kavandite järgi. Eesti taasiseseisvumise järel on hoonet Mart Kalmu, Leila Pärtelpoja, Mari ja Kaarel Kurismaa ning Ülar Saare juhendamisel renoveeritud. Riigikogu esimehe kabineti vaiba (1938) kavandas Adamson-Eric, kontorimööbli kujundasid 1997. a. EKA sisearhitektuuri üliõpilased L. Pärtelpoja juhendamisel. 23 ill

  13. Tagasi algusesse : Raekoja restaureerimise viis aastakümmet = Back to the Start : Five Decades of Restoration at the Town Hall / Teddy Böckler

    Index Scriptorium Estoniae

    Böckler, Teddy, 1930-2005

    2004-01-01

    1944. a. hävinud tornikiivri taastamisest. 1959. a. alanud raekoja arhitektuuri taastamisest. Kaaristu avati 1960. a. Interjööri taastamisest. 1971. a. alanud restaureerimisperioodist (sisekujundus: Leila Pärtelpoeg, Udo Umberg). 1991. a. alanud töödest: võlvkeldri taastamine, kohviku kujundamine. Tornikiivri ja tuulelipu Vana Toomas uuega asendamisest (1996). Lääneviilu tuulelipu uuendamisest (1999). 2000. a. alanud raekoja välispindade restaureerimisest, pööningu koristamisest. 2004. aastaks toimunud muudatustest interjööris

  14. Tagasi algusesse : Raekoja restaureerimise viis aastakümmet = Back to the Start : Five Decades of Restoration at the Town Hall / Teddy Böckler

    Index Scriptorium Estoniae

    Böckler, Teddy, 1930-2005

    2004-01-01

    1944. a. hävinud tornikiivri taastamisest. 1959. a. alanud raekoja arhitektuuri taastamisest. Kaaristu avati 1960. a. Interjööri taastamisest. 1971. a. alanud restaureerimisperioodist (sisekujundus: Leila Pärtelpoeg, Udo Umberg). 1991. a. alanud töödest: võlvkeldri taastamine, kohviku kujundamine. Tornikiivri ja tuulelipu Vana Toomas uuega asendamisest (1996). Lääneviilu tuulelipu uuendamisest (1999). 2000. a. alanud raekoja välispindade restaureerimisest, pööningu koristamisest. 2004. aastaks toimunud muudatustest interjööris

  15. Parimad 2009: maaülikool, Apollo, Baltika, Röa paviljon / Tanel Veenre

    Index Scriptorium Estoniae

    Veenre, Tanel, 1977-

    2010-01-01

    Eesti Sisearhitektide Liidu aastapreemiad. Ajaloolise interjööri preemia: Röa pargipaviljon - autor Leila Pärtelpoeg. Ühiskondliku interjööri preemia: Eesti Maaülikooli spordihoone - autorid Katrin Kaevats ja Jaan Port. Büroo preemia: Baltika büroohoone - autorid AB Studio 3, Kolm Pluss Üks. Kaupluse preemia: Apollo raamatupood Solarise keskuses - autorid Tüüne-Kristin ja Urmo Vaikla. Näitus "Eesti parimad interjöörid" Arhitektuuri- ja Disainigaleriis 30. maini 2010

  16. ESL aastapreemia 2005 žürii. ESL aastapreemia 2005 žürii koosoleku protokoll : 8. märts 2006 / Mari Kurismaa

    Index Scriptorium Estoniae

    Kurismaa, Mari, 1956-

    2006-01-01

    2005. a. publitsistikapreemia Leila Pärtelpojale raamatu "Pööningul. Auf dem Dachboden" eest, näitusekujunduse preemia ühendusele Laika, Belka &Strelka Eesti Maanteemuuseumi näituse "Tee ajalugu" eest, ajaloolise interjööri preemia Juta Lemberile Rahvusooper Estonia publikuruumide kujunduse eest, ühiskondliku interjööri preemia Katrin Kaevatsile ja Peeter Perele Pääsküla raamatukogu interjööri eest ning Meelis Pressile TTP ärihoone eest

  17. Ficciones diaspóricas: identidad y participación en los blogs de tres desterradas venezolanas / Diasporic Fictions: Identity and Participation in Three Blogs by Exiled Venezuelan Women

    Directory of Open Access Journals (Sweden)

    Raquel Rivas Rojas

    2014-01-01

    Full Text Available The narrative of exile plays now a significant role in contemporary Venezuelan literature. As diaspora spreads the notion of homeland has been modified and extended. Part of this discursive reconstruction appears in texts that point to a new type of narrative of identity in which different forms of attachment to the global community are produced. Studying texts from Mirtha Rivero, Liliana Lara and Leila Macor, this article explores the ways in which some Venezuelan female writers living abroad construct the experience of uprooting sharing their thoughts in blogs and web portals, reformulating inherited notions of belonging.

  18. Kolleegist parem / Andres Kurg

    Index Scriptorium Estoniae

    Kurg, Andres, 1975-

    2006-01-01

    Eesti Sisearhitektide Liidu aastapreemiad 2005: parima ühiskondliku interjööri preemia võitis Pääsküla raamatukogu (Katrin Kaevats, Urmas Muru, Peeter Pere), näitusekujunduse preemia sai Maanteemuuseum (Krista Lepland, Malle Jürgenson, Tea Tammelaan, OÜ Laika, Belka & Strelka), ajaloolise interjööri preemia läks renoveeritud Estonia teatrile (Juta Lember, Aulo Padar), publitsistikapreemia sai Leila Pärtelpoja raamat "Pööningul", teise ühiskondliku ruumi preemia võitis TTP ärihoone Pirital (Meelis Press). Kommentaar Tiina Jõgedalt

  19. Lethal subarachnoid bleeding under immunosuppressive therapy due to mycotic arteritis

    Energy Technology Data Exchange (ETDEWEB)

    Weigel, S.; Kloska, S.; Freund, M. [Dept. of Clinical Radiology, Univ. Hospital of Muenster, Muenster (Germany); Kehl, H.G. [Dept. of Pediatric Cardiology, Univ. Hospital of Muenster, Muenster (Germany)

    2003-12-01

    A subarachnoid haemorrhage (SAH) occurred 67 days after cardiac transplantation in 10-year-old girl with consecutive immunocompromising therapy. Neither digital subtraction angiography (DSA) nor computed tomographic angiography showed signs of intracranial vascular malformations. One month before the lethal SAH occurred, she had developed arterial hypertension and attacks of severe headache with cerebrospinal fluid (CSF) pleocytosis while CT scans showed an infarct of the left thalamus. Pathologic findings established the rare diagnosis of SAH due to aspergillosis-related mycotic arteritis. Imaging characteristics are presented. (orig.)

  20. ERK1/2 inhibition attenuates cerebral blood flow reduction and abolishes ET(B) and 5-HT(1B) receptor upregulation after subarachnoid hemorrhage in rat

    DEFF Research Database (Denmark)

    Beg, Saema A S; Hansen-Schwartz, Jacob A; Vikman, Petter J

    2006-01-01

    -regulated kinase (ERK1/2). In the present study, we hypothesized that inhibition of ERK1/2 alters the ET(B) and 5-HT(1B) receptor upregulation and at the same time prevents the sustained cerebral blood flow (CBF) reduction associated with SAH. The ERK1/2 inhibitor SB386023-b was injected intracisternally...... in conjunction with and after the induced SAH in rats. At 2 days after the SAH, cerebral arteries were harvested for quantitative real-time polymerase chain reaction, immunohistochemistry and analysis of contractile responses to endothelin-1 (ET-1; ET(A) and ET(B) receptor agonist) and 5-carboxamidotryptamine (5...

  1. Early events triggering delayed vasoconstrictor receptor upregulation and cerebral ischemia after subarachnoid hemorrhage

    DEFF Research Database (Denmark)

    Povlsen, Gro Klitgaard; Johansson, Sara Ellinor; Larsen, Carl Christian

    2013-01-01

    that the drop in cerebral blood flow (CBF) and wall tension experienced by cerebral arteries in acute SAH is a key triggering event. We here investigate the importance of the duration of this acute CBF drop in a rat SAH model in which a fixed amount of blood is injected into the prechiasmatic cistern either......Upregulation of vasoconstrictor receptors in cerebral arteries, including endothelin B (ETB) and 5-hydroxytryptamine 1B (5-HT(1B)) receptors, has been suggested to contribute to delayed cerebral ischemia, a feared complication after subarachnoid hemorrhage (SAH). This receptor upregulation has been...

  2. Social cognition impairments after aneurysmal subarachnoid haemorrhage: Associations with deficits in interpersonal behaviour, apathy, and impaired self-awareness.

    Science.gov (United States)

    Buunk, Anne M; Spikman, Jacoba M; Veenstra, Wencke S; van Laar, Peter Jan; Metzemaekers, Jan D M; van Dijk, J Marc C; Meiners, Linda C; Groen, Rob J M

    2017-08-01

    Behavioural disturbances are frequently found after aneurysmal subarachnoid haemorrhage (aSAH). Social cognition impairments have been suggested as a possible underlying mechanism for behavioural problems. Also, aSAH is likely to result in damage affecting frontal-subcortical circuits underlying social cognition. Therefore, we aimed to investigate social cognition after aSAH and its associations with behavioural problems (deficits in interpersonal behaviour, apathy, and impaired self-awareness) and focal as well as diffuse brain damage. 88 aSAH patients (in the subacute phase post-aSAH) and 60 age-, sex- and education-matched healthy controls participated. Tasks for emotion recognition, Theory of Mind (ToM), and empathy as well as questionnaires were used. Cortical infarctions in frontal and non-frontal areas on MRI, aneurysm circulation and aSAH-related events were taken into account. Compared to healthy controls, aSAH patients performed significantly worse on tasks for emotion recognition, ToM and empathy. Poor performance on ToM and emotion recognition was associated with proxy-ratings indicating impaired interpersonal behaviour and apathy and with indications of impaired self-awareness. No associations were found between deficits in social cognition and frontal or non-frontal cortical lesions on MRI. Also, aneurysm circulation and aSAH-related events such as hydrocephalus, vasospasm, and treatment method did not explain why and how social cognitive deficits did occur after aSAH. In conclusion, emotion recognition, ToM and empathy were clearly impaired in aSAH patients and these deficits were related to apathy and deficits in interpersonal behaviour as reported by proxies and to impaired self-awareness. This association strengthens the assumption of impaired social cognition as an underlying construct of behavioural problems after aSAH. Consequently, social cognition tests and proxy-ratings should be used in clinical practice, irrespective of lesion location on

  3. Late cerebral ischaemia after subarachnoid haemorrhage

    DEFF Research Database (Denmark)

    Edvinsson, L; Povlsen, G K

    2011-01-01

    the MEK-ERK1/2 pathway. Inhibition of MEK-ERK1/2 signalling has been shown to prevent cerebrovascular receptor upregulation and normalize CBF and neurological function after SAH in rats. At the same time, in rat SAH, certain cytokines and BBB-regulating proteins are upregulated in cerebral artery smooth...... muscles and treatment with MEK-ERK1/2 inhibitors prevents the induction of these proteins. Thus, inhibitors of MEK-ERK1/2 signalling exert multimodal beneficial effects in SAH....

  4. Relation between arterial hypertension and hearing loss

    Directory of Open Access Journals (Sweden)

    Mondelli, Maria Fernanda Capoani Garcia

    2009-03-01

    Full Text Available Objective: To verify the relationship between systemic arterial hypertension (SAH and hearing loss in middle-aged patient. Method: This study was carried out in the period from January to December 2007. The research was composed by 392 patients of both genders, aged from 45 to 60 years old. Anamnesis and threshold tonal audiometry data were analyzed. Results: There was a significant association between SAH and hearing loss. Conclusion: The results showed an evident association between SAH and hearing loss, which requires the disclosure of a preventive process.

  5. Drug treatment of cerebral vasospasm after subarachnoid hemorrhage following aneurysms

    Institute of Scientific and Technical Information of China (English)

    Yongfei Liu; HanCheng Qiu; Juan Su; WeiJian Jiang

    2016-01-01

    Cerebral vasospasm (CVS) is a common and severe complication of aneurysmal subarachnoid hemorrhage (aSAH). Despite the improvement in treatment of aSAH, CVS complicating aSAH has remained the main cause of death. CVS begins most often on the third day after the ictal event and reaches the maximum on the 5th–7th postictal days. Several therapeutic modalities have been employed to prevent or reverse CVS. The aim of this review is to summate all the available drug treatment modalities for vasospasm.

  6. Cerebral Salt-wasting Syndrome and Inappropriate Antidiuretic Hormone Syndrome after Subarachnoid Hemorrhaging.

    Science.gov (United States)

    Nakajima, Hanako; Okada, Hiroshi; Hirose, Kazuki; Murakami, Toru; Shiotsu, Yayoi; Kadono, Mayuko; Inoue, Mamoru; Hasegawa, Goji

    2017-01-01

    Hyponatremia is a common finding after subarachnoid hemorrhaging (SAH) and can be caused by either cerebral salt-wasting syndrome (CSWS) or syndrome of inappropriate antidiuretic hormone (SIADH). Distinguishing between these two entities can be difficult because they have similar manifestations, including hyponatremia, serum hypo-osmolality, and high urine osmolality. We herein report the case of a 60-year-old man who suffered from SAH complicated by hyponatremia. During his initial hospitalization, he was diagnosed with CSWS. He was readmitted one week later with hyponatremia and was diagnosed with SIADH. This is the first report of SAH causing CSWS followed by SIADH. These two different sources of hyponatremia require different treatments.

  7. Association of the NOS3 intron-4 VNTR polymorphism with aneurysmal subarachnoid hemorrhage

    DEFF Research Database (Denmark)

    Staalsø, Jonatan Myrup; Edsen, Troels; Kotinis, Alexandros;

    2014-01-01

    OBJECT: The nitric oxide system has been linked to the pathogenesis of aneurysmal subarachnoid hemorrhage (SAH). The authors performed a case-control study to investigate the association between SAH and common genetic variants within the endothelial nitric oxide synthase gene (NOS3). METHODS: Three......-VNTR. Haplotype analysis revealed that no single haplotype containing the b-allele was responsible for the observed genotype effect. CONCLUSIONS: The authors' results suggest that the NOS3 27-bp-VNTR b/b genotype independent of other risk factors act in concert with male sex to substantially increase risk of SAH....... This effect is not mediated by any single NOS3 haplotype....

  8. Síndrome metabólico y sus componentes en pacientes con síndrome de apnea-hipoapnea del sueño Metabolic syndrome and its components in patients with sleep apnea syndrome

    Directory of Open Access Journals (Sweden)

    M. Tumbeiro

    2011-12-01

    Full Text Available Fundamento. El síndrome de apnea-hipoapnea del sueño (SAHS es un factor de riesgo reconocido de patología cardiovascular y la evidencia reciente sugiere que está relacionado con el síndrome metabólico (SM. El objetivo del estudio fue conocer la prevalencia de los componentes individuales del SM y del SM como entidad, en pacientes con sospecha clínica de SAHS, y ver si ambas entidades están en relación con la obesidad central. Material y métodos. Se estudiaron prospectivamente a 486 pacientes consecutivos, 359 hombres (73,9%, con una edad media de 57,3 ± 13,5 años y un índice de masa corporal (IMC de 32,1 ± 6,5 kg/m² con sospecha clínica de SAHS. El SAHS se diagnosticó por registro nocturno. Un Indice de Apnea-Hipoapnea (IAH > 5 era considerado diagnóstico de SAHS. El SM era diagnosticado siguiendo los criterios de la International Diabetes Federation. Resultados. De los pacientes estudiados 325 (66,9% eran SAHS de grado moderado-grave. El IAH medio fue de 30,2 ± 23,8. De 456 pacientes (93,8% teníamos datos para el diagnóstico de SM y su prevalencia fue del 64,7% (295 pacientes. En el análisis multivariante, tanto la edad como el perímetro abdominal se comportaron como predictores de SAHS y de SM (pBackground. Sleep Apnea Syndrome (SAHS represents a significant risk factor for the development of cardiovascular disease and evidence suggests a relation with Metabolic Syndrome (MS. The aim of this study was to determine the prevalence of individual components of MS and of MS as an entity, in patients with clinical suspicion of SAHS, and their relation to central obesity. Methods. We examined the records of 486 consecutive patients, 359 (73.9% men, with a mean age of 57.3 ± 13.5 years and a mean body mass index (BMI of 32.1 ± 6.5 kg/m², with clinical suspicion of SAHS. SAHS was diagnosed from the nocturnal register. An Apnea-Hipopnea Index (AHI > 5 was considered SAHS. MS was evaluated according to the diagnostic criteria of

  9. Teaching Biology to the Visually Impaired: Accommodating Students' Special Needs.

    Science.gov (United States)

    Womble, Mark D.; Walker, Gary R.

    2001-01-01

    Describes how to teach a visually-oriented biology lecture and laboratory course to blind students. Using several techniques in the laboratory enabled a student to have a meaningful laboratory experience. (SAH)

  10. Subarachnoid hemorrhage associated with von Willebrand's disease--case report.

    Science.gov (United States)

    Nakau, Reiko; Nomura, Motohiro; Kida, Shinya; Yamashita, Junkoh; Kinoshita, Akira; Nitta, Hisashi; Muramatsu, Naoki

    2005-12-01

    A 59-year-old woman with type IIA von Willebrand's disease (VWD) presented with subarachnoid hemorrhage (SAH). Computed tomography showed SAH in the right sylvian fissure and intracranial hemorrhage in the right temporal lobe. Angiography demonstrated an aneurysm at the bifurcation of the right middle cerebral artery. Neck clipping was performed on the 3rd day after the onset with intra- and postoperative administration of factor VIII/von Willebrand factor concentrate. No excessive bleeding occurred. Patients with prolonged bleeding time should be screened for VWD before surgery. This is a rare case of VWD presenting with SAH secondary to ruptured intracranial aneurysm. The clinical characteristics and the management of SAH in a patient with VWD are discussed.

  11. Utility of ApneaLinkTM for the diagnosis of sleep apnea-hypopnea syndrome Utilidad del ApneaLinkT para el diagnóstico del síndrome apnea-hipopnea del sueño

    Directory of Open Access Journals (Sweden)

    Carlos A. Nigro

    2010-02-01

    Full Text Available Portable sleep studies may play an important role to take decisions on patients referred for suspicion of Sleep Apnea-Hypopnea Syndrome (SAHS. The aim of this study was to evaluate the diagnostic accuracy of automated analysis of ApneaLinkT in patients with suspicion of SAHS. All participants (75 performed the ApneaLink and polysomnography (PSG simultaneously in the sleep laboratory. The two recordings were interpreted blindly. The ApneaLink software calculated: (1 risk indicator (RI-a combination of apnea/hypopnea index (AHI plus inspiratory flow limitation events and (2 the AHI. ApneaLinkT and SAHS were defined in three ways: AHI or respiratory disturbance index (RDI = 5, 10 and 15 respectively. ROC curves analysis was performed. The sensitivity (S, specificity (E and positive and negative likelihood ratio (LR+, LR- for the different thresholds for RI or AHI were calculated; 66 patients were included (47 men, mean age 51, median RDI 10.6, mean BMI 29.3 kg/m². The best cut off points of RI were: SAHS = RDI = 5: RI > 9 (S 80%, E 100%, LR- 0.20; SAHS = RDI = 10: RI > 13 (S 92%, E 93%, LR+ 13.7 LR- 0.089; SAHS = RDI = 15 =: RI > 16 (S 93.5%, E 91%, LR+ 10.9, LR- 0.071. The AHI had a similar diagnostic accuracy to RI for the different definitions of SAHS. The RI and AHI obtained from automated analysis of ApneaLinkT were highly sensitive and specific to diagnose moderate to severe SAHS.Los equipos portátiles para estudios del sueño pueden tener un rol importante para tomar decisiones en pacientes con sospecha de Síndrome Apneas-Hipopneas del Sueño (SAHS. El objetivo del estudio fue evaluar la exactitud diagnóstica del análisis automático del ApneaLinkT en pacientes con sospecha de SAHS. Setenta y cinco sujetos realizaron simultáneamente el ApneaLinkT y una polisomnografía (PSG en el laboratorio de sueño. Los dos registros fueron interpretados en forma ciega. Un programa calculó: (1 el índice apnea/hipopnea (IAH, (2 el indicador de

  12. Types of Vasculitis

    Science.gov (United States)

    ... muscle weakness and paralysis (an inability to move). Kawasaki Disease Kawasaki (KAH-wah-SAH-ke) disease is a ... in the body, including arteries, veins, and capillaries. Kawasaki disease also is known as mucocutaneous (myu-ko-kyu- ...

  13. Meteorology Online.

    Science.gov (United States)

    Kahl, Jonathan D. W.

    2001-01-01

    Describes an activity to learn about meteorology and weather using the internet. Discusses the National Weather Service (NWS) internet site www.weather.gov. Students examine maximum and minimum daily temperatures, wind speed, and direction. (SAH)

  14. Sudden death and cervical spine: A new contribution to pathogenesis for sudden death in critical care unit from subarachnoid hemorrhage; first report – An experimental study

    Directory of Open Access Journals (Sweden)

    Hizir Kazdal

    2017-01-01

    Conclusion: We noticed interestingly that C6–C8 DRG degenerations were secondary to the vasospasm of ASA, following SAH. Cardiorespiratory disturbances or arrest can be explained with these mechanisms.

  15. The detection of sleep apnea in the awake patient. The 'saw-tooth' sign.

    Science.gov (United States)

    Sanders, M H; Martin, R J; Pennock, B E; Rogers, R M

    1981-06-19

    We studied 21 subjects, 13 of whom had the sleep apnea hypersomnolence syndrome associated with upper airway obstruction during sleep (SAHS-UAO) to determine if "saw-toothing" on the flow-volume loop was significantly associated with the phenomenon of airway occlusion during sleep. A "saw-tooth" pattern was present on the flow-volume loop in 11 of 13 subjects with SAHS-UAO. The presence of saw-toothing correlated with fluttering of tissue that was visualized in the upper airway via the fiberoptic bronchoscope. The specificity of the saw-tooth pattern for SAHS-UAO was 100%. Generalized obesity may indirectly influence the presence of saw-toothing due to deposition of what appeared to be adipose tissue in the pharyngeal walls. Although the number of subjects in this study is small, saw-toothing on the flow-volume loop appears to be an important aid in the diagnosis of SAHS-UAO.

  16. Science Technology Society Simulations: Engaging Students with Issues-based Scenarios.

    Science.gov (United States)

    Bodzin, Alec M.; Mamlok, Rachel

    2000-01-01

    Describes Science Technology and Society (STS) simulations that teach students about human experiences involving controversial issues. When students are taught using controversial and authentic issues, science instruction becomes current and engaging. (SAH)

  17. Low plasma arginine:asymmetric dimethyl arginine ratios predict mortality after intracranial aneurysm rupture

    DEFF Research Database (Denmark)

    Staalsø, Jonatan Myrup; Bergström, Anita; Edsen, Troels

    2013-01-01

    Asymmetrical dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthases, predicts mortality in cardiovascular disease and has been linked to cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH). In this prospective study, we assessed whether circulating ADMA, arginine...

  18. In Search of Explanatory Frameworks: An Analysis of Richard Feynman's Lecture "Atoms in Motion."

    Science.gov (United States)

    Treagust, David F.; Harrison, Allan G.

    2000-01-01

    Discusses the various aspects of explanations that make up an explanatory framework and the notion of pedagogical content knowledge. Analyzes an exemplary set of physics explanations to identify the individual and holistic characteristics of an effective explanation. (Author/SAH)

  19. Cardiac dysfunction after aneurysmal subarachnoid hemorrhage : Relationship with outcome

    NARCIS (Netherlands)

    van der Bilt, Ivo; Hasan, Djo; van den Brink, Renee; Cramer, Maarten-Jan; van der Jagt, Mathieu; van Kooten, Fop; Meertens, John; van den Berg, Maarten; Groen, Rob; ten Cate, Folkert; Kamp, Otto; Goette, Marco; Horn, Janneke; Groeneveld, Johan; Vandertop, Peter; Algra, Ale; Visser, Frans; Wilde, Arthur; Rinkel, Gabriel

    2014-01-01

    OBJECTIVE: To assess whether cardiac abnormalities after aneurysmal subarachnoid hemorrhage (aSAH) are associated with delayed cerebral ischemia (DCI) and clinical outcome, independent from known clinical risk factors for these outcomes. METHODS: In a prospective, multicenter cohort study, we

  20. Myocarditis in patients with subarachnoid hemorrhage : A histopathologic study

    NARCIS (Netherlands)

    van der Bilt, Ivo A C; Vendeville, Jean Paul; van de Hoef, Tim P.; Begieneman, Mark P V; Lagrand, Wim K.; Kros, Johan M.; Wilde, Arthur A M; Rinkel, Gabriel J E; Niessen, Hans W M

    Cardiac abnormalities after subarachnoid hemorrhage (SAH) such as electrocardiographic changes, echocardiographic wall motion abnormalities, and elevated troponin levels are independently associated with a poor prognosis. They are caused by catecholaminergic stress coinciding with influx of

  1. Evaluation of headache severity after aneurysmal subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Rachel Swope, PharmD, BCPS

    2014-12-01

    Conclusions: Headache after SAH is persistent and treatment refractory. There may be an association with development of vasospasm and worsening of headache. Novel treatment strategies to attenuate headache in this population are needed.

  2. Georg von Bekesy, Nobel Laureate in Physiology, Experimental Physicist and Art Collector Was Born 100 Years Ago.

    Science.gov (United States)

    Kovacs, Laszlo

    2001-01-01

    Describes the life and accomplishments of Georg von Bekesy. Discusses his educational background and research career, and describes his extensive work on the ear, particularly the inner ear or cochlea. (SAH)

  3. Prevalence of hypopituitarism after intracranial operations not directly associated with the pituitary gland

    National Research Council Canada - National Science Library

    Fleck, Steffen Kristian; Wallaschofski, Henri; Rosenstengel, Christian; Matthes, Marc; Kohlmann, Thomas; Nauck, Matthias; Schroeder, Henry Werner Siegfried; Spielhagen, Christin

    2013-01-01

    ...) and subarachnoid hemorrhage (SAH) has steadily increased. Moreover, recent studies have found that a clinically relevant number of patients develop pituitary insufficiency after intracranial operations and radiation treatment for non-pituitary tumors...

  4. Student Science Teachers' Accounts of a Well-Remembered Event about Classroom Management.

    Science.gov (United States)

    Zuckerman, June Trop

    2000-01-01

    Discusses how 36 student science teachers described and responded to one of their own classroom management problems. Based on student teachers' written accounts of a well-remembered event about classroom management. (SAH)

  5. Animal Watching: Outdoors and In.

    Science.gov (United States)

    McLure, John W.

    2001-01-01

    Describes using domesticated, wild, or feral animals to teach students about nature and animal behavior. Connections can be made with psychology, economics, genetics, history, art, and other disciplines. The study of animal behavior provides opportunities for harmless student experimentation. (SAH)

  6. Trends in socioeconomic inequalities in self-assessed health in 17 European countries between 1990 and 2010

    DEFF Research Database (Denmark)

    Hu, Yannan; van Lenthe, Frank J; Borsboom, Gerard J

    2016-01-01

    declining trends in the prevalence of less-than-good SAH in many countries, particularly in Southern and Eastern Europe and the Baltic states. In all countries, less-than-good SAH was more prevalent in lower educational and manual groups. For all countries together, absolute inequalities in SAH were mostly......, and there was generally no correspondence between the two when we compared the trends within countries. In order to develop policies or interventions that effectively reduce inequalities in SAH, a better understanding of the causes of these inequalities is needed.......BACKGROUND: Between the 1990s and 2000s, relative inequalities in all-cause mortality increased, whereas absolute inequalities decreased in many European countries. Whether similar trends can be observed for inequalities in other health outcomes is unknown. This paper aims to provide...

  7. EDITORIAL

    Directory of Open Access Journals (Sweden)

    Penyunting Penyunting

    2015-04-01

    Full Text Available Siyâsah yang  diserap  ke dalam Bahasa Indonesia secara utuh menjadi siasat, senyatanya telah mengalami penyempitan dan bahkan penyimpangan makna aslinya. Karena, kata siasat ini lebih dimaknai sebagai cara-cara praktis mencapai tujuan dan mengusung makna kelicikan. Padahal kata siyâsah yang berasal dari Bahasa Mongol sâsah dan diserap ke dalam Bahasa Persia (dan juga Bahasa Arab menjadi siyâsah memiliki makna undang-undang dan tatanan. Begitu juga kata politic yang berasal dari Bahasa Yunani politia dan juga polis yang bermakna kota sebagai lawan barbar juga mengalami penyempitan arti menjadi sekadar seni merebut kuasa. Politik telah menjadikan  dirinya sebagai mangsa kebiadaban. Itulah gambaran  kehidupan politik saat ini. Politik menjadi sekadar siasat licik meraih dan mempertahankan kekuasaan. Sungguh, bahasa adalah cermin jujur sebuah peradaban.

  8. The Silent Revolution Continues.

    Science.gov (United States)

    Perlin, John

    2001-01-01

    Discusses the reliability and versatility of using photovoltaics whereby solar cells convert sunlight directly into electricity. The growing concern of global warming promises to transform photovoltaics into a major energy producer. (Author/SAH)

  9. Foraging Behavior in Guppies: Do Size and Color of Prey Make a Difference?

    Science.gov (United States)

    Rop, Charles J.

    2001-01-01

    Describes an animal behavior experiment using guppies. Students observe the behavior of a guppy as it feeds on prey and make observations, collect and analyze data, draw conclusions, and design their own experiments. (SAH)

  10. Extracerebral Organ Dysfunction and Sleep Disorders in Subarachnoid Hemorrhage

    NARCIS (Netherlands)

    Schuiling, Wouter Jan

    2006-01-01

    Cardiac and pulmonary complications are common in subarachnoid hemorrhage (SAH), but also other extracerebral complications are frequently observed. This thesis focuses on the occurrence of extracerebral organ dysfunction and the additional value of markers of these medical complications in

  11. Extracerebral Organ Dysfunction and Sleep Disorders in Subarachnoid Hemorrhage

    NARCIS (Netherlands)

    Schuiling, Wouter Jan

    2006-01-01

    Cardiac and pulmonary complications are common in subarachnoid hemorrhage (SAH), but also other extracerebral complications are frequently observed. This thesis focuses on the occurrence of extracerebral organ dysfunction and the additional value of markers of these medical complications in prognost

  12. Early brain injury and subarachnoid hemorrhage: Where are we at present?

    Directory of Open Access Journals (Sweden)

    Tumul Chowdhury

    2013-01-01

    Full Text Available The current era has adopted many new innovations in nearly every aspect of management of subarachnoid hemorrhage (SAH; however, the neurological outcome has still not changed significantly. These major therapeutic advances mainly addressed the two most important sequels of the SAH-vasospasm and re-bleed. Thus, there is a possibility of some different pathophysiological mechanism that would be responsible for causing poor outcome in these patients. In this article, we have tried to compile the current role of this different yet potentially treatable pathophysiological mechanism in post-SAH patients. The main pathophysiological mechanism for the development of early brain injury (EBI is the apoptotic pathways. The macro-mechanism includes increased intracranial pressure, disruption of the blood-brain barrier, and finally global ischemia. Most of the treatment strategies are still in the experimental phase. Although the role of EBI following SAH is now well established, the treatment modalities for human patients are yet to be testified.

  13. Posterior spinal artery aneurysm rupture after 'Ecstasy' abuse.

    Science.gov (United States)

    Johnson, Jeremiah; Patel, Shnehal; Saraf-Lavi, Efrat; Aziz-Sultan, Mohammad Ali; Yavagal, Dileep R

    2015-07-01

    Posterior spinal artery (PSA) aneurysms are a rare cause of subarachnoid hemorrhage (SAH). The commonly abused street drug 3,4-methylenedioxymethamphetamine (MDMA) or 'Ecstasy' has been linked to both systemic and neurological complications. A teenager presented with neck stiffness, headaches and nausea after ingesting 'Ecstasy'. A brain CT was negative for SAH but a CT angiogram suggested cerebral vasculitis. A lumbar puncture showed SAH but a cerebral angiogram was negative. After a spinal MR angiogram identified abnormalities on the dorsal surface of the cervical spinal cord, a spinal angiogram demonstrated a left PSA 2 mm fusiform aneurysm. The patient underwent surgery and the aneurysmal portion of the PSA was excised without postoperative neurological sequelae. 'Ecstasy' can lead to neurovascular inflammation, intracranial hemorrhage, SAH and potentially even de novo aneurysm formation and subsequent rupture. PSA aneurysms may be treated by endovascular proximal vessel occlusion or open surgical excision.

  14. Consequences and coping strategies six years after a subarachnoid hemorrhage - A qualitative study

    National Research Council Canada - National Science Library

    Hanna C Persson; Karin Törnbom; Katharina S Sunnerhagen; Marie Törnbom

    2017-01-01

    .... There is a lack of knowledge regarding long-term consequences experienced. Purpose To explore experiences of the care and rehabilitation as well as the consequences and strategies used to cope with everyday life six years post SAH...

  15. Hemostasis and fibrinolysis in delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage : a systematic review

    NARCIS (Netherlands)

    Boluijt, Jacoline; Meijers, Joost C. M.; Rinkel, Gabriel J. E.; Vergouwen, Mervyn D. I.

    2015-01-01

    Delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) has been associated with microthrombosis, which can result from activated hemostasis, inhibited fibrinolysis, or both. We systematically searched the PUBMED and EMBASE databases to identify hemostatic or fibrinolytic par

  16. Sequence Classification: 512829 [

    Lifescience Database Archive (English)

    Full Text Available BLE BIFUNCTIONAL PROTEIN (MTA/SAH NUCLEOSIDASE) (P46): 5'-METHYLTHIOADENOSINE NUCLEOSIDASE AND S-ADENOSYLHOMOCYSTEINE NUCLEOSIDASE || http://www.ncbi.nlm.nih.gov/protein/17548091 ...

  17. Regulation of microRNAs miR-30a and miR-143 in cerebral vasculature after experimental subarachnoid hemorrhage in rats

    DEFF Research Database (Denmark)

    Müller, Anne Holt; Povlsen, Gro Klitgaard; Edvinsson, Lars;

    2015-01-01

    in cerebral arteries post-SAH. Two miRNAs, miR-30a and miR-143, were significantly upregulated in cerebral arteries after SAH when compared to sham-operated animals. However, none of these exhibited significantly altered serum levels after SAH versus post-sham surgery. The most robust upregulation was seen...... for miR-143, which has several predicted targets and is a strong regulator of vascular morphology. We hypothesize that miR-30a and miR-143 may play a role in the vascular wall changes seen after SAH. CONCLUSIONS: We report that miR-30a and miR-143 in the cerebral arteries show significant changes over...

  18. Familial aggregation of intracranial aneurysms in an Inuit patient population in Kalaallit Nunaat (Greenland)

    DEFF Research Database (Denmark)

    Lindgaard, Lars; Eskesen, Vagn; Gjerris, Flemming

    2003-01-01

    The incidence of subarachnoid hemorrhage (SAH) and intracranial aneurysm (IA) has been reported to be higher in Greenlandic Inuits than in Caucasian Danes, but the rate of familial aggregation in Inuits is unknown....

  19. Erythropoietin in patients with aneurysmal subarachnoid haemorrhage: a double blind randomised clinical trial

    DEFF Research Database (Denmark)

    Springborg, J B; Møller, C; Gideon, P;

    2007-01-01

    BACKGROUND: Erythropoietin (EPO) is neuroprotective in experimental models of stroke and subarachnoid haemorrhage (SAH) and possibly in patients with thromboembolic stroke. We studied the efficacy and safety of EPO in patients with SAH. METHODS: A larger scale clinical trial was planned but preli......BACKGROUND: Erythropoietin (EPO) is neuroprotective in experimental models of stroke and subarachnoid haemorrhage (SAH) and possibly in patients with thromboembolic stroke. We studied the efficacy and safety of EPO in patients with SAH. METHODS: A larger scale clinical trial was planned...... group but the difference was statistically insignificant. In the EPO-treated patients the CSF concentration of EPO increased 600-fold. Except for a higher extracelullar concentration of glycerol in the EPO group probably caused by the poorer clinical condition of these patients, there were...

  20. Observation of Autoregulation Indices During Ventricular CSF Drainage After Aneurysmal Subarachnoid Hemorrhage : A Pilot Study

    NARCIS (Netherlands)

    Aries, Marcel J. H.; de Jong, Sytse F.; van Dijk, J. Marc C.; Regtien, Joost; Depreitere, Bart; Czosnyka, Marek; Smielewski, Peter; Elting, Jan Willem J.

    2015-01-01

    Cerebral autoregulation is increasingly recognized as a factor that requires evaluation when managing poor grade aneurysmal subarachno SAH) patients. In this single center pilot study, we investigated whether intraventricular intracranial pressure (ICP) derived when

  1. Astrocyte Ca2+ Signaling Drives Inversion of Neurovascular Coupling after Subarachnoid Hemorrhage.

    Science.gov (United States)

    Pappas, Anthony C; Koide, Masayo; Wellman, George C

    2015-09-30

    Physiologically, neurovascular coupling (NVC) matches focal increases in neuronal activity with local arteriolar dilation. Astrocytes participate in NVC by sensing increased neurotransmission and releasing vasoactive agents (e.g., K(+)) from perivascular endfeet surrounding parenchymal arterioles. Previously, we demonstrated an increase in the amplitude of spontaneous Ca(2+) events in astrocyte endfeet and inversion of NVC from vasodilation to vasoconstriction in brain slices obtained from subarachnoid hemorrhage (SAH) model rats. However, the role of spontaneous astrocyte Ca(2+) signaling in determining the polarity of the NVC response remains unclear. Here, we used two-photon imaging of Fluo-4-loaded rat brain slices to determine whether altered endfoot Ca(2+) signaling underlies SAH-induced inversion of NVC. We report a time-dependent emergence of endfoot high-amplitude Ca(2+) signals (eHACSs) after SAH that were not observed in endfeet from unoperated animals. Furthermore, the percentage of endfeet with eHACSs varied with time and paralleled the development of inversion of NVC. Endfeet with eHACSs were present only around arterioles exhibiting inversion of NVC. Importantly, depletion of intracellular Ca(2+) stores using cyclopiazonic acid abolished SAH-induced eHACSs and restored arteriolar dilation in SAH brain slices to two mediators of NVC (a rise in endfoot Ca(2+) and elevation of extracellular K(+)). These data indicate a causal link between SAH-induced eHACSs and inversion of NVC. Ultrastructural examination using transmission electron microscopy indicated that a similar proportion of endfeet exhibiting eHACSs also exhibited asymmetrical enlargement. Our results demonstrate that subarachnoid blood causes a delayed increase in the amplitude of spontaneous intracellular Ca(2+) release events leading to inversion of NVC. Significance statement: Aneurysmal subarachnoid hemorrhage (SAH)--strokes involving cerebral aneurysm rupture and release of blood onto the

  2. Increasing numbers of nonaneurysmal subarachnoid hemorrhage in the last 15 years: antithrombotic medication as reason and prognostic factor?

    Science.gov (United States)

    Konczalla, Juergen; Kashefiolasl, Sepide; Brawanski, Nina; Senft, Christian; Seifert, Volker; Platz, Johannes

    2016-06-01

    OBJECT Subarachnoid hemorrhage (SAH) is usually caused by a ruptured intracranial aneurysm, but in some patients no source of hemorrhage can be detected. More recent data showed increasing numbers of cases of spontaneous nonaneurysmal SAH (NASAH). The aim of this study was to analyze factors, especially the use of antithrombotic medications such as systemic anticoagulation or antiplatelet agents (aCPs), influencing the increasing numbers of cases of NASAH and the clinical outcome. METHODS Between 1999 and 2013, 214 patients who were admitted to the authors' institution suffered from NASAH, 14% of all patients with SAH. Outcome was assessed according to the modified Rankin Scale (mRS) at 6 months. Risk factors were identified based on the outcome. RESULTS The number of patients with NASAH increased significantly in the last 15 years of the study period. There was a statistically significant increase in the rate of nonperimesencephalic (NPM)-SAH occurrence and aCP use, while the proportion of elderly patients remained stable. Favorable outcome (mRS 0-2) was achieved in 85% of cases, but patients treated with aCPs had a significantly higher risk for an unfavorable outcome. Further analysis showed that elderly patients, and especially the subgroup with a Fisher Grade 3 bleeding pattern, had a high risk for an unfavorable outcome, whereas the subgroup of NPM-SAH without a Fisher Grade 3 bleeding pattern had a favorable outcome, similar to perimesencephalic (PM)-SAH. CONCLUSIONS Over the years, a significant increase in the number of patients with NASAH has been observed. Also, the rate of aCP use has increased significantly. Risk factors for an unfavorable outcome were age > 65 years, Fisher Grade 3 bleeding pattern, and aCP use. Both "PM-SAH" and "NPM-SAH without a Fisher Grade 3 bleeding pattern" had excellent outcomes. Patients with NASAH and a Fisher Grade 3 bleeding pattern had a significantly higher risk for an unfavorable outcome and death. Therefore, for further

  3. Sex differences in intracranial arterial bifurcations

    DEFF Research Database (Denmark)

    Lindekleiv, Haakon M; Valen-Sendstad, Kristian; Morgan, Michael K;

    2010-01-01

    Subarachnoid hemorrhage (SAH) is a serious condition, occurring more frequently in females than in males. SAH is mainly caused by rupture of an intracranial aneurysm, which is formed by localized dilation of the intracranial arterial vessel wall, usually at the apex of the arterial bifurcation. T....... The female preponderance is usually explained by systemic factors (hormonal influences and intrinsic wall weakness); however, the uneven sex distribution of intracranial aneurysms suggests a possible physiologic factor-a local sex difference in the intracranial arteries....

  4. Pituitary dysfunction in survivors of spontaneous subarachnoid hemorrhage of anterior communicating artery and middle cerebral artery aneurysms: A comparative study

    Directory of Open Access Journals (Sweden)

    Pinaki Dutta

    2012-01-01

    Full Text Available Background: The data on incidence of hypopituitarism after SAH are conflicting. Furthermore, it is still not known whether there is any difference in hormonal deficiencies between SAH due to anterior communicating artery (A-com and middle cerebral artery (MCA aneurysms. Materials and Methods: This study includes both retrospective and prospective arms. The data collected included baseline demographic profile, clinical severity on admission to the hospital by the Hunt and Hess grading system and World Federation of Neurological Surgeons (WFNS grading, radiological severity of bleed by the Fisher′s classification, and treatment details. All the patients underwent detailed hormonal evaluation at baseline and 6 months in prospective group while at the end of 1 year in the retrospective group. Hormonal deficiencies between patients with A-com and MCA aneurysmal SAH were compared using appropriate statistical tests. Results: Of 60 patients studied, 47 patients (A-com: 28 and MCA: 19 were in the retrospective group, while 13 patients (A-com-9, MCA-4 were in the prospective group. The baseline data were comparable between the two groups. At or after 6 months follow-up, 19 (31.6% patients, 10 patients with A-com and 9 patients with MCA aneurysmal SAH, had some form of hormone deficiency. Furthermore, there was no difference in endocrine dysfunctions between the two groups. There was no correlation between the severity of hormonal deficiency and the clinical severity of SAH grade by Hunt and Hess and radiological grade of SAH by Fisher′s grade. Conclusion: Hormonal deficiencies are not uncommon in patients with SAH. There is no difference in hormonal deficiencies and severity of hypopituitarism in patients with SAH due to A-com and MCA bleed.

  5. Chronic hypopituitarism is uncommon in survivors of aneurysmal subarachnoid haemorrhage.

    Science.gov (United States)

    Hannon, M J; Behan, L A; O'Brien, M M; Tormey, W; Javadpour, M; Sherlock, M; Thompson, C J

    2015-01-01

    The incidence of hypopituitarism after aneurysmal subarachnoid haemorrhage (SAH) is unclear from the conflicting reports in the literature. As routine neuroendocrine screening for hypopituitarism for all patients would be costly and logistically difficult, there is a need for precise data on the frequency of hypopituitarism and on factors which might predict the later development of pituitary dysfunction. We aimed to: (i) Establish the incidence of long-term hypopituitarism in patients with aneurysmal SAH. (ii) Determine whether data from patients' acute admission with SAH could predict the occurrence of long-term hypopituitarism. One hundred patients were studied prospectively from the time of presentation with acute SAH. Plasma cortisol, plasma sodium and a variety of clinical and haemodynamic parameters were sequentially measured for the first 12 days of their acute admission. Forty-one patients then underwent dynamic pituitary testing at median 15 months following SAH (range 7-30 months), with insulin tolerance test (ITT) or, if contraindicated, a glucagon stimulation test (GST) plus short synacthen test (SST). If symptoms of cranial diabetes insipidus (CDI) were present, a water deprivation test was also performed. Forty-one patients attended for follow-up dynamic pituitary testing. Although 14 of 100 had acute glucocorticoid deficiency immediately following SAH, only two of 41 had long-term adrenocorticotrophic hormone (ACTH) deficiency and four of 41 had growth hormone (GH) deficiency. None were hypothyroid or gonadotrophin deficient. None had chronic CDI or hyponatraemia. There was no association between acute glucocorticoid deficiency, acute CDI or acute hyponatraemia and long-term pituitary dysfunction. Both anterior and posterior hypopituitarism are very uncommon following SAH and are not predicted by acute clinical, haemodynamic or endocrinological parameters. Routine neuroendocrine screening is not justified in SAH patients. © 2014 John Wiley & Sons

  6. Sensitivity of a Clinical Decision Rule and Early Computed Tomography in Aneurysmal Subarachnoid Hemorrhage

    Directory of Open Access Journals (Sweden)

    Dustin G. Mark

    2015-10-01

    Full Text Available Introduction: Application of a clinical decision rule for subarachnoid hemorrhage, in combination with cranial computed tomography (CT performed within six hours of ictus (early cranial CT, may be able to reasonably exclude a diagnosis of aneurysmal subarachnoid hemorrhage (aSAH. This study’s objective was to examine the sensitivity of both early cranial CT and a previously validated clinical decision rule among emergency department (ED patients with aSAH and a normal mental status. Methods: Patients were evaluated in the 21 EDs of an integrated health delivery system between January 2007 and June 2013. We identified by chart review a retrospective cohort of patients diagnosed with aSAH in the setting of a normal mental status and performance of early cranial CT. Variables comprising the SAH clinical decision rule (age >40, presence of neck pain or stiffness, headache onset with exertion, loss of consciousness at headache onset were abstracted from the chart and assessed for inter-rater reliability. Results: One hundred fifty-five patients with aSAH met study inclusion criteria. The sensitivity of early cranial CT was 95.5% (95% CI [90.9-98.2]. The sensitivity of the SAH clinical decision rule was also 95.5% (95% CI [90.9-98.2]. Since all false negative cases for each diagnostic modality were mutually independent, the combined use of both early cranial CT and the clinical decision rule improved sensitivity to 100% (95% CI [97.6-100.0]. Conclusion: Neither early cranial CT nor the SAH clinical decision rule demonstrated ideal sensitivity for aSAH in this retrospective cohort. However, the combination of both strategies might optimize sensitivity for this life-threatening disease.

  7. Cerebral Vasospasm in Traumatic Brain Injury

    OpenAIRE

    Kramer, Daniel R.; Winer, Jesse L.; B. A. Matthew Pease; Arun P. Amar; Mack, William J.

    2013-01-01

    Vasospasm following traumatic brain injury (TBI) may dramatically affect the neurological and functional recovery of a vulnerable patient population. While the reported incidence of traumatic vasospasm ranges from 19%–68%, the true incidence remains unknown due to variability in protocols for its detection. Only 3.9%–16.6% of patients exhibit clinical deficits. Compared to vasospasm resulting from aneurysmal SAH (aSAH), the onset occurs earlier and the duration is shorter. Overall, the clinic...

  8. [Arterial hypertension and sleep apnea hypopnea syndrome in primary care].

    Science.gov (United States)

    Bayó Llibre, J; Riel Cabrera, R; Mellado Breña, E; Filomena Paci, J; Priego Artero, M; García Alfaro, F J; Grau Granero, J M; Vázquez González, D; López Solana, J; Fernández San Martín, M I

    2015-01-01

    Sleep apnea hypopnea syndrome (SAHS) is frequent in hypertensive patients and plays a role in a greater incidence of cardiovascular morbidity-mortality. This study aims to know the clinical profile of hypertensive patients with SAHS compared to hypertensive patients without SAHS to know which variables should be used to orient their screening from primary care. An observational, descriptive, retrospective study of cases (hypertensive patients with SAHS) and controls (hypertensive patients without) was performed in an urban health care center. Based on a computerized registry of the site, patients diagnosed of SAHS and hypertension over 30 years of age were selected. For each case, one control case of hypertensive patients without SAHS paired by age and gender was randomly obtained. A total of 64 cases and 64 controls were selected. Standing out in the bivariate analysis were greater BMI (34.3±12.8 vs. 28.6±3.6), predominance of obesity (70.3 vs. 35.9%), metabolic syndrome (77.3 vs. 42.2%), consumption of psychopharmaceuticals (19.7 vs. 7.8%) and anithypertensive drugs (26.5 vs. 14.0%), ischemic heart disease (20.3 vs. 9.4%) in the case group versus control group (P<.05 for all the variables). The multivariate analysis showed that only the presence of metabolic syndrome was related with the presence of SAHS in hypertensive patients (OR 4.65; 95% CI: 2.03-10.64; P<.001). Screening for SAHS should be performed in hypertensive patients seen in primary care if they have metabolic syndrome criteria. Copyright © 2014 SEHLELHA. Published by Elsevier Espana. All rights reserved.

  9. Aneurysmal subarachnoid haemorrhage in pregnancy: a case series.

    Science.gov (United States)

    Guida, Maurizio; Maurizio, Guida; Altieri, Roberto; Roberto, Altieri; Palatucci, Valeria; Valeria, Palatucci; Visconti, Federica; Federica, Visconti; Pascale, Renato; Renato, Pascale; Marra, Marialuisa; Marialuisa, Marra; Locatelli, Giampiero; Giampiero, Locatelli; Saponiero, Renato; Renato, Saponiero; Tufano, Rosalba; Rosalba, Tufano; Bifulco, Francesca; Francesca, Bifulco; Piazza, Ornella

    2012-01-01

    Pregnancy is a recognized risk factor for aneurysmal subarachnoid hemorrhage (SAH). Headache is very frequent in normal pregnancy and it is a common sign shared between several intracranial diseases. We present a case series of 10 women in the third trimester of pregnancy admitted to our intensive care unit (ICU) with neurological signs and symptoms. 4 of these patients were diagnosed with SAH. Data in this study suggest that a timely diagnosis and an appropriate treatment is crucial for mother and baby.

  10. Aneurysmal subarachnoid haemorrhage in pregnancy: a case series

    OpenAIRE

    Guida, Maurizio; Altieri, Roberto; Palatucci, Valeria; Visconti, Federica; Pascale, Renato; Marra, Marialuisa; Locatelli, Giampiero; Saponiero, Renato; Tufano, Rosalba; Bifulco, Francesca; Piazza, Ornella

    2012-01-01

    Pregnancy is a recognized risk factor for aneurysmal subarachnoid hemorrhage (SAH). Headache is very frequent in normal pregnancy and it is a common sign shared between several intracranial diseases. We present a case series of 10 women in the third trimester of pregnancy admitted to our intensive care unit (ICU) with neurological signs and symptoms. 4 of these patients were diagnosed with SAH. Data in this study suggest that a timely diagnosis and an appropriate treatment is crucial for moth...

  11. Neuroprotective Roles of l-Cysteine in Attenuating Early Brain Injury and Improving Synaptic Density via the CBS/H2S Pathway Following Subarachnoid Hemorrhage in Rats.

    Science.gov (United States)

    Li, Tong; Wang, Lingxiao; Hu, Quan; Liu, Song; Bai, Xuemei; Xie, Yunkai; Zhang, Tiantian; Bo, Shishi; Gao, Xiangqian; Wu, Shuhua; Li, Gang; Wang, Zhen

    2017-01-01

    l-Cysteine is a semi-essential amino acid and substrate for cystathionine-β-synthase (CBS) in the central nervous system. We previously reported that NaHS, an H2S donor, significantly alleviated brain damage after subarachnoid hemorrhage (SAH) in rats. However, the potential therapeutic value of l-cysteine and the molecular mechanism supporting these beneficial effects have not been determined. This study was designed to investigate whether l-cysteine could attenuate early brain injury following SAH and improve synaptic function by releasing endogenous H2S. Male Wistar rats were subjected to SAH induced by cisterna magna blood injection, and l-cysteine was intracerebroventricularly administered 30 min after SAH induction. Treatment with l-cysteine stimulated CBS activity in the prefrontal cortex (PFC) and H2S production. Moreover, l-cysteine treatment significantly ameliorated brain edema, improved neurobehavioral function, and attenuated neuronal cell death in the PFC; these effects were associated with a decrease in the Bax/Bcl-2 ratio and the suppression of caspase-3 activation 48 h after SAH. Furthermore, l-cysteine treatment activated the CREB-brain-derived neurotrophic factor (BDNF) pathway and intensified synaptic density by regulating synapse proteins 48 h after SAH. Importantly, all the beneficial effects of l-cysteine in SAH were abrogated by amino-oxyacetic acid, a CBS inhibitor. Based on these findings, l-cysteine may play a neuroprotective role in SAH by inhibiting cell apoptosis, upregulating CREB-BDNF expression, and promoting synaptic structure via the CBS/H2S pathway.

  12. Neuroprotective Roles of l-Cysteine in Attenuating Early Brain Injury and Improving Synaptic Density via the CBS/H2S Pathway Following Subarachnoid Hemorrhage in Rats

    Directory of Open Access Journals (Sweden)

    Gang Li

    2017-05-01

    Full Text Available l-Cysteine is a semi-essential amino acid and substrate for cystathionine-β-synthase (CBS in the central nervous system. We previously reported that NaHS, an H2S donor, significantly alleviated brain damage after subarachnoid hemorrhage (SAH in rats. However, the potential therapeutic value of l-cysteine and the molecular mechanism supporting these beneficial effects have not been determined. This study was designed to investigate whether l-cysteine could attenuate early brain injury following SAH and improve synaptic function by releasing endogenous H2S. Male Wistar rats were subjected to SAH induced by cisterna magna blood injection, and l-cysteine was intracerebroventricularly administered 30 min after SAH induction. Treatment with l-cysteine stimulated CBS activity in the prefrontal cortex (PFC and H2S production. Moreover, l-cysteine treatment significantly ameliorated brain edema, improved neurobehavioral function, and attenuated neuronal cell death in the PFC; these effects were associated with a decrease in the Bax/Bcl-2 ratio and the suppression of caspase-3 activation 48 h after SAH. Furthermore, l-cysteine treatment activated the CREB–brain-derived neurotrophic factor (BDNF pathway and intensified synaptic density by regulating synapse proteins 48 h after SAH. Importantly, all the beneficial effects of l-cysteine in SAH were abrogated by amino-oxyacetic acid, a CBS inhibitor. Based on these findings, l-cysteine may play a neuroprotective role in SAH by inhibiting cell apoptosis, upregulating CREB–BDNF expression, and promoting synaptic structure via the CBS/H2S pathway.

  13. Cerebral Hemodynamic Changes Induced by a Lumbar Puncture in Good-Grade Subarachnoid Hemorrhage

    OpenAIRE

    Schmidt, Eric A.; Stein Silva; Jean François Albucher; Aymeric Luzi; Isabelle Loubinoux; Anne Christine Januel; Christophe Cognard; Pierre Payoux; François Chollet

    2012-01-01

    Background Patients with good-grade subarachnoid hemorrhage (SAH) are those without initial neurological deficit. However, they can die or present severe deficit due to secondary insult leading to brain ischemia. After SAH, in a known context of energy crisis, vasospasm, hydrocephalus and intracranial hypertension contribute to unfavorable outcome. Lumbar puncture (LP) is sometimes performed in an attempt to reduce intracranial pressure (ICP) and release headaches. We hypothesize that in good...

  14. Modification of -Adenosyl--Homocysteine as Inhibitor of Nonstructural Protein 5 Methyltransferase Dengue Virus Through Molecular Docking and Molecular Dynamics Simulation

    Directory of Open Access Journals (Sweden)

    Usman Sumo Friend Tambunan

    2017-04-01

    Full Text Available Dengue fever is still a major threat worldwide, approximately threatening two-fifths of the world’s population in tropical and subtropical countries. Nonstructural protein 5 (NS5 methyltransferase enzyme plays a vital role in the process of messenger RNA capping of dengue by transferring methyl groups from S -adenosyl- l -methionine to N7 atom of the guanine bases of RNA and the RNA ribose group of 2′OH, resulting in S -adenosyl- l -homocysteine (SAH. The modification of SAH compound was screened using molecular docking and molecular dynamics simulation, along with computational ADME-Tox (absorption, distribution, metabolism, excretion, and toxicity test. The 2 simulations were performed using Molecular Operating Environment (MOE 2008.10 software, whereas the ADME-Tox test was performed using various software. The modification of SAH compound was done using several functional groups that possess different polarities and properties, resulting in 3460 ligands to be docked. After conducting docking simulation, we earned 3 best ligands (SAH-M331, SAH-M2696, and SAH-M1356 based on ΔG binding and molecular interactions, which show better results than the standard ligands. Moreover, the results of molecular dynamics simulation show that the best ligands are still able to maintain the active site residue interaction with the binding site until the end of the simulation. After a series of molecular docking and molecular dynamics simulation were performed, we concluded that SAH-M1356 ligand is the most potential SAH-based compound to inhibit NS5 methyltransferase enzyme for treating dengue fever.

  15. Cerebrospinal fluid total protein cannot reliably distinguish true subarachnoid haemorrhage from other causes of raised cerebrospinal fluid net bilirubin and net oxyhaemoglobin absorbances.

    Science.gov (United States)

    Birch, Katherine; Burrows, Gillian; Cruickshank, Anne; Egner, William; Holbrook, Ian; Lewis, Emma; McNeilly, Jane; Patel, Dina; Worthington, Viki

    2014-11-01

    In cerebrospinal fluid (CSF) spectrophotometry, if the net bilirubin absorbance (NBA) and net oxyhaemoglobin absorbance (NOA) are both raised with a visible oxyhaemoglobin peak, the revised national guidelines for analysis of CSF bilirubin advise interpreting the results as 'Consistent with subarachnoid haemorrhage (SAH)' regardless of the CSF total protein concentration of the specimen. We wanted to study the range of CSF total protein concentrations found in confirmed SAH to establish if the CSF total protein value can give further guidance on the likelihood of SAH. Consecutive cases from five different hospital sites were included if the CSF NBA was greater than 0.007 AU and the NOA was greater than 0.02 AU with a visible oxyhaemoglobin peak. For the cases identified, the laboratory information management system and patient records were interrogated to identify the total protein concentration of the CSF specimen and whether SAH had ultimately been confirmed or excluded by other methods and supporting evidence. Results from 132 patients were included. The CSF total protein range in confirmed SAH was 0.23-3.08 g/L with a median concentration of 0.7 g/L (n = 51). In the SAH excluded group, the CSF total protein range was 0.43-29 g/L with a median concentration of 1.9 g/L (n = 81). Although confirmed SAH was not associated with the very highest concentrations of CSF total protein, a definite CSF protein cut-off concentration above which SAH could reliably be excluded cannot be recommended. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  16. Resveratrol Attenuates Acute Inflammatory Injury in Experimental Subarachnoid Hemorrhage in Rats via Inhibition of TLR4 Pathway.

    Science.gov (United States)

    Zhang, Xiang-Sheng; Li, Wei; Wu, Qi; Wu, Ling-Yun; Ye, Zhen-Nan; Liu, Jing-Peng; Zhuang, Zong; Zhou, Meng-Liang; Zhang, Xin; Hang, Chun-Hua

    2016-08-12

    Toll-like receptor 4 (TLR4) has been proven to play a critical role in neuroinflammation and to represent an important therapeutic target following subarachnoid hemorrhage (SAH). Resveratrol (RSV), a natural occurring polyphenolic compound, has a powerful anti-inflammatory property. However, the underlying molecular mechanisms of RSV in protecting against early brain injury (EBI) after SAH remain obscure. The purpose of this study was to investigate the effects of RSV on the TLR4-related inflammatory signaling pathway and EBI in rats after SAH. A prechiasmatic cistern SAH model was used in our experiment. The expressions of TLR4, high-mobility group box 1 (HMGB1), myeloid differentiation factor 88 (MyD88), and nuclear factor-κB (NF-κB) were evaluated by Western blot and immunohistochemistry. The expressions of Iba-1 and pro-inflammatory cytokines in brain cortex were determined by Western blot, immunofluorescence staining, or enzyme-linked immunosorbent assay. Neural apoptosis, brain edema, and neurological function were further evaluated to investigate the development of EBI. We found that post-SAH treatment with RSV could markedly inhibit the expressions of TLR4, HMGB1, MyD88, and NF-κB. Meanwhile, RSV significantly reduced microglia activation, as well as inflammatory cytokines leading to the amelioration of neural apoptosis, brain edema, and neurological behavior impairment at 24 h after SAH. However, RSV treatment failed to alleviate brain edema and neurological deficits at 72 h after SAH. These results indicated that RSV treatment could alleviate EBI after SAH, at least in part, via inhibition of TLR4-mediated inflammatory signaling pathway.

  17. 3D-CT angiography in high-grade aneurysmal subarachnoid hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Kikuchi, Kenji; Suda, Yoshitaka; Shioya, Hitoshi; Shindo, Kenjiro [Yuri Kumiai General Hospital, Honjo, Akita (Japan)

    1998-03-01

    We analyzed the role of 3D-CT angiography (3D-CTA) in the management of high-grade patients with severe subarachnoid hemorrhage (SAH) who were classified as Grade 5 by the Hunt-Kosnik grading system. From February 1995 to January 1997, 86 out of 92 patients with SAH were studied using 3D-CTA. There were 30 Grade 5 SAH patients (32.6%) including 5 patients who arrived in cardiopulmonary arrest (CPA). There were 13 men and 17 women, ranging in age from 46 to 89 years. Two-thirds were older than age 65 years. All patients underwent CT scan and were diagnosed with SAH. Excluding 5 CPA patients and one other patient, the remaining 24 patients successfully underwent 3D-CTA. As a result, ruptured aneurysms responsible for the SAH were clearly delineated in 19 patients (79.2%), and their anatomical relationships to the surrounding vessels were easily assessed. There were 8 patients with ICA aneurysms, 5 with MCA aneurysms, 2 with ACoA aneurysms, 2 with VA aneurysms, 1 with distal ACA aneurysm and 1 with distal PICA aneurysm. Intracranial vessels were not seen in 4 patients, 3 of whom had huge intracerebral hematomas associated with severe SAH. Proximal clipping was performed in a 46-years-old man with dissecting VA aneurysm. He later gained consciousness and became a surgical candidate. A 62-years-old woman underwent coil embolization for the large ICPC aneurysm after the level of her consciousness improved slightly following ventricular drainage. In conclusion, 3D-CTA can be performed safely and has a high detection rate of ruptured aneurysm even in patients with severe SAH. The results from these studies may gain further insight into epidemiology of SAH and ruptured aneurysms. (author)

  18. Ruptured Dissecting Aneurysm of the Middle Cerebral Artery with Spontaneous Resolution: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Ihn, Yon Kwon; Jung, Won Sang [Dept. of Radiology, St Vincent' s Hospital, The Catholic University of Korea College of Medicine, Suwon (Korea, Republic of)

    2011-11-15

    Dissecting aneurysms of the middle cerebral artery (MCA) are known to cause cerebral infarcts in younger people and can also cause subarachnoid hemorrhage (SAH) or intracranial hemorrhage. Bleeding caused by an isolated dissecting aneurysm of the MCA is relatively rare. We report the case of a young woman with SAH that occurred subsequent to a ruptured dissecting aneurysm of the MCA which resolved spontaneously as demonstrated by angiography.

  19. Sex differences in intracranial arterial bifurcations

    DEFF Research Database (Denmark)

    Lindekleiv, Haakon M; Valen-Sendstad, Kristian; Morgan, Michael K

    2010-01-01

    Subarachnoid hemorrhage (SAH) is a serious condition, occurring more frequently in females than in males. SAH is mainly caused by rupture of an intracranial aneurysm, which is formed by localized dilation of the intracranial arterial vessel wall, usually at the apex of the arterial bifurcation....... The female preponderance is usually explained by systemic factors (hormonal influences and intrinsic wall weakness); however, the uneven sex distribution of intracranial aneurysms suggests a possible physiologic factor-a local sex difference in the intracranial arteries....

  20. Trends in monitoring patients with aneurysmal subarachnoid haemorrhage

    DEFF Research Database (Denmark)

    Springborg, J B; Frederiksen, H-J; Eskesen, V

    2005-01-01

    After aneurysmal subarachnoid haemorrhage (SAH), the clinical outcome depends upon the primary haemorrhage and a number of secondary insults in the acute post-haemorrhagic period. Some secondary insults are potentially preventable but prevention requires prompt recognition of cerebral or systemic...... with the conventional monitoring systems, for example intracranial pressure measurements, transcranial Doppler ultrasound and modern neuro-imaging, direct assessment of biochemical markers by intracerebral microdialysis is promising in the advancement of neurointensive care of patients with SAH. A successfully...

  1. Predicting symptomatic cerebral vasospasm after aneurysmal subarachnoid hemorrhage with an artificial neural network in a pediatric population.

    Science.gov (United States)

    Skoch, Jesse; Tahir, Rizwan; Abruzzo, Todd; Taylor, John M; Zuccarello, Mario; Vadivelu, Sudhakar

    2017-08-29

    Artificial neural networks (ANN) are increasingly applied to complex medical problem solving algorithms because their outcome prediction performance is superior to existing multiple regression models. ANN can successfully identify symptomatic cerebral vasospasm (SCV) in adults presenting after aneurysmal subarachnoid hemorrhage (aSAH). Although SCV is unusual in children with aSAH, the clinical consequences are severe. Consequently, reliable tools to predict patients at greatest risk for SCV may have significant value. We applied ANN modeling to a consecutive cohort of pediatric aSAH cases to assess its ability to predict SCV. A retrospective chart review was conducted to identify patients < 21 years of age who presented with spontaneously ruptured, non-traumatic, non-mycotic, non-flow-related intracranial arterial aneurysms to our institution between January 2002 and January 2015. Demographics, clinical, radiographic, and outcome data were analyzed using an adapted ANN model using learned value nodes from the adult aneurysmal SAH dataset previously reported. The strength of the ANN prediction was measured between - 1 and 1 with - 1 representing no likelihood of SCV and 1 representing high likelihood of SCV. Sixteen patients met study inclusion criteria. The median age for aSAH patients was 15 years. Ten underwent surgical clipping and 6 underwent endovascular coiling for definitive treatment. One patient experienced SCV and 15 did not. The ANN applied here was able to accurately predict all 16 outcomes. The mean strength of prediction for those who did not exhibit SCV was - 0.86. The strength for the one patient who did exhibit SCV was 0.93. Adult-derived aneurysmal SAH value nodes can be applied to a simple AAN model to accurately predict SCV in children presenting with aSAH. Further work is needed to determine if ANN models can prospectively predict SCV in the pediatric aSAH population in toto; adapted to include mycotic, traumatic, and flow

  2. Elevated Serum S-Adenosylhomocysteine in Cobalamin Deficient Megaloblastic Anemia

    OpenAIRE

    Guerra-Shinohara, Elvira M.; Morita, Olga E.; Pagliusi,Regina A; Blaia-d’Avila, Vera L.; Allen, Robert H.; Stabler, Sally P.

    2007-01-01

    Impaired methylation due to accumulation of S-adenosylhomocysteine (SAH) may contribute to the pathophysiology of cobalamin deficient anemia. We assayed serum S-adenosylmethionine (SAM), SAH, total homocysteine (tHcy), and methylmalonic acid (MMA) in 15 subjects with cobalamin deficient megaloblastic anemia and compared results to 19 subjects with anemia/pancytopenia due to other causes. Cobalamin deficient subjects had a median hematocrit of 20% and mean cell volume of 111.7 fL. The median s...

  3. Voltage-dependent anion channels (VDACs) promote mitophagy to protect neuron from death in an early brain injury following a subarachnoid hemorrhage in rats.

    Science.gov (United States)

    Li, Jian; Lu, Jianfei; Mi, Yongjie; Shi, Zhao; Chen, Chunhua; Riley, John; Zhou, Changman

    2014-07-21

    The term mitophagy is coined to describe the selective removal of mitochondria by autophagy but the process itself is still contentious, especially in the early period following subarachnoid hemorrhage (SAH). In the present study, we investigated the role of mitophagy following 48h after SAH injury in rats. Specifically evaluating whether mitophagy, through voltage dependant anion channels (VDACs) interacting with microtubule-associated protein 1 light chain 3, could orchestrate the induction of apoptotic and necrotic cell death in neurons, a VDAC1siRNA and an activitor Rapamycian (RAPA), were engaged. One hundred and twelve male Sprague-Dawley rats were randomly divided into 4 groups: Sham, SAH, SAH+VDAC1siRNA, and SAH+RAPA. Outcomes measured included mortality rate, brain edema, BBB disruption, and neurobehavioral testing. We also used western blotting techniques to analyze the expressions of key mitophagic/autophagic proteins and pro-apoptotic protein such as ROS, VDAC1, LC-3II and Caspase-3. Rapamycin treatment significantly improved the mortality rate, cerebral edema, and neurobehavioral deficits; apoptotic and necrotic cell death in neurons were reduced by Rapamycin following SAH injury. However, VDAC1siRNA worsened the brain injury following SAH. Immunohistochemical staining and western blot analysis demonstrated a decreased expression of VDAC1, LC3II, and an increase of ROS and Caspase-3 followed by VDAC1siRNA administration. In conclusion, mitophagy induced by VDAC1 following SAH injury may in fact play a significant role in neuroprotection, the mechanism which may be through the attenuation of the apoptosic and necrosic molecular pathways. This translates a preservation of functional integrity and an improvement in mortality.

  4. Intracranial Aneurysm with Systemic Lupus Erythematosus Treated by Endovascular Intervention

    Directory of Open Access Journals (Sweden)

    P Shrestha

    2010-03-01

    Full Text Available Systemic lupus erythematosus (SLE is a chronic disease with multiple pathologies that can affect every organ system of the body including central nervous system. Intracerebral aneurysms and subarachnoid hemorrhage (SAH are one of comparatively rarer manifestations of central nervous system SLE. Here we present a case of known SLE complicated by the rupture of intra cerebral aneurysm at basilar artery tip which was successfully treated with endovascular coiling. Keywords: cerebral aneurysm, endovascular surgery, SAH, SLE

  5. A multicenter prospective cohort study of volume management after subarachnoid hemorrhage: circulatory characteristics of pulmonary edema after subarachnoid hemorrhage.

    Science.gov (United States)

    Obata, Yoshiki; Takeda, Junichi; Sato, Yohei; Ishikura, Hiroyasu; Matsui, Toru; Isotani, Eiji

    2016-08-01

    OBJECT Subarachnoid hemorrhage (SAH) is often accompanied by pulmonary complications, which may lead to poor outcomes and death. This study investigated the incidence and cause of pulmonary edema in patients with SAH by using hemodynamic monitoring with PiCCO-plus pulse contour analysis. METHODS A total of 204 patients with SAH were included in a multicenter prospective cohort study to investigate hemodynamic changes after surgical clipping or coil embolization of ruptured cerebral aneurysms by using a PiCCO-plus device. Changes in various hemodynamic parameters after SAH were analyzed statistically. RESULTS Fifty-two patients (25.5%) developed pulmonary edema. Patients with pulmonary edema (PE group) were significantly older than those without pulmonary edema (non-PE group) (p = 0.017). The mean extravascular lung water index was significantly higher in the PE group than in the non-PE group throughout the study period. The pulmonary vascular permeability index (PVPI) was significantly higher in the PE group than in the non-PE group on Day 6 (p = 0.029) and Day 10 (p = 0.011). The cardiac index of the PE group was significantly decreased biphasically on Days 2 and 10 compared with that of the non-PE group. In the early phase (Days 1-5 after SAH), the daily water balance of the PE group was slightly positive. In the delayed phase (Days 6-14 after SAH), the serum C-reactive protein level and the global end-diastolic volume index were significantly higher in the PE group than in the non-PE group, whereas the PVPI tended to be higher in the PE group. CONCLUSIONS Pulmonary edema that occurs in the early and delayed phases after SAH is caused by cardiac failure and inflammatory (i.e., noncardiogenic) conditions, respectively. Measurement of the extravascular lung water index, cardiac index, and PVPI by PiCCO-plus monitoring is useful for identifying pulmonary edema in patients with SAH.

  6. The Role of ABO Blood Group in Cerebral Vasospasm, Associated Intracranial Hemorrhage, and Delayed Cerebral Ischemia in 470 Patients with Subarachnoid Hemorrhage.

    Science.gov (United States)

    Dubinski, Daniel; Won, Sae-Yeon; Konczalla, Jürgen; Mersmann, Jan; Geisen, Christof; Herrmann, Eva; Seifert, Volker; Senft, Christian

    2017-01-01

    Rupture of an intracranial aneurysm usually presents with an acute onset and requires multidisciplinary intensive care treatment and the overall death and disability rates are high. The ABO blood type is known to play an important role in hemostasis, thrombosis, and vascular NO response. The aspect of ABO blood type in onset, clinical progress, and outcome after subarachnoid hemorrhage (SAH) is largely unexplored. We conducted this study to elucidate the association of ABO blood type with the occurrence and outcome of aneurysmal SAH. In our retrospective study, 470 patients with aneurysmal SAH treated at our institution were included. We performed a χ(2) test for comparison between blood types and World Federation of Neurosurgical Societies admission status, cerebral vasospasm, delayed infarction, associated intracerebral hemorrhage and Fisher grade for analysis for their association with SAH. No significant difference between blood type and the reviewed variables for SAH outcome were identified: World Federation of Neurosurgical Societies admission status (odds ratio, 1.12; 95% confidence interval [CI], 0.7-1.6; P = 0.56); SAH-associated intracerebral hemorrhage (odds ratio, 0.81; 95% CI, 0.5-1.3; P = 0.36); cerebral vasospasm (odds ratio, 1.08; 95% CI, 0.7-1.6; P = 0.71); DCI (odds ratio, 1.23; 95% CI, 0.8-1.8; P = 0.30); Fisher grade (odds ratio, 1.13; 95% CI, 0.7-1.6; P = 0.19). Although a possible relationship between the ABO blood group and the clinical course of patients with SAH was hypothesized, our study showed no significant influence of patient's ABO blood type on cerebral vasospasm onset, SAH-associated intracerebral hemorrhage, or delayed infarction. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Quantitation of S-Adenosylmethionine and S-Adenosylhomocysteine in Plasma Using Liquid Chromatography-Electrospray Tandem Mass Spectrometry.

    Science.gov (United States)

    Arning, Erland; Bottiglieri, Teodoro

    2016-01-01

    We describe a simple stable isotope dilution method for accurate determination of S-adenosylmethionine (SAM) and S-adenosylhomocysteine (SAH) in plasma as a diagnostic test. SAM and SAH are key metabolic intermediates of methionine metabolism and the methylation cycle. Determination of SAM and SAH in plasma was performed by high performance liquid chromatography coupled with electrospray positive ionization tandem mass spectrometry (HPLC-ESI-MS/MS). Calibrators (SAM and SAH) and internal standards ((2)H3-SAM and (2)H4-SAH) were included in each analytical run for calibration. Sample preparation involved combining 20 μL sample with 180 μL of internal standard solution consisting of heavy isotope labeled internal standards in mobile phase A and filtering by ultracentrifugation through a 10 kd MW cutoff membrane. Sample filtrate (3 μL) was injected by a Shimadzu Nexera LC System interfaced with a 5500 QTRAP(®) (AB Sciex). Chromatographic separation was achieved on a 250 mm × 2.0 mm EA:faast column from Phenomenex. Samples were eluted at a flow rate of 0.20 mL/min with a binary gradient with a total run time of 10 min. The source operated in positive ion mode at an ion spray voltage of +5000 V. SAM and SAH resolved by a gradient to 100 % methanol with retention times of 6.0 and 5.7 min, respectively. The observed m/z values of the fragment ions were m/z 399 → 250 for SAM, m/z 385 → 136 for SAH, m/z 402 → 250 for (2)H3-SAM, m/z 203 → 46. The calibration curve was linear over the ranges of 12.5-5000 nmol/L for SAM and SAH.

  8. A model of subarachnoid hemorrhage in rats

    Institute of Scientific and Technical Information of China (English)

    Liao-liaoLI; Xiao-liangWANG

    2004-01-01

    AIM: To build a simple and repeatable animal model of subarachnoid hemorrhage (SAH). METHODS: SAH was introduced by passing a nylon thread up through the right internal carotid artery and piercing a hone in the right anterior cerebral artery. At 12 and 24 h, the rats were evaluated with rotarod test and the behavior scale (5-point scale). RESULTS: The ratswere trained through rotarod test and then randomly divided into

  9. Resveratrol Attenuates Acute Inflammatory Injury in Experimental Subarachnoid Hemorrhage in Rats via Inhibition of TLR4 Pathway

    Directory of Open Access Journals (Sweden)

    Xiang-Sheng Zhang

    2016-08-01

    Full Text Available Toll-like receptor 4 (TLR4 has been proven to play a critical role in neuroinflammation and to represent an important therapeutic target following subarachnoid hemorrhage (SAH. Resveratrol (RSV, a natural occurring polyphenolic compound, has a powerful anti-inflammatory property. However, the underlying molecular mechanisms of RSV in protecting against early brain injury (EBI after SAH remain obscure. The purpose of this study was to investigate the effects of RSV on the TLR4-related inflammatory signaling pathway and EBI in rats after SAH. A prechiasmatic cistern SAH model was used in our experiment. The expressions of TLR4, high-mobility group box 1 (HMGB1, myeloid differentiation factor 88 (MyD88, and nuclear factor-κB (NF-κB were evaluated by Western blot and immunohistochemistry. The expressions of Iba-1 and pro-inflammatory cytokines in brain cortex were determined by Western blot, immunofluorescence staining, or enzyme-linked immunosorbent assay. Neural apoptosis, brain edema, and neurological function were further evaluated to investigate the development of EBI. We found that post-SAH treatment with RSV could markedly inhibit the expressions of TLR4, HMGB1, MyD88, and NF-κB. Meanwhile, RSV significantly reduced microglia activation, as well as inflammatory cytokines leading to the amelioration of neural apoptosis, brain edema, and neurological behavior impairment at 24 h after SAH. However, RSV treatment failed to alleviate brain edema and neurological deficits at 72 h after SAH. These results indicated that RSV treatment could alleviate EBI after SAH, at least in part, via inhibition of TLR4-mediated inflammatory signaling pathway.

  10. [Systemic arterial hypertension in México. A consensus to mitigate its comorbidities].

    Science.gov (United States)

    Pérez-Rodríguez, Gilberto

    2016-01-01

    Given that systemic arterial hypertension (SAH) is the most common illness presented by the adults who come to primary care in México, in this supplement a group of cardiologists, as well as other specialists, from the Instituto Mexicano del Seguro Social (IMSS) offer a systematic review, a critical analysis, and a national consensus of guidelines as a frame of reference to the daily clinical practice in order to mitigate SAH in México.

  11. Case–control association study of polymorphisms in the angiotensinogen and angiotensin-converting enzyme genes and coronary artery disease and systemic artery hypertension in African-Brazilians and Caucasian-Brazilians

    Indian Academy of Sciences (India)

    Ricardo Bonfim-Silva; Larissa Oliveira Guimarães; Jandson Souza Santos; Jaqueline Fagundes Pereira; Ana Angélica Leal Barbosa; Domingos Lazaro Souza Rios

    2016-03-01

    The rennin–angiotensin–aldosterone system (RAAS) is a critical pathway in regulating blood pressure and salt/water homeostasis, possessing an intimate relationship with the development of systemic artery hypertension (SAH). Once hypertension is considered a risk factor for coronary artery disease (CAD), the RAAS is also related to this pathology. This investigation aimed to analyse if the frequencies of AGT M235T (rs699) and ACE I/D (rs4646994) polymorphisms are associated with CAD and SAH in African-Brazilians and Caucasian-Brazilians. In this study we analysed 714 subjects who underwent coronary angiography to detect obstructive lesions and CAD, as well as blood pressure measurement and SAH, grouped according to ethnicity: 266 African-Brazilians and 448 Caucasian-Brazilians. Among CAD and SAH cases and controls, the genotype and allele frequencies of ACE I/D polymorphism were similar in both ethnic groups. The AGT 235TT genotype and 235T allele frequencies were higher in SAH cases (32%, 54.7%) versus controls in Caucasian-Brazilians (19.8%, 46.4%; = 0.038, = 0.031, respectively). The AGT 235TT (OR = 1.8; = 0.028) demonstrated to be an independent factor risk in a multivariate logistic regression increasing SAH risk in Caucasians but not in African-Brazilians. In summary, AGT M235T polymorphism was associated with SAH risk in Caucasian-Brazilians, and no association was detected with CAD. No association was also observed in ACE I/D polymorphism either in CAD or SAH in African-Brazilians and Caucasian-Brazilians.

  12. Functionalized graphene oxide as a drug carrier for loading pirfenidone in treatment of subarachnoid hemorrhage.

    Science.gov (United States)

    Yang, Lijun; Wang, Feng; Han, Haie; Yang, Liang; Zhang, Gengshen; Fan, Zhenzeng

    2015-05-01

    Subarachnoid hemorrhage (SAH) is a life-threatening disease that causes high morbidity and mortality. Pirfenidone is a SAH drug that prevents secondary bleeding and cerebral infarction. To improve its therapeutic efficacy, this study aimed to employ a functionalized graphene oxide nanosheet (FGO) as a drug carrier loading pirfenidone to treat SAH. The graphene oxide nanosheet was introduced with transcription activator peptide (Tat), followed by functionalization with methoxy polyethylene glycol (mPEG) and loading with pirfenidone. The pirfenidone-loaded FGO (pirfenidone-FGO) exhibits better treatment efficacy than the single pirfenidone due to more effective loading and controlled release of the drug in tissue. The introduction of Tat and mPEG onto GO nanosheet contributes to the ability to cross the blood-brain barrier and the stability in blood circulation of the drug. At lower pH values, the highly efficient release of the drug from the pirfenidone-FGO exerts effective treatment to acidic inflammatory lesion after severe SAH. Besides its treatment function, FGO is also shown as a strong near infrared absorbing material which can be applied in photoacoustic imaging, allowing rapid real-time monitoring with deep resolution of brain tissues after SAH. The treatment efficacy of pirfenidone-FGO for central nervous system injuries is further demonstrated by hematoxylin and eosin staining of coronal brain slices, as well as measurements of brain water content and blood-brain barrier permeability. Our study supports the potential of FGO in clinical application in treatment of SAH.

  13. Midsagittal jaw movement analysis for the scoring of sleep apneas and hypopneas.

    Science.gov (United States)

    Senny, Frédéric; Destiné, Jacques; Poirrier, Robert

    2008-01-01

    Given the importance of the detection and classification of sleep apneas and hypopneas (SAHs) in the diagnosis and the characterization of the SAH syndrome, there is a need for a reliable noninvasive technique measuring respiratory effort. This paper proposes a new method for the scoring of SAHs based on the recording of the midsagittal jaw motion (MJM, mouth opening) and on a dedicated automatic analysis of this signal. Continuous wavelet transform is used to quantize respiratory effort from the jaw motion, to detect salient mandibular movements related to SAHs and to delineate events which are likely to contain the respiratory events. The classification of the delimited events is performed using multilayer perceptrons which were trained and tested on sleep data from 34 recordings. Compared with SAHs scored manually by an expert, the sensitivity and specificity of the detection were 86.1% and 87.4%, respectively. Moreover, the overall classification agreement in the recognition of obstructive, central, and mixed respiratory events between the manual and automatic scorings was 73.1%. The MJM signal is hence a reliable marker of respiratory effort and allows an accurate detection and classification of SAHs.

  14. Myocarditis in patients with subarachnoid hemorrhage: A histopathologic study.

    Science.gov (United States)

    van der Bilt, Ivo A C; Vendeville, Jean-Paul; van de Hoef, Tim P; Begieneman, Mark P V; Lagrand, Wim K; Kros, Johan M; Wilde, Arthur A M; Rinkel, Gabriel J E; Niessen, Hans W M

    2016-04-01

    Cardiac abnormalities after subarachnoid hemorrhage (SAH) such as electrocardiographic changes, echocardiographic wall motion abnormalities, and elevated troponin levels are independently associated with a poor prognosis. They are caused by catecholaminergic stress coinciding with influx of inflammatory cells into the heart. These abnormalities could be a sign of a myocarditis, potentially giving insight in pathophysiology and treatment options. These inflammatory cells are insufficiently characterized, and it is unknown whether myocarditis is associated with SAH. Myocardium of 25 patients who died of SAH and 18 controls was stained with antibodies identifying macrophages (CD68), lymphocytes (CD45), and neutrophil granulocytes (myeloperoxidase). Myocytolysis was visualized using complement staining (C3d). CD31 was used to identify putative thrombi. We used Mann-Whitney U testing for analysis. In the myocardium of SAH patients, the amount of myeloperoxidase-positive (P Myocarditis, consisting of an influx of neutrophil granulocytes, lymphocytes, and macrophages, coinciding with myocytolysis and thrombi in intramyocardial arteries, occurs in patients with SAH but not in controls. These findings might explain the cardiac abnormalities after SAH and may have implications for treatment.

  15. Norepinephrine as a Potential Aggravator of Symptomatic Cerebral Vasospasm: Two Cases and Argument for Milrinone Therapy

    Directory of Open Access Journals (Sweden)

    F. A. Zeiler

    2014-01-01

    Full Text Available Background. During hypertensive therapy for post-subarachnoid hemorrhage (SAH symptomatic vasospasm, norepinephrine is commonly used to reach target blood pressures. Concerns over aggravation of vasospasm with norepinephrine exist. Objective. To describe norepinephrine temporally related deterioration in neurological examination of two post-SAH patients in vasospasm. Methods. We retrospectively reviewed two charts of patients with delayed cerebral ischemia (DCI post-SAH who deteriorated with norepinephrine infusions. Results. We identified two patients with DCI post-SAH who deteriorated during hypertensive therapy with norepinephrine. The first, a 43-year-old male presented to hospital with DCI, failed MABP directed therapy with rapid deterioration in exam with high dose norepinephrine and MABP of 140–150 mm Hg. His exam improved on continuous milrinone and discontinuation of norepinephrine. The second, a 39-year-old female who developed DCI on postbleed day 8 responded to milrinone therapy upfront. During further deterioration and after angioplasty, norepinephrine was utilized to drive MABP to 130–140 mm Hg. Progressive deterioration in examination occurred after angioplasty as norepinephrine doses escalated. After discontinuation of norepinephrine and continuation of milrinone, function dramatically returned but not to baseline. Conclusions. The potential exists for worsening of DCI post-SAH with hypertensive therapy directed by norepinephrine. A potential role exists for vasodilation and inotropic directed therapy with milrinone in the setting of DCI post-SAH.

  16. Nrf2/HO-1 mediates the neuroprotective effect of mangiferin on early brain injury after subarachnoid hemorrhage by attenuating mitochondria-related apoptosis and neuroinflammation.

    Science.gov (United States)

    Wang, Zefeng; Guo, Songxue; Wang, Junxing; Shen, Yuanyuan; Zhang, Jianmin; Wu, Qun

    2017-09-19

    Early brain injury (EBI) is involved in the process of cerebral tissue damage caused by subarachnoid hemorrhage (SAH), and multiple mechanisms, such as apoptosis and inflammation, participate in its development. Mangiferin (MF), a natural C-glucoside xanthone, has been reported to exert beneficial effects against several types of organ injury by influencing various biological progresses. The current study aimed to investigate the potential of MF to protect against EBI following SAH via histological and biological assessments. A rat perforation model of SAH was established, and MF was subsequently administered via intraperitoneal injection at a low and a high dose. High-dose MF significantly lowered the mortality of SAH animals and ameliorated their neurological deficits and brain edema. MF also dose-relatedly attenuated SAH-induced oxidative stress and decreased cortical cell apoptosis by influencing mitochondria-apoptotic proteins. In addition, MF downregulated the activation of the NLRP3 inflammasome and NF-κB as well as the production of inflammatory cytokines, and the expression of Nrf2 and HO-1 was upregulated by MF. The abovementioned findings indicate that MF is neuroprotective against EBI after SAH and Nrf2/HO-1 cascade may play a key role in mediating its effect through regulation of the mitochondrial apoptosis pathway and activation of the NLRP3 inflammasome and NF-κB.

  17. Neuropeptide Y and vasoactive intestinal peptide in experimental subarachnoid hemorrhage; Immunocytochemistry, radioimmunoassay and pharmacology

    Energy Technology Data Exchange (ETDEWEB)

    Alafaci, C.; Jansen, I. (Department of Experimental Research, Lund University, Malmoe General Hospital (Sweden)); Uddman, R. (Department of Otorhinolaryngology, Lund University, Malmoe General Hospital (Sweden)); Delgado, T.; Svendgaard, N.A. (Department of Neurosurgery, University Hospital, Lund (Sweden)); Edvinsson, L. (Department of Internal Medicine, University Hospital, Lund (Sweden)); Ekman, R. (Department of Psychiatry and Neurochemistry, University Hospital, Lund (Sweden))

    1991-01-01

    The involvement of noradrenaline (NA), neuropeptide Y, (NPY), 5-hydroxytryptamine (5-HT), acetylcholine (ACh) and vasoactive intestinal polypeptide (VIP) has been examined in the late phase of spasm after an experimental subarachnoid hemorrhage (SAH) in a rat model. Immunocytochemistry and radioimmunoassay of blood vessels from the circle of Willis did not show significant differences in NPY- and VIP-like immunoreactivity 2 days post SAH as compared to control vessels. The postjunctional effects of NA, NPY, 5-HT, Ach and VIP were studied two days after SAH using a sensitive in vitro system. NPY induced contractions were significantly (p<0.01) weaker (lower E{sub max}) in SAH as compared to control rats while the relaxant responses to ACh and VIP were slightly increased after SAH. These observations reveal that in a rat model of SAH, with an approximately 20% in vivo constriction at two days, dynamic changes occur in cerebral artery reactivity without any obvious change in sympathetic or parasympathetic perivascular nerve networks. (author).

  18. Functional analysis of Pro-inflammatory properties within the cerebrospinal fluid after subarachnoid hemorrhage in vivo and in vitro

    Directory of Open Access Journals (Sweden)

    Schneider Ulf C

    2012-02-01

    Full Text Available Abstract Background To functionally characterize pro-inflammatory and vasoconstrictive properties of cerebrospinal fluid after aneurysmal subarachnoid hemorrhage (SAH in vivo and in vitro. Methods The cerebrospinal fluid (CSF of 10 patients suffering from SAH was applied to the transparent skinfold chamber model in male NMRI mice which allows for in vivo analysis of the microcirculatory response to a superfusat. Microvascular diameter changes were quantified and the numbers of rolling and sticking leukocytes were documented using intravital multifluorescence imaging techniques. Furthermore, the pro-inflammatory properties of CSF were assessed in vitro using a monocyte transendothelial migration assay. Results CSF superfusion started to induce significant vasoconstriction on days 4 and 6 after SAH. In parallel, CSF superfusion induced a microvascular leukocyte recruitment, with a significant number of leukocytes rolling (day 6 and sticking (days 2-4 to the endothelium. CSF of patients presenting with cerebral edema induced breakdown of blood vessel integrity in our assay as evidenced by fluorescent marker extravasation. In accordance with leukocyte activation in vivo, significantly higher in vitro monocyte migration rates were found after SAH. Conclusion We functionally characterized inflammatory and vasoactive properties of patients' CSF after SAH in vivo and in vitro. This pro-inflammatory milieu in the subarachnoid space might play a pivotal role in the pathophysiology of early and delayed brain injury as well as vasospasm development following SAH.

  19. Isolated acute nontraumatic cortical subarachnoid hemorrhage: Etiologies based on MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Eun; Kang, Myung Jin; Kim, Sang Hyeon [Dept. of Radiology, Dong-A University Medical Center, Busan (Korea, Republic of)

    2016-06-15

    The purpose of this study was to identify common underlying etiologies that may be responsible for isolated acute nontraumatic cortical subarachnoid hemorrhage (cSAH) by analysis of magnetic resonance imaging (MRI) findings of the brain. From August 2005 to February 2014, 15 cSAH patients were admitted to our institution. All patients with cSAH underwent brain MRI and magnetic resonance angiography as a part of their initial evaluation. An analysis of the patients' medical history, clinical presentations, and brain MRI findings was retrospectively performed. Among the combined pathologies that were suspected causes of cSAH, 11 patients showed acute or subacute cerebral infarctions at the ipsilateral hemisphere of cSAH on the diffusion-weighted images. Four of 11 patients had only cerebral infarction, but the other 7 had combined vasculopathy of extra- and intracranial arteries. Four of 15 patients who did not have cerebral infarction, had intracranial artery stenosis, or showed possible cerebral amyloid angiopathy, or no abnormal findings on the brain MRI. Ischemic stroke, such as cerebral infarction or vasculopathy of the extra and intracranial arteries is regarded as a common underlying etiology of the cSAH based on MRI findings.

  20. Determining rural risk for aneurysmal subarachnoid hemorrhages: A structural equation modeling approach

    Science.gov (United States)

    Nichols, Linda Jayne; Gall, Seana; Stirling, Christine

    2016-01-01

    An aneurysmal subarachnoid hemorrhage (aSAH) carries a high disability burden. The true impact of rurality as a predictor of outcome severity is unknown. Our aim is to clarify the relationship between the proposed explanations of regional and rural health disparities linked to severity of outcome following an aSAH. An initial literature search identified limited data directly linking geographical location, rurality, rural vulnerability, and aSAH. A further search noting parallels with ischemic stroke and acute myocardial infarct literature presented a number of diverse and interrelated predictors. This a priori knowledge informed the development of a conceptual framework that proposes the relationship between rurality and severity of outcome following an aSAH utilizing structural equation modeling. The presented conceptual framework explores a number of system, environmental, and modifiable risk factors. Socioeconomic characteristics, modifiable risk factors, and timely treatment that were identified as predictors of severity of outcome following an aSAH and within each of these defined predictors a number of contributing specific individual predictors are proposed. There are considerable gaps in the current knowledge pertaining to the impact of rurality on the severity of outcome following an aSAH. Absent from the literature is any investigation of the cumulative impact and multiplicity of risk factors associated with rurality. The proposed conceptual framework hypothesizes a number of relationships between both individual level and system level predictors, acknowledging that intervening predictors may mediate the effect of one variable on another. PMID:27695237

  1. Awareness on Sustainable Affordable Housing Among Homebuyers in Malaysia

    Directory of Open Access Journals (Sweden)

    Ang Salem

    2017-01-01

    Full Text Available This paper concerns about the delivery of Sustainable Affordable Housing (SAH in Malaysia. The built environment, operation and demolishment of housing have the profound impact on our nature environment. SAH can be a solution toward sustainability development because it considered from an environmental friendly, socially enhancing, and economically benefits perfectives towards housing development. This paper aims to explore the awareness of homebuyers in Malaysia towards sustainable affordable housing. This research used the method of unstructured interview among homebuyers toward SAH in Malaysia. Based on the finding of the study, the awareness of homebuyers in SAH are relatively inadequate. Respondents are required the brief explanation on concept and elements of SAH for continue the interview. Based on Porter Five Forces Model, homebuyers’ requirements hold the bargaining power of customers to determine the features of housing provided by property provider. The knowledge of homebuyers on SAH is crucial for the sustainable development, because homebuyers are one of the key drivers for implementing the sustainable requirements in housing development.

  2. SIRT3 Expression Decreases with Reactive Oxygen Species Generation in Rat Cortical Neurons during Early Brain Injury Induced by Experimental Subarachnoid Hemorrhage

    Science.gov (United States)

    Huang, Wei; Huang, Yong; Huang, Ren-qiang; Gu, Jin-mao; Dong, Yan

    2016-01-01

    Sirtuin3 (SIRT3) is an important protein deacetylase which predominantly presents in mitochondria and exhibits broad bioactivities including regulating energy metabolism and counteracting inflammatory effect. Since inflammatory cascade was proved to be critical for pathological damage following subarachnoid hemorrhage (SAH), we investigated the overall expression and cell-specific distribution of SIRT3 in the cerebral cortex of Sprague-Dawley rats with experimental SAH induced by internal carotid perforation. Results suggested that SIRT3 was expressed abundantly in neurons and endothelia but rarely in gliocytes in normal cerebral cortex. After experimental SAH, mRNA and protein expressions of SIRT3 decreased significantly as early as 8 hours and dropped to the minimum value at 24 h after SAH. By contrast, SOD2 expression increased slowly as early as 12 hours after experimental SAH, rose up sharply at the following 12 hours, and then was maintained at a higher level. In conclusion, attenuated SIRT3 expression in cortical neurons was associated closely with enhanced reactive oxygen species generation and cellular apoptosis, implying that SIRT3 might play an important neuroprotective role during early brain injury following SAH. PMID:28053989

  3. Astaxanthin Alleviates Early Brain Injury Following Subarachnoid Hemorrhage in Rats: Possible Involvement of Akt/Bad Signaling

    Directory of Open Access Journals (Sweden)

    Xiang-Sheng Zhang

    2014-07-01

    Full Text Available Apoptosis has been proven to play a crucial role in early brain injury pathogenesis and to represent a target for the treatment of subarachnoid hemorrhage (SAH. Previously, we demonstrated that astaxanthin (ATX administration markedly reduced neuronal apoptosis in the early period after SAH. However, the underlying molecular mechanisms remain obscure. In the present study, we tried to investigate whether ATX administration is associated with the phosphatidylinositol 3-kinase-Akt (PI3K/Akt pathway, which can play an important role in the signaling of apoptosis. Our results showed that post-SAH treatment with ATX could cause a significant increase of phosphorylated Akt and Bad levels, along with a significant decrease of cleaved caspase-3 levels in the cortex after SAH. In addition to the reduced neuronal apoptosis, treatment with ATX could also significantly reduce secondary brain injury characterized by neurological dysfunction, cerebral edema and blood-brain barrier disruption. In contrast, the PI3K/Akt inhibitor, LY294002, could partially reverse the neuroprotection of ATX in the early period after SAH by downregulating ATX-induced activation of Akt/Bad and upregulating cleaved caspase-3 levels. These results provided the evidence that ATX could attenuate apoptosis in a rat SAH model, potentially, in part, through modulating the Akt/Bad pathway.

  4. Determining rural risk for aneurysmal subarachnoid hemorrhages: A structural equation modeling approach.

    Science.gov (United States)

    Nichols, Linda Jayne; Gall, Seana; Stirling, Christine

    2016-01-01

    An aneurysmal subarachnoid hemorrhage (aSAH) carries a high disability burden. The true impact of rurality as a predictor of outcome severity is unknown. Our aim is to clarify the relationship between the proposed explanations of regional and rural health disparities linked to severity of outcome following an aSAH. An initial literature search identified limited data directly linking geographical location, rurality, rural vulnerability, and aSAH. A further search noting parallels with ischemic stroke and acute myocardial infarct literature presented a number of diverse and interrelated predictors. This a priori knowledge informed the development of a conceptual framework that proposes the relationship between rurality and severity of outcome following an aSAH utilizing structural equation modeling. The presented conceptual framework explores a number of system, environmental, and modifiable risk factors. Socioeconomic characteristics, modifiable risk factors, and timely treatment that were identified as predictors of severity of outcome following an aSAH and within each of these defined predictors a number of contributing specific individual predictors are proposed. There are considerable gaps in the current knowledge pertaining to the impact of rurality on the severity of outcome following an aSAH. Absent from the literature is any investigation of the cumulative impact and multiplicity of risk factors associated with rurality. The proposed conceptual framework hypothesizes a number of relationships between both individual level and system level predictors, acknowledging that intervening predictors may mediate the effect of one variable on another.

  5. Twenty-four-hour changes of S-adenosylmethionine, S-adenosylhomocysteine adenosine and their metabolizing enzymes in rat liver; possible physiological significance in phospholipid methylation.

    Science.gov (United States)

    Chagoya de Sánchez, V; Hernández-Muñoz, R; Sánchez, L; Vidrio, S; Yáñez, L; Suárez, J

    1991-01-01

    1. The metabolic control of adenosine concentration in the rat liver through the 24-hr cycle is related to the activity of adenosine-metabolizing enzymes [5'-nucleotidase (5'N), adenosine deaminase (A.D.), adenosine kinase (A.K.) and S-adenosylhomocysteine hydrolase (SAH-H)]. 2. Two peaks of adenosine were observed, one at 12:00 hr caused by high activity of 5'N and SAH-H, and the other at 02:00 hr, caused by a decrease in purine catabolism and purine utilization, low activity of SAH-H and de novo purine formation. 3. The similarity of the adenosine and S-adenosylmethionine (SAM) profiles through the 24-hr cycle suggests a role of adenosine in transmethylation reactions, because, during the night (02:00 hr), the metabolic conditions favor the formation and accumulation of S-adenosylhomocysteine (SAH), with consequent inhibition of transmethylation reactions. 4. In the 24-hr variation of phosphatidylcholine (PC) and phosphatidylethanolamine (PE), the lowest ratio of PC/PE was observed at 24:00-02:00 hr when SAH concentration is high, whereas the highest PC/PE ratio occurs at the same time as one of the SAM/SAH ratio maxima.

  6. Pseudo-subarachnoid hemorrhage in cryptococcal meningitis: MRI findings and pathological study.

    Science.gov (United States)

    Nakae, Yoshiharu; Kudo, Yosuke; Yamamoto, Ryoo; Johkura, Ken

    2013-12-01

    A pseudo-subarachnoid hemorrhage (pseudo-SAH) is a brain computed tomography (CT) finding that is seen as high-density areas along the basal cisterns, the sylvian vallecula/fissure, the tentorium cerebella, or the cortical sulci, although no SAH is found upon lumbar puncture or at autopsy. There is one report of cryptococcal meningitis presenting as pseudo-SAH, but the explanatory pathology is unknown. A 68-year-old woman with headache, fever, decreased hearing, and decreased vision was admitted to our hospital. Cerebrospinal fluid India ink staining was positive, and culture yielded Cryptococcus neoformans. Cryptococcus meningitis was diagnosed. Head CT and magnetic resonance imaging (MRI) showed no abnormality upon admission, but 1 month later, head CT showed iso- to high-density areas within the sulci, and fluid-attenuated inversion recovery MRI showed high signal intensity within the convexity sulci resembling an SAH. These areas were enhanced by gadolinium on T1-weighted images. Lumber puncture produced no evidence of bleeding. Biopsy of the left frontal lobe sulci was performed, and histopathological study revealed inflammation and granulation with capsules of C. neoformans. The inflammation and granulation at the convexity sulci induced by the C. neoformans infection explained the pseudo-SAH in this case. Physicians should be aware that cryptococcal meningitis-induced inflammation and granulation at the sulci can present as pseudo-SAH on CT and MRI.

  7. Melatonin attenuated early brain injury induced by subarachnoid hemorrhage via regulating NLRP3 inflammasome and apoptosis signaling.

    Science.gov (United States)

    Dong, Yushu; Fan, Chongxi; Hu, Wei; Jiang, Shuai; Ma, Zhiqiang; Yan, Xiaolong; Deng, Chao; Di, Shouyin; Xin, Zhenlong; Wu, Guiling; Yang, Yang; Reiter, Russel J; Liang, Guobiao

    2016-04-01

    Subarachnoid hemorrhage (SAH) is a devastating condition with high morbidity and mortality rates due to the lack of effective therapy. Nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome activation associated with the upregulation of apoptotic signaling pathway has been implicated in various inflammatory diseases including hemorrhagic insults. Melatonin is reported to possess substantial anti-inflammatory properties, which is beneficial for early brain injury (EBI) after SAH. However, the molecular mechanisms have not been clearly identified. This study was designed to investigate the protective effects of melatonin against EBI induced by SAH and to elucidate the potential mechanisms. The adult mice were subjected to SAH. Melatonin or vehicle was injected intraperitoneally 2 hr after SAH. Melatonin was neuroprotective, as shown by increased survival rate, as well as elevated neurological score, greater survival of neurons, preserved brain glutathione levels, and reduced brain edema, malondialdehyde concentrations, apoptotic ratio, and blood-brain barrier (BBB) disruption. Melatonin also attenuated the expressions of NLRP3, apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC), cleaved caspase-1, interleukin-1β (IL-1β), and interleukin-6 (IL-6); these changes were also associated with an increase in the anti-apoptotic factor (Bcl2) and reduction in the pro-apoptotic factor (Bim). In summary, our results demonstrate that melatonin treatment attenuates the EBI following SAH by inhibiting NLRP3 inflammasome-associated apoptosis.

  8. Copeptin as a marker for severity and prognosis of aneurysmal subarachnoid hemorrhage.

    Directory of Open Access Journals (Sweden)

    Christian Fung

    Full Text Available BACKGROUND: Grading of patients with aneurysmal subarachnoid hemorrhage (aSAH is often confounded by seizure, hydrocephalus or sedation and the prediction of prognosis remains difficult. Recently, copeptin has been identified as a serum marker for outcomes in acute ischemic stroke and intracerebral hemorrhage (ICH. We investigated whether copeptin might serve as a marker for severity and prognosis in aSAH. METHODS: Eighteen consecutive patients with aSAH had plasma copeptin levels measured with a validated chemiluminescence sandwich immunoassay. The primary endpoint was the association of copeptin levels at admission with the World Federation of Neurological Surgeons (WFNS grade score after resuscitation. Levels of copeptin were compared across clinical and radiological scores as well as between patients with ICH, intraventricular hemorrhage, hydrocephalus, vasospasm and ischemia. RESULTS: Copeptin levels were significantly associated with the severity of aSAH measured by WFNS grade (P = 0.006, the amount of subarachnoid blood (P = 0.03 and the occurrence of ICH (P = 0.02. There was also a trend between copeptin levels and functional clinical outcome at 6-months (P = 0.054. No other clinical outcomes showed any statistically significant association. CONCLUSIONS: Copeptin may indicate clinical severity of the initial bleeding and may therefore help in guiding treatment decisions in the setting of aSAH. These initial results show that copeptin might also have prognostic value for clinical outcome in aSAH.

  9. Melatonin Attenuates Early Brain Injury via the Melatonin Receptor/Sirt1/NF-κB Signaling Pathway Following Subarachnoid Hemorrhage in Mice.

    Science.gov (United States)

    Zhao, Lei; Liu, Haixiao; Yue, Liang; Zhang, Jingbo; Li, Xia; Wang, Bodong; Lin, Yan; Qu, Yan

    2017-04-01

    Melatonin (Mel) has been reported to alleviate early brain injury (EBI) following subarachnoid hemorrhage (SAH). The activation of silent information regulator 1 (Sirt1), a histone deacetylase, has been suggested to be beneficial in SAH. However, the precise role of Sirt1 in Mel-mediated protection against EBI following SAH has not been elucidated. The present study aims to evaluate the role of melatonin receptor/Sirt1/nuclear factor-kappa B (NF-κB) in this process. The endovascular perforation SAH model was used in male C57BL/6J mice, and melatonin was administrated intraperitoneally (150 mg/kg). The mortality, SAH grade, neurological score, brain water content, and neuronal apoptosis were evaluated. The expression of Sirt1, acetylated-NF-κB (Ac-NF-κB), Bcl-2, and Bax were detected by western blot. To study the underlying mechanisms, melatonin receptor (MR) antagonist luzindole and Sirt1 small interfering RNA (siRNA) were administrated to different groups. The results suggest that Mel improved the neurological deficits and reduced the brain water content and neuronal apoptosis. In addition, Mel enhanced the expression of Sirt1 and Bcl-2 and decreased the expression of Ac-NF-κB and Bax. However, the protective effects of Mel were abolished by luzindole or Sirt1 siRNA. In conclusion, our results demonstrate that Mel attenuates EBI following SAH via the MR/Sirt1/NF-κB signaling pathway.

  10. Pattern not volume of bleeding predicts angiographic vasospasm in nonaneurysmal subarachnoid hemorrhage.

    Science.gov (United States)

    Raya, Amanda; Zipfel, Gregory J; Diringer, Michael N; Dacey, Ralph G; Derdeyn, Colin P; Rich, Keith M; Chicoine, Michael R; Dhar, Rajat

    2014-01-01

    Spontaneous idiopathic subarachnoid hemorrhage (SAH) with a perimesencephalic bleeding pattern is usually associated with a benign course, whereas a diffuse bleeding pattern has been associated with a higher risk of vasospasm and disability. We evaluated whether volume of bleeding explains this disparity. Pattern and amount of bleeding (by Hijdra and intraventricular hemorrhage scores) were assessed in 89 patients with nonaneurysmal SAH. Outcomes included angiographic vasospasm, delayed cerebral ischemia, and functional outcome at 1 year. Diffuse bleeding was associated with significantly higher Hijdra and intraventricular hemorrhage scores than perimesencephalic SAH, P≤0.003. Angiographic vasospasm was more likely in diffuse versus perimesencephalic SAH (45% versus 27%; odds ratio, 2.9; P=0.08), but adjustment for greater blood burden only partially attenuated this trend (adjusted odds ratio, 2.2; 95% confidence interval, 0.69-7.2; P=0.18); delayed cerebral ischemia was only seen in those with diffuse bleeding. Patients with diffuse bleeding were less likely to be discharged home (68% versus 90%; P=0.01) and tended to have more residual disability (modified Rankin scale, 3-6; 20% versus 6%; P=0.18). Nonaneurysmal SAH can still result in vasospasm and residual disability, especially in those with diffuse bleeding. This disparity is only partially accounted for by greater cisternal or intraventricular blood, suggesting that the mechanism and distribution of bleeding may be as important as the amount of hemorrhage in patients with idiopathic SAH.

  11. Dynamical Changes of the Serum Nitric Oxide(NO) Concentrations after Subarachnoid Hemorrhage(SAlH) and the Effects of Acanthopanax Senticosus

    Institute of Scientific and Technical Information of China (English)

    She Zheng Ming; Qian Hong Fa

    2000-01-01

    Objective. To explore the dynamical changes of the serum NO concentrations after SAH and the effects of acanthopanax senti cosus. Background. No, as a vascul ar regulat i on factor, Plays an important role on cerebral blood circulation .High intention has been paid to the rclationaship betveen No and cerebral vasospasm following SAH. Methods. The serum NO concentrat,ons of simple SAH group and acanthopanax senticosus--treated group were dynamically measured in the 2nd, 4th and 6th day after onset. Results. The serum NO concentrations of simple SAH group and acanthopanax scnticosus-treated group in the 4th and 6th day after onset were obviously lower than those of control group(P<0.01,P<0.05).The serum NO concentrations of the two groups reached their minimum in the 4th day after onset and then went up gradually in the 6th day. The content of the red blood cell in the cerebrospinal tiui of the simple SAH group was significamily contrary related to the Serum N0 concentration in the 4 th day (r=-0. 69. P< 0. 01). Discussion. The Sources , Synthesis, functious of No , the relationship between No and SAl and the effects of acanthopanax Senticoaus were discussed. Conclusion. The serum NO concentrations of the patients after SAH decrease and that may be involvea in the mechanism of cerebral vasospasm (CVS). Acanthopanax senticosus can increase the serum NO concentrations.

  12. Nontraumatic convexal subarachnoid hemorrhage concomitant with acute ischemic stroke.

    Science.gov (United States)

    Nakajima, Makoto; Inatomi, Yuichiro; Yonehara, Toshiro; Hirano, Teruyuki; Ando, Yukio

    2014-07-01

    Nontraumatic convexal subarachnoid hemorrhage (cSAH) rarely occurs subsequent to acute ischemic stroke. The incidence, clinical background characteristics, and outcomes in acute ischemic stroke patients with cSAH were investigated. Our stroke center database was reviewed to identify patients with acute ischemic stroke/transient ischemic attack (TIA) who demonstrated acute cSAH within 14 days of admission between 2005 and 2011. Background characteristics, clinical course, and outcomes at discharge and 3 months after onset were investigated in these patients. Of 4953 acute stroke/TIA patients, cSAH was observed in 8 (.14%) patients (7 men, mean age 71 years): 7 were detected incidentally, and the other was found immediately after a convulsion. Two patients died during their hospital stay, 1 died after discharge, and 3 were dependent at 3 months. Major artery occlusion or severe stenosis was observed in 5 patients. Two patients subsequently developed subcortical hemorrhage. On gradient echo imaging, lobar cerebral microbleeds were observed in 2 patients, and chronic superficial siderosis was observed in 2 patients. In this retrospective review of cases with ischemic stroke and cSAH, over half of patients had occlusion of major arteries. Cerebral amyloid angiopathy was suggested by magnetic resonance imaging findings and subsequent events in 3 patients. The overall outcome was unfavorable although the causal relationship with cSAH was unclear. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  13. Altered Resting-State Connectivity within Executive Networks after Aneurysmal Subarachnoid Hemorrhage.

    Directory of Open Access Journals (Sweden)

    Monica Maher

    Full Text Available Aneurysmal subarachnoid hemorrhage (aSAH is associated with significant mortality rates, and most survivors experience significant cognitive deficits across multiple domains, including executive function. It is critical to determine the neural basis for executive deficits in aSAH, in order to better understand and improve patient outcomes. This study is the first examination of resting-state functional Magnetic Resonance Imaging in a group of aSAH patients, used to characterize changes in functional connectivity of the frontoparietal network. We scanned 14 aSAH patients and 14 healthy controls, and divided patients into "impaired" and "unimpaired" groups based on a composite executive function score. Impaired patients exhibited significantly lower quality of life and neuropsychological impairment relative to controls, across multiple domains. Seed-based functional connectivity analysis demonstrated that unimpaired patients were not significantly different from controls, but impaired patients had increased frontoparietal connectivity. Patients evidenced increased frontoparietal connectivity as a function of decreased executive function and decreased mood (i.e. quality of life. In addition, T1 morphometric analysis demonstrated that these changes are not attributable to local cortical atrophy among aSAH patients. These results establish significant, reliable changes in the endogenous brain dynamics of aSAH patients, that are related to cognitive and mood outcomes.

  14. Anxiety and depression after spontaneous subarachnoid hemorrhage.

    Science.gov (United States)

    Morris, Paul Graham; Wilson, J T Lindsay; Dunn, Laurence

    2004-01-01

    Relatively little attention has been paid to emotional outcome after subarachnoid hemorrhage (SAH). This study assessed levels of anxiety and depression among SAH survivors and related these to clinical indices. Seventy SAH patients from a consecutive series of neurosurgical admissions participated in semistructured assessments of functional outcome; 52 of the patients also returned standardized measures of emotional outcome. These data were compared with clinical indices collected during the initial hospital admission. Moderate to severe levels of anxiety were present in approximately 40% of patients 16 months after hemorrhage, with approximately 20% experiencing moderate to severe levels of depression. Although anxiety was more likely to be reported at interview by those with an SAH of Fisher Grade 4, the standardized measures of anxiety and depression were not associated with severity of hemorrhage or any other clinical variables. Both anxiety and depression were significantly associated with outcome indices such as return to work and engagement in social activities. Anxiety is a significant and lasting problem for approximately 40% of survivors of SAH. It is suggested that measures taken to prevent or treat such anxiety among survivors of SAH may serve to significantly improve functional outcome.

  15. The relationship between apnoea hypopnoea index and Gensini score in patients with acute myocardial infarction undergoing emergency primary percutaneous coronary intervention.

    Science.gov (United States)

    Zhu, Cai-Ping; Li, Tao-Ping; Wang, Xiao; Zhao, Yu-Hua; Zhou, Shi-Xi; Fu, Yan; Jiang, Yi-Wei; Xiao, Xue-Ping

    2017-08-01

    Sleep apnoea hypopnoea syndrome (SAHS) is characterised by repetitive nocturnal hypoxemia and has a high prevalence among patients with acute myocardial infarction (AMI). But there are few studies on patients with AMI undergoing emergency primary percutaneous coronary intervention (pPCI). In this study, we want to find the prevalence of SAHS among patients with AMI undergoing emergency pPCI and determine whether SAHS would worsen the condition among these people, and especially affect the damage degree of the coronary artery. Over four months, 95 patients admitted for the first time for AMI were observed. All of them had emergency primary PCIs. A total of 86 patients accepted the sleep study and were divided into four groups according to the apnoea hypopnoea index (AHI): SAHS was diagnosed when AHI ≥5/h and was defined as mild for AHI ≥5/h and emergency pPCI. There were significant differences in average ages, smoking and arrhythmia (Pemergency pPCI, there is a high prevalence of SAHS. There are also positive correlations between AHI and Gensini score, and pro-BNP. Therefore, guided by the results, should we conduct a routine screening to those patients normally and could we relieve the damage to the coronary artery by curing the SAHS?

  16. The AGTR1 gene A1166C polymorphism as a risk factor and outcome predictor of primary intracerebral and aneurysmal subarachnoid hemorrhages.

    Science.gov (United States)

    Adamski, Mateusz G; Golenia, Aleksandra; Turaj, Wojciech; Baird, Alison E; Moskala, Marek; Dziedzic, Tomasz; Szczudlik, Andrzej; Slowik, Agnieszka; Pera, Joanna

    2014-01-01

    Associations between the angiotensin II type 1 receptor (AGTR1) gene A1166C polymorphism and hypertension, aortic abdominal aneurysms (as a risk factor) as well as cardiovascular disorders (as a risk factor and an outcome predictor) have been demonstrated. We aimed to investigate the role of this polymorphism as risk factors and outcome predictors in primary intracerebral hemorrhage (PICH) and aneurysmal subarachnoid hemorrhage (aSAH). We have prospectively recruited 1078 Polish participants to the study: 261 PICH patients, 392 aSAH patients, and 425 unrelated control subjects. The A1166C AGTR1 gene polymorphism was studied using the tetra-primer ARMS-PCR method. Allele and genotype frequencies were compared with other ethnically different populations. The A1166C polymorphism was not associated with the risk of PICH or aSAH. Among the aSAH patients the AA genotype was associated with a good outcome, defined by a Glasgow Outcome Scale of 4 or 5 (pAGTR1 polymorphism and outcome of aSAH patients, but not with the risk of PICH or aSAH. Copyright © 2014 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  17. Effect of Aneurysmal Subarachnoid Hemorrhage on Word Generation

    Directory of Open Access Journals (Sweden)

    Daniella Ladowski

    2014-01-01

    Full Text Available Background. Aneurysmal subarachnoid hemorrhage (aSAH survivors commonly exhibit impairment on phonemic and semantic fluency tests; however, it is unclear which of the contributing cognitive processes are compromised in aSAH patients. One method of disentangling these processes is to compare initial word production, which is a rapid, semiautomatic, frontal-executive process, and late phase word production, which is dependent on more effortful retrieval and lexical size and requires a more distributed neural network. Methods. Seventy-two individuals with aSAH and twenty-five control subjects were tested on a cognitive battery including the phonemic and semantic fluency task. Demographic and clinical information was also collected. Results. Compared to control subjects, patients with aSAH were treated by clipping and those with multiple aneurysms were impaired across the duration of the phonemic test. Among patients treated by coiling, those with anterior communicating artery aneurysms or a neurological complication (intraventricular hemorrhage, vasospasm, and edema showed worse output only in the last 45 seconds of the phonemic test. Patients performed comparably to control subjects on the semantic test. Conclusions. These results support a “diffuse damage” hypothesis of aSAH, indicated by late phase phonemic fluency impairment. Overall, the phonemic and semantic tests represent a viable, rapid clinical screening tool in the postoperative assessment of patients with aSAH.

  18. Ischemia-modified albumin is not better than creatine kinase-MB and cardiac troponin I in predicting a cardiac injury in nontraumatic subarachnoid hemorrhage.

    Science.gov (United States)

    Baydin, Ahmet; Amanvermez, Ramazan; Tuncel, Özgür Korhan; Ocak, Metin; Meric, Murat; Cokluk, Cengiz

    2015-04-01

    The aims were to investigate the role of serum ischemia-modified albumin (IMA), tumor necrosis factor α (TNF-α), and myeloperoxidase (MPO) and to evaluate the relationship between IMA and cardiac markers (creatine kinase myocardial isoenzyme [CK-MB] and cardiac troponin I [cTnI]) related to cardiac abnormalities in adult patients after nontraumatic subarachnoid hemorrhage (SAH). Twenty-nine patients with nontraumatic SAH admitted to the emergency department and 20 healthy adults as the control group were included in the study. Ischemia-modified albumin, TNF-α, MPO, CK-MB, cTnI, and leukocyte count (white blood cell [WBC]) in the circulation were measured on admission. Ischemia-modified albumin, TNF-α, and MPO levels were higher by mean values of 11.6%, 9.5%, and 2.9%, respectively, in patients with SAH compared with control group. However, levels of these parameters were not statistically different between the groups (P > .05). However, WBC, CK-MB, and cTnI values were significantly higher in patients with SAH compared with healthy control (P MB, and cTnI tests to differentiate between patients after SAH and controls according to receiver operating characteristic curve. The results suggest that IMA is not better than CK-MB and cTnI in predicting a cardiac injury in patients after nontraumatic SAH. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. [Sleep apnea-hypopnea syndrome: risk factors in children and adolescents; a systematic review].

    Science.gov (United States)

    Aguilar Cordero, M J; Sánchez López, A M; Mur Villar, N; García García, I; Guisado Barrilao, R

    2013-11-01

    The sleep apnea-hypopnea syndrome (SAHS) is a disorder that currently affects a large number of children and adolescents. The aim of this review is to assess the factors causing this condition and the risk of suffering another disease associated with SAHS. The 50 articles selected for inclusion in this review were identified through GOOGLE SCHOLAR. The validity of the items was established by the degree of evidence obtained, by recommendations made in this respect and by the applicability to the situation observed. The review considers studies of SAHS in children and adolescents, taking into account those relating this disorder with obesity, hypertension, physical activity and other variables. The studies reviewed show that SAHS is associated with childhood obesity and that it increases the risk of cerebro-cardiovascular disease. It is also shown that SAHS decreases children's and adolescents' physical capacity and quality of life. Psychological aspects are also affected, impacting on academic performance, which is poorer than in healthy children. Therefore, early paediatric diagnosis of SAHS is important in order to prevent associated disorders.

  20. Effect of N-acetylcysteine on vasospasm in subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Nelson de Azambuja Pereira Filho

    2010-12-01

    Full Text Available Vasospasm remains an extremely serious complication that affects patients presenting with subarachnoid hemorrhage (SAH due to ruptured intracranial aneurysms. The current therapeutic armamentarium is still insufficient in many cases, and the search for new therapies is necessary. In this study, we evaluated the effect of N-acetylcysteine (NAC on cerebral arterial vasospasm using an experimental model. Twenty-four wistar rats were divided into 4 groups: [1] Control, [2] SAH, [3] SAH+NAC and [4] SAH+Placebo. The experimental model employed double subarachnoid injections of autologous blood. The proposed dose of NAC was 250 mg/kg intraperitoneally per day. We analyzed the inner area of the basilar artery to assess the action of NAC. The experimental model proved to be very adequate, with a mortality rate of 4%. The inner area of the basilar artery in the SAH group showed significant difference to the control group (p=0.009. The use of NAC significantly reduced vasospasm as compared to the untreated group (p=0.048 and established no significant difference to the control group (p=0.098. There was no significant improvement with the administration of placebo (p=0.97. The model of the dual hemorrhage proved to be very useful for vasospasm simulation, with overall low mortality. The administration of NAC significantly reduced vasospasm resulting from SAH, and may represent a new therapeutic alternative.

  1. Molecular epidemiology of viral hemorrhagic septicemia virus in the Great Lakes region

    Science.gov (United States)

    Winton, James; Kurath, Gael; Batts, William

    2008-01-01

    Viral hemorrhagic septicemia virus (VHSV) is considered by many nations and international organizations to be one of the most important viral pathogens of finfish (Office International des Epizooties 2007). For several decades following its initial characterization in the 1950s, VHSV was thought to be limited to Europe where it was regarded as an endemic pathogen of freshwater fish that was especially problematic for farmed rainbow trout, an introduced species (Wolf 1988; Smail 1999). Subsequently, it was shown that VHSV was present among many species of marine and anadromous fishes in both the Pacific and Atlantic Oceans where it has been associated with substantial mortality among both wild and cultured fish (Meyers and Winton 1995; Skall et al. 2005).

  2. Neuroscience and the fallacies of functionalism.

    Science.gov (United States)

    Reddy, William M

    2010-01-01

    Smail's "On Deep History and the Brain" is rightly critical of the functionalist fallacies that have plagued evolutionary theory, sociobiology, and evolutionary psychology. However, his attempt to improve on these efforts relies on functional explanations that themselves oversimplify the lessons of neuroscience. In addition, like explanations in evolutionary psychology, they are highly speculative and cannot be confirmed or disproved by evidence. Neuroscience research is too diverse to yield a single picture of brain functioning. Some recent developments in neuroscience research, however, do suggest that cognitive processing provides a kind of “operating system” that can support a great diversity of cultural material. These developments include evidence of “top-down” processing in motor control, in visual processing, in speech recognition, and in “emotion regulation.” The constraints that such a system may place on cultural learning and transmission are worth investigating. At the same time, historians are well advised to remain wary of the pitfalls of functionalism.

  3. Hakem Kurulu

    OpenAIRE

    ,

    2014-01-01

    (ERÜ), Ali KOZAN (Nevşehir Ü.), İsmail KÖKSAL (Fırat Ü.), Saffet KÖSE (Selçuk Ü.), Mustafa KÖYLÜ (Ondokuzmayıs Ü.), Sönmez KUTLU (Ankara Ü.), Ali KUŞAT (ERÜ), Cenan KUVANCI (ERÜ), Kasım KÜÇÜKALP (Uludağ Ü.), Habil NAZLIGÜL (ERÜ), A. Yaşar OCAK (Hacettepe Ü.), Mesut OKUMUŞ (Hitit Ü.), Muhittin OKUMUŞLAR (Selçuk Ü.), Cihan OKUYUCU (Fatih Ü.), Fahrettin OLGUNER (Marmara Ü.), Ahmet ÖNKAL (Selçuk Ü.), Talip OZDEŞ (Cumhuriyet Ü.), Salim ÖZER (ERÜ), Kadir ÖZKÖSE (Cumhuriyet Ü.), Muzaffer ÖZLİ ...

  4. Hakem Kurulu

    OpenAIRE

    ,

    2013-01-01

    KILIÇ (Atatürk Ü.), Kadir KINAR (ERÜ), Mehmet KINIK (Fatih Ü.), Ferdi KOÇ (ERÜ), M. Akif KOÇ (Ankara Ü.), Turan KOÇ (İstanbul Sabahattin Zaim Ü.), Himmet KONUR (Dokuz Eylül Ü.), Mehmet KORKMAZ (ERÜ), Ali KOZAN (Nevşehir Ü.), İsmail KÖKSAL (Fırat Ü.), Saffet KÖSE (Selçuk Ü.), Mustafa KÖYLÜ (Ondokuzmayıs Ü.), Sönmez KUTLU (Ankara Ü.), Ali KUŞAT (ERÜ), Cenan KUVANCI (ERÜ), Kasım KÜÇÜKALP (Uludağ Ü.), Habil NAZLIGÜL (ERÜ), A. Yaşar OCAK (Hacettepe Ü.), Ejder OKUMUŞ (Eskişehir Osmangazi Ü.),...

  5. Hakem Kurulu

    OpenAIRE

    ,

    2014-01-01

    KILIÇ (Atatürk Ü.), Kadir KINAR (ERÜ), Mehmet KINIK (Fatih Ü.), Ferdi KOÇ (ERÜ), M. Akif KOÇ (Ankara Ü.), Turan KOÇ (İstanbul Sabahattin Zaim Ü.), Himmet KONUR (Dokuz Eylül Ü.), Mehmet KORKMAZ (ERÜ), Ali KOZAN (Nevşehir Ü.), İsmail KÖKSAL (Fırat Ü.), Saffet KÖSE (Selçuk Ü.), Mustafa KÖYLÜ (Ondokuzmayıs Ü.), Sönmez KUTLU (Ankara Ü.), Ali KUŞAT (ERÜ), Cenan KUVANCI (ERÜ), Kasım KÜÇÜKALP (Uludağ Ü.), Habil NAZLIGÜL (ERÜ), A. Yaşar OCAK (Hacettepe Ü.), Ejder OKUMUŞ (Eskişehir Osmangazi Ü.),...

  6. MELAMET IN THE DIVAN OF SARBAN AHMED SĂRBĂN AHMED DĮVĂNI’NDA MELĂMĮİLİK

    Directory of Open Access Journals (Sweden)

    Bekir KAYABAŞI

    2010-01-01

    Full Text Available Sarban Ahmed is one of poet melami sheik in the 16th century. Since his sheik İsmail Masuki died and his follow up by state, cause to slow up activity of tariqat. Sarban Ahmed use to poems that contiued to faith tariqat of disciples. He process to theme of melamet, when write to form of ottoman poetry. We look for concept of melamet to Ahmed Sarban’s poems that inside to meaning borders of ottoman poetry. Sarban Ahmed 16. yüzyıl şair Melami şeyhlerindendir. Şeyhi, İsmail Maşukî’nin tarikat inançları yüzünden öldürülmüş olması, Sarban Ahmed’in devlet otoritesi tarafından takip ediliyor olması, tarikatın yer altına çekilerek faaliyetlerini yavaşlatması sonucunu doğurmuştur. Sarban Ahmed, müritlerinin tarikat inançlarını devam ettirmek için şiirlerini kullanmıştır. Divan şiiri nazım biçimiyle yazdığı şiirlerinde melamet temasını işlemiştir. Bu çalışmada, Divan şiirinin anlam sınırları çerçevesinde Sarban Ahmed şiirlerindeki Melamilik anlayışını tespit etmeye çalıştık.

  7. Research on Static Analysis Methods and Evaluation Models of Android Malware%Android 恶意软件的静态分析方法及评判模型研究

    Institute of Scientific and Technical Information of China (English)

    郑鹭斌

    2015-01-01

    According to the special format of android software,this paper use the decompilation control library to realize analysis of apk installation package,then read the software configuration files,smail files,code documents and so on.After summarizing the existing static analysis methods of malicious software,it present a comprehensive static analysis method,includes permission,header files,services,system API,constant and other key code feature.This paper establish a database of malicious code feature,and use the regular expression to fuzzy match suspicious malicious code.Finally,it proposed a malicious coefficient quantization and determination model.%针对 Android 软件的特殊格式,利用反编译的控件库,实现 APK 安装包的内容解析,并读取软件的配置文件、smail 文件、代码文件等内容。归纳现有的恶意软件静态分析方法,提出一种更全面的静态分析方法,分析内容包括申请权限、头文件、服务、系统 API、常量等关键代码特征信息,并建立恶意代码特征库,然后,利用正则表达式进行特征模糊匹配,检测软件的可疑恶意代码。最后,提出一个恶意系数的量化判定模型。

  8. SINDROME DE APNEAS/HIPOPNEAS DURANTE EL SUEÑO EN EDAD PEDIÁTRICA

    Directory of Open Access Journals (Sweden)

    Navazo Eguía A

    2006-08-01

    Full Text Available SUMMARY:Sleep disordered breathing (SDB is a common condition in children. Sleep Apnea/Hypopnea syndrome (SAHS in children is a frequent sleep disorder, with a prevalence estimated to be 1 - 3% of all children. The most frequent cause of SAHS in children is the adenotonsillar hypertrophy. SAHS in children can result in severe complications if left untreated such as impaired physical growth, delayed development, poor school performance and in severe cases, hypertension and cor pulmonale, nevertheless, yet it is an under recognized condition. The gold standard diagnostic technique is the nocturnal polysomnography (PSG, guidelines for performing laboratory-based polysomnography in children have been established, the sleep laboratory should be a nonthreatening environment and personnel with pediatric training should record, score and interpret the study. The diagnostic criteria for SAHS in adults is not useful for diagnosis of SAHS in children. Adenotonsillectomy is the most common treatment for children with SAHS.RESUMEN:Los trastornos respiratorios del sueño en los niños, en particular el Síndrome de Apneas/Hipopneas durante el sueño (SAHS, es una patología frecuente, que afecta entre el 1 - 3% de la población infantil, siendo su causa más frecuente la hipertrofia adenoamigdalar. Es una enfermedad infradiagnosticada y que conlleva importantes complicaciones como son alteraciones del crecimiento, alteraciones cognitivas e incluso en casos severos Cor Pulmonale. La polisomnografía nocturna (PSG, es la técnica diagnóstica de elección para el diagnóstico del SAHS en los niños, pero en la población infantil es necesario tener en cuenta una serie de consideraciones, como son la edad de la población que se estudia, entorno adecuado y la necesidad de técnicos entrenados en el cuidado de los niños. Los criterios diagnósticos del SAHS para adultos no son útiles en los niños. El tratamiento de elección en los niños con SAHS es la

  9. Chronic hydrocephalus after experimental subarachnoid hemorrhage.

    Directory of Open Access Journals (Sweden)

    Peter Lackner

    Full Text Available Chronic communicating hydrocephalus is a significant health problem affecting up to 20% of survivors of spontaneous subarachnoid hemorrhage (SAH. The development of new treatment strategies is hampered by the lack of well characterized disease models. This study investigated the incidence of chronic hydrocephalus by evaluating the temporal profile of intracranial pressure (ICP elevation after SAH, induced by endovascular perforation in rats. Twenty-five adult male Sprague-Dawley rats (260-320 g were subjected to either endovascular perforation or sham surgery. Five animals died after SAH induction. At 7, 14 and 21 days after surgery ICP was measured by stereotaxic puncture of the cisterna magna in SAH (n=10 and SHAM (n=10 animals. On day 21 T-maze test was performed and the number of alterations and latency to decision was recorded. On day 23, samples were processed for histological analyses. The relative ventricle area was evaluated in coronal Nissl stained sections. On day 7 after surgery all animals showed normal ICP. The absolute ICP values were significantly higher in SAH compared to SHAM animals on day 21 (8.26±4.53 mmHg versus 4.38±0.95 mmHg but not on day 14. Observing an ICP of 10 mmHg as cut-off, 3 animals showed elevated ICP on day 14 and another animal on day 21. The overall incidence of ICP elevation was 40% in SAH animals. On day 21, results of T-maze testing were significantly correlated with ICP values, i.e. animals with elevated ICP showed a lower number of alterations and a delayed decision. Histology yielded a significantly higher (3.59 fold increased relative ventricle area in SAH animals with ICP elevation compared to SAH animals without ICP elevation. In conclusion, the current study shows that experimental SAH leads to chronic hydrocephalus, which is associated with ICP elevation, behavioral alterations and ventricular dilation in about 40% of SAH animals.

  10. Role of protease activated receptor-1 and 4 in the activation of microglia following subarachnoid hemorrhage%蛋白酶活化受体1/4参与大鼠蛛网膜下腔出血后脑内小胶质细胞的活化

    Institute of Scientific and Technical Information of China (English)

    闫军浩; 张卫光; 周长满

    2012-01-01

    Objective To investigate the role of protease activated receptor-1 and 4 ( PAR-1, PAR-4) in the activation of microglia following subarachnoid hemorrhage (SAH). Methods One hundred male SD rats were randomly divided into: sham, SAH + control siRNA, SAH + PAR-1 siRNA, SAH + PAR-4 siRNA and SAH + PAR-1/4 siRNA groups, 20 in each group. The drugs were administrated intracerebroventricularly at 1 hour after SAH. At the 6th and 24th hour after SAH, the neurological deficits, brain water content and Evans blue content were evaluated, at the same time, the expression of tumor necrosis factor α (TNF-α) and intercellular cell adhesion molecule-1 (ICA M -1) were also measured by using immunohistochemistry and Western blotting. Results PAR-1 siRNA or PAR-4 siRNA coold significantly ameliorate the neurological deficits and decrease vascular permeability (P<0. 05). In addition, the expression of TNF-a and ICAM-1 was also decreased by PAR-lsiRNA or PAR-4 siRNA treatment. The combination of PAR-land PAR4 siRNA played more powerful roles than either of them. Conclusion PAR-1 and 4 mediate the activation of microglia in the brain following SAH. Through suppressing the expression of inflammatory factors, PAR-lsiRNA and/or PAR-4 siRNA play neurovascular protective roles in the brain following SAH.%目的 探讨蛋白酶活化受体1/4(PAR-1/4)对蛛网膜下腔出血(SAH)后大鼠脑内小胶质细胞活化的影响. 方法 雄性SD大鼠100只,随机分为sham组、SAH+ control siRNA组、SAH+ PAR-1 siRNA组、SAH+PAR-4 siRNA组以及SAH +PAR-1/4 siRNA组,每组20只.应用血管内插线法建立大鼠SAH模型,治疗组在术后1h脑室注射相应剂量药物.在SAH后6h和24h,观察了各组大鼠神经功能学缺陷、脑水含量和脑内伊文思蓝含量,同时应用免疫组织化学和Western blotting方法检测了脑内肿瘤坏死因子α(TNF-α)和细胞间黏附分子-1( ICAM-1)的表达. 结果 单独应用PAR-1 siRNA或PAR-4 siRNA均可减轻SAH后大鼠的神

  11. Inhibitory effects of omega-3 fatty acids on early brain injury after subarachnoid hemorrhage in rats: Possible involvement of G protein-coupled receptor 120/β-arrestin2/TGF-β activated kinase-1 binding protein-1 signaling pathway.

    Science.gov (United States)

    Yin, Jia; Li, Haiying; Meng, Chengjie; Chen, Dongdong; Chen, Zhouqing; Wang, Yibin; Wang, Zhong; Chen, Gang

    2016-06-01

    Omega-3 fatty acids have been reported to improve neuron functions during aging and in patients affected by mild cognitive impairment, and mediate potent anti-inflammatory via G protein-coupled receptor 120 (GPR120) signal pathway. Neuron dysfunction and inflammatory response also contributed to the progression of subarachnoid hemorrhage (SAH)-induced early brain injury (EBI). This study was to examine the effects of omega-3 fatty acids on SAH-induced EBI. Two weeks before SAH, 30% Omega-3 fatty acids was administered by oral gavage at 1g/kg body weight once every 24h. Specific siRNA for GPR120 was exploited. Terminal deoxynucleotidyl transferase dUTP nick end labeling, fluoro-Jade B staining, and neurobehavioral scores and brain water content test showed that omega-3 fatty acids effectively suppressed SAH-induced brain cell apoptosis and neuronal degradation, behavioral impairment, and brain edema. Western blot, immunoprecipitation, and electrophoretic mobility shift assays results showed that omega-3 fatty acids effectively suppressed SAH-induced elevation of inflammatory factors, including cyclooxygenase-2, monocyte chemoattractant protein-1, and inducible nitric oxide synthase. In addition, omega-3 fatty acids could inhibit phosphorylation of transforming growth factor β activated kinase-1 (TAK1), MEK4, c-Jun N-terminal kinase, and IkappaB kinase as well as activation of nuclear factor kappa B through regulating GPR120/β-arrestin2/TAK1 binding protein-1 pathway. Furthermore, siRNA-induced GPR120 silencing blocked the protective effects of omega-3 fatty acids. Here, we show that stimulation of GPR120 with omega-3 fatty acids pretreatment causes anti-apoptosis and anti-inflammatory effects via β-arrestin2/TAK1 binding protein-1/TAK1 pathway in the brains of SAH rats. Fish omega-3 fatty acids as part of a daily diet may reduce EBI in an experimental rat model of SAH.

  12. Troponin elevation in subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Ioannis N. Mavridis

    2015-03-01

    Full Text Available Troponin (tr elevation in aneurysmal subarachnoid hemorrhage (SAH patients is often difficult to be appropriately assessed by clinicians, causing even disagreements regarding its management between neurosurgeons and cardiologists. The purpose of this article was to review the literature regarding the clinical interpretation of tr elevation in SAH. We searched for articles in PubMed using the key words: “troponin elevation” and “subarachnoid hemorrhage”. All of them, as well as relative neurosurgical books, were used for this review. Some type of cardiovascular abnormality develops in most SAH patients. Neurogenic stunned myocardium is a frequent SAH complication, due to catecholamine surge which induces cardiac injury, as evidenced by increased serum tr levels, electrocardiographic (ECG changes and cardiac wall motion abnormalities. Tr elevation, usually modest, is an early and specific marker for cardiac involvement after SAH and its levels peak about two days after SAH. Cardiac tr elevation predictors include poor clinical grade, intraventricular hemorrhage, loss of consciousness at ictus, global cerebral edema, female sex, large body surface area, lower systolic blood pressure, higher heart rate and prolonged Q-Tc interval. Elevated tr levels are associated with disability and death (especially tr >1 μg/L, worse neurological grade, systolic and diastolic cardiac dysfunction, pulmonary congestion, longer intensive care unit stay and incidence of vasospasm. Tr elevation is a common finding in SAH patients and constitutes a rightful cause of worry about the patients' cardiac function and prognosis. It should be therefore early detected, carefully monitored and appropriately managed by clinicians.

  13. Insurance status is associated with treatment allocation and outcomes after subarachnoid hemorrhage.

    Directory of Open Access Journals (Sweden)

    Charles Hobson

    Full Text Available Subarachnoid hemorrhage (SAH is a particularly devastating type of stroke which is responsible for one third of all stroke-related years of potential life lost before age 65. Surgical treatment has been shown to decrease both morbidity and mortality after subarachnoid hemorrhage. We hypothesized that payer status other than private insurance is associated with lower allocation to surgical treatment for patients with SAH and worse outcomes.We examined the association between insurance type and surgical treatment allocation and outcomes for patients with SAH while adjusting for a wide range of patient and hospital factors. We analyzed the Nationwide Inpatient Sample hospital discharge database using survey procedures to produce weighted estimates representative of the United States population.We studied 21047 discharges, representing a weighted estimate of 102595 patients age 18 and above with a discharge diagnosis of SAH between 2003 and 2008.Multivariable logistic and generalized linear regression analyses were used to assess for any associations between insurance status and surgery allocation and outcomes.Despite the benefits of surgery 66% of SAH patients did not undergo surgical treatment to prevent rebleeding. Mortality was more than twice as likely for patients with no surgical treatment compared to those who received surgery. Medicare patients were significantly less likely to receive surgical treatment.Nearly two thirds of patients with SAH don't receive operative care, and Medicare patients were significantly less likely to receive surgical treatment than other patients. Bias against the elderly and those with chronic illness and disability may play a part in these findings. A system of regionalized care for patients presenting with SAH may reduce disparities and improve appropriate allocation to surgical care and deserves prospective study.

  14. Detrended Fluctuation Analysis of Heart Rate to Detect Sleep Stage for Patients with Sleep Apnea Hypopnea Syndrome%利用心率的去趋势波动分析提取睡眠呼吸暂停低通气综合症患者的睡眠结构信息

    Institute of Scientific and Technical Information of China (English)

    郑慧君; 王海涛; 曹征涛; 朱莹莹; 姬超; 俞梦孙

    2009-01-01

    以经基于心率变异性的睡眠分期大都是针对健康人进行的,拟利用心率变异性分析睡眠呼吸暂停低通气综合症(SAHS)病人的睡眠结构.根据微动敏感式床垫式睡眠监测系统(MSMSMS)所得10名健康者的心率和30名不同程度SAHS患者的心率,利用去趋势波动分析(DFA)方法,计算他们在各睡眠阶段的标度指数.实验结果显示,SAHS患者各个睡眠阶段的标度指数具有明显差异,与健康者也有不同,为基于心率变异性对SAHS患者进行睡眠分期以及SAHS患者的判定提供了依据.%This study is purposed to distinguish sleep stage based on heart rate variability for sleep apnea hypopnea syndrome (SAHS) patients. The heart rate of 10 healthy subjects and 30 SAHS petients,detected from the micro-movement sensitive mattress sleep monitoring system (MSMSMS),was analyzed using detrended fluctuation analysis (DFA),and fractal exponents in different sleep stage were calculated. The results showed that the fractal exponents had significant differences in different sleep stage for the SAHS patients,and they were also different between healthy subjects and SAHS patients. All of these gave the potential for the application of heart rate variability in distinguishing sleep stage of SAHS patients and diagnosing SAHS as well.

  15. Neuroprotective Effects of a Smoothened Receptor Agonist against Early Brain Injury after Experimental Subarachnoid Hemorrhage in Rats

    Science.gov (United States)

    Hu, Quan; Li, Tong; Wang, Lingxiao; Xie, Yunkai; Liu, Song; Bai, Xuemei; Zhang, Tiantian; Bo, Shishi; Xin, Danqing; Xue, Hao; Li, Gang; Wang, Zhen

    2017-01-01

    The sonic hedgehog (Shh) signaling pathway plays a fundamental role in the central nervous system (CNS) development, but its effects on neural cell survival and brain repair after subarachnoid hemorrhage (SAH) has not been well-investigated. The present study was undertaken to evaluate the influence of an agonist of the Shh co-receptor Smoothened (Smo), purmorphamine (PUR), on early brain injury (EBI) as well as the underlying mechanisms after SAH. PUR was administered via an intraperitoneal injection with a dose of 0.5, 1, and 5 mg/kg at 2, 6, 24, and 46 h after SAH in rat model. The results showed that PUR treatment significantly ameliorated brain edema, improved neurobehavioral function, and attenuated neuronal cell death in the prefrontal cortex (PFC), associated with a decrease in Bax/Bcl-2 ratio and suppression of caspase-3 activation at 48 h after SAH. PUR also promoted phospho-ERK levels. Additionally, PUR treatment markedly decreased MDA concentration accompanied with the elevation in the expression of nuclear factor erythroid 2-related factor 2 and heme oxygenase-1 in PFC. Notably, PUR treatment significantly reversed the changes of Shh pathway mediators containing Patched, Gli1, and Shh by SAH insult, and the neuroprotection of PUR on SAH was blocked by Smo antagonist cyclopamine. These results indicated that PUR exerts neuroprotection against SAH-evoked injury in rats, mediated in part by anti-apoptotic and anti-oxidant mechanism, up-regulating phospho-ERK levels, mediating Shh signaling molecules in the PFC. PMID:28149272

  16. Role of Neurexin-1β and Neuroligin-1 in Cognitive Dysfunction After Subarachnoid Hemorrhage in Rats

    Science.gov (United States)

    Shen, Haitao; Chen, Zhouqing; Wang, Yang; Gao, Anju; Li, Haiying; Cui, Yonghua; Zhang, Li; Xu, Xiang; Wang, Zhong

    2015-01-01

    Background and Purpose— Neurexin-1β and neuroligin-1 play an important role in the formation, maintenance, and regulation of synaptic structures. This study is to estimate the potential role of neurexin-1β and neuroligin-1 in subarachnoid hemorrhage (SAH)-induced cognitive dysfunction. Methods— In vivo, 228 Sprague–Dawley rats were used. An experimental SAH model was induced by single blood injection to prechiasmatic cistern. Primary cultured hippocampal neurons were exposed to oxyhemoglobin to mimic SAH in vitro. Specific small interfering RNAs and expression plasmids for neurexin-1β and neuroligin-1 were exploited both in vivo and in vitro. Western blot, immunofluorescence, immunoprecipitation, neurological scoring, and Morris water maze were performed to evaluate the mechanism of neurexin-1β and neuroligin-1, as well as neurological outcome. Results— Both in vivo and in vitro experiments showed SAH-induced decrease in the expressions of neurexin-1β and neuroligin-1 and the interaction between neurexin-1β and neuroligin-1 in neurons. In addition, the interaction between neurexin-1β and neuroligin-1 was reduced by their knockdown and increased by their overexpression. The formation of excitatory synapses was inhibited by oxyhemoglobin treatment, which was significantly ameliorated by overexpression of neurexin-1β and neuroligin-1 and aggravated by the knockdown of neurexin-1β and neuroligin-1. More importantly, neurexin-1β and neuroligin-1 overexpression ameliorated SAH-induced cognitive dysfunction, whereas neurexin-1β and neuroligin-1 knockdown induced an opposite effect. Conclusions— Enhancing the expressions of neurexin-1β and neuroligin-1 could promote the interaction between them and the formation of excitatory synapses, which is helpful to improve cognitive dysfunction after SAH. Neurexin-1β and neuroligin-1 might be good targets for improving cognitive function after SAH. PMID:26219651

  17. Fatal subarachnoid hemorrhage following ischemia in vertebrobasilar dolichoectasia.

    Science.gov (United States)

    Sokolov, Arseny A; Husain, Shakir; Sztajzel, Roman; Croquelois, Alexandre; Lobrinus, Johannes A; Thaler, David; Städler, Claudio; Hungerbühler, Hansjörg; Caso, Valeria; Rinkel, Gabriel J; Michel, Patrik

    2016-07-01

    Vertebrobasilar dolichoectasia (VBD) is a chronic disorder with various cerebrovascular and compressive manifestations, involving subarachnoid hemorrhage (SAH). Occurrence of SAH shortly after worsening of clinical VBD symptoms has occasionally been reported. The goal of the study was to examine this association, in particular its pathophysiology, clinical precursor signs, time course, and outcome.To this end, in a retrospective multicenter study, we analyzed 20 patients with VBD and SAH in regard to preceding clinical symptoms, presence of vertebrobasilar thrombosis and ischemia, outcome and neuropathological correlates.Median age of the 7 female and 13 male patients was 70 years (interquartile range [IQR] 18.3 years). Fourteen patients (70%) presented with new or acutely worsening posterior fossa signs at a median of 3 days prior to SAH (IQR 2, range 0.5-14). A thrombus within the VBD was detected in 12 patients (60%). Thrombus formation was associated with clinical deterioration (χ = 4.38, P = 0.04) and ponto-cerebellar ischemia (χ = 8.09, P = 0.005). During follow-up after SAH, 13 patients (65%) died, after a median survival time of 24 hours (IQR 66.2, range 2-264 hours), with a significant association between proven ponto-cerebellar ischemia and case fatality (χ = 6.24, P = 0.01).The data establish an association between clinical deterioration in patients with VBD, vertebrobasilar ischemia, and subsequent SAH. Antithrombotic treatment after deterioration appears controversial and SAH outcome is frequently fatal. Our data also indicate a short window of 3 days that may allow for evaluating interventional treatment, preferably within randomized trials.

  18. Telmisartan ameliorates oxidative stress and subarachnoid haemorrhage-induced cerebral vasospasm.

    Science.gov (United States)

    Erdi, Fatih; Keskin, Fatih; Esen, Hasan; Kaya, Bulent; Feyzioglu, Bahadir; Kilinc, Ibrahim; Karatas, Yasar; Cuce, Gokhan; Kalkan, Erdal

    2016-03-01

    Growing evidence suggests that oxidative stress is one of the factors contributing to subarachnoid haemorrhage (SAH)-induced cerebral vasospasm. SAH-induced cerebral vasospam alters thioredoxin (Trx) cycle enzymes and thioredoxin-interacting protein (TXNIP) as an important endogenous antioxidant system. In this study, we have explored the effects of telmisartan on the vascular morphological changes, endothelial apoptosis, tissue oxidative stress status and the level of Trx cycle enzymes/ TXNIP in a rabbit SAH model. Forty male New Zealand rabbits were randomly divided into five groups of eight rabbits each: control group, sham group, SAH group, SAH + vehicle group and SAH + telmisartan group. SAH was created by a single cisterna magna blood injection. SAH + telmisartan group received telmisartan treatment (5 mg/kg intraperitoneal, once daily) for 72 h. The brainstem tissue Trx1, Trx2, Trx reductase (TrxR), TrxR1and TXNIP levels were investigated. Total oxidant status (TOS), total antioxidant status (TAS), malondialdehyde (MDA) levels and tumour necrosis factor alpha (TNF alpha) levels were investigated. Basilar artery segments were investigated for cross-sectional area, wall thickness measurements and endothelial apoptosis. Telmisartan treatment restored the lowered level of Trx1, TrxR, TAS and the expression of TrxR1 seen in SAH. Telmisartan treatment also decreased TXNIP expression, TOS, MDA and TNF alpha levels. Morphological changes of cerebral vasospasm were attenuated after treatment. Endothelial apoptosis significantly reduced. Treatment with telmisartan ameliorates oxidative stress and SAH-induced cerebral vasospasm in rabbits. These effects of telmisartan may be associated with downregulation of TXNIP and upregulation of Trx/TrxR.

  19. Risk factors correlated with hydrocephalus after aneurysmal subarachnoid hemorrhage%动脉瘤性蛛网膜下腔出血后慢性脑积水形成相关危险因素分析

    Institute of Scientific and Technical Information of China (English)

    陈璇; 程万春; 高小平; 梁辉; 余翔

    2011-01-01

    Objective To study the risk factors of chronic hydrocephalus after aneurismal subarachnoid hemorrhage (aSAH). Methods The clinical data of 170 patients with aSAH were respectively studied. Hydrocephalus was confirmed on the basis of the findings of CT scans 3 week after aSAH. Univariate analysis was performed to assess the relationship between the possible risk factors and the occurrence of hydrocephalus. Those factors statistically associated with the occurrence of hydrocephalus were further analyzed using the logistic regression analysis. Results There were three risk factors for the development of hydrocephalus after aSAH: Hunt-Hess grade ( high) at admission (P = 0.006), repeated SAH (P = 0.007) and increasing age (P = 0.010). Conclusions The development of hydrocephalus after aSAH is multifactorial.%目的 探讨动脉瘤性蛛网膜下腔出血( aSAH)后慢性脑积水形成的危险因素.方法 回顾分析170例aSAH患者临床资料,应用出血后3周的CT评价aSAH后慢性脑积水;先将可能的危险因素与脑积水之间行显著性检验,再用多元回归加以明确,得到回归方程.结果 aSAH后慢性脑积水易患因素依次为入院时较高Hunt - Hess分级(P=0.006)、反复多次出血(P=0.007)、高龄(P=0.010).结论 aSAH后慢性脑积水形成为多因素共同作用的结果.

  20. Fatal subarachnoid hemorrhage following ischemia in vertebrobasilar dolichoectasia

    Science.gov (United States)

    Sokolov, Arseny A.; Husain, Shakir; Sztajzel, Roman; Croquelois, Alexandre; Lobrinus, Johannes A.; Thaler, David; Städler, Claudio; Hungerbühler, Hansjörg; Caso, Valeria; Rinkel, Gabriel J.; Michel, Patrik

    2016-01-01

    Abstract Vertebrobasilar dolichoectasia (VBD) is a chronic disorder with various cerebrovascular and compressive manifestations, involving subarachnoid hemorrhage (SAH). Occurrence of SAH shortly after worsening of clinical VBD symptoms has occasionally been reported. The goal of the study was to examine this association, in particular its pathophysiology, clinical precursor signs, time course, and outcome. To this end, in a retrospective multicenter study, we analyzed 20 patients with VBD and SAH in regard to preceding clinical symptoms, presence of vertebrobasilar thrombosis and ischemia, outcome and neuropathological correlates. Median age of the 7 female and 13 male patients was 70 years (interquartile range [IQR] 18.3 years). Fourteen patients (70%) presented with new or acutely worsening posterior fossa signs at a median of 3 days prior to SAH (IQR 2, range 0.5–14). A thrombus within the VBD was detected in 12 patients (60%). Thrombus formation was associated with clinical deterioration (χ2 = 4.38, P = 0.04) and ponto-cerebellar ischemia (χ2 = 8.09, P = 0.005). During follow-up after SAH, 13 patients (65%) died, after a median survival time of 24 hours (IQR 66.2, range 2–264 hours), with a significant association between proven ponto-cerebellar ischemia and case fatality (χ2 = 6.24, P = 0.01). The data establish an association between clinical deterioration in patients with VBD, vertebrobasilar ischemia, and subsequent SAH. Antithrombotic treatment after deterioration appears controversial and SAH outcome is frequently fatal. Our data also indicate a short window of 3 days that may allow for evaluating interventional treatment, preferably within randomized trials. PMID:27399083

  1. Topiramate attenuates early brain injury following subarachnoid haemorrhage in rats via duplex protection against inflammation and neuronal cell death.

    Science.gov (United States)

    Tian, Yong; Guo, Song-Xue; Li, Jian-Ru; Du, Hang-Gen; Wang, Chao-Hui; Zhang, Jian-Min; Wu, Qun

    2015-10-05

    Early brain injury (EBI) following aneurysmal subarachnoid haemorrhage (SAH) insults contributes to the poor prognosis and high mortality observed in SAH patients. Topiramate (TPM) is a novel, broad-spectrum, antiepileptic drug with a reported protective effect against several brain injuries. The current study aimed to investigate the potential of TPM for neuroprotection against EBI after SAH and the possible dose-dependency of this effect. An endovascular perforation SAH model was established in rats, and TPM was administered by intraperitoneal injection after surgery at three different doses (20mg/kg, 40mg/kg, and 80mg/kg). The animals' neurological scores and brain water content were evaluated, and ELISA, Western blotting and immunostaining assays were conducted to assess the effect of TPM. The results revealed that TPM lowers the elevated levels of myeloperoxidase and proinflammatory mediators observed after SAH in a dose-related fashion, and the nuclear factor-kappa B (NF-κB) signalling pathway is the target of neuroinflammation regulation. In addition, TPM ameliorated SAH-induced cortical neuronal apoptosis by influencing Bax, Bcl-2 and cleaved caspase-3 protein expression, and the effect of TPM was enhanced in a dose-dependent manner. Various dosages of TPM also upregulated the protein expression of the γ-aminobutyric acid (GABA)-ergic signalling molecules, GABAA receptor (GABAAR) α1, GABAAR γ2, and K(+)-Cl(-) co-transporter 2 (KCC2) together and downregulated Na(+)-K(+)-Cl(-) co-transporter 1 (NKCC1) expression. Thus, TPM may be an effective neuroprotectant in EBI after SAH by regulating neuroinflammation and neuronal cell death.

  2. Fisetin alleviates early brain injury following experimental subarachnoid hemorrhage in rats possibly by suppressing TLR 4/NF-κB signaling pathway.

    Science.gov (United States)

    Zhou, Chen-hui; Wang, Chun-xi; Xie, Guang-bin; Wu, Ling-yun; Wei, Yong-xiang; Wang, Qiang; Zhang, Hua-sheng; Hang, Chun-hua; Zhou, Meng-liang; Shi, Ji-xin

    2015-12-10

    Early brain injury (EBI) determines the unfavorable outcomes after subarachnoid hemorrhage (SAH). Fisetin, a natural flavonoid, has anti-inflammatory and neuroprotection properties in several brain injury models, but the role of fisetin on EBI following SAH remains unknown. Our study aimed to explore the effects of fisetin on EBI after SAH in rats. Adult male Sprague-Dawley rats were randomly divided into the sham and SAH groups, fisetin (25mg/kg or 50mg/kg) or equal volume of vehicle was given at 30min after SAH. Neurological scores and brain edema were assayed. The protein expression of toll-like receptor 4 (TLR 4), p65, ZO-1 and bcl-2 was examined by Western blot. TLR 4 and p65 were also assessed by immunohistochemistry (IHC). Enzyme-linked immunosorbent assay (ELISA) was performed to detect the production of pro-inflammatory cytokines. Terminal deoxynucleotidyl transferase-mediated uridine 5'-triphosphate-biotin nick end-labeling (TUNEL) was perform to assess neural cell apoptosis. High-dose (50mg/kg) fisetin significantly improved neurological function and reduced brain edema at both 24h and 72h after SAH. Remarkable reductions of TLR 4 expression and nuclear factor κB (NF-κB) translocation to nucleus were detected after fisetin treatment. In addition, fisetin significantly reduced the productions of pro-inflammatory cytokines, decreased neural cell apoptosis and increased the protein expression of ZO-1 and bcl-2. Our data provides the evidence for the first time that fisetin plays a protective role in EBI following SAH possibly by suppressing TLR 4/NF-κB mediated inflammatory pathway. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. Prevalence of superficial siderosis following singular, acute aneurysmal subarachnoid hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Lummel, N.; Bochmann, K. [Ludwig-Maximilian-University, Department of Neuroradiology, Klinikum Grosshadern, Munich (Germany); Bernau, C. [Leibniz-Rechenzentrum, Munich (Germany); Thon, N. [Ludwig-Maximilian-University, Department of Neurosurgery, Klinikum Grosshadern, Munich (Germany); Linn, J. [Technical University, Department of Neuroradiology, Klinikum Dresden, Dresden (Germany)

    2015-04-01

    Superficial siderosis is presumably a consequence of recurrent bleeding into the subarachnoid space. The objective of this study was to assess the prevalence of superficial siderosis after singular, aneurysmal subarachnoid hemorrhage (SAH) in the long term. We retrospectively identified all patients who presented with a singular, acute, aneurysmal SAH at our institution between 2010 and 2013 and in whom a magnetic resonance imaging (MRI) including T2*-weighted imaging was available at least 4 months after the acute bleeding event. MRI scans were judged concerning the presence and distribution of superficial siderosis. Influence of clinical data, Fisher grade, localization, and cause of SAH as well as the impact of neurosurgical interventions on the occurrence of superficial siderosis was tested. Seventy-two patients with a total of 117 MRIs were included. Mean delay between SAH and the last available MRI was 47.4 months (range 4-129). SAH was Fisher grade 1 in 2 cases, 2 in 4 cases, 3 in 10 cases, and 4 in 56 cases. Superficial siderosis was detected in 39 patients (54.2 %). In all patients with more than one MRI scan, localization and distribution of superficial siderosis did not change over time. Older age (p = 0.02) and higher degree of SAH (p = 0.03) were significantly associated with the development of superficial siderosis. Superficial siderosis develops in approximately half of patients after singular, aneurysmal SAH and might be more common in patients with an older age and a greater amount of blood. However, additional factors must play a role in whether a patient is prone to develop superficial siderosis or not. (orig.)

  4. New angiographic measurement tool for analysis of small cerebral vessels: application to a subarachnoid haemorrhage model in the rat

    Energy Technology Data Exchange (ETDEWEB)

    Turowski, B.; Moedder, U. [Heinrich-Heine University, Institute of Diagnostic Radiology, Neuroradiology, Duesselorf (Germany); Haenggi, D.; Steiger, H.J. [Heinrich-Heine University, Department of Neurosurgery, Duesseldorf (Germany); Beck, A.; Aurich, V. [Heinrich-Heine University, Institute of Informatics, Duesseldorf (Germany)

    2007-02-15

    Exact quantification of vasospasm by angiography is known to be difficult especially in small vessels. The purpose of the study was to develop a new method for computerized analysis of small arteries and to demonstrate feasibility on cerebral angiographies of rats acquired on a clinical angiography unit. A new software tool analysing grey values and subtracting background noise was validated on a vessel model. It was tested in practice in animals with subarachnoid haemorrhage (SAH). A total of 28 rats were divided into four groups: SAH untreated, SAH treated with local calcium antagonist, SAH treated with placebo, and sham-operated. The diameters of segments of the internal carotid, caudal cerebral, middle cerebral, rostral cerebral and the stapedial arteries were measured and compared to direct measurements of the diameters on magnified images. There was a direct correlation between the cross-sectional area of vessels measured in a phantom and the measurements acquired using the new image analysis method. The spread of repeated measurements with the new software was small compared to the spread of direct measurements of vessel diameters on magnified images. Application of the measurement tool to experimental SAH in rats showed a statistically significant reduction of vasospasm in the SAH groups treated with nimodipine-releasing pellets in comparison to all the other groups combined. The presented computerized method for analysis of small intracranial vessels is a new method allowing precise relative measurements. Nimodipine-releasing subarachnoidal pellets reduce vasospasm, but further testing with larger numbers is necessary. The tool can be applied to human angiography without modification and offers the promise of substantial progress in the diagnosis of vasospasm after SAH. (orig.)

  5. S-adenosylmethionine and S-adenosylhomocysteine in plasma and cerebrospinal fluid in Rett syndrome and the effect of folinic acid supplementation.

    Science.gov (United States)

    Hagebeuk, Eveline E O; Duran, Marinus; Abeling, Nico G G M; Vyth, Arno; Poll-The, Bwee Tien

    2013-11-01

    Rett syndrome is a neurodevelopmental disorder characterized by cognitive and locomotor regression and stereotypic hand movements. The disorder is caused by mutations in the X chromosomal MECP2 a gene encoding methyl CpG-binding protein. It has been associated with disturbances of cerebral folate homeostasis, as well as with speculations on a compromised DNA-methylation. Folinic acid is the stable form of folate. Its derived intermediate 5-MTHF supports the conversion of homocysteine to methionine, the precursor of S-adenosylmethionine (SAM). This in turn donates its methyl group to various acceptors, including DNA, thereby being converted to S-adenosylhomocysteine (SAH). The SAM/SAH ratio reflects the methylation potential. The goal of our study was to influence DNA methylation processes and ameliorate the clinical symptoms in Rett syndrome. Therefore we examined the hypothesis that folinic acid supplementation, besides increasing cerebrospinal fluid (CSF) 5-MTHF (p = 0.003), influences SAM and SAH and their ratio. In our randomized, double-blind crossover study on folinic acid supplementation, ten female Rett patients received both folinic acid and placebo for 1 year each. It was shown that both SAM and SAH levels in the CSF remained unchanged following folinic acid administration (p = 0.202 and p = 0.097, respectively) in spite of a rise of plasma SAM and SAH (p = 0.007; p = 0.009). There was no significant change in the SAM/SAH ratio either in plasma or CSF. The apparent inability of Rett patients to upregulate SAM and SAH levels in the CSF may contribute to the biochemical anomalies of the Rett syndrome. Our studies warrant further attempts to promote DNA methylation in the true region of interest, i.e. the brain.

  6. Flair MR imaging in the Detection of subarachnoid hemorrhage : comparison with CT and T1-weighted MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Min, Soo Hyun; Kim, Soo Youn; Lee, Ghi Jai; Shim, Jae Chan; Oh, Tae Kyung; Kim, Ho Kyun [College of Medicine, Jnje University, Seoul (Korea, Republic of)

    2000-03-01

    To compare the findings of fluid-attenuated inversion recovery (FLAIR) MR imaging in the detection of subarachnoid hemorrhage (SAH), with those of precontrast CT and T1-weighted MR imaging. In 13 patients (14 cases) with SAH, FLAIR MR images were retrospectively analyzed and compared with CT (10 patients, 11 cases) and T1-weighted MR images (9 cases). SAH was confirmed on the basis of high density along the subarachnoid space, as seen on precontrast CT, or lumbar puncture. MR imaging was performed on a 1.0T unit. FLAIR MR and CT images were obtained during the acute stage(less than 3 days after ictus) in 10 and 9 cases, respectively, during the subacute stage (4-14 days after ictus) in two cases and one, respectively, and during the chronic stage (more than 15 days after ictus) in two cases and one, respectively. CT was performed before FLAIR MR imaging, and the interval between CT and FLAIR ranged from 24 hours (6 cases) to 2-3 (2 cases) or 4-7 days (3 cases). In each study, the conspicuity of visualization of SAH was graded as excellent, good, fair, or negative at five locations (sylvian fissure, cortical sulci, anterior basal cistern, posterior basal cistern, and perimesencephalic cistern). In all cases, subarachnoid hemorrhages were demonstrated as high signal intensity areas on FLAIR images. The detection rates for SAH on CT and T1-weighted MR images were 100% (11/11) and 89% (8/9), respectively. FLAIR was superior to T1-weighted imaging in the detection of SAH at all sites except the anterior basal cistern (p less than 0.05) and superior to CT in the detection of SAH at the cortical sulci (p less than 0.05). On FLAIR MR images, subarachnoid hemorrhages at all stages are demonstrated as high signal intensity areas; the FLAIR MR sequence is thus considered useful in the detection of SAH. In particular FLAIR is more sensitive than CT for the detection of SAH in the cortical sulci. (author)

  7. Acute Cholecystitis as a Cause of Fever in Aneurysmal Subarachnoid Hemorrhage

    Directory of Open Access Journals (Sweden)

    Na Rae Yang

    2017-05-01

    Full Text Available Background Fever is a very common complication that has been related to poor outcomes after aneurysmal subarachnoid hemorrhage (aSAH. The incidence of acalculous cholecystitis is reportedly 0.5%–5% in critically ill patients, and cerebrovascular disease is a risk factor for acute cholecystitis (AC. However, abdominal evaluations are not typically performed for febrile patients who have recently undergone aSAH surgeries. In this study, we discuss our experiences with febrile aSAH patients who were eventually diagnosed with AC. Methods We retrospectively reviewed 192 consecutive patients who underwent aSAH from January 2009 to December 2012. We evaluated their characteristics, vital signs, laboratory findings, radiologic images, and pathological data from hospitalization. We defined fever as a body temperature of >38.3°C, according to the Society of Critical Care Medicine guidelines. We categorized the causes of fever and compared them between patients with and without AC. Results Of the 192 enrolled patients, two had a history of cholecystectomy, and eight (4.2% were eventually diagnosed with AC. Among them, six patients had undergone laparoscopic cholecystectomy. In their pathological findings, two patients showed findings consistent with coexistent chronic cholecystitis, and two showed necrotic changes to the gall bladder. Patients with AC tended to have higher white blood cell counts, aspartame aminotransferase levels, and C-reactive protein levels than patients with fevers from other causes. Predictors of AC in the aSAH group were diabetes mellitus (odds ratio [OR], 8.758; P = 0.033 and the initial consecutive fasting time (OR, 1.325; P = 0.024. Conclusions AC may cause fever in patients with aSAH. When patients with aSAH have a fever, diabetes mellitus and a long fasting time, AC should be suspected. A high degree of suspicion and a thorough abdominal examination of febrile aSAH patients allow for prompt diagnosis and treatment of this

  8. Hyponatremia in aneurysmal subarachnoid hemorrhage is due to the syndrome of inappropriate antidiuresis and acute glucocorticoid deficiency

    LENUS (Irish Health Repository)

    Hannon, M J

    2011-06-01

    Hyponatraemia is the most common electrolyte abnormality following subarachnoid haemorrhage (SAH) and contributes to increased morbidity and mortality. Retrospective data suggests that the syndrome of inappropriate diuresis (SIAD) is the most common cause of hyponatraemia in SAH, though cerebral salt wasting has been postulated by some workers to be the predominant abnormality. Data which has shown acute glucocorticoid deficiency following SAH has suggested that some cases of euvolaemic hyponatraemia may also be caused by this mechanism.We prospectively studied the hormonal and haemodynamic influences involved in the development of hyponatraemia in 100 patients (61% female, median age 53 (range 16-82)) with non-traumatic aneurysmal SAH. Each patient had plasma sodium (pNa), urea, osmolality, glucose and 0900h cortisol (PC), and urinary sodium and osmolality measured on days 1, 2, 3, 4, 6, 8, 10 and 12 following SAH. Fluid balance and haemodynamic parameters were recorded daily. Results were compared with 15 patients admitted to ITU following vascular surgery. A PC<300nmol\\/L in a patient in ITU was regarded clinically as inappropriately low.49% of patients developed hyponatraemia (pNa<135 mmol\\/L), including 14% who developed clinically significantly hyponatraemia (pNa<130 mmol\\/L). 36\\/49 (73.4%) developed hyponatraemia between days 1 and 3 post SAH. The median duration of hyponatraemia was 3 days (range 1–10 days).In 35\\/49 (71.4%), hyponatraemia was due to SIAD as defined by standard diagnostic criteria. 14% of SAH patients had at least one PC<300nmol\\/L; 5 of these (35.7%) developed hyponatraemia. In 4 patients hyponatraemia was preceded by acute cortisol deficiency and responded to hydrocortisone treatment. In contrast, all controls had PC>500 nmol\\/L on day 1, and >300 nmol on days 3–12. There were no cases of cerebral salt wasting. There was no relationship between the incidence of hyponatraemia and the defined anatomical territory or severity of

  9. 蛛网膜下隙出血患者水钠紊乱的影响因素及护理%Factors Analysis and Nursing Strategy of Water-saline Disorder of Subarachnoid Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    郭小叶; 魏艳; 赵书敏

    2014-01-01

    Objective To explore the related factors that affect water-saline disorder in patients with subarachnoid hemorrhage and its nursing strategy.Methods Clinical data of 183 cases of SAH were analyzed retrospectively.Re-sults Water-saline disorder occurred within 5 to 8 days of the onset of the main manifestations of hyponatremia, accounting for 85.5%.The SAH patients water-saline disorder was related to the Hunt-Hess graded,inap-propriate antidiuretic hormone secretion,cerebral salt wasting syndrome and intracranial hypertension. Conclusion Nurses should pay attention to the continuous supervision of water-saline metabolism,and take early and targeted nursing strategies based on the related factors of water-saline disorder to improve SAH patient’s prognosis.%探讨蛛网膜下隙出血(subarachnoid hemorrhage,SAH)患者水钠紊乱的影响因素及护理对策.方法回顾性分析并总结西安交通大学医学院第一附属医院2007年1月至2012年6月收治的183例 SAH 患者的临床资料.结果水钠紊乱多发生在 SAH 患者发病后的5~8 d 内,主要表现为低血钠,占85.5%.SAH 患者水钠紊乱与 Hunt-Hess 分级、抗利尿激素分泌异常综合征(inappropriate antidiuretic hormone secretion,SIADH)、脑盐耗综合征(cerebral salt wasting syndrome, CSWS)及颅内压增高有关.结论护理人员应高度重视对 SAH 患者水钠代谢的持续监护,针对产生水钠紊乱的影响因素及早采取有效的护理对策,从而改善 SAH 患者的预后.

  10. Effect of early mobilization and rehabilitation on complications in aneurysmal subarachnoid hemorrhage.

    Science.gov (United States)

    Karic, Tanja; Røe, Cecilie; Nordenmark, Tonje Haug; Becker, Frank; Sorteberg, Wilhelm; Sorteberg, Angelika

    2017-02-01

    OBJECTIVE Early rehabilitation is effective in an array of acute neurological disorders but it is not established as part of treatment guidelines after aneurysmal subarachnoid hemorrhage (aSAH). This may in part be due to the fear of aggravating the development of cerebral vasospasm, which is the most feared complication of aSAH. The aim of this study was to evaluate the effect of early rehabilitation and mobilization on complications during the acute phase and within 90 days after aSAH. METHODS This was a prospective, interventional study that included patients with aSAH at the neuro-intermediate ward after aneurysm repair. The control group received standard treatment, whereas the early rehab group underwent early rehabilitation and mobilization in addition to standard treatment. Clinical and radiological characteristics of patients with aSAH, progression in mobilization, and treatment variables were registered. The frequency and severity of cerebral vasospasm, cerebral infarction acquired in conjunction with the aSAH, and acute and chronic hydrocephalus, as well as pulmonary and thromboembolic complications, were compared between the 2 groups. RESULTS Clinical and radiological characteristics of patients with aSAH were similar between the groups. The early rehab group was mobilized beginning on the first day after aneurysm repair. The significantly quicker and higher degree of mobilization in the early rehab group did not increase complications. Clinical cerebral vasospasm was not as frequent in the early rehab group and it also tended to be less severe. Each step of mobilization achieved during the first 4 days after aneurysm repair reduced the risk of severe vasospasm by 30%. Acute and chronic hydrocephalus were similar in both groups, but there was a tendency toward earlier shunt implantation among patients in the control group. Pulmonary infections, thromboembolic events, and death before discharge or within 90 days after the ictus were similar between the 2

  11. Ethyl Pyruvate Attenuates Early Brain Injury Following Subarachnoid Hemorrhage in the Endovascular Perforation Rabbit Model Possibly Via Anti-inflammation and Inhibition of JNK Signaling Pathway.

    Science.gov (United States)

    Lv, Tao; Miao, Yi-Feng; Jin, Yi-Chao; Yang, Shao-Feng; Wu, Hui; Dai, Jiong; Zhang, Xiao-Hua

    2017-02-25

    Early brain injury (EBI) following subarachnoid hemorrhage (SAH) is the main cause to poor outcomes of SAH patients, and early inflammation plays an important role in the acute pathophysiological events. It has been demonstrated that ethyl pyruvate (EP) has anti-inflammatory and neuroprotective effects in various critical diseases, however, the role of EP on EBI following SAH remains to be elucidated. Our study aimed to evaluate the effects of EP on EBI following SAH in the endovascular perforation rabbit model. All rabbits were randomly divided into three groups: sham, SAH + Vehicle (equal volume) and SAH + EP (30 mg/kg/day). MRI was performed to estimate the reliability of the EBI at 24 and 72 h after SAH. Neurological scores were recorded to evaluate the neurological deficit, ELISA kit was used to measure the level of tumor necrosis factor-α (TNF-α), and western blot was used to detect the expression of TNF-α, tJNK, pJNK, bax and bcl-2 at 24 and 72 h after SAH. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) and Fluoro-jade B (FJB) staining were used to detect neuronal apoptosis and neurodegeneration respectively, meanwhile hematoxylin and eosin (H&E) staining was used to assess the degree of vasospasm. Our results demonstrated that EP alleviated brain tissue injury (characterized by diffusion weighted imaging and T2 sequence in MRI scan), and significantly improved neurological scores at 72 h after SAH. EP decreased the level of TNF-α and downregulated pJNK/tJNK and bax/bcl-2 in cerebral cortex and hippocampus effectively both at 24 and 72 h after SAH. Furthermore, EP reduced TUNEL and FJB positive cells significantly. In conclusion, the present study supported that EP afforded neuroprotective effects possibly via reducing TNF-α expression and inhibition of the JNK signaling pathway. Therefore, EP may be a potent therapeutic agent to attenuate EBI following SAH.

  12. Impact of anesthesia on pathophysiology and mortality following subarachnoid hemorrhage in rats

    Directory of Open Access Journals (Sweden)

    Hockel Konstantin

    2012-03-01

    Full Text Available Abstract Background Anesthesia is indispensable for in vivo research but has the intrinsic potential to alter study results. The aim of the current study was to investigate the impact of three common anesthesia protocols on physiological parameters and outcome following the most common experimental model for subarachnoid hemorrhage (SAH, endovascular perforation. Methods Sprague-Dawley rats (n = 38 were randomly assigned to (1 chloral hydrate, (2 isoflurane or (3 midazolam/medetomidine/fentanyl (MMF anesthesia. Arterial blood gases, intracranial pressure (ICP, mean arterial blood pressure (MAP, cerebral perfusion pressure (CPP, and regional cerebral blood flow (rCBF were monitored before and for 3 hours after SAH. Brain water content, mortality and rate of secondary bleeding were also evaluated. Results Under baseline conditions isoflurane anesthesia resulted in deterioration of respiratory parameters (arterial pCO2 and pO2 and increased brain water content. After SAH, isoflurane and chloral hydrate were associated with reduced MAP, incomplete recovery of post-hemorrhagic rCBF (23 ± 13% and 87 ± 18% of baseline, respectively and a high anesthesia-related mortality (17 and 50%, respectively. Anesthesia with MMF provided stable hemodynamics (MAP between 100-110 mmHg, high post-hemorrhagic rCBF values, and a high rate of re-bleedings (> 50%, a phenomenon often observed after SAH in humans. Conclusion Based on these findings we recommend anesthesia with MMF for the endovascular perforation model of SAH.

  13. Critical care management of patients following aneurysmal subarachnoid hemorrhage: recommendations from the Neurocritical Care Society's Multidisciplinary Consensus Conference.

    Science.gov (United States)

    Diringer, Michael N; Bleck, Thomas P; Claude Hemphill, J; Menon, David; Shutter, Lori; Vespa, Paul; Bruder, Nicolas; Connolly, E Sander; Citerio, Giuseppe; Gress, Daryl; Hänggi, Daniel; Hoh, Brian L; Lanzino, Giuseppe; Le Roux, Peter; Rabinstein, Alejandro; Schmutzhard, Erich; Stocchetti, Nino; Suarez, Jose I; Treggiari, Miriam; Tseng, Ming-Yuan; Vergouwen, Mervyn D I; Wolf, Stefan; Zipfel, Gregory

    2011-09-01

    Subarachnoid hemorrhage (SAH) is an acute cerebrovascular event which can have devastating effects on the central nervous system as well as a profound impact on several other organs. SAH patients are routinely admitted to an intensive care unit and are cared for by a multidisciplinary team. A lack of high quality data has led to numerous approaches to management and limited guidance on choosing among them. Existing guidelines emphasize risk factors, prevention, natural history, and prevention of rebleeding, but provide limited discussion of the complex critical care issues involved in the care of SAH patients. The Neurocritical Care Society organized an international, multidisciplinary consensus conference on the critical care management of SAH to address this need. Experts from neurocritical care, neurosurgery, neurology, interventional neuroradiology, and neuroanesthesiology from Europe and North America were recruited based on their publications and expertise. A jury of four experienced neurointensivists was selected for their experience in clinical investigations and development of practice guidelines. Recommendations were developed based on literature review using the GRADE system, discussion integrating the literature with the collective experience of the participants and critical review by an impartial jury. Recommendations were developed using the GRADE system. Emphasis was placed on the principle that recommendations should be based not only on the quality of the data but also tradeoffs and translation into practice. Strong consideration was given to providing guidance and recommendations for all issues faced in the daily management of SAH patients, even in the absence of high quality data.

  14. Histopathological Findings in Brains of Patients Who Died in the Acute Stage of Poor-grade Subarachnoid Hemorrhage

    Science.gov (United States)

    SATOMI, Junichiro; HADEISHI, Hiromu; YOSHIDA, Yasuji; SUZUKI, Akifumi; NAGAHIRO, Shinji

    2016-01-01

    Patients with poor-grade aneurysmal subarachnoid hemorrhage (SAH) are likely to die due to irreversible acute-stage primary brain damage. However, the mechanism(s) and pathology responsible for their high mortality rate remain unclear. We report our findings on the brains of individuals who died in the acute stage of SAH. An autopsy was performed on the brains of 11 SAH patients (World Federation of Neurosurgical Societies grade 5) who died within 3 days of admission and who did not receive respiratory assistance. All brains were free of intracranial hematoma and hydrocephalus; all harbored ruptured aneurysms. In all brains, multiple infarcts with perifocal edema were scattered throughout the cortex and subcortical white matter of the whole brain. Infarcts with a patchy – were more often seen than infarcts with a wedge-shaped pattern. Microscopic examination revealed multiple areas with cytotoxic edema and neuronal death indicative of acute ischemic changes. Edema and congestion were more obvious in areas where the subarachnoid clot tightly adhered to the pia mater. Pathologically, the brains of deceased patients with acute poor-grade SAH were characterized by edema and multifocal infarcts spread throughout the whole brain; they were thought to be attributable to venous ischemia. Diffuse disturbance in venous drainage attributable to an abrupt increase in the intracranial pressure and focal disturbances due to tight adhesion of the subarachnoid clot to the pia mater, may contribute strongly to irreversible brain damage in the acute stage of SAH. PMID:27357086

  15. Prostaglandin E2 EP4 Receptor Activation Attenuates Neuroinflammation and Early Brain Injury Induced by Subarachnoid Hemorrhage in Rats.

    Science.gov (United States)

    Xu, Jie; Xu, Zhen; Yan, Ai

    2017-02-27

    Activation of E prostanoid 4 receptor (EP4) shows neuroprotective effects in multiple central nervous system (CNS) lesions, but the roles of EP4 receptor in subarachnoid hemorrhage (SAH) are not explored. This study was designed to research the effects of EP4 modulation on early brain injury (EBI) after experimental SAH in rats. We found that the administration of EP4 selective agonist AE1-329 significantly improved neurological dysfunction, blood brain barrier (BBB) damage and brain edema at 24 h after SAH. Furthermore, AE1-329 obviously reduced the number of activated microglia and the mRNA and protein levels of pro-inflammatory cytokines, and increased Ser1177 phosphorylated endothelial nitric oxide synthase (Ser1177 p-eNOS). Moreover, AE1-329 significantly reduced the number of TUNEL-positive cells and active caspase-3 in cortex after SAH. The EP4 selective antagonist AE3-208 was also administrated and the opposite effects were achieved. Our results indicate that activation of EP4 protects brain from EBI through downregulating neuroinflammation reaction after SAH.

  16. Male Gender and Arterial Hypertension are Plaque Predictors at Coronary Computed Tomography Angiography

    Science.gov (United States)

    Oliveira, Joselina Luzia Menezes; Hirata, Mario Hiroyuki; Sousa, Amanda Guerra de Moraes Rego; Gabriel, Fabíola Santos; Hirata, Thiago Dominguez Crespo; Tavares, Irlaneide da Silva; Melo, Luiza Dantas; Dória, Fabiana de Santana; Sousa, Antônio Carlos Sobral; Pinto, Ibraim Masciarelli Francisco

    2015-01-01

    Background Systemic Arterial Hypertension (SAH) is one of the main risk factors for Coronary Artery Disease (CAD), in addition to male gender. Differences in coronary artery lesions between hypertensive and normotensive individuals of both genders at the Coronary Computed Tomography Angiography (CCTA) have not been clearly determined. Objective To Investigate the calcium score (CS), CAD extent and characteristics of coronary plaques at CCTA in men and women with and without SAH. Methods Prospective cross-sectional study of 509 patients undergoing CCTA for CAD diagnosis and risk stratification, from November 2011 to December 2012, at Instituto de Cardiologia Dante Pazzanese. Individuals were stratified according to gender and subdivided according to the presence (HT +) or absence (HT-) of SAH. Results HT+ women were older (62.3 ± 10.2 vs 57.8 ± 12.8, p = 0.01). As for the assessment of CAD extent, the HT+ individuals of both genders had significant CAD, although multivessel disease is more frequent in HT + men. The regression analysis for significant CAD showed that age and male gender were the determinant factors of multivessel disease and CS ≥ 100. Plaque type analysis showed that SAH was a predictive risk factor for partially calcified plaques (OR = 3.9). Conclusion Hypertensive men had multivessel disease more often than women. Male gender was a determinant factor of significant CAD, multivessel disease, CS ≥ 100 and calcified and partially calcified plaques, whereas SAH was predictive of partially calcified plaques. PMID:25861034

  17. Clinical characteristics of ruptured distal middle cerebral artery aneurysms: Review of the literature.

    Science.gov (United States)

    Tsutsumi, Keiji; Horiuchi, Tetsuyoshi; Nagm, Alhusain; Toba, Yasuyuki; Hongo, Kazuhiro

    2017-01-10

    Middle cerebral artery (MCA) aneurysms usually arise at the primary MCA bifurcation or trifurcation. Distal MCA aneurysms are rarely considered as sources of aneurysmal subarachnoid hemorrhage (SAH). It has been reported that ruptured distal MCA aneurysms are associated with head trauma, neoplastic emboli, arterial dissection, or bacterial infection. We experienced five cases of ruptured distal MCA aneurysms and evaluated their clinical characteristics. Retrospective analysis of aneurysmal SAH at Kobayashi Neurosurgical Neurological Hospital was performed from January, 2004 to December, 2014. Clinical characteristics of ruptured distal MCA aneurysms were analyzed using our database. Among 191 aneurysmal SAH patients, there were five ruptured distal MCA aneurysms. All patients did not have any specific medical problems such as infectious disease, head trauma, or cardiac disorders. The incidence of ruptured distal MCA aneurysm was higher than expected and was equivalent to 9.4% of the total ruptured MCA aneurysms. Strong male predominance (80%) and M2-3 junction aneurysm preponderance (80%) were observed. In addition, there were only two patients (40%) with intracerebral hematoma in our study. We reported five cases of ruptured distal MCA aneurysms. Although ruptured distal MCA aneurysms are thought to be rare as sources of aneurysmal SAH, the incidence of ruptured distal MCA aneurysm was 9.4% of all ruptured MCA aneurysms in our study. Ruptured distal MCA aneurysms should be considered as sources of aneurysmal SAH without intracerebral hematoma.

  18. Problems with diagnosis by fluid-attenuated inversion recovery magnetic resonance imaging in patients with acute aneurysmal subarachnoid hemorrhage.

    Science.gov (United States)

    Shimoda, Masami; Hoshikawa, Kaori; Shiramizu, Hideki; Oda, Shinri; Matsumae, Mitsunori

    2010-01-01

    The diagnostic efficacy of fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging and computed tomography (CT) for acute subarachnoid hemorrhage (SAH) were compared and the problems with diagnosis were investigated in 81 patients with aneurysmal SAH within 24 hours after onset who underwent FLAIR imaging and CT on admission. The number of hematomas in the cisterns and ventricles were evaluated by clot scores. In addition, the frequency of undetected hematomas was calculated for the cisterns and ventricles. Clot scores were significantly higher for FLAIR imaging than for CT in the lateral sylvian, quadrigeminal, and convexity cisterns. On the other hand, clot scores were significantly higher for CT than for FLAIR imaging in the interhemispheric and medial sylvian cisterns. The overall frequency of undetected SAH was 2% for FLAIR imaging and 14% for CT. With the exception of the interhemispheric and medial sylvian cisterns, the frequency of undetected SAH was higher for CT than for FLAIR imaging. In this study, FLAIR imaging was more sensitive than CT for the detection of acute SAH within 24 hours after onset. However, the diagnostic efficacy of FLAIR imaging was reduced in comparatively tight cisterns.

  19. Intercomparison of the South Asian High in NCEP1, NCEP2, and ERA-40 Reanalyses and in Station Observations

    Institute of Scientific and Technical Information of China (English)

    FU Jian-Jian; LI Shuanglin

    2012-01-01

    The South Asian Highs (SAHs) at 100 hPa over China in the three reanalysis datasets NCEP1, NCEP2, and ERA-40 are evaluated by using station observation data. The results demonstrate a substantial discrepancy even between the reanalyses. First, the data of the three reanalyses generally underestimate the intensity of the SAH in the China domain. Second, there are interdecadal changes in the SAH, with highs in the 1960s and 1980s and lows in the 1970s, 1990s, and 2000s. This interdecadal variation of the SAH can be well depicted with NCEP1 data, but the high in the 1980s is missed by ERA-40. The NCEP2 corresponds well with NCEP 1 and captures the decreasing trend after 1979. Furthermore, the NCEP1 reanalysis overestimates the interdecadal changes of SAH, while ERA-40 underestimates the interdecadal changes. This work suggests that much caution should be exerted when the reanalysis datasets are adopted to study the interdecadal variability of SAH.

  20. Usefulness of B-mode and doppler sonography for the diagnosis of severe acute viral hepatitis A.

    Science.gov (United States)

    Shin, Sang Wook; Kim, Tae Yeob; Jeong, Woo Kyoung; Kim, Yongsoo; Kim, Jinoo; Kim, Young Hwan; Park, Hwan Cheol; Sohn, Joo Hyun

    2015-01-01

    To investigate B-mode and Doppler ultrasonography (US) features correlating with laboratory findings for the diagnosis of severe acute hepatitis (SAH) in patients with hepatitis A virus infection. Thirty-nine consecutive serologically proven patients were enrolled. Decreased parenchymal echotexture, periportal tracking, gallbladder wall change, and splenomegaly were assessed on B-mode images. Blood flow velocities were measured in the main portal (V(PORTAL)) and in the hepatic veins, and the hepatic venous pulsatility index was calculated. SAH was defined as high model for end-stage liver disease (MELD) score ≥ 15 with or without coagulopathy. The relationship between US features and laboratory findings was assessed, and SAH diagnosis was evaluated. Serum alanine transaminase and prothrombin time were significantly different depending on the presence of gallbladder wall change and splenomegaly (p hepatic venous waveform and hepatic venous pulsatility index were significantly correlated with MELD score. For the diagnosis of SAH, the area under the receiver operating characteristic curve of V(PORTAL) was 0.798. It reached 0.869 in the patients with typical GB change. Both B-mode and Doppler US correlated well with several laboratory variables and may be helpful to diagnose SAH in patients with hepatitis A virus infection. © 2014 Wiley Periodicals, Inc.

  1. Superficial siderosis is a warning sign for future intracranial hemorrhage.

    Science.gov (United States)

    Linn, Jennifer; Wollenweber, Frank A; Lummel, Nina; Bochmann, Katja; Pfefferkorn, Thomas; Gschwendtner, Andreas; Bruckmann, Hartmut; Dichgans, Martin; Opherk, Christian

    2013-01-01

    Supratentorial superficial siderosis (SS) is a frequent imaging marker of cerebral amyloid angiopathy (CAA). It is most probably caused by focal subarachnoid hemorrhages (fSAHs). Based on single-case observations, it has been proposed that such fSAHs might be a predisposing factor for future intracranial hemorrhage. Here we tested the hypothesis if a SS as a residue of fSAHs must be regarded as a warning sign for future intracranial hemorrhage. Fifty-one consecutive patients with SS and no apparent cause other than possible or probable CAA were identified through a database search and followed-up for a median interval of 35.3 months (range 6-120 months). Main outcome measures were rate and location of new intracranial hemorrhages. Twenty-four patients (47.1 %) had experienced any new intracranial hemorrhage, 18 patients (35.3 %) had an intracerebral hemorrhage (ICH), and in 13 of them (25.5 %), the hemorrhage was located at the site of pre-existing siderosis. Six patients (11.7 %) had developed a new subarachnoid hemorrhage (SAH), four of them at the site of siderosis. Patients with SS are at substantial risk for subsequent intracranial hemorrhage. SS can be considered a warning sign of future ICH or SAH, which frequently occur adjacent to pre-existing SS. Prospective studies are needed to confirm these findings.

  2. Roller coaster-associated subarachnoid hemorrhage--report of 2 cases.

    Science.gov (United States)

    Rutsch, Sebastian; Niesen, Wolf-Dirk; Meckel, Stephan; Reinhard, Matthias

    2012-04-15

    The most common neurological injuries associated with roller coaster rides are subdural hematoma and cervical artery dissection. We report two cases of roller-coaster associated subarachnoid hemorrhage (SAH). A 40-year-old healthy man developed a strong, holocephalic headache during a roller coaster ride. SAH Hunt & Hess grade II and Fisher grade 3 was diagnosed. An underlying aneurysm of the anterior communicating artery was successfully treated with coil embolization. A 41-year-old female (smoker, otherwise healthy) experienced a sudden, strong headache and diplopia during a roller coaster ride. A perimesencephalic SAH (Hunt & Hess grade II, Fisher grade 3) was disclosed by a CT scan. No aneurysm was detected on angiography. Both patients were discharged without neurological disability. In conclusion, SAH is a rare but relevant differential diagnosis in cases of acute headache during roller coaster rides. Both aneurysmal and non-aneurysmal perimesencephalic SAH can occur. A combination of mechanical factors and excessive blood pressure rises in vulnerable persons is discussed.

  3. Diagnosis and treatment of the chronic hydrocephalus following aneurysmal subarachnoid hemorrhage%动脉瘤性蛛网膜下腔出血后慢性脑积水的诊治

    Institute of Scientific and Technical Information of China (English)

    吴志敏; 李俊

    2011-01-01

    Objective To explore the diagnosis and treatment of chronic hydrocephalus following aneurysmal subarachnoid hemorrhage (aSAH). Method The clinical data of 33 patients with hydrocephalus following aSAH who underwent ventriculo-peritoneal shunt in our department were analyzed retrospectively. Result Of 33 patients, 27 were recovered well, 3 mild disabled, 2 severely disabled and 1 died. Conclusions The chronic hydrocephalus is a common complication following aSAH. The ventriculo-peritoneal shunt is an effective method to treat the chronic hydrocephalus following aSAH.%目的 探讨动脉瘤性蛛网膜下腔出血(aSAH)后慢性脑积水的诊断与治疗方法.方法 回顾性分析33例经手术治疗的aSAH后慢性脑积水患者的临床资料.结果 治疗后随访6月~2年,按GOS评分,恢复良好27例,轻残3例,重残2例,死亡1例.结论 慢性脑积水是aSAH后的常见并发症,脑室-腹腔分流术是aSAH后慢性脑积水的有效治疗方法.

  4. Metabolic pattern of the acute phase of subarachnoid hemorrhage in a novel porcine model: studies with cerebral microdialysis with high temporal resolution.

    Directory of Open Access Journals (Sweden)

    Christoffer Nyberg

    Full Text Available BACKGROUND: Aneurysmal subarachnoid hemorrhage (SAH may produce cerebral ischemia and systemic responses including stress. To study immediate cerebral and systemic changes in response to aneurysm rupture, animal models are needed. OBJECTIVE: To study early cerebral energy changes in an animal model. METHODS: Experimental SAH was induced in 11 pigs by autologous blood injection to the anterior skull base, with simultaneous control of intracranial and cerebral perfusion pressures. Intracerebral microdialysis was used to monitor concentrations of glucose, pyruvate and lactate. RESULTS: In nine of the pigs, a pattern of transient ischemia was produced, with a dramatic reduction of cerebral perfusion pressure soon after blood injection, associated with a quick glucose and pyruvate decrease. This was followed by a lactate increase and a delayed pyruvate increase, producing a marked but short elevation of the lactate/pyruvate ratio. Glucose, pyruvate, lactate and lactate/pyruvate ratio thereafter returned toward baseline. The two remaining pigs had a more severe metabolic reaction with glucose and pyruvate rapidly decreasing to undetectable levels while lactate increased and remained elevated, suggesting persisting ischemia. CONCLUSION: The animal model simulates the conditions of SAH not only by deposition of blood in the basal cisterns, but also creating the transient global ischemic impact of aneurysmal SAH. The metabolic cerebral changes suggest immediate transient substrate failure followed by hypermetabolism of glucose upon reperfusion. The model has features that resemble spontaneous bleeding, and is suitable for future research of the early cerebral and systemic responses to SAH that are difficult to study in humans.

  5. Superficial siderosis of the central nervous system induced by a single-episode of traumatic subarachnoid hemorrhage: a study using MRI-enhanced gradient echo T2 star-weighted angiography.

    Science.gov (United States)

    Zhao, Hongwei; Wang, Jin; Lu, Zhonglie; Wu, Qingjie; Lv, Haijuan; Liu, Hu; Gong, Xiangyang

    2015-01-01

    The purpose of this study was to examine whether a single episode of traumatic subarachnoid hemorrhage (tSAH) could cause superficial siderosis of the central nervous system (SS-CNS).This study was approved by the local ethics committee. Thirty-two patients with a history of a single episode of tSAH were enrolled in the study. An episode of tSAH was confirmed in patients based on a CT scan or a lumbar puncture, and a follow-up examination was conducted at least six weeks after the brain trauma. A follow-up MRI examination was performed, using enhanced gradient echo T2 star-weighted angiography (ESWAN) to detect hemosiderin deposition on the cortical surface. The extent to which hemosiderin deposition was associated with several clinical factors was investigated. Various degrees of hemosiderin deposition were detected in 31 of 32 (96.9%) single-episode tSAH patients. Analysis of contingency tables revealed an association between the regions of subarachnoid bleeding based on CT images and the regions of hemosiderin deposition based on ESWAN images (χ2 = 17.73, P<0.05). SS-CNS was determined to be a common consequence after a single episode of tSAH. The extent of hemosiderin deposition is closely correlated with the initial bleeding sites and bleeding volume.

  6. Prevalence of electrocardiographic changes in patients with acute aneurysmal subarachnoid hemorrhage and their relationship with outcome

    Directory of Open Access Journals (Sweden)

    Saktheeswaran Mahesh Kumar

    2013-01-01

    Full Text Available Background: Electrocardiographic (ECG alterations occurring after subarachnoid hemorrhage (SAH have been described frequently, but the prognostic significance of these changes has not been well characterized. Aim and Objectives: To report the prevalence and patterns of ECG alterations in patients with acute aneurysmal SAH and to study the relationship between ECG alterations and the neurological outcome, if any. Materials and Methods: Records of consecutive patients admitted to the neurosurgical intensive care unit of the SCTIMST, Trivandrum between January 1999 and January 2011 with acute aneurysmal SAH were retrospectively analyzed. Results: Of the 321 patients with SAH, 190 (59.2% had abnormal ECGs. Repolarization abnormalities were the most common, with T wave inversion in the anterolateral leads occurring in 155 (48.3% patients. By univariate analysis, female sex, Glasgow Coma Score (GCS at admission of I, ST segment depression or T inversion in anterolateral leads, prolonged corrected QT interval, and sinus bradycardia were associated with increased risk of death. By multivariate analysis, only GCS and WFNS grade independently predicted mortality and none of the ECG changes predicted the same. Presence of tall T waves in anterior leads, T inversion in anterolateral leads, sinus bradycardia, and WFNS grade >1 were independently associated with GCS <15 and poor outcome at discharge. Conclusions: In patients with acute aneurysmal SAH, repolarization abnormalities are the commonest ECG alterations. ECG alterations do not independently predict death, but independently predict poor discharge neurological status.

  7. Prevalence of high blood pressure in Brazilian adolescents and quality of the employed methodological procedures: systematic review

    Directory of Open Access Journals (Sweden)

    Marina Gabriella Pereira de Andrada Magalhães

    2013-12-01

    Full Text Available OBJECTIVE: To review the literature on studies that estimated the prevalence of high blood pressure (HBP or systemic arterial hypertension (SAH in Brazilian adolescents, considering the employed methodological procedures. METHODS: Bibliographical research of prevalence studies of HBP/SAH in adolescents from 1995 to 2010. The search was conducted in the electronic databases PubMed/Medline, Lilacs, SciELO, and Isi Adolec. The descriptors "hypertension", "BP", "teen", "students", "cross-sectional", "prevalence" and "Brazil" were used in Portuguese and English. Furthermore, a score ranging from 0 to 18 based on Recommendations for Blood Pressure Measurement in Humans and Experimental Animals and the VI Brazilian Guidelines of Hypertension was elaborated, in order to analyze the procedures used to measure BP in studies. RESULTS: Twenty-one articles were identified, mostly published in the last 10 years, and 90.5% were performed in school-based and regions of the Southeast, Northeast and South. The prevalence of HBP/SAH ranged from 2.5 to 30.9%. The score of the studies ranged from 0 to 16. A significant negative correlation (rho = -0.504; p = 0.020 was observed between the prevalence of HBP/SAH and the score of BP measurement quality. CONCLUSION: The great variability of PAE/SAH estimates appears to be influenced by methodological procedures used in the studies.

  8. Time from onset of SIRS to antibiotic administration and outcomes after subarachnoid hemorrhage.

    Science.gov (United States)

    Guterman, Elan L; Kamel, Hooman; Azran, Carmil; Shah, Maulik P; Claude Hemphill, J; Smith, Wade S; Navi, Babak B

    2014-08-01

    The interval from presentation with systemic inflammatory response syndrome (SIRS) to the start of antibiotic administration affects mortality in patients with sepsis. However, patients with subarachnoid hemorrhage (SAH) often develop SIRS directly from their brain injury, making it a less useful indicator of infection. We therefore hypothesized that SIRS would not be a suitable trigger for antibiotics in this population. We examined the time from the development of SIRS until antibiotic initiation and its relationship to long-term neurological outcomes in patients with nontraumatic SAH. Patients' baseline characteristics, time of antibiotic administration, and hospital course were collected from retrospective chart review. The primary outcome, 6-month functional status, was prospectively determined using blinded, structured interviews incorporating the modified Rankin Scale (mRS). Sixty-six of 70 patients with SAH during the study period had 6-month follow-up and were included in this analysis. SIRS developed in 57 patients (86%, 95% CI 78-95%). In ordinal logistic regression models controlling for age and illness severity, the time from SIRS onset until antibiotic initiation was not associated with 6-month mRS scores (OR per hour, 0.994; 95% CI 0.987-1.001). In this cohort of patients with SAH, time from SIRS onset until antibiotic administration was not related to functional outcomes. Our results indicate that SIRS is nonspecific in patients with SAH, and support the safety of withholding antibiotics in those who lack additional evidence of infection or hemodynamic deterioration.

  9. Superficial siderosis of the central nervous system induced by a single-episode of traumatic subarachnoid hemorrhage: a study using MRI-enhanced gradient echo T2 star-weighted angiography.

    Directory of Open Access Journals (Sweden)

    Hongwei Zhao

    Full Text Available The purpose of this study was to examine whether a single episode of traumatic subarachnoid hemorrhage (tSAH could cause superficial siderosis of the central nervous system (SS-CNS.This study was approved by the local ethics committee. Thirty-two patients with a history of a single episode of tSAH were enrolled in the study. An episode of tSAH was confirmed in patients based on a CT scan or a lumbar puncture, and a follow-up examination was conducted at least six weeks after the brain trauma. A follow-up MRI examination was performed, using enhanced gradient echo T2 star-weighted angiography (ESWAN to detect hemosiderin deposition on the cortical surface. The extent to which hemosiderin deposition was associated with several clinical factors was investigated. Various degrees of hemosiderin deposition were detected in 31 of 32 (96.9% single-episode tSAH patients. Analysis of contingency tables revealed an association between the regions of subarachnoid bleeding based on CT images and the regions of hemosiderin deposition based on ESWAN images (χ2 = 17.73, P<0.05. SS-CNS was determined to be a common consequence after a single episode of tSAH. The extent of hemosiderin deposition is closely correlated with the initial bleeding sites and bleeding volume.

  10. Recombinant human brain-derived neurotrophic factor prevents neuronal apoptosis in a novel in vitro model of subarachnoid hemorrhage.

    Science.gov (United States)

    Li, Mingchang; Wang, Yuefei; Wang, Wei; Zou, Changlin; Wang, Xin; Chen, Qianxue

    2017-01-01

    Subarachnoid hemorrhage (SAH) is a hemorrhagic stroke with high mortality and morbidity. An animal model for SAH was established by directly injecting a hemolysate into the subarachnoid space of rats or mice. However, the in vitro applications of the hemolysate SAH model have not been reported, and the mechanisms remain unclear. In this study, we established an in vitro SAH model by treating cortical pyramidal neurons with hemolysate. Using this model, we assessed the effects of recombinant human brain-derived neurotrophic factor (rhBDNF) on hemolysate-induced cell death and related mechanisms. Cortical neurons were treated with 10 ng/mL or 100 ng/mL rhBDNF prior to application of hemolysate. Hemolysate treatment markedly increased cell loss, triggered apoptosis, and promoted the expression of caspase-8, caspase-9, and cleaved caspase-3. rhBDNF significantly inhibited hemolysate-induced cell loss, neuronal apoptosis, and expression of caspase-8, caspase-9, and cleaved caspase-3. Our data revealed a previously unrecognized protective activity of rhBDNF against hemolysate-induced cell death, potentially via regulation of caspase-9-, caspase-8-, and cleaved caspase-3-related apoptosis. This study implicates that hemolysate-induced cortical neuron death represents an important in vitro model of SAH.

  11. Subarachnoid hemorrhage with transient ischemic attack: Another masquerader in cerebral venous thrombosis

    Directory of Open Access Journals (Sweden)

    Bhawna Sharma

    2010-01-01

    Full Text Available Cerebral venous thrombosis has a wide spectrum of clinical manifestations that may mimic many other neurological disorders and lead to frequent misdiagnoses or delay in diagnosis. The most frequent symptoms and signs are headache, seizures, focal deficits, and papilledema. A number of rare atypical manifestations have been described. Cerebral venous thrombosis may present with an isolated intracranial hypertension type picture, thunderclap headache, attacks of migraine with aura, isolated psychiatric disturbances, pulsatile tinnitus, isolated or multiple cranial nerve involvement, and occasionally as subarachnoid hemorrhage (SAH or transient ischemic attack. Our patient presented with thunderclap headache and transient ischemic attack like episode with obvious SAH on CT scan. Acute SAH suggests the presence of a vascular lesion, such as ruptured aneurysm, and CVT is not generally considered in the diagnostic workup of SAH. The case emphasizes the importance of cerebral venous study in nonaneurysmal cases of SAH. It is important to have a high index of suspicion in such atypical cases to avoid delay in diagnosis.

  12. Sisearhitektide Liit premeeris / Triin Ojari

    Index Scriptorium Estoniae

    Ojari, Triin, 1974-

    2004-01-01

    ESL aastapreemiad 2003: parima ajaloolise interjööri ja parima kodu preemia - Leila Pärtelpoja ja Karl-Erik Tarbe kujundatud Villa Tannenrode Lükati teel Tallinnas, parim ühiskondlik interjöör - 3+1 arhitektide (Markus Kaasik, Andres Ojari, Ilmar Valdur, kaasautorid Ralf Lõoke, Kalle Komissarov; söögikoha tegi Taavi Aunre ja ühiskondliku mööbli Gert Sarv) kujundatud Mustamäe keskus, publitsistikapreemia - EKA sisearhitektuuri kateedri kataloog "Eesti Kunstiakadeemia sisearhitektuuri osakond 2002-2003". Ära märgiti kaks tooteseeriat: EGO garderoobid (EGO Mööbel OÜ) ning Jan J. Grapsi loodud "Incognito" mööblisari

  13. Determinants and prevalence of depression in patients with chronic renal disease, and their caregivers

    Directory of Open Access Journals (Sweden)

    Hawamdeh S

    2017-07-01

    Full Text Available Sana Hawamdeh, Aljawharah Mohammed Almari, Asrar Salem Almutairi, Wireen Leila T Dator College of Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia Introduction: This study explored the prevalence of depression among the patients with chronic kidney disease and their caregivers and its association to their demographic profile.Methods: A descriptive, correlational, cross-sectional study that used the Hamilton rating scale tool to assess the prevalence of depression among 226 patients undergoing hemodialysis and 105 of their caregivers in a hospital in Saudi Arabia.Results: Patients with chronic renal disease and their caregivers experience depression at varying levels. Depression was positively associated with the socioeconomic and marital status of the patients. Socioeconomic status of the caregivers was seen to be associated with their depression.Conclusion: Depression is highly prevalent among patients with chronic renal disease and their caregivers. Keywords: caregivers, chronic renal disease, depression

  14. Sisearhitektide Liit premeeris / Triin Ojari

    Index Scriptorium Estoniae

    Ojari, Triin, 1974-

    2004-01-01

    ESL aastapreemiad 2003: parima ajaloolise interjööri ja parima kodu preemia - Leila Pärtelpoja ja Karl-Erik Tarbe kujundatud Villa Tannenrode Lükati teel Tallinnas, parim ühiskondlik interjöör - 3+1 arhitektide (Markus Kaasik, Andres Ojari, Ilmar Valdur, kaasautorid Ralf Lõoke, Kalle Komissarov; söögikoha tegi Taavi Aunre ja ühiskondliku mööbli Gert Sarv) kujundatud Mustamäe keskus, publitsistikapreemia - EKA sisearhitektuuri kateedri kataloog "Eesti Kunstiakadeemia sisearhitektuuri osakond 2002-2003". Ära märgiti kaks tooteseeriat: EGO garderoobid (EGO Mööbel OÜ) ning Jan J. Grapsi loodud "Incognito" mööblisari

  15. Current and emerging treatment options for myopic choroidal neovascularization

    Directory of Open Access Journals (Sweden)

    El Matri L

    2015-04-01

    Full Text Available Leila El Matri, Ahmed Chebil, Fedra Kort Department B of Ophthalmology, Hedi Rais Institute of Ophthalmology, Faculty of Medicine of Tunis, University of El Manar, Tunis, Tunisia Abstract: Choroidal neovascularization (CNV is the main cause of visual impairment in highly myopic patients younger than 50 years of age. There are different treatments for myopic CNV (mCNV, with 5- to 10-year outcomes currently. Chorioretinal atrophy is still the most important determinant factor for visual outcome. The purpose of this study is to provide an overview of the current treatments for mCNV, including laser, surgical management, verteporfin photodynamic therapy, and mainly anti-vascular endothelial growth factor therapy. Emerging treatment options are also discussed. Keywords: myopia, choroidal neovascularization, current treatment, emerging treatment

  16. Lower urinary tract symptoms after total and subtotal hysterectomy

    DEFF Research Database (Denmark)

    Gimbel, Helga; Zobbe, Vibeke; Andersen, Birthe Jakobsen

    2005-01-01

    with stress and urinary incontinence in the TAH group. No other differences were found between the two operation methods. The number of women with urinary incontinence and frequency was reduced from study entry for follow-up, while double/triple voiding was increased. Incontinent women had significantly lower......The aim of this Danish multicenter trial was to compare the proportion of women with lower urinary tract symptoms after total abdominal hysterectomy (TAH) and subtotal abdominal hysterectomy (SAH) for benign uterine disorders. A total of 319 women were randomized to TAH (n = 158) or SAH (n = 161......). Women were followed up for 1 year by strict data collection procedures, including postal questionnaires. Results were analyzed by intention-to-treat analyses. Urinary incontinence was found less often among TAH women than among SAH women. This was due to a larger reduction of the number of women...

  17. Virtual Screening of Natural Products, Molecular Docking and Dynamics Simulations on M.tuberculosis S-adenosyl-L-homocysteine Hydrolase

    Directory of Open Access Journals (Sweden)

    Abdul-Rashid B. Sampaco Iii

    2015-12-01

    Full Text Available The activated methyl cycle of Mycobacterium tuberculosis(Mtbis responsible for the regeneration of S-adenosyl methionine (SAM from S-adenosyl-L-homocysteine (SAH. Inhibition of the key enzymes in this transformation may lead to accumulation of SAH and depletion of SAM in the Mtb cell. This has detrimental effects onthe bacterium’s cellular processes. Virtual screening of natural products from the Philippines and those in Ambinter database against S-adenosyl-L-homocysteine hydrolase (SAHH yielded the tautomer of the molecule, methyl 4-({2-[(4-hydroxy-2-oxo-1,2-dihydro-3-quinolinylcarbonyl]hydrazino}sulfonylphenylcarbamate, which displays better binding energy (-307.64 kcal/mol than the substrate, SAH (-270.601 kcal/mol. Molecular dynamics simulations at body temperature indicated that the hit-SAHH complex is more stable than the enzyme-substrate complex.

  18. Recurrent craniospinal subarachnoid hemorrhage in cerebral amyloid angiopathy

    Directory of Open Access Journals (Sweden)

    Mathew Alexander

    2013-01-01

    Full Text Available Cerebral amyloid angiopathy (CAA usually manifests as cerebral hemorrhage, especially as nontraumatic hemorrhages in normotensive elderly patients. Other manifestations are subarachnoid (SAH, subdural, intraventricular hemorrhage (IVH and superficial hemosiderosis. A 52-year-old hypertensive woman presented with recurrent neurological deficits over a period of 2 years. Her serial brain magnetic resonance imaging and computed tomography scans showed recurrent SAH hemorrhage, and also intracerebral, IVH and spinal hemorrhage, with superficial siderosis. Cerebral angiograms were normal. Right frontal lobe biopsy showed features of CAA. CAA can present with unexplained recurrent SAH hemorrhage, and may be the initial and prominent finding in the course of disease in addition to superficial cortical siderosis and intracerebal and spinal hemorrhages.

  19. Blockade of the MEK/ERK pathway with a raf inhibitor prevents activation of pro-inflammatory mediators in cerebral arteries and reduction in cerebral blood flow after subarachnoid hemorrhage in a rat model

    DEFF Research Database (Denmark)

    Maddahi, Aida; Ansar, Saema; Chen, Qingwen

    2011-01-01

    hours, cerebral arteries were harvested, and iNOS, interleukin (IL)-6, IL-1ß, matrix metalloproteinase (MMP)-9, tissue inhibitors of metalloproteinase (TIMP)-1, and phosphorylated ERK1/2 were investigated by immunofluorescence, real-time polymerase chain reaction (PCR), and Western blot analysis....... Cerebral blood flow (CBF) was measured using autoradiography. Protein levels of MMP-9, TIMP-1, iNOS, IL-6, and IL-1ß were increased after SAH, as were mRNA levels of IL-6, MMP-9, and TIMP-1. After SAH, pERK1/2 was increased, but CBF was reduced. Treatment with SB-386023-b at 0 or 6 hours after SAH...

  20. Blockade of the MEK/ERK pathway with a raf inhibitor prevents activation of pro-inflammatory mediators in cerebral arteries and reduction in cerebral blood flow after subarachnoid hemorrhage in a rat model

    DEFF Research Database (Denmark)

    Maddahi, Aida; Ansar, Saema; Chen, Qingwen

    2011-01-01

    hours, cerebral arteries were harvested, and iNOS, interleukin (IL)-6, IL-1β, matrix metalloproteinase (MMP)-9, tissue inhibitors of metalloproteinase (TIMP)-1, and phosphorylated ERK1/2 were investigated by immunofluorescence, real-time polymerase chain reaction (PCR), and Western blot analysis....... Cerebral blood flow (CBF) was measured using autoradiography. Protein levels of MMP-9, TIMP-1, iNOS, IL-6, and IL-1β were increased after SAH, as were mRNA levels of IL-6, MMP-9, and TIMP-1. After SAH, pERK1/2 was increased, but CBF was reduced. Treatment with SB-386023-b at 0 or 6 hours after SAH...

  1. Signal transduction in cerebral arteries after subarachnoid hemorrhage-a phosphoproteomic approach

    DEFF Research Database (Denmark)

    Parker, Benjamin; Larsen, Martin Røssel; Povlsen, Gro Klitgaard

    2013-01-01

    After subarachnoid hemorrhage (SAH), pathologic changes in cerebral arteries contribute to delayed cerebral ischemia and poor outcome. We hypothesize such changes are triggered by early intracellular signals, targeting of which may prevent SAH-induced vasculopathy. We performed an unbiased quanti......-induced signaling components downstream and upstream of ERK1/2.Journal of Cerebral Blood Flow & Metabolism advance online publication, 29 May 2013; doi:10.1038/jcbfm.2013.78....... quantitative analysis of early SAH-induced phosphorylations in cerebral arteries and evaluated identified signaling components as targets for prevention of delayed vasculopathy and ischemia. Labeled phosphopeptides from rat cerebral arteries were quantified by high-resolution tandem mass spectrometry. Selected...

  2. Transcranial regional cerebral oxygen desaturation predicts delayed cerebral ischaemia and poor outcomes after subarachnoid haemorrhage: a correlational study.

    Science.gov (United States)

    Yousef, Khalil M; Balzer, Jeffrey R; Crago, Elizabeth A; Poloyac, Samuel M; Sherwood, Paula R

    2014-12-01

    To examine the relationship between regional cerebral oxygen saturation (rSO2), delayed cerebral ischaemia (DCI), and outcomes after aneurysmal subarachnoid haemorrhage (aSAH). Subjects (n = 163) with aSAH, age 21-75 years, and Fisher grade >1 were included in the study. Continuous rSO2 monitoring was performed for 5-10 days after injury using near-infrared spectroscopy with sensors over the frontal/temporal cortex. rSO250 (OR 3.25, 95%CI 1.58-6.69), positive predictive value (PPV) = 70%. Subjects with rSO2 50 (OR 2.7, 95%CI 1.1-7.2), PPV = 70%. These results suggest that NIRS has the potential for detecting DCI after aSAH. This potential needs to be further explored in a larger prospective study. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Analysis of the Simulated Climatic Characters of the South Asia High with a Flexible Coupled Ocean-Atmosphere GCM

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The ability of a climate model to reproduce the climatic characters of the South Asia High (SAH) is assessed by analyzing the 110-yr output of a Flexible Coupled GCM, version 0 (FGCM-0). Comparing the results of FGCM-0 with the NCEP/NCAR reanalysis data, the major findings show that FGCM-0 has better results in simulation of the geopotential height field at 100 hPa, and reproduces fairly the main atmospheric circulation centers. However, there are still some differences in the simulated results compared with the reanalysis data. The coupled model also successfully reproduces the mean seasonal variation of the SAH,that is, it moves from the Pacific Ocean to the Asian continent, remaining over the Tibetan Plateau from winter to summer, and then withdraws from the Tibetan Plateau to the Pacific Ocean from summer to winter. However, such observed relationships between the SAH positions and the summer precipitation patterns cannot be fairly reproduced in the FGCM-0.

  4. Early endovascular treatment of aneurysmal subarachnoid hemorrhage complicated by neurogenic pulmonary edema and Takotsubo-like cardiomyopathy.

    Science.gov (United States)

    Manto, Andrea; De Gennaro, Angela; Manzo, Gaetana; Serino, Antonietta; Quaranta, Gaetano; Cancella, Claudia

    2014-06-01

    Aneurysmal subarachnoid hemorrhage (SAH) may be associated with acute cardiopulmonary complications, like neurogenic pulmonary edema (NPE) and Takotsubo-like cardiomyopathy (TCM). These dysfunctions seem to result from a neurogenically induced overstimulation of the sympathetic nervous system through the brain-heart connection and often complicate poor grade aneurysmal SAH. The optimal treatment modality and timing of intervention in this clinical setting have not been established yet. Early endovascular therapy seems to be the fitting treatment in this particular group of patients, in which surgical clipping is often contraindicated due to the added risk of craniotomy. Herein we describe the case of a woman admitted to the emergency department with aneurysmal SAH complicated by NPE-TCM, in which early endovascular coiling was successfully performed. Our case, characterized by a favorable outcome, further supports the evidence that early endovascular treatment should be preferred in this peculiar clinical scenario.

  5. Cortical subarachnoid hemorrhage associated with reversible cerebral vasoconstriction syndrome after elective triplet cesarean delivery.

    Science.gov (United States)

    Albano, Beatrice; Del Sette, Massimo; Roccatagliata, Luca; Gandolfo, Carlo; Primavera, Alberto

    2011-06-01

    Reversible cerebral vasoconstriction syndromes (RCVS) comprise a group of disorders characterized by prolonged, but reversible vasoconstriction of the cerebral arteries, usually associated with acute-onset, severe, recurrent headaches, with or without additional neurological signs and symptoms. Various complications of this condition have been observed, such as cortical subarachnoid hemorrhages (cSAH), intracerebral hemorrhages, reversible posterior leukoencephalopathy, ischaemic strokes and transient ischaemic attacks. It is important to include RCVS in thunderclap headache differential diagnosis and among non-aneurismatic subarachnoid hemorrhage causes. In the past years, thanks to the major diffusion of new diagnostic tools such as magnetic resonance, computed tomography and digital subtraction angiography, RCVS have been demonstrated to be more frequent than previously thought. We report an illustrative case of a woman affected by a small cSAH, associated to RCVS, after elective triplet cesarean delivery. To our knowledge, this is the first case of cSAH associated to RCVS after a triplet pregnancy.

  6. Longitudinal left ventricular myocardial dysfunction assessed by 2D colour tissue Doppler imaging in a dog with systemic hypertension and severe arteriosclerosis.

    Science.gov (United States)

    Nicolle, A P; Carlos Sampedrano, C; Fontaine, J J; Tessier-Vetzel, D; Goumi, V; Pelligand, L; Pouchelon, J-L; Chetboul, V

    2005-03-01

    A 12-year-old sexually intact male Vendee Griffon Basset was presented for acute pulmonary oedema. Severe systemic systolic arterial hypertension (SAH) was diagnosed (290 mmHg). Despite blood and abdominal ultrasound tests, the underlying cause of the systemic hypertension could not be determined, and primary SAH was therefore suspected. Conventional echocardiography showed eccentric left ventricular hypertrophy with normal fractional shortening. Despite this apparent normal systolic function, 2D colour tissue Doppler imaging (TDI) identified a marked longitudinal systolic left ventricular myocardial alteration, whereas radial function was still preserved. Three months later, the dog underwent euthanasia because of an acute episode of distal aortic thromboembolism. Necropsy revealed severe aortic and iliac arteriosclerosis. SAH related to arteriosclerosis is a common finding in humans, but has not been previously described in dogs. Moreover, its consequence on longitudinal myocardial function using TDI has never been documented before in this species.

  7. Migraine and risk of hemorrhagic stroke

    DEFF Research Database (Denmark)

    Gaist, David; González-Pérez, Antonio; Ashina, Messoud

    2014-01-01

    BACKGROUND: We investigated the association between hemorrhagic stroke and migraine using data from The Health Improvement Network database. FINDINGS: We ascertained 1,797 incident cases of intracerebral hemorrhage (ICH) and 1,340 of subarachnoid hemorrhage (SAH). Density-based sampling was used...... to select 10,000 controls free from hemorrhagic stroke. Using unconditional logistic regression models, we calculated the risk of hemorrhagic stroke associated with migraine, adjusting for age, sex, calendar year, alcohol, body mass index, hypertension, previous cerebrovascular disease, oral contraceptive...... use, and health services utilization.The risk (odds ratio [OR]) of ICH among migraineurs was 1.2 (95% confidence interval [CI] 0.9-1.5), and of SAH was (1.2, 95% CI 0.9-1.5). The association with ICH was stronger for migraine diagnosed ≥20 years prior to ICH (OR 1.6, 95% CI 1.0-2.4), but not with SAH...

  8. [Does cerebral salt wasting syndrome exist?].

    Science.gov (United States)

    Leblanc, P-E; Cheisson, G; Geeraerts, T; Tazarourte, K; Duranteau, J; Vigué, B

    2007-11-01

    Increased natriuresis is a frequent situation after subarachnoid haemorrhage (SAH). It may be responsible for hyponatremia, which can be dangerous in case of severe hypo-osmolarity or hypovolemia. Inappropriate secretion of antidiuretic hormone or cerebral salt wasting syndrome (CSWS) have been incriminated for hyponatremia after SAH, but it remains difficult to distinguish between both syndromes. There are many explanations for increased natriuresis after SAH, depending on the level of blood pressure, the volemia, and the presence or not of natriuretic peptides. The cerebral insult and the treatments, which are done to fight against elevated intracranial pressure or vasospasm, can modify any of these parameters. So it appears that the word "cerebral" in CSWS is probably not a good term and it would be better to talk about appropriate or non-appropriate natriuretic response. Corticoïds or urea can be useful for controlling hypernatriuresis.

  9. Spontaneous subarachnoid hemorrhage due to ruptured cavernous internal carotid artery aneurysm after medical prolactinoma treatment.

    Science.gov (United States)

    Khalsa, Siri Sahib; Hollon, Todd C; Shastri, Ravi; Trobe, Jonathan D; Gemmete, Joseph J; Pandey, Aditya S

    2016-06-08

    Aneurysms of the cavernous segment of the internal carotid artery (ICA) are believed to have a low risk of subarachnoid haemorrhage (SAH), given the confines of the dural rings and the anterior clinoid process. The risk may be greater when the bony and dural protection has been eroded. We report a case of spontaneous SAH from rupture of a cavernous ICA aneurysm in a patient whose large prolactinoma had markedly decreased in size as the result of cabergoline treatment. After passing a balloon test occlusion, the patient underwent successful endovascular vessel deconstruction. This case suggests that an eroding skull base lesion may distort normal anterior cranial base anatomy and allow communication between the cavernous ICA and subarachnoid space. The potential for SAH due to cavernous ICA aneurysm rupture should be recognised in patients with previous pituitary or other skull base lesions adjacent to the cavernous sinus.

  10. Transpulmonary Thermodilution-Based Management of Neurogenic Pulmonary Edema After Subarachnoid Hemorrhage.

    Science.gov (United States)

    Mutoh, Tatsushi; Kazumata, Ken; Ueyama-Mutoh, Tomoko; Taki, Yasuyuki; Ishikawa, Tatsuya

    2015-11-01

    Neurogenic pulmonary edema (NPE) is a potentially catastrophic but treatable systemic event after subarachnoid hemorrhage (SAH). The development of NPE most frequently occurs immediately after SAH, and the severity is usually self-limiting. Despite extensive research efforts and a breadth of collective clinical experience, accurate diagnosis of NPE can be difficult, and effective hemodynamic treatment options are limited. Recently, a bedside transpulmonary thermodilution device has been introduced that traces physiological patterns consistent with current theories regarding the mechanism (hydrostatic or permeability PE) of NPE. This article provides an overview of the clinical usefulness of the advanced technique for use in the neurointensive care unit for the diagnosis and management of post-SAH NPE.

  11. Delayed rebleeding of a spontaneously thrombosed aneurysm after subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Muhammad Omar Chohan

    2014-01-01

    Full Text Available Background: This report provides a rare documentation of spontaneous thrombosis of a ruptured aneurysm followed by delayed recanalization and subsequent rerupture. Case Description: A 47-year-old female presented with spontaneous subarachnoid hemorrhage (SAH. Four aneurysms were identified on CT angiogram including a basilar apex aneurysm, considered source of bleeding. Cerebral angiogram on postbleed day (PBD #1 showed spontaneous thrombosis of basilar apex aneurysm. The patient was discharged to a nursing home on PBD #18 after two subsequent studies showed no recanalization of the basilar aneurysm. The patient returned on PBD #26 with a second episode of spontaneous SAH. The previously thrombosed basilar aneurysm had recanalized and reruptured, which was now treated with coil embolization. Conclusion: We are not aware of a previous report of saccular cerebral aneurysm documenting spontaneous thrombosis after SAH and recanalization with second hemorrhage. This occurrence presents a dilemma regarding the timing and frequency of subsequent cerebrovascular imaging and treatment.

  12. Syringomyelia and spinal arachnoiditis resulting from aneurysmal subarachnoid hemorrhage: Report of two cases and review of the literature

    Directory of Open Access Journals (Sweden)

    Taylor J Abel

    2014-01-01

    Full Text Available Syringomyelia resulting from arachnoiditis secondary to aneurysmal subarachnoid hemorrhage (SAH is an extremely rare clinical entity with few cases reported in the literature. The presentation, management, and pathogenesis of syringomyelia in this setting is poorly understood. We describe the presentation, radiology, management, and outcomes in two patients with syringomyelia resulting from arachnoiditis secondary to aneurysmal SAH and review the literature on this rare condition. Case number 1 was treated successfully with syrinx-subarachnoid shunt after extensive lysis of adhesions. Case number 2 was treated with syringoperitoneal shunt. Both patients had radiographic decreased syrinx size postoperatively. These patients add to the small literature on syringomyelia occurring secondary to SAH-associated arachnoiditis. The radiographic outcomes demonstrate that in the appropriately selected patient, syrinx-subarachnoid or syringoperitoneal shunting are viable options.

  13. Mortality after hemorrhagic stroke

    DEFF Research Database (Denmark)

    González-Pérez, Antonio; Gaist, David; Wallander, Mari-Ann

    2013-01-01

    OBJECTIVE: To investigate short-term case fatality and long-term mortality after intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) using data from The Health Improvement Network database. METHODS: Thirty-day case fatality was stratified by age, sex, and calendar year after ICH...... during the first year of follow-up compared with controls (ICH: hazard ratio [HR] 2.60, 95% confidence interval [CI] 2.09-3.24, p year (ICH: HR 2.02, 95% CI 1.75-2.32, p ... and SAH using logistic regression. Cox proportional hazards regression analyses were used to estimate the risk of death during the first year of follow-up and survivors at 1 year. RESULTS: Case fatality after ICH was 42.0%, compared with 28.7% after SAH. It increased with age (ICH: 29.7% for 20-49 years...

  14. Dysnatremia as a poor prognostic indicator in patients with acute subarachnoid hemorrhage.

    Science.gov (United States)

    Spatenkova, Vera; Bradac, Ondrej; de Lacy, Patricia; Skrabalek, Pavel; Suchomel, Petr

    2017-08-01

    Dysnatremias are common and carry a risk of poor prognosis in acute subarachnoid hemorrhage (SAH) patients. The aim of this study was to determine the frequency and outcome of dysnatremias in 344 SAH patients treated by a targeted sodium management regimen. We performed a 10-year observational dysnatremia study. Hyponatremia was defined as serum sodium (SNa) below 135 mmol/L, hypernatremia SNa above 150 mmol/L. Dysnatremia occurred in 35.8% patients; this was more frequently hyponatremia (19.8%) with a mean SNa 132.23±2.09 mmol/L, (16.0% mild, 3.2% moderate, 0.6% severe). Hypernatremia occurred less commonly in 11.9%, Psodium management regimen in acute SAH patients showed that dysnatremias were frequent, predominantly hyponatremia of which the more usual causes were CSW and not SIADH. Hypernatremia was shown to be an independent risk factor for inpatient mortality and poor outcome.

  15. Serum C-reactive protein levels predict neurological outcome after aneurysmal subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Flávio Ramalho Romero

    2012-03-01

    Full Text Available OBJECTIVES: Our aim was to evaluate the relationship between serum C-reactive protein (CRP levels and the neurological prognosis and development of vasospasm in patients with aneurysmal subarachnoid hemorrhage (aSAH. METHODS: Eighty-two adult patients with aSAH diagnoses were prospectively evaluated. Glasgow Coma Scale (GCS score, Hunt and Hess grade, Fisher grade, cranial CT scans, digital subtraction angiography studies and daily neurological examinations were recorded. Serial serum CRP measurements were obtained daily between admission and the tenth day. Glasgow Outcome Scale (GOS and the modified Rankin Scale (mRS were used to assess the prognosis. RESULTS: Serum CRP levels were related to severity of aSAH. Patients with lower GCS scores and higher Hunt and Hess and Fisher grades presented statistically significant higher serum CRP levels. Patients with higher serum CRP levels had a less favorable prognosis. CONCLUSIONS: Increased serum CRP levels were strongly associated with worse clinical prognosis in this study.

  16. Alterations of voltage-dependent calcium channel currents in basilar artery smooth muscle cells at early stage of subarachnoid hemorrhage in a rabbit model.

    Directory of Open Access Journals (Sweden)

    Xianqing Shi

    Full Text Available OBJECTIVE: To investigate the changes in the currents of voltage-dependent calcium channels (VDCCs in smooth muscle cells of basilar artery in a rabbit model of subarachnoid hemorrhage (SAH. METHODS: New Zealand white rabbits were randomly divided into five groups: sham (C, normal (N, 24 hours (S1, 48 hours (S2 and 72 hours (S3 after SAH. Non-heparinized autologous arterial blood (1 ml/kg was injected into the cisterna magna to create SAH after intravenous anesthesia, and 1 ml/kg of saline was injected into cisterna magna in the sham group. Rabbits in group N received no injections. Basilar artery in S1, S2, S3 group were isolated at 24, 48, 72 hours after SAH. Basilar artery in group C was isolated at 72 hours after physiological saline injection. Basilar artery smooth muscle cells were isolated for all groups. Whole-cell patch-clamp technique was utilized to record cell membrane capacitance and VDCCs currents. The VDCCs antagonist nifedipine was added to the bath solution to block the Ca(++ channels currents. RESULTS: There were no significant differences in the number of cells isolated, the cell size and membrane capacitance among all the five groups. VDCC currents in the S1-S3 groups had higher amplitudes than those in control and sham groups. The significant change of current amplitude was observed at 72 hours after SAH, which was higher than those of 24 and 48 hours. The VDCCs were shown to expression in human artery smooth muscle cells. CONCLUSIONS: The changes of activation characteristics and voltage-current relationship at 72 hours after SAH might be an important event which leads to a series of molecular events in the microenvironment of the basilar artery smooth muscle cells. This may be the key time point for potential therapeutic intervention against subarachnoid hemorrhage.

  17. CT angiography versus 3D rotational angiography in patients with subarachnoid hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Bechan, R.S.; Peluso, J.P.; Sluzewski, M.; Rooij, W.J. van [Sint Elisabeth Ziekenhuis Tilburg, Department of Radiology, Tilburg (Netherlands); Rooij, S.B. van [Medisch Centrum Alkmaar, Department of Radiology, Alkmaar (Netherlands); Sprengers, M.E.; Majoie, C.B. [Academisch Medisch Centrum, Department of Radiology, Amsterdam (Netherlands)

    2015-12-15

    CT angiography (CTA) is increasingly used as primary diagnostic tool to replace digital subtraction angiography (DSA) in patients with subarachnoid hemorrhage (SAH). However, 3D rotational angiography (3DRA) has substituted DSA as a reference standard. In this prospective observational study, we compare CTA with 3DRA of all cerebral vessels in a large cohort of patients with SAH. Of 179 consecutive patients with SAH admitted between March 2013 and July 2014, 139 underwent 64- to 256-detector row CTA followed by complete cerebral 3DRA within 24 h. In 86 patients (62 %), 3DRA was performed under general anesthesia. Two observers from outside hospitals reviewed CTA data. In 118 of 139 patients (85 %), 3DRA diagnosed the cause of hemorrhage: 113 ruptured aneurysms, three arterial dissections, one micro-arteriovenous malformation (AVM), and one reversible vasoconstriction syndrome. On CTA, both observers missed all five non-aneurysmal causes of SAH. Sensitivity of CTA in depicting ruptured aneurysms was 0.88-0.91, and accuracy was 0.88-0.92. Of 113 ruptured aneurysms, 28 were ≤3 mm (25 %) and of 95 additional aneurysms, 71 were ≤3 mm (75 %). Sensitivity of depicting aneurysms ≤3 mm was 0.28-0.43. Of 95 additional aneurysms, the two raters missed 65 (68 %) and 58 (61 %). Sensitivity in detection was lower in aneurysms of the internal carotid artery than in other locations. CTA had some limitations as primary diagnostic tool in patients with SAH. All non-aneurysmal causes for SAH and one in ten ruptured aneurysms were missed. Performance of CTA was poor in aneurysms ≤3 mm. The majority of additional aneurysms were not depicted on CTA. (orig.)

  18. Acute subarachnoid hemorrhage: using 64-slice multidetector CT angiography to ''triage'' patients' treatment

    Energy Technology Data Exchange (ETDEWEB)

    Agid, R.; Lee, S.K.; Willinsky, R.A.; Farb, R.I.; TerBrugge, K.G. [Toronto Western Hospital, Division of Neuroradiology, Department of Medical Imaging, Toronto, Ontario (Canada)

    2006-11-15

    To evaluate the clinical role of CT angiography (CTA) in patients with acute subarachnoid hemorrhage (SAH) for treatment decision-making. Consecutive patients with acute SAH had CTA using a 64-slice scanner for initial clinical decision-making. Image processing included multiplanar volume reformatted (MPVR) maximum intensity projections (MIP) and 3D volume-rendered reconstructions. CTAs were used for (1) evaluating the cause of SAH, and (2) triaging aneurysm-bearing patients to the more appropriate management, either surgical clipping or endovascular coiling. CTA findings were confirmed by neurosurgical exploration or catheter angiography (digital subtraction angiography, DSA). Successful coiling provided evidence that triaging to endovascular treatment was correct. Included in the study were 73 patients. CTA findings were confirmed by DSA or neurosurgical operation in 65 patients, and of these 65, 47 had aneurysmal SAH, 3 had vasculitis, 1 had arterial dissection and 14 had no underlying arterial abnormality. The cause of SAH was detected with CTA in 62 out of the 65 patients (95.4%, sensitivity 94%, specificity 100%). CTA revealed the aneurysm in 46 of 47 patients (98%, sensitivity 98%, specificity 100%, positive predictive value 100%, negative predictive value 82.3%), 1 of 3 vasculitides and 1 of 1 dissection. Of the 46 patients with aneurysm, 44 (95.7%) were referred for treatment based on CTA. In 2 patients (2 of 46, 4.4%) CTA was not informative enough to choose treatment requiring DSA. Of the 44 patients, 27 (61.4%) were referred to endovascular treatment and successful coiling was achieved in 25 (25 of 27, 92.6%). CTA using a 64-slice scanner is an accurate tool for detecting and characterizing aneurysms in acute SAH. CTA is useful in the decision process whether to coil or clip an aneurysm. (orig.)

  19. Heart Rate Variability for Preclinical Detection of Secondary Complications after Subarachnoid Hemorrhage

    Science.gov (United States)

    Schmidt, J. Michael; Sow, Daby; Crimmins, Michael; Albers, David; Agarwal, Sachin; Claassen, Jan; Connolly, E. Sander; Elkind, Mitchell S. V.; Hripcsak, George; Mayer, Stephan A.

    2015-01-01

    Introduction We sought to determine if monitoring heart rate variability (HRV) would enable preclinical detection of secondary complications after subarachnoid hemorrhage (SAH). Methods We studied 236 SAH patients admitted within the first 48 hours of bleed onset, discharged after SAH day 5, and had continuous electrocardiogram records available. The diagnosis and date of onset of infections and DCI events were prospectively adjudicated and documented by the clinical team. Continuous ECG was collected at 240 Hz using a high-resolution data acquisition system. The Tompkins Hamilton algorithm was used to identify R-R intervals excluding ectopic and abnormal beats. Time, frequency, and regularity domain calculations of HRV were generated over the first 48 hours of ICU admission and 24 hours prior to the onset of each patient's first complication, or SAH day 6 for control patients. Clinical prediction rules to identify infection and DCI events were developed using bootstrap aggregation and cost sensitive meta-classifiers. Results The combined infection and DCI model predicted events 24 hours prior to clinical onset with high sensitivity (87%) and moderate specificity (66%), and was more sensitive than models that predicted either infection or DCI. Models including clinical and HRV variables together substantially improved diagnostic accuracy (AUC 0.83) compared to models with only HRV variables (AUC 0.61). Conclusions Changes in HRV after SAH reflect both delayed ischemic and infectious complications. Incorporation of concurrent disease severity measures substantially improves prediction compared to using HRV alone. Further research is needed to refine and prospectively evaluate real-time bedside HRV monitoring after SAH. PMID:24610353

  20. Ultra-early Detection of Microcirculatory Injury as Predictor of Developing Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage.

    Science.gov (United States)

    Gölitz, Philipp; Hoelter, Philip; Rösch, Julie; Roessler, Karl; Knossalla, Frauke; Doerfler, Arnd

    2017-08-15

    Delayed cerebral ischemia (DCI) still remains a major complication after subarachnoid hemorrhage (SAH). The aim of our study was to evaluate whether flow analysis of admission digital subtraction angiography (DSA) using parametric color coding (PCC), a postprocessing algorithm, allows ultra-early identification of SAH patients at risk for developing subsequent symptomatic vasospasm. In this study 52 patients who suffered SAH from aneurysm rupture, were retrospectively enrolled. Of the patients 26 developed DCI and angiographically proven cerebral vasospasm and 26 age, gender-and clinical status-matched SAH patients without DCI served as controls. Using PCC, the following flow parameters were calculated: cerebral circulation time (CirT), cortical relative time to peak (rTTP) and microvascular transit time (TT). Mean cerebral CirT and cortical rTTP were longer in the DCI group (6.42 s ± 1.54 and 3.16 s ± 0.86, respectively) than in the non-DCI group (5.77 s ± 1.86 and 3.11 s ± 1.41, respectively), but without statistical significance. The mean microvascular TT was statistically significantly (p = 0.04) longer in the DCI group (3.19 s ± 0.78) than in the non-DCI group (2.67 s ± 0.73). Angiographic flow analysis might be suitable for ultra-early detection and quantitative assessment of microcirculatory injury in SAH patients, predictive of developing subsequent DCI. Prolonged microvascular TT seems to be a significant independent factor positively associated with DCI development. Identifying SAH patients at risk for DCI ultra-early after ictus might contribute to initiate prophylactic therapies before clinical deterioration.

  1. The influence of addiction risk on nursing students' expectations of patients' pain reports: a clinical vignette approach.

    Science.gov (United States)

    Miceli, Paula C; Katz, Joel

    2009-01-01

    To examine the influence of addiction risk (substance abuse history [SAH]) and pain relief (PR) on nursing and non-nursing students' perceptions of pain in a postoperative vignette patient. Using a 2 x 2 design, the independent variables SAH (present/+, absent/-) and PR (adequate, little) were varied systematically to produce four vignettes. Participants were randomly assigned to receive one of the four vignettes that described a 45-year-old man after a total hip replacement. Participants rated the vignette patient's experienced and reported pain intensity (PI) on a 0 mm to 100 mm visual analogue scale and addiction risk on a 0 mm to 100 mm visual analogue scale. A pain congruence (PC) score was calculated (PC = reported PI -- experienced PI), and was interpreted as congruent (+/-2 mm) or incongruent (+2 mm to +100 mm for expected pain over-reporting; -2 mm to -100 mm for expected pain under-reporting). Responses from undergraduate nursing (n=89) and non-nursing (n=88) students were analyzed. The estimated addiction risk was significantly lower in nursing (14% to 45%) versus non-nursing students (50%). Nursing students' mean PC scores were not significantly altered by SAH alone. Expectations of pain over-reporting were observed under conditions of SAH+/adequate PR, but not SAH+/little PR. In non-nursing students, SAH and PR were significant and independent factors influencing mean PC scores in the direction of pain over-reporting. Under most conditions, nursing students expected pain under-reporting by the postoperative vignette patient. However, nursing students did expect pain to be over-reported when addiction risk was high and PR was adequate. These data suggest that nursing students' expectations regarding pain over- and under-reporting were sensitive to perceptions of addiction risk, but involved additional factors (eg, level of PR).

  2. Clinical evaluation of flat-panel detector compared with multislice computed tomography in 65 patients with acute intracranial hemorrhage: initial results. Clinical article.

    Science.gov (United States)

    Struffert, Tobias; Eyupoglu, Ilker Y; Huttner, Hagen B; Engelhorn, Tobias; Doelken, Marc; Saake, Marc; Ganslandt, Oliver; Doerfler, Arnd

    2010-10-01

    The goal in this study was to compare flat-panel detector (FD) CT with multislice (MS) CT in the visualization of intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), intraventricular hemorrhage, and external ventricular drains (EVDs) to evaluate the diagnostic quality and limitations of the new FD CT imaging modality. Neuroimages obtained in 65 patients, including 24 with EVDs, were reviewed by 2 independent, experienced clinicians. Lesions in all patients were investigated with FD CT and MS CT. The numbers of slices positive for ICH and SAH were counted, and for ICH the diameter and area of the lesion was measured. The positioning of drains was assessed. The presence of ventricular blood was noted. Statistical analysis was performed by calculating the Pearson correlation coefficient (r) to evaluate the level of inter- and intraobserver agreement, and linear regression analysis was done to visualize the results of the numbers of ICH- and SAH-positive slices. The authors found high interobserver agreement regarding the number of slices with evidence of ICH (r = 0.89 for MS CT, r = 0.78 for FD CT) and SAH (r = 0.88 for MS CT, r = 0.9 for FD CT). Thin layers of blood in the ventricles were not detected on FD CT in 36.4% of cases. Six of 7 perimesencephalic SAHs were not seen on FD CT scans. The EVDs could be assessed with both modalities in 83.3% of cases, but the position of the drain could not be determined with FD CT in 16.7% (4 of 24 cases). In some respects, FD CT is of limited use for the visualization of intracranial hemorrhage. However, despite limited contrast resolution, ICH and EVDs can be reliably demonstrated. Perimesencephalic SAH and thin layers of blood in the occipital horns may not be detected using FD CT. Further evaluation and improvement of the image quality is necessary before FD CT will provide identical quality in comparison with MS CT.

  3. Monitoreo del sueño en conductores de ómnibus y camiones: factor relevante a considerar para la renovación de la licencia de conducir Sleep monitoring in bus and truck drivers: relevant factor to consider for the renewal of the driving license

    Directory of Open Access Journals (Sweden)

    Jorge Rey de Castro

    2010-06-01

    Full Text Available La información publicada indica que hasta un tercio de los accidentes de tránsito son producidos por la somnolencia del conductor. El síndrome de apnea-hipopnea del sueño (SAHS es una enfermedad orgánica que causa somnolencia. Puede diagnosticarse por medio de un registro del sueño y controlarse con modalidades terapéuticas distintas y de diferente complejidad según su gravedad, lo que determina el costo final del manejo del SAHS. En los pacientes que emplean disciplinadamente la terapia, los resultados son muy buenos y logran controlar la somnolencia, mejoran la calidad de vida del afectado, protegen su salud y disminuyen ostensiblemente el riesgo de accidentes durante la conducción debido a somnolencia. Ponemos en consideración de las autoridades responsables la aplicación de estas pruebas en choferes con sospecha de SAHS que renuevan licencias de conducir de tipo A-II y A-III.The available information indicates that up to one third of the road traffic accidents are produced by the driver’s sleepiness. Sleep apnea-hypopnea syndrome (SAHS is an organic disease that causes sleepiness. It can be diagnosed by a sleep register and can be controlled by different therapeutic means, varying their complexity according to its severity, which determines the final cost of the management of SAHS. In patients using the therapy thoroughly, the results are very good and achieve to control the sleepiness, improve the quality of life of the affected subject, protect his health and markedly decrease the risk of accidents due to sleepiness during driving. We put into consideration of the respective authorities the application of these tests in drivers suspected of having SAHS who renew their driving licenses type A-II and A-III.

  4. Hypocortisolism in noncomatose patients during the acute phase of subarachnoid hemorrhage.

    Science.gov (United States)

    Lanterna, Luigi A; Spreafico, Veronica; Gritti, Paolo; Prodam, Flavia; Signorelli, Antonio; Biroli, Francesco; Aimaretti, Gianluca

    2013-10-01

    Hypopituitarism represents a common long-term complication of subarachnoid hemorrhage (SAH). The incidence of hypocortisolism may be higher during the acute phase of SAH. Although hypocortisolism may be harmful in critically ill SAH patients, data are still lacking. The primary objective of this study was to investigate the incidence of hypocortisolism during the acute phase of SAH (15 days). Secondary objectives included an analysis of the relationship between hypocortisolism and outcome and the computation of the cortisol-time secretion curve. Clinical data of a consecutive series of 26 noncomatose patients with aneurysmal SAH were collected prospectively. The sample size was calculated considering an expected proportion of hypocortisolism of 30%, a confidence level of 95%, and a total width of confidence interval of 0.35. The definition of hypocortisolism (as taken from a statement from the critical care medicine task forces) includes random total cortisol Hypocortisolism was diagnosed in 11 patients (42.3%). Cortisol increment after stimulation test was always >9 μg/dl, suggesting a hypothalamic-pituitary impairment. Hypocortisolism was independently associated with a higher risk of poor outcome (P = .046) even after adjusting for age and Hunt and Hess grade. The cortisol-time secretion curve showed a peak at day 5 and a minimum at day 8. The peak at day 5 correlated with the risk of delayed cerebral ischemia (P = .001), and the cortisol concentration slope between days 1 and 8 correlated with the risk of poor outcome (P = .033). Patients with SAH are at high risk of secondary hypocortisolism during the first 15 days after bleeding. Hypocortisolism independently increases the risk of poor outcome. The acute phase of hypothalamo-pituitary dysfunction, as reflected by an abnormal day-by-day cortisol secretion pattern, may affect the risk of delayed cerebral ischemia. Copyright © 2013 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  5. Subarachnoid hemorrhage and visuospatial and visuoperceptive impairment: disruption of the mirror neuron system.

    Science.gov (United States)

    Plata-Bello, Julio; Modroño, Cristián; Acosta-López, Silvia; Pérez-Martín, Yaiza; Marcano, Francisco; García-Marín, Víctor; González-Mora, José Luis

    2016-10-12

    Nearly 20 % of patients who suffer a subarachnoid hemorrhage (SAH) still display cognitive impairment even a year after follow-up. Visuospatial and visuoperceptive domains may be impaired in this cognitive impairment and may not have been fully studied in these patients. Furthermore, these cognitively impaired domains have been associated with activity in the so-called mirror neuron system (MNS). The aim of the study is to analyze the pattern of brain activity with an MNS task-based functional magnetic resonance imaging (fMRI) study in SAH patients. A complete neuropsychological assessment and fMRI study (with observation and execution conditions) were performed in patients with a history of SAH registered in the database of the Hospital Universitario de Canarias and a healthy control group. The patients had to meet all the following inclusion criteria for the study (less than 50 years old; SAH with a Fisher score 1-3; no vasospasm or ischemia; minimum follow-up of one year). Twelve SAH patients were studied. Three of which displayed visuospatial/visuoperceptive impairment. fMRI study showed the presence of higher activity in MNS regions in these patients than in patients with normal visuospatial/visuoperceptive functions. Furthermore, there was a negative correlation between the test scores and brain activity in premotor regions of the studied patients. SAH patients with visuospatial/visuoperceptive impairment have greater activity in the MNS regions. This finding may be associated with a subcortical dysfunction, leading to a disruption of neural activity and less efficient behavior of this brain network.

  6. Effect of epigenetic modification with trichostatin A and S-adenosylhomocysteine on developmental competence and POU5F1-EGFP expression of interspecies cloned embryos in dog.

    Science.gov (United States)

    Mousai, M; Hosseini, S M; Hajian, M; Jafarpour, F; Asgari, V; Forouzanfar, M; Nasr-Esfahani, M H

    2015-10-01

    Adult canine fibroblasts stably transfected with either cytomegalovirus (CMV) or POU5F1 promoter-driven enhanced green fluorescent protein (EGFP) were used to investigate if pre-treatment of these donor cells with two epigenetic drugs [trichostatin A (TSA), or S-adenosylhomocysteine (SAH)] can improve the efficiency of interspecies somatic cell nuclear transfer (iSCNT). Fluorescence-activated cell sorting (FACS), analyses revealed that TSA, but not SAH, treatment of both transgenic and non-transgenic fibroblasts significantly increased acetylation levels compared with untreated relatives. The expression levels of Bcl2 and P53 were significantly affected in TSA-treated cells compared with untreated cells, whereas SAH treatment had no significant effect on cell apoptosis. Irrespective of epigenetic modification, dog/bovine iSCNT embryos had overall similar rates of cleavage and development to 8-16-cell and morula stages in non-transgenic groups. For transgenic reconstructed embryos, however, TSA and SAH could significantly improve development to 8-16-cell and morula stages compared with control. Even though, irrespective of cell transgenesis and epigenetic modification, none of the iSCNT embryos developed to the blastocyst stage. The iSCNT embryos carrying CMV-EGFP expressed EGFP at all developmental stages (2-cell, 4-cell, 8-16-cell, and morula) without mosaicism, while no POU5F1-EGFP signal was observed in any stage of developing iSCNT embryos irrespective of TSA/SAH epigenetic modifications. These results indicated that bovine oocytes partially remodel canine fibroblasts and that TSA and SAH have marginal beneficial effects on this process.

  7. Delayed ischaemic neurological deficits after subarachnoid haemorrhage are associated with clusters of spreading depolarizations.

    Science.gov (United States)

    Dreier, Jens P; Woitzik, Johannes; Fabricius, Martin; Bhatia, Robin; Major, Sebastian; Drenckhahn, Chistoph; Lehmann, Thomas-Nicolas; Sarrafzadeh, Asita; Willumsen, Lisette; Hartings, Jed A; Sakowitz, Oliver W; Seemann, Jörg H; Thieme, Anja; Lauritzen, Martin; Strong, Anthony J

    2006-12-01

    Progressive ischaemic damage in animals is associated with spreading mass depolarizations of neurons and astrocytes, detected as spreading negative slow voltage variations. Speculation on whether spreading depolarizations occur in human ischaemic stroke has continued for the past 60 years. Therefore, we performed a prospective multicentre study assessing incidence and timing of spreading depolarizations and delayed ischaemic neurological deficit (DIND) in patients with major subarachnoid haemorrhage (SAH) requiring aneurysm surgery. Spreading depolarizations were recorded by electrocorticography with a subdural electrode strip placed on cerebral cortex for up to 10 days. A total of 2110 h recording time was analysed. The clinical state was monitored every 6 h. Delayed infarcts after SAH were verified by serial CT scans and/or MRI. Electrocorticography revealed 298 spreading depolarizations in 13 of the 18 patients (72%). A clinical DIND was observed in seven patients 7.8 days (7.3, 8.2) after SAH. DIND was time-locked to a sequence of recurrent spreading depolarizations in every single case (positive and negative predictive values: 86 and 100%, respectively). In four patients delayed infarcts developed in the recording area. As in the ischaemic penumbra of animals, delayed infarction was preceded by progressive prolongation of the electrocorticographic depression periods associated with spreading depolarizations to >60 min in each case. This study demonstrates that spreading depolarizations have a high incidence in major SAH and occur in ischaemic stroke. Repeated spreading depolarizations with prolonged depression periods are an early indicator of delayed ischaemic brain damage after SAH. In view of experimental evidence and the present clinical results, we suggest that spreading depolarizations with prolonged depressions are a promising target for treatment development in SAH and ischaemic stroke.

  8. Interleukin-1 receptor antagonist is beneficial after subarachnoid haemorrhage in rat by blocking haem-driven inflammatory pathology

    Directory of Open Access Journals (Sweden)

    Andrew D. Greenhalgh

    2012-11-01

    Subarachnoid haemorrhage (SAH is a major contributor to the burden of stroke on society. Treatment options are limited and animal models of SAH do not always mimic key pathophysiological hallmarks of the disease, thus hindering development of new therapeutics. Inflammation is strongly associated with brain injury after SAH in animals and patients, and inhibition of the pro-inflammatory cytokine interleukin-1 (IL-1 represents a possible therapeutic target. Here we report that a rupture of the middle cerebral artery in the rat produces heterogeneous infarct patterns similar to those observed in human SAH. Administration of the IL-1 receptor antagonist (IL-1Ra reduced blood-brain barrier breakdown, and the extent of breakdown correlated with brain injury. After SAH, haem oxygenase-1 (HO-1 was strongly expressed around the bleed site and in the cortex and striatum, indicating the presence of free haem, a breakdown product of haemoglobin. HO-1 expression was also found in the same regions as microglial/macrophage expression of IL-1α. The direct effect of haem on IL-1α expression was confirmed in vitro using organotypic slice culture (OSC. Haem-induced cell death was dependent on IL-1 signalling, with IL-1Ra completely blocking cellular injury. Furthermore, stimulation of mouse primary mixed glial cells with haem induced the release of IL-1α, but not IL-1β. Thus, we suggest that haem, released from lysed red blood cells (RBCs in the subarachnoid space, acts as a danger-associated molecular pattern (DAMP driving IL-1-dependent inflammation. These data provide new insights into inflammation after SAH-induced brain injury and suggest IL-1Ra as a candidate therapeutic for the disease.

  9. Cerebral microbleeds in patients with acute subarachnoid hemorrhage.

    Science.gov (United States)

    Jeon, Sang-Beom; Parikh, Gunjan; Choi, H Alex; Badjatia, Neeraj; Lee, Kiwon; Schmidt, J Michael; Lantigua, Hector; Connolly, E Sander; Mayer, Stephan A; Claassen, Jan

    2014-02-01

    Cerebral microbleeds (CMBs) are commonly found after stroke but have not previously been studied in patients with subarachnoid hemorrhage (SAH). To study the prevalence, radiographic patterns, predictors, and impact on outcome of CMBs in patients with SAH. We analyzed retrospectively 39 consecutive patients who underwent T2*-weighted gradient-echo imaging within 7 days after onset of spontaneous SAH. We report the frequency and location of CMBs and show their association with demographics, vascular risk factors, the Hunt-Hess grade, the modified Fisher Scale, the Acute Physiological and Chronic Health Evaluation II, magnetic resonance imaging findings including diffusion-weighted imaging lesions, and laboratory data, as well as data on rebleeding, global cerebral edema, delayed cerebral ischemia, seizures, the Telephone Interview for Cognitive Status, and the modified Rankin Scale. Eighteen patients (46%) had CMBs. Of these patients, 9 had multiple CMBs, and overall a total of 50 CMBs were identified. The most common locations of CMBs were lobar (n = 23), followed by deep (n = 15) and infratentorial (n = 12). After adjustment for age and history of hypertension, CMBs were related to the presence of diffusion-weighted imaging lesions (odds ratio, 5.24; 95% confidence interval, 1.14-24.00; P = .03). Three months after SAH, patients with CMBs had nonsignificantly higher modified Rankin Scale scores (odds ratio, 2.50; 95% confidence interval, 0.67-9.39; P = .18). This study suggests that CMBs are commonly observed and associated with diffusion-weighted imaging lesions in patients with SAH. Our findings may represent a new mechanism of tissue injury in SAH. Further studies are needed to investigate the clinical implications of CMBs.

  10. Magnesium Lithospermate B, an Active Extract of Salvia miltiorrhiza, Mediates sGC/cGMP/PKG Translocation in Experimental Vasospasm

    Directory of Open Access Journals (Sweden)

    Chih-Zen Chang

    2014-01-01

    Full Text Available Background. Soluble guanylyl cyclases (sGCs and Ras homolog gene family, member A (rhoA/Ras homolog gene family kinase(rho-kinase plays a role in vascular smooth muscle relaxation in subarachnoid hemorrhage (SAH. It is of interest to examine the effect of MLB on rhoA/ROCK and sGC/cGMP/PKG expression. Methods. A rodent SAH model was employed. Tissue samples were for sGCα1, sGCβ1, PKG, rhoA, ROCK (Western blot, and cGMP (ELISA measurement. Results. MLB morphologically improved convolution of the internal elastic lamina, distortion of endothelial wall, and necrosis of the smooth muscle in the SAH rats. Expressed cGMP, sGCα1, sGCβ1, and PKG in the SAH groups were reduced (P<0.01, and MLB precondition significantly induced cGMP, sGCα1, sGCβ1, and PKG. L-NAME reversed the vasodilation effect of MLB, reduced the bioexpression of PKG and cGMP (P<0.01, and tends to reduce sGCα1 level and induce rhoA, ROCK level in MLB precondition + SAH groups. Conclusion. These results demonstrate that sGC/cGMP/PKG and NO/ET pathways play pivotal roles in SAH-induced vasospasm. Through activating sGC/cGMP/PKG pathway and partially by inactivating rho-kinase in a NO-dependent mechanism, MLB shows promise to be an effective strategy for the treatment of this disease entity.

  11. Zr (IV COMPLEXES OF SOME NITROGEN-OXYGEN DONOR LIGANDS (SEMICARBAZONES & SALICYLALDAZINE

    Directory of Open Access Journals (Sweden)

    Z F DAWOOD

    2002-06-01

    Full Text Available Complexes containing mixed ligands of zirconium (IV have been synthesized by the reaction of zirconium (IV nitrate (Zr(NO34, 5H2O with salicylaldazine (SAH2 and semicarbazone ligands benzaldehyde semicarbazone (BSCH, 4-methoxybenzaldehyde semicarbzone (MBSCH, 2-chlorobenzaldehyde semicrbazone (CISCH and cinnamaldehyde semicarbazone (CinSCH forming complexes of the type [Zr2(SAH2(SCH2](NO38 and [Zr2(SA2 (SC2](NO32 in neutral and basic medium respectively. The ligands and their complexes are characterized physico-chemically.

  12. Nimodipine in aneurysmal subarachnoid hemorrhage: a randomized study of intravenous or peroral administration

    DEFF Research Database (Denmark)

    Kronvall, Erik; Undrén, Per; Rommer, Bertil Roland;

    2009-01-01

    OBJECT: The calcium antagonist nimodipine has been shown to reduce the incidence of ischemic complications following aneurysmal subarachnoid hemorrhage (SAH). Although most randomized studies have been focused on the effect of the peroral administration of nimodipine, intravenous infusion...... and new cerebral infarctions according to MR imaging studies were recorded. RESULTS: Baseline characteristics (age, sex distribution, clinical status on admission, radiological findings, and aneurysm treatment) did not differ between the treatment groups. There was no significant difference...... of patients with new infarctions on MR imaging. CONCLUSIONS: The results suggest that there is no clinically relevant difference in efficacy between peroral and intravenous administration of nimodipine in preventing DINDs or cerebral vasospasm following SAH....

  13. Impaired blood dendritic cell numbers and functions after aneurysmal subarachnoid hemorrhage.

    Directory of Open Access Journals (Sweden)

    Antoine Roquilly

    Full Text Available PREVIOUS PRESENTATION: Portions of this study were presented at the Annual Congress of Société Française d'Anesthésie et de Réanimation in Paris, September 2012. BACKGROUND: Toll-like receptor (TLR agonists are promising therapy for the prevention of nosocomial infections in critical ill patients. We aimed to analyze the TLR-reactivity of circulating dendritic cells (DC as assessed by cytokine production after an ex vivo challenge with TLR agonists in aneurysmal subarachnoid hemorrhage (SAH patients. METHODS AND FINDINGS: A single-center prospective observational study took place in one intensive care unit of a teaching hospital. Blood samples were harvested on days 2, 5 and 10 in 21 severe SAH patients requiring mechanical ventilation and 17 healthy controls. DC production of cytokines (Tumour Necrosis Factor, TNF-α; Interleukin, IL-12; and Interferon, IFN-α was assessed by intracellular immunostaining on TLR-3, 4, 7/8 and 9 stimulations. SAH patients had decreased numbers of blood myeloid (mDCs and plasmacytoid DCs (pDCs on days 2, 5 and 10. Compared with the healthy controls, the frequency of mDCs producing TNF-α after TLR-3 stimulation was decreased in the SAH patients. The frequency of myeloid DCs producing IL-12 after TLR-3 and 4 stimulations was also decreased in the SAH patients. In contrast, the mDCs response to TLR-7/8 was not impaired in the SAH patients. The frequency of pDCs producing TNF-α(+ and IFN-α(+ on TLR-7/8 stimulation were reduced at all of the tested times in the SAH patients, whereas reactivity to TLR-9 was preserved. On day 2, the pDCs from non-survivor patients (n=8 had a decreased ability to produce IFN-α on TLR-9 stimulation compared with the survivors. CONCLUSIONS: These data suggest functional abnormalities of circulating pDCs and mDCs that could be important for immunomodulation after SAH.

  14. Neuroprotective effects of edaravone on early brain injury in rats after subarachnoid hemorrhage

    Institute of Scientific and Technical Information of China (English)

    GAO Yang; DING Xin-sheng; XU Shu; WANG Wei; ZUO Qi-long; KUAI Feng

    2009-01-01

    Background The underlying mechanism of early neurobiological impairment after subarachnoid hemorrhage (SAH) is not well understood,but the system of reactive oxygen superoxide (ROS) might be involved.Edaravone (MC1-186),a potent free radical scavenger that prevents apoptosis of neurons,was thus used in this study to see its possible therapeutic effect in early brain injury due to SAH in a rat model.Methods One hundred and twenty male Sprague-Dawley rats were randomly assigned to four groups:group 1,control rats receiving sham operation only;group 2,rats with SAH treated by saline;group 3,rats with SAH treated with 1 mg/kg MCI-186 injected intraperitoneally;and group 4,rats with SAH treated with 3 mg/kg MC1-186.Treated with either saline or MC1-186 twice daily for two consecutive days after SAH,the rats were sacrificed for measurements of malondialdehyde (MDA) and activity of superoxide dismutase (SOD) and histological analysis of caspase-3 protein by Western blotting and immunohistochemical staining.In addition,mortality and neurological scores were statistically analyzed by the chi-square test and Dunn's procedure respectively for each group.One-way analysis of variance followed by the Tukey's procedure was also used in data analysis.Results The rats in group 2 that received saline only showed neurological impairment as well as elevated mortality,and were found to have significantly increased levels of MDA and caspase-3,but reduced SOD activities in brain tissues (P<0.05).When treated with MC1-186 at two different dosages,the rats in groups 3 and 4 had markedly decreased levels of MDA and caspase-3 but increased SOD activities in the brain tissue (P<0.05),along with improved scores of neurological evaluation (P<0.05).Conclusions This study sheds some lights on the therapy of SAH-induced early brain injury by providing the promising data indicating that MC1-186,a radical scavenger,can efficiently diminish apoptosis of neurons and thus prevent the function

  15. Role of unphosphorylated transcription factor STAT3 in late cerebral ischemia after subarachnoid hemorrhage

    DEFF Research Database (Denmark)

    Samraj, Ajoy K; Müller, Anne H; Grell, Anne-Sofie

    2014-01-01

    Molecular mechanisms behind increased cerebral vasospasm and local inflammation in late cerebral ischemia after subarachnoid hemorrhage (SAH) are poorly elucidated. Using system biology tools and experimental SAH models, we have identified signal transducer and activator of transcription 3 (STAT3......) transcription factor as a possible major regulatory molecule. On the basis of the presence of transcription factor binding sequence in the promoters of differentially regulated genes (significant enrichment PE: 6 × 10(5)) and the consistent expression of STAT3 (mRNA, P=0.0159 and Protein, P=0.0467), we...

  16. Improvement in neurological outcome and abolition of cerebrovascular endothelin B and 5-hydroxytryptamine 1B receptor upregulation through mitogen-activated protein kinase kinase 1/2 inhibition after subarachnoid hemorrhage in rats

    DEFF Research Database (Denmark)

    Larsen, Carl Christian; Povlsen, Gro Klitgaard; Rasmussen, Marianne Nelly Paola;

    2011-01-01

    )) and 5-hydroxytryptamine 1B (5-HT(1B)) receptors has been demonstrated in cerebral artery smooth muscles in the delayed ischemic phase after experimental SAH, and intracellular signaling via the mitogen-activated protein kinase kinase (MEK)-extracellular signal-regulated kinase 1/2 pathway has been shown......Delayed cerebral ischemia after subarachnoid hemorrhage (SAH) remains a major cause of death and disability. It has been hypothesized that cerebrovascular upregulation of vasoconstrictor receptors is a key step in the development of delayed cerebral ischemia. Upregulation of endothelin-B (ET(B...

  17. Viabilidad del pago de servicios ambientales hidrológicos PSAH en el Perú – Evaluación del piloto de conservación del servicio ecosistémico en Moyabamba – San Martín – lineamientos para políticas públicas en PSAH

    OpenAIRE

    Tipacti Milachay, Miguel Ángel

    2009-01-01

    Con el objetivo de contribuir en la definición de Políticas Públicas para (a gestión sostenible de los servicios ambientales hidrológicos (SAH) en el Perú; la presente investigación hace un análisis del panorama andino y nacional respecto al tema del pago de servicios ambientales hidrológicos. Asimismo, evalúa una de las pocas experiencias que se vienen desarrollando en el Perú, como es el caso de SAH en Moyobamba en el departamento de San Martín. Por lo actual y novedoso del tema se fusi...

  18. Matrix Metalloproteinases in Cerebral Vasospasm following Aneurysmal Subarachnoid Hemorrhage

    Directory of Open Access Journals (Sweden)

    Vivek Mehta

    2013-01-01

    Full Text Available Delayed cerebral vasospasm is a significant cause of morbidity and mortality following aneurysmal subarachnoid hemorrhage (SAH. While the cellular mechanisms underlying vasospasm remain unclear, it is believed that inflammation may play a critical role in vasospasm. Matrix metalloproteinasees (MMPs are a family of extracellular and membrane-bound proteases capable of degrading the blood-rain barrier (BBB. As such, MMP upregulation following SAH may result in a proinflammatory extravascular environment capable of inciting delayed cerebral vasospasm. This paper presents an overview of MMPs and describes existing data pertinent to delayed cerebral vasospasm.

  19. Protein kinase C inhibition prevents upregulation of vascular ET(B) and 5-HT(1B) receptors and reverses cerebral blood flow reduction after subarachnoid haemorrhage in rats

    DEFF Research Database (Denmark)

    Beg, Saema S; Hansen-Schwartz, Jacob A; Vikman, Petter J;

    2007-01-01

    type 1B (5-HT(1B)) receptor upregulation and prevent the associated cerebral blood flow (CBF) reduction. The PKC inhibitor RO-31-7549 or vehicle was injected intracisternally after the induced SAH in rats (n=3 to 10 in each groups for each method). The involvement of the PKC isoforms was investigated...... by quantitative real-time polymerase chain reaction and immunohistochemistry, respectively. Administration of RO-31-7549 prevented the upregulated contraction elicited by application of ET-1 and 5-CT in cerebral arteries and kept the ET(B) and 5-HT(1B) receptor mRNA and protein levels at pre-SAH levels. Regional...

  20. MR angiography follow-up 10 years after cryptogenic nonperimesencephalic subarachnoid hemorrhage.

    Directory of Open Access Journals (Sweden)

    Holger Wenz

    Full Text Available Long-term magnetic resonance angiography (MRA follow-up studies regarding cryptogenic nonperimesencephalic subarachnoid hemorrhage (nSAH are scarce. This single-centre study identified all patients with angiographically verified cryptogenic nSAH from 1998 to 2007: The two main objectives were to prospectively assess the incidence of de novo aneurysm with 3.0-MRI years after cryptogenic nSAH in patients without evidence for further hemorrhage, and retrospectively assess patient demographics and outcome.From prospectively maintained report databases all patients with angiographically verified cryptogenic nSAH were identified. 21 of 29 patients received high-resolution 3T-MRI including time-of-flight and contrast-enhanced angiography, 10.2 ± 2.8 years after cryptogenic nSAH. MRA follow-up imaging was compared with initial digital subtraction angiography (DSA and CT/MRA. Post-hemorrhage images were related to current MRI with reference to persistent lesions resulting from delayed cerebral ischemia (DCI and post-hemorrhagic siderosis. Patient-based objectives were retrospectively abstracted from clinical databases.29 patients were identified with cryptogenic nSAH, 17 (59% were male. Mean age at time of hemorrhage was 52.9 ± 14.4 years (range 4 - 74 years. 21 persons were available for long-term follow-up. In these, there were 213.5 person years of MRI-follow-up. No de novo aneurysm was detected. Mean modified Rankin Scale (mRS during discharge was 1.28. Post-hemorrhage radiographic vasospasm was found in three patients (10.3%; DCI-related lesions occurred in one patient (3.4%. Five patients (17.2% needed temporary external ventricular drainage; long-term CSF shunt dependency was necessary only in one patient (3.4%. Initial DSA retrospectively showed a 2 x 2 mm aneurysm of the right distal ICA in one patient, which remained stable. Post-hemorrhage siderosis was detected 8.1 years after the initial bleeding in one patient (4.8%.Patients with

  1. Pifithrin-α reduces cerebral vasospasm by attenuating apoptosis of endothelial cells in a subarachnoid haemorrhage model of rat

    Institute of Scientific and Technical Information of China (English)

    YAN Jun-hao; ZHOU Chang-man; YANG Xiao-mei; CHEN Chun-hua; HU Qin; ZHAO Jing; SHI Xian-zhong; LUAN Li-ju; YANG Lei; QIN Li-hua

    2008-01-01

    Background The mechanism of cerebral vasospasm following subarachnoid haemorrhage(SAH)is not understood.Here,we hypothesized that apoptosis of endothelial cells induced by p53 and its target gene em dash p53 upregulated modulator of apoptosis(PUMA)played an important role in development of cerebral vasospasm.We also observed the effects of a p53 inhibitor,pifithrin-α(PFT-α),on reducing the expression of p53 and PUMA,consequently decreasing the apoptosis of endothelial cells and alleviating cerebral vasospasm.Methods Male Sprague-Dawley rats weighing 300-350 g were randomly divided into five groups:a control group (sham surgery),a SAH group,a SAH+dimethyl sulfoxide(DMSO)group,a SAH+PFT-α(0.2 mg/kg)group and a SAH+PFr-α(2.0 mg/kg)group.PFT-α was injected intraperitoneally immediately after SAH.Rats were sacrificed 24hours after SAH.Western blot and immunohistochemical staining were used to detect the levels of p53,PUMA and caspase-3 protein.In addition,mortality and neurological scores were assessed for each group.Statistical significance was assured by analysis of variance performed in one way ANOVA followed by the Tukey test.The neurological and mortality scores were analyzed by Dunn's method and Fisher exact test,respectively.Results After SAH,Western blot and immunohistochemical staining showed the levels of p53,PUMA and caspase-3 in the endothelial cells and the numbers of TdT mediated dUTP nick end labelling(TUNEL)positive endothelial cells were all significantly increased in the basilar arteries (P<0.05),but significantly reduced by PFT-α(P<0.05).These changes were accompanied by increasing diameters and declining wall thickness of basilar arteries(P<0.05),as well as reduced mortality and neurological deficits of the rats(P<0.05).Conclusions PFT-α could protect cerebral vessels from development of vasospasm and improve neurological outcome as well as reduce the mortality via suppressing apoptosis induced by p53 in the endothelial cells of

  2. Síndrome metabólico y sus componentes en pacientes con síndrome de apnea-hipoapnea del sueño Metabolic syndrome and its components in patients with sleep apnea syndrome

    OpenAIRE

    M. Tumbeiro; Acuña,A.; M. T. Alves; R. Dacal; Marcos, P.

    2011-01-01

    Fundamento. El síndrome de apnea-hipoapnea del sueño (SAHS) es un factor de riesgo reconocido de patología cardiovascular y la evidencia reciente sugiere que está relacionado con el síndrome metabólico (SM). El objetivo del estudio fue conocer la prevalencia de los componentes individuales del SM y del SM como entidad, en pacientes con sospecha clínica de SAHS, y ver si ambas entidades están en relación con la obesidad central. Material y métodos. Se estudiaron prospectivamente a 486 paciente...

  3. Functional independence: A comparison of the changes during neurorehabilitation between patients with non-traumatic subarachnoid hemorrhage and intracerebral hemorrhage or acute ischemic stroke

    DEFF Research Database (Denmark)

    Stabel, Henriette Holm; Pedersen, Asger Roer; Johnsen, Søren Paaske

    2017-01-01

    Objective To compare the changes in functional independence measured by the FIM after specialized neurorehabilitation between patients with nontraumatic subarachnoid hemorrhage (SAH) and patients with intracerebral hemorrhage (ICH) or acute ischemic stroke (AIS). Design Historical cohort study......) comprised patients with a first-time nontraumatic SAH (n=212) and age-matched patients with a first-time ICH/AIS (n=448). Interventions Not applicable. Main Outcome Measures Crude and adjusted comparisons of FIM (total and item by item) measured at baseline and at discharge. Results Patients...

  4. Effects of continuous prostacyclin infusion on regional blood flow and cerebral vasospasm following subarachnoid haemorrhage

    DEFF Research Database (Denmark)

    Rasmussen, Rune; Juhler, Marianne; Wetterslev, Jørn

    2014-01-01

    BACKGROUND: One of the main causes of mortality and morbidity following subarachnoid hemorrhage (SAH) is the development of cerebral vasospasm, a frequent complication arising in the weeks after the initial bleeding. Despite extensive research, no effective treatment of vasospasm exists to date. ...

  5. Quality of life after aneurysmal subarachnoid haemorrhage

    NARCIS (Netherlands)

    Passier, P.E.C.A.

    2011-01-01

    The general aim of this thesis was to increase our understanding of quality of life (QoL) after aneurysmal subarachnoid haemorrhage (SAH), and the most important determinants of QoL, in order to tailor appropriate rehabilitation programs and thereby enhance their effectiveness. We reviewed the liter

  6. 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.

  7. Automatic quantification of subarachnoid hemorrhage on noncontrast CT

    NARCIS (Netherlands)

    Boers, A.M.; Zijlstra, I.A.; Gathier, C.S.; Berg, van den R.; Slump, C.H.; Marquering, H.A.; Majoie, C.B.

    2014-01-01

    Quantification of blood after SAH on initial NCCT is an important radiologic measure to predict patient outcome and guide treatment decisions. In current scales, hemorrhage volume and density are not accounted for. The purpose of this study was to develop and validate a fully automatic method for SA

  8. Hints for the Improvement of Quality Teaching in Introductory Engineering Statistics Courses.

    Science.gov (United States)

    Acosta Felipe M. Aparicio

    2000-01-01

    Proposes a way to improve the quality of statistics teaching to undergraduate engineering students. Teaching quality can be understood as a goal to be achieved in three nurtured phases: (1) course planning; (2) adoption of methodological approach; and (3) evaluation of results. (Author/SAH)

  9. Changes in Cerebral Perfusion around the Time of Delayed Cerebral Ischemia in Subarachnoid Hemorrhage Patients

    NARCIS (Netherlands)

    Dankbaar, J. W.; de Rooij, N. K.; Smit, E. J.; Velthuis, B. K.; Frijns, C. J. M.; Rinkel, G. J. E.; van der Schaaf, I. C.

    2011-01-01

    Background: Because the pathogenesis of delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) is unclear, we studied cerebral perfusion at different time points around the occurrence of DCI. Methods: We prospectively enrolled 53 patients admitted to the University Medical Center Utrech

  10. Essences végétales et techniques de restauration des zones d ...

    African Journals Online (AJOL)

    SARAH

    30 sept. 2013 ... *Auteur correspondant, E-mail : vkindomihou@yahoo.fr; Tél:(+229) 95 02 30 58. Original ... écosystèmes soudano-sahéliens dégradés au Nord-Bénin. Méthodologie et ...... Langues, Arts et Sciences humaines (FLASH),.

  11. Debating Whether Dinosaurs Should Be "Cloned" from Ancient DNA To Promote Cooperative Learning in an Introductory Evolution Course.

    Science.gov (United States)

    Soja, Constance M.; Huerta, Deborah

    2001-01-01

    Describes an interactive internet exercise that enables students to engage in cooperative library and web research on a controversial topic in science, specifically the cloning of extinct lifeforms. Creates a dynamic learning environment in a large introductory geology course and demonstrates the importance of scientific literacy. (Author/SAH)

  12. The determinants of health among the population aged 50 and over: evidence from Croatia

    Directory of Open Access Journals (Sweden)

    Sime Smolic

    2017-03-01

    Full Text Available The aim of this paper is to explore the association between demographic, socio-economic and physical health variables and self-assessed health (SAH of people aged 50 years and over in Croatia. Cross-sectional data was collected in 2012 in the survey “The Economics of Ageing in Croatiaˮ that was based on the SHARE (Survey of Health Ageing and Retirement in Europe study. Altogether 761 individuals aged 50 and over were included in the working sample that has been used in statistical analysis. Data were analysed in an ordered logistic regression model. The results show that females were more likely to report a higher category of SAH than males. Higher educational level was a statistically significant predictor of higher SAH, when controlled for other variables. This study, unlike other studies in Croatia, introduces a set of physical health variables as the determinants of health. Our results suggest that people aged 50 and over with fewer limitations, health related symptoms and diagnosed chronic conditions were more likely to report higher levels of SAH. These findings could be beneficial to policymakers in their efforts to improve health among elderly in Croatia.

  13. Urban and Rural Air Pollution: A Cross-Age Study of School Students' Ideas.

    Science.gov (United States)

    Myers, George; Boyes, Edward; Stanisstreet, Martin

    2000-01-01

    Explores ideas about the causes and consequences of urban and rural air pollution of secondary school students aged 11-16 years (n=786) using a questionnaire. Students thought the air in towns and cities was more polluted than the air in the countryside. (Author/SAH)

  14. Ficolin-3-mediated lectin complement pathway activation in patients with subarachnoid hemorrhage

    DEFF Research Database (Denmark)

    Zanier, Elisa R; Zangari, Rosalia; Munthe-Fog, Lea

    2014-01-01

    OBJECTIVES: To assess the involvement of ficolin-3, the main initiator of the lectin complement pathway (LCP), in subarachnoid hemorrhage (SAH) pathology and outcome. METHODS: In this preliminary exploratory study, plasma concentration of ficolin-3 and of ficolin-3-mediated functional LCP activit...

  15. Cooperative Learning as a Tool To Teach Vertebrate Anatomy.

    Science.gov (United States)

    Koprowski, John L.; Perigo, Nan

    2000-01-01

    Describes a method for teaching biology that includes more investigative exercises that foster an environment for cooperative learning in introductory laboratories that focus on vertebrates. Fosters collaborative learning by facilitating interaction between students as they become experts on their representative vertebrate structures. (SAH)

  16. Novel Mitochondria-Targeted Heat-Soluble Proteins Identified in the Anhydrobiotic Tardigrade Improve Osmotic Tolerance of Human Cells

    OpenAIRE

    Sae Tanaka; Junko Tanaka; Yoshihiro Miwa; Horikawa, Daiki D.; Toshiaki Katayama; Kazuharu Arakawa; Atsushi Toyoda; Takeo Kubo; Takekazu Kunieda

    2015-01-01

    Tardigrades are able to tolerate almost complete dehydration through transition to a metabolically inactive state, called "anhydrobiosis". Late Embryogenesis Abundant (LEA) proteins are heat-soluble proteins involved in the desiccation tolerance of many anhydrobiotic organisms. Tardigrades, Ramazzottius varieornatus, however, express predominantly tardigrade-unique heat-soluble proteins: CAHS (Cytoplasmic Abundant Heat Soluble) and SAHS (Secretory Abundant Heat Soluble) proteins, which are se...

  17. Magnesium and aspirin treatment in patients with subarachnoid haemorrhage. Comparison of effects after endovascular and neurosurgical aneurysm occlusion

    NARCIS (Netherlands)

    van den Bergh, Walter M; Algra, Ale; Rinkel, Gabriel J E

    2009-01-01

    OBJECTIVE: Aneurysm treatment with endovascular coiling is associated with a better outcome than neurosurgical clipping in patients with subarachnoid haemorrhage (SAH). The better outcome after coiling may decrease the risk reduction from other treatments in these patients, and thus may increase sam

  18. Ehrlichia Meningitis Mimicking Aneurysmal Subarachnoid Hemorrhage: A Case Study for Medical Decision-Making Heuristics.

    Science.gov (United States)

    Dredla, Brynn; Freeman, William D

    2016-04-01

    Thunderclap headache is a sudden and severe headache that can occur after an aneurysmal subarachnoid hemorrhage (SAH). Subarachnoid hemorrhage is a medical emergency that requires prompt attention and hospitalization. Patients with thunderclap headache often undergo a noncontrast head computed tomography (CT) scan to ascertain SAH bleeding and, if the scan is negative, then undergo a lumbar puncture to look for cerebrospinal fluid (CSF) red blood cells (RBCs), which would be consistent with an aneurysmal leak. If the initial CT is negative and CSF is positive for RBCs, patients are usually admitted to the hospital for evaluation of intracranial aneurysm. We encountered a patient with thunderclap headache whose initial head CT was negative for SAH and whose CSF tested positive for RBCs. The patient was referred to our center for evaluation and management of aneurysmal SAH. However, on careful review of the patient's medical history, serum laboratory values, and spinal fluid values, the patient was diagnosed with Ehrlichia chaffeensis meningitis. While Ehrlichia meningitis is rare, it is important to recognize the clinical clues that could help avoid formal cerebral angiography, a costly and potentially unnecessary procedure. We present how this case represented a cognitive framing bias and anchoring heuristic as well as steps that medical providers can use to prevent such cognitive errors in diagnosis.

  19. A case of subarachnoid hemorrhage revealed by an acute coronary syndrome (ACS).

    Science.gov (United States)

    Hatim, Abdedaim; El Otmani, Wafae; Houssa, Mehdi Ait; Atmani, Noureddine; Moutakiallah, Younes; Haimeur, Charqui; Drissi, Mohammed

    2015-01-01

    The subarachnoid hemorrhage (SAH) is definitely the best descriptive model of the interaction between cardiovascular system and cerebral damage. The underlying mechanism of cardiovascular alterations after SAH is linked to the adrenergic discharge related to aneurysm rupture. Cardiac and pulmonary complications are common after severe brain injury, especially the aneurismal subarachnoid hemorrhage. Acute neurogenic pulmonary edema is not exceptional; it may occur in 20% of cases and commonly follows a severe subarachnoid hemorrhage. Severe myocardial damage with cardiogenic shock may possibly reveal the SAH (3% of cases) and mislead to wrong diagnosis of ACS with dramatic therapeutic consequences. The contribution of CT and cerebral angiography is essential for diagnosis and treatment. Surgical or endovascular treatment depends on location, size and shape of the aneurysm, on patient's age, neurological status and existence of concomitant diseases. We report the case of a 58 years old patient, with a past medical history of diabetes and hypertension, admitted for acute pulmonary edema with cardiogenic shock. This case illustrates an unusual presentation of aneurismal SAH in a patient presenting with an acute coronary syndrome.

  20. Predictive Factors for Rebleeding After Aneurysmal Subarachnoid Hemorrhage : Rebleeding Aneurysmal Subarachnoid Hemorrhage Study

    NARCIS (Netherlands)

    van Donkelaar, Carlina; Bakker, Nicolaas A.; Veeger, Nic J. G. M.; Uyttenboogaart, Maarten; Metzemaekers, Jan D. M.; Luijckx, Gert-Jan; Groen, Rob J. M.; van Dijk, J. Marc C.

    Background and Purpose-Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating type of stroke associated with high morbidity and mortality. One of the most feared complications is an early rebleeding before aneurysm repair. Predictors for such an often fatal rebleeding are largely unknown. We