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  1. Perturbed and spontaneous regional cerebral blood flow responses to changes in blood pressure after high-level spinal cord injury: the effect of midodrine.

    PubMed

    Phillips, Aaron A; Krassioukov, Andrei V; Ainslie, Philip N; Warburton, Darren E R

    2014-03-15

    Individuals with spinal cord injury (SCI) above the T6 spinal segment suffer from orthostatic intolerance. How cerebral blood flow (CBF) responds to orthostatic challenges in SCI is poorly understood. Furthermore, it is unclear how interventions meant to improve orthostatic tolerance in SCI influence CBF. This study aimed to examine 1) the acute regional CBF responses to rapid changes in blood pressure (BP) during orthostatic stress in individuals with SCI and able-bodied (AB) individuals; and 2) the effect of midodrine (alpha1-agonist) on orthostatic tolerance and CBF regulation in SCI. Ten individuals with SCI >T6, and 10 age- and sex-matched AB controls had beat-by-beat BP and middle and posterior cerebral artery blood velocity (MCAv, PCAv, respectively) recorded during a progressive tilt-test to quantify the acute CBF response and orthostatic tolerance. Dynamic MCAv and PCAv to BP relationships were evaluated continuously in the time domain and frequency domain (via transfer function analysis). The SCI group was tested again after administration of 10 mg midodrine to elevate BP. Coherence (i.e., linearity) was elevated in SCI between BP-MCAv and BP-PCAv by 35% and 22%, respectively, compared with AB, whereas SCI BP-PCAv gain (i.e., magnitudinal relationship) was reduced 30% compared with AB (all P < 0.05). The acute (i.e., 0-30 s after tilt) MCAv and PCAv responses were similar between groups. In individuals with SCI, midodrine led to improved PCAv responses 30-60 s following tilt (10 ± 3% vs. 4 ± 2% decline; P < 0.05), and a 59% improvement in orthostatic tolerance (P < 0.01). The vertebrobasilar region may be particularly susceptible to hypoperfusion in SCI, leading to increased orthostatic intolerance.

  2. Perturbed and spontaneous regional cerebral blood flow responses to changes in blood pressure after high-level spinal cord injury: the effect of midodrine

    PubMed Central

    Phillips, Aaron A.; Krassioukov, Andrei V.; Ainslie, Philip N.

    2014-01-01

    Individuals with spinal cord injury (SCI) above the T6 spinal segment suffer from orthostatic intolerance. How cerebral blood flow (CBF) responds to orthostatic challenges in SCI is poorly understood. Furthermore, it is unclear how interventions meant to improve orthostatic tolerance in SCI influence CBF. This study aimed to examine 1) the acute regional CBF responses to rapid changes in blood pressure (BP) during orthostatic stress in individuals with SCI and able-bodied (AB) individuals; and 2) the effect of midodrine (alpha1-agonist) on orthostatic tolerance and CBF regulation in SCI. Ten individuals with SCI >T6, and 10 age- and sex-matched AB controls had beat-by-beat BP and middle and posterior cerebral artery blood velocity (MCAv, PCAv, respectively) recorded during a progressive tilt-test to quantify the acute CBF response and orthostatic tolerance. Dynamic MCAv and PCAv to BP relationships were evaluated continuously in the time domain and frequency domain (via transfer function analysis). The SCI group was tested again after administration of 10 mg midodrine to elevate BP. Coherence (i.e., linearity) was elevated in SCI between BP-MCAv and BP-PCAv by 35% and 22%, respectively, compared with AB, whereas SCI BP-PCAv gain (i.e., magnitudinal relationship) was reduced 30% compared with AB (all P < 0.05). The acute (i.e., 0–30 s after tilt) MCAv and PCAv responses were similar between groups. In individuals with SCI, midodrine led to improved PCAv responses 30–60 s following tilt (10 ± 3% vs. 4 ± 2% decline; P < 0.05), and a 59% improvement in orthostatic tolerance (P < 0.01). The vertebrobasilar region may be particularly susceptible to hypoperfusion in SCI, leading to increased orthostatic intolerance. PMID:24436297

  3. Local, Regional, and Spinal Anesthesia in Ruminants.

    PubMed

    Edmondson, Misty A

    2016-11-01

    Local, regional, and spinal anesthesias are safe, effective, often more desirable procedures for ruminants than general anesthesia. Many procedures can be performed safely and humanely in ruminants using a combination of physical restraint, mild sedation, and local, regional, or spinal anesthesia. This article focuses on the use of local anesthetics for providing anesthesia for dehorning, procedures of the nose and eye, laparotomy, reproductive procedures, teat repair, and procedures on the distal limb. Local, regional, and spinal anesthesia techniques are safe effective methods for providing anesthesia for common surgical procedures and analgesia for painful conditions in cattle and small ruminants.

  4. Regional neurovascular coupling and cognitive performance in those with low blood pressure secondary to high-level spinal cord injury: improved by alpha-1 agonist midodrine hydrochloride.

    PubMed

    Phillips, Aaron A; Warburton, Darren E R; Ainslie, Philip N; Krassioukov, Andrei V

    2014-05-01

    Individuals with high-level spinal cord injury (SCI) experience low blood pressure (BP) and cognitive impairments. Such dysfunction may be mediated in part by impaired neurovascular coupling (NVC) (i.e., cerebral blood flow responses to neurologic demand). Ten individuals with SCI >T6 spinal segment, and 10 age- and sex-matched controls were assessed for beat-by-beat BP, as well as middle and posterior cerebral artery blood flow velocity (MCAv, PCAv) in response to a NVC test. Tests were repeated in SCI after 10 mg midodrine (alpha1-agonist). Verbal fluency was measured before and after midodrine in SCI, and in the control group as an index of cognitive function. At rest, mean BP was lower in SCI (70 ± 10 versus 92 ± 14 mm Hg; P<0.05); however, PCAv conductance was higher (0.56 ± 0.13 versus 0.39 ± 0.15 cm/second/mm Hg; P<0.05). Controls exhibited a 20% increase in PCAv during cognition; however, the response in SCI was completely absent (P<0.01). When BP was increased with midodrine, NVC was improved 70% in SCI, which was reflected by a 13% improved cognitive function (P<0.05). Improvements in BP were related to improved cognitive function in those with SCI (r(2)=0.52; P<0.05). Impaired NVC, secondary to low BP, may partially mediate reduced cognitive function in individuals with high-level SCI.

  5. Regional neurovascular coupling and cognitive performance in those with low blood pressure secondary to high-level spinal cord injury: improved by alpha-1 agonist midodrine hydrochloride

    PubMed Central

    Phillips, Aaron A; Warburton, Darren ER; Ainslie, Philip N; Krassioukov, Andrei V

    2014-01-01

    Individuals with high-level spinal cord injury (SCI) experience low blood pressure (BP) and cognitive impairments. Such dysfunction may be mediated in part by impaired neurovascular coupling (NVC) (i.e., cerebral blood flow responses to neurologic demand). Ten individuals with SCI >T6 spinal segment, and 10 age- and sex-matched controls were assessed for beat-by-beat BP, as well as middle and posterior cerebral artery blood flow velocity (MCAv, PCAv) in response to a NVC test. Tests were repeated in SCI after 10 mg midodrine (alpha1-agonist). Verbal fluency was measured before and after midodrine in SCI, and in the control group as an index of cognitive function. At rest, mean BP was lower in SCI (70±10 versus 92±14 mm Hg; P<0.05); however, PCAv conductance was higher (0.56±0.13 versus 0.39±0.15 cm/second/mm Hg; P<0.05). Controls exhibited a 20% increase in PCAv during cognition; however, the response in SCI was completely absent (P<0.01). When BP was increased with midodrine, NVC was improved 70% in SCI, which was reflected by a 13% improved cognitive function (P<0.05). Improvements in BP were related to improved cognitive function in those with SCI (r2=0.52; P<0.05). Impaired NVC, secondary to low BP, may partially mediate reduced cognitive function in individuals with high-level SCI. PMID:24473484

  6. Contrast enhanced ultrasound imaging for assessment of spinal cord blood flow in experimental spinal cord injury.

    PubMed

    Dubory, Arnaud; Laemmel, Elisabeth; Badner, Anna; Duranteau, Jacques; Vicaut, Eric; Court, Charles; Soubeyrand, Marc

    2015-05-07

    Reduced spinal cord blood flow (SCBF) (i.e., ischemia) plays a key role in traumatic spinal cord injury (SCI) pathophysiology and is accordingly an important target for neuroprotective therapies. Although several techniques have been described to assess SCBF, they all have significant limitations. To overcome the latter, we propose the use of real-time contrast enhanced ultrasound imaging (CEU). Here we describe the application of this technique in a rat contusion model of SCI. A jugular catheter is first implanted for the repeated injection of contrast agent, a sodium chloride solution of sulphur hexafluoride encapsulated microbubbles. The spine is then stabilized with a custom-made 3D-frame and the spinal cord dura mater is exposed by a laminectomy at ThIX-ThXII. The ultrasound probe is then positioned at the posterior aspect of the dura mater (coated with ultrasound gel). To assess baseline SCBF, a single intravenous injection (400 µl) of contrast agent is applied to record its passage through the intact spinal cord microvasculature. A weight-drop device is subsequently used to generate a reproducible experimental contusion model of SCI. Contrast agent is re-injected 15 min following the injury to assess post-SCI SCBF changes. CEU allows for real time and in-vivo assessment of SCBF changes following SCI. In the uninjured animal, ultrasound imaging showed uneven blood flow along the intact spinal cord. Furthermore, 15 min post-SCI, there was critical ischemia at the level of the epicenter while SCBF remained preserved in the more remote intact areas. In the regions adjacent to the epicenter (both rostral and caudal), SCBF was significantly reduced. This corresponds to the previously described "ischemic penumbra zone". This tool is of major interest for assessing the effects of therapies aimed at limiting ischemia and the resulting tissue necrosis subsequent to SCI.

  7. Ambulatory blood pressure monitoring in spinal cord injury: clinical practicability.

    PubMed

    Hubli, Michèle; Krassioukov, Andrei V

    2014-05-01

    Trauma to the spinal cord often results not only in sensorimotor but also autonomic impairments. The loss of autonomic control over the cardiovascular system can cause profound blood pressure (BP) derangements in subjects with spinal cord injury (SCI) and may therefore lead to increased cardiovascular disease (CVD) risk in this population. The use of ambulatory blood pressure monitoring (ABPM) allows insights into circadian BP profiles, which have been shown to be of good prognostic value for cardiovascular morbidity and mortality in able-bodied subjects. Past studies in SCI subjects using ABPM have shown that alterations in circadian BP patterns are dependent on the spinal lesion level. Tetraplegic subjects with sensorimotor complete lesions have a decreased daytime arterial BP, loss of the physiological nocturnal BP dip, and higher circadian BP variability, including potentially life-threatening hypertensive episodes known as autonomic dysreflexia (AD), compared with paraplegic and able-bodied subjects. The proposed underlying mechanisms of these adverse BP alterations mainly are attributed to a lost or decreased central drive to sympathetic spinal preganglionic neurons controlling the heart and blood vessels. In addition, several maladaptive anatomical changes within the spinal cord and the periphery, as well as the general decrease of physical daily activity in SCI subjects, account for adverse BP changes. ABPM enables the identification of adverse BP profiles and the associated increased risk for CVD in SCI subjects. Concurrently, it also might provide a useful clinical tool to monitor improvements of AD and lost nocturnal dip after appropriate treatments in the SCI population.

  8. Effects of epidural and spinal anesthesia on blood rheology.

    PubMed

    Odoom, J A; Bovill, J G; Hardeman, M R; Oosting, J; Zuurmond, W W

    1992-06-01

    This study was designed to compare the influence of epidural and spinal anesthesia on blood viscosity. We studied 22 patients, ASA classification I, who underwent elective knee or ankle arthroscopy and received epidural (n = 11) or spinal (n = 11) anesthesia with plain bupivacaine, and 10 control volunteers, who did not undergo surgery or receive anesthesia. There were significant decreases in hematocrit, plasma viscosity, and whole-blood viscosity at high (70 s-1), medium (0.5 s-1), and low (0.05 s-1) shear rates. The magnitude of changes was similar in all groups but occurred earlier in the control group (between 10 and 30 min) and after spinal administration (between 10 and 30 min) rather than after epidural administration (between 30 and 60 min) of bupivacaine. Only spinal anesthesia was associated with a decrease in erythrocyte deformability. The observed rheologic changes are attributed to hemodilution from the intravenous administration of fluids and the redistribution of fluid in the intravascular and extravascular compartments after sympathetic blockade and to postural changes rather than the effect of bupivacaine on blood elements.

  9. The cross-talk between autophagy and endoplasmic reticulum stress in blood-spinal cord barrier disruption after spinal cord injury.

    PubMed

    Zhou, Yulong; Wu, Yanqing; Liu, Yanlong; He, Zili; Zou, Shuang; Wang, Qingqing; Li, Jiawei; Zheng, Zengming; Chen, Jian; Wu, Fenzan; Gong, Fanhua; Zhang, Hongyu; Xu, Huazi; Xiao, Jian

    2017-01-03

    Spinal cord injury induces the disruption of blood-spinal cord barrier and triggers a complex array of tissue responses, including endoplasmic reticulum (ER) stress and autophagy. However, the roles of ER stress and autophagy in blood-spinal cord barrier disruption have not been discussed in acute spinal cord trauma. In the present study, we respectively detected the roles of ER stress and autophagy in blood-spinal cord barrier disruption after spinal cord injury. Besides, we also detected the cross-talking between autophagy and ER stress both in vivo and in vitro. ER stress inhibitor, 4-phenylbutyric acid, and autophagy inhibitor, chloroquine, were respectively or combinedly administrated in the model of acute spinal cord injury rats. At day 1 after spinal cord injury, blood-spinal cord barrier was disrupted and activation of ER stress and autophagy were involved in the rat model of trauma. Inhibition of ER stress by treating with 4-phenylbutyric acid decreased blood-spinal cord barrier permeability, prevented the loss of tight junction (TJ) proteins and reduced autophagy activation after spinal cord injury. On the contrary, inhibition of autophagy by treating with chloroquine exacerbated blood-spinal cord barrier permeability, promoted the loss of TJ proteins and enhanced ER stress after spinal cord injury. When 4-phenylbutyric acid and chloroquine were combinedly administrated in spinal cord injury rats, chloroquine abolished the blood-spinal cord barrier protective effect of 4-phenylbutyric acid by exacerbating ER stress after spinal cord injury, indicating that the cross-talking between autophagy and ER stress may play a central role on blood-spinal cord barrier integrity in acute spinal cord injury. The present study illustrates that ER stress induced by spinal cord injury plays a detrimental role on blood-spinal cord barrier integrity, on the contrary, autophagy induced by spinal cord injury plays a furthersome role in blood-spinal cord barrier integrity in

  10. The cross-talk between autophagy and endoplasmic reticulum stress in blood-spinal cord barrier disruption after spinal cord injury

    PubMed Central

    He, Zili; Zou, Shuang; Wang, Qingqing; Li, Jiawei; Zheng, Zengming; Chen, Jian; Wu, Fenzan; Gong, Fanhua; Zhang, Hongyu; Xu, Huazi; Xiao, Jian

    2017-01-01

    Spinal cord injury induces the disruption of blood-spinal cord barrier and triggers a complex array of tissue responses, including endoplasmic reticulum (ER) stress and autophagy. However, the roles of ER stress and autophagy in blood-spinal cord barrier disruption have not been discussed in acute spinal cord trauma. In the present study, we respectively detected the roles of ER stress and autophagy in blood-spinal cord barrier disruption after spinal cord injury. Besides, we also detected the cross-talking between autophagy and ER stress both in vivo and in vitro. ER stress inhibitor, 4-phenylbutyric acid, and autophagy inhibitor, chloroquine, were respectively or combinedly administrated in the model of acute spinal cord injury rats. At day 1 after spinal cord injury, blood-spinal cord barrier was disrupted and activation of ER stress and autophagy were involved in the rat model of trauma. Inhibition of ER stress by treating with 4-phenylbutyric acid decreased blood-spinal cord barrier permeability, prevented the loss of tight junction (TJ) proteins and reduced autophagy activation after spinal cord injury. On the contrary, inhibition of autophagy by treating with chloroquine exacerbated blood-spinal cord barrier permeability, promoted the loss of TJ proteins and enhanced ER stress after spinal cord injury. When 4-phenylbutyric acid and chloroquine were combinedly administrated in spinal cord injury rats, chloroquine abolished the blood-spinal cord barrier protective effect of 4-phenylbutyric acid by exacerbating ER stress after spinal cord injury, indicating that the cross-talking between autophagy and ER stress may play a central role on blood-spinal cord barrier integrity in acute spinal cord injury. The present study illustrates that ER stress induced by spinal cord injury plays a detrimental role on blood-spinal cord barrier integrity, on the contrary, autophagy induced by spinal cord injury plays a furthersome role in blood-spinal cord barrier integrity in

  11. Targeting the blood-spinal cord barrier: A therapeutic approach to spinal cord protection against ischemia-reperfusion injury.

    PubMed

    Hu, Ji; Yu, Qijing; Xie, Lijie; Zhu, Hongfei

    2016-08-01

    One of the principal functions of physical barriers between the blood and central nervous system protects system (i.e., blood brain barrier and blood-spinal cord barrier) is the protection from toxic and pathogenic agents in the blood. Disruption of blood-spinal cord barrier (BSCB) plays a key role in spinal cord ischemia-reperfusion injury (SCIRI). Following SCIRI, the permeability of the BSCB increases. Maintaining the integrity of the BSCB alleviates the spinal cord injury after spinal cord ischemia. This review summarizes current knowledge of the structure and function of the BSCB and its changes following SCIRI, as well as the prevention and cure of SCIRI and the role of the BSCB.

  12. Ambulatory Blood Pressure Monitoring in Spinal Cord Injury: Clinical Practicability

    PubMed Central

    Hubli, Michèle

    2014-01-01

    Abstract Trauma to the spinal cord often results not only in sensorimotor but also autonomic impairments. The loss of autonomic control over the cardiovascular system can cause profound blood pressure (BP) derangements in subjects with spinal cord injury (SCI) and may therefore lead to increased cardiovascular disease (CVD) risk in this population. The use of ambulatory blood pressure monitoring (ABPM) allows insights into circadian BP profiles, which have been shown to be of good prognostic value for cardiovascular morbidity and mortality in able-bodied subjects. Past studies in SCI subjects using ABPM have shown that alterations in circadian BP patterns are dependent on the spinal lesion level. Tetraplegic subjects with sensorimotor complete lesions have a decreased daytime arterial BP, loss of the physiological nocturnal BP dip, and higher circadian BP variability, including potentially life-threatening hypertensive episodes known as autonomic dysreflexia (AD), compared with paraplegic and able-bodied subjects. The proposed underlying mechanisms of these adverse BP alterations mainly are attributed to a lost or decreased central drive to sympathetic spinal preganglionic neurons controlling the heart and blood vessels. In addition, several maladaptive anatomical changes within the spinal cord and the periphery, as well as the general decrease of physical daily activity in SCI subjects, account for adverse BP changes. ABPM enables the identification of adverse BP profiles and the associated increased risk for CVD in SCI subjects. Concurrently, it also might provide a useful clinical tool to monitor improvements of AD and lost nocturnal dip after appropriate treatments in the SCI population. PMID:24175653

  13. Propitious Therapeutic Modulators to Prevent Blood-Spinal Cord Barrier Disruption in Spinal Cord Injury.

    PubMed

    Kumar, Hemant; Ropper, Alexander E; Lee, Soo-Hong; Han, Inbo

    2016-05-18

    The blood-spinal cord barrier (BSCB) is a specialized protective barrier that regulates the movement of molecules between blood vessels and the spinal cord parenchyma. Analogous to the blood-brain barrier (BBB), the BSCB plays a crucial role in maintaining the homeostasis and internal environmental stability of the central nervous system (CNS). After spinal cord injury (SCI), BSCB disruption leads to inflammatory cell invasion such as neutrophils and macrophages, contributing to permanent neurological disability. In this review, we focus on the major proteins mediating the BSCB disruption or BSCB repair after SCI. This review is composed of three parts. Section 1. SCI and the BSCB of the review describes critical events involved in the pathophysiology of SCI and their correlation with BSCB integrity/disruption. Section 2. Major proteins involved in BSCB disruption in SCI focuses on the actions of matrix metalloproteinases (MMPs), tumor necrosis factor alpha (TNF-α), heme oxygenase-1 (HO-1), angiopoietins (Angs), bradykinin, nitric oxide (NO), and endothelins (ETs) in BSCB disruption and repair. Section 3. Therapeutic approaches discusses the major therapeutic compounds utilized to date for the prevention of BSCB disruption in animal model of SCI through modulation of several proteins.

  14. Impaired blood-brain/spinal cord barrier in ALS patients.

    PubMed

    Garbuzova-Davis, Svitlana; Hernandez-Ontiveros, Diana G; Rodrigues, Maria C O; Haller, Edward; Frisina-Deyo, Aric; Mirtyl, Santhia; Sallot, Sebastian; Saporta, Samuel; Borlongan, Cesario V; Sanberg, Paul R

    2012-08-21

    Vascular pathology, including blood-brain/spinal cord barrier (BBB/BSCB) alterations, has recently been recognized as a key factor possibly aggravating motor neuron damage, identifying a neurovascular disease signature for ALS. However, BBB/BSCB competence in sporadic ALS (SALS) is still undetermined. In this study, BBB/BSCB integrity in postmortem gray and white matter of medulla and spinal cord tissue from SALS patients and controls was investigated. Major findings include (1) endothelial cell damage and pericyte degeneration, (2) severe intra- and extracellular edema, (3) reduced CD31 and CD105 expressions in endothelium, (4) significant accumulation of perivascular collagen IV, and fibrin deposits (5) significantly increased microvascular density in lumbar spinal cord, (6) IgG microvascular leakage, (7) reduced tight junction and adhesion protein expressions. Microvascular barrier abnormalities determined in gray and white matter of the medulla, cervical, and lumbar spinal cord of SALS patients are novel findings. Pervasive barrier damage discovered in ALS may have implications for disease pathogenesis and progression, as well as for uncovering novel therapeutic targets.

  15. Mild hypothermia, blood loss and complications in elective spinal surgery.

    PubMed

    Guest, James D; Vanni, S; Silbert, L

    2004-01-01

    Spinal surgery carries risks of incidental spinal cord and nerve root injury. Neuroprotection, to minimize the extent of such injuries, is desirable. However, no neuroprotective strategies have been conclusively validated in nonvascular spinal surgery. Mild hypothermia resulting from general anesthesia is a readily achievable potential neuroprotective strategy. Mild hypothermia, however, has been associated with wound infection, increased operative blood loss and other complications. No previous studies have specifically evaluated whether mild hypothermia is associated with an increased risk of these complications in elective spinal surgery. We investigated the association between incidental mild hypothermia, perioperative complications and operative blood loss. This is a retrospective study employing cohort analysis, rank analysis and single and multivariate linear regression. The setting was the Veterans Administration Medical Center, a teaching hospital of the University of Miami. Data on a total of 70 adult veterans aged 23 to 81 years undergoing complex spinal procedures in which passive cooling was employed during surgical decompression. The variables measured were temperature, blood loss, mean arterial pressure (MAP) and duration of anesthesia. The outcome measured was the presence or absence of complications. After 70 patients had been acquired, regression and rank analyses were performed to test for a link between mild hypothermia and blood loss. In addition, two cohorts, patients who experienced complications, and those who did not experience complications in the perioperative period, were compared for several variables including three measures of exposure to hypothermia. Surgical procedures included 60 cervical, 1 occipitocervical, 1 cervicothoracic, 7 thoracic and 1 thoracolumbar procedure. Hypothermia followed induction of anesthesia; esophageal or bladder temperature was monitored. Cooling was passive; warming utilized a forced air blanket

  16. Effect of lycopene on the blood-spinal cord barrier after spinal cord injury in mice.

    PubMed

    Zhang, Qian; Wang, Jianbo; Gu, Zhengsong; Zhang, Qing; Zheng, Hong

    2016-09-05

    The current study aimed to investigate the effect of lycopene on the blood-spinal cord barrier (BSCB) after spinal cord injury (SCI) in a mouse model. Lycopene inhibited lipid peroxidation and oxidative DNA damage as a highly efficient antioxidant and free radical scavenger. Lycopene (4 mg/kg/d) was administrated immediately following SCI. The permeability of the BSCB and water content in the spinal cord tissue were evaluated. Additionally, levels of expression of tight junction proteins and heme oxygenase-1 (HO-1) were determined with Western blotting. An enzyme-linked immunosorbent assay analysis of spinal cord tissue homogenates was performed 48 h after SCI to evaluate the expression of inflammation-related cytokines. In addition, recovery of motor function was assessed 1 d, 2 d, 5 d, 10 d, and 15 d after SCI using the Basso Mouse Scale to score locomotion. Compared to the group with an untreated SCI, mice with an SCI treated with lycopene had significantly reduced spinal cord tissue water content and BSCB permeability. Furthermore, motor function of mice with an SCI was also greatly improved by lycopene administration. The expression of the proinflammatory factors TNF-α and NF-kB increased markedly 48 h after SCI, and their upregulation was significantly attenuated by lycopene treatment. The expression of molecules that protect tight junctions, zonula occluden-1 and claudin-5, was upregulated by lycopene treatment after SCI. Taken together, these results clearly indicate that lycopene attenuated SCI by promoting repair of the damaged BSCB, so lycopene is a novel and promising treatment for SCI in humans.

  17. Intranasal nerve growth factor bypasses the blood-brain barrier and affects spinal cord neurons in spinal cord injury

    PubMed Central

    Aloe, Luigi; Bianchi, Patrizia; De Bellis, Alberto; Soligo, Marzia; Rocco, Maria Luisa

    2014-01-01

    The purpose of this work was to investigate whether, by intranasal administration, the nerve growth factor bypasses the blood-brain barrier and turns over the spinal cord neurons and if such therapeutic approach could be of value in the treatment of spinal cord injury. Adult Sprague-Dawley rats with intact and injured spinal cord received daily intranasal nerve growth factor administration in both nostrils for 1 day or for 3 consecutive weeks. We found an increased content of nerve growth factor and enhanced expression of nerve growth factor receptor in the spinal cord 24 hours after a single intranasal administration of nerve growth factor in healthy rats, while daily treatment for 3 weeks in a model of spinal cord injury improved the deficits in locomotor behaviour and increased spinal content of both nerve growth factor and nerve growth factor receptors. These outcomes suggest that the intranasal nerve growth factor bypasses blood-brain barrier and affects spinal cord neurons in spinal cord injury. They also suggest exploiting the possible therapeutic role of intranasally delivered nerve growth factor for the neuroprotection of damaged spinal nerve cells. PMID:25206755

  18. The post-occipital spinal venous sinus of the Nile crocodile Crocodylus niloticus: its anatomy and use for blood sample collection and intravenous infusions.

    PubMed

    Myburgh, Jan G; Kirberger, Robert M; Steyl, Johan C A; Soley, John T; Booyse, Dirk G; Huchzermeyer, Fritz W; Lowers, Russel H; Guillette, Louis J

    2014-05-05

    The post-occipital sinus of the spinal vein is often used for the collection of blood samples from crocodilians. Although this sampling method has been reported for several crocodilian species, the technique and associated anatomy has not been described in detail in any crocodilian, including the Nile crocodile (Crocodylus niloticus). The anatomy of the cranial neck region was investigated macroscopically, microscopically, radiographically and by means of computed tomography. Latex was injected into the spinal vein and spinal venous sinus of crocodiles to visualise the regional vasculature. The spinal vein ran within the vertebral canal, dorsal to and closely associated with the spinal cord and changed into a venous sinus cranially in the post-occipital region. For blood collection, the spinal venous sinus was accessed through the interarcuate space between the atlas and axis (C1 and C2) by inserting a needle angled just off the perpendicular in the midline through the craniodorsal cervical skin, just cranial to the cranial borders of the first cervical osteoderms. The most convenient method of blood collection was with a syringe and hypodermic needle. In addition, the suitability of the spinal venous sinus for intravenous injections and infusions in live crocodiles was evaluated. The internal diameter of the commercial human epidural catheters used during these investigations was relatively small, resulting in very slow infusion rates. Care should be taken not to puncture the spinal cord or to lacerate the blood vessel wall using this route for blood collection or intravenous infusions.

  19. Early radiation-induced endothelial cell loss and blood-spinal cord barrier breakdown in the rat spinal cord.

    PubMed

    Li, Yu-Qing; Chen, Paul; Jain, Vipan; Reilly, Raymond M; Wong, C Shun

    2004-02-01

    Using a rat spinal cord model, this study was designed to characterize radiation-induced vascular endothelial cell loss and its relationship to early blood-brain barrier disruption in the central nervous system. Adult rats were given a single dose of 0, 2, 8, 19.5, 22, 30 or 50 Gy to the cervical spinal cord. At various times up to 2 weeks after irradiation, the spinal cord was processed for histological and immunohistochemical analysis. Radiation-induced apoptosis was assessed by morphology and TdT-mediated dUTP nick end labeling combined with immunohistochemical markers for endothelial and glial cells. Image analysis was performed to determine endothelial cell and microvessel density using immunohistochemistry with endothelial markers, namely endothelial barrier antigen, glucose transporter isoform 1, laminin and zonula occludens 1. Blood-spinal cord barrier permeability was assessed using immunohistochemistry for albumin and (99m)Tc-diethylenetriamine pentaacetic acid as a vascular tracer. Endothelial cell proliferation was assessed using in vivo BrdU labeling. During the first 24 h after irradiation, apoptotic endothelial cells were observed in the rat spinal cord. The decrease in endothelial cell density at 24 h after irradiation was associated with an increase in albumin immunostaining around microvessels. The decrease in the number of endothelial cells persisted for 7 days and recovery of endothelial density was apparent by day 14. A similar pattern of blood-spinal cord barrier disruption and recovery of permeability was observed over the 2 weeks, and an increase in BrdU-labeled endothelial cells was seen at day 3. These results are consistent with an association between endothelial cell death and acute blood-spinal cord barrier disruption in the rat spinal cord after irradiation.

  20. Blood flow increase by cervical spinal cord stimulation in middle cerebral and common carotid arteries.

    PubMed

    Robaina, Francisco; Clavo, Bernardino; Catalá, Luis; Caramés, Miguel Á; Morera, Jesús

    2004-01-01

    The effect of spinal cord stimulation (SCS) on cerebral blood flow (CBF) has, in the past, been evaluated by semiquantitative techniques, but has not been used to treat CBF diseases. The aim of this study was to assess the effect of cervical SCS on regional blood flow by both semiquantitative and quantitative methods. Thirty-five patients with cervical SCS-implanted devices were enrolled. The following parameters were measured before and after cervical SCS: systolic and diastolic velocity (cm/s) in the middle cerebral artery (MCA) by transcranial Doppler (TCD) and volume blood flow quantification (ml/min) in the common carotid artery (CCA) by color Doppler. During cervical SCS there was a significant and bilateral increase in systolic (21%) and diastolic (26%) velocity in the MCA and in CCA blood flow (50%). We conclude that cervical SCS increases blood flow in the middle cerebral artery and common carotid artery. The consistent increase supports the potential usefulness of cervical SCS as an adjuvant treatment for cerebral blood flow diseases.

  1. The Blood-Testis Barrier and Male Sexual Dysfunction following Spinal Cord Injury

    DTIC Science & Technology

    2014-10-01

    AWARD NUMBER: W81XWH-12-1-0481 TITLE: The Blood-Testis Barrier and Male Sexual Dysfunction following Spinal Cord Injury PRINCIPAL INVESTIGATOR...AND SUBTITLE: l The Blood-Testis Barrier and Male Sexual Dysfunction following Spinal Cord Injury 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-12-1...input into the male sexual organs. SCI-dependent male infertility is characterized by a significant reduction in numbers and quality of functional

  2. The post-occipital spinal venous sinus of the Nile crocodile (Crocodylus niloticus): Its anatomy and use for blood sample collection and intravenous infusions.

    PubMed

    Myburgh, Jan G; Kirberger, Robert M; Steyl, Johan C A; Soley, John T; Booyse, Dirk G; Huchzermeyer, Fritz W; Lowers, Russel H; Guillette, Louis J

    2014-05-05

    The post-occipital sinus of the spinal vein is often used for the collection of blood samples from crocodilians. Although this sampling method has been reported for several crocodilian species, the technique and associated anatomy has not been described in detail in any crocodilian, including the Nile crocodile (Crocodylus niloticus). The anatomy of the cranial neck region was investigated macroscopically, microscopically, radiographically and by means of computed tomography. Latex was injected into the spinal vein and spinal venous sinus of crocodiles to visualise the regional vasculature. The spinal vein ran within the vertebral canal, dorsal to and closely associated with the spinal cord and changed into a venous sinus cranially in the post-occipital region. For blood collection, the spinal venous sinus was accessed through the interarcuate space between the atlas and axis (C1 and C2) by inserting a needle angled just off the perpendicular in the midline through the craniodorsal cervical skin, just cranial to the cranial borders of the first cervical osteoderms. The most convenient method of blood collection was with a syringe and hypodermic needle. In addition, the suitability of the spinal venous sinus for intravenous injections and infusions in live crocodiles was evaluated. The internal diameter of the commercial human epidural catheters used during these investigations was relatively small, resulting in very slow infusion rates. Care should be taken not to puncture the spinal cord or to lacerate the blood vessel wall using this route for blood collection or intravenous infusions.

  3. Breakdown of Blood-Brain and Blood-Spinal Cord Barriers During Acute Methamphetamine Intoxication: Role of Brain Temperature.

    PubMed

    Kiyatkin, Eugene A; Sharma, Hari S

    2016-01-01

    Methamphetamine (METH) is a powerful and often-abused stimulant with potent addictive and neurotoxic properties. While it is generally believed that structural brain damage induced by METH results from oxidative stress, in this work we present data suggesting robust disruption of blood-brain and blood-spinal cord barriers during acute METH intoxication in rats. We demonstrate the relationships between METH-induced brain hyperthermia and widespread but structure-specific barrier leakage, acute glial cell activation, changes in brain water and ionic homeostasis, and structural damage of different types of cells in the brain and spinal cord. Therefore, METH-induced leakage of the blood-brain and blood-spinal cord barriers is a significant contributor to different types of functional and structural brain abnormalities that determine acute toxicity of this drug and possibly neurotoxicity during its chronic use.

  4. Spinal cord excitability is not influenced by elevated blood lactate levels.

    PubMed

    Coco, Marinella; Alagona, Giovanna; Perciavalle, Valentina; Cicirata, Valentina; Perciavalle, Vincenzo

    2011-01-01

    The aim of the present study was to examine the association of high blood lactate levels, induced with a maximal cycling or with an intravenous infusion, with spinal cord excitability. The study was carried out on 17 male athletes; all the subjects performed a maximal cycling test on a mechanically braked cycloergometer, while 6 of them were submitted to the intravenous infusion of a lactate solution (3 mg/kg in 1 min). Before the exercise or the injection, also at the end as well as 5 and 10 min after the conclusion, venous blood lactate was measured and excitability of the spinal α-motoneurons was evaluated by using the H reflex technique. In both experimental conditions, it has been observed that an exhaustive exercise is associated with a strong increase of blood lactate (but not of blood glucose) and with a significant reduction of spinal excitability. Since a similar augment of blood lactate induced by an intravenous infusion, in subjects not performing any exercise, is not associated with significant changes of spinal excitability, it can be concluded that the increase of blood lactate levels during a maximal exercise is not per se capable of modifying the excitability of spinal α-motoneurons.

  5. The effect of music on the level of cortisol, blood glucose and physiological variables in patients undergoing spinal anesthesia.

    PubMed

    Mottahedian Tabrizi, Elaheh; Sahraei, Hedayat; Movahhedi Rad, Saeid; Hajizadeh, Ebrahim; Lak, Marziyeh

    2012-01-01

    Surgical procedures performed using spinal anesthetic techniques present a special challenge to anesthesiologists, because patients are awake and are exposed to multiple anxiety provoking visual and auditory stimuli. Therefore, this study was carried out to define the effect of music on the level of cortisol, blood glucose and physiological variables in patients under spinal anesthesia. In this semi-experimental research, 90 men aging from 18-48 years with ASA (acetylsalicylic acid) class I, who underwent urological and abdominal surgery, were investigated. Patients were divided randomly into three groups of thirty subjects. Music group (headphone with music), Silence group (headphone without music) and the control group (without interference). The level of cortisol and blood sugar was measured half an hour before and after the operation. Moreover, the physiological indicators in each of these three groups were monitored and recorded from ten minutes before getting spinal anesthesia to ten minutes after the operation. The level of blood cortisol didn't have any increase in the music group after operation compared to the time before that. However, in the groups of silence and control this level had risen (p< 0.05). The level of blood glucose in music group had declined and in the other two groups it had increased. Our data showed that listening to music during surgery under regional anesthesia has effects on cortisol levels and some of the physiological variables. Therefore the researcher offers to be used music therapy as a complementary method in patients on the reduce anxiety.

  6. The effect of music on the level of cortisol, blood glucose and physiological variables in patients undergoing spinal anesthesia

    PubMed Central

    Mottahedian Tabrizi, Elaheh; Sahraei, Hedayat; Movahhedi Rad, Saeid; Hajizadeh, Ebrahim; Lak, Marziyeh

    2012-01-01

    Surgical procedures performed using spinal anesthetic techniques present a special challenge to anesthesiologists, because patients are awake and are exposed to multiple anxiety provoking visual and auditory stimuli. Therefore, this study was carried out to define the effect of music on the level of cortisol, blood glucose and physiological variables in patients under spinal anesthesia. In this semi-experimental research, 90 men aging from 18-48 years with ASA (acetylsalicylic acid) class I, who underwent urological and abdominal surgery, were investigated. Patients were divided randomly into three groups of thirty subjects. Music group (headphone with music), Silence group (headphone without music) and the control group (without interference). The level of cortisol and blood sugar was measured half an hour before and after the operation. Moreover, the physiological indicators in each of these three groups were monitored and recorded from ten minutes before getting spinal anesthesia to ten minutes after the operation. The level of blood cortisol didn't have any increase in the music group after operation compared to the time before that. However, in the groups of silence and control this level had risen (p< 0.05). The level of blood glucose in music group had declined and in the other two groups it had increased. Our data showed that listening to music during surgery under regional anesthesia has effects on cortisol levels and some of the physiological variables. Therefore the researcher offers to be used music therapy as a complementary method in patients on the reduce anxiety. PMID:27350774

  7. Increase of blood flow in skin and spinal cord following activation of small diameter primary afferents.

    PubMed

    Koltzenburg, M; Lewin, G; McMahon, S

    1990-02-12

    Activation of unmyelinated primary afferents produces vasodilatation and plasma extravasation in the skin. Here, using the laser Doppler technique to measure changes in blood flow and the Evans blue technique for quantification of plasma extravasation, we have asked whether the stimulation of C-fibre precipitates the same phenomena in the spinal cord. Our results show that there is an increase of blood flow, but no extravasation in the ipsilateral lumbar enlargement of the spinal cord following supramaximal electrical stimulation of the sciatic nerve. The blood flow increases were small and short-lived compared with those seen in skin, and could be completely explained by concomitant blood pressure changes. Hence, whilst the same substances are apparently released from the peripheral and central terminals of primary afferent fibres, their ability to produce vasodilatation and extravasation is absent or severely restricted in the spinal cord.

  8. Regional cerebral blood flow in schizophrenia

    SciTech Connect

    Mathew, R.J.; Duncan, G.C.; Weinman, M.L.; Barr, D.L.

    1982-10-01

    Regional cerebral blood flow (rCBF) was measured via xenon133 inhalation technique in 23 patients with schizophrenia and 18 age- and sex-matched controls. The mean blood flow to both hemispheres was found to be lower for the patients. The patients and their controls did not differ on interhemispheric differences in blood flow. There were no differences in rCBF between medicated and unmedicated, subchronic and chronic, and paranoid and nonparanoid patients. Hallucinations were associated with reduced blood flow to several postcentral regions.

  9. Geometric Structure of 3D Spinal Curves: Plane Regions and Connecting Zones

    PubMed Central

    Berthonnaud, E.; Hilmi, R.; Dimnet, J.

    2012-01-01

    This paper presents a new study of the geometric structure of 3D spinal curves. The spine is considered as an heterogeneous beam, compound of vertebrae and intervertebral discs. The spine is modeled as a deformable wire along which vertebrae are beads rotating about the wire. 3D spinal curves are compound of plane regions connected together by zones of transition. The 3D spinal curve is uniquely flexed along the plane regions. The angular offsets between adjacent regions are concentrated at level of the middle zones of transition, so illustrating the heterogeneity of the spinal geometric structure. The plane regions along the 3D spinal curve must satisfy two criteria: (i) a criterion of minimum distance between the curve and the regional plane and (ii) a criterion controlling that the curve is continuously plane at the level of the region. The geometric structure of each 3D spinal curve is characterized by the sizes and orientations of regional planes, by the parameters representing flexed regions and by the sizes and functions of zones of transition. Spinal curves of asymptomatic subjects show three plane regions corresponding to spinal curvatures: lumbar, thoracic and cervical curvatures. In some scoliotic spines, four plane regions may be detected. PMID:25031873

  10. Spinal cord stimulation for a woman with complex regional pain syndrome who wished to get pregnant.

    PubMed

    Ito, Shoji; Sugiura, Takeshi; Azami, Takafumi; Sasano, Hiroshi; Sobue, Kazuya

    2013-02-01

    A woman with complex regional pain syndrome (CRPS) in the right lower extremity who wished to discontinue medications to get pregnant underwent implantation of a spinal cord stimulation system (SCS). An electrode lead was placed at Th(10-11) in the epidural space, accessed via the L(2-3) interspace with a paramedian approach, and a pulse generator was implanted in the left buttock. She kept the SCS on 24 h a day. After she had experienced several chemical abortions, finally she got pregnant via artificial insemination. She had an uneventful delivery of a healthy baby by cesarean resection under spinal anesthesia. In a patient with CRPS who has an implanted SCS system and wishes to get pregnant, the electrode lead into the low thoracic epidural space should be accessed via the high lumbar intervertebral space in consideration of a future requirement for spinal or epidural anesthesia for cesarean section. The generator should be placed in the buttock to prevent impairment of the SCS system being caused by the enlarged abdomen during pregnancy. Although we were apprehensive of adverse effects owing to the electromagnetic field force and change of blood flow in the pelvic viscera, our patient had a successful delivery. SCS is a favorable option for patients with CRPS who wish to get pregnant.

  11. Phenylbutyrate prevents disruption of blood-spinal cord barrier by inhibiting endoplasmic reticulum stress after spinal cord injury

    PubMed Central

    Zhou, Yulong; Ye, Libing; Zheng, Binbin; Zhu, Sipin; Shi, Hongxue; Zhang, Hongyu; Wang, Zhouguang; Wei, Xiaojie; Chen, Daqing; Li, Xiaokun; Xu, Huazi; Xiao, Jian

    2016-01-01

    This study aims to investigate the role of endocytoplasmic reticulum (ER) stress induced by spinal cord injury (SCI) in blood-spinal cord barrier (BSCB) disruption and the effect of phenylbutyrate (PBA) on BSCB disruption after SCI. After a moderate contusion injury at the T9 level of spinal cord with a vascular clip, PBA was immediately administered into injured rat via intraperitoneal injection (100 mg/kg) and then further treated once a day for 2 weeks for behavior test. Spinal cord was collected at 1 day post-injury for evaluation of the effects of ER stress and PBA on BSCB disruption after SCI. PBA significantly attenuated BSCB permeability and degradation of tight junction molecules such as P120, β-catenin, Occludin and Claudin5 at 1 day after injury and improved functional recovery in the rat model of trauma. The BSCB protective effect of PBA is related to the inhibition of ER stress induced by SCI. In addition, PBA significantly inhibited the increase of ER stress markers and prevents loss of tight junction and adherens junction proteins in TG-treated human brain microvascular endothelial cells (HBMEC). Taken together, our data demonstrate that therapeutic strategies targeting ER stress may be suitable for the therapy of preserving BSCB integrity after SCI. PBA may be a new candidate as a therapeutic agent for protecting SCI by a compromised BSCB. PMID:27186310

  12. Postradiation regional cerebral blood flow in primates

    SciTech Connect

    Cockerham, L.G.; Cerveny, T.J.; Hampton, J.D.

    1986-06-01

    Early transient incapacitation (ETI) is the complete cessation of performance during the first 30 min after radiation exposure and performance decrement (PD) is a reduction in performance at the same time. Supralethal doses of radiation have been shown to produce a marked decrease in regional cerebral blood flow in primates concurrent with hypotension and a dramatic release of mast cell histamine. In an attempt to elucidate mechanisms underlying the radiation-induced ETI/PD phenomenon and the postradiation decrease in cerebral blood flow, primates were exposed to 100 Gy (1 Gy = 100 rads), whole-body, gamma radiation. Pontine and cortical blood flows were measured by hydrogen clearance, before and after radiation exposure. Systemic blood pressures were determined simultaneously. Systemic arterial histamine levels were determined preradiation and postradiation. Data obtained indicated that radiated animals showed a decrease in blood flow of 63% in the motor cortex and 51% in the pons by 10 min postradiation. Regional cerebral blood flow of radiated animals showed a slight recovery 20 min postradiation, followed by a fall to the 10 min nadir by 60 min postradiation. Immediately, postradiation systemic blood pressure fell 67% and remained at that level for the remainder of the experiment. Histamine levels in the radiated animals increased a hundredfold 2 min postradiation. This study indicates that regional cerebral blood flow decreases postradiation with the development of hypotension and may be associated temporally with the postradiation release of histamine.

  13. Local cooling reduces regional bone blood flow.

    PubMed

    Venjakob, Arne J; Vogt, Stephan; Stöckl, Klaus; Tischer, Thomas; Jost, Philipp J; Thein, Eckart; Imhoff, Andreas B; Anetzberger, Hermann

    2013-11-01

    Local cooling is very common after bone and joint surgery. Therefore the knowledge of bone blood flow during local cooling is of substantial interest. Previous studies revealed that hypothermia leads to vasoconstriction followed by decreased blood flow levels. The aim of this study was to characterize if local cooling is capable of inducing reduced blood flow in bone tissue using a stepwise-reduced temperature protocol in experimental rabbits. To examine bone blood flow we utilized the fluorescent microsphere (FM) method. In New Zealand white rabbits one randomly chosen hind limb was cooled stepwise from 32 to 2°C, whereas the contra lateral hind limb served as control. Injection of microspheres was performed after stabilization of bone and muscle temperature at each temperature level. Bones were removed, dissected and fluorescence intensity was determined to calculate blood flow values. We found that blood flow of all cooled regions decreased relative to the applied external temperature. At maximum cooling blood flow was almost completely disrupted, indicating local cooling as powerful regulatory mechanism for regional bone blood flow (RBBF). Postoperative cooling therefore may lead to strongly decreased bone blood flow values. As a result external cooling has capacity to both diminish bone healing and reduce bleeding complications.

  14. Deletion mapping of the spinal muscular atrophy region

    SciTech Connect

    Burgein, L.; Lefebvre, S.; Buriet, P.

    1994-09-01

    Autosomal recessive childhood spinal muscular atrophies (SMA) are divided into severe (Type I) and mild forms (Types II and III). Using a combination of fine genetic and physical mapping, we constructed a YAC contig of the 5q13 region spanning the disease locus and showed the presence of low copy-repeats in this region. Allele segregation was analyzed at the closest genetic loci detected by markers C212 and C272 in 201 SMA families. Inherited and de novo deletions were observed in 9 unrelated SMA patients. Moreover, deletion events were statistically associated with type I SMA patients as shown by marked heterozygosity deficiency for the loci studied. Genetic analysis with all polymorphic DNA markers derived from the YAC contig has allowed to define the smallest rearrangement between the loci detected by C161 and the C212-C272-C171, covering a 1Mb interval. A large scale physical map of this region has been constructed using pulsed field gel electrophoresis (PFGE) and rare cutter restriction endonucleases. Comparison of the physical map has been established both in patients harboring deletions and unaffected controls using various anonymous probes derived from the YAC contig. This analysis has allowed us to define a physical interval in which at least a portion of the SMA gene must be located. Search for genes within this interval will contribute to the identification of the disease gene or genes.

  15. A probe for blood-vessel and spinal interiors

    NASA Technical Reports Server (NTRS)

    Frazer, R. E.

    1978-01-01

    Probe design allows insertion into lumen of blood vessels to perform oximetry and investigate plaque on interior vessel walls. Probe is more accurate than standard oximetry procedures of determining oxygenation of circulating blood.

  16. [Injury to major blood vessels in anterior thoracic and lumbar spinal surgery].

    PubMed

    Stulík, J; Vyskocil, T; Bodlák, P; Sebesta, P; Kryl, J; Vojácek, J; Pafko, P

    2006-04-01

    The anterior approach to the thoracic and lumbar spine is used with increasing frequency for various indications. With the advent of prosthetic intervertebral disc replacement, its use has become even more frequent and has often been associated with serious complications. The aim of this study was to evaluate vascular complications in patients who underwent anterior spinal surgery of the thoracic and lumbar spine. We performed a total of 531 operations of the thoracolumbar spine from the anterior approach. In 12 cases, after exposure of the body of the first or second thoracic vertebrae, we employed the Smith-Robinson technique to expose the cervical spine. We used sternotomy in six, posterolateral thoracotomy in 209, the pararectal retroperitoneal approach in 239, anterolateral lumbotomy in 58 and the transperitoneal approach in seven patients. The aim of surgery was somatectomy in 190 patients and discectomy in 341 patients. Sternotomy and transperitoneal approaches were carried out by a thoracic or vascular surgeon and all the other procedures were done by the first author. The indications for spinal surgery included an accident in 171, tumor in 56, spondylodiscitis in 43 and a degenerative disease in 261 patients. All patients indicated for anterior spinal surgery were examined by conventional radiography in two projections, and this was completed by CT sagittal and frontal reconstructions of the affected region. Most patients also underwent MR imaging. The Smith-Robinson approach was used for exposure of T1 or T2. Sternotomy was indicated for treatment of T2-T4 and also T1 in the patients with a short, thick neck. Access to T3-L1 was gained by posterolateral thoracotomy, in most cases performed as a minimally invasive transpleural procedure. For access to the lumbar spine we usually used the retropleural approach from a pararectal incision or lumbotomy. We preferred the pararectal retroperitoneal approach in L2-S1 degenerative disease, L5 fractures, and L5-S1

  17. The Blood-testis-barrier and Male Sexual Dysfunction Following Spinal Cord Injury

    DTIC Science & Technology

    2013-10-01

    dependent male infertility is characterized by a significant reduction in numbers and quality of functional sperm. The mechanism(s) underlying this...term effects on the blood-testis-barrier as a mechanism underlying male infertility following spinal cord injury. Goals/Milestones (Example) CY12/13

  18. Personality and regional cerebral blood flow.

    PubMed

    Mathew, R J; Weinman, M L; Barr, D L

    1984-05-01

    The extraversion-introversion dimension of personality is believed to have an inverse relationship with cortical arousal. Brain capillary perfusion is a well established index of brain function and arousal. Regional cerebral blood flow was measured in 51 right-handed females whose personality structure was examined with the Eysenck Personality Inventory (EPI). Significant inverse correlations were found between the brain blood flow and the extraversion-introversion score of EPI.

  19. Blood-spinal cord barrier breakdown and pericyte deficiency in peripheral neuropathy.

    PubMed

    Sauer, Reine-Solange; Kirchner, Juliane; Yang, Shaobing; Hu, Liu; Leinders, Mathias; Sommer, Claudia; Brack, Alexander; Rittner, Heike L

    2017-10-01

    The blood-spinal cord barrier (BSCB) prevents leakage of molecules, such as pronociceptive mediators, into the spinal cord, but its role in the pathophysiology of neuropathic pain is not completely understood. Rats with chronic constriction injury (CCI) develop mechanical allodynia, thermal hypersensitivity, and reduced motor performance (Rota-Rod test) compared with sham-injured mice-similar to mice with spared nerve injury (SNI). The BSCB becomes permeable for small and large tracers 1 day after nerve ligation. Messenger RNA (mRNA) expression of tight junction proteins (TJPs) occludin, claudin-1, claudin-5, claudin-19, tricellulin, and ZO-1 significantly declines 7-14 days after CCI or SNI. ZO-1 and occludin are reduced in the cell membrane. In capillaries isolated from the spinal cord, immunoreactivity of claudin-5 and ZO-1 is fainter. In parallel, the number of platelet-derived growth factor receptor β (PDGF-β)(+) and CD13(+) pericytes in the spinal cord drops. Reduced levels of cytosolic transcription factors like β-catenin, but not SMAD4 and SLUG, could account for reduced TJP mRNA. In summary, neuropathy-induced allodynia/hypersensitivity is accompanied by a loss of pericytes in the spinal cord and a leaky BSCB. A better understanding of these pathways and mechanisms in neuropathic pain might foster the design of novel treatments to maintain spinal cord homeostasis. © 2017 New York Academy of Sciences.

  20. Somatotopic arrangement of thermal sensory regions in the healthy human spinal cord determined by means of spinal cord functional MRI.

    PubMed

    Stroman, Patrick W; Bosma, Rachael L; Tsyben, Anastasia

    2012-09-01

    Previous functional MRI studies of normal sensory function in the human spinal cord, including right-to-left symmetry of activity, have been influenced by order effects between repeated studies. In this study, we apply thermal sensory stimulation to four dermatomes within each functional MRI time-series acquisition. Each of the four dermatomes receives a unique stimulation paradigm, such that the four paradigms form a linearly independent set, enabling detection of each individual stimulus response. Functional MRI data are shown spanning the cervical spinal cord and brainstem in 10 healthy volunteers. Results of general linear model analysis demonstrate consistent patterns of activity within the spinal cord segments corresponding to each dermatome, and a high degree of symmetry between right-side and left-side stimulation. Connectivity analyses also demonstrate consistent areas of activity and connectivity between spinal cord and brainstem regions corresponding to known anatomy. However, right-side and left-side responses are not at precisely the same rostral-caudal positions, but are offset by several millimeters, with left-side responses consistently more caudal than right-side responses. The results confirm that distinct responses to multiple interleaved sensory stimuli can be distinguished, enabling studies of sensory responses within the spinal cord without the confounding effects of comparing sequential studies.

  1. Spinal muscular atrophy patient detection and carrier screening using dried blood spots on filter paper.

    PubMed

    Harahap, Nur Imma Fatimah; Harahap, Indra Sari Kusuma; Kaszynski, Richard Hideki; Nurputra, Dian Kesuma Pramudya; Hartomo, Tri Budi; Pham, Huyen Thi Van; Yamamoto, Tomoto; Morikawa, Satoru; Nishimura, Noriyuki; Rusdi, Imam; Widiastuti, Retno; Nishio, Hisahide

    2012-02-01

    Spinal muscular atrophy (SMA) is a common autosomal recessive neuromuscular disorder. It is caused by mutations in the SMN1, and its clinical severity is modified by copy number variations of the SMN2. According to previous studies, deletion of SMN1 exon 7 is the most frequently observed in patients with SMA. Therefore, molecular analyses exploiting this genetic lesion could be beneficial in the diagnosis of SMA. Unfortunately, in many geographical regions, physicians do not have the latest molecular screening technologies at their immediate disposal. Thus, to overcome this issue, we developed an SMA-diagnosing system using dried blood spots (DBS) placed on filter paper to facilitate remote diagnosis. In this study, we validate the applicability of DBS on Flinders Technology Associates (FTA) filter paper for detecting SMN1 exon 7 deletions and copy number variations of SMN1 and SMN2. To detect exon 7 deletions in SMN1, polymerase chain reaction (PCR)-restriction fragment length polymorphism analysis was conducted by using DNA extracted from the DBS on FTA filter paper that had been stored at room temperature for a period of up to 4 years. To determine the copy numbers of SMN1 and SMN2, we carried out SYBR green-based real-time PCR by using the same blood specimens. The results obtained from the DBS on FTA filter paper were in complete concordance with those analyses using fresh blood specimens. This indicates that DBS on filter papers is a reliable method for SMA patient detection and carrier screenings. The SMA-diagnosing system, combined with the mailing of DBS on filter paper, will be beneficial for patients suffering from neuromuscular disorders in areas with limited or no access to diagnostic facilities with molecular capabilities.

  2. [Effect of noxious stimulation on regional distribution of propofol in canine spinal cord].

    PubMed

    Lin, Chun-shui; Xu, Jin-dong; Gu, Miao-ning; Chen, Ying; Zhou, Feng-zhi

    2010-05-01

    To observe the regional distribution of propofol in canine spinal cord under noxious stimulation. Twelve healthy hybrid dogs (12-18 months old, weighing 10-12 kg) were randomly divided into control group (n=6) and stimulation group (n=6). All the dogs were anesthetized with a single bolus dose of propofol (7 mg/kg) in 15 seconds followed by propofol infusion at a constant rate of 70 mg/kg/h via the great saphenous vein of the right posterior limb. In the stimulation group, the tails of the dogs were clamped for 5 min after 45 min of propofol infusion. Blood samples were taken from the internal carotid artery and internal jugular vein at 50 min after propofol infusion to detect plasma propofol concentrations by high-pressure liquid chromatography (HPLC). The dogs were then immediately sacrificed by decapitation and the frontal horn, posterior horn, intermediate zone, frontal funiculus, posterior funiculus and lateral funiculus of the spinal cord were dissected for determination of propol content by HPLC. The plasma concentrations of propofol in the internal carotid artery and internal jugular vein were 5.07-/+0.23 and 5.03-/+0.10 microg/ml in the stimulation group, respectively showing no significant differences from those in the control group (5.09-/+0.03 and 5.08-/+0.03 microg/ml, P>0.05). In the control group, the propofol concentration was 5.09-/+0.08 microg/g in the frontal horm, 5.10-/+0.08 microg/g in the posterior horn, 5.05-/+0.19 microg/g in the intermediate zone, 5.06-/+0.14 microg/g in the frontal funiculus, 5.06-/+0.15 microg/g in the posterior funiculus and 5.06-/+0.41 microg/g in the lateral funiculus, showing no significant differences (P>0.05). The propofol concentrations in the frontal horn (7.65-/+0.47 microg/g) and posterior funiculus (7.06-/+0.82 microg/g) in the stimulation group were significantly higher than those in the other spinal cord tissues (P<0.05) and those in the control group (P<0.05). At 50 min after intravenous injection of

  3. Propofol protects against blood-spinal cord barrier disruption induced by ischemia/reperfusion injury

    PubMed Central

    Xie, Li-jie; Huang, Jin-xiu; Yang, Jian; Yuan, Fen; Zhang, Shuang-shuang; Yu, Qi-jing; Hu, Ji

    2017-01-01

    Propofol has been shown to exert neuroprotective effects on the injured spinal cord. However, the effect of propofol on the blood-spinal cord barrier (BSCB) after ischemia/reperfusion injury (IRI) is poorly understood. Therefore, we investigated whether propofol could maintain the integrity of the BSCB. Spinal cord IRI (SCIRI) was induced in rabbits by infrarenal aortic occlusion for 30 minutes. Propofol, 30 mg/kg, was intravenously infused 10 minutes before aortic clamping as well as at the onset of reperfusion. Then, 48 hours later, we performed histological and mRNA/protein analyses of the spinal cord. Propofol decreased histological damage to the spinal cord, attenuated the reduction in BSCB permeability, downregulated the mRNA and protein expression levels of matrix metalloprotease-9 (MMP-9) and nuclear factor-κB (NF-κB), and upregulated the protein expression levels of occludin and claudin-5. Our findings suggest that propofol helps maintain BSCB integrity after SCIRI by reducing MMP-9 expression, by inhibiting the NF-κB signaling pathway, and by maintaining expression of tight junction proteins. PMID:28250758

  4. Spinal cord blood flow measured by /sup 14/C-iodoantipyrine autoradiography during and after graded spinal cord compression in rats

    SciTech Connect

    Holtz, A.; Nystroem, B.G.; Gerdin, B.

    1989-05-01

    The relations between degree of thoracic spinal cord compression causing myelographic block, reversible paraparesis, and extinction of the sensory evoked potential on one hand, and spinal cord blood flow on the other, were investigated. This was done in rats using the blocking weight-technique and /sup 14/C-iodoantipyrine autoradiography. A load of 9 g caused myelographic block. Five minutes of compression with that load caused a reduction of spinal cord blood flow to about 25%, but 5 and 60 minutes after the compression spinal cord blood flow was restored to 60% of the pretrauma value. A load of 35 g for 5 minutes caused transient paraparesis. Recovery to about 30% was observed 5 and 60 minutes thereafter. During compression at a load of 55 g, which caused almost total extinction of sensory evoked potential and irreversible paraplegia, spinal cord blood flow under the load ceased. The results indicate that myelographic block occurs at a load which does not cause irreversible paraparesis and that a load which permits sensory evoked potential to be elicited results in potentially salvageable damage.

  5. Selective increase of two ABC drug efflux transporters at the blood-spinal cord barrier suggests induced pharmacoresistance in ALS.

    PubMed

    Jablonski, Michael R; Jacob, Dena A; Campos, Christopher; Miller, David S; Maragakis, Nicholas J; Pasinelli, Piera; Trotti, Davide

    2012-08-01

    ATP-binding cassette (ABC) drug efflux transporters in the CNS are predominantly localized to the luminal surface of endothelial cells in capillaries to impede CNS accumulation of xenobiotics. Inflammatory mediators and cellular stressors regulate their activity. Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease of upper and lower motor neurons characterized by extensive neuroinflammation. Here we tested the hypothesis that disease-driven changes in ABC transporter expression and function occur in ALS. Given the multitude of ABC transporters with their widespread substrate recognition, we began by examining expression levels of several ABC transporters. We found a selective increase in only two transporters: P-glycoprotein (P-gp) and breast cancer resistance protein (BCRP) both at mRNA and protein levels, in the SOD1-G93A mouse model of ALS, specifically in disease-affected CNS regions. Detailed analysis revealed a similar disease-driven increase in P-gp and BCRP levels in spinal cord microvessels, indicating that their altered expression occurs at the blood spinal cord barrier. Transport activity of P-gp and BCRP increased with disease progression in spinal cord and cerebral cortex capillaries. Finally, P-gp and BCRP protein expression also increased in spinal cords of ALS patients. Preclinical drug trials in the mouse model of ALS have failed to decisively slow or arrest disease progression; pharmacoresistance imparted by ABC transporters is one possible explanation for these failures. Our observations have large implications for ALS therapeutics in humans and suggest that the obstacle provided by these transporters to drug treatments must be overcome to develop effective ALS pharmacotherapies. Copyright © 2012 Elsevier Inc. All rights reserved.

  6. Correlation of force control with regional spinal DTI in patients with cervical spondylosis without signs of spinal cord injury on conventional MRI.

    PubMed

    Lindberg, Påvel G; Sanchez, Katherine; Ozcan, Fidan; Rannou, François; Poiraudeau, Serge; Feydy, Antoine; Maier, Marc A

    2016-03-01

    The aim of this study was to investigate spinal cord structure in patients with cervical spondylosis where conventional MRI fails to reveal spinal cord damage. We performed a cross-sectional study of patients with cervical spondylosis without conventional MRI findings of spinal cord damage and healthy controls. Subjects were studied using spinal diffusion tensor imaging (DTI), precision grip and foot force-tracking tasks, and a clinical examination including assessment of neurological signs. A regional analysis of lateral and medial spinal white matter across multiple cervical levels (C1-C5) was performed. DTI revealed reduced fractional anisotropy (FA) and increased radial diffusivity (RD) in the lateral spinal cord at the level of greatest compression (lowest Pavlov ratio) in patients (p < 0.05). Patients with spondylosis had greater error and longer release duration in both grip and foot force-tracking. Similar spinal cord deficits were present in patients without neurological signs. Increased error in grip and foot tracking (low accuracy) correlated with increased RD in the lateral spinal cord at the level of greatest compression (p ≤ 0.01). Spinal DTI can detect subtle spinal cord damage of functional relevance in cervical spondylosis, even in patients without signs on conventional T2-imaging and without neurological signs. DTI reveals spinal cord changes in cervical spondylosis with few symptoms. DTI changes were present despite normal spinal cord on conventional MRI. DTI parameters correlated with force control accuracy in hand and foot. Spinal DTI is a promising technique for patients with cervical spondylosis.

  7. Cost and utilization of blood transfusion associated with spinal surgeries in the United States.

    PubMed

    Blanchette, Christopher M; Wang, Peter F; Joshi, Ashish V; Asmussen, Mikael; Saunders, William; Kruse, Peter

    2007-03-01

    The purpose of this study was to examine factors associated with the utilization and cost of blood transfusion during and post-spinal fusion surgery. A retrospective, observational study of 42,029 inpatients undergoing spinal fusion surgery in United States hospitals participating in the Perspective( Comparative Database for inpatient use was conducted. Descriptive analysis, logistic regression, and ordinary least squares (OLS) regression were used to describe the factors associated with the use and cost of allogeneic blood transfusion (ABT). Hospitalization costs were $18,690 (SD=14,159) per patient, erythropoietin costs were $85.25 (SD=3,691.66) per patient, and topical sealant costs were $414.34 (SD=1,020.06) per patient. Sub-analysis of ABT restricted to users revealed ABT costs ranged from $312.24 (SD=543.35) per patient with whole blood to $2,520 (SD=3,033.49) per patient with fresh frozen plasma. Patients that received hypotensive anesthesia (OR,1.61; 95% CI, 1.47-1.77), a volume expander (OR,1.95; 95% CI, 1.75-2.18), autologous blood (OR, 2.04; 95% CI, 1.71-2.42), or an erythropoietic agent (OR=1.64; 95% CI, 1.27-2.12) had a higher risk of ABT. Patients that received cell salvage had a lower risk of transfusion (OR=0.40; 95% CI, 0.32-0.50). Most blood avoidance techniques have low utilization or do not reduce the burden of transfusion associated with spinal fusion.

  8. Severe blood loss during spinal reconstructive procedures: the potential usefulness of topical hemostatic agents.

    PubMed

    Block, Jon E

    2005-01-01

    Complex spinal reconstructive procedures are invariably associated with excessive intraoperative blood loss that significantly increases the risk of severe perioperative complications. In some cases, excessive hemorrhage is equivalent to estimated total blood volume. Unfortunately, widely exposed bony surfaces are not amenable to standard hemostatic maneuvers utilized during soft tissue surgery. This article evaluates the clinical effectiveness of several approaches to blood management in this setting, and hypothesizes that underappreciated topical hemostatic agents may provide benefit by reducing the need for autologous predonation, banked donor blood or antifibrinolytic agents. Topical agents combining collagen, thrombin and fibrin have demonstrated initial promise by inducing platelet aggregation and initiating the clotting cascade when applied directly to bleeding bony sites. Clinical studies are clearly warranted.

  9. Symptomatic Triple-Region Spinal Stenosis Treated with Simultaneous Surgery: Case Report and Review of the Literature

    PubMed Central

    Schaffer, Joseph C.; Raudenbush, Brandon L.; Molinari, Christine; Molinari, Robert W.

    2015-01-01

    Study Design Case report. Objectives Symptomatic triple-region spinal stenosis (TRSS), defined as spinal stenosis in three different regions of the spine, is extremely rare. To our knowledge, treatment with simultaneous decompressive surgery is not described in the literature. We report a case of a patient with TRSS who was treated successfully with simultaneous decompressive surgery in three separate regions of the spine. Methods A 50-year-old man presented with combined progressive cervical and thoracic myelopathy along with severe lumbar spinal claudication and radiculopathy. He underwent simultaneous decompressive surgery in all three regions of his spine and concomitant instrumented fusion in the cervical and thoracic regions. Results Estimated blood loss for the procedure was 600 mL total (250 mL cervical, 250 mL thoracic, 100 mL lumbar) and operative time was ∼3.5 hours. No changes were noted on intraoperative monitoring. The postoperative course was uncomplicated. The patient was discharged to inpatient rehabilitation on postoperative day (POD) 7 and discharged home on POD 11. At 6-month follow-up, his gait and motor function was improved and returned to normal in all extremities. He remains partially disabled due to chronic back pain. Conclusions This report is the first of symptomatic TRSS treated with simultaneous surgery in three different regions of the spine. Simultaneous triple region stenosis surgery appears to be an effective treatment option for this rare condition, but may be associated with prolonged hospital stay after surgery. PMID:26682102

  10. The organization of spinal motor neurons in a monotreme is consistent with a six-region schema of the mammalian spinal cord.

    PubMed

    Mitchelle, Amer; Watson, Charles

    2016-09-01

    The motor neurons in the spinal cord of an echidna (Tachyglossus aculeatus) have been mapped in Nissl-stained sections from spinal cord segments defined by spinal nerve anatomy. A medial motor column of motor neurons is found at all spinal cord levels, and a hypaxial column is found at most levels. The organization of the motor neuron clusters in the lateral motor column of the brachial (C5 to T3) and crural (L2 to S3) limb enlargements is very similar to the pattern previously revealed by retrograde tracing in placental mammals, and the motor neuron clusters have been tentatively identified according to the muscle groups they are likely to supply. The region separating the two limb enlargements (T4 to L1) contains preganglionic motor neurons that appear to represent the spinal sympathetic outflow. Immediately caudal to the crural limb enlargement is a short column of preganglionic motor neurons (S3 to S4), which it is believed represents the pelvic parasympathetic outflow. The rostral and caudal ends of the spinal cord contain neither a lateral motor column nor a preganglionic column. Branchial motor neurons (which are believed to supply the sternomastoid and trapezius muscles) are present at the lateral margin of the ventral horn in rostral cervical segments (C2-C4). These same segments contain the phrenic nucleus, which belongs to the hypaxial column. The presence or absence of the main spinal motor neuron columns in the different regions echidna spinal cord (and also in that of other amniote vertebrates) provides a basis for dividing the spinal cord into six main regions - prebrachial, brachial, postbrachial, crural, postcrural and caudal. The considerable biological and functional significance of this subdivision pattern is supported by recent studies on spinal cord hox gene expression in chicks and mice. On the other hand, the familiar 'segments' of the spinal cord are defined only by the anatomy of adjacent vertebrae, and are not demarcated by intrinsic gene

  11. Regional cerebral blood flow in childhood headache

    SciTech Connect

    Roach, E.S.; Stump, D.A.

    1989-06-01

    Regional cerebral blood flow (rCBF) was measured in 16 cranial regions in 23 children and adolescents with frequent headaches using the non-invasive Xenon-133 inhalation technique. Blood flow response to 5% carbon dioxide (CO2) was also determined in 21 patients, while response to 50% oxygen was measured in the two patients with hemoglobinopathy. Included were 10 patients with a clinical diagnosis of migraine, 4 with musculoskeletal headaches, and 3 with features of both types. Also studied were 2 patients with primary thrombocythemia, 2 patients with hemoglobinopathy and headaches, 1 patient with polycythemia, and 1 with headaches following trauma. With two exceptions, rCBF determinations were done during an asymptomatic period. Baseline rCBF values tended to be higher in these young patients than in young adults done in our laboratory. Localized reduction in the expected blood flow surge after CO2 inhalation, most often noted posteriorly, was seen in 8 of the 13 vascular headaches, but in none of the musculoskeletal headache group. Both patients with primary thrombocythemia had normal baseline flow values and altered responsiveness to CO2 similar to that seen in migraineurs; thus, the frequently reported headache and transient neurologic signs with primary thrombocythemia are probably not due to microvascular obstruction as previously suggested. These data support the concept of pediatric migraine as a disorder of vasomotor function and also add to our knowledge of normal rCBF values in younger patients. Demonstration of altered vasomotor reactivity to CO2 could prove helpful in children whose headache is atypical.

  12. Does a kaolin-impregnated hemostatic dressing reduce intraoperative blood loss and blood transfusions in pediatric spinal deformity surgery?

    PubMed

    Abbott, Emily M; Nandyala, Sreeharsha V; Schwend, Richard M

    2014-09-01

    Retrospective case-control study. To evaluate the hemostatic benefits of using a kaolin-impregnated dressing during pediatric spinal deformity correction surgery. Minimizing blood loss and transfusions are clear benefits for patient safety. A technique common in both severe trauma and combat medicine that has not been reported in the spine literature is wound packing with a kaolin-impregnated hemostatic dressing. Estimated blood loss and transfusion amounts were analyzed in a total of 117 retrospectively identified cases. The control group included 65 patients (46 females, 19 males, 12.7±4.5 yr, 10.2±4.8 levels fused) who received standard operative care with gauze packing between June 2007 and March 2010. The treatment group included 52 patients (33 females, 19 males, 13.9±3.2 yr, 10.4±4.3 levels fused) who underwent intraoperative packing with QuikClot Trauma Pads (QCTP, Z-Medica Corporation) for all surgical procedures from July 2010 to August 2011. No other major changes in the use of antifibrinolytics or perioperative, surgical, or anesthesia technique were noted. Statistical differences were analyzed using analysis of covariance in R with P value of less than 0.05. The statistical model included sex, age, weight, scoliosis type, the number of vertebral levels fused, and surgery duration as covariates. The treatment group had 40% less intraoperative estimated blood loss than the control group (974 mL vs. 1620 mL) (P<0.001). Patients who received the QCTP treatment also had 42% less total perioperative transfusion volume (499 mL vs. 862 mL) (P<0.01). The use of a kaolin-impregnated intraoperative trauma pad seems to be an effective and inexpensive method to reduce intraoperative blood loss and transfusion volume in pediatric spinal deformity surgery. 3.

  13. Not just the brain: methamphetamine disrupts blood-spinal cord barrier and induces acute glial activation and structural damage of spinal cord cells.

    PubMed

    Kiyatkin, Eugene A; Sharma, Hari S

    2015-01-01

    Acute methamphetamine (METH) intoxication induces metabolic brain activation as well as multiple physiological and behavioral responses that could result in life-threatening health complications. Previously, we showed that METH (9 mg/kg) used in freely moving rats induces robust leakage of blood-brain barrier, acute glial activation, vasogenic edema, and structural abnormalities of brain cells. These changes were tightly correlated with drug-induced brain hyperthermia and were greatly potentiated when METH was used at warm ambient temperatures (29°C), inducing more robust and prolonged hyperthermia. Extending this line of research, here we show that METH also strongly increases the permeability of the blood-spinal cord barrier as evidenced by entry of Evans blue and albumin immunoreactivity in T9-12 segments of the spinal cord. Similar to the blood-brain barrier, leakage of bloodspinal cord barrier was associated with acute glial activation, alterations of ionic homeostasis, water tissue accumulation (edema), and structural abnormalities of spinal cord cells. Similar to that in the brain, all neurochemical alterations correlated tightly with drug-induced elevations in brain temperature and they were enhanced when the drug was used at 29°C and brain hyperthermia reached pathological levels (>40°C). We discuss common features and differences in neural responses between the brain and spinal cord, two inseparable parts of the central nervous system affected by METH exposure.

  14. Gender differences in regional cerebral blood flow

    SciTech Connect

    Gur, R.E.; Gur, R.C. )

    1990-01-01

    Gender differences have been noted in neurobehavioral studies. The 133xenon inhalation method for measuring regional cerebral blood flow (rCBF) can contribute to the understanding of the neural basis of gender differences in brain function. Few studies have examined gender differences in rCBF. In studies of normal subjects, women have higher rates of CBF than men, and this is related to age. Usually by the sixth decade men and women have similar flow rates. Fewer studies on rCBF in schizophrenia have examined sex differences. The pattern of higher flows for females maintains, but its correlates with gender differences in clinical as well as other parameters of brain function remain to be examined.

  15. Spatial fluctuation of regional myocardial blood flows.

    PubMed

    Matsumoto, T; Ebata, J; Tsujioka, K; Ogasawara, Y; Kajiya, F

    1997-12-01

    Digital radiography (100 pixels/mm2) combined with the technique of 3H-labeled desmethylimipramine deposition was employed to visualize regional blood flow distributions in rabbit left ventricular myocardium. A fluctuated pattern of myocardial flow and its dependence on arterial oxygen tension (PaO2) was evaluated with the coefficient of variation (CV) computed at each step of coarse-graining; flow images were revisualized by increasing pixel area (PA) step by step from 0.01 to 1 mm2. The CV values decreased with hypoxia at all resolution levels, suggesting that there is a vascular regulatory mechanism for making myocardial perfusion uniform in response to decreased PaO2. In both perfusion states, CV decreased with increasing PA. The relationship between CV and PA fitted the noninteger power law function, implying an apparent fractality of CV.

  16. Whole transcriptome sequencing in blood provides a diagnosis of spinal muscular atrophy with progressive myoclonic epilepsy (SMA-PME).

    PubMed

    Kernohan, Kristin D; Frésard, Laure; Zappala, Zachary; Hartley, Taila; Smith, Kevin S; Wagner, Justin; Xu, Hongbin; McBride, Arran; Bourque, Pierre R; Consortium, Care Rare Canada; Bennett, Steffany A L; Dyment, David A; Boycott, Kym M; Montgomery, Stephen B; Warman-Chardon, Jodi

    2017-03-02

    At least 15% of disease-causing mutations affect mRNA splicing. Many splicing mutations are missed in a clinical setting due to limitations of in silico prediction algorithms or their location in non-coding regions. Whole transcriptome sequencing is a promising new tool to identify these mutations; however, it will be a challenge to obtain disease relevant tissue for RNA. Here, we describe an individual with a sporadic atypical spinal muscular atrophy, in whom clinical DNA sequencing reported one pathogenic ASAH1 mutation (c.458A>G;p.Tyr153Cys). Transcriptome sequencing on patient leukocytes identified a highly significant and atypical ASAH1 isoform not explained by c.458A>G(p<10(-16) ). Subsequent Sanger-sequencing identified the splice mutation responsible for the isoform (c.504A>C;p.Lys168Asn) and provided a molecular diagnosis of autosomal recessive spinal muscular atrophy with progressive myoclonic epilepsy (SMA-PME). Our findings demonstrate the utility of RNA sequencing from blood to identify splice-impacting disease mutations for non-hematological conditions, providing a diagnosis for these otherwise unsolved patients. This article is protected by copyright. All rights reserved.

  17. De novo and inherited deletions of the 5q13 region in spinal muscular atrophies

    SciTech Connect

    Melki, J.; Lefebvre, S.; Burglen, L.; Burlet, P.; Clermont, O.; Reboullet, S.; Benichou, B.; Zeviani, M. ); Millasseau, P. ); Le Paslier, D. )

    1994-06-03

    Spinal muscular atrophies (SMAs) represent the second most common fatal autosomal recessive disorder after cystic fibrosis. Childhood spinal muscular atrophies are divided into severe (type I) and mild forms (types II and III). By a combination of genetic and physical mapping, a yeast artificial chromosome contig of the 5q13 region spanning the disease locus was constructed that showed the presence of low copy repeats in this region. Allele segregation was analyzed at the closest genetic loci detected by markers C212 and C272 in 201 SMA families. Inherited and de novo deletions were observed in nine unrelated SMA patients. Moreover, deletions were strongly suggested in at least 18 percent of SMA type I patients by the observation of marked heterozygosity deficiency for the loci studied. These results indicate that deletion events are statistically associated with the severe form of spinal muscular atrophy. 25 refs., 5 figs.

  18. Telomeric Region of the Spinal Muscular Atrophy Locus Is Susceptible to Structural Variations.

    PubMed

    Noguchi, Yoriko; Onishi, Akira; Nakamachi, Yuji; Hayashi, Nobuhide; Harahap, Nur Imma Fatimah; Rochmah, Mawaddah Ar; Shima, Ai; Yanagisawa, Shinichiro; Morisada, Naoya; Nakagawa, Taku; Iijima, Kazumoto; Kasagi, Shimpei; Saegusa, Jun; Kawano, Seiji; Shinohara, Masakazu; Tairaku, Shinya; Saito, Toshio; Kubo, Yuji; Saito, Kayoko; Nishio, Hisahide

    2016-05-01

    Most patients with spinal muscular atrophy lack the survival motor neuron 1 gene (SMN1) in the telomeric region of the spinal muscular atrophy locus on chromosome 5q13. On the other hand, the copy number of SMN2, a centromeric homolog of SMN1, is increased in many of these patients. This study aimed to clarify the mechanism underlying these structural variations. We determined the copy numbers of telomeric and centromeric genes in the spinal muscular atrophy locus of 86 patients and 22 control subjects using multiplex ligation-dependent probe amplification analysis. Then, we chose 74 patients lacking SMN1 exons 7 and 8, and compared their dataset with that of 22 control subjects retaining SMN1 exons 7 and 8. The SMN2 copy number was shown to vary widely and to correlate with the disease severity of the patients. Interestingly, telomeric NAIP and telomeric GTF2H2 showed similar tendencies. We also noted positive correlations among the copy number of SMN2 and the telomeric genes of the spinal muscular atrophy locus. However, the copy numbers of centromeric NAIP and centromeric GTF2H2 were stable among the patients, with both approximating a value of two. Our findings suggested that the telomeric region of the spinal muscular atrophy locus appears to be susceptible to structural variation, whereas the centromeric region is stable. Moreover, according to our results, new SMN2 copies may be generated in the telomeric region of the spinal muscular atrophy locus, supporting the SMN1-to-SMN2 gene conversion theory. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Oxygen Supplementation is Effective in Attenuating Maternal Cerebral Blood Deoxygenation After Spinal Anesthesia for Cesarean Section.

    PubMed

    Hirose, Noriya; Kondo, Yuko; Maeda, Takeshi; Suzuki, Takahiro; Yoshino, Atsuo; Katayama, Yoichi

    2016-01-01

    The purpose of this study was to measure changes in maternal cerebral blood oxygenation using near-infrared spectroscopy (NIRS) for 15 min after spinal anesthesia performed for cesarean section, and to determine the efficacy of supplemental oxygen in maintaining maternal cerebral blood oxygenation. Thirty patients were randomly assigned to either receive 100% oxygen via a facemask at a constant flow rate of 3 l/min throughout the study (O2 group), or were evaluated without supplemental oxygen (Air group). Changes in cerebral blood oxygenation were evaluated using the following parameters: oxy-hemoglobin (Hb), deoxy-Hb, and total-Hb concentrations, as well as tissue oxygen index (TOI), measured over the forehead by NIRS. Mean arterial pressure (MAP) and heart rate (HR) were also recorded throughout the study. Mean oxy-Hb, total-Hb, TOI, and MAP in both groups decreased significantly from baseline values (P<0.05). The reduction in oxy-Hb and TOI in the Air group was significantly greater than that in the O2 group (oxy-Hb: -4.72 vs. -2.96 μmol/l; P<0.05, TOI: -6.82 vs. -1.68%; P<0.01); however, there were no significant differences in the reduction of total-Hb and MAP between the groups. Mean deoxy-Hb in the Air group was significantly higher than that in the O2 group (0.02 vs. -1.01 μmol/l; P<0.05). The results of the present study demonstrate that oxygen supplementation attenuates cerebral blood deoxygenation secondary to the reduction in cerebral blood flow following spinal anesthesia.

  20. Mitochondrial oxidative phosphorylation transcriptome alterations in human amyotrophic lateral sclerosis spinal cord and blood.

    PubMed

    Ladd, Amy C; Keeney, Paula M; Govind, Maria M; Bennett, James P

    2014-12-01

    Origins of onset and progression of motor neurodegeneration in amyotrophic lateral sclerosis (ALS) are not clearly known, but may include impairment of mitochondrial bioenergetics. We used quantitative PCR approaches to analyze the mitochondrial oxidative phosphorylation (OXPHOS) transcriptomes of spinal cord tissue and peripheral blood mononuclear cells (PBMC) from persons with sporadic ALS compared with those without neurological disease. Expression measurements of 88 different nuclear (n) and mitochondrial (mt) DNA-encoded OXPHOS genes showed mtDNA-encoded respiratory gene expression was significantly decreased in ALS spinal cord by 78-84% (ANOVA p < 0.002). We observed the same phenomenon in freshly isolated PBMC from ALS patients (reduced 24-35%, ANOVA p < 0.001) and reproduced it in a human neural stem cell model treated with 2',3'-dideoxycytidine (ddC) (reduced 52-78%, ANOVA p < 0.001). nDNA-encoded OXPHOS genes showed heterogeneously and mostly decreased expression in ALS spinal cord tissue. In contrast, ALS PBMC and ddC-treated stem cells showed no significant change in expression of nDNA OXPHOS genes compared with controls. Genes related to mitochondrial biogenesis (PGC-1α, TFAM, ERRα, NRF1, NRF2 and POLG) were queried with inconclusive results. Here, we demonstrate there is a systemic decrease in mtDNA gene expression in ALS central and peripheral tissues that support pursuit of bioenergetic-enhancing therapies. We also identified a combined nDNA and mtDNA gene set (n = 26), downregulated in spinal cord tissue that may be useful as a biomarker in the development of cell-based ALS models.

  1. Transplantation of human umbilical cord blood or amniotic epithelial stem cells alleviates mechanical allodynia after spinal cord injury in rats.

    PubMed

    Roh, Dae-Hyun; Seo, Min-Soo; Choi, Hoon-Seong; Park, Sang-Bum; Han, Ho-Jae; Beitz, Alvin J; Kang, Kyung-Sun; Lee, Jang-Hern

    2013-01-01

    Stem cell therapy is a potential treatment for spinal cord injury (SCI), and a variety of different stem cell types have been grafted into humans suffering from spinal cord trauma or into animal models of spinal injury. Although several studies have reported functional motor improvement after transplantation of stem cells into injured spinal cord, the benefit of these cells for treating SCI-induced neuropathic pain is not clear. In this study, we investigated the therapeutic effect of transplanting human umbilical cord blood-derived mesenchymal stem cells (hUCB-MSCs) or amniotic epithelial stem cells (hAESCs) on SCI-induced mechanical allodynia (MA) and thermal hyperalgesia (TH) in T13 spinal cord hemisected rats. Two weeks after SCI, hUCB-MSCs or hAESCs were transplanted around the spinal cord lesion site, and behavioral tests were performed to evaluate changes in SCI-induced MA and TH. Immunohistochemical and Western blot analyses were also performed to evaluate possible therapeutic effects on SCI-induced inflammation and the nociceptive-related phosphorylation of the NMDA NR1 receptor subunit. While transplantation of hUCB-MSCs showed a tendency to reduce MA, transplantation of hAESCs significantly reduced MA. Neither hUCB-MSC nor hAESC transplantation had any effect on SCI-induced TH. Transplantation of hAESCs also significantly reduced the SCI-induced increase in NMDA receptor NR1 subunit phosphorylation (pNR1) expression in the spinal cord. Both hUCB-MSCs and hAESCs reduced the SCI-induced increase in spinal cord expression of the microglial marker, F4/80, but not the increased expression of GFAP or iNOS. Taken together, these findings demonstrate that the transplantation of hAESCs into the injured spinal cord can suppress mechanical allodynia, and this effect seems to be closely associated with the modulation of spinal cord microglia activity and NR1 phosphorylation.

  2. Motor neurons control blood vessel patterning in the developing spinal cord

    PubMed Central

    Himmels, Patricia; Paredes, Isidora; Adler, Heike; Karakatsani, Andromachi; Luck, Robert; Marti, Hugo H.; Ermakova, Olga; Rempel, Eugen; Stoeckli, Esther T.; Ruiz de Almodóvar, Carmen

    2017-01-01

    Formation of a precise vascular network within the central nervous system is of critical importance to assure delivery of oxygen and nutrients and for accurate functionality of neuronal networks. Vascularization of the spinal cord is a highly stereotypical process. However, the guidance cues controlling blood vessel patterning in this organ remain largely unknown. Here we describe a new neuro-vascular communication mechanism that controls vessel guidance in the developing spinal cord. We show that motor neuron columns remain avascular during a developmental time window, despite expressing high levels of the pro-angiogenic vascular endothelial growth factor (VEGF). We describe that motor neurons express the VEGF trapping receptor sFlt1 via a Neuropilin-1-dependent mechanism. Using a VEGF gain-of-function approach in mice and a motor neuron-specific sFlt1 loss-of-function approach in chicken, we show that motor neurons control blood vessel patterning by an autocrine mechanism that titrates motor neuron-derived VEGF via their own expression of sFlt1. PMID:28262664

  3. Correlation of Oxidative and Antioxidative Processes in the Blood of Patients with Cervical Spinal Cord Injury.

    PubMed

    Woźniak, Bartosz; Woźniak, Alina; Mila-Kierzenkowska, Celestyna; Kasprzak, Heliodor Adam

    2016-01-01

    The effect of cervical spinal cord injury (CSCI) on oxidative stress parameters was assessed. The study was conducted in 42 patients with CSCI (studied group), 15 patients with cerebral concussion, without CSCI (Control II), and 30 healthy volunteers (Control I). Blood was taken from the basilic vein: before and seven days after the spinal cord decompression surgery (mean time from CSCI to surgery: 8 hours) in the studied group and once in the controls. Thiobarbituric acid reactive substances (TBARS) and conjugated dienes (CD) concentrations, and glutathione peroxidase (GPx), catalase (CAT), and creatine kinase (CK) activities before the surgery were higher in the studied group than in the controls. Reduced glutathione concentration was similar in all groups. Superoxide dismutase (SOD) in the studied group was 16% lower (P ≤ 0.001) than in Control I. Lipid peroxidation products, and GPx and CAT activities in erythrocytes seven days after the surgery were lower (P ≤ 0.001), while SOD was 25% higher (P ≤ 0.001) than before the surgery. CK in blood plasma after the surgery was 34% lower (P ≤ 0.001) than before it. CSCI is accompanied by oxidative stress. Surgical and pharmacological treatment helps to restore the oxidant-antioxidant balance.

  4. Spinal projections from the presumptive midbrain locomotor region in the mouse.

    PubMed

    Liang, Huazheng; Paxinos, George; Watson, Charles

    2012-04-01

    The mesencephalic locomotor region (MLR) plays an important role in the control of locomotion, but there is ongoing debate about the anatomy of its connections with the spinal cord. In this study, we have examined the spinal projections of the mouse precuneiform nucleus (PrCnF), which lies within the boundaries of the presumptive MLR. We used both retrograde and anterograde labeling techniques. Small clusters of labeled neurons were seen in the medial portion of the PrCnF following fluoro-gold injections in the upper cervical spinal cord. Fewer labeled neurons were seen in the PrCnF after upper thoracic injections. Following the injection of anterograde tracer (biotinylated dextran amine) into the PrCnF, labeled fibers were clearly observed in the spinal cord. These fibers traveled in the ventral and lateral funiculi, and terminated mainly in the medial portions of laminae 7, 8, and 9, as well as area 10, with an ipsilateral predominance. Our observations indicate that projections from the PrCnF to the spinal cord may provide an anatomical substrate for the role of the MLR in locomotion.

  5. Chronic effects of simultaneous electromyostimulation and vibration on leg blood flow in spinal cord injury.

    PubMed

    Menéndez, H; Ferrero, C; Martín-Hernández, J; Figueroa, A; Marín, P J; Herrero, A J

    2016-12-01

    Randomized two-group parallel. The objective of this study was to analyze the adaptations on the popliteal artery (mean blood velocity (MBV), peak blood velocity (PBV), arterial resting diameter (RD) and blood flow (BF)) induced by 12 weeks of simultaneous application of whole-body vibration and electromyostimulation (WBV+ES) in patients with spinal cord injury (SCI). Secondarily, the musculoskeletal effects of this therapy on the gastrocnemius muscle thickness (MT) and femoral neck bone mineral density (BMD) were analyzed. Valladolid, Spain. Seventeen SCI patients (American Spinal Injury Association (ASIA) A or B) were randomly assigned to the experimental group (EG=9) or the control group (CG=8). Each subject was assessed in four different occasions: at baseline, after 6 weeks (Post-6) and 12 weeks of the treatment (Post-12) and 8 weeks after the end of the treatment (Post-20). Subjects in the EG performed 30 10-min sessions of WBV+ES during 12 weeks. In the EG, RD increased compared with the baseline value at Post-6 (9.5%, P<0.01), Post-12 (19.0%, P<0.001) and Post-20 (16.7%, P<0.001). Similarly, in the EG, BF increased compared with the baseline value and with CG only at Post-12 ((33.9%, P<0.01) and (72.5%, P<0.05), respectively). Similarly, WBV+ES increased the MT of the gastrocnemius. BMD of both hips remained invariable during the study. CG showed no change at any point. WBV+ES improved popliteal artery BF, RD and MT after 12 weeks in SCI patients. This increase in RD remained above baseline after 8 weeks. The combination of WBV and ES could be considered a promising alternative to reverse the musculoskeletal atrophy and improve peripheral vascular properties in SCI patients.

  6. Large Increase in Blood Pressure After Extubation and High Body Mass Index Elevate the Risk of Spinal Epidural Hematoma After Spinal Surgery.

    PubMed

    Yamada, Kentaro; Abe, Yuichiro; Satoh, Shigenobu; Yanagibashi, Yasushi; Hyakumachi, Takahiko; Masuda, Takeshi

    2015-07-01

    Matched case-control study. To identify factors other than a multilevel procedure that increase the risk of symptomatic postoperative spinal epidural hematoma (SEH). Postoperative SEH is a potentially devastating complication of spinal surgery. Previous studies that reported risk factors for postoperative SEH all identified a multilevel procedure as a risk factor, but the other risk factors remain unclear. Patients who developed postoperative SEH requiring surgical evacuation were identified from database. Each patient was matched with 3 controls who underwent spinal decompression at the same number of levels in the same part of the spine by the same surgeon during the preceding or following year. Multiple logistic regression analysis was performed to identify the risk factors for postoperative SEH to obtain adjusted odds ratios with 95% confidence intervals. Clinical outcomes after evacuation were investigated separately divided with or without severe paralysis or time until the second surgery. Postoperative SEH evacuation was performed after 32 of 8250 (0.39%) spinal decompression procedures. The incidence was significantly higher after thoracic procedures (2.41%) than after cervical (0.21%) or lumbar (0.39%) procedures. Multivariate analysis identified a 50 mm Hg or greater increase in systolic blood pressure after extubation (adjusted odds ratio: 3.22, 95% confidence interval: 1.22-8.51) and higher body mass index (adjusted odds ratio 1.15, 95% confidence interval: 1.01-1.31) as risk factors. Among 14 patients with severe paralysis due to postoperative SEH, those who underwent evacuation within 24 hours of the onset had a significantly better improvement in clinical outcome and Frankel grade than did those after 24 hours. A 50 mm Hg or greater increase in systolic blood pressure after extubation and high body mass index were identified as risk factors for SEH. Appropriate blood pressure control especially at the end of surgery is important for the prevention of

  7. Assessment of skin blood content and oxygenation in spinal cord injured subjects during reactive hyperemia.

    PubMed

    Hagisawa, S; Ferguson-Pell, M; Cardi, M; Miller, S D

    1994-01-01

    This study was undertaken to determine whether the reactive hyperemia response following ischemia in spinal cord injured (SCI) individuals is different from that which occurs in able-bodied (AB) individuals. The reactive hyperemia response was produced by applying a pressure of 150 mmHg for 300 s, 600 s, and 900 s to the skin over the greater trochanter in 10 SCI and 10 AB subjects using a computer-controlled pneumatic indentation system. The changes in blood content and oxygenation in the superficial vessels of the skin, associated with indentation, were monitored using reflectance spectrophotometry. A brief pressure of 80 mmHg, to simulate finger pressing (blanching), was applied to the same site to detect changes in reflow behavior during the hyperemic period. The results indicate that the reactive hyperemia response in SCI group was not substantially different from AB group although the reflow rate after load release was slower in the SCI group compared with the AB group.

  8. Different ways to balance the spine: subtle changes in sagittal spinal curves affect regional muscle activity.

    PubMed

    Claus, Andrew P; Hides, Julie A; Moseley, G Lorimer; Hodges, Paul W

    2009-03-15

    Exploratory study of regional muscle activity in different postures. To detail the relationship between spinal curves and regional muscle activity. Sagittal balanced spinal posture (C7 above S1 in the sagittal plane) is a goal for spinal surgery and conservative ergonomics. Three combinations of thoracolumbar and lumbar spinal curves can be considered sagittal balanced postures: (i) flat-at both regions, (ii) long lordosis-lordotic at both regions, and (iii) short lordosis-thoracic kyphosis and lumbar lordosis. This study compares regional muscle activity between these 3 sagittal balanced postures in sitting, as well as a slump posture. Fine-wire electromyography (EMG) electrodes were inserted into the lumbar multifidus (deep and superficial), iliocostalis (lateral and medial), longissimus thoracis, and transversus abdominis in 14 healthy male volunteers. Fine-wire or surface EMG electrodes were also used to record activity of the obliquus internus, obliquus externus, and rectus abdominis muscles. Root mean square EMG amplitude in the flat, long lordosis, short lordosis, and slump sitting postures were normalized to maximal voluntary contraction, and also to the peak activity across the sitting postures. Muscle activity was compared between postures with a linear mixed model analysis. Of the extensor muscles, it was most notable that activity of the deep and superficial fibers of lumbar multifidus increased incrementally in the 3 sagittal balanced postures; flat, long lordosis, and short lordosis (P < 0.05). Of the abdominal muscles, obliquus internus was more active in short lordosis than the other postures (P < 0.05). Comparing the sagittal balanced postures, the flat posture showed the least muscle activity (similar to the slump posture at most muscles examined). Discrete combinations of muscle activity supported the 3 different sagittal balanced postures in sitting, providing new detail for surgeons, researchers, and therapists to distinguish between different

  9. CB1 cannabinoid receptor enrichment in the ependymal region of the adult human spinal cord.

    PubMed

    Paniagua-Torija, Beatriz; Arevalo-Martin, Angel; Ferrer, Isidro; Molina-Holgado, Eduardo; Garcia-Ovejero, Daniel

    2015-12-04

    Cannabinoids are involved in the regulation of neural stem cell biology and their receptors are expressed in the neurogenic niches of adult rodents. In the spinal cord of rats and mice, neural stem cells can be found in the ependymal region, surrounding the central canal, but there is evidence that this region is largely different in adult humans: lacks a patent canal and presents perivascular pseudorosettes, typically found in low grade ependymomas. Using Laser Capture Microdissection, Taqman gene expression assays and immunohistochemistry, we have studied the expression of endocannabinoid system components (receptors and enzymes) at the human spinal cord ependymal region. We observe that ependymal region is enriched in CB1 cannabinoid receptor, due to high CB1 expression in GFAP+ astrocytic domains. However, in human spinal cord levels that retain central canal patency we found ependymal cells with high CB1 expression, equivalent to the CB1(HIGH) cell subpopulation described in rodents. Our results support the existence of ependymal CB1(HIGH) cells across species, and may encourage further studies on this subpopulation, although only in cases when central canal is patent. In the adult human ependyma, which usually shows central canal absence, CB1 may play a different role by modulating astrocyte functions.

  10. CB1 cannabinoid receptor enrichment in the ependymal region of the adult human spinal cord

    PubMed Central

    Paniagua-Torija, Beatriz; Arevalo-Martin, Angel; Ferrer, Isidro; Molina-Holgado, Eduardo; Garcia-Ovejero, Daniel

    2015-01-01

    Cannabinoids are involved in the regulation of neural stem cell biology and their receptors are expressed in the neurogenic niches of adult rodents. In the spinal cord of rats and mice, neural stem cells can be found in the ependymal region, surrounding the central canal, but there is evidence that this region is largely different in adult humans: lacks a patent canal and presents perivascular pseudorosettes, typically found in low grade ependymomas. Using Laser Capture Microdissection, Taqman gene expression assays and immunohistochemistry, we have studied the expression of endocannabinoid system components (receptors and enzymes) at the human spinal cord ependymal region. We observe that ependymal region is enriched in CB1 cannabinoid receptor, due to high CB1 expression in GFAP+ astrocytic domains. However, in human spinal cord levels that retain central canal patency we found ependymal cells with high CB1 expression, equivalent to the CB1HIGH cell subpopulation described in rodents. Our results support the existence of ependymal CB1HIGH cells across species, and may encourage further studies on this subpopulation, although only in cases when central canal is patent. In the adult human ependyma, which usually shows central canal absence, CB1 may play a different role by modulating astrocyte functions. PMID:26634814

  11. Effect of Spinal Manipulation of Upper Cervical Vertebrae on Blood Pressure: Results of a Pilot Sham-Controlled Trial.

    PubMed

    Goertz, Christine M; Salsbury, Stacie A; Vining, Robert D; Long, Cynthia R; Pohlman, Katherine A; Weeks, William B; Lamas, Gervasio A

    2016-06-01

    The purpose of this pilot sham-controlled clinical trial was to estimate the treatment effect and safety of toggle recoil spinal manipulation for blood pressure management. Fifty-one participants with prehypertension or stage 1 hypertension (systolic blood pressure ranging from 135 to 159 mm Hg or diastolic blood pressure ranging from 85 to 99 mm Hg) were allocated by an adaptive design to 2 treatments: toggle recoil spinal manipulation or a sham procedure. Participants were seen by a doctor of chiropractic twice weekly for 6 weeks and remained on their antihypertensive medications, as prescribed, throughout the trial. Blood pressure was assessed at baseline and after study visits 1, 6 (week 3), and 12 (week 6), with the primary end point at week 6. Analysis of covariance was used to compare mean blood pressure changes from baseline between groups at each end point, controlling for sex, age, body mass index, and baseline blood pressure. Adjusted mean change from baseline to week 6 was greater in the sham group (systolic, -4.2 mm Hg; diastolic, -1.6 mm Hg) than in the spinal manipulation group (systolic, 0.6 mm Hg; diastolic, 0.7 mm Hg), but the difference was not statistically significant. No serious and few adverse events were noted. Six weeks of toggle recoil spinal manipulation did not lower systolic or diastolic blood pressure when compared with a sham procedure. No serious adverse events from either treatment were reported. Our results do not support a larger clinical trial. Further research to understand the potential mechanisms of action involving upper cervical manipulation on blood pressure is warranted before additional clinical investigations are conducted. Copyright © 2016. Published by Elsevier Inc.

  12. Retinoic Acid Induced-Autophagic Flux Inhibits ER-Stress Dependent Apoptosis and Prevents Disruption of Blood-Spinal Cord Barrier after Spinal Cord Injury

    PubMed Central

    Zhou, Yulong; Zhang, Hongyu; Zheng, Binbin; Ye, Libing; Zhu, Sipin; Johnson, Noah R; Wang, Zhouguang; Wei, Xiaojie; Chen, Daqing; Cao, Guodong; Fu, Xiaobing; Li, Xiaokun; Xu, Hua-Zi; Xiao, Jian

    2016-01-01

    Spinal cord injury (SCI) induces the disruption of the blood-spinal cord barrier (BSCB) which leads to infiltration of blood cells, an inflammatory response, and neuronal cell death, resulting spinal cord secondary damage. Retinoic acid (RA) has a neuroprotective effect in both ischemic brain injury and SCI, however the relationship between BSCB disruption and RA in SCI is still unclear. In this study, we demonstrated that autophagy and ER stress are involved in the protective effect of RA on the BSCB. RA attenuated BSCB permeability and decreased the loss of tight junction (TJ) molecules such as P120, β-catenin, Occludin and Claudin5 after injury in vivo as well as in Brain Microvascular Endothelial Cells (BMECs). Moreover, RA administration improved functional recovery in the rat model of SCI. RA inhibited the expression of CHOP and caspase-12 by induction of autophagic flux. However, RA had no significant effect on protein expression of GRP78 and PDI. Furthermore, combining RA with the autophagy inhibitor chloroquine (CQ) partially abolished its protective effect on the BSCB via exacerbated ER stress and subsequent loss of tight junctions. Taken together, the neuroprotective role of RA in recovery from SCI is related to prevention of of BSCB disruption via the activation of autophagic flux and the inhibition of ER stress-induced cell apoptosis. These findings lay the groundwork for future translational studies of RA for CNS diseases, especially those related to BSCB disruption. PMID:26722220

  13. The effect of an NK1 receptor antagonist on blood spinal cord barrier permeability following balloon compression-induced spinal cord injury.

    PubMed

    Leonard, Anna V; Vink, Robert

    2013-01-01

    The blood spinal cord barrier (BSCB) is disrupted following spinal cord injury (SCI) resulting in vasogenic edema and increased intrathecal pressure (ITP). The neuropeptide substance P (SP) has been implicated in the development of blood-brain barrier (BBB) disruption, edema, and increased intracranial pressure following brain injury, although it has not been investigated in SCI. The balloon compression model of experimental SCI has many advantages in that it replicates the "closed" environment observed clinically. Accordingly, this study characterized whether this model produces an increase in BSCB permeability and edema, and whether a SP, NK1 tachykinin receptor antagonist, N-acetyl-L-tryptophan (NAT) reduces such BSCB disruption and edema formation. At 30 min post-injury, animals were administered 2.5 mg/kg NAT or saline. Subgroups of animals were assessed for BSCB permeability (Evan's Blue) and spinal cord edema (wet weight/dry weight). BSCB permeability and edema were significantly increased in injured groups compared with sham (p < 0.001). There was no significant difference between vehicle and NAT treatment. We conclude that the balloon compression model of SCI produces significant BSCB disruption although NAT treatment did not attenuate BSCB permeability or edema. Further studies are required to fully elucidate the role of SP following SCI.

  14. Ex-vivo expanded human blood-derived CD133+ cells promote repair of injured spinal cord.

    PubMed

    Kamei, Naosuke; Kwon, Sang-Mo; Alev, Cantas; Nakanishi, Kazuyoshi; Yamada, Kiyotaka; Masuda, Haruchika; Ishikawa, Masakazu; Kawamoto, Atsuhiko; Ochi, Mitsuo; Asahara, Takayuki

    2013-05-15

    Human blood-derived CD133(+) cell populations, which are believed to represent a hematopoietic/endothelial progenitor fraction, have the ability to promote the repair of injured spinal cord in animal models. However, the mechanisms by which CD133(+) cell transplantation promotes spinal cord regeneration remain to be clarified. Another possible hurdle on the way to clinical applicability of these cells is their scarce representation in the overall population of mononuclear cells. We therefore analyzed and compared ex-vivo expanded human cord blood derived CD133(+) cells with freshly isolated CD133(+) cells as well as corresponding CD133(-) control mononuclear cells in respect to their ability to promote spinal cord repair using in vitro assays and cell transplantation into a mouse spinal cord injury model. In vitro, expanded cells as well as fresh CD133(+) cells formed endothelial progenitor cell (EPC) colonies, whereas CD133(-) cells formed no EPC colonies. In vivo, the administration of fresh CD133(+) and expanded cells enhanced angiogenesis, astrogliosis, axon growth and functional recovery after injury. In contrast, the administration of CD133(-) cells failed to promote axon growth and functional recovery, but moderately enhanced angiogenesis and astrogliosis. In addition, high-dose administration of expanded cells was highly effective in the induction of regenerative processes at the injured spinal cord. Copyright © 2013 Elsevier B.V. All rights reserved.

  15. Regional differences in lumbar spinal posture and the influence of low back pain

    PubMed Central

    Mitchell, Tim; O'Sullivan, Peter B; Burnett, Angus F; Straker, Leon; Smith, Anne

    2008-01-01

    Background Spinal posture is commonly a focus in the assessment and clinical management of low back pain (LBP) patients. However, the link between spinal posture and LBP is not fully understood. Recent evidence suggests that considering regional, rather than total lumbar spine posture is important. The purpose of this study was to determine; if there are regional differences in habitual lumbar spine posture and movement, and if these findings are influenced by LBP. Methods One hundred and seventy female undergraduate nursing students, with and without LBP, participated in this cross-sectional study. Lower lumbar (LLx), Upper lumbar (ULx) and total lumbar (TLx) spine angles were measured using an electromagnetic tracking system in static postures and across a range of functional tasks. Results Regional differences in lumbar posture and movement were found. Mean LLx posture did not correlate with ULx posture in sitting (r = 0.036, p = 0.638), but showed a moderate inverse correlation with ULx posture in usual standing (r = -0.505, p < 0.001). Regional differences in range of motion from reference postures in sitting and standing were evident. BMI accounted for regional differences found in all sitting and some standing measures. LBP was not associated with differences in regional lumbar spine angles or range of motion, with the exception of maximal backward bending range of motion (F = 5.18, p = 0.007). Conclusion This study supports the concept of regional differences within the lumbar spine during common postures and movements. Global lumbar spine kinematics do not reflect regional lumbar spine kinematics, which has implications for interpretation of measures of spinal posture, motion and loading. BMI influenced regional lumbar posture and movement, possibly representing adaptation due to load. PMID:19014712

  16. Regional differences in lumbar spinal posture and the influence of low back pain.

    PubMed

    Mitchell, Tim; O'Sullivan, Peter B; Burnett, Angus F; Straker, Leon; Smith, Anne

    2008-11-18

    Spinal posture is commonly a focus in the assessment and clinical management of low back pain (LBP) patients. However, the link between spinal posture and LBP is not fully understood. Recent evidence suggests that considering regional, rather than total lumbar spine posture is important. The purpose of this study was to determine; if there are regional differences in habitual lumbar spine posture and movement, and if these findings are influenced by LBP. One hundred and seventy female undergraduate nursing students, with and without LBP, participated in this cross-sectional study. Lower lumbar (LLx), Upper lumbar (ULx) and total lumbar (TLx) spine angles were measured using an electromagnetic tracking system in static postures and across a range of functional tasks. Regional differences in lumbar posture and movement were found. Mean LLx posture did not correlate with ULx posture in sitting (r = 0.036, p = 0.638), but showed a moderate inverse correlation with ULx posture in usual standing (r = -0.505, p < 0.001). Regional differences in range of motion from reference postures in sitting and standing were evident. BMI accounted for regional differences found in all sitting and some standing measures. LBP was not associated with differences in regional lumbar spine angles or range of motion, with the exception of maximal backward bending range of motion (F = 5.18, p = 0.007). This study supports the concept of regional differences within the lumbar spine during common postures and movements. Global lumbar spine kinematics do not reflect regional lumbar spine kinematics, which has implications for interpretation of measures of spinal posture, motion and loading. BMI influenced regional lumbar posture and movement, possibly representing adaptation due to load.

  17. Electroencephalographic evoked pain response is suppressed by spinal cord stimulation in complex regional pain syndrome: a case report.

    PubMed

    Hylands-White, Nicholas; Duarte, Rui V; Beeson, Paul; Mayhew, Stephen D; Raphael, Jon H

    2016-12-01

    Pain is a subjective response that limits assessment. The purpose of this case report was to explore how the objectivity of the electroencephalographic response to thermal stimuli would be affected by concurrent spinal cord stimulation. A patient had been implanted with a spinal cord stimulator for the management of complex regional pain syndrome of both hands for 8 years. Following ethical approval and written informed consent we induced thermal stimuli using the Medoc PATHWAY Pain & Sensory Evaluation System on the right hand of the patient with the spinal cord stimulator switched off and with the spinal cord stimulator switched on. The patient reported a clinically significant reduction in thermal induced pain using the numerical rating scale (71.4 % reduction) with spinal cord stimulator switched on. Analysis of electroencephalogram recordings indicated the occurrence of contact heat evoked potentials (N2-P2) with spinal cord stimulator off, but not with spinal cord stimulator on. This case report suggests that thermal pain can be reduced in complex regional pain syndrome patients with the use of spinal cord stimulation and offers objective validation of the reported outcomes with this treatment.

  18. Changes of blood flow, oxygen tension, action potential and vascular permeability induced by arterial ischemia or venous congestion on the spinal cord in canine model.

    PubMed

    Kobayashi, Shigeru; Yoshizawa, Hidezo; Shimada, Seiichiro; Guerrero, Alexander Rodríguez; Miyachi, Masaya

    2013-01-01

    It is generally considered that the genesis of myelopathy associated with the degenerative conditions of the spine may result from both mechanical compression and circulatory disturbance. Many references about spinal cord tissue ischemic damage can be found in the literature, but not detailed studies about spinal cord microvasculature damage related to congestion or blood permeability. This study investigates the effect of ischemia and congestion on the spinal cord using an in vivo model. The aorta was clamped as an ischemia model of the spinal cord and the inferior vena cava was clamped as a congestion model at the 6th costal level for 30 min using forceps transpleurally. Measurements of blood flow, partial oxygen pressure, and conduction velocity in the spinal cord were repeated over a period of 1 h after release of clamping. Finally, we examined the status of blood-spinal cord barrier under fluorescence and transmission electron microscope. Immediately after clamping of the inferior vena cava, the central venous pressure increased by about four times. Blood flow, oxygen tension and action potential were more severely affected by the aorta clamping; but this ischemic model did not show any changes of blood permeability in the spinal cord. The intramedullar edema was more easily produced by venous congestion than by arterial ischemia. In conclusions, venous congestion may be a preceding and essential factor of circulatory disturbance in the compressed spinal cord inducing myelopathy.

  19. The correlation between dietary fat intake and blood pressure among people with spinal cord injury

    PubMed Central

    Sabour, Hadis; Norouzi-Javidan, Abbas; Soltani, Zahra; Mousavifar, Seyede Azemat; Latifi, Sahar; Emami-Razavi, Seyed Hassan; Ghodsi, Seyed Mohammad

    2016-01-01

    Background: Studies have demonstrated the effect of different dietary fats on blood pressure (BP) in general population. However, these associations have not yet been described in people with spinal cord injury (SCI). Methods: Referred patients to Brain and SCI Research Center between 2011 and 2014 have been invited to participate. Only paraplegic individuals were recruited and patients with injury at cervical or higher thoracic sections were excluded to omit the bias effect of autonomic dysreflexia. Dietary intakes were assessed by recording consumed foods by 24-hour dietary recall interviews using Nutritionist IV 3.5.3 modified for Iranian foods. Systolic BP (SBP) and diastolic BP (DBP) were measured 3 times and the mean values entered analysis. Results: Higher intakes of cholesterol were related to higher BP (P = 0.010 and 0.011 for SBP and DBP, respectively). Similarly, intake of saturated fat was positively correlated to both SBP (P = 0.016, r = 0.21) and DBP (P = 0.011, r = 0.22). The effect of eicosapentaenoic acid (EPA) on BP was insignificant (P = 0.760 and 0.720 for SBP and DBP, respectively). However, intake of docosahexaenoic acid (DHA) was related to lower BP among people with SCI. Conclusion: This study has demonstrated that higher intakes of cholesterol and saturated fat are associated with increased BP, whereas DHA is an antihypertensive agent. Dietary modifications with reduction of cholesterol and saturated fat along with intake of additional DHA supplements may help to reduce BP in spinal cord injured-individuals with hypertension. PMID:27648172

  20. Inhibiting endoplasmic reticulum stress by lithium chloride contributes to the integrity of blood-spinal cord barrier and functional recovery after spinal cord injury

    PubMed Central

    He, Zili; Zhou, Yulong; Wang, Qingqing; Li, Jiawei; Zheng, Zengming; Chen, Jian; Zhang, Hongyu; Wang, Zhouguang; Xu, Huazi; Xiao, Jian

    2017-01-01

    Endoplasmic reticulum (ER) stress play important roles in the spinal cord injury (SCI), which including blood-spinal cord barrier (BSCB) disruption. Lithium chloride (LiCl) is a clinical drug for bipolar mood disorders and contributes to neuroprotection. This study aims to investigate the effects of LiCl on BSCB disruption and the ER stress pathway induced by spinal cord injury. We examined the integrity of the BSCB with Evans Blue dye and macrophages extravasation, measured the microvessels loss, the junction proteins degeneration, the activation ER stress, and the locomotor function recovery. Our data indicated that LiCl treatment could attenuates BSCB disruption and improved the recovery of functional locomotion in rats SCI model, reduced the structure damage and number loss of microvessels, increased the expressions of junction proteins, including p120, β-catenin, occludin, and claudin-5, via reversed the upregulated ER stress associated proteins. In addition, LiCl significantly inhibited the increase of ER stress markers and prevents loss of junction proteins in thapsigargin (TG)-treated human brain microvascular endothelial cells (HBMEC). These findings suggest that LiCl treatment alleviates BSCB disruption and promote the neurological function recovery after SCI, partly through inhibiting the activation of ER stress. PMID:28386329

  1. The development of catecholaminergic nerves in the spinal cord of rat. II. Regional development.

    PubMed

    Commissiong, J W

    1983-12-01

    The development of noradrenergic and dopaminergic nerves in 5 regions of the developing spinal cord of rat, from fetal day (FD) 16, to the young adult stage was studied. The normal synthetic capacity of adrenergic nerves in the ventral horn of the cervical and lumbar regions developed at the same time, and at the same rate, despite their spatial separation, and before similar development of the noradrenergic nerves in the dorsal horn and zona intermedia. In the ventral horn, the synthesis of NE from injected L-DOPA, as well as the release and metabolism of NE are well-established at 12 h (ND 0.5) after birth. In the dorsal horn these developments occur later at ND 4. Except in the dorsal horn of the cervical region, there was no easily observable, consistent pattern in the development of regional spinal dopaminergic innervation. The capacity of the developing cord to synthesize dopamine (DA) from injected DOPA is significantly developed at FD 16 (the earliest time studied), and peaked in all regions as early as ND 4. Control experiments indicate that 100%, and only 10% respectively of NE and DA synthetized from injected DOPA, occurred in descending monoaminergic fibers. Norepinephrine is synthesized exclusively in noradrenergic nerves. Cells appear transiently in the developing cord at FD 18, that are capable of synthesizing catecholamines (probably mainly DA) from injected DOPA. During postnatal development of the cord, and to a less extent in the adult, the network of catecholaminergic nerves actually present, is more extensive than that normally revealed during routine fluorescence microscopy. The results are discussed in the context of current attempts to understand the functional importance of catecholaminergic nerves in the mammalian spinal cord, and elsewhere in the CNS.

  2. Transplantation of mononuclear cells from human umbilical cord blood promotes functional recovery after traumatic spinal cord injury in Wistar rats

    PubMed Central

    Rodrigues, L.P.; Iglesias, D.; Nicola, F.C.; Steffens, D.; Valentim, L.; Witczak, A.; Zanatta, G.; Achaval, M.; Pranke, P.; Netto, C.A.

    2011-01-01

    Cell transplantation is a promising experimental treatment for spinal cord injury. The aim of the present study was to evaluate the efficacy of mononuclear cells from human umbilical cord blood in promoting functional recovery when transplanted after a contusion spinal cord injury. Female Wistar rats (12 weeks old) were submitted to spinal injury with a MASCIS impactor and divided into 4 groups: control, surgical control, spinal cord injury, and one cell-treated lesion group. Mononuclear cells from umbilical cord blood of human male neonates were transplanted in two experiments: a) 1 h after surgery, into the injury site at a concentration of 5 x 106 cells diluted in 10 µL 0.9% NaCl (N = 8-10 per group); b) into the cisterna magna, 9 days after lesion at a concentration of 5 x 106 cells diluted in 150 µL 0.9% NaCl (N = 12-14 per group). The transplanted animals were immunosuppressed with cyclosporin-A (10 mg/kg per day). The BBB scale was used to evaluate motor behavior and the injury site was analyzed with immunofluorescent markers to label human transplanted cells, oligodendrocytes, neurons, and astrocytes. Spinal cord injury rats had 25% loss of cord tissue and cell treatment did not affect lesion extension. Transplanted cells survived in the injured area for 6 weeks after the procedure and both transplanted groups showed better motor recovery than the untreated ones (P < 0.05). The transplantation of mononuclear cells from human umbilical cord blood promoted functional recovery with no evidence of cell differentiation. PMID:22183246

  3. Regional cerebral blood flow changes associated with ethanol intoxication

    SciTech Connect

    Mathew, R.J.; Wilson, W.H.

    1986-11-01

    Regional cerebral blood flow (CBF) was measured via the 133Xenon inhalation technique in 26 healthy volunteers before and 60 minutes after the oral administration of ethyl alcohol or placebo on a double-blind basis. The cerebral blood flow values, corrected for test-retest differences in carbon dioxide showed a significant bilateral increase after ethanol administration. Blood levels of ethanol, estimated with a breath analyser, did not correlate with the CBF changes.

  4. Cardiac cryosurgery: regional myocardial blood flow of ventricular cryolesions

    SciTech Connect

    Holman, W.L.; Ikeshita, M.; Lease, J.G.; Smith, P.K.; Ungerleider, R.M.; Cox, J.L.

    1986-11-01

    Cryosurgery is one of three methods introduced recently for the treatment of ventricular tachyarrhythmias. Cryothermic exposure ablates arrhythmogenic ventricular myocardium, and produces a dense fibrous scar with a sharp border to histologically normal tissue. Myocardial blood flow in the region of the cryolesion, however, has not been quantitated. The purpose of this study was to measure regional blood flow within and around the cryolesion in an attempt to identify ischemic zones that might become arrhythmogenic. Left ventricular cryolesions were created in eleven adult dogs. Two weeks later, the animals underwent radioactive tracer microsphere injection for quantitation of regional myocardial blood flow. The fibrotic cryolesion demonstrated a significantly depressed blood flow (0.44 +/- 0.07 ml/min/g) compared to blood flow in control tissue (1.36 +/- 0.12 ml/min/g) (P less than 0.001). A 1-mm strip of myocardium immediately adjacent to the cryolesion, as well as other myocardium surrounding and subjacent to the cryolesion, did not show a significant decrease in regional blood flow. The border between the fibrotic cryolesion and the surrounding myocardium is, therefore, sharply defined not only in terms of histology but also in regards to regional blood flow. These data lend further support to the safe clinical use of cryothermia in the treatment of refractory ventricular tachycardia.

  5. Intravenous Infusion of Magnesium Chloride Improves Epicenter Blood Flow during the Acute Stage of Contusive Spinal Cord Injury in Rats

    PubMed Central

    Muradov, Johongir M.

    2013-01-01

    Abstract Vasospasm, hemorrhage, and loss of microvessels at the site of contusive or compressive spinal cord injury lead to infarction and initiate secondary degeneration. Here, we used intravenous injection of endothelial-binding lectin followed by histology to show that the number of perfused microvessels at the injury site is decreased by 80–90% as early as 20 min following a moderate T9 contusion in adult female rats. Hemorrhage within the spinal cord also was maximal at 20 min, consistent with its vasoconstrictive actions in the central nervous system (CNS). Microvascular blood flow recovered to up to 50% of normal volume in the injury penumbra by 6 h, but not at the epicenter. A comparison with an endothelial cell marker suggested that many microvessels fail to be reperfused up to 48 h post-injury. The ischemia was probably caused by vasospasm of vessels penetrating the parenchyma, because repeated Doppler measurements over the spinal cord showed a doubling of total blood flow over the first 12 h. Moreover, intravenous infusion of magnesium chloride, used clinically to treat CNS vasospasm, greatly improved the number of perfused microvessels at 24 and 48 h. The magnesium treatment seemed safe as it did not increase hemorrhage, despite the improved parenchymal blood flow. However, the treatment did not reduce acute microvessel, motor neuron or oligodendrocyte loss, and when infused for 7 days did not affect functional recovery or spared epicenter white matter over a 4 week period. These data suggest that microvascular blood flow can be restored with a clinically relevant treatment following spinal cord injury. PMID:23302047

  6. Assessment of skin blood flow following spinal manual therapy: a systematic review.

    PubMed

    Zegarra-Parodi, Rafael; Park, Peter Yong Soo; Heath, Deborah M; Makin, Inder Raj S; Degenhardt, Brian F; Roustit, Matthieu

    2015-04-01

    Skin blood flow (SBF) indexes have been used to describe physiological mechanisms associated with spinal manual therapy (SMT). The aims of the current review were to assess methods for data collection, assess how investigators interpreted SBF changes, and formulate recommendations to advance manual medicine research. A database search was performed in PubMed, Cochrane Library, the Physiotherapy Evidence Database, and the Cumulative Index to Nursing and Allied Health Literature through April 2014. Articles were included if at least 1 outcome measure was changes in 1 SBF index following SMT. The database search yielded 344 records. Two independent authors applied the inclusion criteria. Twenty studies met the inclusion criteria. Selected studies used heterogeneous methods to assess short-term post-SMT changes in SBF, usually vasoconstriction, which was interpreted as a general sympathoexcitatory effect through central mechanisms. However, this conclusion might be challenged by the current understanding of skin sympathetic nervous activity over local endothelial mechanisms that are specifically controlling SBF. Evaluation of SBF measurements in peripheral tissues following SMT may document physiological responses that are beyond peripheral sympathetic function. Based on the current use of SBF indexes in clinical and physiological research, 14 recommendations for advancing manual medicine research using laser Doppler flowmetry are presented.

  7. Peripheral and central sensitization in remote spinal cord regions contribute to central neuropathic pain after spinal cord injury

    PubMed Central

    Carlton, Susan M.; Du, Junhui; Tan, Huai Yu; Nesic, Olivera; Hargett, Gregory L.; Bopp, Anne C.; Yamani, Ammar; Lin, Qing; Willis, William D.; Hulsebosch, Claire E.

    2009-01-01

    Central neuropathic pain (CNP) developing after spinal cord injury (SCI) is described by the region affected: above-level, at-level and below-level pain occurs in dermatomes rostral, at/near, or below the SCI level, respectively. People with SCI and rodent models of SCI develop above-level pain characterized by mechanical allodynia and thermal hyperalgesia. Mechanisms underlying this pain are unknown and the goals of this study were to elucidate components contributing to the generation of above-level CNP. Following a thoracic (T10) contusion, forelimb nociceptors had enhanced spontaneous activity and were sensitized to mechanical and thermal stimulation of the forepaws 35 days post-injury. Cervical dorsal horn neurons showed enhanced responses to non-noxious and noxious mechanical stimulation as well as thermal stimulation of receptive fields. Immunostaining dorsal root ganglion (DRG) cells and cord segments with activating transcription factor 3 (ATF3, a marker for neuronal injury) ruled out neuronal damage as a cause for above-level sensitization since few C8 DRG cells expressed AFT3 and cervical cord segments had few to no ATF3-labeled cells. Finally, activated microglia and astrocytes were present in thoracic and cervical cord at 35 days post-SCI, indicating a rostral spread of glial activation from the injury site. Based on these data, we conclude that peripheral and central sensitization as well as reactive glia in the uninjured cervical cord contribute to CNP. We hypothesize that reactive glia in the cervical cord release pro-inflammatory substances which drive chronic CNP. Thus a complex cascade of events spanning many cord segments underlies above-level CNP. PMID:19853381

  8. Barriers to implementing intermittent catheterisation in spinal cord injury patients in Northwest Regional Spinal Injuries Centre, Southport, U.K.

    PubMed

    Vaidyanathan, Subramanian; Soni, Bakul M; Singh, Gurpreet; Oo, Tun; Hughes, Peter L

    2011-01-05

    Intermittent catheterisation is the preferred method of managing the neurogenic bladder in patients with spinal cord injury. However, spinal cord physicians experienced problems when trying to implement an intermittent catheterisation regime in some spinal cord injury patients in the northwest of England. We present illustrative cases to describe practical difficulties encountered by patients while trying to adopt an intermittent catheterisation regime. Barriers to intermittent catheterisation are (1) caregivers or nurses are not available to carry out five or six catheterisations a day; (2) lack of time to perform intermittent catheterisations; (3) unavailability of suitable toilet facilities in public places, including restaurants and offices; (4) redundant prepuce in a male patient, which prevents ready access to urethral meatus; (5) urethral false passage; (6) urethral sphincter spasm requiring the use of flexible-tip catheters and á-adrenoceptor-blocking drugs; (7) reluctance to perform intermittent catheterisation in patients >60 years by some health professionals; and (8) difficulty in accessing the urethral meatus for catheterisation while the patient is sitting up, especially in female patients. These cases demonstrate the urgent need for provision of trained caregivers who can perform intermittent catheterisation, and improvement in public facilities that are suitable for performing catheterisation in spinal cord injury patients. Further, vigilance should be exercised during each catheterisation in order to prevent complications, such as urethral trauma and consequent false passages. Health professionals should make additional efforts to implement intermittent catheterisation in female spinal cord injury patients and in those >60 years.

  9. Isolation of cDNA clones from within the spinal muscular atrophy (SMA) disease gene region

    SciTech Connect

    McLean, M.; Roy, N.; Tamai, K.

    1994-09-01

    Spinal muscular atrophy (SMA) is a recessive neuromuscular disease characterized by death of spinal cord {alpha} motor neurons, resulting in skeletal muscle atrophy. The critical SMA disease gene region on 5q13.1 contains families of microsatellite repeat sequences which exist at multiple subloci that are dispersed over a 100 to 200 kbp region. We have detected significant linkage disequilibrium between SMA type 1, the most severe form of the disorder, and two subloci of one such microsatellite, the CATT-1 family of microsatellites. Furthermore, a recombination event in a chromosome of an individual with SMA type 1 mapping between the members of two other extended microsatellite families, including CMS-1, has been observed. Combining this with previously reported recombinants refines the critical SMA region to approximately 300 kbp. P1 artificial chromosome (PAC), YAC and cosmid clones which possess both CMS-1 alleles which bracket this recombination event, as well as CATT-1 alleles showing linkage disequilibrium with SMA, have been used to probe cDNA libraries from human and other mammalian sources in search of genes within this interval; three of these cDNAs are currently being tested as candidates for the SMA gene.

  10. Effect of spinal cord compression on local vascular blood flow and perfusion capacity by Alshareef M, Krishna V, Ferdous J, Aishareef A, Kindy M, Kolachalama VB, et al.

    PubMed Central

    Epstein, Nancy E.

    2016-01-01

    Background: Different degrees of blood flow/vascular compromise occur with anterior, posterior, or circumferential spinal cord compression/spinal cord injury (SCI). SCI is also divided into primary and secondary injury. Primary SCI refers to the original neurological damage to tissues, whereas secondary injury reflects interruption of normal blood flow leading to further inflammatory response/other local changes which contribute to additional neurological injury. Methods: The authors developed a quantitative “3-D finite element fluid structure interaction model” of spinal cord blood flow to better document the mechanisms of secondary ischemic damage occurring in the spinal cord anteriorly, posteriorly, or circumferentially. This included assessment of the anterior spinal artery (ASA) and five arterial branches (L1, L2, L3, R1, R2), but excluded the microvasculature. Results: Different locations of cord compression resulted in alternative patterns of spinal cord ischemia. Anterior spinal artery (ASA) flow was substantially reduced by direct anterior compression, but resulted in the least vascular compromise. Alternatively, posterior compression resulted in a significant and critical reduction of distal ASA blood flow and, therefore, correlated with the greatest susceptibility to acute ischemia. Counterintuitively, they concluded “at equivalent degrees of dural occlusion, the loss of branch blood flow under anterior posterior compression was intermediate to predictions for purely posterior or anterior loading.” Conclusion: Utilizing a computational three-dimensional model, Alshareef et al. observed that anterior cervical cord compression resulted in the least severe compromise of ASA blood flow to the spinal cord, whereas posterior cord compression/SCI maximally reduced distal ASA blood flow potentiating acute ischemia. Therefore, the latter warranted the earliest surgical intervention. PMID:27843686

  11. Wnts Are Expressed in the Ependymal Region of the Adult Spinal Cord.

    PubMed

    Gonzalez-Fernandez, Carlos; Arevalo-Martin, Angel; Paniagua-Torija, Beatriz; Ferrer, Isidro; Rodriguez, Francisco J; Garcia-Ovejero, Daniel

    2016-10-08

    The Wnt family of proteins plays key roles during central nervous system development and in several physiological processes during adulthood. Recently, experimental evidence has linked Wnt-related genes to regulation and maintenance of stem cells in the adult neurogenic niches. In the spinal cord, the ependymal cells surrounding the central canal form one of those niches, but little is known about their Wnt expression patterns. Using microdissection followed by TaqMan® low-density arrays, we show here that the ependymal regions of young, mature rats and adult humans express several Wnt-related genes, including ligands, conventional and non-conventional receptors, co-receptors, and soluble inhibitors. We found 13 genes shared between rats and humans, 4 exclusively expressed in rats and 9 expressed only in humans. Also, we observed a reduction with age on spontaneous proliferation of ependymal cells in rats paralleled by a decrease in the expression of Fzd1, Fzd8, and Fzd9. Our results suggest a role for Wnts in the regulation of the adult spinal cord neurogenic niche and provide new data on the specific differences in this region between humans and rodents.

  12. Regional (spinal, epidural, caudal) versus general anaesthesia in preterm infants undergoing inguinal herniorrhaphy in early infancy.

    PubMed

    Jones, Lisa J; Craven, Paul D; Lakkundi, Anil; Foster, Jann P; Badawi, Nadia

    2015-06-09

    With improvements in neonatal intensive care, more preterm infants are surviving the neonatal period and presenting for surgery in early infancy. Inguinal hernia is the most common condition requiring early surgery, appearing in 38% of infants whose birth weight is between 751 grams and 1000 grams. Approximately 20% to 30% of otherwise healthy preterm infants having general anaesthesia for inguinal hernia surgery at a postmature age have at least one apnoeic episode within the postoperative period. Research studies have failed to adequately distinguish the effects of apnoeic episodes from other complications of extreme preterm gestation on the risk of brain injury, or to investigate the potential impact of postoperative apnoea upon longer term neurodevelopment. In addition to episodes of apnoea, there are concerns that anaesthetic and sedative agents may have a direct toxic effect on the developing brain of preterm infants even after reaching postmature age. It is proposed that regional anaesthesia may reduce the risk of postoperative apnoea, avoid the risk of anaesthetic-related neurotoxicity and improve neurodevelopmental outcomes in preterm infants requiring surgery for inguinal hernia at a postmature age. To determine if regional anaesthesia reduces postoperative apnoea, bradycardia, the use of assisted ventilation, and neurological impairment, in comparison to general anaesthesia, in preterm infants undergoing inguinal herniorrhaphy at a postmature age. The following databases and resources were searched: the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, 2015, Issue 2), MEDLINE (December 2002 to 25 February 2015), EMBASE (December 2002 to 25 February 2015), controlled-trials.com and clinicaltrials.gov, reference lists of published trials and abstracts published in Pediatric Research and Pediatric Anesthesia. Randomised and quasi-randomised controlled trials of regional (spinal, epidural, caudal) versus general anaesthesia, or

  13. The ependymal region of the adult human spinal cord differs from other species and shows ependymoma-like features

    PubMed Central

    Arevalo-Martin, Angel; Paniagua-Torija, Beatriz; Florensa-Vila, José; Ferrer, Isidro; Grassner, Lukas; Molina-Holgado, Eduardo

    2015-01-01

    Several laboratories have described the existence of undifferentiated precursor cells that may act like stem cells in the ependyma of the rodent spinal cord. However, there are reports showing that this region is occluded and disassembled in humans after the second decade of life, although this has been largely ignored or interpreted as a post-mortem artefact. To gain insight into the patency, actual structure, and molecular properties of the adult human spinal cord ependymal region, we followed three approaches: (i) with MRI, we estimated the central canal patency in 59 control subjects, 99 patients with traumatic spinal cord injury, and 26 patients with non-traumatic spinal cord injuries. We observed that the central canal is absent from the vast majority of individuals beyond the age of 18 years, gender-independently, throughout the entire length of the spinal cord, both in healthy controls and after injury; (ii) with histology and immunohistochemistry, we describe morphological properties of the non-lesioned ependymal region, which showed the presence of perivascular pseudorosettes, a common feature of ependymoma; and (iii) with laser capture microdissection, followed by TaqMan® low density arrays, we studied the gene expression profile of the ependymal region and found that it is mainly enriched in genes compatible with a low grade or quiescent ependymoma (53 genes); this region is enriched only in 14 genes related to neurogenic niches. In summary, we demonstrate here that the central canal is mainly absent in the adult human spinal cord and is replaced by a structure morphologically and molecularly different from that described for rodents and other primates. The presented data suggest that the ependymal region is more likely to be reminiscent of a low-grade ependymoma. Therefore, a direct translation to adult human patients of an eventual therapeutic potential of this region based on animal models should be approached with caution. PMID:25882650

  14. The ependymal region of the adult human spinal cord differs from other species and shows ependymoma-like features.

    PubMed

    Garcia-Ovejero, Daniel; Arevalo-Martin, Angel; Paniagua-Torija, Beatriz; Florensa-Vila, José; Ferrer, Isidro; Grassner, Lukas; Molina-Holgado, Eduardo

    2015-06-01

    Several laboratories have described the existence of undifferentiated precursor cells that may act like stem cells in the ependyma of the rodent spinal cord. However, there are reports showing that this region is occluded and disassembled in humans after the second decade of life, although this has been largely ignored or interpreted as a post-mortem artefact. To gain insight into the patency, actual structure, and molecular properties of the adult human spinal cord ependymal region, we followed three approaches: (i) with MRI, we estimated the central canal patency in 59 control subjects, 99 patients with traumatic spinal cord injury, and 26 patients with non-traumatic spinal cord injuries. We observed that the central canal is absent from the vast majority of individuals beyond the age of 18 years, gender-independently, throughout the entire length of the spinal cord, both in healthy controls and after injury; (ii) with histology and immunohistochemistry, we describe morphological properties of the non-lesioned ependymal region, which showed the presence of perivascular pseudorosettes, a common feature of ependymoma; and (iii) with laser capture microdissection, followed by TaqMan® low density arrays, we studied the gene expression profile of the ependymal region and found that it is mainly enriched in genes compatible with a low grade or quiescent ependymoma (53 genes); this region is enriched only in 14 genes related to neurogenic niches. In summary, we demonstrate here that the central canal is mainly absent in the adult human spinal cord and is replaced by a structure morphologically and molecularly different from that described for rodents and other primates. The presented data suggest that the ependymal region is more likely to be reminiscent of a low-grade ependymoma. Therefore, a direct translation to adult human patients of an eventual therapeutic potential of this region based on animal models should be approached with caution.

  15. Locomotor Training and Factors Associated with Blood Glucose Regulation After Spinal Cord Injury.

    PubMed

    Chilibeck, Philip D; Guertin, Pierre A

    2017-01-01

    Individuals with spinal cord injury (SCI) have increased rates of glucose intolerance, insulin insensitivity, and type II diabetes caused mainly by the deconditioning of paralyzed muscle. The purpose of this systematic review was to determine the effectiveness of locomotor training in individuals with SCI on blood glucose control. We searched studies on locomotor training for individuals with SCI with outcomes of glucose, insulin, or outcomes that could change glucose handling (i.e. increases in muscle mass, shifts in muscle fiber type composition, changes in transport proteins, or enzymes involved in glucose metabolism) in PubMed and EMBASE. Eleven studies (10 with incomplete SCI; 1 with complete SCI) were included in our review. Locomotor training included body weight supported treadmill training (BWSTT) with manual or robotic assistance, with and without functional electrical stimulation (FES), or involved FES-assisted over ground training. Six months of locomotor training in individuals with SCI resulted in significant decreases in glucose (15%) and insulin (33%) areas under the curve during oral glucose tolerance tests. Two to twelve months of locomotor training reversed some of the muscle atrophy - with muscle being the site of most glucose consumption, this is important for glucose control. Training also increased capacity for glucose storage, enzymes involved in glucose phosphorylation (hexokinase) and oxidation (citrate synthase), and glucose transport proteins (GLUT-4). Fiber type composition shifted to a slower fiber type, which favors glucose handling. There were no effects on fat mass. Locomotor training in individuals with SCI (generally an incomplete injury) increases capacity to handle glucose and results in muscular changes that should reduce the risk of type II diabetes. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  16. Acute effects of simultaneous electromyostimulation and vibration on leg blood flow in spinal cord injury.

    PubMed

    Menéndez, H; Ferrero, C; Martín-Hernández, J; Figueroa, A; Marín, P J; Herrero, A J

    2016-05-01

    Randomized crossover. To analyze the acute effects of isolated and simultaneous application of whole-body vibration (WBV) and electromyostimulation (ES) on popliteal artery blood velocity (BV) and skin temperature (ST) of the calf in subjects with spinal cord injury (SCI). Valladolid, Spain. Ten subjects with SCI were assessed in five different sessions. After a familiarization session, four interventions were applied in random order; WBV, ES, simultaneous WBV and ES (WBV+ES), and 30 s of WBV followed by 30 s of ES (WBV30/ES30). Each intervention consisted of 10 sets × 1 min ON+1 min OFF. Subjects were seated on their own wheelchairs with their feet on the vibration platform (10 Hz, 5 mm peak-to-peak), and ES was applied on the gastrocnemius muscle of both legs (8 Hz, 400 μs). The simultaneous application (WBV+ES) produced the greatest increase in mean BV (MBV; 36% and 42%, respectively) and peak BV (PBV; 30% and 36%, respectively) during the intervention. This intervention produced the greatest mean increases in MBV (21%) and PBV (19%) during the recovery period. Last, this intervention produced the highest increase in ST during the intervention (2.1 °C). The simultaneous application of WBV+ES seems to produce a greater increase in MBV and PBV of the popliteal artery and ST of the calf than the isolated (WBV or ES) or consecutive application of both stimuli (WBV30/ES30). This study provides an efficient therapeutic methodology to improve peripheral arterial properties, which is pivotal in SCI patient's rehabilitation.

  17. Noninvasive method of estimating human newborn regional cerebral blood flow

    SciTech Connect

    Younkin, D.P.; Reivich, M.; Jaggi, J.; Obrist, W.; Delivoria-Papadopoulos, M.

    1982-12-01

    A noninvasive method of estimating regional cerebral blood flow (rCBF) in premature and full-term babies has been developed. Based on a modification of the /sup 133/Xe inhalation rCBF technique, this method uses eight extracranial NaI scintillation detectors and an i.v. bolus injection of /sup 133/Xe (approximately 0.5 mCi/kg). Arterial xenon concentration was estimated with an external chest detector. Cerebral blood flow was measured in 15 healthy, neurologically normal premature infants. Using Obrist's method of two-compartment analysis, normal values were calculated for flow in both compartments, relative weight and fractional flow in the first compartment (gray matter), initial slope of gray matter blood flow, mean cerebral blood flow, and initial slope index of mean cerebral blood flow. The application of this technique to newborns, its relative advantages, and its potential uses are discussed.

  18. Prevalence of facet joint pain in chronic spinal pain of cervical, thoracic, and lumbar regions

    PubMed Central

    Manchikanti, Laxmaiah; Boswell, Mark V; Singh, Vijay; Pampati, Vidyasagar; Damron, Kim S; Beyer, Carla D

    2004-01-01

    Background Facet joints are a clinically important source of chronic cervical, thoracic, and lumbar spine pain. The purpose of this study was to systematically evaluate the prevalence of facet joint pain by spinal region in patients with chronic spine pain referred to an interventional pain management practice. Methods Five hundred consecutive patients with chronic, non-specific spine pain were evaluated. The prevalence of facet joint pain was determined using controlled comparative local anesthetic blocks (1% lidocaine or 1% lidocaine followed by 0.25% bupivacaine), in accordance with the criteria established by the International Association for the Study of Pain (IASP). The study was performed in the United States in a non-university based ambulatory interventional pain management setting. Results The prevalence of facet joint pain in patients with chronic cervical spine pain was 55% 5(95% CI, 49% – 61%), with thoracic spine pain was 42% (95% CI, 30% – 53%), and in with lumbar spine pain was 31% (95% CI, 27% – 36%). The false-positive rate with single blocks with lidocaine was 63% (95% CI, 54% – 72%) in the cervical spine, 55% (95% CI, 39% – 78%) in the thoracic spine, and 27% (95% CI, 22% – 32%) in the lumbar spine. Conclusion This study demonstrated that in an interventional pain management setting, facet joints are clinically important spinal pain generators in a significant proportion of patients with chronic spinal pain. Because these patients typically have failed conservative management, including physical therapy, chiropractic treatment and analgesics, they may benefit from specific interventions designed to manage facet joint pain. PMID:15169547

  19. Axons with highly branched terminal regions successfully regenerate across spinal midline transections in the adult cat.

    PubMed

    Fenrich, Keith K; Rose, P Ken

    2011-11-01

    We recently reported that some, but not all, axotomized propriospinal commissural interneurons (PCI) of the adult mammal can regenerate through spinal midsagittal transection injury sites (Fenrich and Rose [2009] J Neurosci 29:12145-12158). In this model, regenerating axons grow through a lesion site surrounded by a dense deposition of chondroitin sulfate proteoglycans (CSPG), which are typically inhibitory to regenerating axons. However, the mechanisms that lead some regenerating axons to grow through spinal cord injury (SCI) sites while others remain trapped in the CSPG zones or retract to their soma remain unknown. As a first step toward elucidating these mechanisms, here we show that the ability of PCI axons to regenerate across a SCI site depends on the branching patterns of their distal terminals. Using 3D reconstruction techniques through multiple serial sections and immunohistochemical analyses, we found that at 7 days postinjury a majority of PCI axons terminated in CSPG zones ipsilateral of the spinal midline. Conversely, at 9 days postinjury some PCI axons had regenerated across the midline, but others terminated outside the CSPG zones near their soma. Furthermore, we show that the most successful regenerators were those with the most extensive branching patterns, whereas those that terminated outside the CSPG zones had terminal regions indistinguishable from dystrophic terminals. Our results demonstrate that the morphological characteristics of regenerating axons play an important role in their ability to regenerate across SCI sites, and that the branching patterns of some regenerating axons are more extensive and have a far greater complexity than previously reported. Copyright © 2011 Wiley-Liss, Inc.

  20. Spinal stab injury with retained knife blades: 51 Consecutive patients managed at a regional referral unit.

    PubMed

    Enicker, Basil; Gonya, Sonwabile; Hardcastle, Timothy C

    2015-09-01

    Spinal stab wounds presenting with retained knife blades (RKB) are uncommon, often resulting in spinal cord injury (SCI) with catastrophic neurological consequences. The purpose of this study is to report a single unit's experience in management of this pattern of injury at this regional referral centre. Retrospective review of medical records identified 51 consecutive patients with spinal stabs presenting with a RKB at the Neurosurgery Department at Inkosi Albert Luthuli Central Hospital between January 2003 and February 2015. The data was analyzed for patient characteristics, level of the RKB, neurological status using the ASIA impairment scale, associated injuries, radiological investigations, management, hospital length of stay, complications and mortality. The mean age was 28±10.9 years (range 14-69), with 45 (88%) males (M: F=7.5:1). The median Injury Severity Score was 16 (range 4-26). RKB were located in the cervical [9,18%], thoracic [38,74%], lumbar [2,4%] and sacral [2,4%] spine. Twelve patients (24%) sustained complete SCI (ASIA A), while 21 (41%) had incomplete (ASIA B, C, D), of which 17 had features of Brown-Sequard syndrome. Eighteen (35%) patients were neurologically intact (ASIA E). There were 8 (16%) associated pneumothoraces and one vertebral artery injury. Length of hospital stay was 10±7.1 days (range 1-27). One patient (2%) died during this period. Stab injuries to the spine presenting with RKB are still prevalent in South Africa. Resources should be allocated to prevention strategies that decrease the incidence of inter-personal violence. All RKBs should be removed in the operating theatre by experienced surgeons to minimise complications. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Blood pressure changes during sexual stimulation, ejaculation and midodrine treatment in men with spinal cord injury.

    PubMed

    Courtois, Frédérique J; Charvier, Kathleen F; Leriche, Albert; Vézina, Jean-Guy; Côté, Magalie; Bélanger, Marc

    2008-02-01

    To explore the effectiveness of various sources of self-stimulation, including oral midodrine, in triggering ejaculation in men with spinal cord injury (SCI), and to document the systematic variations in blood pressure at ejaculation and consider a revised definition of autonomic dysreflexia. The study included 62 men with SCI lesions from C2 to L2. Ejaculation potential was assessed with various sources of stimulation, beginning with natural stimulation, followed, if the test was negative, by penile vibrator stimulation (PVS) followed, if the test was again negative, by PVS combined with oral midodrine, started at 5 mg and increased in 5 mg steps up to 25 mg. The success rate of ejaculation was recorded, as were blood pressure (BP) changes measured at baseline and at ejaculation (or on the last trial if the test was negative). Reported sensations were also recorded and compared during positive and negative tests. Overall, 89% of the patients reached ejaculation with one mode or another of stimulation. When patients had a negative result with natural stimulation, 56% were salvaged by PVS, and when PVS was negative, another 22% were salvaged by midodrine combined with PVS. The mean systolic BP increased by 35 mmHg at ejaculation during PVS and by 11 mmHg after midodrine, and a subsequent 29 mmHg at ejaculation during PVS combined with midodrine. By contrast, negative tests showed a relatively stable BP; the difference in changes in BP during positive and negative tests was significant (P < 0.01). Increases in BP during positive tests declined significantly more often within the limits of autonomic dysreflexia than negative tests (P < 0.01). These results support the view that most men with SCI can obtain an ejaculation when a wide spectrum of stimulation is used, including natural stimulation, PVS, and PVS combined with oral midodrine. Positive tests were associated with significant increases in BP, in contrast to negative tests, where BP was relatively stable. This

  2. Cordycepin-enriched WIB-801C from Cordyceps militaris improves functional recovery by attenuating blood-spinal cord barrier disruption after spinal cord injury.

    PubMed

    Lee, Jee Youn; Choi, Hye Young; Baik, Hyung Hwan; Ju, Bong G; Kim, Won-Ki; Yune, Tae Young

    2017-05-05

    Cordyceps militaris is an ingredient of traditional Chinese medicine and have been widely used for inflammatory diseases and cancer. Cordycepin is one of the major bioactive components of Cordyceps militaris, and has been known to have anti-inflammatory and anti-oxidant effects. In the present study, we examined whether WIB-801C, a standardized and cordycepin-enriched extract of caterpillar fungus (Cordyceps militaris), would attenuate blood-spinal cord barrier (BSCB) disruption by inhibiting matrix metalloprotease (MMP)-9 activity, leading to improvement of functional outcomes after spinal cord injury (SCI). Male Sprague-Dawley rats were subjected to contusive SCI using a New York University (NYU) impactor, and WIB-801C (50mg/kg) was administered at 2h and 8h after injury orally and further treated once a day for indicated time points. BSCB disruption, MMP-9 activity, blood infiltration, inflammation, neuronal apoptosis, axonal loss, demyelination, and neurological deficit were evaluated. We found that WIB-801C significantly attenuated BSCB disruption by inhibiting MMP-9 expression and activation after injury. The infiltration of neutrophils at 1 d and macrophage at 5 d after SCI was also ameliorated by WIB-801C as compared with vehicle control. In addition, the expression of inflammatory cytokines and mediators such as Tnf-α, IL-1β, IL-6, Cox-2, and inos as well as chemokines such as Gro-α and Mip-2α was significantly inhibited by WIB-801C. Furthermore, WIB-801C inhibits p38MAPK activation and proNGF production in microglia after injury. These events eventually led to the inhibition of apoptotic cell death of neurons and oligodendrocytes, improved functional recovery and attenuated demyelination and axon loss after SCI. Our results suggest that WIB-801C can be used as a therapeutic agent after SCI by attenuating BSCB disruption followed inflammation. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  3. Construction of a yeast artifical chromosome contig spanning the spinal muscular atrophy disease gene region

    SciTech Connect

    Kleyn, P.W.; Wang, C.H.; Vitale, E.; Pan, J.; Ross, B.M.; Grunn, A.; Palmer, D.A.; Warburton, D.; Brzustowicz, L.M.; Gilliam, T.G. ); Lien, L.L.; Kunkel, L.M. )

    1993-07-15

    The childhood spinal muscular atrophies (SMAs) are the most common, serious neuromuscular disorders of childhood second to Duchenne muscular dystrophy. A single locus for these disorders has been mapped by recombination events to a region of 0.7 centimorgan (range, 0.1-2.1 centimorgans) between loci D5S435 and MAP1B on chromosome 5q11.2-13.3. By using PCR amplification to screen yeast artificial chromosome (YAC) DNA pools and the PCR-vectorette method to amplify YAC ends, a YAC contig was constructed across the disease gene region. Nine walk steps identified 32 YACs, including a minimum of seven overlapping YAC clones (average size, 460 kb) that span the SMA region. The contig is characterized by a collection of 30 YAC-end sequence tag sites together with seven genetic markers. The entire YAC contig spans a minimum of 3.2 Mb; the SMA locus is confined to roughly half of this region. Microsatellite markers generated along the YAC contig segregate with the SMA locus in all families where the flanking markers (D5S435 and MAP1B) recombine. Construction of a YAC contig across the disease gene region is an essential step in isolation of the SMA-encoding gene. 26 refs., 3 figs., 1 tab.

  4. Construction of a yeast artificial chromosome contig spanning the spinal muscular atrophy disease gene region.

    PubMed Central

    Kleyn, P W; Wang, C H; Lien, L L; Vitale, E; Pan, J; Ross, B M; Grunn, A; Palmer, D A; Warburton, D; Brzustowicz, L M

    1993-01-01

    The childhood spinal muscular atrophies (SMAs) are the most common, serious neuromuscular disorders of childhood second to Duchenne muscular dystrophy. A single locus for these disorders has been mapped by recombination events to a region of 0.7 centimorgan (range, 0.1-2.1 centimorgans) between loci D5S435 and MAP1B on chromosome 5q11.2-13.3. By using PCR amplification to screen yeast artificial chromosome (YAC) DNA pools and the PCR-vectorette method to amplify YAC ends, a YAC contig was constructed across the disease gene region. Nine walk steps identified 32 YACs, including a minimum of seven overlapping YAC clones (average size, 460 kb) that span the SMA region. The contig is characterized by a collection of 30 YAC-end sequence tag sites together with seven genetic markers. The entire YAC contig spans a minimum of 3.2 Mb; the SMA locus is confined to roughly half of this region. Microsatellite markers generated along the YAC contig segregate with the SMA locus in all families where the flanking markers (D5S435 and MAP1B) recombine. Construction of a YAC contig across the disease gene region is an essential step in isolation of the SMA-encoding gene. Images Fig. 1 PMID:8341701

  5. Pineal region tumors: results of radiation therapy and indications for elective spinal irradiation. [/sup 60/Co; x ray

    SciTech Connect

    Griffin, B.R.; Griffin, T.W.; Tong, D.Y.K.; Russell, A.H.; Kurtz, J.; Laramore, G.E.; Groudine, M.

    1981-05-01

    Eighteen patients with pineal region tumors seen from November 1960 to November 1978 were reviewed. Thirteen patients treated with radiation therapy received tumor doses in the 4000 to 5500 rad range. The five year survival and five year disease-free survival were 73 and 63% respectively. Spinal cord metastasis occurred in 2 of 13 (15%) patients. Attempts at salvage radiotherapy for these patients were unsuccessful. Computerized tomography (CT) scan provides an excellent method of evaluating the response of pineal region tumors to radiation. Rapid regression of the tumor mass on CT scan reflects the highly radioresponsive nature of germinomas, the tumor type most likely to disseminate throughout the neuraxis. This principle can be exploited to select unbiopsied patients with a high risk of spinal cord metastasis for prophylactic spinal radiation at an early stage of treatment.

  6. Regional myocardial blood flow in man during dipyridamole coronary vasodilation

    SciTech Connect

    Sorensen, S.G.; Groves, B.M.; Horwitz, L.D.; Chaudhuri, T.K.

    1985-06-01

    Regional myocardial blood flow before and after intravenous dipyridamole (0.56 mg/kg) was measured during cardiac catheterization in 11 patients using the /sup 133/Xe washout technique. Significant increases in heart rate and decreases in systolic blood pressure were observed with dipyridamole infusion. However, double product and cardiac output did not differ before or after drug infusion. Regional myocardial blood flow increased from 67 to 117 ml/100 mg/min in myocardial segments supplied by nonobstructed coronary arteries. In stenotic coronary arteries, flow increased from 57 to 79 ml/100 mg/min with dipyridamole. We conclude that dipyridamole infusion results in flow differences which discriminate stenotic from nonstenotic coronary arteries.

  7. Laser-Doppler flowmetry. A review of its application for measuring cerebral and spinal cord blood flow.

    PubMed

    Frerichs, K U; Feuerstein, G Z

    1990-01-01

    Laser-Doppler flowmetry is a new technique for noninvasive and continuous measurement of local microcirculatory cerebral and spinal-cord blood flow. The flow estimate by this technique is based on the assessment of the Doppler shift of low-power laser light, which is scattered by moving red blood cells. Laser-Doppler flowmetry has been validated for various organs, including the central nervous system. These studies revealed a linear relationship between relative changes of the Doppler signal and blood flow over a wide range of pharmacological as well as pathological flow alterations, including cerebral ischemia. The usefulness of laser-Doppler flowmetry in experimental as well as clinical applications has received growing attention. The superiority of the technique lies in its high spatial and temporal resolution. Disadvantages are the difficulty of obtaining absolute flow values and the sensitivity to artifacts. The versatility and on-line capacity of laser-Doppler flowmetry might allow new insights into the pathophysiology of alterations of the cerebral and spinal-cord microcirculation.

  8. Sub-dural hematoma following spinal anesthesia treated with epidural blood patch and burr-hole evacuation: a case report.

    PubMed

    K, Krishnakumar; Chatterjee, Nilay; Shrivastava, Adesh; Davis, Josemine; N, Suresh Nair

    2013-02-01

    The appearance of a subdural hematoma (SDH) following spinal anesthesia is a serious and rare complication which mandates prompt diagnosis, although the treatment modalities are not well codified. Patients with post-dural puncture headache (PDPH) non-responsive to conservative measures and/or those patients with a change of the character of the headache should be considered seriously. In symptomatic patients, evacuation of SDH is essential but epidural blood patch should be strongly considered as it can prevent reappearance of SDH by sealing the dural defect.

  9. Blood detection in the spinal column of whole cooked chicken using an optical fibre based sensor system

    NASA Astrophysics Data System (ADS)

    Sheridan, C.; O'Farrell, M.; Lyons, W. B.; Lewis, E.; Flanagan, C.; Jackman, N.

    2005-01-01

    An optical fibre based sensor has been developed to aid the quality assurance of food cooked in industrial ovens by monitoring the product in situ as it cooks. The sensor measures the product colour as it cooks by examining the reflected visible light from the surface as well as the core of the product. This paper examines the use of the sensor for the detection of blood in the spinal area of cooked whole chickens. The results presented here show that the sensor can be successfully used for this purpose.

  10. Isolation and characterization of candidate genes of the 5q13 region in spinal muscular atrophy

    SciTech Connect

    Lefebvre, S.; Reboullet, S.; Benichou, B.

    1994-09-01

    Based on a fine genetic and physical map of the region deleted in spinal muscular atrophy, we defined the smallest rearrangements encompassing the SMA gene. This interval is entirely contained in the 903D1 YAC clone. Several approaches to identify candidate genes were applied, including the search for interspecies conservation, exon trapping amplification and direct cDNA selection. Combining these strategies, six different cDNA molecules mapping to the YAC contig were isolated. Four cDNA molecules were isolated using the exon trapping system. They map to chromosome 5p and to more than one locus within the 5q13 region. They are homologous to each other and share sequence homology with the {beta}-glucuronidase gene. Based on interspecies conservation, a fifth candidate gene was identified. Sequence analyses of the cDNAs revealed no homologies with any other described genes. This gene mapped to two loci within the 5q13 region. Two other cDNA molecules isolated by direct cDNA selection are also under investigation. Complete characterization and fine physical mapping of those genes with respect to the physical interval defined by the deletions of the SMA region will allow the identification of the disease gene (or genes).

  11. SPECT study of regional cerebral blood flow in Alzheimer disease

    SciTech Connect

    Bonte, F.J.; Ross, E.D.; Chehabi, H.H.; Devous, M.D. Sr.

    1986-07-01

    A common cause of dementia in late midlife and old age is Alzheimer disease (AD), which affects more than one in 20 individuals over the age of 65. Past studies of regional cerebral blood flow (rCBF) in patients with AD here suggested blood flow abnormalities, but findings have differed. We have studied 37 patients diagnosed as having AD with inhalation and washout of /sup 133/Xe and single-photon emission computed tomography (SPECT), obtaining evidence of abnormal rCBF patterns in 19. Flow reductions were most common in the temporoparietal regions and were occasionally found in the frontal areas. Investigators using positron-emission tomography (PET) have identified similar findings with respect to rCBF and regional oxygen, glucose, and protein metabolism. The SPECT determination of rCBF, which gives information similar to that provided by PET, may assume importance in the diagnosis of AD and in the differential diagnosis of the dementias.

  12. Continuous regional blood flow measurement during environmental heating in rats

    SciTech Connect

    Kregel, K.C.; Wall, P.T.; Gisolfi, C.V.

    1986-03-05

    With prolonged exposure to high ambient temperatures, shifting regional blood flows reflect the dominance of cardiovascular over thermoregulatory requirements. Hypotension and decreased cardiac output contribute to the circulatory failure noted in heat stroke. The purpose of this study was to investigate changes in regional blood flows during prolonged exposure (50-70 min) to 45/sup 0/C heat. Sprague-Dawley rats (250-450 g) were implanted with pulsed Doppler flow probes on the superior mesenteric, caudal, and left iliac arteries. Measurements included blood flows in kHz Doppler shift, colonic (T/sub c/) and tail-skin temperatures, and mean arterial blood pressure (MABP). As T/sub c/ rose from 37/sup 0/ to 42/sup 0/C, iliac flow remained relatively constant, caudal flow rose to peak values of 257-600%, and mesenteric flow declined 60-88% relative to baseline. The rise in caudal blood flow occurred within the first 5 min of exposure whereas the decline in mesenteric flow was progressive; MABP rose to peak levels of 180 mm Hg. Heart rate rose to 500-630 bpm. At T/sub c/ above 42/sup 0/C, mesenteric flow increased in several animals (36-75%) and MABP began to fall. The authors hypothesize that the hypotension observed with prolonged heat exposure in the rat is in part attributed to the inability of the animal to sustain splanchnic vasoconstriction.

  13. Regional neurohypophysial and hypothalamic blood flow in rats during hypercapnia

    SciTech Connect

    Bryan, R.M. Jr.; Myers, C.L.; Page, R.B.

    1988-08-01

    Regional cerebral blood flow (rCBF) was measured in the neurohypophysis and hypothalamus in normocapnic and hypercapnic rats using (/sup 14/C)isopropyliodoamphetamine. Rats were surgically prepared using nitrous oxide and halothane and placed in plaster restraining casts. Hypercapnia was produced by increasing the fractional concentration of inspired CO/sub 2/ (FICO/sub 2/). rCBF in normocapnic rats was higher in the paraventricular nucleus, supraoptic nucleus, median eminence, and neural lobe than rates previously measured by use of diffusible tracers. During hypercapnia blood flow increased linearly with arterial PCO/sub 2/ (PACO/sub 2/) in all regions except the median eminence and neural lobe, which were not affected by hypercapnia. When rats were pretreated with phentolamine (1 mg/kg) to block the alpha-adrenergic receptors, blood flow in the median eminence and neural lobe increased significantly during hypercapnia. We conclude that blood flow in the cell bodies of the paraventricular nucleus and supraoptic nucleus is regulated differently during hypercapnia than blood flow in the nerve terminals in the median eminence and neural lobe. Furthermore, vasodilation produced by increased CO/sub 2/ is offset by alpha-receptor stimulation in the median eminence and neural lobe.

  14. Modelling the endothelial blood-CNS barriers: a method for the production of robust in vitro models of the rat blood-brain barrier and blood-spinal cord barrier

    PubMed Central

    2013-01-01

    Background Modelling the blood-CNS barriers of the brain and spinal cord in vitro continues to provide a considerable challenge for research studying the passage of large and small molecules in and out of the central nervous system, both within the context of basic biology and for pharmaceutical drug discovery. Although there has been considerable success over the previous two decades in establishing useful in vitro primary endothelial cell cultures from the blood-CNS barriers, no model fully mimics the high electrical resistance, low paracellular permeability and selective influx/efflux characteristics of the in vivo situation. Furthermore, such primary-derived cultures are typically labour-intensive and generate low yields of cells, limiting scope for experimental work. We thus aimed to establish protocols for the high yield isolation and culture of endothelial cells from both rat brain and spinal cord. Our aim was to optimise in vitro conditions for inducing phenotypic characteristics in these cells that were reminiscent of the in vivo situation, such that they developed into tight endothelial barriers suitable for performing investigative biology and permeability studies. Methods Brain and spinal cord tissue was taken from the same rats and used to specifically isolate endothelial cells to reconstitute as in vitro blood-CNS barrier models. Isolated endothelial cells were cultured to expand the cellular yield and then passaged onto cell culture inserts for further investigation. Cell culture conditions were optimised using commercially available reagents and the resulting barrier-forming endothelial monolayers were characterised by functional permeability experiments and in vitro phenotyping by immunocytochemistry and western blotting. Results Using a combination of modified handling techniques and cell culture conditions, we have established and optimised a protocol for the in vitro culture of brain and, for the first time in rat, spinal cord endothelial cells

  15. Regional cerebral blood flow and blood volume in patients with subcortical arteriosclerotic encephalopathy (SAE).

    PubMed

    Gückel, Friedemann J; Brix, Gunnar; Hennerici, Michael; Lucht, Robert; Ueltzhöffer, Christine; Neff, Wolfgang

    2007-10-01

    The aim of the present study was a detailed analysis of the regional cerebral blood flow and blood volume in patients with subcortical arteriosclerotic encephalopathy (SAE) by means of functional magnetic resonance imaging (MRI). A group of 26 patients with SAE and a group of 16 age-matched healthy volunteers were examined. Using a well-established dynamic susceptibility contrast-enhanced MRI method, the regional cerebral blood flow (rCBF) and blood volume (rCBV) were quantified for each subject in 12 different regions in the brain parenchyma. As compared to healthy volunteers, patients with SAE showed significantly reduced rCBF and rCBV values in white matter regions and in the occipital cortex. Regions containing predominantly grey matter show almost normal rCBF and rCBV values. In conclusion, quantitative analysis of rCBF and rCBV values demonstrates clearly that SAE is a disease that is associated with a reduced microcirculation predominantly in white matter.

  16. Isolation of cDNAs from the spinal muscular atrophy gene region with yeast artificial chromosomes

    SciTech Connect

    Deng, H.X.; He, X.X.; Hung, W.Y.

    1994-09-01

    Spinal muscular atrophy (SMA) is an autosomal recessive disorder characterized by degeneration of anterior horn cells, leading to progressive paralysis of voluntary muscles. The SMA gene(s) is located at 5q11.2-q13.3, between D5S435 and D5S112. To isolate potential candidate gene(s) responsible for SMA, we used the YACs within the SMA gene region as probes to screen a human brainstem cDNA library. Thirteen cDNA clones were isolated. Their sizes range from 0.7 kb to 5 kb. Seven clones were found to be unique in sequence; the remaining six clones contain repetitive sequences. Five out of these seven unique clones have been used as probes to screen a phage genomic DNA library. Phage genomic clones isolated with individual unique cDNA were used for fluorescence in situ hybridization to identify the origin of cDNAs. These five unique sequences are all located in the 5q13 region, indicating the reliability of our screening method. All the thirteen clones have been partially sequenced (about 300 bp) from each end. No homology has been found with any known EST or known genes. No cross hybridization was detected among the unique clones, suggesting that there may be distinct new genes encoded in this region.

  17. Novel application of pre-operative vertebral body embolization to reduce intraoperative blood loss during a three-column spinal osteotomy for non-oncologic spinal deformity.

    PubMed

    Tuchman, Alexander; Mehta, Vivek A; Mack, William J; Acosta, Frank L

    2015-04-01

    Three column osteotomies (3CO) of the lumbar spine are powerful corrective procedures used in the treatment of kyphoscoliosis. Their efficacy comes at the cost of high reported complication rates, notably significant estimated blood loss (EBL). Previously reported techniques to reduce EBL have had modest efficacy. Here we describe a potential technique to decrease EBL during pedicle subtraction osteotomy (PSO) of the lumbar spine by means of pre-operative vertebral body embolization - a technique traditionally used to reduce blood loss prior to spinal column tumor resection. We present a 62-year-old man with iatrogenic kyphoscoliosis who underwent staged deformity correction. Stage 1 involved thoracolumbar instrumentation followed by transarterial embolization of the L4 vertebral body through bilateral segmental arteries. A combination of polyvinyl alcohol particles and Gelfoam (Pfizer, New York, NY, USA) were used. Following embolization there was decreased angiographic blood flow to the small vessels of the L4 vertebral body, while the segmental arteries remained patent. Stage 2 consisted of an L4 PSO and fusion. The EBL during the PSO procedure was 1L, which compared favorably to that during previous PSO at this institution as well as to quantities reported in previous literature. There have been no short term (5 month follow-up) complications attributable to the vertebral body embolization or surgical procedure. Although further investigation into this technique is required to better characterize its safety and efficacy in reducing EBL during 3CO, we believe this patient illustrates the potential utility of pre-operative vertebral embolization in the setting of non-oncologic deformity correction surgery. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. A YAC contig of the region containing the spinal muscular atrophy gene (SMA): Identification of an unstable region

    SciTech Connect

    Carpten, J.D.; DiDonato, C.J.; Ingraham, S.E.

    1994-11-15

    The authors report a 3.0-Mb YAC contig of the region 5q11.2-q13.3, which is where the spinal muscular atrophy gene has been localized. Three total genomic YAC libraries were screened by the polymerase chain reaction (PCR), and 45 YACs were recovered. These YACs were characterized for sequence tag site (STS) content, and overlaps were confirmed by vectorette PCR. Of the 45 YACs, 20 were isolated with the polymorphic marker CATT-1, which demonstrates significant allelic association with the SMA gene and maps within the 850-kb interval defined by the markers D5S557 and D5S823. Haplotyping of these YACs and their mother cell line indicates that the majority of YACs from this region contain deletions. Furthermore, a 1.9-Mb CATT-1 YAC that was negative for MAP1B and D5S435 and nonchimeric by FISH analysis provides a minimum distance between MAP1B and D5S435. 30 refs., 2 figs., 3 tabs.

  19. Biomarker for Spinal Muscular Atrophy: Expression of SMN in Peripheral Blood of SMA Patients and Healthy Controls

    PubMed Central

    Czech, Christian; Tang, Wakana; Bugawan, Teodorica; Mano, Calvin; Horn, Carsten; Iglesias, Victor Alejandro; Fröhner, Stefanie; Zaworski, Phillip G.; Paushkin, Sergey; Chen, Karen; Kremer, Thomas

    2015-01-01

    Spinal muscular atrophy is caused by a functional deletion of SMN1 on Chromosome 5, which leads to a progressive loss of motor function in affected patients. SMA patients have at least one copy of a similar gene, SMN2, which produces functional SMN protein, although in reduced quantities. The severity of SMA is variable, partially due to differences in SMN2 copy numbers. Here, we report the results of a biomarker study characterizing SMA patients of varying disease severity. SMN copy number, mRNA and Protein levels in whole blood of patients were measured and compared against a cohort of healthy controls. The results show differential regulation of expression of SMN2 in peripheral blood between patients and healthy subjects. PMID:26468953

  20. Spinal cord stimulation, conception, pregnancy, and labor: case study in a complex regional pain syndrome patient.

    PubMed

    Segal, R

    1999-01-01

    Introduction. Interventional modalities for pain treatment are reserved for patients failing multidisciplinary pain management, including psychological, physical, pharmacological, and anesthetic techniques. Objective. Medications for intractable pain may be unacceptable because the risk of teratogenic effects. The purpose of this study is to find out whether spinal cord stimulation may be safe during conception, pregnancy, and delivery. Materials and Methods. We report a 30-year old, female, neonatal nurse who developed left hand burning pain, swelling, coldness, and weakness following a mild brachial plexus injury in a motor vehicle accident. The patient responded well to a combination of Neurontin, Trazadone, Ultram, and Vicodin. A year later, the patient married and wanted to become pregnant but was afraid of possible teratogenic effects of the medications. Therefore, she requested an interventional modality for control of her symptoms. We recommended spinal cord stimulation (SCS) based on our excellent experience with this modality in the management of complex regional pain syndromes (CRPS). However, we did inform the patient that no data had been published regarding the safety of this modality in pregnancy and labor. Results. Cervical SCS resulted in excellent pain control and discontinuation of the medications. Thirteen months later, she delivered a healthy five pound baby girl. Mother and baby were discharged home in two days. The SCS was not turned off at any time during the labor and delivery. Conclusion. SCS was safe for implantation in our case study of a pregnant woman. This may constitute a new indication for SCS in patients otherwise successfully managed with non-interventional modalities for pain control.

  1. Acute management of traumatic spinal cord injury in a Greek and a Swedish region: a prospective, population-based study.

    PubMed

    Divanoglou, A; Seiger, A; Levi, R

    2010-06-01

    Prospective, population-based study. This paper is part of the Stockholm Thessaloniki Acute Traumatic Spinal Cord Injury Study (STATSCIS). To characterize patient populations and to compare acute management after traumatic spinal cord injury (TSCI). The Greater Thessaloniki region in Greece and the Greater Stockholm region in Sweden. Inception cohorts with acute TSCI that were hospitalized during the study period, that is September 2006 to October 2007, were identified. Overall, 81 out of 87 cases consented to inclusion in Thessaloniki and 47 out of 49 in Stockholm. Data from Thessaloniki were collected through physical examinations, medical record reviews and communication with TSCI cases and medical teams. Data from Stockholm were retrieved from the Nordic Spinal Cord Injury Registry. There were no significant differences between study groups with regard to core clinical characteristics. In contrast, there were significant differences in (1) transfer logistics from the scene of trauma to a tertiary-level hospital (number of intermediate admissions, modes of transportation and duration of transfer) and (2) acute key therapeutic interventions, that is, the use of mechanical ventilation (49% in Thessaloniki versus 20% in Stockholm), and performance of tracheostomy (36% in Thessaloniki versus 15% in Stockholm); spinal surgery was performed significantly more often and earlier in Stockholm than in Thessaloniki. Despite largely similar core clinical characteristics, Stockholm and Thessaloniki cases underwent significantly different acute management, most probably to be attributed to adaptations to the differing regional approaches of care one following a systematic approach of SCI care and the other not.

  2. Human placental lactogen decreases regional blood flow in anesthetized pigs.

    PubMed

    Grossini, E; Molinari, C; Battaglia, A; Mary, D A S G; Ribichini, F; Surico, N; Vacca, G

    2006-01-01

    In 22 pigs anesthetized with sodium pentobarbitone, changes in blood flow caused by infusion of human placental lactogen into the left renal, external iliac, and anterior descending coronary arteries were assessed using electromagnetic flowmeters. In 17 pigs, infusion of human placental lactogen whilst keeping the heart rate and arterial pressure constant decreased coronary, renal and iliac flow. In 5 additional pigs, increasing the dose of human placental lactogen produced a dose-related decrease in regional blood flow. The mechanisms of the above response were studied in 15 of the 17 pigs by repeating the experiment of infusion. The human placental lactogen-induced decrease in regional blood flow was not affected by blockade of cholinergic receptors (5 pigs) or of alpha-adrenergic receptors (5 pigs), but it was abolished by blockade of beta2-adrenergic receptors (5 pigs). The present study showed that intra-arterial infusion of human placental lactogen primarily decreased coronary, renal and iliac blood flow. The mechanism of this response was shown to be due to the inhibition of a vasodilatory beta2-adrenergic receptor-mediated effect.

  3. Changes in regional blood volume and blood flow during static handgrip.

    PubMed

    Stewart, Julian M; Montgomery, Leslie D; Glover, June L; Medow, Marvin S

    2007-01-01

    Increased blood pressure (BP) and heart rate during exercise characterizes the exercise pressor reflex. When evoked by static handgrip, mechanoreceptors and metaboreceptors produce regional changes in blood volume and blood flow, which are incompletely characterized in humans. We studied 16 healthy subjects aged 20-27 yr using segmental impedance plethysmography validated against dye dilution and venous occlusion plethysmography to noninvasively measure changes in regional blood volumes and blood flows. Static handgrip while in supine position was performed for 2 min without postexercise ischemia. Measurements of heart rate and BP variability and coherence analyses were used to examine baroreflex-mediated autonomic effects. During handgrip exercise, systolic BP increased from 120 +/- 10 to 148 +/- 14 mmHg, whereas heart rate increased from 60 +/- 8 to 82 +/- 12 beats/min. Heart rate variability decreased, whereas BP variability increased, and transfer function amplitude was reduced from 18 +/- 2 to 8 +/- 2 ms/mmHg at low frequencies of approximately 0.1 Hz. This was associated with marked reduction of coherence between BP and heart rate (from 0.76 +/- 0.10 to 0.26 +/- 0.05) indicative of uncoupling of heart rate regulation by the baroreflex. Cardiac output increased by approximately 18% with a 4.5% increase in central blood volume and an 8.5% increase in total peripheral resistance, suggesting increased cardiac preload and contractility. Splanchnic blood volume decreased reciprocally with smaller decreases in pelvic and leg volumes, increased splanchnic, pelvic and calf peripheral resistance, and evidence for splanchnic venoconstriction. We conclude that the exercise pressor reflex is associated with reduced baroreflex cardiovagal regulation and driven by increased cardiac output related to enhanced preload, cardiac contractility, and splanchnic blood mobilization.

  4. Repeated topical application of growth hormone attenuates blood-spinal cord barrier permeability and edema formation following spinal cord injury: an experimental study in the rat using Evans blue, ([125])I-sodium and lanthanum tracers.

    PubMed

    Nyberg, F; Sharma, H S

    2002-01-01

    The neuroprotective efficacy of growth hormone on a focal spinal cord trauma induced alteration in the blood-spinal cord barrier (BSCB) and edema formation was examined in a rat model. Under Equithesin anaesthesia, one segment laminectomy was done over the T10-11 segments. Spinal cord injury was produced by making an incision into the right dorsal horn of the T10-11 segments (2 mm deep and 4 mm long). The animals were allowed to survive 5 h after injury. Highly purified rat growth hormone [rGH, 25 microl of a 1microg/ml solution) was applied over 10 sec topically on the exposed surface of the spinal cord 30 min before injury. The identical doses of the rGH were repeated 0 min, 30 min, 60 min, 120 min, 180 min and 240 min following injury. Saline (0.9% NaCl) treated traumatised rats at identical intervals served as controls. Traumatised rats treated with saline exhibited marked edema formation and extravasation of Evans blue and ([125])Iodine tracers in the spinal cord. At the ultrastructural level, perivascular edema and exudation of lanthanum across the endothelial cells was quite frequent in the spinal cord. Pretreatment with rGH significantly attenuated the edema formation and the extravasation of tracers in the spinal cord. In these rats, perivascular edema and infiltration of lanthanum across the endothelial cells was not much evident. These observations show that the rGH has the capacity to reduce the early manifestations of microvascular permeability disturbances and edema formation following trauma and further suggest a possible therapeutic potential of the hormone for the treatment of spinal cord injuries.

  5. Regional blood flow during continuous low-dose endotoxin infusion

    SciTech Connect

    Fish, R.E.; Lang, C.H.; Spitzer, J.A.

    1986-01-01

    Escherichia coli endotoxin (ET) was administered to adult rats by continuous IV infusion from a subcutaneously implanted osmotic pump (Alzet). Cardiac output and regional blood flow were determined by the radiolabeled microsphere method after 6 and 30 hr of ET or saline infusion. Cardiac output (CO) of ET rats was not different from time-matched controls, whereas arterial pressure was 13% lower after 30 hr of infusion. After both 6 and 30 hr of ET, pancreatic blood flow and percentage of cardiac output were lower than in controls. Estimated portal venous flow was decreased at each time point, and an increased hepatic arterial flow (significant after 30 hr) resulted in an unchanged total hepatic blood flow. Blood flow to most other tissues, including epididymal fat, muscle, kidneys, adrenals, and gastrointestinal tract, was similar between treatments. Maintenance of blood flow to metabolically important tissues indicates that the previously reported alterations in in vitro cellular metabolism are not due to tissue hypoperfusion. Earlier observations of in vitro myocardial dysfunction, coexistent with the significant impairment in pancreatic flow, raise the possibility that release of a myocardial depressant factor occurs not only in profound shock but also under less severe conditions of sepsis and endotoxemia.

  6. Regional cerebral blood flow and depersonalization after tetrahydrocannabinol administration.

    PubMed

    Mathew, R J; Wilson, W H; Chiu, N Y; Turkington, T G; Degrado, T R; Coleman, R E

    1999-07-01

    The aim of this study was to examine the relationship between depersonalization induced by tetrahydrocannabinol (THC), and regional brain activation. Cerebral blood flow (CBF) was measured by means of positron emission tomography (PET) in 59 normal right-handed volunteers before and following intravenous infusions of THC. After THC, CBF showed a global increase which was more marked in the right hemisphere, frontal lobes and anterior cingulate. Regression analyses showed positive correlations between the right frontal and anterior cingulate and depersonalization.

  7. Refined linkage map of chromosome 5 in the region of the spinal muscular atrophy gene

    SciTech Connect

    Melki, J.; Burlet, P.; Clermont, O.; Pascal, F.; Paul, B.; Abdelhak, S.; Munnich, A. ); Sherrington, R.; Gurling, H. Middlesex School of Medicine, London ); Nakamura, Yusuke ); Weissenbach, J. Genethon, Evry ); Lathrop, M. )

    1993-03-01

    The genetic map in the region of human chromosome 5 that harbors the gene for autosomal recessive forms of spinal muscular atrophy (SMA) has been refined by a multilocus linkage study in 50 SMA-segregating families. Among six markers spanning 8 cM for combined sexes, four were shown to be tightly linked to the SMA locus. Multipoing linkage analysis was used to establish the best estimate of the SMA gene location. The data suggest that the most likely location for the SMA locus is between blocks AFM114ye7 (D5S465)/EF5.15 (D5S125) and MAP-1B/JK53 (D5S112) at a sex-combined genetic distance of 2.4 and 1.7 cM, respectively. Thus the SMA gene lies in the 4-cM region between these two blocks. This information is of primary importance for designing strategies for isolating the SMA gene. 16 refs., 2 figs., 4 tabs.

  8. Regional blood flow and nociceptive stimuli in rabbits: patterning by medullary raphe, not ventrolateral medulla

    PubMed Central

    Blessing, W W; Nalivaiko, E

    2000-01-01

    Regional blood flow was measured with Doppler ultrasonic probes in anaesthetized rabbits. We used focal microinjections of pharmacological agents to investigate medullary pathways mediating ear pinna vasoconstriction elicited by electrical stimulation of the spinal tract of the trigeminal nerve or by pinching the lip, and pathways mediating mesenteric vasoconstriction elicited by electrical stimulation of the afferent abdominal vagus nerve. Bilateral injection of kynurenate into the rostral ventrolateral medulla reduced arterial pressure and prevented the mesenteric vasoconstriction and the rise in arterial pressure elicited by abdominal vagal stimulation. However, kynurenate did not prevent ear pinna vasoconstriction or the fall in pressure elicited by trigeminal tract stimulation. Similar injections of muscimol also failed to prevent the trigeminally elicited cardiovascular changes. Injections of kynurenate into the raphe–parapyramidal area did not diminish trigeminally elicited ear vasoconstriction or the depressor response. However, injections of muscimol substantially reduced or abolished the trigeminally elicited ear vasoconstriction, without affecting the depressor response. raphe–parapyramidal muscimol injections also entirely abolished ear vasoconstriction elicited by pinching the rabbit's lip. The trigeminal depressor response does not depend on either the rostral ventrolateral medulla or the raphe–parapyramidal region. Mesenteric vasoconstriction elicited by stimulation of the afferent abdominal vagus nerve is mediated via the rostral ventrolateral medulla, but ear vasoconstriction elicited by lip pinch or by stimulation of the trigeminal tract is mediated by the raphe–parapyramidal region. Our study is the first to suggest a brainstem pathway mediating cutaneous vasoconstriction elicited by nociceptive stimulation. PMID:10747198

  9. Diffusion tensor imaging of white and grey matter within the spinal cord of normal Beagle dogs: Sub-regional differences of the various diffusion parameters.

    PubMed

    Yoon, Hakyoung; Park, Noh-Won; Ha, Yun-Mi; Kim, Jaehwan; Moon, Won-Jin; Eom, Kidong

    2016-09-01

    Diffusion tensor imaging (DTI) is an advanced diffusion weighted imaging technique that can identify early stage lesions and Wallerian degeneration within the spinal cord; these changes are difficult to recognise on conventional magnetic resonance imaging (MRI). The only DTI parameters previously investigated in dogs are fractional anisotropy and mean diffusivity (MD). The aim of this study was to evaluate multiple DTI parameters in sub-regional areas of the spinal cord in normal Beagles. All imaging data were obtained from the lumbar spinal cord (L1-L3) of ten normal dogs using a 3 Tesla MRI scanner. Transverse multi-shot echo planar imaging sequences (b values = 0 and 800 s/mm(2); 12 directions) were used for DTI. Regions of interest were selected from sub-regions of the white and grey matter, and from the whole spinal cord, in the transverse plane in all DTI maps. The DTI parameters in spinal cord sub-regions in the transverse plane were significantly different amongst the white matter, grey matter and whole spinal cord (P < 0.05 for all DTI parameters except MD), as well as between white matter sub-regions (P < 0.05 for most DTI parameters except radial diffusivity, MD and planar index). DTI-based sub-regional analysis of white and grey matter may be useful for regional evaluation of the dog spinal cord.

  10. The Blood Testis Barrier and Male Sexual Dysfunction following Spinal Cord Injury

    DTIC Science & Technology

    2015-10-01

    21702-5012 Approved for Public Release; Distribution Unlimited Nearly 70% of males exhibit a profound loss of fertility following spinal cord injury... fertility . This should be clearly understood to be separate from SCI-dependent erectile dysfunction that is due to a loss of neural input into the male... fertility via FXR- (farnesoid X receptor alpha) and TGR5 (G-protein- coupled bile acid receptor 1; GPBAR1) receptor signaling in mice, causing sloughing

  11. Respiratory and cardiovascular responses of the exercising chicken to spinal cord cooling at different ambient temperatures. I. Cardiovascular responses and blood gases.

    PubMed

    Barnas, G M; Gleeson, M; Rautenberg, W

    1985-01-01

    We measured oxygen consumption (VO2), heart rate (HR), stroke volume (SV), cardiac output (CO) and mean arterial blood pressure (MBPa) of chickens during 15 min treadmill exercise at 0.5 ms-1 and 0.8 ms-1 at thermoneutral (23 degrees C), low (9 degrees C) and high (34 degrees C) ambient temperature (Ta); the vertebral canal was cooled to 34 degrees C during the middle 5 min of each exercise period. PO2, PCO2, pH and oxygen content (CO2) of the arterial and mixed venous blood were also measured. VO2 during exercise was not significantly affected by Ta. Spinal cord cooling produced definite increases in VO2, CO and SV during 0.5 ms-1 exercise at 9 degrees C; otherwise, effects of spinal cord cooling were not significant. HR, SV and CO were all linearly related to VO2; these relationships were unaffected by spinal cord cooling or Ta. Blood pressure did not increase during exercise. PaCO2 and P-vCO2 did not increase significantly during exercise. The arterial-venous CO2 difference was increased by exercise only at 34 degrees C. The chickens generally hyperventilated at 34 degrees C Ta compared to the other Ta values. No consistent effect on blood gases or on pH and CO2 of the blood could be attributed to spinal cord cooling.

  12. Analysis of inventory strategies for blood components in a regional blood center using process simulation.

    PubMed

    Baesler, Felipe; Nemeth, Matías; Martínez, Cristina; Bastías, Alfonso

    2014-02-01

    The storage of blood components is an important concern in the blood supply chain. Because these are perishable products, the definition of good inventory policies is crucial to reduce shortages and spills. To analyze and propose inventory policies in a regional blood center, a discrete event simulation model was created using simulation software (Arena 12.0, Rockwell Software). The model replicates the activities that are performed along the supply chain including donation arrivals, testing, production, inventory management, and dispatching. Twelve different scenarios were analyzed, with each one representing different inventory policies composed of a combination of an optimal inventory, a reorder point, and a level of extra donations. The best scenario demonstrates that it is possible to decrease unsatisfied demand and wastage of red blood cell units by 2.5 and 3%, respectively, when compared to current practices. This study shows that simulation is an alternative that can be used to model inventory components in blood centers. A responsible selection of inventory variables can improve the capability of the system to respond to the final patient requirements. © 2013 American Association of Blood Banks.

  13. PEGlated magnetic polymeric liposome anchored with TAT for delivery of drugs across the blood-spinal cord barrier.

    PubMed

    Wang, Hanjie; Zhang, Shuangnan; Liao, Zhenyu; Wang, Chunyuan; Liu, Yang; Feng, Shiqing; Jiang, Xinguo; Chang, Jin

    2010-09-01

    Due to the existence of the blood-spinal cord barrier (BSCB), many therapeutic macromolecular agents, such as drugs, protein and gene, cannot pass through this barrier to reach the site of injury, all of which restricts the treatment of spinal cord injuries (SCI). In this study, TAT-conjugated PEGlated Magnetic polymeric liposomes (TAT-PEG-MPLs) formed from PEGlated amphiphilic octadecyl quaternized carboxymethyl chitosan (PEG-OQCMC), cholesterol (Chol), superparamagnetic nanoparticles, and transactivating-transduction protein (TAT), were prepared successfully and evaluated the properties in vitro and in vivo. The result indicated that TAT-PEG-MPLs were spherical in solution, with significantly small mean diameter (83.2 nm) and excellent magnetism (magnetization saturation values of 43.5 emu/g). In vitro experiment, the uptake of PEG-MPLs with TAT by MCF-7 cells was greater than that of the PEG-MPLs without TAT. Most importantly, in vivo experiment, a low MRI signal was observed in the T(2)-weighted images; Histological analysis, Cryo-TEM and flame atomic absorption spectrophotometry revealed that TAT-PEG-MPLs nanoparticles significantly accumulated around the site of the SCI even inside the nerve cells. These nanoparticles may provide a promising carrier to locate to the lesion site, deliver therapeutic macromolecular agents across the BSCB and penetrate into the nerve cells for the treatment of SCI. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

  14. Patients' perceptions of their roles in goal setting in a spinal cord injury regional rehabilitation program.

    PubMed

    Draaistra, Harriett; Singh, Mina D; Ireland, Sandra; Harper, Theresa

    2012-01-01

    Goal setting is a common practice in rehabilitation, yet there is a paucity of literature exploring patients' perceptions of their roles in this process. This study was conducted using a qualitative descriptive methodology to explore patients' perceptions of their roles in setting goals in a spinal cord injury regional rehabilitation program. Imogene King's theory of goal attainment was used to frame the study. Data were collected through interviews and analyzed using a content analysis. The results revealed four themes: Visioning, Redefining, Brainstorming, and Rebuilding Participants (n = 13) envisioned their roles as setting an overarching priority goal, defining detailed rehabilitation goals, sharing knowledge with the team, and rebuilding skills to attain goals. Implications for nursing practice include the need to understand patients' experiences and perceptions, share knowledge, and support effective communication to promote collaborative goal setting. A need to enhance health professionals' education to fully understand factors influencing patients' abilities to set rehabilitation goals, and future research in methods to promote patients' engagement in goal setting was also clearly indicated.

  15. [Carrier screening for spinal muscular atrophy in 4719 pregnant women in Shanghai region].

    PubMed

    Gong, Bo; Zhang, Li; Hou, Ya-ping; Hu, He-yu; Li, Hai-chuan; Tan, Mei-yu; Chen, Jin; Yu, Jing

    2013-12-01

    Spinal muscular atrophy (SMA) is a common and fatal autosomal recessive disorder. Approximately 94% of SMA patients are caused by homozygous deletion of SMN1 gene. SMA carrier screening is recommended considering the high carrier frequency (1 in 35-50) as well as severity of the disease. A prospective population-based cohort study was carried out on 4719 pregnant women from Shanghai region. Copy numbers of SMN1 and SMN2 genes were effectively determined with denaturing high performance liquid chromatography (DHPLC) technique. The method has detected 94% of SMA cases with deletion or conversion of the SMN1 genes. Ninety SMA carriers with only one copy of the SMN1 gene were identified among the 4719 pregnant woman. The carrier rate was 1.9%. Respectively, 1.2% and 0.6% of the carriers were caused by SMN1 gene deletion and SMN1 gene conversion. Through this study, we have determined the frequency of SMA mutation carriers in a population of pregnant women. The result may provide a basis for genetic counseling in order to reduce the rate of SMA affected births.

  16. Physical and transcriptional mapping of the spinal muscular atrophy disease gene region

    SciTech Connect

    Brahe, C.; Zappata, S.; Anzevino, R.

    1994-09-01

    The locus responsible for childhood-onset spinal muscular atrophies (SMA) has recently been mapped to an area of approximately 1.6 Mb at 5q13, flanked by the loci D5S435 and D5S557. From this region we have isolated cosmids derived from four different libraries, one constructed from a radiation hybrid and the other three from large overlapping YACs (Y116, Y122 and Y97) covering approximately 1.3 Mb of the YAC contig established by Kleyn et al. (1993). Pulsed field maps were constructed of these YACs and the cosmids were located and aligned in partial contigs. To identify genes we screened the cosmids both for the presence of exons using oligonucleotides corresponding to splice-site junctions and for the presence of evolutionarily conserved sequences. So far we detected a 5{prime} splice site in two sets of overlapping clones. Partial sequencing of subclones revealed long open reading frames, displaying no homology with known sequences. Conserved sequences were found in one of these and three additional cosmids. These DNA fragments potentially mark the sites of candidate SMA genes. Isolation of corresponding cDNAs is in progress.

  17. Meso-diencephalic regions projecting to spinal cord and dorsal column nuclear complex in the hedgehog-tenrec, Echinops telfairi.

    PubMed

    Künzle, H

    1992-01-01

    The distribution of neurons projecting to the spinal cord and dorsal column nuclear complex was investigated in the mesodiencephalic regions of the lesser hedgehog-tenrec, Echinops telfairi (Insectivora) by using the retrograde flow technique. While only few neurons projected to the dorsal column nuclear complex, numerous cells were found to give rise to spinal projections. Rubro-spinal neurons of various sizes were distributed over the entire rostrocaudal extent of the contra-lateral nucleus; a few neurons were also located ipsilaterally, Unlike that of the opossum, the projection appeared to be somatotopically organised. Interstitio-spinal neurons were differentiated into several subpopulations according to their location and laterality of projection. In the ipsilateral periventricular grey, in addition, there was a distinct population of cells possibly corresponding to the nucleus of Darkschewitsch. The mesencephalic central grey contained relatively few labeled neurons, the great majority of them being mesencephalic trigeminal, ectopic cuneiform or midline cells. Labeled cuneiform and midline cells, on the other hand, were quite numerous, extending both from a level just caudal to the trochlear nucleus to levels far beyond the rostral tip of the somatic oculomotor nucleus. The discrepancy between the poorly differentiated oculomotor nuclei and the apparently well-developed Edinger-Westphal complex is discussed. Hypothalamo-spinal neurons were essentially restricted to dorsal regions: the hypothalamic paraventricular nucleus (PAV), the dorso-medial (DmHy) and dorso-intermediate cell groups as well as the lateral hypothalamic zone. The latter two cell groups were bilaterally labeled, while the labeled neurons in DmHy and PAV were located predominantly ipsilaterally. Labeled neurons in the amygdala, colliculus superior and mesencephalic trigeminal nucleus were only found following cervical injections; all other mentioned areas and the posterior commissure complex

  18. Quantifying cerebral blood flow: regional regulation with global implications.

    PubMed

    Small, Scott A

    2004-10-01

    In 1948, Seymour S. Kety and Carl F. Schmidt published back-to-back papers in the JCI that are widely acknowledged as landmarks. Upon publication, the studies resolved a century-old debate, irrefutably demonstrating that cerebral blood flow is regionally regulated. The reported findings turned out to be so powerful in their implications that they provided the inspirational spark that illuminated a brand-new field: functional brain imaging. Thus these papers are landmarks of the rarest kind, not only ending a controversy, but also giving birth to one of the most exciting fields within modern day neuroscience.

  19. The Non-Invasive Measurement of Regional Cerebral Blood Flow

    PubMed Central

    Wilson, Edwin M.; Wills, Edward L.

    1977-01-01

    The non-invasive, repeatable measurement of bilateral, regional cerebral blood flow in man is achieved through the application of the 133xenon inhalation method. The clinical utility of the methodology is enhanced by integrating the method into a computer system which combines on-line data acquisition with rapid data analysis and display. The subsequent statistical analysis of the results from specific patient categories and normal populations is facilitated by a computerized data base coupled with the primary computer system. ImagesFig. 2

  20. Sequential assessment of regional cerebral blood flow, regional cerebral blood volume, and blood-brain barrier in focal cerebral ischemia: a case report

    SciTech Connect

    Di Piero, V.; Perani, D.; Savi, A.; Gerundini, P.; Lenzi, G.L.; Fazio, F.

    1986-06-01

    Regional CBF (rCBF) and regional cerebral blood volume (rCBV) were evaluated by N,N,N'-trimethyl-N'-(2)-hydroxy-3-methyl-5-(123I)iodobenzyl-1, 3-propanediamine-2 HCl- and /sup 99m/TC-labeled red blood cells, respectively, and single-photon emission computerized tomography (SPECT) in a patient with focal cerebral ischemia. Sequential transmission computerized tomography (TCT) and SPECT functional data were compared with clinical findings to monitor the pathophysiological events occurring in stroke. A lack of correlation between rCBF-rCBV distributions and blood-brain barrier (BBB) breakdown was found in the acute phase. In the face of more prolonged alteration of BBB, as seen by TCT enhancement, a rapid evolution of transient phenomena such as luxury perfusion was shown by SPECT studies. Follow-up of the patient demonstrated a correlation between the neurological recovery and a parallel relative improvement of the cerebral perfusion.

  1. Surgical treatment of spinal lipoma without spina bifida at lumbar region-three case reports-.

    PubMed

    Sugawara, Atsushi; Kim, Kyongsong; Isobe, Masanori; Matsumoto, Ryoji; Isu, Toyohiko

    2009-12-01

    Three men aged 40 to 60 years presented with rare lumbar spinal intradural lipomas without spina bifida manifesting as worsening numbness, pain of the lower extremities, and bladder dysfunction. All 3 patients underwent decompressive laminectomy. The lipoma and cauda equina nerves were dissected from the dura mater under the operating microscope, untethering the spinal cord and returning the cauda equina nerves to the original position. Duralplasty was performed using an expanded polytetrafluoroethylene sheet. Postoperatively, all patients experienced improvement of their neurological deficits. In the surgical treatment of spinal lipomas, the primary purpose is untethering and decompression, which can be achieved by untethering the spinal cord, returning the cauda equina nerves to the normal position, laminectomy, and duralplasty, without removal of the lipoma.

  2. Regional brain blood flow in man during acute changes in arterial blood gases

    PubMed Central

    Willie, C K; Macleod, D B; Shaw, A D; Smith, K J; Tzeng, Y C; Eves, N D; Ikeda, K; Graham, J; Lewis, N C; Day, T A; Ainslie, P N

    2012-01-01

    Despite the importance of blood flow on brainstem control of respiratory and autonomic function, little is known about regional cerebral blood flow (CBF) during changes in arterial blood gases. We quantified: (1) anterior and posterior CBF and reactivity through a wide range of steady-state changes in the partial pressures of CO2 () and O2 () in arterial blood, and (2) determined if the internal carotid artery (ICA) and vertebral artery (VA) change diameter through the same range. We used near-concurrent vascular ultrasound measures of flow through the ICA and VA, and blood velocity in their downstream arteries (the middle (MCA) and posterior (PCA) cerebral arteries). Part A (n= 16) examined iso-oxic changes in , consisting of three hypocapnic stages (=∼15, ∼20 and ∼30 mmHg) and four hypercapnic stages (=∼50, ∼55, ∼60 and ∼65 mmHg). In Part B (n= 10), during isocapnia, was decreased to ∼60, ∼44, and ∼35 mmHg and increased to ∼320 mmHg and ∼430 mmHg. Stages lasted ∼15 min. Intra-arterial pressure was measured continuously; arterial blood gases were sampled at the end of each stage. There were three principal findings. (1) Regional reactivity: the VA reactivity to hypocapnia was larger than the ICA, MCA and PCA; hypercapnic reactivity was similar. With profound hypoxia (35 mmHg) the relative increase in VA flow was 50% greater than the other vessels. (2) Neck vessel diameters: changes in diameter (∼25%) of the ICA was positively related to changes in (R2, 0.63 ± 0.26; P < 0.05); VA diameter was unaltered in response to changed but yielded a diameter increase of +9% with severe hypoxia. (3) Intra- vs. extra-cerebral measures: MCA and PCA blood velocities yielded smaller reactivities and estimates of flow than VA and ICA flow. The findings respectively indicate: (1) disparate blood flow regulation to the brainstem and cortex; (2) cerebrovascular resistance is not solely modulated at the level of the arteriolar pial vessels; and (3

  3. [Hemodynamic and respiratory conditions of patients with obstetric fistulae operated under spinal anesthesia at the Regional Reference Hospital in Manakara, Madagascar].

    PubMed

    Martinetti, Andrianimaro Florelia; Franklin, Rabenjarison; Lalao, Randriamboavonjy Rado; Judicael, Harioly Nirina Marie Osé; Yvonne, Rasolonjatovo Tsiorintsoa; Andriambelo, Rajaonera Tovohery; Nicole, Rakotoarison Ratsaraharimanana Catherine; Enintsoa, Raveloson Nasolotsiry; Edwige, Ravaomanana

    2016-01-01

    The objective was to evaluate the hemodynamic and respiratory conditions of patients who had undergone obstetric fistula surgery and to report our experience in the management of these patients. We conducted a descriptive cross-sectional study in the Operating Room and Intensive Care Unit of the Regional Reference Hospital in Manakara from 20 to 30 August 2013. All patients who had undergone obstetric fistula surgery under spinal anesthesia were included in the study. We excluded patients classified as ASA> 2 and those with cardiovascular or respiratory disorders. After pre-anesthetic consultation and preoperative assessments, patients received bupivacaine 12.5 mg with adrenaline 0,5% isobar intrathecal. They were placed in the Trendelenburg position for 5 minutes after the injection of anesthesia and during surgery. Intraoperative sensory level, blood pressure, heart rate, respiratory rate and peripheral capillary oxygen saturation (SpO2) were recorded. 57 patients were retained. The sensory and motor block were excellent in all patients. A metameric level higher than T6 was achieved in 56.36% of patients. Despite a few episodes of hypertension and tachycardia, no patient had respiratory or cardiovascular problems associated with Trendelenburg position. Only sensory level and respiratory rate showed a correlation with Trendelenburg position (p=0,01). This study suggests that Trendelenburg position can be used during spinal anesthesia if an appropriate anesthetic is administered, paying particular attention to changes in position and taking into account the pre-anesthetic examination.

  4. Regional blood flows in running normotensive and renal hypertensive dogs.

    PubMed

    Liard, J F

    1986-08-01

    The influence of short-term hypertension on the haemodynamic response to exercise was studied by measuring arterial pressure and regional blood flow (radio-active microspheres) in dogs at two levels of treadmill exercise (5 km/h at 0 degrees and 10 km/h at 4.5 degrees). One group of dogs (n = 5) had one-kidney, one clip hypertension of 1-week duration and was compared to normotensive controls (n = 5). Both groups exhibited similar increases in heart rate, but arterial pressure increased only in the normotensive dogs. Left ventricular myocardial blood flow increased significantly in both groups. However, the increase was more pronounced in the hypertensive dogs. In some groups of active skeletal muscles (biceps brachii, tibialis cranialis), increases in blood flow in excess of 30-fold were observed during exercise in normotensive animals. Several muscles showed exaggerated increases in flow in hypertensive dogs. Perfusion of the brain, the kidneys and the splanchnic area was not compromised in either group of dogs. We conclude that in one-kidney, one clip hypertension of 1-week duration, when structural cardiovascular changes are presumably far from being completely developed, vasodilatation to increased metabolic demands in the myocardium and in most skeletal muscles is not limited in response to mild to moderate levels of exercise, and that perfusion of other vascular beds is not compromised.

  5. Monoamine Release in the Cat Lumbar Spinal Cord during Fictive Locomotion Evoked by the Mesencephalic Locomotor Region.

    PubMed

    Noga, Brian R; Turkson, Riza P; Xie, Songtao; Taberner, Annette; Pinzon, Alberto; Hentall, Ian D

    2017-01-01

    Spinal cord neurons active during locomotion are innervated by descending axons that release the monoamines serotonin (5-HT) and norepinephrine (NE) and these neurons express monoaminergic receptor subtypes implicated in the control of locomotion. The timing, level and spinal locations of release of these two substances during centrally-generated locomotor activity should therefore be critical to this control. These variables were measured in real time by fast-cyclic voltammetry in the decerebrate cat's lumbar spinal cord during fictive locomotion, which was evoked by electrical stimulation of the mesencephalic locomotor region (MLR) and registered as integrated activity in bilateral peripheral nerves to hindlimb muscles. Monoamine release was observed in dorsal horn (DH), intermediate zone/ventral horn (IZ/VH) and adjacent white matter (WM) during evoked locomotion. Extracellular peak levels (all sites) increased above baseline by 138 ± 232.5 nM and 35.6 ± 94.4 nM (mean ± SD) for NE and 5-HT, respectively. For both substances, release usually began prior to the onset of locomotion typically earliest in the IZ/VH and peaks were positively correlated with net activity in peripheral nerves. Monoamine levels gradually returned to baseline levels or below at the end of stimulation in most trials. Monoamine oxidase and uptake inhibitors increased the release magnitude, time-to-peak (TTP) and decline-to-baseline. These results demonstrate that spinal monoamine release is modulated on a timescale of seconds, in tandem with centrally-generated locomotion and indicate that MLR-evoked locomotor activity involves concurrent activation of descending monoaminergic and reticulospinal pathways. These gradual changes in space and time of monoamine concentrations high enough to strongly activate various receptors subtypes on locomotor activated neurons further suggest that during MLR-evoked locomotion, monoamine action is, in part, mediated by extrasynaptic neurotransmission in

  6. Interactive retinal blood flow analysis of the macular region.

    PubMed

    Tian, Jing; Somfai, Gábor Márk; Campagnoli, Thalmon R; Smiddy, William E; Debuc, Delia Cabrera

    2016-03-01

    The study of retinal hemodynamics plays an important role to understand the onset and progression of diabetic retinopathy. In this work, we developed an interactive retinal analysis tool to quantitatively measure the blood flow velocity (BFV) and blood flow rate (BFR) in the macular region using the Retinal Function Imager (RFI). By employing a high definition stroboscopic fundus camera, the RFI device is able to assess retinal blood flow characteristics in vivo. However, the measurements of BFV using a user-guided vessel segmentation tool may induce significant inter-observer differences and BFR is not provided in the built-in software. In this work, we have developed an interactive tool to assess the retinal BFV and BFR in the macular region. Optical coherence tomography data was registered with the RFI image to locate the fovea accurately. The boundaries of the vessels were delineated on a motion contrast enhanced image and BFV was computed by maximizing the cross-correlation of pixel intensities in a ratio video. Furthermore, we were able to calculate the BFR in absolute values (μl/s). Experiments were conducted on 122 vessels from 5 healthy and 5 mild non-proliferative diabetic retinopathy (NPDR) subjects. The Pearson's correlation of the vessel diameter measurements between our method and manual labeling on 40 vessels was 0.984. The intraclass correlation (ICC) of BFV between our proposed method and built-in software was 0.924 and 0.830 for vessels from healthy and NPDR subjects, respectively. The coefficient of variation between repeated sessions was reduced significantly from 22.5% to 15.9% in our proposed method (p<0.001). Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Interactive Retinal Blood Flow Analysis of the Macular Region

    PubMed Central

    Tian, Jing; Somfai, Gábor Márk; Campagnoli, Thalmon R.; Smiddy, William E.; Debuc, Delia Cabrera

    2015-01-01

    The study of retinal hemodynamics plays an important role to understand the onset and progression of diabetic retinopathy which is a leading cause of blindness in American adults. In this work, we developed an interactive retinal analysis tool to quantitatively measure the blood flow velocity (BFV) and blood flow rate (BFR) in the macular region using the Retinal Function Imager (RFI-3005, Optical Imaging, Rehovot, Israel). By employing a high definition stroboscopic fundus camera, the RFI device is able to assess retinal blood flow characteristics in vivo even in the capillaries. However, the measurements of BFV using a user-guided vessel segmentation tool may induce significant inter-observer differences and BFR is not provided in the built-in software. In this work, we have developed an interactive tool to assess the retinal BFV as well as BFR in the macular region. Optical coherence tomography (OCT) data from commercially available devices were registered with the RFI image to locate the fovea accurately. The boundaries of the vessels were delineated on a motion contrast enhanced image and BFV was computed by maximizing the cross-correlation of pixel intensities in a ratio video. Furthermore, we were able to calculate the BFR in absolute values (μl/s) which other currently available devices targeting the retinal microcirculation are not yet capable of. Experiments were conducted on 122 vessels from 5 healthy and 5 mild non-proliferative diabetic retinopathy (NPDR) subjects. The Pearson's correlation of the vessel diameter measurements between our method and manual labeling on 40 vessels was 0.984. The intraclass correlation (ICC) of BFV between our proposed method and built-in software were 0.924 and 0.830 for vessels from healthy and NPDR subjects, respectively. The coefficient of variation between repeated sessions was reduced significantly from 22.5% in the RFI built-in software to 15.9% in our proposed method (p<0.001). PMID:26569349

  8. Massive Blood Transfusion during Revision Total Hip Arthroplasty under Combined Spinal Epidural Anaesthesia

    PubMed Central

    Kandemir, Tünay; Kandemir, Erbin; Aşkın, Tuğba; Dal, Tülay; Kılıç, Yeliz; Ünver, Süheyla

    2016-01-01

    Revision total hip arthroplasty (THA) is an orthopaedic surgery that is known to be associated with excessive bleeding. The rates of mortality and morbidity are high in patients with massive haemorrhage. The patient in this study was administered blood products with high fresh frozen plasma/red blood cell (RBC) suspension ratio and high platelet/RBC suspension ratio without waiting for haemostasis test results. This study suggests that this approach might prove beneficial in reducing the incidence of intra- and postoperative complications. this study presents our experience with a patient who underwent THA and required a transfusion that was three times her estimated total blood volume. The patient was successfully managed with close monitoring of haemorrhage and timely administration of blood and blood products before hypotension and loss of consciousness occurred. PMID:27366558

  9. Effect of fluorocarbon-for-blood exchange on regional blood flow in rats

    SciTech Connect

    Lee, P.A.; Sylvia, A.L.; Piantadosi, C.A. )

    1988-04-01

    Cerebrocirculatory responses to total perfluorocarbon (FC-43)-for-blood replacement were studied in anesthetized, ventilated rats breathing 100% O{sub 2}. Changes in total and regional cerebral blood flow (CBF) were measured using the radiolabeled-microsphere technique. The data were compared with two control groups of hemoglobin-circulated animals; one group was exposed to arterial hypoxia and the other to isovolemic hemodilution with Krebs-Henseleit-albumin (KHA) solution. Exchange transfusion with FC-43 doubled total and regional CBF, causing preferential flow increases to the cortex and cerebellum. Estimated cerebrovascular resistance fell to 50% of the preexchange value. Both hemodilution and hypoxia control experiments produced CBF responses similar to those obtained in FC-43 animals. Although calculated arterial O{sub 2} contents in all three groups of animals were similar, blood viscosity was normal in hypoxic rats and reduced in KHA and FC-43 animals. Since arterial and cerebrovenous Po{sub 2}s were both high in fluorocarbon-circulated rats, over results suggest that decreased O{sub 2} content and perhaps lower viscosity of the circulating fluorocarbon were responsible for increases in CBF required to maintain sufficient delivery of O{sub 2} to the brain.

  10. Spinal cord stimulation in adolescents with complex regional pain syndrome type I (CRPS-I).

    PubMed

    Olsson, Gunnar L; Meyerson, Björn A; Linderoth, Bengt

    2008-01-01

    Complex regional pain syndrome type I (CRPS-I) is not uncommon in children, particularly in adolescent girls. Most often, the condition involves a foot and is characterized by spontaneous pain, tactile allodynia and dysautonomic signs. There is usually a history of a minor, local trauma but sometimes no reasonable cause can be identified, and there are no signs of persistent tissue injury giving rise to ongoing nociception. Common analgesics are generally of no benefit, and the standard treatment includes sociopsychological support, physiotherapy, tricyclic antidepressants and antiepileptic drugs, sympathetic blocks (SB), and cognitive-behavioural therapy. For a minority of patients who prove to be resistant to such therapies, spinal cord stimulation (SCS) may be tried. The present study comprises seven girls, 11-14 years of age, presenting with severe, incapacitating and therapy-resistant CRPS-I, who were subjected to SCS. In two of them, percutaneous electrode implantation had to be performed in general anaesthesia. Trial stimulation was performed in all, but one. In two cases, it was not possible to produce paraesthesias that entirely covered the pain area. A pain relieving effect of SCS was usually not reported until after 1-2 weeks of trial stimulation. After another 2-6 weeks, pain alleviation was complete in five of the seven patients, one to eight years after the intervention. In one case, a local infection necessitated the removal of the electrode; nevertheless a few days of trial stimulation produced substantial pain relief that still persists. In four patients, the SCS use was gradually diminished and eventually the device could be removed. The favourable outcome in all seven cases with no or minor remaining symptoms and without severe recurrences illustrates that SCS may also be an efficient treatment in paediatric cases with exceptionally therapy resistant forms of CRPS I.

  11. Predictors of allogeneic blood transfusion in spinal fusion for pediatric patients with idiopathic scoliosis in the United States, 2004-2009.

    PubMed

    Yoshihara, Hiroyuki; Yoneoka, Daisuke

    2014-10-15

    Analysis of population-based National Hospital Discharge Survey data collected for the Nationwide Inpatient Sample. To examine the predictors of allogeneic blood transfusion (ALBT) in spinal fusion for pediatric patients with idiopathic scoliosis. Spinal fusion for pediatric patients with idiopathic scoliosis is associated with major blood loss and often necessitates ALBT. The Nationwide Inpatient Sample was used to identify pediatric patients with idiopathic scoliosis who underwent spinal fusion from 2004 to 2009, using the International Classification of Diseases, Ninth Revision, Clinical Modification codes. Then, patients who received ALBT were identified using the appropriate International Classification of Diseases, Ninth Revision, Clinical Modification code. Patient demographics, surgical variables, and hospital characteristics were retrieved. Multivariate logistic regression analysis was performed to identify the predictors of ALBT in spinal fusion for pediatric patients with idiopathic scoliosis. The odds ratio (OR) increased with increasing Elixhauser Comorbidity Score (score 1: OR, 1.55; 95% confidence interval [95% CI], 1.23-1.97; score 2: OR, 2.23; 95% CI, 1.69-2.93; score 3: OR, 2.73; 95% CI, 1.6-4.66; score≥4: OR, 4.18; 95% CI, 1.93-9.06). Patients who underwent posterior approach or anterior and posterior approach surgical procedures were more likely to receive ALBT compared with those who underwent anterior approach surgery (posterior: OR, 2.24; 95% CI, 1.22-4.08; anterior and posterior: OR, 3.35; 95% CI, 1.69-6.63). Patients with a spinal fusion of 9 or more levels were more likely to receive ALBT compared with those with a spinal fusion of 4 to 8 levels (OR, 1.39; 95% CI, 1.05-1.85). There was no difference between patients with or without autologous-related blood transfusion (OR, 0.92; 95% CI, 0.59-1.43). This study identified significant predictors of ALBT in spinal fusion for pediatric patients with idiopathic scoliosis. These factors need to

  12. Total knee replacement induces peripheral blood lymphocytes apoptosis and it is not prevented by regional anesthesia - a randomized study.

    PubMed

    Kosel, Juliusz; Rusak, Małgorzata; Gołembiewski, Łukasz; Dąbrowska, Milena; Siemiątkowski, Andrzej

    2016-01-01

    Among the many changes caused by a surgical insult one of the least studied is postoperative immunosuppression. This phenomenon is an important cause of infectious complications of surgery such as surgical site infection or hospital acquired pneumonia. One of the mechanisms leading to postoperative immunosuppression is the apoptosis of immunological cells. Anesthesia during surgery is intended to minimize harmful changes and maintain perioperative homeostasis. The aim of the study was evaluation of the effect of the anesthetic technique used for total knee replacement on postoperative peripheral blood lymphocyte apoptosis. 34 patients undergoing primary total knee replacement were randomly assigned to two regional anesthetic protocols: spinal anesthesia and combined spinal-epidural anesthesia. 11 patients undergoing total knee replacement under general anesthesia served as control group. Before surgery, immediately after surgery, during first postoperative day and seven days after the surgery venous blood samples were taken and the immunological status of the patient was assessed with the use of flow cytometry, along with lymphocyte apoptosis using fluorescent microscopy. Peripheral blood lymphocyte apoptosis was seen immediately in the postoperative period and was accompanied by a decrease of the number of T cells and B cells. There were no significant differences in the number of apoptotic lymphocytes according to the anesthetic protocol. Changes in the number of T CD3/8 cells and the number of apoptotic lymphocytes were seen on the seventh day after surgery. Peripheral blood lymphocyte apoptosis is an early event in the postoperative period that lasts up to seven days and is not affected by the choice of the anesthetic technique. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  13. [Total knee replacement induces peripheral blood lymphocytes apoptosis and it is not prevented by regional anesthesia - a randomized study].

    PubMed

    Kosel, Juliusz; Rusak, Małgorzata; Gołembiewski, Łukasz; Dąbrowska, Milena; Siemiątkowski, Andrzej

    2016-01-01

    Among the many changes caused by a surgical insult one of the least studied is postoperative immunosuppression. This phenomenon is an important cause of infectious complications of surgery such as surgical site infection or hospital acquired pneumonia. One of the mechanisms leading to postoperative immunosuppression is the apoptosis of immunological cells. Anesthesia during surgery is intended to minimize harmful changes and maintain perioperative homeostasis. The aim of the study was evaluation the effect of the anesthetic technique used for total knee replacement on postoperative peripheral blood lymphocyte apoptosis. 34 patients undergoing primary total knee replacement were randomly assigned to two regional anesthetic protocols: spinal anesthesia and combined spinal-epidural anesthesia. 11 patients undergoing total knee replacement under general anesthesia served as control group. Before surgery, immediately after surgery, during first postoperative day and seven days after the surgery venous blood samples were taken and the immunological status of the patient was assessed with the use of flow cysts 87 m, along with lymphocyte apoptosis using fluorescent microscopy. Peripheral blood lymphocyte apoptosis was seen immediately in the postoperative period and was accompanied by a decrease of the number of T cells and B cells. There were no significant differences in the number of apoptotic lymphocytes according to the anesthetic protocol. Changes in the number of T CD3/8 cells and the number of apoptotic lymphocytes were seen on the seventh day after surgery. Peripheral blood lymphocyte apoptosis is an early event in the postoperative period lasts up to seven days and is not affected by the choice of the anesthetic technique. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  14. Bipolar Sealer Device Reduces Blood Loss and Transfusion Requirements in Posterior Spinal Fusion for Degenerative Lumbar Scoliosis: A Randomized Control Trial.

    PubMed

    Wang, Xuesong; Sun, Gang; Sun, Ruifu; Ba, Chenglei; Gong, Xiaojin; Liu, Weibo; Zhai, Rui

    2016-03-01

    A prospective, randomized, controlled clinical study. To determine the efficacy of bipolar sealer device in reducing perioperative blood loss and transfusions in degenerative lumbar scoliosis patients undergoing primary posterior spinal fusion. It has recently been used successfully in pediatric spine surgery, particularly in idiopathic and neuromuscular deformities. However, there is a dearth of literature on prospective study of the efficacy of bipolar sealer device in reducing perioperative blood loss and transfusions in patients undergoing degenerative lumbar scoliosis surgery. A total of 100 consecutive degenerative lumbar scoliosis patients who had undergone primary decompression and posterior spinal fusion with segmental spinal instrumentation between June 2010 and June 2012 were prospectively randomized into 1 of 2 groups according to whether bipolar sealer device for intraoperative/postoperative blood management was used or not. Demographic distribution, perioperative blood loss, blood transfusion rate, the length of stay, and postoperative complications were analyzed. The operation time was significantly shorter in the study group than in the control group, 223.4 versus 248.9 minutes (P=0.026). There was significantly lower intraoperative estimated blood loss in the bipolar sealer group, 407 versus 696 mL (P=0.000). Of the patients with the use of bipolar sealer device, the mean red blood cell transfusion requirement during hospitalization was significantly less than the control group, 0.4 versus 1.1 U/patient (P=0.003). Furthermore, significant difference existed in allogenic blood transfusion rate between the 2 cohorts. Within the study group (with the use of bipolar sealer device), the entire perioperative allogenic blood transfusion rate was 18.0% compared with 40.0% of the control group (P=0.015). There were no complications related directly to the use of the bipolar sealer. Utilization of a bipolar sealer during correction of lumbar degenerative

  15. Anatomical mechanism of spontaneous recovery in regions caudal to thoracic spinal cord injury lesions in rats

    PubMed Central

    Li, Lu-sheng; Yu, Hao; Raynald, Raynald; Wang, Xiao-dong; Dai, Guang-hui; Cheng, Hong-bin; Liu, Xue-bin

    2017-01-01

    Background The nerve fibre circuits around a lesion play a major role in the spontaneous recovery process after spinal cord hemisection in rats. The aim of the present study was to answer the following question: in the re-control process, do all spinal cord nerves below the lesion site participate, or do the spinal cord nerves of only one vertebral segment have a role in repair? Methods First we made a T7 spinal cord hemisection in 50 rats. Eight weeks later, they were divided into three groups based on distinct second operations at T7: ipsilateral hemisection operation, contralateral hemisection, or transection. We then tested recovery of hindlimbs for another eight weeks. The first step was to confirm the lesion had role or not in the spontaneous recovery process. Secondly, we performed T7 spinal cord hemisections in 125 rats. Eight weeks later, we performed a second single hemisection on the ipsilateral side at T8–T12 and then tested hindlimb recovery for another six weeks. Results In the first part, the Basso, Beattie, Bresnahan (BBB) scores and the electrophysiology tests of both hindlimbs weren’t significantly different after the second hemisection of the ipsilateral side. In the second part, the closer the second hemisection was to T12, the more substantial the resulting impairment in BBB score tests and prolonged latency periods. Conclusions The nerve regeneration from the lesion area after hemisection has no effect on spontaneous recovery of the spinal cord. Repair is carried out by all vertebrae caudal and ipsilateral to the lesion, with T12 being most important. PMID:28097067

  16. Ictal regional cerebral blood flow in frontal lobe seizures.

    PubMed

    Duncan, R; Patterson, J; Hadley, D; Roberts, R

    1997-10-01

    99mTC (single photon emission computed tomography) (HMPAO SPECT) was carried out during 16 frontal-lobe seizures in 15 patients. Focal changes in regional cerebral blood flow were seen during all seizures. In 9 of 16 seizures SPECT showed hyperperfusion localized to one frontal lobe. In 1 of 16 seizures ictal hypoperfusion was seen in one frontal lobe. In 2 of 16 seizures there was hyperperfusion in both frontal lobes, and in 4 of 16 seizures hyperperfusion involved the frontal lobe or lobes plus other lobes of the brain. These changes were accompanied by hyperperfusion of subcortical structures in 13 seizures. SPECT thus localized to one frontal lobe in 10 of 16 seizures, and localized to the frontal lobes without lateralizing in two further seizures. No seizure showed a pattern of perfusion similar to that reported in mesial-temporal-lobe seizures. We conclude that ictal SPECT may provide useful localizing information in frontal-lobe seizures.

  17. Engineering angiogenesis following spinal cord injury: A coculture of neural progenitor and endothelial cells in a degradable polymer implant leads to an increase in vessel density and formation of the blood-spinal cord barrier

    PubMed Central

    Rauch, Millicent Ford; Hynes, Sara Royce; Bertram, James; Redmond, Andrew; Robinson, Rebecca; Williams, Cicely; Xu, Hao; Madri, Joseph A.; Lavik, Erin B.

    2009-01-01

    Angiogenesis precedes recovery following spinal cord injury (SCI), and its extent correlates with neural regeneration suggesting that angiogenesis may play a role in repair. An important precondition for studying the role of angiogenesis is the ability to induce it in a controlled manner. Previously, we showed that a coculture of endothelial cells (ECs) and neural progenitor cells (NPCs) promoted the formation of stable tubes in vitro and stable, functional vascular networks in vivo in a subcutaneous model. We sought to test whether a similar coculture would lead to formation of stable functional vessels in the spinal cord following injury. We created microvascular networks in a biodegradable two component implant system and tested the ability of the coculture or controls (lesion control, implant alone, implant plus ECs, or implant plus NPCs) to promote angiogenesis in a rat hemisection model of spinal cord injury. The coculture implant led to a four fold increase in functional vessels compared to the lesion control, implant alone, or implant plus NPCs groups and a 2 fold increase in functional vessels over the implant plus ECs group. Furthermore, half of the vessels in the coculture implant exhibited positive staining for the endothelial barrier antigen, a marker for formation of the blood spinal cord barrier (BSB). No other groups showed positive staining for the BSB in the injury epicenter. This work provides a novel method to induce angiogenesis following SCI and a foundation for studying its role in repair. PMID:19120441

  18. Measurement of regional myocardial blood flow with multiple colored microspheres.

    PubMed

    Kowallik, P; Schulz, R; Guth, B D; Schade, A; Paffhausen, W; Gross, R; Heusch, G

    1991-03-01

    The use of radioactive microspheres (RM) for the measurement of regional myocardial blood flow (RMBF) is limited and inaccessible to many investigators due to radiation safety concerns and radioactive waste disposal problems. Therefore, a new method for the measurement of RMBF using colored microspheres (CM) was developed. Polystyrene spheres (diameter, 15 +/- 0.1 [SD] micron; density, 1.09 g/ml) were dyed with one of five colors. With the injection of CM into the left atrium or into a coronary perfusion line, RMBF and its distribution can be determined. CM are extracted from the myocardium and blood by digestion with potassium hydroxide and subsequent microfiltration. The dyes are then recovered from the CM within a defined volume of a solvent, and their concentrations are determined by spectrophotometry. The separation of composite absorbance spectra by spectrophotometry with the CM technique was as good as the separation of energy spectra by a gamma-counter using the RM technique. Leaching of dye from the CM was less than 0.1% during a 2-month period in vitro. Significant leaching of dye from the microspheres also did not occur during 8 hours in the blood and myocardium of four anesthetized dogs in vivo. For further validation of this method, pairs of CM and RM (15.5 +/- 0.1 [SD] microns) were simultaneously injected under five different RMBF conditions (range, 0-10 ml/[min.g]) into the left anterior descending coronary artery of four anesthetized pigs, with coronary inflow as a flow reference, or into the left atrium of four anesthetized dogs using aortic blood withdrawal as a reference. The relation between RMBF determined by CM and RM was CM = 0.01 + 1.00.RM (r = 0.98, n = 1,080 data points) in the pigs, and CM = -0.19 + 0.92.RM (r = 0.97, n = 1,813 data points) in the dogs. Measurement of RMBF with CM yields values very similar to those of RM. Their use is less expensive and avoids all the disadvantages related to radioactivity, thus offering an alternative

  19. Gelatine matrix with human thrombin decreases blood loss in adolescents undergoing posterior spinal fusion for idiopathic scoliosis: a multicentre, randomised clinical trial.

    PubMed

    Helenius, I; Keskinen, H; Syvänen, J; Lukkarinen, H; Mattila, M; Välipakka, J; Pajulo, O

    2016-03-01

    In a multicentre, randomised study of adolescents undergoing posterior spinal fusion for idiopathic scoliosis, we investigated the effect of adding gelatine matrix with human thrombin to the standard surgical methods of controlling blood loss. Patients in the intervention group (n = 30) were randomised to receive a minimum of two and a maximum of four units of gelatine matrix with thrombin in addition to conventional surgical methods of achieving haemostasis. Only conventional surgical methods were used in the control group (n = 30). We measured the intra-operative and total blood loss (intra-operative blood loss plus post-operative drain output). Each additional hour of operating time increased the intra-operative blood loss by 356.9 ml (p < 0.001) and the total blood loss by 430.5 ml (p < 0.001). Multiple linear regression analysis showed that the intervention significantly decreased the intra-operative (-171 ml, p = 0.025) and total blood loss (-177 ml, p = 0.027). The decrease in haemoglobin concentration from the day before the operation to the second post-operative day was significantly smaller in the intervention group (-6 g/l, p = 0.013) than in the control group. The addition of gelatine matrix with human thrombin to conventional methods of achieving haemostasis reduces both the intra-operative blood loss and the decrease in haemoglobin concentration post-operatively in adolescents undergoing posterior spinal fusion for idiopathic scoliosis. A randomised clinical trial showed that gelatine matrix with human thrombin decreases intra-operative blood loss by 30% when added to traditional surgical haemostatic methods in adolescents undergoing posterior spinal fusion for idiopathic scoliosis. ©2016 The British Editorial Society of Bone & Joint Surgery.

  20. Epidural Injections for Spinal Pain

    MedlinePlus

    ... back or leg pain after spinal surgery) Other injuries to spinal nerves, vertebrae and surrounding tissues Bone ... Bleeding if a blood vessel is inadvertently damaged. Injury to the nerves at the injection site. Temporary ...

  1. Regional cerebral blood flow in normal pressure hydrocephalus.

    PubMed Central

    Graff-Radford, N R; Rezai, K; Godersky, J C; Eslinger, P; Damasio, H; Kirchner, P T

    1987-01-01

    Regional cerebral blood flow (rcbf) was studied preoperatively and at 2 and 6 months postoperatively in 22 normal pressure hydrocephalus patients using xenon-133 inhalation and single photon emission computed tomography. Sixteen of the 22 patients improved (improved group) and six did not (unimproved group). The following comparisons were made: (1) preoperative rcbf in the improved group, to 14 normal elderly volunteers and to that in 59 SDAT (senile dementia of the Alzheimer type) patients; (2) preoperative rcbf in the improved and unimproved groups to determine if rcbf could predict surgical outcome; (3) pre- to postoperative rcbf in the improved group to see if increased cbf accounted for clinical improvement. The findings were: (1) preoperative rcbf in the improved group was lower than that in normal controls but was the same as that in SDAT; however, the ratios of rcbf values in anterior and posterior brain regions were significantly different between improved group and SDAT (p = 0.02); (2) an anterior/posterior ratio of 1.05 correctly classified surgical outcome in 19/22 patients; five of six in the unimproved group were above this cut off while 14/16 in the improved group were below; (3) in the improved group rcbf increased at 2 but not at 6 months after surgery without a corresponding reduction of clinical signs, supporting the notion that increase in cbf probably does not account for clinical improvement in normal pressure hydrocephalus. Images PMID:3501800

  2. Predictors of failure of awake regional anesthesia for neonatal hernia repair: data from the General Anesthesia compared to Spinal anesthesia (GAS) study: comparing apnoea and neurodevelopmental outcomes

    PubMed Central

    Frawley, Geoff; Bell, Graham; Disma, Nicola; Withington, Davinia E.; de Graaff, Jurgen C.; Morton, Neil S.; McCann, Mary Ellen; Arnup, Sarah J.; Bagshaw, Oliver; Wolfler, Andrea; Bellinger, David; Davidson, Andrew J.

    2015-01-01

    Background Awake regional anesthesia (RA) is a viable alternative to general anesthesia (GA) for infants undergoing lower abdominal surgery. Benefits include lower incidence of postoperative apnea and avoidance of anesthetic agents that may increase neuroapoptosis and worsen neurocognitive outcomes. The General Anesthesia compared to Spinal anesthesia (GAS) study compares neurodevelopmental outcomes following awake RA or GA in otherwise healthy infants. Our aim was to describe success and failure rates of RA in this study and report factors associated with failure. Methods This was a nested cohort study within a prospective randomized, controlled, observer blind, equivalence trial. Seven hundred twenty two infants ≤ 60 weeks postmenstrual age, scheduled for herniorrhaphy under anesthesia were randomly assigned to receive RA (spinal, caudal epidural or combined spinal caudal anesthetic) or GA with sevoflurane. The data of 339 infants, where spinal or combined spinal caudal anesthetic was attempted, was analyzed. Possible predictors of failure were assessed including: patient factors, technique, experience of site and anesthetist and type of local anesthetic. Results RA was sufficient for the completion of surgery in 83.2% of patients. Spinal anesthesia was successful in 86.9% of cases and combined spinal caudal anesthetic in 76.1%. Thirty four patients required conversion to GA and an additional 23 (6.8%) required brief sedation. Bloody tap on the first attempt at lumbar puncture was the only risk factor significantly associated with block failure (OR = 2.46). Conclusions The failure rate of spinal anesthesia was low. Variability in application of combined spinal caudal anesthetic limited attempts to compare the success of this technique to spinal alone. PMID:26001028

  3. Predictors of Failure of Awake Regional Anesthesia for Neonatal Hernia Repair: Data from the General Anesthesia Compared to Spinal Anesthesia Study--Comparing Apnea and Neurodevelopmental Outcomes.

    PubMed

    Frawley, Geoff; Bell, Graham; Disma, Nicola; Withington, Davinia E; de Graaff, Jurgen C; Morton, Neil S; McCann, Mary Ellen; Arnup, Sarah J; Bagshaw, Oliver; Wolfler, Andrea; Bellinger, David; Davidson, Andrew J

    2015-07-01

    Awake regional anesthesia (RA) is a viable alternative to general anesthesia (GA) for infants undergoing lower abdominal surgery. Benefits include lower incidence of postoperative apnea and avoidance of anesthetic agents that may increase neuroapoptosis and worsen neurocognitive outcomes. The General Anesthesia compared to Spinal anesthesia study compares neurodevelopmental outcomes after awake RA or GA in otherwise healthy infants. The aim of the study is to describe success and failure rates of RA and report factors associated with failure. This was a nested cohort study within a prospective, randomized, controlled, observer-blind, equivalence trial. Seven hundred twenty-two infants 60 weeks or less postmenstrual age scheduled for herniorrhaphy under anesthesia were randomly assigned to receive RA (spinal, caudal epidural, or combined spinal caudal anesthetic) or GA with sevoflurane. The data of 339 infants, where spinal or combined spinal caudal anesthetic was attempted, were analyzed. Possible predictors of failure were assessed including patient factors, technique, experience of site and anesthetist, and type of local anesthetic. RA was sufficient for the completion of surgery in 83.2% of patients. Spinal anesthesia was successful in 86.9% of cases and combined spinal caudal anesthetic in 76.1%. Thirty-four patients required conversion to GA, and an additional 23 patients (6.8%) required brief sedation. Bloody tap on the first attempt at lumbar puncture was the only risk factor significantly associated with block failure (odds ratio = 2.46). The failure rate of spinal anesthesia was low. Variability in application of combined spinal caudal anesthetic limited attempts to compare the success of this technique to spinal alone.

  4. Mapping of retrotransposon sequences in the unstable region surrounding the spinal muscular atrophy locus in 5q13

    SciTech Connect

    Francis, M.J.; Nesbit, M.A.; Theodosiou, A.M.

    1995-05-20

    The mutation that underlies the autosomal recessive disorder spinal muscular atrophy (SMA) is located on chromosome 5q13. Recent studies show that SMA patients frequently have deletions and rearrangements in this region compared to normal controls. During the isolation of candidate cDNAs for the disease, the authors identified a sequence that shows high homology to the THE-1 retrotransposon gene family. Using YAC fragmentation techniques, they have refined the localization of this sequence to the domain known to show instability in SMA patients. The implication of these results for the mechanism of the mutation in SMA is discussed. 20 refs., 1 fig.

  5. Efferents from the lateral frontal cortex to spinomedullary target areas, trigeminal nuclei, and spinally projecting brainstem regions in the hedgehog tenrec.

    PubMed

    Künzle, H; Lotter, G

    1996-08-12

    This study was done in the Madagascan lesser hedgehog tenrec, an insectivore with a very poorly differentiated neocortex. The cortical region, known to give rise to spinal projections, was injected with tracer, and the cortical efferents to brainstem and spinal cord were analyzed. Bulbar reticular fields, in addition, were identified according to their cells of origin and the laterality of their spinal projections after injection of tracer. Only few cortical fibers could be traced from the bulbar pyramid into the ipsilateral spinal cord, particularly to the lateral funiculus. The projections to the dorsal column nuclei and the classical spinally projecting brainstem regions were also weak. Faint projections were demonstrated to the nucleus of the posterior commissure and the nucleus of Darkschewitsch. In comparison to other mammals, there was no evidence that the contralateral cortico-bulbo-spinal pathway was strengthened, substituting for the almost non-existent contralateral corticospinal projection. Unlike the sensorimotor apparatus controlling limb and body movements, the brainstem regions controlling the head and neck received prominent cortical projections. Direct corticotrigeminal projections and indirect pathways were well represented. The projections to the trigeminal nuclei and the lateral reticular fields were clearly bilateral; those to the superior colliculus were predominantly ipsilateral. The corticobulbar fibers left the pyramid along its entire extent; the principal trigeminal nucleus and the dorsolateral pontine tegmentum were supplied by additional fibers of the corticotegmental tract. The lateral frontal cortex also projected densely to the dorsolateral hypothalamus, the periaqueductal gray, and the adjacent mesencephalic tegmentum, components of the emotional motor system.

  6. Difference in intraosseous blood vessel volume and number in osteoporotic model mice induced by spinal cord injury and sciatic nerve resection.

    PubMed

    Ding, Wen-Ge; Yan, Wei-hong; Wei, Zhao-Xiang; Liu, Jin-Bo

    2012-07-01

    In the present study, we examined intraosseous blood vessel parameters of the tibial metaphysis in mice using microcomputed tomography (µCT) to investigate the relationship between post-nerve-injury osteoporosis and local intraosseous blood vessel volume and number. Mice were randomly divided into groups receiving spinal cord injury (SCI), sciatic nerve resection group (NX), or intact controls (30 mice/group). Four weeks after surgery, mice were perfused with silicone and the distribution of intraosseous blood vessels analyzed by μCT. The bone density, μCT microstructure, biomechanical properties, and the immunohistochemical and biochemical indicators of angiogenesis were also measured. The SCI group showed significantly reduced tibial metaphysis bone density, μCT bone microstructure, tibial biomechanical properties, indicators of angiogenesis, and intraosseous blood vessel parameters compared to the NX group. Furthermore, the spinal cord-injured mice exhibited significantly decreased intraosseous blood vessel volume and number during the development of osteoporosis. In conclusion, these data suggest that decreased intraosseous blood vessel volume and number may play an important role in the development of post-nerve-injury osteoporosis.

  7. Regional variations in the extent and timing of motoneuron cell death in the lumbosacral spinal cord of the chick embryo.

    PubMed

    Williams, C; Wohlenberg, G; O'Donovan, M J

    1987-08-01

    We have examined the distribution of motoneurons in different segments of the chick lumbosacral spinal cord before and after the period of motoneuron cell death. The extent of cell death was found to be greatest at the boundaries of the lumbosacral cord where over 60% of the motoneurons died and least in the central region where only 30% died. After cell death at stage 40 the number of motoneurons in each segment was linearly correlated with segment length, suggesting that growth of the segment and motoneuron numbers may be regulated by a common factor. The time of completion of motoneuron cell death exhibited a rostrocaudal gradient along the lumbar cord. Cell death was complete in the anterior segments by stage 35 but not until stage 38 in the caudal 4 segments. The regional variations in the extent and timing of motoneuron cell death suggest that the relative importance of the factors mediating cell death vary in different regions of the lumbar cord.

  8. Hox genes and region-specific sensorimotor circuit formation in the hindbrain and spinal cord.

    PubMed

    Di Bonito, Maria; Glover, Joel C; Studer, Michèle

    2013-12-01

    Homeobox (Hox) genes were originally discovered in the fruit fly Drosophila, where they function through a conserved homeodomain as transcriptional regulators to control embryonic morphogenesis. In vertebrates, 39 Hox genes have been identified and like their Drosophila counterparts they are organized within chromosomal clusters. Hox genes interact with various cofactors, such as the TALE homeodomain proteins, in recognition of consensus sequences within regulatory elements of their target genes. In vertebrates, Hox genes display spatially restricted patterns of expression within the developing hindbrain and spinal cord, and are considered crucial determinants of segmental identity and cell specification along the anterioposterior and dorsoventral axes of the embryo. Here, we review their later roles in the assembly of neuronal circuitry, in stereotypic neuronal migration, axon pathfinding, and topographic connectivity. Importantly, we will put some emphasis on how their early-segmented expression patterns can influence the formation of complex vital hindbrain and spinal cord circuitries.

  9. High-resolution melting (HRM) analysis as a feasible method for detecting spinal muscular atrophy via dried blood spots.

    PubMed

    Er, Tze-Kiong; Kan, Tzu-Min; Su, Yu-Fa; Liu, Ta-Chih; Chang, Jan-Gowth; Hung, Shih-Ya; Jong, Yuh-Jyh

    2012-11-12

    Spinal muscular atrophy (SMA) is a neurodegenerative disease with the leading genetic cause of infant mortality. More than 95% of patients with SMA have a homozygous disruption in the survival motor neuron1 (SMN1) gene, caused by mutation, deletion, or rearrangement. Recently, treatment in humans in the immediate postnatal period, prior to the development of weakness or very early in the course of the disease, may be effective. Therefore, our objective was to establish a feasible method for SMA screening. High-resolution melting (HRM) analysis is rapidly becoming the most important mutation-scanning methodology that allows mutation scanning and genotyping without the need for costly labeled oligonucleotides. In the current study, we aim to develop a method for identifying the substitution of single nucleotide in SMN1 exon 7 (c.840C>T) by HRM analysis. Genomic DNA was extracted from peripheral blood samples and dried blood spots obtained from 30 patients with SMA and 30 normal individuals. All results were previously confirmed by denaturing high-performance liquid chromatography (DHPLC). In order to identify the substitution of single nucleotide in SMN1 exon 7 (c.840C>T) by HRM analysis, a primer set was used in HRM analysis. At first, we failed to identify the substitution of single nucleotide in SMN1 exon 7 (c.840C>T) by HRM analysis because the homozygous CC and homozygous TT cannot be distinguished by HRM analysis. Therefore, all samples were mixed with a known SMN1/SMN2 copy number (SMN1/SMN2=0:3), which we may call driver. This strategy is used to differentiate between homozygous CC and homozygous TT. After mixing with driver, the melting profile of homozygous CC becomes heteroduplex; however, the homozygous TT remains the same in the normalized and temperature-shifted difference plots. HRM analysis can be successfully applied to screen SMA via DNA obtained from whole blood and dried blood spots. We strongly believe that HRM analysis, a high-throughput method

  10. Effects of cannabidiol (CBD) on regional cerebral blood flow.

    PubMed

    Crippa, José Alexandre de Souza; Zuardi, Antonio Waldo; Garrido, Griselda E J; Wichert-Ana, Lauro; Guarnieri, Ricardo; Ferrari, Lucas; Azevedo-Marques, Paulo M; Hallak, Jaime Eduardo Cecílio; McGuire, Philip K; Filho Busatto, Geraldo

    2004-02-01

    Animal and human studies have suggested that cannabidiol (CBD) may possess anxiolytic properties, but how these effects are mediated centrally is unknown. The aim of the present study was to investigate this using functional neuroimaging. Regional cerebral blood flow (rCBF) was measured at rest using (99m)Tc-ECD SPECT in 10 healthy male volunteers, randomly divided into two groups of five subjects. Each subject was studied on two occasions, 1 week apart. In the first session, subjects were given an oral dose of CBD (400 mg) or placebo, in a double-blind procedure. SPECT images were acquired 90 min after drug ingestion. The Visual Analogue Mood Scale was applied to assess subjective states. In the second session, the same procedure was performed using the drug that had not been administered in the previous session. Within-subject between-condition rCBF comparisons were performed using statistical parametric mapping (SPM). CBD significantly decreased subjective anxiety and increased mental sedation, while placebo did not induce significant changes. Assessment of brain regions where anxiolytic effects of CBD were predicted a priori revealed two voxel clusters of significantly decreased ECD uptake in the CBD relative to the placebo condition (p<0.001, uncorrected for multiple comparisons). These included a medial temporal cluster encompassing the left amygdala-hippocampal complex, extending into the hypothalamus, and a second cluster in the left posterior cingulate gyrus. There was also a cluster of greater activity with CBD than placebo in the left parahippocampal gyrus (p<0.001). These results suggest that CBD has anxiolytic properties, and that these effects are mediated by an action on limbic and paralimbic brain areas.

  11. Regional cerebral blood flow in essential hypertension: data evaluation by a mapping system

    SciTech Connect

    Rodriguez, G.; Arvigo, F.; Marenco, S.; Nobili, F.; Romano, P.; Sandini, G.; Rosadini, G.

    1987-01-01

    Regional cerebral blood flow was studied by means of the 133Xe inhalation method in 26 untreated and 10 treated patients with essential hypertension. The untreated subjects were divided into newly and previously diagnosed groups to assess the relation between regional cerebral blood flow and the duration of hypertension. The overall flow reduction was more marked in the frontal and temporal regions in the previously diagnosed group, and this was attributed to pathological changes in the district served by the middle cerebral artery. Regional temporal lobe impairment was also noted in the newly diagnosed and treated subjects. A significant correlation was found between regional cerebral blood flow and mean arterial blood pressure.

  12. Intramedullary spinal epidermoid cyst of the cervicodorsal region: A rare entity.

    PubMed

    Kumar, Ashok; Singh, Pritish; Jain, Pramod; Badole, C M

    2010-01-01

    Intramedullary spinal epidermoid cysts are rare, with only few cases having been reported in the literature. We are reporting a case of a 10-year-old female child who presented with symptoms of meningitis with progressive paraparesis. Magnetic resonance imaging of the spine revealed an intramedullary epidermoid cyst from C6 to D5. Near-total excision of the tumor was performed. Histopathological report confirmed the diagnosis of epidermoid cyst. The patient showed progressive recovery.

  13. The influence of protein-calorie malnutrition on the development of paranodal regions in spinal roots. A study with the OTAN method on rat.

    PubMed

    Nordborg, C

    1977-11-28

    During the early postnatal development of spinal roots in rats paranodal regions were often found, containing OTAN-positive inclusions in the Schwann cell cytoplasm. The presence of OTAN-positive paranodal regions showed variations in time, which were synchronous for ventral and dorsal roots. Dorsal roots, however, showed a more marked presence during development than ventral roots. Spinal roots of animals submitted to a 50% food restriction, were shown to contain more OTAN-positive paranodal regions than controls. This was true for ventral as well as dorsal roots. It is suggested that crowding of internodal segments could be one factor, determining the presence of paranodal, OTAN-positive material.

  14. Assessment of Neuroprotective Properties of Melissa officinalis in Combination With Human Umbilical Cord Blood Stem Cells After Spinal Cord Injury

    PubMed Central

    Hosseini, Seyed Ruhollah; Joghataei, Mohammad Taghi; Hooshmandi, Mehdi; Sadraie, Seyed Homayoon; Yaghoobi, Kayvan; Mohammadi, Alireza

    2016-01-01

    Introduction The pathophysiology of spinal cord injury (SCI) has a classically bad prognosis. It has been demonstrated that human umbilical cord blood stem cells (hUCBSCs) and Melissa officinalis (MO) are useful for the prevention of neurological disease. Methods Thirty-six adult male rats were randomly divided into intact, sham, control (SCI), MO, hUCBSC, and MO-hUCBSC groups. Intraperitoneal injection of MO (150 mg/kg) was commenced 24 hr post-SCI and continued once a day for 14 days. Intraspinal grafting of hUCBSCs was commenced immediately in the next day. The motor and sensory functions of all animals were evaluated once a week after the commencement of SCI. Electromyography (EMG) was performed in the last day in order to measure the recruitment index. Immunohistochemistry, reverse transcription-polymerase chain reaction, and transmission electron microscopy evaluations were performed to determine the level of astrogliosis and myelination. Results The results revealed that motor function (MO-hUCBSC: 15 ± 0.3, SCI: 8.2 ± 0.37, p < .001), sensory function (MO-hUCBSC: 3.57 ± 0.19, SCI: 6.38 ± 0.23, p < .001), and EMG recruitment index (MO-hUCBSC: 3.71 ± 0.18, SCI: 1.6 ± 0.1, p < .001) were significantly improved in the MO-hUCBSC group compared with SCI group. Mean cavity area (MO-hUCBSC: 0.03 ± 0.03, SCI: 0.07 ± 0.004, p < .001) was reduced and loss of lower motor neurons (MO-hUCBSC: 7.6 ± 0.43, SCI: 3 ± 0.12, p < .001) and astrogliosis density (MO-hUCBSC: 3.1 ± 0.15, SCI: 6.25 ± 1.42, p < 0.001) in the ventral horn of spinal cord were prevented in MO-hUCBSC group compared with SCI group. Conclusion The results revealed that the combination of MO and hUCBSCs in comparison with the control group has neuroprotective effects in SCI. PMID:27815336

  15. Optical monitoring of spinal cord hemodynamics, a feasibility study

    NASA Astrophysics Data System (ADS)

    Shadgan, Babak; Kwon, Brian K.; Streijger, Femke; Manouchehri, Neda; So, Kitty; Shortt, Katelyn; Cripton, Peter A.; Macnab, Andrew

    2017-02-01

    Background: After an acute traumatic spinal cord injury (SCI), the spinal cord is subjected to ischemia, hypoxia, and increased hydrostatic pressure which exacerbate further secondary damage and neuronal deficit. The purpose of this pilot study was to explore the use of near infrared spectroscopy (NIRS) for non-invasive and real-time monitoring of these changes within the injured spinal cord in an animal model. NIRS is a non-invasive optical technique that utilizes light in the near infrared spectrum to monitor changes in the concentration of tissue chromophores from which alterations in tissues oxygenation and perfusion can be inferred in real time. Methods: A custom-made miniaturized NIRS sensor was developed to monitor spinal cord hemodynamics and oxygenation noninvasively and in real time simultaneously with invasive, intraparenchymal monitoring in a pig model of SCI. The spinal cord around the T10 injury site was instrumented with intraparenchymal probes inserted directly into the spinal cord to measure oxygen pressure, blood flow, and hydrostatic pressure, and the same region of the spinal cord was monitored with the custom-designed extradural NIRS probe. We investigated how well the extradural NIRS probe detected intraparenchymal changes adjacent to the injury site after alterations in systemic blood pressure, global hypoxia, and traumatic injury generated by a weight-drop contusion. Results: The NIRS sensor successfully identified periods of systemic hypoxia, re-ventilation and changes in spinal cord perfusion and oxygenation during alterations of mean arterial pressure and following spinal cord injury. Conclusion: This pilot study indicates that extradural NIRS monitoring of the spinal cord is feasible as a non-invasive optical method to identify changes in spinal cord hemodynamics and oxygenation in real time. Further development of this technique would allow clinicians to monitor real-time physiologic changes within the injured spinal cord during the

  16. Modeling the impact of spinal cord stimulation paddle lead position on impedance, stimulation threshold, and activation region.

    PubMed

    Xiaoyi Min; Kent, Alexander R

    2015-08-01

    The effectiveness of spinal cord stimulation (SCS) for chronic pain treatment depends on selection of appropriate stimulation settings, which can be especially challenging following posture change or SCS lead migration. The objective of this work was to investigate the feasibility of using SCS lead impedance for determining the location of a SCS lead and for detecting lead migration, as well as the impact of axial movement and rotation of the St. Jude Medical PENTA™ paddle in the dorsal-ventral or medial-lateral directions on dorsal column (DC) stimulation thresholds and neural activation regions. We used a two-stage computational model, including a finite element method model of field potentials in the spinal cord during stimulation, coupled to a biophysical cable model of mammalian, myelinated nerve fibers to calculate tissue impedance and nerve fiber activation within the DC. We found that SCS lead impedance was highly sensitive to the distance between the lead and cerebrospinal fluid (CSF) layer. In addition, among all the lead positions studied, medial-lateral movement resulted in the most substantial changes to SC activation regions. These results suggest that impedance can be used for detecting paddle position and lead migration, and therefore for guiding SCS programming.

  17. Immediate effects of spinal manipulative therapy on regional antinociceptive effects in myofascial tissues in healthy young adults.

    PubMed

    Srbely, John Z; Vernon, Howard; Lee, David; Polgar, Miranda

    2013-01-01

    The purpose of this study was to investigate if spinal manipulative therapy (SMT) can evoke immediate regional antinociceptive effects in myofascial tissues by increasing pressure pain thresholds (PPTs) over myofascial trigger points in healthy young adults. A total of 36 participants (19 men, 17 women; age, 28.0 [5.3] years; body mass index, 26.5 [5.7] kg/m(2)) with clinically identifiable myofascial trigger points in the infraspinatus and gluteus medius muscles were recruited from the University of Guelph, Ontario, Canada. Participants were randomly allocated to 2 groups. Participants in the test group received chiropractic SMT targeted to the C5-C6 spinal segment. Participants in the control group received sham SMT. The PPT was recorded from the right infraspinatus and gluteus medius muscles at baseline (preintervention) and 1, 5, 10, and 15 minutes postintervention. Three participants were disqualified, resulting in a total of 33 participants analyzed. Significant increases in the PPT (decreased pain sensitivity) were observed in the test infraspinatus group when compared with test gluteus medius, control infraspinatus, and control gluteus medius groups (P < .05). No significant differences in PPT were observed at any time point when comparing test gluteus medius, control infraspinatus, and control gluteus medius groups (P > .05). This study showed that SMT evokes short-term regional increases in PPT within myofascial tissues in healthy young adults. Copyright © 2013 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  18. The spinal muscular atrophy gene region at 5q13.1 has a paralogous chromosomal region at 6p21.3.

    PubMed

    Banyer, J L; Goldwurm, S; Cullen, L; van der Griend, B; Zournazi, A; Smit, D J; Powell, L W; Jazwinska, E C

    1998-03-01

    Paralogous regions are duplicated segments of chromosomal DNA that have been acquired during the evolution of the genome. Subsequent divergent evolution of the genes within paralogous regions can lead to the formation of gene families. Here, we report the identification of a region on Chromosome (Chr) 6 at 6p21.3 that is paralogous with the Spinal Muscular Atrophy (SMA) gene region on Chr 5 at 5q13.1. Partial characterization of this region identified nine sequences all of which are highly homologous to DNA sequences of the SMA gene region at 5q13.1. These sequences include four beta-glucuronidase sequences, two retrotransposon sequences, a novel cDNA, a Sequence Tagged Site (STS), and one that is homologous to exon 9 of the Neuronal Apoptosis Inhibitor Protein (NAIP) gene. The 6p21.3 paralogous SMA region may contain genes that are related to those in the SMA region at 5q13.1; however, a direct association of this region with SMA is unlikely given that no linkage of SMA with Chr 6 has been reported.

  19. Tubercular Spinal Epidural Abscess of the Lumbosacral Region without Osseous Involvement: Comparison of Spinal MRI and Pathological Findings of the Resected Tissue.

    PubMed

    Zhang, QingLong; Koga, Hisashi

    2016-01-01

    We herein present a case of tubercular spinal epidural abscess (SEA) without osseous involvement that mimicked an acute bacterial abscess. This case manifested quite unusual findings not only radiographically, but also clinically compared with previously reported cases of tubercular SEA.

  20. Modification of loco-regional microenvironment in brain tumors by spinal cord stimulation. Implications for radio-chemotherapy.

    PubMed

    Clavo, B; Robaina, F; Valcarcel, B; Catala, L; Perez, J L; Cabezon, A; Jorge, I J; Fiuza, D; Hernandez, M A; Jover, R; Carreras, J L

    2012-01-01

    The effectiveness of radiotherapy and chemotherapy in high grade gliomas (HGG) depends on tumor micro-environment. We summarize our experience of the influence of spinal cord stimulation (SCS) on this micro-environment. Patients with HGG (n = 26) were assessed pre- and post-SCS, using: (1) Doppler in middle cerebral arteries (MCA) and (2) in common carotid arteries (CCA); (3) tumor blood-flow using single photon emission computed tomography (SPECT); (4) tumor-pO(2) (mmHg) using polarographic probes (eight tumor areas from five patients); and (5) tumor glucose metabolism using (18)F-fluoro-2-deoxyglucose ((18)FDG) positron emission tomography ((18)FDG-PET). Pre-SCS: tumor blood-flow was lower (P < 0.001) than peri-tumor areas and healthy contra-lateral areas. Tumor-pO(2) was lower (P < 0.042) than healthy tissue. Tumor glucose metabolism was higher than peri-tumor areas (P = 0.017) and healthy contra-lateral areas (P = 0.048). Post-SCS: there were increases in: MCA blood-flow (P ≤ 0.002), CCA blood-flow (P ≤ 0.013), tumor blood-flow (P = 0.033), tumor glucose metabolism (P = 0.027) and tumor-pO(2) (P = 0.022). The percentage of hypoxic values decreased (P = 0.007). SCS can modify tumor micro-environment. The potential usefulness of SCS in improving the effectiveness of radio-chemotherapy in HGG needs to be evaluated.

  1. Complex repetitive arrangements of gene sequence in the candidate region of the spinal muscular atrophy gene in 5q13

    SciTech Connect

    Theodosiou, A.M.; Nesbit, A.M.; Daniels, R.J.; Campbell, L.; Francis, M.J.; Christodoulou, Z.; Morrison, K.E.; Davies, K.E. |

    1994-12-01

    Childhood-onset proximal spinal muscular atrophy (SMA) is a heritable neurological disorder, which has been mapped by genetic linkage analysis to chromosome 5q13, in the interval between markers D5S435 and D5S557. Here, we present gene sequences that have been isolated from this interval, several of which show sequence homologies to exons of {beta}-glucuronidase. These gene sequences are repeated several times across the candidate region and are also present on chromosome 5p. The arrangement of these repetitive gene motifs is polymorphic between individuals. The high degree of variability observed may have some influence on the expression of the genes in the region. Since SMA is not inherited as a classical autosomal recessive disease, novel genomic rearrangements arising from aberrant recombination events between the complex repeats may be associated with the phenotype observed.

  2. Temporal and Regional Expression of Glucose-Dependent Insulinotropic Peptide and Its Receptor in Spinal Cord Injured Rats

    PubMed Central

    Marcos, Ana Beatriz W.; Forner, Stefania; Martini, Alessandra C.; Patrício, Eliziane S.; Clarke, Julia R.; Costa, Robson; Felix-Alves, João; Vieira, Vilberto José; de Andrade, Edinéia Lemos; Mazzuco, Tânia Longo; Calixto, João Batista

    2016-01-01

    Abstract Spinal cord injury (SCI) results in loss of movement, sensibility, and autonomic control at the level of the lesion and at lower parts of the body. Several experimental strategies have been used in attempts to increase endogenous mechanisms of neuroprotection, neuroplasticity, and repair, but with limited success. It is known that glucose-dependent insulinotropic peptide (GIP) and its receptor (GIPR) can enhance synaptic plasticity, neurogenesis, and axonal outgrowth. However, their role in the injury has never been studied. The aim of this study was to evaluate the changes in expression levels of both GIP and GIPR in acute and chronic phases of SCI in rats. Following SCI (2 to 24 h after damage), the rat spinal cord showed a lesion in which the epicenter had a cavity with hemorrhage and necrosis. Furthermore, the lesion cavity also showed ballooned cells 14 and 28 days after injury. We found that SCI induced increases in GIPR expression in areas neighboring the site of injury at 6 h and 28 days after the injury. Moreover, higher GIP expression was observed in these regions on day 28. Neuronal projections from the injury epicenter showed an increase in GIP immunoreactivity 24 h and 14 and 28 days after SCI. Interestingly, GIP was also found in progenitor cells at the spinal cord canal 24 h after injury, whereas both GIP and GIPR were present in progenitor cells at the injury epicenter 14 days after in SCI animals. These results suggest that GIP and its receptor might be implicated with neurogenesis and the repair process after SCI. PMID:26421658

  3. Temporal and Regional Expression of Glucose-Dependent Insulinotropic Peptide and Its Receptor in Spinal Cord Injured Rats.

    PubMed

    Marcos, Ana Beatriz W; Forner, Stefania; Martini, Alessandra C; Patrício, Eliziane S; Clarke, Julia R; Costa, Robson; Felix-Alves, João; Vieira, Vilberto José; de Andrade, Edinéia Lemos; Mazzuco, Tânia Longo; Calixto, João Batista; Figueiredo, Claudia Pinto

    2016-02-01

    Spinal cord injury (SCI) results in loss of movement, sensibility, and autonomic control at the level of the lesion and at lower parts of the body. Several experimental strategies have been used in attempts to increase endogenous mechanisms of neuroprotection, neuroplasticity, and repair, but with limited success. It is known that glucose-dependent insulinotropic peptide (GIP) and its receptor (GIPR) can enhance synaptic plasticity, neurogenesis, and axonal outgrowth. However, their role in the injury has never been studied. The aim of this study was to evaluate the changes in expression levels of both GIP and GIPR in acute and chronic phases of SCI in rats. Following SCI (2 to 24 h after damage), the rat spinal cord showed a lesion in which the epicenter had a cavity with hemorrhage and necrosis. Furthermore, the lesion cavity also showed ballooned cells 14 and 28 days after injury. We found that SCI induced increases in GIPR expression in areas neighboring the site of injury at 6 h and 28 days after the injury. Moreover, higher GIP expression was observed in these regions on day 28. Neuronal projections from the injury epicenter showed an increase in GIP immunoreactivity 24 h and 14 and 28 days after SCI. Interestingly, GIP was also found in progenitor cells at the spinal cord canal 24 h after injury, whereas both GIP and GIPR were present in progenitor cells at the injury epicenter 14 days after in SCI animals. These results suggest that GIP and its receptor might be implicated with neurogenesis and the repair process after SCI.

  4. Whole blood pathogen reduction technology and blood safety in sub-Saharan Africa: A systematic review with regional discussion.

    PubMed

    Nkohkwo, Asa'ah; Agbor, Gabriel; Asongalem, Emmanuel; Tagny, Claude; Asonganyi, Tazoacha

    2016-01-01

    Despite vast improvements in transfusion services in sub-Saharan Africa over the last decade, there remain serious concerns on the safety and adequacy of the blood supply across the region. This review paper ascertains the role of pathogen reduction technology (PRT) in improving blood safety and supply adequacy in the region. The state of blood safety in sub-Saharan Africa was reviewed. Meetings, seminars and correspondence were undertaken with key clinicians, scientists and professional bodies in the region, including the World Health Organization's Regional Office for Africa, to examine the suitability of PRT for improving the safety of whole blood transfusion, a prevalent transfusion format in the region. Existing literature suggests that combining PRT with current blood safety measures (such as serology) would improve the safety and adequacy of the blood supply for transfusions in sub-Saharan Africa. This was echoed by the findings of the stakeholder meetings. Following a detailed appraisal of two leading PRT systems, the Mirasol(®) PRT System and the Cerus S-303 System, we suggest that companies conduct comprehensive toxicological evaluation of the agents used for PRT and publish this in the scientific literature. We also recommend that the safety and efficacy of these technologies should be established in a randomised clinical trial conducted in sub-Saharan Africa.

  5. Whole blood pathogen reduction technology and blood safety in sub-Saharan Africa: A systematic review with regional discussion

    PubMed Central

    Agbor, Gabriel; Asongalem, Emmanuel; Tagny, Claude; Asonganyi, Tazoacha

    2016-01-01

    Background Despite vast improvements in transfusion services in sub-Saharan Africa over the last decade, there remain serious concerns on the safety and adequacy of the blood supply across the region. Objective This review paper ascertains the role of pathogen reduction technology (PRT) in improving blood safety and supply adequacy in the region. Method The state of blood safety in sub-Saharan Africa was reviewed. Meetings, seminars and correspondence were undertaken with key clinicians, scientists and professional bodies in the region, including the World Health Organization’s Regional Office for Africa, to examine the suitability of PRT for improving the safety of whole blood transfusion, a prevalent transfusion format in the region. Results Existing literature suggests that combining PRT with current blood safety measures (such as serology) would improve the safety and adequacy of the blood supply for transfusions in sub-Saharan Africa. This was echoed by the findings of the stakeholder meetings. Conclusion Following a detailed appraisal of two leading PRT systems, the Mirasol® PRT System and the Cerus S-303 System, we suggest that companies conduct comprehensive toxicological evaluation of the agents used for PRT and publish this in the scientific literature. We also recommend that the safety and efficacy of these technologies should be established in a randomised clinical trial conducted in sub-Saharan Africa. PMID:28879109

  6. Effects of pressure applied during standardized spinal mobilizations on peripheral skin blood flow: A randomised cross-over study.

    PubMed

    Zegarra-Parodi, Rafael; Pazdernik, Vanessa K; Roustit, Matthieu; Park, Peter Yong Soo; Degenhardt, Brian F

    2016-02-01

    Peripheral skin blood flow (SBF) changes during and after spinal mobilization (SM), evaluated with laser Doppler flowmetry, may document physiological responses associated with SM. To document variations in SBF during and after application of an SM and evaluate influence of pressure on SBF by applying the same standardized SM with 3 different nonnoxious pressures. Cross-over design with 4 interventions on 4 different days: control (no touch) and 3 SMs applied rhythmically at 5%, 40%, or 80% of pain pressure threshold (sham SM, low-pressure SM, or high-pressure SM, respectively). Thirty-two individuals participated. The inspiratory gasp (IG) test was our positive control of vasoconstriction through excitation of the skin sympathetic nervous activity (SSNA). Each session comprised 5 phases: (1) baseline at the end of a 20-min acclimatization, (2) IG test, (3) post-IG phase, (4) SM phase or no manual contact for control, and (5) post-SM phase. A Biopac MP36 system collected SBF data, and a Novel Pliance-X system recorded pressure data. Equal and significant bilateral vasodilation occurred during application of unilateral sham SM, low-pressure SM, and high-pressure SM. Post-SM significant vasodilation persisted after high-pressure SM. The current study is the first to describe bilateral peripheral SBF changes occurring during and 5 min after application of standardized SMs. Our post-SM vasodilation suggests involvement of mechanisms other than the putative SSNA-excitatory mechanism proposed with skin conductance measurements. Persistence of post-SM vasodilation following only high-pressure SM suggests possible pressure-dependent mechanisms. However, further research is warranted to clarify our findings. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. The development of whole blood titanium levels after instrumented spinal fusion – Is there a correlation between the number of fused segments and titanium levels?

    PubMed Central

    2012-01-01

    Background Most modern spinal implants contain titanium and remain in the patient’s body permanently. Local and systemic effects such as tissue necrosis, osteolysis and malignant cell transformation caused by implants have been described. Increasing tissue concentration and whole blood levels of ions are necessary before a disease caused by a contaminant develops. The aim of the present study was the measurement of whole blood titanium levels and the evaluation of a possible correlation between these changes and the number of fused segments. Methods A prospective study was designed to determine changes in whole blood titanium levels after spinal fusion and to analyze the correlation to the number of pedicle screws, cross connectors and interbody devices implanted. Blood samples were taken preoperatively in group I (n = 15), on the first, second and 10th day postoperatively, as well as 3 and 12 months after surgery. Group II (n = 16) served as a control group of volunteers who did not have any metal implants in the body. Blood samples were taken once in this group. The number of screw-rod-connections and the length of the spinal fusion were determined using radiographic pictures. This study was checked and approved by the ethical committee of the University of Tuebingen. Results The mean age in group I was 47 ± 22 years (range 16 - 85 years). There were three male (20%) and twelve female (80%) patients. The median number of fused segments was 5 (range 1 to 11 segments). No statistically significant increase in the titanium level was seen 12 months after surgery (mean difference: -7.2 μg/l, 95% CI: -26.9 to 12.5 μg/l, p = 0.446). By observing the individual titanium levels, 4 out of 15 patients demonstrated an increase in titanium levels 12 months after surgery. No statistically significant correlation between fused segments (r = -0.188, p = 0.503) length of instrumentation (r = -0.329, p = 0.231), number of

  8. Spine segmentation from C-arm CT data sets: application to region-of-interest volumes for spinal interventions

    NASA Astrophysics Data System (ADS)

    Buerger, C.; Lorenz, C.; Babic, D.; Hoppenbrouwers, J.; Homan, R.; Nachabe, R.; Racadio, J. M.; Grass, M.

    2017-03-01

    Spinal fusion is a common procedure to stabilize the spinal column by fixating parts of the spine. In such procedures, metal screws are inserted through the patients back into a vertebra, and the screws of adjacent vertebrae are connected by metal rods to generate a fixed bridge. In these procedures, 3D image guidance for intervention planning and outcome control is required. Here, for anatomical guidance, an automated approach for vertebra segmentation from C-arm CT images of the spine is introduced and evaluated. As a prerequisite, 3D C-arm CT images are acquired covering the vertebrae of interest. An automatic model-based segmentation approach is applied to delineate the outline of the vertebrae of interest. The segmentation approach is based on 24 partial models of the cervical, thoracic and lumbar vertebrae which aggregate information about (i) the basic shape itself, (ii) trained features for image based adaptation, and (iii) potential shape variations. Since the volume data sets generated by the C-arm system are limited to a certain region of the spine the target vertebra and hence initial model position is assigned interactively. The approach was trained and tested on 21 human cadaver scans. A 3-fold cross validation to ground truth annotations yields overall mean segmentation errors of 0.5 mm for T1 to 1.1 mm for C6. The results are promising and show potential to support the clinician in pedicle screw path and rod planning to allow accurate and reproducible insertions.

  9. Regionalization and intersegmental coordination of rhythm-generating networks in the spinal cord of the chick embryo.

    PubMed

    Ho, S; O'Donovan, M J

    1993-04-01

    We have examined the regionalization and coordination of rhythm-generating networks in the isolated spinal cord of the chick embryo between embryonic days 9 and 13, by recording the pattern of rhythmic activity recorded from muscle nerves and ventral roots following a variety of lesions. We found that the capacity for rhythmic activity is distributed along the rostrocaudal axis of the cord but can be expressed in a single, isolated segment. Specializations within the lumbosacral cord were investigated by isolating particular regions and recording their motor output. The rostral part of the lumbosacral cord generates more cycles than the caudal part, and this difference becomes more pronounced with development. In the unlesioned cord, motoneuron activity is synchronized along the rostrocaudal axis. Lesion experiments revealed that the synchronization of motoneuron activity and the synaptic drive to caudal motoneurons is mediated in part by propriospinal pathways traveling in the ventrolateral white matter tracts and by synaptic interactions within the gray matter. The dorsal fiber tracts may also be involved but their effects appear to be weak. Lesions in dorsal-ventral and mediolateral planes were used to localize regions critical for rhythmogenesis and for the alternation of flexor and extensor motoneurons. Rhythmic activity with alternation persisted in spinal cords in which the dorsal and medial half had been removed. Severe medial or dorsal lesions, resulting in a thin strip of lateral or ventral gray matter, altered the phasing of motoneuron activity from alternating to synchronous without effects on cycle timing. These results suggest that the critical neural components for alternation are located close to and dorsomedial to the lateral motor column, and that the capacity for rhythmogenesis is distributed widely throughout the ventral gray matter and is not localized to specific nuclei.

  10. Regional Myocardial Blood Flow and Ultrastructure Following Acute Temporary Ischemia.

    DTIC Science & Technology

    1982-01-01

    kidneys of dogs and cats , and suggest some element present in whole blood, but not present in filtered blood may serve to further damage ischemic...minutes of myocardial ischemia in the dog as Krug et al. (66) has reported in the cat . Finally, in this experiment the relationship of inhibited reflow...transient inhibition of flow. One has to wonder if their 6 cats with smaller areas of risk are more like the dogs in this study and may also have had

  11. Gluteal blood flow and oxygenation during electrical stimulation-induced muscle activation versus pressure relief movements in wheelchair users with a spinal cord injury.

    PubMed

    Smit, C A J; Zwinkels, M; van Dijk, T; de Groot, S; Stolwijk-Swuste, J M; Janssen, T W J

    2013-09-01

    Prolonged high ischial tuberosities pressure (IT pressure), decreased regional blood flow (BF) and oxygenation (%SO2) are risk factors for developing pressure ulcers (PUs) in patients with spinal cord injury (SCI). Electrical stimulation (ES)-induced gluteal and hamstring muscle activation may improve pressure distribution by changing the shape of the buttocks while sitting and also increase BF and %SO2. To compare acute effects of ES-induced gluteal and hamstring muscle activation with pressure relief movements (PRMs) on IT pressure, BF and %SO2. Twelve men with SCI performed PRMs - push-ups, bending forward and leaning sideward - and received surface ES (87±19 mA) to the gluteal and hamstring muscles while sitting in their wheelchair. Ischial tuberosities pressure was measured using a pressure mapping system; (sub)cutaneous BF and %SO2 were measured using reflection spectroscopy and laser Doppler, respectively. Compared with rest (156±26 mm Hg), IT pressure was significantly lower during all other conditions (push-ups 19±44; bending forward 56±33; leaning sideward 44±38; ES 67±45 mm Hg). For the whole group, all PRMs significantly augmented BF (+39 to -96%) and %SO2 (+6.0 to -7.9%-point), whereas ES-induced muscle activation did only for peak BF. In all, 63% of the participants showed an increased BF (average 52%) with ES. PRMs acutely reduced IT pressure and improved oxygenation and BF in SCI. The currently used ES method cannot replace PRMs, but it may be used additionally. ES-induced muscle activation is not as effective for acute pressure relief, but the frequency of stimulation is much higher than the performance of PRMs and can therefore be more effective in the long term.

  12. Material basis for inhibition of Dragon's Blood on evoked discharges of wide dynamic range neurons in spinal dorsal horn of rats.

    PubMed

    Guo, Min; Chen, Su; Liu, Xiangming

    2008-11-01

    In vivo experiments were designed to verify the analgesic effect of Dragon's Blood and the material basis for this effect. Extracellular microelectrode recordings were used to observe the effects of Dragon's Blood and various combinations of the three components (cochinchinenin A, cochinchinenin B, and loureirin B) extracted from Dragon's Blood on the discharge activities of wide dynamic range (WDR) neurons in spinal dorsal horn (SDH) of intact male Wistar rats evoked by electric stimulation at sciatic nerve. When the Hill's coefficients describing the dose-response relations of drugs were different, based on the concept of dose equivalence, the equations of additivity surfaces which can be applied to assess the interaction between three drugs were derived. Adopting the equations and Tallarida's isobole equations used to assess the interaction between two drugs with dissimilar dose-response relations, the effects produced by various combinations of the three components in modulating the evoked discharge activities of WDR neurons were evaluated. Results showed that Dragon's Blood and its three components could inhibit the evoked discharge frequencies of WDR neurons in a concentration-dependent way. The Hill's coefficients describing dose-response relations of three components were different. Only the combined effect of cochinchinenin A, cochinchinenin B and loureirin B was similar to that of Dragons Blood. Furthermore, the combined effect was synergistic. This investigation demonstrated that through the synergistic interaction of the three components Dragon's Blood could interfere with the transmission and processing of pain signals in spinal dorsal horn. All these further proved that the combination of cochinchinenin A, cochinchinenin B, and loureirin B was the material basis for the analgesic effect of Dragon's Blood.

  13. Tubercular spinal epidural abscess involving the dorsal-lumbar-sacral region without osseous involvement.

    PubMed

    Arora, Sumit; Kumar, Ramesh

    2011-07-27

    Musculoskeletal tuberculosis is known for its ability to present in various forms and guises at different sites. Tubercular spinal epidural abscess (SEA) is an uncommon infectious entity. Its presence without associated osseous involvement may be considered an extremely rare scenario. We present a rare case of tubercular SEA in an immune-competent 35-year-old male patient. The patient presented with acute cauda equina syndrome and was shown to have multisegmental SEA extending from D5 to S2 vertebral level without any evidence of vertebral involvement on MRI. The patient made an uneventful recovery following surgical decompression and antitubercular chemotherapy. The diagnosis was confirmed by histopathological demonstration of Mycobacterium tuberculosis in drained pus. Such presentation of tubercular SEA has not been reported previously in the English language based medical literature to the best of our knowledge.

  14. Spinal Cord Injury

    MedlinePlus

    ... Circulatory control. A spinal cord injury may cause circulatory problems ranging from low blood pressure when you rise ( ... deep vein thrombosis or a pulmonary embolus. Another problem with circulatory control is a potentially life-threatening rise in ...

  15. Effects on regional cerebral blood flow of transcendental meditation.

    PubMed

    Jevning, R; Anand, R; Biedebach, M; Fernando, G

    1996-03-01

    Previous blood flow measurements in this laboratory have indicated increased nonrenal nonhepatic blood flow during behaviorally induced rest states, especially during the stylized mental technique of transcendental meditation (TM). We have hypothesized that increased cerebral blood flow (CBF) may account for most of the increased nonrenal nonhepatic blood flow during TM. In this report we describe increased frontal and occipital CBF in TM determined by the electrical impedance plethysmographic methodology known as rheoencephalography (REG), which allows noninvasive, nondisturbing, continuous CBF monitoring. We also report high correlation between increased CBF and decreased cerebrovascular resistance (CVR) during TM, suggesting that a contributing vascular mechanism to the increased CBF may be decreased CVR. Because only a small amount of stage 1 sleep was observed during TM and because stage 1 sleep has been reported to be accompanied by decreased CBF, we believe that sleep did not contribute to the CBF increase. The data of this study are consistent with the hypothesis that blood flow changes during TM comprise a patterned response subserving needs of increased cerebral activity.

  16. Mixing problems in using indicators for measuring regional blood flow

    SciTech Connect

    Ushioda, E.; Nuwayhid, B.; Tabsh, K.; Erkkola, R.; Brinkman, C.R.; Assali, N.S.

    1982-01-01

    A basic requirement for using indicators for measuring blood flow is adequate mixing of the indicator with blood prior to sampling the site. This requirement has been met by depositing the indicator in the heart and sampling from an artery. Recently, authors have injected microspheres into veins and sampled from venous sites. The present studies were designed to investigate the mixing problems in sheep and rabbits by means of Cardio-Green and labeled microspheres. The indicators were injected at different points in the circulatory system, and blood was sampled at different levels of the venous and arterial systems. Results show the following: (a) When an indicator of small molecular size (Cardio-Green) is allowed to pass through the heart chambers, adequate mixing is achieved, yielding accurate and reproducible results. (b) When any indicator (Cardio-Green or microspheres) is injected into veins, and sampling is done at any point in the venous system, mixing is inadequate, yielding flow results which are inconsistent and erratic. (c) For an indicator or large molecular size (microspheres), injecting into the left side of the heart and sampling from arterial sites yield accurate and reproducible results regardless of whether blood is sampled continuously or intermittently.

  17. Augmentation of Regional Cerebral Blood Flow by Microvascular Anastomosis

    DTIC Science & Technology

    1974-06-01

    the Adult Foxhound after Middle Cerebral Root Occlusion 5 ABSTRACT Intracranial surgical procedures for cerebrovascular occlusive disease...11 I. INTRODUCTION Recent advances in stroke therapy have been highlighted by the development of direct intracraniai surgical approaches to...experimental acute stroke in dogs. J. Neurosurg. 38:26-31, 1973. 2. Fein, J, M. and Boulos, R, Local cerebral blood flow in experimental middle

  18. Griffonia simplicifolia Isolectin B4 Identifies a Specific Subpopulation of Angiogenic Blood Vessels Following Contusive Spinal Cord Injury in the Adult Mouse

    PubMed Central

    BENTON, RICHARD L.; MADDIE, MELISSA A.; MINNILLO, DANIELLE R.; HAGG, THEO; WHITTEMORE, SCOTT R.

    2009-01-01

    After traumatic spinal cord injury (SCI), disruption and plasticity of the microvasculature within injured spinal tissue contribute to the pathological cascades associated with the evolution of both primary and secondary injury. Conversely, preserved vascular function most likely results in tissue sparing and subsequent functional recovery. It has been difficult to identify subclasses of damaged or regenerating blood vessels at the cellular level. Here, adult mice received a single intravenous injection of the Griffonia simplicifolia isolectin B4 (IB4) at 1–28 days following a moderate thoracic (T9) contusion. Vascular binding of IB4 was maximally observed 7 days following injury, a time associated with multiple pathologic aspects of the intrinsic adaptive angiogenesis, with numbers of IB4 vascular profiles decreasing by 21 days postinjury. Quantitative assessment of IB4 binding shows that it occurs within the evolving lesion epicenter, with affected vessels expressing a temporally specific dysfunctional tight junctional phenotype as assessed by occludin, claudin-5, and ZO-1 immunoreactivities. Taken together, these results demonstrate that intravascular lectin delivery following SCI is a useful approach not only for observing the functional status of neovascular formation but also for definitively identifying specific subpopulations of reactive spinal microvascular elements. PMID:18092342

  19. Griffonia simplicifolia isolectin B4 identifies a specific subpopulation of angiogenic blood vessels following contusive spinal cord injury in the adult mouse.

    PubMed

    Benton, Richard L; Maddie, Melissa A; Minnillo, Danielle R; Hagg, Theo; Whittemore, Scott R

    2008-03-01

    After traumatic spinal cord injury (SCI), disruption and plasticity of the microvasculature within injured spinal tissue contribute to the pathological cascades associated with the evolution of both primary and secondary injury. Conversely, preserved vascular function most likely results in tissue sparing and subsequent functional recovery. It has been difficult to identify subclasses of damaged or regenerating blood vessels at the cellular level. Here, adult mice received a single intravenous injection of the Griffonia simplicifolia isolectin B4 (IB4) at 1-28 days following a moderate thoracic (T9) contusion. Vascular binding of IB4 was maximally observed 7 days following injury, a time associated with multiple pathologic aspects of the intrinsic adaptive angiogenesis, with numbers of IB4 vascular profiles decreasing by 21 days postinjury. Quantitative assessment of IB4 binding shows that it occurs within the evolving lesion epicenter, with affected vessels expressing a temporally specific dysfunctional tight junctional phenotype as assessed by occludin, claudin-5, and ZO-1 immunoreactivities. Taken together, these results demonstrate that intravascular lectin delivery following SCI is a useful approach not only for observing the functional status of neovascular formation but also for definitively identifying specific subpopulations of reactive spinal microvascular elements.

  20. Blood flow and epithelial thickness in different regions of feline oral mucosa and skin.

    PubMed

    Johnson, G K; Squier, C A; Johnson, W T; Todd, G L

    1987-07-01

    The relationship between epithelial thickness and blood flow was examined in 6 mucosal and 3 skin regions of the cat. Blood flow to these tissues was determined using the radiolabelled microsphere method. From histologic sections the proportion of the tissue biopsy occupied by epithelium and the average epithelial thickness were calculated. The oral tissues had a significantly higher blood flow than the skin regions (p less than 0.05). In terms of epithelial thickness, the tissues could be divided into 4 groups (p less than 0.05). These were: a) palate; b) gingival regions and dorsum of the tongue; c) lip and buccal mucosa; d) all skin regions. When epithelial thickness was related to blood flow there was a significant positive correlation (p less than 0.005) indicating that a thicker epithelium is associated with a higher blood flow. This finding may reflect the greater metabolic demands of the thicker epithelia.

  1. Ectopic adrenal cortical adenoma in the spinal region: case report and review of the literature.

    PubMed

    Makino, Keishi; Kojima, Ryota; Nakamura, Hideo; Morioka, Motohiro; Iyama, Ken-ichi; Shigematsu, Kazuto; Kuratsu, Jun-ichi

    2010-10-01

    Ectopic adrenal cortical neoplasms are extremely rare; few involve the central nervous system (CNS). We report a 17-month-old girl with spinal adrenal cortical neoplasms. She was unable to crawl or stand and was irritable at night. Her appearance was asymmetrical; the right side of her face and her lower right leg were enlarged. In addition, she manifested hyperplasia of the thymus, fibrous hyperplasia of the bladder, and hamartoma in the liver. However, all abnormalities were asymptomatic. Magnetic resonance imaging (MRI) revealed well-circumscribed masses within the dura mater at the T12-L1 and L3-L4 level. Histology disclosed that the lesions were composed of sheets and nests of round and polygonal cells with mostly round regular nuclei; eosinophilic to clear cytoplasm was abundant. Immunohistochemically, the tumor cells were strongly positive for inhibin-alpha, positive for synaptophysin and vimentin, and negative for GFAP, EMA, S-100, NSA, and chromogranin A. In addition, the nuclei stained positive for steroidogenic factor 1 (Ad4BP/SF-1), which is involved in adrenal steroidogenesis. This case confirms the occurrence of adrenocortical adenoma in the CNS. We suggest that this tumor should be considered in the differential diagnosis of CNS tumors.

  2. The utility of erythrocyte sedimentation rate values and white blood cell counts after spinal deformity surgery in the early (≤3 months) post-operative period.

    PubMed

    Kuhn, Margaret G; Lenke, Lawrence G; Bridwell, Keith H; O'Donnell, June C; Luhmann, Scott J

    2012-03-01

    The erythrocyte sedimentation rate (ESR) and white blood cell (WBC) count are frequently obtained in the work-up of post-operative fever. However, their diagnostic utility depends upon comparison with normative peri-operative trends which have not yet been described. The purpose of this study is to define a range of erythrocyte sedimentation rates and white blood cell counts following spinal instrumentation and fusion in non-infected patients. Seventy-five patients underwent spinal instrumentation and fusion. The erythrocyte sedimentation rate and white blood cell count were recorded pre-operatively, at 3 and 7 days post-operatively, and at 1 and 3 months post-operatively. Both erythrocyte sedimentation rate and white blood cell count trends demonstrated an early peak, followed by a gradual return to normal. Peak erythrocyte sedimentation rates occurred within the first week post-operatively in 98% of patients. Peak white blood cell counts occurred with the first week in 85% of patients. In the absence of infection, the erythrocyte sedimentation rate was abnormally elevated in 78% of patients at 1 month and in 53% of patients at 3 months post-operatively. The white blood cell count was abnormally elevated in only 6% of patients at 1 month post-operatively. Longer surgical time was associated with elevated white cell count at 1 week post-operatively. The fusion of more vertebral levels had a negative relationship with elevated erythrocyte sedimentation rate at 1 week post-operatively. The anterior surgical approach was associated with significantly lower erythrocyte sedimentation rate at 1 month post-operatively and with lower white cell count at 1 week post-operatively. In non-infected spinal fusion surgeries, erythrocyte sedimentation rates are in the abnormal range in 78% of patients at 1 month and in 53% of patients at 3 months post-operatively, suggesting that the erythrocyte sedimentation rate is of limited diagnostic value in the early post

  3. Transplanted Peripheral Blood Stem Cells Mobilized by Granulocyte Colony-Stimulating Factor Promoted Hindlimb Functional Recovery After Spinal Cord Injury in Mice.

    PubMed

    Takahashi, Hiroshi; Koda, Masao; Hashimoto, Masayuki; Furuya, Takeo; Sakuma, Tsuyoshi; Kato, Kei; Okawa, Akihiko; Inada, Taigo; Kamiya, Koshiro; Ota, Mitsutoshi; Maki, Satoshi; Takahashi, Kazuhisa; Yamazaki, Masashi; Mannoji, Chikato

    2016-01-01

    Granulocyte colony-stimulating factor (G-CSF) mobilizes peripheral blood stem cells (PBSCs) derived from bone marrow. We hypothesized that intraspinal transplantation of PBSCs mobilized by G-CSF could promote functional recovery after spinal cord injury. Spinal cords of adult nonobese diabetes/severe immunodeficiency mice were injured using an Infinite Horizon impactor (60 kdyn). One week after the injury, 3.0 µl of G-CSF-mobilized human mononuclear cells (MNCs; 0.5 × 10(5)/µl), G-CSF-mobilized human CD34-positive PBSCs (CD34; 0.5 × 10(5)/µl), or normal saline was injected to the lesion epicenter. We performed immunohistochemistry. Locomotor recovery was assessed by Basso Mouse Scale. The number of transplanted human cells decreased according to the time course. The CD31-positive area was significantly larger in the MNC and CD34 groups compared with the vehicle group. The number of serotonin-positive fibers was significantly larger in the MNC and CD34 groups than in the vehicle group. Immunohistochemistry revealed that the number of apoptotic oligodendrocytes was significantly smaller in cell-transplanted groups, and the areas of demyelination in the MNC- and CD34-transplanted mice were smaller than that in the vehicle group, indicating that cell transplantation suppressed oligodendrocyte apoptosis and demyelination. Both the MNC and CD34 groups showed significantly better hindlimb functional recovery compared with the vehicle group. There was no significant difference between the two types of transplanted cells. Intraspinal transplantation of G-CSF-mobilized MNCs or CD34-positive cells promoted angiogenesis, serotonergic fiber regeneration/sparing, and preservation of myelin, resulting in improved hindlimb function after spinal cord injury in comparison with vehicle-treated control mice. Transplantation of G-CSF-mobilized PBSCs has advantages for treatment of spinal cord injury in the ethical and immunological viewpoints, although further exploration

  4. Regional gastric mucosal blood flow measurements by hydrogen gas clearance in the anesthetized rat and rabbit.

    PubMed

    Leung, F W; Guth, P H; Scremin, O U; Golanska, E M; Kauffman, G L

    1984-07-01

    Hydrogen gas clearance using 3% hydrogen in air and platinum contact electrodes was employed for measuring antral and corpus mucosal blood flow in anesthetized animals. Significantly greater antral than corpus mucosal blood flow was consistently demonstrated. Corpus but not antral mucosal blood flow showed a significant dose-related increase with intravenous pentagastrin. Vasopressin induced a significant dose-related decrease in both antral and corpus mucosal blood flow. Simultaneous measurement of basal corpus mucosal blood flow by hydrogen gas clearance and of gastric mucosal blood flow by aminopyrine clearance gave similar values, but the changes with intravenous pentagastrin or vasopressin measured by aminopyrine clearance were of a much higher order of magnitude. Hydrogen gas clearance, however, reflected changes in left gastric artery blood flow much more closely than did aminopyrine clearance. Therefore, we conclude that the hydrogen gas clearance technique as described is valid for measuring regional gastric mucosal blood flow. It is safe and has potential application in human studies.

  5. Experimental syringohydromyelia induced by adhesive arachnoiditis in the rabbit: changes in the blood-spinal cord barrier, neuroinflammatory foci, and syrinx formation.

    PubMed

    Kobayashi, Shigeru; Kato, Katsura; Rodríguez Guerrero, Alexander; Baba, Hisatoshi; Yoshizawa, Hidezo

    2012-06-10

    There are many histological examinations of syringohydromyelia in the literature. However, there has been very little experimental work on blood permeability in the spinal cord vessels and ultrastructural changes. We prepared an animal model of spinal adhesive arachnoiditis by injecting kaolin into the subarachnoid space at the eighth thoracic vertebra of rabbits. The animals were evaluated 4 months later. Of the 30 rabbits given kaolin injection into the cerebrospinal fluid, 23 showed complete circumferential obstruction. In the 7 animals with partial obstruction of the subarachnoid space, intramedullary changes were not observed. However, among the 23 animals showing complete obstruction of the subarachnoid space, dilatation of the central canal (hydromyelia) occurred in 21, and intramedullary syrinx (syringomyelia) was observed in 11. In animals with complete obstruction, fluorescence microscopy revealed intramedullary edema around the central canal, extending to the posterior columns. Electron microscopy of hydromyelia revealed a marked reduction of villi on the ependymal cells, separation of the ependymal cells, and cavitation of the subependymal layer. The dilated perivascular spaces indicate alterations of fluid exchange between the subarachnoid and extracellular spaces. Syringomyelia revealed that nerve fibers and nerve cells were exposed on the surface of the syrinx, and necrotic tissue was removed by macrophages to leave a syrinx. Both pathologies differ in their mechanism of development: hydromyelia is attributed to disturbed reflux of cerebrospinal fluid, while tissue necrosis due to disturbed intramedullary blood flow is considered to be involved in formation of the syrinx in syringomyelia.

  6. Junctional neurulation: a unique developmental program shaping a discrete region of the spinal cord highly susceptible to neural tube defects.

    PubMed

    Dady, Alwyn; Havis, Emmanuelle; Escriou, Virginie; Catala, Martin; Duband, Jean-Loup

    2014-09-24

    In higher vertebrates, the primordium of the nervous system, the neural tube, is shaped along the rostrocaudal axis through two consecutive, radically different processes referred to as primary and secondary neurulation. Failures in neurulation lead to severe anomalies of the nervous system, called neural tube defects (NTDs), which are among the most common congenital malformations in humans. Mechanisms causing NTDs in humans remain ill-defined. Of particular interest, the thoracolumbar region, which encompasses many NTD cases in the spine, corresponds to the junction between primary and secondary neurulations. Elucidating which developmental processes operate during neurulation in this region is therefore pivotal to unraveling the etiology of NTDs. Here, using the chick embryo as a model, we show that, at the junction, the neural tube is elaborated by a unique developmental program involving concerted movements of elevation and folding combined with local cell ingression and accretion. This process ensures the topological continuity between the primary and secondary neural tubes while supplying all neural progenitors of both the junctional and secondary neural tubes. Because it is distinct from the other neurulation events, we term this phenomenon junctional neurulation. Moreover, the planar-cell-polarity member, Prickle-1, is recruited specifically during junctional neurulation and its misexpression within a limited time period suffices to cause anomalies that phenocopy lower spine NTDs in human. Our study thus provides a molecular and cellular basis for understanding the causality of NTD prevalence in humans and ascribes to Prickle-1 a critical role in lower spinal cord formation.

  7. Ability of non-invasive intermittent blood pressure monitoring and a continuous non-invasive arterial pressure monitor (CNAP™) to provide new readings in each 1-min interval during elective caesarean section under spinal anaesthesia.

    PubMed

    McCarthy, T; Telec, N; Dennis, A; Griffiths, J; Buettner, A

    2012-03-01

    We compared the ability of automated non-invasive intermittent oscillometric blood pressure monitoring with a new device, CNAP(TM) (continuous non-invasive arterial pressure) to provide a new blood pressure reading in each 1-min interval between spinal anaesthesia and delivery during caesarean section. We also compared the accuracy of continuous non-invasive arterial pressure readings with non-invasive blood pressure measurements before spinal anaesthesia. Fifty-nine women participated. The non-invasive and continuous non-invasive monitors displayed new blood pressure readings in a mean of 82% (11%) and 83% (13%) (p = 0.97) of the one-minute intervals between spinal anaesthesia and delivery, respectively. Continuous non-invasive arterial pressure was more likely to fail on two or more consecutive minutes (p=0.001). From the pre-spinal readings, the mean bias, defined as non-invasive-continuous non-invasive arterial pressure, and limits of agreement (±2SD mean bias) for systolic, diastolic and mean blood pressure respectively were +1.3 (±26.0), -2.9 (±21.8) and +2.6 (±20.4) mmHg. The new monitor has disadvantages compared with conventional non-invasive intermittent blood pressure monitoring. Anaesthesia © 2012 The Association of Anaesthetists of Great Britain and Ireland.

  8. Automatic detection of blood versus non-blood regions on intravascular ultrasound (IVUS) images using wavelet packet signatures

    NASA Astrophysics Data System (ADS)

    Katouzian, Amin; Baseri, Babak; Konofagou, Elisa E.; Laine, Andrew F.

    2008-03-01

    Intravascular ultrasound (IVUS) has been proven a reliable imaging modality that is widely employed in cardiac interventional procedures. It can provide morphologic as well as pathologic information on the occluded plaques in the coronary arteries. In this paper, we present a new technique using wavelet packet analysis that differentiates between blood and non-blood regions on the IVUS images. We utilized the multi-channel texture segmentation algorithm based on the discrete wavelet packet frames (DWPF). A k-mean clustering algorithm was deployed to partition the extracted textural features into blood and non-blood in an unsupervised fashion. Finally, the geometric and statistical information of the segmented regions was used to estimate the closest set of pixels to the lumen border and a spline curve was fitted to the set. The presented algorithm may be helpful in delineating the lumen border automatically and more reliably prior to the process of plaque characterization, especially with 40 MHz transducers, where appearance of the red blood cells renders the border detection more challenging, even manually. Experimental results are shown and they are quantitatively compared with manually traced borders by an expert. It is concluded that our two dimensional (2-D) algorithm, which is independent of the cardiac and catheter motions performs well in both in-vivo and in-vitro cases.

  9. Spinal Stenosis

    MedlinePlus

    ... and allows you to stand and bend. Spinal stenosis causes narrowing in your spine. The narrowing puts ... and spinal cord and can cause pain. Spinal stenosis occurs mostly in people older than 50. Younger ...

  10. Rapid Transport of CCL11 across the Blood-Brain Barrier: Regional Variation and Importance of Blood Cells

    PubMed Central

    Erickson, Michelle A.; Morofuji, Yoichi; Owen, Joshua B.

    2014-01-01

    Increased blood levels of the eotaxin chemokine C-C motif ligand 11 (CCL11) in aging were recently shown to negatively regulate adult hippocampal neurogenesis. How circulating CCL11 could affect the central nervous system (CNS) is not clear, but one possibility is that it can cross the blood-brain barrier (BBB). Here, we show that CCL11 undergoes bidirectional transport across the BBB. Transport of CCL11 from blood into whole brain (influx) showed biphasic kinetics, with a slow phase preceding a rapid phase of uptake. We found that the slow phase was explained by binding of CCL11 to cellular components in blood, whereas the rapid uptake phase was mediated by direct interactions with the BBB. CCL11, even at high doses, did not cause BBB disruption. All brain regions except striatum showed a delayed rapid-uptake phase. Striatum had only an early rapid-uptake phase, which was the fastest of any brain region. We also observed a slow but saturable transport system for CCL11 from brain to blood. C-C motif ligand 3 (CCR3), an important receptor for CCL11, did not facilitate CCL11 transport across the BBB, although high concentrations of a CCR3 inhibitor increased brain uptake without causing BBB disruption. Our results indicate that CCL11 in the circulation can access many regions of the brain outside of the neurogenic niche via transport across the BBB. This suggests that blood-borne CCL11 may have important physiologic functions in the CNS and implicates the BBB as an important regulator of physiologic versus pathologic effects of this chemokine. PMID:24706984

  11. Rapid transport of CCL11 across the blood-brain barrier: regional variation and importance of blood cells.

    PubMed

    Erickson, Michelle A; Morofuji, Yoichi; Owen, Joshua B; Banks, William A

    2014-06-01

    Increased blood levels of the eotaxin chemokine C-C motif ligand 11 (CCL11) in aging were recently shown to negatively regulate adult hippocampal neurogenesis. How circulating CCL11 could affect the central nervous system (CNS) is not clear, but one possibility is that it can cross the blood-brain barrier (BBB). Here, we show that CCL11 undergoes bidirectional transport across the BBB. Transport of CCL11 from blood into whole brain (influx) showed biphasic kinetics, with a slow phase preceding a rapid phase of uptake. We found that the slow phase was explained by binding of CCL11 to cellular components in blood, whereas the rapid uptake phase was mediated by direct interactions with the BBB. CCL11, even at high doses, did not cause BBB disruption. All brain regions except striatum showed a delayed rapid-uptake phase. Striatum had only an early rapid-uptake phase, which was the fastest of any brain region. We also observed a slow but saturable transport system for CCL11 from brain to blood. C-C motif ligand 3 (CCR3), an important receptor for CCL11, did not facilitate CCL11 transport across the BBB, although high concentrations of a CCR3 inhibitor increased brain uptake without causing BBB disruption. Our results indicate that CCL11 in the circulation can access many regions of the brain outside of the neurogenic niche via transport across the BBB. This suggests that blood-borne CCL11 may have important physiologic functions in the CNS and implicates the BBB as an important regulator of physiologic versus pathologic effects of this chemokine.

  12. Roles of dorsal column pathway and transient receptor potential vanilloid type 1 in augmentation of cerebral blood flow by upper cervical spinal cord stimulation in rats.

    PubMed

    Yang, X; Farber, J P; Wu, M; Foreman, R D; Qin, C

    2008-04-09

    Clinical and basic studies have indicated that upper cervical spinal cord stimulation (cSCS) significantly increases cerebral blood flow (CBF), but the mechanisms are incompletely understood. This investigation was conducted to differentiate between stimulation of dorsal column fibers and upper cervical spinal cord cell bodies in cSCS-induced increases in CBF and decreases in cerebrovascular resistance (CVR). cSCS (50 Hz, 0.2 ms, 1 min) was applied on the left C1-C2 dorsal column of pentobarbital anesthetized, ventilated and paralyzed male rats. Laser Doppler flowmetry probes were placed bilaterally over the parietal cortex, and arterial pressure was monitored. cSCS at 30%, 60%, and 90% of motor threshold (MT) produced vasodilation bilaterally in cerebral cortices. Subsequently, cSCS was applied at 90% MT, and ipsilateral responses were recorded. Ibotenic acid (0.3 mg/ml, 0.1 ml) placed on dorsal surface of C1-C2 (n=7) to suppress cell body activity, did not affect cSCS-induced %DeltaCBF (42.5+/-8.1% vs. 36.8+/-7.1%, P>0.05) and %DeltaCVR (-19.4+/-4.2% vs. -15.2+/-5.6%, P>0.05). However, bilateral transection of the dorsal column at rostral C1 (n=8) abolished cSCS-induced changes in CBF and CVR. Also, rostral C1 transection (n=7) abolished cSCS-induced changes in CBF and CVR. Resinferatoxin (RTX), an ultrapotent transient receptor potential vanilloid type 1 (TRPV1) agonist, was used to inactivate TRPV1 containing nerve fibers/cell bodies. RTX (2 microg/ml, 0.1 ml) placed on the C1-C2 spinal cord (n=7) did not affect cSCS-induced %DeltaCBF (60.2+/-8.1% vs. 46.3+/-7.7%, P>0.05) and %DeltaCVR (-25.5+/-3.5% vs. -21.4+/-8.9%, P>0.05). However, i.v. RTX (2 microg/kg, n=9) decreased cSCS-induced %DeltaCBF from 65.0+/-9.5% to 27.4+/-7.2% (P<0.05) and %DeltaCVR from -28.0+/-7.6% to -14.8+/-4.2% (P<0.05). These results indicated that cSCS-increases in CBF and decreases in CVR occurred via rostral spinal dorsal column fibers and did not depend upon C1-C2 cell bodies. Also

  13. Regional Blood-Brain Barrier Responses to Central Cholinergic Activity

    DTIC Science & Technology

    1989-07-30

    regions were of particular interest because they show the largest decreases in glucose metabolism following limbic seizures ( Ben - Ari et al., 1981). It is...following seizures ( Ben - Ari et. al., 1981). The piriform cortex-amygdala also appears to be a generator of epileptiform activity in a variety of seizure...produced by PTZ. Such studies are ongoing and the results will be given in subsequent reports. 11 REFERENCES Ben - Ari , Y., D. Richie, E. Tremblay and G

  14. Vascular anatomy of the spinal cord

    SciTech Connect

    Thron, A.K.

    1988-01-01

    The book summarizes the anatomic guidelines of external blood supply to the spinal cord. The basic principles of arterial supply and venous drainage are illustrated by explicit schemes for quick orientation. In the first part of the book, systematic radiologic-anatomic investigations of the superficial and deep vessels of all segments of the spinal cord are introduced. The microvascular morphology is portrayed by numerous microradiographic sections in all three dimensions without overshadowing. The three-dimensional representation of the vascular architecture illustrates elementary outlines and details of arterial territories, anastomotic cross-linking as well as the capillary system, particularly the hitherto unknown structure of the medullary venous system with its functionally important anastomoses and varying regional structures. These often now radiologic-anatomic findings are discussed as to their functional and pathophysiologic impact and constitute the basic on which to improve one's understanding of vascular syndromes of the spinal cord.

  15. Identification of candidate genes in the spinal muscular atrophy gene region

    SciTech Connect

    Carter, T.A.; Wang, C.H.; Vitale, E.

    1994-09-01

    The SMA disease gene region on chromosome 5q13 has been characterized by the presence of low copy repeat element DNA and concomitant genomic instability. The identification of candidate genes has been complicated by the low-copy repeat sequences which include coding and non-coding DNA. To circumvent this problem, we have focused on the identification and characterization of exonic DNA sequence isolated from YAC-derived bacteriophage subclones. Contrary to hybridization-based protocols which identify all closely homologous genes, exons isolated in this manner are known to map the disease gene region. Exon trapping was limited to an approximately 400 kb {open_quotes}minimum genetic region{close_quotes} defined by recombination mapping. Approximately six new genes have been identified by this method. One of the candidate genes is expressed predominantly in muscle and demonstrates sequence homology with known translational regulatory proteins. Physical mapping places the gene within the minimal genetic region and adjacent to a region characterized with genomic instability. We will report our progress in the identification of disease-specific mutations in this gene based upon comparison of normal and SMA cDNA sequence, amplification and sequencing of SMA DNA samples, and RT-PCR sequencing studies.

  16. [Intravenous anesthesia with perfused propofol combined with loco-regional spinal anesthesia].

    PubMed

    Lo Presti, C; Vitalone, V; Fusco, G; Assisi, P

    1993-04-01

    The authors review the advantages and disadvantages of general and regional anesthesia in bad clinical conditions. The purpose of this study was to evaluate the efficacy of Blended Anesthesia (association of general anesthesia with a regional technique) in 25 patients belonging to ASA classes II-III-IV, undergoing surgery for various disease. General anesthesia was provided by perfusion of propofol, after a peridural or subarachnoid continuous anesthesia was started. Patients were either in spontaneous or controlled ventilation. There were no cases of hypotension or other important side effects and the majority of patients judged good the anesthetic technique in regard to lack of pain, exhaustion and recall of operation.

  17. Prevalence of pre-high blood pressure and high blood pressure among non-overweight children and adolescents using international blood pressure references in developed regions in China.

    PubMed

    Tian, Changwei; Xu, Shuang; Wang, Hua; Wang, Wenming; Shen, Hui

    2017-09-01

    There is a lack of data on the prevalence of pre-high blood pressure (PreHBP) and high blood pressure (HBP), based on recent international blood pressure references, in non-overweight children and adolescents. To describe the prevalence of PreHBP and HBP in non-overweight children and adolescents in developed regions of China. In total, 588 097 non-overweight children and adolescents aged 6-17 years from the National Surveys on Chinese Students' Constitution and Health in 2015 were included. The prevalence of PreHBP was 13.41% and subjects in urban areas had a higher prevalence of PreHBP (14.14%) than those in rural areas (12.92%). Subjects in regions with a high (13.56%) or moderate (13.61%) socioeconomic status showed a higher prevalence of PreHBP than those in regions with a relatively low socioeconomic status (12.76%). A similar pattern was found for the prevalence of HBP, and the prevalence of HBP was 18.25% for all participants, 20.55% for subjects in urban areas, 16.71% in rural areas, 18.76% in high socioeconomic areas, 18.62% in moderate socioeconomic areas and 16.70% in relatively low socioeconomic areas. A large proportion of non-overweight children and adolescents had elevated blood pressure and there were urban-rural and socioeconomic disparities in the prevalence of elevated blood pressure.

  18. Dosimetric comparison between proton and photon beams in the moving gap region in cranio-spinal irradiation (CSI).

    PubMed

    Cheng, Chee-Wai; Das, Indra J; Srivastava, Shiv P; Zhao, Li; Wolanski, Mark; Simmons, Joseph; Johnstone, Peter A S; Buchsbaum, Jeffrey C

    2013-04-01

    To investigate the moving gap region dosimetry in proton beam cranio-spinal irradiation (CSI) to provide optimal dose uniformity across the treatment volume. Proton beams of ranges 11.6 cm and 16 cm are used for the spine and the brain fields, respectively. Beam profiles for a 30 cm snout are first matched at the 50% level (hot match) on the computer. Feathering is simulated by shifting the dose profiles by a known distance two successive times to simulate a 2 × feathering scheme. The process is repeated for 2 mm and 4 mm gaps. Similar procedures are used to determine the dose profiles in the moving gap for a series of gap widths, 0-10 mm, and feathering step sizes, 4-10 mm, for a Varian iX 6MV beam. The proton and photon dose profiles in the moving gap region are compared. The dose profiles in the moving gap exhibit valleys and peaks in both proton and photon beam CSI. The dose in the moving gap for protons is around 100% or higher for 0 mm gap, for both 5 and 10 mm feathering step sizes. When the field gap is comparable or larger than the penumbra, dose minima as low as 66% is obtained. The dosimetric characteristics for 6 MV photon beams can be made similar to those of the protons by appropriately combining gap width and feathering step size. The dose in the moving gap region is determined by the lateral penumbras, the width of the gap and the feathering step size. The dose decreases with increasing gap width or decreasing feathering step size. The dosimetric characteristics are similar for photon and proton beams. However, proton CSI has virtually no exit dose and is beneficial for pediatric patients, whereas with photon beams the whole lung and abdomen receive non-negligible exit dose.

  19. Spectrophotometer properties of vein blood plasma in UF-region patients with sharp surgical pathology of abdominal region organs

    NASA Astrophysics Data System (ADS)

    Guminestskij, S. G.; Polianski, I. J.; Motrich, A. V.; Grunchuk, F. W.

    2006-05-01

    It is set that there are two maximums in UF- region absorption of vein blood plasma of a man: at λ = 235 nm and at λ = 280 nm. It is shown that there are the substantial changes of values of the optical density D comparative with controls (for donors) exactly in a maximum at development of sharp surgical diseases of organs of abdominal region λ = 280 nm, in that time as maximum at λ = 235 nm in this plan is not informing. Resulted results of researches of dynamics of changes of optical properties of vein blood plasma in UF- region of patients with pathology of abdominal region organs in after operating period (sharp appendicitis, sharp pancreatitis, intestinal impassability and others like that), which can have the diagnostic value.

  20. Effects of graded doses of epinephrine on regional myocardial blood flow during cardiopulmonary resuscitation in swine

    SciTech Connect

    Brown, C.G.; Werman, H.A.; Davis, E.A.; Hobson, J.; Hamlin, R.L.

    1987-02-01

    Although epinephrine has been shown to improve myocardial blood flow during cardiopulmonary resuscitation (CPR), the effects of standard as well as larger doses of epinephrine on regional myocardial blood flow have not been examined. In this study we compared the effects of various doses of epinephrine on regional myocardial blood flow after a 10 min arrest in a swine preparation. Fifteen swine weighing greater than 15 kg each were instrumented for regional myocardial blood flow measurements with tracer microspheres. Regional blood flow was measured during normal sinus rhythm. After 10 min of ventricular fibrillation, CPR was begun and regional myocardial blood flow was determined. Animals were then randomly assigned to receive 0.02, 0.2, or 2.0 mg/kg epinephrine by peripheral injection. One minute after drug administration, regional myocardial blood flow measurements were repeated. The adjusted regional myocardial blood flows (ml/min/100 g) for animals given 0.02, 0.2, and 2.0 mg/kg epinephrine, respectively, were as follows: left atrium, 0.9, 67.4, and 58.8; right atrium, 0.3, 46.2, and 38.5; right ventricle, 0.7, 82.3, and 66.9; right interventricular septum, 1.7, 125.5, and 99.1; left interventricular septum, 2.8, 182.8, 109.5; mesointerventricular septum, 16.8, 142.2, and 79.2; left ventricular epicardium, 19.2, 98.5 and 108.7; left ventricular mesocardium, 22.8, 135.0, and 115.8; and left ventricular endocardium, 2.5, 176.1, and 132.9). All comparisons between the groups receiving 0.02 and 0.2 mg/kg epinephrine were statistically significant (p less than .05).

  1. An overview of a hierarchy of planning models for Regional Blood Bank Management.

    PubMed

    Cohen, M A; Pierskalla, W P; Sassetti, R J; Consolo, J

    1979-01-01

    Optimal regionalization of a blood banking system requires a hierarchical structure based on an analysis of preexisting elements in the region to determine at what level of activity economics of scale, cost effectiveness and efficiency will be greatest. We have applied operations research techniques to segments of the blood service complex. This paper is an overview of the general results of this research. From analysis of the data in each segment, a mathematical response function is developed for such managerial processes as demand forecasting, requirements computation, crossmatch and recycle control at each level of the hierarchy in a regional system. These processes in independent hospital blood banks are contrasted with those in hospital blood banks and transfusion services which are dependent on central blood banks for their supply. An example is presented of a model which is useful in the planning of a regional system. Implementation of these hierarchical models in hospital blood banks can reduce outdating, size of inventories and shortage. In central blood banks, these models can minimize shipment quantities, determine optimal transshipments and the most efficient routing.

  2. High-resolution intravital imaging reveals that blood derived macrophages but not resident microglia facilitate secondary axonal dieback in traumatic spinal cord injury

    PubMed Central

    Evans, Teresa A.; Barkauskas, Deborah S.; Myers, Jay; Hare, Elisabeth G.; You, Jingquang; Ransohoff, Richard M.; Huang, Alex Y.; Silver, Jerry

    2014-01-01

    After traumatic spinal cord injury, functional deficits increase as axons die back from the center of the lesion and the glial scar forms. Axonal die back occurs in two phases: an initial axon intrinsic stage that occurs over the first several hours and a secondary phase which takes place over the first few weeks after injury. Here, we examine the secondary phase, which is marked by infiltration of macrophages. Using powerful time lapse multi-photon imaging, we captured images of interactions between Cx3cr1+/GFP macrophages and microglia and Thy-1YFP axons in a mouse dorsal column crush spinal cord injury model. Over the first few weeks after injury, axonal retraction bulbs within the lesion are static except when axonal fragments are lost by a blebbing mechanism in response to physical contact followed by phagocytosis by mobile Cx3Cr1+/GFP cells. Utilizing a radiation chimera model to distinguish marrow-derived cells from radio-resistant CNS resident microglia, we determined that the vast majority of accumulated cells in the lesion are derived from the blood and only these are associated with axonal damage. Interestingly, CNS-resident Cx3Cr1+/GFP microglia did not increasingly accumulate nor participate in neuronal destruction in the lesion during this time period. Additionally, we found that the blood-derived cells consisted mainly of singly labeled Ccr2+/RFP macrophages, singly labeled Cx3Cr1+/GFP macrophages and a small population of double-labeled cells. Since all axon destructive events were seen in contact with a Cx3Cr1+/GFP cell, we infer that the CCR2 single positive subset is likely not robustly involved in axonal dieback. Finally, in our model, deletion of CCR2, a chemokine receptor, did not alter the position of axons after dieback. Understanding the in vivo cellular interactions involved in secondary axonal injury may lead to clinical treatment candidates involving modulation of destructive infiltrating blood monocytes. PMID:24468477

  3. Regional blood flows during induced hypotension produced by nitroprusside or trimethaphan in the rhesus monkey.

    PubMed

    Sivarajan, M; Amory, D W; McKenzie, S M

    1985-08-01

    In monkeys anesthetized with 70% nitrous oxide and 0.5% inspired halothane in oxygen, we measured changes in systemic hemodynamics and regional blood flows produced by nitroprusside and trimethaphan. Regional blood flow measurements were made using the radioactive microsphere technique. Control measurements were made before infusion of nitroprusside and trimethaphan into each animal in sequence in amounts adequate to reduce mean arterial pressure to approximately 55 +/- 5 mm Hg. Measurements were made during each drug infusion after a stable period of hypotension lasting at least 30 min. During nitroprusside infusion, cerebral blood flow remained unchanged, but myocardial blood flow increased significantly. However, pressure-rate product, an indirect measure of myocardial oxygen consumption, was unchanged, implying that myocardial blood flow exceeded myocardial oxygen requirement. During trimethaphan infusion, cerebral blood flow decreased, although cerebral metabolic rate for oxygen was unchanged due to increased oxygen extraction by the brain. Trimethaphan also produced a decrease in myocardial blood flow that was in proportion to the decrease in myocardial oxygen requirement as indicated by pressure-rate product. Neither drug produced changes in renal or total hepatic blood flows. We conclude that brain oxygen reserve is decreased during hypotension induced by trimethaphan. Blood flows to other organs are not significantly impaired in monkeys during hypotension to a mean arterial pressure of approximately 55 mm Hg induced by either nitroprusside or trimethaphan.

  4. [Early surgery management of pelvic region pressure ulcers versus directed cicatrization in a population of spinal cord injured patients].

    PubMed

    Le Chapelain, L; Fyad, J P; Beis, J M; Thisse, M O; André, J M

    2001-12-01

    To estimate the benefit brought by an early surgery management of pelvis region pressure ulcers compared to medical processing in a population of subjects spinal cord disabled. The studied population consist of 53 patients (62 pressure ulcers) divided into two groups: the group 1 includes 30 patients (34 pressure ulcers) presenting pressure ulcers stage III or IV (NPUAP scale) with early surgery management, included consecutively during a period of 2 years; the group 2 includes 23 patients (28 escarres) included in a retrospective way, with medical processing by the same team of care. The criteria of judgment are the delay of healing and the delay of delivery of the station sat in the armchair. In the group 1, the average delay of healing is of 42 days and the average delay of delivery for the armchair of 39 days. In the group 2 healing can be obtained only in 13 cases and in an average delay of 180 days. Differences are significant (p < 0.05). The originality of this study results in the comparison of two processing within two groups of patients having close demographic characteristics. It clearly shows the interest of the early surgery of the pelvic pressure ulcers comparing to medical processing and illustrates the requirement for a close cooperation between teams specialized in plastic surgery and teams specialized physical medicine.

  5. Fine mapping and narrowing of the genetic interval of the spinal muscular atrophy region by linkage studies

    SciTech Connect

    Wirth, B.; Voosen, B.; Roehrig, D.; Piechaczek, B.; Ruonk-Schoeneborn, S.; Zerres, K. ); Knapp, M. )

    1993-01-01

    The gene for autosomal recessive proximal spinal muscular atrophy (SMA) has recently been mapped to chromosome 5q12.2-q13, within a genetic distance of about 6 cM, and is proximally flanked by the locus D5S6 and distally by D5S112. Here, we report linkage analyses in 64 SMA families with nine polymorphic markers closely linked to the SMA gene which allowed us to narrow the SMA region to about 4cM and to define a new proximal genetic border by the locus D5S125 EF(TG/AG)[sub n]. Based on haplotype analysis and specific recombination event,the following order of the loci was determined: 5cen- D5S76-D5S6-D5S125-SMA-(5[prime]MAP-1B-3[prime]MApP[center dot]1 B)/D5S112-JK53CAI/2-(D5S39-D5S127)-5qter. The location of the SMA gene between D5Sl25 and MAP[center dot]1B is further supported by multipoint linkage analysis. 18 refs., 3 figs., 4 tabs.

  6. In Vivo Two-Photon Imaging of Axonal Dieback, Blood Flow, and Calcium Influx with Methylprednisolone Therapy after Spinal Cord Injury

    PubMed Central

    Tang, Peifu; Zhang, Yiling; Chen, Chao; Ji, Xinran; Ju, Furong; Liu, Xingyu; Gan, Wen-Biao; He, Zhigang; Zhang, Shengxiang; Li, Wei; Zhang, Lihai

    2015-01-01

    Severe spinal cord injury (SCI) can cause neurological dysfunction and paralysis. However, the early dynamic changes of neurons and their surrounding environment after SCI are poorly understood. Although methylprednisolone (MP) is currently the standard therapeutic agent for treating SCI, its efficacy remains controversial. The purpose of this project was to investigate the early dynamic changes and MP's efficacy on axonal damage, blood flow, and calcium influx into axons in a mouse SCI model. YFP H-line and Thy1-GCaMP transgenic mice were used in this study. Two-photon microscopy was used for imaging of axonal dieback, blood flow, and calcium influx post-injury. We found that MP treatment attenuated progressive damage of axons, increased blood flow, and reduced calcium influx post-injury. Furthermore, microglia/macrophages accumulated in the lesion site after SCI and expressed the proinflammatory mediators iNOS, MCP-1 and IL-1β. MP treatment markedly inhibited the accumulation of microglia/macrophages and reduced the expression of the proinflammatory mediators. MP treatment also improved the recovery of behavioral function post-injury. These findings suggest that MP exerts a neuroprotective effect on SCI treatment by attenuating progressive damage of axons, increasing blood flow, reducing calcium influx, and inhibiting the accumulation of microglia/macrophages after SCI. PMID:25989524

  7. In vivo two-photon imaging of axonal dieback, blood flow, and calcium influx with methylprednisolone therapy after spinal cord injury.

    PubMed

    Tang, Peifu; Zhang, Yiling; Chen, Chao; Ji, Xinran; Ju, Furong; Liu, Xingyu; Gan, Wen-Biao; He, Zhigang; Zhang, Shengxiang; Li, Wei; Zhang, Lihai

    2015-05-19

    Severe spinal cord injury (SCI) can cause neurological dysfunction and paralysis. However, the early dynamic changes of neurons and their surrounding environment after SCI are poorly understood. Although methylprednisolone (MP) is currently the standard therapeutic agent for treating SCI, its efficacy remains controversial. The purpose of this project was to investigate the early dynamic changes and MP's efficacy on axonal damage, blood flow, and calcium influx into axons in a mouse SCI model. YFP H-line and Thy1-GCaMP transgenic mice were used in this study. Two-photon microscopy was used for imaging of axonal dieback, blood flow, and calcium influx post-injury. We found that MP treatment attenuated progressive damage of axons, increased blood flow, and reduced calcium influx post-injury. Furthermore, microglia/macrophages accumulated in the lesion site after SCI and expressed the proinflammatory mediators iNOS, MCP-1 and IL-1β. MP treatment markedly inhibited the accumulation of microglia/macrophages and reduced the expression of the proinflammatory mediators. MP treatment also improved the recovery of behavioral function post-injury. These findings suggest that MP exerts a neuroprotective effect on SCI treatment by attenuating progressive damage of axons, increasing blood flow, reducing calcium influx, and inhibiting the accumulation of microglia/macrophages after SCI.

  8. Radiofrequency bipolar hemostatic sealer reduces blood loss, transfusion requirements, and cost for patients undergoing multilevel spinal fusion surgery: a case control study.

    PubMed

    Frank, Steven M; Wasey, Jack O; Dwyer, Ian M; Gokaslan, Ziya L; Ness, Paul M; Kebaish, Khaled M

    2014-07-05

    A relatively new method of electrocautery, the radiofrequency bipolar hemostatic sealer (RBHS), uses saline-cooled delivery of energy, which seals blood vessels rather than burning them. We assessed the benefits of RBHS as a blood conservation strategy in adult patients undergoing multilevel spinal fusion surgery. In a retrospective cohort study, we compared blood utilization in 36 patients undergoing multilevel spinal fusion surgery with RBHS (Aquamantys, Medtronic, Minneapolis, MN, USA) to that of a historical control group (n = 38) matched for variables related to blood loss. Transfusion-related costs were calculated by two methods. Patient characteristics in the two groups were similar. Intraoperatively, blood loss was 55% less in the RBHS group than in the control group (810 ± 530 vs. 1,800 ± 1,600 mL; p = 0.002), and over the entire hospital stay, red cell utilization was 51% less (2.4 ± 3.4 vs. 4.9 ± 4.5 units/patient; p = 0.01) and plasma use was 56% less (1.1 ± 2.4 vs. 2.5 ± 3.4 units/patient; p = 0.03) in the RBHS group. Platelet use was 0.1 ± 0.5 and 0.3 ± 0.6 units/patient in the RBHS and control groups, respectively (p = 0.07). The perioperative decrease in hemoglobin was less in the RBHS group than in the control group (-2.0 ± 2.2 vs. -3.2 ± 2.1 g/dL; p = 0.04), and hemoglobin at discharge was higher in the RBHS group (10.5 ± 1.4 vs. 9.7 ± 0.9 g/dL; p = 0.01). The estimated transfusion-related cost savings were $745/case by acquisition cost and approximately 3- to 5-fold this amount by activity-based cost. The use of RBHS in patients undergoing multilevel spine fusion surgery can conserve blood, promote higher hemoglobin levels, and reduce transfusion-related costs.

  9. Salvianolic acid A ameliorates the integrity of blood-spinal cord barrier via miR-101/Cul3/Nrf2/HO-1 signaling pathway.

    PubMed

    Yu, De-Shui; Wang, Yan-Song; Bi, Yun-Long; Guo, Zhan-Peng; Yuan, Ya-Jiang; Tong, Song-Ming; Su, Rui-Chao; Ge, Li-Hao; Wang, Jian; Pan, Ya-Li; Guan, Ting-Ting; Cao, Yang

    2017-02-15

    Salvianolic acid A (Sal A), a bioactive compound isolated from the Chinese medicinal herb Danshen, is used for the prevention and treatment of cardiovascular diseases. However, the protective function of Sal A on preserving the role of blood-spinal cord barrier (BSCB) after spinal cord injury (SCI) is unclear. The present study investigated the effects and mechanisms of Sal A (2.5, 5, 10mg/kg, i.p.) on BSCB permeability at different time-points after compressive SCI in rats. Compared to the SCI group, treatment with Sal A decreased the content of the Evans blue in the spinal cord tissue at 24h post-SCI. The expression levels of tight junction proteins and HO-1 were remarkably increased, and that of p-caveolin-1 protein was greatly decreased after SCI Sal A. The effect of Sal A on the expression level of ZO-1, occluding, and p-caveolin-1 after SCI was blocked by the HO-1 inhibitor, zinc protoporphyrin IX (ZnPP). Also, Sal A inhibited the level of apoptosis-related proteins and improved the motor function until 21days after SCI. In addition, Sal A significantly increased the expression of microRNA-101 (miR-101) in the RBMECs under hypoxia. AntagomiR-101 markedly increased the RBMECs permeability and the expression of the Cul3 protein by targeting with 3'-UTR of its mRNA. The expression of nuclear factor erythroid 2-related factor 2 (Nrf2) and HO-1 was significantly increased after agomiR-101 treatment. Therefore, Sal A could improve the recovery of neurological function after SCI, which could be correlated with the repair of BSCB integrity by the miR-101/Cul3/Nrf2/HO-1 signaling pathway.

  10. Comparison of Cellular Architecture, Axonal Growth, and Blood Vessel Formation Through Cell-Loaded Polymer Scaffolds in the Transected Rat Spinal Cord

    PubMed Central

    Madigan, Nicolas N.; Chen, Bingkun K.; Knight, Andrew M.; Rooney, Gemma E.; Sweeney, Eva; Kinnavane, Lisa; Yaszemski, Michael J.; Dockery, Peter; O'Brien, Timothy; McMahon, Siobhan S.

    2014-01-01

    The use of multichannel polymer scaffolds in a complete spinal cord transection injury serves as a deconstructed model that allows for control of individual variables and direct observation of their effects on regeneration. In this study, scaffolds fabricated from positively charged oligo[poly(ethylene glycol)fumarate] (OPF+) hydrogel were implanted into rat spinal cords following T9 complete transection. OPF+ scaffold channels were loaded with either syngeneic Schwann cells or mesenchymal stem cells derived from enhanced green fluorescent protein transgenic rats (eGFP-MSCs). Control scaffolds contained extracellular matrix only. The capacity of each scaffold type to influence the architecture of regenerated tissue after 4 weeks was examined by detailed immunohistochemistry and stereology. Astrocytosis was observed in a circumferential peripheral channel compartment. A structurally separate channel core contained scattered astrocytes, eGFP-MSCs, blood vessels, and regenerating axons. Cells double-staining with glial fibrillary acid protein (GFAP) and S-100 antibodies populated each scaffold type, demonstrating migration of an immature cell phenotype into the scaffold from the animal. eGFP-MSCs were distributed in close association with blood vessels. Axon regeneration was augmented by Schwann cell implantation, while eGFP-MSCs did not support axon growth. Methods of unbiased stereology provided physiologic estimates of blood vessel volume, length and surface area, mean vessel diameter, and cross-sectional area in each scaffold type. Schwann cell scaffolds had high numbers of small, densely packed vessels within the channels. eGFP-MSC scaffolds contained fewer, larger vessels. There was a positive linear correlation between axon counts and vessel length density, surface density, and volume fraction. Increased axon number also correlated with decreasing vessel diameter, implicating the importance of blood flow rate. Radial diffusion distances in vessels significantly

  11. Comparison of cellular architecture, axonal growth, and blood vessel formation through cell-loaded polymer scaffolds in the transected rat spinal cord.

    PubMed

    Madigan, Nicolas N; Chen, Bingkun K; Knight, Andrew M; Rooney, Gemma E; Sweeney, Eva; Kinnavane, Lisa; Yaszemski, Michael J; Dockery, Peter; O'Brien, Timothy; McMahon, Siobhan S; Windebank, Anthony J

    2014-11-01

    The use of multichannel polymer scaffolds in a complete spinal cord transection injury serves as a deconstructed model that allows for control of individual variables and direct observation of their effects on regeneration. In this study, scaffolds fabricated from positively charged oligo[poly(ethylene glycol)fumarate] (OPF(+)) hydrogel were implanted into rat spinal cords following T9 complete transection. OPF(+) scaffold channels were loaded with either syngeneic Schwann cells or mesenchymal stem cells derived from enhanced green fluorescent protein transgenic rats (eGFP-MSCs). Control scaffolds contained extracellular matrix only. The capacity of each scaffold type to influence the architecture of regenerated tissue after 4 weeks was examined by detailed immunohistochemistry and stereology. Astrocytosis was observed in a circumferential peripheral channel compartment. A structurally separate channel core contained scattered astrocytes, eGFP-MSCs, blood vessels, and regenerating axons. Cells double-staining with glial fibrillary acid protein (GFAP) and S-100 antibodies populated each scaffold type, demonstrating migration of an immature cell phenotype into the scaffold from the animal. eGFP-MSCs were distributed in close association with blood vessels. Axon regeneration was augmented by Schwann cell implantation, while eGFP-MSCs did not support axon growth. Methods of unbiased stereology provided physiologic estimates of blood vessel volume, length and surface area, mean vessel diameter, and cross-sectional area in each scaffold type. Schwann cell scaffolds had high numbers of small, densely packed vessels within the channels. eGFP-MSC scaffolds contained fewer, larger vessels. There was a positive linear correlation between axon counts and vessel length density, surface density, and volume fraction. Increased axon number also correlated with decreasing vessel diameter, implicating the importance of blood flow rate. Radial diffusion distances in vessels

  12. An Inter-regional US Blood Supply Simulation Model to Evaluate Blood Availability to Support Planning for Emergency Preparedness and Medical Countermeasures.

    PubMed

    Simonetti, Arianna; Ezzeldin, Hussein; Walderhaug, Mark; Anderson, Steven A; Forshee, Richard A

    2017-08-23

    Planning for a response to threats like pandemics or mass casualty events is a national priority. The US blood supply system can be particularly vulnerable to such events. It is important to understand the impacts of emergency situations on blood availability and the resiliency of the US blood supply system. On the basis of the Stock-and-Flow simulation model of the US blood supply system, we developed an inter-regional blood transfer system representing the action of multiple blood collectors and distributors to enable effective planning of strategies to minimize collection and donation disruptions to the blood supply system in the event of a national emergency. We simulated a pandemic or mass casualty event on both a national and an inter-regional blood supply system. Differences in the estimated impacts demonstrated the importance of incorporating spatial and temporal variations of blood collection and utilization across US regions. The absence of blood shortage in both emergency scenarios highlighted the resilience of the inter-regional system to meet the potential associated blood demand. Our inter-regional model considered complex factors and can be a valuable tool to assist regulatory decision-making and strategic planning for emergency preparedness to avoid and mitigate associated adverse health consequences. (Disaster Med Public Health Preparedness. 2017;page 1 of 10).

  13. Probing depth and dynamic response of speckles in near infrared region for spectroscopic blood flow imaging

    NASA Astrophysics Data System (ADS)

    Yokoi, Naomichi; Aizu, Yoshihisa

    2016-04-01

    Imaging method based on bio-speckles is a useful means for blood flow visualization of living bodies and, it has been utilized for analyzing the condition or the health state of living bodies. Actually, the sensitivity of blood flow is influenced by tissue optical properties, which depend on the wavelength of illuminating laser light. In the present study, we experimentally investigate characteristics of the blood flow images obtained with two wavelengths of 780 nm and 830 nm in the near-infrared region. Experiments are conducted for sample models using a pork layer, horse blood layer and mirror, and for a human wrist and finger, to investigate optical penetration depth and dynamic response of speckles to the blood flow velocity for two wavelengths.

  14. Effects of wheelchair cushions and pressure relief maneuvers on ischial interface pressure and blood flow in people with spinal cord injury.

    PubMed

    Sonenblum, Sharon E; Vonk, Teddie E; Janssen, Thomas W; Sprigle, Stephen H

    2014-07-01

    To investigate the effectiveness and interactions of 2 methods of pressure ulcer prevention, wheelchair cushions and pressure relief maneuvers, on interface pressure (IP) and blood flow of the buttocks. Within-subject repeated measures. Rehabilitation center. Wheelchair users with a spinal cord injury or disorder (N=17). Participants performed 3 forward leans and 2 sideward leans with different degrees of lean while seated on each of 3 different wheelchair cushions. IP measured with a custom sensor and blood flow measured with laser Doppler flowmetry were collected at the ischial tuberosity. Pressure relief maneuvers had a significant main effect on the ischial IP (P<.001); all maneuvers except for the small frontward lean resulted in a significant reduction in IP compared with upright sitting. Blood flow significantly varied across postures (P<.001) with flow during upright sitting and small forward leans being significantly lower than during the full and intermediate leans in both the forward and sideward directions. The results of the study highlight the importance of positioning wheelchair users in a manner that facilitates in-seat movement. Regardless of the cushion being used, the pressure relief maneuvers resulted in very large reductions in IPs and significant increases in buttock blood flow. Only the small frontward lean was shown to be ineffective in reducing pressure or increasing blood flow. Because these pressure relief maneuvers involved postural changes that can occur during functional activities, these pressure relief maneuvers can become a part of volitional pressure relief and functional weight shifts. Therefore, clinical instruction should cover both as a means to impart sitting behaviors that may lead to better tissue health. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  15. Regional cerebral blood flow estimates in newborn lamb using amplitude-mode color Doppler ultrasound.

    PubMed

    Taylor, G A

    1996-01-01

    To establish the feasibility of determining changes in regional cerebral blood flow using amplitude-mode color Doppler ultrasound in the newborn lamb. Regional cerebral blood flow was modified by intrastriatal injection of N -methyl-D-aspartic acid (NMDA) in two newborn lambs and compared with that in a control animal receiving only intrastriatal saline. Serial color Doppler ultrasound energy images were obtained in coronal projection at the level of the foramen of Monro, before and at 20, 40, and 60 min after NMDA or saline injection using a 7.0-MHz linear transducer. Real-time images were obtained and transferred onto a computer workstation. Regions of interest were drawn over each striatum and cerebral hemisphere and were analyzed for mean pixel intensity (MPI) at each interval. Paired regional cerebral blood flow (r-CBF) determinations (radiolabeled microsphere technique) were also obtained in every animal. MPI and r-CBF for each anatomic region were compared using linear regression. Mean color pixel intensities increased significantly in the ipsilateral basal ganglia and cerebral hemisphere (p < 0.0001) in both animals injected with NMDA, but not in the animal injected with normal saline (p < 0.63). A strong and significant linear correlation was found between MPI and r-CBF for striatum (r = 0.89, p < 0.0001) and cerebral hemisphere (r = 0.85, p < 0.0001). Amplitude-mode color Doppler ultrasound shows potential for technically simple determination of serial changes in regional cerebral blood flow in infants.

  16. Blood

    MedlinePlus

    ... The liquid part, called plasma, is made of water, salts, and protein. Over half of your blood is plasma. The solid part of your blood contains red blood cells, white blood cells, and platelets. Red ...

  17. Effects of subanesthetic doses of ketamine on regional cerebral blood flow, oxygen consumption, and blood volume in humans.

    PubMed

    Långsjö, Jaakko W; Kaisti, Kaike K; Aalto, Sargo; Hinkka, Susanna; Aantaa, Riku; Oikonen, Vesa; Sipilä, Hannu; Kurki, Timo; Silvanto, Martti; Scheinin, Harry

    2003-09-01

    Animal experiments have demonstrated neuroprotection by ketamine. However, because of its propensity to increase cerebral blood flow, metabolism, and intracranial pressure, its use in neurosurgery or trauma patients has been questioned. 15O-labeled water, oxygen, and carbon monoxide were used as positron emission tomography tracers to determine quantitative regional cerebral blood flow (rCBF), metabolic rate of oxygen (rCMRO2), and blood volume (rCBV), respectively, on selected regions of interest of nine healthy male volunteers at baseline and during three escalating concentrations of ketamine (targeted to 30, 100, and 300 ng/ml). In addition, voxel-based analysis for relative changes in rCBF and rCMRO2 was performed using statistical parametric mapping. The mean +/- SD measured ketamine serum concentrations were 37 +/- 8, 132 +/- 19, and 411 +/- 71 ng/ml. Mean arterial pressure was slightly elevated (maximally by 15.3%, P < 0.001) during ketamine infusion. Ketamine increased rCBF in a concentration-dependent manner. In the region-of-interest analysis, the greatest absolute changes were detected at the highest ketamine concentration level in the anterior cingulate (38.2% increase from baseline, P < 0.001), thalamus (28.5%, P < 0.001), putamen (26.8%, P < 0.001), and frontal cortex (25.4%, P < 0.001). Voxel-based analysis revealed marked relative rCBF increases in the anterior cingulate, frontal cortex, and insula. Although absolute rCMRO2 was not changed in the region-of-interest analysis, subtle relative increases in the frontal, parietal, and occipital cortices and decreases predominantly in the cerebellum were detected in the voxel-based analysis. rCBV increased only in the frontal cortex (4%, P = 0.022). Subanesthetic doses of ketamine induced a global increase in rCBF but no changes in rCMRO2. Consequently, the regional oxygen extraction fraction was decreased. Disturbed coupling of cerebral blood flow and metabolism is, however, considered unlikely because

  18. Indirect Measurement of Regional Axon Diameter in Excised Mouse Spinal Cord with Q-space Imaging: Simulation and Experimental Studies

    PubMed Central

    Ong, Henry H.; Wright, Alex C.; Wehrli, Suzanne L.; Souza, Andre; Schwartz, Eric D.; Hwang, Scott N.; Wehrli, Felix W.

    2008-01-01

    Q-space imaging (QSI), a diffusion MRI technique, can provide quantitative tissue architecture information at cellular dimensions not amenable by conventional diffusion MRI. By exploiting regularities in molecular diffusion barriers, QSI can estimate the average barrier spacing such as the mean axon diameter in white matter (WM). In this work, we performed ex vivo QSI on cervical spinal cord sections from healthy C57BL/6 mice at 400MHz using a custom-designed uniaxial 50T/m gradient probe delivering a 0.6 µm displacement resolution capable of measuring axon diameters on the scale of 1 µm. After generating QSI-derived axon diameter maps, diameters were calculated using histology from seven WM tracts (dorsal corticospinal, gracilis, cuneatus, rubrospinal, spinothalamic, reticulospinal, and vestibulospinal tracts) each with different axon diameters. We found QSI-derived diameters from regions drawn in the seven WM tracts (1.1 to 2.1 µm) to be highly correlated (r2 = 0.95) with those calculated from histology (0.8 to 1.8 µm). The QSI-derived values overestimated those obtained by histology by approximately 20%, which is likely due to the presence of extra-cellular signal. Finally, simulations on images of synthetic circular axons and axons from histology suggest that QSI-derived diameters are informative despite diameter and axon shape variation and the presence of intra-cellular and extra-cellular signal. QSI may be able to quantify nondestructively changes in WM axon architecture due to pathology or injury at the cellular level. PMID:18342541

  19. Effect of stimulation of trigeminal ganglion on regional cerebral blood flow in cats

    SciTech Connect

    Goadsby, P.J.; Duckworth, J.W. )

    1987-08-01

    Regional cerebral blood flow was studied in the cat, with and without trigeminal ganglion stimulation, by the intravenous injection of the tracer ({sup 14}C)iodoantipyrine and subsequent regional brain dissection. Electrical activation of the trigeminal ganglion led to a selective increase in regional blood flow in the frontal and parietal cortex that was bilateral without change in the posterior cortex, deep cerebral nuclei, white matter, or brain stem. Unilateral intracranial section of the facial nerve blocked the response in the ipsilateral frontal and parietal cortex, whereas bilateral facial nerve section blocked the contralateral frontal cortical response. The contralateral parietal cortical increase in blood flow was not affected by facial nerve section and may thus represent the result of metabolic activation of sensory cortex.

  20. Associations of Dietary Fat, Regional Adiposity, and Blood Pressure in Men

    PubMed Central

    Williams, Paul T.; Fortmann, Stephen P.; Terry, Richard B.; Garay, Susan C.; Vranizan, Karen M.; Ellsworth, Nancy; Wood, Peter D.

    2010-01-01

    Mediterranean populations have low incidence rates of cardiovascular disease and hypertension that may be due, in part, to dietary factors, particularly a relatively high intake of monounsaturated fat as olive oil. In this study, nutritional components (as grams per 4200 kJ) (1 kcal = 4.2 kJ) from three-day food records were examined in association with resting blood pressure in a cross-sectional survey of 76 sedentary middle-aged American men, aged 30 to 55 years, with resting blood pressures below 160/100 mm Hg. Systolic and diastolic blood pressures correlated significantly and inversely with monounsaturated fat consumption. Polyunsaturated fat consumption also correlated inversely with diastolic blood pressure; however, this relationship became nonsignificant when adjusted for an index of regional adiposity that characterizes the male-type obesity pattern. Detailed analyses of specific fatty acids showed that the correlations with monounsaturates were specific to oleic acid, and the correlation with polyunsaturates was specific to linoleic acid. Multiple regression analysis suggested that 18.2% of the variance in systolic blood pressure and 23.2% of the variance in diastolic blood pressure were related to monounsaturated and polyunsaturated fat consumption and regional adiposity. Thus, increased consumption of monounsaturated fat is related inversely to resting blood pressure, although causality remains to be determined. PMID:3586249

  1. Spinal tuberculosis: A review

    PubMed Central

    Garg, Ravindra Kumar; Somvanshi, Dilip Singh

    2011-01-01

    Spinal tuberculosis is a destructive form of tuberculosis. It accounts for approximately half of all cases of musculoskeletal tuberculosis. Spinal tuberculosis is more common in children and young adults. The incidence of spinal tuberculosis is increasing in developed nations. Genetic susceptibility to spinal tuberculosis has recently been demonstrated. Characteristically, there is destruction of the intervertebral disk space and the adjacent vertebral bodies, collapse of the spinal elements, and anterior wedging leading to kyphosis and gibbus formation. The thoracic region of vertebral column is most frequently affected. Formation of a ‘cold’ abscess around the lesion is another characteristic feature. The incidence of multi-level noncontiguous vertebral tuberculosis occurs more frequently than previously recognized. Common clinical manifestations include constitutional symptoms, back pain, spinal tenderness, paraplegia, and spinal deformities. For the diagnosis of spinal tuberculosis magnetic resonance imaging is more sensitive imaging technique than x-ray and more specific than computed tomography. Magnetic resonance imaging frequently demonstrates involvement of the vertebral bodies on either side of the disk, disk destruction, cold abscess, vertebral collapse, and presence of vertebral column deformities. Neuroimaging-guided needle biopsy from the affected site in the center of the vertebral body is the gold standard technique for early histopathological diagnosis. Antituberculous treatment remains the cornerstone of treatment. Surgery may be required in selected cases, e.g. large abscess formation, severe kyphosis, an evolving neurological deficit, or lack of response to medical treatment. With early diagnosis and early treatment, prognosis is generally good. PMID:22118251

  2. [The practice of neonatal umbilical blood gas analysis in the "Alsace" regional French perinatal network].

    PubMed

    Kellenberger, F; Akladios, C Y; Sananes, N; Gaudineau, A; Langer, B

    2016-10-01

    The assessment of neonatal well-being is paramount in delivery rooms. For that purpose, it is recommended in France to carry out a systematic neonatal umbilical cord blood gas analysis. The aim of this study is to evaluate how umbilical cord blood gas sampling is realised, analysed and interpreted by midwives in a French regional perinatal network. We conducted a survey focused on randomly selected midwives partitioning in different maternities that constitute the "Alsace" regional perinatal network. A questionnaire concerning the modalities of umbilical cord blood sampling, its analysis and the interpretation of results was used during interviews with included midwives. Fifty-one midwives were included in the study (15.8% of whom were working in delivery rooms). Only 13% of maternities constituting the perinatal network did not realise systematic neonatal umbilical cord blood analysis. Among interviewed midwives, 78.4% reported umbilical cord clamping after the first breath of the child. Among the midwives included, 86.3% of them realise sampling from the umbilical artery and 29.4% from both umbilical artery and vein. For 86.3% of interviewed midwives, the leitmotif of realising umbilical blood sampling was medico-legal. More than two third of included midwives interpret blood gas taking into account two parameters (either pH and base excess, or lactate). They settled at 7.0-7.2, the limit below which a newborn might present sequelae. This study shows that the neonatal umbilical cord blood gas analysis at birth is almost systematic in this regional French perinatal network. It is realised primarily for medico-legal purpose. However, there are significant variations in sampling procedures and interpretation. This should lead to the establishment within each maternity of a neonatal umbilical cord blood gas sampling protocol along with a midwifery training program. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  3. Newborn blood spot screening test using multiplexed real-time PCR to simultaneously screen for spinal muscular atrophy and severe combined immunodeficiency.

    PubMed

    Taylor, Jennifer L; Lee, Francis K; Yazdanpanah, Golriz Khadem; Staropoli, John F; Liu, Mei; Carulli, John P; Sun, Chao; Dobrowolski, Steven F; Hannon, W Harry; Vogt, Robert F

    2015-02-01

    Spinal muscular atrophy (SMA) is a motor neuron disorder caused by the absence of a functional survival of motor neuron 1, telomeric (SMN1) gene. Type I SMA, a lethal disease of infancy, accounts for the majority of cases. Newborn blood spot screening (NBS) to detect severe combined immunodeficiency (SCID) has been implemented in public health laboratories in the last 5 years. SCID detection is based on real-time PCR assays to measure T-cell receptor excision circles (TREC), a byproduct of T-cell development. We modified a multiplexed real-time PCR TREC assay to simultaneously determine the presence or absence of the SMN1 gene from a dried blood spot (DBS) punch in a single reaction well. An SMN1 assay using a locked nucleic acid probe was initially developed with cell culture and umbilical cord blood (UCB) DNA extracts, and then integrated into the TREC assay. DBS punches were placed in 96-well arrays, washed, and amplified directly using reagents specific for TREC, a reference gene [ribonuclease P/MRP 30kDa subunit (RPP30)], and the SMN1 gene. The assay was tested on DBS made from UCB units and from peripheral blood samples of SMA-affected individuals and their family members. DBS made from SMA-affected individuals showed no SMN1-specific amplification, whereas DBS made from all unaffected carriers and UCB showed SMN1 amplification above a well-defined threshold. TREC and RPP30 content in all DBS were within the age-adjusted expected range. SMA caused by the absence of SMN1 can be detected from the same DBS punch used to screen newborns for SCID. © 2014 American Association for Clinical Chemistry.

  4. The effects of activation procedures on regional cerebral blood flow in humans

    SciTech Connect

    Rozenfeld, D.; Wolfson, L.I.

    1981-07-01

    Regional cerebral blood flow (r-CBF) can be measured using 133XE and collimated detectors. The radionuclide can be administered either by inhalation or intracarotid injection. Comparison of blood flow determinations at rest and during performance of an activity identifies those brain regions that become active during the performance of the activity. Relatively specific patterns of r-CBF are observed during hand movements, sensory stimulation, eye movements, speech, listening, and reading. Regional CBF changes during reasoning and memorization are less specific and less well characterized. It is clear that brain lesions affect r-CBF responses to various activities, but this effect has not been well correlated with functional deficits or recovery of function. Regional CBF measurement gives information about brain activity and the functional response to experimental manipulation. This approach may well add to our understanding of normal, as well as pathologic, brain functioning.

  5. Roles of dorsal column pathway and TRPV1 in augmentation of cerebral blood flow by upper cervical spinal cord stimulation in rats

    PubMed Central

    Yang, Xiaoli; Farber, Jay P.; Wu, Mingyuan; Foreman, Robert D.; Qin, Chao

    2008-01-01

    Clinical and basic studies have indicated that upper cervical spinal cord stimulation (cSCS) significant increases cerebral blood flow (CBF), but the mechanisms are incompletely understood. This investigation was conducted to differentiate between stimulation of dorsal column fibers and upper cervical spinal cord cell bodies in cSCS-induced increases in CBF and decreases in cerebral vascular resistance (CVR). cSCS (50 Hz, 0.2 ms, 1 min) was applied on the left C1-C2 dorsal column n pentobarbital anesthetized, ventilated and paralyzed male rats. Laser Doppler flowmetry probes were placed bilaterally over the parietal cortex, and arterial pressure was monitored. cSCS at 30%, 60%, and 90% of motor threshold (MT) produced vasodilation bilaterally in cerebral cortices. Subsequently, cSCS was applied at 90% MT, and ipsilateral responses were recorded. Ibotenic acid (0.3mg/ml, 0.1ml) placed on dorsal surface of C1-C2 (n=7) to suppress cell body activity, did not affect cSCS-induced %□CBF (42.5±8.1% vs 36.8±7.1%, P>0.05□and %□CVR (−19.4±4.2% vs −15.2±5.6%, P>0.05). However, bilateral transection of the dorsal column at rostral C1 (n=8) abolished cSCS-induced changes in CBF and CVR. Also, rostral C1 transection (n=7) abolished cSCS-induced changes in CBF and CVR. Resinferatoxin (RTX), an ultra potent TRPV1 agonist, was used to inactivate TRPV1 containing nerve fibers / cell bodies. RTX (2 µg/ml□0.1ml) placed on the C1-C2 spinal cord (n=7) did not affect cSCS-induced %ΔCBF (60.2±8.1% vs 46.3±7.7%, P>0.05) and %ΔCVR (−25.5±3.5% vs −21.4±8.9%, P>0.05). However, intravenous RTX (2 µg/kg, n=9) decreased cSCS-induced %ΔCBF from 65.0±9.5% to 27.4±7.2% (P<0.05) and %ΔCVR from −28.0±7.6% to −14.8±4.2% (P<0.05). These results indicated that cSCS-increases in CBF and decreases in CVR occurred via rostral spinal dorsal column fibers and did not depend upon C1-C2 cell bodies. Also, our results suggested that cerebral but not spinal TRPV1 was

  6. A randomised controlled trial comparing weight adjusted dose versus fixed dose prophylactic phenylephrine infusion on maintaining systolic blood pressure during caesarean section under spinal anaesthesia.

    PubMed

    Mwaura, Lucy; Mung'ayi, Vitalis; Kabugi, Jimmie; Mir, Samina

    2016-06-01

    Spinal anaesthesia is the standard of care for elective caesarean delivery. It has advantages over general anaesthesia. However the sympathetic blockade induced by spinal anaesthesia results in an 80 percent incidence of hypotension without prophylactic management. Current evidence supports co-loading with intravenous fluids in conjunction with the use of vasopressors as the most effective way to prevent and treat the hypotension. Phenylephrine is the accepted vasopressor of choice in the parturient. A prophylactic phenylephrine infusion combined with a fluid co-load is proven to be an effective and safe method of maintaining maternal hemodynamic stability. While most published studies have assessed the effectiveness of a prophylactic phenylephrine fixed dose infusion, few studies have assessed the effect of a prophylactic phenylephrine weight adjusted dose infusion on maintaining maternal hemodynamic stability following spinal anesthesia for a cesarean delivery. To compare the incidence of hypotension between women undergoing elective caesarean section under spinal anaesthesia, receiving prophylactic phenylephrine infusion at a fixed dose of 37.5 micrograms per minute versus a weight adjusted dose of 0.5 micrograms per kilogram per minute. One hundred and eight patients scheduled for non-urgent caesarean section under spinal anaesthesia were randomized into 2 groups; control group and intervention group using a computer generated table of numbers. Control group; Received prophylactic phenylephrine fixed dose infusion at 37.5 micrograms per minute. Intervention group; Received prophylactic phenylephrine weight adjusted dose infusion at 0.5 micrograms per kilogram per minute. The two groups had similar baseline characteristics in terms of; Age, sex, weight and height. There was a 35.2% incidence of hypotension in the fixed dose group and an 18.6% incidence of hypotension in the weight adjusted dose group. This difference was found to be of borderline statistical

  7. [Role of quality control for improvement of blood components in the Regional Blood Centre of Ouagadougou in Burkina Faso, 2014].

    PubMed

    Nebie, K; Sawadogo, S; Kafando, E; Bationo, E M; Dahourou, H; Ouattara, S; Kienou, K; Nana, S; Kaba, L; Fretz, C; Murphy, E L

    2017-06-02

    In Burkina Faso, blood components must comply with national standards. Then, all Transfusion services must implement a quality control process to ensure compliance. Our study aims to establish the main characteristics of blood components of the regional transfusion center of Ouagadougou, and evaluate the capability of this center to improve its manufacturing process. We conducted from marsh to December 2014 a pre-post study, assessing blood components' characteristics before and after the implementation of a six months' improvement plan. The assessed parameters were: volume, hematocrit (Ht) and hemoglobin (Hb) levels in RBCs; volume and the number of platelets in PPCs; and volume and concentration of clotting factor VIII in fresh frozen plasma (FFP), respectively. Three hundred and twelve RBCs and 280 PCs were randomly selected for the first series of controls, and 215 RBCs, 54 PCs and 60 FFP were selected for the second series of controls. We compared the mean values of the components parameters and the overall non-compliance rates for each series. The average Hb level of RBCs was respectively 47.8±8.9g and 54.7±7.2g in the first and second series compare to a standard of≥40g. Non-compliance rates of Hb level decreased significantly from 17.6% to 1.4%. For PCs units, the mean number of platelets was 0.14±0.10×10(11) and 0.30±0.15×10(11) in the first and second period compare to a standard of 0.5×10(11). Non-compliance rates for platelets number were high 97.1% and 72.2%. The study demonstrates that only RBCs complied with national standards. The study also demonstrates the capability of CRTSO to improve blood components' processing even if for PCs and FFP, NC rates remain high. QC must be maintained and expanded to the others regional blood centers of the country. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  8. Disodium cromoglycate, a mast-cell stabilizer, alters postradiation regional cerebral blood flow in primates

    SciTech Connect

    Cockerham, L.G.; Doyle, T.F.; Pautler, E.L.; Hampton, J.D.

    1986-01-01

    Early transient incapacitation (ETI) is the complete cessation of performance during the first 30 min after radiation exposure, and performance decrement (PD) is a reduction in performance at the same time. Supralethal doses of radiation have been shown to produce a marked decrease in regional cerebral blood flow in primates concurrent with systemic hypotension and a dramatic release of mast-cell histamine. In an attempt to elucidate mechanisms underlying the radiation-induced ETI/PD phenomena and the postradiation decrease in cerebral blood flow, primates were given the mast-cell stabilizers disodium cromoglycate (DSCG) or BRL 22321 before exposure to 100 Gy whole-body gamma radiation. Hypothalamic and cortical blood flows were measured by hydrogen clearance, before and after radiation exposure. Systemic blood pressures were determined simultaneously. The data indicated that DSCG was successful in diminishing postradiation decrease in cerebral blood flow. Irradiated animals pretreated with DSCG, showed only a 10% decrease in hypothalamic blood flow 60 min postradiation, while untreated, irradiated animals showed a 57% decrease. The cortical blood flow of DSCG treated, irradiated animals showed a triphasic response, with a decrease of 38% at 10 min postradiation, then a rise to 1% below baseline at 20 min, followed by a fall to 42% below baseline by 50 min postradiation. In contrast, the untreated, irradiated animals showed a steady decrease in cortical blood flow to 79% below baseline by 50 min postradiation. There was no significant difference in blood-pressure response between the treated and untreated, irradiated animals. Systemic blood pressure showed a 60% decrease at 10 min postradiation, falling to a 71% decrease by 60 min.

  9. High-resolution intravital imaging reveals that blood-derived macrophages but not resident microglia facilitate secondary axonal dieback in traumatic spinal cord injury.

    PubMed

    Evans, Teresa A; Barkauskas, Deborah S; Myers, Jay T; Hare, Elisabeth G; You, Jing Qiang; Ransohoff, Richard M; Huang, Alex Y; Silver, Jerry

    2014-04-01

    After traumatic spinal cord injury, functional deficits increase as axons die back from the center of the lesion and the glial scar forms. Axonal dieback occurs in two phases: an initial axon intrinsic stage that occurs over the first several hours and a secondary phase which takes place over the first few weeks after injury. Here, we examine the secondary phase, which is marked by infiltration of macrophages. Using powerful time-lapse multi-photon imaging, we captured images of interactions between Cx3cr1(+/GFP) macrophages and microglia and Thy-1(YFP) axons in a mouse dorsal column crush spinal cord injury model. Over the first few weeks after injury, axonal retraction bulbs within the lesion are static except when axonal fragments are lost by a blebbing mechanism in response to physical contact followed by phagocytosis by mobile Cx3Cr1(+/GFP) cells. Utilizing a radiation chimera model to distinguish marrow-derived cells from radio-resistant CNS-resident microglia, we determined that the vast majority of accumulated cells in the lesion are derived from the blood and only these are associated with axonal damage. Interestingly, CNS-resident Cx3Cr1(+/GFP) microglia did not increasingly accumulate nor participate in neuronal destruction in the lesion during this time period. Additionally, we found that the blood-derived cells consisted mainly of singly labeled Ccr2(+/RFP) macrophages, singly labeled Cx3Cr1(+/GFP) macrophages and a small population of double-labeled cells. Since all axon destructive events were seen in contact with a Cx3Cr1(+/GFP) cell, we infer that the CCR2 single positive subset is likely not robustly involved in axonal dieback. Finally, in our model, deletion of CCR2, a chemokine receptor, did not alter the position of axons after dieback. Understanding the in vivo cellular interactions involved in secondary axonal injury may lead to clinical treatment candidates involving modulation of destructive infiltrating blood monocytes. Copyright © 2014

  10. Regional Myocardial Blood Volume and Flow: First-Pass MR Imaging with Polylysine-Gd-DTPA

    PubMed Central

    Wilke, Norbert; Kroll, Keith; Merkle, Hellmut; Wang, Ying; Ishibashi, Yukata; Xu, Ya; Zhang, Jiani; Jerosch-Herold, Michael; Mühler, Andreas; Stillman, Arthur E.; Bassingthwaighte, James B.; Bache, Robert; Ugurbil, Kamil

    2010-01-01

    The authors investigated the utility of an intravascular magnetic resonance (MR) contrast agent, poly-L-lysine-gadolinium diethylenetriaminepentaacetic acid (DTPA), for differentiating acutely ischemic from normally perfused myocardium with first-pass MR imaging. Hypoperfused regions, identified with microspheres, on the first-pass images displayed significantly decreased signal intensities compared with normally perfused myocardium (P < .0007). Estimates of regional myocardial blood content, obtained by measuring the ratio of areas under the signal intensity-versus-time curves in tissue regions and the left ventricular chamber, averaged 0.12 mL/g ± 0.04 (n = 35), compared with a value of 0.11 mL/g ± 0.05 measured with radiolabeled albumin in the same tissue regions. To obtain MR estimates of regional myocardial blood flow, in situ calibration curves were used to transform first-pass intensity-time curves into content-time curves for analysis with a multiple-pathway, axially distributed model. Flow estimates, obtained by automated parameter optimization, averaged 1.2 mL/min/g ± 0.5 [n = 29), compared with 1.3 mL/min/g ± 0.3 obtained with tracer microspheres in the same tissue specimens at the same time. The results represent a combination of T1-weighted first-pass imaging, intravascular relaxation agents, and a spatially distributed perfusion model to obtain absolute regional myocardial blood flow and volume. PMID:7766986

  11. [Measurement of regional blood flow using hydrogen gas generated by electrolysis (author's transl)].

    PubMed

    Koshu, K; Endo, S; Takaku, A; Saito, T

    1981-10-01

    Electrolytically generated hydrogen gas used to measure local blood flow by Stosseck et al. The data obtained by their method, however, did not correlated well with that obtained by original Aukland's method, hydrogen clearance method. We have tried to record the concentration of hydrogen gas after electrolytic generation of hydrogen gas at the white matter of the mongrel dogs. As a result, we found that its curves could be approximated to monoexponential curves during the first several minutes. This fact was also noticed in the experiment, in which circulation had been stopped due to cardiac arrest. A simple equation to calculate the regional blood flow was brought out through the approximation mentioned above. The values calculated by this new equation correlated well with that obtained by original hydrogen clearance method. This new method to detect the regional blood flow is simple and easy. Therefore it may contribute to some experiments, especially to the experiments with small animals.

  12. Spinal Stenosis

    MedlinePlus

    ... spurs and narrowing of the spinal canal A computed tomography (CT) scan, which takes more detailed images of the back and spinal canal A magnetic resonance imaging (MRI) scan of the spine to take pictures ...

  13. Spinal Stenosis

    MedlinePlus

    ... Staff Spinal stenosis is a narrowing of the open spaces within your spine, which can put pressure on ... only on the vertebrae in the neck. It opens up the space within the spinal canal by creating a hinge ...

  14. Spinal injury

    MedlinePlus

    ... and drive. Do not dive into pools, lakes, rivers, and other bodies of water, particularly if you cannot determine the depth of the ... Central nervous system Spinal cord injury Spinal anatomy Two person roll - ...

  15. Prevalence of HCV among the young male blood donors of Quetta region of Balochistan, Pakistan.

    PubMed

    Khan, Ayesha; Tareen, Abdul Malik; Ikram, Aamer; Rahman, Hazir; Wadood, Abdul; Qasim, Muhammad; Khan, Kalimullah

    2013-03-13

    Hepatitis C, caused by hepatitis C virus (HCV) is a contagious disease of the liver which infects more than 170 million people world-wide and around 16 million in Pakistan. HCV associated infection spreads mainly by blood-to-blood contact. In recent years, many studies have been conducted to determine the prevalence of HCV infection in Pakistan; however, no data is available on HCV infection from the largest province of Pakistan. Therefore, the present study focuses on the prevalence of HCV infection in the young male blood donor population of Quetta region of Balochistan, Pakistan. A total of 356 blood samples were collected from blood donors (age range 17-25 years) at Combined Military Hospital (CMH), Quetta, Balochistan, Pakistan. Blood samples were screened for HCV positivity by Immunochromatographic test (ICT) and Enzyme Linked Immunosorbant Assay (ELISA). Out of 356 blood samples, the overall HCV prevalence was 20.8%. Among the HCV positive cases, the age group with 25 years was more frequently infected with a prevalence of 26.3%. The present study provides the preliminary information about high HCV prevalence among the young male donor population in Balochistan province. This data may be helpful in formulating public health strategy for the prevention of risk factors associated with spreading of the disease. Furthermore, we recommend that in public sector hospitals and health care units ELISA should be preferred for anti-HCV detection over ICT.

  16. Prevalence of HCV among the young male blood donors of Quetta region of Balochistan, Pakistan

    PubMed Central

    2013-01-01

    Background Hepatitis C, caused by hepatitis C virus (HCV) is a contagious disease of the liver which infects more than 170 million people world-wide and around 16 million in Pakistan. HCV associated infection spreads mainly by blood-to-blood contact. In recent years, many studies have been conducted to determine the prevalence of HCV infection in Pakistan; however, no data is available on HCV infection from the largest province of Pakistan. Therefore, the present study focuses on the prevalence of HCV infection in the young male blood donor population of Quetta region of Balochistan, Pakistan. Methods A total of 356 blood samples were collected from blood donors (age range 17–25 years) at Combined Military Hospital (CMH), Quetta, Balochistan, Pakistan. Blood samples were screened for HCV positivity by Immunochromatographic test (ICT) and Enzyme Linked Immunosorbant Assay (ELISA). Results Out of 356 blood samples, the overall HCV prevalence was 20.8%. Among the HCV positive cases, the age group with 25 years was more frequently infected with a prevalence of 26.3%. Conclusions The present study provides the preliminary information about high HCV prevalence among the young male donor population in Balochistan province. This data may be helpful in formulating public health strategy for the prevention of risk factors associated with spreading of the disease. Furthermore, we recommend that in public sector hospitals and health care units ELISA should be preferred for anti-HCV detection over ICT. PMID:23497435

  17. Role of the TLR4 pathway in blood-spinal cord barrier dysfunction during the bimodal stage after ischemia/reperfusion injury in rats.

    PubMed

    Li, Xiao-Qian; Lv, Huang-Wei; Tan, Wen-Fei; Fang, Bo; Wang, He; Ma, Hong

    2014-03-28

    Spinal cord ischemia-reperfusion (I/R) involves two-phase injury, including an initial acute ischemic insult and subsequent inflammatory reperfusion injury, resulting in blood-spinal cord barrier (BSCB) dysfunction involving the TLR₄ pathway. However, the correlation between TLR₄/MyD₈₈-dependent and TLR₄/TRIF-dependent pathways in BSCB dysfunction is not fully understood. The aim of this study is to characterize inflammatory responses in spinal cord I/R and the events that define its clinical progression with delayed neurological deficits, supporting a bimodal mechanism of injury. Rats were intrathecally pretreated with TAK-242, MyD₈₈ inhibitory peptide, or Resveratrol at a 12 h interval for 3 days before undergoing 14-minute occlusion of aortic arch. Evan's Blue (EB) extravasation and water content were detected at 6, 12, 18, 24, 36, 48, and 72 h after reperfusion. EB extravasation, water content, and NF-κB activation were increased with time after reperfusion, suggesting a bimodal distribution, as maximal increasing were detected at both 12 and 48 h after reperfusion. The changes were directly proportional to TLR₄ levels determined by Western blot. Double-labeled immunohistochemical analysis was also used to detect the relationship between different cell types of BSCB with TLR₄. Furthermore, NF-κB and IL-1β were analyzed at 12 and 48 h to identify the correlation between MyD₈₈-dependent and TRIF-dependent pathways. Rats without functional TLR₄ and MyD₈₈ attenuated BSCB leakage and inflammatory responses at 12 h, suggesting the ischemic event was largely mediated by MyD₈₈-dependent pathway. Similar protective effects observed in rats with depleted TLR₄, MyD₈₈, and TRIF receptor at 48 h infer that the ongoing inflammation which occurred in late phase was mainly initiated by TRIF-dependent pathway and such inflammatory response could be further amplified by MyD₈₈-dependent pathway. Additionally, microglia appeared to play

  18. Upregulation of tachykinin NK-1 and NK-3 receptor binding sites in the spinal cord of spontaneously hypertensive rat: impact on the autonomic control of blood pressure

    PubMed Central

    Cloutier, Frank; Ongali, Brice; Deschamps, Kathleen; Brouillette, Jonathan; Neugebauer, Witold; Couture, Réjean

    2006-01-01

    Effects of intrathecally (i.t.) injected tachykinin NK-1 and -3 receptor agonists and antagonists were measured on mean arterial blood pressure (MAP) and heart rate (HR) in awake unrestrained spontaneously hypertensive rats (SHR,15-week-old) and age-matched Wistar Kyoto rats (WKY). Quantitative in vitro autoradiography was also performed on the lower thoracic spinal cord of both strains and Wistar rats using specific radioligands for NK-1 receptor ([125I]HPP[Arg3,Sar9,Met(O2)11]SP (3–11)) and NK-3 receptor ([125I]HPP-Asp-Asp-Phe-N-MePhe-Gly-Leu-Met-NH2). The NK-1 agonist [Sar9,Met(O2)11]SP (650 and 6500 pmol) decreased MAP and increased HR in WKY. The fall in MAP was blunted in SHR and substituted by increases in MAP (65–6500 pmol) and more sustained tachycardia. The NK-3 agonist senktide (6.5–65 pmol) evoked marked increases in MAP and HR (SHR>>>WKY), yet this response was rapidly desensitized. Cardiovascular effects of [Sar9,Met(O2)11]SP (650 pmol) and senktide (6.5 pmol) were selectively blocked by the prior i.t. injection of LY303870 (NK-1 antagonist, 65 nmol) and SB235375 (NK-3 antagonist, 6.5 nmol), respectively. Antagonists had no direct effect on MAP and HR in both strains. Densities of NK-1 and -3 receptor binding sites were significantly increased in all laminae of the spinal cord in SHR when compared to control WKY and Wistar rats. The dissociation constant was however not affected in SHR for both NK-1 (Kd=2.5 nM) and NK-3 (Kd=5 nM) receptors. Data highlight an upregulation of NK-1 and -3 receptor binding sites in the thoracic spinal cord of SHR that may contribute to the hypersensitivity of the pressor response to agonists and to the greater sympathetic activity seen in this model of arterial hypertension. PMID:16491095

  19. Effect of coronary stenotic lesions on regional myocardial blood flow at rest

    SciTech Connect

    Nichols, A.B.; Brown, C.; Han, J.; Nickoloff, E.L.; Esser, P.D.

    1986-10-01

    To determine the effect of atherosclerotic coronary lesions on myocardial blood flow in patients at rest, regional myocardial blood flow was measured distal to stenotic lesions in 29 patients with isolated proximal lesions of the left anterior descending artery. Severity of coronary stenosis was measured by computer-assisted cinevideodensitometric analysis of digitized coronary arteriograms. Regional myocardial blood flow was measured from the clearance rate of intracoronary /sup 133/Xe injected into the left main coronary artery and recorded with a multicrystal scintillation camera. In 21 patients with stenotic lesions ranging from 19% to 84% area reduction, distal regional myocardial blood flow was normal. In all eight patients with reduced regional myocardial blood flow distal to left anterior descending lesions, the minimum area of each stenotic lesion was less 0.80 mm2 (mean 0.34 +/- 0.2 mm2), minimum calculated diameter was less than 1 mm (mean 0.59 +/- 0.3 mm), and percent stenosis, based on the reduction in cross-sectional area, was greater than 85% (mean 94 +/- 4%). For all patients, distal flow, expressed as a fraction of normal flow, correlated with the lesion cross-sectional area (r = .84), minimum luminal diameter (r = .84), and percent area stenosis (r = -.70). Thus, resting myocardial blood flow distal to stenotic lesions of the proximal coronary arteries remains normal until the degree of narrowing is severe. The dimensions observed for critical coronary stenotic lesions correlate well with theoretical predictions based on fluid mechanics and with experimental preparations in laboratory animals.

  20. Stress-resistant neural stem cells positively influence regional energy metabolism after spinal cord injury in mice.

    PubMed

    Schwerdtfeger, Karsten; Mautes, Angelika E M; Bernreuther, Christian; Cui, Yifang; Manville, Jérôme; Dihné, Marcel; Blank, Simon; Schachner, Melitta

    2012-02-01

    The importance of stem cells to ameliorate the devastating consequences of traumatic injuries in the adult mammalian central nervous system calls for improvements in the capacity of these cells to cope, in particular, with the host response to the injury. We have previously shown, however, that in the acutely traumatized spinal cord local energy metabolism led to decreased ATP levels after neural stem cell (NSC) transplantation. As this might counteract NSC-mediated regenerative processes, we investigated if NSC selected for increased oxidative stress resistance are better suited to preserve local energy content. For this purpose, we exposed wild-type (WT) NSC to hydrogen peroxide prior to transplantation. We demonstrate here that transplantation of WT-NSC into a complete spinal cord compression injury model even lowers the ATP content beyond the level detected in spinal cord injury-control animals. Compared to WT-NSC, stress-resistant (SR) NSC did not lead to a further decrease in ATP content. These differences between WT- and SR-NSC were observed 4 h after the lesion with subsequent transplantation. At 24 h after lesioning, these differences were no more as obvious. Thus, in contrast to native NSC, transplantation of NSC selected for oxidative stress resistance can positively influence local energy metabolism in the first hours after spinal cord compression. The functional relevance of this observation has to be tested in further experiments.

  1. Blood

    MedlinePlus

    ... that die or are lost from the body. White Blood Cells White blood cells (WBCs, and also ... of severe pain. previous continue Diseases of the White Blood Cells Neutropenia (pronounced: new-truh-PEE-nee- ...

  2. Spinal Headaches

    MedlinePlus

    ... spinal cord and, in the lower spine, the lumbar and sacral nerve roots. During a spinal tap, a sample of ... injected into your spinal canal to numb the nerves in the lower half of your ... also known as post-lumbar puncture headaches — resolve on their own with no ...

  3. Serious Adverse Events and Spinal Manipulative Therapy of the Low Back Region: A Systematic Review of Cases.

    PubMed

    Hebert, Jeffrey J; Stomski, Norman J; French, Simon D; Rubinstein, Sidney M

    2015-01-01

    The purpose of this study was to systematically search the literature for studies reporting serious adverse events following lumbopelvic spinal manipulative therapy (SMT) and to describe the case details. A systematic search was conducted in PubMed including MEDLINE, EMBASE, CINAHL, and The Cochrane Library up to January 12, 2012, by an experienced reference librarian. Study selection was performed by 2 independent reviewers using predefined criteria. We included cases involving individuals 18 years or older who experienced a serious adverse event following SMT applied to the lumbar spine or pelvis by any type of provider (eg, chiropractic, medical, physical therapy, osteopathic, layperson). A serious adverse event was defined as an untoward occurrence that results in death or is life threatening, requires hospital admission, or results in significant or permanent disability. We included studies published in English, German, Dutch, and Swedish. A total of 2046 studies were screened, and 41 studies reporting on 77 cases were included. Important case details were frequently unreported, such as descriptions of SMT technique, the pre-SMT presentation of the patient, the specific details of the adverse event, time from SMT to the adverse event, factors contributing to the adverse event, and clinical outcome. Adverse events consisted of cauda equina syndrome (29 cases, 38% of total); lumbar disk herniation (23 cases, 30%); fracture (7 cases, 9%); hematoma or hemorrhagic cyst (6 cases, 8%); or other serious adverse events (12 cases, 16%) such as neurologic or vascular compromise, soft tissue trauma, muscle abscess formation, disrupted fracture healing, and esophageal rupture. This systematic review describes case details from published articles that describe serious adverse events that have been reported to occur following SMT of the lumbopelvic region. The anecdotal nature of these cases does not allow for causal inferences between SMT and the events identified in this

  4. Review of the secondary injury theory of acute spinal cord trauma with emphasis on vascular mechanisms.

    PubMed

    Tator, C H; Fehlings, M G

    1991-07-01

    In patients with spinal cord injury, the primary or mechanical trauma seldom causes total transection, even though the functional loss may be complete. In addition, biochemical and pathological changes in the cord may worsen after injury. To explain these phenomena, the concept of the secondary injury has evolved for which numerous pathophysiological mechanisms have been postulated. This paper reviews the concept of secondary injury with special emphasis on vascular mechanisms. Evidence is presented to support the theory of secondary injury and the hypothesis that a key mechanism is posttraumatic ischemia with resultant infarction of the spinal cord. Evidence for the role of vascular mechanisms has been obtained from a variety of models of acute spinal cord injury in several species. Many different angiographic methods have been used for assessing microcirculation of the cord and for measuring spinal cord blood flow after trauma. With these techniques, the major systemic and local vascular effects of acute spinal cord injury have been identified and implicated in the etiology of secondary injury. The systemic effects of acute spinal cord injury include hypotension and reduced cardiac output. The local effects include loss of autoregulation in the injured segment of the spinal cord and a marked reduction of the microcirculation in both gray and white matter, especially in hemorrhagic regions and in adjacent zones. The microcirculatory loss extends for a considerable distance proximal and distal to the site of injury. Many studies have shown a dose-dependent reduction of spinal cord blood flow varying with the severity of injury, and a reduction of spinal cord blood flow which worsens with time after injury. The functional deficits due to acute spinal cord injury have been measured electrophysiologically with techniques such as motor and somatosensory evoked potentials and have been found proportional to the degree of posttraumatic ischemia. The histological effects

  5. Accuracy and precision of regional multiharmonic Fourier analysis of gated blood-pool images.

    PubMed

    Machac, J; Horowitz, S F; Broder, D; Goldsmith, S J

    1984-12-01

    In order to estimate the precision and accuracy of parameters derived from segmental multiharmonic Fourier analysis of gated blood-pool images, a Monte Carlo computer noise simulation was tested on five sample regional time-activity curves. The first three Fourier harmonics were retained and the precision and accuracy of parameters of ventricular function were calculated, varying the ejection fraction, segment size, and framing rate. Precision improved with higher ejection fraction, higher counts per frame, or higher framing rate. There was no change in precision as the framing rate changed at fixed total counts. Accuracy changed little with changing framing rate. Thus, for segmental analysis there is no advantage to using a higher framing rate. Regions five or more pixels in size are recommended for reliable results. This study provides useful information for the optimization of acquisition and processing conditions for regional gated blood-pool analysis.

  6. A kinematic and kinetic analysis of spinal region in subjects with and without recurrent low back pain during one leg standing.

    PubMed

    Sung, Paul S; Leininger, Peter M

    2015-08-01

    The purpose of this study was to evaluate the relationship between normalized kinematic and kinetic stability indices for spinal regions with eyes-open and eyes-closed conditions during non-dominant leg standing between subjects with recurrent low back pain and control subjects. The kinematic stability index for the spinal regions (core spine model, lumbar spine, lower and upper thorax) and the kinetic stability index from force plate were measured. All participants were asked to maintain non-dominant leg standing with the dominant hip and knee flexed approximately 90 degrees for 25 seconds. Forty-two participants enrolled in the study, including 22 subjects with low back pain (12 male, 10 female) and 20 control subjects (12 male, 8 female). For the kinematic index for stability, the visual condition (F=30.06, p=0.0001) and spinal region (F=10.82, p=0.002) were statistically significant. The post hoc test results indicated a significant difference in the lumbar spine compared with the upper and lower thorax and the core spine model. The kinetic stability (average [standard deviation]) during the eyes-closed condition significantly decreased in the low back pain group (t=-3.24, p=0.002). The subjects with recurrent low back pain demonstrated higher lumbar spine stability in eyes-open condition. This higher stability of the lumbar spine might be due to a possible pain avoiding strategy from the standing limb. The low back pain group also significantly decreased kinetic stability during the eyes-closed condition. Clinicians need to consider both kinetic and kinematic indices while considering visual condition for lumbar spine stability in subjects with recurrent low back pain. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Genetic screening of spinal muscular atrophy using a real-time modified COP-PCR technique with dried blood-spot DNA.

    PubMed

    Ar Rochmah, Mawaddah; Harahap, Nur Imma Fatimah; Niba, Emma Tabe Eko; Nakanishi, Kenta; Awano, Hiroyuki; Morioka, Ichiro; Iijima, Kazumoto; Saito, Toshio; Saito, Kayoko; Lai, Poh San; Takeshima, Yasuhiro; Takeuchi, Atsuko; Bouike, Yoshihiro; Okamoto, Maya; Nishio, Hisahide; Shinohara, Masakazu

    2017-10-01

    Spinal muscular atrophy (SMA) is a common neuromuscular disorder caused by mutations in SMN1. More than 95% of SMA patients carry homozygous SMN1 deletion. SMA is the leading genetic cause of infant death, and has been considered an incurable disease. However, a recent clinical trial with an antisense oligonucleotide drug has shown encouraging clinical efficacy. Thus, early and accurate detection of SMN1 deletion may improve prognosis of many infantile SMA patients. A total of 88 DNA samples (37 SMA patients, 12 carriers and 39 controls) from dried blood spots (DBS) on filter paper were analyzed. All participants had previously been screened for SMN genes by PCR restriction fragment length polymorphism (PCR-RFLP) using DNA extracted from freshly collected blood. DNA was extracted from DBS that had been stored at room temperature (20-25°C) for 1week to 5years. To ensure sufficient quality and quantity of DNA samples, target sequences were pre-amplified by conventional PCR. Real-time modified competitive oligonucleotide priming-PCR (mCOP-PCR) with the pre-amplified PCR products was performed for the gene-specific amplification of SMN1 and SMN2 exon 7. Compared with PCR-RFLP using DNA from freshly collected blood, results from real-time mCOP-PCR using DBS-DNA for detection of SMN1 exon 7 deletion showed a sensitivity of 1.00 (CI [0.87, 1.00])] and specificity of 1.00 (CI [0.90, 1.00]), respectively. We combined DNA extraction from DBS on filter paper, pre-amplification of target DNA, and real-time mCOP-PCR to specifically detect SMN1 and SMN2 genes, thereby establishing a rapid, accurate, and high-throughput system for detecting SMN1-deletion with practical applications for newborn screening. Copyright © 2017 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  8. Long-term evolution of blood lipid profiles and glycemic levels in patients after spinal cord injury.

    PubMed

    Vidal, J; Javierre, C; Curià, F J; Garrido, E; Lizarraga, M-A; Segura, R

    2003-03-01

    To analyze the lipid and glycemic profiles in relation to age, time elapsed post injury and the level of injury in a group of patients with SCI. 2135 subjects with SCI were recruited during the annual routine health check-up carried out at the Institut Guttmann of Badalona, in Spain. The patients were classified according to the level of SCI and their age. Serum lipid profiles and glycemic (glucose) levels were determined. Data was collected between 1996 and 2001, all biochemical analysis being performed by the same laboratory. Serum cholesterol levels show a statistically significant correlation with patient's age(P<0.001) and with time elapsed after injury (P<0.05). Differences can be observed between the values obtained from the different injury level groups (F=22.14; P<0.001). LDL-c shows a statistically significant difference between the four different age groups (F=3.51, P<0.05). There is an increase in plasma triglycerides related to the increase in age of the patients without observable differences between the injury level groups. The concentration of serum glucose increases with age (P<0.001) and also with the time elapsed after injury (P<0.05). There is a direct relationship between various biochemical parameters (total cholesterol, LDL-c and glucose) and the age of the patients, but not with the severity or time of evolution of the spinal cord injury.

  9. Regional blood flow in the domestic fowl immediately following chronic acceleration

    SciTech Connect

    Weidner, W.J.; Hoffman, L.F.; Clark, S.D.

    1982-07-01

    In order to examine the effects of chronic low G acceleration on blood flow distribution and cardiac output, chickens (N.10) were centrifuged at +2Gz for 30-61 d. Controls (N.12) were not centrifuged. The animals were anesthetized with sodium pentobarbital after removal from the centrifuge and surgically prepared in order to measure cardiac output and regional blood flows by the reference sample method with /sup 85/Sr labeled microspheres (15 +/- 5 mum diam.). Both brachial arteries were cannulated to withdraw timed, paired blood samples at a known rate. The chest was opened and a cannula inserted into the left ventricle for administration of microspheres. Tissue samples were taken after completion of experimental procedures and their radioactivity was determined. The cardiac outputs in the two groups were not significantly different. Regional blood flows to the kidney, eyes, and skeletal muscle were significantly increased in the animals subjected to chronic +2Gz. While the mechanism by which these increases in blood flow occurred is not known, results indicate that chronic exposure to hyperdynamic gravitational fields can alter circulatory dynamics. We conclude that the cardiovascular system is directly involved in the process of adaptation to chronic positive acceleration.

  10. Effects of inhaled nitric oxide on regional blood flow are consistent with intravascular nitric oxidedelivery

    PubMed Central

    Cannon, Richard O.; Schechter, Alan N.; Panza, Julio A.; Ognibene, Frederick P.; Pease-Fye, Margaret E.; Waclawiw, Myron A.; Shelhamer, James H.; Gladwin, Mark T.

    2001-01-01

    Nitric oxide (NO) may be stabilized by binding to hemoglobin, by nitrosating thiol-containing plasma molecules, or by conversion to nitrite, all reactions potentially preserving its bioactivity in blood. Here we examined the contribution of blood-transported NO to regional vascular tone in humans before and during NO inhalation. While breathing room air and then room air with NO at 80 parts per million, forearm blood flow was measured in 16 subjects at rest and after blockade of forearm NO synthesis with NG-monomethyl-L-arginine (L-NMMA) followed by forearm exercise stress. L-NMMA reduced blood flow by 25% and increased resistance by 50%, an effect that was blocked by NO inhalation. With NO inhalation, resistance was significantly lower during L-NMMA infusion, both at rest and during repetitive hand-grip exercise. S-nitrosohemoglobin and plasma S-nitrosothiols did not change with NO inhalation. Arterial nitrite levels increased by 11% and arterial nitrosyl(heme)hemoglobin levels increased tenfold to the micromolar range, and both measures were consistently higher in the arterial than in venous blood. S-nitrosohemoglobin levels were in the nanomolar range, with no significant artery-to-vein gradients. These results indicate that inhaled NO during blockade of regional NO synthesis can supply intravascular NO to maintain normal vascular function. This effect may have application for the treatment of diseases characterized by endothelial dysfunction. PMID:11457881

  11. Dorsal spinal venous occlusion in the rat.

    PubMed

    Martinez-Arizala, A; Mora, R J; Madsen, P W; Green, B A; Hayashi, N

    1995-04-01

    Occlusion of the major components of the spinal venous system is usually associated with spinal arteriovenous malformations or systemic thrombophlebitis. Although spinal venous system dysfunction has been implicated in compressive cord syndromes, myelopathies from decompression sickness, and spinal cord trauma, its pathophysiology remains unclear. To characterize disorders associated with spinal venous occlusion, we developed a model in the rat produced by focally coagulating the dorsal spinal vein transdurally at the T7 and T10 vertebral levels. Following such occlusion, venous stasis, sludging and perivascular hemorrhages in the small venous branches were observed. By 1 week postocclusion, animals developed hindlimb paralysis from which they partially recovered over time. Histologic examination in the acute phase disclosed tissue necrosis, edema, and hemorrhages predominantly in the dorsal aspect of the spinal cord. This was gradually replaced by an intense macrophagic infiltration and the partial formation of a cystic cavity by 1 month. These findings indicate that dorsal spinal vein occlusion in the rat causes significant neurologic and pathologic alterations. We conclude that this procedure produces a relevant animal model for the study of the pathophysiology of spinal venous occlusion, and it allows the characterization of its effects on spinal cord blood flow, the blood-spinal cord barrier, and the development of edema independent of cord compression. Our findings in this model provide an insight into one of the mechanisms of injury extension in spinal cord trauma and other disorders associated with spinal venous dysfunction.

  12. Early development of arterial spin labeling to measure regional brain blood flow by MRI.

    PubMed

    Koretsky, Alan P

    2012-08-15

    Two major avenues of work converged in the late 1980's and early 1990's to give rise to brain perfusion MRI. The development of anatomical brain MRI quickly had as a major goal the generation of angiograms using tricks to label flowing blood in macroscopic vessels. These ideas were aimed at getting information about microcirculatory flow as well. Over the same time course the development of in vivo magnetic resonance spectroscopy had as its primary goal the assessment of tissue function and in particular, tissue energetics. For this the measurement of the delivery of water to tissue was critical for assessing tissue oxygenation and viability. The measurement of the washin/washout of "freely" diffusible tracers by spectroscopic based techniques pointed the way for quantitative approaches to measure regional blood flow by MRI. These two avenues came together in the development of arterial spin labeling (ASL) MRI techniques to measure regional cerebral blood flow. The early use of ASL to measure brain activation to help verify BOLD fMRI led to a rapid development of ASL based perfusion MRI. Today development and applications of regional brain blood flow measurements with ASL continues to be a major area of activity.

  13. [Long term effect of spinal cord stimulation in a patient with complex regional pain syndrome and phantom pain syndrome type 1 after amputation].

    PubMed

    Enggaard, Thomas Peter; Scherer, Christian; Nikolajsen, Lone; Andersen, Claus

    2008-02-04

    The development of stump and phantom pain after limb amputation in patients with complex regional pain syndrome (CRPS) is very frequent. Stump pain is typically recurred CRPS and the possibilities for effective pharmacological pain relief are often limited. Spinal cord stimulation (SCS) has a well-documented pain relieving effect in patients with CRPS. This case story summarises the long term effect of SCS in a patient with CRPS after two amputations of the right leg. Pharmacological pain therapies as well as Guanethidine blockade were found to be ineffective.

  14. [Spinal cord stimulation in teenager with complex regional pain syndrome for Lyme’s disease. Case report and review of the literature].

    PubMed

    Mejía-Terrazas, G E; López-Ruiz, V G; Infante-Cosío, G; Carapia-Sadurni, A; Hernández-Méndez-Villamil, E

    2015-01-01

    Lyme disease is an emerging pathology in Mexico, producer of painful muscle skeletal either neurotic pain difficult to control. We present the case of a teenager girl who has complex regional pain type II of pelvic limb secondary to it, where it established a multidisciplinary management that finally was controlled with the placement of a spinal cord stimulator. We consider this as an unusual situation in an adolescent, as well as its evolution by 60 months where the literature only was reported in a few cases.

  15. Regional cerebral blood flow in dialysis encephalopathy and primary degenerative dementia

    SciTech Connect

    Mathew, R.J.; Rabin, P.; Stone, W.J.; Wilson, W.H.

    1985-07-01

    Regional cerebral blood flow (CBF) was measured in patients with dialysis encephalopathy, primary degenerative dementia, dialysis patients with no central nervous system (CNS) complications, and normal controls. Both groups of dialysis patients (with and without CNS complications) demonstrated higher CBF values, and the dementia patients, lower CBF values than the controls. The dialysis patients had lower hematocrit, which correlated inversely with the cerebral blood flow. No such correlations were present in normals and patients with primary degenerative dementia. The dialysis patients and controls obtained similar CBF when the flow values were adjusted for the differences in hematocrit.

  16. Regional measurements of blood flow in experimental RG-2 rat gliomas

    SciTech Connect

    Groothuis, D.R.; Pasternak, J.F.; Fischer, J.M.; Blasberg, R.G.; Bigner, D.D.; Vick, N.A.

    1983-07-01

    Regional measurements of blood flow (F) were performed in transplanted intracerebral RG-2 rat gliomas using (14C)iodoantipyrine, Kety-Schmidt blood flow equations, and quantitative autoradiography. Twenty-nine intracranial tumors in ten rats were analyzed by location; 18 intraparenchymal, seven meningeal, two third-ventricular, and two fourth-ventricular tumors were studied. For all tumors, averaged mean F was 91 +/- 33 (S.D.) ml/hg/min. In all but one tumor, mean F was intermediate between normal cortex and corpus callosum values. There was moderate regional variation: averaged mean F was lower in tumor center (78 +/- 47 ml/hg/min) than in tumor periphery (93 +/- 30 ml/hg/min). Within individual tumors, F showed moderate variation which correlated to some extent with histological features; a regional F of less than 10 ml/hg/min was observed in only one tumor within an area of necrosis. F in regions of brain immediately surrounding the tumor was higher than in tumor periphery. Blood flow to RG-2 tumors seems unlikely to limit drug delivery any more than to normal brain, and the consistent levels from tumor to tumor and within individual tumors make the RG-2 model an excellent one with which to study drug delivery in experimental brain tumors.

  17. Regional cerebral blood flow utilizing the gamma camera and xenon inhalation: reproducibility and clinical applications

    SciTech Connect

    Fox, R.A.; Knuckey, N.W.; Fleay, R.F.; Stokes, B.A.; Van der Schaaf, A.; Surveyor, I.

    1985-11-01

    A modified collimator and standard gamma camera have been used to measure regional cerebral blood flow following inhalation of radioactive xenon. The collimator and a simplified analysis technique enables excellent statistical accuracy to be achieved with acceptable precision in the measurement of grey matter blood flow. The validity of the analysis was supported by computer modelling and patient measurements. Sixty-one patients with subarachnoid hemorrhage, cerebrovascular disease or dementia were retested to determine the reproducibility of our method. The measured coefficient of variation was 6.5%. Of forty-six patients who had a proven subarachnoid hemorrhage, 15 subsequently developed cerebral ischaemia. These showed a CBF of 42 +/- 6 ml X minute-1 X 100 g brain-1 compared with 49 +/- 11 ml X minute-1 X 100 g brain-1 for the remainder. There is evidence that decreasing blood flow and low initial flow correlate with the subsequent onset of cerebral ischemia.

  18. Regional blood acidification enhances extracorporeal carbon dioxide removal: a 48-hour animal study.

    PubMed

    Zanella, Alberto; Mangili, Paolo; Redaelli, Sara; Scaravilli, Vittorio; Giani, Marco; Ferlicca, Daniela; Scaccabarozzi, Diletta; Pirrone, Federica; Albertini, Mariangela; Patroniti, Nicolò; Pesenti, Antonio

    2014-02-01

    Extracorporeal carbon dioxide removal has been proposed to achieve protective ventilation in patients at risk for ventilator-induced lung injury. In an acute study, the authors previously described an extracorporeal carbon dioxide removal technique enhanced by regional extracorporeal blood acidification. The current study evaluates efficacy and feasibility of such technology applied for 48 h. Ten pigs were connected to a low-flow veno-venous extracorporeal circuit (blood flow rate, 0.25 l/min) including a membrane lung. Blood acidification was achieved in eight pigs by continuous infusion of 2.5 mEq/min of lactic acid at the membrane lung inlet. The acid infusion was interrupted for 1 h at the 24 and 48 h. Two control pigs did not receive acidification. At baseline and every 8 h thereafter, the authors measured blood lactate, gases, chemistry, and the amount of carbon dioxide removed by the membrane lung (VCO2ML). The authors also measured erythrocyte metabolites and selected cytokines. Histological and metalloproteinases analyses were performed on selected organs. Blood acidification consistently increased VCO2ML by 62 to 78%, from 79 ± 13 to 128 ± 22 ml/min at baseline, from 60 ± 8 to 101 ± 16 ml/min at 24 h, and from 54 ± 6 to 96 ± 16 ml/min at 48 h. During regional acidification, arterial pH decreased slightly (average reduction, 0.04), whereas arterial lactate remained lower than 4 mEq/l. No sign of organ and erythrocyte damage was recorded. Infusion of lactic acid at the membrane lung inlet consistently increased VCO2ML providing a safe removal of carbon dioxide from only 250 ml/min extracorporeal blood flow in amounts equivalent to 50% production of an adult man.

  19. Effect of blood donation-mediated volume reduction on regional right ventricular deformation in healthy subjects.

    PubMed

    Açar, Göksel; Alizade, Elnur; Avci, Anıl; Cakir, Hakan; Efe, Suleyman Cagan; Kalkan, Mehmet Emin; Tabakci, Mehmet Mustafa; Toprak, Cuneyt; Tanboğa, Ibrahim Halil; Esen, Ali Metin

    2014-03-01

    Strain (S) and strain rate (SR) are known to be altered in diseases associated with right ventricular (RV) pressure/volume overload and RV myocardial dysfunction; however determinants of S/SR are incompletely understood. The aim of this study was to examine the effect of blood donation-mediated volume reduction on regional RV deformation in healthy young adults. Study population was composed of 61 consecutive healthy subjects who were volunteers for blood donation. All underwent standard echocardiography and two-dimensional S and SR imaging by speckle tracking before and after 450 mL blood donation. We found no change in RV lateral wall SR in all three segments. However, the S in the apical and mid segments of the RV lateral wall immediately decreased after blood donation [-26.2 ± 3.3 vs. -23.2 ± 3.3 % (p < 0.0001) and -28.2 ± 3.4 vs. -27.1 ± 3.2 % (p = 0.009), respectively], whereas no change was observed in the basal segment. Moreover, changes in systolic S on the apical segment of the RV lateral wall before and after blood donation were significantly correlated with the changes in the RV size [end-diastolic area index, r = - 0.369 (p = 0.003) and end-systolic area index, r = - 0.319 (p = 0.012)] and changes in the stroke volume index [r = - 0.436 (p < 0.001)]. Blood donation-mediated volume reduction in healthy subjects caused a regional difference in RV longitudinal deformation with the lower mid and apical S that was related to parameters of volume load severity. However, RV systolic SR was found to be resistant to the effects of volume depletion.

  20. Revascularization for acute regional infarct: superior protection with warm blood cardioplegia.

    PubMed

    Horsley, W S; Whitlark, J D; Hall, J D; Gott, J P; Pan-Chih; Huang, A H; Park, Y; Jones, D P; Guyton, R A

    1993-12-01

    Continuous retrograde warm blood cardioplegia was compared with two widely used hypothermic myocardial protection techniques in a canine model of acute regional myocardial ischemia with subsequent revascularization. Animals (n = 30) underwent 45 minutes of left anterior descending coronary artery occlusion then cardioplegic arrest (60 minutes), followed by separation from cardiopulmonary bypass and data collection. The cold oxygenated crystalloid cardioplegia group (CC; n = 8) and the cold blood cardioplegia group (CC; n = 10) had cardiopulmonary bypass at 28 degrees C, antegrade arrest, and intermittent retrograde delivery. The warm blood cardioplegia group (WB; n = 12) had normothermic cardiopulmonary bypass, antegrade arrest, and continuous retrograde delivery. Overall ventricular function (preload recruitable stroke work relationship; ergs x 10(3)/mL) was significantly (p < 0.001) better for WB (WB, 80 +/- 11; CB, 67 +/- 13; CC, 57 +/- 12). Systolic function (maximum elastance relationship; mm Hg/mL) was also significantly (p < 0.001) better for WB (WB, 11.6 +/- 3.6; CB, 8.6 +/- 2.7; CC, 6.2 +/- 1.3). Diastolic function (stress-strain relationship; dynes x 10(3)/cm2) revealed significantly (p < 0.001) decreased compliance for CC (WB, 20 +/- 6; CB, 19 +/- 7; CC, 27 +/- 11). Left anterior descending coronary artery regional adenosine triphosphate/adenosine diphosphate ratios were significantly (p = 0.02) worse for CC (WB, 10.2 +/- 2.3; CB, 9.4 +/- 2.6; CC, 5.6 +/- 1.5). Myocardial edema significantly (p = 0.03) increased over time only in the CC animals (WB, 0.4% +/- 2.3%; CB, -0.3% +/- 3.6%; CC, 5.5% +/- 2.3%). In this model of acute regional myocardial ischemia and revascularization, continuous retrograde warm aerobic blood cardioplegia provided superior myocardial protection compared with cold oxygenated crystalloid cardioplegia with intermediate results for cold blood cardioplegia.

  1. Regional pulmonary blood flow in sitting and supine man during and after acute hypoxia

    PubMed Central

    Dawson, Arthur

    1969-01-01

    Regional pulmonary blood flow was measured by external counting of intravenously injected 133Xe during 20 min of breathing 14.2% oxygen and during 20 min of recovery from hypoxia. 16 normal human volunteers were studied, nine sitting and seven supine. During hypoxia there was a slight but significant increase in relative perfusion of the upper portions of the lungs in both the sitting and supine subjects. During recovery from hypoxia, blood flow distribution differed significantly from the control. The erect subjects showed increased relative perfusion of the lung bases and the supine subjects showed increased relative perfusion of the upper zones. Comparison of the distribution of inhaled and intravenously injected isotope showed that in the sitting subjects the altered distribution during hypoxia tended to make alveolar oxygen tension more uniform. In the supine subjects, however, the shift in blood flow increased the perfusion of the regions with the lowest ventilation/perfusion, tending to accentuate uneven alveolar oxygen tension. Therefore it does not seem that the altered blood flow distribution during hypoxia was due to selective vasoconstriction in the regions of lowest alveolar oxygen tension, but rather that vasoconstriction was greatest in the lower lung zones because the vessels there are more responsive to hypoxia. During mild acute hypoxia, vasoconstrictor tone does not seem to effectively match ventilation and perfusion. The altered distribution of pulmonary blood flow during recovery from hypoxia suggests the occurrence of posthypoxic vasodilation. Failure to consider this possibility may lead to erroneous interpretation of pulmonary hemodynamic measurements made after the inspired oxygen concentration has been changed. PMID:5764012

  2. Usutu Virus Antibodies in Blood Donors and Healthy Forestry Workers in the Lombardy Region, Northern Italy.

    PubMed

    Percivalle, Elena; Sassera, Davide; Rovida, Francesca; Isernia, Paola; Fabbi, Massimo; Baldanti, Fausto; Marone, Piero

    2017-09-01

    Usutu virus (USUV), a member of the genus Flavivirus, is known to circulate at low prevalence in Northern Italy, and has been reported to cause overt infection. USUV was first reported in Europe in 2001, but a retrospective study showed that it has been present in Italy at least since 1996. Seroprevalence data for USUV antibodies in sera are being collected in different European countries, showing circulation at low prevalence in human populations. Interestingly, two consecutive studies in Northern Italy indicate a possible increase in the presence of the virus, from 0% to 0.23% seroprevalence in blood donors. In this study, antibodies against USUV were measured in 3 consecutive blood samples collected from October 2014 to December 2015 from 33 forestry workers in the Po river valley, while samples from 200 blood donors from the same geographical area were tested in parallel. Neutralizing and IgG antibodies were found in six forestry workers (18.1%) and in two blood donors (1%). Our results indicate that USUV circulation in the examined area, part of a highly populated region in Northern Italy, is higher than expected. Healthy subjects exhibit a higher prevalence than what was found in a previous report in an adjoining region (0.23%), while the population at risk shows a much higher prevalence value (18.1%).

  3. Regional cerebral blood flow response in gray matter heterotopia during finger tapping: an activation study with positron emission tomography.

    PubMed

    Hatazawa, J; Sasajima, T; Shimosegawa, E; Fujita, H; Okudera, T; Kanno, I; Mineura, K; Uemura, K

    1996-03-01

    We examined regional cerebral blood flow response in a patient with gray matter heterotopia located beneath the sensorimotor cortex during a finger tapping task. We found regional cerebral blood flow was specifically increased during contralateral finger tapping. This indicated the possibility of functional differentiation of the ectopic neurons despite incomplete migration.

  4. Perfusion assessment in rat spinal cord tissue using photoplethysmography and laser Doppler flux measurements

    NASA Astrophysics Data System (ADS)

    Phillips, Justin P.; Cibert-Goton, Vincent; Langford, Richard M.; Shortland, Peter J.

    2013-03-01

    Animal models are widely used to investigate the pathological mechanisms of spinal cord injury (SCI), most commonly in rats. It is well known that compromised blood flow caused by mechanical disruption of the vasculature can produce irreversible damage and cell death in hypoperfused tissue regions and spinal cord tissue is particularly susceptible to such damage. A fiberoptic photoplethysmography (PPG) probe and instrumentation system were used to investigate the practical considerations of making measurements from rat spinal cord and to assess its suitability for use in SCI models. Experiments to assess the regional perfusion of exposed spinal cord in anesthetized adult rats using both PPG and laser Doppler flowmetry (LDF) were performed. It was found that signals could be obtained reliably from all subjects, although considerable intersite and intersubject variability was seen in the PPG signal amplitude compared to LDF. We present results from 30 measurements in five subjects, the two methods are compared, and practical application to SCI animal models is discussed.

  5. Differential oxidative stress and DNA damage in rat brain regions and blood following chronic arsenic exposure.

    PubMed

    Mishra, D; Flora, S J S

    2008-05-01

    Chronic arsenic poisoning caused by contaminated drinking water is a wide spread and worldwide problem particularly in India and Bangladesh. One of the possible mechanisms suggested for arsenic toxicity is the generation of reactive oxygen species (ROS). The present study was planned 1) to evaluate if chronic exposure to arsenic leads to oxidative stress in blood and brain - parts of male Wistar rats and 2) to evaluate which brain region of the exposed animals was more sensitive to oxidative injury. Male Wistar rats were exposed to arsenic (50A ppm sodium arsenite in drinking water) for 10A months. The brain was dissected into five major parts, pons medulla, corpus striatum, cortex, hippocampus, and cerebellum. A number of biochemical variables indicative of oxidative stress were studied in blood and different brain regions. Single-strand DNA damage using comet assay was also assessed in lymphocytes. We observed a significant increase in blood and brain ROS levels accompanied by the depletion of GSH/GSSG ratio and glucose-6-phosphate dehydrogenase (G6PD) activity in different brain regions of arsenic-exposed rats. Chronic arsenic exposure also caused significant single-strand DNA damage in lymphocytes as depicted by comet with a tail in arsenic-exposed cells compared with the control cells. On the basis of results, we concluded that the cortex region of the brain was more sensitive to oxidative injury compared with the other regions studied. The present study, thus, leads us to suggest that arsenic induces differential oxidative stress in brain regions with cortex followed by hippocampus and causes single-strand DNA damage in lymphocytes.

  6. [INFECTION OF BLOOD-SUCKING MOSQUITOES (DIPTERA: CULICIDAE) WITH DIROFILARIAE (SPIRURIDA, ONCHOCERCIDAE) IN THE TULA REGION].

    PubMed

    Bogacheva, A S; Ganushkina, L A; Lopatina, Yu V

    2016-01-01

    Blood-sucking mosquitoes (n = 2277) collected in Tula and its Region in 2013-2014 were examined using a PCR assay for dirofilariae. A total of 12 species from 4 genera (Culiseta, Aedes, Ochlerotatus [foreign character] Culex) out of 18 found mosquito species were infected with Dirofilaria immitis and D. repens. The proportion of the infected mosquitoes was 2.5% (D. immitis, 1.5%; D.repens, 1%). According to preliminary data, the most efficient Dirofilaria vectors, in the Tula Region may be Ae. vexans, Ae. geniculatus, Och. cantans, and Cx. pipiens.

  7. Effects of cardiac sympathetic nerve stimulation on regional coronary blood flow

    SciTech Connect

    Haws, C.W.; Green, L.S.; Burgess, M.J.; Abildskov, J.A.

    1987-02-01

    The purpose of this study was to examine the effects of cardiac sympathetic nerve stimulation on regional coronary blood flow following ..beta..-blockade. In 17 anesthetized dogs treated with propranolol (2 mg/kg iv) regional myocardial perfusion was measured (radio labelled microspheres) during control and during stimulation of the ventrolateral, ventromedial, or recurrent cardiac nerve. Ventrolateral nerve stimulation produced 25.5 +/- 3.4 and 23.5 +/- 3.1% (mean +/- SE) decreases in coronary blood flow in the posterior and lateral quadrants of the left ventricle. Ventromedial nerve stimulation produced 18.6 +/- 2.8, 15.4 +/- 2.8, and 10.1 +/- 3.2% decreases in flow in the anterior, septal, and lateral left ventricle, respectively. Recurrent cardiac nerve stimulation produced 16.4 +/- 2.1, 15.6 +/- 2.2, and 13.6 +/- 2.5% decreases in flow in the anterior and septal left ventricle and right ventricle, respectively. Ventrolateral nerve stimulation resulted in a small but significant increase in the endocardial-to-epicardial blood flow ratio in the posterolateral left ventricle. The authors conclude that the cardiac sympathetic nerves have selective regional effects on myocardial perfusion that could contribute to fine regulation of flow in the normal heart and could have beneficial or adverse effects in the setting of coronary stenosis or occlusion.

  8. Computed tomographic measurement of the xenon brain-blood partition coefficient and implications for regional cerebral blood flow: a preliminary report.

    PubMed

    Kelcz, F; Hilal, S K; Hartwell, P; Joseph, P M

    1978-05-01

    The calculation of regional cerebral blood flow requires, in addition to the measurement of the clearance, a knowledge of the regional brain-blood partition coefficient. The usual 133Xe washout techniques do not measure this latter parameter but use published values for normal brain tissue. This may lead to large errors in pathological tissue because the partition coefficient changes significantly in brain tumors. Investigations have begun into the use of CT and stable xenon to produce a cross sectional view of the brain in terms of its brain-blood partition coefficients. Results of experiments using an iodine phantom and xenon inhalation in animals are presented.

  9. Spinal infections.

    PubMed

    Tay, Bobby K-B; Deckey, Jeffrey; Hu, Serena S

    2002-01-01

    Spinal infections can occur in a variety of clinical situations. Their presentation ranges from the infant with diskitis who is unwilling to crawl or walk to the adult who develops an infection after a spinal procedure. The most common types of spinal infections are hematogenous bacterial or fungal infections, pediatric diskitis, epidural abscess, and postoperative infections. Prompt and accurate diagnosis of spinal infections, the cornerstone of treatment, requires a high index of suspicion in at-risk patients and the appropriate evaluation to identify the organism and determine the extent of infection. Neurologic function and spinal stability also should be carefully evaluated. The goals of therapy should include eradicating the infection, relieving pain, preserving or restoring neurologic function, improving nutrition, and maintaining spinal stability.

  10. Closed-Loop Feedback Computer-Controlled Phenylephrine for Maintenance of Blood Pressure During Spinal Anesthesia for Cesarean Delivery: A Randomized Trial Comparing Automated Boluses Versus Infusion.

    PubMed

    Ngan Kee, Warwick D; Tam, Yuk-Ho; Khaw, Kim S; Ng, Floria F; Lee, Shara W Y

    2017-07-01

    We previously described the use of closed-loop feedback computer-controlled infusion of phenylephrine for maintaining blood pressure (BP) during spinal anesthesia for cesarean delivery. In this study, we report a modified system in which phenylephrine is delivered by intermittent boluses rather than infusion. We hypothesized that the use of computer-controlled boluses would result in more precise control of BP compared with infusions. Two hundred fourteen healthy patients having spinal anesthesia for elective cesarean delivery were randomized to have their systolic BP maintained by phenylephrine administered by computer-controlled continuous infusion or computer-controlled intermittent boluses. From induction of anesthesia until the time of uterine incision, a noninvasive BP monitor was set to cycle at 1-minute intervals. In the infusion group, the infusion rate was automatically adjusted after each BP measurement using a previously described algorithm. In the bolus group, the algorithm was modified so that the mass of drug that would have been delivered over 1 minute was instead injected as a rapid intravenous bolus after each BP measurement. The precision of BP control was assessed using performance error calculations and compared between groups, with the primary outcome defined as median absolute performance error, and the latter being a measure of inaccuracy showing an average of the magnitudes of the differences of measured BP values above or below the target values. The precision of BP control was greater, as shown by smaller values for median absolute performance error, in the bolus group (median 4.38 [quartiles 3.22, 6.25] %) versus the infusion group (5.39 [4.12, 7.04] %, P = .008). In the bolus group, phenylephrine consumption was smaller; this was associated with smaller values for median performance error compared with the continuous infusion group (P < .001), which indicates that values for systolic BP, averaged over time, were slightly lower in the

  11. Phase III Clinical Trial Assessing Safety and Efficacy of Umbilical Cord Blood Mononuclear Cell Transplant Therapy of Chronic Complete Spinal Cord Injury.

    PubMed

    Zhu, Hui; Poon, Waisang; Liu, Yansheng; Leung, Gilberto Ka-Kit; Wong, Yatwa; Feng, Yaping; Ng, Stephanie C P; Tsang, Kam Sze; Sun, David T F; Yeung, David K; Shen, Caihong; Niu, Fang; Xu, Zhexi; Tan, Pengju; Tang, Shaofeng; Gao, Hongkun; Cha, Yun; So, Kwok-Fai; Fleischaker, Robert; Sun, Dongming; Chen, John; Lai, Jan; Cheng, Wendy; Young, Wise

    2016-11-01

    Umbilical cord blood-derived mononuclear cell (UCB-MNC) transplants improve recovery in animal spinal cord injury (SCI) models. We transplanted UCB-MNCs into 28 patients with chronic complete SCI in Hong Kong (HK) and Kunming (KM). Stemcyte Inc. donated UCB-MNCs isolated from human leukocyte antigen (HLA 4:6)-matched UCB units. In HK, four patients received four 4-l injections (1.6 million cells) into dorsal entry zones above and below the injury site, and another four received 8-l injections (3.2 million cells). The eight patients were an average of 13 years after C5-T10 SCI. Magnetic resonance diffusion tensor imaging of five patients showed white matter gaps at the injury site before treatment. Two patients had fiber bundles growing across the injury site by 12 months, and the rest had narrower white matter gaps. Motor, walking index of SCI (WISCI), and spinal cord independence measure (SCIM) scores did not change. In KM, five groups of four patients received four 4-l (1.6 million cells), 8-l (3.2 million cells), 16-l injections (6.4 million cells), 6.4 million cells plus 30 mg/kg methylprednisolone (MP), or 6.4 million cells plus MP and a 6-week course of oral lithium carbonate (750 mg/day). KM patients averaged 7 years after C3-T11 SCI and received 36 months of intensive locomotor training. Before surgery, only two patients walked 10 m with assistance and did not need assistance for bladder or bowel management before surgery. The rest could not walk or do their bladder and bowel management without assistance. At about a year (4187 weeks), WISCI and SCIM scores improved: 15/20 patients walked 10 m (p=0.001) and 12/20 did not need assistance for bladder management (p=0.001) or bowel management (p=0.002). Five patients converted from complete to incomplete (two sensory, three motor; p=0.038) SCI. We conclude that UCB-MNC transplants and locomotor training improved WISCI and SCIM scores. We propose further clinical trials.

  12. Phase I-II Clinical Trial Assessing Safety and Efficacy of Umbilical Cord Blood Mononuclear Cell Transplant Therapy of Chronic Complete Spinal Cord Injury.

    PubMed

    Zhu, Hui; Poon, Waisang; Liu, Yansheng; Leung, Gilberto Ka-Kit; Wong, Yatwa; Feng, Yaping; Ng, Stephanie C P; Tsang, Kam Sze; Sun, David T F; Yeung, David K; Shen, Caihong; Niu, Fang; Xu, Zhexi; Tan, Pengju; Tang, Shaofeng; Gao, Hongkun; Cha, Yun; So, Kwok-Fai; Fleischaker, Robert; Sun, Dongming; Chen, John; Lai, Jan; Cheng, Wendy; Young, Wise

    2016-11-01

    Umbilical cord blood-derived mononuclear cell (UCB-MNC) transplants improve recovery in animal spinal cord injury (SCI) models. We transplanted UCB-MNCs into 28 patients with chronic complete SCI in Hong Kong (HK) and Kunming (KM). Stemcyte Inc. donated UCB-MNCs isolated from human leukocyte antigen (HLA ≥4:6)-matched UCB units. In HK, four patients received four 4-μl injections (1.6 million cells) into dorsal entry zones above and below the injury site, and another four received 8-μl injections (3.2 million cells). The eight patients were an average of 13 years after C5-T10 SCI. Magnetic resonance diffusion tensor imaging of five patients showed white matter gaps at the injury site before treatment. Two patients had fiber bundles growing across the injury site by 12 months, and the rest had narrower white matter gaps. Motor, walking index of SCI (WISCI), and spinal cord independence measure (SCIM) scores did not change. In KM, five groups of four patients received four 4-μl (1.6 million cells), 8-μl (3.2 million cells), 16-μl injections (6.4 million cells), 6.4 million cells plus 30 mg/kg methylprednisolone (MP), or 6.4 million cells plus MP and a 6-week course of oral lithium carbonate (750 mg/day). KM patients averaged 7 years after C3-T11 SCI and received 3-6 months of intensive locomotor training. Before surgery, only two patients walked 10 m with assistance and did not need assistance for bladder or bowel management before surgery. The rest could not walk or do their bladder and bowel management without assistance. At about a year (41-87 weeks), WISCI and SCIM scores improved: 15/20 patients walked 10 m ( p = 0.001) and 12/20 did not need assistance for bladder management ( p = 0.001) or bowel management ( p = 0.002). Five patients converted from complete to incomplete (two sensory, three motor; p = 0.038) SCI. We conclude that UCB-MNC transplants and locomotor training improved WISCI and SCIM scores. We propose further clinical trials.

  13. Spinal brucellosis.

    PubMed

    Tali, E Turgut; Koc, A Murat; Oner, A Yusuf

    2015-05-01

    Spinal involvement in human brucellosis is a common condition and a significant cause of morbidity and mortality, particularly in endemic areas, because it is often associated with therapeutic failure. Most chronic brucellosis cases are the result of inadequate treatment of the initial episode. Recognition of spinal brucellosis is challenging. Early diagnosis is important to ensure proper treatment and decrease morbidity and mortality. Radiologic evaluation has gained importance in diagnosis and treatment planning, including interventional procedures and monitoring of all spinal infections.

  14. Distribution of ABO and Rh-D blood groups in the Benin area of Niger-Delta: Implication for regional blood transfusion.

    PubMed

    Enosolease, Mathew Ebose; Bazuaye, Godwin Nosa

    2008-01-01

    ABO and Rhesus (Rh) blood group antigens are hereditary characters and are useful in population genetic studies, in resolving medico-legal issues and more importantly in compatibility test in blood transfusion practice. Data on frequency distribution of ABO and Rh-D in Niger-Delta region of Nigeria are not available; hence we made an attempt to retrospectively analyze the records on the blood donors, transfusion recipients and patients attending antenatal care or some other medical interventions. Over a twenty-year period between 1986 and 2005, a total of 160,431 blood samples were grouped for ABO and Rh-D at the blood bank of the University of Benin Teaching Hospital, Benin City, Nigeria. Blood group distribution among these samples showed phenotypes A, B, AB and O as 23.72%, 20.09%, 2.97% and 53.22%, respectively. The Rh-D negative phenotype was found among 6.01% of the samples tested.

  15. Abnormal resting regional cerebral blood flow patterns and their correlates in schizophrenia

    SciTech Connect

    Mathew, R.J.; Wilson, W.H.; Tant, S.R.; Robinson, L.; Prakash, R.

    1988-06-01

    Regional cerebral blood flow (CBF) was measured under resting conditions in 108 right-handed schizophrenic inpatients and a matched group of normal controls with the xenon 133 inhalation technique. Forty-six patients were free of all medication for two weeks. There were no significant differences in CBF to the two hemispheres. The patients showed a comparatively reduced anteroposterior (AP) gradient for CBF. Though there were no differences in frontal flow, the patients had higher flow to several postcentral brain regions, bilaterally. Cerebral blood flow in the patients correlated inversely with age and positively with carbon dioxide level. Women had higher flow than men. Duration of the illness was the only significant predictor of the reduced AP gradient in patients. Higher left temporal and right parietal flow were found to be the best discriminators between patients and controls. Mean hemispheric flow to both hemispheres and several brain regions correlated with the total score and the item, unusual thought content, of the Brief Psychiatric Rating Scale. There were no differences in regional CBF between medicated and unmedicated patients.

  16. A Rapid, Accurate and Simple Screening Method for Spinal Muscular Atrophy: High-Resolution Melting Analysis Using Dried Blood Spots on Filter Paper.

    PubMed

    Sa'adah, Nihayatus; Harahap, Nur Imma Fatimah; Nurputra, Dian Kesumapramudya; Rochmah, Mawaddah Ar; Morikawa, Satoru; Nishimura, Noriyuki; Sadewa, Ahmad Hamim; Astuti, Indwiani; Haryana, Sofia Mubarika; Saito, Toshio; Saito, Kayoko; Nishio, Hisahide

    2015-01-01

    Spinal muscular atrophy (SMA) is a common neuromuscular disorder caused by mutation of the survival of the motor neuron 1 (SMN1) gene. More than 95% of SMA patients carry a homozygous deletion of SMN1. SMA can be screened for by polymerase chain reaction and high-resolution melting analysis (PCR-HRMA) using DNA extracted from dried blood spots (DBSs) stored on filter paper. However, there are two major problems with this approach. One is the frequent poor quality/quantity of DNA extracted from DBSs on filter paper, and the other is the difficulty in designing primer sets or probes to separate allele-specific melting curves. In this study, we addressed these problems and established a rapid, accurate and simple screening system for SMA with PCR-HRMA using DNA extracted from DBSs on filter paper. Seventy individuals were assayed in this study, 42 SMA patients and 28 controls, all of whom had been previously been screened for SMA by polymerase chain reaction-restriction fragment length polymorphism analysis (PCR-RFLP) using DNA extracted from freshly collected blood. In this study, the DNA of each individual was extracted from dried blood that had been spotted onto cards and stored at room temperature (20 - 25 degrees C) for between 1 and 8 years. PCR amplification of 30 or 45 cycles was performed using 50 ng of DNA and was immediately followed by HRMA. SMN1 and SMN2 products were co-amplified using a previously designed primer set (R111 and 541C770) containing two single nucleotide differences. The absorbance ratio at 260/280 of DNA extracted from DBSs ranged from 1.49 to 2.1 (mean ± SD; 1.66 ± 0.12), suggesting high-purity DNA. Thirty cycles of PCR amplification were insufficient to amplify the target alleles; PCR with 45 cycles was, however, successful in 69 out of 70 samples. PCR-HRMA using the R111/541C770 primer set enabled separation of the normalized melting curves of the samples with no SMN1 from those with SMN1 and SMN2. DBSs on filter paper can be a good

  17. A Comparative Study of SMN Protein and mRNA in Blood and Fibroblasts in Patients with Spinal Muscular Atrophy and Healthy Controls

    PubMed Central

    Wadman, Renske I.; Stam, Marloes; Jansen, Marc D.; van der Weegen, Yana; Wijngaarde, Camiel A.; Harschnitz, Oliver; Sodaar, Peter; Braun, Kees P. J.; Dooijes, Dennis; Lemmink, Henny H.; van den Berg, Leonard H.; van der Pol, W. Ludo

    2016-01-01

    Background Clinical trials to test safety and efficacy of drugs for patients with spinal muscular atrophy (SMA) are currently underway. Biomarkers that document treatment-induced effects are needed because disease progression in childhood forms of SMA is slow and clinical outcome measures may lack sensitivity to detect meaningful changes in motor function in the period of 1–2 years of follow-up during randomized clinical trials. Objective To determine and compare SMN protein and mRNA levels in two cell types (i.e. PBMCs and skin-derived fibroblasts) from patients with SMA types 1–4 and healthy controls in relation to clinical characteristics and SMN2 copy numbers. Materials and methods We determined SMN1, SMN2-full length (SMN2-FL), SMN2-delta7 (SMN2-Δ7), GAPDH and 18S mRNA levels and SMN protein levels in blood and fibroblasts from a total of 150 patients with SMA and 293 healthy controls using qPCR and ELISA. We analyzed the association with clinical characteristics including disease severity and duration, and SMN2 copy number. Results SMN protein levels in PBMCs and fibroblasts were higher in controls than in patients with SMA (p<0.01). Stratification for SMA type did not show differences in SMN protein (p>0.1) or mRNA levels (p>0.05) in either cell type. SMN2 copy number was associated with SMN protein levels in fibroblasts (p = 0.01), but not in PBMCs (p = 0.06). Protein levels in PBMCs declined with age in patients (p<0.01) and controls (p<0.01)(power 1-beta = 0.7). Ratios of SMN2-Δ7/SMN2-FL showed a broad range, primarily explained by the variation in SMN2-Δ7 levels, even in patients with a comparable SMN2 copy number. Levels of SMN2 mRNA did not correlate with SMN2 copy number, SMA type or age in blood (p = 0.7) or fibroblasts (p = 0.09). Paired analysis between blood and fibroblasts did not show a correlation between the two different tissues with respect to the SMN protein or mRNA levels. Conclusions SMN protein levels differ considerably between

  18. Age and regional cerebral blood flow at rest and during cognitive activity

    SciTech Connect

    Gur, R.C.; Gur, R.E.; Obrist, W.D.; Skolnick, B.E.; Reivich, M.

    1987-07-01

    The relationship between age and regional cerebral blood flow (rCBF) activation for cognitive tasks was investigated with the xenon (Xe 133) inhalation technique. The sample consisted of 55 healthy subjects, ranging in age from 18 to 72 years, who were studied during rest and during the performance of verbal analogy and spatial orientation tasks. The dependent measures were indexes of gray-matter rCBF and average rCBF (gray and white matter) as well as the percentage of gray-matter tissue. Advanced age was associated with reduced flow, particularly pronounced in anterior regions. However, the extent and pattern of rCBF changes during cognition was unaffected by age. For the percentage of gray matter, there was a specific reduction in anterior regions of the left hemisphere. The findings suggest the utility of this research paradigm for investigating neural underpinnings of the effects of dementia on cognitive functioning, relative to the effects of normal aging.

  19. Effect of cable cerclage on regional blood circulation in rabbits: a scintigraphic study.

    PubMed

    Karakoyun, Ozgur; Sahin, Ertan; Erol, Mehmet Fatih; Karıksız, Mesut; Küçükkaya, Metin

    2016-12-01

    To evaluate changes in blood circulation of the femoral cortex in rabbits using scintigraphy before and after cable cerclage alone or combined with an intramedullary Kirschner wire. Ten New Zealand rabbits were used. For the right femur, a 2-mm-thick cable was placed around the mid-diaphyseal region and squeezed with a 400-N force and locked with a clip. For the left femur, a 1.8-mm Kirschner wire was inserted retrogradely into the medullary canal, and a 2-mm-thick cable was applied using the same technique. The blood perfusion ratio of the region of interest (ROI) before and after surgery was evaluated using scintigraphy. For the right femurs, the mean ROI perfusion ratio decreased by 45% from 2.51 to 1.37 after intervention (p=0.001). For the left femurs, the mean ROI perfusion ratio decreased by 56% from 2.12 to 0.92 after intervention (p<0.001). The mean ROI perfusion ratio post-intervention was higher in the right than left femurs (p=0.017). Cable cerclage around the femoral cortex significantly decreased blood circulation in the area.

  20. A new seeded region growing technique for retinal blood vessels extraction.

    PubMed

    Sajadi, Atefeh Sadat; Sabzpoushan, Seyed Hojat

    2014-07-01

    Distribution of retinal blood vessels (RBVs) in retinal images has an important role in the prevention, diagnosis, monitoring and treatment of diseases, such as diabetes, high blood pressure, or heart disease. Therefore, detection of the exact location of RBVs is very important for Ophthalmologists. One of the frequently used techniques for extraction of these vessels is region growing-based Segmentation. In this paper, we propose a new region growing (RG) technique for RBVs extraction, called cellular automata-based segmentation. RG techniques often require manually seed point selection, that is, human intervention. However, due to the complex structure of vessels in retinal images, manual tracking of them is very difficult. Therefore, to make our proposed technique full automatic, we use an automatic seed point selection method. The proposed RG technique was tested on Digital Retinal Images for Vessel Extraction database for three different initial seed sets and evaluated against the manual segmentation of retinal images available at this database. Three quantitative criteria including accuracy, true positive rate and false positive rate, were considered to evaluate this method. The visual scrutiny of the segmentation results and the quantitative criteria show that, using cellular automata for extracting the blood vessels is promising. However, the important point at here is that the correct initial seeds have an effective role on the final results of segmentation.

  1. Effect of histamine on regional cerebral blood flow of the parietal lobe in rats.

    PubMed

    Yang, Peng-Bo; Chen, Xin-Lin; Zhao, Jian-Jun; Zhang, Jian-Shui; Zhang, Jun-Feng; Tian, Yu-Mei; Liu, Yong

    2010-09-01

    Histamine is a powerful modulator that regulates blood vessels and blood flow. The effect of histamine on the extracortical vessels has been well described, while much less is known about the effect of histamine on intracortical vessels. In this study, we investigated the effect of histamine on regional cerebral blood flow in rat parietal lobe with laser Doppler flowmetry. The pharmacological characteristics of distinct ways (intracerebroventricular injection, intraperitoneal injection, and cranial window infusion) in applying histamine to the brain were also obtained and compared. Histamine applied in three ways all produced a decrease of rCBF in parietal lobe in a concentration-dependent manner. Cranial window infusion was the most effective way and intraperitoneal injection of L-histidine was the most ineffective, although it is a simple and applied way. To determine which type of receptor takes part in the vessel contraction induced by histamine, H1 receptor antagonist, diphenhydramine, and H2 receptor antagonist, cimetidine, were applied, respectively, before histamine administration. When the injection of cimetidine was conducted in advance, histamine still resulted in a decrease of infusion amount; while the injection of diphenhydramine was conducted in advance, the infusion of blood amount wasn't changed. These findings indicated that histamine could result in a reduction of rCBF in the rat parietal lobe and this effect of histamine may attribute partly to its combination with H1 receptor.

  2. Effects of Fructose vs Glucose on Regional Cerebral Blood Flow in Brain Regions Involved With Appetite and Reward Pathways

    PubMed Central

    Page, Kathleen A.; Chan, Owen; Arora, Jagriti; Belfort-DeAguiar, Renata; Dzuira, James; Roehmholdt, Brian; Cline, Gary W.; Naik, Sarita; Sinha, Rajita; Constable, R. Todd; Sherwin, Robert S.

    2014-01-01

    Importance Increases in fructose consumption have paralleled the increasing prevalence of obesity, and high-fructose diets are thought to promote weight gain and insulin resistance. Fructose ingestion produces smaller increases in circulating satiety hormones compared with glucose ingestion, and central administration of fructose provokes feeding in rodents, whereas centrally administered glucose promotes satiety. Objective To study neurophysiological factors that might underlie associations between fructose consumption and weight gain. Design, Setting, and Participants Twenty healthy adult volunteers underwent 2 magnetic resonance imaging sessions at Yale University in conjunction with fructose or glucose drink ingestion in a blinded, random-order, crossover design. Main Outcome Measures Relative changes in hypothalamic regional cerebral blood flow (CBF) after glucose or fructose ingestion. Secondary outcomes included whole-brain analyses to explore regional CBF changes, functional connectivity analysis to investigate correlations between the hypothalamus and other brain region responses, and hormone responses to fructose and glucose ingestion. Results There was a significantly greater reduction in hypothalamic CBF after glucose vs fructose ingestion (–5.45 vs 2.84 mL/g per minute, respectively; mean difference, 8.3 mL/g per minute [95% CI of mean difference, 1.87-14.70]; P=.01). Glucose ingestion (compared with baseline) increased functional connectivity between the hypothalamus and the thalamus and striatum. Fructose increased connectivity between the hypothalamus and thalamus but not the striatum. Regional CBF within the hypothalamus, thalamus, insula, anterior cingulate, and striatum (appetite and reward regions) was reduced after glucose ingestion compared with baseline (P<.05 significance threshold, family-wise error [FWE] whole-brain corrected). In contrast, fructose reduced regional CBF in the thalamus, hippocampus, posterior cingulate cortex, fusiform

  3. Effects of fructose vs glucose on regional cerebral blood flow in brain regions involved with appetite and reward pathways.

    PubMed

    Page, Kathleen A; Chan, Owen; Arora, Jagriti; Belfort-Deaguiar, Renata; Dzuira, James; Roehmholdt, Brian; Cline, Gary W; Naik, Sarita; Sinha, Rajita; Constable, R Todd; Sherwin, Robert S

    2013-01-02

    Increases in fructose consumption have paralleled the increasing prevalence of obesity, and high-fructose diets are thought to promote weight gain and insulin resistance. Fructose ingestion produces smaller increases in circulating satiety hormones compared with glucose ingestion, and central administration of fructose provokes feeding in rodents, whereas centrally administered glucose promotes satiety. To study neurophysiological factors that might underlie associations between fructose consumption and weight gain. Twenty healthy adult volunteers underwent 2 magnetic resonance imaging sessions at Yale University in conjunction with fructose or glucose drink ingestion in a blinded, random-order, crossover design. Relative changes in hypothalamic regional cerebral blood flow (CBF) after glucose or fructose ingestion. Secondary outcomes included whole-brain analyses to explore regional CBF changes, functional connectivity analysis to investigate correlations between the hypothalamus and other brain region responses, and hormone responses to fructose and glucose ingestion. There was a significantly greater reduction in hypothalamic CBF after glucose vs fructose ingestion (-5.45 vs 2.84 mL/g per minute, respectively; mean difference, 8.3 mL/g per minute [95% CI of mean difference, 1.87-14.70]; P = .01). Glucose ingestion (compared with baseline) increased functional connectivity between the hypothalamus and the thalamus and striatum. Fructose increased connectivity between the hypothalamus and thalamus but not the striatum. Regional CBF within the hypothalamus, thalamus, insula, anterior cingulate, and striatum (appetite and reward regions) was reduced after glucose ingestion compared with baseline (P < .05 significance threshold, family-wise error [FWE] whole-brain corrected). In contrast, fructose reduced regional CBF in the thalamus, hippocampus, posterior cingulate cortex, fusiform, and visual cortex (P < .05 significance threshold, FWE whole-brain corrected). In

  4. Regional heritability mapping method helps explain missing heritability of blood lipid traits in isolated populations.

    PubMed

    Shirali, M; Pong-Wong, R; Navarro, P; Knott, S; Hayward, C; Vitart, V; Rudan, I; Campbell, H; Hastie, N D; Wright, A F; Haley, C S

    2016-03-01

    Single single-nucleotide polymorphism (SNP) genome-wide association studies (SSGWAS) may fail to identify loci with modest effects on a trait. The recently developed regional heritability mapping (RHM) method can potentially identify such loci. In this study, RHM was compared with the SSGWAS for blood lipid traits (high-density lipoprotein (HDL), low-density lipoprotein (LDL), plasma concentrations of total cholesterol (TC) and triglycerides (TG)). Data comprised 2246 adults from isolated populations genotyped using ∼300 000 SNP arrays. The results were compared with large meta-analyses of these traits for validation. Using RHM, two significant regions affecting HDL on chromosomes 15 and 16 and one affecting LDL on chromosome 19 were identified. These regions covered the most significant SNPs associated with HDL and LDL from the meta-analysis. The chromosome 19 region was identified in our data despite the fact that the most significant SNP in the meta-analysis (or any SNP tagging it) was not genotyped in our SNP array. The SSGWAS identified one SNP associated with HDL on chromosome 16 (the top meta-analysis SNP) and one on chromosome 10 (not reported by RHM or in the meta-analysis and hence possibly a false positive association). The results further confirm that RHM can have better power than SSGWAS in detecting causal regions including regions containing crucial ungenotyped variants. This study suggests that RHM can be a useful tool to explain some of the 'missing heritability' of complex trait variation.

  5. Regional heritability mapping method helps explain missing heritability of blood lipid traits in isolated populations

    PubMed Central

    Shirali, M; Pong-Wong, R; Navarro, P; Knott, S; Hayward, C; Vitart, V; Rudan, I; Campbell, H; Hastie, N D; Wright, A F; Haley, C S

    2016-01-01

    Single single-nucleotide polymorphism (SNP) genome-wide association studies (SSGWAS) may fail to identify loci with modest effects on a trait. The recently developed regional heritability mapping (RHM) method can potentially identify such loci. In this study, RHM was compared with the SSGWAS for blood lipid traits (high-density lipoprotein (HDL), low-density lipoprotein (LDL), plasma concentrations of total cholesterol (TC) and triglycerides (TG)). Data comprised 2246 adults from isolated populations genotyped using ∼300 000 SNP arrays. The results were compared with large meta-analyses of these traits for validation. Using RHM, two significant regions affecting HDL on chromosomes 15 and 16 and one affecting LDL on chromosome 19 were identified. These regions covered the most significant SNPs associated with HDL and LDL from the meta-analysis. The chromosome 19 region was identified in our data despite the fact that the most significant SNP in the meta-analysis (or any SNP tagging it) was not genotyped in our SNP array. The SSGWAS identified one SNP associated with HDL on chromosome 16 (the top meta-analysis SNP) and one on chromosome 10 (not reported by RHM or in the meta-analysis and hence possibly a false positive association). The results further confirm that RHM can have better power than SSGWAS in detecting causal regions including regions containing crucial ungenotyped variants. This study suggests that RHM can be a useful tool to explain some of the ‘missing heritability' of complex trait variation. PMID:26696135

  6. Proliferation, migration, and differentiation of endogenous ependymal region stem/progenitor cells following minimal spinal cord injury in the adult rat.

    PubMed

    Mothe, A J; Tator, C H

    2005-01-01

    Ependymal cells of the adult mammalian spinal cord exhibit stem/progenitor cell properties following injury. In the present study, we utilized intraventricular injection of 1,1'-dioctadecyl-6,6'-di(4-sulfophenyl)-3,3,3',3'-tetramethylindocarbocyanine (DiI) to label the ependyma lining the central canal to allow tracking of the migration of endogenous ependymal cells and their progeny after spinal cord injury (SCI). We developed a minimal injury model that preserved the integrity of the central canal and did not interfere with ependymal cell labeling. Three days following SCI, there was an 8.6-fold increase in the proliferative labeling index of the ependymal cells at the level of the needle track based on bromodeoxyuridine labeling, compared with 1 day post-injury. Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) positive cells were not detected in the ependyma or surrounding gray matter, indicating that ependymal cells do not undergo apoptosis in response to minimal injury. Nestin was rapidly induced in the ependyma by 1 day and expression peaked by 7 days post-injury. We quantitated the number and distance of ependymal cell migration following minimal injury. The number of ependymal cells migrating from the region of the central canal increased by 3 days following minimal injury and DiI-labeled glial fibrillary acidic protein expressing cells were detected 14 days post-SCI, most of which migrated within 70 microm of the region of the central canal. These results show that a minimal SCI adjacent to the ependyma is sufficient to induce an endogenous ependymal cell response where ependymal stem/progenitor cells proliferate and migrate from the region of the central canal, differentiating primarily into astrocytes.

  7. Regional blood flow responses to thermal challenge and exercise in rats

    SciTech Connect

    Wall, P.T.; Kregel, K.C.; Gisolfi, C.V.

    1986-03-05

    The authors recent work has explored interactions between circulation and thermoregulation controls. To further study the interaction of these systems, they chose to use Doppler flow probes to investigate regional blood flow in animals exposed to cool/hot environments (15/sup 0/C/40/sup 0/C, 60 min) and treadmill exercise (15-17 and 22-25 m/min, 15 min, 22/sup 0/C). In 7 350 gm male SD rats flow probes were implanted on the proximal portions of the superior mesenteric (M), iliac (hindlimb, H) and caudal (C) arteries. Blood flows (BF) in kHz doppler shifts were recorded continuously. Heart rates (HR) were obtained from phasic flow recordings. Colonic (T/sub c/) temperature was recorded from a copper-constantin thermocouple. The findings suggest the Doppler technique may be an appropriate tool to study the interactions between circulatory and temperature regulatory controls in this animal model.

  8. Effectiveness of confidential unit exclusion in screening blood donors of the regional blood bank in Londrina, Paraná State

    PubMed Central

    Vogler, Ingridt Hildegard; Saito, Mariza; Spinosa, Adriana Aparecida; da Silva, Marilza Celina; Munhoz, Egberto; Reiche, Edna Maria Vissoci

    2011-01-01

    Background For transfusion purposes, blood donors must be accepted both in clinical and serological evaluations and must not have excluded their own donation using the confidential unit exclusion. Aim The objective of this study was to verify whether blood donors who choose self exclusion are more likely to be positive in serological tests than donors who do not. Methods A cross-sectional analysis was carried out of 51,861 consecutive whole blood donations from January 2004 to December 2008 at a public blood bank in Londrina, Southern Brazil. Results Self exclusion was chosen in 1672 (3.2%) donations, most frequently by first-time blood donors (p-value < 0.0001), by blood donors from external collections (p-value < 0.0001), by men (p value < 0.0001) and by under 30-year-old donors (p-value < 0.0001). The frequency of positive serology was 5.3% in the group that chose self exclusion and 3.5% in the group that did not choose self exclusion (p-value < 0.0001). Conclusions These results show that confidential unit exclusion used in this blood bank is effective and is inexpensive. However, the diagnostic power to detect blood-borne infections was low and resulted in the discard of a high number of blood bags without any direct or indirect serologic markers of pathogens. The use of confidential unit exclusion could be replaced with molecular tests to screen blood donors. PMID:23049338

  9. Dombrock genotyping in Brazilian blood donors reveals different regional frequencies of the HY allele

    PubMed Central

    Piassi, Fabiana Chagas Camargos; Santos, Silvana Maria Eloi; de Castilho, Lilian Maria; Baleotti Júnior, Wilson; Suzuki, Rodrigo Buzinaro; da Cunha, Débora Moura

    2013-01-01

    Background Dombrock blood group system genotyping has revealed various rearrangements of the Dombrock gene and identified new variant alleles in Brazil (i.e., DO*A-SH, DO*A-WL and DO*B-WL). Because of the high heterogeneity of the Brazilian population, interregional differences are expected during the investigation of Dombrock genotypes. Objective The present study aims to determine the frequencies of Dombrock genotypes in blood donors from Minas Gerais and compare the frequencies of the HY and JO alleles to those of another population in Brazil. Methods The frequencies of the DO alleles in Minas Gerais, a southeastern state of Brazil, were determined from the genotyping of 270 blood donors. Genotyping involved polymerase chain reaction and restriction fragment length polymorphism analysis to identify the 323G>T, 350C>T, 793A>G, and 898C>G mutations, which are related to the HY, JO, DO*A/DO*B, and DO*A-WL/DO*B-WL alleles, respectively. Moreover, the frequencies of rare HY and JO alleles were statistically compared using the chi-square test with data from another Brazilian region. Results The HY allele frequency in Minas Gerais (2.4%) was almost twice that of the JO allele (1.5%). The frequency of the HY allele was significantly higher (p-value = 0.001) than that in another Brazilian population and includes a rare homozygous donor with the Hy- phenotype. In addition, the DO*A-WL and DO*B-WL alleles, which were first identified in Brazil, were found in the state of Minas Gerais. Conclusions The data confirm that the frequencies of DO alleles differ between regions in Brazil. The population of Minas Gerais could be targeted in a screening strategy to identify the Hy- phenotype in order to develop a rare blood bank. PMID:24478605

  10. Eulogy to August Karl Gustav Bier on the 100th anniversary of intravenous regional block and the 110th anniversary of the spinal block.

    PubMed

    dos Reis, Almiro

    2008-01-01

    August Karl Gustav Bier introduced two important techniques in regional block: intravenous regional block and subarachnoid block, widely used nowadays. Since the first one celebrates its 100th anniversary and the second its 110th anniversary, it is only fair that we pay homage to this extraordinary physician who created them. This report describes his family, school, academic course, and medical residency data, professional and university activities, personality, retirement, and death of A. K. G. Bier. It describes his countless contributions to Medicine and to Anesthesiology in particular. It discusses his research on intravenous regional block, many of them still valid nowadays or not completely explained. It mentions his initial studies and the controversies on his role in the creation of spinal block. It tells the experiences he had in both World Wars. It also mentions the great contributions of Bier to culture, sports, physical education and, especially, to ecology when he created the famous Sauen Forest. Finally, the well deserved honors he received in his home country and in other countries are mentioned. A. K. G. Bier created and introduced two notable and still current methods of regional blocks in Anesthesiology and was a great defender of the preservation of the environment. Therefore, since this year we celebrate the 100th anniversary of intravenous regional block, his biography deserves to be told as a tribute to this important German physician.

  11. Effect of naloxone on regional cerebral blood flow during endotoxin shock in conscious rats

    SciTech Connect

    Law, W.R.; Ferguson, J.L. )

    1987-09-01

    Maintenance of cerebral blood flow (CBF) is vital during cardiovascular shock. Since opioids have been implicated in the pathophysiology of endotoxin shock and have been shown to alter cerebral perfusion patterns, the authors determined whether opioids were responsible for any of the changes in regional CBF observed during endotoxin shock and whether the use of naloxone might impair or aid in the maintenance of CBF. When blood flow (BF) is studied with radioactively-labeled microspheres in rats, the left ventricle of the heart is often cannulated via the right carotid artery. Questions have arisen concerning the potential adverse effects of this method on CBF in the hemisphere ipsilateral to the ligated artery. They measured right and left regional CBF by use of this route of cannulation. Twenty-four hours after cannulations were performed, flow measurements were made using radiolabeled microspheres in conscious unrestrained male Sprague-Dawley rats (300-400 g) before and 10, 30, and 60 min after challenging with 10 mg/kg Escherichia coli endotoxin (etx) or saline. Naloxone (2 mg/kg) or saline was given as a treatment 25 min post-etx. They found no significant differences between right and left cortical, midbrain, or cerebellar BF at any time in any treatment group. Therefore naloxone treatment of endotoxin shock may be beneficial in preventing decreases in regional CBF.

  12. Analysis of immediate transfusion incidents reported in a regional blood bank

    PubMed Central

    de Sousa Neto, Adriana Lemos; Barbosa, Maria Helena

    2011-01-01

    Background Blood transfusion is imperative when treating certain patients; however, it is not risk free. In addition to the possible transmission of contagious infectious diseases, incidents can occur immediately after transfusion and at a later time. Aims This study aimed to examine the immediate transfusion incidents reported in a regional blood bank in the state of Minas Gerais between December 2006 and December 2009. A retrospective quantitative epidemiological study was conducted. Data were obtained from 202 transfusion incident reports of 42 health institutions served by the blood bank. Data processing and analysis were carried out using the Statistical Package for the Social Sciences (SPSS) software. Results The rate of immediate transfusion incidents reported in the period was 0.24%; febrile non-hemolytic reactions were the most common type of incident (56.4%). The most frequent clinical manifestations listed in transfusion incident reports were chills (26.9%) and fever (21.6%). There was a statistically significant association (p-value < 0.05) between the infusion of platelet concentrates and febrile non-hemolytic reactions and between fresh frozen plasma and febrile non-hemolytic reaction. The majority (73.3%) of transfused patients who suffered immediate transfusion incidents had already been transfused and 36.5% of the cases had previous transfusion incident reports. Conclusions Data from the present study corroborate the implementation of new professional training programs aimed at blood transfusion surveillance. These measures should emphasize prevention, identification and reporting of immediate transfusion incidents aiming to increase blood transfusion quality and safety. PMID:23049336

  13. Evaluation of blood glucose concentration measurement using photoacoustic spectroscopy in near-infrared region

    NASA Astrophysics Data System (ADS)

    Namita, Takeshi; Sato, Mitsuki; Kondo, Kengo; Yamakawa, Makoto; Shiina, Tsuyoshi

    2017-03-01

    Diabetes, a typical lifestyle-related disease, is an important disease presenting risks of various complications such as retinopathy, kidney failure, and nervous neuropathy. To treat diabetes, regular and continual self-measurement of blood glucose concentrations is necessary to maintain blood glucose levels and to prevent complications. Usually, daily measurements are taken using invasive methods such as finger-prick blood sampling. Some non-invasive optical techniques have been proposed to reduce pain and infection risk, however, few practical techniques exist today. To realize highly accurate and practical measurement of blood glucose concentrations, the feasibility of a photoacoustic method using near-infrared light was evaluated. A photoacoustic signal from a solution of glucose in water (+0-5 g/dl) or equine blood (+0-400 mg/dl) was measured using a hydrophone (9 mm diameter) at 800-1800 nm wavelengths. We investigated the relation between the glucose solution concentration and the photoacoustic signal intensity or peak position of the received photoacoustic signal (i.e. speed of sound in solutions). Results show that the signal intensity and sound speed of the glucose solution increase with increased glucose concentration for wavelengths at which light absorbance of glucose is high. For quantitative estimation of the glucose solution concentration, the photoacoustic signal intensity ratio between two wavelengths, at which dependence of the signal intensity on glucose concentration is high and low, was calculated. Results confirmed that the signal intensity ratios increase linearly with the glucose concentration. These analyses verified the feasibility of glucose level estimation using photoacoustic measurement in the near-infrared region.

  14. Spinal hemangiomas.

    PubMed

    Healy, M; Herz, D A; Pearl, L

    1983-12-01

    Three new cases of spinal cord compression due to vertebral hemangioma are reported. The clinical presentation, with spinal pain, radicular radiation, and paraparesis, is similar to that of primary lymphoma, metastatic tumor, and disc disease. If the characteristic plain film changes of vertical trabeculations and striations are present, the preoperative diagnosis is facilitated, but in the majority of cases these are not seen. In some instances, vertebral body or pedicle erosion is present. A myelographic epidural block will be seen on further study. Spinal arteriography can prove helpful. Surgical decompression results in marked neurological improvement if intervention takes place before the onset of complete paralysis. The authors recommend that the diagnosis of vertebral hemangioma be considered in the differential diagnosis of epidural spinal cord compression whenever considered in the differential diagnosis of epidural spinal cord compression whenever a primary malignant neoplasm cannot be identified.

  15. Subdural Thoracolumbar Spine Hematoma after Spinal Anesthesia: A Rare Occurrence and Literature Review of Spinal Hematomas after Spinal Anesthesia.

    PubMed

    Maddali, Prasanthi; Walker, Blake; Fisahn, Christian; Page, Jeni; Diaz, Vicki; Zwillman, Michael E; Oskouian, Rod J; Tubbs, R Shane; Moisi, Marc

    2017-02-16

    Spinal hematomas are a rare but serious complication of spinal epidural anesthesia and are typically seen in the epidural space; however, they have been documented in the subdural space. Spinal subdural hematomas likely exist within a traumatically induced space within the dural border cell layer, rather than an anatomical subdural space. Spinal subdural hematomas present a dangerous clinical situation as they have the potential to cause significant compression of neural elements and can be easily mistaken for spinal epidural hematomas. Ultrasound can be an effective modality to diagnose subdural hematoma when no epidural blood is visualized. We have reviewed the literature and present a full literature review and a case presentation of an 82-year-old male who developed a thoracolumbar spinal subdural hematoma after spinal epidural anesthesia. Anticoagulant therapy is an important predisposing risk factor for spinal epidural hematomas and likely also predispose to spinal subdural hematomas. It is important to consider spinal subdural hematomas in addition to spinal epidural hematomas in patients who develop weakness after spinal epidural anesthesia, especially in patients who have received anticoagulation.

  16. Subdural Thoracolumbar Spine Hematoma after Spinal Anesthesia: A Rare Occurrence and Literature Review of Spinal Hematomas after Spinal Anesthesia

    PubMed Central

    Maddali, Prasanthi; Walker, Blake; Fisahn, Christian; Page, Jeni; Diaz, Vicki; Zwillman, Michael E; Oskouian, Rod J; Tubbs, R. Shane

    2017-01-01

    Spinal hematomas are a rare but serious complication of spinal epidural anesthesia and are typically seen in the epidural space; however, they have been documented in the subdural space. Spinal subdural hematomas likely exist within a traumatically induced space within the dural border cell layer, rather than an anatomical subdural space. Spinal subdural hematomas present a dangerous clinical situation as they have the potential to cause significant compression of neural elements and can be easily mistaken for spinal epidural hematomas. Ultrasound can be an effective modality to diagnose subdural hematoma when no epidural blood is visualized. We have reviewed the literature and present a full literature review and a case presentation of an 82-year-old male who developed a thoracolumbar spinal subdural hematoma after spinal epidural anesthesia. Anticoagulant therapy is an important predisposing risk factor for spinal epidural hematomas and likely also predispose to spinal subdural hematomas. It is important to consider spinal subdural hematomas in addition to spinal epidural hematomas in patients who develop weakness after spinal epidural anesthesia, especially in patients who have received anticoagulation. PMID:28357164

  17. Regional glucose utilization and blood flow following graded forebrain ischemia in the rat: correlation with neuropathology

    SciTech Connect

    Ginsberg, M.D.; Graham, D.I.; Busto, R.

    1985-10-01

    Regional patterns of cerebral glucose utilization (rCMRglc) and blood flow (rCBF) were examined in the early recovery period following transient forebrain ischemia in order to correlate early postischemic physiological events with regionally selective patterns of ischemic neuropathology. Wistar rats were subjected to 30 or 60 minutes of graded forebrain ischemia by a method combining unilateral occlusion of the common carotid artery with moderate elevation of intracranial pressure and mild hypotension; this procedure results in a high-grade ischemic deficit affecting chiefly the lateral neocortex, striatum, and hippocampus ipsilateral to the carotid occlusion. Simultaneous measurements of rCMRglc and rCBF made in regional tissue samples after 2 and 4 hours of postischemic recirculation using a double-tracer radioisotopic strategy revealed a disproportionately high level of glucose metabolism relative to blood flow in the early postischemic striatum, owing to the resumption of nearly normal rCMRglc in the face of depressed flow. In contrast, the neocortex, which had been equally ischemic, showed parallel depressions of both metabolism and blood flow during early recovery. Light microscopy at 4 and 8 hours after recovery revealed the striatum to be the predominant locus of ischemic neuronal alterations, whereas neocortical lesions were much less prominent in extent and severity at this time. The resumption of normal levels of metabolism in the setting of a disproportionate depression of rCBF in the early postischemic period may accentuate the process of neuronal injury initiated by ischemia and may contribute to the genesis of neuronal necrosis in selectively vulnerable areas of the forebrain.

  18. Attenuation of regional cerebral blood flow during memory processing after coronary artery bypass surgery.

    PubMed

    Badgaiyan, Rajendra D; Weise, Steven; Wack, David S; Vidal Melo, Marcos F

    2014-09-01

    Reports of memory impairment after cardiac surgery are controversial. To address this controversy, we used positron emission tomography to examine changes in regional cerebral blood flow (rCBF) during memory processing before and after elective coronary artery bypass grafting surgery. In postoperative scans, we observed significantly reduced rCBF in 2 of the most important memory processing areas: the medial temporal lobe (P = 0.023) and the prefrontal cortex (P = 0.002). The results suggest postoperative attenuation of rCBF in brain areas involved in memory processing. These reductions could be used to evaluate severity of memory impairment after coronary artery bypass grafting surgery in patients at risk.

  19. Regional cerebral blood flow for singers and nonsingers while speaking, singing, and humming a rote passage

    SciTech Connect

    Formby, C.; Thomas, R.G.; Halsey, J.H. Jr. )

    1989-05-01

    Two groups of singers (n = 12,13) and a group of nonsingers (n = 12) each produced the national anthem by (1) speaking and (2) singing the words and by (3) humming the melody. Regional cerebral blood flow (rCBF) was measured at rest and during each phonation task from seven areas in each hemisphere by the {sup 133}Xe-inhalation method. Intrahemisphere, interhemisphere, and global rCBF were generally similar across phonation tasks and did not yield appreciable differences among the nonsingers and the singers.

  20. Human T-Cell Lymphotropic Virus Types 1 and 2 Seropositivity among Blood Donors at Mbarara Regional Blood Bank, South Western Uganda

    PubMed Central

    Uchenna Tweteise, Patience; Natukunda, Bernard; Bazira, Joel

    2016-01-01

    Background. The human T-cell lymphotropic virus types 1 and 2 (HTLV 1/2) are retroviruses associated with different pathologies. HTLV-1 causes adult T-cell leukemia/lymphoma (ATL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP); HTLV-2 is not clearly associated with a known clinical disease. Both viruses may be transmitted by whole blood transfusion, from mother to child predominantly through breastfeeding, and by sexual contact. Presently, none of the regional blood banks in Uganda perform routine pretransfusion screening for HTLV. The aim of this study was to determine the prevalence of anti-human T-cell lymphotropic virus types 1/2 (HTLV-1/2) antibodies among blood donors at Mbarara Regional Blood Bank in South Western Uganda. A cross-sectional study was conducted between June 2014 and September 2014. Methodology. Consecutive blood samples of 368 blood donors were screened for anti-HTLV-1/2 antibodies using an enzyme linked immunosorbent assay (ELISA). Samples reactive on a first HTLV-1/2 ELISA were further retested in duplicate using the same ELISA. Of the three hundred and sixty-eight blood donors (229 (62.2%) males and 139 (37.8%) females), only two male donors aged 20 and 21 years were HTLV-1/2 seropositive, representing a prevalence of 0.54%. Conclusion. HTLV-1/2 prevalence is low among blood donors at Mbarara Regional Blood Bank. Studies among other categories of people at risk for HTLV 1/2 infection should be carried out. PMID:27034840

  1. Human T-Cell Lymphotropic Virus Types 1 and 2 Seropositivity among Blood Donors at Mbarara Regional Blood Bank, South Western Uganda.

    PubMed

    Uchenna Tweteise, Patience; Natukunda, Bernard; Bazira, Joel

    2016-01-01

    Background. The human T-cell lymphotropic virus types 1 and 2 (HTLV 1/2) are retroviruses associated with different pathologies. HTLV-1 causes adult T-cell leukemia/lymphoma (ATL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP); HTLV-2 is not clearly associated with a known clinical disease. Both viruses may be transmitted by whole blood transfusion, from mother to child predominantly through breastfeeding, and by sexual contact. Presently, none of the regional blood banks in Uganda perform routine pretransfusion screening for HTLV. The aim of this study was to determine the prevalence of anti-human T-cell lymphotropic virus types 1/2 (HTLV-1/2) antibodies among blood donors at Mbarara Regional Blood Bank in South Western Uganda. A cross-sectional study was conducted between June 2014 and September 2014. Methodology. Consecutive blood samples of 368 blood donors were screened for anti-HTLV-1/2 antibodies using an enzyme linked immunosorbent assay (ELISA). Samples reactive on a first HTLV-1/2 ELISA were further retested in duplicate using the same ELISA. Of the three hundred and sixty-eight blood donors (229 (62.2%) males and 139 (37.8%) females), only two male donors aged 20 and 21 years were HTLV-1/2 seropositive, representing a prevalence of 0.54%. Conclusion. HTLV-1/2 prevalence is low among blood donors at Mbarara Regional Blood Bank. Studies among other categories of people at risk for HTLV 1/2 infection should be carried out.

  2. SPECT determination of regional cerebral blood flow in hypertensive patients before and after clonidine

    SciTech Connect

    Devous, M.D.; Reed, W.G.; Chehabi, H.H.; Bonte, F.J.

    1985-05-01

    Regional cerebral blood flow (rCBF) was determined by SPECT of 133-Xe inert gas washout in 18 hypertensive patients (PTS) upon admission and after treatment with oral clonidine (CL, 0.2 mg, then 0.1 mg/hr until diastolic pressure reached 105 mm Hg or fell by 30 mm Hg). CL reduced mean arterial pressure (MAP) from 160 (200/140) to 133 (150/100) mm Hg over 4-6 hr. RCBF was quantitated in 14 gray matter regions from cross-sectional images and analyzed for differences from normal controls and changes with CL. Initial rCBF was lower in HI PTS than in either normal controls of LO PTS in all brain regions. CL lowered MAP in HI PTS by 52 +- 15 mm Hg and caused reduction in all gray matter regions except right frontal and right temporal (mean reduction 5 +- 2 ml/min/100 g, rho<.05). RCBF images were also evaluated by two trained observers for initial regional defects and for changes with CL. LO PTS were more likely to have defects in rCBF images at rest which would resolve with CL. HI PTS frequently had normal images at rest and developed defects with CL. In summary, the study suggests that SPECT may be useful in detecting rCBF abnormalities in hypertensive PTS at rest and following reductions in MAP.

  3. Lower-Extremity Functional Electrical Stimulation Decreases Platelet Aggregation and Blood Coagulation in Persons With Chronic Spinal Cord Injury: A Pilot Study

    PubMed Central

    Kahn, Nighat N; Feldman, Susan P; Bauman, William A

    2010-01-01

    Background: Individuals with spinal cord injury (SCI) develop premature cardiovascular disease. Regular exercise reduces the incidence and symptoms of cardiovascular disease in able-bodied individuals; these salutary effects of exercise have not been documented in persons with SCI. Objective: To evaluate the effects of functional electrical stimulation leg cycle ergometry (FES-LCE) exercise training on platelet aggregation and blood coagulation in persons with SCI. Participants: Subjects (n  =  14) with stable chronic (>1 year) paraplegia (T1–T10) or tetraplegia (C4–C8). Methods: Blood samples were collected before and after the first and eighth sessions (2 sessions per week for 4 weeks) of FES exercise. Results: Platelet aggregation was inhibited by 20% after the first session and by 40% (P < 0.001) after the eighth session. Thrombin activity was unchanged after the first session (10.7 ± 0.85 s to 10.43 ± 0.56 s) and decreased after the eighth session (12.5 ± 1.98 s to 11.1 ± 1.7 s; P < 0.0003). Antithrombin III activity increased after the first (103.8% ± 8.9% to 110% ± 6.9%; P < 0.0008) and eighth sessions (107.8% ± 12.1% to 120.4% ± 13.1%; P < 0.0001). Cyclic adenosine monophosphate increased after the first (9.9% ± 2.5% to 15.8% ± 3%; P < 0.001) and eighth sessions (17.8% ± 4.2% to 36.5% ± 7.6%; P < 0.0001). After the eighth session, factors V and X increased significantly (88% ± 27% to 103% ± 23%, P < 0.0001; 100% ± 40% to 105% ± 7%, P < 0.01, respectively); factors VII and VIII and fibrinogen did not change significantly. A significant reduction in platelet activation/aggregation was demonstrated in response to FES-LCE. The decrease in thrombin level was caused by the simultaneous increase in antithrombin activity. Conclusion: These findings provide new insight into the potential protective effects of FES-LCE against the risk of cardiovascular disease. PMID:20486534

  4. Prevalance of ABO and Rhesus Blood Groups in Blood Donors: A Study from a Tertiary Care Teaching Hospital of Kumaon Region of Uttarakhand.

    PubMed

    Garg, Parul; Upadhyay, Saloni; Chufal, Sanjay Singh; Hasan, Yuman; Tayal, Ishwer

    2014-12-01

    Backround: ABO and Rhesus (Rh) blood group antigens are hereditary characters and are useful in population genetic studies, in resolving medico-legal issues and more importantly for the immunologic safety of blood during transfusion. This study is aimed to determine the distribution pattern of the ABO and Rh blood groups among blood donors in Kumaon region of Uttarakhand and compare it with other data from similar studies within the India and all over the world. It is a retrospective study carried out at blood bank of Shushila Tewari Hospital of Government Medical College, Haldwani from January 2012 to December 2013. The study was conducted on 12,701 blood donors. ABO and Rh typing was done using slide agglutination method with antisera ABO and Rh (Tulip diagnostics ltd). Doubtful cases were confirmed by tube agglutination method and reverse grouping using known pooled A and B cells. The age group and sex of donors, frequency of ABO and Rh blood groups were reported in simple percentages. The predominant donors belonged to age group between 18-35years (84.28%). Male donors were more than female donors, ratio being 352:1. Replacement donors (99.71%) were much more than voluntary donors (0.91%). The most common blood group was B (32.07%) and least common being AB (10.53%). Blood group 'O' and 'A' had same frequency. The prevalence of Rhesus positive and negative distribution in the studied population was 94.49% and 5.51% respectively. Blood group frequency with respect to ABO and Rhesus positive was found to be shown by formula B> O>A >AB. The frequency for ABO and Rhesus negative was given by the formula B>A>O>AB. Knowledge of frequencies of the different blood groups is very important for blood banks and transfusion service policies that could contribute significantly to the National Health System.

  5. The influence of gravity on regional lung blood flow in humans: SPECT in the upright and head-down posture.

    PubMed

    Ax, M; Sanchez-Crespo, A; Lindahl, S G E; Mure, M; Petersson, J

    2017-06-01

    Previous studies in humans have shown that gravity has little influence on the distribution of lung blood flow while changing posture from supine to prone. This study aimed to evaluate the maximal influence of posture by comparison of regional lung blood flow in the upright and head-down posture in 8 healthy volunteers, using a tilt table. Regional lung blood flow was marked by intravenous injection of macroaggregates of human albumin labeled with (99m)Tc or (113m)In, in the upright and head-down posture, respectively, during tidal breathing. Both radiotracers remain fixed in the lung after administration. The distribution of radioactivity was mapped using quantitative single photon emission computed tomography (SPECT) corrected for attenuation and scatter. All images were obtained supine during tidal breathing. A shift from upright to the head-down posture caused a clear redistribution of blood flow from basal to apical regions. We conclude that posture plays a role for the distribution of lung blood flow in upright humans, and that the influence of posture, and thereby gravity, is much greater in the upright and head-down posture than in horizontal postures. However, the results of the study demonstrate that lung structure is the main determinant of regional blood flow and gravity is a secondary contributor to the distribution of lung blood flow in the upright and head-down positions.NEW & NOTEWORTHY Using a dual-isotope quantitative SPECT method, we demonstrated that although a shift in posture redistributes blood flow in the direction of gravity, the results are also consistent with lung structure being a greater determinant of regional blood flow than gravity. To our knowledge, this is the first study to use modern imaging methods to quantify the shift in regional lung blood flow in humans at a change between the upright and head-down postures. Copyright © 2017 the American Physiological Society.

  6. Regional cerebral blood flow in stroke: hemispheric effects of cognitive activity.

    PubMed

    Gur, R C; Gur, R E; Silver, F L; Obrist, W D; Skolnick, B E; Kushner, M; Hurtig, H I; Reivich, M

    1987-01-01

    Regional cerebral blood flow (rCBF) was measured with the xenon-133 inhalation technique in 15 patients with unilateral cerebral infarction and 12 matched controls. Measurements were performed during a standard resting baseline condition and during the performance of standardized verbal analogies and spatial line orientation tasks. Resting and activated CBF were lower in patients than in controls, and there were differences in the hemispheric pattern of activated CBF. Control subjects replicated earlier findings of asymmetric increase in CBF for the cognitive tasks, whereas patients showed abnormalities in lateralized CBF changes consistent with side of infarction. These findings underscore the utility of cognitive challenges in the study of rCBF in stroke. This can lead to an experimental paradigm in clinical studies of the relation between behavioral deficits and regional brain dysfunction and may also improve the utility of CBF measurements in clinical settings.

  7. Comparing the trends of elevated blood pressure in appalachian and non-Appalachian regions.

    PubMed

    Shandera-Ochsner, Anne L; Han, Dong Y; Rose, Danny; Aroor, Sushanth R; Schmitt, Frederick; Bellamy, Lisa M; Dobbs, Michael R

    2014-10-01

    As an established risk factor for cardiovascular disease and stroke, hypertension risks are often thought to be more prevalent in Appalachian mountain ranges when compared with other neighboring counterpart regions. This study evaluated blood pressure (BP) readings among 2358 Kentucky residents attending community stroke risk screening events held in 15 counties, including nine Appalachian counties (n=1134) and six non-Appalachian counties (n=1224). With high BP being operationally defined as ≥140/90 mm Hg, 41.5% of Appalachian county residents had elevated BP compared with 42.6% among those from non-Appalachian counties. Although the counties with the highest rates of elevated BP did tend to reside in the Appalachian region, there was no significant difference between rates of elevated BP in Appalachia vs non-Appalachian counties. This dataset is proposed as a pilot project to encourage further pursuit of a larger controlled project.

  8. Regional cerebral blood flow during comprehension and speech (in cerebrally healthy subjects)

    SciTech Connect

    Lechevalier, B.; Petit, M.C.; Eustache, F.; Lambert, J.; Chapon, F.; Viader, F. )

    1989-07-01

    Regional cerebral blood flow (rCBF) was measured by the xenon-133 inhalation method in 10 cerebrally healthy subjects at rest and during linguistic activation tests. These consisted of a comprehension test (binaural listening to a narrative text) and a speech test (making sentences from a list of words presented orally at 30-s intervals). The comprehension task induced a moderate increase in the mean right CBF and in both inferior parietal areas, whereas the speech test resulted in a diffuse increase in the mean CBF of both hemispheres, predominating regionally in both inferior parietal, left operculary, and right upper motor and premotor areas. It is proposed that the activation pattern induced by linguistic stimulation depends on not only specific factors, such as syntactic and semantic aspects of language, but also the contents of the material proposed and the attention required by the test situation.

  9. [Dynamics of elements distribution in blood, depending on age, by example of Moscow Region residents].

    PubMed

    Yuvs, G G; Ignatova, T N; Anuchin, A M; Lebedeva, V L; Shilov, V V; Khapalyuk, A V

    2015-01-01

    Elemental status of a person determines the qualitative and quantitative content of chemical elements in the human body. This marker allows us to estimate the level of imbalance of chemical elements and therefore health risks. The method for simultaneous quantitative and qualitative analysis of 67 elements in biomaterials has been proposed. The detailed elemental analysis of whole blood samples of 1711 healthy people (age range 0-100 years) of Moscow Region has been performed. A number of patterns of age-related changes of the element status conditionally healthy people has been estimated. Na content in the samples increased with the age of the person. Presumably, this result reflects the studied populations nutrition disorders associated with immoderate consumption of table salt. The maximum content of Ca was observed in blood samples of people age range 0-20 years (66-69 mg/kg), the Ca content in the blood samples of people age range 26-85 years was significantly lower (59-62 mg/kg). The maximum decrease of Ca was detected in blood samples of people age range of 85-100 years (57-59 mg/kg). Thisreductionin the concentration of Ca, apparently due to age-related changes of Ca balance, correlates with decrease of bone mineral density and bone mass. Iron content decreased in the blood samples of people age range 10-100 years from 480 to 390 mg/kg. Selenium content in blood of people age range 0-25 years linearly increased, remained stable high in the blood of people age range 25-55 years (0,13-0,136 mg/kg) and then gradually decreased. A graph of As content dependence from a person's age is a mirror image of the graph of Se content dependence from a person's age, which is evidence of the antagonistic effects of these elements. Graphic changes in the content of rare earth elements Eu and Ho reflect the unidirectional trend of these elements accumulation. The maximum content of these elements was observed in blood samples of people age range of 25-65 years. Perhaps a

  10. [High blood pressure and obesity in indigenous Ashaninkas of Junin region, Peru].

    PubMed

    Romero, Candice; Zavaleta, Carol; Cabrera, Lilia; Gilman, Robert H; Miranda, J Jaime

    2014-01-01

    In order to determine the prevalence of high blood pressure and obesity in indigenous Ashaninkas, with limited contact with Western culture, a cross-sectional study was conducted in 2008 in five Ashaninka communities of the Junin region in the jungle of Peru. Individuals aged 35 or older were included. 76 subjects were evaluated (average age 47.4 years old, 52.6 % women) corresponding to 43.2% of the eligible population. The prevalence of hypertension was 14.5% (CI 95%: 6.4-22.6) and the prevalence of obesity, according to body mass index, was 4% (CI 95%: 0-8.4). No differences were observed in gender or in blood pressure levels by age group. Compared with previous studies in non-indigenous people of the Peruvian jungle, the prevalence of high blood pressure was higher while the prevalence of obesity was lower. Our findings are a call to be aware of the situation of chronic non-communicable diseases in indigenous populations in the Peruvian Amazon.

  11. Effect of ethanol on jejunal regional blood flow in the rabbit.

    PubMed

    Buell, M G; Beck, I T

    1983-01-01

    The effects of intraluminal ethanol perfusion (3.0% and 6.0% vt/vol) on mucosal morphology, water transport, and regional blood flow were examined in in vivo jejunal segments of pentobarbital-anesthetized rabbits. Compared with control segments, ethanol-perfused segments exhibited morphological alterations of the mucosa consisting of subepithelial fluid accumulation (bleb formation), exfoliation of enterocytes, and vascular congestion. The prevalence of epithelial damage was significantly increased in the segments perfused with 6% ethanol. Net water transport was significant (p less than 0.025) depressed in segments perfused with 3.0% and 6.0% wt/vol ethanol. In animals in which the control segment was absorbing water, ethanol led to a depression in net water absorption or to the reversal of absorption to net secretion. In animals in which the control segment exhibited secretion, ethanol led to an enhanced net secretion. Blood flow through the total jejunal wall and through the luminal layer (consisting of mucosa plus submucosa) was significantly (p less than 0.05) increased by the presence of 3.0% and 6.0% wt/vol ethanol in the intestinal lumen. Blood flow in the external layer of the jejunum (consisting of muscularis plus serosa) did not change significantly. It therefore appears that the ethanol-induced alterations in jejunal mucosal morphology and water transport are accompanied by a localized mucosal or submucosal hyperemia, or both. However, a direct cause and effect relationship between these remains to be established.

  12. Impact of methamphetamine on regional metabolism and cerebral blood flow after traumatic brain injury.

    PubMed

    O'Phelan, Kristine; Ernst, Thomas; Park, Dalnam; Stenger, Andrew; Denny, Katherine; Green, Deborah; Chang, Cherylee; Chang, Linda

    2013-10-01

    Substance abuse is a frequent comorbid condition among patients with traumatic brain injury (TBI), but little is known about its potential additive or interactive effects on tissue injury or recovery from TBI. This study aims to evaluate changes in regional metabolism and cerebral perfusion in subjects who used methamphetamine (METH) prior to sustaining a TBI. We hypothesized that METH use would decrease pericontusional cerebral perfusion and markers of neuronal metabolism, in TBI patients compared to those without METH use. This is a single center prospective observational study. Adults with moderate and severe TBI were included. MRI scanning was performed on a 3 Tesla scanner. MP-RAGE and FLAIR sequences as well as Metabolite spectra of NAA and lactate in pericontusional and contralateral voxels identified on the MP-RAGE scans. A spiral-based FAIR sequence was used for the acquisition of cerebral blood flow (CBF) maps. Regional CBF images were analyzed using ImageJ open source software. Pericontusional and contralateral CBF, NAA, and lactate were assessed in the entire cohort and in the METH and non-METH groups. Seventeen subjects completed the MR studies. Analysis of entire cohort: pericontusional NAA concentrations (5.81 ± 2.0 mM/kg) were 12% lower compared to the contralateral NAA (6.98 ± 1.2 mM/kg; p = 0.03). Lactate concentrations and CBF were not significantly different between the two regions; however, regional CBF was equally reduced in the two regions. Subgroup analysis: 41% of subjects tested positive for METH. The mean age, Glasgow Coma Scale, and time to scan did not differ between groups. The two subject groups also had similar regional NAA and lactate. Pericontusional CBF was 60% lower in the METH users than the non-users, p = 0.04; contralateral CBF did not differ between the groups. This small study demonstrates that tissue metabolism is regionally heterogeneous after TBI and pericontusional perfusion was significantly reduced in the METH

  13. Regional Cerebral Blood Flow (rCBF) in Developmental Dyslexia: Activation during Reading in a Surface and Deep Dyslexic.

    ERIC Educational Resources Information Center

    Hynd, George W.; And Others

    1987-01-01

    The exploratory study examined patterns of regional cerebral blood flow in a surface and a deep dyslexic during reading. Significant differences in gray matter blood flow were found between subjects and normal controls. Also differences existed between the surface and deep dyslexic in the distribution of cortical perfusion. (Author/DB)

  14. Regional Cerebral Blood Flow (rCBF) in Developmental Dyslexia: Activation during Reading in a Surface and Deep Dyslexic.

    ERIC Educational Resources Information Center

    Hynd, George W.; And Others

    1987-01-01

    The exploratory study examined patterns of regional cerebral blood flow in a surface and a deep dyslexic during reading. Significant differences in gray matter blood flow were found between subjects and normal controls. Also differences existed between the surface and deep dyslexic in the distribution of cortical perfusion. (Author/DB)

  15. Spinal epidural abscess.

    PubMed

    Miftode, E; Luca, V; Mihalache, D; Leca, D; Stefanidis, E; Anuţa, C; Sabadis, L

    2001-01-01

    In a retrospective study, 68 patients with Spinal Epidural Abscess (SEA) were reviewed. Of these, 66% had different predisposing factors such as staphylococcal skin infections, surgical procedures, rachicentesis, trauma, spondilodiscitis. Abscess had a lumbar region location in 53% of cases. Staphylococcus aureus was the most frequent etiological agent (81%). The overall rate of mortality in SEA patients was 13.2%.

  16. Comparable Cerebral Blood Flow in Both Hemispheres During Regional Cerebral Perfusion in Infant Aortic Arch Surgery.

    PubMed

    Rüffer, André; Tischer, Philip; Münch, Frank; Purbojo, Ariawan; Toka, Okan; Rascher, Wolfgang; Cesnjevar, Robert Anton; Jüngert, Jörg

    2017-01-01

    Cerebral protection during aortic arch repair can be provided by regional cerebral perfusion (RCP) through the innominate artery. This study addresses the question of an adequate bilateral blood flow in both hemispheres during RCP. Fourteen infants (median age 11 days [range, 3 to 108]; median weight, 3.6 kg [range, 2.8 to 6.0 kg]) undergoing RCP (flow rate 54 to 60 mL · kg(-1) · min(-1)) were prospectively included. Using combined transfontanellar/transtemporal two- and three-dimensional power/color Doppler sonography, cerebral blood flow intensity in the main cerebral vessels was displayed. Mean time average velocities were measured with combined pulse-wave Doppler in the basilar artery, and both sides of the internal carotid, anterior, and medial cerebral arteries. In addition, bifrontal regional cerebral oximetry (rSO2) was assessed. Comparing both hemispheres, measurements were performed at target temperature (28°C) during full-flow total body perfusion (TBP) and RCP. A regular circle of Willis with near-symmetric blood flow intensity to both hemispheres was visualized in all infants during both RCP and TBP. In the left internal carotid artery, blood flow direction was mixed (retrograde, n = 5; antegrade, n = 8) during TBP and retrograde during RCP. Comparison between sides showed comparable cerebral time average velocities and rSO2, except for higher time average velocities in the right internal carotid artery (TBP p = 0.019, RCP p = 0.09). Unilateral comparison between perfusion methods revealed significantly higher rSO2 in the right hemisphere during TBP (82% ± 9%) compared with RCP (74% ± 11%, p = 0.036). Bilateral assessment of cerebral rSO2 and time average velocity in the main great cerebral vessels suggests that RCP is associated with near-symmetric blood flow intensity to both hemispheres. Further neurodevelopmental studies are necessary to verify RCP for neuroprotection during aortic arch repair. Copyright © 2017 The Society of Thoracic

  17. [Evoked potentials and regional cerebral blood flow changes in conversion disorder: a case report and review].

    PubMed

    Gürses, Nadide; Temuçin, Cağri Mesut; Lay Ergün, Eser; Ertuğrul, Aygün; Ozer, Suzan; Demir, Başaran

    2008-01-01

    Conversion disorder is defined as the presence of functional impairment in motor, sensory or neurovegetative systems which cannot be explained by a general medical condition. Although the diagnostic systems emphasize the absence of an organic basis for the dysfunction in conversion disorder, there has been a growing interest in the specific functional brain correlates of conversion symptoms in recent years, particularly by examining neuroimaging and neurophysiological measures. In this case report, regional cerebral blood flow changes and evoked potentials of a patient with conversion symptoms are presented. Somatosensory evoked potentials (SEP) of this patient with conversion disorder who had signs of movement disorder revealed that the latency to N20, P 25 waves were in normal limits while the amplitudes of the P25 and N33 components were extremely high (giant SEP). Regional cerebral blood flow assessment revealed hypoperfusion in the left parietal and temporal lobes of the brain. Three months after the first assessment, the control scans showed that the left parietal hypoperfusion disappeared while the left temporal hypoperfusion was still present. The following SEP evaluations which were repeated twice in three months intervals after the initial recordings, showed the persistence of the abnormalities in somatosensorial measures. The neurophysiological and neuroimaging findings in conversion disorder were reviewed and the results of the evaluations of this case were discussed in this article.

  18. A neutral lipophilic technetium-99m complex for regional cerebral blood flow imaging

    SciTech Connect

    Narra, R.K.; Nunn, A.D.; Kuczynski, B.L.; DiRocco, R.J.; Feld, T.; Silva, D.A.; Eckelman, W.C. )

    1990-08-01

    Technetium-99m-DMG-2MP (Chloro(bis(2,3-butanedionedioxime(1-)-0)(2,3- butanedionedioximato (2-)-N,N{prime},N{double prime},N{prime}{double prime},N{double prime}{double prime},N{prime}{double prime}{double prime}) (2-methylpropyl borato (2-))technetium)), also known as SQ 32097 is a member of a family of neutral lipophilic compounds generally known as boronic acid adducts of technetium dioxime complexes (BATOs). After i.v. administration, the concentration of ({sup 99m}Tc)DMG-2MP in various regions of the brain appears to be proportional to blood flow. In rats, 1.1% ID was in the brain at 5 min postinjection when the blood contained less than 3% ID. Over 24 hr excretion was 59% in the feces and 23% in the urine. The activity in monkey brain at 5 min was 2.8% ID and it cleared with a t1/2 of 86 min. Autoradiographs of monkey brain sections showed excellent regional detail with a gray/white ratio of 3.6 at 10 min. The distribution of ({sup 99m}Tc)DMG-2MP in the monkey brain corresponds to the known cytoarchitectural pattern of cerebral glucose metabolism. The properties of ({sup 99m}Tc)DMG-2MP make it a potentially useful agent for cerebral perfusion imaging in man.

  19. Regional cerebral blood flow study with 123I-IMP in patients with degenerative dementia

    SciTech Connect

    Ohnishi, T.; Hoshi, H.; Nagamachi, S.; Jinnouchi, S.; Futami, S.; Watanabe, K.; Mitsuyama, Y. )

    1991-05-01

    Regional cerebral blood flow was evaluated by single-photon emission CT (SPECT) with 123I-N-isopropyl-p-iodoamphetamine (123I-IMP) in 11 patients with dementia of the Alzheimer type, three patients with progressive dementia and motor neuron disease, and eight healthy control subjects. Regional blood flow measurements in the bilateral frontal, parietal association, and temporal cortices were lower in the Alzheimer dementia patients than in controls. Flow deficits in the parietal association cortex were demonstrated in all patients with Alzheimer-type dementia; these deficits were correlated with the severity of disease. Lateral hemispheric asymmetry was seen in nine of 11 patients with Alzheimer-type dementia. In all three patients with progressive dementia and motor neuron disease, flow deficits were demonstrated in the bilateral frontal and temporal cortices, but no flow deficits were seen in the parietal association cortex. Brain SPECT with 123I-IMP may be useful in the differential diagnosis and evaluation of the severity of degenerative dementia.

  20. Effects of fluid-percussion brain injury on regional cerebral blood flow and pial arteriolar diameter.

    PubMed

    DeWitt, D S; Jenkins, L W; Wei, E P; Lutz, H; Becker, D P; Kontos, H A

    1986-05-01

    The effects of two levels of fluid-percussion brain injury on cerebral blood flow (CBF) and pial arteriolar diameter were investigated in cats. Regional CBF was measured using the radioactive microsphere technique. Experimental brain injury resulted in changes in arterial blood pressure, CBF, and pial arteriolar diameter that were related to the severity of the injury. Low-level injury (1.88 +/- 0.11 atm, mean +/- standard error of the mean) resulted in a slight transient increase in CBF which had returned to preinjury levels by 30 minutes. High-level injury (2.68 +/- 0.19 atm) resulted in larger, statistically significant (p less than 0.01) increases in whole-brain CBF, decreases in cerebrovascular resistance, and increases in pial arteriolar diameter 1 minute postinjury. One hour after injury, CBF had returned to preinjury levels while cerebral perfusion pressure was significantly (p less than 0.01) reduced. There was no evidence of reduced CBF in any region studied. Pial arterioles dilated during the posttraumatic hypertensive period and then returned to control diameters within 1 hour after injury. Changes in the diameter of pial arterioles were significantly correlated with posttraumatic changes in CBF.

  1. Effects of frequent marijuana use on memory-related regional cerebral blood flow.

    PubMed

    Block, Robert I; O'Leary, Daniel S; Hichwa, Richard D; Augustinack, Jean C; Boles Ponto, Laura L; Ghoneim, M M; Arndt, Stephan; Hurtig, Richard R; Watkins, G Leonard; Hall, James A; Nathan, Peter E; Andreasen, Nancy C

    2002-05-01

    It is uncertain whether frequent marijuana use adversely affects human brain function. Using positron emission tomography (PET), memory-related regional cerebral blood flow was compared in frequent marijuana users and nonusing control subjects after 26+ h of monitored abstention. Memory-related blood flow in marijuana users, relative to control subjects, showed decreases in prefrontal cortex, increases in memory-relevant regions of cerebellum, and altered lateralization in hippocampus. Marijuana users differed most in brain activity related to episodic memory encoding. In learning a word list to criterion over multiple trials, marijuana users, relative to control subjects, required means of 2.7 more presentations during initial learning and 3.1 more presentations during subsequent relearning. In single-trial recall, marijuana users appeared to rely more on short-term memory, recalling 23% more than control subjects from the end of a list, but 19% less from the middle. These findings indicate altered memory-related brain function in marijuana users.

  2. Effects of Yahom on the regional cerebral blood flow in rat using fluorescence videomicroscopy.

    PubMed

    Jariyapongskul, Amporn; Pathumraj, Suthiluk; Niimi, Hideyuki

    2006-01-01

    This study was conducted to investigate effects of Yahom on the regional cerebral blood flow (rCBF) in rats using fluorescence videomicroscopy. Male Wistar Furth rats weighing 200-250 g were used, and divided into three groups: experimental I, II and control groups. The experimental I and II groups received single oral administration of Yahom 2 and 4 g/kg.bw, and topical application of Yahom on the pial cerebral cortex, respectively, while the control group received oral administration of 1 ml of 5% Tween. The rCBF was monitored using laser Doppler flowmetry at different periods (5-120 minutes) after the administration of Yahom or Tween. The mean arterial pressure (MAP) was measured through a femoral artery. The cerebral microcirculation was observed and recorded under an intravital fluorescence videomicroscopic system. The arteriolar diameter was measured based on the recorded videomicroscopic images. The MAP and rCBF increased after the oral administration of Yahom, while they did not alter in the control group. The maximum responses of MAP and rCBF were approximately 16% and 33% at 45 min and 30 min after the administration of Yahom 4 g/kg.bw, respectively. The topical application of Yahom induced vasodilation in the pial microvessels. In conclusion, single oral administration of Yahom may increase the regional cerebral blood flow under the effect of cerebral microvascular vasodilation.

  3. [Dopamine and noradrenaline effects in the blood flux regional on therapeutic in the septic shock].

    PubMed

    Miranda, Milena Penteado Ferraro; Soriano, Francisco Garcia; Secoli, Silvia Regina

    2008-03-01

    Norepinephrine and dopamine are used, in the state of shock, with the intention of offering hemodynamic support and to reestablish tissue perfusion. The pharmacological effects of these vasopressors can be diverse, for this reason, their use requires, through the clinician, an interpretation of the hemodynamic effects with observation of the systemic variations and region. With this in mind, the objective of this study was to analyze the publications regarding the effects of norepinephrine and low-dose dopamine in hepatosplenic perfusion and renal in treatment of septic shock. Articles were selected (n = 27) concerning the use of norepinephrine and dopamine in septic shock, published during the period of 1997 to September 2007, revised in PubMed, data base of the National Library of Medicine (NLM). The MESH method was utilized with the descriptors norepinephrine, dopamine and sepsis. The effects of dopamine and norepinephrine in kidney perfusion are similar; there is an increase in diuresis and no change in creatinine clearance. Norepinephrine did not affect kidney tissue perfusion in spite of the increase of vascular tone. Regarding the splancnic effects, these drugs showed an increase in blood flow, though redistributing the blood in this compartment. The best agent for the hemodynamic reestablishment that keeps the adequate regional perfusion remains inconclusive.

  4. Duffy blood group genotypes among African-Brazilian communities of the Amazon region.

    PubMed

    Perna, S J Q; Cardoso, G L; Guerreiro, J F

    2007-03-29

    Duffy blood group genotype was studied in 95 unrelated subjects from four African-Brazilian communities of the Amazon region: Trombetas, Pitimandeua, Curiaú, and Mazagão Velho. Genotyping was performed using an allele-specific primer polymerase chain reaction technique for determining the three major alleles at FY blood group, and as expected, FY*O allele was the most common one, with frequencies ranging from 56.4% in Mazagão Velho to 72.2% in Pitimandeua, whereas the FY*O/FY*O genotype was found with frequencies between 32.3% in Mazagão Velho and 58.8% in Curiaú. Genotype and allele distributions in the four Amazonian communities are consistent with a predominantly African origin with some degree of local differentiation and admixture with people of Caucasian ancestry and/or Amerindians. These results reveal that the impact of the FY*O/FY*O genotype on the transmission and endemicity of the vivax malaria deserves to be investigated in full detail in an attempt to identify the contribution of host biological factors and explain the non-homogeneous prevalence of malaria in the region expressed by its different levels of exposure.

  5. Blood

    MedlinePlus

    ... spans vary from a few days to months. New cells are constantly being formed in the bone marrow. ... the bloodstream and are constantly being replaced by new cells. Blood also contains important proteins called clotting factors , ...

  6. Regional patterns of blood-brain barrier breakdown during epileptiform seizures induced by various convulsive agents.

    PubMed

    Nitsch, C; Klatzo, I

    1983-06-01

    In unrestrained rabbits with generalized epileptic seizures induced by systemic application of convulsant drugs, regional changes in blood-brain barrier (BBB) permeability to macromolecules were investigated using Evans Blue (EB) as indicator. BBB leakage due to seizures was present only in animals in which the mean arterial blood pressure rose about 50 mm Hg with the onset of convulsive motor activity. However, a blood pressure increase was not necessarily associated with the occurrence of BBB opening. Pentylenetetrazole-induced seizures resulted in bilateral EB leakage mainly in the hypothalamus, with exception of the mammillary bodies, and the preoptic area, and they were associated, in most cases, with an intensive staining of the cerebellum and also of the midbrain tegmentum. In contrast, seizures due to the GABA receptor blocker bicuculline brought about a penetration of the dye in the region of the pallidum, whereas the GABA synthesis inhibitor methoxypyridoxine produced BBB breakdown in the hippocampus. Methionine-sulfoximine convulsions resulted in a selective stain of the corpora mammillaria, and kainic acid induced a diffuse leakage in neocortical brain areas. As a rule, BBB breakdown was bilateral and confined to anatomically limited brain areas, suggesting that BBB integrity was not only disturbed by abrupt increases in the intraluminal pressure, but was also influenced from the brain tissue. The fluorescence microscopic observations revealed that the tracer penetrated into the neuropil through larger vessels. It had the tendency to accumulate in neurons. In case of the hippocampus, CA2 pyramidal cells revealed more intense uptake of EB than those of the adjacent fields.

  7. Diurnal variation in baseline human regional cerebral blood flow demonstrated by PET

    SciTech Connect

    Diehl, D.J.; Mintun, M.A.; Moore, R.Y.

    1994-05-01

    We have previously described the diurnal variation in regional cerebral blood flow (rCBF) response to bright light in human subjects as demonstrated by the positron emission tomography (PET) activation method. In this abstract, we report the differences in rCBF (an indicator of differences in regional neuronal activity) between the evening and midday dim light baseline scans which served as the control states in the above bright light activation study. Five right-handed, healthy volunteers underwent both an evening (8pm) and a midday (12N) O-15 water PET scanning session. Each scanning session was preceded by one hour of dim light adaptation (50 lux) and consisted of six rCBF scans at three different light intensities in an AABBCC sequence (A=50 lux, B=2500 lux, C=7000lux). Significant differences in rCBF between the evening and midday 50 lux states were identified using the statistical parametric mapping method developed by Friston et al (p<.001). The evening scans demonstrated areas of greater relative blood flow in the pineal gland, the lateral temporal cortex bilaterally, the right lateral prefrontal cortex, the superior aspect of the anterior cingulate, and the left thalamus. The midday scans showed areas of greater relative blood flow in the visual cortex, the left lateral prefrontal cortex. the inferior aspect of the anterior cingulate, the left parietal cortex and the cerebellum. Our results demonstrate an extensive diurnal variation in baseline human rCBF. This indicates that time of day may be an important variable in conducting and interpreting functional brain imaging studies. Furthermore, these results suggest possible neuroanatomical substrates through which the circadian system may regulate the various physiologic and behavioral processes that manifest circadian rhythms.

  8. Regional grey matter shrinks in hypertensive individuals despite successful lowering of blood pressure.

    PubMed

    Jennings, J R; Mendelson, D N; Muldoon, M F; Ryan, C M; Gianaros, P J; Raz, N; Aizenstein, H

    2012-05-01

    The aim of the study was to determine whether the reduction in brain grey matter volume associated with hypertension persisted or was remediated among hypertensive patients newly treated over the course of a year. A total of 41 hypertensive patients were assessed over the course of a 1-year successful anti-hypertensive treatment. Brain areas identified previously in cross-sectional studies differing in volume between hypertensive and normotensive individuals were examined with a semi-automated measurement technique (automated labelling pathway). Volumes of grey matter regions were computed at baseline after a year of treatment and compared with archival data from normotensive individuals. Reductions in regional grey matter volume over the follow-up period were observed despite successful treatment of blood pressure (BP). The comparison group of older, but normotensive, individuals showed no significant changes over a year in the regions tested in the treated hypertensive group. These novel results suggest that essential hypertension is associated with regional grey matter shrinkage, and successful reduction of BP may not completely counter that trend.

  9. Cerebral blood flow in schizophrenia: effects of memory processing on regional activation.

    PubMed

    Gur, R E; Jaggi, J L; Shtasel, D L; Ragland, J D; Gur, R C

    1994-01-01

    Regional cerebral blood flow (rCBF) was measured with the 133Xenon clearance technique and a high resolution (254 detectors) scanner during the performance of a verbal and a facial memory task in 18 patients with schizophrenia and 18 sociodemographically matched controls. Patients and controls had comparable resting rCBF, but differed in global and hemispheric rCBF changes induced by the memory tasks. Patients had less global increase, which was relatively higher in the left hemisphere, and this was more pronounced for the verbal task. Although controls showed appropriate laterality changes (L > R for verbal and R > L for facial memory) in the midtemporal region, patients failed to show such a focal pattern. They did not show appropriate laterality change in the midtemporal region, but instead showed such changes in other regions. Patients showed greatest impairment in specificity of verbal recognition performance, and this correlated with severity of hallucinations and delusions. This supports a model of left temporal lobe dysfunction in schizophrenia.

  10. Effects of emotional discrimination tasks on cerebral blood flow: regional activation and its relation to performance.

    PubMed

    Gur, R C; Skolnick, B E; Gur, R E

    1994-07-01

    Facial discrimination tasks were applied as activation probes during physiologic neuroimaging ("neurobehavioral probes"). The stimuli pictured professional actors and actresses, posing degrees of happy and sad emotion. Cortical cerebral blood flow (CBF) was determined using the 133Xenon inhalation method during resting baseline, two emotional (happy from neutral and sad from neutral faces) and one nonemotional discrimination task (age). The three tasks produced CBF increase over baseline, which was greater in the right hemisphere (Task x Hemisphere interaction, p = .0001). There were regionally specific effects (Task x Region x Hemisphere interaction, p = .022). Relative to the age discrimination task, both emotion discrimination tasks were associated with greater right parietal activation. In addition, the happy discrimination task induced greater left frontal activation relative to the sad discrimination task. While overall magnitude of CBF increase did not show regionally specific correlations with performance, laterality did show such specificity. Sad discrimination performance correlated with greater right parietal activation, while performance on the happy discrimination task correlated with left frontal activation. Age discrimination performance correlated with higher activated right temporal CBF. These results support the hypothesis of right hemispheric involvement in facial processing and further suggest regionally specific hemispheric participation in happy and sad emotional discrimination. The study underscores the utility of performance measures for understanding the behavioral significance of activation effects in physiologic neuroimaging studies.

  11. Variations in the lumbosacral ligament and associated changes in the lumbosacral region resulting in compression of the fifth dorsal root ganglion and spinal nerve.

    PubMed

    Briggs, C A; Chandraraj, S

    1995-01-01

    Sixty-five lumbosacral regions from adult cadavers were dissected and the position and relations of the lumbosacral ligament noted. The lumbosacral ligament was present in all specimens; in 22 (34%) it extended medially across the ventral ramus of the fifth lumbar nerve, and in six (9%) of these the underlying nerve was compressed and visibly flattened. On two of these specimens the nerve, together with its dorsal root ganglion, was removed, processed, and stained with Masson's trichrome. The compressed nerve showed increased thickness of endoneurial and perineurial connective tissue, and the cells of the dorsal root ganglion were smaller and surrounded by increased connective tissue, particularly at the periphery of the ganglion. Observation of the lumbosacral ligament and surrounding anatomical structures suggests that anatomical variation in this region may be attributed to the health of the lumbosacral articular elements. In those specimens showing compression of the fifth lumbar spinal nerve there was also narrowing of the lumbosacral interspace. In these the disc itself was compressed and showed degenerative changes. The articular processes at the lumbosacral joint were irregular, with thinning and fissuring of the artiuclar cartilage. It is suggested that the processes which lead to the further development of the ligament, by the formation of additional fibrous bands, are mechanical in nature and result from instability at the lumbosacral region itself. Instability subsequently leads to the initiation of a chain of degenerative changes, involving pathology at the lumbosacral disc and zygapophyseal joints.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Regional cerebral blood flow in Parkinson disease with nonpsychotic visual hallucinations.

    PubMed

    Oishi, N; Udaka, F; Kameyama, M; Sawamoto, N; Hashikawa, K; Fukuyama, H

    2005-12-13

    Patients with Parkinson disease (PD) often experience visual hallucinations (VH) with retained insight (nonpsychotic) but the precise mechanism remains unclear. To clarify which neural substrates participate in nonpsychotic VH in PD, the authors evaluated regional cerebral blood flow (rCBF) changes in patients with PD and VH. The authors compared 24 patients with PD who had nonpsychotic VH (hallucinators) and 41 patients with PD who had never experienced VH (non-hallucinators) using SPECT images with N-isopropyl-p-[(123)I]iodoamphetamine. There were no significant differences in age, sex, duration of disease, doses of PD medications, Hoehn and Yahr scale, or Mini-Mental State Examination (MMSE) scores between the two groups. The rCBF data were analyzed using statistical parametric mapping (SPM). The rCBF in the right fusiform gyrus was lower in the hallucinators than in the non-hallucinators (corrected p < 0.05 at cluster levels). The hallucinators revealed higher rCBF in the right superior and middle temporal gyri than the non-hallucinators (uncorrected p < 0.001). These significant differences were demonstrated after MMSE scores and duration of disease, which are the relevant factors associated with VH, were covariated out. Nonpsychotic visual hallucinations in Parkinson disease (PD) may be associated with hypoperfusion in the right fusiform gyrus and hyperperfusion in the right superior and middle temporal gyri. These temporal regions are important for visual object recognition and these regional cerebral blood flow changes are associated with inappropriate visual processing and are responsible for nonpsychotic visual hallucinations in PD.

  13. Regional Choroidal Blood Flow and Multifocal Electroretinography in Experimental Glaucoma in Rhesus Macaques

    PubMed Central

    Nork, T. Michael; Kim, Charlene B. Y.; Munsey, Kaitlyn M.; Dashek, Ryan J.; Hoeve, James N. Ver

    2014-01-01

    Purpose. To test a hypothesis of regional variation in the effect of experimental glaucoma on choroidal blood flow (ChBF) and retinal function. Methods. Five rhesus macaques underwent laser trabecular destruction (LTD) to induce elevated intraocular pressure (IOP). Intraocular pressures were elevated for 56 to 57 weeks. Multifocal electroretinographic (mfERG) and multifocal visual evoked cortical potential (mfVEP) testing were performed at regular intervals before and during the period of IOP elevation. At euthanasia, the IOP was manometrically controlled at 35 (experimentally glaucomatous eye) and 15 (fellow control eye) mm Hg. Fluorescent microspheres were injected into the left ventricle. Regional ChBF was determined. Results. All of the experimentally glaucomatous eyes exhibited supranormal first-order kernel (K1) root mean square (RMS) early portions of the mfERG waveforms and decreased amplitudes of the late waveforms. The supranormality was somewhat greater in the central macula. Second-order kernel, first slice (K2.1) RMS mfVEP response was inversely correlated (R2 = 0.97) with axonal loss. Total ChBF was reduced in the experimentally glaucomatous eyes. The mean blood flow was 893 ± 123 and 481 ± 37 μL/min in the control and glaucomatous eyes, respectively. The ChBF showed regional variability with the greatest proportional decrement most often found in the central macula. Conclusions. This is the first demonstration of globally reduced ChBF in chronic experimental glaucoma in the nonhuman primate. Both the alteration of mfERG waveform components associated with outer retinal function and the reduction in ChBF were greatest in the macula, suggesting that there may be a spatial colocalization between ChBF and some outer retinal effects in glaucoma. PMID:25370515

  14. Apparent gene conversions involving the SMN gene in the region of the spinal muscular atrophy locus on chromosome 5

    SciTech Connect

    Steege, G. van der; Grootscholten, P.M.; Cobben, J.M.; Scheffer, H.; Buys, C.H.C.M.

    1996-10-01

    The survival motor neuron (SMN) gene has been described as a determining gene for spinal muscular atrophy (SMA). SMN has a closely flanking, nearly identical copy ({sup C}BCD541). Gene and copy gene can be discriminated by sequence differences in exons 7 and 8. The large majority of SMA patients show homozygous deletions of at least exons 7 and 8 of the SMN gene. A minority of patients show absence of SMN exon 7 but retention of exon 8. This is explained by results of our present analysis of 13 such patients providing evidence for apparent gene-conversion events between SMN and the centromeric copy gene. Instead of applying a separate analysis for absence or presence of SMN exons 7 and 8, we used a contiguous PCR from intron 6 to exon 8. In every case we found a chimeric gene with a fusion of exon 7 of the copy gene and exon 8 of SMN and absence of a normal SMN gene. Similar events, including the fusion counterpart, were observed in a group of controls, although in the presence of a normal SMN gene. Chimeric genes as the result of fusions of parts of SMN and {sup C}BCD541 apparently are far from rare and may partly explain the frequently observed SMN deletions in SMA patients. 23 refs., 4 figs.

  15. The examination of soft tissue compliance in the thoracic region for the development of a spinal manipulation training mannequin

    PubMed Central

    Starmer, David J.; Duquette, Sean A.; Stainsby, Brynne E.; Giuliano, Anthony M.

    2015-01-01

    Purpose: To determine if the soft tissue compliance of the thoracic paraspinal musculature differs based on gender and body type to help create a foam human analogue mannequin to assist in the training of spinal manipulative therapy. Methods: 54 volunteers were grouped based on their gender and body types. In the prone position, thoracic paraspinal soft tissue compliance was measured at T1, T3 T6, T9 and T12 vertebrae levels bilaterally using a tissue compliance meter. Results: There was no significant difference in tissue compliance when comparing the genders except at T1 (p=0.026). When comparing body types, significantly higher tissue compliance was found between endomorphs and the other groups. No significant difference was found between ectomorphs and mesomorphs. The compliance for the participants in this study ranged from 0.122 mm/N to 0.420 mm/N. Conclusion: There are significant differences in thoracic spine soft tissue compliance in healthy asymptomatic patients between genders in the upper thoracic spine, and between different body types throughout the thoracic spine. It may be beneficial to create multiple versions of practice mannequins to simulate variations amongst different patients. PMID:26136607

  16. Spinal Infections

    MedlinePlus

    ... spinal infection include fever, chills, headache, neck stiffness, pain, wound redness and tenderness, and wound drainage. In some cases, patients may notice new weakness, numbness or tingling sensations in the arms and/or legs. The symptoms ...

  17. Spinal stenosis

    MedlinePlus

    ... stenosis; Degenerative spine disease; Back pain - spinal stenosis; Low back pain - stenosis; LBP - stenosis ... Resnick DK, Shaffer WO, Loeser JD. Surgery for low back pain: a review of the evidence for an American ...

  18. Spinal tumor

    MedlinePlus

    ... Livingstone; 2014:chap 49. Read More Brain tumor - children Hodgkin lymphoma Metastasis Spinal cord trauma Review Date 8/15/2016 Updated by: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review ...

  19. Spinal Fusion

    MedlinePlus

    ... concept of fusion is similar to that of welding in industry. Spinal fusion surgery, however, does not ... bone taken from the patient has a long history of use and results in predictable healing. Autograft ...

  20. Spinal Fusion

    MedlinePlus

    ... concept of fusion is similar to that of welding in industry. Spinal fusion surgery, however, does not ... bone taken from the patient has a long history of use and results in predictable healing. Autograft ...

  1. Spinal Stenosis

    MedlinePlus

    ... and which nerves are affected. In the neck (cervical spine) Numbness or tingling in a hand, arm, foot ... spine imaging with an MRI or CT. Spinal injuries. Car accidents and other trauma can cause dislocations ...

  2. Performance of a closed-loop feedback computer-controlled infusion system for maintaining blood pressure during spinal anaesthesia for caesarean section: a randomized controlled comparison of norepinephrine versus phenylephrine.

    PubMed

    Ngan Kee, Warwick D; Khaw, Kim S; Tam, Yuk-Ho; Ng, Floria F; Lee, Shara W

    2017-06-01

    Closed-loop feedback computer-controlled vasopressor infusion has been previously described for maintaining blood pressure during spinal anaesthesia for caesarean section but there are limited data available comparing the relative performance of different vasopressors. The aim of this study was to compare the performance of norepinephrine versus phenylephrine in this system. Data from a randomized, two-arm parallel group, double-blinded controlled trial were reanalyzed. 104 patients scheduled for elective caesarean section under spinal anaesthesia were randomized to receive computer-controlled closed-loop infusion of either norepinephrine 5 µg ml(-1) or phenylephrine 100 µg ml(-1). This was started immediately after induction of spinal anaesthesia and used an algorithm designed to maintain systolic blood pressure near baseline until fetal delivery. Performance error calculations were used to compare the performance of the two vasopressors. The primary outcome was defined as the median absolute performance error. Median performance error, wobble and divergence were also compared. Median absolute performance error was smaller in the norepinephrine group (median 3.79 [interquartile range 2.82-5.17] %) versus the phenylephrine group (4.70 [3.23-6.57] %, P = 0.028). In addition, median performance error was smaller (0.75 [-1.56-2.52] %) versus 2.61 [0.83-4.57] %, P = 0.002) and wobble was smaller (2.85 [2.07-5.17] %) versus 3.39 [2.62-4.90] %, P = 0.028) in the norepinephrine group versus the phenylephrine group. Divergence was similar between groups. The precision of the control of blood pressure was greater with norepinephrine compared with phenylephrine at the drug concentrations used.

  3. Assessment of regional myocardial blood flow and regional fractional oxygen extraction in dogs, using 15O-water and 15O-hemoglobin.

    PubMed

    Parker, J A; Beller, G A; Hoop, B; Holman, B L; Smith, T W

    1978-04-01

    A new approach to the assessment of regional myocardial blood flow and fractional oxygen extraction has been developed using 15O-water (H2-15O) and 15O-hemoglobin (15O-Hb). Bolus doses (1 mCi) of H2-15O and 15O-Hb were injected 10 minutes apart into the left main coronary artery of 12 normal dogs. Sequential images of regional myocardial tracer clearance were obtained over 5 minutes with a positron camera. Myocardial blood flow calculated from the monoexponential washout of H2-15O after background correction was 78 +/- 6 (SE) ml/100 g per min. Functional images of regional blood flow in which the image of peak activity was divided by the integrated image of H2-15O washout were derived by computer processing. These images demonstrated homogeneous blood flow in the normal myocardium. Fractional myocardial O2 extraction was determined from an image of initial distribution of O2 used (obtained by extrapolating back to time zero the series of images obtained after 15O-Hb administration), divided by initial distribution of O2 delivered (obtained by back extrapolating H2-15O washout). These functional images showed uniform distribution of fractional O2 extraction in the normal myocardium. Thus, these studies show that regional myocardial blood flow and regional oxygen extraction can be measured simultaneously by sequential imaging after serial intracoronary injections of H2-15O and 15O-Hb.

  4. Clustering of murine lung metastases reflects fractal nonuniformity in regional lung blood flow.

    PubMed

    Kendal, W S

    In the experimental metastasis assay certain animals, from groups of similarly treated animals, develop more lung metastases than expected from random chance alone. This clustering of metastases is characterized by a power function relationship, sigma(2) = amu(b), between the variance, sigma(2), and mean, mu, of the numbers of lung metastases per animal (a and b are constants). To determine whether this clustering could be an artifact of experimental metastasis, whether it could be influenced by different experimental conditions, and to attempt to clarify its cause, 22 published data sets from experimental metastasis utilizing 2,145 mice, as well as 8 data sets from spontaneous metastasis utilizing 1,020 mice were analyzed. In these experiments cell cloning, cell-cell fusion, treatment with a protein kinase C inhibitor, treatment with cell adhesion compounds, and transfection with either the ras oncogene, the sialidase gene, or the urokinase sense and antisense genes were used to influence metastasis. They employed 14 different cell lines and 6 different strains of inbred mice. Clustering of metastasis was evident in animals from the spontaneous metastasis assays as well as from the experimental metastasis assays. It was apparent whether mice were injected with tumor cells derived from clones or from cell lines. Clustering was demonstrated within each data set, regardless of the experimental conditions employed. A single variance to mean power function (with a = 2.2 and b = 1.51) characterized the clustering in the 30 data sets. The regional distribution of blood flow through lungs and other organs is nonuniform, exhibiting a fractal symmetry on change of scale. This symmetry implies that the variance of a region's blood flow is related to its mean by the same power function as was observed with metastasis. Indeed, measurements of blood flow from isolated canine lungs yield b = 1.56, similar to the corresponding figure from murine lung metastasis. These findings

  5. Inhibition of nitric oxide synthesis accelerates the recovery of polysynaptic reflex potentials after transient spinal cord ischemia in cats.

    PubMed

    Nemoto, T; Sekikawa, T; Suzuki, T; Moriya, H; Nakaya, H

    1997-04-01

    Nitric Oxide (NO) has been implicated as a mediator of neuronal injury in vascular stroke. On the other hand, NO is suggested to play a neuroprotective role by increasing blood flow during cerebral ischemia. In order to evaluate the role of NO in the spinal cord ischemia, effects of nitric oxide synthase (NOS) inhibition on the recovery of reflex potentials after a transient spinal cord ischemia were examined in urethane-chloralose anesthetized spinal cats. Spinal cord ischemia was produced by occlusion of the thoracic aorta and the both internal mammary arteries for 10 min. Regional blood flow (RBF) in the spinal cord was continuously measured with a laser-Doppler flow meter. The monosynaptic (MSR) and polysynaptic reflex (PSR) potentials elicited by electrical stimulation of the tibial nerve, were recorded from the L7 or S1 ventral root. The recovery process of spinal reflex potentials was reproducible when the oclusion was repeated twice at an interval of 120 min. Pretreatment with N(G)-monomethyl-L-arginine (L-NMMA, 10 mg/kg), a NOS inhibitor significantly accelerated the recovery of PSR potentials after spinal cord ischemia. The accelerating effect of L-NMMA on the recovery of PSR potentials was abolished by co-administration of L-arginine (1 mg/kg/min) but not by that of D-arginine (1 mg/kg/min). L-NMMA failed to improve RBF in the spinal cord during ischemia and reperfusion. Nitroprusside (10 microg/kg/min), a NO donor, retarded the recovery of PSR potentials after spinal cord ischemia. These results suggest that NO production has a significant influence on the functional recovery after transient spinal cord ischemia.

  6. Spinal deformity.

    PubMed

    Bunnell, W P

    1986-12-01

    Spinal deformity is a relatively common disorder, particularly in teenage girls. Early detection is possible by a simple, quick visual inspection that should be a standard part of the routine examination of all preteen and teenage patients. Follow-up observation will reveal those curvatures that are progressive and permit orthotic treatment to prevent further increase in the deformity. Spinal fusion offers correction and stabilization of more severe degrees of scoliosis.

  7. Dynamic change of collateral flow varying with distribution of regional blood flow in acute ischemic rat cortex

    NASA Astrophysics Data System (ADS)

    Wang, Zhen; Luo, Weihua; Zhou, Fangyuan; Li, Pengcheng; Luo, Qingming

    2012-12-01

    Cerebral blood flow (CBF) is critical for the maintenance of cerebral function by guaranteed constant oxygen and glucose supply to brain. Collateral channels (CCs) are recruited to provide alternatives to CBF to ischemic regions once the primary vessel is occluded during ischemic stroke. However, the knowledge of the relationship between dynamic evolution of collateral flow and the distribution of regional blood flow remains limited. In this study, laser speckle imaging was used to assess dynamic changes of CCs and regional blood flow in a rat cortex with permanent middle cerebral artery occlusion (MCAo). We found that CCs immediately provided blood flow to ischemic territories after MCAo. More importantly, there were three kinds of dynamic changes of CCs during acute stroke: persistent CC, impermanent CC, and transient CC, respectively, related to different distributions of regional blood flow. Although there was the possible occurrence of peri-infarct depolarization (PID) during ischemia, there was no obvious significance about the onset time and duration of CCs between rats with and without PID. These results suggest that the initial arising of CCs does not ensure their persistence, and that collateral flow could be varied with distribution of regional blood flow in acute ischemic stroke, which may facilitate the understanding of collateral recruitment and promote the development of collateral therapeutics in the future.

  8. Tracking Spinal Cord Injury: Differences in Cytokine Expression of IGF-1, TGF- B1, and sCD95l Can Be Measured in Blood Samples and Correspond to Neurological Remission in a 12-Week Follow-Up.

    PubMed

    Ferbert, Thomas; Child, Christopher; Graeser, Viola; Swing, Tyler; Akbar, Michael; Heller, Raban; Biglari, Bahram; Moghaddam, Arash

    2017-02-01

    Neuroinflammation presumably has an important impact on the secondary phase of spinal cord injury and is regulated by pro- and anti-inflammatory cytokines. We analyzed serum levels of three different cytokines (insulin-like-growth-factor [IGF]-1, tumor growth factor [TGF]-β1, and soluble CD 95 ligand [sCD95L]), in blood samples of 23 patients admitted with acute traumatic spinal cord injury between November 2010 and July 2013 with a follow-up period of 12 weeks. Quantification was performed using Human Quantikine Immunoassays, classification of neurological impairment was performed using the American Spinal Cord Injury Impairment Scale at time of admission and after 12 weeks. After an initial drop of all three cytokine serum levels, IGF-1, TGF-β1, and sCD95L showed significantly increased serum levels during the acute and sub-acute phases. For IGF-1 and sCD95L, we could also observe significantly higher serum levels in patients without neurological improvement compared with patients who had improvement after 12 weeks. In this study, we were able to show differences in cytokine serum levels in patients with different neurological outcome. Measuring the serum level patterns of IGF-1, TGF-β1, and sCD95L might be a useful tool for prognosis in patients with neurological improvement and tracking the pathophysiology in further studies. Further, our observations might link promising therapeutic efforts in numerous animal studies and future studies in human patients.

  9. Impacts of small arteriovenous malformations (AVM) on regional cerebral blood flow and glucose metabolism

    SciTech Connect

    Liu, R.S.; Yeh, S.H.; Chu, L.S.

    1994-05-01

    This study assessed the effects of small AVMs (<3 cm) on the regional cerebral blood flow (rCBF) by Tc-99m HMPAO SPECT and on the glucose metabolism (rCGlcM) by [F-18]-FDG PET. Seven AVM patients (pts) were studied. All AVMs were confirmed by cerebral angiography and CT/MR scans. Tc-99m HMPAO SPECT and [F-18]-PDG PET images were interpreted visually to detect the changes of rCBF and rCGlcM. All pts except one brain stem AVM had defects in the regions of nidi on HMPAO and FDG images. FDG PET disclosed low rCGlcM in surrounding areas of AVMs in 6 pts, while HMPAO SPECT detected only 4 cases. One AVM had increased rCBF surrounding the nidus despite of decreased rCGlcM in the same region. Five pts had abnormal rCGlcM over ipsilateral remote cortex but only one had corresponding abnormal rCBF. Contralateral cortical hypofunction was noted in 3 pts by FDG PET but none by HMPAO SPECT. Cross cerebellar diaschisis was found in 2 AVMs by FDG PET and only one by HMPAO SPECT. All regions with abnormal HMPAO uptake did not look as discernibly as seen on the FDG PET scan. CT/MR scans detected the nidi of AVMs of all pts and old hemorrhage in one pt. In conclusion, either HMPAO SPECT or FDG PET is sensitive to detect the functional abnormalities in the region of nidus of small AVM and the surrounding brain tissue. FDG PET is better than HMPAO SPECT to detect functional changes in the remote cortex and diaschisis.

  10. Nonuniform, age-related decrements in regional sweating and skin blood flow

    PubMed Central

    Alexander, Lacy M.; Kenney, W. Larry

    2013-01-01

    Aging is associated with attenuated thermoregulatory function that varies regionally over the body. Decrements in vasodilation and sweating are well documented with age, yet limited data are available concerning the regional relation between these responses. We aimed to examine age-related alterations in the relation between regional sweating (RSR) and skin blood flow (SkBF) to thermal and pharmacological stimuli. Four microdialysis fibers were inserted in the ventral forearm, abdomen, thigh, and lower back of eight healthy aged subjects (64 ± 7 yr) and nine young (23 ± 3 yr) during 1) ACh dose response (1 × 10−7 to 0.1 M, mean skin temperature 34°C) and 2) passive whole body heating to Δ1°C rise in oral temperature (Tor). RSR and SkBF were measured over each microdialysis membrane using ventilated capsules and laser-Doppler flowmetry. Maximal SkBF was measured at the end of both protocols (50 mM SNP). Regional sweating thresholds and RSR were attenuated in aged vs. young at all sites (P < 0.0001) during whole body heating. Vasodilation thresholds were similar between groups (P > 0.05). Attenuated SkBF were observed at the arm and back in the aged, representing 56 and 82% of those in the young at these sites, respectively (0.5 ΔTor). During ACh perfusion, SkBF (P = 0.137) and RSR were similar between groups (P = 0.326). Together these findings suggest regional age-related decrements in heat-activated sweat gland function but not cholinergic sensitivity. Functional consequences of such thermoregulatory impairment include the compromised ability of older individuals to defend core temperature during heat exposure and a subsequently greater susceptibility to heat-related illness and injury. PMID:23926135

  11. The effect of clonidine infusion on distribution of regional cerebral blood flow in volunteers.

    PubMed

    Bonhomme, Vincent; Maquet, Pierre; Phillips, Christophe; Plenevaux, Alain; Hans, Pol; Luxen, Andre; Lamy, Maurice; Laureys, Steven

    2008-03-01

    Through their action on the locus coeruleus, alpha2-adrenoceptor agonists induce rapidly reversible sedation while partially preserving cognitive brain functions. Our goal in this observational study was to map brain regions whose activity is modified by clonidine infusion so as to better understand its loci of action, especially in relation to sedation. Six ASA I-II right-handed volunteers were recruited. Electroencephalogram (EEG) was monitored continuously. After a baseline H2(15)O activation scan, clonidine infusion was started at a rate ranging from 6 to 10 microg x kg(-1) x h(-1). A sequence of 11 similar scans was then performed at 8 min intervals. Plasma clonidine concentration was measured. Using statistical parametric mapping, we sought linear correlations between normalized regional cerebral blood flow (rCBF), an indicator of regional brain activity, and plasma clonidine concentration or spindle EEG activity. Clonidine induced clinical sedation and EEG patterns (spindles) comparable to early stage nonrapid eye movement sleep. A significant negative linear correlation between clonidine concentration and rCBF or spindle activity was observed in the thalamus, prefrontal, orbital and parietal association cortex, posterior cingulate cortex, and precuneus. The EEG patterns and decreases in rCBF of specific brain regions observed during clonidine-induced sedation are similar to those of early stage nonrapid eye movement sleep. Patterns of deactivated brain regions are also comparable to those observed during general anesthesia or vegetative state, reinforcing the hypothesis that alterations in the activity of a common network occur during these modified conscious states.

  12. Profile of Rh, Kell, Duffy, Kidd, and Diego blood group systems among blood donors in the Southwest region of the Paraná state, Southern Brazil.

    PubMed

    Zacarias, Joana Maira Valentini; Langer, Ieda Bernadete Volkweis; Visentainer, Jeane Eliete Laguila; Sell, Ana Maria

    2016-12-01

    The aim of this study was to assess the distribution of alleles and genotypes of the blood group systems Rh, Kell, Duffy, Kidd, and Diego in 251 regular blood donors registered in the hemotherapy unit of the Southwestern region of Paraná, Southern Brazil. The frequencies were obtained by direct counting on a spreadsheet program and statistical analyses were conducted in order to compare them with other Brazilian populations using chi-squared with Yates correction on OpenEpi software. The frequencies of RHD* negative, RHCE*c/c and RHCE*e/e were higher than expected for the Caucasian population. A difference was also observed for FY alleles, FY*01/FY*01 genotype and FY*02N.01 -67T/C (GATA Box mutation). Two homozygous individuals were defined as a low frequency phenotype K + k- (KEL*01.01/KEL*01.01) and, for Diego blood group system the rare DI*01 allele was found in ten blood donors, of which one was DI*01/DI* 01 (0.4%). The allele and genotype frequencies of Kidd blood group system were similar to expected to Caucasians. The results showed the direction in which to choose donors, the importance of extended genotyping in adequate blood screening and the existence of rare genotypes in Brazilian regular blood donors.

  13. Spinal Cord Tumor

    MedlinePlus

    Spinal cord tumor Overview By Mayo Clinic Staff A spinal tumor is a growth that develops within your ... as vertebral tumors. Tumors that begin within the spinal cord itself are called spinal cord tumors. There are ...

  14. Spinal fusion - series (image)

    MedlinePlus

    ... vertebrae are the bones that make up the spinal column, which surrounds and protects the spinal cord. The ... cushions between vertebrae, and absorb energy while the spinal column flexes, extends, and twists. Nerves from the spinal ...

  15. Assessment of regional pulmonary blood flow using (68)Ga-DOTA PET.

    PubMed

    Velasco, Carlos; Mateo, Jesus; Santos, Arnoldo; Mota-Cobian, Adriana; Herranz, Fernando; Pellico, Juan; Mota, Ruben A; España, Samuel; Ruiz-Cabello, Jesus

    2017-12-01

    In vivo determination of regional pulmonary blood flow (PBF) is a valuable tool for the evaluation of many lung diseases. In this study, the use of (68)Ga-DOTA PET for the in vivo quantitative determination of regional PBF is proposed. This methodology was implemented and tested in healthy pigs and validated using fluorescent microspheres. The study was performed on young large white pigs (n = 4). To assess the reproducibility and consistency of the method, three PET scans were obtained for each animal. Each radiotracer injection was performed simultaneously to the injection of fluorescent microspheres. PBF images were generated applying a two-compartment exchange model over the dynamic PET images. PET and microspheres values were compared by regression analysis and Bland-Altman plot. The capability of the proposed technique to produce 3D regional PBF images was demonstrated. The correlation evaluation between (68)Ga-DOTA PET and microspheres showed a good and significant correlation (r = 0.74, P < 0.001). Assessment of PBF with the proposed technique allows combining the high quantitative accuracy of PET imaging with the use of (68)Ga/(68)Ge generators. Thus, (68)Ga-DOTA PET emerges as a potential inexpensive method for measuring PBF in clinical settings with an extended use.

  16. Single-photon tomographic determination of regional cerebral blood flow in psychiatric disorders

    SciTech Connect

    Devous, M.D. Sr.; Rush, A.J.; Schlesser, M.A.; Debus, J.; Raese, J.D.; Chehabi, H.H.; Bonte, F.J.

    1984-01-01

    Regional cerebral blood flow (rCBF) was measured by single-photon emission computed tomography (SPECT) of 133-Xe washout in 29 normal volunteers, 22 unipolar endogenous depressives (UPE), 9 unipolar nonendogenous depressives (UPNE), 13 bipolar depressed patients (BPD), and 14 schizophrenic patients (SCHZ). RCBF was measured 2 and 6 cm above and parallel to the cantho-meatal line and quantitated in 14 gray matter regions. Most subjects were drug-free for 4-14 days. Diagnoses were made by experienced clinicians employing the Research Diagnostic Criteria, the Hamilton Rating Scale, and the dexamethasone suppression test. SCHZ were rated with the Brief Psychiatric Rating Scale. UPE had reduced flow compared to normals in the right parietal and temporal lobes and a nonsignificant trend toward left temporal flow reductions. UPNE were not different from normal or other patient groups. BPD had significant flow elevations in the left hemisphere relative to normal, and in both hemispheres relative to UPE. SCHZ were not significantly different from normal or other patient groups. Anterior-posterior flow shifts were evaluated by subtracting parietal or temporal flows from frontal flows. SCHZ demonstrated a greater posterior shift (lower relative frontal lobe flow) in comparison to both UPE and UPNE. The most significant regional flow abnormalities were observed as frontal flow reductions in individual SCHZ, although these were not significant in the whole group in comparison to normal.

  17. The Effect of Prophylactic Phenylephrine and Ephedrine Infusions on Umbilical Artery Blood pH in Women With Preeclampsia Undergoing Cesarean Delivery With Spinal Anesthesia: A Randomized, Double-Blind Trial.

    PubMed

    Higgins, Nicole; Fitzgerald, Paul C; van Dyk, Dominique; Dyer, Robert A; Rodriguez, Natalie; McCarthy, Robert J; Wong, Cynthia A

    2017-09-25

    Spinal anesthesia for cesarean delivery is associated with a high incidence of hypotension. Phenylephrine results in higher umbilical artery pH than ephedrine when used to prevent or treat hypotension in healthy women. We hypothesized that phenylephrine compared to ephedrine would result in higher umbilical artery pH in women with preeclampsia undergoing cesarean delivery with spinal anesthesia. This study was a randomized double-blind clinical trial. Nonlaboring women with preeclampsia scheduled for cesarean delivery with spinal anesthesia at Prentice Women's Hospital of Northwestern Medicine were randomized to receive prophylactic infusions of phenylephrine or ephedrine titrated to maintain systolic blood pressure >80% of baseline. Spinal anesthesia consisted of hyperbaric 0.75% bupivacaine 12 mg, fentanyl 15 µg, and morphine 150 µg. The primary outcome was umbilical arterial blood pH and the secondary outcome was umbilical artery base excess. One hundred ten women were enrolled in the study and 54 per group were included in the analysis. There were 74 and 72 infants delivered in the ephedrine and phenylephrine groups, respectively. The phenylephrine:ephedrine ratio for umbilical artery pH was 1.002 (95% confidence interval [CI], 0.997-1.007). Mean [standard deviation] umbilical artery pH was not different between the ephedrine 7.20 [0.10] and phenylephrine 7.22 [0.07] groups (mean difference -0.02, 95% CI of the difference -0.06 to 0.07; P = .38). Median (first, third quartiles) umbilical artery base excess was -3.4 mEq/L (-5.7 to -2.0 mEq/L) in the ephedrine group and -2.8 mEq/L (-4.6 to -2.2mEq/L) in the phenylephrine group (difference -0.6 mEq/L, 95% CI of the difference -1.6 to 0.3 mEq/L; P = .10). When adjusted for gestational age and infant gender, umbilical artery pH did not differ between groups. There were also no differences in the umbilical artery pH stratified by magnesium therapy or by the severity of preeclampsia. We were unable to demonstrate a

  18. Regional fibre stress-fibre strain area as an estimate of regional blood flow and oxygen demand in the canine heart.

    PubMed Central

    Delhaas, T; Arts, T; Prinzen, F W; Reneman, R S

    1994-01-01

    1. In the present study the relation between regional left ventricular contractile work, regional myocardial blood flow and oxygen uptake was assessed during asynchronous electrical activation. 2. In analogy to the use of the pressure-volume area for the estimation of global oxygen demand, the fibre stress-fibre strain area, as assessed regionally, was used to estimate regional oxygen demand. The more often used relation between the pressure-sarcomere length area and regional oxygen demand was also assessed. 3. Experiments were performed in six anaesthetized dogs with open chests. Regional differences in mechanical work were generated by asynchronous electrical activation of the myocardial wall. The ventricles were paced from the right atrium, the left ventricular free wall, the left ventricular apex or the right ventricular outflow tract. Regional fibre strain was measured at the epicardial anterior left ventricular free wall with a two-dimensional video technique. 4. Regional fibre stress was estimated from left ventricular pressure, the ratio of left ventricular cavity volume to wall volume, and regional deformation. Total mechanical power (TMP) was calculated from the fibre stress-fibre strain area (SSA) and the duration of the cardiac cycle (tcycle) using the equation: TMP = SSA/tcycle. Regional myocardial blood flow was measured with radioactive microspheres. Regional oxygen uptake was estimated from regional myocardial blood flow values and arteriovenous differences in oxygen content. 5. During asynchronous electrical activation, total mechanical power, pressure-sarcomere length area, myocardial blood flow and oxygen uptake were significantly lower in early than in late activated regions (P < 0.05). 6. Within the experiments, the correlation between the pressure-sarcomere length area and regional oxygen uptake was not significantly lower than the one between total mechanical power (TMP) and regional oxygen uptake (VO2,reg). However, variability of this

  19. Effects of histamine and related compounds on regional cerebral blood flow in rats.

    PubMed

    Suzuki, G; Chen, Z; Sugimoto, Y; Fujii, Y; Kamei, C

    1999-11-01

    The effects of histamine and related compounds on regional cerebral blood flow (rCBF) in the hippocampus of conscious rats were studied. Intracerebroventricular injection of histamine caused a dose-dependent increase in rCBF in the hippocampus, and similar findings were observed with not only the H1 agonist, 2-thiazolylethylamine, but also the H2 agonist, dimaprit. Intraperitoneal injection of L-histidine also resulted in an increase in rCBF in the hippocampus, in parallel with elevation of histamine content in the brain. The increase in rCBF in the hippocampus induced by L-histidine was antagonized by both H1 and H2 antagonists (diphenhydramine, pyrilamine and zolantidine). In addition, when both antagonists were injected simultaneously, an additive effect was observed in antagonism of the L-histidine-induced increase in rCBF. L-Histidine caused no marked changes in blood pressure even at a dose of 1,500 mg/kg, which showed an increase in rCBF in the hippocampus. These results indicate that histamine elicited an increase in rCBF via both H1 and H2 receptors.

  20. Numerical simulations of the blood flow in the patient-specific arterial cerebral circle region.

    PubMed

    Reorowicz, Piotr; Obidowski, Damian; Klosinski, Przemyslaw; Szubert, Wojciech; Stefanczyk, Ludomir; Jozwik, Krzysztof

    2014-05-07

    The Cerebral Circle Region, also known as the Circle of Willis (CoW), is a loop of arteries that form arterial connections between supply arteries to distribute blood throughout the cerebral mass. Among the population, only 25% to 50% have a complete system of arteries forming the CoW. 3D time-varying simulations for three different patient-specific artery anatomies of CoW were performed in order to gain a better insight into the phenomena existing in the cerebral blood flow. The models reconstructed on the basis of computer tomography images start from the aorta and include the largest arteries that supply the CoW and the arteries of CoW. Velocity values measured during the ultrasound examination have been compared with the results of simulations. It is shown that the flow in the right anterior artery in some cases may be supplied from the left internal carotid artery via the anterior communicating artery. The investigations conducted show that the computational fluid dynamic tool, which provides high resolution in both time and space domains, can be used to support physicians in diagnosing patients of different ages and various anatomical arterial structures.

  1. Vancomycin MIC creep in MRSA blood culture isolates from Germany: a regional problem?

    PubMed

    Kehrmann, J; Kaase, M; Szabados, F; Gatermann, S G; Buer, J; Rath, P-M; Steinmann, J

    2011-05-01

    The aim of this study was to assess the vancomycin MIC distribution for MRSA blood culture isolates over a period of six years in Germany. The study examined 287 MRSA isolates from blood cultures collected at several hospitals in two German cities between 2004 and 2009. The vancomycin MIC was determined by Etest. Genotypic features of the MRSA strains with vancomycin MIC ≥ 1 mg/L were determined by semiautomated repetitive-sequence-based polymerase chain reaction. The range of vancomycin MIC as determined by Etest was 0.25 to 2.0 mg/L. The geometric mean MIC increased by 1.34-fold in city A over the study period (p < 0.05), but there was no meaningful change in city B (a 1.09-fold increase, p > 0.05). Furthermore, in city A a shift in vancomycin MICs occurred as an increase in the percentage of isolates with MIC ≥ 1 mg/L from period one (2004-2006) to period two (2007-2009) (p < 0.0001). Typing results showed that in city A a single clone was predominant (55% of the creep isolates). In this study, the creep phenomenon seems to be a regional problem. We suggest that all hospitals should monitor their local status of elevated vancomycin MICs in invasive MRSA isolates.

  2. Regional cerebral blood flow changes during visually induced subjective sadness in healthy elderly persons.

    PubMed

    Paradiso, Sergio; Robinson, Robert G; Boles Ponto, Laura L; Watkins, G Leonard; Hichwa, Richard D

    2003-01-01

    This study examined regional cerebral blood flow (rCBF) changes associated with visually induced sad affect in healthy elderly persons. Subjects viewed sadness-laden, happiness-laden, and emotionally neutral image sets while rCBF was recorded using [(15)O] water PET. The sad image set included human faces and scenery/objects ("scenes"). To control for secondary sensory processing, the neutral and happy comparison sets included exclusively either human faces or scenes. During the sad condition, the ventral prefrontal and temporal cortices were more active compared with happy and neutral scenes conditions and the thalamus was more active compared with happy and neutral faces conditions. Ventral prefrontal cortex and thalamus were associated with processing of sad visual stimuli, whether compared with neutral or happy stimuli. The specific findings associated with sad affect were contingent on the comparison stimuli content (scenes or human faces), not affect (i.e., comparison with neutral or happy conditions).

  3. The effects of CT drift on xenon/CT measurement of regional cerebral blood flow.

    PubMed

    Kearfott, K J; Lu, H C; Rottenberg, D A; Deck, M D

    1984-01-01

    A systematic increase in computed tomography (CT) number of approximately 0.13 Hounsfield unit per scan (HU/scan) was observed when serial DeltaScan 2020 CT scans of a uniform water phantom were equally spaced at 0.5, 1.0, or 2.0 min and a shaped aluminum beam-hardening filter was employed. Much smaller drifts (less than 0.06 HU/scan) were observed with flat aluminum or shaped beryllium oxide filters. This machine drift, which was not associated with a rise in water phantom temperature and did not consistently correlate with estimated x-ray tube heat, could result in a significant overestimation of regional cerebral blood flow (rCBF) for a xenon/CT rCBF protocol involving 5-7 sequential scans obtained at 1-min interscan intervals.

  4. Smart catheter flow sensor for real-time continuous regional cerebral blood flow monitoring

    NASA Astrophysics Data System (ADS)

    Li, Chunyan; Wu, Pei-Ming; Hartings, Jed A.; Wu, Zhizhen; Ahn, Chong H.; LeDoux, David; Shutter, Lori A.; Narayan, Raj K.

    2011-12-01

    We present a smart catheter flow sensor for real-time, continuous, and quantitative measurement of regional cerebral blood flow using in situ temperature and thermal conductivity compensation. The flow sensor operates in a constant-temperature mode and employs a periodic heating and cooling technique. This approach ensures zero drift and provides highly reliable data with microelectromechanical system-based thin film sensors. The developed flow sensor has a sensitivity of 0.973 mV/ml/100 g/min in the range from 0 to 160 ml/100 g/min with a linear correlation coefficient of R2 = 0.9953. It achieves a resolution of 0.25 ml/100 g/min and an accuracy better than 5 ml/100 g/min.

  5. [Research on calculation of the regional cerebral blood volume based on minimum mean square error method].

    PubMed

    Chen, Jie; Li, Ying; Wang, Rongren; He, Renjie; Rao, Liyun

    2014-12-01

    In this paper, the Fourier transform based minimum mean square error (FT-based MMSE) method is used to calculate the regional cerebral blood volume (rCBV) in magnetic resonance (MR) perfusion imaging, and the method is improved to handle the existing noise in the imaging process. In the experiments with signal-to-noise ratio (SNR) of 50 dB, the rCBV values were compared with the results using MMSE method. The effects of different SNRs on the estimation of rCBV were analyzed. The experimental results showed that MMSE was a simple way to filter the measurement noise, and could calculate rCBV accurately. Compared with other existing methods, the present method is not sensitive to environment, and furthermore, it is suitable to deal with the perfusion images acquired from the environment with larger SNR.

  6. [Regional cerebral blood flow-SPECT "OFF-ON": a case report of catatonia].

    PubMed

    Moreno Caballero, M; Corchos González, N; De Antonio Rubio, I; Gómez-Río, M; Guerrero Velázquez, J F; Rodríguez Fernández, A; Llamas Elvira, J M

    2014-01-01

    We report the case of a patient with a long history of dysthymia and major depressive episodes requiring repeated hospitalization. We describe the most recent episode, associated with catatonia symptomatology and features suggestive of cognitive impairment. The absence of a clear initial psychopharmacological response alongside the clinical severity made the patient a potential candidate for electroconvulsive therapy (ECT). A regional cerebral blood flow SPECT (SPECT-rCBF), performed to rule out concomitant Alzheimer disease (AD), revealed a markedly decreased neocortical uptake, with no definitive pattern of concomitant primary cognitive impairment. Because a gradual clinical improvement was observed in the patient, with evidence of enhanced cerebral reperfusion in a second SPECT-rCBF study at two weeks after admission, the application of ECT was discounted and an expectant attitude was adopted.

  7. Fractal regional myocardial blood flows pattern according to metabolism, not vascular anatomy.

    PubMed

    Yipintsoi, Tada; Kroll, Keith; Bassingthwaighte, James B

    2016-02-01

    Regional myocardial blood flows are markedly heterogeneous. Fractal analysis shows strong near-neighbor correlation. In experiments to distinguish control by vascular anatomy vs. local vasomotion, coronary flows were increased in open-chest dogs by stimulating myocardial metabolism (catecholamines + atropine) with and without adenosine. During control states mean left ventricular (LV) myocardial blood flows (microspheres) were 0.5-1 ml·g(-1)·min(-1) and increased to 2-3 ml·g(-1)·min(-1) with catecholamine infusion and to ∼4 ml·g(-1)·min(-1) with adenosine (Ado). Flow heterogeneity was similar in all states: relative dispersion (RD = SD/mean) was ∼25%, using LV pieces 0.1-0.2% of total. During catecholamine infusion local flows increased in proportion to the mean flows in 45% of the LV, "tracking" closely (increased proportionately to mean flow), while ∼40% trended toward the mean. Near-neighbor regional flows remained strongly spatially correlated, with fractal dimension D near 1.2 (Hurst coefficient 0.8). The spatial patterns remain similar at varied levels of metabolic stimulation inferring metabolic dominance. In contrast, adenosine vasodilation increased flows eightfold times control while destroying correlation with the control state. The Ado-induced spatial patterns differed from control but were self-consistent, inferring that with full vasodilation the relaxed arterial anatomy dominates the distribution. We conclude that vascular anatomy governs flow distributions during adenosine vasodilation but that metabolic vasoregulation dominates in normal physiological states.

  8. Effect of body warming on regional blood flow distribution in conscious hypoxic one-month-old rabbits.

    PubMed

    Seifert, Erin L; Sant Anna, Guilherme M; Rohlicek, Charles V

    2006-01-01

    Previous experiments have shown that warming hypoxic infants reduces total peripheral vascular resistance. This suggests that the usual vasoconstriction of less essential vascular beds during hypoxia may be reduced and that the normal redistribution of blood flow to more vital organs may be compromised. Evaluate the effect of body warming during hypoxia on the distribution of blood flow. The fluorescent microsphere technique was used to compare regional blood flow in 1-month-old rabbits during systemic hypoxia (10% inspired O2) with (n = 9) and without (n = 10) body warming. Blood flow was measured in brain, stomach, small intestine, hindlimb muscle, skin, and kidneys. Arterial blood pressure, whole-body O2 consumption, arterial blood O2 saturation and blood gases were also measured. In hypoxia all animals decreased body temperature (-2 degrees C). With hypoxia blood flow increased to brain and hindlimb muscle; decreased to stomach, small intestine, and kidneys, and was unchanged in skin. The increase in brain-blood flow maintained O2 delivery at normoxic levels. Rewarming to the normoxic body temperature significantly changed blood flow in hypoxia. Brain blood flow increased by 102 +/- 30% (mean +/- SEM) thereby increasing O2 delivery by 50 +/- 23% above normoxic values. Blood flow also increased to skin, stomach, and small intestine. However, O2 delivery to these tissues remained below normoxic levels. Warming during hypoxia may impose an additional cardiovascular demand. The changes in the pattern of blood flow distribution with mild warming during hypoxia support the hypothesis that warming represents a significant heat stress. Copyright 2006 S. Karger AG, Basel.

  9. [Effects of ablation of the hindlimb on the organization of the ventral horn of the spinal cord in the lumbar region of green lizard embryos (Lacerta viridis Laur.)].

    PubMed

    Raynaud, A; Clairambault, P

    1978-01-01

    After extirpation of an hind limb in embryos of Lacerta viridis, numerous motor neuroblasts degenerate on the operated side, in the ventral horn of the lumbar spinal cord and the corresponding motor column is reduced or disappears. The lumbar spinal ganglia are affected and reduced on the operated side.

  10. Alteration of brain regional homogeneity of monkeys with spinal cord injury: A longitudinal resting-state functional magnetic resonance imaging study.

    PubMed

    Rao, Jia-Sheng; Ma, Manxiu; Zhao, Can; Liu, Zuxiang; Yang, Zhao-Yang; Li, Xiao-Guang

    2015-11-01

    To investigate the longitudinal brain regional homogeneity (ReHo) changes in nonhuman primate after spinal cord injury (SCI) by resting-state functional magnetic resonance imaging (fMRI). Three adult female rhesus monkeys underwent unilateral thoracic cord injury. A resting-state fMRI examination was performed in the healthy stage and 4, 8, and 12 weeks after the injury. The ReHo value of each voxel in the monkey brain was calculated and compared between pre- and post-SCI monkeys with paired t test. The regions of interest (ROIs) in the significantly changed ReHo regions were set. The correlations between the ReHo change and the time after injury were also determined. Compared with those in healthy period, the ReHo values of the left premotor cortex and the anterior cingulate cortex (ACC) in post-SCI rhesus monkeys significantly increased in 4-week follow-up examinations. The ReHo values of posterior cingulate cortex, left precuneus, left temporal parietooccipital area, and bilateral superior parietal lobules decreased at 8-week follow-up examinations. In 12-week follow-up examinations, the ReHo values of the left postcentral gyrus, right caudate nucleus, and superior temporal gyrus increased. Correlation analysis showed positive correlations between left ACC and the postoperative time. SCI can change the regional synchronism of brain activity in sensorimotor system and the default mode network. These findings may help us to understand the potential pathophysiological changes in the central nervous system after SCI. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Humoral Control of Regional Blood Flow in Hemorrhagic Shock in Non-Resuscitated and Resuscitated Animals.

    DTIC Science & Technology

    1987-07-17

    to perfusion with autologous normal (non-shock) blood. This increased resistance could be eliminated with phentolamine . However, oxygen consumption...perfusion with normal blood of 2.1 resistance units during perfusion with shock blood (pɘ.001). In a total of 17 phentolamine treated pig limbs...mL/min for normal blood and 1.4 mL/min for shock blood. None of these differences was statistically significant. The findings show that phentolamine

  12. Improved blood culture identification by FilmArray in cultures from regional hospitals compared with teaching hospital cultures.

    PubMed

    Inglis, Timothy J J; Bzdyl, Nicole; Chua, I-Ly Joanna; Urosevic, Nadezda M; Leung, Michael J; Geelhoed, Elizabeth

    2016-01-01

    Rapid identification of bacteria isolated from blood cultures by direct matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) is now in wide spread use in major centres but is not yet feasible in smaller hospital laboratories. A FilmArray multiplex PCR panel for blood culture isolate identification (BCID) provides an alternative approach to near point-of-care microbial identification in regional hospitals. We assessed the accuracy and time to identification of the BCID FilmArray in a consecutive series of 149 blood cultures from 143 patients in a teaching hospital and smaller regional hospitals, currently identified by direct MALDI-TOF and proprietary molecular methods. The BCID FilmArray contained 18 of 34 species and 20 of 23 species isolated from teaching and regional hospital, respectively. Overall, 85 % of the teaching hospital and 100 % of the regional hospital monomicrobial blood cultures were identified, compared with 60 and 68 %, respectively, for direct MALDI-TOF on the same cultures. There were no incorrect results from blood cultures containing Staphylococcus aureus, streptococci, Pseudomonas aeruginosa or Enterobacteriaceae. The three discrepant results were all in mixed cultures. The mean reduction in time to identification of blood culture isolates was 53 h, which did not include the time required to transport cultures from regional centres to a central laboratory. The overall performance of the BCID FilmArray is stronger in blood cultures from smaller regional hospitals that encounter a narrower range of bacterial species dominated by the commonest species. This approach is more suited to smaller clinical laboratories than the MALDI-TOF direct method.

  13. Acute and Chronic Changes in Aquaporin 4 Expression After Spinal Cord Injury

    PubMed Central

    Nesic, Olivera; Lee, Julieann; Ye, Zaiming; Unabia, Geda C.; Rafati, Danny; Hulsebosch, Claire E.; Perez-Polo, J. Regino

    2007-01-01

    The effect of spinal cord injury (SCI) on the expression levels and distribution of water channel aquaporin 4 (AQP4) has not been studied. We have found AQP4 in gray and white matter astrocytes in both uninjured and injured rat spinal cords. AQP4 was detected in astrocytic processes that were tightly surrounding neurons and blood vessels, but more robustly in glia limitans externa and interna, which were forming an interface between spinal cord parenchyma and cerebrospinal fluid (CSF). Such spatial distribution of AQP4 suggests a critical role that astrocytes expressing AQP4 play in the transport of water from blood/CSF to spinal cord parenchyma and vice versa. SCI induced biphasic changes in astrocytic AQP4 levels, including its early down-regulation and subsequent persistent up-regulation. However, changes in AQP4 expression did not correlate well with the onset and magnitude of astrocytic activation, when measured as changes in GFAP expression levels. It appears that reactive astrocytes began expressing increased levels of AQP4 after migrating to the wound area (thoracic region) two weeks after SCI, and AQP4 remained significantly elevated for months after SCI. We also showed that increased levels of AQP4 spread away from the lesion site to cervical and lumbar segments, but only in chronically injured spinal cords. Although overall AQP4 expression levels increased in chronically-injured spinal cords, AQP4 immunolabeling in astrocytic processes forming glia limitans externa was decreased, which may indicate impaired water transport through glia limitans externa. Finally, we also showed that SCI-induced changes in AQP4 protein levels correlate, both temporally and spatially, with persistent increases in water content in acutely and chronically injured spinal cords. Although correlative, this finding suggests a possible link between AQP4 and impaired water transport/edema/syringomyelia in contused spinal cords. PMID:17074445

  14. YAC contigs of the Rab1 and wobbler (wr) spinal muscular atrophy gene region on proximal mouse chromosome 11 and of the homologous region on human chromosome 2p

    SciTech Connect

    Wedemeyer, N.; Lengeling, A.; Ronsiek, M.

    1996-03-05

    Despite rapid progress in the physical characterization of murine and human genomes, little molecular information is available on certain regions, e.g., proximal mouse chromosome 11 (Chr 11) and human chromosome 2p (Chr2p). We have localized the wobbler spinal atrophy gene wr to proximal mouse Chr 11, tightly linked to Rab1, a gene coding for a small GTP-binding protein, and Glns-ps1, an intronless pseudogene of the glutamine synthetase gene. We have not used these markers to construct a 1.3-Mb yeast artificial chromosome (YAC) contig of the Rab1 region on mouse Chr 11. Four YAC clones isolated from two independent YAC libraries were characterized by rare-cutting analysis, fluorescence in situ hybridization (FISH), and sequence-tagged site (STS) isolation and mapping. Rab1 and Glns-ps1 were found to be only 200 kb apart. A potential CpG island near a methylated NarI site and a trapped exon, ETG1.1, were found over 250 kb from Rab1. Two overlapping YACs were identified that contained a 150-kb region of human Chr 2p, comprising the RAB1 locus, AHY1.1, and the human homologue of ETG1.1, indicating a high degree of conservation of this region in the two species. We mapped AHY1.1 and thus human RAB1 on Chr 2p13.4-p14 using somatic cell hybrids and a radiation hybrid panel, thus extending a known region of conserved synteny between mouse Chr 11 and human Chr 2p. Recently, the gene LMGMD2B for a human recessive neuromuscular disease, limb girdle muscular dystrophy type 2B, has been mapped to 2p13-p16. The conservation between the mouse Rab1 and human RAB1 regions will be helpful in identifying candidate genes for the wobbler spinal muscular atrophy and in clarifying a possible relationship between wr and LMGMD2B. 33 refs., 7 figs., 3 tabs.

  15. Effects of arterial cannulation stress on regional cerebral blood flow in major depressive disorder.

    PubMed

    Savitz, Jonathan; Nugent, Allison C; Cannon, Dara M; Carlson, Paul J; Davis, Rebecca; Neumeister, Alexander; Rallis-Frutos, Denise; Fromm, Steve; Herscovitch, Peter; Drevets, Wayne C

    2012-01-01

    Individuals with major depressive disorder (MDD) display abnormal neurophysiological responses to psychological stress but little is known about their neurophysiological responses to physiological stressors. Using [(15)O-H(2)O] positron emission tomography we assessed whether the regional cerebral blood flow (rCBF) response to arterial cannulation differed between patients with MDD and healthy controls (HCs). Fifty-one MDD patients and 62 HCs were scanned following arterial cannulation and 15 MDD patients and 17 HCs were scanned without arterial cannulation. A region-of-interest analysis showed that a significantly increased rCBF of the anterior cingulate cortex and right amygdala was associated with arterial cannulation in MDD. A whole brain analysis showed increased rCBF of the right post-central gyrus, left temporopolar cortex, and right amygdala during arterial cannulation in MDD patients. The rCBF in the right amygdala was significantly correlated with depression severity. Conceivably, the limbic response to invasive physical stress is greater in MDD subjects than in HCs.

  16. Reduced serotonin synthesis and regional cerebral blood flow after anxiolytic treatment of social anxiety disorder.

    PubMed

    Frick, Andreas; Åhs, Fredrik; Appel, Lieuwe; Jonasson, My; Wahlstedt, Kurt; Bani, Massimo; Merlo Pich, Emilio; Bettica, Paolo; Långström, Bengt; Lubberink, Mark; Fredrikson, Mats; Furmark, Tomas

    2016-11-01

    Social anxiety disorder (SAD) is associated with increased fear-related neural activity in the amygdala and we recently found enhanced serotonin synthesis rate in the same region. Anxiolytic agents like selective serotonin re-uptake inhibitors (SSRIs) and neurokinin-1 receptor (NK1R) antagonists reduce amygdala activity and may attenuate serotonin formation according to animal studies. Here, we examined the effects of SSRI pharmacotherapy, NK1R antagonism, and placebo on serotonin synthesis rate in relation to neural activity, measured as regional cerebral blood flow (rCBF), and symptom improvement in SAD. Eighteen SAD patients were randomized to receive daily double-blind treatment for six weeks either with the SSRI citalopram (n=6; 40mg), the NK1R antagonist GR205171 (n=6; 5mg; 4 weeks following 2 weeks of placebo), or placebo (n=6). Serotonin synthesis rate at rest and rCBF during stressful public speaking were assessed, before and after treatment, using positron emission tomography with the tracers [(11)C]5-hydroxytryptophan and [(15)O]water respectively. The Liebowitz Social Anxiety Scale (LSAS-SR) indexed symptom severity. All groups exhibited attenuated amygdala serotonin synthesis rate after treatment, which was associated with reduced amygdala rCBF during public speaking and accompanied by symptom improvement. These results are consistent with the notion that serotonin in the amygdala exerts an anxiogenic influence and, conversely, that anxiolysis is achieved through decreased serotonin formation in the amygdala.

  17. Regional cerebral blood flow changes in early-onset anorexia nervosa before and after weight gain.

    PubMed

    Komatsu, Hiroko; Nagamitsu, Shinichiro; Ozono, Shuichi; Yamashita, Yushiro; Ishibashi, Masatoshi; Matsuishi, Toyojiro

    2010-09-01

    To investigate the changes of regional cerebral blood flow (rCBF) in early-onset anorexia nervosa (AN) before and after weight gain, we examined resting rCBF using single photon emission computed tomography (SPECT) with [(123)I]iodoamphetamine ((123)I-IMP). Ten female children with AN (mean age 13.2 years old) participated in this study. SPECT examinations were performed in all patients twice at the beginning of treatment and after weight gain. The mean body mass index (BMI) was changed from 13.1 to 16.6 during 4 months treatment period. Automatic voxel-based analysis of the images was carried out using statistical parametric mapping (SPM) software. Relatively increased rCBF in the bilateral parietal lobe and limbic lobe including the posterior cingulate cortex (PCC) were observed after weight gain in early-onset AN. There was no significant decrease in the rCBF after weight gain. A significant positive correlation was observed between BMI and rCBF in the right thalamus, right parietal lobe, and right cerebellum. These results suggested that weight gain during the process of recovery from early-onset AN might activate specific brain regions which are possibly relevant to the pathophysiological aspects of the disorder. Copyright 2009 Elsevier B.V. All rights reserved.

  18. Tandem Spinal Stenosis: A Systematic Review.

    PubMed

    Overley, Samuel C; Kim, Jun S; Gogel, Brooke A; Merrill, Robert K; Hecht, Andrew C

    2017-09-05

    Tandem spinal stenosis refers to spinal canal diameter narrowing in at least 2 distinct regions of the spine, most commonly the lumbar and cervical regions. This entity can be an asymptomatic radiographic finding, or it can present with severe myelopathy and lower-extremity symptoms. Tandem spinal stenosis may impact surgeon decision-making when planning either cervical or lumbar spine surgery, and there is currently no consensus in the literature regarding the treatment algorithm for operative intervention. A MEDLINE literature search was performed using PubMed, the Cochrane Database of Systematic Reviews, and Embase from January 1980 to February 2015 using Medical Subject Heading queries for the terms "tandem spinal stenosis," "cervical stenosis AND lumbar stenosis," and "concomitant spinal stenosis." We included studies involving adult patients, tandem spinal stenosis of the cervical and lumbar regions, and a minimum of 5 patients. Articles that did not discuss spinal disorders or only explored disorders at a single spinal region were excluded. The initial database review resulted in 234 articles. After abstracts were reviewed, only 17 articles that met inclusion criteria were identified: 2 cadaveric studies, 5 clinical studies of patients with radiographic tandem spinal stenosis, and 10 clinical studies of patients with symptomatic tandem spinal stenosis. Tandem spinal stenosis is a common condition present in up to 60% of patients with spinal stenosis. This disorder, however, is often overlooked, which can lead to serious complications. Identification of tandem spinal stenosis is paramount as a first step in management and, although there is still no preferred intervention, both staged and simultaneous procedures have been shown to be effective. Surgeons may utilize a single, staged, or combined approach to decompression, always addressing cervical myelopathy as a priority.

  19. Use of an electronic barcode system for patient identification during blood transfusion: 3-year experience in a regional hospital.

    PubMed

    Chan, J C W; Chu, R W; Young, B W Y; Chan, F; Chow, C C; Pang, W C; Chan, C; Yeung, S H; Chow, P K; Lau, J; Leung, P M K

    2004-06-01

    To evaluate the use of an electronic barcode system for patient identification during blood transfusion. Retrospective study. Regional hospital, Hong Kong. For all patients requiring blood transfusion between May 1999 and April 2002, with the exception of patients in the psychiatric wards and the accident and emergency department, a portable, hand-held scan-and-print electronic device was used to verify and document patients' identity at two critical points of transfusion: blood sampling for the compatibility test and blood administration. Scope of use of the electronic device, cost, effectiveness, staff compliance, problems and solution for improvement. In the first 3 years of hospital-wide use of the new device, no incidents of blood transfusion to wrong patients, or wrong labelling of blood samples, occurred with 41,00 blood sampling procedures and administration of 27 000 units of blood. Blood sampling took 6 minutes to complete with the use of the electronic device-similar to that taken by the conventional second-checker system. Among hospital staff, the compliance rate of using the new device approached 90%. Battery problems occurred in 12% of episodes of use of the device. The electronic barcode system was effective in reducing human error related to bedside transfusion procedures. The future goal is to tailor-make a more efficient device with additional functions.

  20. Positron emission tomography in the newborn: extensive impairment of regional cerebral blood flow with intraventricular hemorrhage and hemorrhagic intracerebral involvement

    SciTech Connect

    Volpe, J.J.; Herscovitch, P.; Perlman, J.M.; Raichle, M.E.

    1983-11-01

    Positron emission tomography (PET) now provides the capability of measuring regional cerebral blood flow with high resolution and little risk. In this study, we utilized PET in six premature infants (920 to 1,200 g) with major intraventricular hemorrhage and hemorrhagic intracerebral involvement to measure regional cerebral blood flow during the acute period (5 to 17 days of age). Cerebral blood flow was determined after intravenous injection of H/sub 2/O, labeled with the positron-emitting isotope, /sup 15/O. Findings were similar and dramatic in all six infants. In the area of hemorrhagic intracerebral involvement, little or no cerebral blood flow was detected. However, in addition, surprisingly, a marked two- to fourfold reduction in cerebral blood flow was observed throughout the affected hemisphere, well posterior and lateral to the intracerebral hematoma, including cerebral white matter and, to a lesser extent, frontal, temporal, and parietal cortex. In the one infant studied a second time, ie, at 3 months of age, the extent and severity of the decreased cerebral blood flows in the affected hemisphere were similar to those observed on the study during the neonatal period. At the three autopsies, the affected left hemisphere showed extensive infarction, corroborating the PET scans. These observations, the first demonstration of the use of PET in the determination of regional cerebral blood flow in the newborn, show marked impairments in regional cerebral blood flow in the hemisphere containing an apparently restricted intracerebral hematoma, indicating that the hemorrhagic intracerebral involvement is only a component of a much larger lesion, ischemic in basic nature, ie, an infarction. This large ischemic lesion explains the poor neurologic outcome in infants with intraventricular hemorrhage and hemorrhagic intracerebral involvement.

  1. Regional cerebral blood flow and abnormal eating behavior in Prader-Willi syndrome.

    PubMed

    Ogura, Kaeko; Fujii, Toshikatsu; Abe, Nobuhito; Hosokai, Yoshiyuki; Shinohara, Mayumi; Fukuda, Hiroshi; Mori, Etsuro

    2013-05-01

    Prader-Willi syndrome (PWS) is a genetically determined neurodevelopmental disorder and is generally regarded as a genetic model of obesity. Individuals with PWS exhibit behavioral symptoms including temper tantrums, rigid thinking, and compulsive behavior. The most striking feature of PWS is abnormal eating behavior, including hyperphagia, intense preoccupation with food, and incessant food seeking. To explore brain regions associated with the behavioral symptoms of PWS, we investigated differences in resting-state regional cerebral blood flow (rCBF) between individuals with PWS and healthy controls. Correlation analyses were also performed to examine the relationship between rCBF and altered eating behavior in PWS individuals. Twelve adults with PWS and 13 age- and gender-matched controls underwent resting-state single photon emission computerized tomography (SPECT) with N-isopropyl-p-[(123)I] iodoamphetamine (IMP). The rCBF data were analyzed on a voxel-by-voxel basis using SPM5 software. The results demonstrated that compared with controls, individuals with PWS had significantly lower rCBF in the right thalamus, left insular cortex, bilateral lingual gyrus, and bilateral cerebellum. They had significantly higher rCBF in the right inferior frontal gyrus, left middle/inferior frontal gyrus (anterior and posterior clusters), and bilateral angular gyrus. Additionally, rCBF in the left insula, which was significantly lower in PWS individuals, was negatively correlated with the eating behavior severity score. These results suggest that specific brain regions, particularly the left insula, may be partly responsible for the behavioral symptoms in PWS. Copyright © 2012 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  2. Changes in regional cerebral blood flow following antidepressant treatment in late-life depression.

    PubMed

    Ishizaki, Junko; Yamamoto, Hideki; Takahashi, Taro; Takeda, Maki; Yano, Madoka; Mimura, Masaru

    2008-08-01

    Reversible/irreversible abnormalities of regional cerebral blood flow (rCBF) are seen in patients with depression. However, in late-life depression there is little evidence of a longitudinal change in rCBF through remission. We examined whether the decreased rCBF in individuals with late-life depression resolves following treatment. Twenty-five depressed patients older than 55 years completed the Hamilton Rating Scale for Depression and single photon emission computed tomography before and after a mean of 13.7 weeks of pharmacotherapy. Quantitative analyses were performed using the Statistical Parametric Mapping procedure. Patients with depression demonstrated decreased rCBF in the anterior ventral and dorsal medial prefrontal cortex (PFC), including anterior cingulate cortices, bilateral ventrolateral PFC to temporal cortices, and bilateral medial to lateral parieto-occipital lobes relative to healthy controls. No particular areas showed increased rCBF. Following pharmacotherapy, rCBF significantly increased in the left dorsolateral PFC to precentral areas and the right parieto-occipital regions. However, decreased rCBF at baseline in the anterior ventral/dorsal medial PFC, bilateral ventrolateral PFC, bilateral temporal lobes, and bilateral parietal lobes did not show significant improvement after treatment. Remarkable improvements in rCBF in the left dorsolateral PFC to precentral regions are consistent with the hypothesis that neuronetworks including the left frontal cortex may be functionally and reversibly involved in late-life unipolar major depression (state-dependent). In contrast, neural circuits including bilateral medial, dorsolateral, and parietal areas may reflect underlying and continuous pathognomonic brain dysfunction of depression (trait-dependent).

  3. Spatio-temporal flow analysis in bileaflet heart valve hinge regions: potential analysis for blood element damage.

    PubMed

    Simon, Hélène A; Dasi, Lakshmi P; Leo, Hwa-Liang; Yoganathan, Ajit P

    2007-08-01

    Point-wise velocity measurements have been traditionally acquired to estimate blood damage potential induced by prosthetic heart valves with emphasis on peak values of velocity magnitude and Reynolds stresses. However, the inherently Lagrangian nature of platelet activation and hemolysis makes such measurements of limited predictive value. This study provides a refined fluid mechanical analysis, including blood element paths and stress exposure times, of the hinge flows of a CarboMedics bileaflet mechanical heart valve placed under both mitral and aortic conditions and a St Jude Medical bileaflet valve placed under aortic conditions. The hinge area was partitioned into characteristic regions based on dominant flow structures and spatio-temporal averaging was performed on the measured velocities and Reynolds shear stresses to estimate the average bulk stresses acting on blood elements transiting through the hinge. A first-order estimate of viscous stress levels and exposure times were computed. Both forward and leakage flow phases were characterized in each partition by dynamic flows dependent on subtle leaflet movements and transvalvular pressure fluctuations. Blood elements trapped in recirculation regions may experience exposure times as long as the entire forward flow phase duration. Most calculated stresses were below the accepted blood damage threshold. Estimates of the stress levels indicate that the flow conditions within the boundary layers near the hinge and leaflet walls may be more detrimental to blood cells than bulk flow conditions, while recirculation regions may promote thrombus buildup.

  4. Variations of the sciatic nerve anatomy and blood supply in the gluteal region: a review of the literature.

    PubMed

    Kanawati, Andrew James

    2014-11-01

    Variations of the sciatic nerve anatomy and blood supply are complex and largely not dealt with in common anatomy texts. Variations of the sciatic nerve anatomy can be divided into the height of division of its branches, relation of the branches to the piriformis muscle, and its blood supply. These variations should be well known to any surgeon operating in this anatomical region. It is unknown whether these variations increase the risk of surgical injury and consequent morbidity. This paper will review the current knowledge regarding anatomical variations of the sciatic nerve and its blood supply.

  5. Associations between regional differences in polychlorinated biphenyls and dichlorodiphenyldichloroethylene in blood of nestling bald eagles and reproductive productivity.

    PubMed

    Bowerman, William W; Best, David A; Giesy, Ohn P; Shieldcastle, Mark C; Meyer, Michael W; Postupalsky, Sergej; Sikarskie, James G

    2003-02-01

    The relationship between regional reproduction rates of bald eagles (Haliaeetus leucocephalus) and concentrations of p.p'-dichlorodiphenyldichloroethylene (p,p'-DDE) and total polychlorinated biphenyls (PCBs) in blood plasma from nestling bald eagles was assessed. Blood was analyzed from 309 nestlings from 10 subpopulations of eagles across the Great Lakes region. Geometric mean concentrations of p,p'-DDE and total PCBs were inversely correlated to the productivity and success rates of nesting bald eagles within nine subpopulations. Nestlings eight weeks of age and older had significantly greater geometric mean concentrations of total PCBs and p,p'-DDE than nestlings less than eight weeks of age. The ability to use measurements of p,p'-DDE and total PCBs in nestling blood to determine the potential impact of these contaminants on adult nesting on a regional scale was demonstrated.

  6. [Blood Flow and Regional Blood Flow Rate in the Middle Cerebral Artery during Surgical Leg Lengthening in Patients with Congenital and Acquired Limb Shortening].

    PubMed

    Schurov, V A; Popkov, A V

    2015-01-01

    This is a comparative study of changes in blood flow rate in the popliteal artery, the arteries of bone regenerate and cerebral arteries in 45 patients with congenital and acquired diseases of the limbs at different stages of surgical lengthening of 3-15 cm shortened shin by Ilizarov method. We observed an increase in regional blood flow rate in all patients during the periods of distraction and fixation. A 25% increase in blood flow rate in the middle cerebral artery on the contralateral side was found only in patients of the first adult age with acquired limb shortening. Basing on the analysis of the reaction of cerebral arteries during a functional test with additional muscle work, we suggested that the absence of reaction in congenital diseases is caused by relative excess of somatic afferentation which results from morphological and functional immaturity of brain regulatory systems.

  7. Defining new borders of the spinal muscular atrophy (SMA) candidate region by two new microsatellites and isolation of cDNAs

    SciTech Connect

    Wirth, B.; Schoenling, J.; Dadze, A.

    1994-09-01

    A high number of cosmids and phages were identified that contained di-, tri-, and tetranucleotide repeats. These clones were isolated from STSs that map to the SMA region as well as from three cosmid and one phage library that had been prepared from YACs which span the SMA candidate interval. We developed two new microsatellites, A31 (D5S823) and 95/23, which enabled us to define new borders of the SMA region and to reduce it to approximately 700 kb. Physically, the marker A31 maps to the overlapping region of the YACs y116, y55 and y122 at about 550 kb distal to the locus D5S435. A recombination in one SMA type I family places A31 proximal to the SMA gene. The multicopy microsatellite, 95/23, developed from a cosmid including the STS y97U revealed in a consanguine SMA type I family different alleles, while all proximal markers were heterozygous. This suggests a location of 95/23 distal to the SMA gene. Furthermore, we tested 157 German SMA families (100 SMA type I, 50 SMA type II and 20 SMA type III) for linkage disequilibrium with the marker AG1-CA which reveals no recombination with the SMA gene. We found in SMA type I families strong allelic association between the 100 bp allele and the SMA gene. In 7 families we got deletions within the AG1-CA microsatellite. On the way to isolate the SMA gene, we hybridized whole cosmid and YAC inserts to cDNA libraries of spinal cord, brain and muscle. Seven cDNAs were initially identified and cDNA walking was used to begin the isolation of whole transcribed sequences.

  8. Antidepressant treatment with MAO-inhibitors during general and regional anesthesia: a review and case report of spinal anesthesia for lower extremity surgery without discontinuation of tranylcypromine.

    PubMed

    Krings-Ernst, Ilana; Ulrich, Sven; Adli, Mazda

    2013-10-01

    Monoamine oxidase-(MAO)-inhibitors are a treatment of last resort in treatment resistant depression, which is regarded as a condition of increased psychiatric risk. General and regional anesthesia for elective surgery during use of long-term MAO-inhibitors remains a matter of debate because of an increased risk of drug interactions and decreased sympathetic stability. A series of case reports and new comparative studies reveal the safety of anesthesia/analgesia in non-cardiac surgery without discontinuation of the MAO-inhibitor if best effort is made for maintenance of sympathetic homeostasis and if known drug interactions are avoided. Very few reports with severe adverse incidents have been noted. Severe cardiovascular morbidity, a contraindication of MAO-inhibitors, probably contributed to peri- and postoperative complications. According to new studies, the risk of pharmacokinetic drug interactions is lower for tranylcypromine than for phenelzine. In the present case, a 66-year-old psychiatric patient on permanent treatment with 20 mg/day tranylcypromine was admitted for forefoot surgery. Anesthetic premedication consisted of 7.5 mg oral midazolam. Intravenous midazolam (0.5 mg) was dispensed for intraoperative sedation. After local anesthesia of the puncture site with 30 mg isobar prilocaine, spinal anesthesia was achieved by a single shot of 13.5 mg hyperbar bupivacaine (0.5%) intrathecally. Postoperative regional and general analgesia were accomplished by a peripheral nerve block with 50 mg isobar bupivacaine as well as oral etoricoxib and oxycodone. No peri- or postoperative complications were encountered. It is concluded that general or regional anesthesia for noncardiac surgery without discontinuation of MAO-inhibitor treatment may be a safe intervention after careful evaluation of an individual's perioperative and psychiatric risk. The increased psychiatric risk in patients treated with MAO-inhibitors outweighs the increased, however manageable

  9. Analysis of complex repeat sequences within the spinal muscular atrophy (SMA) candidate region in 5q13

    SciTech Connect

    Davies, K.E.; Morrison, K.E.; Daniels, R.I.

    1994-09-01

    We previously reported that the 400 kb interval flanked the polymorphic loci D5S435 and D5S557 contains blocks of a chromosome 5 specific repeat. This interval also defines the SMA candidate region by genetic analysis of recombinant families. A YAC contig of 2-3 Mb encompassing this area has been constructed and a 5.5 kb conserved fragment, isolated from a YAC end clone within the above interval, was used to obtain cDNAs from both fetal and adult brain libraries. We describe the identification of cDNAs with stretches of high DNA sequence homology to exons of {beta} glucuronidase on human chromosome 7. The cDNAs map both to the candidate region and to an area of 5p using FISH and deletion hybrid analysis. Hybridization to bacteriophage and cosmid clones from the YACs localizes the {beta} glucuronidase related sequences within the 400 kb region of the YAC contig. The cDNAs show a polymorphic pattern on hybridization to genomic BamH1 fragments in the size range of 10-250 kb. Further analysis using YAC fragmentation vectors is being used to determine how these {beta} glucuronidase related cDNAs are distributed within 5q13. Dinucleotide repeats within the region are being investigated to determine linkage disequilibrium with the disease locus.

  10. A regional blood flow model for glucose and insulin kinetics during hemodialysis.

    PubMed

    Schneditz, Daniel; Galach, Magda; Thomaseth, Karl; Waniewski, Jacek

    2013-01-01

    The distribution and elimination of a bolus of glucose injected during hemodialysis (HD) was examined using a distributed double-pool regional blood flow model. Intracorporeal glucose disposal was assumed as insulin-independent (λ) in the central high-flow compartment comprising blood, brain, and internal organs, including pancreatic insulin secretion (a, C1) and hepatic insulin clearance (α). Insulin-dependent (γ) glucose utilization was allocated to the low-flow system comprising muscle, skin, and bone. This model was compared with a compact single-pool model using the same model parameters except for the distribution volume (V). Six parameters (C1, a, α, λ, γ, and V) were identified from data obtained in seven nondiabetic patients (59-115 kg). The fraction Fd of glucose removed by HD significantly (p < 0.05) correlated with baseline glucose concentration Cg,0 (5.561 ± 0.646 mmol/L; r = 0.535), extracorporeal clearance Kg (0.137 ± 0.024 L/min; r = 0.537), a (0.278 ± 0.095 L/mmol, r = -0.586), and λ (0.099 ± 0.078 L/min, r = -0.587). V was much larger in the double-compartment (17.8 ± 5.1 L) than in the single-compartment model (10.0 ± 3.0 L). The modeled glucose compartment volumes could be of interest for fluid management in HD patients. The use of extracorporeal glucose disposal to detect impaired glucose utilization (a, λ) remains to be validated in diabetic HD patients.

  11. [Effects of therapeutic complexes including balneoradonokinesitherapy, electromyostimulation and low-frequency magnetotherapy on regional blood flow in patients with postrraumatic gonarthritis].

    PubMed

    Raspopova, E A; Udartsev, E Iu

    2006-01-01

    Balneoradonokinesitherapy alone and its combination with electrostimulation and low-frequency magnetotherapy were used for the treatment of regional blood flow disorders in 76 patients with posttraumatic gonarthritis. Balneoradonokinesitherapy in combination with electromyostimulation improved blood circulation. When low-frequency magnetotherapy was added to the latter complex, the regress of regional blood flow disorders of a damaged extremity was most significant.

  12. The arterial supply of the human spinal cord: a new approach to the arteria radicularis magna of Adamkiewicz.

    PubMed

    Rodriguez-Baeza, A; Muset-Lara, A; Rodriguez-Pazos, M; Domenech-Mateu, J M

    1991-01-01

    The arteria radicularis magna (Adamkiewicz's artery) was studied in 30 human spinal cords after arterial injection. The artery was present in all cases, between T8 and L2, and was identified by its diameter and position. The arteria radicularis magna was the main blood supply to the lowest region of the spinal cord. In one out of three cases it accompanied the ventral root at T9, and in 80% of the cases studied it was found on the left side. The arteria radicularis magna had a posterior component in 63% of the cases. We did not observe specific radiculo-medullary arteries in the conus medullaris region.

  13. Disodium Cromoglycate, A Mast-Cell Stabilizer, Alters Postradiation Regional Cerebral Blood Flow in Primates

    DTIC Science & Technology

    1986-01-01

    Systemic blood pressures were determined si- multaneously. The data indicated that DSCG was successful in diminishing postra- diation decrease in cerebral...blood flow, Irradiated animals pretreated with DSCG , showed only a 10% decrease in hypothalamic blood flow 60 min postradiation, while untreated...irradiated animals showed’ a 57% decrease. The cortical blood flow of DSCG treated, irradiated animal ’Iweda triphasic response, with a decrease of 38

  14. Refined physical map of the Spinal Muscular Atrophy gene (SMA) region at 5q13 based on YAC and cosmid contiguous arrays

    SciTech Connect

    Roy, N.; Yaraghi, Z.; McLean, M.D.

    1995-04-10

    The gene for the autosomal recessive neurodegenerative disorder spinal muscular atrophy has been mapped to a region of 5q13 flanked proximally by CMS-1 and distally by D5S557. We present a 2-Mb yeast artificial chromosome (YAC) contig constructed from three libraries encompassing the D5S435/D5S629/CMS-1-SMA-D5S557/D5S112 interval. The D5S629/CMS-1-SMA-D5S557 interval is unusual insofar as chromosome 5-specific repetitive sequences are present and many of the simple tandem repeats (STR) are located at multiple loci that are unstable in our YAC clones. A long-range restriction map that demonstrates the SMA-containing interval to be 550 kb is presented. Moreover, a 210-kb cosmid array from both a YAC-specific and a chromosome 5-specific cosmid library encompassing the multilocus STRs CATT-1, CMS-1, D5F149, D5F150, and D5F153 has been assembled. We have recently reported strong linkage disequilibrium with Type I SMA for two of these STRs, indicating that the gene is located in close proximity to or within our cosmid clone array. 39 refs., 5 figs., 2 tabs.

  15. High resolution physical mapping of the spinal muscular atrophy (SMA) region utilizing YAC, PAC, and cosmid clones

    SciTech Connect

    Roy, N.; Yaraghi, Z.; Besner, A.

    1994-09-01

    The childhood SMAs are a group of autosomal recessive disorders characterized by anterior horn cells degeneration resulting in muscular wasting and weakness. All three types have been mapped to a 1.4 Mb region of 5q13.1 flanked centromerically by D5S435 and telomerically by D5S557. Several groups including our own have generated YAC contigs of the region documenting deletion, duplications and repetitive sequences. We have generated a higher resolution contiguous array of cosmid clones encompassing the region containing the microsatellites (MSRs) CATT-1 and CMS-1. These MSRs exist in multiple copies, termed subloci, which are present in a variable number among chromosomes. We have mapped four of the CATT-1 subloci, two of that we have shown to be in linkage disequilibrium with SMA, to a 100 kb interval within our cosmid array. The lack of a representation of all the CMS-1 subloci in our YAC and cosmid clones, in addition to the instability of these MSRs within the YAC clones, has rendered mapping problematic. Due to the reported stability of P1 artificial chromosomes (PAC), we have also constructed a contiguous array of 11 PAC clones spanning this critical interval. The unequivocal orientation of the contig along 5q13 has been confirmed by analysis with 4 genetic markers, 4 single copy probes and 3 STSs. Preliminary analysis has shown greater retention of MSR alleles in the PACs, suggesting their greater stability when compared to YACs. Mapping of cosmid and PAC clones derived from different individuals has allowed us to map the multiple CMS-1 and CATT-1 subloci along 5q13. We have identified a recombination event indicating that the SMA gene lies telomeric to one CMS sublocus. Placement of this sublocus in our physical map has enabled further refinement of the critical SMA region from previous estimates of 700 kb to an approximate 300 kb interval flanked by the markers CMS and D5S557.

  16. Regional cerebral blood flow measurement with intravenous ( sup 15 O)water bolus and ( sup 18 F)fluoromethane inhalation

    SciTech Connect

    Herholz, K.; Pietrzyk, U.; Wienhard, K.; Hebold, I.; Pawlik, G.; Wagner, R.; Holthoff, V.; Klinkhammer, P.; Heiss, W.D. )

    1989-09-01

    In 20 patients with ischemic cerebrovascular disease, classic migraine, or angiomas, we compared paired dynamic positron emission tomographic measurements of regional cerebral blood flow using both ({sup 15}O)water and ({sup 18}F)fluoromethane as tracers. Cerebral blood flow was also determined according to the autoradiographic technique with a bolus injection of ({sup 15}O)water. There were reasonable overall correlations between dynamic ({sup 15}O)water and ({sup 18}F)fluoromethane values for cerebral blood flow (r = 0.82) and between dynamic and autoradiographic ({sup 15}O)water values for cerebral blood flow (r = 0.83). We found a close correspondence between abnormal pathologic findings and visually evaluated cerebral blood flow tomograms obtained with the two tracers. On average, dynamic ({sup 15}O)water cerebral blood flow was 6% lower than that measured with ({sup 18}F)fluoromethane. There also was a general trend toward a greater underestimation with ({sup 15}O)water in high-flow areas, particularly in hyperemic areas, probably due to incomplete first-pass extraction of ({sup 15}O)water. Underestimation was not detected in low-flow areas or in the cerebellum. Absolute cerebral blood flow values were less closely correlated between tracers and techniques than cerebral blood flow patterns. The variability of the relation between absolute flow values was probably caused by confounding effects of the variation in the circulatory delay time. The autoradiographic technique was most sensitive to this type error.

  17. Reduced pulmonary blood flow in regions of injury 2 hours after acid aspiration in rats.

    PubMed

    Richter, Torsten; Bergmann, Ralf; Musch, Guido; Pietzsch, Jens; Koch, Thea

    2015-01-01

    Aspiration-induced lung injury can decrease gas exchange and increase mortality. Acute lung injury following acid aspiration is characterized by elevated pulmonary blood flow (PBF) in damaged lung areas in the early inflammation stage. Knowledge of PBF patterns after acid aspiration is important for targeting intravenous treatments. We examined PBF in an experimental model at a later stage (2 hours after injury). Anesthetized Wistar-Unilever rats (n = 5) underwent unilateral endobronchial instillation of hydrochloric acid. The PBF distribution was compared between injured and uninjured sides and with that of untreated control animals (n = 6). Changes in lung density after injury were measured using computed tomography (CT). Regional PBF distribution was determined quantitatively in vivo 2 hours after acid instillation by measuring the concentration of [(68)Ga]-radiolabeled microspheres using positron emission tomography. CT scans revealed increased lung density in areas of acid aspiration. Lung injury was accompanied by impaired gas exchange. Acid aspiration decreased the arterial pressure of oxygen from 157 mmHg [139;165] to 74 mmHg [67;86] at 20 minutes and tended toward restoration to 109 mmHg [69;114] at 110 minutes (P < 0.001). The PBF ratio of the middle region of the injured versus uninjured lungs of the aspiration group (0.86 [0.7;0.9], median [25%;75%]) was significantly lower than the PBF ratio in the left versus right lung of the control group (1.02 [1.0;1.05]; P = 0.016). The PBF pattern 2 hours after aspiration-induced lung injury showed a redistribution of PBF away from injured regions that was likely responsible for the partial recovery from hypoxemia over time. Treatments given intravenously 2 hours after acid-induced lung injury may not preferentially reach the injured lung regions, contrary to what occurs during the first hour of inflammation. Please see related article: http://dx.doi.org/10.1186/s12871-015-0014-z.

  18. Noninvasive quantification of regional blood flow in the human heart using N-13 ammonia and dynamic positron emission tomographic imaging

    SciTech Connect

    Hutchins, G.D.; Schwaiger, M.; Rosenspire, K.C.; Krivokapich, J.; Schelbert, H.; Kuhl, D.E. )

    1990-04-01

    Evaluation of regional myocardial blood flow by conventional scintigraphic techniques is limited to the qualitative assessment of regional tracer distribution. Dynamic imaging with positron emission tomography allows the quantitative delineation of myocardial tracer kinetics and, hence, the measurement of physiologic processes such as myocardial blood flow. To test this hypothesis, positron emission tomographic imaging in combination with N-13 ammonia was performed at rest and after pharmacologically induced vasodilation in seven healthy volunteers. Myocardial and blood time-activity curves derived from regions of interest over the heart and ventricular chamber were fitted using a three compartment model for N-13 ammonia, yielding rate constants for tracer uptake and retention. Myocardial blood flow (K1) averaged 88 +/- 17 ml/min per 100 g at rest and increased to 417 +/- 112 ml/min per 100 g after dipyridamole infusion (0.56 mg/kg) and handgrip exercise. The coronary reserve averaged 4.8 +/- 1.3 and was not significantly different in the septal, anterior and lateral walls of the left ventricle. Blood flow values showed only a minor dependence on the correction for blood metabolites of N-13 ammonia. These data demonstrate that quantification of regional myocardial blood flow is feasible by dynamic positron emission tomographic imaging. The observed coronary flow reserve after dipyridamole is in close agreement with the results obtained by invasive techniques, indicating accurate flow estimates over a wide range. Thus, positron emission tomography may provide accurate and noninvasive definition of the functional significance of coronary artery disease and may allow the improved selection of patients for revascularization.

  19. Dual role of cerebral blood flow in regional brain temperature control in the healthy newborn infant.

    PubMed

    Iwata, Sachiko; Tachtsidis, Ilias; Takashima, Sachio; Matsuishi, Toyojiro; Robertson, Nicola J; Iwata, Osuke

    2014-10-01

    Small shifts in brain temperature after hypoxia-ischaemia affect cell viability. The main determinants of brain temperature are cerebral metabolism, which contributes to local heat production, and brain perfusion, which removes heat. However, few studies have addressed the effect of cerebral metabolism and perfusion on regional brain temperature in human neonates because of the lack of non-invasive cot-side monitors. This study aimed (i) to determine non-invasive monitoring tools of cerebral metabolism and perfusion by combining near-infrared spectroscopy and echocardiography, and (ii) to investigate the dependence of brain temperature on cerebral metabolism and perfusion in unsedated newborn infants. Thirty-two healthy newborn infants were recruited. They were studied with cerebral near-infrared spectroscopy, echocardiography, and a zero-heat flux tissue thermometer. A surrogate of cerebral blood flow (CBF) was measured using superior vena cava flow adjusted for cerebral volume (rSVC flow). The tissue oxygenation index, fractional oxygen extraction (FOE), and the cerebral metabolic rate of oxygen relative to rSVC flow (CMRO₂ index) were also estimated. A greater rSVC flow was positively associated with higher brain temperatures, particularly for superficial structures. The CMRO₂ index and rSVC flow were positively coupled. However, brain temperature was independent of FOE and the CMRO₂ index. A cooler ambient temperature was associated with a greater temperature gradient between the scalp surface and the body core. Cerebral oxygen metabolism and perfusion were monitored in newborn infants without using tracers. In these healthy newborn infants, cerebral perfusion and ambient temperature were significant independent variables of brain temperature. CBF has primarily been associated with heat removal from the brain. However, our results suggest that CBF is likely to deliver heat specifically to the superficial brain. Further studies are required to assess the

  20. Paeonol Protects Rat Heart by Improving Regional Blood Perfusion during No-Reflow

    PubMed Central

    Ma, Lina; Chuang, Chia-Chen; Weng, Weiliang; Zhao, Le; Zheng, Yongqiu; Zhang, Jinyan; Zuo, Li

    2016-01-01

    No-reflow phenomenon, defined as inadequate perfusion of myocardium without evident artery obstruction, occurs at a high incidence after coronary revascularization. The mechanisms underlying no-reflow is only partially understood. It is commonly caused by the swelling of endothelial cells, neutrophil accumulation, and vasoconstriction, which are all related to acute inflammation. Persistent no-reflow can lead to hospitalization and mortality. However, an effective preventive intervention has not yet been established. We have previously found that paeonol, an active extraction from the root of Paeonia suffruticosa, can benefit the heart function by inhibiting tissue damage after ischemia, reducing inflammation, and inducing vasodilatation. To further investigate the potential cardioprotective action of paeonol on no-reflow, healthy male Wistar rats were randomly divided into four groups: sham, ischemia-reperfusion (I/R) injury (left anterior descending coronary artery was ligated for 4 h followed by reperfusion for 8 h), and I/R injury pretreated with paeonol at two different doses. Real-time myocardial contrast echocardiography was used to monitor regional blood perfusion and cardiac functions. Our data indicated that paeonol treatment significantly reduces myocardial infarct area and no-reflow area (n = 8; p < 0.05). Regional myocardial perfusion (A·β) and cardiac functions such as ejection fraction, stroke volume, and fractional shortening were elevated by paeonol (n = 8; p < 0.05). Paeonol also lowered the serum levels of lactate dehydrogenase, creatine kinase, cardiac troponin T, and C-reactive protein, as indices of myocardial injury. Paeonol exerts beneficial effects on attenuating I/R-associated no-reflow injuries, and may be considered as a potential preventive treatment for cardiac diseases or post-coronary revascularization in which no-reflow often occurs. PMID:27493631

  1. Prolonged disturbances of regional cerebral blood flow in transient ischemic attacks

    SciTech Connect

    Hartmann, A.

    1985-11-01

    Regional cerebral blood flow (rCBF) was measured over both hemispheres in 20 patients with unilateral transient ischemic attacks (TIA) of the territory of the internal carotid artery on the day of the TIA. rCBF was estimated with the nontraumatic Xenon 133-inhalation technique using the initial slope index. 13 patients experienced their first TIA, 7 had several attacks. In 14 patients the first rCBF-measurement was performed during the presentation of clinical symptoms. The 2nd rCBF-measurement was done on day 2, the last one on day 7. Scans of the 15 patients studied with CT were normal. On day 1 mean rCBF of the TIA-side was significantly lower than that of the contralateral hemispheres. 22% of all areas showed a significant reduction of flow compared to mean rCBF. Mean rCBF of both the TIA- and the contralateral side was significantly reduced compared to the bi-hemispheric mean rCBF of a control group with no history of TIA or completed strokes but at least 2 risk factors for cerebrovascular disease. Whereas mean rCBF did not change in the contralateral side it increased significantly (+6.9%) in the TIA-side from day 1 to day 2 but not from there to day 7. This is reflected by the increase of the total number of ROI with normal flow from day 1 to day 2. Considering the actual flow and the flow course of that tissue which was believed to be responsible for the clinical symptoms the following regional patterns were observed: normal rCBF in 6 patients; early return to normal concomitant to the clinical course (n = 4).

  2. Patient motion effects on the quantification of regional myocardial blood flow with dynamic PET imaging

    SciTech Connect

    Hunter, Chad R. R. N.; Kemp, Robert A. de; Klein, Ran; Beanlands, Rob S.

    2016-04-15

    Purpose: Patient motion is a common problem during dynamic positron emission tomography (PET) scans for quantification of myocardial blood flow (MBF). The purpose of this study was to quantify the prevalence of body motion in a clinical setting and evaluate with realistic phantoms the effects of motion on blood flow quantification, including CT attenuation correction (CTAC) artifacts that result from PET–CT misalignment. Methods: A cohort of 236 sequential patients was analyzed for patient motion under resting and peak stress conditions by two independent observers. The presence of motion, affected time-frames, and direction of motion was recorded; discrepancy between observers was resolved by consensus review. Based on these results, patient body motion effects on MBF quantification were characterized using the digital NURBS-based cardiac-torso phantom, with characteristic time activity curves (TACs) assigned to the heart wall (myocardium) and blood regions. Simulated projection data were corrected for attenuation and reconstructed using filtered back-projection. All simulations were performed without noise added, and a single CT image was used for attenuation correction and aligned to the early- or late-frame PET images. Results: In the patient cohort, mild motion of 0.5 ± 0.1 cm occurred in 24% and moderate motion of 1.0 ± 0.3 cm occurred in 38% of patients. Motion in the superior/inferior direction accounted for 45% of all detected motion, with 30% in the superior direction. Anterior/posterior motion was predominant (29%) in the posterior direction. Left/right motion occurred in 24% of cases, with similar proportions in the left and right directions. Computer simulation studies indicated that errors in MBF can approach 500% for scans with severe patient motion (up to 2 cm). The largest errors occurred when the heart wall was shifted left toward the adjacent lung region, resulting in a severe undercorrection for attenuation of the heart wall. Simulations

  3. The effect of amphetamine on regional cerebral blood flow during cognitive activation in schizophrenia

    SciTech Connect

    Daniel, D.G.; Weinberger, D.R.; Jones, D.W.; Zigun, J.R.; Coppola, R.; Handel, S.; Bigelow, L.B.; Goldberg, T.E.; Berman, K.F.; Kleinman, J.E. )

    1991-07-01

    To explore the role of monoamines on cerebral function during specific prefrontal cognitive activation, we conducted a double-blind placebo-controlled crossover study of the effects of 0.25 mg/kg oral dextroamphetamine on regional cerebral blood flow (rCBF) as determined by 133Xe dynamic single-photon emission-computed tomography (SPECT) during performance of the Wisconsin Card Sorting Test (WCST) and a sensorimotor control task. Ten patients with chronic schizophrenia who had been stabilized for at least 6 weeks on 0.4 mg/kg haloperidol participated. Amphetamine produced a modest, nonsignificant, task-independent, global reduction in rCBF. However, the effect of amphetamine on task-dependent activation of rCBF (i.e., WCST minus control task) was striking. Whereas on placebo no significant activation of rCBF was seen during the WCST compared with the control task, on amphetamine significant activation of the left dorsolateral prefrontal cortex (DLPFC) occurred (p = 0.0006). Both the mean number of correct responses and the mean conceptual level increased (p less than 0.05) with amphetamine relative to placebo. In addition, with amphetamine, but not with placebo, a significant correlation (p = -0.71; p less than 0.05) emerged between activation of DLPFC rCBF and performance of the WCST task. These findings are consistent with animal models in which mesocortical catecholaminergic activity modulates and enhances the signal-to-noise ratio of evoked cortical activity.

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

    PubMed Central

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

    2015-01-01

    Symptoms of acute mountain sickness (AMS) may appear above 2,500 m altitude, if the time allowed for acclimatization is insufficient. As the mechanisms underlying brain adaptation to the hypobaric hypoxic environment are not fully understood, a prospective study was performed investigating neurophysiological changes by means of near infrared spectroscopy, electroencephalograpy (EEG), and transcranial doppler sonography at 100, 3,440 and 5,050 m above sea level in the Khumbu Himal, Nepal. Fourteen of the 26 mountaineers reaching 5,050 m altitude developed symptoms of AMS between 3,440 and 5,050 m altitude (Lake-Louise Score ⩾3). Their EEG frontal beta activity and occipital alpha activity increased between 100 and 3,440 m altitude, i.e., before symptoms appeared. Cerebral blood flow velocity (CBFV) in the anterior and middle cerebral arteries (MCAs) increased in all mountaineers between 100 and 3,440 m altitude. During further ascent to 5,050 m altitude, mountaineers with AMS developed a further increase in CBFV in the MCA, whereas in all mountaineers CBFV decreased continuously with increasing altitude in the posterior cerebral arteries. These results indicate that hypobaric hypoxia causes different regional changes in CBFV despite similar electrophysiological changes. PMID:26082017

  5. The regional cerebral blood flow changes in major depressive disorder with and without psychotic features.

    PubMed

    Gonul, Ali Saffet; Kula, Mustafa; Bilgin, Arzu Guler; Tutus, Ahmet; Oguz, Aslan

    2004-09-01

    Depressive patients with psychotic features demonstrate distinct biological abnormalities in the hypothalamic-pituitary-adrenal axis (HPA), dopaminergic activity, electroencephalogram sleep profiles and measures of serotonergic function when compared to nonpsychotic depressive patients. However, very few functional neuroimaging studies were specifically designed for studying the effects of psychotic features on neuroimaging findings in depressed patients. The objective of the present study was to compare brain Single Photon Emission Tomography (SPECT) images in a group of unmedicated depressive patients with and without psychotic features. Twenty-eight patients who fully met DSM-IV criteria for major depressive disorder (MDD, 12 had psychotic features) were included in the study. They were compared with 16 control subjects matched for age, gender and education. Both psychotic and nonpsychotic depressed patients showed significantly lower regional cerebral blood flow (rCBF) values in the left and right superior frontal cortex, and left anterior cingulate cortex compared to those of controls. In comparison with depressive patients without psychotic features (DwoPF), depressive patients with psychotic features (DwPF) showed significantly lower rCBF perfusion ratios in left parietal cortex, left cerebellum but had higher rCBF perfusion ratio in the left inferior frontal cortex and caudate nucleus. The present study showed that DwPF have a different rCBF pattern compared to patients without psychotic features. Abnormalities involving inferior frontal cortex, striatum and cerebellum may play an important role in the generation of psychotic symptoms in depression.

  6. Effects of simulated weightlessness on regional blood flow specifically during cardiovascular stress

    NASA Technical Reports Server (NTRS)

    Harrison, D. C.

    1986-01-01

    Significant changes in the cardiovasular system of humans and animals have been observed following exposure to prolonged periods of weightlessness during space flight. Although adaption to weightlessness is relatively uncomplicated, marked changes in cardiovascular deconditioning become evident upon return to normal gravity, including orthostatic hypotension and tachycardia. Some evidence that myocardial degeneration occurs has been demonstrated in animals who have been immobilized for two months. Also, evidence of possible loss of myocardial mass following manned space flight has been obtained by means of echocardiographic studies. These findings have serious implications in light of the increasing frequency and duration of Space Shuttle missions and the prospect of extended space station missions in the future. A number of both military and civilian investigators, including middle-aged scientists, will probably encounter prolonged periods of weightlessness. It has been imperative, therefore, to determine the effects of prolonged weightlessness on cardiovascular deconditioning and whether such effects are cumulative or reversible. The research project conducted under NASA Cooperative Agreement NCC 2-126 was undertaken to determine the effects of prolonged simulated weightlessness on regional blood flow. Research results are reported in the three appended publications.

  7. Continuous Descending Modulation of the Spinal Cord Revealed by Functional MRI

    PubMed Central

    Bosma, Rachael L.; Cotoi, Andreea I.; Leung, Roxanne H.; Kornelsen, Jennifer; Lawrence-Dewar, Jane M.; Pukall, Caroline F.; Staud, Roland

    2016-01-01

    Spontaneous variations in spinal cord activity may arise from regulation of any of a number of functions including sensory, motor, and autonomic control. Here, we use functional MRI (fMRI) of healthy participants to identify properties of blood oxygenation-level dependent (BOLD) variations in the spinal cord in response to knowledge that either a noxious stimulus is impending, or that no stimulus is to be expected. Expectation of a noxious stimulus, or no stimulus, is shown to have a significant effect on wide-spread BOLD signal variations in the spinal cord over the entire time period of the fMRI acquisition. Coordination of BOLD responses between/within spinal cord and brainstem regions are also influenced by this knowledge. We provide evidence that such signal variations are the result of continuous descending modulation of spinal cord function. BOLD signal variations in response to noxious stimulation of the hand are also shown, as in previous studies. The observation of both continuous and reactive BOLD responses to emotional/cognitive factors and noxious peripheral stimulation may have important implications, not only for our understanding of endogenous pain modulation, but also in showing that spinal cord activity is under continuous regulatory control. PMID:27907094

  8. REGIONAL CEREBRAL BLOOD FLOW DURING ACUTE HYPOXIA IN INDIVIDUALS SUSCEPTIBLE TO ACUTE MOUNTAIN SICKNESS

    PubMed Central

    Dyer, Edward AW; Hopkins, Susan R; Perthen, Joanna E; Buxton, Richard B; Dubowitz, David J

    2008-01-01

    Individuals susceptible to high altitude pulmonary edema show altered pulmonary vascular responses within minutes of exposure to hypoxia. We hypothesized that a similar acute-phase vulnerability to hypoxia may exist in the brain of individuals susceptible to acute mountain sickness (AMS). In established AMS and high-altitude cerebral edema, there is a propensity for vasogenic white matter edema. We therefore hypothesized that increased cerebral blood flow (CBF) during acute hypoxia would also be disproportionately greater in white matter (WM) than grey matter (GM) in AMS-susceptible subjects. We quantified regional CBF using arterial spin labeling MRI during 30-minutes hypoxia (FIO2=0.125) in 2 groups: AMS-susceptible (AMS-S, n=6) who invariably experienced AMS at altitude, and AMS-resistant (AMS-R, n=6) who never experienced AMS despite multiple rapid ascents. SaO2 during hypoxia did not differ between groups (AMS-S=87±4%, AMSR=89±3%, p=0.3). Steady-state whole-brain CBF increased in hypoxia (p<0.005), but did not differ between groups (Normoxia: AMS-S=42.7±14.0ml/100g/min, AMS-R=41.7±10.1ml/100g/min, Hypoxia: AMS-S=47.8±19.5ml/100g/min, AMS-R=48.2±10.1ml/100g/min, p=0.65), and cerebral oxygen delivery remained constant. The percent change in CBF did not differ between brain regions or between groups (although absolute CBF change was greater in GM): (GM: AMS-S=6.1±7.7ml/100g/min (10±11%), AMS-R=8.3±5.7ml/100g/min (17±11%) p=0.57; WM: AMS-S=4.3±5.1ml/100g/min (12±15%), AMS-R=4.8±2.9ml/100g/min (16±9%), p= 0.82). Conclusion: CBF increases in acute hypoxia, but is not different between WM and GM, irrespective of AMS susceptibility. Acute phase differences in regional CBF during acute hypoxia are not a primary feature of susceptibility to AMS. PMID:18088570

  9. Repeatability of regional myocardial blood flow calculation in 82Rb PET imaging.

    PubMed

    Knešaurek, Karin; Machac, Josef; Zhang, Zhuangyu

    2009-01-29

    We evaluated the repeatability of the calculation of myocardial blood flow (MBF) at rest and pharmacological stress, and calculated the coronary flow reserve (CFR) utilizing 82Rb PET imaging. The aim of the research was to prove high repeatability for global MBF and CFR values and good repeatability for regional MBF and CFR values. The results will have significant impact on cardiac PET imaging in terms of making it more affordable and increasing its use. 12 normal volunteers were imaged at rest and during pharmacological stress, with 2220 MBq of 82Rb each. A GE Advance PET system was used to acquire dynamic 50-frame studies. MBF was calculated with a 2-compartmental model using a modified PMOD program (PMOD; University Hospital Zurich, Zurich, Switzerland). Two differential equations, describing a 2-compartmental model, were solved by numerical integration and using Levenberg-Marquardt's method for fitting data. The PMOD program defines 16 standard segments and calculates myocardial flow for each segment, as well as average septal, anterior, lateral, inferior and global flow. Repeatability was evaluated according to the method of Bland and Altman. Global rest and stress MBF, as well as global CFR, showed very good repeatability. No significant differences were found between the paired resting global MBF (0.63 +/- 0.13 vs. 0.64 +/- 0.13 mL/min/g; mean difference, -1.0% +/- 2.6%) and the stress global MBF (1.37 +/- 0.23 vs. 1.37 +/- 0.24; mean difference, 0.1% +/- 2.3%). Global CFR was highly reproducible (2.25 +/- 0.56 vs. 2.22 +/- 0.54, P = not statistically significant; mean difference, 1.3% +/- 14.3%). Repeatability coefficients for global rest MBF were 0.033 (5.2%) and stress MBF 0.062 (4.5%) mL/min/g. Regional rest and stress MBF and CFR have shown good reproducibility. The average per sector repeatability coefficients for rest MBF were 0.056 (8.5%) and stress MBF 0.089 (6.3%) mL/min/g, and average repeatability coefficient for CFR was 0.25 (10.6%). The

  10. Blood zinc levels in nursing women from different regions of the West Bank of Palestine.

    PubMed

    Shawahna, Ramzi; Zyoud, Ahed; Jallad, Donia; Hadwan, Labebah; Ihssan, Neeran; Hilal, Hikmat

    2017-07-06

    Pregnant and nursing women are at higher risk of zinc deficiency which can have detrimental consequences on health. We assessed blood zinc levels in 72 nursing women from the West Bank of Palestine and investigated the association between sociodemographic variables and blood zinc levels. Blood samples were analyzed for their zinc contents using graphite furnace atomic absorption spectrophotometry. Blood and data collection were performed between July and December 2016. The median blood zinc level was 4.53 mg/L (interquartile range of 0.38 mg/L). In unadjusted analyses, blood zinc levels were higher in nursing women who lived in cities (p-value <.001), had higher household income (p-value <.001), whose husbands had a white collar job (p-value <.05), were nonsmokers (p-value <.05), did not use hair dyes (p-value <.05), and consumed energy beverages (p-value <.001). Multiple linear analysis showed that living in cities and consuming energy beverages remained significantly associated with higher blood zinc levels (p-value <.05). Blood zinc levels were in the range previously reported for similar non-malnourished populations. Nursing women living in cities and those consuming energy beverages tended to have higher blood zinc levels. Urbanized lifestyle might have enhanced blood zinc levels in nursing women.

  11. Regional redistribution of blood flow in the external and internal carotid arteries during acute hypotension.

    PubMed

    Ogoh, Shigehiko; Lericollais, Romain; Hirasawa, Ai; Sakai, Sadayoshi; Normand, Hervé; Bailey, Damian M

    2014-05-15

    The present study examined to what extent an acute bout of hypotension influences blood flow in the external carotid artery (ECA) and the corresponding implications for blood flow regulation in the internal carotid artery (ICA). Nine healthy male participants were subjected to an abrupt decrease in arterial pressure via the thigh-cuff inflation-deflation technique. Duplex ultrasound was employed to measure beat-to-beat ECA and ICA blood flow. Compared with the baseline normotensive control, acute hypotension resulted in a heterogeneous blood flow response. ICA blood flow initially decreased following cuff release and then returned quickly to baseline levels. In contrast, the reduction in ECA blood flow persisted for 30 s following cuff release. Thus, the contribution of common carotid artery blood flow to the ECA circulation decreased during acute hypotension (-10 ± 4%, P < 0.001). This finding suggests that a preserved reduction in ECA blood flow, as well as dynamic cerebral autoregulation likely prevent a further decrease in intracranial blood flow during acute hypotension. The peripheral vasculature of the ECA may, thus, be considered an important vascular bed for intracranial cerebral blood flow regulation.

  12. The Effect of Ondansetron and Dexamethasone on Nausea and Vomiting under Spinal Anesthesia

    PubMed Central

    Kalani, Navid; Zabetian, Hasan; Sanie, Mohammad Sadegh; Deylami, Mansour; Radmehr, Mohammad; Sahraei, Reza; Kargar Jahromi, Hossein; Kooti, Wesam

    2017-01-01

    BACKGROUND During abdominal surgery under regional anesthesia, nausea may happen due to several contributing factors. This study compared the effects of ondansetron and dexamethasone on nausea and vomiting under spinal anesthesia. METHODS One hundred and twenty patients of 15 to 35 years old with ASA class I and II were enrolled. Before administering either ondansetron or dexamethasone, blood pressure and heart rate of the patients were recorded. The patients received 70 mg of 5% lidocaine for spinal anesthesia. Patients who received 6 mg of ondansetron were considered as group A, while group B received 8 mg of dexamethasone. The level of nausea and vomiting, blood pressure, heart rate and respiratory rate of each patient was measured at 1, 5, 10, 15 and 30 minutes after spinal anesthesia and during recovery (every 5 minutes). RESULTS There was a significant difference between nausea and vomiting between the two groups after spinal anesthesia within the first and fifth minutes. There was no significant difference between nausea and vomiting between the two groups within 10, 15 and 30 minutes and during recovery at 5, 10, 15 and 30 minutes. CONCLUSION Dexamethasone and ondansetron were shown to equally reduce the incidence of nausea and vomiting under spinal anesthesia and can be recommended as a good choice for prevention of nausea and vomiting during surgeries. PMID:28289619

  13. Regional cerebral blood flow in mood disorders. I. Comparison of major depressives and normal controls at rest

    SciTech Connect

    Sackeim, H.A.; Prohovnik, I.; Moeller, J.R.; Brown, R.P.; Apter, S.; Prudic, J.; Devanand, D.P.; Mukherjee, S. )

    1990-01-01

    We measured regional cerebral blood flow with the xenon 133 inhalation technique in 41 patients with major depressive disorder and 40 matched, normal controls during an eyes-closed, resting condition. The depressed group had a marked reduction in global cortical blood flow. To examine topographic abnormalities, traditional multivariate analyses were applied, as well as a new scaled subprofile model developed to identify abnormal functional neural networks in clinical samples. Both approaches indicated that the depressed sample had an abnormality in topographic distribution of blood flow, in addition to the global deficit. The scaled subprofile model identified the topographic abnormality as being due to flow reduction in the depressed patients in selective frontal, central, superior temporal, and anterior parietal regions. This pattern may reflect dysfunction in the parallel distributed cortical network involving frontal and temporoparietal polymodal association areas. The extent of this topographic abnormality, as revealed by the scaled subprofile model, was associated with both patient age and severity of depressive symptoms.

  14. Autistic Traits, ADHD Symptoms, Neurological Soft Signs and Regional Cerebral Blood Flow in Adults with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Manouilenko, Irina; Pagani, Marco; Stone-Elander, Sharon; Odh, Richard; Brolin, Fredrik; Hatherly, Robert; Jacobsson, Hans; Larsson, Stig A.; Bejerot, Susanne

    2013-01-01

    The resting regional cerebral blood flow (rCBF) patterns related to co-occurring symptoms such as inattention, hyperactivity, neurological soft signs and motor problems have not yet been disclosed in autism spectrum disorders (ASD). In this study thirteen adults with ASD and ten matched neurotypical controls underwent PET. The scores of rating…

  15. Autistic Traits, ADHD Symptoms, Neurological Soft Signs and Regional Cerebral Blood Flow in Adults with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Manouilenko, Irina; Pagani, Marco; Stone-Elander, Sharon; Odh, Richard; Brolin, Fredrik; Hatherly, Robert; Jacobsson, Hans; Larsson, Stig A.; Bejerot, Susanne

    2013-01-01

    The resting regional cerebral blood flow (rCBF) patterns related to co-occurring symptoms such as inattention, hyperactivity, neurological soft signs and motor problems have not yet been disclosed in autism spectrum disorders (ASD). In this study thirteen adults with ASD and ten matched neurotypical controls underwent PET. The scores of rating…

  16. Alterations in Blood Coagulation and Viscosity Among Young Male Cigarette Smokers of Al-Jouf Region in Saudi Arabia.

    PubMed

    Almarshad, Hassan A; Hassan, Fathelrahman M

    2016-05-01

    Hemorheology, a measure of rheological properties of blood, is often correlated with cerebral blood flow and cardiac output; an increased blood viscosity may increase the risk of thrombosis or thromboembolic events. Previous studies have reported a large variation in hemorheological properties of blood among smokers. This prompted us to conduct coagulation experiments to evaluate the effect of cigarette smoking on hematological parameters, like cell counts, and coagulation parameters among young males in Al-Jouf region, Saudi Arabia. The hematological and coagulation parameters were used to relate the changes in viscosity and coagulation to smoking. A total of 321 male participants (126 nonsmokers and 195 smokers) were enrolled into the study as randomized sample. Complete blood count was measured by hematology analyzer, and coagulation tests were performed by coagulation analyzer. Thettest analysis was performed to compare the relationships of variables between the 2 groups. The results confirmed that smoking alters some hematology parameters leading to significant deterioration in blood flow properties. Smoking also increased the hematocrit (HCT), whole blood viscosity (WBV), and plasma viscosity (PV) but decreased the international normalized ratio (INR). The decrease in INR was found to be associated with the increase in WBV, PV, and HCT. Further investigations are necessary to assess the reversibility of such changes in cessation of smoking or other elements of influence.

  17. Effect of centrally administered endothelin agonists on systemic and regional blood circulation in the rat: role of sympathetic nervous system.

    PubMed

    Gulati, A; Kumar, A; Morrison, S; Shahani, B T

    1997-08-01

    The aims of the present study were to determine (1) the hypotensive and regional circulatory effects of centrally administered endothelin (ET) ETA and ETB agonists, and (2) the role of the sympathetic nervous system in the mediation of hypotensive effects due to centrally administered ET-1. The systemic haemodynamics and regional blood circulation in urethane anaesthetized rats following intracerebroventricular (i.c.v.) administration of ET-1, ET-2, SRT6b, ET-3 and SRT6c (10, 30 and 90 ng) were determined by a radioactive microsphere technique. The effect of centrally administered ET-1 on sympathetic nerve activity was also analysed. Systemic haemodynamics and regional blood circulation were determined before (baseline) and 30 min after administration of ET agonists. Cumulative administration of three doses of saline (5 microliters, i.c.v. at 30 min intervals) did not produce any significant cardiovascular effects. ET-1, ET-2 and SRT6b produced a decrease in blood pressure (51%, 47% and 41%, respectively) along with a decrease in cardiac output (58%, 60% and 45%, respectively) and stroke volume. Heart rate and total peripheral resistance were not affected. ET-1, ET-2 and SRT6b also produced a significant reduction in blood flow to the brain, kidneys, heart, portal, mesentery and pancreas, gastrointestinal tract (GIT) and musculoskeletal system. The effect of ET-2 on the cardiovascular system was less intense in comparison with ET-1 and SRT6b. Centrally administered specific ETB receptor agonists ET-3 and SRT6c did not produce any change in systemic haemodynamics and regional blood flow. Centrally administered ET-1 (90 ng) produced a significant decrease (61%) in sympathetic nerve activity 30 min after drug administration, along with a fall in blood pressure. It is concluded that centrally administered ETA agonists produce significant cardiovascular effects mediating through the sympathetic nervous system.

  18. Traumatic spinal cord injury.

    PubMed

    Ahuja, Christopher S; Wilson, Jefferson R; Nori, Satoshi; Kotter, Mark R N; Druschel, Claudia; Curt, Armin; Fehlings, Michael G

    2017-04-27

    Traumatic spinal cord injury (SCI) has devastating consequences for the physical, social and vocational well-being of patients. The demographic of SCIs is shifting such that an increasing proportion of older individuals are being affected. Pathophysiologically, the initial mechanical trauma (the primary injury) permeabilizes neurons and glia and initiates a secondary injury cascade that leads to progressive cell death and spinal cord damage over the subsequent weeks. Over time, the lesion remodels and is composed of cystic cavitations and a glial scar, both of which potently inhibit regeneration. Several animal models and complementary behavioural tests of SCI have been developed to mimic this pathological process and form the basis for the development of preclinical and translational neuroprotective and neuroregenerative strategies. Diagnosis requires a thorough patient history, standardized neurological physical examination and radiographic imaging of the spinal cord. Following diagnosis, several interventions need to be rapidly applied, including haemodynamic monitoring in the intensive care unit, early surgical decompression, blood pressure augmentation and, potentially, the administration of methylprednisolone. Managing the complications of SCI, such as bowel and bladder dysfunction, the formation of pressure sores and infections, is key to address all facets of the patient's injury experience.

  19. The Effect of Lumbar Disc Herniation on Musculoskeletal Loadings in the Spinal Region During Level Walking and Stair Climbing

    PubMed Central

    Kuai, Shengzheng; Liao, Zhenhua; Zhou, Wenyu; Guan, Xinyu; Ji, Run; Zhang, Rui; Guo, Daiqi; Liu, Weiqiang

    2017-01-01

    Background People with low back pain (LBP) alter their motion patterns during level walking and stair climbing due to pain or fear. However, the alternations of load sharing during the two activities are largely unknown. The objective of this study was to investigate the effect of LBP caused by lumbar disc herniation (LDH) on the muscle activities of 17 main trunk muscle groups and the intradiscal forces acting on the five lumbar discs. Material/Methods Twenty-six healthy adults and seven LDH patients were recruited to perform level walking and stair climbing in the Gait Analysis Laboratory. Eight optical markers were placed on the bony landmarks of the spinous process and pelvis, and the coordinates of these markers were captured during the two activities using motion capture system. The coordinates of the captured markers were applied to developed musculoskeletal model to calculate the kinetic variables. Results LDH patients demonstrated higher muscle activities in most trunk muscle groups during both level walking and stair climbing. There were decreases in anteroposterior shear forces on the discs in the pathological region and increases in the compressive forces on all the lumbar discs during level walking. The symmetry of mediolateral shear forces was worse in LDH patients than healthy adults during stair climbing. Conclusions LDH patients exhibited different kinetic alternations during level walking and stair climbing. However, both adaptive strategies added extra burdens to the trunk system and further increased the risk for development of LDH. PMID:28796755

  20. Properties of convective delivery in spinal cord gray matter: laboratory investigation and computational simulations.

    PubMed

    Endo, Toshiki; Fujii, Yushi; Sugiyama, Shin-Ichiro; Zhang, Rong; Ogita, Shogo; Funamoto, Kenichi; Saito, Ryuta; Tominaga, Teiji

    2015-10-30

    OBJECT Convection-enhanced delivery (CED) is a method for distributing small and large molecules locally into the interstitial space of the spinal cord. Delivering these molecules to the spinal cord is otherwise difficult due to the blood-spinal cord barrier. Previous research has proven the efficacy of CED for delivering molecules over long distances along the white matter tracts in the spinal cord. Conversely, the characteristics of CED for delivering molecules to the gray matter of the spinal cord remain unknown. The purpose of this study was to reveal regional distribution of macromolecules in the gray and white matter of the spinal cord with special attention to the differences between the gray and white matter. METHODS Sixteen rats (F344) underwent Evans blue dye CED to either the white matter (dorsal column, 8 rats) or the gray matter (ventral horn, 8 rats) of the spinal cord. The rates and total volumes of infusion were 0.2 μl/min and 2.0 μl, respectively. The infused volume of distribution was visualized and quantified histologically. Computational models of the rat spinal cord were also obtained to perform CED simulations in the white and gray matter. RESULTS The ratio of the volume of distribution to the volume of infusion in the gray matter of the spinal cord was 3.60 ± 0.69, which was comparable to that of the white matter (3.05 ± 0.88). When molecules were injected into the white matter, drugs remained in the white matter tract and rarely infused into the adjacent gray matter. Conversely, when drugs were injected into the gray matter, they infiltrated laterally into the white matter tract and traveled longitudinally and preferably along the white matter. In the infusion center, the areas were larger in the gray matter CED than in the white matter (Mann-Whitney U-test, p < 0.01). In computational simulations, the aforementioned characteristics of CED to the gray and white matter were reaffirmed. CONCLUSIONS In the spinal cord, the gray and white

  1. Assessment of Glial Scar, Tissue Sparing, Behavioral Recovery and Axonal Regeneration following Acute Transplantation of Genetically Modified Human Umbilical Cord Blood Cells in a Rat Model of Spinal Cord Contusion

    PubMed Central

    Mukhamedshina, Yana O.; Garanina, Ekaterina E.; Masgutova, Galina A.; Galieva, Luisa R.; Sanatova, Elvira R.; Chelyshev, Yurii A.; Rizvanov, Albert A.

    2016-01-01

    Objective and Methods This study investigated the potential for protective effects of human umbilical cord blood mononuclear cells (UCB-MCs) genetically modified with the VEGF and GNDF genes on contusion spinal cord injury (SCI) in rats. An adenoviral vector was constructed for targeted delivery of VEGF and GDNF to UCB-MCs. Using a rat contusion SCI model we examined the efficacy of the construct on tissue sparing, glial scar severity, the extent of axonal regeneration, recovery of motor function, and analyzed the expression of the recombinant genes VEGF and GNDF in vitro and in vivo. Results Transplantation of UCB-MCs transduced with adenoviral vectors expressing VEGF and GDNF at the site of SCI induced tissue sparing, behavioral recovery and axonal regeneration comparing to the other constructs tested. The adenovirus encoding VEGF and GDNF for transduction of UCB-MCs was shown to be an effective and stable vehicle for these cells in vivo following the transplantation into the contused spinal cord. Conclusion Our results show that a gene delivery using UCB-MCs-expressing VEGF and GNDF genes improved both structural and functional parameters after SCI. Further histological and behavioral studies, especially at later time points, in animals with SCI after transplantation of genetically modified UCB-MCs (overexpressing VEGF and GDNF genes) will provide additional insight into therapeutic potential of such cells. PMID:27003408

  2. Reduced and reversed temperature dependence of blood oxygenation in an ectothermic scombrid fish: implications for the evolution of regional heterothermy?

    PubMed

    Clark, Timothy Darren; Rummer, J L; Sepulveda, C A; Farrell, A P; Brauner, C J

    2010-01-01

    Tunas (family Scombridae) are exceptional among most teleost fishes in that they possess vascular heat exchangers which allow heat retention in specific regions of the body (termed 'regional heterothermy'). Seemingly exclusive to heterothermic fishes is a markedly reduced temperature dependence of blood-oxygen (blood-O(2)) binding, or even a reversed temperature dependence where increasing temperature increases blood-O(2) affinity. These unusual binding properties have been documented in whole blood and in haemoglobin (Hb) solutions, and they are hypothesised to prevent oxygen loss from arteries to veins within the vascular heat exchangers and/or to prevent excessive oxygen unloading to the warm tissues and ensure an adequate supply of oxygen to tissues positioned efferent to the heat exchangers. The temperature sensitivity of blood-O(2) binding has not been characterised in an ectothermic scombrid (mackerels and bonitos), but the existence of the unusual binding properties in these fishes would have clear implications for their proposed association with regional heterothermy. Accordingly, the present study examined oxygenation of whole blood of the chub mackerel (Scomber japonicus) at 10, 20 and 30 degrees C and at 0.5, 1 and 2% CO(2). Oxygen affinity was generally highest at 20 degrees C for all levels of CO(2). Temperature-independent binding was observed at low (0.5%) CO(2), where the PO(2) at 50% blood-O(2) saturation (P (50)) was not statistically different at 10 and 30 degrees C (2.58 vs. 2.78 kPa, respectively) with an apparent heat of oxygenation (H degrees ) close to zero (-6 kJ mol(-1)). The most significant temperature-mediated difference occurred at high (2%) CO(2), where the P (50) at 10 degrees C was twofold higher than that at 20 degrees C with a corresponding H degrees of +43 kJ mol(-1). These results provide clear evidence of independent and reversed open-system temperature effects on blood oxygenation in S. japonicus, and it is therefore

  3. [Spinal column: implants and revisions].

    PubMed

    Krieg, S M; Meyer, H S; Meyer, B

    2016-03-01

    Non-fusion spinal implants are designed to reduce the commonly occurring risks and complications of spinal fusion surgery, e.g. long duration of surgery, high blood loss, screw loosening and adjacent segment disease, by dynamic or movement preserving approaches. This principle could be shown for interspinous spacers, cervical and lumbar total disc replacement and dynamic stabilization; however, due to the continuing high rate of revision surgery, the indications for surgery require as much attention and evidence as comparative data on the surgical technique itself.

  4. Surgical anatomy and blood supply of the fascial layers of the temporal region.

    PubMed

    Abul-Hassan, H S; von Drasek Ascher, G; Acland, R D

    1986-01-01

    In 15 fresh cadavers (30 sides), we studied the two layers of fascia in the temporal region, with particular regard to their blood supply and to their usefulness--together or separately--as microvascular free-tissue autografts. The superficial temporal fascia (temporoparietal fascia, epicranial aponeurosis) lies immediately deep to the hair follicles. It is part of the subcutaneous musculoaponeurotic system and is continuous in all directions with other structures belonging to that layer--including the galea above and the SMAS layer of the face below. The deep temporal fascia (temporalis fascia, investing fascia of temporalis) is separated from the superficial fascia by an avascular plane of loose areolar tissue. It completely invests the superficial aspect of the temporalis muscle down to (but not beyond) the zygomatic arch. It is firmly attached to periosteum all around the margin of the muscles. Below it is attached to the upper border of the zygomatic arch. We found the deep temporal fascia to be supplied solely by the middle temporal artery, a constant branch of the superficial temporal. The middle temporal artery arises 1 to 3 cm below the upper border of the zygomatic arch, runs always superficial to the arch, and enters the deep temporal fascia immediately above that layer's attachment to the zygomatic arch. If the middle temporal vessels are protected, the two layers of temporal fascia can be raised together as a fully vascularized tissue island. This island can be fashioned as a bilobed or a double-layered flap, depending on the manner of dissection. The potential surgical usefulness of these findings is discussed.

  5. Spinal Osteosarcoma

    PubMed Central

    Katonis, P.; Datsis, G.; Karantanas, A.; Kampouroglou, A.; Lianoudakis, S.; Licoudis, S.; Papoutsopoulou, E.; Alpantaki, K.

    2013-01-01

    Although osteosarcoma represents the second most common primary bone tumor, spinal involvement is rare, accounting for 3%–5% of all osteosarcomas. The most frequent symptom of osteosarcoma is pain, which appears in almost all patients, whereas more than 70% exhibit neurologic deficit. At a molecular level, it is a tumor of great genetic complexity and several genetic disorders have been associated with its appearance. Early diagnosis and careful surgical staging are the most important factors in accomplishing sufficient management. Even though overall prognosis remains poor, en-block tumor removal combined with adjuvant radiotherapy and chemotherapy is currently the treatment of choice. This paper outlines histopathological classification, epidemiology, diagnostic procedures, and current concepts of management of spinal osteosarcoma. PMID:24179411

  6. Regional Fat Distribution and Blood Pressure Level and Variability: The Dallas Heart Study.

    PubMed

    Yano, Yuichiro; Vongpatanasin, Wanpen; Ayers, Colby; Turer, Aslan; Chandra, Alvin; Carnethon, Mercedes R; Greenland, Philip; de Lemos, James A; Neeland, Ian J

    2016-09-01

    Our aim was to investigate the associations of regional fat distribution with home and office blood pressure (BP) levels and variability. Participants in the Dallas Heart Study, a multiethnic cohort, underwent 5 BP measurements on 3 occasions during 5 months (2 in home and 1 in office) and quantification of visceral adipose tissue, abdominal subcutaneous adipose tissue, and liver fat by magnetic resonance imaging, and lower body subcutaneous fat by dual x-ray absorptiometry. The relation of regional adiposity with short-term (within-visit) and long-term (overall visits) mean BP and average real variability was assessed with multivariable linear regression. We have included 2595 participants with a mean age of 44 years (54% women; 48% black), and mean body mass index was 29 kg/m(2) Mean systolic BP/diastolic BP was 127/79 mm Hg and average real variability systolic BP was 9.8 mm Hg during 3 visits. In multivariable-adjusted models, higher amount of visceral adipose tissue was associated with higher short-term (both home and office) and long-term mean systolic BP (β[SE]: 1.9[0.5], 2.7[0.5], and 2.1[0.5], respectively; all P<0.001) and with lower long-term average real variability systolic BP (β[SE]: -0.5[0.2]; P<0.05). In contrast, lower body fat was associated with lower short-term home and long-term mean BP (β[SE]: -0.30[0.13] and -0.24[0.1], respectively; both P<0.05). Neither subcutaneous adipose tissue or liver fat was associated with BP levels or variability. In conclusion, excess visceral fat was associated with persistently higher short- and long-term mean BP levels and with lower long-term BP variability, whereas lower body fat was associated with lower short- and long-term mean BP. Persistently elevated BP, coupled with lower variability, may partially explain increased risk for cardiac hypertrophy and failure related to visceral adiposity. © 2016 American Heart Association, Inc.

  7. Differences in Blood Pressure in Infants After General Anesthesia Compared to Awake Regional Anesthesia (GAS Study-A Prospective Randomized Trial).

    PubMed

    McCann, M E; Withington, D E; Arnup, S J; Davidson, A J; Disma, N; Frawley, G; Morton, N S; Bell, G; Hunt, R W; Bellinger, D C; Polaner, D M; Leo, A; Absalom, A R; von Ungern-Sternberg, B S; Izzo, F; Szmuk, P; Young, V; Soriano, S G; de Graaff, J C

    2017-09-