• Title/Summary/Keyword: Ischemia and reperfusion

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Efficacy of Combining Proximal Balloon Guiding Catheter and Distal Access Catheter in Thrombectomy with Stent Retriever for Anterior Circulation Ischemic Stroke

  • Kim, Sang Hwa;Choi, Jae Hyung;Kang, Myung Jin;Cha, Jae Kwan;Kim, Dae Hyun;Nah, Hyun Wook;Park, Hyun Seok;Kim, Sang Hyun;Huh, Jae Taeck
    • Journal of Korean Neurosurgical Society
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    • v.62 no.4
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    • pp.405-413
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    • 2019
  • Objective : We evaluated efficacy of combining proximal balloon guiding catheter (antegrade flow arrest) and distal access catheter (aspiration at the site of occlusion) in thrombectomy for anterior circulation ischemic stroke. Methods : We retrospectively analyzed 116 patients who underwent mechanical thrombectomy with stent retriever. The patients were divided by the techniques adopted, the combined technique (proximal balloon guiding catheter and large bore distal access catheter) group (n=57, 49.1%) and the conventional (guiding catheter with stent retriever) technique group (n=59, 50.9%). We evaluated baseline characteristics (epidemiologic data, clinical and imaging characteristics) and procedure details (the number of retrieval attempts, procedure time), as well as angiographic (thrombolysis in cerebral infarction (TICI) score, distal thrombus migration) and clinical outcome (National Institutes of Health Stroke Scale at discharge, modified Rankin Scale [mRS] at 3 months) of them. Results : The number of retrieval attempts was lower (p=0.002) and the first-pass successful reperfusion rate was higher (56.1% vs. 28.8%; p=0.003) in the combined technique group. And the rate of final result of TICI score 3 was higher (68.4% vs. 28.8%; p<0.01) and distal thrombus migration rate was also lower (15.8% vs. 40.7%; p=0.021) in the combined technique group. Early strong neurologic improvement (improvement of National Institutes of Health Stroke Scale ${\geq}11$ or National Institutes of Health Stroke Scale ${\leq}1$ at discharge) rate (57.9% vs. 36.2%; p=0.02) and favorable clinical outcome (mRS at 3 months ${\leq}2$) rate (59.6% vs. 33.9%; p=0.005) were also better in the combined technique group. Conclusion : The combined technique needs lesser attempts, decreases distal migration, increases TICI 3 reperfusion and achieves better clinical outcomes.

Scintigraphic Assessment of Myocardial Viability (신티그라피에 의한 심근생존능 평가)

  • Bom, Hee-Seung
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.2
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    • pp.155-160
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    • 1993
  • The identification of viable myocardium in patients with coronary artery disease and left ventricular dysfunction is an issue of increasing clinical relavance in the current era of myocardial revascularization. There are at least two forms of reversible myocardial dysfunction. Early reperfusion does not always lead to immediate functional improvement; rather, the return of contractility in tissue salvaged by reperfusion is delayed for hours, days or even weeks, a phenomenon that has been termed "stunned myocardium". Some patients with coronary artery disease show myocardial dysfunction at rest which are associated with reduced perfusion, and which disappear after revascularization; this phenomenon has been termed "hibernating myocardium". Recently, cardiac imaging techniques that evaluate myocardial viability on the basis of perfusion-contraction mismatch and inotropic reserve have gained substantial popularity and clinical success. This review focus on the application of $^{201}TI$ and $^{99m}Tc-MIBI$ to address myocardial viability in patients with hibernating and stunned myocardium. It is clear that 4-hour redistribution images of $^{201}TI$ underestimate ischemia and overestimate scar. Delayed imaging and reinjection imaging have been developed for the assessment of viability. Among many protocols suggested, stress-redistribution-reinjection imaging gained most popularity. Although $^{99m}Tc-MIBI$ could identify myocardial viability, $^{201}TI$ reinjection technique was regarded as superior to it. In conclusion, $^{201}TI$ stress, 4-hr rest redistribution, and reinjection imaging technique may be the most preferable method for evaluation of myocardial viability.

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Effects of Verapamil in Cardioplegic Perfusates on the Ischemic Myocardium in Isolated Rat Heart (흰쥐의 적출된 심장에서 Verapamil이 허혈성 심근에 미치는 효과)

  • Kim, Su-Cheol;Jo, Gyu-Seok;Park, Ju-Cheol;Yu, Se-Yeong
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.119-124
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    • 1997
  • Using isolated rat heart preparations, we observed the protective effe ts of verapamil cardioplegia on ischemic myocardial injury. Isolated rat hearts were subjected to global ischemia at $25^{\circ}C$ Twenty four isolated Sprague Dawley rat hearts underwent 30 minutes of the retrograde nonworking perfusion with Krebs-Henseleit buffer solution followed by $25^{\circ}C$ cardioplegic solution (St. Thomas'Hospital Cardioplegic Solution) for 60 minutes. Before ischemic arrest, rat hearts were treated with cold cardioplegic solution in control group (n=12) and cold cardioplegic solution with verapamil (1 mg/L) in experimental group (n=12). After 60 minutes of ischemia, hemodynamic and biochemical parameters such as heart rate, left ventricular pressure (LVP), + dp/dt max, coronary flow and creatine phosphokinase (CPK) were measured before giving cardioplegia and 30 minutes after reperfusion. Verapamil group exhibited greater recovery of heart rate, LVP, +dpldt max, coronary flow and CPK than control group (p < 0.05).

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Effects of Medicinal Plant Extract on the Change of Cerebral Hemodynamic in Rats (약용식물 추출물이 흰쥐의 뇌혈류학적 변화에 미치는 영향)

  • Park, Sung-Jin;Hahm, Tae-Shik;Kim, Cheun-An
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.39 no.4
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    • pp.506-510
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    • 2010
  • As an attempt to develop new functional health beverage by using medicinal herb, we investigated the effect of medicinal plant extract (MPE) on mean arterial blood pressure (MABP) and regional cerebral blood flow (rCBF) of rats. The changes of MABP and rCBF were determined by LDF methods. LDF allows for real time, noninvasive, continuous recordings of local CBF. MABP in MPE treated rats showed significant change of MPE 1.0 and 10.0 mg/kg. MPE i.v. administration showed significant increase of rCBF in a dose-dependent manner. Propranolol pretreated MABP showed significant change in the increase of MPE. rCBF of propranolol pretreated rats showed significant change from the i.v. injection concentration of 1.0 and 10.0 mg/kg. The ischemia/reperfusion induced oxidative stress may have contributed to cerebral damage in rats, and the present study provides clear evidence for the beneficial effect of MPE on ischemia induced brain injury. Also, the action mechanism in elevation effect of MPE on rCBF might be concerned with the role of $\beta$-adrenoceptor. The exact component and mechanism remains for the future study.

Sertad1 Induces Neurological Injury after Ischemic Stroke via the CDK4/p-Rb Pathway

  • Li, Jianxiong;Li, Bin;Bu, Yujie;Zhang, Hailin;Guo, Jia;Hu, Jianping;Zhang, Yanfang
    • Molecules and Cells
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    • v.45 no.4
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    • pp.216-230
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    • 2022
  • SERTA domain-containing protein 1 (Sertad1) is upregulated in the models of DNA damage and Alzheimer's disease, contributing to neuronal death. However, the role and mechanism of Sertad1 in ischemic/hypoxic neurological injury remain unclear. In the present study, our results showed that the expression of Sertad1 was upregulated in a mouse middle cerebral artery occlusion and reperfusion model and in HT22 cells after oxygen-glucose deprivation/reoxygenation (OGD/R). Sertad1 knockdown significantly ameliorated ischemia-induced brain infarct volume, neurological deficits and neuronal apoptosis. In addition, it significantly ameliorated the OGD/R-induced inhibition of cell viability and apoptotic cell death in HT22 cells. Sertad1 knockdown significantly inhibited the ischemic/hypoxic-induced expression of p-Rb, B-Myb, and Bim in vivo and in vitro. However, Sertad1 overexpression significantly exacerbated the OGD/R-induced inhibition of cell viability and apoptotic cell death and p-Rb, B-Myb, and Bim expression in HT22 cells. In further studies, we demonstrated that Sertad1 directly binds to CDK4 and the CDK4 inhibitor ON123300 restores the effects of Sertad1 overexpression on OGD/R-induced apoptotic cell death and p-Rb, B-Myb, and Bim expression in HT22 cells. These results suggested that Sertad1 contributed to ischemic/hypoxic neurological injury by activating the CDK4/p-Rb pathway.

Effect of Chengsimyeunja-eum (淸心蓮子飮) and Sunghyangjungi-san (星香正氣散) on Streptozotocin-induced Ischemic Damaged Diabetic Rats (청심연자음(淸心蓮子飮)과 성향정기산(星香正氣散)이 Streptozotocin유발(誘發) 당뇨(糖尿)흰쥐의 뇌허혈 손상(腦虛血 損傷)에 미치는 영향(影響))

  • Park, Soon-Il;Lee, Won-Chul
    • The Journal of Korean Medicine
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    • v.28 no.3 s.71
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    • pp.216-231
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    • 2007
  • Objectives : Chengsimyeunja-eum and Sunghyangjungi-san are prescriptions used for cerebral infarction clinically; it is known that these formulas reduce ischemic damage. According to previous research data, controlling certain types of glucose is considered to decrease the risk of cerebral infarction. Based on this fact, we investigated the effects of Chengsimyeunja-eum and Sunghyangjungi-san extracts on reperfusion following ischemic damage to diabetic rats, the change of c-FOS and Bax positive neurons in the hippocampus and cerebral cortex and protein through immunohistochemical methods, changes of serum glucose level, serum triglyceride level, and hepatic glucokinase activity. Methods : We induced ischemic damaged in diabetic rats, and the rats were administered Chengsimyeunja-eum and Sunghyangjungi-san extracts. Results : Chengsimyeunja-eum demonstrated significant decrease of c-Fos positive neurons in both hippocampus and cerebral cortex as well as a significant decrease of Bax positive neurons in hippocampus after ischemic damage on diabetic rats and decrease of serum glucose level after ischemic damage on diabetic rats. Sunghyangjungi-san demonstrated significant decreases of c-Fos and Bax positive neurons in both hippocampus and cerebral cortex after ischemic damage on diabetic rats. Conclusions : Chengsimyeunja-eum, effect on glucose level control, has a remarkable effect of protection of neurons not effective on glucose level. Sunghyangjungi-san showed neuroprotective effect through preventing neuronal cell death.

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Novel Three-Dimensional Knitted Fabric for Pressure Ulcer Prevention: Preliminary Clinical Application and Testing in a Diabetic Mouse Model of Pressure Ulcers

  • Kim, Sungae;Hong, Jamin;Lee, Yongseong;Son, Daegu
    • Archives of Plastic Surgery
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    • v.49 no.2
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    • pp.275-284
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    • 2022
  • Background Population aging has led to an increased incidence of pressure ulcers, resulting in a social burden and economic costs. We developed a three-dimensional knitted fabric (3-DKF) with a pressure-reducing function that can be applied topically in the early stages of pressure ulcers to prevent progression. Methods We evaluated the effects of the 3-DKF in a streptozotocin-induced diabetes mellitus pressure ulcer mouse model, and the fabric was preliminarily applied to patients. Twelve-week-old male C57BL/6 mice were used for the animal experiments. In the pressure ulcer mouse model, an ischemia-reperfusion injury was created using a magnet on the dorsa of the mice. Pressure was measured with BodiTrak before and after applying the 3-DKF to 14 patients at risk of sacral pressure ulcers. Results In the 3-DKF-applied mice group, the ulcers were shallower and smaller than those in the control group. Compared with the mice in the control group, the 3-DKF group had lower platelet-derived growth factor-α and neutrophil elastase expression, as parameters related to inflammation, and increased levels of transforming growth factor (TGF)-β1, TGF-β3, proliferating cell nuclear antigen, and α-smooth muscle actin, which are related to growth factors and proliferation. Additionally, typical normal tissue staining patterns were observed in the 3-DKF group. In the preliminary clinical analysis, the average skin pressure was 26.2 mm Hg before applying the 3-DKF, but it decreased to an average of 23.4 mm Hg after 3-DKF application. Conclusion This study demonstrated that the newly developed 3-DKF was effective in preventing pressure ulcers through testing in a pressure ulcer animal model and preliminary clinical application.

Sevoflurane Postconditioning Reduces Hypoxia/Reoxygenation Injury in Cardiomyocytes via Upregulation of Heat Shock Protein 70

  • Zhang, Jun;Wang, Haiyan;Sun, Xizhi
    • Journal of Microbiology and Biotechnology
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    • v.31 no.8
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    • pp.1069-1078
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    • 2021
  • Sevoflurane postconditioning (SPostC) has been proved effective in cardioprotection against myocardial ischemia/reperfusion injury. It was also reported that heat shock protein 70 (HSP70) could be induced by sevoflurane, which played a crucial role in hypoxic/reoxygenation (HR) injury of cardiomyocytes. However, the mechanism by which sevoflurane protects cardiomyocytes via HSP70 is still not understood. Here, we aimed to investigate the related mechanisms of SPostC inducing HSP70 expression to reduce the HR injury of cardiomyocytes. After the HR cardiomyocytes model was established, the cells transfected with siRNA for HSP70 (siHSP70) or not were treated with sevoflurane during reoxygenation. The lactate dehydrogenase (LDH) level was detected by colorimetry while cell viability and apoptosis were detected by MTT and flow cytometry. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and Western blotting were used to detect HSP70, apoptosis-, cell cycle-associated factors, iNOS, and Cox-2 expressions. Enzyme-linked immuno sorbent assay (ELISA) was used to measure malondialdehyde (MDA) and superoxide dismutase (SOD). SPostC decreased apoptosis, cell injury, oxidative stress and inflammation and increased viability of HR-induced cardiomyocytes. In addition, SPostC downregulated Bax and cleaved caspase-3 levels, while SPostC upregulated Bcl-2, CDK-4, Cyclin D1, and HSP70 levels. SiHSP70 had the opposite effect that SPostC had on HR-induced cardiomyocytes. Moreover, siHSP70 further reversed the effect of SPostC on apoptosis, cell injury, oxidative stress, inflammation, viability and the expressions of HSP70, apoptosis-, and cell cycle-associated factors in HR-induced cardiomyocytes. In conclusion, this study demonstrates that SPostC can reduce the HR injury of cardiomyocytes by inducing HSP70 expression.

Neuroprotective effects of Korean White ginseng and Red ginseng in an ischemic stroke mouse model

  • Jin, Myungho;Kim, Kyung-Min;Lim, Chiyeon;Cho, Suin;Kim, Young Kyun
    • Journal of Ginseng Research
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    • v.46 no.2
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    • pp.275-282
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    • 2022
  • Background: Stroke is a neurological disorder characterized by brain tissue damage following a decrease in oxygen supply to brain due to blocked blood vessels. Reportedly, 80% of all stroke cases are classified as cerebral infarction, and the incidence rate of this condition increases with age. Herein, we compared the efficacies of Korean White ginseng (WG) and Korean Red Ginseng (RG) extracts (WGex and RGex, respectively) in an ischemic stroke mouse model and confirmed the underlying mechanisms of action. Methods: Mice were orally administered WGex or RGex 1 h before middle cerebral artery occlusion (MCAO), for 2 h; the size of the infarct area was measured 24 h after MCAO induction. Then, the neurological deficit score was evaluated and the efficacies of the two extracts were compared. Finally, their mechanisms of action were confirmed with tissue staining and protein quantification. Results: In the MCAO-induced ischemic stroke mouse model, WGex and RGex showed neuroprotective effects in the cortical region, with RGex demonstrating superior efficacy than WGex. Ginsenoside Rg1, a representative indicator substance, was not involved in mediating the effects of WGex and RGex. Conclusion: WGex and RGex could alleviate the brain injury caused by ischemia/reperfusion, with RGex showing a more potent effect. At 1,000 mg/kg body weight, only RGex reduced cerebral infarction and edema, and both anti-inflammatory and anti-apoptotic pathways were involved in mediating these effects.