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Yuanyuan Zhu, Colin Ophus, Mychailo B Toloczko, Danny J Edwards
Dislocation imaging using transmission electron microscopy (TEM) has been an invaluable tool for characterizing crystallographic defects in metals. Compared to conventional TEM imaging, diffraction contrast imaging scanning transmission electron microscopy (DCI STEM) with appropriate setting can provide better defect contrast with almost negligible bend contour artifacts, enabling more effective analysis of dislocation structures. Here, we investigated why STEM can suppresses bend contour, and how dislocation contrast behaves along with different STEM imaging parameters...
June 7, 2018: Ultramicroscopy
Bong Jun Kim, Youngmi Kim, Sung-Eun Kim, Jin Pyeong Jeon
OBJECTIVE: Haptoglobin (Hp) comprising two light (α) and two heavy (β) chains has an anti-oxidant effect following free hemoglobin binding. Among three phenotypes including Hp1-1 (two α1), Hp2-1 (α1 and α2), and Hp2-2 (two α2), a higher protective effect for toxic-free hemoglobin was reported for Hp2-2 than Hp1-1. However, few studies have focused on Hp2-1 in outcome. This study examined the α1 and α2 expression, and evaluated the correlation of Hp2-1 with subarachnoid hemorrhage (SAH) outcome...
June 11, 2018: World Neurosurgery
Michelle L Allen, Tobias Kulik, Salah G Keyrouz, Rajat Dhar
BACKGROUND: Induced hypertension (IH) remains the mainstay of medical management for delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH). However, raising blood pressure above normal levels may be associated with systemic and neurological complications, of which posterior reversible encephalopathy syndrome (PRES) has been increasingly recognized. OBJECTIVE: To ascertain the frequency and predisposing factors for PRES during IH therapy. METHODS: We identified 68 patients treated with IH from 345 SAH patients over a 3-yr period...
June 8, 2018: Neurosurgery
Ahmad Razif Omar, Mohtar Ibrahim, Adil Hussein
A diver presented with total loss of vision in the left eye and right hemiparesis following a routine no-stop scuba dive to 20 metres' depth. A diagnosis of decompression illness (DCI) with acute ophthalmic artery air embolism and left carotid artery insult causing acute anterior circulatory ischaemia was made. He underwent seven hyperbaric treatments leading to a full recovery. Magnetic resonance angiography revealed an underlying left anterior cerebral artery A1 segment hypoplasia. Making a prompt diagnosis and early hyperbaric oxygen treatment are crucial to halt further tissue damage from ischaemia in central nervous system DCI...
June 30, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
David J Doolette, Simon J Mitchell
Divers suspected of suffering decompression illness (DCI) in locations remote from a recompression chamber are sometimes treated with in-water recompression (IWR). There are no data that establish the benefits of IWR compared to conventional first aid with surface oxygen and transport to the nearest chamber. However, the theoretical benefit of IWR is that it can be initiated with a very short delay to recompression after onset of manifestations of DCI. Retrospective analyses of the effect on outcome of increasing delay generally do not capture this very short delay achievable with IWR...
June 30, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
Hubert Lee, Jeffrey J Perry, Shane W English, Fahad Alkherayf, Joanne Joseph, Steven Nobile, Linghong Linda Zhou, Howard Lesiuk, Richard Moulton, Charles Agbi, John Sinclair, Dar Dowlatshahi
OBJECTIVE The aim of this study was to derive a clinically applicable decision rule using clinical, radiological, and laboratory data to predict the development of delayed cerebral ischemia (DCI) in aneurysmal subarachnoid hemorrhage (aSAH) patients. METHODS Patients presenting over a consecutive 9-year period with subarachnoid hemorrhage (SAH) and at least 1 angiographically evident aneurysm were included. Variables significantly associated with DCI in univariate analysis underwent multivariable logistic regression...
June 8, 2018: Journal of Neurosurgery
J D G Cifuentes, P N Thota, R Lopez
Opiates can cause heartburn and spastic esophageal dysmotility but their role in noncardiac chest pain (NCCP) is not known. Our aim was to characterize opiate effects on esophageal function using esophageal pH monitoring and high-resolution manometry (HREM) in these patients.We performed a cross sectional study of opiate users with NCCP who underwent HREM and esophageal pH study from 2010 to 2017 using opiate nonusers as a comparison group. Demographic data, symptoms, opiate use, endoscopic findings, esophageal pH study parameters, and HREM data were abstracted...
May 26, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Limin Zhang, Bing Zhang, Sihua Qi
Cardiac abnormalities (echocardiographic wall motion abnormality (WMA), biomarker elevation of cardiac troponin (cTn), B-type natriuretic peptide (BNP), or N-terminal prohormone of B-type natriuretic peptide (NT-proBNP)) frequently occur after subarachnoid hemorrhage (SAH). The clinical significance of cardiac abnormalities after SAH remains controversial. This meta-analysis was performed to assess the association between cardiac abnormalities and patient outcomes, including delayed cerebral ischemia (DCI), poor outcome, and death in SAH patients...
May 26, 2018: Neurosurgical Review
Andrej Paľa, Max Schneider, Christine Brand, Maria Teresa Pedro, Yigit Özpeynirci, Bernd Schmitz, Christian Rainer Wirtz, Thomas Kapapa, Ralph König, Michael Braun
Cerebral vasospasm (CV) and delayed cerebral ischemia (DCI) are major factors that limit good outcome in patients with spontaneous subarachnoid hemorrhage (SAH). Continuous therapy with intra-arterial calcium channel blockers has been introduced as a new step in the invasive treatment cascade of CV and DCI. Sedation is routinely necessary for this procedure. We report about the feasibility to apply this therapy in awake compliant patients without intubation and sedation. Out of 67 patients with invasive endovascular treatment of cerebral vasospasm due to spontaneous SAH, 5 patients underwent continuous superselective intracarotid nimodipine therapy without intubation and sedation...
May 26, 2018: Neurosurgical Review
Fawaz Al-Mufti, Krishna Amuluru, Nitesh Damodara, Mohammad El-Ghanem, Rolla Nuoman, Naveed Kamal, Sarmad Al-Marsoummi, Nicholas A Morris, Neha S Dangayach, Stephan A Mayer
Delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (SAH) is an important cause of further morbidity and mortality after an already devastating condition. Though traditionally attributed to vasospasm of large capacitance arteries and the resulting down-stream disruption of cerebral blood flow, the pathogenesis of DCI has proven to be more complex with early brain injury, blood-brain barrier disruption, microthrombosis, cortical spreading depolarizations, and the failure of cerebral autoregulation as newly elucidated factors...
July 15, 2018: Journal of the Neurological Sciences
Tipada Samseethong, Thanarat Suansanae, Kullapat Veerasarn, Anusak Liengudom, Chuthamanee Suthisisang
BACKGROUND: Guidelines for aneurysm subarachnoid hemorrhage (aSAH) management recommend treatment with nimodipine to all patients to reduce delayed cerebral ischemia (DCI) and poor clinical outcome. However, it did not give the most beneficial time to start therapy and route of administration. OBJECTIVES: To compare the DCI occurrence and clinical outcome among aSAH patients who received nimodipine treatment at different times. METHODS: A retrospective cohort study was conducted by collecting data from medical chart reviews between August 30, 2010, and October 31, 2015, at Prasart Neurological Institute, Thailand...
May 1, 2018: Annals of Pharmacotherapy
Jiawei Cai, Wenhua Fang, Fuxiang Chen, Zhangya Lin, Yuanxiang Lin, Lianghong Yu, Peisen Yao, Dezhi Kang
OBJECTIVE: To seek a cerebral perfusion pressure (CPP) threshold that can reduce the occurrence of delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH). METHODS: We analyzed the clinical data of patients with the diagnosis of aSAH and underwent CPP monitoring in our department from February 2014 to December 2015. CPP was divided into four specified thresholds by every 10 mmHg increments, which were from 50 mmHg to 80 mmHg. The totally time ratio of CPP below each threshold was calculated...
May 16, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Federica Fraticelli, Claudio Celentano, Isaia Al Zecca, Giacoma Di Vieste, Basilio Pintaudi, Marco Liberati, Marica Franzago, Marta Di Nicola, Ester Vitacolonna
AIMS: Gestational diabetes mellitus (GDM) is the most common metabolic disorder of pregnancy. The aim of the study is to compare the effect of different dosages of inositol stereoisomers supplementation on insulin resistance levels and several maternal-fetal outcomes in GDM women. METHODS: Participants were randomly allocated to receive daily: 400 mcg folic acid (control treatment), 4000 mg myo-inositol plus 400 mcg folic acid (MI treatment), 500 mg D-chiro-inositol plus 400 mcg folic acid (DCI treatment) or 1100/27...
May 17, 2018: Acta Diabetologica
Martin N Stienen, Christian Fung, Philippe Bijlenga, Daniel W Zumofen, Rodolfo Maduri, Thomas Robert, Martin A Seule, Serge Marbacher, Olivia Geisseler, Peter Brugger, Klemens Gutbrod, Christian Chicherio, Andreas U Monsch, Valérie Beaud, Stefania Rossi, Severin Früh, Nicole Schmid, Nicolas R Smoll, Emanuela Keller, Luca Regli
BACKGROUND: The exact relationship between delayed cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage (aSAH) and neuropsychological impairment remains unknown, as previous studies lacked a baseline examination after aneurysm occlusion but before the DCI-period. Neuropsychological evaluation of acutely ill patients is often applied in a busy intensive care unit (ICU), where distraction represents a bias to the obtained results. OBJECTIVE: To evaluate the relationship between DCI and neuropsychological outcome after aSAH by comparing the Montreal Cognitive Assessment (MoCA) results in aSAH patients with and without DCI at 3 mo with a baseline examination before the DCI-period (part 1)...
May 11, 2018: Neurosurgery
Fawaz Al-Mufti, Jens Witsch, Nathan Manning, Michael Crimmins, Krishna Amuluru, Sachin Agarwal, Soojin Park, Joshua Z Willey, Hooman Kamel, E Sander Connolly, Philip M Meyers, Jan Claassen
INTRODUCTION: Cerebral collateral circulation has been studied extensively in ischemic stroke where it has been shown to be a predictor of reperfusion, final infarct size, and outcome. Little is known about the significance of the collaterals in the setting of aneurysmal subarachnoid hemorrhage (aSAH). We sought to evaluate the effect of cerebral vasospasm on the development of cerebral collaterals following aneurysmal subarachnoid hemorrhage and the effects of the latter on delayed cerebral ischemia (DCI)...
May 14, 2018: Journal of Neurointerventional Surgery
Claudia Ramos, Jon Duque-Grajales, Jorge Rendón, Alejandro Montoya-Betancur, Ana Baena, David Pineda, Carlos Tobón
INTRODUCTION: Although the social and economic consequences of Colombian internal conflicts mainly affected the civilian population, they also had other implications. The ex-combatants, the other side of the conflict, have been the subject of many studies that question their personality structures and antisocial features. Results suggest that ex-combatants usually have characteristics of an antisocial personality disorder (ASPD) that is related with their behaviour. METHODS: Quantitative EEG (qEEG) was used to evaluate differences in cortical activity patterns between an ex-combatants group and a control group...
April 2018: Revista Colombiana de Psiquiatría
Ming-Wun Wong, Wei-Yi Lei, Jui-Sheng Hung, Tso-Tsai Liu, Chih-Hsun Yi, Chien-Lin Chen
BACKGROUND: Provocative tests were used to provide additional information during performing high resolution manometry (HRM). The study aimed to evaluate whether it is feasible to test esophageal function with different esophageal provocative tests during HRM. METHODS: 23 healthy volunteers (9 women; mean age 25 years, range 21-30 years) underwent water-perfused HRM. Each subject received 10 liquid swallows, 10 solid swallows, 10 liquid swallows with abdominal compression, and 5 multiple rapid swallowing (MRS)...
May 9, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
Le Yang, Wen Tao Lai, Yuan Shui Wu, Jin An Zhang, Xin Hui Zhou, Jian Yan, Chao Fang, Er Ming Zeng, Bin Tang, Chang Long Peng, Yue Zhao, Tao Hong
BACKGROUND: Delayed cerebral ischemia (DCI) is a late phase of consequences of subarachnoid hemorrhage (SAH) that causes poor outcome and has become the focus of current research. The aim of this study was to characterize an experimental SAH technique for studying DCI after SAH. NEW METHOD: A double injection SAH rat model with a tiny incision was introduced. At 7 days post-SAH induction, the diameter and luminal cross-sectional area (CSA) of the basilar artery (BA) were measured...
May 5, 2018: Journal of Neuroscience Methods
Daniela Adami, Joachim Berkefeld, Johannes Platz, Jürgen Konczalla, Waltraud Pfeilschifter, Stefan Weidauer, Marlies Wagner
BACKGROUND AND PURPOSE: Delayed cerebral ischemia (DCI) is a complication of aneurysmal subarachnoid hemorrhage (SAH). Arterial cerebral vasospasm (CVS) is discussed as the main pathomechanism for DCI. Due to positive effects of per os nimodipine, intraarterial nimodipine application is used in patients with DCI. Further, percutaneous transluminal balloon angioplasty (PTA) is applied in focal high-grade spasm of intracranial arteries. However, clinical benefits of those techniques are unconfirmed in randomized trials so far, and complications might occur...
May 4, 2018: Journal of Neuroradiology. Journal de Neuroradiologie
Taiwei Dong, Nian Chen, Xiao Ma, Jian Wang, Jing Wen, Qian Xie, Rong Ma
OBJECTIVE: Borneol has been used to treat stroke in China since ancient times. In our previous research, we demonstrated the effect of borneol on cerebral ischaemia injury via meta-analysis. The neurovascular unit (NVU) is the structural basis of the preservation of the brain microenvironment and is believed to be a promising target in treating stroke. In this research, we explored the roles of three kinds of borneol, namely, L-borneolum (B1), D-borneolum (B2) and synthetic borneol (B3), in the NVU with permanent middle cerebral artery occluded (pMCAO) rats...
June 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
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