Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0032290 (aspiration pneumonia)
 2,291 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Human status epilepticus (SE) is consistently associated with cognitive problems, and with widespread neuronal necrosis in hippocampus and other brain regions. In animal models, convulsive SE causes extensive neuronal necrosis. Nonconvulsive SE in adult animals also leads to widespread neuronal necrosis in vulnerable regions, although lesions develop more slowly than they would in the presence of convulsions or anoxia. In very young rats, nonconvulsive normoxic SE spares hippocampal pyramidal cells, but other types of neurons may not show the same resistance, and inhibition of brain growth, DNA and protein synthesis, and of myelin formation and of synaptogenesis may lead to altered brain development. Lesions induced by SE may be epileptogenic by leading to misdirected regeneration. In SE, glutamate, aspartate, and acetylcholine play major roles as excitatory neurotransmitters, and GABA is the dominant inhibitory neurotransmitter. GABA metabolism in substantia nigra (SN) plays a key role in seizure arrest. When seizures stop, a major increase in GABA synthesis is seen in SN postictally. GABA synthesis in SN may fail in SE. Extrasynaptic factors may also play an important role in seizure spread and in maintaining SE. Glial immaturity, increased electronic coupling, and SN immaturity facilitate SE development in the immature brain. Major increases in cerebral blood flow (CBF) protect the brain in early SE, but CBF falls in late SE as blood pressure falters. At the same time, large increases in cerebral metabolic rate for glucose and oxygen continue throughout SE. Adenosine triphosphate (ATP) depletion and lactate accumulation are associated with hypermetabolic neuronal necrosis. Excitotoxic mechanisms mediated by both N-methyl-D-aspartate (NMDA) and non-NMDA glutamate receptors open ionic channels permeable to calcium and play a major role in neuronal injury from SE. Hypoxia, systemic lactic acidosis, CO2 narcosis, hyperkalemia, hypoglycemia, shock, cardiac arrhythmias, pulmonary edema, acute renal tubular necrosis, high output failure, aspiration pneumonia, hyperpyrexia, blood leukocytosis and CSF pleocytosis are common and potentially serious complications of SE. Our improved understanding of the pathophysiology of brain damage in SE should lead to further improvement in treatment and outcome.
 ...
PMID:Pathophysiological mechanisms of brain damage from status epilepticus. 838 2

The purpose of this study was to determine the effects of pressure control inverse ratio ventilation (PC-IRV) and PEEP (in which both mean airway pressure and tidal volume were the same), on the gas exchange and the hemodynamics in 40 dogs in which the bronchi were injected with 2 ml.kg-1 0.1 N-hydrochloric acid. The dogs were classified into 5 groups and were ventilated with 5 kinds of ventilatory modes for 8 hours. The control group was ventilated by volume control ventilation (VCV) without PEEP, using a Servo Ventilator 900 C. Group A was ventilated artificially by VCV with 5 cm H2O PEEP for 3 hours after administrering hydrochloric acid; the group was then ventilated with PC-IRV for the next 5 hours. Group B was ventilated with the reversed ventilatory modes of group A. Group C was ventilated by VCV with 10 cm H2O PEEP after injecting hydrochloric acid, and a ventilatory mode with PC-IRV was used for the next 5 hours. Group D received the reversed ventilatory modes of group C. In all groups, PaO2 decreased from about 140 to 70 mmHg by injecting hydrochloric acid. PEEP improved arterial oxygenation significantly depending on the PEEP level, but PC-IRV did not improve PaO2 in the dogs in which aspiration pneumonia was induced. In group C, PaO2 showed the highest increase. PC-IRV decreased PaCO2. It was concluded that PC-IRV did not improve arterial oxygenation but showed a favorable effect for CO2 elimination in dogs with aspiration pneumonia induced by hydrochloric acid.
 ...
PMID:[The comparison of IRV and PEEP on gas exchanges in dogs with aspiration pneumonia]. 925 6