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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In recent years, mono and biplane cardioangiography has been used to calculate the left ventricular volume. In order to evaluate the reliability of the various methods currently most used, a study of 14 hearts removed during autopsy was carried out. The left ventricle was filled with a mixture of paraffin and Lipiodol, the hearts were then X-rayed in anteroposterior projection (AP), laterolateral (LL) and left oblique posterior (OPS) at 30 degrees. The ventricles were opened and the real volume of the cost was obtained by means of the measurement of the volume of displaced liquid. The left ventricular volume was calculated using the methods of Dodge and coll., Sandler and Dodge, Greene and coll. and Kennedy and coll. The data obtained were statistically worked out. With all the tecniques used, there was a good correlation between values of true volume and the volume calculated with the angiographic methods. The coefficient of correlation varied between 0,940 (Dodge and coll. method) and 0,979 (Sandler and Dodge method). A more detailed analysis however, demonstrated that in the hearts with lower volumes, the correlation coefficient is lower and completely unsatisfactory with the methods of Kennedy and coll. and the method of Greene and coll. In these cases some indexes of ventricualr function (stroke volume, ejection fraction) may be not reliable.
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PMID:[Cardioangiographic evaluation of the left ventricular volume: an analysis of the various formulas used (author's transl)]. 125 29

Levels of platelet-activating factor (PAF) in blood from patients with ischemic stroke were determined by radioimmunoassay (RIA). Using 2 ml of blood as a starting material, PAF was detected in 11 out of 17 stroke patients and 3 of 25 age-matched healthy controls. This implies that blood level of PAF is higher in stroke patients than in controls. Plasma levels of PAF-like lipid(s) (PAF-LL) were also estimated in the same subjects by a bioassay based on aggregation of human polymorphonuclear neutrophils. PAF-LL was detected in plasma samples of all subjects and the average values in patients and controls were 294 +/- 211 pg/ml and 140 +/- 122 pg/ml, respectively. There was a statistically significant difference between these two values (p less than 0.01). Separation of plasma lipids by HPLC gave a single peak in bioassay, which had the same elution volume as authentic PAF. When each fraction was subjected to RIA, the fractions corresponded to phosphatidylcholine (PC) or lysoPC also showed the immunoreactivity, however, the purification procedure using an octadecylsilica gel cartridge eliminated such cross-reacting compounds. We conclude that blood PAF is higher in patients with ischemic stroke than in healthy subjects. Besides, there may be bioactive phospholipid molecules other than PAF, which level in plasma is also higher in stroke patients.
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PMID:Increased levels of blood platelet-activating factor (PAF) and PAF-like lipids in patients with ischemic stroke. 157 85

Comparative studies on nine genetic hypertensive rat strains [two stroke-prone spontaneously hypertensive rats (SHRSP) and Dahl salt-sensitive (DS) strains, and one strain each of spontaneously hypertensive rats (SHR), Lyon hypertensive rats (LH), Milan hypertensive strain (MHS), genetically hypertensive rats (GH) and Sabra hypertensive rats (SBH)] and their respective controls [two Dahl salt-resistent (DR) strains and one strain each of Wistar-Kyoto rats (WKY), Lyon normotensive rats (LN); Lyon low blood pressure rats (LL), Milan normotensive strain (MNS), genetically normotensive rats (GN) and Sabra normotensive rats (SBN) and their original strain, Sabra rats (SB)], in groups consisting of 6-10 males from each strain, were carried out at 10-12 weeks of age under the same experimental conditions. After checking the developmental course of blood pressure and changes in body weight, they were killed at 12 weeks of age for blood analysis and organ-weight examinations. The SHRSP and SHR showed markedly higher blood pressure levels and earlier blood pressure rises in comparison with other hypertensive strains, although they had higher blood pressure than their respective controls. Among various organ weights examined, all hypertensive strains commonly showed increases in left ventricular weight in proportion to blood pressure rises. Kidney weights were significantly decreased only in MHS compared with MNS, while they were either unchanged or significantly greater in other hypertensive strains. Weights of adrenal glands were greater in the two strains of DS and in LH than in their respective control strains. These comparative data indicate possible differences in the pathogenic mechanism involved in these genetic hypertensive rat strains.
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PMID:Comparison of various genetic hypertensive rat strains. 346 95

Our purpose was to study the interaction between Na(+) content and fluid volume on rehydration (RH) and restoration of fluid spaces and cardiovascular (CV) function. Ten men completed four trials in which they exercised in a 35 degrees C environment until dehydrated by 2. 9% body mass, were rehydrated for 180 min, and exercised for an additional 20 min. Four RH regimens were tested: low volume (100% fluid replacement)-low (25 mM) Na(+) (LL), low volume-high (50 mM) Na(+) (LH), high volume (150% fluid replacement)-low Na(+) (HL), and high volume-high Na(+) (HH). Blood and urine samples were collected and body mass was measured before and after exercise and every hour during RH. Before and after the dehydration exercise and during the 20 min of exercise after RH, cardiac output was measured. Fluid compartment (intracellular and extracellular) restoration and percent change in plasma volume were calculated using the Cl(-) and hematocrit/Hb methods, respectively. RH was greater (P < 0.05) in HL and HH (102.0 +/- 15.2 and 103.7 +/- 14.7%, respectively) than in LL and LH (70.7 +/- 10.5 and 75.9 +/- 6.3%, respectively). Intracellular RH was greater in HL (1.12 +/- 0.4 liters) than in all other conditions (0.83 +/- 0.3, 0.69 +/- 0.2, and 0.73 +/- 0.3 liter for LL, LH, and HH, respectively), whereas extracellular RH (including plasma volume) was greater in HL and HH (1.35 +/- 0.8 and 1.63 +/- 0.4 liters, respectively) than in LL and LH (0.83 +/- 0.3 and 1.05 +/- 0.4 liters, respectively). CV function (based on stroke volume, heart rate, and cardiac output) was restored equally in all conditions. These data indicate that greater RH can be achieved through larger volumes of fluid and is not affected by Na(+) content within the range tested. Higher Na(+) content favors extracellular fluid filling, whereas intracellular fluid benefits from higher volumes of fluid with lower Na(+). Alterations in Na(+) and/or volume within the range tested do not affect the degree of restoration of CV function.
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PMID:Postexercise rehydration: effect of Na(+) and volume on restoration of fluid spaces and cardiovascular function. 1100 62

This study evaluates stroke patients with upper-limb (UL) motor deficits using measures of impairment and "activity limitation" to quantify recovery of UL function poststroke and to identify predictors of UL function and predictors of UL recovery following stroke. The study also compares the recovery of UL function with that of the lower limb (LL). Measures of impairment and "activity limitation" of the UL and LL improved over the first 5 weeks. The Box and Block Test performance improved the most over 5 weeks (standardized response mean [SRM] = 1.34), followed closely by the 5-meter walk test (SRM = 0.97). Performances on measures of UL "activity limitation" measured at 1 week poststroke were the most important predictors of UL function 5 weeks poststroke. The results of this study do not support the belief that recovery of LL function is faster than that of UL.
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PMID:Upper-limb function and recovery in the acute phase poststroke. 1574 51

This study aimed to investigate the relationship between the expression of the molecular markers, extracellular matrix metalloproteinase inducer (EMMPRIN), galectin-3, and microvessel density (MVD) with MRI invasive features in invasive and noninvasive pituitary adenomas. MRI was performed preoperatively in 34 patients with histologically verified pituitary adenomas. The expression of EMMPRIN, galectin-3, and MVD was determined by using immunohistochemical techniques on excised surgical specimen from all patients. Correlative analyses between invasive MRI features and expression of EMMPRIN, galectin-3, and MVD were determined between invasive and noninvasive pituitary adenomas. Among MRI invasive features, adenoma crossing the lateral line (LL) of the internal carotid artery (ICA), percentage of intracavernous ICA encasement by the tumor over 50%, sphenoidal sinus invasion, irregular tumor shape, and bilateral ICA asymmetry correlated with increased expression of EMMPRIN and galectin-3 (P<.05), but tumor cystic necrosis and tumor apoplexy did not correlate with EMMPRIN and galectin-3 expression (P>.05). The invasive MRI features did not correlate with MVD expression. This study demonstrated that EMMPRIN and galectin-3 were associated with aggressiveness and invasion by pituitary adenoma. Furthermore, EMMPRIN and galectin-3 were two potential molecular markers for assessing the invasive potential of pituitary adenoma and may provide useful targets for molecular therapeutic strategy against invasive pituitary adenomas.
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PMID:The relationship between MRI invasive features and expression of EMMPRIN, galectin-3, and microvessel density in pituitary adenoma. 2151 51

There is a need to identify biomarkers that predict degree of chronic speech fluency/language impairment and potential for improvement after stroke. We previously showed that the Arcuate Fasciculus lesion load (AF-LL), a combined variable of lesion site and size, predicted speech fluency in patients with chronic aphasia. In the current study, we compared lesion loads of such a structural map (i.e., AF-LL) with those of a functional map [i.e., the functional gray matter lesion load (fGM-LL)] in their ability to predict speech fluency and naming performance in a large group of patients. The fGM map was constructed from functional brain images acquired during an overt speaking task in a group of healthy elderly controls. The AF map was reconstructed from high-resolution diffusion tensor images also from a group of healthy elderly controls. In addition to these two canonical maps, a combined AF-fGM map was derived from summing fGM and AF maps. Each canonical map was overlaid with individual lesion masks of 50 chronic aphasic patients with varying degrees of impairment in speech production and fluency to calculate a functional and structural lesion load value for each patient, and to regress these values with measures of speech fluency and naming. We found that both AF-LL and fGM-LL independently predicted speech fluency and naming ability; however, AF lesion load explained most of the variance for both measures. The combined AF-fGM lesion load did not have a higher predictability than either AF-LL or fGM-LL alone. Clustering and classification methods confirmed that AF lesion load was best at stratifying patients into severe and non-severe outcome groups with 96% accuracy for speech fluency and 90% accuracy for naming. An AF-LL of greater than 4 cc was the critical threshold that determined poor fluency and naming outcomes, and constitutes the severe outcome group. Thus, surrogate markers of impairments have the potential to predict outcomes and can be used as a stratifier in experimental studies.
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PMID:Predicting speech fluency and naming abilities in aphasic patients. 2433 11

Previous studies comparing the patterns of recovery for upper (UL) and lower limbs (LL) reported similar patterns of motor recovery of extremities. However, the influence of clinical stroke subtypes on the difference between recovery of extremities has never been investigated. The aim of this study is to compare the time course of the UL and LL in a sample of patients who have had distinct subtypes of ischemic stroke. A total of 443 consecutive patients following ischemic stroke were assessed at admission, discharge, and 1 month after discharge with the arm and leg motor parts of the Fugl-Meyer scale. Separate analyses were carried out for the entire sample and for samples of each stroke subtype classified according to the Oxfordshire Community Stroke Project. All groups showed significant improvements in motor function (P<0.001). Within the group of patients with total anterior circulation infarcts, the LL showed greater improved motor recovery than the UL (P<0.001). No significant difference was found between the time course of UL and LL motor recovery in the entire sample and in the other groups. This study confirms similar motor recovery of limbs in the entire sample, but also shows that the LL has greater recovery than the UL in patients with total anterior circulation infarcts. Functional prognosis should take into account the distinct stroke subtypes.
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PMID:Differences in motor recovery between upper and lower limbs: does stroke subtype make the difference? 2709 15

Transcranial magnetic stimulation (TMS) is used to examine corticospinal tract integrity after stroke, however, generating motor-evoked potentials (MEPs) in the lower limb (LL) can be difficult. Previous studies have used activation of the target leg to facilitate MEPs in the LL but this may not be possible after stroke due to hemiplegia. The dominance of the target limb may also be important, however the neurophysiological effects of LL dominance are not known. We investigated whether voluntary activation of the non-target leg combined with optimal TMS coil orientation increases corticomotor excitability in healthy adults, and whether limb dominance influences these results. TMS was delivered to induce a posterior-anterior (PA) and a medial-lateral (ML) cortical current in 22 healthy adults. MEPs were recorded in tibialis anterior (TA) with the participant at rest and when activating the non-target leg. We found that non-target leg activation increased corticomotor excitability in the target leg (reduced rest motor threshold (RMT) and MEP latency, and increased recruitment curve slope). ML cortical current also reduced RMT and MEP latency. The degree of footedness correlated with the degree of RMT asymmetry, with a PA but not ML cortical current direction. In summary, cross-facilitation by activating the non-target leg in a task requiring postural stabilisation and inducing ML current increase corticomotor excitability regardless of limb dominance. This protocol may have practical application in testing CST integrity after stroke when paretic limb thresholds are high, by increasing the likelihood of eliciting a MEP.
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PMID:Effects of non-target leg activation, TMS coil orientation, and limb dominance on lower limb motor cortex excitability. 2784 Jan 87

Neuroimaging-derived markers are used to model post-stroke impairment. Among these, lesion size, corticospinal-tract lesion-load (CST-LL) and resting-state functional-connectivity (rs-FC) have been correlated with impairment. It has been shown that the sensory cortex (S1) is associated with motor learning and is essential for post-stroke recovery; yet stroke-induced changes in S1 connectivity alone are yet to be investigated. We aim to determine whether interhemispheric rs-FC could be used to refine imaging models of stroke-related impairment. Subjects' post-stroke and age-matched controls underwent rs-fMRI. Stroke-related disability was correlated with lesion size, CST-LL and interhemispheric S1 and M1 rs-FC as independent seeds. Regression analyses were performed to assess the contribution of these markers in stroke-related deficits. Post-stroke subjects showed an asymmetrical pattern of rs-FC in which affected hemisphere S1 and M1 were mostly connected with ipsi-lesional regions. Correlations between rs-FC and stroke-severity were found. Adding rs-FC of S1 to the regression model of impairment decreased the variance 31% compared to lesion size only. After a stroke, S1 interhemispheric connectivity is decreased, with S1 only connected with ipsi-lesional regions. This asymmetry correlates with neurological and motor impairment. Furthermore, when combined with lesion anatomical measures, S1 connectivity might be an important marker in explaining stroke outcome.
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PMID:Interhemispheric connectivity of primary sensory cortex is associated with motor impairment after stroke. 3013 96


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