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

Effects of hypothermic potassium cardioplegia on left ventricular performance and myocardial damage were assessed in 35 patients undergoing coronary artery bypass surgery. Hemodynamic data and enzymatic evidence of left ventricular ischemic damage were examined and compared in the immediate postoperative period. Left ventricular stroke work index showed a significant depression during the first hour with gradual recovery and a significant increase after 24 h. Myocardial specific isoenzyme creatine kinase (CK-MB) showed a very good nonlinear relationship with stroke work index within the whole range, whereas lactate dehydrogenase isoenzyme (LDH-I) had no relationship with the stroke work index. There was a high incidence of transient postoperative arrhythmias and electrical activity took a long time to stabilize. Left ventricular ultrastructure was generally well preserved. The results of this study demonstrate adequate structural and functional preservation of left ventricle by hypothermic potassium cardioplegia.
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PMID:Preservation of left ventricular function during coronary artery bypass graft surgery. 278 95

Following acute stroke, creatine kinase and other enzymes are released into the cerebrospinal fluid and blood from injured brain tissue. To determine whether regional differences in brain enzyme activity might exist and therefore affect the amount of enzyme released, we quantified the levels of creatine kinase, adenylate kinase, and lactate dehydrogenase in 12 regions of normal canine brain (n = 4). Adenylate kinase activity varied the least among regions (49 +/- 7 units/g), followed by lactate dehydrogenase activity (122 +/- 28 units/g). The pattern for both adenylate kinase and lactate dehydrogenase was higher activity in predominantly gray matter areas, lower activity in white matter, and intermediate activity in mixed regions. The distribution of creatine kinase brain isoenzyme and mitochondrial creatine kinase in canine brain was less predictable, showing wider variations among regions (isoenzyme, 462 +/- 116 units/g; mitochondrial, 42 +/- 20 units/g). Even cerebral gray matter demonstrated substantial regional variations in creatine kinase brain isoenzyme, ranging from 606 units/g in the parietal cortex to 329 units/g in the temporal cortex. We conclude that the content of creatine kinase brain isoenzyme varies more than twofold among areas of brain. This regional variation may be important in the interpretation of creatine kinase brain isoenzyme measurements in cerebrospinal fluid and serum used to assess neurologic injury following stroke.
Stroke 1988 Feb
PMID:Regional creatine kinase, adenylate kinase, and lactate dehydrogenase in normal canine brain. 283 Jun 84

Past studies of acute canine right ventricular (RV) ischemia have failed to demonstrate early irreversible injury or decreased function; however, the dog has extensive collateral circulation that may attenuate RV myocardial injury. The aim of this study was to measure RV function using contrast ventriculography and assess myocardial injury by immunohistochemical evaluation of creatine kinase (CK), lactate dehydrogenase (LDH), and tropomyosin (TROP) as well as by electron microscopy after right coronary occlusion in 14 closed-chest pigs. Significant depression in RV ejection fraction and stroke volume index after 10 minutes and was observed (P less than 0.05). CK, LDH, and TROP were positive in control tissue with a diminution of CK and LDH staining along the subendocardium after 15 minutes of ischemia. Irreversible ultrastructural injury in conjunction with large losses of CK and LDH became evident after 30 minutes. Thus, in the pig, which has a coronary anatomy similar to humans, significant RV dysfunction and irreversible myocardial injury can be demonstrated after 15 to 30 minutes of ischemia.
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PMID:Demonstration of early ischemic injury in porcine right ventricular myocardium. 292 87

Dynamic measurements in the cerebrospinal fluid (CSF) of the activities of lactate dehydrogenase (LDH), its first isoenzyme (LDH1), aspartate amino transferase (AsAT), alanine amino transferase (AlAT), creatine phosphokinase (CPK), gamma-glutamyl transpeptidase (GGT) and alkaline phosphatases (ALP) were performed in 99 patients with ischemic stroke. The mean activities of LDH, LDH1, AsAT, CPC and GGT in the CSF of the patients significantly exceeded those in the control group during the first and second weeks of the disease. The increased activities of LDH, LDH1, CPK and AsAT in patients with ischemic stroke indicate the severity of cerebral lesion and resultant hypoxia of the cerebral tissue. High levels of enzymic activity, particularly over a long period of time, always predict a poor outcome.
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PMID:[Enzymatic activity of the cerebrospinal fluid in patients with cerebral infarct]. 324 70

We studied energy metabolism after experimental subarachnoid hemorrhage in rats. Four different cerebral areas were tested: frontal cortex, occipital cortex, hippocampus, and brainstem. Vmax of the following enzymatic activities was evaluated: in the homogenate: hexokinase, phosphofructokinase, and lactate dehydrogenase for the glycolytic pathway, and glucose-6-phosphate dehydrogenase for the hexose monophosphate shunt; in the purified nonsynaptic mitochondria: NAD+-isocitrate dehydrogenase, citrate synthase, and succinate dehydrogenase for the Krebs cycle, and cytochrome oxidase for the electron transfer chain. We also evaluated some parameters related to the respiration of nonsynaptic mitochondria (State 3, State 4, uncoupled state, respiratory control ratio, and ADP:O ratio). Subarachnoid hemorrhage did not significantly affect Vmax of the enzymatic activities related to anaerobic and aerobic metabolism; however, mitochondrial respiration was affected, particularly in the presence of NADH-producing substrates (glutamate + malate).
Stroke 1988 Mar
PMID:Bioenergetics of different brain areas after experimental subarachnoid hemorrhage in rats. 335 25

Organotypic cultures of rat cerebella were exposed to anoxia for 30 min. Prostacyclin (0.5 micrograms/ml medium) or 0.05 M Tris buffer pH 7.5 were added to the cultures immediately before exposure to anoxia. Cultures for histological, histoenzymatic and electron microscopic examination were taken immediately, 30 min and one, three, 24 and 72 h following anoxia. Cultures pretreated with prostacyclin showed a marked decrease in lactate dehydrogenase activity. Electron microscopic examination revealed that severe swelling and degenerative changes of neurons and glia induced by anoxia were much less pronounced in cultures treated with PGI2. Prostacyclin pretreatment also resulted in the appearance of morphological features of activation in glial cells. The results indicate that prostacyclin exerts a cytoprotective effect on the nerve tissue in vitro, predominantly reducing cell swelling and acidosis. This direct protection, besides vascular action of prostacyclin, may provide a basis for its beneficial clinical effect in ischemic stroke.
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PMID:The effect of prostacyclin on the morphological and enzymatic properties of CNS cultures exposed to anoxia. 351 27

The degree of red cell destruction in human recipients of the total artificial heart has not previously been described. Fifteen patients implanted with a Jarvik-7 total artificial heart for either temporary or permanent heart replacement were reviewed. Clinically significant elevations of plasma free hemoglobin and serum lactate dehydrogenase were demonstrated in patients receiving the standard (100 ml) Jarvik-7 containing Medtronic-Hall valves and powered by pulses of compressed air delivered at a dP/dT of 6000 mm Hg/sec to 8000 mm Hg/sec. Reduction of the dP/dT by drive unit modification greatly reduced the plasma free hemoglobin and lactate dehydrogenase in subsequent patients. Introduction of the smaller (70 ml) total artificial heart was not associated with greater hemolysis once dP/dT had been reduced. With the current driver delivering systolic pulses at less than 4500 mm Hg/sec, both size hearts are free of clinically relevant hemolysis. In addition, it appears that attempts to eliminate hemolysis completely by lowering heart rates, cardiac outputs, or driving pressures are potentially dangerous. The eventual development of embolic cerebrovascular accidents is associated statistically with heart rates below 80 beats/min. These data reassure implanting physicians that the updated Jarvik-7 total artificial heart system does not induce worrisome hemolysis. In addition, this study has uncovered a link between eventual cerebrovascular accident and low heart rate, implying that purposeful application of heart rates around 100 beats/min may provide a significant margin of protection against cerebrovascular accident during implantation.
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PMID:Indexes of hemolysis in human recipients of the Jarvik-7 total artificial heart: a cooperative report of fifteen patients. 361 56

The alpha-keto acid dehydrogenase complex and its component enzymes, lactate dehydrogenase, pyruvate carboxylase, cytochrome c oxidase, succinate-cytochrome c reductase, NADH-cytochrome c reductase, and the concentration of cytochromes and enzymes of beta-oxidation in muscle from a patient with mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes were studied and no specific defect was found. These results raise the possibility that the mitochondrial changes in the patient may be secondary.
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PMID:Biochemical studies in mitochondrial encephalomyopathy. 368 14

The relation of central haemodynamic changes to subsequent mortality and peak enzyme activity was investigated in 190 patients with acute myocardial infarction. The mean delay time from onset of symptoms to the haemodynamic study was 7.2 hours. Major exclusion criteria were heart rate less than 65 beats min-1, systolic blood pressure less than 105 mmHg and lung rales to a distance of greater than 10 cm above the lung bases. Nine patients (4.7%) died within 15 days and 16 patients (8.4%) within 90 days after the infarction. Compared to survivors, non-survivors were characterized by baseline depression of cardiac index, stroke volume index and left ventricular stroke work index, while pulmonary capillary wedge pressure and peripheral resistance were increased. However, a wide overlap between survivors and non-survivors makes the predictive value low in the individual patient. Peak serum aspartate aminotransferase (S-ASAT) activity was weakly related to baseline pulmonary capillary wedge pressure (r = 0.28; P less than 0.001) and stroke volume index (r = -0.22; P less than 0.01). The correlation to pulmonary capillary wedge pressure was only found in anterior (r = 0.34) infarcts. Peak serum lactate dehydrogenase (LD1) was not correlated with baseline haemodynamics.
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PMID:Central haemodynamics in acute myocardial infarction in relation to mortality and peak enzyme activity. 373 97

Creatine kinase (CK), brain CK (CKBB), lactate dehydrogenase (LD), and aspartate aminotransferase (ASAT) levels were determined in cerebrospinal fluid (CSF) obtained from 35 patients with acute stroke. In patients with transient, minor neurological disturbances, only LD levels increased; in those who remained comatose and died, the levels of all the enzymes, except ASAT, increased. Patients who remained with focal motor defects had increased CK and LD levels, while CKBB and ASAT levels were variable. In most of the CSF samples, muscle CK activity was also detectable, suggestive of a leakage from blood to CSF. The pattern of the enzyme increase could be related to the causative mechanisms for the strokes. The study suggests that CSF enzyme determinations may provide supplementary information as to the extent and severity of brain damage and the recovery potentials of selected patient groups with strokes.
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PMID:Enzyme level changes in the cerebrospinal fluid of patients with acute stroke. 395 19


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