Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0599766 (functional recovery)
 13,441 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Intravenous administration of human mesenchymal stem cells (hMSCs) prepared from adult bone marrow has been reported to ameliorate functional deficits after cerebral artery occlusion in rats. Several hypotheses to account for these therapeutic effects have been suggested, and current thinking is that neuroprotection rather than neurogenesis is responsible. To enhance the therapeutic benefits of hMSCs potentially, we transfected hMSCs with the glial cell line-derived neurotrophic factor (GDNF) gene using a fiber-mutant F/RGD adenovirus vector and investigated whether GDNF gene-modified hMSCs (GDNF-hMSCs) could contribute to functional recovery in a rat permanent middle cerebral artery occlusion (MCAO) model. We induced MCAO by using intraluminal vascular occlusion, and GDNF-hMSCs were intravenously infused into the rats 3 hr later. MRI and behavioral analyses revealed that rats receiving GDNF-hMSCs or hMSCs exhibited increased recovery from ischemia compared with the control group, but the effect was greater in the GDNF-hMSC group. Thus, these results suggest that intravenous administration of hMSCs transfected with the GDNF gene using a fiber-mutant adenovirus vector may be useful in the cerebral ischemia and may represent a new strategy for the treatment of stroke.
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PMID:Intravenous administration of glial cell line-derived neurotrophic factor gene-modified human mesenchymal stem cells protects against injury in a cerebral ischemia model in the adult rat. 1699 18

This article analyzes the mechanisms underlying the potentiation of functional recovery poststroke by cell-based and pharmacologic agents, which amplify endogenous neurogenesis in the subventricular zone and angiogenesis in the border of the ischemic lesion in the animal. Discussion of the interaction between angiogenesis and neurogenesis is provided and data are described demonstrating a role for matrix metalloproteinases expressed in periinfarct vasculature as chemotactic for neuroblasts migrating from the subventricular zone. Monitoring angiogenesis and structural changes in the ischemic brain associated with functional recovery by means of MRI is described. We demonstrate that injured brain can be stimulated to promote angiogenesis and neurogenesis, which are coupled restorative processes that contribute to functional recovery from stroke and that MRI indices of these neurorestorative events are highly correlative with neurologic function and may be used in real-time monitoring of recovery from stroke.
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PMID:Neurogenesis, angiogenesis, and MRI indices of functional recovery from stroke. 1726 47

There has recently been a tremendous increase in imaging technology and imaging methodology enabling noninvasive exploration of brain function to such an intricate degree as to enable measurements of very small spatial and short temporal cerebral operations responsible for neurological and functional recovery after stroke. This has allowed conceptualization of rehabilitation strategies designed to maximally enhance rehabilitation protocols tailored to the individual patient's deficits. Rehabilitation strategies may now be designed and optimized by employing methods to synchronize functional training of brain regions ascribed to those areas innately undergoing neuronal plasticity change responsible for stroke recovery. In order to effectively apply these noninvasive imaging methods, one must have a clear understanding of the physics and technique of the imaging methodologies and how these are best applied to understand brain physiology during the stroke recovery process to provide a solid rationale for development of rehabilitation protocols. Nuclear medicine imaging is first presented as a diagnostic method to assess the stroke process. The initial brain damage and resulting neurological disability can be primarily assessed in terms of changes in the vascular and hemodynamic status of the cerebral circulation in addition to alterations in the metabolic status around the infarction region. Techniques for assessing perfusion and metabolism include regional cerebral blood flow (rCBF), single photon emission computed tomography (SPECT), and F-18 2-Fluoro-2-deoxy-D-glucose (F-18 FDG) positron emission tomography (PET). In addition, hemodynamic vascular insufficiency can be assessed using O-15 O2 oxygen extraction PET and rest and Diamox rCBF SPECT. The status of the peri-infarction region can be characterized in terms of components of diaschisis and ischemia using proton magnetic resonance spectroscopy imaging ((1)H MRSI) and rest/stress rCBF assessment of cerebral vascular reserve. As the brain recovers from cerebral infarction, areas of reorganization and energy utilization by the brain can be measured using oxygen extraction methods with PET, F-18 FDG glucose utilization by PET, and functional magnetic resonance imaging (fMRI) measures using the blood oxygenation level dependent (BOLD) technique. In addition, high field MRI imaging of the brain is now able to provide detailed fractional anisotropy (FA) maps to characterize changes in white matter by fiber tracking mapping using diffusion tensor imaging. Imaging of the stroke recovery process focuses on the physiologic model of stroke characterized by rCBF, metabolism, 1H spectroscopic measures of N-acetyl aspartate (NAA), choline (Ch) and creatine (Cr) in the peri-infarction zone as well as in the extended stroke penumbra including areas of distant ''pure'' diaschisis unencumbered with the confound of cerebral ischemia. Data is presented describing the results of application of imaging methodologies as the patient undergoes rehabilitation that demonstrates the importance of blood flow and metabolic changes in the contralesional frontal lobe both during the resting state and during motor and speech activation paradigms. The results of advanced imaging technologies on cerebral damage and cerebral reorganization during rehabilitation are presented in the context of furthering designs of rehabilitation strategies. Success can be monitored to assess the optimization of rehabilitation strategy design to maximize neurological recovery from stroke by employing facilitatory methods to maximally synchronize rehabilitation techniques with recovery of functionally counterpart areas of viable brain.
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PMID:Nuclear medicine in the rehabilitative treatment evaluation in stroke recovery. Role of diaschisis resolution and cerebral reorganization. 1726 87

Microvascular obstruction (MVO) is an important and independent determinant of post-infarct remodeling. Fifty-two patients with a successfully reperfused ST-segment elevation acute myocardial infarction (MI) were studied with MRI in the first week and at 4 months post-infarction. On early (i.e., 2-5 min) post-contrast MRI, MVO was detected in 32 patients with an MVO to infarct ratio of 36.3 +/- 24.9%. On late (i.e., 10-25 min) post-contrast MRI, MVO was detected in only 27 patients, with an MVO to infarct ratio of 15.9 +/- 13.9%. MVO infarcts (n = 32) were associated with higher cardiac enzymes (troponin I, P = 0.016), and lower pre-revascularization thrombolysis in myocardial infarction (TIMI) flow (P = 0.018) than non-MVO infarcts (n = 20). Infarct size was larger in MVO infarcts (25.0 +/- 14.3 g) than non-MVO infarcts (12.5 +/- 7.9 g), P = 0.0007. Systolic wall thickening in the infarct and peri-infarct area, and left ventricular (LV) ejection fraction (EF) were worse in MVO (46.1 +/- 7.2%) than non-MVO infarcts (50.5 +/- 6.6%, P = 0.038). At 4 months, MVO infarcts showed more adverse remodeling and lack of functional improvement, whereas non-MVO infarcts improved significantly (LV EF at 4 months, MVO, 47.5 +/- 7.8%, P = 0.31; non-MVO, 55.2 +/- 10.3%, P = 0.0028). In the majority of patients with successfully reperfused ST-segment elevation MI, MVO is observed, whose present and maximal extent can be best evaluated on early post-contrast MRI. Presence of MVO is associated with more extensive infarctions, and characterized by greater adverse LV remodeling and lack of functional recovery.
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PMID:Determinants and impact of microvascular obstruction in successfully reperfused ST-segment elevation myocardial infarction. Assessment by magnetic resonance imaging. 1736 20

This study examined effect of a new intervertebral cervical disc prosthesis in relieving the neurological symptoms and signs, improving the patients' ability to perform daily activities, reducing pain, and maintaining the stability and segmental motion. From December 2003 to October 2004, 12 patients, who had received 14 replacements of cervical artificial discs, were followed-up for 2 to 8 months (with a mean of 5.2 months). Of them 5 had cervical spondylotic myelopathy and 7 had cervical disc herniation. The patients included 7 males and 5 females, with their age ranging from 35 to 62 y and a mean of 50.3 y. Single-level replacements were performed in 10 cases and 2 cases received two-level replacement. Operation time of the single-level surgery averaged 130+/-50 min and the time of two-level surgery was 165+/-53 min on average (from skin incision to skin suturing). Neurological or vascular complications during or after surgery was not observed. Japanese Orthopedic Association scores (JOA scores) increased from 8.6 to 15.8 on average. There was no prothesis subsidence or excursion. Replaced segments were stable and the range of motion was partially restored, being 4.68 degrees (3.6 degrees -6.1 degrees ) in flexion and extension position and 3.51 degrees (2.5 degrees -4.6 degrees ), 3.42 degrees (2.6 degrees -4.3 degrees ) in left and right bending position. No obvious loss of physiological curvature was noted. CT or MRI follow-up showed that excursion was less than 1.5 mm) in 2 of 14 levels and between 1.5 mm and 3 mm) in 1 of 14 levels. No ossification in the replaced levels was observed. It is concluded that satisfactory short-term results were achieved in the 12 cases of artificial disc replacements. Different from anterior cervical discectomy and fusion, the replacement could achieve quick functional recovery and did not lead to the movement limitation of cervical vertebrae. At least a 5-years follow-up was needed to assess the long-term effect of the prosthesis on its neighboring segments.
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PMID:Follow-up study on the motion range after treatment of degenerative disc disease with the Bryan cervical disc prosthesis. 1749 90

The most frequently diagnosed complication of vertebrobasilar dolichoectasia (VBD) is the compression of structures adjacent to the vertebral and basilar arteries. A giant VBD with only slight compressive symptoms is unusual. In this setting, the diagnosis of VBD may be casually revealed after the occurrence of a posterior circulation stroke, another potential complication. We report a 48-year-old woman who presented a two-month history of continuous buzz and a slight right-sided hearing loss that was followed by a cerebellar ischemic stroke. Brain CT and MRI revealed a marked compression of the brainstem due to an ectatic, tortuous and partially thrombosed basilar artery (BA). The largest cross-sectional diameter of BA was 18 mm. The patient had a good functional recovery within the two-month follow-up after stroke with modified Rankin scale score (mRSS)=2. At the one-year follow-up, patient still kept the complaints of continuous buzz, slight right-sided hearing loss and the mRSS was the same. We call attention for an unusual giant VBD that caused an impressive brainstem compression with displacement of important structures in an oligosymptomatic patient. Diagnosis was made only after the occurrence of a stroke. Despite of the good functional recovery after stroke, the presence of significant atherosclerotic changes and the large BA diameter may indicate a poor outcome. However, after one year, she remains oligosymptomatic.
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PMID:Oligosymptomatic and giant basilar artery dolichoectasia discovered after a stroke: case report. 1760 42

Cardiac MRI has long been recognized as an accurate and reliable means of evaluating cardiac anatomy and ventricular function. Considerable progress has been made in the field of cardiac MRI, and cardiac MRI can provide accurate evaluation of myocardial ischemia and infarction (MI). Late gadolinium (Gd)-enhanced MRI can clearly delineate subendocardial infarction, and the assessment of transmural extent of infarction on late enhanced MRI has been shown to be useful in predicting functional recovery of dysfunctional myocardium in patients after MI. Stress first-pass contrast-enhanced (CE) myocardial perfusion MRI can be used to detect subendocardial ischemia, and recent studies have demonstrated the high diagnostic accuracy of stress myocardial perfusion MRI for detecting significant coronary artery disease (CAD). Free-breathing, whole-heart coronary MR angiography (MRA) was recently introduced as a method that can provide visualization of all three major coronary arteries within a single three-dimensional (3D) acquisition. With further improvements in MRI techniques and the establishment of a standardized study protocol, cardiac MRI will play a pivotal role in managing patients with ischemic heart disease.
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PMID:Magnetic resonance imaging for ischemic heart disease. 1765 49

Preoperative delayed-enhanced magnetic resonance imaging (DE-MRI) was performed to estimate myocardial viability in a 57-year-old man with ischemic cardiomyopathy in order to decide the best course of treatment. The patient was diagnosed as having congestive heart failure with triple-vessel involvement (ejection fraction of 7%, end-diastolic volume index of 160 ml/m2, end-systolic volume index of 148 ml/m2). 99mTc-sestamibi single-photon emission computed tomography revealed severe reduction of the uptake at both stress and resting phases in the anterior, lateral and inferior segments. However, DE-MRI demonstrated transmural hyperenhancement to be <25% within the whole ventricular wall, implying that, though there was extensive subendoventricular myocardial infarction, there was substantial viable myocardium. Therefore, with the expectation that functional recovery was possible with coronary revascularization alone, we performed a complete revascularization with off-pump coronary artery bypass grafting. Six months after the operation, catheterization demonstrated dramatic improvement in ventricular function, with the ejection fraction having increased to 36%. This case suggests that preoperative assessment of myocardial viability by DE-MRI could help cardiac surgeons to choose the best treatment for patients with ischemic cardiomyopathy.
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PMID:Reverse-remodeling after coronary artery bypass grafting in ischemic cardiomyopathy: assessment of myocardial viability by delayed-enhanced magnetic resonance imaging can help cardiac surgeons. 1767 Jul 32

Spinal cord injury (SCI) causes delayed secondary biochemical alterations that lead to tissue loss and associated neurological dysfunction. Up-regulation of cell cycle proteins occurs in both neurons and glia after SCI and may contribute to these changes. The present study examined the role of cell cycle activation on secondary injury after severe SCI in rat. SCI caused cell cycle protein up-regulation associated with neuronal and oligodendroglial apoptosis, glial scar formation and microglial activation. Treatment with the cell cycle inhibitor flavopiridol reduced cell cycle protein induction and significantly improved functional recovery versus vehicle-treated controls at 21 and 28 days post-injury. Treatment also significantly reduced lesion volume, as measured by MRI and histology, decreased astrocytic reactivity, attenuated neuronal and oligodendroglial apoptosis and reduced the production of factors associated with microglial activation. Thus, flavopiridol treatment improves outcome after SCI by inhibiting cell cycle pathways, resulting in beneficial multifactorial actions on neurons and glia.
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PMID:Cell cycle activation contributes to post-mitotic cell death and secondary damage after spinal cord injury. 1769 Jan 31

Systemic lupus erythematosus is a multisystem disease with a large spectrum of clinical manifestations and a variable course. Lupus is marked by both humoral and cellular immunologic abnormalities, including multiple auto-antibodies especially anti DNA antibodies. Epidemiology - female predominance, occurring usually between second and fourth decade of life, more frequently in hispanic and black patients. Family predominance has been noticed. Provocative agents - ultraviolet light, viral infections, drugs and situational stresses. Pathogenesis - pathological features can affect a large spectrum of internal organs and systems - osteoarticulary injuries, skin rash, lymphadenopathy, glomerulonephritis, myocarditis, digestive system lesions. Musculo skeletal abnormalities include migratory arthritis, effusion and stiffness in small and large joints. Articular erosions are uncommon. Skeletal abnormalities include osteopenia and osteonecrosis, due to two pathological mechanisms: vasculitis and long term corticotherapy. Fifteen to twenty percent of SLE patients are affected by femoral head avascular necrosis (FHAN). Diagnosis rests on clinical signs - hip pain, limited range of motion, walking with a limp.; radiological findings - best grouped in Arlet-Ficat standing system; MRI - high sensitivity, especially in infraradiological stages. Treatment - in incipient stages core decompression represents the best therapeutical option. In advanced, arthritis stages, total hip arthroplasty (THA) is the standart treatment. Three implant types are available: bipolar, uncemented and cemented. An increased number of cotyloidites occurred after bipolar implants. Emphasised osteopenia and excessive bleeding represent contraindications for uncemented implants. Considering all of this, cemented implants are considered, the right choice, methacrylate cement providing strong and durable fixation of THA implants to bone. No meaningful differences were observed in postoperative functional recovery between LSE patients and other etiology FHAN patients.
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PMID:Total hip arthroplasty in secondary systemic lupus erythematosus femoral head avascular necrosis. 1796 53


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