Chronic sublethal hypoxia induces brain adaptations associated with changes in neurovascular behavior. Changes to the neurovasculature also influence the formation of the brain-blood barrier (BBB). In this study, I investigated the influence of chronic sublethal hypoxia on astrocytes, using the coculture transwell model of primary cultured astrocytes and RBE4 (brain endothelial) cells. Using a 3D collagen gel model, cytoplasmic processes of astrocytes extended to clumps of endothelial cells. The numbers of astrocytes increased in cocultured and chronic hypoxic environments in the transwell model. Western blotting showed increased production of glial fibrillar acidic protein (GFAP) and proliferating cellular nuclear antigen (PCNA) in chronic hypoxia. I also confirmed the influence of hypoxia on the behavior of astrocytes in this model, using confocal microscopy. The numbers of cytoplasmic processes of astrocytes within the membrane increased in z sections. These data support the idea that chronic hypoxia might induce alterations in the formation of the BBB as part of the adaptation of the brain to chronic hypoxia. These transwell and 3D collagen gel models will probably be useful for functional as well as morphological experiments.
Anoxia* ; Astrocytes* ; Blood-Brain Barrier ; Blotting, Western ; Brain ; Coculture Techniques* ; Collagen ; Cytoplasm ; Endothelial Cells ; Membranes ; Microscopy, Confocal

Object of this study was to make comparison between acetazolamide and dipyridamole activated SPECT for measurement of cerebral vascular reserve capacity. This study was also carried out to evaluate response in acetazolamide and dipyridamole activated SPECT in relation to clinical parameters, such as Glasgow Coma Scale, Hunt & Hess grade, Fisher grade and Glasgow Outcome Scale. It is concluded from study that. Acetazolamide and dipyridamole activated SPECT study proved to be valuable for cerebral vascular reserve capacity. Dipyridamole activated SPECT study was somewhat equivocal because of systemic vascular dilatation effect, but this problem could be resolved by Gamma Count Ratio. Although there were minimal transient side effect of dipyridamole such as dizziness, no complication.
Acetazolamide* ; Dilatation ; Dipyridamole* ; Dizziness ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Subarachnoid Hemorrhage ; Tomography, Emission-Computed, Single-Photon*

This study was conducted to review the clinical features of antrochoanal polyp and to evaluate the effectiveness of transnasal endoscopic sinus surgery as a primary surgical method in treating antrochoanal polyp. We reviewed the profiles, which included clinical symptoms, past surgical history, surgical techniques and operative findings, of 57 patients (62 cases) treated for antrochoanal polyp with transnasal endoscopic sinus surgery during the past four years. Out of this subject pool, 45 patients (50 cases) underwent follow-up examinations and were analyzed. The follow-up periods ranged from 18 to 63 months and averaged 33 months. About half of the cases involved pediatric-to-young-adult patients (under 20 years) and five cases were bilateral. The most frequent site of origin was the natural ostium of the maxillary sinus, followed by the posteromedial wall and the posterolateral wall. Recurrences after endoscopic sinus surgery were observed in five cases, which were subsequently treated with revision endoscopic sinus surgery. In these cases of recurrence, there was no evidence of recurrence during a mean follow-up period of 30 months. These results suggest that transnasal endoscopic sinus surgery may be appropriate for the primary treatment of antrochoanal polyp and useful in the treatment of recurrent cases, especially those involving children.
Child ; Follow-Up Studies ; Humans ; Maxillary Sinus ; Polyps* ; Recurrence

Background: There has been no comparison of the determinants of admission route between acute ischemic stroke (AIS) and acute myocardial infarction (AMI). We examined whether factors associated with direct versus transferred-in admission to regional cardiocerebrovascular centers (RCVCs) differed between AIS and AMI. Methods: Using a nationwide RCVC registry, we identified consecutive patients presenting with AMI and AIS between July 2016 and December 2018. We explored factors associated with direct admission to RCVCs in patients with AIS and AMI and examined whether those associations differed between AIS and AMI, including interaction terms between each factor and disease type in multivariable models. To explore the influence of emergency medical service (EMS) paramedics on hospital selection, stratified analyses according to use of EMS were also performed. Results: Among the 17,897 and 8,927 AIS and AMI patients, 66.6% and 48.2% were directly admitted to RCVCs, respectively. Multivariable analysis showed that previous coronary heart disease, prehospital awareness, higher education level, and EMS use increased the odds of direct admission to RCVCs, but the odds ratio (OR) was different between AIS and AMI (for the first 3 factors, AMI > AIS; for EMS use, AMI < AIS). EMS use was the single most important factor for both AIS and AMI (OR, 4.72 vs. 3.90). Hypertension and hyperlipidemia increased, while living alone decreased the odds of direct admission only in AMI;additionally, age (65–74 years), previous stroke, and presentation during non-working hours increased the odds only in AIS. EMS use weakened the associations between direct admission and most factors in both AIS and AMI. Conclusions Various patient factors were differentially associated with direct admission to RCVCs between AIS and AMI. Public education for symptom awareness and use of EMS is essential in optimizing the transportation and hospitalization of patients with AMI and AIS.