OBJECTIVETo study the impacts of electroacupuncture (EA) on memory impairment after cerebral infarction through the observation of hydrogen proton magnetic resonance spectroscopy (1H-MRS) of brain tissue metabolites in the patients of cerebral infarction.

METHODSSixty cases of memory impairment after cerebral infarction were randomized into an observation group and a control group, 30 cases in each one. The conventional rehabilitation training and medication were applied to all the patients. In the observation group, beside the basic treatment, EA was applied to bilateral Ezhongxian (MS 1), Dingzhongxian (MS 5), Dingniehouxiexian (MS 7), Hegu (LI 4), Taichong (LR 3), Zusanli (ST 36), Taixi (KI 3), Xuanzhong (GB 39) and Fengchi (GB 20). The treatment was given once a day, 5 times a week, for 8 weeks. The clinical memory scale was used for the score evaluation before and after treatment in all the patients. The magnetic resonance image (MRI) and 1H-MRS scanning were applied to the head. The ratio of N-acetyl aspartate (NAA) and creatine (Cr) and the ratio of choline (Cho) and Cr were determined in the foci of cerebral infarction.

RESULTSEight weeks later, the scores of clinical memory scale were all increased after treatment as compared with those before treatment in the two group (all P<0. 01). The ratio of NAA and Cr was increased as compared with that before treatment (P<0. 05); the ratio of Cho and Cr was reduced as compared with that before treatment (P<0. 05). The changes in the observation group were more obvious than those in the control group (all P<0. 05).

CONCLUSIONOn the basis of the conventional medication and rehabilitation training, EA improves the metabolism of brain tissue and memory function of the patients. The efficacy of this therapy is better than that of medication combined with rehabilitation training.

Adult ; Aged ; Aged, 80 and over ; Brain ; diagnostic imaging ; Cerebral Infarction ; complications ; diagnostic imaging ; Electroacupuncture ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Memory ; Memory Disorders ; etiology ; psychology ; therapy ; Middle Aged ; Radiography

We report the case of a female who died of suspected acute myocardial infarction. Post-mortem CT angiography (PMCTA) was performed with intravascular contrast infusion before the standard autopsy, and it successfully demonstrated the complete thrombotic occlusion of a coronary artery and also a corresponding perfusion defect on myocardium. We herein describe the PMCTA findings of a cardiac death with special emphasis on the potential benefits of this novel CT technique in forensic practice.
*Autopsy ; Coronary Occlusion/*diagnosis/etiology/radiography ; Coronary Vessels/pathology/radiography ; Female ; Humans ; Middle Aged ; Myocardial Infarction/etiology/pathology ; Myocardium ; Thrombosis/complications/*diagnosis ; Tomography, X-Ray Computed

BACKGROUND/AIMS: In the bare-metal stent era, routine follow-up coronary angiography (RFU CAG) was used to ensure stent patency. With the advent of drug-eluting stents (DESs) with better safety and efficacy profiles, RFU CAG has been performed less often. There are few data on the clinical impact of RFU CAG after second- or third-generation DES implantation in clinically stable patients with coronary artery disease; the aim of this study was to examine this issue. METHODS: We analyzed clinical outcomes retrospectively of 259 patients who were event-free at 12-month after stent implantation and did not undergo RFU CAG (clinical follow-up group) and 364 patients who were event-free prior to RFU CAG (angiographic follow-up group). Baseline characteristics were compared between the groups. RESULTS: The Kaplan-Meier estimated total survival and major adverse cardiac event (MACE)-free survival did not differ between the groups (p = 0.100 and p = 0.461, respectively). The cumulative MACE rate was also not different between the groups (hazard ratio, 0.85; 95% confidence interval, 0.35 to 2.02). In the angiographic follow-up group, 8.8% revascularization was seen at RFU CAG. CONCLUSIONS: RFU CAG did not affect long-term clinical outcome after second- or third-generation DES implantation in clinically stable patients.
Aged ; *Coronary Angiography ; Coronary Artery Bypass ; Coronary Artery Disease/radiography/*therapy ; Coronary Restenosis/etiology/radiography/surgery ; Coronary Vessels/*radiography ; Disease Progression ; Disease-Free Survival ; *Drug-Eluting Stents ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Myocardial Infarction/etiology/radiography/surgery ; Patient Selection ; Percutaneous Coronary Intervention/adverse effects/*instrumentation ; Predictive Value of Tests ; Proportional Hazards Models ; Prosthesis Design ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Outcome

This study aimed to investigate inflammatory edema after cerebral ischemia through 7.0T MRI and proton magnetic resonance spectroscopy (MRS). All SD rats were randomly divided into sham operated group and middle cerebral artery occlusion (MCAO)-1 day, -3 day and -7 day groups. MRI scan of the brain was performed on a 7.0 Tesla MRI scanner. The volume of positive signals in the ischemic side was detected by using a T2 weighted spinecho multislice sequence; the changes in the height of water-peak were measured with point resolved spectroscopy (PRESS) sequences; cortical edema was detected by using wet-dry weight method; the degrees of nerve injury were evaluated by Bederson neurological score system; double-labeling immunofluorescence technique was used to explore the molecular mechanisms of post-ischemia cerebral edema. The results showed that high T2WI signals were observed in MCAO-1 day, -3 day and -7 day groups, and the water-peak height and water-peak area of MCAO groups were higher than those of sham operated group (P<0.05). Neurological score results were consistent with the degree of brain edema, and a large number of microglia accumulated in the ischemic cortex. Our results suggested that non-invasive MRI technology with the advantage of high spatial resolution and tissue resolution can comprehensively and dynamically observe inflammatory edema after cerebral ischemia from a three-dimensional space, and contribute to evaluation and treatments in clinic.
Animals ; Brain ; diagnostic imaging ; pathology ; Brain Edema ; diagnostic imaging ; etiology ; Brain Ischemia ; complications ; CD11b Antigen ; metabolism ; Immunohistochemistry ; Infarction, Middle Cerebral Artery ; complications ; Inflammation ; diagnostic imaging ; etiology ; Magnetic Resonance Imaging ; methods ; Magnetic Resonance Spectroscopy ; Male ; Microglia ; metabolism ; Microscopy, Confocal ; Microscopy, Fluorescence ; Radiography ; Rats ; Rats, Sprague-Dawley ; Reproducibility of Results ; Time Factors

A 53-yr-old man underwent radiofrequency ablation to treat persistent atrial flutter. After the procedure, the chest pain was getting worse, and the electrocardiogram showed ST-segment elevation in inferior leads with reciprocal changes. Immediate coronary angiography showed total occlusion with thrombi at the distal portion of the right coronary artery, which was very close to the ablation site. Intervention with thrombus aspiration and balloon dilatation was successful, and the patient recovered without any kind of sequelae. Although the exact mechanism is obscure, the most likely explanation is a thermal injury to the vascular wall that ruptured into the lumen and formed thrombus. Vasospasm and thromboembolism can also be other possibilities. This case raise the alarm to cardiologists who perform radiofrequency ablation to treat various kinds of cardiac arrhythmias, in that myocardial infarction has been rarely considered one of the complications.
Acute Disease ; Angioplasty, Balloon, Coronary ; Atrial Flutter/*surgery ; Catheter Ablation/*adverse effects ; Chest Pain/etiology ; Coronary Occlusion/etiology ; Coronary Vessels/radiography ; Humans ; Male ; Middle Aged ; Myocardial Infarction/*diagnosis/etiology/therapy ; Thrombosis/surgery

We report a case of delayed cerebral infarction due to stent longitudinal folding deformation following carotid artery stenting using a self-expandable stent with an open-cell design. The stented segment of the left common carotid artery was divided into two different lumens by this folding deformation, and the separated lumens became restricted with in-stent thrombosis. Although no established method of managing this rare complication exists, a conservative approach was taken with administration of anticoagulant and dual antiplatelet therapy. No neurological symptoms were observed during several months of clinical follow-up after discharge.
Aged ; Anticoagulants/therapeutic use ; Carotid Arteries/radiography ; Cerebral Infarction/*diagnosis/therapy ; Humans ; Male ; Platelet Aggregation Inhibitors/therapeutic use ; Stents/*adverse effects ; Thrombosis/drug therapy/*etiology ; Ticlopidine/analogs & derivatives/therapeutic use ; Tomography, X-Ray Computed

No abstract available.
Anticoagulants/therapeutic use ; Antithyroid Agents/therapeutic use ; Graves Disease/*complications/diagnosis/drug therapy ; Humans ; Infarction/diagnosis/drug therapy/*etiology ; Kidney/*blood supply/radiography ; Male ; Middle Aged ; *Thyroid Gland/radionuclide imaging/ultrasonography ; Thyrotoxicosis/diagnosis/drug therapy/*etiology ; Tomography, X-Ray Computed ; Treatment Outcome

OBJECTIVECerebral infarction (CI) is one of severe diseases of central nervous system in neonates, and some infants with CI could have poor prognosis in the long term. This study aimed to analyze the clinical data and prognosis of all neonatal cases with cerebral infarction in recent years and to help future clinical work.

METHODTotally 58 neonatal cases with CI admitted to NICU of the hospital from January 1999 to December 2010 were included in this study. We analyzed all clinical data and prognosis by retrospective analysis.

RESULTSFifty-two term babies and six preterm babies were included. There were altogether 51 cases with asphyxia and 7 with hemorrhagic cerebral infarction. Perinatal hypoxia-ischemia was the most common high-risk factor and it accounted for 46.6%. Seizure was the most frequent initial symptom and the most common clinical manifestation (accounted for 77.6%), and it was followed by intermittent cyanosis, apnea and lethargy. Cerebral CT scan and magnetic resonance imaging were major methods to help to make the diagnosis and they also had close relation with prognosis. Diffusion weighted imaging was very helpful to diagnose infarction in early stage. Left middle cerebral artery was the most common artery to be involved. Supportive therapy and symptomatic treatment were the main methods in the acute stage of neonatal cerebral infarction. Those babies with poor prognosis mostly had large infarction involving cerebral hemisphere, thalamus and basal ganglia.

CONCLUSIONSNeonatal cerebral infarction was a severe brain injury affecting long tern nervous system prognosis. Perinatal hypoxia was the most common high-risk factor and seizure was the most frequent initial symptom. Diffusion weighted imaging was valuable to diagnose infarction in early stage. Most of infants with poor prognosis had large infarction involving hemisphere, thalamus and basal ganglia. Early diagnosis with brain imaging would be helpful for rehabilitation therapy and improving prognosis.

Brain ; diagnostic imaging ; pathology ; Cerebral Infarction ; diagnosis ; etiology ; pathology ; therapy ; Cerebral Palsy ; etiology ; Humans ; Hypoxia-Ischemia, Brain ; complications ; Incidence ; Infant ; Infant, Newborn ; Magnetic Resonance Imaging ; Male ; Prognosis ; Radiography ; Retrospective Studies ; Risk Factors ; Seizures ; etiology ; Ultrasonography, Doppler, Color

Bronchial Arteries ; diagnostic imaging ; Embolization, Therapeutic ; methods ; Hemoptysis ; therapy ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; etiology ; Radiography

The aim of this study is to compare clinical outcomes for seven years, between sirolimus-eluting stent (SES) and bare metal stent (BMS). During the BMS and drug-eluting stent (DES) transition period (from April 2002 to April 2004), 434 consecutive patients with 482 lesions underwent percutaneous coronary intervention, using BMS or SES. Using propensity score matching, 186 patients with BMS and 166 patients with SES were selected. Seven year clinical outcomes of major adverse cardiac events (MACE), such as cardiac death, myocardial infarction (MI) and ischemia-driven target vessel revascularization (TVR), and angiographic definite stent thrombosis (ST) were compared. At one-year follow up, patients with SES showed significantly lower MACE (9.1% in BMS vs 3.0% in SES, P = 0.024). However, cumulative MACE for 7 yr was not significantly different between two groups (24.7% in BMS vs 17.4% in SES, P = 0.155). There was no significant difference in MI, TVR, death and ST. The TVR were gradually increased from 1 to 7 yr in SES, on the contrary to that of BMS. In conclusion, although SES showed better clinical outcomes in the early period after implantation, it did not show significant benefits in the long-term follow up, compared with that of BMS.
Aged ; Angioplasty, Balloon, Coronary/adverse effects/*methods ; Coronary Angiography ; Coronary Stenosis/mortality/radiography/*therapy ; Databases, Factual ; *Drug-Eluting Stents ; Female ; Follow-Up Studies ; Humans ; Ischemia/etiology ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Myocardial Infarction/etiology ; Myocardial Revascularization ; Registries ; Sirolimus/*therapeutic use ; *Stents ; Thrombosis/etiology