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ID 14486
Eprint ID
14486
FullText URL
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Title Alternative
Effects of heparin-urokinase on the brain damage induced by complete global brain ischemia
Author
Morimoto, Naoki
Abstract
The effect of heparin-urokinase (H-U) on the prevention of brain damage induced by ischemia was evaluated in 31 dogs subjected to an 18 min of complete global brain ischemia. Complete brain ischemia was produced by clamping the ascending aorta with aorto-atrial and aorto-femoral bypass formation. Post-ischemic cerebral blood flow (CBF) and other hemodynamic parameters were measured for 7 hours after ischemia in 15 dogs (acute study). Neurologic outcome was evaluated for 7 days after ischemia in 16 dogs (chronic study). Fifteen minutes after restoration of circulation to the brain, an intravenous bolus of heparin 100 I.U./kg and urokinase 3000 I.U./kg, was given, followed by continuous intravenous infusion of heparin 0.25 I.U./kg/min and urokinase 8.3 I.U./kg/min for 6 hours. H-U significantly improved both post-ischemic CBF and neurologic outcome. H-U was effective in treating brain damage when given 15 min after ischemia. These results suggest that H-U improved both post ischemic CBF and neurologic outcome owing to amelioration of the deterioration of microcirculation.
Keywords
完全全脳虚血
へパリン
ウロキナーゼ
No-reflow 現象
遅発性脳血流減少
Note
原著
Published Date
1991
Publication Title
岡山医学会雑誌
Publication Title Alternative
Journal of Okayama Medical Association
Volume
volume103
Issue
issue1-2
Publisher
岡山医学会
Publisher Alternative
Okayama Medical Association
Start Page
173
End Page
181
ISSN
0030-1558
NCID
AN00032489
Content Type
Journal Article
Official Url
https://www.jstage.jst.go.jp/article/joma1947/103/1-2/103_1-2_173/_article/-char/ja/
Related Url
http://www.okayama-u.ac.jp/user/oma/
References
1) Hossmann KA : Post-ischemic resuscitation of the brain : selective vulnerability versus global resistance. Progress in Brain Research Vol. 63 Kogure, Hossmann, Siesjo and Welsheds, Elsevier Science Publishers B.V. (1985) pp3-17.
2) Safar P : Resuscitation from clinical death : Pathophysiologic limits and therapeutic potentials. Crit Care Med (1988) 16, 923-924.
3) Ames AIII, Wright RL, Kowada M, Thurston JM and Majno G : Cerebral ischemia : II. The no-reflow phenomenon. Am J Pathol (1968) 52, 437-453.
4) Kowada M, Ames AIII, Majno G and Wright RL : Cerebral ischemia : I. An improved experimental method for study ; cardiocascular effects and demonstration of an early vascular lesion in the rabbit. J Neurosurg (1968) 26, 150-157.
5) Chiang J, Kowada M and Ames AIII, Wright RL and Majno G : Cerebral ischemia : III. Vascular changes. Am J Path (1968) 52, 455-476.
6) Cantu RC, Ames III : Distribution of vascular lesions by cerebral ischemia. Neurology (1969) 19, 128-132.
7) Hossmann KA, Lechtape-Gruter H and Hossmann V : The role of blood flow for the recovery of the brain after prolonged ischemia. Z Neurol (1973) 204, 281-299.
8) Nemoto EM, Snyder JV, Carroll RG and Morita H : Grobal ischemia in dogs : Cerebro-vascular CO2 reactivity and autoregulation. Stroke (1975) 6, 425-431.
9) Miller CL, Lampard DG, Alexander K and Brown WA : Local cerebral blood flow following transient cerebral ischemia. I. Onset of impairment reperfusion within the first hour following transient fore-brain ischemia. Stroke (1980) 11, 534-541.
10) Pulsinelli WA, Levy DE and Duffy TE : Regional cerebral blood flow and glucose metabolism following transient fore-brain ischemia. Ann Neurol (1982) 11, 499-509.
11) Olney JW, Rhee V and Ho OL : Kainic acid : a powerful neurotoxic analogue of glutamate. Brain Res (1974) 77, 507-512.
12) Benvensite H, Drejer J, Schouboe A and Diemer NH : Elevation of the extracellular concentrations of glutamate and aspartate in rat hippocampus during transient cerebral ischemia monitored by intrarcerebral microdialysis. J Neurochem (1984) 43, 1369-1374.
13) Ernster L : Biochemistry of reoxygenation injury. Crit Care Med (1988) 16, 947-953.
14) Bodsch W, Takahashi K : Selective neuronal vulnerability to cerebral protein-and RNA-synthesis in the hippocampus of the gerbil brain. Cerebral ischemia. Bes, Braquet, Paoletti and Siesjo eds, Excerpta Medica, Amsterdam, New York Oxford (1984) pp197-208
15) Steen PA, Michenfelder JD and Milde JH : Incomplete versus complete cerebral ischemia : Improved outcome with a minimal blood flow. Ann Neurol (1979) 6, 389-398
16) Marshall LF, Durity F, Lounsburry R, Graham MB, Welsh F and Langfitt TW : Experimental cerebral oligemia and ischemia produced by intracranial hypertention. J Neurosurg (1975) 43, 323-328.
17) Levy DE, Brieley JB and plum F : Ischemic brain damage in the gerbil in the absence of "no-reflow". J Nerol Neurosurg Psychiatry (1975) 38, 1197-1205.
18) Giscoid SE, Safar P, Rao G, Moossy J, Kelsey S and Alexander H : Multifaceted tharapy after global brain ischemia in monkeys. Stroke (1984) 15, 803-812.
19) Steen PA, Newberg LA, Milde JH and Michenfelder JD : Cerebral blood flow and neurologic outcome when nimodipine is given after complete cerebral ischemia in dog. J Cereb Blood Flow Metab (1984) 4, 82-87.
20) Sakabe T, Nagai I, Ishikawa T, Takeshita H, Masuda T, Matumoto M and Tateixhi A : Nicardipine increase cerebral ischemia.
21) 橋本秀則:上行大動脈遮断と大動脈・右房・大腿静脈間バイパスによる完全全脳虚血法に関する研究.麻酔(1989)38,859-867.
22) 田村 晃,浅野孝雄,卓 允桔:水素クリアランス法による脳局所血流量の測定―方法およびVenous Out Flow 法との相関.脳神外科(1978)30,47-54.
23) Safar P, Stezoski SW and Nemoto EM : Ameliolation of brain damage after 12 minutes cardiac arrest in dogs. Arch Neurol (1976) 33, 91-95.
24) Takagi S, Cocito L and Hossmann KA : Blood recirculation and pharmacological responsiveness of the cerebral vasculature following prolonged ischemia of cat brain. Stroke (1977) 8, 707-712.
25) Hossmann KA : Treatment of experimental cerebral ischemia. J Cereb Blood Flow Metab (1982) 2, 275-297.
26) Siesjo BK : Cell damage in the brain. J Cereb Blood Flow and Metab (1981) 1, 155-185.
27) Safar P, Bleyaert A, Nemoto EM, Moossy J and Snyder JV : Resuscitation after global brain ischemia-anoxia. Crit Care Med (1978) 6, 215-227.
28) 丸山征郎:血管凝固異常と脳血管障害 神経進歩(1988)32、248-258.
29) Grφgaard B, Schurer L, Gerdin B and Arfors KE : Delayed hypoperfusion after incomplete forebrain ischemia in the rat. The role of polymorphonuclear leukocytes. J Cereb Blood Flow Metab (1989) 9, 500-505.
30) Hossmann KA, Hossmann V : Coagulopathy following experimental cerebral ischemia. Stroke (1977) 8, 249-254.
31) Pasini FL, Pasqui AL, Ceccatelli L, CapecchiPL, Oricco A and DiPerri T : Heparin inhibition of polymorphonuclear leukocyte activation in vitro. A possible pharmacological approach to granulocyte-mediated vascular damage. Thromb Res (1984) 35, 527-537.
32) Cario MS, Allen J, Higgins C, Baehner RL and Boxer LA : Synergistic effect of heperin and chemotacitc factor on polymorphonuclear leukocyte aggregation and degranulation. Am J Pathol (1979) 113, 67-74.
33) 鎮目研吾:脳主幹動脈閉塞および狭窄症の超急性期におけるウロキナーゼ動注療法.脳卒中(1988)10,85-93.
34) Smith MJ, Kagstrom E, Rosen I and Siesjo BK : Effect of the calcium antagonist nimodipine on the delayed hypoperfusion following incomplete ischemia in the rat. J Cereb Blood Flow Metab (1983) 3, 543-546.
language
日本語
Copyright Holders
岡山医学会
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publisher
Refereed
True
Eprints Journal Name
joma