Leukaemia inhibitory factor prevents injury induced proliferation of striatal dopamine uptake sites.

The injury associated with implantation of an inert gelatin matrix (gel foam) into normal mouse striatum induces a long-lived increase in binding of [3H]mazindol to presynaptic dopamine uptake sites, probably due to proliferation of striatal dopaminergic terminals. Because of the known effects of leukaemia inhibitory factor (LIF) on catecholaminergic cells, we tested the hypothesis that LIF may alter the striatal dopaminergic response to injury in vivo. Application of LIF to mouse striatum in a gel foam implant abolished the usual injury induced proliferation of dopamine uptake sites.

Risk factors for lacunar infarction syndromes.

Background And Purpose: Lacunar infarction is an important stroke subgroup with unique clinical and pathologic features, but its relative risks for associated risk factors have been rarely documented. To address this matter, we studied 203 consecutive patients with first-ever stroke due to lacunar infarction admitted to four general hospitals during the period 1985 to 1992.

Methods: We obtained information concerning risk factor exposure status among the patients by interview using a structured questionnaire and by comparison with age- and sex-matched neighborhood controls.

The proximal aorta: a source of stroke.

The availability of the sophisticated imaging techniques of transoesophageal echocardiography and epiaortic ultrasound scanning have drawn attention to the ascending aorta and aortic arch as a potential source of embolic stroke. Several studies have shown an association between atheroma in this region and cerebral ischaemic events. Although aortic atheroma is associated with vascular disease in other arterial territories, two large controlled studies have shown it to be a risk factor for stroke, independently of other major risk factors such as carotid vascular disease, cardiac disease and hypertension.

Early reperfusion in the 'spectacular shrinking deficit' demonstrated by single-photon emission computed tomography.

The "spectacular shrinking deficit" (SSD) refers to a syndrome of profound hemispheric ischemia that resolves rapidly over hours to days, leaving patients with minimal residual neurologic deficits. The SSD is postulated to result from rapid embolic lysis, fragmentation, and migration along the internal carotid/middle cerebral artery axis, leading to restored tissue perfusion before irreversible tissue damage has occurred. We performed serial single-photon emission computed tomographic (SPECT) cerebral perfusion measurements during the first 48 hours in 36 patients admitted with major hemispheric ischemia, to compare the cerebral perfusion changes between patients who developed SSD (n = 5) and those who did not (n = 31).

Magnetic cortical stimulation in acute spinal cord injury.

We studied 25 patients within 6 hours of acute spinal cord injury using magnetically evoked cortical motor evoked potentials (MEPs). The subjects included 16 quadriplegics with cervical spine injuries and eight paraplegics. MEPs were recorded from abductor digiti minimi (ADM), biceps, flexor hallucis brevis, and tibialis anterior muscles on each side using appropriate directions of coil current.

Proximal aortic atheroma. An independent risk factor for cerebral ischemia.

Background And Purpose: Transesophageal echocardiography frequently demonstrates aortic atheroma in patients with cerebral and peripheral emboli. The aim of this study was to determine whether atheroma in the ascending aorta and arch is an independent risk factor for cerebral ischemia.

Methods: We studied 215 consecutive patients with a first stroke or transient ischemic attack and 202 community-based control subjects using transesophageal echocardiography to detect aortic atheroma and potential cardiac sources for embolism.

Diagnosis and imaging of stroke.

Background: Less than 20 years ago the diagnosis of stroke was almost entirely based on clinical features. Since the mid-1970s sophisticated ultrasonography, computed tomography, magnetic resonance imaging, angiography and spectroscopy, single-photon emission computed tomography and positron emission tomography have been developed in rapid succession.

Current Use Of Neuroimaging In Stroke Patients: By using a combination of imaging modalities it is now possible to show nearly all of the vascular tree from the left ventricle of the heart through to small arteries within the brain.

Dietary factors and the risk of glioma in adults: results of a case-control study in Melbourne, Australia.

In a population-based case-control study of 416 incident gliomas in adults carried out in Melbourne, Australia, between 1987 and 1991, 409 age-sex-matched case-control pairs (243 male and 166 female) had adequate data available to examine associations between the dietary intake of N-nitroso compounds, N-nitroso precursors, other nutrients including N-nitroso inhibitors, and the risk of glioma. Dietary intakes were based on the reported frequency of consumption of 59 food items. Increased odds ratio (OR) were observed in males who consumed high levels of bacon, corned meats, apples, melons and oil.

Evidence that patent foramen ovale is not a risk factor for cerebral ischemia in the elderly.

Patent foramen ovale (PFO) may be a risk factor for ischemic stroke in young patients. The aim of this study was to assess the importance of PFO in subjects with a wider age range using patient-control methodology. Transesophageal contrast echocardiography and carotid imaging were performed in 220 consecutive patients with cerebral ischemia (mean age 66 +/- 13 years) and in 202 community-based control subjects (mean age 64 +/- 11 years).

The PACE pilot study: 12-month results and implications for future primary prevention trials in the elderly. (Prevention with low-dose Aspirin of Cardiovascular disease in the Elderly).

Objective: To document compliance with medication, drop-out and drop-in rates, and baseline cardiovascular event rates during the pilot phase of the PACE (Prevention with low-dose Aspirin of Cardiovascular disease in the Elderly) study.

Design: Randomized, double-blind, placebo-controlled trial of low-dose aspirin therapy.

Setting: Community-based, in general practices and residential retirement villages, in Victoria, Australia.

Reperfusion after thrombolytic therapy in ischemic stroke measured by single-photon emission computed tomography.

Background And Purpose: We used 99mTc-hexamethylpropyleneamine oxime single-photon emission computed tomography (SPECT) to study cerebral perfusion in patients treated with streptokinase for acute ischemic stroke in an open and prospective study. Our primary aims were (1) to compare the extent of reperfusion between patients who had received thrombolytic therapy and a control group studied during the same period who were ineligible to receive such therapy and (2) to determine if, among all patients, reperfusion led to improved outcome.

Methods: Fifty-seven patients (22 treated with streptokinase) had two SPECT studies performed, the first before streptokinase administration and the second 24 hours later.

Transoesophageal echocardiography in the investigation of stroke: experience in 135 patients with cerebral ischaemic events.

Background: The importance of cardiogenic embolism as a cause of cerebral ischaemic events may be underestimated if potential cardiac sources of embolism remain undetected. Transoesophageal echocardiography (TOE) is more sensitive in detecting such abnormalities than earlier methods and may result in more frequent recognition of cardiogenic embolism.

Aims: To establish in an unselected stroke population the prevalence of potential cardiac sources of embolism detectable on TOE and their relationship to atrial fibrillation and carotid stenosis.

Surgical damage stimulates proliferation of dopamine uptake sites in normal mouse brain.

To test the hypothesis that proliferation of host dopaminergic tissue in response to injury plays an important role in the response to intrastriatal grafting, we transplanted autologous adrenal medullary to striatum in normal C57-black mice and compared this procedure with transplantation of non-dopaminergic tissue (frontal cortex) or a non-cellular matrix (Gelfoam). [3H]Mazindol autoradiography revealed that all three protocols resulted in a marked proliferation of dopamine uptake sites 10 months after transplantation.

Intra-arterial streptokinase in acute ischaemic stroke. A pilot study.

Aims: To assess the safety and efficacy of the intra-arterial administration of streptokinase within 24 hours of acute ischaemic stroke.

Methods: Patients who presented to the Austin Hospital casualty department between 3 and 22 hours after an acute stroke were considered for the study. Eligible patients had pretreatment non-contrast computed tomographic scans of the brain to exclude haemorrhage.

Dopa resistance in multiple-system atrophy: loss of postsynaptic D2 receptors.

Postmortem autoradiography was used to explore the mechanisms underlying L-dopa resistance in 2 patients with multiple-system atrophy. Indices of striatal presynaptic dopamine terminal loss and dopamine (D1 and D2) receptors were provided by 3H-mazindol, 3H-SCH 23390, and 125I-sulpiride binding. Neuronal loss, gliosis, and loss of postsynaptic D2 receptors preferentially involved the middle and posterior of the putamen, that region of the striatum most intimately involved in motor function.