Our findings suggest that global end-diastolic volume index impacts both delayed cerebral ischemia and pulmonary edema after subarachnoid hemorrhage. Maintaining global end-diastolic volume index slightly above normal levels has promise as a fluid management goal during the treatment of subarachnoid hemorrhage.
We report herein the case of a patient in whom metastatic colon carcinoma was found within an inguinal hernia sac. According to Lejar's classification, colon carcinomas within inguinal hernias are categorized as intrasaccular- and saccular-type tumors. In our patient, asymptomatic transverse colon carcinoma was the primary lesion, and to the best of our knowledge, this is only the fourth case of such a saccular-type tumor to be reported in the literature. To date, 21 cases of intrasaccular tumors have been reported, and saccular-type tumors are considered to be an even rarer entity, unless the patients have obvious ascites, indicating peritonitis carcinomatosa. Histologic examination of the hernia sac is recommended for male patients of advanced age with an inguinal hernia, especially those who have previously undergone surgery for colorectal carcinoma.
Physician-directed prophylactic triple-H administration was not associated with improved clinical outcomes or quantitative hemodynamic indicators for intravascular volume. Further, GEDI-directed intervention studies are warranted to better define management algorithms for SAH patients with the aim of preventing DCI.
Plant lycopene exhibits antioxidant activity in animal tissues. Transient cerebral ischemia/reperfusion in Mongolian gerbils resulted in delayed neuronal death in hippocampal regions. We examined the antioxidant effects of lycopene because we expected lycopene to attenuate ischemia-related neuronal damage by controlling apoptosis at the gene level. The gerbils were divided into two groups: the normal feeding (control) group that received normal market food (MF) and the lycopene group that received MF containing lycopene (5 mg in 100 g MF food). After 1.5-2.0 months (when body weight were 60-65 g), the lycopene level was 38.2 ± 17.6 ng/ml in serum and 11.9 ± 4.0 μg/g-wet weight tissue in the liver. Levels of B cell leukemia-2, an apoptosis-suppressing protein, decreased in control animal brains 1, 3, and 7 days after surgery, whereas the levels increased in lycopene-treated animal brains. Moreover, cysteinyl aspartate-specific protease-3 activity increased gradually after ischemia, but was suppressed in the lycopene-treated animal brains 7 days after surgery. Finally, hippocampal superoxide dismutase (SOD) activity decreased in the control group 3 h after ischemia and, gradually increased thereafter, whereas it was significantly elevated in the lycopene group. Thus, orally administered lycopene is accumulated in the body, and provided protections against ischemia/reperfusion-induced brain injury by inducing an increase in SOD activity and inhibiting apoptosis.
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