Thorén, M. et al. (2017) Predictors for cerebral edema in acute ischemic stroke treated with intravenous thrombolysis. Stroke, 48(9), pp. 2464 -2471 . (doi:10.1161 This is the author's final accepted version.There may be differences between this version and the published version. You are advised to consult the publisher's version if you wish to cite from it.http://eprints.gla.ac.uk/145896/
AbstractBackground -Cerebral edema (CED) is a severe complication of acute ischemic stroke.
Gastrointestinal stromal tumors (GISTs) are clinically distinct mesenchymal tumors, which generally result from expression of mutant KIT or PDGFRA receptor tyrosine kinase oncogenes. Most GISTs feature strong expression of KIT that serves as a crucial diagnostic adjunct. However, a subset of tumors lacks KIT expression and otherwise may also be difficult to distinguish from other sarcomas, including leiomyosarcoma. Because various carbonic anhydrase (CA) isozymes have been identified as potential treatment targets against different cancers, we evaluated CA II expression in 175 GISTs. Western blotting experiments indicated that CA II is highly expressed in GIST cell lines. Immunohistochemically, 95% of GISTs showed positive signal. The CA II expression in GISTs did not correlate with particular KIT or PDGFRA mutation types. CA II immunoreactivity was absent or low in other mesenchymal tumor categories analyzed. High CA II expression was associated with a better disease-specific survival rate than low or no expression (Mantel-Cox test, Po0.0001). The present results indicate that CA II is overexpressed in most GISTs, is quite selective to this tumor type among mesenchymal tumors, and therefore might be a useful biomarker in diagnostics.
Super-refractory status epilepticus is a condition characterized by recurrence of status epilepticus despite use of deep general anesthesia, and it has high morbidity and mortality rates. We report a case of a 17-year-old boy with a prolonged super-refractory status epilepticus that eventually resolved after commencing deep brain stimulation of the centromedian nucleus of the thalamus. Later attempt to reduce stimulation parameters resulted in immediate relapse of status epilepticus, suggesting a pivotal role of deep brain stimulation in the treatment response. Deep brain stimulation may be a treatment option in super-refractory status epilepticus when other treatment options have failed. ANN NEUROL 2017;81:142-146.
Background
Chronic infections have been reported to be risk factors for both coronary heart disease and ischemic stroke.
DNA
of oral bacteria, mainly from the viridans streptococci group, has been detected in coronary thrombus aspirates of myocardial infarction and cerebral aneurysms. Viridans streptococci are known to cause infective endocarditis and possess thrombogenic properties. We studied the presence of oral bacterial
DNA
in thrombus aspirates of patients with acute ischemic stroke treated with mechanical thrombectomy.
Methods and Results
Thrombus aspirates and arterial blood were taken from 75 patients (69% men; mean age, 67 years) with acute ischemic stroke. The presence of
Streptococcus
species, mainly the
Streptococcus mitis
group, belonging to viridans streptococci as well as
Porphyromonas gingivalis
and
Aggregatibacter actinomycetemcomitans
in samples were determined using a quantitative polymerase chain reaction with specific primers and probes. The relative amount of bacterial
DNA
in a sample was determined with the comparative threshold cycle method. Bacterial
DNA
was detected in 84% (n=63) of aspired thrombi, and 16% (n=12) of samples were considered bacterial
DNA
negative.
DNA
of
Streptococcus
species, mainly the
S mitis
group, was found in 79% (n=59) of samples. The median relative amount of
Streptococcus
species
DNA
was 5.10‐fold higher compared with the control blood samples from the same patients. All thrombi were negative for both
P gingivalis
and
A actinomycetemcomitans
.
Conclusions
This is the first study showing the common presence of bacterial
DNA
from viridans streptococci in aspired thrombi of patients with acute ischemic stroke. Streptococcal bacteria, mostly of oral origin, may contribute to the progression and thrombotic events of cerebrovascular diseases.
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