Alzheimer’s disease (AD) is a most common age-related neurodegenerative disease. AD is characterized by a progressive loss of neurons causing cognitive dysfunction. The cerebellum is closely associated with integration of movement, including motor coordination, control, and equilibrium. In the present study, we evaluated the effect of tread-mill exercise on the survival of Purkinje neurons in relation with reactive astrocyte in the cerebellum using Aβ25–35–induced AD rats. AD was induced by a bilateral intracerebroventricular (ICV) injection of Aβ25–35. The rats in the exercise groups were forced to run on a motorized treadmill for 30 min once a day for 4 weeks, starting 2 days after Aβ25–35 injection. In the present results, ICV injection of Aβ25–35 deteriorated motor coordination and balance. The number of calbindin-positive cells in the cerebellar vermis was decreased and glial fibrillary acidic protein (GFAP) expression in the cerebellar vermis was increased in the Aβ25–35-induced AD rats. Treadmill exercise improved motor coordination and balance. Treadmill exercise increased the number of Purkinje neurons and suppressed GFAP expression in the cerebellar vermis. The present study demonstrated that treadmill exercises alleviated dysfunction of motor coordination and balance by reduction of Purkinje cell loss through suppressing reactive astrocytes in the cerebellum of AD rats. The present study provides the possibility that treadmill exercise might be an important therapeutic strategy for the symptom improvement of AD patients.

Acute coronary artery obstruction is a rare but potentially fatal complication of aortic valve replacement (AVR) surgery [1,2]. This adverse event can be induced by sudden coronary spasm, embolization of calcium plaque on the coronary arterial walls or aortic root, or intraoperative iatrogenic events [3].We present the near-fatal case of a patient who experienced a significant left main coronary ostial obstruction immediately after weaning from cardiopulmonary bypass (CPB). In the case presented here, early detection of regional wall motion abnormalities (RWMAs) in the left coronary arterial territory using intraoperative transesophageal echocardiography (TEE) prevented delayed diagnosis and poor outcome. CASE REPoRTA 60-year-old woman was referred to our hospital with dys- Acute coronary artery obstruction is a rare but fatal complication of surgical aortic valve replacement (AVR). Sudden coronary spasm, embolization of calcium plaque, and surgical factors can induce acute coronary syndrome after AVR. Here, we report a case of left main coronary ostial obstruction that occurred immediately after weaning from cardiopulmonary bypass. This case highlights the importance of coronary ostial flow patency and assessment of regional wall motion abnormalities with intraoperative transesophageal echocardiography in AVR.

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Background Although serum creatinine concentration has been traditionally used as an index of renal function in clinical practice, it is considered relatively inaccurate, especially in patients with mild renal dysfunction. This study investigated the usefulness of preoperative estimated glomerular filtration rate (eGFR) in predicting complications after cardiovascular surgery in patients with normal serum creatinine concentrations. Methods This study included 2208 adults undergoing elective cardiovascular surgery. Preoperative eGFR was calculated using Chronic Kidney Disease Epidemiology Collaboration equations. The relationships between preoperative eGFR and 90 day postoperative composite major complications were analyzed, including 90 day all-cause mortality, major adverse cardiac and cerebrovascular events, severe acute kidney injury, respiratory and gastrointestinal complications, wound infection, sepsis, and multi-organ failure. Results Of the 2208 included patients, 185 (8.4%) had preoperative eGFR < 60 mL/min/1.73 m 2 and 328 (14.9%) experienced postoperative major complications. Multivariable logistic regression analyses showed that preoperatively decreased eGFR was independently associated with an increased risk of composite 90 day major postoperative complications (adjusted odds ratio: 1.232; 95% confidence interval [CI]: 1.148–1.322; P <  0.001). eGFR was a better discriminator of composite 90 day major postoperative complications than serum creatinine, with estimated c-statistics of 0.724 (95% CI: 0.694–0.754) for eGFR and 0.712 (95% CI: 0.680–0.744) for serum creatinine ( P = 0.008). Conclusions Decreased eGFR was significantly associated with an increased risk of major complications after cardiovascular surgery in patients with preoperatively normal serum creatinine concentrations. Electronic supplementary material The online version of this article (10.1186/s12871-019-0763-1) contains supplementary material, which is available to authorized users.