Background and Purpose-Perihematomal edema contributes to secondary brain injury in intracerebral hemorrhage (ICH). Increase of matrix metalloproteinases (MMPs) and growth factors is considerably involved in blood-brain barrier disruption and neuronal cell death in ICH models. We therefore hypothesized that increased levels of these molecular markers are associated with perihematomal edema and clinical outcome in ICH patients. Methods-Fifty-nine patients with spontaneous ICH admitted within 24 hours of symptom onset were prospectively investigated. Noncontrast CT was performed on admission for diagnosis of ICH and quantification of initial hematoma volume. MRI was performed on day 3 to evaluate perihematomal edema. Concentrations of MMP-3, MMP-9, as well as vascular endothelial growth factor and angiopoietin-1 on admission were determined by enzyme-linked immunosorbent assays. Clinical outcome was assessed by modified Rankin Scale at 90 days. Results-Increased MMP-3 levels were independently associated with perihematomal edema volume (P<0.05). Cytotoxic edema surrounding the hematoma was seen in 36 (61%) cases on 3-day MRI. Cytotoxic edema did not correlate with the level of any of the biomarkers studied. Levels of MMP-3 ≥12.4 ng/mL and MMP-9 ≥192.4 ng/mL but not vascular endothelial growth factor and angiopoietin-1 predicted poor clinical outcome at 90 days (modified Rankin Scale >3) independent of stroke severity and hematoma volume at baseline (odds ratio, 25.3, P=0.035; odds ratio, 68.9, P=0.023; respectively). Conclusions-MMPs 3 and 9 seem to be significantly involved in secondary brain injury and outcome after primary ICH in humans, and thus should be further evaluated as targets for therapeutic strategies in this devastating disorder. (Stroke. 2013;44:658-663.)

The nonadiabatic dynamics of keto isocytosine in the gas phase has been investigated using the on-the-fly trajectory surface hopping method based on two electronic-structure methods: SA-CASSCF and ADC(2). The results estimate an excited-state lifetime of around 1000 fs at the SA-CASSCF level, while a much shorter lifetime of 250-350 fs is obtained at the ADC(2) level. Although three conical intersections (CIs) (Ethyl. I, Ethyl. II and C[double bond, length as m-dash]O stretching) are relevant to the nonadiabatic decay of keto isocytosine, their contributions to the nonadiabatic decay are highly dependent on the electronic-structure methods employed in the dynamics simulation. The Ethyl. II CI is the main channel in the dynamics simulations at the SA-CASSCF level, while the C[double bond, length as m-dash]O stretching CI becomes dominant at the ADC(2) levels. Other high-level electronic-structure methods (MR-CISD and MS-CASPT2) are involved to benchmark our dynamics results. Through the analysis of the reaction pathways from the ground state minimum to the relevant CIs, we expect that the excited-state dynamical features obtained at the MR-CISD and MS-CASPT2 levels should be very similar to those at the SA-CASSCF level. The comparison of results obtained using different excited-state electronic-structure methods could provide guidance for further studies of similar systems.