A Clinical Observation of Delayed Neurologic Deterioration Following Carbon Monoxide Poisoning

Some patients with anoxic exposure develop new neurologic deficits after periods of delay when they recover from the initial anoxia. This Delayed Neurologic Deterioration(DND) is most commonly seen following carbon monoxidelf'O) poisoning. This study was done to further describe the clinical features of this interesting but rare entity. We reviewed the records and brain scans of 37 patients who were admitted to Seoul National University Hospital because of DND following CO poisoning during the period January 1980 to December 1986. On reviewing the data, we were able to see certain patterns. Age may be important in the development of DND. Most patients were in their 40's to 60's. Patients with severe CO poisoning may be at higher risk of developing DND. However many patients with DND had brief periods of unconsciousness during acute poisoning. The lucid interval was usually 1-4 weeks. Long lucid interval may predict good prognosis. Global encephalopathy was the most common. Post-CO Parkinsonism was diagnosed in 5. Parkinsonism was part of global encephalopathy. They improved with L-dopa better than with anticholinergics. Low density in the globus pallidus may not be associated with Parkinsonism. Diffuse brain atrophy was the most common radiological finding

Ruthenium anchored on carbon nanotube electrocatalyst for hydrogen production with enhanced Faradaic efficiency

Developing efficient and stable electrocatalysts is crucial for the electrochemical production of pure and clean hydrogen. For practical applications, an economical and facile method of producing catalysts for the hydrogen evolution reaction (HER) is essential. Here, we report ruthenium (Ru) nanoparticles uniformly deposited on multi-walled carbon nanotubes (MWCNTs) as an efficient HER catalyst. The catalyst exhibits the small overpotentials of 13 and 17 mV at a current density of 10 mA cm(-2) in 0.5M aq. H2SO4 and 1.0M aq. KOH, respectively, surpassing the commercial Pt/C (16 mV and 33 mV). Moreover, the catalyst has excellent stability in both media, showing almost "zeroloss" during cycling. In a real device, the catalyst produces 15.4% more hydrogen per power consumed, and shows a higher Faradaic efficiency (92.28%) than the benchmark Pt/C (85.97%). Density functional theory calculations suggest that Ru-C bonding is the most plausible active site for the HER

Dissociating stable nitrogen molecules under mild conditions by cyclic strain engineering

All quiet on the nitrogen front. The dissociation of stable diatomic nitrogen molecules (N-2) is one of the most challenging tasks in the scientific community and currently requires both high pressure and high temperature. Here, we demonstrate that N-2 can be dissociated under mild conditions by cyclic strain engineering. The method can be performed at a critical reaction pressure of less than 1 bar, and the temperature of the reaction container is only 40 degrees C. When graphite was used as a dissociated N* receptor, the normalized loading of N to C reached as high as 16.3 at/at %. Such efficient nitrogen dissociation is induced by the cyclic loading and unloading mechanical strain, which has the effect of altering the binding energy of N, facilitating adsorption in the strain-free stage and desorption in the compressive strain stage. Our finding may lead to opportunities for the direct synthesis of N-containing compounds from N-2

Postreperfusion Blood Pressure Variability After Endovascular Thrombectomy Affects Outcomes in Acute Ischemic Stroke Patients With Poor Collateral Circulation

Background and Purpose: We evaluated the effect of 24 h blood pressure variability (BPV) on clinical outcomes in acute ischemic stroke patients with successful recanalization after endovascular recanalization therapy (ERT).Methods: Patients with anterior circulation occlusion were evaluated if they underwent ERT based on multiphase computed tomography angiography and achieved successful recanalization (≥thrombolysis in cerebral ischemia 2b). Collateral degrees were dichotomized based on the pial arterial filling score, with a score of 0–3 defined as a poor collateral status. BPV parameters include mean, standard deviation, coefficient of variation, and variation independent of the mean (VIM) for systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure, and pulse rate (PR). These parameters were measured for 24 h after ERT and were analyzed according to occlusion sites and stroke mechanisms. Associations of BPV parameters with clinical outcomes were investigated with stratification based on the baseline collateral status.Results: BPV was significantly different according to the occlusion sites and stroke mechanisms, and higher BPV was observed in patients with internal carotid artery occlusion or cardioembolic occlusion. After adjustment for confounders, most BPV parameters remained significant to predict functional outcomes at 3 months in patients with poor collateral circulation. However, no significant association was found between BPV parameters and clinical outcomes in patients with good collateral circulation.Conclusion: Postreperfusion BP management by decreasing BPV may have influence on improving clinical outcome in cases of poor collateral circulation among patients achieving successful recanalization after ERT

Unilateral Trigeminal Mandibular Motor Neuropathy Caused by Tumor in the Foramen Ovale

Pure trigeminal motor neuropathy is characterized by trigeminal motor weakness without signs of trigeminal sensory or other cranial nerve involvement. We describe a 63-year-old woman with progressive weakness and atrophy of the left masticatory muscles. She had no sensory disturbance. The diagnosis of pure trigeminal motor neuropathy was made on the basis of clinical and electrophysiologic studies. Magnetic resonance imaging of the brain revealed enhancement of the enlarged mandibular branch of the trigeminal nerve coursing through the left foramen ovale. Our observations suggest that pure trigeminal motor neuropathy can be induced by a tumor

Rotigotine transdermal system as add-on to oral dopamine agonist in advanced Parkinsons disease: an open-label study

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.Abstract Background Achieving optimal symptom control with minimal side effects is a major goal in clinical practice. Dual-agent dopamine receptor agonist (DA) therapy in Parkinsons disease (PD) may represent a promising approach to treatment, as the combination of different pharmacokinetic/pharmacological profiles may result in a lesser need for high dosages and, accordingly, may be well tolerated. The objective of the current study was to investigate safety and efficacy of rotigotine transdermal system as add-on to oral DA in patients with advanced PD inadequately controlled with levodopa and low-dose oral DA. Methods PD0015 was an open-label, multinational study in patients with advanced-PD and sleep disturbance or early-morning motor impairment. Patients were titrated to optimal dose rotigotine (≤8 mg/24 h) over 1–4 weeks and maintained for 4–7 weeks (8-week treatment). Dosage of levodopa and oral DA (pramipexole ≤1.5 mg/day, ropinirole ≤6.0 mg/day) was stable. Primary variable was Clinical Global Impressions (CGI) item 4: side effects, assessing safety. Other variables included adverse events (AEs), Patient Global Impressions of Change (PGIC), Unified Parkinsons Disease Rating Scale (UPDRS) II and III, Parkinsons Disease Sleep Scale (PDSS-2), Pittsburgh Sleep Quality Index (PSQI), and off time. Results Of 90 patients who received rotigotine, 79 (88%) completed the study; 5 (6%) withdrew due to AEs. Most (83/89; 93%) had a CGI-4 score <3 indicating that rotigotine add-on therapy did not interfere with functioning; 6 (7%) experienced drug-related AEs that interfered with functioning (score ≥3). AEs occurring in ≥5% were application site pruritus (13%), dizziness (10%), orthostatic hypotension (10%), nausea (8%), dyskinesia (8%), and nasopharyngitis (6%). Numerical improvements in motor function (UPDRS III), activities of daily living (UPDRS II), sleep disturbances (PDSS-2, PSQI), and reduction in off time were observed. The majority (71/88; 81%) improved on PGIC. Conclusions Addition of rotigotine transdermal system to low-dose oral DA in patients with advanced-PD was feasible and may be associated with clinical benefit. Trial registration ClinicalTrials.gov identifier NCT01723904 . Trial registration date: November 6, 2012

Transplantation of Neural Stem Cells in Anosmic Mice

ObjectivesTreating olfactory dysfunction is a challenge for physicians. One of the therapeutic options could be transplantation of stem cells. In this study, neural stem cells were transplanted into anosmic mice.MethodsNeural stem cells were generated from the olfactory bulb of green fluorescent protein (GFP)-transgenic C57BL6 mice. Anosmia were induced by injection of intraperitoneal 3-methylindole. The neural stem cells were transplanted transnasally on the next day. The olfactory function was evaluated by a food-finding test once a week. The olfactory neuroepithelium was harvested for histologic examination and protein analysis at 4 weeks.ResultsTwenty-five percent (6/24) of the control mice that were not transplanted with neural stem cells survived at 4 weeks while 67% (8/12) of the transplanted mice survived (P=0.029). The food finding test showed that the transplanted mice resumed finding food at 3 weeks while the control mice resumed finding food at 4 weeks. GFP-positive cells were observed in the olfactory neuroepithelium of the transplanted mice. Western blotting revealed that the olfactory marker protein expression was significantly lower in the control mice than that in the transplanted mice.ConclusionThis study demonstrated that improvement of mouse survival was achieved and recovery of olfactory function was promoted by transnasal transplantation of neural stem cells in the anosmic mouse model. These results indicate that stem cells might be one of the future modalities for treating olfactory impairment