Goreisan Inhibits Upregulation of Aquaporin 4 and Formation of Cerebral Edema in the Rat Model of Juvenile Hypoxic-Ischemic Encephalopathy

Secondary cerebral edema regulation is of prognostic significance in hypoxic-ischemic encephalopathy (HIE), and aquaporin 4 (AQP4) plays an important role in the pathogenesis of cerebral edema. The traditional Japanese herbal medicine Goreisan relieves brain edema in adults; however, its effect and pharmacological mechanism in children are unknown. We investigated the effects of Goreisan on HIE-associated brain edema and AQP4 expression in a juvenile rat model, established by combined occlusion of middle cerebral and common carotid arteries. Magnetic resonance imaging showed that the lesion areas were significantly smaller in the Goreisan- (2 g/kg) treated group than in the nontreated (saline) group at 24 and 48 h postoperatively. AQP4 mRNA levels in the lesion and nonlesion sides were significantly suppressed in the Goreisan group compared with the nontreated group 36 h postoperatively. Western blotting revealed that levels of AQP4 protein were significantly decreased in the Goreisan group compared with the nontreated group in the lesion side 72 h postoperatively, but not at 12 or 36 h. After 14 days, the Goreisan group had a significantly better survival rate. These findings suggest that Goreisan suppresses brain edema in HIE and improves survival in juvenile rats, possibly via regulation of AQP4 expression and function

A peripartum major cerebral infarction in a patient with moyamoya disease following previous bilateral STA-MCA anastomosis: A case report

Background: Although the incidence is rare, patients with moyamoya disease are at risk of stroke during pregnancy. Therefore, there is limited information regarding appropriate peripartum management. Herein, we report a case of major postpartum cerebral infarction in a patient with moyamoya disease, despite previous direct bilateral anastomosis of the superficial temporal artery to the middle cerebral artery (STA-MCA). Case description: The patient was a 32-year-old woman who had undergone direct STA-MCA anastomosis and encephalo-myo-synangiosis in her childhood. This was her second pregnancy. She sustained a major ischemic stroke in the left middle cerebral artery area on postpartum day 3, which resulted in right hemiplegia and aphasia. On magnetic resonance angiography, simultaneous interruption of antegrade flow of the left middle cerebral artery and STA-MCA anastomosis was observed. The patency of these vessels was confirmed before the first pregnancy. The patient’s consciousness was impaired for several days due to edema in the infarct area. However, her condition improved following conservative treatment with osmotic diuretics and antiplatelet therapy; the patient recovered independent gait and her aphasia improved after 5 months of inpatient rehabilitation. Conclusions: Careful monitoring of women with moyamoya disease is recommended during pregnancy and the peripartum period even if direct or indirect anastomosis has been previously performed

Localization of D-β-Aspartyl Residue-Containing Proteins in Various Tissues

Prior to the emergence of life, it is believed that only L-amino acids were selected for formation of protein and that D-amino acids were eliminated on the primitive Earth. Whilst homochirality is essential for life, the occurrence of proteins containing D-β-aspartyl (Asp) residues in various tissues from elderly subjects has been reported recently. Here, we demonstrate the presence of a D-β-Asp-containing protein in the cardiac muscle of heart, blood vessels of the lung, chief cells of the stomach, longitudinal and circular muscle of the stomach, small intestine and large intestine. Since the D-β-Asp residue occurs through a succinimide intermediate, this isomer may potentially be generated in proteins more easily than initially thought. Formation of the D-β-Asp residue in proteins may be related to stress