Postoperative Spinal Epidural Hematoma: The Danger Caused by the Misuse of Thrombin-Containing Local Hemostatics

Study DesignRetrospective case-control study.PurposeTo examine the hypothesis that the misuse of thrombin-containing local hemostatics (TCLH) increases the risk of postoperative spinal epidural hematoma (POSEH).Overview of LiteratureMany studies have focused on hypocoagulability as a risk factor for POSEH. However, there are no prior reports on the increased risk of POSEH in hypercoagulable states.MethodsPosterior instrumented lumbar spine surgery cases over 2 consecutive years were divided into two groups: a study group (98 patients in whom TCLH was used) and a control group (176 patients in whom TCLH was not used). The excess TCLH matrix that was not associated with blood clot was not removed from the patients in the study group. The senior author decided whether to use TCLH or not. Suction drains were used in all patients. The demographics, coagulation-related factors, and intraoperative factors of the patients in the two groups were analyzed. The development of POSEH was compared between the two groups.ResultsThe two groups were homogenous in demographics (age and sex), coagulation-related factors (platelet count, prothrombin time, activated partial thromboplastin time, and platelet function analysis), and surgical factors (total blood loss, operation time, blood loss/10 minutes, number of fusion segments, posterolateral fusion/posterior lumbar interbody fusion, and virgin or revision surgery). POSEH developed more frequently in the patients in the study group than in those in the control group (14/98 patients, 14.3% vs. 3/176 patients, 1.7%, respectively; p=0.001; odds ratio, 17.1).ConclusionsTCLH causes blood clot not only at the edge of damaged vessels but also at the site of extravascular blood. Excess TCLH matrix not associated with blood clot at the epidural space can enhance POSEH development because early clotted hematomas do not drain through suction drains

Transcriptional activation of hypoxia-inducible factor-1 (HIF-1) in myeloid cells promotes angiogenesis through VEGF and S100A8

Emerging evidence indicates that myeloid cells are essential for promoting new blood vessel formation by secreting various angiogenic factors. Given that hypoxia-inducible factor (HIF) is a critical regulator for angiogenesis, we questioned whether HIF in myeloid cells also plays a role in promoting angiogenesis. To address this question, we generated a unique strain of myeloid-specific knockout mice targeting HIF pathways using human S100A8 as a myeloid-specific promoter. We observed that mutant mice where HIF-1 is transcriptionally activated in myeloid cells (by deletion of the von Hippel-Lindau gene) resulted in erythema, enhanced neovascularization in matrigel plugs, and increased production of vascular endothelial growth factor (VEGF) in the bone marrow, all of which were completely abrogated by either genetic or pharmacological inactivation of HIF-1. We further found that monocytes were the major effector producing VEGF and S100A8 proteins driving neovascularization in matrigel. Moreover, by using a mouse model of hindlimb ischemia we observed significantly improved blood flow in mice intramuscularly injected with HIF-1-activated monocytes. This study therefore demonstrates that HIF-1 activation in myeloid cells promotes angiogenesis through VEGF and S100A8 and that this may become an attractive therapeutic strategy to treat diseases with vascular defects.X1137Ysciescopu

Interactions of Dopamine D1 and N-methyl-D-Aspartate Receptors are Required for Acute Cocaine-Evoked Nitric Oxide Efflux in the Dorsal Striatum

Alterations in nitric oxide (NO) release in response to psychostimulants in the striatum cause a plastic change contributing to the development and expression of addiction. In this study, regulation of NO efflux evoked by acute cocaine in the dorsal striatum was investigated using real-time detection of NO in vivo. We found that acute systemic injection of cocaine (20 mg/kg) increased NO efflux, which was reduced by the intrastriatal infusion of the dopamine D1 receptor antagonist, SCH23390 (7.5 nmol), and the dopamine D2 receptor agonist, quinpirole (5 nmol). Increased levels of NO efflux by acute cocaine were also reduced by the intrastriatal infusion of the N-methyl-D-aspartate (NMDA) receptor antagonists, MK801 (2 nmol) and AP5 (2 nmol). These findings suggest that interactions of dopamine D1 receptors and NMDA receptors after acute exposure to cocaine participate in the upregulation of NO efflux in the dorsal striatum

Elevated CO2 may alter pheromonal communication in Helicoverpa armigera (Lepidoptera: Noctuidae)

Carbon dioxide (CO2) as a greenhouse gas has been increasing in recent decades. Because an elevated atmospheric CO2 influences insect physiology and behaviour, we hypothesize that pheromone-mediated communication in the moth is affected by an increased CO2 level. We test the behavioural responses of male Helicoverpa armigera to sex pheromone in a wind tunnel, demonstrating a significant reduction of approaching behaviour to the odour source at a high CO2 level (1000ppm). Electroantennogram (EAG) responses of male to the pheromone component are also significantly suppressed in high CO2 environments (600 and 1000ppm), indicating that a high CO2 level inhibits both behavioural and electrophysiological responses of male to the sex pheromone. Interestingly, the EAG response of the whole head preparation of males is influenced more by the elevated CO2 level than that of the antenna-cut preparation. A sequential increase of CO2 levels from an ambient CO2 level also decreases the EAG response of the whole head but not of the labial palp-removed head, implying a potential mediation of labial palp in the head where the CO2 receptor is located. By contrast, sex pheromone production in females reared under or shifted to an elevated CO2 condition is increased, and the putative underlying mechanism for this is discussed. The present study provides an insight into the adaptive strategy of moth pheromone communication in a changing environment

Measurement of pressure distribution inside a cross corrugated heat exchanger using micro-channel pressure tappings

Paper presented at the 9th International Conference on Heat Transfer, Fluid Mechanics and Thermodynamics, Malta, 16-18 July, 2012.This paper suggests a novel method to measure pressure distribution inside a cross corrugated heat exchanger using microchannel pressure tappings. The microchannel embedded corrugated sheet is fabricated. Especially, the hydraulic diameter of the non-circular microchannel is measured. The specially designed pressure chamber is made to control the reference pressure. The pressure response is examined theoretically and experimentally in terms of delay time and peak pressure. The delay time shows linear decreases to the length of the microchannel and the peak pressure also decreases with increasing frequency of reference pressure. The microchannel pressure tapping is applicable to the steady pressure measurement but not to the transient pressure measurement. Finally, 20 corrugated sheets and one microchannel embedded corrugated sheet are stacked to form the cross corrugated heat exchanger. The static and stagnation pressures inside the heat exchanger are measured. The measured friction factor is compared with that in previous reports.dc201

DNA hydrogel delivery vehicle for light-triggered and synergistic cancer therapy

A DNA hydrogel is reported as a delivery vehicle for gold nanorods and doxorubicin. The two photothermal and chemo cancer agents were co-loaded using electrostatic and DNA binding interactions, respectively. Light-triggered and highly synergistic combination cancer therapy was demonstrated in cellular and animal models.open111817sciescopu

Targeting SDF-1/CXCR4 to inhibit tumour vasculature for treatment of glioblastomas

Local recurrence of glioblastomas is a major cause of patient mortality after definitive treatment. This review discusses the roles of the chemokine stromal cell-derived factor-1 and its receptor CXC chemokine receptor 4 (CXCR4) in affecting the sensitivity of glioblastomas to irradiation. Blocking these molecules prevents or delays tumour recurrence after irradiation by inhibiting the recruitment of CD11b+ monocytes/macrophages that participate in revascularising the tumour. We review the literature pertaining to the mechanism by which revascularisation occurs following tumour irradiation using experimental models. Areas of interest and debate in the literature include the process by which endothelial cells die after irradiation and the identity/origin of the cells that reconstitute the tumour blood vessels after injury. Understanding the processes that mediate tumour revascularisation will guide the improvement of clinical strategies for preventing recurrence of glioblastoma after irradiation

Drinking behaviors by stress level in Korean university students

The purposes of this study are to estimate the stress level of university students, and to verify the relationships between stress level and drinking behavior. A questionnaire survey was administered to 430 university students in the Gangwon area in Korea from November 5 to November 28, 2008, and data from 391 students were used for the final statistical analysis. The most stressful factor was "Worry about academic achievements" (2.86 by Likert-type 4 point scale). The subjects were divided into two groups, a low stress group (≤ 65.0) and a high stress group (≥ 66.0), by the mean value (65.1) and median value (66.0) of the stress levels. The drinking frequency was not different between the two stress groups, but the amount of alcohol consumption was significantly different (P < 0.05). The portion of students reporting drinking "7 glasses or over" was higher in the lower stress group than in the higher stress group. In addition, factor 6, "Lack of learning ability", was negatively correlated with drinking frequency and the amount of alcohol consumption (P < 0.05), and factor 3, "Worry about academic achievements", was negatively correlated with the amount of drinking (P < 0.05). The major motive for drinking was "When overjoyed or there is something to celebrate" (2.62), and the main expected effect of drinking was "Drinking enables me to get together with people and shape my sociability" (2.73). The higher stress group showed significantly higher scores on several items in the categories of motives (P < 0.01), negative experience (P < 0.05), and expected effects (P < 0.05) of drinking than the lower stress group. Our results imply that university students at the lower stress level may drink more from social motives in positive drinking environments, while those at the higher stress level may have more problematic-drinking despite their smaller amount of alcohol consumption