Posttreatment With High-Dose Albumin Reduces Histopathological Damage and Improves Neurological Dificit Following Fluid percussion Brain Injury in Rats

Belayev, Ludmila,Alonso, Ofelia F.,Huh, Pil-Woo,Zhao, Weizhao,Busto, Raul,Ginsberg, Myron D. 가톨릭대학교 2000 Bulletin of The Catholic Research Institutes of Me Vol.28 No.-

We have recently shown that high-dose human serum albumin (HSA) therapy confers marked histological protection in experimental middle cerebral artery occlusion. Thus, the purpose of this study was to determine whether treatment with high-dose HSA would protect in a rat model of traumatic brain injury (TBI). Twenty-four prior to TBI, the fluid percussion interface was positioned parasagittally over the right cerebral cortex. On the following day, fasted rats were anesthetized with 3% halothane, 70% nitrous oxide, and 30% oxygen and received right parieto-occipital parasagittal fluid-percussion injury (1.5-2.0 atm). Cranial and rectal temperatures were monitored throughout the experiment and held at normothermic levels (36.5-37.5℃) by a warming lamp above the animal's head. The agent (25% human serum albumin, HSA) or vehicle (sodium chloride 0.9%) was administered i.v. (1% of body weight) 15 min after trauma. Behavioral function was evaluated in all rats before and after TBI (at 2 h, 24 h, 48 h, 72 h, and 7days). Neurological function was graded on a scale of 0-12 (normal score = 0; maximal score = 12). Seven days after TBI, brains were perfusion-fixed, coronal sections at various levels were digitized, and contusion areas in the superficial, middle and deep layers of cortex and in the underlying fimbria were measured. HAS significantly improved the neurological score compared to saline at 24 h, 72 h, and 7days after TBI (6.0 ± 0.6 [albumin] versus 8.4 ±0.5 [saline]; 3.67 ±0.7 versus 6.8 ±1.0; and 2.6 ±0.6 versus 5.7 ± 0.8, respectively; p < 0.05). HAS therapy also significantly reduced total contusion area (0.89 ± 0.2 versus 1.82 ±0.3 ㎟; p = 0.02). Our findings document that high-concentration albumin therapy instituted 15 min after trauma significantly improves the neurological score and reduces histological damage. We believe that this pharmacological agent may have promising potential for the clinical treatment of brain injury. (Journal of Neurotrauma 16(6):445-453, 1999)

High-Dose Albumin Therapy Administered Protects Against Both Fluid-Percussion Brain Injury and Global Ischemia in Rats

Ginsberg, Myron D.,Belayev, Ludmila,Alonso, Ofelia F.,Saul, Isabel,Huh, Pil-Woo,Femandez. G.,Zhao, Weizhao,Finotti, Nicoletta,Busto, Raul 가톨릭대학교 2000 Bulletin of The Catholic Research Institutes of Me Vol.28 No.-

Introduction : We have recently shown that high-dose human serum albumin (HAS) therapy confers marked histological protection in experimental middle cerebral artery occlusion. The effects of high-dose HAS therapy on traumatic brain injury and global ischemia have not been assessed. Thus, the purpose of this study was to determine whether treatment with high-dose Has would protect in rat models of traumatic brain injury and global ischemia. Methods : Fluid-percussion traumatic brain injury (TBI): These studies were carried out on 18 fasted male Sprague-Dawley rats, weighing between 310 and 405g. Animals were initially anesthetized with 3% halothane, 70% nitrous oxide and a balance of oxygen and received right parieto-occipital parasagittal fluid-percussion injury (1.5-2.0 atm) as previously described. Cranial temperature was monitored throughout the experiment by a thermistor probe inserted into the left temporalis muscle and held at normothermic levels (36.5-37.5℃) by a warming lamp above the animal's head. Rectal temperature was also monitored and was maintained at 37-38℃ throughout the study. The agent (25% human serum albumin, HSA) or vehicle (sodium chloride 0.9%) was administered i.v. (1% of body weight) 15 min after trauma. Behavioral function was evaluated at all rats before and after TBI (at 2h, 24h. 48h, 72h and 7 days). Neurological function was graded on a scale of 0-12 (normal score = 0, maximal score = 12). Seven days after TBI, brains were perfusion-fixed, coronal sections at various levels were digitized, and contusion areas in superficial, middle and deep layers of cortex and in fimbria were measured. Global cerebral ischemia : Twenty-six fasted Wistar rats underwent bilateral common carotid artery occlusion for 10 min with simultaneous reduction of MABP to 50 mmHg by withdrawal of arterial blood, as previously described. Five min after termination of ischemia, animals were treated the same manner as described above. Neurological function was evaluated before ischemia, as well as 3h, 1, 2, 3 and 7 days after ischemia (normal score=16, maximal deficit=0), as previously described. Seven days after ischemia, brains were perfusion-fixed and ischemic neuronal injury in the hippocampal CA 1 area was assessed quantitatively and graded on a O to 3 scale (O=no damage; 1=minimal; 2=moderate; 3=severe damage). Results : Rectal and cranial (temporalis muscle) temperatures, arterial blood pressure, plasma glucose and blood gases in all animals of this study showed no significant differences between groups. TBI : HSA significantly improved the neurological score compared to saline at 24h after TBI(6.4 ± 0.7 and 8.4 ±0.5, respectively; p=0.03). HSA therapy also significantly reduced total contusion area (Fig. 1). (Data in figures represent mean values ±S.E.M.). Global cerebral ischemia : A significant improvement of neurological deficits by treatment with HSA was observed at 3h, 1, 2, 3 and 7 days after global ischemia (Fig 2). The cumulative histological lesion score for the left and right hippocampi was 2.9 in the saline group and 1.9 in the HSA-treated group (p<00002, Students t-test). Conclusions : Our findings document that high-concentration albumin therapy instituted 15 min after trauma or 5 min after global ischemia significantly improves the neurological score and reduces histological damage. This pharmacological agent has promising potential for the treatment of brain injury. (Journal of Cerebral Blood Flow and Metabolism [Suppl.1]19:S187, 1999)

Clinical outcomes after a new arthroscopic assisted fixation technique of acute acromioclavicular joint dislocation

Pedro Amaro,Luís Pires,Paulo Rego,Raul Alonso 대한정형외과 스포츠의학회 2022 Arthroscopy and Orthopedic Sports Medicine Vol.9 No.2

Background: Multiple surgical techniques have been described for the treatment of unstable acromioclavicular (AC) dislocation injuries. However, consensus on the most adequate procedure is yet to be established. This study aimed to evaluate the clinical and radiological results of a single cohort of patients treated with an arthroscopically assisted endobutton coracoclavicular (CC) reconstruction and AC suture anchor-button internal brace technique. Methods: A total of 15 patients were evaluated with a minimum follow-up of two years. The clinical evaluation comprised a complete physical examination of both shoulders and an assessment of shoulder function scores. Bilateral anteroposterior stress views were obtained before and at the time of the last follow-up for radiological evaluation. Additionally, the CC distance and AC distance were measured on both sides. Results: On average, 94.8 points and 32.6 points were noted in the constant score and the University of California-Los Angeles shoulder scale, respectively. Regarding the constant score, the contralateral side averaged 96 points. This difference was not statistically significant. The average CC difference was reduced from 13 mm preoperatively to 2 mm postoperatively. The average AC difference was reduced from 16 mm preoperatively to 3.5 mm postoperatively. The mean time to return to sport was 3.6 months, and the mean time to return to professional competition was four months. Conclusion: An arthroscopically assisted endobutton CC reconstruction and AC suture anchor-button internal brace technique with excellent functional results and good radiological outcomes having a low complication rate has been reported by this study.