From 1979 to 1982, 35 samples of cyclic AMP and cyclic GMP in plasma and 16 samples of those in CSF were determined in cases diagnosed as transient ischemic attacks. Among these patients 23 were males and 12 females. The age range was 43-81 years old (average 62.5). 23 cases occurred in the carotid system and 12 cases in the vertebro-basilar system. Method of study was modified Gilman's protein-bound method in group I (24 cases) and radioimmunoassay method in group II (11 cases). The results of studies showed that plasma cAMP level was 40.58±28.86 pM/ml. (control 14.3±0.76) and CSF cAMP was 21.5±19.6 pM/ml. (control 13.0±0.71) in Goup I patients, and plasma cAMP level was 32.31±7.57 pM/ml. (control 23.22±0.51), cGMP level 17.23±4.31 pM/ml. (control 5.90±0.19); CSF level of cAMP was 16.04±2.75 pM/ml. (control 5.88±2.44), cGMP level 12.87±4.25 pM/ml. (control 2.33±1.88) in Group II patients. As compared to the normal control value, it seemed that cAMP and cGMP were significantly increased in plasma of TIA cases, but not so significant in CSF. Follow up studies showed that 4 cases who revealed higher cAMP levels in plasma, developed cerebral infarctions later, and the others usually showed better prognosis.
In 1979, Goldsmith et al, first reported on the topic of “Omental transposition to brain of stroke patients”. Since then, China began top ractise this procedure in many parts of the country. This paper presents 66 cases treated with omentum transplantation collected from nine medical units in this country. Sex : male 55, Female 13. Age ranged from 25 to 68; the duration of illness from 2 months to 5 years. Out of the 66 cases, 62 were studied angiographically before operation, which revealed evidence of internal carotid artery occulusion in 19 cases, internal carotid artery stenosis in 8, middle cerebral artery occlusion in 26, Moyamoya disease in 4, normal findings in 5.
The application of positron emission tomography (PET) to the study of cerebral ischemic disorders allows for the first time to measure at the local level the cerebral metabolic rate of oxygen (CMRO2) and/or the cerebral glucose utilization (CMR Glc), together with cerebral blood flow (CBF). The high incidence and morbidity of stroke and the limitations of animal stroke models appear to amply justify the financial and human investment necessary for this endeavour. PET can theoretically provide clues to a number of yet unanswered questions, such as 1) are there any quantitative patterns of changes in CBF and CMRO2 that can predict final tissue outcome, i.e. structural integrity or necrosis, in acute ischemic stroke? Do these patterns suggest any adapted therapeutic approach to improve the outcome of the tissue otherwise condemned to necrosis? What are the effects of therapy on local CBF and CMRO2 is acute ischemic stroke? Does the circumscribed structural damage induce functional alterations at remote sites, yet structurally intact? What would be the role of such remote functional changes in the clinical symptomatology and the final degree of clinical recovery? Is PET able to demonstrate chronic hemodynamic ischemia and, so, to help in the selection of patients for surgical revascularization procedures, the circulatory and metabolic effects of which could then be locally measured? Could the combined measurement of CMRO2 and CMR Glc determine the conditions of occurrence and prognostic significance of uncoupling of glucose oxidation? Can local tissue pH be measured in cerebral ischemia? We have addressed a number of the above questions in our PET center, using either the oxygen-15 contiunous inhalation technique to measure CBF and CMRO2, or the 18F-Fluoro-2-Deoxy-D-Glucose (FDG) technique (usign the “kinetic” approach) to measure CMR Glc, or both combined techniques; preliminary studies of the cerebral acid-base balance have have used 11C labeled DMO as a pH sentitive tracer. Our main findings can be summariesd as follows :