Displaying all 11 publications

Abstract:
Sort:
  1. Idris Z, Ghani RI, Musa KI, Ibrahim MI, Abdullah M, Nyi NN, et al.
    Asian J Surg, 2007 Jul;30(3):200-8.
    PMID: 17638640
    To determine whether or not multimodality monitoring technique would result in a better outcome score than single modality monitoring in severely head injured patients.
    Matched MeSH terms: Brain Injuries/physiopathology*
  2. Kumaraswamy N, Naziah A, Abdullah J, Ariff MMed AR, Abdullah MR, Ghazaime G
    J Clin Neurosci, 2002 May;9(3):251-5.
    PMID: 12093129
    Malaysia had the second highest crude accident rate in the world until 1998. Most children who were involved in these road traffic accidents required intensive neurosurgical care management. We report a prospective study on 36 paediatric neurotrauma patients in rural North East West Malaysia who underwent uniform intensive therapy and were subsequently followed up over a period of 2 years. The modified paediatric Glasgow Coma Scale with support of the revised Wechlser Intelligence Scale for children was used to test the outcome of these children over a period of two years. All patients were managed aggressively in our intensive care as well as our high dependency units. Our results indicate that improvement in outcome is seen after a six month period. Midline shift, duration of coma and duration of transport were found to be significant variables associated with bad outcome. Other variables i.e. age, sex, Glasgow Coma Scale on admission and on site, and lesions of the dominant lobe were not found to be associated with good outcome in these patients.
    Matched MeSH terms: Brain Injuries/physiopathology
  3. Lim FT, Ogawa S, Parhar IS
    Brain Res, 2016 11 01;1650:60-72.
    PMID: 27568467 DOI: 10.1016/j.brainres.2016.08.033
    Injury to neuronal tissues in the central nervous system (CNS) of mammals results in neural degeneration and sometime leads to loss of function, whereas fish retain a remarkable potential for neuro-regeneration throughout life. Thus, understanding the mechanism of neuro-regeneration in fish CNS would be useful to improve the poor neuro-regenerative capability in mammals. In the present study, we characterized a neuro-regenerative process in the brain of a cichlid, tilapia, Oreochromis niloticus. Morphological observations showed that the damaged brain region (habenula) successfully regrew and reinnervated axonal projections by 60 days post-damage. A fluorescent carbocyanine tracer, DiI tracing revealed a recovery of the major neuronal projection from the regenerated habenula to the interpenduncular nucleus by 60 days post-damage. TUNEL assay showed a significant increase of apoptotic cells (~234%, P<0.01) at one day post-damage, while the number of bromodeoxyuridine (BrdU)-positive proliferative cells were significantly increased (~92%, P<0.05) at 7 days post-damage compared with sham-control fish. To demonstrate a potential role of apoptotic activity in the neuro-regeneration, effects of degenerative neural tissue on cell proliferation were examined in vivo. Implantation of detached neural but not non-neural tissues into the cranial cavity significantly (P<0.01) increased the number of BrdU-positive cells nearby the implantation regions at 3 days after the implantation. Furthermore, local injection of the protein extract and cerebrospinal fluid collected from injured fish brain significantly induced cell proliferation in the brain. These results suggest that factor(s) derived from apoptotic neural cells may play a critical role in the neuro-regeneration in teleost brain.
    Matched MeSH terms: Brain Injuries/physiopathology
  4. Shadli RM, Pieter MS, Yaacob MJ, Rashid FA
    Brain Inj, 2011;25(6):596-603.
    PMID: 21534737 DOI: 10.3109/02699052.2011.572947
    The influence of apolipoprotein (APOE) on neuropsychological outcome was investigated in 19 patients (25.79 ± 7.22 years) with mild-to-moderate traumatic brain injury and 14 matched healthy control subjects (27.43 ± 6.65 years).
    Matched MeSH terms: Brain Injuries/physiopathology
  5. Liew BS, Johari SA, Nasser AW, Abdullah J
    Med J Malaysia, 2009 Dec;64(4):280-8.
    PMID: 20954551
    Patients with isolated severe head injury with diffuse axonal injury and without any surgical lesion may be treated safely without cerebral resuscitation and intracranial pressure (ICP) monitoring. Seventy two patients were divided into three groups of patients receiving treatment based on ICP-CPP-targeted, or conservative methods either with or without ventilation support. The characteristics of these three groups were compared based on age, gender, Glasgow Coma Scale (GCS), pupillary reaction to light, computerized tomography scanning according to the Marshall classification, duration of intensive care unit (ICU) stays, Glasgow Outcome Score (GOS) and possible complications. There were higher risk of mortality (p < 0.001), worse GCS improvement upon discharge (p < 0.001) and longer ICU stays (p = 0.016) in ICP group compared to Intubation group. There were no significant statistical differences of GOS at 3rd and 6th months between all three groups.
    Matched MeSH terms: Brain Injuries/physiopathology
  6. Kiflie A, Alias NA, Abdul-Kareem MM, Mar W, Abdullah J, Naing NN
    Med J Malaysia, 2006 Oct;61(4):466-73.
    PMID: 17243525 MyJurnal
    A total of 31 adult patients with moderate and severe head injury were assessed clinically on admission for Glasgow Coma Scale (GCS) and short test of mental status (STMS) on follow-up and compared to their initial and follow up CT scan. Good predictors were admission GCS, midline shift, volume of subdural haemorrhage in the initial CT scan of the brain as well as the presence of post-traumatic hydrocephalus, gliosis and site of gliosis in the follow-up CT scan. There was no direct correlation between the significant predictors on the first CT scan and the follow-up CT scan of the brain.
    Matched MeSH terms: Brain Injuries/physiopathology
  7. Kandasamy R, Kanti Pal H, Swamy M, Abdullah J
    Int J Neurosci, 2013 Jun;123(6):385-91.
    PMID: 23270401 DOI: 10.3109/00207454.2012.761983
    Nitric oxide has a definitive role in the complex pathophysiology of traumatc brain injury (TBI). This prospective cohort study investigated the changes in nitric oxide metabolite (NOx) levels in cerebrospinal fluid (CSF) and their correlation with factors associated with severity and prognosis after severe TBI. NOx levels were measured in CSF obtained via ventriculostomy in 44 adult patients admitted after severe TBI (Glasgow Coma Scale ≤ 8/15). The overall mean level of CSF NOx in the study population was 7.40 ± 1.59 μmol/L. Levels of CSF NOx were found to be significantly higher in subgroups of patients with poorer outcome measured by Glasgow Outcome Scale score (p < 0.042), in patients with high intracranial pressure (ICP) readings (p < 0.027) and in those with higher Marshall computed tomography (CT) grading scores (p < 0.026). Simple logistic regression demonstrated that CSF NOx levels were a significant predictor of ICP (b = 0.493, 95%CI: 1.03, 2.58, p = 0.033). A patient with 1 μmol/L increase in NOx level had 1.6 times the odds to have an ICP ≥ 20 mmHg when other confounders were not adjusted. NOx level is also a significant predictor of Marshall CT grading (b = 0.473, 95%CI: 1.02, 2.50, p = 0.037). A patient with 1 μmol/L increase in NOx level had 1.6 times the odds to have a high Marshall grade when other confounders were not adjusted. It can be concluded that CSF NOx levels may serve as a potentially useful biomarker in severe TBI given its significant association with ICP readings as well as Marshall CT grading.
    Matched MeSH terms: Brain Injuries/physiopathology
  8. Estraneo A, Fiorenza S, Magliacano A, Formisano R, Mattia D, Grippo A, et al.
    Neurology, 2020 09 15;95(11):e1488-e1499.
    PMID: 32661102 DOI: 10.1212/WNL.0000000000010254
    OBJECTIVE: This international multicenter, prospective, observational study aimed at identifying predictors of short-term clinical outcome in patients with prolonged disorders of consciousness (DoC) due to acquired severe brain injury.

    METHODS: Patients in vegetative state/unresponsive wakefulness syndrome (VS/UWS) or in minimally conscious state (MCS) were enrolled within 3 months from their brain injury in 12 specialized medical institutions. Demographic, anamnestic, clinical, and neurophysiologic data were collected at study entry. Patients were then followed up for assessing the primary outcome, that is, clinical diagnosis according to standardized criteria at 6 months postinjury.

    RESULTS: We enrolled 147 patients (44 women; mean age 49.4 [95% confidence interval 46.1-52.6] years; VS/UWS 71, MCS 76; traumatic 55, vascular 56, anoxic 36; mean time postinjury 59.6 [55.4-63.6] days). The 6-month follow-up was complete for 143 patients (VS/UWS 70; MCS 73). With respect to study entry, the clinical diagnosis improved in 72 patients (VS/UWS 27; MCS 45). Younger age, shorter time postinjury, higher Coma Recovery Scale-Revised total score, and presence of EEG reactivity to eye opening at study entry predicted better outcome, whereas etiology, clinical diagnosis, Disability Rating Scale score, EEG background activity, acoustic reactivity, and P300 on event-related potentials were not associated with outcome.

    CONCLUSIONS: Multimodal assessment could identify patients with higher likelihood of clinical improvement in order to help clinicians, families, and funding sources with various aspects of decision-making. This multicenter, international study aims to stimulate further research that drives international consensus regarding standardization of prognostic procedures for patients with DoC.

    Matched MeSH terms: Brain Injuries/physiopathology*
  9. Yan EB, Frugier T, Lim CK, Heng B, Sundaram G, Tan M, et al.
    J Neuroinflammation, 2015 May 30;12:110.
    PMID: 26025142 DOI: 10.1186/s12974-015-0328-2
    During inflammation, the kynurenine pathway (KP) metabolises the essential amino acid tryptophan (TRP) potentially contributing to excitotoxicity via the release of quinolinic acid (QUIN) and 3-hydroxykynurenine (3HK). Despite the importance of excitotoxicity in the development of secondary brain damage, investigations on the KP in TBI are scarce. In this study, we comprehensively characterised changes in KP activation by measuring numerous metabolites in cerebrospinal fluid (CSF) from TBI patients and assessing the expression of key KP enzymes in brain tissue from TBI victims. Acute QUIN levels were further correlated with outcome scores to explore its prognostic value in TBI recovery.

    METHODS: Twenty-eight patients with severe TBI (GCS ≤ 8, three patients had initial GCS = 9-10, but rapidly deteriorated to ≤8) were recruited. CSF was collected from admission to day 5 post-injury. TRP, kynurenine (KYN), kynurenic acid (KYNA), QUIN, anthranilic acid (AA) and 3-hydroxyanthranilic acid (3HAA) were measured in CSF. The Glasgow Outcome Scale Extended (GOSE) score was assessed at 6 months post-TBI. Post-mortem brains were obtained from the Australian Neurotrauma Tissue and Fluid Bank and used in qPCR for quantitating expression of KP enzymes (indoleamine 2,3-dioxygenase-1 (IDO1), kynurenase (KYNase), kynurenine amino transferase-II (KAT-II), kynurenine 3-monooxygenase (KMO), 3-hydroxyanthranilic acid oxygenase (3HAO) and quinolinic acid phosphoribosyl transferase (QPRTase) and IDO1 immunohistochemistry.

    RESULTS: In CSF, KYN, KYNA and QUIN were elevated whereas TRP, AA and 3HAA remained unchanged. The ratios of QUIN:KYN, QUIN:KYNA, KYNA:KYN and 3HAA:AA revealed that QUIN levels were significantly higher than KYN and KYNA, supporting increased neurotoxicity. Amplified IDO1 and KYNase mRNA expression was demonstrated on post-mortem brains, and enhanced IDO1 protein coincided with overt tissue damage. QUIN levels in CSF were significantly higher in patients with unfavourable outcome and inversely correlated with GOSE scores.

    CONCLUSION: TBI induced a striking activation of the KP pathway with sustained increase of QUIN. The exceeding production of QUIN together with increased IDO1 activation and mRNA expression in brain-injured areas suggests that TBI selectively induces a robust stimulation of the neurotoxic branch of the KP pathway. QUIN's detrimental roles are supported by its association to adverse outcome potentially becoming an early prognostic factor post-TBI.

    Matched MeSH terms: Brain Injuries/physiopathology
  10. Isa R, Wan Adnan WA, Ghazali G, Idris Z, Ghani AR, Sayuthi S, et al.
    Neurosurg Focus, 2003 Dec 15;15(6):E1.
    PMID: 15305837
    The determination of cerebral perfusion pressure (CPP) is regarded as vital in monitoring patients with severe traumatic brain injury. Besides indicating the status of cerebral blood flow (CBF), it also reveals the status of intracranial pressure (ICP). The abnormal or suboptimal level of CPP is commonly correlated with high values of ICP and therefore with poor patient outcomes. Eighty-two patients were divided into three groups of patients receiving treatment based on CPP and CBF, ICP alone, and conservative methods during two different observation periods. The characteristics of these three groups were compared based on age, sex, time between injury and hospital arrival, Glasgow Coma Scale score, pupillary reaction to light, surgical intervention, and computerized tomography scanning findings according to the Marshall classification system. Only time between injury and arrival (p = 0.001) was statistically significant. There was a statistically significant difference in the proportions of good outcomes between the multimodality group compared with the group of patients that underwent a single intracranial-based monitoring method and the group that received no monitoring (p = 0.003) based on a disability rating scale after a follow up of 12 months. Death was the focus of outcome in this study in which the multimodality approach to monitoring had superior results.
    Matched MeSH terms: Brain Injuries/physiopathology*
  11. Lim FT, Ogawa S, Parhar IS
    J. Chem. Neuroanat., 2016 11;77:176-186.
    PMID: 27427471 DOI: 10.1016/j.jchemneu.2016.07.005
    Sprouty-related protein-2 (Spred-2) is a negative regulator of extracellular signal-regulated kinases (ERK) pathway, which is important for cell proliferation, neuronal differentiation, plasticity and survival. Nevertheless, its general molecular characteristics such as gene expression patterns and potential role in neural repair in the brain remain unknown. Thus, this study aimed to characterise the expression of spred-2 in the zebrafish brain. Digoxigenin-in situ hybridization showed spred-2 mRNA-expressing cells were mainly seen in the proliferative zones such as the olfactory bulb, telencephalon, optic tectum, cerebellum, and the dorsal and ventral hypothalamus, and most of which were neuronal cells. To evaluate the potential role of spred-2 in neuro-regeneration, spred-2 gene expression was examined in the dorsal telencephalon followed by mechanical-lesion. Real-time PCR showed a significant reduction of spred-2 mRNA levels in the telencephalon on 1-day till 2-days post-lesion and gradually increased to normal levels as compared with intact. Furthermore, to confirm involvement of Spred-2 signalling in the cell proliferation after brain injury, double-labelling of spred-2 in-situ hybridization with immunofluorescence of BrdU and phosphorylated-ERK1/2 (p-ERK1/2), a downstream of Spred-2 was performed. Increase of BrdU and p-ERK1/2 immunoreactive cells suggest that a decrease in spred-2 after injury might associated with activation of the ERK pathway to stimulate cell proliferation in the adult zebrafish brain. The present study demonstrates the possible role of Spred-2 signalling in cell proliferative phase during the neural repair in the injured zebrafish brain.
    Matched MeSH terms: Brain Injuries/physiopathology
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links