Document Detail

Ischemic preconditioning to prevent lethal ischemic spinal cord injury in a swine model.
MedLine Citation:
PMID:  18615318     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Paraplegia is a serious complication of thoracic and thoracoabdominal aortic operations and is the result of ischemic spinal cord injury induced by low perfusion pressure during cross-clamping of the aorta. Ischemic preconditioning (IPC) of the heart or brain with reversible sublethal ischemic injury induces resistance to subsequent lethal ischemia. The aim of this study is to investigate whether ischemic tolerance can be induced by IPC of the spinal cord in a swine model. STUDY DESIGN: The animals were randomly divided into three groups: the sham group (n = 3), control group (n = 6) and IPC group (n = 8). In the sham group, we performed a left thoracotomy without any ischemic injury. In the IPC group, the swine received a reversible ischemic spinal cord injury by aortic clamping for 20 min, whereas in the control group, no aortic cross-clamping was performed. Forty-eight hours later, the animals in both the IPC and control groups underwent aortic clamping for 30 min. Neurological examination was done 24 h later, and then the animals were euthanized for histopathology and a malonedialdehyde spectrophotometry assay of the spinal cord tissue. RESULTS: A statistically significant difference in neurological outcome was observed between the control and IPC groups at 24 h after ischemic injury. The incidence of paraplegia and severe paresis was 100% in the control group and 62.5% in the IPC group (p = .028). Between control and IPC groups, there was no statistically significant difference in histopathology and only a borderline statistical difference in the malonedialdehyde assay of the ischemic spinal cord (p = .0745). CONCLUSION: In this study, IPC induced protection against a 30-min ischemic insult of the spinal cord, although complete recovery was not achieved (standing up or walking). We expect that combining this IPC with other existing protective methods might lead to a synergistic effect, which warrants further investigation.
Jeong-Sang Lee; Jong-Myeon Hong; Yong-Joo Kim
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of investigative surgery : the official journal of the Academy of Surgical Research     Volume:  21     ISSN:  1521-0553     ISO Abbreviation:  J Invest Surg     Publication Date:    2008 Jul-Aug
Date Detail:
Created Date:  2008-07-10     Completed Date:  2008-09-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8809255     Medline TA:  J Invest Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  209-14     Citation Subset:  IM    
Department of Thoracic and Cardiovascular Surgery, Seoul National University, Boramae Hospital, Seoul, South Korea.
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MeSH Terms
Disease Models, Animal
Ischemic Preconditioning*
Malondialdehyde / metabolism
Paraplegia / etiology
Spinal Cord / pathology
Spinal Cord Ischemia / complications,  pathology,  prevention & control*
Reg. No./Substance:

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