A5052248745- Traumatic Brain Injury and Neurovascular Disturbances
- Intracranial Aneurysms: Treatment and Complications
- Anesthesia and Neurotoxicity Research
- Neurosurgical Procedures and Complications
- Anesthesia and Pain Management
- Intensive Care Unit Cognitive Disorders
- Photoacoustic and Ultrasonic Imaging
- Cerebrospinal fluid and hydrocephalus
- Neuroinflammation and Neurodegeneration Mechanisms
- Intracerebral and Subarachnoid Hemorrhage Research
- Anesthesia and Sedative Agents
- Ultrasound and Hyperthermia Applications
- Acute Ischemic Stroke Management
- Neurogenetic and Muscular Disorders Research
- Hemodynamic Monitoring and Therapy
- Thermal Regulation in Medicine
- Spinal Cord Injury Research
- Cerebrovascular and Carotid Artery Diseases
- Respiratory Support and Mechanisms
- S100 Proteins and Annexins
- Cardiac, Anesthesia and Surgical Outcomes
- Cardiac Arrest and Resuscitation
- Pediatric Pain Management Techniques
- Intraoperative Neuromonitoring and Anesthetic Effects
- Ultrasound Imaging and Elastography
Washington University in St. Louis
2016-2025
Neurological Surgery
2017-2024
Beijing Tian Tan Hospital
2023
Capital Medical University
2023
Harborview Medical Center
2022
Seattle University
2022
University of Washington
2022
Pain and Rehabilitation Medicine
2017
Harvard University
2011-2016
Boston Children's Hospital
2011-2016
To describe the perioperative medical care, anesthetic considerations, and risk of postanesthetic respiratory failure in patients with pediatric spinal muscular atrophy (SMA).There is a retrospective chart review carried out at an urban, tertiary care hospital. All ICD-9 codes corresponding to SMA diagnoses were identified, records screened for management. Medical reviewed demographic, clinical, outcome data.Twenty-five children (10 type I, 8 II, 7 III) accounted 56 general regional cases....
Sonobiopsy is an emerging technology that combines focused ultrasound (FUS) with microbubbles to enrich circulating brain disease-specific biomarkers for noninvasive molecular diagnosis of diseases. Here, we report the first-in-human prospective trial sonobiopsy in high-grade glioma patients evaluate its feasibility and safety enriching plasma tumor biomarkers. A nimble FUS device integrated a clinical neuronavigation system was used perform following established workflow neuronavigation....
Ketamine induces neuroapoptosis in neonatal rodents. However, these experimental paradigms were performed without concurrent noxious stimulation, a condition that does not reflect the interaction of anesthesia and surgical stimulation. Noxious stimulation with analgesic drugs has been shown to have divergent patterns neuronal activation cell death. We hypothesized would attenuate ketamine-induced caspase-3 activation.Postnatal day 7 Sprague-Dawley rat pups randomized 6-h exposure ketamine...
Background and objective While several experimental studies have demonstrated the neuroprotective role of volatile anesthetics after spinal cord injury (SCI), impact on improving neurologic outcomes in cord-injured patients is not known. Hence, this study aimed to examine functional chronic cervical SCI undergoing peripheral nerve transfer procedures. Methods We conducted a retrospective analysis involving adult with upper extremity paralysis procedures between September 1, 2015, January 31,...
Clinical observation suggests that the number of serious epidural catheter-associated infections have increased recently in children. This increase is likely attributed to an reporting and frequency analgesia usage. Estimates infection rates are difficult determine primarily because insufficient study large pediatric populations. In this retrospective study, authors investigated incidence soft tissue after use continuous spanning 17 yr. A total 10,653 catheters were used 7,792 The majority...
Previous studies in infant rats and case-control of human infants undergoing surgery have raised concerns about potential neurodevelopmental toxicities general anesthesia. Spinal anesthesia is an alternative to for some surgeries. To test toxicity, a spinal model was developed.Rats postnatal ages 7, 14, 21 days were assigned no treatment, 1% isoflurane either 1 h or 6 h, lumbar injection saline bupivacaine at doses 3.75 mg/kg (low dose) 7.5 (high dose). Subgroups animals underwent...
Currently available local anesthetics have analgesic durations in humans generally less than 12 hours. Prolonged-duration will be useful for postoperative analgesia. Previous studies showed that rats, combinations of tetrodotoxin (TTX) with bupivacaine had supra-additive effects on sciatic block durations. In those studies, epinephrine combined TTX prolonged blocks more 10-fold, while reducing systemic toxicity. TTX, formulated as Tectin, is phase III clinical trials an injectable chronic...
Altered patterns of genetic expression induced by isoflurane preconditioning in mouse brain have not yet been investigated. The aim our pilot study is to examine the temporal sequence changes transcriptome cortex produced preconditioning.
Focused ultrasound (FUS) combined with microbubbles is a promising technique for noninvasive, reversible, and spatially targeted blood-brain barrier opening, clinical trials currently ongoing. Despite the fast development of this technology, there lack established quality assurance (QA) strategies to ensure procedure consistency safety. To address challenge, study presents evaluation passive acoustic detection-based QA protocol FUS-induced opening (FUS-BBBO) procedure.
The choice of anesthetic technique, general anesthesia (GA) versus Monitored Anesthesia Care, may impact the outcome patients undergoing endovascular treatment acute ischemic stroke (AIS). aim this study was to identify factors associated with good discharge in receiving GA for AIS.Electronic medical records above 18 years old who underwent AIS under at a Comprehensive Stroke Center from 2010 2014 were reviewed. Good defined as modified Rankin Score 0 2 and poor 3 6; logistic regression...
Delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (SAH) is characterized by large-artery vasospasm, distal autoregulatory dysfunction, cortical spreading depression, and microvessel thrombi. Large-artery vasospasm has been identified as an independent predictor of poor outcome in numerous studies. Recently, several animal studies have a strong protective role for inhalational anesthetics against secondary brain injury SAH including DCI-a phenomenon referred to...
Delayed cerebral ischemia (DCI) is the largest treatable cause of poor outcome after aneurysmal subarachnoid hemorrhage (SAH). Nuclear Factor Kappa-light-chain-enhancer Activated B cells (NF-kB), a transcription factor known to function as pivotal mediator inflammation, upregulated in SAH and pathologically associated with vasospasm. We previously showed that brief exposure isoflurane, an inhalational anesthetic, provided multifaceted protection against DCI SAH. The aim our current study...
Background: Placement of a cuffed endotracheal tube for the administration general anesthesia is routine. The cuff inflated with air to achieve an adequate seal prevent micro-aspiration. Over inflation can decrease mucosal perfusion, leading pressure necrosis and nerve palsies. Inadequate lead micro aspiration. So has be monitored kept within prescribed limits 20-30 cms water.Aim Study: To observe effect different positions on in patients undergoing neurosurgical procedures.Materials...
Abstract Objective Delayed cerebral ischemia ( DCI ) is an independent risk factor for poor outcome after aneurysmal subarachnoid hemorrhage SAH and multifactorial in etiology. While prior studies have suggested a role matrix metalloproteinase‐9 MMP ‐9) early brain injury , its contribution to the pathophysiology of unclear. Methods In first experiment, wild‐type WT ‐9 −/− mice were subjected sham or endovascular perforation surgery. separate experiments, administered vehicle minocycline...
Early brain injury may be a more significant contributor to poor outcome after aneurysmal subarachnoid hemorrhage (aSAH) than vasospasm and delayed cerebral ischemia. However, studying this process has been hampered by lack of means quantifying the spectrum injury. Global edema (GCE) is most widely accepted manifestation early but currently assessed only through subjective, qualitative or semi-quantitative means. Selective sulcal volume (SSV), CSF above lateral ventricles, proposed as...
Introduction Anesthetic conditioning has been shown to provide neuroprotection in several neurological disorders. Whether anesthetic provides protection against peripheral nerve injuries remains unknown. The aim of our current study is investigate the impact isoflurane on functional outcomes after injury (PNI) a rodent sciatic model. Methods Adult male Lewis rats underwent cut and repair exposed none (Group 1, sham), single exposure 2), three-time 3), six-time 4). Isoflurane was established...
Delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (SAH) has been identified as an independent predictor of poor outcome in numerous studies.To investigate the potential protective role inhalational anesthetics against angiographic vasospasm, DCI, and neurologic SAH patients.After Institutional Review Board approval, data were collected retrospectively for patients who received general anesthesia aneurysm repair between January 1st, 2010 May 31st, 2018. Primary outcomes...
Background Delayed cerebral ischemia remains a common and profound risk factor for poor outcome after subarachnoid hemorrhage (SAH). The aim of our current study is to define the role endothelial nitric oxide synthase (eNOS) in isoflurane conditioning‐induced neurovascular protection SAH. Methods Results Ten‐ 14‐week‐old male wild‐type mice (C57BL/6) as controls eNOS knockout (strain # 002684) were obtained study. Animals underwent either sham surgery, SAH or with conditioning. Anesthetic...
Background Recent evidence implicates inflammation as a key driver in delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage (SAH). Inducible nitric oxide synthase (iNOS) is one of the known major mediators inflammation. We previously showed that an inhalational anesthetic, isoflurane, provides strong protection against SAH. Our current study aims to define role iNOS isoflurane conditioning-induced mouse model Methods and Results The experiments used 10- 14-week-old male...
Importance Telemedicine for clinical decision support has been adopted in many health care settings, but its utility improving intraoperative not assessed. Objective To pilot the implementation of a real-time telemedicine program and evaluate whether it reduces postoperative hypothermia hyperglycemia as well other quality measures. Design, Setting, Participants This single-center randomized trial (Anesthesiology Control Tower–Feedback Alerts to Supplement Treatments [ACTFAST-3]) was...
We recently reported that isoflurane conditioning provided multifaceted protection against subarachnoid hemorrhage (SAH)-induced delayed cerebral ischemia (DCI), and this was through the upregulation of endothelial nitric oxide synthase (eNOS). SIRT1, an NAD-dependent deacetylase, shown to be one critical regulators eNOS. The aim our current study is examine role SIRT1 in conditioning-induced neurovascular SAH-induced DCI. Mice were divided into four groups: sham, SAH, or SAH with (with...