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Implications of cerebral autoregulation as an early predictor in rat model with post-cardiac arrest brain injury

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dc.contributor.advisor홍, 지만-
dc.contributor.author최, 은실-
dc.date.accessioned2023-11-16T05:43:54Z-
dc.date.available2023-11-16T05:43:54Z-
dc.date.issued2023-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/26835-
dc.language.isoen-
dc.titleImplications of cerebral autoregulation as an early predictor in rat model with post-cardiac arrest brain injury-
dc.title.alternative심정지 후 뇌 손상을 수반하는 쥐 모델에서 초기 예측인자로서 대뇌 자동조절의 의미-
dc.typeThesis-
dc.identifier.urlhttp://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000032470-
dc.subject.keywordpost-cardiac arrest brain injury-
dc.subject.keywordglobal cerebral ischemia-
dc.subject.keywordprognosis-
dc.subject.keywordcerebral autoregulation-
dc.subject.keywordendothelial dysfunction-
dc.subject.keyword심정지 후 뇌손상-
dc.subject.keyword전 지구적 뇌허혈-
dc.subject.keyword예후-
dc.subject.keyword대뇌자동조절능-
dc.subject.keyword내피기능장애-
dc.description.degreeDoctor-
dc.contributor.department대학원 의생명과학과-
dc.contributor.affiliatedAuthor최, 은실-
dc.date.awarded2023-
dc.type.localTheses-
dc.citation.date2023-
dc.embargo.liftdate9999-12-31-
dc.embargo.terms9999-12-31-
dc.description.tableOfContentsⅠ. INTRODUCTION 1

A. Cardiac arrest 1

1. Clinical significance of cardiac arrest 1

2. Current treatments for cardiac arrest: Targeted temperature management 2

B. Post-cardiac arrest brain injury 3

1. Epidemiology and clinical symptoms of post-cardiac arrest syndrome 3

2. Pathophysiology of post-cardiac arrest brain injury 4

3. Current animal model of PCABI 5

C. Current prognosis methods following cardiac arrest 5

1. Prognosis methods 6

2. Prognosis methods: clinical examination, brainstem reflexes 7

3. Prognosis methods: electrophysiology 8

4. Prognosis methods: biochemical markers 10

5. Prognosis methods: neuroimaging 10

D. A new perspective on prognostic evaluation: cerebral autoregulation 11

1. Cerebral autoregulation 11

2. Clinical evidence for cerebral autoregulation in acute brain injury 13

3. Acetazolamide as a vasodilatory stimulus 14

4. Impairment mechanism of cerebral autoregulation 15

E. Aims of this study 16

Ⅱ. MATERIALS AND METHODS 17

A. Ethics statement 17

B. Animal and general procedures 17

C. Animal models 18

D. Targeted Temperature Management (TTM) 21

E. Neurological behavior test 23

F. In vivo brain imaging 23

1. Cerebral autoregulation 23

2. MRI 24

G. Tissue sampling and region of interest 24

H. Immunohistochemistry 25

I. Cresyl violet staining 26

J. Western blot 26

K. RT-PCR 27

L. ELISA 28

M. Electrophysiology 28

N. Pupillary light reflex (PLR) 29

O. Human subjects 30

P. Statistical analysis 31

Ⅲ. RESULTS 36

PART Ⅰ. A novel global ischemia-reperfusion model simulating post-cardiac arrest brain injury 36

1. Establishment of a global ischemia-reperfusion model 36

2. Aggravated neurological function and brain damage in the chimeric model 43

PART Ⅱ. Implications of cerebral autoregulation as an early predictor in rat models with post-cardiac arrest brain injury 48

1. Pupil light reflex test as a prognostic factor in a global ischemia-reperfusion model 48

2. Electrophysiological examination as a prognostic factor in a chimeric model 50

3. Cerebral autoregulation as a prognostic factor in various ischemia-reperfusion rat models 55

PART Ⅲ. Expression of factors associated with cerebral autoregulation in sham and chimeric models 62

1. Correlation of cerebral autoregulation and inflammatory, blood-brain barrier (BBB) factor expression in sham and chimeric groups 62

2. Comparison of DDAH/ADMA/NO pathway in the sham and chimeric models 65

PART Ⅳ. Neuroprotective effect of targeted temperature management (TTM) in ischemia-reperfusion models 69

1. The effect of cell viability and inflammation in global ischemia-reperfusion model with TTM procedure 69

2. Changes in cerebral autoregulation patterns and related factors according to targeted temperature management 75

Ⅳ. DISCUSSION 83

Ⅴ. CONCLUSION 93

REFERENCES 94

국문요약 111		-
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