Metabolic brain disease
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Metabolic brain disease · Dec 2002
ReviewHypothermia for the management of intracranial hypertension in acute liver failure.
Increased intracranial pressure in patients with acute liver failure (ALF) remains a major immediate cause of mortality. Several studies in animal models of ALF set the stage for the clinical application of moderate hypothermia in man. ⋯ Data from studies in patients undergoing liver transplantation for ALF suggest that increases in intracranial pressure can be prevented during the dissection and reperfusion phases of the operation if the patients are maintained hypothermic during surgery. The present review focuses upon the clinical aspects of using hypothermia as a treatment of increased intracranial pressure in patients with ALF.
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Metabolic brain disease · Mar 1996
ReviewAlterations of thiamine phosphorylation and of thiamine-dependent enzymes in Alzheimer's disease.
There is a growing body of evidence to suggest that thiamine neurochemistry is disrupted in Alzheimer's Disease (AD). Studies in autopsied brain tissue from neuropathologically proven AD patients reveal significantly reduced activities of the thiamine phosphate dephosphorylating enzymes thiamine diphosphatase (TDPase) and thiamine monophosphatase (TMPase) as well as the thiamine diphosphate-dependent enzymes, pyruvate dehydrogenase complex, alpha-ketoglutarate dehydrogenase (alpha KGDH) and transketolase. ⋯ Decreased TDP concentrations and concomitantly increased TMP in autopsied brain tissue from AD patients and in CSF from patients with Dementia of the Alzheimer Type suggests that CNS thiamine phosphorylation-dephosphorylation mechanisms are disrupted in AD. alpha KGDH is a rate-limiting enzyme for cerebral glucose utilization and decreases in its activity are associated with lactic acidosis, cerebral energy failure and neuronal cell loss. Deficiencies of TDP-related metabolic processes could therefore participate in neuronal cell death mechanisms in AD.