Cerebral tumor necrosis factor α expression and long-term neurocognitive performance after cardiopulmonary bypass in rats Bettina Jungwirth, MD, Kristine.

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Cerebral tumor necrosis factor α expression and long-term neurocognitive performance after cardiopulmonary bypass in rats Bettina Jungwirth, MD, Kristine Kellermann, DVM, Ma Qing, MD, G. Burkhard Mackensen, MD, Manfred Blobner, MD, Eberhard F. Kochs, MD The Journal of Thoracic and Cardiovascular Surgery Volume 138, Issue 4, Pages 1002-1007 (October 2009) DOI: 10.1016/j.jtcvs.2009.06.022 Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Diagram of the experimental design. Three groups were studied: the cardiopulmonary bypass (CPB) group, the sham-operated group, and the control group. Short-term groups survived 4 hours, whereas long-term groups survived 10 days. End points were as follows: polymerase chain reaction (PCR), immunohistochemistry (IHC), hematoxylin and eosin staining (HE), and, in the long-term groups, results of the modified hole-board test (mHBT). The Journal of Thoracic and Cardiovascular Surgery 2009 138, 1002-1007DOI: (10.1016/j.jtcvs.2009.06.022) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Immunohistochemistry of coronal brain sections 4 hours and 10 days after cardiopulmonary bypass (CPB) and the sham operation (Sham). The number of tumor necrosis factor α (TNF-α)–positive neurons (A) and astrocytes (B) in the hippocampus is increased in all 4 groups compared with that seen in untreated control animals (∗P < .05 vs untreated control group). The dashed line marks the upper 95% confidence interval of the untreated control animals. The Journal of Thoracic and Cardiovascular Surgery 2009 138, 1002-1007DOI: (10.1016/j.jtcvs.2009.06.022) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Tumor necrosis factor α (TNF-α) mRNA expression in the brain 4 hours after cardiopulmonary bypass (CPB) and the sham operation compared with that seen in control animals. TNF-α mRNA/β-actin mRNA ratios were increased after both CPB and the sham operation, with higher expression in the CPB group. ∗P < .05 vs untreated control animals; §P < .05 versus the sham group. The Journal of Thoracic and Cardiovascular Surgery 2009 138, 1002-1007DOI: (10.1016/j.jtcvs.2009.06.022) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Neurocognitive function of rats at various times before and after cardiopulmonary bypass (CPB) and the sham operation. Overall cognitive performance (time needed to complete the test; A) was impaired on the first 4 postoperative days after CPB and the sham operation (P < .05) but improved over time and reached baseline values on postoperative day 6 (P < .05). Visuospatial long-term memory (number of wrong choices; B) was comparable among groups (P > .05). Visuospatial short-term memory (number of repeated choices; C) was comparable among groups (P > .05). OP, Operation. The Journal of Thoracic and Cardiovascular Surgery 2009 138, 1002-1007DOI: (10.1016/j.jtcvs.2009.06.022) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions