Magnetodendrimers allow endosomal magnetic labeling and in vivo tracking of stem cells.

Magnetic resonance (MR) tracking of magnetically labeled stem and progenitor cells is an emerging technology, leading to an urgent need for magnetic probes that can make cells highly magnetic during their normal expansion in culture. We have developed magnetodendrimers as a versatile class of magnetic tags that can efficiently label mammalian cells, including human neural stem cells (NSCs) and mesenchymal stem cells (MSCs), through a nonspecific membrane adsorption process with subsequent intracellular (non-nuclear) localization in endosomes. The superparamagnetic iron oxide nanocomposites have been optimized to exhibit superior magnetic properties and to induce sufficient MR cell contrast at incubated doses as low as 1 microg iron/ml culture medium. When containing between 9 and 14 pg iron/cell, labeled cells exhibit an ex vivo nuclear magnetic resonance (NMR) relaxation rate (1/T2) as high as 24-39 s-1/mM iron. Labeled cells are unaffected in their viability and proliferating capacity, and labeled human NSCs differentiate normally into neurons. Furthermore, we show here that NSC-derived (and LacZ-transfected), magnetically labeled oligodendroglial progenitors can be readily detected in vivo at least as long as six weeks after transplantation, with an excellent correlation between the obtained MR contrast and staining for beta-galactosidase expression. The availability of magnetodendrimers opens up the possibility of MR tracking of a wide variety of (stem) cell transplants.

Proton magnetic resonance spectroscopic imaging in children with recurrent primary brain tumors.

PURPOSE: Proton magnetic resonance spectroscopic imaging ((1)H-MRSI) is a noninvasive technique for spatial characterization of biochemical markers in tissues. We measured the relative tumor concentrations of these biochemical markers in children with recurrent brain tumors and evaluated their potential prognostic significance. PATIENTS AND METHODS: (1)H-MRSI was performed on 27 children with recurrent primary brain tumors referred to our institution for investigational drug trials. Diagnoses included high-grade glioma (n = 10), brainstem glioma (n = 7), medulloblastoma/peripheral neuroectodermal tumor (n = 6), ependymoma (n = 3), and pineal germinoma (n = 1). (1)H-MRSI was performed on 1. 5-T magnetic resonance imagers before treatment. The concentrations of choline (Cho) and N-acetyl-aspartate (NAA) in the tumor and normal brain were quantified using a multislice multivoxel method, and the maximum Cho:NAA ratio was determined for each patient's tumor. RESULTS: The maximum Cho:NAA ratio ranged from 1.1 to 13.2 (median, 4.5); the Cho:NAA ratio in areas of normal-appearing brain tissue was less than 1.0. The maximum Cho:NAA ratio for each histologic subtype varied considerably; approximately equal numbers of patients within each tumor type had maximum Cho:NAA ratios above and below the median. Patients with a maximum Cho:NAA ratio greater than 4.5 had a median survival of 22 weeks, and all 13 patients died by 63 weeks. Patients with a Cho:NAA ratio less than or equal to 4.5 had a projected survival of more than 50% at 63 weeks. The difference was statistically significant (P =.0067, log-rank test). CONCLUSION: The maximum tumor Cho:NAA ratio seems to be predictive of outcome in children with recurrent primary brain tumors and should be evaluated as a prognostic indicator in newly diagnosed childhood brain tumors.

Basal ganglia iron in tardive dyskinesia: an MRI study.

Alterations in brain iron could play an important role in the development of tardive dyskinesia in patients receiving neuroleptic medication. To test this hypothesis, magnetic resonance imaging scans of the brain were performed on 21 chronic schizophrenic patients. Ten patients met research diagnostic criteria for persistent tardive dyskinesia, and 11 were free of tardive dyskinesia. All patients had received long-term neuroleptic treatment and were on a stable neuroleptic dose for at least 3 months before scanning. The signal intensity of basal ganglia structures was obtained as a quantitative estimate of brain iron content. No difference was found in the signal intensity ratios between the two groups. This suggests that iron deposition in the basal ganglia, at least as assessed by this measure, does not play a role in the pathophysiology of tardive dyskinesia.

Methylprednisolone effect on brain volume and enhancing lesions in MS before and during IFNbeta-1b.

OBJECTIVE: To determine the effect of IV methylprednisolone (IVMP) on brain fraction volume (BFV), contrast-enhancing (CE) lesions, and white matter lesion load (WMLL) in patients with relapsing-remitting MS treated for acute exacerbations. BACKGROUND: MRI metrics of MS disease activity are being used as outcome measures in early phase treatment trials, however the short-term effects of IVMP treatment on cerebral atrophy are unknown. METHODS: Serial monthly MRI were performed in 26 patients enrolled in a baseline vs treatment trial with interferon beta-1b (IFNbeta-1b) who were followed for 3 months before and after IVMP. All 26 patients were evaluated while receiving IFNbeta-1b, and 12 patients were also studied during the baseline stage of the trial (NHx). Acute exacerbations were treated with IVMP (1 g/d) for 3 to 5 days. Precontrast and postcontrast T1-weighted and proton density T2-weighted fast spin-echo images were analyzed. RESULTS: Fifty-six acute exacerbations were evaluated. For the 3 months before IVMP, there was no difference in WMLL or BFV compared to month IVMP was administered. There was a significant decrease in BFV at month 1 after IVMP in the IFNbeta-1b and NHx groups. Compared to the month IVMP was administered, there was a difference in the CE lesions for months -3 and -1 prior (p < 0.039) in NHx patients. Following IVMP, CE lesions decreased (p < 0.0004) for months 1, 2, and 3 in both groups, but there was no effect on WMLL. CONCLUSIONS: BFV and CE lesions were significantly decreased for 1 month (BFV) and 3 months (CE lesions) following IVMP. Therefore, MRI studies should be delayed by probably at least 2 months following IVMP to avoid a possible confounding steroid effect in a clinical trial.

Changes in LH and prolactin in arteriosclerotic femal breeder rats.

Serum levels of LH and prolactin were measured in repeatedly-bred, arteriosclerotic female rats. Serum LH was abnormally decreased on the afternoon of proestrus and estrus. The extent of the depression of circulating LH levels parallels the severity of the arteriosclerosis. Serum prolactin was significantly increased above normal at proestrus, and the degree of prolactin increase was also correlated with the degree of severity of arteriosclerosis. It is suggested that frequent and repeated pregnancies affect the hypothalamic-pituitary-adrenal-gonadal axis leading to hormonal and metabolic imbalance, which may play a causal role in the pathogenesis of the spontaneous arteriosclerosis which appears in repeatedly-bred rats.

Metabolic responses following isoproterenol-induced myocardial infarction in arteriosclerotic breeder vs. non-arteriosclerotic virgin and ovariectomized female rats.

Intact and ovariectomized, non-arteriosclerotic female rats and arteriosclerotic, breeder female rats were subjected to myocardial infarction by the administration of 2 subcutaneous injections, 24 hr apart, of the beta-adrenergic stimulator, isoproterenol. The animals were sacrificed at regular hourly intervals following each injection and then on days 4, 6, 8, 10, 12, and 16 thereafter. Measurement of serum insulin and free fatty acids (FFA) demonstrated a blunted response in these metabolic parameters in the case of the ovariectomized virgin rats. The non-arteriosclerotic, intact virgin rats exhibited dynamic changes in serum insulin, glucose, FFA and corticosterone (Cmpd. B) following both isoproterenol injections, whereas the arteriosclerotic breeder rats manifested elevated levels of these parameters on Day 1, but did not display any increases in serum levels, except for FFA, following the second isoproterenol injection on Day 2. In spite of the hormonal alterations brought about by the gonadectomy and their differing metabolic response, the ovariectomized females did not have a mortality rate significantly different from the intact females. Thus, the presence or absence of ovarian estrogens seemingly does not affect the progress of an isoproterenol-induced myocardial infarction.

Responses of group III and IV muscle afferents to distension of the peripheral vascular bed.

This study was undertaken to test the hypothesis that group III and IV afferents with endings in skeletal muscle signal the distension of the peripheral vascular network. The responses of these slowly conducting afferents to pharmacologically induced vasodilation and to acute obstruction of the venous drainage of the hindlimbs were studied in barbiturate-anesthetized cats. Afferent impulses arising from endings in the triceps surae muscles were recorded from the L(7) and S(1) dorsal roots. Fifteen of the 48 group IV and 3 of the 19 group III afferents tested were stimulated by intra-aortic injections of papaverine (2-2.5 mg/kg). Sixty-two percent of the afferents that responded to papaverine also responded to isoproterenol (50 microg/kg). Seven of the 36 group IV and 2 of the 12 group III afferents tested were excited by acute distension of the hindlimb venous system. Four of the seven group IV afferents responding to venous distension also responded to papaverine (57 vs. 13% for the nonresponding). Finally, we observed that most of the group IV afferents that were excited by dynamic contractions of the triceps surae muscles also responded either to venous distension or to vasodilatory agents. These results are consistent with the histological findings that a large number of group IV endings have their receptive fields close to the venules and suggest that they can be stimulated by the deformation of these vascular structures when peripheral conductance increases. Moreover, such a mechanism offers the possibility of encoding both the effects of muscle contraction through intramuscular pressure changes and the distension of the venular system, thereby monitoring the activity of the veno-muscular pump.

Effect on airway caliber of stimulation of the hypothalamic locomotor region.

Airway dilation is one of the many autonomic responses to exercise. Two neural mechanisms are believed to evoke these responses: central command and the muscle reflex. Previously, we found that activation of central command, evoked by electrical and chemical stimulation of the mesencephalic locomotor region, constricted the airways rather than dilated them. In the present study we examined in decerebrate paralyzed cats the role played by the hypothalamic locomotor region, the activation of which also evokes central command, in causing the airway dilator response to exercise. We found that activation of the hypothalamic locomotor region by electrical and chemical stimuli evoked fictive locomotion and, for the most part, airway constriction. Fictive locomotion also occurred spontaneously, and this too, for the most part, was accompanied by airway constriction. We conclude that central command plays a minor role in the airway dilator response to exercise.

Characterization of differences between multiple sclerosis and normal brain: a global magnetization transfer application.

BACKGROUND AND PURPOSE: Although the exact nature of the physiological differences between normal and multiple sclerosis (MS) brains are unknown, it has been shown that their global magnetization transfer ratio (MTR) values are significantly different. To more fully understand these differences, we examined MTR values by using 30 distinct measures. We provide a unique illustration of these differences through a derived normal-to-MS transform. METHODS: Global MTR values for the group of normal subjects and for the group of MS subjects were characterized by 30 different measures involving simple statistics, histographic characteristics, MTR order information, and MTR range information. The measures that were significantly different with respect to these two groups were discovered. From the mean MTR histogram of the two groups, a transform was created to describe a conversion between the two brain states. Normal data were passed through this transform, creating a set of pseudo-MS data. The measures that were significantly different from the normal and pseudo-MS data were also obtained in order to verify the accuracy of the transform. RESULTS: Seventeen of the 30 measures were determined to be significantly different when comparing the sets of normal and MS data. The same set of 17 measures were found to be significantly different when comparing the normal and pseudo-MS data. CONCLUSION: The differences in the global MTR values of normal and MS subjects are statistically significant compared with a large number of measures (alpha = 0.05). A normal-to-MS transform is a novel method for illustrating these differences.

Serial MR imaging of experimental autoimmune encephalomyelitis induced by human white matter or by chimeric myelin-basic and proteolipid protein in the common marmoset.

BACKGROUND AND PURPOSE: Experimental autoimmune encephalomyelitis (EAE) in the marmoset was monitored by serial MR imaging to determine correlates to the natural-history MR studies in multiple sclerosis (MS). The relationships of MR-revealed lesions to clinical status and histopathologic findings were also explored. METHODS: We induced EAE by subcutaneous inoculation in two marmosets by human white matter (HWM) and in seven marmosets by MP4 (a chimeric recombinant fusion protein of myelin-basic and proteolipid protein) in adjuvant along with intravenous inactivated pertussis vaccine to facilitate the disease process. The HWM-inoculated animals were induced with Freund's adjuvant as the established model of marmoset EAE. The MP4-inoculated animals were induced with either Freund's incomplete adjuvant or TiterMax as part of a preclinical treatment trial. MR imaging was performed at 1.5 T at baseline, and repeated at 1- to 2-week intervals for a period of up to 16 weeks in six EAE-induced marmosets, and intermittently for up to 70 weeks in three EAE-induced and two control marmosets. Proton density- (PD-) and T2-weighted, pre- and postgadopentetate dimeglumine enhancement, T1-weighted, and magnetization transfer (MT) images were obtained. The brains were prepared for histologic evaluation of lesion distribution and counts, characterization of lesions as demyelinating or inflammatory, and histopathologic scoring. The clinical, MR, and pathologic scoring were done on grading systems, and correlated for evaluation. RESULTS: White matter (WM) changes after EAE induction were observed first at 9 days in the HWM-induced animals and at 2.5 weeks in the MP4-induced animals, with subsequent week-to-week fluctuations on PD- and T2-weighted images. Contrast-enhancing lesions were not observed in all animals. MR-revealed WM lesions correlated to histopathologic analysis of EAE lesions, measuring from 0.5 mm to 1.5 mm. The lesion count and extent of demyelination was greater in the HWM-induced animals than in the MP4-induced animals. Some MR-revealed lesions correlated directly to clinical symptoms, but the majority of lesions were clinically silent. CONCLUSION: On MR images, lesions in the EAE marmoset model were confined to the WM, and their development, resolution, distribution, and enhancing characteristics fluctuated over the duration of the study. The dynamic presentation of MR-revealed lesions confirms the parallels between EAE in the marmoset and relapsing-remitting MS. Clinical symptoms alone were not representative of ongoing pathologic brain lesions. Therefore, serial MR imaging serves as a very important adjunct to clinical and histologic surveillance of the development of new and the persistence of existing brain lesions in this animal model of MS.

Are postsynaptic nicotinic end-plate receptors involved in lead toxicity?

The effects of Pb2+ on the postsynaptic nicotinic end-plate receptor were examined in the perfused mouse hemidiaphragm preparation. Postsynaptic nicotinic responses, evoked by pressure ejection of ACh, were blocked by Pb2+ in a transient way. After 9-12 min of exposure to 1 microM Pb2+ the amplitude of the depolarization induced by 1 mM ACh was reduced to 39.5 +/- 11% of the control value. During continued exposure to Pb2+ this blocking effect was reversed and after 30 min of exposure to 1 microM Pb2+ the amplitude of the ACh-induced depolarization had returned to the control value. The amplitude and the frequency of miniature end-plate potentials were not altered in the presence of 1 microM Pb2+. Under voltage clamp conditions the effects of Pb2+ on the ACh-induced inward current were similar to those of Pb2+ on the ACh-induced depolarization. After 12 min of exposure to 1 microM Pb2+ the inward current induced by 1 mM ACh was reduced to 44% of the control value and after 30 min the ACh-induced inward current had recovered to 94% of the control value. It is concluded that, in addition to the generally established mechanism of action of Pb2+ at the muscle end-plate, Pb2+ blocks the postsynaptic nicotinic receptor-mediated response at a relative low concentration. The contribution of these postsynaptic effects to the neurotoxic symptoms of Pb2+ remains to be established.

From the Journals.

Nutritional knowledge of primary health-care workers Autografts for older patients' leg ulcers.

Nutrient intake and the risk of pressure sore development in older patients.

This study explored the possibility of a link between diet prior to admission to hospital and the development of pressure sores in older patients. The intention was to use this information to develop a nutrient prediction score and nutrient risk indicator. Thirty patients over the age of 75, admitted with either a fractured neck of femur or for hip replacement surgery, formed the study population. A Waterlow assessment was completed on admission and each patient answered a specially developed food frequency questionnaire. Patients in both diagnostic groups had Waterlow scores which put them into the high-risk category. A total of 20 pressure sores developed in the two groups of patients during their stay in hospital. Patients admitted for hip replacement had higher nutrient intake values than patients with fractured neck of femur and they also had a higher occurrence of pressure sores. Overall diet for all patients appeared to be adequate; however, the diet of patients with fractured neck of femur was significantly lower in both iron and vitamin C than that of patients having hip replacement surgery. The nutritional assessment tool was not as sensitive as expected and further development and validation are needed. While no firm conclusions can be drawn from this small study, the results do emphasise the importance of adequate diet in elderly patients prior to admission, especially for planned admissions for hip replacement.

From the Journals.

FINDING THE TRUE PREVALENCE OF LEG ULCERS WOUND CARE AND MRSA.

Nutritional intake and wound healing in elderly people.

A review of the role of nutrients in wound healihg and of the methods used to estimate nutritional intake in elderly people.

From the Journals.

LOCAL COMPRESSION AND BLOOD FLOW UNDERNUTRITION OF HOSPITAL PATIENTS.

Serum insulin changes in arteriosclerotic breeder female rats versus non-arteriosclerotic virgin rats.

Immunoreactive serum insulin (IRI), glucose, free fatty acids (FFA), and corticosterone (Cmpd. B) were measured in non-arteriosclerotic virgin versus arteriosclerotic, breeder female rats exhibiting normal 4-day cycles. In the arteriosclerotic breeder females, the normal increase in IRI during proestrus and estrus did not occur. The IRI levels during these times were comparable to the minimal levels found during metestrus in the non-arteriosclerotic virgin rats and were even lower than the IRI levels or ovariectomized rats. Since both young and old non-arteriosclerotic virgin rats had similar IRI patterns, the lack of cyclic insulin change in the arteriosclerotic breeder rats is not considered to be age-related. Instead, these changes are ascribed to hypothalamic-pituitary-adrenal hyperactivity associated with repeated reproductive activity and the development of arteriosclerosis.

Serum prolactin levels in rats following isoproterenol-induced myocardial infarction.

Circulating prolactin levels were monitored in nonarteriosclerotic, arteriosclerotic, and hormonally sterilized male and female Sprague-Dawley rats during the acute necrosis and repair phases of myocardial infarction induced by isoproterenol. Male rats are particularly prone to succumb to acute myocardial ischemia but reduction of androgen levels by neonatal sterilization improved survival considerably. Circulating prolactin levels are greatly increased, particularly in females, during acute myocardial ischemia. Since androgens suppress the hypothalamic center for prolactin release, prolactin levels were delayed and transitory in males. It is suggested that the superior survival of female rats may be related to their greater production of prolactin during acute stages of myocardial ischemia, which would dampen the tachycardia-inducing effects of the potent beta-adrenergic stimulating agent, isoproterenol.

Metabolic response after isoproterenol-induced myocardial infarction in arteriosclerotic breeder vs nonarteriosclerotic virgin intact and gonadectomized male rats.

Male, nonarteriosclerotic (virgin) intact and castrated, Sprague-Dawley rats and male, arteriosclerotic (breeder) rats were subjected to an acute and massive myocardial infarct, by treating them with two large, subcutaneous doses of isoproterenol, spaced 24 hr apart. Serum insulin and glucose rose abruptly after the first injection of isoproterenol, but not after the second injection. Free fatty acids rose, most markedly, in the intact, nonarteriosclerotic rats, less in the arteriosclerotic breeders, and least in the castrates. These changes in free fatty acids coincided with numerical survival, i.e., greatest number of survivors in castrates. The castrated males also manifested the least amount of congestive heart failure and showed the greatest capacity to affect myocardial repair. It is suggested that reduced androgen levels may have an ameliorative effect on the usual pathogenesis of isoproterenol-induced myocardial infarction in rats.