Tracking inflammation in the epileptic rat brain by bi-functional fluorescent and magnetic nanoparticles.

Correct localization of epileptic foci can improve surgical outcome in patients with drug-resistant seizures. Our aim was to demonstrate that systemically injected nanoparticles identify activated immune cells, which have been reported to accumulate in epileptogenic brain tissue. Fluorescent and magnetite-labeled nanoparticles were injected intravenously to rats with lithium-pilocarpine-induced chronic epilepsy. Cerebral uptake was studied ex vivo by confocal microscopy and MRI. Cellular uptake and biological effects were characterized in vitro in murine monocytes and microglia cell lines. Microscopy confirmed that the nanoparticles selectively accumulate within myeloid cells in the hippocampus, in association with inflammation. The nanoparticle signal was also detectable by MRI. The in vitro studies demonstrate rapid nanoparticle uptake and good cellular tolerability. We show that nanoparticles can target myeloid cells in epileptogenic brain tissue. This system can contribute to pre-surgical and intra-surgical localization of epileptic foci, and assist in detecting immune system involvement in epilepsy.

Increasing magnetite contents of polymeric magnetic particles dramatically improves labeling of neural stem cell transplant populations.

Safe and efficient delivery of therapeutic cells to sites of injury/disease in the central nervous system is a key goal for the translation of clinical cell transplantation therapies. Recently, 'magnetic cell localization strategies' have emerged as a promising and safe approach for targeted delivery of magnetic particle (MP) labeled stem cells to pathology sites. For neuroregenerative applications, this approach is limited by the lack of available neurocompatible MPs, and low cell labeling achieved in neural stem/precursor populations. We demonstrate that high magnetite content, self-sedimenting polymeric MPs [unfunctionalized poly(lactic acid) coated, without a transfecting component] achieve efficient labeling (≥90%) of primary neural stem cells (NSCs)-a 'hard-to-label' transplant population of major clinical relevance. Our protocols showed high safety with respect to key stem cell regenerative parameters. Critically, labeled cells were effectively localized in an in vitro flow system by magnetic force highlighting the translational potential of the methods used.

Dying Arteriovenous Fistulas - All Is Not Lost Yet!

BACKGROUND: The aim of this study was to see the efficacy of different surgical procedures performed for the salvage of failing arteriovenous fistulas. Study design: Prospective observational study. Study was conducted at Department of Vascular surgery, CMH Rawalpindi from 1st August 2017 to 31st December 2018. METHODS: Those surgical procedures were included which were done for the AVFs that failed to mature due to stealing veins or developed complications like thrombosis, hematoma, pseudo or true aneurysm, steal syndrome, stenosis and venous hypertension. The procedures like stealing vein ligation, hematoma evacuation, thrombectomies, redo-anastomosis, pseudo aneurysm excision, aneurysmorrhaphies, excision of stenotic segment, RUDI for steal syndrome and central veno venous bypasses for central vein occlusion were assessed for their efficacy. RESULTS: Sixty-two patients were included. 21 stealing veins were ligated, 15 for fistula maturation and 6 for venous hypertension. Twelve out of these 15 non-maturing AVFs, matured after ligation of stealing vein (80%). In case of reverse vein ligation for venous hypertension all the 6 patients showed reduction in their limb swelling (100%). Nine thrombectomies were performed, 7 were successful (78%). Nine patients presented with stenosis. In 3 patients with stenosis near the anastomotic site, a proximal AVF was formed. In 2 patients the stenotic segment was excised and end to end anastomosis was done. In 1 patient an interposing vein graft was used. In 3 patients, the flow was redirected to basilic vein. All the patients had patent AVF on follow up (100%). In 8 non-infected pseudo aneurysms, excision and end to end anastomosis was done in 3, aneurysmorrhaphies in 2 and revision of the anastomosis in 3 cases. Seven out of 8 (87.5%) had good patency on follow up. In 7 patients with true aneurysm and 3 with bleeding from needle prick site sinus, aneurysmorrhaphies were performed. Two wound site hematomas were evacuated. Two patients presented with severe limb swelling due to central venous occlusion for whom a veno venous cross over bypass was done with good results. In 1 patient with steal syndrome, RUDI was done with acceptable results. CONCLUSIONS: Failing arteriovenous fistula can be salvaged by a variety of techniques provided that it is picked up in time..

Foam Sclerotherapy: An Emerging, Minimally Invasive And Safe Modality Of Treatment For Varicose Veins.

BACKGROUND: Ultrasound guided foam sclerotherapy is an outdoor, office based and minimally invasive procedure for the treatment of varicose veins. This study was carried out to highlight the potential of foam sclerotherapy as a first line treatment for varicose vein. METHODS: This prospective observational study was conducted at CMH Rawalpindi, form 1 Aug 2017 to 30 Aug 2018The demographic and outcome data of the patients, who underwent ultrasound guided foam sclerotherapy, were collected and analysed. RESULTS: A total of 662 patients and 752 legs were treated with foam sclerotherapy. Four hundred and ten (61.93%) were males and 252 (38.06%) were females. Their ages ranged from 17 to 68 years with the mean age of 43.21 years. Six hundred and sixty-eight (88.82%) legs were having Great Saphenous Vein while 84 (11.17%) legs were having short saphenous vein disease. Maximum legs 256 (34.04%) had C3 disease. single session of Foam sclerotherapy was enough in 511 (67.95%) legs, while 197 (26.19%) legs were treated with two and 44 (5.85%) legs were treated with three sessions of foam sclerotherapy. Percentages of main trunk occlusion were 98.01% at 1 month while 97.39% at 3 months follow up. Only 2 (0.30%) patients had Deep Venous Thrombosis while 3 (0.45%) patients had thrombophlebitis which required surgery. CONCLUSION: Ultrasound Guided Foam sclerotherapy is an OPD based, innovative, minimally invasive and safe method of treatment for varicose veins. In the context of prevalence of varicose vein disease in our community, it relieves the Burdon of operation theatre list and creates the theatre space for vascular surgeon for arterial Surgery.

Magnetic Nanoparticle-Mediated Targeting of Cell Therapy Reduces In-Stent Stenosis in Injured Arteries.

Although drug-eluting stents have dramatically reduced the recurrence of restenosis after vascular interventions, the nonselective antiproliferative drugs released from these devices significantly delay reendothelialization and vascular healing, increasing the risk of short- and long-term stent failure. Efficient repopulation of endothelial cells in the vessel wall following injury may limit complications, such as thrombosis, neoatherosclerosis, and restenosis, through reconstitution of a luminal barrier and cellular secretion of paracrine factors. We assessed the potential of magnetically mediated delivery of endothelial cells (ECs) to inhibit in-stent stenosis induced by mechanical injury in a rat carotid artery stent angioplasty model. ECs loaded with biodegradable superparamagnetic nanoparticles (MNPs) were administered at the distal end of the stented artery and localized to the stent using a brief exposure to a uniform magnetic field. After two months, magnetic localization of ECs demonstrated significant protection from stenosis at the distal part of the stent in the cell therapy group compared to both the proximal part of stent in the cell therapy group and the control (stented, nontreated) group: 1.7-fold (p < 0.001) less reduction in lumen diameter as measured by B-mode and color Doppler ultrasound, 2.3-fold (p < 0.001) less reduction in the ratios of peak systolic velocities as measured by pulsed wave Doppler ultrasound, and 2.1-fold (p < 0.001) attenuation of stenosis as determined through end point morphometric analysis. The study thus demonstrates that magnetically assisted delivery of ECs is a promising strategy for prevention of vessel lumen narrowing after stent angioplasty procedure.