A preclinical study of diffusion-weighted MRI contrast as an early indicator of thermal ablation.

PURPOSE: Intraoperative T2 -weighted (T2-w) imaging unreliably captures image contrast specific to thermal ablation after transcranial MR-guided focused ultrasound surgery, impeding dynamic imaging feedback. Using a porcine thalamotomy model, we test the unproven hypothesis that intraoperative DWI can improve dynamic feedback by detecting lesioning within 30 minutes of transcranial MR-guided focused ultrasound surgery. METHODS: Twenty-five thermal lesions were formed in six porcine models using a clinical transcranial MR-guided focused ultrasound surgery system. A novel diffusion-weighted pulse sequence monitored the formation of T2-w and diffusion-weighted lesion contrast after ablation. Using postoperative T2-w contrast to indicate lesioning, apparent intraoperative image contrasts and diffusion coefficients at each lesion site were computed as a function of time after ablation, observed peak temperature, and observed thermal dose. Lesion sizes segmented from imaging and thermometry were compared. Image reviewers estimated the time to emergence of lesion contrast. Intraoperative image contrasts were analyzed using receiver operator curves. RESULTS: On average, the apparent diffusion coefficient at lesioned sites decreased within 5 minutes after ablation relative to control sites. In-plane lesion areas on intraoperative DWI varied from postoperative T2-w MRI and MR thermometry by 9.6±9.7 mm2 and -4.0±7.1 mm2 , respectively. The 0.25, 0.5, and 0.75 quantiles of the earliest times of observed T2-w and diffusion-weighted lesion contrast were 10.7, 21.0, and 27.8 minutes and 3.7, 8.6, and 11.8 minutes, respectively. The T2-w and diffusion-weighted contrasts and apparent diffusion coefficient values produced areas under the receiver operator curve of 0.66, 0.80, and 0.74, respectively. CONCLUSION: Intraoperative DWI can detect MR-guided focused ultrasound surgery lesion formation in the brain within several minutes after treatment.

Modified Nanoemulsions with Iron Oxide for Magnetic Resonance Imaging.

A nanoemulsion (NE) is a surfactant-based, oil-in-water, nanoscale, high-energy emulsion with a mean droplet diameter of 400-600 nm. When mixed with antigen and applied nasally, a NE acts as a mucosal adjuvant and induces mucosal immune responses. One possible mechanism for the adjuvant effect of this material is that it augments antigen uptake and distribution to lymphoid tissues, where the immune response is generated. Biocompatible iron oxide nanoparticles have been used as a unique imaging approach to study the dynamics of cells or molecular migration. To study the uptake of NEs and track them in vivo, iron oxide nanoparticles were synthesized and dispersed in soybean oil to make iron oxide-modified NEs. Our results show that iron oxide nanoparticles can be stabilized in the oil phase of the nanoemulsion at a concentration of 30 µg/µL and the iron oxide-modified NEs have a mean diameter of 521 nm. In vitro experiments demonstrated that iron oxide-modified NEs can affect uptake by TC-1 cells (a murine epithelial cell line) and reduce the intensity of magnetic resonance (MR) images by shortening the T2 time. Most importantly, in vivo studies demonstrated that iron oxide-modified NE could be detected in mouse nasal septum by both transmission electron microscopy and MR imaging. Altogether these experiments demonstrate that iron oxide-modified NE is a unique tool that can be used to study uptake and distribution of NEs after nasal application.

High-throughput 3D spheroid culture and drug testing using a 384 hanging drop array.

Culture of cells as three-dimensional (3D) aggregates can enhance in vitro tests for basic biological research as well as for therapeutics development. Such 3D culture models, however, are often more complicated, cumbersome, and expensive than two-dimensional (2D) cultures. This paper describes a 384-well format hanging drop culture plate that makes spheroid formation, culture, and subsequent drug testing on the obtained 3D cellular constructs as straightforward to perform and adapt to existing high-throughput screening (HTS) instruments as conventional 2D cultures. Using this platform, we show that drugs with different modes of action produce distinct responses in the physiological 3D cell spheroids compared to conventional 2D cell monolayers. Specifically, the anticancer drug 5-fluorouracil (5-FU) has higher anti-proliferative effects on 2D cultures whereas the hypoxia activated drug commonly referred to as tirapazamine (TPZ) are more effective against 3D cultures. The multiplexed 3D hanging drop culture and testing plate provides an efficient way to obtain biological insights that are often lost in 2D platforms.

Gestational diabetes: a review of the treatment options.

More than three decades since the original published description of gestational diabetes mellitus (GDM), no consensus exists regarding its implications or management. Targeting fetal macrosomia as the greatest morbidity, treatment strategies for this pregnancy-induced disease of insulin resistance have largely been modeled from therapies proven successful in pregnant women with type 2 diabetes mellitus. Surrounded by a rapidly expanding array of treatment options for insulin-resistant diabetes, potentially legitimate concerns about teratogenicity and fetal metabolic effects have limited clinical trials of insulin analogs and oral antihyperglycemic agents during pregnancy. So far, only insulin lispro and glyburide (glibenclamide) have been tested prospectively in randomized trials of women with GDM. In limited studies, both of these agents have compared favorably with standard insulin regimens, and neither appear to cause any fetal or neonatal harm. Although acknowledged by the American Diabetes Association (ADA) and the American College of Obstetricians and Gynecologists (ACOG), these seminal studies have not yet prompted a recommendation from either organization on how to utilize insulin analogs or oral antihyperglycemic agents in the treatment of GDM. Although they lack an evidence base for many therapeutic strategies for GDM, the current ADA and ACOG guidelines still provide a reasonable set of treatment recommendations.

Enhanced visual memory during hypnosis as mediated by hypnotic responsiveness and cognitive strategies.

To investigate the hypothesis that hypnosis has an enhancing effect on imagery processing, as mediated by hypnotic responsiveness and cognitive strategies, four experiments compared performance of low and high, or low, medium, and high, hypnotically responsive subjects in waking and hypnosis conditions on a successive visual memory discrimination task that required detecting differences between successively presented picture pairs in which one member of the pair was slightly altered. Consistently, hypnotically responsive individuals showed enhanced performance during hypnosis, whereas nonresponsive ones did not. Hypnotic responsiveness correlated .52 (p less than .001) with enhanced performance during hypnosis, but it was uncorrelated with waking performance (Experiment 3). Reaction time was not affected by hypnosis, although high hypnotizables were faster than lows in their responses (Experiments 1 and 2). Subjects reported enhanced imagery vividness on the self-report Vividness of Visual Imagery Questionnaire during hypnosis. The differential effect between lows and highs was in the anticipated direction but not significant (Experiments 1 and 2). As anticipated, hypnosis had no significant effect on a discrimination task that required determining whether there were differences between pairs of simultaneously presented pictures. Two cognitive strategies that appeared to mediate visual memory performance were reported: (a) detail strategy, which involved the memorization and rehearsal of individual details for memory, and (b) holistic strategy, which involved looking at and remembering the whole picture with accompanying imagery. Both lows and highs reported similar predominantly detail-oriented strategies during waking; only highs shifted to a significantly more holistic strategy during hypnosis. These findings suggest that high hypnotizables have a greater capacity for cognitive flexibility (Batting, 1979) than do lows. Results are discussed in terms of several theoretical approaches: Paivio's (1971) dual-coding theory and Craik and Tulving's (1975) depth of processing theory. Additional discussion is given to the question of whether hypnosis involves a shift in cerebral dominance, as reflected by the cognitive strategy changes and enhanced imagery processing.