Trace element concentration in human brain. Activation analysis of cobalt, iron, rubidium, selenium, zinc, chromium, silver, cesium, antimony and scandium

MR signal intensity of the perirolandic cortex in the neonate and infant

Our purpose was the study the magnetic resonance (MR) signal intensity of the perirolandic gyri perinatally and to correlate it with the histological findings in formalin-fixed brains, focusing on myelination. MRI of 20 neurologically normal neonates and infants, of 37-64 weeks postconception (PCA), were studied retrospectively. We reviewed four formalin-fixed brains of infants 37-46 weeks PCA microscopically. The posterior cortex of the precentral gyrus (P-PRE) and the anterior cortex of the postcentral gyrus (A-PST) had different signal intensity from the adjacent surrounding cortex. On T1-weighted images P-PRE and A-PST gave higher signal 41-44 weeks PCA; on T2-weighted images, they gave lower signal 37-51 weeks PCA. Histological examination revealed very little myelination of the nerve fibres within both the P-PRE and the A-PST, while considerable myelination was present in the internal capsule and central corona radiata. The changes in signal intensity in the perirolandic gyri may reflect not only the degree of myelination but also the more advanced development of the nerve cells, associated with rapid proliferation and formation of oligodendroglial cells, synapses and dendrites. They could be another important landmark for brain maturation.

Determination of selenium in the human brain by graphite furnace atomic absorption spectrometry

For the investigation of neurological disorders, a development of simple and accessible methods for determining selenium in human brain samples is required. We devised a method of determining selenium using graphite furnace atomic absorption spectrometry (GFAAS). An electrodeless discharge lamp provided the sufficient sensitivity to determine brain selenium. The matrix interferences were avoided by using high temperature, a prolonged pyrolysis step, and a palladium matrix modifier. The technique of standard addition was used to evaluate the sample concentrations. The accuracy of the method was confirmed by a bovine liver reference material. The detection limit of selenium was 0.04 ng. The determined selenium concentrations of human brain cortex and white matter were higher than those of putamen (115-155 and 206-222 ng/g wet wt, respectively). These GFAAS values agreed with those obtained by fluorometric analysis (r = 0.91, n = 10). Moreover, the GFAAS values were compatible to those reported by other researchers (99-274 ng/g wet wt), in which selenium concentrations in putamen also tended to be higher than the other two regions. We conclude that GFAAS is useful for selenium analysis in brain samples.

Effects of dietary selenium on mood in healthy men living in a metabolic research unit

Eleven healthy men were confined in a metabolic research unit for 120 days in a double-blind study of the effects of dietary selenium on mood as assessed by the Profile of Mood States-Bipolar Form. At an intake of 2800 kcal/day, the diet of conventional foods provided 80 micrograms/day of selenium for the first 21 days, then either 13 or 356 micrograms/day for the remaining 99 days. There were no significant changes in any of the mood scales due to dietary selenium. However, in the low-selenium group, the changes in the agreeable-hostile and the elated-depressed subscales were correlated with initial erythrocyte selenium concentration; that is, the lower the initial selenium status, the more the mood scores decreased. These results suggest that persons with low selenium status might experience relatively depressed moods and support the idea that selenium plays a special role in the brain. However, these studies do not support the notion that selenium supplementation could promote improvements in mood in persons eating a typical U.S. diet.

Concentration of rare earth elements, As, and Th in human brain and brain tumors, determined by neutron activation analysis

Toxic elements As and Th, six rare-earth elemental profiles of brain tumor tissues from 16 patients of astrocytomas (grade I-III), and normal human brain tissues of 18 male, age-matched autopsies serving as controls have been studied by radiochemical neutron activation analysis. P-204 [di(2-ethylhexyl) phosphate] extraction chromatography column was used for group separation of rare-earth element (REE) by one step. Compared with the normal brain tissues, the analytical results showed that the concentrations of Th, La, Ce, Gd, and Lu were significantly higher in tumor tissues (P < 0.01 or 0.001). The possible effects of REE on tumor cell were discussed.

Signal intensity on MRI of basal ganglia in multiple sclerosis

It has been reported that a relative reduction in signal intensity on T2 weighted MRI may be seen in the basal ganglia of patients with multiple sclerosis and furthermore that this is due to excessive iron deposition. The basal ganglia are, however, rarely involved clinically or pathologically in multiple sclerosis, casting some doubt on this finding. Therefore MRI was carried out in 46 patients with definite multiple sclerosis and 42 age matched controls. Contiguous, 5 mm thick axial dual echo spin-echo images of the brain were obtained on a 1.5T imager. Visual rating scales were used to measure the lesion load as well as the signal intensity of the globus pallidus, putamen, caudate nucleus, substantia nigra, red nucleus, and thalamus. There was a mild degree of low signal intensity in the patient group in the thalamus only. The signal intensity of the thalamus and putamen was never lower than that of the globus pallidus. Low signal in the basal ganglia is rarely, if ever, found in multiple sclerosis and is not a useful radiological sign.

Al, Zn, Cu, Mn and Fe levels in brain in Alzheimer's disease

The aim of our experiments was to investigate the possible element concentration changes in Alzheimer's disease. Our project incorporated the determination of the regional distribution of elements in normal human brain, too. Five elements (Al, Zn, Cu, Mn and Fe) have been measured in 10 different regions of 20 normal brains (mean age 70 years) and in brain parts of patients with Alzheimer's disease (9 individuals). Analyses were carried out by inductively coupled plasma atomic emission spectrometry (ICP-AES) and instrumental neutron activation analysis (INAA) techniques. Analytical precision and accuracy were investigated by NIST standard reference material. In a comparison between the healthy and Alzheimer patients' concentration data using statistical treatment these elements showed difference as a function of the Alzheimer disease (AD).

Role of mitochondria in the etiology and pathogenesis of Parkinson's disease

We discuss the etiology and pathogenesis of Parkinson's disease (PD). Our group and others have found a decrease in complex I of the mitochondrial electron transfer complex in the substantia nigra of patients with PD; in addition, we reported loss of the alpha-ketoglutarate dehydrogenase complex (KGDHC) in the substantia nigra. Dual loss of complex I and the KGDHC will deleteriously affect the electron transport and ATP synthesis; we believe that energy crisis is the most important mechanism of nigral cell death in PD. Oxidative stress has also been implicated as an important contributor to nigral cell death in PD, but we believe that oxidative stress is a secondary phenomenon to respiratory failure, because respiratory failure will increase oxygen free-radical formation and consume glutathione. The primary cause of mitochondrial respiratory failure has not been elucidated yet, but additive effect of environmental neurotoxins in genetically predisposed persons appears to be the most likely possibility.

Hereditary ceruloplasmin deficiency with hemosiderosis: a clinicopathological study of a Japanese family

A hereditary ceruloplasmin deficiency associated with severe iron deposition in visceral organ and brain tissues found on histopathological examination at autopsy is discussed. Three siblings of consanguineous Japanese parents were studied. Their clinical symptoms were progressive dementia, extrapyramidal disorders, cerebellar ataxia, and diabetes mellitus, all of which appeared when they were between 30 and 50 years old. All had serum ceruloplasmin deficiencies and increased serum ferritin concentrations. The dentate nucleus, thalamus, putamen, caudate nucleus, and liver of each one showed low signal intensities on T1- and T2-weighted magnetic resonance images. Examination of the central nervous system revealed severe destruction of the basal ganglia and dentate nucleus, with considerable iron deposition in neuronal and glial cells, whereas the cerebral cortex showed mild iron deposition in glial cells without neuronal involvement. An electron microscopic study with energy-dispersive x-ray analysis showed iron depositions in the hepatocytes, of both the neural and glial cells of the brain. We consider this a new disease entity because of the primary ceruloplasmin deficiency.

Striatonigral degeneration: iron deposition in putamen correlates with the slit-like void signal of magnetic resonance imaging

We report three patients with striatonigral degeneration highlighting the correlation between magnetic resonance imaging (MRI) and the pathological changes. The "slit-like void signal" observed in the putamen is typical of striatonigral degeneration and can be used to assist diagnosis during life. Our histochemical studies support the concept that increased iron deposition in the putamen is responsible for this MRI picture.

High intensity in the globus pallidus on proton and T2-weighted MRI in a case of dentato-ruburo-pallido-luysian atrophy of myoclonus epilepsy type

Although marked atrophy of the tegmentum of the mid-brain is a known computed tomography (CT) and magnetic resonance imaging (MRI) feature in patients with dentato-ruburo-pallido-luysian atrophy (DRPLA), this is the first report of marked high signal intensity of the globus pallidus on proton and T2-weighted MR images in a patient in the early stage of DRPLA of the myoclonus epilepsy type. We suggest that the globus pallidus may be involved in the early stage of DRPLA of this type. Magnetic resonance imaging is considered to be useful for the early detection of involvement of the globus pallidus and in the clinical diagnosis of DRPLA.

Suppression of protein synthesis in the reperfused brain

BACKGROUND

Brain ischemia and reperfusion produce profound protein synthesis alterations, the extent and persistence of which are dependent on the nature of the ischemia, the brain region, the cell layer within a region, and the particular proteins studied. After transient ischemia, most brain regions recover their protein synthesis capability; however, recovery in the selectively vulnerable areas is poor. It is unknown whether this phenomenon itself provokes or is a consequence of the process of neuronal death.

SUMMARY OF REVIEW

Protein synthesis suppression during ischemia is due to energy depletion, but this is quickly reversed upon recirculation. Reperfusion does not appear to damage DNA or transcription mechanisms, although there are changes in the profile of transcripts being made. Similarly, purified ribosomes isolated from reperfused brains can make the normal repertoire of proteins and heat-shock proteins. However, during early reperfusion, newly synthesized messenger RNAs appear to accumulate in the nucleus; this alteration in RNA handling could reflect disruption at any of several steps, including posttranscriptional processing, nuclear pore transport, cytoskeletal binding, or formation of the translation initiation complex. Another mechanism that may be responsible for protein synthesis suppression during late reperfusion is progressive membrane destruction, with consequent shifts in the concentration of ions crucial for ribosomal function.

CONCLUSIONS

Protein synthesis suppression after ischemia likely involves a progression of multiple mechanisms during reperfusion. Although the recent work reviewed here offers new insight into the potential mechanisms disrupting protein synthesis, detailed understanding will require further investigation.

Age distribution and iron dependency of the T2 relaxation time in the globus pallidus and putamen

Heavily T2-weighted spin echo sequences of the brain show age-dependent low signal intensity in many extrapyramidal nuclei. Although it has been suggested that this low intensity results from non-haem iron, the specific influence of non-haem iron on the T2 relaxation time has not been quantified and remains controversial. The T2 relaxation times of the globus pallidus and putamen were measured from MRI at 1.5T in 27 healthy patients, by using a mathematical model. They were then plotted as a function of age and compared to the curve of age-dependent iron concentration determined post mortem. The curves of T2 relaxation time in the basal ganglia are congruent with published curves of iron concentration, indicating a high probability that the changes in T2 relaxation times and the low signal in the basal ganglia result from the local, age-dependent iron deposition. Individual measurements of T2 relaxation time show less variation before than after 45 years of age, indicating the influence of a second, more individual factor.

Selenium in the central nervous system of rats exposed to 75-Se L-selenomethionine and sodium selenite

The aim of the present study is to investigate the accumulation and retention of organic and inorganic selenium in the central nervous system (CNS) of the rat. Selenium accumulation was investigated after oral treatment (3.0 mg Se/L drinking water) or ip injection (1.7 mg Se/kg body wt) of rats exposed to 75-Se L-selenomethionine (SeMeth) or sodium selenite (NaSe). Significant higher concentrations were observed after exposure to organic compared to inorganic selenium after oral as well as ip administration. Highest concentrations in both experiments were observed in cerebellum followed by the nearly identical levels in the cerebral hemisphere and spinal cord independent of the chemical form of selenium or the route of administration. The difference in concentrations observed between the different parts of the CNS investigated in each group were, however, not significant. Retention of selenium in the CNS was investigated after a single ip injection (1.7 mg Se/kg body wt) of 75-Se SeMeth or NaSe. In both groups, we observed an initial fast excretion phase followed by a slower excretion phase resembling a first-order reaction. Organic selenium disappeared much slower from all parts of the central nervous system compared to NaSe after a single injection.

Neuroleptic-induced movement disorders and body iron status

1. The distribution of iron in the human brain, what is known about its biological functions, and the interaction of neuroleptics with iron suggest that this trace metal may play an important role in the pathogenesis of neuroleptic-induced movement disorders (NIMD). 2. The availability of magnetic resonance imaging has made some of the hypotheses testable in human subjects. 3. This article is a brief overview of the current literature on the association between NIMD and brain iron.

Transferrin receptors of rat and human brain and cerebral microvessels and their status in Alzheimer's disease

We studied the regional distribution of specific [125I]transferrin binding to transferrin receptors in the brains and cerebral microvessels of humans and rats. We also assessed transferrin receptors in subjects with Alzheimer's disease. Human diferric [125I]transferrin bound to regional brain and cerebral microvessels with high affinity (dissociation constants of 1-10 nM), and the maximal binding densities ranged from 30 to 90 pmol/mg protein in the brain and were several-fold higher in cerebral microvessels. In Alzheimer's disease, transferrin receptor densities were significantly reduced in the hippocampus and the temporal and occipital cortex but were unchanged in the frontal and parietal cortex and the cerebellum. Although [125I]transferrin binding was higher in cerebral microvessels from subjects with Alzheimer's disease than in those of age-matched controls, this difference did not attain statistical significance. These results suggest that transferrin receptor density was decreased in some cortical areas including the hippocampus in Alzheimer's disease but relatively unchanged in cerebral microvessels.

Distribution and number of transferrin receptors in Parkinson's disease and in MPTP-treated mice

Transferrin is a glycoprotein that functions primarily to deliver iron to the cell. Recent studies suggest that the transferrin receptor mediates the intracellular delivery and transport of iron bound to transferrin in the CNS. Iron-catalyzed free radical generation has been proposed as a possible cause of nigral cell death in Parkinson's disease. Our hypothesis is that abnormal iron handling by the transferrin receptor may contribute to the formation of free radical species which catalyze the lipid peroxidation of nigral cell membranes. We have assessed the number of transferrin receptors on membrane fractions prepared from the human striatum from control subjects and patients with Parkinson's disease. Equilibrium-binding studies demonstrated a reversible, saturable, and high-affinity transferrin binding site (KD = 3 nM) in human brain membranes. Regional binding assays indicate that the number of transferrin receptors in the putamen was reduced significantly in Parkinson's disease. The density of transferrin receptors was unaltered in membranes prepared from the caudate nuclei and the globus pallidus. To address the possibility that transferrin receptors are located on dopaminergic terminals, we have examined the distribution and number of transferrin receptors in the striatum of MPTP-treated mice using in vitro autoradiographic methods. In these experiments, the loss of dopaminergic terminals in the striatum was visualized by differential [3H]mazindol uptake site autoradiography. A marked reduction in the density of both transferrin receptors and [3H]mazindol binding sites was observed in the mouse striatum 7 days post-MPTP treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

The impact of selenium supplementation on mood

The possibility that a subclinical deficiency of the trace element selenium might exist in a sample of the British population was examined by giving a selenium supplement for 5 weeks. Using a double-blind cross-over design, 50 subjects received either a placebo or 100 mcg selenium on a daily basis. On three occasions they filled in the Profile of Moods States. A food frequency questionnaire was used to estimate the intake of selenium in the diet. Intake was associated with a general elevation of mood and in particular, a decrease in anxiety. The change in mood when taking the active tablet was correlated with the level of selenium in the diet, which was estimated from a food frequency questionnaire. The lower the level of selenium in the diet the more reports of anxiety, depression, and tiredness, decreased following 5 weeks of selenium therapy. The results are discussed in terms of the low level of selenium in the food chain in some parts of the world.

Treatment with deferoxamine during ischemia improves functional and metabolic recovery and reduces reperfusion-induced oxygen radical generation in rabbit hearts

BACKGROUND

Iron may play a central role in oxygen radical generation during myocardial ischemia and after reperfusion. Because conditions during ischemia may also liberate iron, we hypothesized that administration of the iron chelator deferoxamine during ischemia would result in improved functional and metabolic recovery after postischemic reperfusion.

METHODS AND RESULTS

Isolated, perfused rabbit hearts were studied by phosphorus-31 nuclear magnetic resonance spectroscopy. The hearts received one of three treatments: deferoxamine at the onset of 30 minutes of global ischemia (n = 9), deferoxamine as a bolus followed by a continuous 15-minute infusion begun at reflow (n = 9), or standard perfusate (n = 7). Hearts treated with deferoxamine during ischemia showed better recovery of developed pressure than did control hearts (63.2 +/- 7.5% versus 41.2 +/- 2.9% of baseline) (p = 0.02) and better recovery of myocardial phosphocreatine content (92.4 +/- 10.3% versus 68.2 +/- 4.5% of baseline, p less than 0.05). These functional and metabolic benefits were comparable to those obtained with deferoxamine treatment during early reperfusion. In 15 additional hearts, intraischemic treatment with deferoxamine resulted in no reduction in oxygen radical concentrations as measured on frozen tissue by electron paramagnetic resonance spectroscopy at end ischemia, but the treatment eliminated the reperfusion-induced increase of free radical generation observed in control hearts (2.9 +/- 0.01 versus 7.0 +/- 0.07 microM, p less than 0.001). The magnitude of reduction was similar to that when deferoxamine was given at the onset of reflow (2.4 +/- 0.02 microM, p less than 0.001 versus control).

CONCLUSIONS

These results demonstrate improved functional and metabolic recovery of myocardium treated with deferoxamine during ischemia, accompanied by a reduction in reperfusion-induced oxygen free-radical generation to the same degree as reflow treatment, confirming the importance of iron in the pathogenesis of myocardial reperfusion injury.

Phospholipid peroxidation induced by the catechol-Fe3+(Cu2+) complex: a possible mechanism of nigrostriatal cell damage

Ferric or cupric ions significantly promoted a peroxidative cleavage of unsaturated phospholipids in liposomes in vitro after coordinating with dopa and dopamine. Either alpha-tocopherol or desferrioxamine completely abolished the dopa-Fe3+ complex-induced phospholipid peroxidation, while superoxide dismutase, catalase, or sodium benzoate did not. A ferroxidase, ceruloplasmin, significantly inhibited the lipid peroxidation induced by the dopa-Fe3+ complex, indicating the importance of the reduction of the iron moiety in the complex for the lipid peroxidation. A possible mechanism of dopa-Fe3+ complex-induced phospholipid peroxidation is that oxene complexes, such as Fe(V) = O and Fe(IV) = O, produced abstract hydrogen atoms in unsaturated phospholipids to initiate lipid peroxidation.

Regional distribution of potassium, calcium, and six trace elements in normal human brain

Eight elements (i.e. K, Ca, Mn, Fe, Cu, Zn, Se, and Rb) were measured in 50 different regions of 12 normal human brains by particle-induced X-ray emission (PIXE) analysis. The dry weight concentrations of K, Fe, Cu, Zn, Se, and Rb were consistently higher for gray than for white matter areas. The K, Zn and Se concentrations for the regions of mixed composition and, to some extent, also the Rb concentrations, were intermediate between the gray and white matter values, and they tended to decrease with decreasing neuron density. The mean dry weight concentrations of K, Ca, Zn, Se, and Rb in the various brain regions were highly correlated with the mean wet-to-dry weight ratios of these regions. For Mn, Fe, and Cu, however, such a correlation was not observed, and these elements exhibited elevated levels in several structures of the basal ganglia. For K, Fe, and Se the concentrations seemed to change with age. A hierarchical cluster analysis indicated that the structures clustered into two large groups, one comprising gray and mixed matter regions, the other white and mixed matter areas. Brain structures involved in the same physiological function or morphologically similar regions often conglomerated in a single subcluster.

Gallium distribution in several human brain areas

Gallium is an element of increasing biological interest: It is involved in problems related to environmental pollution (Ga compounds are used in electronics industry) and to clinical treatments (Ga radionuclides are employed to detect neoplastic lesions). Moreover, since its chemical behavior is similar to that of aluminum, gallium could play a role in the health effects attributed to this element. Data on naturally occurring Ga levels in human samples from healthy subjects are scanty; regarding the brain, the only reliable values available in the literature were published by Hamilton in 1972/73. In this work, the gallium distribution in several human brain areas, evaluated by radiochemical neutron activation analysis (RNAA), was found to be dishomogeneous. The element concentration determined in dry samples was, in any case, lower than the ppb level.

Magnetic resonance imaging in multiple sclerosis: decreased signal in thalamus and putamen

High-field strength (1.5 Tesla) magnetic resonance imaging in 15 patients with multiple and extensive white-matter lesions and clinically definite multiple sclerosis delineated a previously undescribed finding of abnormally decreased signal intensity on T2-weighted images in the thalamus and putamen. The decreased signal intensity (preferential decreased T2 relaxation time) is most likely to be related to abnormally increased iron accumulation causing local magnetic field heterogeneities.

Application of PIXE analysis to the study of the regional distribution of trace elements in normal human brain

A particle-induced X-ray emission (PIXE) analysis method is presented, which allows measurement of eight elements (i.e., K, Ca, Mn, Fe, Cu, Zn, Se, and Rb) in human brain samples of only a few mg dry weight. The precision and accuracy of the method were investigated by analyzing animal brain matter with both PIXE and instrumental neutron activation analysis (INAA). The method was applied to measure the 8 elements in 46 different regions of 3 human brains. The sections analyzed originated from either the left or the right cerebral hemisphere, brain stem, and cerebellum. For one of the brains, sections were also analyzed from 26 corresponding regions of both hemispheres. For all elements, similar concentrations were found in the corresponding areas of the left and right sides of the brain. The concentrations (in μg/g dry weight) of the elements K, Fe, Cu, Zn, Se, and Rb were consistently higher in cortical structures than in white matter. Deep nuclei and brain stem, which have a mixed composition, showed intermediate values for K, Zn, Se, and Rb. A hierarchical cluster analysis indicated that the various brain regions clustered into two large groups, one comprising gray and mixed matter regions and the other, white and mixed matter brain areas.

Applications of neutron activation analysis to the study of age-related neurological diseases

Although the etiology and pathogenesis of Alzheimer's disease, Pick's disease, and amyotrophic lateral sclerosis are still unknown, it has been suggested that perturbations in element metabolism may play a role. Even if not causative factors, these imbalances may prove to be markers that could aid in diagnosis. We have employed a sequential neutron activation analysis (NAA) procedure to determine elemental concentrations in brain, hair, fingernails, blood, and cerebrospinal fluid (CSF) of these patients and age-matched controls. Samples are first irradiated with accelerator-produced 14-MeV neutrons for determination of nitrogen and phosphorus, then with reactor thermal neutrons for the instrumental determination of 16-18 minor and trace elements, and, finally, reactor-irradiated again, followed by a rapid radiochemical separation procedure (RNAA) to determine four additional elements. Major advantages of NAA are: (1) its simultaneous multielement capability; (2) the relative freedom from reagent and laboratory contamination; (3) the absence of major matrix effects; and (4) an adequate sensitivity for most elements of interest. Ranges of concentrations by INAA and RNAA in selected control tissues and interelement correlations in control brain are presented to illustrate results obtained by the procedure. Longitudinal studies of tissues from Alzheimer's disease (AD) and amyotrophic lateral sclerosis (ALS) patients are still in progress.

Topochemical demonstration of zinc in meningiomas

In agreement with the atomic absorption tests, histochemical demonstration of zinc in meningiomas using the dithizone method revealed a higher level of zinc in fibromatous meningiomas than in its meningiotheliomatous variant. Calcified psammoma bodies and vessels exhibited an intensely positive reaction on their surface. The metabolic function of zinc in the synthesis of fibre proteins, as well as in metallo-enzymes associated with mineralization, explains these findings.

Tissue distribution of some elements in rats

The concentrations of 14 elements were determined in rat whole blood, plasma, brain, heart, skeletal muscle, liver, kidney, spleen, thymus, and bone, using multielement ICP optical emission spectrometry. The tissue to plasma concentration ratios were calculated in order to determine tissue distribution and its homogeneity. The results show the likely sequences of element concentrations in tissues: RB>P≥K>(Fe)>Zn≥Mg>Cu>S>(Sr≥Ca>Na); and of the homogeneity of the distribution: (Fe)<Cu<Rb<Na<Sr<Ca<Zn <P<S<K<Mg.

Ischemia, resuscitation, and reperfusion: mechanisms of tissue injury and prospects for protection

Since its introduction in 1960, CPR has evolved into a complex program involving not only the medical community but also the lay public. Currently, program activities include instruction of the lay public in basic life support techniques, development and deployment of emergency medical systems, recommendations for drug protocols for advanced cardiac life support and, most recently, introduction of new methods for tissue protection following resuscitation. After 25 years of experience, we are beginning to understand the pathophysiology of tissue ischemia during cardiac arrest and the interventions required to improve chances of survival and quality of life of the cardiac arrest victim. Recent data in the literature suggest that modification of certain interventions in the resuscitation program may be needed. The poor neurologic outcomes with prolonged standard CPR show that it is not protective after 4 to 6 minutes of cardiac arrest. Modifications to this technique, including SVC-CPR or IAC-CPR, have not been shown to increase resuscitability or hospital discharge rates. Human studies of open-chest cardiac massage are needed to evaluate this option. Defibrillation is the definitive treatment for ventricular fibrillation. Greater emphasis should be placed on the earliest possible delivery of this treatment modality. Computerized defibrillators may provide greater and earlier access to defibrillation in the homes of patients at high risk of ventricular fibrillation. They may also be applicable by untrained public service personnel (police and firemen), individuals in geographically inaccessible areas (aircraft), or emergency medical technicians in rural areas where skill retention is a significant problem. Calcium has no proved benefit in cardiac resuscitation. There is biochemical evidence that it may be harmful in brain resuscitation. Its use in resuscitation should be discontinued. The dose of epinephrine currently advocated in the ACLS protocols may be inadequate to increase aortic diastolic pressure and coronary and cerebral perfusion pressures and thus aid resuscitation. Animal studies indicate that substantial increases in the current dosage are needed to achieve these effects. Human studies are needed to verify these results. A role for calcium antagonists in the treatment of postarrest encephalopathy has been demonstrated in animals and is currently undergoing clinical trials. Iron-dependent lipid peroxidative cell membrane injury may be important in the pathogenesis of postarrest encephalopathy. Animal studies suggest that the iron chelator deferoxamine may have a significant therapeutic role in the treatment of postarrest encephalopathy.

Studies on the effect of iron overload on rat cortex synaptosomal membranes

Iron as ferrous ammonium sulfate was injected into the cerebral spinal fluid of rats. After three consecutive days of injection of 4 mumol of iron, the total iron content of brain cortex synaptosomes from the iron-treated animals was 2-fold higher than that from control animals receiving the saline vehicle only. Spin label studies of the synaptosomal membranes demonstrated that the lipid region of the membranes became more rigid and, in addition, the mobility of labeled SH groups of membrane proteins decreased after the iron treatment. The cholesterol content was significantly higher in iron-treated animals as compared to controls. Centrophenoxine pretreatment (100 mg/kg body weight daily for 6 weeks) diminished the iron effects. Synaptosomal membrane alterations observed after iron treatment were similar to changes observed previously during aging. This lends support to the notion that free-radical induced damage occurs in brain membranes with increasing age.

Effects of alcohol ingestion on zinc content of human and rat central nervous systems

The abundance of zinc in hippocampal mossy fibers has stimulated investigation of zinc status in various pathologic states in which behavioral or anatomic deficits involving the hippocampus are known to occur. Limited autopsy studies of chronic alcoholic humans have suggested that the content of zinc might be reduced in several brain regions whereas reported attempts to replicate these findings in ethanol-exposed experimental animals have produced inconsistent results. In this comparative study, the zinc concentration in 10 brain regions, all spinal cord segments, and microdissected hippocampal subfields was measured by isotope ratio mass spectrometry. A widespread 15 to 20% reduction in zinc content was observed in all regions of chronic alcoholics compared with controls but a selective involvement of hippocampus was not detected. In the experimental studies, groups of rats were exposed to ethanol by one of three routes: inhalation for 2 weeks, as an ethanol/liquid diet for 3 months, or a single intoxicating i.p. dose. Determinations of tissue uptake of radiozinc and of total zinc content were made. In contrast to human pathologic material, zinc pool size and tissue uptakes were not affected by experimental ethanol administration by any route. This study confirmed that a reduction in zinc concentration occurs in the central nervous system of chronic alcoholics. The animal studies indicated, however, that simple ethanol exposure, even for prolonged periods, does not perturb zinc metabolism in brain. Together, these observations argue that the abnormalities of zinc metabolism in chronic alcoholics are possibly secondary to homeostatic alterations associated with hepatic failure.

Postischemic tissue injury by iron-mediated free radical lipid peroxidation

Cell damage initiated during ischemia matures during reperfusion. Mechanisms involved during reperfusion include the effects of arachidonic acid and its oxidative products prostaglandins and leukotrienes, reperfusion tissue calcium overloading, and damage to membranes by lipid peroxidation. Lipid peroxidation occurs by oxygen radical mechanisms that require a metal with more than one ionic state (transitional metal) for catalysis. We have shown that cellular iron is delocalized from the large molecules where it is normally stored to smaller chemical species during postischemic reperfusion. Postischemic lipid peroxidation is inhibited by the iron chelator deferoxamine. Intervention in the reperfusion injury of membranes by chelation of transitional metals is a new and promising therapeutic possibility for protection of the heart and brain.

Evidence of subclinical extrapyramidal hemosiderosis in cystic fibrosis

We are presenting evidence of subclinical extrapyramidal hemosiderosis in chronic cystic fibrosis (CF) by histological staining and quantitative analysis. Comparison was made between age-matched control (eight cases) and CF brains (14 cases). None of the CF patients had extrapyramidal or other focal CNS symptoms but showed an increased iron pigment, and four cases had a few dystrophic axons (DA) in pallidonigral areas. Histological stain revealed significantly increased iron pigment in pallidonigral and subthalamic nuclei (P less than 0.05, 0.01, 0.01, respectively). The pigment was located in astrocytes, macrophages, neuronal perikarya, and neuropils. The increase was directly proportional to age and numbers of DA in nucleus gracilis/cuneatus. As in previous reports [5, 22], the numbers of DA in nucleus gracilis/cuneatus were higher in CF (P less than 0.01) and varied directly with age (correlation coefficient 0.72). Quantitative analysis disclosed an upward trend of mean iron content in pallidonigral areas. Aluminum was detected in four cases of CF but not in the controls.

Hair trace elements in Friedreich's disease

Concentrations of zinc, copper, manganese, chromium, cobalt and selenium were measured in the hair obtained from subjects with Friedreich's disease, other inherited ataxias and neurological control patients. Although zinc and copper concentrations were significantly higher in Friedreich than in the two control groups, the mean values for all groups were well within the normal range. No major deficiency in zinc or selenium was demonstrated in Friedreich's disease using the approach. This does not, however, indicate that there is no defect in zinc and selenium metabolism, availability or transport in this disorder.

Trace elements in brains of patients with alcohol abuse, endogeneous psychosis and schizophrenia

The concentrations of Co, Fe, Rb, Se and Zn were analysed, by means of neutron activation analysis, in the brains of three patients with alcohol abuse, of one patient with endogeneous psychosis and of one patient with schizophrenia. The patients with alcohol abuse suffered from the Wernicke-Korsakoff syndrome. The data were compared with results from brains which were not diseased ("normals"). Patients with alcohol abuse had diminished values of rubidium in nearly all analysed samples of cerebral nuclei (greater than 30% compared to normals), whereas the Rb values were normal or diminished in cortical regions. The cobalt values were reduced (greater than 20%) in eight out of 14 nuclei and in five out of nine cortical regions. Differences in the Fe and Se values were mainly located in the cerebral nuclei. In the caudate nucleus the patient with endogeneous psychosis had highly significant elevated values of all analysed elements. The element concentrations of the patient with schizophrenia did not significantly differ from those of normal controls. The loss of nearly all elements was conspicuous in those regions which show neuro-pathological cell degeneration or atrophy in the case of Wernicke-Korsakoff syndrome. This loss of element concentrations in patients with alcohol abuse is interpreted as a loss of cellular vitality.

Iron uptake by mammalian cortical neurons

Although iron accumulates in the brain in a number of pathological conditions, including Hallervorden-Spatz syndrome, Parkinson's disease, and neurosyphilis, studies of brain iron metabolism have been performed only rarely. Neuronal-enriched cultures were prepared from fetal mouse brain. After 18 days the cells were exposed to radiolabeled iron. Total iron uptake and incorporation into ferritin were rapid and linear over four hours. The addition of either methylamine or ammonium chloride, both known blockers of transferrin-iron release through their lysosomotropic properties, inhibited total iron uptake. Methylamine also inhibited the rate of ferritin-iron incorporation, most likely by interfering with transferrin-iron release. The data suggest that neuronal iron transport, much like that in other mammalian tissues, is transferrin mediated and that blockers of transferrin-iron release may be of value in conditions in which there is brain iron overload.

The distribution of Timm's stain in the nonsulphide-perfused human hippocampal formation

A detailed description is given of the distribution of Timm's staining in the human hippocampal formation. In sections cut transverse to the long axis of the hippocampal formation the same pattern of staining is seen throughout almost all of the structure, i.e., through all the main body except the most caudal region and, following the medial bend made by the long axis, through most of the pes hippocampi. The staining typically filled almost the whole of the hilus of the dentate gyrus and the whole depth of the adjacent stratum pyramidale and stratum lucidum of subfield CA3. Rostrally, staining was traced into the tip of the uncus. Caudally, staining was traced to the inferior surface of the splenium at the apex of the caudal taper of the hippocampus. No staining was found in the gyrus fasciolaris, indusium griseum, or anterior hippocampal rudiment. Except in the medial part of the pes hippocampi, the Timm's staining did not reach the proximal border of the subfield CA1. In some sections of the main body of the hippocampus a narrow, infragranular stain-free zone was observed in the hilus. In the dentate gyrus of three older subjects, but not in those of three younger subjects, supragranular staining was found. It is argued that the Timm's staining described in this study is specific to the hippocampal mossy fibres. The distribution of the staining is discussed in relation to the boundaries of subfields CA3 and CA2 as delineated by other authors.

Enhancement of 5-hydroxytryptamine uptake in rabbit hypothalamic synaptosomes but not in blood platelets by zinc and lead ex vivo

Lead (0.2%), zinc (0.5%) or their combination was given to rabbits as acetate salts in drinking water for 2 or 4 weeks. Cerebral Pb increased within exposure time but the increase of Zn was marginal when given alone. After combination of Pb + Zn, blood Pb increased but Zn decreased as compared to the administration of the single metal alone. Concurrently brain Pb increased but remained at a lower level as compared with sole Pb administration while brain Zn did not differ from controls. The uptake of 5-hydroxytryptamine (5-HT) into hypothalamic synaptosomes increased 70-85% with Pb, Zn and Pb + Zn after 2 weeks and 93% with Zn and 76% with Pb + Zn after 4 weeks. Dopamine uptake into striatal synaptosomes did not change. Zn decreased endogenous noradrenaline concentrations by 21% and Pb + Zn that of 5-HT by 36% in the striatum. Pb + Zn decreased cortical dopamine concentrations by 26%. Concurrently, 5-HT uptake in blood platelets, platelet numbers and their content of endogenous 5-HT did not change significantly. These results indicate that high Zn and Pb have parallel effects on 5-HT uptake in hypothalamic synaptosomes and their combination may be neurochemically more toxic than the individual metals. The increase of 5-HT uptake in hypothalamic synaptosomes but not in blood platelets requires further methodological work to explain the differences between synaptosomes and platelets.

Trace element concentration in the human pineal body. Activation analysis of cobalt, iron, rubidium, selenium, zinc, antimony and cesium

100 human pineal bodies (56 male and 44 females) were analyzed by means of instrumental neutron activation analysis for trace concentrations of cobalt, iron, rubidium, selenium, zinc, antimony and cesium. The results indicated that the measured element concentrations are not related to body-surface, age and fresh weight. Moreover, the mean absolute cobalt value from 97 pineal bodies is increased by a factor of 1.43 over the mean absolute concentration value of 257 other areas of the brain. The mean zinc content is found to be 3.7 fold higher than the mean zinc value from 269 other samples of brain. The iron values from various brain areas do not differ from those of the pineal body. Compared to other brain regions pineal selenium is increased and rubidium is decreased. Correlating the different element concentrations to each other, a positive correlation is found for selenium and ribidium, a negative correlation for cobalt and zinc. The present data suggest that the measured trace elements are somehow related to specific roles in the physiology and biochemistry of the pineal body. This is supported by the constancy of element concentration over a wide range of increasing fresh weights of the organ. It is considered that zinc, cobalt and iron are involved as constituents of enzymes in the metabolism of amino acids, peptides and proteins of the pineal body. Moreover the conspicuous high zinc content of this organ may be related to a so far undetected neurotransmitter.

Topographical and cytological localization of iron in rat and monkey brains

The topographical localization of endogenous iron in rat and monkey brains coincides with the striato-pallido-nigral and the cerebellar corticonuclear pathways. EM observation reveals that iron is located in the soma and processes of glial cells and, above all, in the inner and outer loop of the myelin sheets. This raises the question of whether iron intervenes in some GABAergic systems.

Rubidium-A possible essential trace element : 1. The rubidium content of whole blood of healthy and dietetically treated children

The rubidium content of whole blood was estimated by instrumental neutron activation analysis. In 46 healthy children it amounts to {ie193-1} g/g dry weight. There was no difference between the values found for infants, toddlers, and school children. In 29 dietetically treated patients with phenylketonuria and maple-syrup-urine disease the values were significantly lower than in healthy children. During the first three months of diet therapy the rubidium levels remained in the lower range of the normal values, decreasing to about 60% of the mean of normal values later on. With increasing length of diet therapy these values tended to decrease. It remains questionable whether these decreased levels reflect only an induced biochemical phenomenon without biological importance, or whether they are the first signs of a deficiency syndrome.

Topographical distribution of arsenic, manganese, and selenium in the normal human brain

The concentrations of arsenic, manganese and selenium per gram wet tissue weight were determined in samples from 24 areas of normal human brain from 5 persons with ages ranging from 15 to 81 years of age. The concentrations of the 3 elements were determined for each sample by means of neutron activation analysis with radiochemical separation. Distinct patterns of distribution were shown for each of the 3 elements. Variations between individuals were found for some but not all brain areas, resulting in coefficients of variation between individuals of about 30% for arsenic, 10% for manganese and 20% for selenium. The results seem to indicate that arsenic is associated with the lipid phase, manganese with the dry matter and selenium with the aqueous phase of brain tissue.

Spinal fluid aluminum levels in patients with Alzheimer disease

Spinal fluid from 180 male patients was examined for aluminum levels. Values were coordinated for age and protein determinations. In addition, values were listed according to the patient's diagnosis. Although in most instances no correlation could be made, 10 patients with Alzheimer disease showed significantly low levels of aluminum.

Multi-element analysis of the rat hippocampus by proton induced X-ray emission spectroscopy (phosphorus, sulphur, chlorine, potassium, calcium, iron, zinc, copper, lead, bromine, and rubidium)

A technique for multi-element analysis of brain tissue by proton induced X-ray emission spectroscopy (PIXE) is described and data from analysis of fixed and unfixed samples from rat hippocampus, neocortex, amygdala, and spinal cord is presented and commented on. The atoms present in the tissue are bombarded with protons which causes the ejection of electrons from the inner shells. When the "holes" are refilled with electrons from outer shells, X-ray quanta characteristic for each element are emitted. Using a high resolution energy dispersive detector a complete X-ray spectrum of the specimen can be recorded in a single measurement. Detection limits less than or approximately 5 p.p.m. of dry matter are obtained for most elements with atomic number greater than 14 (silicon). Around 13 elements were found in concentrations above the detection limits. The grand means for non-fixed hippocampi were e.g. for Zn - 120 p.p.m.; Rb - 20 p.p.m.; Fe - 150 p.p.m.; Pb - 3 p.p.m; Ni - 5 p.p.m.