A roadmap for implanting microelectrode arrays to evoke tactile sensations through intracortical microstimulation

Intracortical microstimulation (ICMS) is a method for restoring sensation to people with paralysis as part of a bidirectional brain-computer interface to restore upper limb function. Evoking tactile sensations of the hand through ICMS requires precise targeting of implanted electrodes. Here we describe the presurgical imaging procedures used to generate functional maps of the hand area of the somatosensory cortex and subsequent planning that guided the implantation of intracortical microelectrode arrays. In five participants with cervical spinal cord injury, across two study locations, this procedure successfully enabled ICMS-evoked sensations localized to at least the first four digits of the hand. The imaging and planning procedures developed through this clinical trial provide a roadmap for other brain-computer interface studies to ensure successful placement of stimulation electrodes.

Evaluation of the performance of a 7-T 8 × 2 transceiver array

The decoupled 8 × 2 transceiver array has been shown to achieve a mean B1 + of 11.7 uT with a coefficient of variation of ~11% over the intracranial brain volume for 7-T MR imaging. However, this array may be thought to give lower signal-to-noise ratio (SNR) and higher g-factors for parallel imaging compared with a radio frequency (RF) receive-only coil due to the latter's higher coil count and use of coil overlap to reduce the mutual impedance. Nonetheless, because the transceiver's highly decoupled design (pertinent for transmission) should also be constructive for reception, we measured the noise correlation, g-factors, and SNR for the decoupled transceiver in comparison with a commercial reference coil. We found that although the transceiver has half the number of receive elements in comparison with the reference coil (16 vs. 32), comparable g-factors and SNR over the head were obtained. From five subjects, the transceiver versus reference coil SNR was 65 ± 10 versus 67 ± 15. The mean noise correlation for all coil pairs was 10% ± 5% and 12% ± 9% (transceiver and reference coil, respectively). As changes in load impedance may alter the S parameters, we also examined the performance of the transceiver with tuned and matched (TM) versus untuned and unmatched (UTM) conditions on five subjects. We found that the noise correlation and SNR are robust to load variation; a noise correlation of 10% ± 5% and 10% ± 6% was determined with TM versus UTM conditions (SNRUTM/SNRTM = 0.97 ± 0.08). Finally, we demonstrate the performance of the array in human brain using T2-weighted turbo spin echo imaging, finding excellent SNR performance in both caudal and rostral brain regions.

Force oscillations underlying precision grip in humans with lesioned corticospinal tracts

Stability of precision grip depends on the ability to regulate forces applied by the digits. Increased frequency composition and temporal irregularity of oscillations in the force signal are associated with enhanced force stability, which is thought to result from increased voluntary drive along the corticospinal tract (CST). There is limited knowledge of how these oscillations in force output are regulated in the context of dexterous hand movements like precision grip, which are often impaired by CST damage due to stroke. The extent of residual CST volume descending from primary motor cortex may help explain the ability to modulate force oscillations at higher frequencies. Here, stroke survivors with longstanding hand impairment (n = 17) and neurologically-intact controls (n = 14) performed a precision grip task requiring dynamic and isometric muscle contractions to scale and stabilize forces exerted on a sensor by the index finger and thumb. Diffusion spectrum imaging was used to quantify total white matter volume within the residual and intact CSTs of stroke survivors (n = 12) and CSTs of controls (n = 14). White matter volumes within the infarct region and an analogous portion of overlap with the CST, mirrored onto the intact side, were also quantified in stroke survivors. We found reduced ability to stabilize force and more restricted frequency ranges in force oscillations of stroke survivors relative to controls; though, more broadband, irregular output was strongly related to force-stabilizing ability in both groups. The frequency composition and temporal irregularity of force oscillations observed in stroke survivors did not correlate with maximal precision grip force, suggesting that it is not directly related to impaired force-generating capacity. The ratio of residual to intact CST volumes contained within infarct and mirrored compartments was associated with more broadband, irregular force oscillations in stroke survivors. Our findings provide insight into granular aspects of dexterity altered by corticospinal damage and supply preliminary evidence to support that the ability to modulate force oscillations at higher frequencies is explained, at least in part, by residual CST volume in stroke survivors.

First report of 68Ga-PRGD2 PET/MRI molecular imaging of vaso-occlusion in a patient with sickle cell disease

Increased vascular cell adhesion (hyperadhesion) to the endothelium is responsible for the hallmark acute pain episodes, or vaso-occlusive crises (VOC), of sickle cell disease. The integrin α_vβ₃ plays an important role in VOC since it mediates sickle red blood cell adhesion to the endothelium, a process that leads to ischemia and painful bone infarction. In the pilot study presented herein, we hypothesized that real-time imaging of hyperadhesion could quantify VOC severity and identify the most vulnerable anatomical sites. We also hypothesized that harnessing hyperadhesion as a proximate event in VOC would provide sensitive, objective evidence of VOC before pain has developed. Specifically, we tested whether positron emission tomography (PET) imaging of integrin α_vβ₃ using the PET tracer ⁶⁸Ga-PRGD2 would successfully image hyperadhesion associated with VOC in a patient with sickle cell disease. We observed persistently higher tracer uptake in the femurs during VOC compared to baseline. In the vessel, after an initial and transient increase during VOC, blood pool activity was similar between baseline and VOC. These findings suggest that PET imaging of integrin α_vβ₃ may be a valuable strategy for imaging of VOC.

Dynamic B0 shimming for multiband imaging using high order spherical harmonic shims

PURPOSE

To describe and implement a strategy for dynamic slice-by-slice and multiband B₀ shimming using spherical harmonic shims in the human brain at 7T.

THEORY

For thin axial slices, spherical harmonic shims can be divided into pairs of shims (z-degenerate and non-z-degenerate) that are spatially degenerate, such that only ½ of the shims (non-z-degenerate) are required for single slice optimizations. However, when combined, the pairs of shims can be used to simultaneously generate the same in-plane symmetries but with different amplitudes as a function of their z location. This enables multiband shimming equivalent to that achievable by single slice-by-slice optimization.

METHODS

All data were acquired at 7T using a spherical harmonic shim insert enabling shimming up through 4th order with two additional 5th order shims (1st-4th+). Dynamic shim updating was achieved using a 10A shim power supply with 2 ms ramps and constrained optimizations to minimize eddy currents.

RESULTS

In groups of eight subjects, we demonstrated that: 1) dynamic updating using 1st-4th+ order shims reduced the SD of the B₀ field over the whole brain from 32.4 ± 2.6 and 24.9 ± 2 Hz with 1st-2nd and 1st-4th+ static global shimming to 15.1 ± 1.7 Hz; 2) near equivalent performance was achieved when dynamically updating only the non-z-degenerate shims (14.3 ± 1.5 Hz), or when a using multiband shim factor of 2, MB_s = 2, and all shims (14.4 ± 2.0 Hz).

CONCLUSION

High order spherical harmonics provide substantial improvements over static global shimming and enable dynamic multiband shimming with near equivalent performance to that of dynamic slice-by-slice shimming. This reduces distortion in echo planar imaging.

Cerebrospinal fluid-suppressed T2 -weighted MR imaging at 7 T for human brain

PURPOSE

T2 -weighted lesional imaging is most commonly performed using inversion recovery turbo spin echoes. At 7 T, however, this acquisition is limited for specific absorption rate and resolution. This work describes and implements a method to generate CSF-suppressed T2 -weighted imaging.

METHODS

The strategy uses a driven equilibrium spin-echo preparation within an inversion recovery with multiple 3D gradient-echo imaging blocks. Images are combined using the self-normalization approach, which achieves CSF suppression through optimized timing of individual blocks and minimizes sources of variation due to coil receptivity, T2* , and proton density. Simulations of the magnetization-prepared fluid-attenuated inversion recovery gradient-echo (MPFLAGRE) method over T1 and T2 relaxation values are performed, and in vivo demonstrations using an 8 × 2 transceiver array in healthy controls are shown.

RESULTS

The specific absorption rate of the calculated MPFLAGRE sequence is 11.1 ± 0.5 W (n = 5 volunteers), which is 74 ± 2% of the US Food and Drug Administration guidelines. This method acquires both contrasts for CSF suppression with detection of long T2 components and T2 -weighted imaging in a single acquisition. In healthy controls, the former contrast generates increased signal in the cortical rim and ependyma. A comparison is shown with a conventional 3D SPACE fluid-attenuated inversion recovery acquisition, and sensitivity to pathology is demonstrated in an epilepsy patient.

CONCLUSION

As applied with the 8 × 2 transceiver, the MPFLAGRE sequence generates both whole-brain contrast suitable for lesional and T2 -weighted imaging at 7 T in fewer than 10 minutes within the US Food and Drug Administration's specific absorption rate guidelines.

Interslice current change constrained B0 shim optimization for accurate high-order dynamic shim updating with strongly reduced eddy currents

PURPOSE

To overcome existing challenges in dynamic B₀ shimming by implementing a shim optimization algorithm which limits shim current amplitudes and their temporal variation through the application of constraints and regularization terms.

THEORY AND METHODS

Spherical harmonic dynamic B₀ shimming is complicated by eddy currents, ill-posed optimizations, and the need for strong power supplies. Based on the fact that eddy current amplitudes are proportional to the magnitude of the shim current changes, and assuming a smoothness of the B₀ inhomogeneity variation in the slice direction, a novel algorithm was implemented to reduce eddy current generation by limiting interslice shim current changes. Shim degeneracy issues and resulting high current amplitudes are additionally addressed by penalizing high solution norms. Applicability of the proposed algorithm was validated in simulations and in phantom and in vivo measurements.

RESULTS

High-order dynamic shimming simulations and measurements have shown that absolute shim current amplitudes and their temporal variation can be substantially reduced with negligible loss in achievable B₀ homogeneity. Whereas conventional dynamic shim updating optimizations improve the B₀ homogeneity, on average, by a factor of 2.1 over second-order static solutions, our proposed routine reached a factor of 2.0, while simultaneously providing a 14-fold reduction of the average maximum shim current changes.

CONCLUSIONS

The proposed algorithm substantially reduces the shim amplitudes and their temporal variation, while only marginally affecting the achievable B₀  homogeneity. As a result, it has the potential to mitigate the remaining challenges in dynamic B₀ shimming and help in making its application more readily available.

Is Magnetic Resonance Imaging Detection of Kidney Iron Deposition Increased in Haptoglobin 2-2 Genotype Carriers with Type 1 Diabetes?

Haptoglobin's (Hp) main role is to bind free hemoglobin (Hb), reducing its oxidative potential. The Hp-Hb complex formed is cleared from the circulation by macrophage receptor CD163. In diabetes, impaired Hp 2-2-Hb CD163 clearance and abnormal glomerular permeability allow the large Hp 2-2-Hb complex to cross the barrier, where its redox active iron leads to cellular toxicity. Although Hp 2-2 predicts renal function decline, whether renal iron deposition differs by Hp is unknown. We used renal quantitative T2* magnetic resonance imaging to estimate iron level in the cortex and medullar of type 1 diabetes (T1D) adults [15 Hp 1-1 and 15 Hp 2-2 carriers of similar age (53 years), duration (45 years), and gender]. Total kidney iron level was estimated as the sum of the cortex and medullar iron. Albuminuria was defined as urinary albumin to creatinine ratio >30 mg/g in two of three samples. Total kidney iron did not differ by gender or Hp but was higher in those with albuminuria (p = 0.05), an association confined to Hp 2-2 carriers (p = 0.04 vs. p = 0.51 in Hp 1-1). These data lead to the hypothesis that kidney iron deposition is increased among Hp 2-2 carriers with albuminuria in T1D. Antioxid. Redox Signal. 29, 735-741.

Fully automated segmentation of cartilage from the MR images of knee using a multi-atlas and local structural analysis method

PURPOSE

To develop a fully automated method to segment cartilage from the magnetic resonance (MR) images of knee and to evaluate the performance of the method on a public, open dataset.

METHODS

The segmentation scheme consisted of three procedures: multiple-atlas building, applying a locally weighted vote (LWV), and region adjustment. In the atlas building procedure, all training cases were registered to a target image by a nonrigid registration scheme and the best matched atlases selected. A LWV algorithm was applied to merge the information from these atlases and generate the initial segmentation result. Subsequently, for the region adjustment procedure, the statistical information of bone, cartilage, and surrounding regions was computed from the initial segmentation result. The statistical information directed the automated determination of the seed points inside and outside bone regions for the graph-cut based method. Finally, the region adjustment was conducted by the revision of outliers and the inclusion of abnormal bone regions.

RESULTS

A total of 150 knee MR images from a public, open dataset (available atwww.ski10.org) were used for the development and evaluation of this approach. The 150 cases were divided into the training set (100 cases) and the test set (50 cases). The cartilages were segmented successfully in all test cases in an average of 40 min computation time. The average dice similarity coefficient was 71.7%±8.0% for femoral and 72.4%±6.9% for tibial cartilage.

CONCLUSIONS

The authors have developed a fully automated segmentation program for knee cartilage from MR images. The performance of the program based on 50 test cases was highly promising.

Quantitative sodium MR imaging of native versus transplanted kidneys using a dual-tuned proton/sodium (1H/ 23Na) coil: initial experience

OBJECTIVES

To compare sodium ((23)Na) characteristics between native and transplanted kidneys using dual-tuned proton ((1)H)/sodium MRI.

METHODS

Six healthy volunteers and six renal transplant patients (3 normal function, 3 acute allograft rejection) were included. Proton/sodium MRI was obtained at 3 T using a dual-tuned coil. Signal to noise ratio (SNR), sodium concentration ([(23)Na]) and cortico-medullary sodium gradient (CMSG) were measured. Reproducibility of [(23)Na] measurement was also tested. SNR, [(23)Na] and CMSG of the native and transplanted kidneys were compared.

RESULTS

Proton and sodium images of kidneys were successfully acquired. SNR and [(23)Na] measurements of the native kidneys were reproducible at two different sessions. [(23)Na] and CMSG of the transplanted kidneys was significantly lower than those of the native kidneys: 153.5 ± 11.9 vs. 192.9 ± 9.6 mM (P = 0.002) and 8.9 ± 1.5 vs. 10.5 ± 0.9 mM/mm (P = 0.041), respectively. [(23)Na] and CMSG of the transplanted kidneys with normal function vs. acute rejection were not statistically different.

CONCLUSIONS

Sodium quantification of kidneys was reliably performed using proton/sodium MRI. [(23)Na] and CMSG of the transplanted kidneys were lower than those of the native kidneys, but without a statistically significant difference between patients with or without renal allograft rejection.

KEY POINTS

Dual-tuned proton/sodium RF coil enables co-registered proton and sodium MRI. Structural and sodium biochemical property can be acquired by dual-tuned proton/sodium MRI. Sodium and sodium gradient of kidneys can be measured by dual-tuned MRI. Sodium concentration was lower in transplanted kidneys than in native kidneys. Sodium gradient of transplanted kidneys was lower than for native kidneys.

Spatiotemporal characteristics and vascular sources of neural-specific and -nonspecific fMRI signals at submillimeter columnar resolution

The neural specificity of hemodynamic-based functional magnetic resonance imaging (fMRI) signals is dependent on both the vascular regulation and the sensitivity of the applied fMRI technique to different types and sizes of blood vessels. In order to examine the specificity of MRI-detectable hemodynamic responses, submillimeter blood oxygenation level-dependent (BOLD) and cerebral blood volume (CBV) fMRI studies were performed in a well-established cat orientation column model at 9.4 T. Neural-nonspecific and -specific signals were separated by comparing the fMRI responses of orthogonal orientation stimuli. The BOLD response was dominantly neural-nonspecific, mostly originating from pial and intracortical emerging veins, and thus was highly correlated with baseline blood volume. Uneven baseline CBV may displace or distort small functional domains in high-resolution BOLD maps. The CBV response in the parenchyma exhibited dual spatiotemporal characteristics, a fast and early neural-nonspecific response (with 4.3-s time constant) and a slightly slower and delayed neural-specific response (with 9.4-s time constant). The nonspecific CBV signal originates from early-responding arteries and arterioles, while the specific CBV response, which is not correlated with baseline blood volume, arises from late-responding microvessels including small pre-capillary arterioles and capillaries. Our data indicate that although the neural specificity of CBV fMRI signals is dependent on stimulation duration, high-resolution functional maps can be obtained from steady-state CBV studies.

Multichannel transceiver dual-tuned RF coil for proton/sodium MR imaging of knee cartilage at 3 T

Sodium magnetic resonance (MR) imaging is a promising technique for detecting changes of proteoglycan (PG) content in cartilage associated with knee osteoarthritis. Despite its potential clinical benefit, sodium MR imaging in vivo is challenging because of intrinsically low sodium concentration and low MR signal sensitivity. Some of the challenges in sodium MR imaging may be eliminated by the use of a high-sensitivity radiofrequency (RF) coil, specifically, a dual-tuned (DT) proton/sodium RF coil which facilitates the co-registration of sodium and proton MR images and the evaluation of both physiochemical and structural properties of knee cartilage. Nevertheless, implementation of a DT proton/sodium RF coil is technically difficult because of the coupling effect between the coil elements (particularly at high field) and the required compact design with improved coil sensitivity. In this study, we applied a multitransceiver RF coil design to develop a DT proton/sodium coil for knee cartilage imaging at 3 T. With the new design, the size of the coil was minimized, and a high signal-to-noise ratio (SNR) was achieved. DT coil exhibited high levels of reflection S11 (∼-21 dB) and transmission coefficient S12 (∼-19 dB) for both the proton and sodium coils. High SNR (range 27-38) and contrast-to-noise ratio (CNR) (range 15-21) were achieved in sodium MR imaging of knee cartilage in vivo at 3-mm(3) isotropic resolution. This DT coil performance was comparable to that measured using a sodium-only birdcage coil (SNR of 28 and CNR of 20). Clinical evaluation of the DT coil on four normal subjects demonstrated a consistent acquisition of high-resolution proton images and measurement of relative sodium concentrations of knee cartilages without repositioning of the subjects during the same MR scanning session.

Restricted growth of U-type infectious haematopoietic necrosis virus (IHNV) in rainbow trout cells may be linked to casein kinase II activity

Previously, we demonstrated that a representative M genogroup type strain of infectious haematopoietic necrosis virus (IHNV) from rainbow trout grows well in rainbow trout-derived RTG-2 cells, but a U genogroup type strain from sockeye salmon has restricted growth, associated with reduced genome replication and mRNA transcription. Here, we analysed further the mechanisms for this growth restriction of U-type IHNV in RTG-2 cells, using strategies that assessed differences in viral genes, host immune regulation and phosphorylation. To determine whether the viral glycoprotein (G) or non-virion (NV) protein was responsible for the growth restriction, four recombinant IHNV viruses were generated in which the G gene of an infectious IHNV clone was replaced by the G gene of U- or M-type IHNV and the NV gene was replaced by NV of U- or M-type IHNV. There was no significant difference in the growth of these recombinants in RTG-2 cells, indicating that G and NV proteins are not major factors responsible for the differential growth of the U- and M-type strains. Poly I:C pretreatment of RTG-2 cells suppressed the growth of both U- and M-type IHNV, although the M virus continued to replicate at a reduced level. Both viruses induced type 1 interferon (IFN1) and the IFN1 stimulated gene Mx1, but the expression levels in M-infected cells were significantly higher than in U-infected cells and an inhibitor of the IFN1-inducible protein kinase PKR, 2-aminopurine (2-AP), did not affect the growth of U- or M-type IHNV in RTG-2 cells. These data did not indicate a role for the IFN1 system in the restricted growth of U-type IHNV in RTG-2 cells. Prediction of kinase-specific phosphorylation sites in the viral phosphoprotein (P) using the NetPhosK program revealed differences between U- and M-type P genes at five phosphorylation sites. Pretreatment of RTG-2 cells with a PKC inhibitor or a p38MAPK inhibitor did not affect the growth of the U- and M-type viruses. However, 100 μm of the casein kinase II (CKII) inhibitor, 5,6-dichloro-1-β-d-ribofuranosylbenzimidazole (DRB), reduced the titre of the U type 8.3-fold at 24 h post-infection. In contrast, 100 μm of the CKII inhibitor reduced the titre of the M type only 1.3-fold at 48 h post-infection. Our data suggest that the different growth of U- and M-type IHNV in RTG-2 cells may be linked to a differential requirement for cellular protein kinases such as CKII for their growth.

Differential growth of U and M type infectious haematopoietic necrosis virus in a rainbow trout-derived cell line, RTG-2

Infectious haematopoietic necrosis virus (IHNV) is one of the most important viral pathogens of salmonids. In rainbow trout, IHNV isolates in the M genogroup are highly pathogenic, while U genogroup isolates are significantly less pathogenic. We show here that, at a multiplicity of infection (MOI) of 1, a representative U type strain yielded 42-fold less infectious virus than an M type strain in the rainbow trout-derived RTG-2 cell line at 24 h post-infection (p.i.). However, at an MOI of 10, there was only fivefold difference in the yield of infectious virus between the U and M strains. Quantification of extracellular viral genomic RNA suggested that the number of virus particles released from cells infected with the U strain at a MOI of 1 was 47-fold lower than from M-infected cells, but U and M virions were equally infectious by particle to infectivity ratios. At an MOI of 1, U strain intracellular viral genome accumulation and transcription were 37- and 12-fold lower, respectively, than those of the M strain at 24 h p.i. Viral nucleocapsid (N) protein accumulation in U strain infections was fivefold lower than in M strain infections. These results suggest that the block in U type strain growth in RTG-2 cells was because of the effects of reduced genome replication and transcription. The reduced growth of the U strain does not seem to be caused by defective genes, because the U and M strains grew equally well in the permissive epithelioma papulosum cyprini cell line at an MOI of 1. This suggests that host-specific factors in RTG-2 cells control the growth of the IHNV U and M strains differently, leading to growth restriction of the U type virus during the RNA synthesis step.

Comparison of the immunogenicity of recombinant VP2 and VP3 of infectious pancreatic necrosis virus and marine birnavirus

Recombinant proteins of truncated viral protein-2 (VP2) (aa 79-359) and VP3 of infectious pancreatic necrosis virus (IPNV) and marine birnavirus (MABV) were expressed in E. coli and their immunogenicities in fish were investigated. The recombinant proteins from IPNV were used to immunize rainbow trout and those from MABV to immunize flounder. The sera from the immunized fishes were assayed for antibody by ELISA and a neutralization test. Both the recombinant VP2 and VP3 produced antibodies in fish but the VP3 antibody titers were higher than that of the VP2 of IPNV and MABV. These results indicate that the recombinant VP3 is more immunogenic than the recombinant VP2.

Multiphasic perfusion computed tomography in hyperacute ischemic stroke: comparison with diffusion and perfusion magnetic resonance imaging

PURPOSE

The purpose of this study was to compare multiphasic perfusion computed tomography (CT) with diffusion and perfusion magnetic resonance imaging (MRI) in predicting final infarct volume, infarct growth, and clinical severity in patients with hyperacute ischemia untreated by thrombolytic therapy.

METHOD

Multiphasic perfusion CT was performed in 19 patients with ischemic stroke within 6 hours of symptom onset. Two CT maps of peak and total perfusion were generated from CT data. Diffusion-weighted imaging (DWI) and perfusion MRI were obtained within 150 minutes after CT. Lesion volumes on CT and MRI were compared with final infarct volume and clinical scores, and mismatch on CT or MRI was compared with infarct growth.

RESULTS

The lesion volume on the CT total perfusion map strongly correlated with MRI relative cerebral blood volume (rCBV), and that on the CT peak perfusion map strongly correlated with MRI relative cerebral blood flow (rCBF) and rCBV (P < 0.001). The lesion volume on unenhanced CT or DWI moderately correlated with final infarct volume, but only lesion volume on unenhanced CT weakly correlated with baseline clinical scores (P = 0.024). The lesion volumes on the CT peak perfusion map and MRI rCBF similarly correlated with final infarct volume and clinical scores and more strongly than those on mean transit time (MTT) or time to peak (TTP). DWI-rCBF or CT mismatch was more predictive of infarct growth than DWI-MTT or DWI-TTP mismatch.

CONCLUSION

Multiphasic perfusion CT is useful and of comparable utility to diffusion and perfusion MRI for predicting final infarct volume, infarct growth, and clinical severity in acute ischemic stroke.

Perfusion MR imaging: clinical utility for the differential diagnosis of various brain tumors

Objective

To determine the utility of perfusion MR imaging in the differential diagnosis of brain tumors.

Materials and Methods

Fifty-seven patients with pathologically proven brain tumors (21 high-grade gliomas, 8 low-grade gliomas, 8 lymphomas, 6 hemangioblastomas, 7 metastases, and 7 various other tumors) were included in this study. Relative cerebral blood volume (rCBV) and time-to-peak (TTP) ratios were quantitatively analyzed and the rCBV grade of each tumor was also visually assessed on an rCBV map.

Results

The highest rCBV ratios were seen in hemangioblastomas, followed by high-grade gliomas, metastases, low-grade gliomas, and lymphomas. There was no significant difference in TTP ratios between each tumor group (p>0.05). At visual assessment, rCBV was high in 17 (81%) of 21 high-grade gliomas and in 4 (50%) of 8 low-grade gliomas. Hemangioblastomas showed the highest rCBV and lymphomas the lowest.

Conclusion

Perfusion MR imaging may be helpful in the differentiation of thevarious solid tumors found in the brain, and in assessing the grade of the various glial tumors occurring there.

Multiphasic perfusion CT in acute middle cerebral artery ischemic stroke: prediction of final infarct volume and correlation with clinical outcome

Objective

To assess the utility of multiphasic perfusion CT in the prediction of final infarct volume, and the relationship between lesion volume revealed by CT imaging and clinical outcome in acute ischemic stroke patients who have not undergone thrombolytic therapy.

Materials and Methods

Thirty-five patients underwent multiphasic perfusion CT within six hours of stroke onset. After baseline unenhanced helical CT scanning, contrast-enhanced CT scans were obtained 20, 34, 48, and 62 secs after the injection of 90 mL contrast medium at a rate of 3 mL/sec. CT peak and total perfusion maps were obtained from serial CT images, and the initial lesion volumes revealed by CT were compared with final infarct volumes and clinical scores.

Results

Overall, the lesion volumes seen on CT peak perfusion maps correlated most strongly with final infarct volumes (R²=0.819, p<0.001, slope of regression line=1.016), but individual data showed that they were less than final infarct volume in 31.4% of patients. In those who showed early clinical improvement (n=6), final infarct volume tended to be overestimated by CT peak perfusion mapping and only on total perfusion maps was there significant correlation between lesion volume and final infarct volume (R²=0.854, p=0.008). The lesion volumes depicted by CT maps showed moderate correlation with baseline clinical scores and clinical outcomes (R=0.445-0.706, p≤0.007).

Conclusion

CT peak perfusion maps demonstrate strong correlation between lesion volume and final infarct volume, and accurately predict final infarct volume in about two-thirds of the 35 patients. The lesion volume seen on CT maps shows moderate correlation with clinical outcome.

Rutaecarpine, a quinazolinocarboline alkaloid, inhibits prostaglandin production in RAW264.7 macrophages

In order to delineate the mechanism involved in the anti-inflammatory activity of rutaecarpine, its effects on the production of prostaglandin (PG) and therein involved enzymes were examined. Rutaecarpine reduced the production of PGE(2) in RAW264.7 cells treated with lipopolysaccharide (LPS) in a dose dependent manner when added to the culture media at the time of stimulation. However, the inhibition of total cellular cyclooxygenase (COX) activity under the same experimental condition was observed only at high concentrations of rutaecarpine. Rutaecarpine did not affected the levels of COX-2 mRNA and protein in macrophages stimulated with LPS. Calcium ionophore A23187 induced-PG production and [(3)H]-arachidonic acid release were significantly decreased by the pretreatment of rutaecarpine for 30 minutes. With the same treatment schedule, however, rutaecarpine failed to alter the activities of cellular COX-1 and COX-2. Collectively, our data suggest that anti-inflammatory effect of rutaecarpine is, at least in part, ascribed to the diminution of PG production through inhibition of arachidonic acid release albeit the nature of its effects on PLA(2) activity remains to be elaborated.

Differential roles of cyclooxygenase isoforms after kainic acid-induced prostaglandin E(2) production and neurodegeneration in cortical and hippocampal cell cultures

Prostaglandins, which are cyclooxygenase (COX) products, are pathologically up-regulated, and have been proven to be closely associated with neuronal death. In this study, we investigated a role of COX isoforms (COX-1 and COX-2) in kainic acid-induced neuronal death in cultured murine cortical or hippocampal neurons. In primary cortical neurons, both indomethacin (COX-1/-2 nonselective inhibitor) and aspirin (COX-1 preferential inhibitor) reduced basal and kainic acid-induced PGE(2) production significantly and prevented neuronal cell death after kainic acid treatment. In contrast, NS398 (COX-2 selective inhibitor) had no effect on kainic acid-induced neuronal cell death. In hippocampal neurons, however, COX-2 inhibitors prevented both kainic acid-induced neuronal death and PGE(2) production. COX-2 expression was remarkably up-regulated by kainic acid in hippocampal neurons; whereas in cortical neurons, COX-2 expression was comparatively less significant. Astrocytes were unresponsive to kainic acid in terms of PGE(2) production and cell death. In conclusion, we suggest that the release of PGE(2) induced by kainic acid occurred through COX-1 activity rather than COX-2 in cortical neurons. The inhibition of PGE(2) release by COX-1 inhibitors prevented kainic acid-induced cortical neuronal death, while in the hippocampal neurons, COX-2 inhibitors prevented kainic acid-induced PGE(2) release and hippocampal neuronal death.

Protein kinase C inhibitors attenuate protective effect of high glucose against hypoxic injury in H9c2 cardiac cells

In this study, we demonstrated that PKC inhibitors significantly attenuated the cardioprotective effect produced by high-glucose (22 mM) treatment for 48 h against hypoxic injury in H9c2 cardiac cells. PKC activators mimicked the cardioprotective effect of high glucose. These results suggest a possible role of PKC activation in high-glucose--induced protection.

High glucose enhances IL-1beta-induced cyclooxygenase-2 expression in rat vascular smooth muscle cells

The changes in vascular prostaglandin production are implicated in the derangement of vascular reactivity in diabetes. However, the mechanism of altered prostaglandin (PG) production in diabetes is largely unknown. In this study, we investigated the effect of high glucose on IL-1beta-induced PG production and the possible underlying mechanism in cultured vascular smooth muscle cell (VSMC). High glucose evoked an augmentation of IL-1beta-induced PG synthesis in a dose dependent manner and enhanced cyclooxygenase (COX) activity, which reached to maximum at 8-12 hours after stimulation. Western blot analysis supported the activity data. Protein kinase C (PKC) inhibitors, H-7 and chelerythrine, significantly inhibited the enhancement of IL-1beta-induced COX-2 expression by high glucose. The activation of PKC by PMA resulted in marked increase of PG production in low glucose group, whilst this was not the case in high glucose group. Furthermore, glucose-enhancing effect was significantly suppressed by zopolrestat, an aldose reductase inhibitor, and sodium pyruvate. These results suggest that the augmenting effect of high glucose on IL-1beta-induced PG production and COX-2 expression is, at least in part, due to increased glucose metabolism via sorbitol pathway following PKC activation.

Outcome from injury: general health, work status, and satisfaction 12 months after trauma

OBJECTIVE

We evaluated outcomes 12 months after trauma in terms of general health, satisfaction, and work status.

METHODS

Two hundred forty-seven patients without severe neurotrauma were evaluated by interview during admission and by mailed self-report 6 and 12 months after trauma. Data were obtained from the Trauma Registry, interviews, and survey instruments. Baseline assessment was obtained with the Short Form 36 (SF36) and the Sickness Impact Profile (SIP) work scale. Outcome measures were the SF36, SIP work scale, Brief Symptom Inventory (BSI) depression scale, the Civilian Mississippi Scale for Posttraumatic Stress Disorder (PTSD), and a satisfaction questionnaire. Three regressions were determined for outcome. The dependent variables were general health and work status (linear) and satisfaction (logistic). Each regression controlled for baseline status and mental health, Injury Severity Score (ISS), and 12-month SF36 physical function before evaluating the effect of outcome mental health.

RESULTS

Follow-up data were available for 75% of the patients at 6 months and 51% at 12 months. The mean age of patients was 37.2 +/- 0.9 years (+/-SEM), and 73% were male. Their average ISS was 13.9 +/- 0.6. Seventy percent of injuries were blunt force, 13.5 % were penetrating, and 16.5 % were burn injuries (mean total body surface area, 13.3 +/- 1.5%). Sixty-four percent of the patients had returned to work at 12 months. Follow-up SF36 mental health was associated with the dependent outcome in each regression. After controlling for baseline status and mental health, ISS, and outcome SF36 physical function, outcome mental health was associated with outcome SF36 general health (p < 0.001), SIP work status (p = 0.017), and satisfaction with recovery (p = 0.005). Outcome SF36 mental health was related to baseline mental health, 12-month PTSD and BSI depression scores, and increased drug and alcohol use.

CONCLUSIONS

Twelve months after trauma, patients' work status, general health, and overall satisfaction with recovery are dependent on outcome mental health. This dependency persists despite measured baseline status, ISS, or physical recovery. The mental disease after trauma is attributable to poor mental health, the development of symptoms of PTSD and depression, and increased substance abuse. Trauma centers that fail to recognize, assess, and treat these injury-related mental health outcomes are not fully assisting their patients to return to optimal function.

Mechanism for antiplatelet effect of onion: AA release inhibition, thromboxane A(2)synthase inhibition and TXA(2)/PGH(2)receptor blockade

Antiplatelet actions of aqueous extract of onion were investigated in rat and human platelet. IC(50)values of onion extract for collagen-, thrombin-, arachidonic acid (AA)-induced aggregations and collagen-induced thromboxane A(2)(TXA(2)) formation were 0.17 +/- 0. 01, 0.23 + 0.03, 0.34 +/- 0.02 and 0.12 +/- 0.01 g/ml, respectively. [(3)H]-AA release induced by collagen (10 microg/ml) in rat platelet was decreased by onion compared to control (22.1 +/- 2.13 and 5.2 +/- 0.82% of total [(3)H]-AA incorporated, respectively). In fura-2 loaded platelets, the elevation of intracellular Ca(2+)concentration stimulated by collagen was inhibited by onion. Onion had no cytotoxic effect in platelet. Onion significantly inhibited TXA(2)synthase activity without influence on COX activity. Platelet aggregation induced by U46619, a stable TXA(2)mimetic, was inhibited by onion, indicating its antagonism for TXA(2)/PGH(2)receptor. These results suggest that the mechanism for antiplatelet effect of onion may, at least partly, involve AA release diminution, TXA(2)synthase inhibition and TXA(2)/PGH(2)receptor blockade.

4-1BB: still in the midst of darkness

4-1BB is a member of the tumor necrosis factor receptor superfamily. The receptor functions mainly as a costimulatory molecule in T lymphocytes. In addition, several lines of evidence have shown that interactions between 4-1BB and its ligand are involved in the antigen presentation process and the generation of cytotoxic T cells. Recent studies, however, have demonstrated that 4-1BB plays more diverse roles: Signals through 4-1BB are important for long-term survival of CD8+ T cells and the induction of helper T cell anergy. Clinically, there is great interest in 4-1BB, because T-cell activation induced by anti-4-1BB monoclonal antibodies is highly efficient in the eradication of established tumor cells in mice. Now, since mice deficient in 4-1BB or the 4-1BB ligand are available, subtle roles played by 4-1BB may be revealed in the near future.

An animal model of neuropathic pain employing injury to the sciatic nerve branches

The present study was conducted to develop a new animal model of neuropathic pain employing injury to the distal sciatic nerve branches. Under halothane anesthesia, the tibial, sural, and/or common peroneal nerves were injured and neuropathic pain behaviors were compared among different groups of rats. Different types of injury produced different levels of neuropathic pain. Rats with injury to the tibial and sural nerves showed the most vigorous mechanical allodynia, cold allodynia, and spontaneous pain. These neuropathic pain behaviors were not relieved by functional sympathectomy using guanethidine. The results suggested that injury to the tibial and sural nerves, while leaving the common peroneal nerve intact, can be used as a new animal model of neuropathic pain and that this model represents sympathetically independent pain (SIP). The present animal model is very simple to produce injury and can produce profound and reliable pain behaviors. These features enable the new animal model to be a useful tool in elucidating the mechanisms of neuropathic pain, especially SIP.

Posttraumatic stress disorder in injured adults: etiology by path analysis

OBJECTIVE

Posttraumatic Stress Disorder (PTSD) impairs outcome from injury. We present a path analysis of factors related to the development of PTSD in injured adults.

METHODS

A prospective cohort of 250 patients without severe neurotrauma was evaluated by interview during admission and by mailed self-report 6 months later. Data were gathered from the trauma registry (age, injury mechanism, and Injury Severity Score), social history (gender, income, education, and social support), and survey instruments. Baseline assessment used the Michigan Critical Events Perception Scale (peritraumatic dissociation and subjective threat to life), the Life Experience Survey (stressful exposure history), and the SF36 (general and mental health). PTSD at 6 months was identified with the civilian Mississippi Scale for PTSD. Data are listed as mean +/- SEM or percent (%). Path analysis was conducted by linear regression and significant (p<0.05) variables are shown. Factors are listed with the standardized beta. A negative beta suggests a protective effect.

RESULTS

The 176 patients (72%) who completed the 6-month follow-up were 37.7+/-0.88 years old; 75% were men; and blunt (70%), penetrating (13.5%), and burn (16.4%) mechanisms caused the injuries. Assault was involved in 14.5% of the cases. Average income was $44,300+/-2,700/yr, education was 13.0+/-0.15 years, and Injury Severity Score was 13.9+/-0.50. A total of 42.3% of the patients developed PTSD. The 39.7% of the variance in PTSD explained by the model was due to intentional injury (beta = 0.27), male gender (beta = -0.21), age (beta = -0.20), peritraumatic dissociation (beta = 0.174), baseline mental health (beta = -0.21), and prior life-threatening illness (beta = -0.29). Peritraumatic dissociation was due to the patient's sense of threat to life (beta = -0.47), and threat was related to Injury Severity Score (beta = 0.2), assault(beta = 0.14), education (beta = -0.15), and age (beta = -0.19). Baseline SF36 mental health was related to social support (beta = 0.27) and income (beta = 0.21). Income was contingent on education (beta = 0.21).

CONCLUSION

PTSD occurred in 42.3% of injured adults 6 months after trauma and was related to assault, dissociation, female gender, youth, poor mental health, and prior illness. By modeling PTSD, we may learn more of the etiology, risk stratification, and potentials for the treatment of this common and important morbidity of injury.

Protein kinase C inhibitors abolish the increased resistance of diabetic rat heart to ischemia-reperfusion injury

Protein kinase C (PKC) has been implicated in ischemic preconditioning, but whether it plays a role in the cardioprotection observed in the diabetic heart is not known. We assessed the possible role of PKC by investigating whether the inhibition of PKC with staurosporine (Stau, 0.01 microM) or chelerythrine (Chel, 1 microM) can abolish the increased resistance to ischemia (25 min)-reperfusion (30 min) injury in Langendorff perfused hearts from streptozotocin-induced 4-week diabetic rats. In the diabetic heart, pre-ischemic left ventricular developed pressure (LVDP), double product (DP: LVDPxheart rate/1,000), +/- dP/dt(max) and coronary flow rate (CFR) were all reduced compared to the control. The pretreatment with Stau or Chel significantly improved these parameters. The post-ischemic contractile function was recovered to a greater extent in the diabetic heart (116.9 +/- 20.5% of pre-ischemic DP) than in the control (23.3 +/- 2.3% of pre-ischemic DP), indicating the increased resistance of the diabetic heart to ischemia-reperfusion injury. The treatment with Stau or Chel abolished the enhanced recovery in the diabetic heart (36.0 +/- 14.6 and 54.1 +/- 12.8% of pre-ischemic DP, respectively). The reduction in post-ischemic end diastolic pressure (EDP) and lactate dehydrogenase (LDH) release in diabetes (13.5 +/- 2.5 mmHg and 27.2 +/- 6.2 U/g heart) compared to the control (55.8 +/- 2.9 mmHg and 60. 3 +/- 5.7 U/g heart) was significantly (p<0.05) increased by pretreatment with Stau (39.0 +/- 4.9 mmHg and 53.1 +/- 7.6 U/g heart) or Chel (36.2 +/- 3.0 mmHg and 48.8 +/- 4.3 U/g heart). Neither Stau nor Chel had any influence on the post-ischemic values of LVDP, DP, +/- dP/dt(max), EDP and LDH release in the control heart. In the conclusion, the present results suggest that PKC activation may, at least in part, contribute to the increased resistance of the diabetic heart to ischemia-reperfusion injury.

Posttraumatic stress disorder after injury: impact on general health outcome and early risk assessment

OBJECTIVE

To evaluate prospectively components of general health outcome after trauma and to report on the further validation of the Michigan Critical Events Perception Scale (MCEPS), an instrument that predicts increased risk for posttraumatic stress disorder (PTSD).

METHODS

Adults without neurologic injury admitted to a Level I trauma center in 1997 were interviewed during hospitalization. Baseline data included demographics, injury mechanism, Injury Severity Score, the Short Form 36 (SF36), and the MCEPS, which measures peri-traumatic dissociation (the sense of depersonalization or derealization during an injury event). Surveys sent by mail and completed 6 months later included the SF36 and civilian Mississippi Scale for PTSD.

RESULTS

A total of 140 patients were interviewed; the 70% (n = 100 patients) who completed the 6-month assessment form the study group. Injuries were categorized as 71% blunt, 13% penetrating, and 16% burn. Mean Injury Severity Score was 13.7+/-0.52. PTSD at 6 months occurred in 42% of the patients and was directly related to MCEPS dissociation (p = 0.001; odds ratio = 3.1; 95% confidence interval, 1.6, 5.9). A stepwise linear regression explains 40% of the variance in 6-month SF36 general health outcome (adjusted R2 = 0.402). The model controls for individual factors related to dissociation, PTSD, and general health outcome. Development of PTSD was independently and inversely related to general health outcome as measured by the SF36 at 6 months (p < 0.001, beta = -0.404). The R2 change of 0.132 for PTSD (vs. 0.082 for 6-month physical function) illustrates that PTSD contributes more to the patient's perceived general health at 6 months than the degree of physical function or injury severity.

CONCLUSIONS

Within hours of injury, the MCEPS identifies patients who are three times more likely to develop PTSD. PTSD compromises self-reported general health outcome in injured adults independent of baseline status, Injury Severity Score, or degree of physical recovery. These data suggest that psychological morbidity is an important part of the patient's perceived general health.

Can you spot the signs of elder mistreatment?

The incidence of elder mistreatment is expected to increase as the baby boom generation ages and more elderly people are living or receiving care at home. Despite increased awareness and reporting of other forms of domestic abuse and neglect, recognition and management of elder abuse lag far behind actual incidents. Drs Kruger and Moon describe the signs of mistreatment as well as the physician's role in reporting and management.

Systemically administered capsazepine prevents the capsaicin-induced functional desensitization and loss of substance P-like immunoreactivity (SP-LI) in guinea-pig bronchi

In this study, we investigated whether the systemically administered capsazepine can prevent the capsaicin-induced desensitization ex vivo in guinea-pig bronchi. Pretreatment with capsaicin (2.5, 5 and 10 mg/kg, s.c.) induced the functional desensitization and the loss of substance P-like immunoreactivity (SP-LI) with a similar potency (ED50: 3.31 +/- 0.57 and 4.81 +/- 0.89 mg/kg, respectively) in isolated guinea-pig bronchi. Capsazepine (30 mg/kg, s.c.) co-administered with capsaicin (5 mg/kg, s.c.) prevented the capsaicin (5 mg/kg, s.c.)-induced functional desensitization and loss of SP-LI. These results suggest that capsazepine can antagonize systemically the desensitizing action of capsaicin at the level of receptor, preventing the loss of SP-LI and the establishment of functional desensitization in guinea-pig bronchi.

Capsaicin-induced desensitization is prevented by capsazepine but not by ruthenium red in guinea pig bronchi

In isolated guinea pig bronchi, the influence of ruthenium red, capsazepine and extracellular Ca2+ on capsaicin-induced desensitization was examined to investigate whether this desensitization was mediated via a specific receptor coupled with an ion channel. Pre-exposure of tissues to capsaicin (1, 3 or 10 microM) caused a dose-dependent desensitization to the second application of capsaicin. However, the contractile responses to exogenous tachykinins were not changed after pre-exposure of tissues to capsaicin. This capsaicin-induced desensitization was prevented by capsazepine (30 microM), but not by ruthenium red added to tissues 20 min before pretreatment with capsaicin (3 microM). While the excitatory contractile response to capsaicin was markedly reduced in the absence of extracellular Ca2+, the desensitization induced by capsaicin was not changed by the removal of extracellular Ca2+. In summary, the results from the present study suggest that in vitro functional desensitization induced by capsaicin in guinea pig bronchi may involve changes in the vanilloid receptor and occur through a ruthenium red-insensitive pathway.

Giant-cell interstitial pneumonia in a gas station worker

Giant-cell interstitial Pneumonia (GIP) is a very uncommon respiratory disease. The majority of cases of GIP are caused by exposure to cobalt, tungsten and other hard metals. In this report, we describe GIP in a patient who worked in gas station and dealt in propane gas vessels. He presented with clinical features of chronic interstitial lung disease and underwent an open lung biopsy that showed DIP-like reaction with large numbers of intra-alveolar macrophages and numerous large, multinucleated histiocytes which were admixed with the macrophages. Analysis of lung tissue for hard metals was done. Cobalt was the main component of detected hard metals. Corticosteroid therapy was started and he recovered fully.

Pharmacokinetics of losartan and its metabolite, EXP3174, after intravenous and oral administration of losartan to rats with streptozotocin-induced diabetes mellitus

The pharmacokinetics of losartan and its active metabolite, EXP3174, were investigated after intravenous and oral administration of the drug, 5 mg/kg, to control rats and streptozotocin-induced diabetes mellitus rats (SIDRs). After 1-min intravenous infusion, the mean arterial plasma concentrations and the resultant area under the plasma concentration-time curve from zero to infinity (AUC) of both losartan and EXP3174 were not significantly different between control rats and the SIDRs. However, the renal clearance (CLR) of losartan (0.181 versus 0.0815 ml/min/kg) and EXP3174 (0.0677 versus 0.0277 ml/min/kg) were significantly faster in SIDRs than in control rats due to significant increase in glomerular filtration rate. After oral administration, the mean arterial plasma concentrations and the resultant AUC of losartan (97 versus 166 micrograms min/ml) and EXP3174 (244 versus 423 micrograms min/ml) were significantly lower in SIDRs than in control rats. The absolute extent of oral bioavailability of losartan, F, (32.5 versus 55.1%) decreased considerably in SIDRs and it was possibly due to the reduced gastrointestinal absorption of losartan by gastrointestinal disorders occurring in the diabetic state. The low F in both groups of rats was at least partially due to the increase in first-pass effects. The CLR of losartan (0.207 versus 0.101 ml/min/kg) and EXP3174 (0.0615 versus 0.0196 ml/min/kg) were significantly faster in SIDRs than in control rats after oral administration of losartan.

Molecular cloning of a novel GTP-binding protein induced in fish cells by rhabdovirus infection

We have cloned and sequenced a cDNA encoding GTP-binding protein from a fish cell, CHSE-214. The clone was 1493 bp long and contained an open reading frame encoding 364 amino acids. It has the five sequence motifs G1-G5 that are conserved in all GTP-binding proteins. Its amino acid sequences are strikingly different from those of the well-characterized G-proteins. However, sequences closely related to this protein are found in various kinds of species including human, Arabidopsis, Drosophila and archaebacteria, suggesting a novel subfamily within the superfamily of the GTP-binding proteins. Northern analysis indicates that this gene is constitutively expressed at a low level in normal cells but is induced by fish rhabdovirus infection at about 24 h post infection and disappears thereafter. Based on these observations, we propose that this protein represents an evolutionarily conserved novel subfamily of GTP-binding proteins which may play an important role in fish rhabdovirus infection.

Psychosocial factors limit outcomes after trauma

BACKGROUND

Psychological morbidity compromises return to work after trauma. We demonstrate this relationship and present methods to identify risks for significant psychological morbidity.

METHODS

Thirty-five adults were evaluated prospectively for return to functional employment after injury using demographic data, validated psychological and health measures, and the Michigan Critical Events Perception Scale. Evaluation was conducted at admission and at 1 and 5 months after injury.

RESULTS

Poor return to work at 5 months was attributable to physical disability (p < 0.05) and psychological disturbance (p < 0.05) in a regression model that controlled for preinjury employment and psychopathologic factors as well as injury severity. A high score on the Impact of Events Scale administered during acute admission predicted development of acute stress disorder at 1 month (p < 0.01, odds ratio (OR) = 9.4) and posttraumatic stress disorder at 5 months (p < 0.05, OR = 6.7). Peritraumatic dissociation on the Michigan Critical Events Perception Scale was predictive for development of acute stress disorder (p < 0.05, OR = 5.8) at 1 month and posttraumatic stress disorder (p < 0.05, OR = 7.5) at 5 months.

CONCLUSION

Psychological morbidity after injury compromises return to work independent of preinjury employment and psychopathologic condition, Injury Severity Score, or ambulation. A high Impact of Events Scale score or peritraumatic dissociation at admission predicts this morbidity.

Brazilin inhibits activities of protein kinase C and insulin receptor serine kinase in rat liver

Hypoglycemic action of brazilin was found to be based on the improvement of peripheral glucose utility, and this action might be correlated with the insulin action pathway. In the present study we investigated the effect of brazilin on the insulin receptor autophosphorylation, protein kinase C (PKC), protein phosphatase and insulin receptor serine kinase in order to confirm whether the hypoglycemic mechanism is concerned with insulin action pathway. Brazilin was found to inhibit PKC and insulin receptor serine kinase, which are involved in the regulation of insulin signal pathway. But any significant effect was not shown on insulin receptor tyrosine kinase activity, autophosphorylation and phosphatase activity. These findings suggest that brazilin might enhance insulin receptor function by decreasing serine phosphorylation, which might mediate hypoglycemic effect of brazilin.

A new silent magnetic resonance imaging using a rotating DC gradient

A new approach to silent MR imaging using a rotating DC gradient has been explored and experimentally studied. Acoustic or sound noise has been one of the problems in examining patients, mainly due to the fast gradient pulsings in interaction with the main magnetic field. The sound noise has been noted to be proportionately louder as the magnetic field strength becomes larger. In this report, we describe a new imaging technique using a mechanically rotating DC gradient coil. The rotating DC gradient coil can effectively replace both phase encoding as well as readout gradient pulsings, and data obtained in this manner can provide a set of projection data that later can be used for projection reconstruction. With some interpolation techniques one can also perform conventional two-dimensional fast Fourier transform image reconstruction. The sound noise intensity compared with the conventional imaging technique, such as the spin-echo sequence, has been reduced down to about -20.7 dB or 117.5 times with this new technique. The experimental pulse sequence and its principle are described and images obtained by the new silent MR imaging technique are reported.

Cardioprotective effects of KR-30450, a novel K+(ATP) opener, and its major metabolite KR-30818 on isolated rat hearts

The cardiac effects of KR-30450 ((-)-(2R)-2-([1,3]-dioxolan-2-yl)-2-methyl-4-(2-oxopyrrolidin++ +-1-yl)-6-nitro-2H-1-benzopyran), a newly synthesized potassium channel activator, and its major metabolite KR-30818 ((-)-(2R)-2-hydroxymethyl-2-methyl-4-(2-oxopyrrolidin-1-yl)-6-nitr o-2H-1-benzopyran) were compared with those of lemakalim, a prototype of this class, in isolated globally ischemic rat hearts. KR-30450 and KR-30818 significantly improved reperfusion cardiac function (LVDP, left ventricular developed pressure; double product, LVDP x heart rate/1000), their potency being 5.2-fold and 0.7-fold greater than lemakalim (ED50 for recovering predrug double product: 0.10, 0.80 and 0.54 microM, respectively). KR-30450 and KR-30818 significantly attenuated reperfusion contracture and lactate dehydrogenase release with potency greater than and equal to lemakalim, respectively. They significantly increased time to contracture (TTC) during ischemia in a dose-dependent manner with a greater potency than lemakalim (EC25 for increasing TTC: 1.2, 2.1 and 3.2 microM, respectively). The protective effects of three compounds on the measured parameters were reversed by glyburide, a selective K+(ATP) blocker. In non-ischemic hearts, KR-30450 and lemakalim exerted weak negative inotropism at high concentrations and KR-30818 had no effects, whereas the three compounds significantly increased coronary flow at doses studied. Glyburide completely reversed preischemic cardiodepressant effects of these compounds but not their effects on coronary flow. In conclusion, KR-30450, a recently developed K+(ATP) opener, exerted more potent cardioprotective effects than lemakalim, and its major metabolite KR-30818 may play a significant role in its action in vivo.

On the Complexation of Cd(II) Ions with Polyacrylic Acid

Complexation of Cd(II) ions with polyacrylic acid has been studied potentiometrically and by 113Cd NMR spectroscopy. A Donnan model proposed by Marinsky (Marinsky, J. A., in "Ion Exchange and Solvent Extraction" (J. A. Marinsky and Y. Marcus, Eds.), Vol. 11, p. 237. Dekker, New York, 1993; Miyajima, T., in "Ion Exchange and Solvent Extraction" (J. A. Marinsky and Y. Marcus, Eds.), Vol. 12, p. 275. Dekker, New York, 1995) has been applied in order to correct for the electrostatic effect on the equilibria inherent in the polyelectrolyte nature of the polyions. The potentiometric studies showed that the bidentate ligand complex, (CdA2)0, is the dominant species, but the formation of monodentate ligand complex, (CdA)+, cannot be neglected at low degree of dissociation of the polyacid. The stability constants of the (CdA)+ and (CdA2)0 complexes have been determined to be approximately 3.2 x 10 and 1.6 x 10(2), respectively. These values are in good agreement with the stability constants of 4.1 x 10 and 1.0 x 10(2) for Cd(acetate) and Cd(glutarate) complexes, where acetate and glutarate ions are the monomer analog ligands of polyacrylic acid. The 113Cd NMR chemical shift change upon dissociation of the polyacid also indicates that the dominant complex is (CdA2)0, but (CdA)+ becomes more appreciable with the decreasing degree of dissociation of the polyacid.

Pharmacokinetic changes of methotrexate after intravenous administration to uranyl nitrate-induced acute renal failure rats

The pharmacokinetic changes of methotrexate (MTX) were investigated after 1-min intravenous (iv) administration of MTX, 8 mg/kg, to the control and the uranyl nitrate-induced acute renal failure (U-ARF) rats. The impaired kidney and liver functions were observed by pretreatment with urinary nitrate based on physiological parameters of plasma and urine, and the tissue microscopy. After 1-min iv infusion of MTX, the plasma concentrations of MTX (except at 1 min) and the total area under the plasma concentration-time curves of MTX (542 versus 297 micrograms min/ml) increased significantly in the U-ARF rats when compared to those in the control rats. This was due to the significantly slower in total body clearance (CL) of MTX (15.2 versus 27.5 ml/min/kg) in the U-ARF rats than that in the control rats. The significantly slower in CL of MTX in the U-ARF rats was due to the significantly slower both renal (1.01 versus 8.39 ml/min/kg, because of the considerably decreased renal tubular secretion of MTX) and nonrenal (14.2 versus 19.1 ml/min/kg, because of the considerably decreased liver metabolism) clearances in the U-ARF rats. All 11 control rats survived until sacrificed (24 h), however, 5 out of 15 U-ARF rats died within 7 h after iv administration of MTX. If the present rat data were to be extrapolated to human beings, iv dose of MTX need to be modified in the acute renal failure patients.

Pharmacokinetic changes of methotrexate after intravenous administration to streptozotocin-induced diabetes mellitus rats

The pharmacokinetic changes of methotrexate (MTX) were investigated after 1-min intravenous (iv) administration of MTX, 8 mg/kg, to the control and the streptozotocin-induced diabetes mellitus (SIDM) rats. After 1-min iv infusion of MTX, plasma concentrations of MTX declined polyexponentially for both groups of rats. In the SIDM rats, the plasma concentrations of MTX were significantly lower up to 5 min, however, significantly higher from 60 min than those in the control rats. In the SIDM rats, the volume of distribution at steady state was significantly higher (1010 versus 265 ml/kg) than that in the control rats, and this was due to the significantly increased unbound fraction of MTX (73.0 versus 58.1%) in serum of SIDM rats. This resulted in a significantly increased mean residence time (53.2 versus 13.8 min) in the SIDM rats. All 12 control rats survived until sacrificed (24 hr), however, 6 out of 15 SIDM rats died within 6 h after iv administration of MTX, suggesting that the iv doses of MTX in diabetes mellitus patients may need to be modified if the present rat data could be extrapolated to human beings.

Demonstration of the second intermediate hosts of Clinostomum complanatum in Korea

A species of metacercariae recovered from the fresh-water fish, collected from Kaumji (Pond), Kaechonji (Pond) and Ssanggyechon (River). Uisong-gun, Kyongsangbuk-do, Korea, was identified as Clinostomum complanatum by morphological observation and experimental infection to chicks. The excysted metacercariae, tongue-shaped and progenetic, were 3.28-4.27 mm in length and 0.94-1.46 mm in width. The adult flukes recovered from the chicks four days after infection were 4.20-4.86 mm long and 1.14-1.49 mm wide. Twelve species of the fresh-water fish were found to be infected with the metacercariae. The infection rate ranged from 1.6% (Zacco temminkii) to 88.9% (Acheilognathus rhombea and Microphysogobio yaluensis). The intensity was highest in Carassius auratus (13.0/fish infected) and the abundance (relative density) was highest in A. rhombea (7.8/fish examined). This survey demonstrated for the first time the source of human infection by C. complanatum in Korea.

The first human case of Diplogonoporus balaenopterae (Cestoda: Diphyllobothriidae) infection in Korea

The first human case of Diplogonoporus balaenopterae infection is reported in Korea. The patient was a 41-year old male who passed a part of cestode strobila, about 1 m long, spontaneously in his stool. He used to eat raw marine fish when he drank alcohol. The worm was identified as D. balaenopterae after morhological observations and literature review. Results of laboratory examination were within normal limits except for slight eosinophilia (6%) and extraordinarily high serum Ig E level (10,182 IU/ml).

The first human case of Clinostomum complanatum (Trematoda: Clinostomidae) infection in Korea

The authors present the first human case of Clinostomum pharyngitis in Taegu, Korea. The patient was a 56-year old male who visited an otolaryngology clinic due to foreign body sensation and pain of the pharyngeal region for 3-4 days. He used to eat raw fresh-water fish. Otolaryngological examinations revealed a living worm adhered to the right posterior pharyngeal wall. The worm removed was identified as C. complanatum after morphological observations. It is likely that more attention should be paid to eating raw fresh-water fish in Korea with regards to Clinostomum pharyngitis.

Staurosporine induces de novo synthesis of prostaglandin H synthase-2 in rat alveolar macrophages

This study was initiated to investigate the possible involvement of prostaglandin H synthase in the staurosporine-induced prostaglandin production. The time course of prostaglandin H synthase activity in macrophages treated with staurosporine (20 nM) showed that the maximum activity was reached in 20 h. The stimulatory effect of staurosporine on thromboxane B2 production was maximum at 50 nM staurosporine and this effect was reversed at higher concentrations. Immunoprecipitation of 35S-labeled enzyme using an antibody specific for prostaglandin H synthase-2 paralleled the changes in enzyme activity. These results indicate that increased de novo synthesis of prostaglandin H synthase-2 is largely, if not solely, responsible for staurosporine-stimulated prostaglandin production in macrophages.

Continuous determination of extracellular space and changes of K+, Na+, Ca2+, and H+ during global ischaemia in isolated rat hearts

Isolated rat hearts were perfused according to the Langendorff technique and prepared to allow the measurement of left ventricular pressure (LVP), the first derivative of LVP (dP/dt), coronary perfusion pressure (CPP) and heart rate (HR). The hearts were perfused with a modified Krebs-Henseleit solution (KHS; control group) or KHS containing tetramethylammonium-chloride (TMA; 100 microM), which did not influence heart haemodynamics or extracellular potassium accumulation during global ischaemia (GI). TMA was used as a marker to determine changes in the size of the extracellular space (ECS) during 60 min of GI. Extracellular concentrations of K+, Na+, Ca2+, H+ and TMA were measured using double-barreled polyvinyl chloride (PVC) mini-electrodes. Relative changes in the ECS size and net cation movements were calculated from the extracellular TMA and cation concentrations. After 60 min of GI ECS decreased by 74% due to a water shift into the intracellular space (ICS). Within 10 s after the onset of GI extracellular potassium concentration increased in a typical triphasic pattern. A biphasic net efflux of K+ was maximal 2 and 15 min after the onset of ischaemia interrupted by a maximal uptake after 7 min, probably due to the stimulation of the Na+/K+ ATPase. The changes in extracellular sodium and calcium concentrations were biphasic; showing an initial increase occurring approximately during the first 20 min after the onset of GI followed by a decrease. Despite the initial increase of extracellular Na+ and Ca2+ maximal net influx of Na+ and Ca2+ were calculated after 2 and 19 min of GI. Accumulation of H+ in the extracellular space occurred mainly during the first 20 min of GI. It is concluded that, (1) TMA is a useful marker for continuous measurement of changes in the size of the ECS during GI; (2) Changes in extracellular ion concentration are influenced markedly by a water shift from the ECS into the ICS; (3) Stimulation of the Na+/K+ pump causes a transient net uptake of K+ and reduces the net influx of Na+; (4) Ca2+ uptake is decreased transiently probably by increased Ca2(+)-ATPase activity; (5) Energy dependent protective mechanisms for the maintainance of intracellular ionic homeostasis are exhausted after approximately 15 to 20 min of GI in isolated working rat hearts.