Archives: 3/2008

4534ser Watching Brain Repair Live on MRIHarvard researchers have developed a method to monitor tissue repair within the brain using MRI and some nifty eye drops.

In this report, Harvard researchers describe how they link a relatively common MRI probe (superparamagnetic iron oxide nanoparticles) to a short DNA sequence that binds to proteins in cells responsible for brain tissue repair (glia and astrocytes). Then, researchers used the eye drops on mice with conditions that cause ‘leaks’ in the blood-brain barrier. When the animals’ brains were scanned using MRI, brain repair activity was visible. Glia and astrocytes help repair brain and nerve tissue, and have a role in numerous diseases and disorders that cause at least microscopic breaches in the blood-brain barrier, including traumatic brain injury, multiple sclerosis, stroke, cardiac arrest, and glioma, among others. Furthermore, the researchers believe that the probes may also help diagnose thinning of vascular walls in brains, which occurs as Alzheimer’s disease progresses.
“When people are sick, the last thing you want to do is puncture their skulls for a biopsy,” said Gerald Weissmann, MD, Editor-in-Chief of The FASEB Journal, “but sometimes this is unavoidable. These probes of genes in action go a long way toward ushering in an age where extracting brain tissue to identify a disease will seem as crude as when doctors measured skulls to diagnose a mental disease.”

Press release: Harvard researchers publish MRI images of genes in action in the living brain

3252bwm Ins and Outs

  • Bias suit rips Brigham&Women’s surgical chief… [Boston Globe]
  • FDA Seeks Civil Penalties from Advanced Bionics… [FDA]
  • iPods and similar devices found not to affect pacemaker function… [Children's Hospital Boston]
  • Revascularization for Unprotected Left Main Coronary Artery Stenosis: Comparison of Percutaneous Coronary Angioplasty Versus Surgical Revascularization… [ACC]
  • Randomized, Multi-Center Study of the Pimecrolimus-Eluting and Pimecrolimus/Paclitaxel-Eluting Coronary Stent System in Patients with De Novo Lesions of the Native Coronary Arteries… [ACC]
  • 12-Month Data from Endeavor IV Show Strong Clinical Efficacy of Medtronic’s Drug-Eluting Stent Across All Patient Groups… [Medtronic]
  • Spirit II Results Support Strength of Boston Scientific’s Two Drug-Eluting Stent Platforms… [Boston Scientific]
  • Real-World Data from ARRIVE Registries Show Favorable Outcomes for TAXUS® Express™ Stent… [Boston Scientific]
  • Allergan and J&J Pump Up Weight-Loss Surgery … [WSJ]
  • Riding the Hospitalist Boom to an IPO … [WSJ]
  • Big Insurers Pay for Online Doctor Visits … [WSJ]
  • Nanomedicine System Engineered To Enhance Therapeutic Effects of Injectable Drugs… [NCI Alliance for Nanotechnology in Cancer]
  • Astrotechnology Brings Nanoparticle Probes Into Sharper Focus… [NCI Alliance for Nanotechnology in Cancer]
  • Major Collaboration Uncovers Surprising New Genetic Clues to Diabetes… [NIH]
  • Folate Scores Another Win in Animal Studies: Brief High Doses of B Vitamin Blunt Damage from Heart Attack… [Johns Hopkins]
  • Large Multi-Center Study Suggests New Genetic Markers for Crohn’s Disease… [Johns Hopkins]
  • Environmental factors linked to development of autoimmune diseases… [UK Medical Research Council]
  • Rates of Rare Mutations Soar Three to Four Times Higher in Schizophrenia… [NIH]
  • Biomarker development in acute kidney injury… [Nature Clinical Practice Nephrology]
  • Synchronized spiking: How oscillating neurons knock their neighbors… [RIKEN Research]
  • Genetics linked to breech babies … [BBC News]
  • How Emotional Reactions Enhance Sense of Smell… [Time]
  • sparrow wide Sparrow, a Smaller, Gentler Stent Goes on Trial
    CardioMind, a Sunnyvale, California startup developing a new coronary stent called Sparrow™, has announced that the device was successfully implanted in a dozen Australian patients as part of an initial clinical trial. The stent was designed to target blood vessels smaller than 2.75 mm in diameter, according to the company.
    sparrow wide2 Sparrow, a Smaller, Gentler Stent Goes on Trial

    The unique design of the CardioMind Sparrow stent permits it to travel within the guidewire lumen to the site of the lesion. There the cardiologist releases the stent and allows it to self-expand to the vessel wall. By contrast, conventional balloon-expandable stents travel over guidewires to the lesion, and thus, by their very design, occupy more volume.

    sparrowMM Sparrow, a Smaller, Gentler Stent Goes on Trial

    The Sparrow stent also offers more flexibility than current stents, making it especially adaptable to treatment of the small, tortuous blood vessels often associated with diabetes.
    To coat the Sparrow stent, CardioMind has licensed the rights to the SynBiosys biodegradable polymer system from SurModics, Inc. “The SynBiosys polymer allows the Sparrow stent to gradually return to a bare metal state, where we as an industry have 15 years of data showing no increase in late stent thrombosis,” says Maroney.

    Press release: CardioMind Launches First-in-Human Trial of Small Vessel, Drug-Eluting Stent…
    CardioMind website with nothing inside…

    epihelmet Hackers Circumvent Browser, Attack Brain
    The world of hacking has achieved another milestone when a team of culprits managed to attack an online forum of epileptics, using Java script pop-ups of seizure inducing imagery. They must have thought it very funny. Perhaps a few months with Tony, the seizure inducing federal cell mate, would help the bastards reconsider.

    The incident, possibly the first computer attack to inflict physical harm on the victims, began Saturday, March 22, when attackers used a script to post hundreds of messages embedded with flashing animated gifs.
    The attackers turned to a more effective tactic on Sunday, injecting JavaScript into some posts that redirected users’ browsers to a page with a more complex image designed to trigger seizures in both photosensitive and pattern-sensitive epileptics.
    RyAnne Fultz, a 33-year-old woman who suffers from pattern-sensitive epilepsy, says she clicked on a forum post with a legitimate-sounding title on Sunday. Her browser window resized to fill her screen, which was then taken over by a pattern of squares rapidly flashing in different colors.
    Fultz says she “locked up.”
    “I don’t fall over and convulse, but it hurts,” says Fultz, an IT worker in Coeur d’Alene, Idaho. “I was on the phone when it happened, and I couldn’t move and couldn’t speak.”
    After about 10 seconds, Fultz’s 11-year-old son came over and drew her gaze away from the computer, then killed the browser process, she says.

    More at Wired
    (hat tip: Engadget)
    Image courtesy of Salmon

    4363ct1 TruePoint PET CT Scanner from Siemens
    Siemens is reporting that their first tomograph with so-called HD-PET technology, a PET-CT unit called Biograph 40 TruePoint, has been installed at the UT Southwestern Medical Center in Dallas.
    4363ct2 TruePoint PET CT Scanner from SiemensSystem features, taken from the product brochure and product website:

    TruePoint PET-CT completely integrates the functional sensitivity of PET with the rich anatomical detail of diagnostic multislice CT. Exclusive technologies, such as the award winning Patient Handling System (PHS), HI-REZ, LSO, Pico-3D, True C, and SureView, offer superb image quality for improved diagnostic confidence. With Biograph’s leading-edge technology, you can be more confident in your ability to detect changes in molecular activity even before anatomical changes become visible.
    TruePoint PET-CT helps you to reveal primary tumors, detect metastases, quantify uptake, and reduce false positives. Whether you’re working in oncology, cardiology, or neurology, you need the most complete set of information possible in order to make a truly accurate diagnosis. Only TruePoint PET-CT reveals the tiniest abnormalities in the clearest detail.

  • HD-PET providing a new level of PET performance
  • LSO crystals for faster scans
  • HI-REZ offering unsurpassed resolution
  • TrueX providing uniform PET resolution and 2x improvement in signal-to-noise ratio
  • TrueV providing the longest axial field of view
  • TrueC offering model-based scatter correction calculated independently for every patient and bed position
  • UFC detectors providing stunning CT image quality
  • SureView ensuring maximum image quality at any speed
  • CARE Dose4D for real-time dose modulation
  • z-Sharp for the highest spatial resolution available
  • Press release: Siemens Installs First High-Definition PET-CT
    Product page: Biograph TruePoint PET-CT

    32521med1 Debris Aspiration During Heart Attack Improves Cardiac Blood Flow, Chances of SurvivalThe latest news from the ongoing meeting of the American College of Cardiology in Chicago is that using the Export® Aspiration Catheter from Medtronic before stenting, in patients with ongoing acute myocardial infarction (AMI), can “significantly improve blood flow and survival rates compared to conventional treatment with percutaneous coronary intervention (PCI) alone.” The study, led by Felix Zijlstra, MD, PhD from University Medical Center Groningen, Netherlands, recruited 1,071 patients who were randomly assigned to PCI supported by the Export aspiration catheter (535 pts) or to PCI using conventional techniques (536 pts).
    From the joint statement by the Society for Cardiovascular Angiography and Interventions and the American College of Cardiology:
    5324wert Debris Aspiration During Heart Attack Improves Cardiac Blood Flow, Chances of Survival

    To assess the quality of myocardial perfusion, the researchers documented myocardial blush grade. A myocardial blush grade of 0 or 1 indicates that little or no x-ray dye has reached from the surface artery into the heart muscle, a sign that the microcirculation is blocked. A myocardial blush grade of 3 indicates that x-ray dye has reached deep into the heart muscle, a sign of good blood flow through the microcirculation. A myocardial blush grade of 2 falls in between. Analysis of the elevated ST-segment on the electrocardiogram — specifically, its return to a normal baseline — was also used to gauge the quality of blood flow to the heart muscle.
    During angiography, researchers observed a blush grade of 0 or 1 in 17 percent of patients treated with the aid of the aspiration catheter and in 26 percent of patients treated with conventional PCI (p less than 0.001). At 30 days, clinical outcomes were strongly related to the degree of myocardial reperfusion. The rate of death in patients with a myocardial blush grade of 0/1, 2 and 3 was 5.2 percent, 2.9 percent and 1.0 percent, respectively (p equals 0.003). The combined rates of repeat heart attack, repeat procedure in the target artery and death in patients with a myocardial blush grade of 0/1, 2 and 3 were 14.1 percent, 8.8 percent and 4.2 percent, respectively (p less than 0.001).
    At one-year follow-up, mortality was significantly lower in patients treated with the aspiration catheter (p equals 0.04), as was a combination of death and heart attack. A similar, highly significant relationship was observed between myocardial blush grade and death, or a combination of death and repeat heart attack (p equals 0.001).
    The study team concluded that the degree of blood perfusion into the heart muscle helps to predict the patient’s clinical condition, and that aspiration of debris from the treated artery during PCI can reduce the risk of death and repeat heart attack, even one year later.

    Device That Clears Debris From Artery Aids Blood Flow in PCI… (.pdf)
    Product page: Export® XT Aspiration Catheter…
    Medtronic press release: Heart Attack Patients Benefit from Thrombus Aspiration Prior to Stenting, Study Shows…

    Spheres bw SIRTeX to Trial Radiation Spheres for Liver CancerAustralian company SIRTeX has received FDA approval to begin trials of their injectable, beta radiating microspheres thought to directly target intrahepatic tumor sites.
    From the product brochure:

    SIR-Spheres microspheres consist of biocompatible microspheres containing yttrium-90 with a size between 20 and 60 microns in diameter. Yttrium-90 is a high-energy pure betaemitting isotope with no primary gamma emission. The maximum energy of the beta particles is 2.27MeV with a mean of 0.93MeV. The maximum range of emissions in tissue is 11mm with a mean of 2.5mm. The half-life is 64.1 hours. In therapeutic use, requiring the isotope to decay to infinity, 94% of the radiation is delivered in 11 days. The average number of particles implanted is 30 – 60 x 106. SIR-Spheres microspheres are a permanent implant.
    SIR-Spheres microspheres are implanted into a hepatic tumor by injection into either the common hepatic artery or the right or left hepatic artery via the chemotherapy catheter port. The SIRSpheres microspheres distribute non-uniformly in the liver, primarily due to the unique physiological characteristics of the hepatic arterial flow, the tumor to normal liver ratio of the tissue vascularity, and the size of the tumor. The tumor usually gets higher density per unit distribution of SIR-Spheres microspheres than the normal liver. The density of SIR-Spheres microspheres in the tumor can be as high as 5 to 6 times of the normal liver tissue. Once SIR-Spheres microspheres are implanted into the liver, they are not metabolized or excreted and they stay permanently in the liver.
    Each device is for single patient use.

    SIRTeX USA website…
    Press release: Sirtex receives US FDA approval for FAST clinical trial (.pdf)
    Product page: Product Package Insert (PDF)

    ozmosis Ozmosis: A New Physician Only CommunityOzmosis, Inc., a Vienna, VA company, is offering a new community site with an emphasis on clinical discussions, practice management and health policy schmoozing. It is touted to be by physicians for physicians. All the members have to be verified during the registration process.
    According to their mission statement:

    Ozmosis, an online Medical Knowledge Exchange, has been working with physicians to improve patient care since 2006. Ozmosis aggregates the collective wisdom and experience of its physicians and transforms individual insights into trusted knowledge for all its members, providing physicians a place where they can turn daily for trusted and reliable clinical, practice management and health policy information. Offered at no cost for verified physicians, Ozmosis accelerates learning and knowledge exchange across medicine and is dedicated to improving collaboration in healthcare.

    The site is currently in private beta, whatever that means.
    46343wrt Ozmosis: A New Physician Only Community
    More at Ozmosis
    More on Scienceroll.com

    43532sch Two Photon Nanoparticles for Tumor RecognitionA porous nanoparticle “capable of absorbing the energy of two photons in the near infrared spectrum, and then re-emitting radiation used for medical imaging by fluorescence” has been developed by an interdisciplinary group of scientists, reports Centre National de la Recherche Scientifique of France:

    At present, the medical imaging of tumor cells is based on the fluorescence emitted by chemical groups that can absorb the energy of a photon. These molecules, called fluorophores, are excited in the visible ultraviolet spectrum. Single-photon imaging thus remains relatively imprecise. This obstacle should soon be overcome thanks to work by scientists from CNRS-associated laboratories.
    These researchers have succeeded in developing organic, two-photon fluorophores (aromatic molecules) that are able simultaneously to absorb two photons in the near infrared spectrum. These were then encapsulated in porous nanoparticles to enable their circulation in a biological medium. The originality of this work resides in the fact that unlike ultraviolet wavelengths, infrared wavelengths penetrate more deeply into tissues and are less energetic, the advantage being that they can explore tumors more profoundly without damaging the tissues. Furthermore, the use of two-photon fluorophores favors access to a 3D spatial resolution, which in the longer term will enable the detection and more targeted treatment of tumor cells. One of the options envisaged may be to encapsulate in the pores of silicon nanoparticles not only the fluorescent agent but also drugs that can locally treat the cancer cells.
    The scientists have also been focusing on the functionalization of these nanoparticles in order to create new biological markers capable of interacting with breast and cervical cancer cells. To achieve this, they grafted on the nanoparticles a monolayer made up of a hydrophilic polymer (PEG: polyethylene glycol) and folic acid. The latter forms the ligand recognized by the receptors of HeLa cells (cervical cancer) and MCF7 cells (breast cancer) (see diagram). These results should enable the 3D targeting and imaging of the tumor. Other functionalizations could be envisaged, enabling the detection of other tumors.

    Link: Two-photon nanoparticles for the improved detection of tumor cells…