Neurodegeneration in Newborn Rats Following Propofol and Sevoflurane Anesthesia

Propofol and sevoflurane are commonly used drugs in pediatric anesthesia. Exposure of newborn rats to a variety of anesthetics has been shown to induce apoptotic neurodegeneration in the developing brain. Newborn Wistar rats were treated with repeated intraperitoneal injections of propofol or sevoflurane inhalation and compared to controls. Brains were examined histopathologically using the De Olmos cupric silver staining. Additionally, a summation score of the density of apoptotic cells was calculated for every brain. Spatial memory learning was assessed by the Morris Water Maze (MWM) test and the hole board test, performed in 7 weeks old animals who underwent the same anesthetic procedure. Brains of propofol-treated animals showed a significant higher neurodegenerative summation score (24,345) when compared to controls (15,872) and to sevoflurane-treated animals (18,870). Treated animals also demonstrated persistent learning deficits in the hole board test, whereas the MWM test revealed no differences between both groups. Among other substances acting via GABAA agonism and/or NMDA antagonism propofol induced neurodegeneration in newborn rat brains whereas a sevoflurane based anesthesia did not. The significance of these results for clinical anesthesia has not been completely elucidated. Future studies have to focus on the detection of safe anesthetic strategies for the developing brain.     

An increase in persistent sodium current contributes to intrinsic neuronal bursting after status epilepticus

Brain damage causes multiple changes in synaptic function and intrinsic properties of surviving neurons, leading to the development of chronic epilepsy. In the widely used pilocarpine-status epilepticus (SE) rat model of temporal lobe epilepsy (TLE), a major alteration is the marked increase in the fraction of intrinsically bursting CA1 pyramidal cells. Here we have differentiated between two types of bursting phenotypes: 1) bursting in response to threshold-straddling excitatory current pulses (low-threshold bursting) and 2) bursting only in response to suprathreshold stimuli (high-threshold bursting). Low-threshold bursting prevailed in 46.5% of SE-experienced neurons sampled 1-4 wk after pilocarpine-SE, but was rarely seen in control neurons (1.9%). As previously shown, it appeared to be driven predominantly by a T-type Ca(2+) current (I(CaT)) in the apical dendrites. After blocking low-threshold bursting with Ni(2+), the same neurons still manifested a high-threshold bursting phenotype. Another 40.1% of SE-experienced neurons displayed only a high-threshold bursting phenotype and the remaining 13.4% of these neurons were nonbursters. Altogether, high-threshold bursting prevailed in 86.6% of SE-experienced neurons, but only in 33.0% of control neurons. Several lines of evidence indicated that high-threshold bursting is driven by persistent Na(+) current (I(NaP)) at or near the soma. Congruently, I(NaP) was 1.5-fold larger in SE-experienced versus control neurons. We conclude that an increase in I(NaP), conjointly with an increase in I(CaT), strongly contributes to the predominance of bursting phenotypes in CA1 pyramidal cells early after pilocarpine-SE and thus likely plays a role in the development of a chronic epileptic condition in this TLE model.     

Intramural hematoma and penetrating aortic ulcer

PURPOSE OF REVIEW: With advances in imaging technology, increased attention has turned to the 'variant forms' of aortic dissection: intramural hematoma and penetrating aortic ulcer. At the same time, the advent of endovascular therapies such as stent-grafting has broadened the base of practitioners capable of intervening in these pathologies from the cardiovascular surgeon to now include vascular surgeons, interventional radiologists, and invasive cardiologists. Accordingly, a reassessment of these conditions is of general interest. RECENT FINDINGS: The natural history of both entities is being elucidated with increasing precision as relatively large single-center and multicenter studies are being reported. Recent attention has focused on application of endovascular technologies to penetrating aortic ulcer, while the principal controversy over intramural hematoma concerns its management when the ascending aorta is involved. SUMMARY: Despite continuing controversy over the outcome of penetrating aortic ulcer managed by medical or open surgical means, thoracic endograft technology is being applied to this entity with high procedural success and low perioperative morbidity by experienced teams internationally. The benefit to patients as the use of this technology expands, however, will depend critically upon selection criteria. Evidence in favor of surgical management of type A intramural hematoma continues to mount, although it is also clear that, in specific circumstances, a nonoperative approach may suffice.     

Eight‐channel transceiver RF coil array tailored for 1H/19F MR of the human knee and fluorinated drugs at 7.0 T

The purpose of this study was to evaluate the feasibility of an eight‐channel dual‐tuned transceiver surface RF coil array for combined ¹H/¹⁹F MR of the human knee at 7.0 T following application of ¹⁹F‐containing drugs. The ¹H/¹⁹F RF coil array includes a posterior module with two ¹H loop elements and two anterior modules, each consisting of one ¹H and two ¹⁹F elements. The decoupling of neighbor elements is achieved by a shared capacitor. Electromagnetic field simulations were performed to afford uniform transmission fields and to be in accordance with RF safety guidelines. Localized ¹⁹F MRS was conducted with 47 and 101 mmol/L of flufenamic acid (FA) – a ¹⁹F‐containing non‐steroidal anti‐inflammatory drug – to determine T₁ and T₂ and to study the ¹⁹F signal‐to‐dose relationship. The suitability of the proposed approach for ¹H/¹⁹F MR was examined in healthy subjects. Reflection coefficients of each channel were less than ?17 dB and coupling between channels was less than ?11 dB. Q_L/Q_U was less than 0.5 for all elements. MRS results demonstrated signal stability with 1% variation. T₁ and T₂ relaxation times changed with concentration of FA: T₁/T₂ = 673/31 ms at 101 mmol/L and T₁/T₂ = 616/26 ms at 47 mmol/L. A uniform signal and contrast across the patella could be observed in proton imaging. The sensitivity of the RF coil enabled localization of FA ointment administrated to the knee with an in‐plane spatial resolution of (1.5 × 1.5) mm² achieved in a total scan time of approximately three minutes, which is well suited for translational human studies. This study shows the feasibility of combined ¹H/¹⁹F MRI of the knee at 7.0 T and proposes T₁ and T₂ mapping methods for quantifying fluorinated drugs in vivo. Further technological developments are necessary to promote real‐time bioavailability studies and quantification of ¹⁹F‐containing medicinal compounds in vivo. Copyright © 2015 John Wiley & Sons, Ltd.