PubMed Health⌕ Search

Biomedical subjects

Justin D Pearlman

Publications and source records attributed to Justin D Pearlman.

6 recordsLinked to original sources

Automated migration analysis based on cell texture: method & reliability.

BACKGROUND: In this paper, we present and validate a way to measure automatically the extent of cell migration based on automated examination of a series of digital photographs. It was designed specifically to identify the impact of Second Hand Smoke (SHS) on endothelial cell migration but has broader applications. The analysis has two stages: (1) preprocessing of image texture, and (2) migration analysis. RESULTS: The output is a graphic overlay that indicates the front lines of cell migration superimposed on each original image, with automated reporting of the distance traversed vs. time. Expert preference compares to manual placement of leading edge shows complete equivalence of automated vs. manual leading edge definition for cell migration measurement. CONCLUSION: Our method is indistinguishable from careful manual determinations of cell front lines, with the advantages of full automation, objectivity, and speed.

Automation↗

Detection of exercise-induced ischemia by changes in B-type natriuretic peptides.

OBJECTIVES: The purpose of this study was to examine the effect of exercise-induced ischemia on levels of B-type natriuretic peptide (BNP) and its inactive N-terminal fragment (NT-pro-BNP)and to determine whether measurement of these peptides can improve the diagnostic accuracy of exercise testing. BACKGROUND: The ability of exercise testing to detect coronary artery disease (CAD) is limited by modest sensitivity and specificity. B-type natriuretic peptides (NT-pro-BNP and BNP) are released by ventricular myocytes in response to wall stress. We hypothesized that exercise-induced ischemia results in increased wall stress and triggers release of NT-pro-BNP and BNP. METHODS: A total of 74 patients with known CAD, normal left ventricular function, and normal resting levels of NT-pro-BNP and BNP who were referred for exercise testing with radionuclide imaging, and 21 healthy volunteers, were enrolled. Blood was drawn before and after maximal exercise and analyzed for NT-pro-BNP and BNP. RESULTS: Of the patients with CAD, 40 had ischemia on perfusion images and 34 did not. Median post-exercise increases in NT-pro-BNP and BNP (DeltaNT-pro-BNP and DeltaBNP) were approximately four-fold higher in the ischemic group than in the nonischemic group (DeltaNT-pro-BNP 14.5 vs. 4 pg/ml, p < 0.0001; DeltaBNP 36.5 vs. 7.5 pg/ml, p < 0.0001). In volunteers, median DeltaNT-pro-BNP was almost identical to that of the nonischemic patient group. At equal specificity to the electrocardiogram (ECG) (58.8%), the sensitivities of DeltaNT-pro-BNP and DeltaBNP for detecting ischemia were 90% and 80%, respectively; in contrast, the sensitivity of the exercise ECG was 37.5%. CONCLUSIONS: Measurement of exercise-induced increases in BNPs more than doubles the sensitivity of the exercise test for detecting ischemia with no loss of specificity.

Adult↗

Novel double contrast MRI technique for intramyocardial detection of percutaneously transplanted autologous cells.

Bone marrow cells (BMC) labeled with iron particles can be injected into the heart and detected with MRI. Improvement in conspicuity of labelled cells would be advantageous. This study examined if double contrast with iron oxide and Gd-DTPA enhances cell MRI after transvascular transplantation in myocardial infarction. Ten pigs with week-old myocardial infarction had transvascular peri-infarct delivery of microspheres alone (Group I, n = 3) or mixed with iron-labeled BMCs (Group II, n = 7). Gradient-echo MRI before and 1 min after systemic Gd-DTPA administration produced regions of interest with hypoenhancement that were compared to contralateral regions for contrast-to-noise (CNR) and signal-to-noise (SNR) ratios. All hearts were harvested for gross and microscopic analysis. Areas of focal hypoenhancement corresponding to the BMCs were detected in the myocardium in Group II. Early after administration of Gd-DTPA CNR increased from 17.58 +/- 8.5 to 27.25 +/- 15.8 (P < 0.05) and SNR from 24.87 +/- 9.6 to 35.08 +/- 15.5 (P < 0.05). There was no hypoenhancement in Group I. Tissue examination confirmed presence of iron-containing cells and microspheres in corresponding segments of the heart. The distribution of microspheres was similar between the groups. Double contrast with cellular iron and Gd-DTPA in surrounding myocardium resulted in improved cell localization by MRI.

Animals↗

Magnetic resonance imaging demonstrates improved regional systolic wall motion and thickening and myocardial perfusion of myocardial territories treated by laser myocardial revascularization.

OBJECTIVES: This study was designed to investigate the use of magnetic resonance (MR) functional and perfusion imaging to evaluate laser myocardial revascularization (LMR). BACKGROUND: Most clinical studies of LMR have shown improvements in angina class and exercise capacity, with minimal or absent improvements in myocardial perfusion and function. METHODS: Fifteen patients who underwent percutaneous Biosense-guided holmium:yttrium aluminum garnet LMR to areas of viable but ischemic myocardium were followed clinically and underwent functional and perfusion MRI at baseline, 30 days and 6 months. RESULTS: The mean age was 64 +/- 11 years; four patients were women. The ejection fraction was 47.4 +/- 14.0%. Angina class at baseline was 3.4 +/- 0.6 and improved to 2.5 +/- 1.4 at six months (p = 0.054). Exercise time at baseline was 298 +/- 97 s and increased to 350 +/- 95 s at 30 days and 365 +/- 79 s at six months, p = 0.04. There were no significant changes in nuclear perfusion scans. Although MR determined that resting radial motion and thickening of the target wall were significantly less than normal at baseline (p < 0.001), they improved significantly during follow-up (wall thickening: baseline, 30.6 +/- 11.7%; day 30, 41.2 +/- 13.3% and day 180, 44.2 +/- 11.9%, p = 0.01). The size of the underperfused myocardial area was 14.5 +/- 5.4% at baseline and was reduced to 6.3 +/- 2.8% at 30 days and 7.7 +/- 3.7% at 6 months (p < 0.001). CONCLUSIONS: This small phase I, open-label, uncontrolled study of MR functional and perfusion imaging in patients undergoing Biosense-guided LMR suggests a beneficial effect of this treatment strategy on myocardial function and perfusion. The efficacy of Biosense-guided LMR is being evaluated in a large phase II, randomized, blinded placebo-controlled trial with an MRI substudy (DIRECT).

Adult↗

Medical imaging techniques in the evaluation of strategies for therapeutic angiogenesis.

Recent advancements in our understanding of the basic biology of angiogenesis have prompted a focus on practical applications, both in cardiovascular disease and in oncology. The focus on practical applications has stimulated development of novel noninvasive tools that provide serial assessment of ongoing vessel growth in vivo. Nuclear imaging (SPECT, PET) and x-ray angiography have been used to assess changes in perfusion and anatomic appearance, respectively, after induced neovascular development. New MRI techniques provide the ability to identify early changes in vivo that are more sensitive to detection of the effects of new vessel growth than x-ray angiography or nuclear imaging. These new MRI techniques include measurement of blood delivery to the myocardium, development of intramyocardial vasculature, and incremental changes in regional myocardial contractile function. With the combination of methods now available, we expect to be able to track key steps of angiogenesis in vivo and to assess the efficacy of angiogenic therapies. These new imaging capabilities offer crucial information which we hope will hasten the identification and deployment of effective pharmaceutical therapies as an adjunct or alternative to invasive treatments of ischemic disease by targeted stimulation of angiogenesis, and of cancer, by targeted inhibition of angiogenesis.

Animals↗