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Biomedical subjects

M Bourguignon

Publications and source records attributed to M Bourguignon.

18 recordsLinked to original sources

In vivo tracking of bone marrow fibroblasts with fluorescent carbocyanine dye.

Recent advances in the field of tissue engineering have culminated in new tissue substitutes that combine a biomaterial and precursor cells. The effectiveness of these materials is generally assessed in animals, but few studies explore the fate of the transplanted cells in vivo, despite its paramount importance for understanding the function of the engineered tissues. Current methods that use reporter genes or chimeric animals are not always well suited to solving tissue-engineering problems. We therefore developed a new method for irreversible labeling of cells to track their fate in vivo. We used a fluorescent lipophilic probe, CM-Dil, that avidly binds to the cell membrane. Human bone marrow stromal fibroblasts could be labeled with 20 microM CM-Dil in 30 min. The CM-Dil was not cytotoxic and did not affect cell proliferation in vitro. Cells could be monitored for up to 30 days when placed in a coral scaffold and implanted intramuscularly or in a bony site. However, the fluorescence intensity decreased roughly in parallel with the number of cell divisions. This fact needs to be taken into account during the design and interpretation of experiments. We believe that this technique is also of interest for other cell types.

Bone Marrow Cells↗

Tissue-engineered bone regeneration.

Bone lesions above a critical size become scarred rather than regenerated, leading to nonunion. We have attempted to obtain a greater degree of regeneration by using a resorbable scaffold with regeneration-competent cells to recreate an embryonic environment in injured adult tissues, and thus improve clinical outcome. We have used a combination of a coral scaffold with in vitro-expanded marrow stromal cells (MSC) to increase osteogenesis more than that obtained with the scaffold alone or the scaffold plus fresh bone marrow. The efficiency of the various combinations was assessed in a large segmental defect model in sheep. The tissue-engineered artificial bone underwent morphogenesis leading to complete recorticalization and the formation of a medullary canal with mature lamellar cortical bone in the most favorable cases. Clinical union never occurred when the defects were left empty or filled with the scaffold alone. In contrast, clinical union was obtained in three out of seven operated limbs when the defects were filled with the tissue-engineered bone.

Animals↗

Health effects of therapeutic use of 131I in hyperthyroidism.

Since 1942, therapy with radioiodine (Na131I) has gained a major role in the treatment of benign thyroid disorders, notably hyperthyroidism caused by Graves' disease or toxic multinodular goiter. The very large series of patients treated so far offer the opportunity for an assessment of both benign and malignant side effects. Hyperthyroidism is sometimes observed after radioiodine therapy due to radiation induced thyroid hormone or by an immunological mechanism. Despite the numerous attempts to design dosage schedules aiming at euthyroidism, hypothyroidism occurs in the majority of patients throughout life. Transient hypothyroidism may be observed within the first year after therapy and is caused by an immunological mechanism. Radioiodine therapy in Graves' disease may induce or worsen ophthalmopathy, which can be prevented by steroids effectively. Hypoparathyroidism and hyperparathyroidism have been reported after radioiodine therapy but probably do not exceed the normal incidence. Sialitis is commonly observed but mostly in patients treated with radioiodine for thyroid cancer. There are no indications for induction of genetic abnormalities after radioiodine therapy although no definite conclusion can be reached. Much attention has been paid to malignant disease. In very large series, no effects of radioiodine therapy on survival have been observed. Some studies report an increased relative risk for certain types of cancer (notably thyroid cancer, stomach cancer, bladder and kidney cancer or hematological malignancies). However, these observations were not confirmed by other large studies, so that no definite conclusion with respect to risk for certain types of malignant disease can be drawn. However, radioiodine therapy for benign thyroid disorders has generally been considered safe and without major side effects, hypothyroidism being the most frequent one.

Humans↗

Aspects of fetal thyroid dose following iodine-131 administration during early stages of pregnancy in patients suffering from benign thyroid disorders.

Detrimental effects on the thyroid of the developing fetus as a result of iodine-131 treatment for thyrotoxicosis of the mother in the first trimester of pregnancy are discussed. Dose estimations under typical clinical circumstances yield a fetal thyroid dose of 100- 450 Sv. This dose may increase considerably if the blood concentration of (131)I in the mother remains high. Under such circumstances there may be fetal thyroid dysfunction, which can lead to severe abnormalities.

Abnormalities, Radiation-Induced↗

Diagnostic nuclear medicine and risk for the fetus.

The possible detrimental effects on the developing embryo subsequent to irradiation are discussed. The doses to the embryo or fetus encountered for the most common procedures in diagnostic nuclear medicine are evaluated with respect to the threshold doses and the risks per cGy. The threshold dose for fatal and non-fatal malformations or other defects is, at the lowest estimate, 5-10 cGy. The dose which the embryo or fetus receives from diagnostic nuclear medicine is below 1 cGy. For the induction of fatal cancer and for genetic defects no threshold dose is assumed. The risk for the induction of cancer is 0.03%-0.05% per cGy. The risk for the induction of genetic defects is even lower (0.024%-0.099% per cGy). It is concluded that for common diagnostic nuclear medicine procedures the risk of detrimental effects on the embryo or fetus due to radiation is negligible. On the basis of present knowledge there are no radiation safety indications for abortus provocatus as a consequence of a diagnostic nuclear medicine study.

Abnormalities, Radiation-Induced↗

FDG accumulation and tumor biology.

The tumoral uptake of fluorine-18-deoxyglucose (FDG) is based upon enhanced glycolysis. Following injection, FDG is phosphorylated and trapped intracellularly. An important mechanism to transport FDG into the transformed cell is based upon the action of glucose transporter proteins; furthermore, highly active hexokinase bound to tumor mitochondria helps to trap FDG into the cell. In addition, enhanced FDG uptake may be due to relative hypoxia in tumor masses, which activates the anaerobic glycolytic pathway. In spite of these processes, FDG uptake is relatively aspecific since all living cells need glucose. Clinical use is therefore recommended in carefully selected patients.

Fluorodeoxyglucose F18↗

Edge detection in brain SPET perfusion imaging: a comparison of several methods.

Four methods of brain edge detection on brain SPET perfusion (99Tcm-hexamethylpropylene amine oxime) images were compared: ellipse adaptation, simple thresholding (four threshold values), a low threshold (40%) followed by 1, 2 or 3 pixel erosion, and the Deriche 3D adaptive cut-off frequency method (four filter widths: alpha = 1, 2, 3 or 4). The SPET data of six patients were reconstructed to obtain 10 axial slices, each 10 mm thick, covering the whole brain. On the 60 axial slices, the methods were compared based on automaticity, computation time and accuracy of edge detection compared with morphological edges drawn manually on the patients' 3D co-registered magnetic resonance imaging (MRI) scans. The proportion of pixels inside the contour defined by the MRI scan but outside the SPET edge (p(i)), and the proportion of pixels inside the contour defined by the SPET image but outside the MRI contour (pe), were calculated. The thresholding methods provided interesting results, particularly the application of a low threshold value (40%), followed by a 2 pixel erosion, which required a computation time of 12 s (p(i) = 5.7 +/- 2.2%; pe = 2.7 +/- 0.9%). Because of adjustments to each slice of the ellipse axis, the processing time of this method was about 3 min (p(i) = 1.5 +/- 1.4%; pe = 11.3 +/- 3.4%). The Deriche 3D filter was time-consuming (6 min for 10 slices on a NXT workstation, SMV International). With this method, the best edge fitting was found with a filter width of 3 and 4 (p(i) = 9.6 +/- 11.1%; pe = 14.1 +/- 23.2%; alpha = 3). Three-dimensional filtering methods must be refined to reduce the computation time and to improve brain edge fitting accuracy when compared with the eroded thresholding method.

Brain↗

Proportional anatomical stereotactic atlas for visual interpretation of brain SPET perfusion images.

A semi-automatic method was developed to determine the anterior (AC) and posterior (PC) commissures on brain single-photon emission tomographic (SPET) perfusion images, and then to draw the proportional anatomical Talairach's grid on each axial SPET image. First, the AC-PC line was defined on SPET images from the linear regression of four internal landmarks (frontal pole of the brain, inferior limit of the anterior corpus callosum, sub-thalamic point and occipital pole). Second, the SPET position of AC and PC points on the AC-PC line was automatically determined from measurements made on hard copies of magnetic resonance (MR) images of the patients. Finally, a proportional Talairach's grid was automatically drawn on each axial SPET image. To assess the accuracy of localization of AC and PC points, co-registered technetium-99m hexamethylpropylene amine oxime SPET and MR images from 11 subjects were used. The mean displacements between estimated points on SPET and true points on MRI (Deltax=sagittal, Deltay=frontal and Deltaz=axial displacement) were calculated. The mean displacements (in mm) were Deltax=-1.4+/-1.8, Deltay=-1.7+/-3.3 and Deltaz=-1. 1+/-2.5 for AC, and Deltax=-1.8+/-1.8, Deltay=0.3+/-3.2 and Deltaz=-1.3+/-2.7 for PC. These displacements represented an error of less than 5 mm at the anterior or posterior pole of the brain or at the vertex. Intra- and inter-observer comparisons did not reveal significant differences in mean displacements. Thus, this semi-automatic method results in reproducible and accurate stereotactic localization of SPET perfusion abnormalities. This method can be used routinely for repeat follow-up studies in the same subject as well as in different individuals without requiring SPET-MRI co-registration.

Algorithms↗

Changes in regional cerebral blood flow during brain maturation in children and adolescents.

Regional cerebral blood flow (rCBF) was studied by SPECT using 133Xe in 42 children, aged 2 days to 19 years, considered as neurologically normal. rCBF was measured on cortical regions and on the cerebellum and thalamus. Curves for reference values and standard deviation were defined for each region. At birth, cortical rCBFs were lower than those for adults; after birth they increased until 5 or 6 yr of age to values 50%-85% higher than those for adults and thereafter decreased, reaching adult levels between 15 and 19 yr. Neonatal values of rCBF on cerebellum and thalamus were slightly higher than adult level, but not significantly; after age 1, they followed the common pattern for cortical curves. When rCBFs were expressed in percent global CBF, they were lower at birth than adult levels in the cortex, then increased and reached a plateau corresponding to the adult value before the second year of age. The time needed to reach normal adult values differed for each cortical region. The shortest time was found on the primary cortex and the longest on the associative cortex. Cognitive development of the child seems to be related to changes in blood flow of the corresponding brain regions.

Adolescent↗

Use of unstable chromosome aberrations for biological dosimetry after the first postirradiation mitosis.

The loss of unstable chromosome aberrations after the first postirradiation mitosis makes their use difficult in radiation dosimetry. We describe here a method which, in a cell population observed at this stage, allows retrospective estimation of the frequencies of the unstable aberrations induced at the time of irradiation, and their use as a dosimeter. The laws controlling the behavior of unstable aberrations during mitosis were defined from a large-scale experiment on irradiated human lymphocytes. For cells undergoing the first, second, or third mitosis after irradiation, relationships were determined between the frequency, at irradiation time, of acentric fragments not arising from formation of dicentrics or rings, and the ratio of dicentrics and centric rings appearing without acentric fragments to the total number of dicentrics plus rings. On the basis of this ratio, the method described here provides an assessment of the postirradiation mitotic activity in a cell population. This assessment permitted estimation of the cell distribution and frequency of dicentrics plus centric rings, and of the frequency of acentric fragments at the time of irradiation. The use of this method for retrospective dosimetry after whole-body irradiation under various conditions of exposure is illustrated.

Animals↗

[The role of isotope methods in evaluating the left ventricular function].

Cardiac angioscintigraphy is a non-invasive, reproducible and reliable technique used to obtain a number of cardiac function parameters, the most important of which is left ventricular ejection fraction. Methodologically, the examination is simple. Fourier's analysis (a mathematical decomposition of ventricular mechanics) provides additional information on some abnormalities and is particularly useful in segmental kinetics studies and in the topographical diagnosis of cardiac rhythm disorders. The technique is indicated mainly for prognostic evaluation and follow-up of patients with left ventricular dysfunction. Metaiodobenzylguanidine (MIBG) cardiac scintigraphy makes it possible to evaluate the reuptake of noradrenaline by neurons, which represents the inactivation pathway of adrenergic neurotransmission and is the principal factor of noradrenaline extraction. MIBG scintigraphy is an indirect way of evaluating left ventricular function in congestive heart failure, as suggested by the results of studies showing correlations between MIBG uptake, left ventricular function indices and disease severity as judged on the basis of evolutive parameters.

3-Iodobenzylguanidine↗

MIBG scintigraphic assessment of cardiac adrenergic activity in response to altitude hypoxia.

High altitude hypoxia induces a decrease in the cardiac chronotropic function at maximal exercise or in response to isoproterenol infusion, suggesting an alteration in the cardiac sympathetic activation. Iodine-123 metaiodobenzylguanidine [( 123I]MIBG) was used to map scintigraphically the cardiac sympathetic neuronal function in six male subjects (aged 32 +/- 7 yr) after an exposure to high altitude that created hypoxic conditions. Results obtained just after return to sea level (RSL) were compared with the normal values obtained after 2 or 3 mo of normoxia (N). A static image was created as the sum of the 16-EKG gated images recorded for 10 min in the anterior view of the chest at 20, 60, 120, and 240 min after injection. Regions of interest were located over the heart (H), lungs (L), and mediastinum (M) regions. There was a significant decrease in the H/M and the L/M ratios in RSL compared to N condition. Plasma norepinephrine concentration was elevated during the stay at altitude but not significantly different in RSL compared to N. In conclusion, cardiac [123I]MIBG uptake is reduced after an exposure to altitude hypoxia, supporting the hypothesis of an hypoxia-induced reduction of adrenergic neurotransmitter reserve in the myocardium. Furthermore, the observed significant decrease in pulmonary MIBG uptake suggests an alteration of endothelial cell function after exposure to chronic hypoxia.

3-Iodobenzylguanidine↗

Automatic drawing of the left epicardial region of interest on thallium 201 scintigraphic images.

An algorithm has been written which automatically selects a left epicardial region of interest on 201Tl myocardial images. It accomplishes a radial search from the geometric center of the myocardium. On each of the 30 profiles, the local maximum of the 1st derivative is selected as the epicardial edge. The algorithm has been tested in 40 patients at stress and redistribution. In ten patients, conventional planar images were obtained in three views. In 30 patients conventional short axis tomographic images were obtained after reconstruction of 32 projections acquired over 180 degrees. The rate of success is 97% for both imaging modalities. This procedure is another step towards fully automated assessment of myocardial defects and redistribution.

Algorithms↗

Phase mapping of radionuclide gated biventriculograms in patients with sustained ventricular tachycardia or Wolff-Parkinson-White syndrome.

Accuracy of Fourier phase mapping of radionuclide gated biventriculograms in detecting the origin of abnormal ventricular activation was studied during ventricular tachycardia or preexcitation. Group I included six patients suffering from clinical recurrent VT; 3 gated blood pool studies were acquired for each patient: during sinus rhythm, right ventricular pacing, and induced sustained VT-Group II included seven patients with Wolff-Parkinson-White syndrome and recurrent paroxysmal tachycardia; 3 gated blood pool studies were acquired for each patient: during sinus rhythm, right atrial pacing and orthodromic reciprocating tachycardia. Each acquisition lasted 5 min, in 30 degrees-40 degrees left anterior oblique projection. In Group I, the Fourier phase mapping was consistent with QRS morphology and axis during VT (5/6), except in one patient with LV aneurysm and LBBB electrical pattern during VT. Origin of VT on phase mapping was located in the right ventricle (n = 2) or in left ventricle (n = 4), at the border of wall motion abnormalities each time they existed (5/6). In Group II, the phase advance correlated with the location of the accessory pathway determined by ECG and endocardial mapping (n = 6) and per-operative epicardial mapping (n = 1). Discrimination between anterior and posterior localisation of paraseptal pathways and location of intermittent preexcitation was not possible. We conclude that Fourier phase mapping is an accurate method for locating the origin of VT and determining its etiology. It can help locate the site of ventricular preexcitation in patients with only one accessory pathway; its accuracy in locating multiple accessory pathways remains unknown.

Adult↗