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Feasibility of Using Hyperosmolar Mannitol as a Liquid Tumor Embolization Agent
Author: Lei Fenga, Beverly A. Kienitzc, Carolyn Matsumotoa, Jeffrey Bruceb, Michael Sistib, Hoang Duongd and John Pile-Spellmana
a Department of Radiology, Columbia University, New York, NY
b Department of Neurosurgery, Columbia University, New York, NY
c Departments of Radiology and Neurological Surgery, University of Wisconsin, Madison, WI
d Department of Radiology, Hollywood Hospital, Hollywood, FL
Address correspondence to Lei Feng, MD, PhD, Department of Radiology, 177 Fort Washington Avenue, MHB 8SK, New York, NY 10032
BACKGROUND AND PURPOSE: This study assesses the cytotoxicity of hyperosmolar mannitol on human endothelial and meningioma cells in vitro and summarizes the initial clinical experience of using mannitol as a liquid tumor embolization agent.
METHODS: Human umbilical vein endothelial cells and primary meningioma cells from surgical specimens were treated with 300, 600, 900, and 1200 mOsm of mannitol, mannitol and iohexol mixture, saline, and iohexol alone. Cell death was evaluated with a Live/Dead kit and quantified with thymidine incorporation. From 1998 to 2004, 23 patients with meningioma were treated with mannitol and 31 patients were treated with polyvinyl alcohol (PVA) particles alone. Angiographic results, procedural complications, intraoperative observation, and estimated blood loss during surgical resection were retrospectively evaluated.
RESULTS: Minimal endothelial cell death was seen after incubation with 300 mOsm of mannitol for 15 minutes, but 43 ± 2% of endothelial cells were damaged by 1200 mOsm of mannitol after 30 minutes. Five meningioma cell lines exhibited significant cell death (22 ± 2%; P < .05) after incubation with mannitol. Satisfactory angiographic results were obtained in all 23 patients. Tumor necrosis was observed intraoperatively and confirmed pathologically. There was no significant difference in estimated blood loss between mannitol- and PVA-embolized patients (407 ± 64 mL vs 381 ± 50 mL; P > .75).
CONCLUSION: High concentration of mannitol can injure endothelial cells and meningioma cells in a short period of time. It is feasible to use mannitol as a liquid embolic agent to treat meningioma.
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Feasibility of Using Hyperosmolar Mannitol as a Liquid Tumor Embolization Agent
Author: Lei Fenga, Beverly A. Kienitzc, Carolyn Matsumotoa, Jeffrey Bruceb, Michael Sistib, Hoang Duongd and John Pile-Spellmana
a Department of Radiology, Columbia University, New York, NY
b Department of Neurosurgery, Columbia University, New York, NY
c Departments of Radiology and Neurological Surgery, University of Wisconsin, Madison, WI
d Department of Radiology, Hollywood Hospital, Hollywood, FL
Address correspondence to Lei Feng, MD, PhD, Department of Radiology, 177 Fort Washington Avenue, MHB 8SK, New York, NY 10032
BACKGROUND AND PURPOSE: This study assesses the cytotoxicity of hyperosmolar mannitol on human endothelial and meningioma cells in vitro and summarizes the initial clinical experience of using mannitol as a liquid tumor embolization agent.
METHODS: Human umbilical vein endothelial cells and primary meningioma cells from surgical specimens were treated with 300, 600, 900, and 1200 mOsm of mannitol, mannitol and iohexol mixture, saline, and iohexol alone. Cell death was evaluated with a Live/Dead kit and quantified with thymidine incorporation. From 1998 to 2004, 23 patients with meningioma were treated with mannitol and 31 patients were treated with polyvinyl alcohol (PVA) particles alone. Angiographic results, procedural complications, intraoperative observation, and estimated blood loss during surgical resection were retrospectively evaluated.
RESULTS: Minimal endothelial cell death was seen after incubation with 300 mOsm of mannitol for 15 minutes, but 43 ± 2% of endothelial cells were damaged by 1200 mOsm of mannitol after 30 minutes. Five meningioma cell lines exhibited significant cell death (22 ± 2%; P < .05) after incubation with mannitol. Satisfactory angiographic results were obtained in all 23 patients. Tumor necrosis was observed intraoperatively and confirmed pathologically. There was no significant difference in estimated blood loss between mannitol- and PVA-embolized patients (407 ± 64 mL vs 381 ± 50 mL; P > .75).
CONCLUSION: High concentration of mannitol can injure endothelial cells and meningioma cells in a short period of time. It is feasible to use mannitol as a liquid embolic agent to treat meningioma.
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Next Stop, Don't Block the Doors: Opening Up Access to Clinical Trials Results
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Diabetes Mellitus Increases the Risk of Active Tuberculosis: A Systematic Review of 13 Observational Studies
Author: Christie Y. Jeon*, Megan B. Murray
1 Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
Several studies have suggested that diabetes mellitus (DM) increases the risk of active tuberculosis (TB). The rising prevalence of DM in TB-endemic areas may adversely affect TB control. We conducted a systematic review and a meta-analysis of observational studies assessing the association of DM and TB in order to summarize the existing evidence and to assess methodological quality of the studies.
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Smoking and health: a physician’s responsibility.
Author: American College of Chest Physicians, American Thoracic Society, Asia Pacific Society
of Respirology, Canadian Thoracic Society, European Respiratory Society, International
Smoking and health: a physician’s responsibility... Read more..
Animal Diseases of Public Health Importance
Author: Gregory D. Orriss
Food and Agriculture Organization of the United Nations, Rome, Italy
The Food and Agriculture Organization's (FAO) interest in emerging diseases caused by foodborne pathogens derives from its role as the leading United Nations agency with a mandate for food quality and safety matters. The Food Quality and Standards Service of FAO's Food and Nutrition Division is active in all areas related to food safety and implements the FAO/World Health Organization Food Standards Program. Its activities include providing assistance to FAO's member nations in addressing problems, strengthening infrastructure, promoting standardization as a means of facilitating trade, and safeguarding the interests of consumers. This paper considers the importance of emerging foodborne diseases from the perspectives of the consumer, international trade in food, producers and processors, and developing countries and addresses prevention and control measures. .. Read more..
Structured education for people with type 2 diabetes
Author: Sean F Dinneen
Effective self management is the cornerstone of good care for people with diabetes. High quality structured education that prepares people for a lifetime with the condition is a key enabler of self management. .. Read more..
Source of Variant Creutzfeldt-Jakob Disease outside United Kingdom
Author: Pascual Sanchez-Juan,*† Simon N. Cousens,‡ Robert G. Will,§ and Cornelia M. van Duijn*
*Erasmus Medical Center, Rotterdam, the Netherlands; †University Hospital "Marqués de Valdecilla," Santander, Spain; ‡London School of Hygiene and Tropical Medicine, London, UK; and §Western General Hospital, Edinburgh, UK
We studied the occurrence of variant Creutzfeldt-Jakob disease (vCJD) outside the United Kingdom in relation to the incidence of indigenous bovine spongiform encephalopathy (BSE) and to the level of live bovines and bovine products imported from the UK during the 1980s and the first half of the 1990s. Our study provides evidence that a country's number of vCJD cases correlates with the number of live bovines it imported from the UK from 1980 to 1990 (Spearman rank correlation coefficient [rs] 0.73, 95% confidence interval [CI] 0.42–0.89, p<0.001). Similar correlations were observed with the number of indigenous BSE cases (rs 0.70, 95% CI 0.37–0.87, p = 0.001) and carcass meat imported from the UK from 1980 to 1996 (rs 0.75, 95% CI 0.45–0.89; p<0.001) Bovine imports from the UK may have been an important source of human exposure to BSE and may have contributed to the global risk for disease... Read more..
Ecologic Immunology of Avian Influenza (H5N1) in Migratory Birds
Author: Thomas P. Weber* and Nikolaos I. Stilianakis*†
*Joint Research Centre, Ispra, Italy; and †University of Erlangen-Nürnberg, Erlangen, Germany
The claim that migratory birds are responsible for the long-distance spread of highly pathogenic avian influenza viruses of subtype H5N1 rests on the assumption that infected wild birds can remain asymptomatic and migrate long distances unhampered. We critically assess this claim from the perspective of ecologic immunology, a research field that analyzes immune function in an ecologic, physiologic, and evolutionary context. Long-distance migration is one of the most demanding activities in the animal world. We show that several studies demonstrate that such prolonged, intense exercise leads to immunosuppression and that migratory performance is negatively affected by infections. These findings make it unlikely that wild birds can spread the virus along established long-distance migration pathways. However, infected, symptomatic wild birds may act as vectors over shorter distances, as appears to have occurred in Europe in early 2006... Read more..
U of M reaches milestone in diabetes research using pig islets
Research offers hope to increase islet supply to cure type 1 diabetes.. Read more..
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