Boston Scientific Corporation (NYSE: BSX) announced that it has completed enrollment in its MAPS(TM) clinical trial, which is studying the coiling of intracranial aneurysms. This prospective, randomized trial commenced enrollment in 2007 and has reached its goal of 630 patients, enrolled at 47 hospitals in 11 countries. Principal investigators for the trial are Anil Gholkar, O.B.E., M.B.B.S., Clay Johnston, M.D., Ph.D., and Cameron McDougall, M.D.

The MAPS trial compares clinical outcomes in patients treated with either bare-platinum GDC® Detachable Coils or Matrix2® Detachable Coils, which are covered with a bio-polymer. The primary endpoint is Target Aneurysm Recurrence (TAR) at one year, a composite clinical endpoint of target aneurysm rupture or re-rupture, re-treatment or neurologic death. Secondary angiographic endpoints will be compared to the primary clinical outcomes over several years to evaluate the long-term predictive value of 12-month angiography.

“The MAPS trial has significant potential to enhance our understanding of the products we use to treat intracranial aneurysms as well as our methods for assessing outcomes,” said Dr. Gholkar. “By conducting rigorous measurement, monitoring and adjudication of clinical outcomes over multiple years, the MAPS trial will establish a critical baseline from which to judge existing treatments as well as future endovascular technologies.”

Aquilla Turk, D.O., is the Chairman of the MAPS Steering Committee and enrolled the final patient in the trial. “With enrollment completed, our focus now turns to data monitoring, completion of follow up and preparation for primary endpoint publication in 2011,” said Dr. Turk. “The Steering Committee is grateful to all the trial investigators who have worked so diligently to reach this milestone.”

“This important trial is the latest example of Boston Scientific’s 24 years of collaboration and leadership in the field of neurointervention and lays the groundwork for continued advances in the minimally invasive treatment of brain aneurysms,” said Mark Paul, President of Boston Scientific’s Neurovascular business. “We appreciate the participation of the 124 physicians and 63 research coordinators, whose efforts led to the successful completion of enrollment.”

Cautionary Statement Regarding Forward-Looking Statements

This press release contains forward-looking statements within the meaning of Section 21E of the Securities Exchange Act of 1934. Forward-looking statements may be identified by words like “anticipate,” “expect,” “project,” “believe,” “plan,” “estimate,” “intend” and similar words. These forward-looking statements are based on our beliefs, assumptions and estimates using information available to us at the time and are not intended to be guarantees of future events or performance. These forward-looking statements include, among other things, statements regarding clinical trials, regulatory approvals, clinical outcomes and product performance. If our underlying assumptions turn out to be incorrect, or if certain risks or uncertainties materialize, actual results could vary materially from the expectations and projections expressed or implied by our forward-looking statements. These factors, in some cases, have affected and in the future (together with other factors) could affect our ability to implement our business strategy and may cause actual results to differ materially from those contemplated by the statements expressed in this press release. As a result, readers are cautioned not to place undue reliance on any of our forward-looking statements.

Factors that may cause such differences include, among other things: future economic, competitive, reimbursement and regulatory conditions; new product introductions; demographic trends; intellectual property; litigation; financial market conditions; and, future business decisions made by us and our competitors. All of these factors are difficult or impossible to predict accurately and many of them are beyond our control. For a further list and description of these and other important risks and uncertainties that may affect our future operations, see Part I, Item 1A – Risk Factors in our most recent Annual Report on Form 10-K filed with the Securities and Exchange Commission, which we may update in Part II, Item 1A – Risk Factors in Quarterly Reports on Form 10-Q we have filed or will file hereafter. We disclaim any intention or obligation to publicly update or revise any forward-looking statements to reflect any change in our expectations or in events, conditions, or circumstances on which those expectations may be based, or that may affect the likelihood that actual results will differ from those contained in the forward-looking statements. This cautionary statement is applicable to all forward-looking statements contained in this document.

Source: Boston Scientific Corporation

Like humans, dogs can also get painful pet arthritis throughout their bodies. But unlike people, who can simply talk about what hurts, how can you spot when your furry little friend has arthritis? Flexcin, the maker of FlexPet dog arthritis treatment, offers these four tell-tail signs so you can bring relief to your pet.

1) No Longer Running & Jumping: Dogs are active animals, even as they age. Running and jumping around are two simple activities enjoyed by happy and healthy dogs. If your dog stops running and jumping, this is the first major sign your pet may have dog joint pain.

2) Difficult Walking Up Stairs: Many homes are built to have multiple levels. If your dog refrains from going upstairs it most likely means they have severe dog joint pain and can’t climb the stairs.

3) Overweight: Although done without harmful intentions, a good majority of people overfeed their dogs that can often lead to obesity problems. When a dog is overweight they put too much pressure on their frame and this can lead to uncomfortable pet arthritis.

4) Less Interested In Being A Pet: When dogs have pet arthritis it can be painful to simply touch or pet your furry little friend. Even gentle petting upsets sore areas that easily exacerbate aches and pains in the joints.

It’s important for every dog owner to monitor for these obvious warning signs and provide a dog arthritis treatment. Once the pet arthritis subsides it’s important to return your dog to a healthy and active lifestyle with a proper diet with the right nutrition.

Source
Flexcin International, Inc.

University of Illinois researchers have found a key to keeping stem cells in their neutral state: It takes a soft touch.

In a paper published in the journal PLoS One, the researchers demonstrated that culturing mouse embryonic stem cells (mESCs) on a soft gel rather than on a hard plate or dish keeps them in their pluripotent state, a ground state with the ability to become any type of tissue. The soft substrate maintains homogeneous pluripotent colonies over long periods of time – without the need for expensive growth chemicals.

“This has huge applications in the future of regenerative medicine,” said mechanical science and engineering professor Ning Wang, who co-led the group with animal sciences professor Tetsuya Tanaka. “It’s an exciting area. There’s still a lot of work to do, but our work is a step toward understanding the basic biology of stem cells.”

The difficulty of maintaining mESC colonies that are homogeneously pluripotent has been one of the main obstacles in stem cell research. Pluripotent stem cells spontaneously differentiate, beginning to turn into specialized tissue types such as skin or muscle. Scientists use chemicals called growth factors to keep mESCs in their unchanged state, but even then it’s not long before the culture is a mixture of cells in various stages of differentiation, with diverse gene expression and morphologies.

Such diversity in a sample makes it very difficult for researchers to induce a culture of stem cells to become a particular type of tissue – the ultimate goal of stem cell research.

“If we start from a homogenous population of undifferentiated cells, differentiation toward the tissue of our interest might become much more homogenous than we’ve been able to achieve,” said Tanaka, who also is affiliated with the U. of I. Institute for Genomic Biology. “So then, in generating a specific cell type – the main application of pluripotent stem cells – I think that there is an advantage to having a homogeneous culture to start with.”

After noticing that pluripotent mESCs tend to stick together in round colonies while cells on the colony edges in contact with the rigid growth plate tend to differentiate more quickly, the team decided to focus on mESC mechanics rather than chemistry. Since stem cells are 10 times softer than mature cells, the researchers wondered if the mechanical forces between the plate and the cells were spurring differentiation. Wang and Tanaka’s earlier research found that even small mechanical forces could be used to direct cell differentiation; could mechanics also hamper differentiation?

The team did side-by-side comparisons of mESCs grown on a traditional medium with growth factor and mESCs grown on a soft gel with the same stiffness as the cells, both with and without growth factor. They found that cells grown on the soft gel had greater homogeneity and pluripotency, even without growth factor, and even more than three months and 20 passages later.

“It’s two sides of the coin: Mechanical force can induce differentiation, and here we said if you can lower the forces between the substrate and the cells, they stay pluripotent. They are complementary processes,” Wang said. “Our paper shows that mechanical environment plays at least as important a role as chemical growth factors, if not greater. In vivo, cells produce growth factors for a short time and then they stop. On the other hand, mechanical forces bear on every cell all the time.”

Next, the researchers want to try their soft-substrate method with induced pluripotent stem cells (iPSCs), mature cells that have been genetically reprogrammed to a pluripotent state. These cells hold a lot of promise for medical applications, but are notoriously hard to culture and not as well understood as embryonic cells.

“We can try culturing mouse iPSCs on the same soft substrate and see if the same benefit applies to achieve homogenous stem cell cultures,” Tanaka said. “If that’s the case, the impact would be significant.”

This work was supported by the National Institutes of Health, the United States Department of Agriculture, and the University of Illinois. Co-authors were graduate students Farhan Chowdhury, Yanzhen Li and Yeh-Chuin Poh, and visiting scholar Tamaki Yokohama-Tamaki.

Source:
Liz Ahlberg
University of Illinois at Urbana-Champaign

Developing a credit-card-sized gas chromatography platform that can analyze volatile compounds within seconds is the next step for Virginia Tech College of Engineering researcher Masoud Agah, who has received a National Science Foundation (NSF) Faculty Early Career Development Program (CAREER) Award to support his research.

Agah, an assistant professor in the Bradley Department of Electrical and Computer Engineering and an affiliate member of the Department of Mechanical Engineering faculty, recently secured a five-year CAREER grant worth $400,000. This is the NSF’s most prestigious award for creative junior faculty who are considered to be future leaders in their academic fields.

Gas chromatography is the primary technique used in a number of scientific, medical, and industrial settings to separate and analyze volatile compounds in gases, liquids, and solids.

Medical researchers, for example, can isolate volatile organic compounds in breath samples for early diagnosis or evaluation of certain metabolic conditions and diseases. Acetone in a patient’s breath can be a marker for diabetes, Agah said, and scientists have identified a group of compounds that appear to be markers for breast cancer.

Gas chromatography is used in the field of environmental monitoring to identify certain air pollutants and drinking water and groundwater contaminants. Homeland security and military personnel can rely on the technique to test air samples for chemical warfare agents, such as sarin and mustard gases. The technique also is widely used in food processing, the petrochemical industry, and a number of other fields.

Currently, gas chromatography systems consist of a gas tank, sample injector, separation column, and gas detector. Samples to be analyzed are vaporized and injected into the column, where compounds are separated and then passed over the detector. Conventional systems tend to be large, fragile, and relatively expensive table-top instruments.

Agah, who established the Microelectromechanical Systems (MEMS) Laboratory (ece.vt.edu/mems/) at Virginia Tech shortly after joining the university in 2005, is attempting to develop a gas chromatographic architecture that will fit on a platform the size of a credit card and will separate and analyze a complex range of compounds in only a few seconds.

To create this new architecture, which he has named “GC Matrix,” Agah is employing MEMS technology. In his laboratory, he is developing gas chromatographic columns with heaters, temperature sensors, pressure sensors, and thermal conductivity detectors that can fit on micro-chips. Agah already has developed columns that can separate a limited number of volatile compounds and chemical warfare agent simulants in less than 10 seconds.

In addition to significantly improving the speed, portability, and performance, Agah’s GC Matrix will consume far less power than conventional instruments.

Once perfected, the GC Matrix could be used in a number of industrial and scientific applications. The apparatus also could be effective in saving lives during crises. Emergency workers, for instance, could easily carry GC Matrix instruments into areas devastated by floods to test water for toxic chemicals, and soldiers on the battlefield could test the air within seconds for signs of chemical warfare agents.

Every CAREER award project includes an educational component. Agah will develop a new university laboratory course on MEMS technology. He also is working with Virginia Tech’s National Society of Black Engineers and the Institute of Electrical and Electronics Engineers’ Teacher in Service Program to establish the High-School Microsystems Engineering Program.

###

Before joining the Virginia Tech faculty in 2005, Agah conducted research at the NSF Center for Wireless Integrated MicroSystems at the University of Michigan-Ann Arbor, where he developed MEMS-based gas chromatography columns for environmental monitoring applications. He completed his Ph.D. in electrical engineering at Michigan and received his B.S. and M.S. degrees from Sharif University of Technology in Iran.

Source: Liz Crumbley

Virginia Tech

Dr. Frederic Charron, researcher at the Institut de recherches cliniques de Montreal (IRCM), and his team have shown for the first time that a key molecule of the vascular system directs axons during the formation of neural circuits. This connection between the nervous system and the vascular system could be a good starting point for the development of therapies for neurodegenerative diseases. The discovery is published by Neuron, a scientific journal of the Cell Press group.

“To properly form neural circuits, developing axons (long extensions of neurons that make the nerves) need molecules to guide them towards their target, in the same way that road signs guide us when we drive,” explains Pierre Fabre, doctoral student in Dr. Charron’s team and first co-author of the article.

The nervous system is not the only system formed during human embryo development. Blood vessels are also organized into a very complex network, which led to the idea that certain molecules could be reused by both the nervous system and the vascular system. In fact, recent studies revealed that the reference points used to guide axons also help blood vessels reach their targets.

“One of the key molecules of the vascular system is the vascular endothelial growth factor, better known as VEGF,” adds Mr. Fabre. “We discovered that VEGF is able to attract nervous system axons. More specifically, we identified Flk-1 as the receptor responsible for this effect, making it a prime target for the development of therapies to re-grow axons after lesions of the central nervous system or neurodegenerative diseases.”

This scientific breakthrough was possible due to an innovative technique developed by Dr. Charron’s laboratory a few years ago. The system uses a microscopic device to control and observe, in real time, the axon’s behaviour in response to guidance molecules. This technique allowed the researchers to follow the axon’s trajectory and revealed VEGF’s role in directing axons.

“This research could have an important long-term impact in the field of spinal cord repair, as the results will help us better understand the development of the spinal cord,” says Dr. Charron, Director of the IRCM’s Molecular Biology of Neural Development research unit. “The more we learn about the molecules needed to appropriately guide axons, the more it will become possible to develop a therapy to treat spinal cord injuries.”

“These new findings are of great interest to the research community as they offer new hope for the treatment of neurodegenerative diseases,” says Dr. Anthony Phillips, CIHR’s Scientific Director of the Institute of Neurosciences, Mental Health and Addiction. “CIHR recognizes the important work of Dr. Charron’s team and this novel discovery linking blood vessels and neurons to neural circuit formation.”

Notes:

This research project was conducted in close collaboration with Dr. Peter Carmeliet’s (senior co-author of the article with Dr. Charron) team at the Vesalius Research Center, in Leuven (Belgium), including Dr. Carmen Ruiz de Almodovar, first co-author of the study with Mr. Fabre.

Research carried out in Dr. Charron’s laboratory was funded by the Canadian Institutes of Health Research (CIHR) and the Fonds de recherche en santГ© du QuГ©bec (FRSQ). Pierre Fabre also holds scholarships from the UniversitГ© de MontrГ©al and the IRCM.

Source:
Julie Langelier

Institut de recherches cliniques de Montreal

By dipping plain cotton cloth in a high-tech broth full of silver nanowires and carbon nanotubes, Stanford researchers have developed a new high-speed, low-cost filter that could easily be implemented to purify water in the developing world.

Instead of physically trapping bacteria as most existing filters do, the new filter lets them flow on through with the water. But by the time the pathogens have passed through, they have also passed on, because the device kills them with an electrical field that runs through the highly conductive “nano-coated” cotton.

In lab tests, over 98 percent of Escherichia coli bacteria that were exposed to 20 volts of electricity in the filter for several seconds were killed. Multiple layers of fabric were used to make the filter 2.5 inches thick.

“This really provides a new water treatment method to kill pathogens,” said Yi Cui, an associate professor of materials science and engineering. “It can easily be used in remote areas where people don’t have access to chemical treatments such as chlorine.”

Cholera, typhoid and hepatitis are among the waterborne diseases that are a continuing problem in the developing world. Cui said the new filter could be used in water purification systems from cities to small villages.

Faster filtering by letting bacteria through

Filters that physically trap bacteria must have pore spaces small enough to keep the pathogens from slipping through, but that restricts the filters’ flow rate.

Since the new filter doesn’t trap bacteria, it can have much larger pores, allowing water to speed through at a more rapid rate.

“Our filter is about 80,000 times faster than filters that trap bacteria,” Cui said. He is the senior author of a paper describing the research that will be published in an upcoming issue of Nano Letters. The paper is available online now.

The larger pore spaces in Cui’s filter also keep it from getting clogged, which is a problem with filters that physically pull bacteria out of the water.

Cui’s research group teamed with that of Sarah Heilshorn, an assistant professor of materials science and engineering, whose group brought its bioengineering expertise to bear on designing the filters.

Silver has long been known to have chemical properties that kill bacteria. “In the days before pasteurization and refrigeration, people would sometimes drop silver dollars into milk bottles to combat bacteria, or even swallow it,” Heilshorn said.

Cui’s group knew from previous projects that carbon nanotubes were good electrical conductors, so the researchers reasoned the two materials in concert would be effective against bacteria. “This approach really takes silver out of the folk remedy realm and into a high-tech setting, where it is much more effective,” Heilshorn said.

Using the commonplace keeps costs down

But the scientists also wanted to design the filters to be as inexpensive as possible. The amount of silver used for the nanowires was so small the cost was negligible, Cui said. Still, they needed a foundation material that was “cheap, widely available and chemically and mechanically robust.” So they went with ordinary woven cotton fabric.

“We got it at Wal-mart,” Cui said.

To turn their discount store cotton into a filter, they dipped it into a solution of carbon nanotubes, let it dry, then dipped it into the silver nanowire solution. They also tried mixing both nanomaterials together and doing a single dunk, which also worked. They let the cotton soak for at least a few minutes, sometimes up to 20, but that was all it took.

The big advantage of the nanomaterials is that their small size makes it easier for them to stick to the cotton, Cui said. The nanowires range from 40 to 100 billionths of a meter in diameter and up to 10 millionths of a meter in length. The nanotubes were only a few millionths of a meter long and as narrow as a single billionth of a meter. Because the nanomaterials stick so well, the nanotubes create a smooth, continuous surface on the cotton fibers. The longer nanowires generally have one end attached with the nanotubes and the other end branching off, poking into the void space between cotton fibers.

“With a continuous structure along the length, you can move the electrons very efficiently and really make the filter very conducting,” he said. “That means the filter requires less voltage.”

Minimal electricity required

The electrical current that helps do the killing is only a few milliamperes strong – barely enough to cause a tingling sensation in a person and easily supplied by a small solar panel or a couple 12-volt car batteries. The electrical current can also be generated from a stationary bicycle or by a hand-cranked device.

The low electricity requirement of the new filter is another advantage over those that physically filter bacteria, which use electric pumps to force water through their tiny pores. Those pumps take a lot of electricity to operate, Cui said.

In some of the lab tests of the nano-filter, the electricity needed to run current through the filter was only a fifth of what a filtration pump would have needed to filter a comparable amount of water.

The pores in the nano-filter are large enough that no pumping is needed – the force of gravity is enough to send the water speeding through.

Although the new filter is designed to let bacteria pass through, an added advantage of using the silver nanowire is that if any bacteria were to linger, the silver would likely kill it. This avoids biofouling, in which bacteria form a film on a filter. Biofouling is a common problem in filters that use small pores to filter out bacteria.

Cui said the electricity passing through the conducting filter may also be altering the pH of the water near the filter surface, which could add to its lethality toward the bacteria.

Cui said the next steps in the research are to try the filter on different types of bacteria and to run tests using several successive filters.

“With one filter, we can kill 98 percent of the bacteria,” Cui said. “For drinking water, you don’t want any live bacteria in the water, so we will have to use multiple filter stages.”

Cui’s research group has gained attention recently for using nanomaterials to build batteries from paper and cloth.

Notes:

David Schoen and Alia Schoen were both graduate students in Materials Science and Engineering when the water-filter research was conducted and are co-lead authors of the paper in Nano Letters. David Schoen is now a postdoctoral researcher at Stanford.
Liangbing Hu, a postdoctoral researcher in Materials Science and Engineering, and Han Sun Kim, a graduate student in Materials Science and Engineering at the time the research was conducted, also contributed to the research and are co-authors of the paper.

Source:
Louis Bergeron
Stanford University

If you are male and drink coffee regularly, at least six cups per day, your chances of developing prostate cancer will be lower, and your risk of getting the more lethal form of prostate cancer that has spread to the bone is 60% less than men who never or rarely drink coffee, say scientists from the Harvard School of Public health.

The findings of this study appear in the Journal of the National Cancer Institute. The authors explain that not many studies have focused on what impact coffee intake might have on the most lethal form of prostate cancer. This is the largest one so far to determine whether coffee might have an effect on lethal prostate cancer risk.

Sixteen million men around the world have survived prostate cancer – 2 million in the USA. It is the most frequently diagnosed male cancer in America and the nation’s second highest cancer killer, the authors informed.

Kathryn Wilson, lead author, said:

“At present we lack an understanding of risk factors that can be changed or controlled to lower the risk of lethal prostate cancer. If our findings are validated, coffee could represent one modifiable factor that may lower the risk of developing the most harmful form of prostate cancer.”

Several biologically active compounds exist in coffee, such as caffeine and phenolic acids. These substances are potent antioxidants; they affect glucose metabolism and levels of sex hormones. The researchers wondered whether they might reduce prostate cancer risk.

Previous studies had shown how coffee can lower the risk of developing breast cancer, liver cancer, cirrhosis of the liver, gallstone disease, diabetes type 2, and Parkinson’s disease.

In order to find out whether regular coffee consumption might influence prostate cancer risk, particularly the lethal form, the scientists evaluated data from the Health Professional Follow-Up Study involving 47,911 US men. The participants had reported coffee consumption habits every four years from 1986 to 2008. During this 22-year period there were 5,035 cases of prostate cancer, including 642 metastatic (lethal) cases.

The authors discovered that a man who drank six cups of coffee or more each day had a nearly 20% reduced risk of developing prostate cancer (any type), and a 60% lower chance ever getting the lethal type. They were surprised to find that both normal and decaffeinated coffee offered the same levels of protection. Even moderate coffee drinkers – those consuming between one to three cups per day – had a 30% reduced risk of developing metastatic prostate cancer.

The researchers concluded in an abstract in the journal:

“We observed a strong inverse association between coffee consumption and risk of lethal prostate cancer. The association appears to be related to non-caffeine components of coffee.”

“Coffee Consumption and Prostate Cancer Risk and Progression in the Health Professionals Follow-up Study”
Kathryn M. Wilson, Julie L. Kasperzyk, Jennifer R. Stark, Stacey Kenfield, Rob M. van Dam, Meir J. Stampfer, Edward Giovannucci, Lorelei A. Mucci
Journal of the National Cancer Institute, doi: 10.1093/jnci/djr151

A new Regenstrief Institute and Indiana University Center for Aging Research (IUCAR) study provides effective strategies to help hospital systems, physicians and other care providers to overcome end zone hurdles and actually take evidence-based research to the patient’s hospital or clinic bedside.

The paper has been published online by the Journal of Clinical Interventions in Aging, a peer-reviewed, open access publication.

“Much good evidence-based research is conducted and published in peer reviewed publications every year. But unfortunately it’s not making its way into medical practice. For example, after numerous studies, the Food and Drug Administration in 1996 approved donepezil, a medication for Alzheimer disease. Yet today, doctors are prescribing this drug to less than 20 percent of eligible individuals,” said first author Malaz Boustani, M.D., IU School of Medicine associate professor of medicine. He is a Regenstrief Institute investigator and an IUCAR center scientist.

“Physicians and other health-care providers need help. Our work provides a blueprint emphasizing how to conduct a non-hierarchical group approach to making that last and most important leap from scientific discovery to the real world,” added Dr. Boustani.

The paper includes a case study of the Aging Brain Care Medical Home (ABC-MedHome), which has successfully brought evidence-based medicine to both the patient and the family caregiver. The program identifies, assesses and manages the biopsychosocial needs of older patients suffering from dementia or depression (and those of their family caregivers) receiving care within the primary care practice with Wishard Health Service, an urban public health care system.

To use the example of a relay race, the model outlined in the JCIA paper enables the doctors, nurses, social workers, administrators and others who directly provide care to patients to seize the baton and provide locally sensitive treatment based on evidence-based research.

“And with so many policy changes, providers can’t do things the way they have always done them. Our paper offers a process to help them select evidence-based modifications and innovations to how they provide and evaluate care to ensure that patients receive the best care possible,” said Dr. Boustani.

Notes:
Co-authors of “Selecting A Change and Evaluating Its Impact on the Performance of a Complex Adaptive Health Care Delivery System” in addition to Dr. Boustani are Stephanie Munger, M.S., of the IU Center for Aging Research and the Regenstrief Institute, Rajesh Gulati, M.D., of the IU School of Medicine; Mickey Vogel, R.N., G.N.P., of the IU Medical Group; Robin A. Beck, M.D., of the IU School of Medicine and Christopher M. Callahan, M.D., of the IU Center for Aging Research, the Regenstrief Institute and the IU School of Medicine.


The study was supported by the National Institute of Mental Health.

Source:
Cindy Fox Aisen
Indiana University School of Medicine

For transplanted beta cells, life is tough. Not only are the insulin-producing cells in a stranger’s body, tucked into the liver rather than the pancreas, they are a bit short on oxygen and blood, and they are often exposed to raised levels of glucose.

Joslin Diabetes Center scientists, however, have shown that the cells can protect themselves by actively adapting to their new homes-findings that may help to aid future transplants aimed at treating type 1 diabetes.

Researchers in the lab of Gordon Weir, M.D., looked at a cellular stress mechanism called the unfolded protein response or endoplasmic reticulum (ER) stress response in beta cells. This response is triggered when the ER, part of the cell’s protein assembly line, struggles to fold newly formed proteins into their exactly right shapes.

Earlier studies suggested this process contributes to the high mortality and low insulin production often displayed in beta cell transplants, which aim to replace cells that the body’s own immune system kills off in type 1 diabetes.

In work reported in the journal PLoS One in June, the scientists compared healthy human beta cells from surgical donors with beta cells that had been transplanted into mice with suppressed immune systems. They found that the transplanted cells strongly activate genes that help to guard against damage from ER stress, and suppress other genes that may trigger cellular attempts to self-destruct.

“Not only is this response likely to be helpful for proper insulin secretion but it also seems to hold back the death mechanisms that can be turned on when ER stress is really aggressive,” says Weir, who is co-head of Joslin’s Research Section on Islet Cell and Regenerative Biology.

“Nature is telling us about mechanisms that might rescue the cells from death,” says Weir, who is also a Professor of Medicine at Harvard Medical School. “Knowing these mechanisms might suggest some treatments, such as genetic manipulations to the cells before they’re transplanted, or drugs after they’re transplanted, that help to guard the cells.”

Weir notes that blood glucose levels run higher in mice than in humans, so that in this way the transplanted cells were in an environment similar to that of an actual transplant. The glucose levels also were similar to those of people with the impaired glucose tolerance that leads toward type 2 diabetes. “This may be a general mechanism for beta cells under stress, so these results may also tell us something about glucose toxicity to beta cells in type 2 diabetes,” he adds.

Jeffrey Kennedy was first author on the paper. Other contributors include Hitoshi Katsuta, Min-Ho Jung, Lorella Marselli, Allison B. Goldfine, and Susan Bonner-Weir from Joslin; and Ulysses J. Balis and Dennis Sgroi from Massachusetts General Hospital. Lead funding was provided by the American Diabetes Association, the Juvenile Diabetes Research Foundation, the National Institutes of Health and the Diabetes Research and Wellness Foundation.

Source: Joslin Diabetes Center

Doylestown Hospital is joining the Jefferson Neuroscience Network (JNN). Through this collaboration, Jefferson and Doylestown Hospital will provide the most sophisticated care and expertise available to patients with time-sensitive neurovascular diseases. By joining this network, Doylestown Hospital patients will have access to: the latest clinical protocols and trials available; community education programs; priority transfers for acutely ill patients to Jefferson Hospital for Neuroscience (JHN); and Jefferson Expert Teleconsulting (JET), the region’s first university-based, high-tech mobile robotic system for neuroscience.

‘Time is Brain’

‘Time is brain’ is the credo among healthcare professionals for diagnosing and treating time-sensitive neurovascular diseases, including arteriovenous malformations (AVMs), brain aneurysms and, especially, stroke. Certain drugs for stroke must be administered within 4.5 hours for best chance of functional recovery. Timely performance of neurological procedures to repair AVMs and aneurysms are similarly urgent. Yet many community hospitals have limited access to the specialists and technology to diagnose and treat patients quickly and accurately.

JET Provides 24/7 Access

Jefferson Expert Teleconsulting (JET) provides network hospitals with 24/7 access to vascular neurologists and neurosurgeons for emergency consultative services. The primary goal of this program is to compliment the care provided by Doylestown Hospital neurologists and/or emergency physicians to those patients presenting with symptoms of a stroke. At the request of the hospital’s physician(s), a Jefferson neurovascular specialist will “beam in” via a robot placed in the network hospital emergency department. After consultation with the patient and/or family, the physicians will determine the best treatment option for the patient. The goal is to keep the patient at the Doylestown Hospital. If the prescribed treatment is unavailable there, the patient and/or family, in discussion with the physicians, may decide to transfer the patient to Jefferson, or to another facility with the clinical expertise and resources to properly treat the patient.

“JET places all of our resources among them, vascular neurologists, dual-trained neurosurgeons, advanced technology and leading clinical trials in which we partner with the National Institutes of Health at the disposal of patients, their families and physicians in need of a first or second expert opinion,” said Robert H. Rosenwasser, M.D., Jewell L. Osterholm, M.D., Professor and Chair, Department of Neurological Surgery at Jefferson Medical College of Thomas Jefferson University, and co-director of the Stroke Program at Thomas Jefferson University Hospital. “Its greatest value is for timely diagnosis and application of treatment for time-sensitive neurovascular diseases, especially stroke. Given its prevalence, it is alarming how few people receive treatment in the appropriate amount of time.”

“Stroke is the third-leading cause of death in the United States but the leading cause of disability. On average, someone suffers a stroke every 45 seconds; someone dies of a stroke every three minutes; and 795,000 people suffer a new or recurrent stroke each year,” said Rodney Bell, M.D., neurologist and co-director of the Jefferson Stroke Center. “With JET, even hospitals in remote areas can provide patients with expert consultation and delivery of appropriate care from an experienced neurologist or neurological surgeon immediately in cases where every minute can make a critical difference.”

How JET Works

Participating hospitals are supplied with a mobile robotic platform manufactured by InTouch Health® that enables the JHN physician to be remotely present. JET’s panoramic visualization system and control interface allow physicians, patients and hospital staff a safe, secure and interactive experience. The JHN physician can view CT scans and lab results remotely, and, with the assistance of the community hospital staff, utilize certain digital medical devices such as digital stethoscopes and otoscopes which can be connected directly to the robot.

If a patient arrives at a participating hospital and does not have a neurologist or neurosurgeon available, or has a neurologist who needs to consult with a stroke specialist, the attending physician contacts JHN. The JHN specialist on call then uses a laptop to connect to the remote hospital via the robot, obtains a medical history by speaking directly with the patient and/or family members, examines the patient and, in consultation with the attending physician, determines what therapy is immediately needed, in real time, without delay. Finally, a decision is made to either admit the patient to the local hospital’s Critical Care Unit or to transfer him/her to Jefferson or to another facility with the clinical expertise and resources to properly treat the patient.

When a suspected stroke patient arrives at Doylestown Hospital, the hospital’s acute stroke team is put on alert. “Since time is such a crucial factor in diagnosing and treating stroke,” said Lawrence Brilliant, M.D., director of Doylestown’s ER, “having this additional level of expertise right at our fingertips is of great benefit to our patients.”

Source: Thomas Jefferson University