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Research ArticleBasic Science Investigation

Serial 18F-FDG PET Demonstrates Benefit of Human Mesenchymal Stem Cells in Treatment of Intracerebral Hematoma: A Translational Study in a Primate Model

Ming Feng, Hua Zhu, Zhaohui Zhu, Junji Wei, Shan Lu, Qin Li, Nan Zhang, Guilin Li, Fang Li, Wenbin Ma, Yihua An, Robert Chunhua Zhao, Chuan Qin and Renzhi Wang
Journal of Nuclear Medicine January 2011, 52 (1) 90-97; DOI: https://doi.org/10.2967/jnumed.110.080325
Ming Feng
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Hua Zhu
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Zhaohui Zhu
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Junji Wei
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Shan Lu
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Qin Li
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Nan Zhang
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Guilin Li
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Fang Li
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Wenbin Ma
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Yihua An
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Robert Chunhua Zhao
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Chuan Qin
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Renzhi Wang
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  • FIGURE 1.
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    FIGURE 1.

    Comparison of neurologic deficit scores (0 = normal, 100 = worst score) between hMSC-treated monkeys and controls. No significant difference was found between hMSC treatment groups and corresponding controls before treatment (week 0). Significantly better scores were observed in both early treatment group (P < 0.05) and late treatment group (P < 0.01) when data were analyzed with 2-way ANOVA with 1 repeated factor of posttreatment week.

  • FIGURE 2.
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    FIGURE 2.

    Serial PET images demonstrating metabolism recovery after ICH establishment. Four typical cases that underwent early (at week 1 after modeling, upper 2 rows) or late (at week 4, lower 2 rows) treatment were shown as control and hMSC-treated monkey brains compared one by one. Pink arrow points to intense 18F-FDG uptake at hematoma region in early hMSC-treated monkey, and orange arrow shows higher 18F-FDG accumulation at ipsilateral basal ganglia 1 wk after hMSC injection as early response. Scale was set according to percentage of maximum signal intensity.

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    FIGURE 3.

    Demonstration of setting regions of interest over serial PET images (A–D) and metabolic recovery (shown as mean ± SD of uptake ratio to contralateral side) according to week after ICH establishment. Adjacent cortex and basal ganglia were evaluated separately (E and F, respectively), and lines connecting means show trend and vertical lines of SD for variability in different groups. Red and orange arrows show time of early and late treatment, respectively.

  • FIGURE 4.
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    FIGURE 4.

    Hematoxylin and eosin staining (×40) of ICH remnants (A: control; B: hMSC-treated) and comparison of MVD at ICH remnants between early treatment group and corresponding control (C) and between late treatment group and its control (D).

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    TABLE 1

    Neurologic Deficit Score for Monkeys After Stroke

    CategoryScore
    Consciousness
     Normal, consistently alert, strongly aggressive, escape-prone0
     Conscious but clouded, strongly aggressive2
     Conscious, poorly aggressive4
     Conscious, light opposition, escape-prone6
     Conscious but clouded and accepting8
     Drowsiness, aroused with stimulation10
     Lethargic, eyes open by strong stimulation16
     Stuporous, aroused with persistent stimulation20
     Light coma, reflex movement only24
     Deep coma, no movement28
    Skeletal muscle coordination
     Normal, walks normally0
     Light, transient abnormality in motor coordination2
     Minimal ataxia, walks with some impairment of gait4
     Ataxia but able to climb the cage6
     Walks with compelling stimulation but has difficulty in climbing the cage8
     Stands spontaneously, falls within a few steps10
     Sits, just able to circle with compelling stimulation12
     Sits or prostrate, cannot stand or sit for long duration, with response to compelling stimulation14
     Posed lateral or dorsal recumbency, with response to compelling stimulation16
     No movement, almost with no response to compelling stimulation18
    Sensory system
     Facial sensation (ipsi-/contralateral, 0–3 × 2)
      Concerted reaction to compelling stimulation (aggression, threaten, escape-prone, expressing goodwill)0/0
      Decrease in concerted reaction to compelling stimulation (obvious decreases in aggressive or threatening expressions)1/1
      Decrease in concerted reaction to compelling stimulation (obvious decreases in expressing goodwill)2/2
      Absent, does not react to compelling stimulation in any area of face3/3
     Pinna reflex (ipsi-/contralateral, 0–3 × 2)
      Twitches ear normally0/0
      Slight reduction in ear twitching, twitches ear by sonic stimulation1/1
      Obvious reduction in ear twitching, no ear twitching by sonic stimulation2/2
      Absent, does not move ear by contact stimulation3/3
     Pain reflex (lower limb, ipsi-/contralateral, 0–5 × 2)
      Strong, quick, complete withdrawal by contact stimulation0/0
      Comparatively quick withdrawal by contact stimulation1/1
      Comparatively slow withdrawal by contact stimulation2/2
      Weak, slow, incomplete, or inconsistent withdrawal by contact stimulation3/3
      Very weak, slow withdrawal by contact stimulation4/4
      Absent, no withdrawal by contact stimulation5/5
    Motor system
     Hand (ipsi-/contralateral, 0–4 × 2)
      Normal0/0
      Light dyskinesia (slow velocity, poor strength, and parasexuality)1/1
      Reduced strength or skill (comparatively obvious dyskinesia)2/2
      Obvious dyskinesia (very slow velocity, very poor strength, and parasexuality)3/3
      Paralysis or useless4/4
     Leg (ipsi-/contralateral, 0–6 × 2)
      Normal0/0
      Light dyskinesia (slow velocity, poor strength, and parasexuality)1/1
      Raises with flexion of knee (comparatively obvious dyskinesia)2/2
      Obvious dyskinesia (very slow velocity, very poor strength, and parasexuality)3/3
      Can move, but not against gravity4/4
      Almost cannot move5/5
      Paralysis or useless6/6
     Upper-limb tone (ipsi-/contralateral, 0–3 × 2)
      Normal0/0
      Lightly spastic or flaccid (occasionally raised fingers when grasping)1/1
      Relatively spastic or flaccid (continued to raise fingers when grasping)2/2
      Obviously spastic or flaccid3/3
     Lower-limb tone (ipsi-/contralateral, 0–3 × 2)
      Normal0/0
      Lightly spastic or flaccid (occasionally raised toes when grasping)1/1
      Relatively spastic or flaccid (continued to raise toes when grasping)2/2
      Obviously spastic or flaccid3/3
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Journal of Nuclear Medicine: 52 (1)
Journal of Nuclear Medicine
Vol. 52, Issue 1
January 1, 2011
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Serial 18F-FDG PET Demonstrates Benefit of Human Mesenchymal Stem Cells in Treatment of Intracerebral Hematoma: A Translational Study in a Primate Model
Ming Feng, Hua Zhu, Zhaohui Zhu, Junji Wei, Shan Lu, Qin Li, Nan Zhang, Guilin Li, Fang Li, Wenbin Ma, Yihua An, Robert Chunhua Zhao, Chuan Qin, Renzhi Wang
Journal of Nuclear Medicine Jan 2011, 52 (1) 90-97; DOI: 10.2967/jnumed.110.080325

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Serial 18F-FDG PET Demonstrates Benefit of Human Mesenchymal Stem Cells in Treatment of Intracerebral Hematoma: A Translational Study in a Primate Model
Ming Feng, Hua Zhu, Zhaohui Zhu, Junji Wei, Shan Lu, Qin Li, Nan Zhang, Guilin Li, Fang Li, Wenbin Ma, Yihua An, Robert Chunhua Zhao, Chuan Qin, Renzhi Wang
Journal of Nuclear Medicine Jan 2011, 52 (1) 90-97; DOI: 10.2967/jnumed.110.080325
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