Lithium Accumulates in Neurogenic Brain Regions as Revealed by High Resolution Ion Imaging.

Lithium (Li) is a potent mood stabilizer and displays neuroprotective and neurogenic properties. Despite extensive investigations, the mechanisms of action have not been fully elucidated, especially in the juvenile, developing brain. Here we characterized lithium distribution in the juvenile mouse brain during 28 days of continuous treatment that result in clinically relevant serum concentrations. By using Time-of-Flight Secondary Ion Mass Spectrometry- (ToF-SIMS) based imaging we were able to delineate temporospatial lithium profile throughout the brain and concurrent distribution of endogenous lipids with high chemical specificity and spatial resolution. We found that Li accumulated in neurogenic regions and investigated the effects on hippocampal neurogenesis. Lithium increased proliferation, as judged by Ki67-immunoreactivity, but did not alter the number of doublecortin-positive neuroblasts at the end of the treatment period. Moreover, ToF-SIMS revealed a steady depletion of sphingomyelin in white matter regions during 28d Li-treatment, particularly in the olfactory bulb. In contrast, cortical levels of cholesterol and choline increased over time in Li-treated mice. This is the first study describing ToF-SIMS imaging for probing the brain-wide accumulation of supplemented Li in situ. The findings demonstrate that this technique is a powerful approach for investigating the distribution and effects of neuroprotective agents in the brain.

Diabetes as a risk factor in patients undergoing groin hernia surgery.

BACKGROUND: Diabetes is a known risk factor for early postoperative complications. Even so, the incidence of acute postoperative complications following routine hernia surgery is seldom described, and the risk for reoperation for recurrence has hardly been studied. Our aim was to explore if diabetes is a significant risk factor for complications after inguinal hernia surgery. METHODS: All inguinal hernia repairs registered in the Swedish Hernia Register between 2002 and 2011 were identified. Information on comorbidity and postoperative complications was obtained through cross-referencing with the National Patient Register at the National Board of Health and Welfare. Complicated diabetes was defined as diabetes with secondary manifestations (corresponding to aDCSI >0). The hazards for postoperative complications and reoperation for recurrence after the index hernia operation were calculated. RESULTS: Altogether 162,713 inguinal hernia repairs on 143,041 patients were registered. Of these, the number of patients with diabetes was 4816 (3.4 %), including 1123 (0.8 %) patients with complicated diabetes (aDCSI > 0). A significantly increased risk for postoperative complications was observed up to 30 days after hernia surgery when adjusted for gender, age, BMI, history of liver disease, kidney disease or HIV/AIDS, type of hernia and surgical method (odds ratio 1.35, 95 % confidence interval 1.14-1.60). No significantly increased risk for reoperation up until December 31, 2011, was observed in either patient group. CONCLUSION: Diabetes seems to increase the risk for postoperative complications within 30 days of inguinal hernia surgery, especially for complicated diabetes. Diabetes does not seem to increase the long-term risk for reoperation for recurrence.