The Photo-Activated Antibacterial Action of Toluidine Blue O in a Collagen Matrix and in Carious Dentine

The main aim of this study was to determine the susceptibility to photo-activated disinfection (PAD) of Streptococcus mutans when the organism was present in a collagen matrix--an environment similar to that which would exist within a carious tooth. In addition, the susceptibility to PAD of bacteria present in carious human teeth was also determined. Light was delivered to the collagen and teeth using a system comprising a 0.8-mm diameter isotropic tip emitting light at 633 +/- 2 nm. A single concentration of TBO (10 microg/ml) was used with both collagen and dentine. Two contact times, 30 and 180 s, were evaluated in intact collagen and additionally, for 180 s only, in collagen partially disrupted by shredding. The effect of energy doses from 1.8 to 14.4 J on the kills attained was assessed by determining the number of surviving viable bacteria. In carious dentine, two contact times, 30 and 60 s and one energy dose, 4.8 J, were used. Antibacterial effects were less than those obtained using planktonic suspensions with a maximum mean log reduction of 1.4 in shredded collagen and dentine. Increasing contact time increased the antibacterial effectiveness in both substrates although this was not always of statistical significance. Shredding the collagen resulted in significantly increased bacterial kills compared to those obtained in intact collagen for the 30-second contact time. The collagen matrix appeared to be a suitable model for carious dentine with advantages of availability and reproducibility. The results of this study have shown that PAD can achieve appreciable kills of oral bacteria, including S. mutans, when the organisms are embedded in a collagen gel or are present in carious teeth.

Glass ionomer cement: evidence pointing to fluorine release in the form of monofluorophosphate in addition to fluoride ion

The fluoride ion released from glass ionomer cements into water is reportedly, in part, complexed with other elements present in the cement. When measured using ion selective electrode potentiometry (ISE) a decomplexant TISAB IV (T) is used to convert all fluoride to F- ion which the ISE can detect. In this study, an additional decomplexing procedure (H) designed to hydrolyse fluorine covalently bonded to phosphorus in the monofluorophosphate (MFP) ion into F- was also used. The soluble products from three glass ionomers were analysed by both techniques (H & T). Five 1 x 10 mm discs were each immersed in 10 ml of de-ionised water. This was changed and 4 ml analysed by T and 4 ml by H at 1, 2, 3, 6, 10, 13, 17, 21, 24, 28, and 31 days. H was greater than T for 161 of the 165 pairs ( chi2=74.7, p=<0.001 ). The total cumulative F release H (in micromol/g cement) at 31 days for AH2 was 122.3, s.d. 30.8; LG26 44.0, s.d. 1.55; LG30 10.0, s.d. 3.15 as compared T results of 100.1, s.d. 31.1; 30.3, s.d. 1.92; 3.7, s.d. 1.36, respectively. In all three cases the H was significantly greater than T (matched pair 't' test with p=0.01 or less). H-T was show to have a very strong associative relationship with t1/2 (R2=0.98 or greater p<0.001 ). Evaluating the ratio of P:F in the cements in comparison with the ratio of additional F measured by H to that measured by T produced a relationship log[(H-T)/T]=0.28 x log[P/F]-0.45 with R2=0.999. It is concluded that glass ionomers release more fluorine than is detected by ISE using TISAB IV. If this F is in the form of MFP this may be released more completely into saliva than F as F-, release of which is substantially reduced by Ca2+, since calcium monofluorophosphate is more soluble than CaF2.

The effect of variable energy input from a novel light source on the photoactivated bactericidal action of toluidine blue O on Streptococcus Mutans

Although the combination of toluidine blue O (TBO) dye and laser light at a wavelength of 633 nm has a bactericidal effect, light from laboratory lasers can only be directed externally at a bacterial colony or suspension. In this study a novel delivery system guided the laser light to an 800-micrometer diameter spherical tip (an isotropic tip) from which light radiated producing a uniform sphere of light within the colony or suspension. The system was highly effective in killing TBO-treated Streptococcus mutans NCTC 10449 in stirred planktonic suspension, killing at least 10(9 )cfu/ml. Antibacterial action increased as the delivered energy dose increased. Energy doses of 1.8 J or more produced 100% kills and log reductions of 8-10 cfu/ml. Neither TBO dye nor light alone had a significant antibacterial effect under the experimental conditions used. The existence of a threshold energy, i.e. a minimum energy required before bactericidal action occurred, could not be demonstrated.

Primary cultures of prostate cells and their ability to activate carcinogens

Differences in the incidence of prostate cancer (CaP) amongst different migrant populations point to causative agents of dietary and/or environmental origin. Prostate tissues were obtained following transurethral resection of the prostate (TURP) or radical retropubic prostatectomy. After surgery, TURP-derived or tumour-adjacent tissue fragments were minced in warm PFMR-4A medium (37 degrees C) and suspensions pipetted into collagen-coated petri dishes. Non-adherent material was removed by washing with fresh medium after 12 h. Adhered cells subsequently reacted positively with monoclonal antibodies to prostate specific antigen (PSA). PSA was also detected in the medium. The genotoxicities of the chemical carcinogens 2-amino-1-methyl-6-phenylimidazo[4,5-b] pyridine (PhIP), its N-hydroxy metabolite (N-OH-PhIP) and benzo[a]pyrene (B[a]P) in adherent cell populations from different donors (n=8) were examined. Cells were treated in suspension for 30 min at 37 degrees C in the presence of the DNA repair inhibitors hydroxyurea (HU) and cytosine arabinoside (ara-C). DNA single-strand breaks were detected in cells by the alkaline single cell-gel electrophoresis ('Comet') assay and quantified by measuring comet tail length (CTL) in microm. All three carcinogens induced dose-related increases in CTLs (P<0.0001) in cells from four donors 24 h post-seeding. However, in cells from a further two donors the genotoxic effects of PhIP, N-OH-PhIP and B[a]P were much less apparent after 48 h than after 24 h in culture. After 96 h in culture, cells from these donors appeared to be resistant to the comet-forming activity of the compounds. However, B[a]P-DNA adducts were still measurable by (32)P-postlabelling for up to 14 days following a 24-h exposure to 50 microM B[a]P in adhered cells from another two donors. This study shows that primary cultures of cells derived from the prostate can activate members of two classes of chemical carcinogens. Further development may provide a robust model system in which to investigate the aetiology of CaP.

The effects of adding fluoride compounds to a fluoride-free glass ionomer cement on subsequent fluoride and sodium release

Studies have shown that ions in a glass ionomer matrix are 1-10% of the amounts present in the original glass. To measure more precisely the release from a cement matrix, known amounts of ions were added to LG30 glass which was fluoride and sodium-free. Cement without additions acted as the control. 1.4-1.6% of each of sodium, calcium and aluminum fluorides were added to three portions of control blend. The sodium and fluoride release into deionised water from five discs of each cements blend was measured for 8 months. This represented complete release for sodium but not for fluoride. Traces of fluoride and sodium in the glass produced low but measurable amounts indicating about a third of the fluoride and substantially all sodium present in LG30 was released. The addition of calcium fluoride had no significant effect on sodium or fluoride release and aluminium fluoride minimal effects. Adding sodium fluoride significantly enhanced release of both ions although fluoride release was less than from a glass containing 5% fluoride. Only small proportions of the additions, 2-5% of the fluoride and 13% of sodium, were released. Sodium and fluoride appeared to be released independently. For LG30 cements additives were poor at supplying extra ions.

Chronic renal failure in Jamaican children

In order to document the incidence, aetiology and outcome of chronic renal failure in Jamaican children, paediatric surgeons and hospital based paediatricians island-wide were contacted, and the nephrology records at the island's paediatric nephrology centres searched for data on children < 12-year-old with chronic renal failure diagnosed for the first time between January 1985 and December 2000. Thirty-four children were identified, 21 were male. The cumulative annual incidence of chronic renal failure was 3.2 per million children aged < 12 years. The incidence is likely underestimated, as some children may have been undiagnosed and/or not referred. Glomerulonephritis was the commonest cause of chronic renal failure (50%) followed by obstructive uropathy, reflux nephropathy, renal dysplasia and chronic pyelonephritis (41.2%). Five children (14.7%) had reflux nephropathy (post obstructive in four). Half the children were already in chronic renal failure at time of presentation. Mortality was 65%. In Jamaica, childhood chronic renal failure is due mainly to potentially treatable diseases. Local physicians should be more aware of potentially progressive renal diseases and their prevention. Earlier referral of difficult cases for nephrological consultation is recommended. A paediatric dialysis/transplant programme is needed.

Fractionated stereotactic radiotherapy for acoustic neuromas

BACKGROUND

When compared to radiosurgery, fractionated stereotactic radiotherapy (FSR) for acoustic neuroma (AN) offers escalation of tumor dose (Gy) and potential sparing of auditory and facial nerve functions.

METHOD

Over the past 6.5 years 287 consecutive patients have received FSR for AN. One hundred fifty patients have follow up greater than 1 year and comprise this report. Non-invasive, repeat-fixation mask allowed simulation via spiral CT. Differential collimation and beam weighting achieved conformality. Three distinct schedules for total dose and fractionation were used. For AN<3.0 cm diameter (mean volume 1.5+/-0.2 cc), > or =3.0 and < or =3.9 cm (mean volume 8.7+/-1.0 cc) and > or =4.0 cm (mean volume 28.3 cc (one case) doses of 5 Gy given in 5 consecutive daily fractions (25 Gy total) (131 patient), 10 fractions of 3 Gy (30 Gy total) (18 pts), or 20 fractions of 2 Gy (1 patient) were given. All treatments were prescribed to the 80% isodose and given via the dedicated 10 MeV accelerator.

FINDINGS

The percentage decreases in tumor size were 14+/-1 (range: 0-100), 15+/-3 (range 0-38) and 8 for the 25, 30 and 40 Gy regimens, respectively. No patient had growth of AN or developed facial weakness. Two patients developed transient decrease in facial sensation. Rates of hearing preservation were similar for both the larger and smaller tumors.

INTERPRETATION

Fractionated stereotactic radiotherapy may preserve normal function and control both small and large acoustic neuromas.

Evaluation of the Digene Hybrid Capture II Assay with the Rapid Capture System for detection of Chlamydia trachomatis and Neisseria gonorrhoeae

Screening for chlamydial and gonococcal infection has been strongly recommended for all sexually active women under the age of 26. Advances in the ability to detect infection by nucleic acid detection techniques have improved access to screening methods in routine clinical practices. To meet the increasing demand for testing, a high-throughput system is desirable. We evaluated the performance of the Hybrid Capture 2 CT/GC (HC2) assay with the Digene Rapid Capture System (HC2-RCS). The results of HC2-RCS for endocervical samples from 330 women were compared to those of culture and the COBAS Amplicor PCR. For detection of chlamydial infection, HC2-RCS had a sensitivity and a specificity similar to those of PCR (P > 0.5) and an improved sensitivity compared to that of culture (P = 0.007). For identification of gonococcal infections, all assays performed similarly (P > 0.5). The performance of HC2-RCS was also compared to that of the manual HC2 format (HC2-M) with these samples and with 911 endocervical samples collected previously. The performance of HC2-RCS was equivalent to that of HC2-M; the overall concordance rates for the detection of chlamydia and gonorrhea were 99.7% (kappa = 0.97) and 99.8% (kappa = 0.97), respectively. When the HC2 assay was performed with a semiautomated system application designed for high throughput, it demonstrated high sensitivity and a high specificity for detection of both Chlamydia trachomatis and Neisseria gonorrhoeae.

C-reactive protein is elevated in symptomatic compared with asymptomatic patients with carotid artery disease

OBJECTIVES

to investigate the level of inflammatory markers between symptomatic and asymptomatic carotid stenosis patients.

DESIGN

cross-sectional study.

MATERIALS AND METHODS

a prospective study of 137 consecutive patients, admitted electively for carotid endarterectomy during 1997-2000, was conducted. 125 patients had cerebrovascular symptoms: either stroke (neurological deficit >24 h), Transient ischaemic attack (neurological deficit<24 h) or amaurosis fugax. Twelve patients were asymptomatic. A medical history and a fasting venous blood sample were taken from each patient around 6 weeks before surgery. The plasma concentrations of cholesterol and of inflammatory markers; (high sensitivity C-reactive protein (hs-CRP), sICAM-1, sVCAM-1, sE-selectin) were determined.

RESULTS

the concentration of hs-CRP in the symptomatic group (3.9 mg/L) was significantly higher than in the asymptomatic group (2.1 mg/L; p = 0.04). These concentrations were within normal range (<10 mg/L). sICAM-1, sVCAM-1, sE-selectin and total cholesterol concentrations were not different between the two groups.

CONCLUSION

plasma hs-CRP was elevated in symptomatic compared to asymptomatic patients with carotid artery disease. High sensitivity C-reactive protein has been shown to be of prognostic value in a number of cardiovascular conditions and this study suggests it may be of value to identify patient at high risk of developing neurological deficits.

The glass ionomer cement: the sources of soluble fluoride

This study aimed to investigate certain processes of fluoride production which enable glass ionomer cements to leach fluoride. Two fluoroaluminosilicate glasses, G338 and LG26 were used. The free and total fluoride which could be dissolved from the glasses was measured, before and after acetic acid washing. Both glasses contained appreciable amounts of soluble fluoride prior to any acid treatment. The latter process reduced the amount to some 75% of the original levels. Replacing the customary polymeric acid with propionic acid produced a cement which disintegrated in water allowing the amount of fluoride generated by the cement forming process to be measured. Cement production increased soluble fluoride by a further 3%. Both glasses behaved similarly when undergoing the various processes. G338 produced significantly greater quantities of fluoride, of the order of 10, compared with LG26 although containing only three times the amount of fluoride in the glass formula. A substantial proportion, over half, of the total fluoride was complexed especially after contact with cement and when G338 was used. During the period of the experiment, 21 days, total fluoride release did not seem to depend on the square root of time.

A new, highly fluorescent terpyridine which responds to zinc ions with a large red-shift in emission

A sequence of three metal-catalysed aryl coupling reactions leads to the new ligand 4'-(4-N,N-diphenylaminophenyl)-2,2':6',2"-terpyridine, the intense ICT emission of which undergoes a large red-shift upon binding of zinc ions, providing a unique response over other common metal ions.

Interactions between glass ionomer cement and alkali metal fluoride solutions: the effect of different cations

This study examines the effect of different cations in equimolar alkali metal fluoride solutions on their interactions with glass ionomer cements. Uptake of both fluoride and cation were measured together with change in solution pH and morphological changes in the cement surface. Two cements were used; AH2, a dental restorative cement containing both fluorine and alkali metal (Na) as glass components and LG30, which contained neither. Discs of cement 1 x 10 mm were set in moulds at 37 degrees C for 1 h then, stored in water for 3 days at 37 degrees C. Discs in each test group (N = 5) were immersed in 10 ml of solutions of either NaF, KF, or RbF, all containing 900ppm F, control discs were stored in water, all at 37 degrees C for 24h. Solutions were analysed for F- by ISE potentiometry, Na+ by the same technique and K+ and Rb+ were analysed by atomic absorption spectrometry. Uptake was obtained by difference between solution used for immersion and the control solution. Solution pH was measured potentiometrically. The surface roughness of the discs was measured by linear stylus profilometry. Fluoride ion uptakes for AH2 were 451 micromol/g NaF, 378 KF, and 318 RbF. The comparable figures for LG30 were 202, 161, and 159. Differences between cements were all statistically significant and also between solutions pairings except for the KF/LG30 vs. RbF/LG30. Uptake of cations was equimolar for AH2/ NaF, AH2/RbF and LG30/KF but M+:F- ratios were significantly above unity for AH2/KF and LG30/NaF and significantly below unity for LG30/RbF. The pH changes were all positive and were significantly higher for AH2 than LG30 and for RbF compared to the other fluoride solutions for each cement (probably because of its lower initial pH). The final pH of all solutions were less than I pH unit from neutral (pH7). The AH2 cement test discs all showed significant increase in roughness (Ra) compared to control discs stored in water whereas the LG30 discs showed no such difference. Regression analysis showed a significant positive correlation between fluoride uptake and Ra. It was concluded that changing the alkali metal cation influenced all four variables examined (F- uptake, M+ uptake, pH change and extent of cement surface roughening).

A non-circadian role for cAMP signaling and CREB activity in Drosophila rest homeostasis

In the fruit fly, Drosophila melanogaster, rest shares features with mammalian sleep, including prolonged immobility, decreased sensory responsiveness and a homeostatic rebound after deprivation. To understand the molecular regulation of sleep-like rest, we investigated the involvement of a candidate gene, cAMP response-element binding protein (CREB). The duration of rest was inversely related to cAMP signaling and CREB activity. Acutely blocking CREB activity in transgenic flies did not affect the clock, but increased rest rebound. CREB mutants also had a prolonged and increased homeostatic rebound. In wild types, in vivo CREB activity increased after rest deprivation and remained elevated for a 72-hour recovery period. These data indicate that cAMP signaling has a non-circadian role in waking and rest homeostasis in Drosophila.

A circadian output in Drosophila mediated by neurofibromatosis-1 and Ras/MAPK

Output from the circadian clock controls rhythmic behavior through poorly understood mechanisms. In Drosophila, null mutations of the neurofibromatosis-1 (Nf1) gene produce abnormalities of circadian rhythms in locomotor activity. Mutant flies show normal oscillations of the clock genes period (per) and timeless (tim) and of their corresponding proteins, but altered oscillations and levels of a clock-controlled reporter. Mitogen-activated protein kinase (MAPK) activity is increased in Nf1 mutants, and the circadian phenotype is rescued by loss-of-function mutations in the Ras/MAPK pathway. Thus, Nf1 signals through Ras/MAPK in Drosophila. Immunohistochemical staining revealed a circadian oscillation of phospho-MAPK in the vicinity of nerve terminals containing pigment-dispersing factor (PDF), a secreted output from clock cells, suggesting a coupling of PDF to Ras/MAPK signaling.

Kinetics of fluoride release from zinc oxide-based cements

Considerable attention has been given to the release of the cariostatic fluoride ion from glass-based dental cements (dental silicate and glass ionomer). In these, the total available fluoride content is not precisely known since fluorine is distributed between the cross-linked aqueous salt matrix, partially dissolved glass, and undissolved glass. In analogous cements based on zinc oxide the fluoride is added as highly soluble SnF2. The object of this study is to compare the F- ion release profiles of commercial zinc polycarboxylate and zinc phosphate containing 4.4 and 3.6% SnF2, respectively. Mixed cements were clamped in split ring moulds to produce discs of 10 mm x 1 mm after storage at 37 degrees C for 1 h. Each was weighed and immersed in 10 ml of deionised water. When this changed, at 13 time intervals up to 98 days, the fluoride content was measured using an ion selective electrode. The mean (N = 3) values obtained were expressed cumulatively [F] in micromol F ion/g cement. The total [F] released was 111 for the zinc polycarboxylate and 286 for zinc phosphate compared with total F in the cements of 561 and 464, respectively. When the cumulative [F] was plotted versus t(1/2) close associations were found for both cements. For the polycarboxylate the regression line [F] = 10.6t(1/2) + 9.9 fitted well over the whole 98 days (R = 0.997). For the phosphate a better fit regression line was obtained using results up to 32 days only; [F] = 36.8t(1/2) - 8.4 (R = 0.999). For t > 32 days results increasingly deviated from this line. These results fitted a regression line of the form [F] = 81.7log(e) t - 87.3 (R = 0.9997). Comparisons are made with data from previous authors both for zinc phosphate cement and glass-based cements and with diffusion theory of F ion release. It is concluded that zinc-based cements provide some indications of how glass-based cements may behave over long periods of release and that zinc phosphate is the material of clinical choice for orthodontic cementation if maximal fluoride release is the prime criterion.

Arginine induced acute pancreatitis alters the actin cytoskeleton and increases heat shock protein expression in rat pancreatic acinar cells

Arginine induced acute pancreatitis was evaluated as a novel and distinct form of experimental pancreatitis with particular attention to the actin cytoskeleton and expression of heat shock or stress proteins. Arginine induced a dose related necrotising pancreatitis in rats, as shown by histological evaluation, and an increase in serum amylase. Severe pancreatitis induced by 4.5 g/kg arginine was accompanied by dramatic changes in the actin cytoskeleton, as visualised with rhodamine phallodin. Intermediate filaments were also disrupted, as visualised by cytokeratin 8/18 immunocytochemistry. Arginine pancreatitis was accompanied by a stress response with a large increase in the small heat shock protein HSP27, as well as HSP70, peaking at 24 hours and localised to acinar cells. There was a lower increase in HSP60 and HSP90 and no effect on GRP78. HSP27 was also shifted to phosphorylated forms during pancreatitis. A lower dose of arginine (3.0 g/kg) induced less pancreatitis but a larger increase in HSP70 and HSP27 expression and phosphorylation of HSP27. Thus HSP expression can be overwhelmed by severe damage. The present work in conjunction with earlier work on caerulein induced pancreatitis indicates that changes in the actin cytoskeleton are an early component in experimental pancreatitis.

N-Acetyltransferases, sulfotransferases and heterocyclic amine activation in the breast

Heterocyclic amines are mammary carcinogens in rats and their N-hydroxy metabolites are substrates for subsequent metabolic activation by N-acetyltransferases (NAT) and sulfotransferases (SULT) in man. We investigated the expression of these enzymes in human breast tissue and the relationship between NAT genotype and NAT mRNA expression or enzyme activity. Immunohistochemical staining of sections of breast tissue identified expression of NAT1 and NAT2 protein in human mammary epithelial cells, but not in the stroma. We also measured the formation of DNA adducts of the heterocyclic amines 2-amino-3-methylimidazo[4,5-f]quinoline (IQ) and 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine in calf thymus DNA after incubation of their promutagenic N-hydroxy metabolites with mammary cytosols prepared from reduction mammoplasty tissue. Experimental observations gained from use of enzyme cofactors and NAT and/or SULT inhibitors on cytosolic enzyme activity, recombinant NAT1 activity and heterocyclic amine-DNA adduct formation suggest that both NAT1 and SULT1A enzymes contribute significantly to the activation of N-hydroxylated heterocyclic amines in mammary tissue. NAT1 mRNA transcript levels were found to be two- to three-fold higher than mRNA transcripts of the NAT2 gene in reduction mammoplasty tissue and mammary epithelial cells. NAT1-specific p-aminobenzoic acid acetylation activity, but not NAT2-specific sulfamethazine acetylation activity, was detectable in mammary cytosols. There was no association apparent between NAT genotype and the levels of NAT mRNA or NAT enzyme activity, or between NAT1 genotype and IQ-DNA adduct formation mediated by mammary cytosols. Western blot analysis of mammary cytosolic protein showed detectable levels of SULT1A1 and SULT1A3.

Intracellular signaling mechanisms activated by cholecystokinin-regulating synthesis and secretion of digestive enzymes in pancreatic acinar cells

The intracellular signaling mechanisms by which cholecystokinin (CCK) and other secretagogues regulate pancreatic acinar function are more complex than originally realized. CCK couples through heterotrimeric G proteins of the Gq family to lead to an increase in intracellular free Ca2+, which shows spatial and temporal patterns of signaling. The actions of Ca2+ are mediated in part by activation of a number of Ca2+-activated protein kinases and the protein phosphatase calcineurin. By the process of exocytosis the intracellular messengers Ca2+, diacylglycerol, and cAMP activate the release of the zymogen granule content in a manner that is poorly understood. This fusion event most likely involves SNARE and Rab proteins present on zymogen granules and cellular membrane domains. More likely related to nonsecretory aspects of cell function, CCK also activates three MAPK cascades leading to activation of ERKs, JNKs, and p38 MAPK. Although the function of these pathways is not well understood, ERKs are probably related to cell growth, and through phosphorylation of hsp27, p38 can affect the actin cytoskeleton. The PI3K (phosphatidylinositol 3-kinase)-mTOR (mammalian target of rapamycin) pathway is important for regulation of acinar cell protein synthesis because it leads to both activation of p70S6K and regulation of the availability of eIF4E in response to CCK. CCK also activates a number of tyrosyl phosphorylation events including that of p125FAK and other proteins associated with focal adhesions.

Molecular components of the circadian system in Drosophila

Much of our current understanding of how circadian rhythms are generated is based on work done with Drosophila melanogaster. Molecular mechanisms used to assemble an endogenous clock in this organism are now known to underlie circadian rhythms in many other species, including mammals. The genetic amenability of Drosophila has led to the identification of some genes that encode components of the clock (so-called clock genes) and others that either link the clock to the environment or act downstream of it. The clock provides time-of-day cues by regulating levels of specific gene products such that they oscillate with a circadian rhythm. The mechanisms that synchronize these oscillations to light are understood to some extent. However, there are still large gaps in our knowledge, in particular with respect to the mechanisms used by the clock to control overt rhythms. It has, however, become clear that in addition to the brain clock, autonomous or semi-autonomous clocks occur in peripheral tissues where they confer circadian regulation on specific functions.

We make foot exams a priority

A simple foot exam takes less than five minutes, but it can help save a limb--or a life. So why doesn't it happen more often?

IUdR polymers for combined continuous low-dose rate and high-dose rate sensitization of experimental human malignant gliomas

Local polymeric delivery enhances IUdR radiosensitization of human malignant gliomas (MG). The combined low-dose rate (LDR) (0.03 Gy/h) and fractionated high-dose rate (HDR) treatments result in cures of experimental MGs. To enhance efficacy, we combined polymeric IUdR delivery, LDR, and HDR for treatments of both subcutaneous and intracranial MGs. In vitro: Cells (U251 MG) were trypsinized and replated in triplicate 1 day prior to LDR irradiation in media either without (control) or with 10 microM IUdR. After 72 hr, LDR irradiation cells were acutely irradiated (1.1 Gy/min) with increasing (0, 1.25, 2.5, 5.0, or 10 Gy) single doses. Implantable IUdR polymers [(poly(bis(p-carboxyphenoxy)-propane) (PCPP): sebaic acid (PCPP:SA), 20:80] (50% loading; 10 mg) were synthesized. In vivo: For flank vs. intracranial tumors, mice had 6 x 10(6) subcutaneous vs. 2 x 10(5) intracranial cells. For intracranial or subcutaneous MGs, mice had intratumoral blank (empty) vs. IUdR polymer treatments. One day after implantation, mice had immediate external LDR (3 cGy/h x 3 days total body irradiation) or HDR (2 Gy BID x 4 days to tumor site) or concurrent treatments. For the in vitro IUdR treatments, LDR resulted in a striking increase in cell-killing when combined with HDR. For the in vivo LDR treatments of flank tumors, the growth delay was greater for the IUdR vs. blank polymer treatments. For the combined LDR and HDR, the IUdR treatments resulted in a dramatic decrease in tumor volumes. On day 60 the log V/V0 were -1.7 +/- 0.22 for combined LDR + HDR + IUdR polymer (P < 0.05 vs. combined LDR + HDR + blank polymer). Survival for the intracranial controls was 22.9 +/- 1.2 days. For the blank polymer + LDR vs. blank polymer + LDR + HDR treatments, survival was 25.3 +/- 1.7 (P = NS) vs. 48.1 +/- 3.5 days (P < 0.05). For IUdR polymer + LDR treatment survival was 27.3 +/- 2.3 days (P = NS). The most striking improvement in survival followed the IUdR polymer + LDR + HDR treatment: 66.0 + 6.4 days (P < 0.05 vs. blank polymer + LDR + HDR). The polymeric IUdR delivery plus combined continuous LDR and HDR treatments results in growth delay and improved survival in animals bearing the MG xenografts. This treatment may hold promise for the treatment of human MGs.

Optimization of multiple-isocenter treatment planning for linac-based stereotactic radiosurgery

OBJECTIVE

Computer-assisted treatment planning for linac-based radiosurgery is still an open research problem, especially for multiple-isocenter procedures, primarily due to its high complexity and computational requirements. This paper focuses on the optimization of multiple-isocenter treatment planning for linac systems, and addresses several important issues associated with multiple isocenters, such as dose conformality, homogeneity, and optimization of isocenter position and dose.

METHODS

The key idea behind our approach is that the desired dose distribution can be decomposed into a number of fundamental components. In the current paper, an analytical form, the so-called Ellipsoidal Dose Distribution Estimation (EDDE) model, represents each component. We establish ways (arc configurations) to achieve such ellipsoidal doses of arbitrary position, orientation, and size. Since the EDDE model is described by relatively few parameters, it allows very quick estimation of the dose distribution corresponding to a particular isocenter and thus makes the optimization of isocenter position very efficient. It is further used in a framework for optimal treatment planning, in which a number of ellipsoidal dose distributions, each corresponding to a different isocenter, are optimally placed to cover the target while sparing healthy tissue.

RESULTS

The general ellipsoidal dose distribution of linac-based radiosurgery is summarized as a mathematical model with the aid of supporting experiments. Comparisons between the EDDE-optimized and clinically implemented plans are made, revealing the superior performance of the former. In addition, a dramatic reduction in planning time is achieved using the EDDE model.

CONCLUSION

The proposed EDDE model is a useful and effective dose model in multiple-isocenter treatment planning for linac-based radiosurgery.

Single nucleotide polymorphisms, metabolic activation and environmental carcinogenesis: why molecular epidemiologists should think about enzyme expression

This commentary was written to stimulate thoughts on, and consideration of, enzyme expression data in target organs when investigating possible associations between polymorphisms in carcinogen activation enzymes, lifestyle/dietary factors and cancer risk. The lung and breast are taken as examples. There is overwhelming evidence for a genotoxic mechanism in lung cancer development, and compelling evidence for the contribution of genotoxins to breast cancer aetiology. A consistent association has been shown where lung cancer risk is decreased by a G-->A polymorphism in the myeloperoxidase (MPO) gene, which is expressed in neutrophils recruited to the lung after chemical or immunological insults. In the breast, a consistent lack of association has been observed for women who are fast N:-acetyltransferase type 2 (NAT2) acetylators consuming cooked meat. This could be explained by the lack of detectable NAT2-associated sulfamethazine acetylation activity in cytosols prepared from mammary tissue, suggesting a minor contribution to carcinogen activation. The recent identification in mammary cytosols of detectable sulfotransferase isoforms (SULT1A1 and SULT1A3), which have high catalytic efficiency for activating N:-hydroxylated heterocyclic amines (HCAs, mutagens in cooked meat), offers a more important role for these enzymes in the metabolic activation of genotoxins in the breast. The possible contribution of MPO and lactoperoxidase enzymes to carcinogen activation in mammary tissue is also considered. Sulfotransferases and peroxidases have wide substrate specificity in terms of carcinogen activation (HCAs, aromatic amines and polycyclic aromatic hydrocarbons-all present in cooked meat and tobacco smoke) compared with NATs (HCAs and aromatic amines only). For gene-environment interactions, investigations into functional polymorphisms in SULT and peroxidase genes may, therefore, offer new evidence for the involvement of genotoxins in the initiation of carcinogenesis. Identification of the isoforms (if any) of carcinogen activation enzymes that are expressed in the organs of interest will help to determine which genes to investigate in these studies.