Radioiodinated N-(alkylaminoalkyl)-substituted 4-methoxy-, 4-hydroxy-, and 4-aminobenzamides: biological investigations for the improvement of melanoma-imaging agents

The syntheses and radiolabelling of 27 new N-(alkylaminoalkyl)-4-methoxy-, -4-hydroxy-, and -4-aminobenzamides are described and evaluated in C57B1/6 mice with subcutaneously transplanted B16 melanoma in order to screen the optimal chemical structure for melanoma scintigraphy. Using T1(TFA)3 for 131I- labelling, a series of radioiodinated 4-methoxy benzamide derivatives proved to exhibit superior melanoma uptake with outstanding melanoma/non-target-tissue ratios. From the benzamide derivatives tested, N-(2-(1'-piperidinyl)ethyl-3-[131I]iodo-4-methoxybenzamide and N-(2-diethylaminoethyl)-3-[131I]iodo-4-methoxybenzamide demonstrated best results. The introduction of 4-hydroxy and 4-amino groups led to less favourable benzamides. While the former compounds showed little melanoma uptake, the latter revealed unfavourable melanoma/non-target-tissue ratios. Additionally, it could be shown that an amino group was inevitably necessary for melanoma uptake, and that dialkylation of the amide nitrogen and replacing CONH by CH2NH revealed less advantageous results.

The MDA-180 coagulation analyser: a laboratory evaluation

We have evaluated the technical performance of the MDA-180 automated coagulation analyser in a working diagnostic hemostasis laboratory environment. The analyser has been on site now for over 18 months, and has undergone considerable testing. More than 22,000 samples have been processed, with over 90% of these via the MDA-180's cap-piercing facility. The instrument has been primarily assessed for its technical ease of use and continued reliability, as well as its analytical performance. The instrument has also been successfully interfaced to, and used with, our Laboratory information (CERNER PATHNET) system. A major feature of our evaluation has been an assessment of the MDA-180's ability to perform assays currently performed using alternative methodology or instrumentation (eg; ELISA methodology or the Coagamate-X2 and ACL-300R instruments), as well as its potential to streamline the technical performance of some of these assays. We have co-evaluated the following assays: PT/INR, APTT, TT, Fibrinogen, Protein C, ATIII, Factors II, V, VII, VIII, IX, X, XI, and XII, Lupus anticoagulant (dRVVT), and heparin (alpha Xa). In addition, a number of different reagents (particularly for PT and APTT assays) have been tested on the instrument. Intra-assay and inter-assay variation appears to be remarkably low (five different plasmas tested: PT: 0.6 to 1.3% and 0.5 to 1.3% respectively; APTT: 0.7 to 3.2% and 0.6 to 3.6% respectively; single day analysis). Other comparative assessment data typically showed good correlation to existing test assay systems. A review of other features which may enhance or detract from the instrument's worth in a given hemostasis laboratory is also presented. In summary however, we conclude that the instrument is reliable, easy to use and capable of fast sample through-put.

Pharmacokinetics of iodine-123-IMBA for melanoma imaging

The development of an effective radiopharmaceutical with affinity for malignant melanoma has been a research goal for some time. The early detection of melanoma metastases would greatly improve the therapy outcome for this disease. This article describes the synthesis of radioiodinated IMBA, N-(2-diethylaminoethyl)-3-[123I/131I]iodo-4-methoxybenzamide 8, its organ distribution, its comparison with BZA and other benzamides, and demonstrates the scintigraphic efficacy of the title compound with three melanoma patients.

METHODS

The syntheses and radioiodination of eight benzamide derivatives are described. After intravenous injection into C57B16-mice subcutaneously transplanted with B16 melanoma, the organ distribution of the respective benzamides were investigated at 1 and 6 hr. n-octanol/phosphate buffer partition coefficients. The wholebody retention, erythrocyte and serum protein bound fractions of radioiodinated benzamides were measured.

RESULTS

While structural changes in the amide substituents of N-(2-dialkylaminoalkyl)-4-iodobenzamides 2-7 resulted in no improvement in organ distribution compared with BZA, the 3-iodo-4-methoxyphenyl form of IMBA showed high melanoma uptake with significantly higher melanoma/nontarget tissue ratios. Compared with BZA the average ratio improved after 1 hr by a factor of eight and was still four times better after 6 hr. BZA and IMBA exhibit almost identical n-octanol/ phosphate buffer partition coefficients, however, IMBA has a faster urinary excretion facilitated by a lower affinity to erythrocytes and serum proteins; this could explain the improved tissue partinioning observed. Scintigraphy of patients with melanoma metastases confirmed the promising characteristics derived from the animal studies.

CONCLUSION

Due to rapid background clearance and high melanoma affinity, IMBA showed high tumor contrast already at 4 hr after injection which makes it a promising new radiopharmaceutical for the scintigraphic detection of melanoma metastases.

Expression of human leukocyte antigens in patients with autogenic and allogenic circulating antisperm antibodies

Circulating antisperm antibodies have been shown to have an adverse effect on a couple's ability to achieve fertilization. This study investigated the HLA class II pattern in couples with infertility associated with antisperm antibodies. Forty-nine couples with significant circulating antisperm antibodies confirmed with immunofluorescence technique and 15 control couples had HLA class II-DR, DQ typing. The Terasaki lymphotoxicity test was used. In women with antisperm antibodies, HLA class II haplotypes DR4, DR6, and DQW3 were more common than in the control group. For the men, DR6 and DQ7 were more common in those with antisperm antibodies, than in controls. With sharing of the haplotypes by the couples, DR4, DR6, and DQ7 were more common in couples with antisperm antibodies, but deficient in DQW3. HLA class II-DR4, DR6, and DR7 sharing in couples and deficiency of DQW3 may be associated with circulating antisperm antibody production.

Tuberculosis in the community: 1. Evaluation of a volunteer health worker programme to enhance adherence to anti-tuberculosis treatment

SETTING

A voluntary health worker project (Operation Elsies River) was started in a high incidence tuberculosis (TB) area in the Western Cape of South Africa, in order to assist the local TB Control programme with case-holding.

OBJECTIVE

To evaluate the effectiveness of this group of volunteers in enhancing adherence of notified TB patients to tuberculosis treatment.

DESIGN

A cohort study was conducted with 351 TB patients (203 children and 148 adults).

RESULTS

The data from the child and the adult groups were analysed separately. The child group was more adherent to TB treatment than adults. The supervision option with staff dedicated to the treatment of TB, such as the clinic and the SANTA crèche, achieved better adherence results for pre-school children. The supervision modalities for adults did not differ in their adherence performance even following adjustment for confounders.

CONCLUSION

The supervision option provided by the volunteers did not significantly improve the adherence of adult patients to antituberculosis treatment.

Filtered plasma as a potential cause of clinical misdiagnosis: inappropriate testing in a haematology laboratory

We have identified situations in which filtered plasma is provided to the laboratory for combined assessment of lupus anticoagulant, as well as other diagnostic haemostasis laboratory procedures. On the basis of laboratory investigation, however, we report that significant errors in test result interpretation can arise should this occur and depending on the specimen processing procedure, and whether filtered plasma is used for multiple assays. Citrated plasma samples were obtained from 12 normal individuals and a portion of each sample filtered using a standard 0.22 micron filter. Small volumes were frozen for later analysis. We could detect a statistically significant difference (P < 0.01) between filtered plasma and non-filtered plasma in most test results. Most notable were changes in the APTT, fibrinogen, FVIII and vWF, where results often fell outside the normal reference range of the assay. Such assay results closely mimic those obtained with type 2 von Willebrand's disease (vWD) patients, thus should filtered plasma unknowingly be tested for vWF, a wrong conclusion of type 2 vWD could easily arise. Assay results for other parameters may similarly draw incorrect conclusions, such as mild haemophilia A and dysfibrinogenaemia. In summary, we report that following filtration not only are a variety of coagulation test results altered, but reduced plasma levels of some coagulation factors could potentially lead clinicians incorrectly to diagnose congenital or acquired deficiencies or defects. We recommend that laboratories note that (other than for lupus anticoagulant) filtered plasma is not appropriate for the coagulation laboratory, and that any abnormal haemostasis test result following such combined testing be considered a potential artifact and independently repeated to confirm any putative abnormality prior to drawing any clinical conclusions.

Behavioural deficits in adult rats following long-term adrenalectomy

Long-term adrenalectomy results in loss of neurones in the hippocampal formation of the adult rat. The effects of long-term adrenalectomy on spatial learning and exploratory behaviour in adrenalectomized (ADX), adrenalectomized normal weight gain (ADXNW), sham operated and naive control male Sprague-Dawley rats were investigated in this study. The ADX rats had significantly longer latencies in the Morris maze task compared to the other groups. In the open-field situation, as a novel finding, the ADX rats showed significantly lower rearing scores compared to other groups. These data indicate that long-term adrenalectomy causes impairment in spatial learning and explorative behaviour in the rat.

An audit of eclampsia

One hundred and three patients with eclampsia were managed during a period of eleven years. The perinatal mortality rate was 136 per 1000 total births and there were six maternal deaths. The maternal mortality rate was less among eclamptics delivered by Caesarean Section. Liberal use of diazepam and/or magnesium sulphate and early recourse to Caesarean Section were integral in the care of these women.

Atmospheric temperature & anovulation in south Indian women with primary infertility

An attempt at correlating atmospheric temperature, humidity and histologically diagnosed anovulatory endometrium has been made. A total of 140 women who had anovulatory endometrium among 1036 patients who had a clinical diagnosis of primary infertility, over a 5 yr period were studied. The principle of Edwards' test was used to analyse the seasonal trends and the seasonal index for the occurrence of anovulatory endometrium, atmospheric temperature and humidity was calculated using the average percentage method. The results suggest that anovulatory cycles in women with infertility tended to occur more during those months in the year when temperature increased (r = 0.63). However, humidity was not related to anovulation.

The effects of dietary levels of inorganic phosphorus, calcium and cholecalciferol on the digestibility of phytate-P by the chick

Male broiler chicks (1-d-old; Ross one) were given either a control diet containing recommended levels of phosphorus, calcium and cholecalciferol or experimental diets low in P and with variable levels of Ca (normal and low) and cholecalciferol (normal or high). The low-P diet with normal levels of Ca and cholecalciferol induced a hypophosphataemia and a hypercalcaemia which was reflected in reduced tibia length and weight and in reduced Ca, P and magnesium contents of tibia. The phytate digestibility remained normal while the retention of P and Ca fell significantly. The lowering of Ca alone elevated phytate digestibility and restored P and Ca retention. The hypercalcaemia and hypophosphataemia remained and tibia mineralization remained impaired. The raising of cholecalciferol alone dramatically increased phytate digestibility and the retention of Ca and P. While this remedied the hypercalcaemia, the hypophosphataemia persisted as did the diminution of tibia weight. The simultaneous lowering of dietary Ca and elevation of cholecalciferol on low-P diets restored all variables to the levels for the control diet. Circulating levels of 1,25-dihydroxycholecalciferol were significantly elevated by low-P diets, more so with high cholecalciferol intakes. However, Ca did not influence 1,25-dihydroxycholecalciferol levels in plasma.

Distribution of toxaphene, DDT, and PCB among lipoprotein fractions in rat and human plasma

The distribution of 14C-toxaphene, 14C-DDT, and 14C-PCB among lipoprotein fractions was studied in vitro and in vivo using rat and human plasma. The association of these substances with rat plasma fractions was similar in both in vitro and in vivo experiments. Thirty-seven to fifty-two per cent of the total radioactivity was associated with the cholesterol-rich high density lipoproteins (HDL2, d = 1.075-1.21 g/ml) and 18-52% was recovered in the albumin-rich bottom fraction (BF, d greater than 1.21 g/ml). A time-dependent redistribution of the radioactivity from the lipoprotein fractions to the BF was also observed in the in vivo studies. In human plasma, the distribution of the three compounds was different and uncorrelated to the cholesterol level of the individual lipoprotein fractions. Toxaphene was almost equally distributed between BF (d greater than 1.21 ml), HDL (d = 1.063-1.21 g/ml) and low density lipoproteins (LDL, d = 1.006-1.063 g/ml) (26%, 27% and 29%, respectively), while only 18% appeared in the very low density lipoprotein (VLDL, d less than 1.006) fraction. In contrast, a large proportion of DDT and PCB radioactivity was recovered in the BF (52% and 62%, respectively) while only 38-48% was present in lipoprotein fractions. The complex nature of the interaction between xenobiotics and plasma lipoproteins is discussed.

Contraceptive steroids as a risk factor for hepatocellular carcinoma: a case/control study in South African black women

The role of contraceptive steroids in the etiology or pathogenesis of hepatocellular carcinoma in urban South African black women was investigated in a hospital-based case and control study. Participating were 46 women, 19 to 54 yr old, with carcinoma, and 92 matched controls. South African blacks have a high incidence of hepatocellular carcinoma, and urban black women have used contraceptive steroids fairly widely for a number of years. Use of contraceptive steroids for longer than 6 mo (mean duration 46.7 mo) was not found to pose a risk for development of hepatocellular carcinoma in this population--relative risk 0.8 (95% confidence interval [C.I.] 0.4 to 1.7). This was also true of use for longer than 8 yr--relative risk 0.6 (95% C.I. 0.2 to 2.5), and if a combination of an estrogen and a progestogen or a progestogen alone was used (relative risk 1.7 [95% C.I. 0.7 to 4.2] and 0.4 [95% C.I. 0.1 to 1.2], respectively). Chronic hepatitis B virus infection was confirmed to have an etiological association with hepatocellular carcinoma, but there was no evidence that contraceptive steroids acted as a co-carcinogen with the virus or, conversely, that they played a causal role in patients negative for hepatitis B surface antigenemia. We cannot, however, exclude the possibility that contraceptive steroids may play a causal role in hepatocellular carcinoma in black women who have never been infected with the hepatitis B virus. Nor was there evidence that contraceptive steroids acted in concert with either cigarette smoking or chronic alcohol abuse in hepatocarcinogenesis.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiovascular lipid accumulation with Coxsackie B virus infection in mice

The authors used a myocarditic coxsackievirus B3 infection in Balb/c mice to investigate cardiovascular lipid accumulation and whether a cholesterol-enriched diet influences the development of the myocardial inflammatory reaction. It was found that, seven days after CB3 infection, the accumulation of 14C-cholesterol increased by 75% (P less than 0.001) in the heart and by 92% (P less than 0.001) in the aorta. This infection also caused extensive inflammatory lesions (4.5% of tissue section area) and lipid accumulation in the myocardium seven days after inoculation. Seven weeks on a 1% cholesterol-enriched diet did not affect the myocardial area damaged (3.9%), the lethality, or immune cell activity (T, B, and natural killer [NK] cells). The response pattern of myocardial lymphocyte subpopulations was studied with an immune histochemical staining technique. The number of Mac 2+ (macrophages), class II expressing cells, or the T cytotoxic, suppressor/T helper cell ratio was not changed by the cholesterol diet. The number of class II cells tended to increase (38%) with cholesterol and was positively correlated (P less than 0.001) with the Mac 2 expression regardless of the cholesterol diet. Although moderate diet-induced hypercholesterolemia did not alter host response to viral infection, these results support the idea that virus and immune cells may cooperate and play a role in arterial and myocardial lipid accumulation, possibly acting as initiating factors for atherosclerosis.

Tissue accumulation of lipoprotein associated toxaphene in normo- and hypolipidemic mice

Normo- and hypolipidemic mice were given a single i.v. injection of 14C-toxaphene associated with low density lipoprotein (LDL), high density lipoprotein (HDL) or dimethyl sulfoxide (DMSO). The tissue distribution of radioactivity was studied 20 min and 4 h after the application. In the normolipidemic mice at 20 min postinjection there was high uptake of the 14C-toxaphene preparations in the liver and adrenals followed after 4 h by a redistribution to the adipose tissues. In the hypolipidemic mice, proportionally less label accumulated initially in the liver and adrenals while more radioactivity was seen in the kidneys and heart. The radioactivity then redistributed to the liver with a very small uptake in the adipose tissue compared to the normolipidemic mice after 4 h. The results indicate that changes in the lipid pattern, e.g. hypolipidemic conditions, may influence the tissue distribution of lipophilic xenobiotics.