Dual energy computed tomography cannot effectively differentiate between calcium pyrophosphate and basic calcium phosphate diseases in the clinical setting

Background

Recent reports suggested that dual-energy CT (DECT) may help discriminate between different types of calcium phosphate crystals in vivo, which would have important implications for the characterization of crystal deposition occurring in osteoarthritis.

Purpose

Our aim was to test the hypothesis that DECT can effectively differentiate basic calcium phosphate (BCP) from calcium pyrophosphate (CPP) deposition diseases.

Methods

Discarded tissue after total knee replacement specimens in a 71 year-old patient with knee osteoarthritis and chondrocalcinosis was scanned using DECT at standard clinical parameters. Specimens were then examined on light microscopy which revealed CPP deposition in 4 specimens (medial femoral condyle, lateral tibial plateau and both menisci) without BCP deposition. Regions of interest were placed on post-processed CT images using Rho/Z maps (Syngo.via, Siemens Healthineers, VB10B) in different areas of CPP deposition, trabecular bone BCP (T-BCP) and subchondral bone plate BCP (C-BCP).

Results

Dual Energy Index (DEI) of CPP was 0.12 (SD ​= ​0.02) for reader 1 and 0.09 (SD ​= ​0.03) for reader 2, The effective atomic number (Zeff) of CPP was 10.83 (SD ​= ​0.44) for reader 1 and 10.11 (SD ​= ​0.66) for reader 2. Nearly all DECT parameters of CPP were higher than those of T-BCP, lower than those of C-BCP, and largely overlapping with Aggregate-BCP (aggregate of T-BCP and C-BCP).

Conclusion

Differentiation of different types of calcium crystals using DECT is not feasible in a clinical setting.

Near-Infrared Imaging of Indocyanine Green Identifies Novel Routes of Lymphatic Drainage from Metacarpophalangeal Joints in Healthy Human Hands

Background: Collecting lymphatic vessel (CLV) dysfunction has been implicated in various diseases, including rheumatoid arthritis (RA). RA patients with active hand arthritis exhibit significantly reduced lymphatic clearance of the web spaces adjacent to the metacarpophalangeal (MCP) joints and a reduction in total and basilic-associated CLVs on the dorsal surface of the hand by near-infrared (NIR) imaging of indocyanine green (ICG). In this pilot study, we assessed direct lymphatic drainage from MCP joints and aimed to visualize the total lymphatic anatomy using novel dual-agent relaxation contrast magnetic resonance lymphography (DARC-MRL) in the upper extremity of healthy human subjects. Methods and Results: Two healthy male subjects >18 years old participated in the study. We performed NIR imaging along with conventional- or DARC-MRL following intradermal web space and intra-articular MCP joint injections. ICG (NIR) or gadolinium (Gd) (MRL) was administered to visualize the CLV anatomy of the upper extremity. Web space draining CLVs were associated with the cephalic side of the antecubital fossa, while MCP draining CLVs were localized to the basilic side of the forearm by near-infrared indocyanine green imaging. The DARC-MRL methods used in this study did not adequately nullify the contrast in the blood vessels, and limited Gd-filled CLVs were identified. Conclusion: MCP joints predominantly drain into basilic CLVs in the forearm, which may explain the reduction in basilic-associated CLVs in the hands of RA patients. Current DARC-MRL techniques show limited identification of healthy lymphatic structures, and further refinement in this technique is necessary. Clinical trial registration number: NCT04046146.

System-specific evaluation of the dual flip angle MRI technique for quantitative T1 measurement

PURPOSE

To investigate if the accuracy of the dual flip angle (DFA) technique for T₁ measurement is affected by the system-specific RF excitation performance.

METHODS

A T₁ phantom, made of 12 vials of unique T₁ value ranging approximately from 200 ms to 2000 ms, was built and tested on seven different clinical scanners. For each experiment, the reference T₁ of each vial was obtained by the inversion recovery-based technique, and the DFA technique was applied repeatedly with several flip angle (FA) pairs conventionally proposed as optimal. The accuracy of the DFA technique for each FA pair was then evaluated by comparing the measured T₁ values for the vials to the references. Any variation of the accuracy was then evaluated across different FA pairs, and across different MRI systems. To improve accuracy with a selected FA pair, the signal ratio (SR) curve, obtained from the phantom, was utilized in a calibration strategy of the DFA technique.

RESULTS

When combined for all the vials, the average ratio of the measured T₁ to the reference generally increased as the FA pair window gradually slid from the smaller to the larger FA values. Furthermore, among several optimal FA pairs, the pair of the best accuracy varied slightly by the MRI system. The accuracy for any FA pair could be improved when the calibration strategy was utilized.

CONCLUSIONS

The RF excitation performance may vary by the specific FA pair and by the specific MRI system, influencing the accuracy of the DFA technique. The system-specific evaluation, and, if needed, its calibration, would help improve the accuracy of the DFA technique.

Pathogens associated with pleuritic pig lungs at an abattoir in Queensland Australia

OBJECTIVE

Pleurisy in pigs has economic impacts in the production stage and at slaughter. This study sought to establish if some micro-organisms can be found in high numbers in lungs with pleurisy by assessing batches of pigs at an abattoir in Queensland Australia.

DESIGN

Samples of lung (including trachea/bronchus and lymph nodes) from a maximum of 5 pleurisy affected pigs were collected from 46 batches of pigs representing 46 Queensland farms.

PROCEDURE

Pleurisy-affected lung areas were cultured by traditional bacteriological methods and bacteria quantified by plate scores. Additionally, tracheal or bronchial swabs and apical lobe fluid were tested for Mycoplasma hyopneumoniae DNA and the superior tracheobronchial lymph nodes were tested for porcine circovirus type 2 DNA by polymerase chain reaction (PCR). All apparently significant bacteria were identified via PCR or sequencing. Typing was undertaken on some of the bacterial isolates.

RESULTS

The most prevalent pathogens were M. hyopneumoniae, Streptococcus suis and Porcine Circovirus type 2, being found in 34, 38 and 31 batches, respectively. Other bacteria found were Actinobacillus species (29 batches), Pasteurella multocida (24 batches), Mycoplasma flocculare (9 batches), Actinobacillus pleuropneumoniae (7 batches), Mycoplasma hyorhinis (4 batches), Bisgaard Taxon 10 (1 batch), Glaesserella parasuis (1 batch), Streptococcus minor (1 batch) and Streptococcus porcinus (1 batch). Most batches had more than one bacterial species.

CONCLUSION

The high percentage of batches infected with S. suis (83%), M. hyopneumoniae (74%) and PCV2 (70%) and clustering by a batch of these pathogens, as well as the presence of many secondary pathogens, suggests synergy between these organisms may have resulted in pleurisy.

Diverse strains of Actinobacillus lignieresii isolated from clinically affected cattle in a geographically restricted area

OBJECTIVE

To investigate whether an outbreak of Actinobacillus lignieresii was caused by one or multiple strains.

METHODS

Nine isolates of A. lignieresii were obtained from the lymph nodes of 15 affected cattle from two farms to determine whether a single strain was involved. An enterobacterial repetitive insertion consensus sequence (ERIC) PCR was used for genotyping, and the repeats-in-toxin genes were analysed by PCR and sequencing.

RESULTS

Isolates from the two farms belonged to two and three genotypes, with a total of four genotypes detected. Genes of the apxICABD operons of some strains had deletions in the apxIA (~697 bp) and in the apxID (~187 bp) genes. The toxin gene deletions and the ERIC PCR patterns suggested the involvement of different A. lignieresii genotypes.

CONCLUSION

There was no evidence that a unique genotype was associated with actinobacillosis on the two farms, confirming that this disease was associated with other contributing factors.

Flood protection ecosystem services in the coast of Puerto Rico: Associations between extreme weather, flood hazard mitigation and gastrointestinal illness

Floods are becoming increasingly influential in coastal cities due to the intensification of extreme weather events. The impacts of flooding go beyond damages to infrastructure, it also affects human health. During floods, discharge of sewage into streets increases exposure to pathogens causing gastrointestinal (GI) illnesses. A potential strategy for coastal protection during weather hazards is the use of flood protection ecosystem services, but their effectiveness at ameliorating the impact of floods on GI illnesses remain understudied. Here we explore the relationship between extreme rainfall, flood protection ecosystem services, and the occurrence of Medicare claims for gastrointestinal (GI) illnesses in Puerto Rico. We first conducted model averaging to detect variables explaining flood impact for the years (1999-2014), and then used these variables as predictors in a spatio-temporal analysis of GI illness in the same period (1999-2013). Our results show that flood impact varies proportionally with extreme rainfall, and inversely with flood protection ecosystem services, particularly due to the presence of karst soils. The protective effect of karst soils is lost when there is a high percentage of people living in flood prone areas, as suggested by a significant interaction effect between these two variables. In support of our hypotheses, cases of GI illness also spike after extreme rainfall events and are affected by the interaction effect of karst soils and people living in flood prone areas. Our results support the linkage between extreme weather events, flood damages and GI illnesses, and suggests a buffering role of ecosystem services that promote rainfall infiltration. The relevance of these ecosystem services, however, is affected by planning decisions such as residential development in flood prone areas. Our results help inform planning strategies for future weather hazards, accounting for the role of natural and built infrastructure on minimizing flood impacts and human health effects.

Abstract OT2-06-03: METAMORPH: METAstatic markers of recurrent tumor PHenotype for breast cancer

Up to 30% of patients diagnosed with breast cancer will develop recurrent disease within their lifetime, and currently this form of the disease is incurable. There are unmet needs to better understand underlying metastatic biology, identify new therapeutic targets and develop better methods for monitoring changes in disease, both to monitor response and elucidate resistance mechanisms. To address these needs, the METAMORPH Study encompasses a comprehensive approach that combines serial molecular tissue profiling at the RNA and DNA level with circulating markers (DTCs, CTCs, plasma tumor DNA), and ongoing assessment of therapeutic response.

METAMORPH is a prospective cohort study of women with suspected or confirmed recurrent breast cancer and accessible tumor by standard clinical biopsy, who are enrolled at the University of Pennsylvania prior to starting a new therapy for recurrent metastatic disease. The aims of this trial are to (1) evaluate the mechanisms through which recurrent breast cancer are genetically distinct from the primary tumor, (2) evaluate the circulating tumor biomarker trajectory of recurrent disease, (3) elucidate “escape pathways” of progressing tumors that emerge during the selective pressure of therapy, and (4) explore clinical utility of tumor and blood testing. The study protocol integrates research aims into clinical care, including a standardized approach to disease assessment and biopsy, pathologic confirmation of histology and receptor subtype, panel-based CLIA-approved genomic profiling, collection of research specimens, and standardized reporting of results, which are returned to patients and physicians. Patients are followed for treatment and outcome, and serial samples are collected at progression. A companion protocol, COMET, provides education about genomic testing and assesses patient understanding and impact of results. To date, 155 patients have enrolled, 142 (92%) have been biopsied, 120 (77%) have had sufficient DNA for molecular profiling and 109 (70%) have had genomic panel testing. Accrual is ongoing, with an initial target of 300 patients. Multiple sites within the UPHS Health System are enrolling. Contact information: angela.demichele@uphs.upenn.edu.

Key words: Metastatic disease, tumor profiling.

Citation Format: DeMichele A, Soucier-Ernst DJ, Clark C, Shih N, Stavropoulos W, Maxwell KN, Feldman M, Lierbamen D, Morrissette JJD, Paul MR, Pan T-C, Wang J, Belka GK, Chen Y, Yee S, Carpenter E, Fox K, Matro J, Clark A, Shah P, Domchek S, Bradbury A, Chodosh L. METAMORPH: METAstatic markers of recurrent tumor PHenotype for breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT2-06-03.

A Keyword Approach to Finding Common Ground in Community-Based Definitions of Human Well-Being

Ecosystem-based management involves the integration of ecosystem services and their human beneficiaries into decision making. This can occur at multiple scales; addressing global issues such as climate change down to local problems such as flood protection and maintaining water quality. At the local scale it can be challenging to achieve a consistent and sustainable outcome across multiple communities, particularly when they differ in resource availability and management priorities. A key requirement for consistent decision support at the community level is to identify common community objectives, as these can form the basis for readily transferable indices of ecosystem benefit and human well-being. We used a keyword-based approach to look for common terminology in community fundamental objectives as a basis for transferable indices of human well-being and then compared those commonalities to community demographics, location, and type. Analysis centered on strategic planning documents readily available from coastal communities in the conterminous United States. We examined strategic planning documents based on eight domains of human well-being, and found that Living Standards and Safety and Security were the most commonly addressed domains, and Health and Cultural Fulfillment were the least. In comparing communities, regional differences were observed in only one well-being domain, Safety and Security, while community type yielded significant differences in five of the eight domains examined. Community type differences followed an urban to rural trend with urban communities focusing on Education and Living Standards, and more rural communities focused on Social Cohesion and Leisure Time. Across all eight domains multivariate analysis suggested communities were distributed along two largely orthogonal gradients; one between Living Standards and Leisure Time and or Connection to Nature, and a second between Safety and Security and Social Priorities (Education/Health/Culture/Social Cohesion). Overall these findings demonstrate the use of automated keyword analysis for obtaining information from community strategic planning documents. Moreover, the results indicate measures and perceptions of well-being at the local scale differ by community type. This information could be used in management of ecosystem services and development of indices of community sustainability that are applicable to multiple communities with similar demographics, regional location, and type.

MR image-based synthetic CT for IMRT prostate treatment planning and CBCT image-guided localization

The purpose of this study was to propose and evaluate a method of creating a synthetic CT (S-CT) from MRI simulation for dose calculation and daily CBCT localization. A pair of MR and CT images was obtained in the same day from each of 10 prostate patients. The pair of MR and CT images was preregistered using the deformable image registration (DIR). Using the corresponding displacement vector field (atlas-DVF), the CT image was deformed to the MR image to create an atlas MR-CT pair. Regions of interest (ROI) on the atlas MR-CT pair were delineated and used to create atlas-ROI masks. 'Leave-one-out' test (one pair of MR and CT was used as subject-MR and subject-CT for evaluation, and the remaining 9 pairs were in the atlas library) was performed. For a subject-MR, autosegmentation and DVFs were generated using DIR between the subject-MR and the 9 atlas-MRs. An S-CT was then generated using the corresponding 9 paired atlas-CTs, the 9 atlas-DVFs and the corresponding atlas-ROI masks. The total 10 S-CTs were evaluated using the Hounsfield unit (HU), the calculated dose distribution, and the auto bony registration to daily CBCT images with respect to the 10 subject-CTs. HU differences (mean ± STD) were (2.4 ± 25.23), (1.18 ± 39.49), (32.46 ± 81.9), (0.23 ± 40.13), and (3.74 ± 144.76) for prostate, bladder, rectal wall, soft tissue outside all ROIs, and bone, respectively. The discrepancy of dose-volume param-eters calculated using the S-CT for treatment planning was small (≤ 0.22% with 95% confidence). Gamma pass rate (2% & 2 mm) was higher than 99.86% inside PTV and 98.45% inside normal structures. Using the 10 S-CTs as the reference CT for daily CBCT localization achieved the similar results compared to using the subject-CT. The translational vector differences were within 1.08 mm (0.37 ± 0.23 mm), and the rotational differences were within 1.1° in all three directions. S-CT created from a simulation MR image using the proposed approach with the preconstructed atlas library can replace the planning CT for dose calculation and daily CBCT image guidance.

Effects of spin-lock field direction on the quantitative measurement of spin-lattice relaxation time constant in the rotating frame (T1ρ) in a clinical MRI system

PURPOSE

To investigate whether the direction of spin-lock field, either parallel or antiparallel to the rotating magnetization, has any effect on the spin-lock MRI signal and further on the quantitative measurement of T1ρ, in a clinical 3 T MRI system.

METHODS

The effects of inverted spin-lock field direction were investigated by acquiring a series of spin-lock MRI signals for an American College of Radiology MRI phantom, while the spin-lock field direction was switched between the parallel and antiparallel directions. The acquisition was performed for different spin-locking methods (i.e., for the single- and dual-field spin-locking methods) and for different levels of clinically feasible spin-lock field strength, ranging from 100 to 500 Hz, while the spin-lock duration was varied in the range from 0 to 100 ms.

RESULTS

When the spin-lock field was inverted into the antiparallel direction, the rate of MRI signal decay was altered and the T1ρ value, when compared to the value for the parallel field, was clearly different. Different degrees of such direction-dependency were observed for different spin-lock field strengths. In addition, the dependency was much smaller when the parallel and the antiparallel fields are mixed together in the dual-field method.

CONCLUSIONS

The spin-lock field direction could impact the MRI signal and further the T1ρ measurement in a clinical MRI system.

A national study of the provision of oncology sperm banking services among Canadian fertility clinics

The purpose of this study was to survey the current state of oncology sperm banking services provided by fertility clinics across Canada. A total of 78 Canadian fertility facilities were invited to complete a questionnaire related to the availability, accessibility, affordability and utilisation of sperm banking services for cancer patients. The total response rate was 59%, with 20 (69%) in vitro fertilisation clinics and 26 (53%) other fertility centres returning the survey. A total of 24 responding facilities accepted oncology sperm banking referrals. The time frame to book the first banking appointment for 19 (79%) facilities was within 2 days. Inconsistent practice was found regarding the consent process for cancer patients who are of minority age. Eight (33%) facilities did not provide any subsidy and charged a standard banking fee regardless of patients' financial situations. Overall, the utilisation of oncology sperm banking services was low despite its availability and established efficacy, suggesting that Canadian cancer patients are notably underserved. The study has highlighted some important issues for further consideration in improving access to sperm banking services for cancer patients, especially for adolescents. Better collaboration between oncology and reproductive medicine to target healthcare providers would help to improve sperm banking rates.

SU-E-J-190: A Possible Non-Typical Measurement in Dynamic Contrast MRI for Brain Tumor Therapy Response Evaluation

PURPOSE

Dynamic susceptibility contrast (DSC) MRI technique can be used for brain tumor therapy response evaluation. However, the typical modeling (Eqs.1) is sometimes problematic in the vicinity of tumor due possibly to the disrupted microvascular environment associated with the disease. The example is well illustrated in Fig.1B, where some MRI time series curves (TSC) keep increasing beyond the baseline value after some time points, which is theoretically prohibited in the typical modeling. This behavior is not related to other systemic error such as motion or system instability, which can be verified by the steady TSC from a CSF region (Fig.1C).To improve the utility of DSC-MRI even in the problematic, but highly interested, regions of the brain, the non-complying TSC was assumed legitimate and its increase rate, linked to the degree of contrast's leakage, was analyzed.

METHODS

DSC-MRI (with manually injected multihance, 0.2 ml/kg) was applied for high grade brain tumor before and after radiation therapy. The scan technique was based on T2*-weighted PRESTO implemented on a Philips 1.5T scanner. The analysis of TSC was performed using an in-house software developed in MATLAB.

RESULTS

The TSCs from several regions of interest (ROI) were obtained (Fig.1). Before radiation therapy, those from ROIs A and C increase beyond the baseline after about 60 frame that coincides with the passage of contrast in other complying TSC. The slope of increasing TSC was determined as shown in Figs. 1B and 1D. After therapy (Fig 1D), the compliance of TSC in ROI C to the typical modeling was quite improved and the degree of leakage shown as slope, as well as the area of leakage (Fig 2), decreased after the therapy, suggesting the therapy possibly repaired the leakage.

CONCLUSION

A non-typical measurement was introduced to improve DSC-MRI's utility in the brain tumor therapy monitoring. American Cancer Society Institutional Research Grant/Upstate Cancer Research Institute.

Structural and functional analysis of the interaction between the agonistic monoclonal antibody Apomab and the proapoptotic receptor DR5

Activation of the proapoptotic receptor death receptor5 (DR5) in various cancer cells triggers programmed cell death through the extrinsic pathway. We have generated a fully human monoclonal antibody (Apomab) that induces tumor cell apoptosis through DR5 and investigated the structural features of its interaction with DR5. Biochemical studies showed that Apomab binds DR5 tightly and selectively. X-ray crystallographic analysis of the complex between the Apomab Fab fragment and the DR5 ectodomain revealed an interaction epitope that partially overlaps with both regions of the Apo2 ligand/tumor necrosis factor-related apoptosis-inducing ligand binding site. Apomab induced DR5 clustering at the cell surface and stimulated a death-inducing signaling complex containing the adaptor molecule Fas-associated death domain and the apoptosis-initiating protease caspase-8. Fc crosslinking further augmented Apomab's proapoptotic activity. In vitro, Apomab triggered apoptosis in cancer cells, while sparing normal hepatocytes even upon anti-Fc crosslinking. In vivo, Apomab exerted potent antitumor activity as a single agent or in combination with chemotherapy in xenograft models, including those based on colorectal, non-small cell lung and pancreatic cancer cell lines. These results provide structural and functional insight into the interaction of Apomab with DR5 and support further investigation of this antibody for cancer therapy.

Histological alterations in male A/J mice following nose-only exposure to tobacco smoke

The incidence and multiplicity of grossly observed and microscopic lesions of the respiratory tract of A/J mice exposed nose-only to mainstream smoke (50, 200, or 400 mg total particulate matter/m3 from 2R4F cigarettes) was compared to those of filtered air controls. Animals were necropsied at the end of exposure (5 mo) or following 4 or 7 mo of recovery. Lungs were visually inspected for tumors at all necropsies and examined histopathologically at 9 and 12 mo. At 5 mo no tumors were recorded. No significant elevations in tumor incidence or multiplicity were recorded although at 9 mo multiplicity was elevated in the mid-exposure group (0.90 versus 0.55 tumors per animal for controls). At 12 mo, multiplicity was increased over the 9-mo necropsy at all exposures except 200 mg/m3; however, there were no dose-related trends in multiplicity or incidence. Histopathological alterations included hyperplasia, metaplasia, and inflammation of the nose and larynx and proliferative lesions of the lungs. At 9 mo, the multiplicity of focal lung lesions was 1.4 per animal in controls but averaged 1.0 among smoke-exposed groups. There was an inverse relation (p < .059) between smoke concentration and the percentage of hyperplastic lesions at 9 mo. At 12 mo the high-exposure group had slightly increased multiplicity of 2.3 lesions compared with 1.6 among controls, while the percentage of hyperplasic lesions was similar between groups. Nose-only inhalation of mainstream tobacco smoke resulted in chronic inflammatory changes of the respiratory tract yet failed to produce statistically significant changes in tumor incidence or multiplicity.

Genetic analysis workshop II: Combined segregation, linkage, and association analysis

A combined segregation, linkage, and association analysis using the program COMBIN was performed on the simulated pedigree data prepared for the Second Genetic Analysis Workshop. The model used in COMBIN is described and the presented results illustrate its effectiveness in the analysis of such data. Linkage analysis was performed and maps for each linkage group are presented.

Does altering patch number and connectivity change the predatory functional response type? Experiments and simulations in an acarine predator–prey system

In multipatch landscapes, understanding the role of patch number and connectivity is key for the conservation of species under processes such as predation. The functional response is the most basic form of the predator–prey interaction. Two common response types exist: a decelerating curvilinear increase in prey consumption with prey density to a plateau (type II) and a sigmoidal-shaped curve (type III). Type II responses have been observed for a variety of predators, though only type III responses allow long-term persistence and are demographically stabilizing. We tested the hypothesis that the functional response type can change from a type II to a type III with increasing patch number and (or) decreasing connectivity. The predatory mite Amblyseius fallacis (Garman, 1948) has previously been shown to have a type II response when feeding on Panonychus ulmi (Koch, 1839). We examined this predator–prey interaction using experiments that varied in patch number, and simulations that varied in both patch number and connectivity. In no experimental or simulation trial did altering patch number or connectivity change the predator's functional response from type II to type III, even with an 80-fold decrease in patch connectivity. How do predators with this demographically destabilizing functional response persist? Hypotheses regarding metapopulations and alternative prey are discussed.

Evaluation of a stereotactic frame for repositioning of the rat brain in serial positron emission tomography imaging studies

For serial imaging studies of the rat brain with positron emission tomography (PET), reproducible positioning of the head can facilitate spatial alignment of images and quantitative analysis. To achieve this aim, we constructed a plastic head frame and tested the positioning reproducibility on a high-resolution small-animal PET scanner, microPET. Two sets of ear bars, with tapers of either 18 degrees (sharp) or 45 degrees (blunt), were evaluated for their relative precision in securing the animal to the frame. For sequential positioning of an animal, average distances from the mean position of 0.51 mm (SD 0.41 mm) and 0.91 mm (SD 0.48 mm) were measured with the sharp and blunt ear bars, respectively. These results show that a rat brain can be reproducibly positioned using the frame, with a variation of position less than the spatial resolution of modern animal PET scanners. Brain regions of interest defined on one scan and copied across subsequent scans of a frame-repositioned animal resulted in an average coefficient of variation of 5.4% (SD 2.7%) using the sharp ear bars and 6.8% (SD 2.5%) using the blunt ear bars. This methodology has the potential to improve quantitative assessment for serial PET studies.

Isolation of a novel protein tyrosine phosphatase inhibitor, 2-methyl-fervenulone, and its precursors from Streptomyces

High-throughput screening identified an extract from Streptomyces sp. IM 2096 with inhibitory activity toward several protein tyrosine phosphatases (PTPs). Four 1,2,4-triazine compounds 2096A-D (1-4) were isolated from this extract and their structures elucidated by interpretation of spectroscopic data and confirmed by degradation and synthesis. The novel glycocyamidine derivatives 1 and 2 are diastereomers and may interconvert. Both are inactive in the PTP inhibition assay. Compounds 1 and 2 are unstable and partially decompose to 3 and glycocyamidine (5) at room temperature. Compound 3, known as MSD-92 or 2-methyl-fervenulone, is a broad-specificity PTP inhibitor with comparable potency to vanadate. The imidazo[4, 5-e]-1,2,4-triazine (4), inactive in the PTP-inhibition assay, may be a degradation product of 3.

The expression of Myf5 in the developing mouse embryo is controlled by discrete and dispersed enhancers specific for particular populations of skeletal muscle precursors

The development of skeletal muscle in vertebrate embryos is controlled by a transcriptional cascade that includes the four myogenic regulatory factors Myf5, Myogenin, MRF4 and MyoD. In the mouse embryo, Myf5 is the first of these factors to be expressed and mutational analyses suggest that this protein acts early in the process of commitment to the skeletal muscle fate. We have therefore analysed the regulation of Myf5 gene expression using transgenic technology and find that its control is markedly different from that of the other two myogenic regulatory factor genes previously analysed, Myogenin and MyoD. We show that Myf5 is regulated through a number of distinct and discrete enhancers, dispersed throughout 14 kb spanning the MRF4/Myf5 locus, each of which drives reporter gene expression in a particular subset of skeletal muscle precursors. This region includes four separate enhancers controlling expression in the epaxial muscle precursors of the body, some hypaxial precursors of the body, some facial muscles and the central nervous system. These elements separately or together are unable to drive expression in the cells that migrate to the limb buds and in some other muscle subsets and to correctly maintain expression at late times. We suggest that this complex mechanism of control has evolved because different inductive signals operate in each population of muscle precursors and thus distinct enhancers, and cognate transcription factors, are required to interpret them.

Oxidative stress, brain white matter damage and intrauterine asphyxia in fetal lambs

In order to examine the role of oxidative stress in asphyxia-induced perinatal brain damage, near-term fetal lambs were subjected to umbilical cord occlusion for approximately 60min until fetal arterial pH diminished to less than 6.9 and base excess to less than -20 meq/l. The levels of superoxide, hydrogen peroxide, glutathione (GSH) and thiobarbiturate-reactive substances (TBARS) within brain grey and white matter were determined at 72h to correlate with morphological changes. Although the topography and extent of brain damage varied somewhat from case to case, ranging from focal infarction in grey or white matter to subtle and patchy alterations of white matter, the telencephalic white matter appeared to bear the brunt of damage as compared to other regions. The parietal white matter, in particular was often the seat of early pathological changes that could be seen in isolation. These white matter changes were accompanied by significant increases in hydrogen peroxide and TBARS levels as compared to those in grey matter. In another set of experiments, 8 different brain regions were assayed for TBARS, GSH and superoxide dismutase (SOD). A highly significant rise in the levels of TBARS was again noted in the parietal and frontal white matter. SOD levels were higher in the frontal and parietal white matter, basal ganglia and cerebellum. Cerebral cortical and hippocampal neurons were relatively unaffected until accompanied by more severe damage to grey and white matter at other sites. These results suggest that the developing telencephalic white matter appears to be most vulnerable to the effects of intrauterine fetal asphyxia and that oxidative stress may be a major contributing factor in the pathogenesis of perinatal hypoxic-ischemic encephalopathy.

Proton resonance assignments and ligand exchange kinetics in high-spin and mixed-spin myoglobin complexes using two-dimensional exchange spectroscopy

The task of assigning resonances in proton nuclear magnetic resonance spectra of paramagnetic heme proteins can be an arduous process, but with the development of multi-dimensional NMR methods the situation has improved. It is demonstrated here that two-dimensional exchange spectroscopic experiments can be used to obtain to assignment correlations for the heme protons of methydroxy-, metthiocyano-, metaquo-, and metimidazole-myoglobin forms. All the assignments are unambiguous and straightforward when the temperature and mixing times are adjusted to minimize nuclear Overhauser cross-peaks from each complex. Moreover, saturation transfer experiments allow the study of ligand binding kinetics. The exchange rates between metaquo- and metimidazole- (or methyl substituted imidazole) myoglobin complexes are estimated. The differences between the exchange rates reflect differences in the hydrophobic and steric interactions between the ligands and the protein moiety.

Functional oral-motor skills: Do they change with age?

Dysphagia, a difficulty eating or drinking, appears to increase with age and is a concern for our growing elderly population. Mastication, tongue mobility, and lip closure are skills of the oral phase of ingestion, and have been shown to deteriorate with age. However, it is not clear whether these changes affect functional feeding. It is also unclear whether dysphagia is the result of the aging process itself, or whether it is secondary to disease. Therefore, the purpose of this study was to identify changes during the oral phase of ingestion in a group of healthy seniors. Functional feeding skills and oral praxis abilities were measured in 79 healthy adults aged 60-97 years. The Modified Functional Feeding Assessment (FFAm) subscale of the Multidisciplinary Feeding Profile (MFP) and the Oral Praxis Subtest (OPS) of the Southern California Sensory Integration Test were administered respectively. An interview followed to obtain information on denture wear, use of hearing aids and glasses, and types of foods avoided. Seniors maintained functional feeding skills throughout the four decades studied. These skills were not age-dependent, but depended on whether or not subjects wore full dentures. Even though all of the seniors maintained functional feeding skills, more seniors in the younger group (7th decade 60%, 8th decade 67%) had difficulty with a variety of food textures such as soft, hard, fibrous, and some with tough skins, than the older group (9th decade 40%, 10th decade 44%). Oral praxis abilities were correlated significantly with age, but not with hearing aid use. Overall, healthy seniors maintained their functional feeding and oral praxis skills. Good health and natural dentition appear to be excellent indicators for functional feeding ability.

In vitro permeability across Caco-2 cells (colonic) can predict in vivo (small intestinal) absorption in man--fact or myth

PURPOSE

To evaluate and optimize the use of Caco-2 cell monolayers to predict the in vivo absorption of a broad range of compounds in man.

METHODS

Caco-2 cells are derived from human adenocarcinoma colon cells and spontaneously differentiate when grown on porous polyethylene terephthalate membranes (PETP) in a 12 well format to form monolayers of polarized cells possessing function similar to intestinal enterocytes. Transport experiments were conducted using 21 day cultured cells in a shaking water bath at 37 degrees C. Radiolabeled mannitol was used to determine monolayer integrity. Apparent permeability coefficient (Papp) was calculated from the appearance of drug in the receiver side.

RESULTS

A strong correlation was observed between in vivo human absorption and in vitro Papp for a variety of compounds (R = 0.95, N = 35). For compounds that are substrates of p-glycoprotein (Pgp), use of a Pgp inhibitor resulted in a better estimate of absorption in humans. The results of this study suggest that the overall ranking of compounds with Papp < 1 x 10(-6) cm/sec, between 1-10 x 10(-5) cm/ sec, and > 10 x 10(-6) cm/sec can be classified as poorly (0-20%), moderately (20-70%) and well (70-100%) absorbed compounds, respectively.

CONCLUSIONS

These data suggest that Caco-2 cells developed under the culturing and transport conditions defined herein can be used to predict in vivo human absorption of compounds regardless of transport mechanism, viz., transcellular, paracellular and carrier-mediated.

The effects of glutathione glycoside in methyl mercury poisoning

The use of glutathione glycoside (GSH-glyc), a compound newly synthesized in our laboratory, was highly effective in raising cellular GSH levels both in vitro and in vivo. Based on mass spectrometry and 1H NMR data, the structure of GSH-glyc was determined to be that of an S-glycoside. Rapid GSH uptake was observed by confocal microscopy in both A549 cells and mouse astrocytes following incubation with GSH-glyc. Intraperitoneal (i.p.) and per oral administration of GSH-glyc in C57BL/6J mice raised GSH concentrations in brain and liver to significantly higher levels than normal. Methyl mercury (MeHg) poisoning of mice with multiple doses of methylmercuric chloride (MMC) induced severe toxic effects associated with marked depletion of brain and liver GSH progressing to death in all animals, whereas the animals primed with GSH-glyc and given MMC and GSH-glyc concurrently were devoid of toxic signs. We suggest, on the basis of D-[3H]glucose and [2- 3H]deoxyglucose uptake studies, that the transport of GSH-glyc across the blood-brain barrier may occur through one of the glucose transport pathways. Although the precise mechanism by which GSH-glyc protects against MeHg poisoning is not clear, it is probable that any one of a number of factors, including conjugation of MeHg, scavenging of free radicals, restoration of reactive thiol groups, and enhancement of MeHg efflux, may have been instrumental. GSH-glyc is a nontoxic compound that can be used to transport GSH into cells, including those of brain and liver, and may prove to be useful for prophylaxis and therapy of tissue injury induced by various neurotoxic compounds, particularly when the capacity to synthesize or regenerate GSH has been compromised.

Efficacy and tolerability of oral ondansetron versus prochlorperazine in the prevention of emesis associated with cyclophosphamide-based chemotherapy and maintenance of health-related quality of life

This study compared the efficacy and tolerability of oral ondansetron (8 mg twice daily [BID] for up to 3 days) with those of phenothiazine prochlorperazine (10 mg BID for up to 3 days) in 133 cancer patients receiving cyclophosphamide-based chemotherapy. In addition, the study evaluated the impact of these treatments on patients' health-related quality of life, measured with both the Functional Living Index-Cancer and the Functional Living Index-Emesis questionnaires. The first dose of study drug was administered 30 minutes before initiation of chemotherapy. Patients received a rescue antiemetic at their request or if the investigator deemed it necessary. There was a statistically significant difference in the number of patients with no emetic episodes over the 3-day study period: 60% in the ondansetron group compared with 21% in the prochlorperazine group. Twenty-five percent of ondansetron-treated patients compared with 68% of prochlorperazine-treated patients experienced three or more emetic episodes, rescue medication use, or withdrawal from the study due to emesis or adverse events. Among patients with at least one emetic episode, the mean time to emesis was significantly longer (13 hours and 37 minutes) in the ondansetron group compared with the prochlorperazine group (9 hours and 30 minutes). Nausea and appetite scores did not differ significantly between groups. The score on the vomiting subscale of the Functional Living Index-Emesis was significantly more favorable in the ondansetron group compared with the prochlorperazine group, indicating better maintenance of health-related quality of life in ondansetron-treated patients. Both treatments were well tolerated. The most common potentially drug-related adverse event was headache, which occurred in significantly more (16%) ondansetron-treated patients compared with prochlorperazine-treated patients (3%). The results of this study demonstrate that oral ondansetron 8 mg BID for up to 3 days is more effective than prochlorperazine 10 mg BID for up to 3 days in the prevention of emesis associated with moderately emetogenic chemotherapy.