Abstract P1116: Genetic Mapping Of Cardiomyocyte Ploidy Phenotypes To Identify Genetic Determinants Of Outcomes After Infarction

Outcomes following cardiac injury are influenced by lifestyle and environment, as well as genetic background. Our interest lies in the latter, where very few genes have successfully been linked to heart failure. Contributors to this low success rate include high genetic diversity of patient populations, inability to control for non-genetic factors, and cellular complexities that contribute to outcomes. We propose utilizing the Hybrid Rat Diversity Panel (HRDP) to assess high throughput surrogate phenotypes, which can be predictive of outcomes after injury when measured in the basal state. This approach can offer a solution to the limitations of association studies for complex diseases like heart failure. Our surrogate phenotype of interest is cardiomyocyte ploidy, where high frequency of diploid cardiomyocytes is predictive of ability to regenerate and functional recovery. Conversely, an increased proportion of polyploid (≥8N) cardiomyocytes is associated with adverse ventricular remodeling and dilated cardiomyopathy. Having analyzed 50 of the 96 strains, we see that frequency of the MNDCMs varies from 1.3-20.3% across strains, while frequency of the highly polyploid CMs (≥8N) varies from 0.8-20.9%. Four strains have been selected for myocardial infarction (MI) studies, including M520 (17.4%) and F344 (20.3%) with high MNDCM content and GK (2.8%) and HXB23 (1.8%) with low MNDCM content. Following MI, both M520 and F344 rats exhibit a higher percentage of BrdU+ cardiomyocytes in the border zone region compared to HXB23 rats, supporting the hypothesis that strains with high MNDCM frequency would be better at mounting a proliferative response. This also translated to a greater functional improvement and smaller scars in M520 rats, but not in F344. Additionally, we looked at the size of cardiomyocytes following MI and found that HXB23 rats (20.9% ≥8N CMs) have an increased cross-sectional area in comparison to the other strains, which may be indicative of concentric hypertrophy in response to injury. The HRDP could serve as a powerful tool for mapping traits related to outcomes following MI, allowing us to identify potential gene candidates that may be interrogated further for future use in precision medicine-based therapies. Mapping studies are ongoing.

Comparison of plant- and egg yolk-based semen diluents on in vitro sperm kinematics and in vivo fertility of frozen-thawed bull semen

Diluents using components of plant origin have been developed as an alternative to animal based extenders for the dilution of bull semen, however, it is unclear if use of these diluents results in in vivo fertility rates similar to those that occur with use of traditional egg yolk-based diluents. The aim of this study was to assess the effect of semen diluent on 60-day non-return rate (NRR) following artificial insemination (AI) with frozen-thawed bull semen. The effect of semen dilution in one of three different commercial diluents (BullXcell - egg yolk-based, OptiXcell - plant-based or AndroMed - plant-based) on post-thaw total and progressive motility as well as kinematic parameters (Experiment 1) and field fertility (Experiment 2, n = 1,480 inseminations) was assessed. Semen stored in OptiXcell had greater post-thaw total and progressive motility than AndroMed (P < 0.05) but did not differ from BullXcell. Semen stored in BullXcell had a greater beat cross frequency and straight line velocity compared to semen stored in AndroMed (P < 0.05) but did not differ when compared with use of OptiXcell; while values for these variables when using OptiXcell and AndroMed did not differ from each other (P > 0.05). There was no difference in any other sperm kinematic parameters (P > 0.05). There was no effect of diluent on 60-day NRR (71.5%, 67.8% and 70.6% for BullXcell, OptiXcell and AndroMed, respectively). In conclusion, while diluent significantly affected post-thaw sperm motility and kinematics, no effect on 60-day NRR was observed. Given that OptiXcell and AndroMed are animal protein-free media these diluents may be a suitable alternative to BullXcell for the storage of frozen-thawed bull semen.

Simultaneous 68Ga DOTATATE Positron Emission Tomography/Magnetic Resonance Imaging in Meningioma Target Contouring: Feasibility and Impact Upon Interobserver Variability Versus Positron Emission Tomography/Computed Tomography and Computed Tomography/Magnetic Resonance Imaging

AIMS

The increasing use of highly conformal radiation techniques to treat meningioma confers a greater need for accurate targeting. Several groups have shown that positron emission tomography/computed tomography (PET/CT) information alters meningioma targets contoured by single observers, but whether this translates into improved accuracy has not been defined. As magnetic resonance imaging (MRI) is the cornerstone of meningioma target contouring, simultaneous PET/MRI may be superior to PET/CT. We assessed whether ⁶⁸Ga DOTATATE PET imaging (from PET/CT and PET/MRI) reduced interobserver variability (IOV) in meningioma target volume contouring.

MATERIALS AND METHODS

Ten patients with meningioma underwent simultaneous ⁶⁸Ga DOTATATE PET/MRI followed by PET/CT. They were selected as it was anticipated that target volume definition in their cases would be particularly challenging. Three radiation oncologists contoured target volumes according to an agreed protocol: gross tumour volume (GTV) and clinical target volume (CTV) on CT/MRI alone, CT/MRI+PET(CT) and CT/MRI+PET(MRI). GTV/CTV Kouwenhoven conformity levels (KCL), regions of contour variation and qualitative differences between PET(CT) and PET(MRI) were evaluated.

RESULTS

There was substantial IOV in contouring. GTV mean KCL: CT/MRI 0.34, CT/MRI+PET(CT) 0.38, CT/MRI+PET(MRI) 0.39 (P = 0.06). CTV mean KCL: CT/MRI 0.31, CT/MRI+PET(CT) 0.35, CT/MRI+PET(MRI) 0.35 (P = 0.04 for all groups; P > 0.05 for individual pairs). One observer consistently contoured largest and one smallest. Observers rarely decreased volumes in relation to PET. Most IOV occurred in bone followed by dural tail, postoperative bed and venous sinuses. Tumour edges were qualitatively clearer on PET(MRI) versus PET(CT), but this did not affect contouring.

CONCLUSION

IOV in contouring challenging meningioma cases was large and only slightly improved with the addition of ⁶⁸Ga DOTATATE PET. Simultaneous PET/MRI for meningioma contouring is feasible, but did not improve IOV versus PET/CT. Whether volumes can be safely reduced according to PET requires evaluation.

A comparison of the psychological burden of PET/MRI and PET/CT scans and association to initial state anxiety and previous imaging experiences

OBJECTIVE

To investigate the level of psychological burden experienced by patients undergoing positron emission tomography (PET)/MRI scanning compared with PET/CT.

METHODS

100 adult patients referred for PET/CT and underwent PET/MRI scanning were eligible. Initial state, psychological burden of PET/CT and PET/MRI, scan satisfaction and preference were assessed using a purpose-designed questionnaire, comprising 61 five-point Likert scale questions and a three-point tick box question indicating preference between PET/CT and PET/MRI. State anxiety was assessed using the state portion of the State Trait Anxiety Inventory. Wilcoxon signed-rank tests compared psychological burden experienced by participants following PET/CT and PET/MRI scan.

RESULTS

A greater level of psychological burden was experienced by patients during PET/MRI than PET/CT p ≤ 0.001, consistent with patients' preference for PET/CT over PET/MRI (p = 0.013). There was a significant relationship between PET/CT psychological burden and initial state (r = 0.386, p ≤ 0.001). No significant relationship was identified between Initial state and psychological burden of PET MRI (r = -0.089; p = 217). There was a significant relationship between psychological burden of PET/CT and PET/MRI (r = 0.354; p = 0.001).

CONCLUSION

Patients' experience increased psychological burden during PET/MRI compared with PET/CT. Previous scanning experiences and patients' interactions prior to and during PET/MRI improved patient satisfaction. Interventions could be implemented to improve imaging outcome.

ADVANCES IN KNOWLEDGE

This study provides evidence for the increased psychological burden of PET/MRI compared with PET/CT, and that people prefer the PET/CT procedure. We have shown that the patients who expressed a preference for PET/MRI demonstrated significantly lower psychological burden for that procedure than those that preferred PET/CT, which indicates that the benefit of reduced psychological burden could be facilitated by an appropriate intervention.

Abstract 41: SH2B3 Is a Genetic Determinant of Cardiac Inflammation and Fibrosis

Background: Genome wide association studies (GWAS) are powerful tools for nominating pathogenic variants, but offer little insight as to how candidate genes impact disease outcome. Such is the case for SH2B adaptor protein 3 (SH2B3), which is associated with coronary artery disease (CAD), atherosclerosis, and risk of myocardial infarction (MI), but its role in post-MI response is completely unknown.

Methods: Using an experimental model of MI (left anterior descending artery [LAD] occlusion) in wild-type (WT) and Sh2b3 knockout (KO) rats, we assessed the role of Sh2b3 in post-MI fibrosis, leukocyte infiltration, angiogenesis, left ventricle (LV) contractility, and inflammatory gene expression. We also confirmed our findings in LV samples from end-stage heart failure patients with or without the MI-associated SH2B3 risk allele.

Results: Compared with WT, Sh2b3 KO rats had significantly increased fibrosis (2.2-fold; P2-fold; P<0.001), which coincided with decreased LV fractional shortening (FS) (-Δ11%; P<0.05) at 7 days post-LAD occlusion. Despite an increased angiogenic potential in Sh2b3 KO rats (1.7-fold; P<0.05), we observed no significant differences in LV capillary density between WT and Sh2b3 KO rats. Of the 903 genes examined, 19 were significantly elevated in the post-LAD occluded hearts of Sh2b3 KO rats relative to WT, of which three (NLRP12, CCR2, and IFNγ) were also significantly elevated in the LV of heart failure (HF) patients carrying the MI-associated rs3184504 [T] SH2B3 risk allele.

Conclusions: These data suggest for the first time that SH2B3 is a master risk factor for MI by impacting both MI incidence and post-MI response.

Dural prostate metastasis resembling a chronic subdural haematoma

Subdural hematoma (SDH) is a common neurosurgical pathology, characteristically recognised on plain CT and can be treated with simple and effective surgical intervention. In contrast, dural metastatic adenocarcinoma of the prostate with SDH and malignant extension into the subdural membranes is extremely rare. We describe the case of a 62-year old Caucasian male, provide a brief review of the literature, and explore the potential role of neoangiogenesis and disseminated intravascular coagulopathy in SDH development.

232 SPECIES-RELATED DIFFERENCES IN BLASTOCYST QUALITY ARE ASSOCIATED WITH DIFFERENCES IN RELATIVE mRNA EXPRESSION

We have previously reported a species-related qualitative difference (in terms of ultrastructural morphology and cryotolerance) between bovine and ovine blastocysts produced under identical conditions of in vitro culture in synthetic oviduct fluid (SOF1, Rizos et al. 2002 Mol. Reprod. Dev. 62, 320–327). The overall objective of this study was to see if these differences were reflected at the transcript level. From each of five IVF replicates, groups of 10 bovine and 10 ovine blastocysts were used. The objective of Experiment 1 was to compare the relative transcript abundance of eight candidate genes between ovine and bovine blastocysts cultured in SOF1. Following real-time quantitative RT-PCR, transcript levels for MnSOD, survivin, and Glut-5 were significantly higher in ovine than in bovine blastocysts (ANOVA, P < 0.05), while transcripts for Cx31, IFN-tau and SOX were significantly more abundant in bovine blastocysts (P < 0.01). For the two remaining transcripts, E-cad and Na/K, there was no difference. The objective of Experiment 2 was to examine the possibility of modifying the pattern of expression in both types of blastocysts by changing the culture medium. Culture took place in SOF1 or SOF2 (Holm et al. 1999 Theriogenology 52, 683–700). Culture of bovine embryos in SOF2 resulted in a significant increase in the level of expression of MnSOD and Glut-5 (P < 0.05) compared to culture in SOF1. For all the other transcripts except survivin, there was a significant decrease in the relative abundance. Culture of ovine embryos in either SOF1 or SOF2 did not have a major influence on transcript abundance; of the eight transcripts examined, the relative abundance of only one, SOX, was significantly altered. Based on the above, the objective of Experiment 3 (3 replicates) was to determine whether the changed pattern of expression in bovine blastocysts produced in SOF2 was associated with an improvement in cryotolerance. Bovine blastocysts produced in both culture media were vitrified and warmed, and survival was assessed by re-expansion and hatching. Blastocysts produced in SOF2 had significantly higher survival rates at 24, 48, and 72 h and significantly higher hatching rates following vitrification and warming than those produced in SOF1 (P < 0.001). In conclusion, we have demonstrated that the apparent differences between ovine and bovine embryos in their adaptability to culture conditions, manifested in differences in embryo morphology and cryotolerance, are related to differences in mRNA relative abundance. This work was supported by Science Foundation Ireland under Grant No. 02/IN1/B78 and by Ministerio de Ciencia y Tecnologia from Spain under Grant No. AGL2003-05783.

State health department and university evaluation of North Carolina's Maternal Outreach Worker Program

INTRODUCTION

The Maternal Outreach Worker (MOW) Program is a social support intervention using lay helpers to provide support, health education, and outreach to Medicaid eligible women at risk for poor pregnancy and parenting outcomes. State Health Department and University collaborators designed a two-pronged evaluation comprised of programwide and interview study components to assess the impact of the program on pregnancy outcomes, health behaviors, and infant health status.

METHODS

Programwide evaluation data are based on 1992-1995 N.C. birth files for the original 24 participating counties and include 1,726 MOW participant births and 12,988 comparison births whose records were linked to birth files and met the study criteria. For the interview study 373 MOW participants and 332 comparison women were personally interviewed three times: during pregnancy, one month postpartum, and one year after delivery.

RESULTS

Risk factors associated with poor pregnancy and parenting outcomes were greater among MOW participants than comparisons in both the programwide and intensive study components. Caucasian MOW participants had slightly higher rates of adequate prenatal care. African Americans were found to have less adequate prenatal care. Fewer than expected LBW and VLBW births were observed for African-American MOW participants. MOW Program participation did not affect the utilization of health and social services for infants. African Americans, regardless of whether they received MOW services, fared better than Caucasians in terms of having their pregnancy needs fulfilled.

CONCLUSIONS

Findings show the need to further explore appropriate measures of maternity support program outcomes and indicate inconsistent program benefit among subpopulations.

An evaluation of consumer perspectives of childbirth and parenting education

As part of a study of childbirth and parenting education in the Australian Capital Territory (O'Meara, 1993a; 1993b) an evaluation of clients' views of the service was undertaken. The evaluation sought to identify indicators of effectiveness and needs. Two independent groups (current and past users, n = 207) were surveyed using an original questionnaire based on predisposing, reinforcing and enabling factors for human behaviour (Green's PRECEDE model). The data were compared and analysed using the related t-test for indicative differences in perceptions of the two groups. Indicative differences that were statistically significant were compared on variables representing users' age, parity and preferred mode of childbirth education (public or private). No evidence was found of significant differences in attitudes, beliefs and values before and after birth attributable to childbirth education. However, the health skills, confidence and emotional preparation for the birth, and the extent of participation in the learning process did not fully measure up to users' expectations. Consumers expect professionalism in the provision of services, with course content specifically tailored to their learning needs, taking into account age and previous experience of childbirth. A comprehensive curriculum is suggested covering all stages of the childbirth process from prepregnancy to parenting.

Monoclonal antibody solution hybridization assay for detection of human immunodeficiency virus nucleic acids

In this report we describe a novel, nonisotopic hybridization assay for the measurement of viral RNA in biological samples. The assay involved a solution-phase reaction between a biotinylated DNA probe and RNA target sequences. Labeled hybrids were detected in an immunoreaction by using a solid-phase anti-biotin antibody and an enzyme-labeled monoclonal antibody specific for DNA-RNA hybrids. This monoclonal antibody solution hybridization assay was compared with an antigen-capture immunoassay for the detection of human immunodeficiency virus in 436 cell culture samples from 60 seropositive patients. The sensitivity and specificity of the hybridization assay were 93.5 and 94.6%, respectively. Detection of human immunodeficiency virus solely by hybridization in the initial sample but not subsequent samples from seven cultures may reflect detection of virus that was present in the patients' lymphocytes but did not replicate in vitro. Since the assay method is adapatable to the detection of either RNA or DNA, it could provide a means for the detection of a wide range of viral nucleic acids.

Pressure distribution in the wrist joint

We performed a study to determine pressure distribution properties of the normal radio-carpal joint. A system was developed for measurement of the contact pressure within the wrist joint surfaces. The transducer was based on Fuji pressure-sensitive paper, which was inserted into the joint space through a dorsal capsular incision. The hand was then positioned using a jig that permitted free axial loading of the joint. Each of five specimens was tested in 36 positions combining flexion/extension with radio/ulnar deviation and supination/pronation. The transducers were analyzed for contact area, scapho-lunate contact area ratio, pressure, and centroid locations using a microcomputer-based video-imaging system. The scaphoid and lunate contact areas on the radius and triangular fibrocartilage were separate and distinct in all wrist positions. Together these contact areas accounted for a relatively small fraction of the total joint surface area (average contact area/total joint area = 0.206, SD = 0.0495). For an applied 103 Newton compressive load, the high pressure averaged 3.17 MPa (SD = 0.83 MPa). Overall, the scaphoid contact area was 1.47 times that of the lunate, although variations occurred with position, as in flexion, in which the scaphoid/lunate area ratio was 0.83. The high-pressure centroids of both scaphoid and lunate contact areas shifted palmarly from 20 degrees of flexion to 20 degrees of extension and then dorsally with further extension. The scaphoid-lunate intercentroid distance averaged 14.91 mm with a range of 10-20 mm.

Load transfer characteristics of the wrist. Part II. Perilunate instability

An experimental model with a static positioning frame, pressure-sensitive film (Fuji), and a microcomputer-based video digitizing system, previously developed by the two senior authors, was used in this study to examine the effects of increasing perilunate instability on the load transfer characteristics of the wrist. These effects included a significant dorsal ulnar shift of the scaphoid centroid with increasing perilunate instability together with a less dramatic palmar ulnar shift of the lunate centroid. Overall, the scaphoid contact area was found to decrease as the stage of perilunate instability increased, even in ulnar deviation and/or extension, which in the normal wrist was found to be the positions that had the greatest scaphoid contact area. Average pressures in the high pressure zones were found to significantly increase in wrists with a stage III instability compared with normal wrists. An increase in the intercentroid (scaphoid/lunate) distance was most evident with the wrist in 20 degrees extension, neutral radioulnar deviation, and 90 degrees supination.

Load transfer characteristics of the wrist. Part I. The normal joint

A static positioning frame allows the positioning of unembalmed human upper extremities in any combination of wrist flexion/extension, radio/ulnar deviation, and pronation/supination. Pressure-sensitive film (Fuji) was used to study the contact areas, scaphoid-lunate area ratios, average high pressures, centroid positions, and intercentroid distances of five wrist joints under a uniform load of 103 Newtons (N) in 36 different positions. The contact areas accounted for only 20.6% of the available joint surface. They shift from a primarily palmar location to a primarily dorsal location when the wrist changes from flexion to extension. Overall the scaphoid contact area was 1.47 times that of the lunate and was generally greatest with the wrist in ulnar deviation. The scapho-lunate contact area ratio increased as wrist position changed from radial to ulnar deviation and/or from flexion to extension. For the constant load of 103 Newtons the high pressure averaged 3.17 megapascals (MPa). The scaphoid and lunate high pressure centroids shifted palmar when wrist position changed from 20 degrees of flexion to 20 degrees of extension and then shifted dorsal with further extension of the wrist. The intercentroid distance averaged 14.91 mm and ranged from 10 to 20 mm.

Hand injuries from shrimp boat winches

Shrimp boat winch injury to the upper extremity was identified in three patients. The injury occurred when the individual's hand became entrapped in the cable and the upper extremity was drawn into the winch mechanism. This resulted in midshaft fractures of one or both bones of the forearm and amputation of a portion of the fourth and fifth fingers. This injury emphasizes the importance of safeguards on the cable system. However, in the absence of safety regulations in the shrimping industry, more of these injuries can be expected.