Liposome-encapsulated EF24-HPβCD inclusion complex: a preformulation study and biodistribution in a rat model

3,5-Bis(2-fluorobenzylidene)-4-piperidone (EF24) is an anti-proliferative diphenyldifluoroketone analog of curcumin with more potent activity. The authors describe a liposome preparation of EF24 using a "drug-in-CD-in liposome" approach. An aqueous solution of EF24 and hydroxypropyl-β-cyclodextrin (HPβCD) inclusion complex (IC) was used to prepare EF24 liposomes. The liposome size was reduced by a combination of multiple freeze-thaw cycles. Co-encapsulation of glutathione inside the liposomes conferred them with the capability of labeling with imageable radionuclide Tc-99m. Phase solubility analysis of EF24-HPβCD mixture provided k(1:1) value of 9.9 M(-1). The enhanced aqueous solubility of EF24 (from 1.64 to 13.8 mg/mL) due to the presence of HPβCD helped in the liposome preparation. About 19% of the EF24 IC was encapsulated inside the liposomes (320.5 ± 2.6 nm) by dehydration-rehydration technique. With extrusion technique, the size of 177 ± 6.5 nm was obtained without any effect on encapsulation efficiency. The EF24-liposomes were evaluated for anti-proliferative activity in lung adenocarcinoma H441 and prostate cancer PC-3 cells. The EF24-liposomes demonstrated anti-proliferative activity superior to that of plain EF24 at 10 μM dose. When injected in rats, the Tc-99m-labeled EF24-liposomes cleared from blood with an α-t(1/2) of 21.4 min and β-t(1/2) of 397 min. Tissue radioactivity counting upon necropsy showed that the majority of clearance was due to the uptake in liver and spleen. The results suggest that using "drug-in-CD-in liposome" approach is a feasible strategy to formulate an effective parenteral preparation of EF24. In vitro studies show that the liposomal EF24 remains anti-proliferative, while presenting an opportunity to image its biodistribution.

A new methodology to preserve the original proportion and integrity of cell-free fetal DNA in maternal plasma during sample processing and storage

OBJECTIVE

To develop a standardized blood collection device that preserves fetal cell-free DNA and minimizes the cell-free DNA background in maternal plasma.

METHODS

Blood samples were drawn from healthy pregnant donors into K(3)EDTA (BD vacutainer) and Cell-free DNA BCT tubes (Streck, Inc.) and kept at ambient temperature. Plasma was separated by centrifugation and cell-free DNA was extracted. Cell-free DNA from plasma was quantified by quantitative real-time polymerase chain reaction.

RESULTS

Blood drawn into Cell-free DNA BCT tubes showed no change in the original proportion of fetal cell-free DNA during a 14-day storage period at ambient temperature. Conversely, maternal blood drawn into K(3)EDTA tubes showed a steady reduction in the original proportion of fetal cell-free DNA over the same time period. Using maternal plasma stored in Cell-free DNA BCT tubes for 14 days, fetal cell-free DNA was amplified 80-fold using whole genome amplification (WGA).

CONCLUSION

Using Streck's Cell-free DNA BCT tubes, it is possible to preserve the original proportion of fetal cell-free DNA for extended times as well as minimize the post-sampling maternal cell-free DNA background. Preserved in this way, fetal cell-free DNA can be amplified by WGA technology to be used in prenatal diagnostic tests.

Accuracy of digitization of bony landmarks for measuring change in scapular attitude

Digitizing bony landmarks is a common technique used to measure scapular position, but it has not been validated against a gold standard. The aim of this study was to determine the accuracy of this technique for four physiological arm movements using optoelectronic markers mounted on scapular bone pins as a gold standard. Eight subjects had bone pins inserted into their lateral scapular spine. Three points were digitized on the scapula with an optoelectronic probe: the medial root of the scapular spine, the posterolateral corner of the acromion, and the inferior angle of the scapula. The four active movements tested in this study were glenohumeral abduction, glenohumeral horizontal adduction, hand behind back, and forward reaching. The three bony landmarks were digitized six times in three different positions for each movement. Data from one subject were rejected secondary to pin loosening. The overall position-specific r.m.s. errors ranged from 2.0° to 12.5°. The full abduction position had considerably higher r.m.s. errors than the other positions (posterior tipping, 12.5°; upward rotation, 7.3°; internal rotation, 12.0°). It appears that the digitization of bony landmarks may be a valid method for measuring changes in scapular attitude with the following caveats: the full abduction position has a high r.m.s. error, and small scapular motions have high percentage errors.

Photobacterium rosenbergii sp. nov. and Enterovibrio coralii sp. nov., vibrios associated with coral bleaching

Six new Vibrio-like isolates originating from different species of bleached and healthy corals around Magnetic Island (Australia) were investigated using a polyphasic approach. Phylogenetic analyses based on 16S rRNA, recA and rpoA gene sequences split the isolates in two new groups. Strains LMG 22223(T), LMG 22224, LMG 22225, LMG 22226 and LMG 22227 were phylogenetic neighbours of Photobacterium leiognathi LMG 4228(T) (95.6 % 16S rRNA gene sequence similarity), whereas strain LMG 22228(T) was related to Enterovibrio norvegicus LMG 19839(T) (95.5 % 16S rRNA gene sequence similarity). The two new groups can be distinguished from closely related species on the basis of several phenotypic features, including fermentation of d-mannitol, melibiose and sucrose, and utilization of different compounds as carbon sources, arginine dihydrolase activity, nitrate reduction, resistance to the vibriostatic agent O/129 and the presence of fatty acids 15 : 0 iso and 17 : 0 iso. The names Photobacterium rosenbergii sp. nov. (type strain LMG 22223(T)=CBMAI 622(T)=CC1(T)) and Enterovibrio coralii sp. nov. (type strain LMG 22228(T)=CBMAI 623(T)=CC17(T)) are proposed to accommodate these new isolates. The G+C contents of the DNA of the two type strains are respectively 47.6 and 48.2 mol%.

Chlamydia psittaci pneumonia presenting as acute generalised peritonism

A 63 year old man presented with the signs of acute generalised peritonism in the presence of a clear chest radiograph. At laparotomy no abnormal findings were noted. Further inquiries revealed a history of recent acquisition of budgerigars, over the following days the chest radiograph developed patchy opacification. Subsequently IgG immunofluorescence confirmed the diagnosis of Chlamydia psittaci. The presentation of psittacosis with gastrointestinal features is well recognised. This is believed to be the first account in the literature of a human case of Chl psittaci pneumonia presenting with acute generalised peritonism indicating an exploratory laparotomy. It is suggested that Chl psittaci pneumonia should be considered in the differential diagnosis of an acute abdomen in the presence of a history of exposure to psittacine birds.

West Nile virus in livestock and wildlife

WN virus is one of the most ubiquitous arboviruses occurring over a broad geographical range and in a wide diversity of vertebrate host and vector species. The virus appears to be maintained in endemic foci on the African continent and is transported annually to temperate climates to the north in Europe and to the south in South Africa. Reports of clinical disease due to natural WN virus infection in wild or domestic animals were much less common than reports of infection (virus isolation or antibody detection). Until recently, records of morbidity and mortality in wild birds were confined to a small number of cases and infections causing encephalitis, sometimes fatal, in horses were reported infrequently. In the period 1996-2001, there was an increase in outbreaks of illness due to WN virus in animals as well as humans. Within the traditional range of WN virus, encephalitis was reported in horses in Italy in 1998 and in France in 2000. The first report of disease and deaths caused by WN virus infection in domestic birds was reported in Israel in 1997-1999, involving hundreds of young geese. In 1999 WN virus reached North America and caused an outbreak of encephalitis in humans in the New York area at the same time as a number of cases of equine encephalitis and deaths in American crows and a variety of other bird species, both North American natives and exotics. Multi-state surveillance for WN virus has been in place since April 2000 and has resulted in the detection of WN virus in thousands of dead birds from an increasing number of species in North America, and also in several species of mammals. The surveillance system that has developed in North America because of the utility of testing dead birds for the rapid detection of WN virus presence has been a unique integration of public health and wildlife health agencies. It has been suggested that the recent upsurge in clinical WN virus infection in wild and domestic animals as well as in humans may be related to the emergence of one or more new strains of WN virus. Virus isolated in New York in 1999 was found to be identical to that from Israel. It was alarming for WN virus to so easily invade the United States and surprising that it became established so quickly in the temperature climate of New York. Its persistence and rapid expansion in the United States leave a number of unanswered questions. New disease characteristics and patterns have occurred and more are evolving as WN virus further invades the western hemisphere. Additional animal research is needed to answer these questions. Some of the research needs include bird migration as a mechanism of virus dispersal, vector and vertebrate host relationships, virus persistence mechanisms, laboratory diagnosis, viral pathogenesis, risk factor studies, vaccine development, and WN virus impact on wildlife (CDC 2001a). Determination of the primary reservoir host species that are involved in the epidemiology of WN virus and the suitable sentinel species for active surveillance are also important research areas.

Flavor threshold for acetaldehyde in milk, chocolate milk, and spring water using solid phase microextraction gas chromatography for quantification

The detection threshold of acetaldehyde was determined on whole, lowfat, and nonfat milks, chocolate-flavored milk, and spring water. Knowledge of the acetaldehyde threshold is important because acetaldehyde forms in milk during storage as a result of light oxidation. It is also a degradation product of poly(ethylene terephthalate) during melt processing, a relatively new packaging choice for milk and water. There was no significant difference in the acetaldehyde threshold in milk of various fat contents, with thresholds ranging from 3939 to 4040 ppb. Chocolate-flavored milk and spring water showed thresholds of 10048 and 167 ppb, respectively, which compares favorably with previous studies. Solid phase microextraction (SPME) was verified as an effective method for the recovery of acetaldehyde in all media with detection levels as low as 200 and 20 ppb in milk and water, respectively, when using a polydimethyl siloxane/Carboxen SPME fiber in static headspace at 45 degrees C for 15 min.

A retrospective cohort study of post mastectomy pain syndrome

Post mastectomy pain syndrome is a condition which can occur following breast surgery and has until recently been regarded as uncommon. Recent reports have suggested that it may affect 20% or more of women following mastectomy. The symptoms are distressing and may be difficult to treat however treatment for neuropathic pain can be successful. This paper reports a retrospective cohort of consecutive mastectomy cases over a six year period in one region of whom 511 survivors were traced and eligible for survey. A total of 408 completed a questionnaire survey which revealed that 175 (43%) had ever suffered from postmastectomy pain syndrome and 119 (29%) reported current symptoms although the majority were decreasing in intensity. A striking finding was the very high cumulative prevalence in younger women (65%) decreasing to 26% in the over 70 year group. The details of the onset, frequency and intensity of symptoms are described along with their natural history. The age effect on the frequency of the syndrome influences the marital status, employment status, housing, and educational status of those who report typical symptoms. Body weight and height are also associated with the frequency of post mastectomy pain syndrome. Relationship between the frequency of post mastectomy pain syndrome and radiotherapy, chemotherapy and the use of tamoxifen are difficult to unravel because of the combinations of pre and post operative treatments received confounded by age. The implications of a much higher frequency of post mastectomy pain are discussed with regard to management and counselling. The high frequency of the syndrome in the younger women is important and possible explanations are explored.

Trends in cervical cancer mortality in South Africa

BACKGROUND

Cervical cancer is an important cause of death throughout the world, especially in less developed countries. Reports of trends in cervical cancer mortality from less developed countries have been limited by poor data quality and inaccurate population estimates. This paper examines trends in cervical cancer mortality in South Africa from 1949 to 1990 and discusses the impact of cytology screening on these trends.

METHODS

Analysis of national mortality statistics and reconstructed population data.

RESULTS

The age-standardized mortality rates for Whites declined after the mid 1960s, while that for Coloureds rose, particularly before the 1970s. These trends were affected predominantly by trends among women in the 35-64 age range.

CONCLUSIONS

The pattern of mortality in successive birth cohorts for Whites is consistent with a reduction in age-specific mortality following the advent of cytological screening. The same pattern is not evident in trends for Coloureds, among whom screening has apparently had a minor impact if any at all. The apparent lack of impact of screening in those groups of women most at risk of cervical cancer lends weight to demands for the implementation of equitable and rational screening programmes for cervical cancer in South Africa and internationally.

Surveillance for equity in cervical cytology screening

BACKGROUND

The opportunistic basis on which screening has been conducted in South Africa has resulted in multiple rescreening of a small proportion of the population (which excludes most women at high risk) and low population coverage. There has consequently been a failure of screening to impact on the incidence of cervical cancer in most of the population.

AIM

To propose the use of the ratio of smears showing cervical intra-epithelial neoplasia (CIN)III: smears showing signs of malignancy as an indicator for the surveillance of equity in cervical cytology screening, and to apply this indicator to an area of the Western Cape of South Africa.

RESULTS

Marked inequity in screening is demonstrated between metropolitan and non-metropolitan area, and between different non-metropolitan districts. Inequity in screening between different age groups of women is also found, and this is associated with an inappropriately young age distribution of screening activity.

CONCLUSIONS

The application of this indicator in the routine surveillance of screening activity may be useful in monitoring progress towards the implementation of more equitable screening programmes, and the validity of the indicator should be tested in other settings.

Ouabain production by cultured adrenal cells

The adrenal cortex releases a sodium pump inhibitor. The present studies tested whether this material was endogenous and identical to ouabain by 1) studying the production of ouabain in long term cultures of adrenocortical cells, 2) seeking evidence that ouabain might be taken up from exogenous sources by adrenocortical cells, 3) examining the release of adrenocortical cells loaded with exogenous ouabain, 4) attempting to stimulate ouabain steroidogenesis in cultured adrenocortical cells, and 5) performing further chemical analysis on ouabain immunoreactivity released by cultured adrenocortical cells. Our results indicate that ouabain immunoreactivity is present in conditioned medium from both murine Y-1 adrenocortical cultures and primary bovine adrenocortical cell (BAC) cultures. We also found that BACs bind and internalize [3H]ouabain. Bound [3H]ouabain is released from BACs by both receptor dissociation and cytoplasmic release of internalized [3H]ouabain. Only one isoform of membrane sodium, potassium-adenosine triphosphatase, alpha 1, was expressed in the adrenal. Authentic ouabain was not metabolized during membrane binding or while present intracellularly. Stimulation of steroidogenesis in Y-1 and BAC with 22R-hydroxycholesterol and 25-hydroxycholesterol was performed and confirmed increased steroidogenesis; however, there was no effect on ouabain immunoreactivity content or release. Comparison of the ouabain binding density in cultured BAC, hepatoma cells, and 3T3 fibroblasts indicated that adrenocortical cells have a high ouabain-binding capacity. HPLC studies of the ouabain immunoreactivity released by bovine adrenocortical cells indicated that essentially no authentic ouabain was secreted. The present studies confirm that both BAC and Y-1 cultures release a ouabain-like material that differs in structure from authentic plant ouabain and is not a product of cholesterol side-chain cleavage.

A recent measles outbreak in Arkansas

On a worldwide level, measles is a common infection, especially in developing countries. In the United States, however, the disease has become very uncommon secondary to the widespread use of immunizations. Because of this, many physicians have not had measles themselves, nor have they treated patients for the infection. This relative rarity may delay diagnosis and the institution of appropriate infection control measures, thus resulting in increased numbers of exposed persons. Until measles is eradicated, measures to ensure appropriate immunization and control outbreaks are essential. A recent small outbreak in Arkansas is reported here along with a review of the disease and the measures to control outbreaks.

Analysis of the neurotoxic plasticizer n-butylbenzenesulfonamide by gas chromatography combined with accurate mass selected ion monitoring

The plasticizer, n-butylbenzenesulfonamide (NBBS), is reported to be neurotoxic when inoculated intracisternally or intraperitoneally into rabbits. Because NBBS is commonly used in the production of polyamide (nylon) plastics and is soluble in water, the disposal of NBBS-containing plastics in landfill sites could result in NBBS appearing in the leachate. Further, NBBS could also be leached from packaging into their contents. To allow us to examine the risks posed by NBBS in the environment, we have developed a quantitative assay for this compound. The assay employs a one-step extraction into dichloromethane followed by gas chromatography with accurate mass selected ion recording. The assay incorporates [13C6]NBBS as an internal standard to allow precise quantitation, and four separate ion chromatograms are recorded. NBBS was found in some Australian domestic solidwaste landfill leachate (from less than 0.3 to 94.6 ng/mL), but ground water in the vicinity of a landfill had only trace quantities of NBBS. NBBS was also quantitated in some bottled and cask wines, and levels varied from not detected to 2.17 ng/mL (n = 14). Additional studies are required to assess the public health risks associated with the use of NBBS as a plasticizer.

Workplace compliance with a no-smoking law: a randomized community intervention trial

BACKGROUND

Compliance with state and local laws restricting smoking in public places and workplaces has not been systematically evaluated.

METHODS

We assessed workplace compliance with a comprehensive no-smoking law adopted in Brookline, Mass, and tested whether mailing information to businesses increased awareness of and compliance with the law. We conducted a random sample telephone survey of 299 businesses (87% response rate). Self-reported compliance was validated by direct observations.

RESULTS

One year after its adoption, the law was popular with businesses. The prevalence of smoking restrictions, smoking policies, and no-smoking signs was 80%, 59%, and 40%, respectively. One third of businesses banned smoking. Full compliance with the law was low, however, because few businesses posted a copy of their smoking policy as required. The mailing increased employers' awareness of the law. Employers sent the mailing also reported better compliance, but this was not confirmed by direct observations.

CONCLUSIONS

The law was popular and contributed to a high prevalence of workplace smoking restrictions. Different interpretations of the law by policymakers and businesses seemed to explain why formal compliance was low. The mailing increased awareness of, but not compliance with, the law.

Morbidity patterns from general practice in Cape Town. A pilot study

A pilot survey of morbidity patterns reflected in general practice was undertaken by a panel of physicians in Cape Town during 1984-1985. Acute upper respiratory tract infections, bronchitis and bronchiolitis were the commonest reasons for contact. A definite pattern of contacts by day of week was noted. The age distribution of the contacts closely matched that of the suburb in which the practice was situated.