Potential Dosimetric Predictors of Patient-Reported Quality of Life for Head and Neck Cancer Following Chemoradiation IMRT

PURPOSE/OBJECTIVE(S)

This study aims to identify both acute and late patient patient-reported salivary quality of life outcomes in patients with head and neck cancer treated with chemoradiation therapy on a prospective trial.

MATERIALS/METHODS

A cohort of 40 patients with head and neck cancers were included in the study. All patients underwent concurrent chemoradiation therapy using IMRT delivery (1 patient on one Linac, 24 patients on a different Linac, and 15 on a helical delivery machine). All patients were asked to complete the University of Washington Quality of Life (UOW-QOL) questionnaire at baseline, immediately after treatment, as well as at 1 month, 3 months, 6 months, 12 month and 18 months post-treatment. For the salivary quality of life (QOL) outcome scores, the possible responses were scored on a discreet scale of 100, 70, 30, and 0, with 100 as normal and 0 as dysfunctional. Dosimetric endpoints achieved based on the treatment plan, such as maximum/mean/minimum doses, V30 (percent volume receiving 30 Gy dose), and Dy (dose received to y percent volume) were collected for the bilateral salivary glands, bilateral temporomandibular joint and bilateral submandibular glands. The associations between these dosimetric parameters and the corresponding salivary QOL scores at each time point were analyzed. A Wilcoxon test was performed to identify any differences in the dosimetry and salivary QOL scores among the four different responses.

RESULTS

At short-term follow-up including 1- and 6-month, the distribution of the mean dose received by the right parotid was significantly different between the patients that reported a salivary QOL score of 30 and those that reported 100, with p-values of 0.007 for the 1-month comparison and 0.006 for the 6-month comparison. This was also seen for the V30, with p-values of 0.027 for the 1-month comparison and 0.013 for the 6-month comparison. At 3 months, the maximum dose received by the left temporomandibular joint was significantly different between the patients that reported 30 and those that reported 70, with a p-value of 0.038. At 6 months, the average dose distribution of the right submandibular gland received between the patients that reported a score of 30 and 100 was also significantly different, with a p-value of 0.006. At the long-term follow-up time points of 12 and 18 months, no significant differences were found.

CONCLUSION

The significant differences seen in the data suggest that the dosimetry may have effects on patient reported salivary QOL at short-term follow-up but not long-term. This provides a new perspective into how a patient's QOL over a period of time could be affected by the amount of dose to critical organs. These results also serve as the basis for further investigation into the actual delivered dose, which could differ from the planned dose due to daily anatomic changes over the course of head and neck radiotherapy delivery. These daily volumetric and dosimetric changes may guide early adaptive treatment to improve patient-reported QOL outcomes.

Human JAK1 gain of function causes dysregulated myelopoeisis and severe allergic inflammation

Primary atopic disorders are a group of inborn errors of immunity that skew the immune system toward severe allergic disease. Defining the biology underlying these extreme monogenic phenotypes reveals shared mechanisms underlying common polygenic allergic disease and identifies potential drug targets. Germline gain-of-function (GOF) variants in JAK1 are a cause of severe atopy and eosinophilia. Modeling the JAK1GOF (p.A634D) variant in both zebrafish and human induced pluripotent stem cells (iPSCs) revealed enhanced myelopoiesis. RNA-Seq of JAK1GOF human whole blood, iPSCs, and transgenic zebrafish revealed a shared core set of dysregulated genes involved in IL-4, IL-13, and IFN signaling. Immunophenotypic and transcriptomic analysis of patients carrying a JAK1GOF variant revealed marked Th cell skewing. Moreover, long-term ruxolitinib treatment of 2 children carrying the JAK1GOF (p.A634D) variant remarkably improved their growth, eosinophilia, and clinical features of allergic inflammation. This work highlights the role of JAK1 signaling in atopic immune dysregulation and the clinical impact of JAK1/2 inhibition in treating eosinophilic and allergic disease.

Social and structural factors associated with substance use within the support network of adults living in precarious housing in a socially marginalized neighborhood of Vancouver, Canada

BACKGROUND

The structure of a social network as well as peer behaviours are thought to affect personal substance use. Where substance use may create health risks, understanding the contribution of social networks to substance use may be valuable for the design and implementation of harm reduction or other interventions. We examined the social support network of people living in precarious housing in a socially marginalized neighborhood of Vancouver, and analysed associations between social network structure, personal substance use, and supporters' substance use.

METHODS

An ongoing, longitudinal study recruited 246 participants from four single room occupancy hotels, with 201 providing social network information aligned with a 6-month observation period. Use of tobacco, alcohol, cannabis, cocaine (crack and powder), methamphetamine, and heroin was recorded at monthly visits. Ego- and graph-level measures were calculated; the dispersion and prevalence of substances in the network was described. Logistic mixed effects models were used to estimate the association between ego substance use and peer substance use. Permutation analysis was done to test for randomness of substance use dispersion on the social network.

RESULTS

The network topology corresponded to residence (Hotel) with two clusters differing in demographic characteristics (Cluster 1 -Hotel A: 94% of members, Cluster 2 -Hotel B: 95% of members). Dispersion of substance use across the network demonstrated differences according to network topology and specific substance. Methamphetamine use (overall 12%) was almost entirely limited to Cluster 1, and absent from Cluster 2. Different patterns were observed for other substances. Overall, ego substance use did not differ over the six-month period of observation. Ego heroin, cannabis, or crack cocaine use was associated with alter use of the same substances. Ego methamphetamine, powder cocaine, or alcohol use was not associated with alter use, with the exception for methamphetamine in a densely using part of the network. For alters using multiple substances, cannabis use was associated with lower ego heroin use, and lower ego crack cocaine use. Permutation analysis also provided evidence that dispersion of substance use, and the association between ego and alter use was not random for all substances.

CONCLUSIONS

In a socially marginalized neighborhood, social network topology was strongly influenced by residence, and in turn was associated with type(s) of substance use. Associations between personal use and supporter's use of a substance differed across substances. These complex associations may merit consideration in the design of interventions to reduce risk and harms associated with substance use in people living in precarious housing.

Growth scaling for the early dynamics of HIV/AIDS epidemics in Brazil and the influence of socio-demographic factors

The early dynamics of an infectious disease outbreak can be affected by various factors including the transmission mode of the disease and host-specific factors. While recent works have highlighted the presence of sub-exponential growth patterns during the early phase of epidemics, empirical studies examining the contribution of different factors to early epidemic growth dynamics are lacking. Here we aim to characterize and explain the early incidence growth patterns of local HIV/AIDS epidemics in Brazil as a function of socio-demographic factors. For this purpose, we accessed annual AIDS incidence series and state-level socio-demographic variables from publicly available databases. To characterize the early growth dynamics of the HIV/AIDS epidemic, we employed the generalized-growth model to estimate with quantified uncertainty the scaling of growth parameter (p) which captures growth patterns ranging from constant incidence (p=0) to sub-exponential (0 < p < 1) and exponential growth dynamics (p=1) at three spatial scales: national, regional, and state levels. We evaluated the relationship between socio-demographic variables and epidemic growth patterns across 27 Brazilian states using mixed-effect regression analyses. We found wide variation in the early dynamics of the AIDS epidemic in Brazil, displaying sub-exponential growth patterns with the p parameter estimated substantially below 1.0. The mean p was estimated to be 0.81 at the national level, with a range of 0.72-0.85 at the regional level, and a range of 0.28-0.96 at the state level. Our findings support the notion that socio-demographic factors contribute to shaping the early growth dynamics of the epidemic at the local level. Gini index and socio-demographic index were negatively associated with the parameter p, whereas urbanicity was positively associated with p_. The results could have theoretical significance in understanding differences in growth scaling across different sexually transmitted disease systems, and have public health implications to guide control.

A randomised controlled trial of cemented and cementless femoral components for metal-on-metal hip resurfacing: a bone mineral density study

The primary purpose of this study of metal-on-metal (MoM) hip resurfacing was to compare the effect of using a cementless or cemented femoral component on the subsequent bone mineral density (BMD) of the femoral neck. This was a single-centre, prospective, double-blinded control trial which randomised 120 patients (105 men and 15 women) with a mean age of 49.4 years (21 to 68) to receive either a cemented or cementless femoral component. Follow-up was to two years. Outcome measures included total and six-point region-of-interest BMD of the femoral neck, radiological measurements of acetabular inclination, neck-shaft and stem-shaft angles, and functional outcome scores including the Harris hip score, the Western Ontario and McMaster Universities Osteoarthritis Index and the University of California at Los Angeles activity scale. In total, 17 patients were lost to follow-up leaving 103 patients at two years. There were no revisions in the cementless group and three revisions (5%) in the cemented group (two because of hip pain and one for pseudotumour). The total BMD was significantly higher in the cementless group at six months (p < 0.001) and one year (p = 0.01) than in the cemented group, although there was a loss of statistical significance in the difference at two years (p = 0.155). All patient outcomes improved significantly: there were no significant differences between the two groups. The results show better preservation of femoral neck BMD with a cementless femoral component after two years of follow-up. Further investigation is needed to establish whether this translates into improved survivorship.

Peri-acetabular bone mineral densityin total hip replacement

OBJECTIVES

To quantify and compare peri-acetabular bone mineral density (BMD) between a monoblock acetabular component using a metal-on-metal (MoM) bearing and a modular titanium shell with a polyethylene (PE) insert. The secondary outcome was to measure patient-reported clinical function.

METHODS

A total of 50 patients (25 per group) were randomised to MoM or metal-on-polyethlene (MoP). There were 27 women (11 MoM) and 23 men (14 MoM) with a mean age of 61.6 years (47.7 to 73.2). Measurements of peri-prosthetic acetabular and contralateral hip (covariate) BMD were performed at baseline and at one and two years' follow-up. The Western Ontario and McMaster Universities osteoarthritis index (WOMAC), University of California, Los Angeles (UCLA) activity score, Harris hip score, and RAND-36 were also completed at these intervals.

RESULTS

At two years, only zone 1 showed a loss in BMD (-2.5%) in MoM group compared with a gain in the MoP group (+2.2%). Zone 2 showed loss in both groups (-2.2% for MoM; -3.9% for MoP) and zones 3 and 4 a gain in both groups (+0.1% for MoM; +3.3% for MoP). No other between-group differences were detected. When adjusting for BMD of the contralateral hip, no differences in BMD were observed. The only significant differences in functional scores at two years were higher UCLA activity (7.3 (sd 1.2) vs 6.1 (sd 1.5); p = 0.01) and RAND-36 physical function (82.1 (sd 13.0) vs 64.5 (sd 26.4); p = 0.02) for MoM bearings versus MoP. One revision was performed in the MoM group, for aseptic acetabular loosening at 11 months.

CONCLUSIONS

When controlling for systemic BMD, there were no significant differences between MoM and MoP groups in peri-acetabular BMD. However, increasing reports of adverse tissue reactions with large head MoM THR have restricted the use of the monoblock acetabular component to resurfacing only.

EvoPipes.net: Bioinformatic Tools for Ecological and Evolutionary Genomics

Recent increases in the production of genomic data are yielding new opportunities and challenges for biologists. Among the chief problems posed by next-generation sequencing are assembly and analyses of these large data sets. Here we present an online server, http://EvoPipes.net, that provides access to a wide range of tools for bioinformatic analyses of genomic data oriented for ecological and evolutionary biologists. The EvoPipes.net server includes a basic tool kit for analyses of genomic data including a next-generation sequence cleaning pipeline (SnoWhite), scaffolded assembly software (SCARF), a reciprocal best-blast hit ortholog pipeline (RBH Orthologs), a pipeline for reference protein-based translation and identification of reading frame in transcriptome and genomic DNA (TransPipe), a pipeline to identify gene families and summarize the history of gene duplications (DupPipe), and a tool for developing SSRs or microsatellites from a transcriptome or genomic coding sequence collection (findSSR). EvoPipes.net also provides links to other software developed for evolutionary and ecological genomics, including chromEvol and NU-IN, as well as a forum for discussions of issues relating to genomic analyses and interpretation of results. Overall, these applications provide a basic bioinformatic tool kit that will enable ecologists and evolutionary biologists with relatively little experience and computational resources to take advantage of the opportunities provided by next-generation sequencing in their systems.

Environmental enrichment selectively increases glutamatergic responses in layer II/III of the auditory cortex of the rat

Prolonged exposure to environmental enrichment (EE) induces behavioral adaptation accompanied by detectable morphological and physiological changes. Auditory EE is associated with an increased auditory evoked potential (AEP) and increased auditory gating in the primary auditory cortex. We sought physiological correlates to such changes by comparing synaptic currents in control vs. EE-raised rats, in a primary auditory cortex (AI) slice preparation. Pharmacologically isolated glutamatergic or GABA(A)-receptor-mediated currents were measured using perforated patch whole-cell recordings. Glutamatergic AMPA receptor (AMPAR)-mediated excitatory postsynaptic currents (EPSCs) displayed a large amplitude increase (64+/-11% in EE vs. control) accompanied by a rise-time decrease (-29+/-6% in EE vs. control) and decrease in pair pulse ratio in layer II/III but not in layer V. Changes in glutamatergic signaling were not associated with changes in the ratio between N-methyl-D aspartate-receptor (NMDAR)-mediated vs. AMPAR-mediated components, in amplitude or pair pulse ratio of GABAergic transmission, or in passive neuronal properties. A realistic computational model was used for integrating in vivo and in vitro results, and for determining how EE synapses correct for phase error of the inputs. We found that EE not only increases the mean firing frequency of the responses, but also improves the robustness of auditory processing by decreasing the dependence of the output firing on the phase difference of the input signals. We conclude that behavioral and electrophysiological differences detected in vivo in rats exposed to an auditory EE are accompanied and possibly caused by selective changes in cortical excitatory transmission. Our data suggest that auditory EE selectively enhances excitatory glutamatergic synaptic transmission in layer II/III without greatly altering inhibitory GABAergic transmission.

Accounting for radioactivity before and after nebulization of tobramycin to insure accuracy of quantification of lung deposition

The ability to predict drug deposition of inhaled drugs used in cystic fibrosis (CF) is important if there is a need to target specific doses of drug to the lungs of individual patients. The gold standard of measuring pulmonary deposition is the quantification of an aerosolized radiolabel either mixed with the drug solution or tagged directly to the compound of interest. Accuracy of the quantification could be assured if there is agreement between the amount of radioactivity before and after administration. Before administration, the radiolabel is concentrated in the well of the nebulizer, whereas after administration, it is distributed throughout the nebulizer, the expiratory filter and connectors, and the upper airway, stomach, trachea, and lung. Not only is the geometry of the distribution that is presented to the gamma camera different, but there are different attenuation factors for the various body tissues. The primary aim of this study was to evaluate the accuracy of the quantification of deposition. Secondary goals were to compare in vitro nebulizer performance with that measured in vivo during the deposition study. Eighty milligrams of tobramycin and technetium bound to human serum albumin was administered to 10 normal adults using a Pari LC Jet Plus (Pari Respiratory Equipment, Inc., Richmond, VA) breath-enhanced nebulizer. Techniques were developed that allowed for the accounting of 99 +/- 2% of the initial radioactivity. The fraction of the rate of lung deposition to total body deposition was the in vivo respirable fraction (0.62 +/- 0.07), which closely agreed with in vitro measurements of respirable fraction (0.62 +/- 0.04). Drug output measured from the change in weight and concentration in the nebulizer systematically overestimated drug output measured by the deposition study. The results indicate that 11.8 of the initial 80 mg would be deposited in the lungs. This technique could be adapted to accurately quantify the amount of deposition on any inhaled therapeutic agent, but caution must be used when extrapolating performance of a nebulizer on the bench to expected deposition in patients.

Do saw palmetto extracts block human alpha1-adrenoceptor subtypes in vivo?

BACKGROUND

To test whether saw palmetto extracts, which act as alpha1-adrenoceptor antagonists in vitro, also do so in vivo in man.

METHODS

In a placebo-controlled, double-blind, four-way cross-over study 12 healthy young men were treated with three different saw palmetto extract preparations (320 mg o.d.) for 8 days each. On the last day, before and 2, 4 and 6 hr after drug intake blood pressure and heart rate were determined and blood samples obtained, which were used in an ex vivo radioreceptor assay with cloned human alpha1-adrenoceptor subtypes.

RESULTS

Saw palmetto extract treatment did not result in alpha1-adrenoceptor subtype occupancy in the radioreceptor assay. Although the saw palmetto extracts caused minor reductions of supine blood pressure, they did not affect blood pressure during orthostatic stress testing and did not alter heart rate under either condition. Moreover, plasma catecholamines remained largely unaltered.

CONCLUSIONS

Despite their alpha1-adrenoceptor antagonist effects in vitro, therapeutically used doses of saw palmetto extracts do not cause alpha1-adrenoceptor antagonism in man in vivo.

Vitamin E deficiency has different effects on brain and liver phospholipid hydroperoxide glutathione peroxidase activities in the rat

The effect of vitamin E deficiency on glutathione peroxidase activity (GPX) and on the activity of a selenoenzyme (phospholipid hydroperoxide glutathione peroxidase (PHGPX) was measured in rat brain and liver. In brain, the activity of both enzymes was in the same range in homogenate and in microsomes. In contrast, in liver homogenate, PHGPX activity was approximately 20 times lower than that of GPX. Very interestingly, PHGPX activity was significantly decreased in brain microsomes by vitamin E deficiency, but slightly significantly increased in liver microsomes. In contrast, GPX activity was not affected in brain by vitamin E deficiency, but was significantly lower in liver homogenate and microsomes. Thus, PHGPX activity is partially controlled by vitamin E in membranes, and PHGPX is probably an enzyme different from GPX.

Restricted unilateral Sydenham's chorea: reversible contralateral striatal hypermetabolism demonstrated on single photon emission computed tomographic scanning

Sydenham's chorea results from group A streptococcus infection and subsequent generation of antineuronal antibodies directed at the caudate nucleus and putamen. Predominantly bilateral, in up to 30% of cases the chorea can be unilaterally restricted. Imaging studies, both structural (magnetic resonance imaging) and functional (positron emission tomography), in patients with bilateral Sydenham's chorea have suggested reversible striatal abnormalities. Two patients with unilateral Sydenham's chorea are presented. Computed tomographic and magnetic resonance imaging were normal in both. However, hexamethylpropylenamine oxime single photon emission tomographic (HMPAO SPECT) studies demonstrated hypermetabolism in the contralateral basal ganglia. Resolution of symptoms in one of the patients coincided with normalization of the SPECT scan. Thus, unilateral striatal hypermetabolism appears to underlie the contralateral chorea observed. A SPECT scan probably should be included in the work-up of new-onset chorea.

Supranormal renographic differential renal function in congenital hydronephrosis: fact, not artifact

PURPOSE

Children with unilateral hydronephrosis, who had been prospectively examined with diethylenetriaminepentaacetic acid (DTPA) and dimercapto-succinic acid (DMSA) renography, were evaluated to determine whether supranormal renographic differential renal function exists.

MATERIALS AND METHODS

A total of 54 children with congenital single system hydronephrosis underwent abdominal ultrasound, voiding cystourethrogram, and DTPA and DMSA renal scans. None had abnormalities of the bladder or contralateral kidney. Differential renal function greater than 55% was defined as supranormal.

RESULTS

Of the 54 patients 15 (28%) with a median age of 4 months (range 0.5 to 66) were identified with supranormal renographic renal function on either DTPA or DMSA. Supranormal renographic renal function was detected by DMSA in 9 cases (mean 57+/-2%), DTPA in 8 (mean 58+/-2%) and both in 2 (mean 57+/-2%). Average function demonstrated in the 15 patients was 55+/-3% (range 51 to 62) with DMSA which was not different from that found with DTPA (mean 55+/-4%, range 46 to 61%). The kidneys with supranormal renographic renal function were significantly larger than hydronephrotic controls according to longitudinal parenchymal area on DMSA. Mean followup was 20 months for 13 patients, with 8 of 13 (62%) undergoing pyeloplasty. Followup DTPA renal scans available in 9 children revealed persistent supranormal function in 6, despite pyeloplasty in 3.

CONCLUSIONS

Supranormal renographic differential renal function does exist in congenital hydronephrosis and when found the kidneys are consistently enlarged. The position of supranormal renographic renal function in the management algorithm of hydronephrosis remains to be elucidated as it does not appear to be a benign prognostic factor.

NT-3-mediated TrkC receptor activation promotes proliferation and cell survival of rodent progenitor oligodendrocyte cells in vitro and in vivo

We have previously described the expression of a functional full-length trkC transcript for neurotrophin-3 (NT-3) receptor in oligodendroglia (OL) cells (Kumar and de Vellis, 1996). To date, the role of NT-3 and its signal transduction cascade in OL remains poorly defined. We report that the NT-3 responsive population of cells in the OL lineage are the progenitor cells and that the addition of NT-3 results in the autophosphorylation of p145TrkC. Furthermore, NT-3-mediated activation of p21ras and mitogen-activated protein kinase (MAPK), extracellular signal-regulated protein kinase2 (ERK2), were also observed in the progenitor OL cells. These protein tyrosine kinase (PTK)-induced responses were sensitive to the presence of K252a, an inhibitor for tyrosine kinase. We have determined that NT-3 promotes progenitor OL cell commitment to enter into S-phase of cell cycle to initiate DNA synthesis, in a manner similar to platelet-derived growth factor-AA (PDGF-AA). NT-3 thus plays a role in cell proliferation when present alone, while augmenting the proliferation capacity of PDGF-AA as indicated by the nuclear binding activity of the transcription factor, E2F-1. Both the initiation and progression of mitotic events were confirmed by the expression of c-myc and cdc2 in the presence of NT-3, PDGF-AA or NT-3 plus PDGF-AA. A cell survival assay examining interleukin 1-beta-converting enzyme (ICE)-like protease-mediated cleavage of poly (ADP-ribose) polymerase (PARP) revealed an increase in OL progenitor cell death in the absence of NT-3 or PDGF-AA. In corroboration with our in vitro studies, in vivo results show an increased expression of the progenitor OL cell marker, glycerol phosphate dehydrogenase (GPDH) within 48 hr following an intracranial injection of NT-3, PDGF-AA, or NT-3 plus PDGF-AA in PN4-5 rats. These novel findings suggest that PDGF-AA potentiates the OL progenitor cell's ability to enter into the S-phase of the cell cycle and that NT-3 can augment this activity. Furthermore, PDGF-AA and NT-3 can block ICE-like protease-mediated PARP fragmentation in progenitor OL cells. These results provide important information which further delineates the signal transduction cascades and the role of NT-3 and PDGF-AA on OL progenitor cells.

The captopril renogram: a new tool for diagnosing and predicting obstruction in childhood hydronephrosis

PURPOSE

We evaluated the difference in response patterns of captopril versus standard renography for assessing hydronephrosis due to suspected ureteropelvic and ureterovesical junction obstruction. This technique may identify hydronephrotic kidneys in which normal function is maintained by vasoactive compensatory mechanisms. Sustained obstruction may cause these mechanisms to fail, and expose the kidneys to permanent functional deterioration in the long term.

MATERIAL AND METHODS

We prospectively studied 15 boys and 8 girls with a mean age of 3.5 years with grades III to IV/IV hydronephrosis. Evaluations included renal sonography, standard diuretic and captopril renography, glomerular filtration rate, voiding cystography, serum creatinine, blood pressure, and urinalysis with culture and sensitivity. Obstruction was suspected at the ureteropelvic junction in 19 kidneys and at the ureterovesical junction in 9. We compared differential function values obtained by standard diuretic and captopril renography.

RESULTS

We observed certain patterns in response to captopril renography, including pattern 1--unilateral decrease in hydronephrotic kidney relative function in 5 of 23 cases, 2--bilateral decreased function in 2, 3--bilateral increased function in 4 and 4--no change in function in 12 on standard renography. When half-time was more than 20 minutes on standard diuretic renography in 8 cases, captopril renography showed an ipsilateral decrease and bilateral increase in glomerular filtration rate in 4 and 1, respectively, and no change in 3. In 12 of the 23 patients (52%) there was no difference in the results of captopril and diuretic renography as well as no change in differential function on standard diuretic renography during 1 1/2 years of observation. Surgical correction was performed in 4 patients in whom half-time was greater than 20 minutes and differential function was decreased on captopril renography.

CONCLUSIONS

Our preliminary study reveals that there may be a role for captopril renography for detecting renin-angiotensin system mediated compensatory mechanisms in obstructive uropathy. When such compensatory mechanisms are activated, they may be unmasked by captopril, producing 1 of 4 patterns on renography and glomerular filtration rate. Patterns may indicate different degrees of impending renal function impairment and, thus, they may become useful for determining the progression of injury, when present, and the appropriate timing of surgical intervention.

Possible role of the choroid plexus in the supply of brain tissue with polyunsaturated fatty acids

Delta-6 desaturase was measured in rat brain microvessels and choroid plexus by incubation in the presence of radioactive linoleic acid. Under our conditions, in 21-day-old animals, delta-6 desaturase was not detected in brain microvessels. In contrast, it was present in choroid plexus (about 21 pmol/min per mg protein). In comparison, the activity in brain was much lower (about 1 pmol/min per mg protein) and higher in liver (about 55 pmol/min per mg protein). Interestingly, during development the activity in choroid plexus peaked at day 6 after birth and declined slightly thereafter. The pattern of incorporation of linoleic acid radioactivity was not the same in choroid plexus and microvessels. These results show that delta-6 desaturase was not detected in brain microvessels but was present in choroid plexus.

Supine and prone SPECT Tc-99m MIBI myocardial perfusion imaging for dipyridamole studies

Aartifactual inferior wall defects of perfusion are a source of frequent concern during TI-201 exercise stress redistribution SPECT imaging in the supine position. These artifactual changes also affect Tc-99m sestamibi dipyridamole myocardial perfusion studies with supine SPECT yielding a specificity of only 58% for right coronary artery (RCA) disease. Complementary SPECT prone imaging will enhance this specificity for inferior wall abnormalities to 79% (P < 0.05) and is recommended for more accurate assessment of RCA stenosis, whether the patient challenge is pharmacological or by exercise.

Uptake of dietary RRR-alpha- and RRR-gamma-tocopherol by nervous tissues, liver and muscle in vitamin-E-deficient rats

The time course of RRR-alpha-tocopherol and RRR-gamma-tocopherol uptake by liver, muscle and selected nervous tissues was studied in vitamin-E-deficient rats fed diets containing either RRR-alpha-tocopherol or RRR-gamma-tocopherol over a 60 day period. Feeding rats with a RRR-alpha-tocopherol-supplemented diet induced in brain, cerebellum, sciatic endoneurium and muscle a marked and regular increase in alpha-tocopherol concentration. In addition, the tocopherol concentration in liver reached a plateau very rapidly. In contrast, feeding rats with a diet containing the same level of RRR-gamma-tocopherol induced a very small increase in gamma-tocopherol concentration in brain, cerebellum, sciatic endoneurium and muscle, no change in alpha-tocopherol concentration of brain and muscle and a slight but significant decrease in alpha-tocopherol concentration in sciatic endoneurium and cerebellum. These results indicate that when gamma-tocopherol was supplied continuously in the diet gamma-tocopherol accumulated significantly in the tissues but to a much lesser extent than when rats were fed with RRR-alpha-tocopherol. These results also show that in the tocopherol-deficient rat, gamma-tocopherol does not significantly affect the residual alpha-tocopherol concentrations in brain or cerebellum, except poorly in sciatic endoneurium.

Comparison of recovery of previously depressed hepatic delta 6 desaturase activity in adult and old rats

The ability to recover hepatic delta 6 desaturase (delta 6D) activity with linoleic acid as substrate was compared in adult and old rats. Male rats fed a diet deficient in alpha-linolenic acid were used either at 6 or 21 months. From these two ages onward, animals were fed a diet containing 10% fish oil for 3 months to reduce delta 6D activity. After this period, some of the animals were killed. The other animals were returned to the original diet deficient in alpha-linolenic acid. Fatty acid composition in liver and brain and hepatic delta 6D activity were analysed 3 and 7 days after the change in diet. When rats were fed the diet containing 10% fish oil, delta 6D activity was lower than in those fed the diet deficient in alpha-linolenic acid. The liver fatty acid composition was altered with disappearance of 22:5 n-6 and a decrease in 18:2 n-6, 20:4 n-6 and 22:4 n-6 accompanied by an increase in 20:5 n-3, 22:5 n-3 and 22:6 n-3. When rats were re-fed the original diet, delta 6D activity returned after 3 days to its initial level in the 9-month-old rats; in 24-month-old animals, recuperation was incomplete. The level of 20:4 n-6 and 18:2 n-6 increased in the liver concurrently with a decrease in levels of 20:5 n-3, 22:5 n-3 and 22:6 n-3. In both age groups, the brain fatty acid profile remained unchanged 7 days after returning to the diet deficient in alpha-linolenic acid.

Comparison of liver microsome enzyme and fatty acid composition recovery in adult and old rats deficient in 18:3n-3 refed a diet containing 18:3n-3

The effect of dietary n-3 deficiency on liver microsome enzymes activities and fatty acid composition was studied in adult (3 months old) and old rats (18 months old). At these two ages, deficient animals were refed with 18:3n-3 diet for 1 or 2 months and the recovery of these parameters was investigated. Cytochrome P 450 level was decreased by n-3 PUFA (Polyunsaturated fatty acid) deficiency. After refeeding, it returned to control values after 1 month. NADH-cytochrome b5 reductase activity was decreased, the activities of NADPH cytochrome c reductase, aminopyrine demethylase, aniline hydroxylase were also decreased, but in old rats they were increased by refeeding. N-3 PUFA deficiency caused a decrease of 18:2n-6 and 22:6n-3 and an increase in 20:4n-6, 22:5n-6 and 18:1n-9. After refeeding, in adult rats, the PUFA level remained lower; in old rats, the MUFA (Monounsaturated fatty acid) and PUFA levels returned to control values. Liver microsomal enzyme activities depend on the degree of unsaturation of fatty acids rather than the specific species of polyunsaturated fatty acids.

Pentoxifylline alone versus pentoxifylline combined with superoxide dismutase prolongs survival in a rat hemorrhagic shock model

Pentoxifylline (PTX) and superoxide dismutase (SOD) have each proven effective in improving survival when administered during resuscitation in animal models of hemorrhagic shock. This study was conducted to determine if PTX and SOD combined would have synergistic effectiveness in the treatment of hemorrhagic shock. Sprague-Dawley rats (n = 40) were phlebotomized at 25 ml/kg for 2 min, then subjected to a 45-min ischemic period, and resuscitated with lactated Ringer's solution (LR) (50 ml/kg) over 1 h. This model resulted in 70% mortality over 72 h when resuscitation was with LR alone. Animals were randomized into groups to receive one of the following agents during resuscitation: PTX in LR, SOD in LR, a combination of PTX and SOD in LR, or LR alone. PTX or SOD alone were effective in prolonging survival. However, the combination of PTX and SOD did not prolong survival above LR control.

Rate of alteration of hepatic mixed-function oxidase system in rats fed different dietary fats

Studies were carried out to evaluate and relate the rate of alteration in mixed-function oxidase system with the changes of the fatty acid composition of rat microsomes induced by different dietary lipids. Male weanling rats were fed from day 21 to 120 with a commercial rat diet or a semisynthetic diet containing no fat or 10% fat consisting of peanut-rapeseed oil, sunflower oil, or salmon oil. In rats fed a fat-free diet, the cytochrome P-450 concentration and aniline hydroxylase, aminopyrine N-demethylase, and NADPH-cytochrome-c reductase activities of liver microsomes at 120 days were, respectively, 26, 16, 10, and 24% lesser than those of rats fed the control diet. However, cytochrome b5 concentration and NADH-cytochrome-b5 reductase activity were, respectively, 33 and 43% higher than those of the control group at the same time. When rats were fed the sunflower oil diet, the cytochrome P-450 concentration and NADH-cytochrome-b5 reductase activity at 120 days were, respectively, 11 and 23% lesser than those of control group. But the cytochrome b5 concentration was 10% higher than that of the control group. In rats fed the fish oil diet, the cytochrome P-450 concentration and NADPH-cytochrome-c reductase, aniline hydroxylase, and aminopyrine N-demethylase activities at 120 days were, respectively, 30, 48, 41, and 31% higher than those of rats fed the control diet. These enzymes were correlated very well (0.84 < r < 0.93), P < 0.05 with dietary sigma polyunsaturated fatty acids (n-3).(ABSTRACT TRUNCATED AT 250 WORDS)

Alteration of delta-6 desaturase by vitamin E in rat brain and liver

delta-6 Desaturase, measured at substrate saturation using linoleic acid, was found to be increased by more than two-fold when the content of vitamin E in brain microsomal membrane suspension was increased (up to 7.5 micrograms/mg membrane protein, i.e. 100 micrograms/g tissue from which microsomes were prepared). In contrast, this activity was reduced by 25% in the liver. This raises the question of the multiple role of vitamin E in membranes, the control of membrane polyunsaturated fatty acids through synthesis, and their protection against peroxidation.

Influence of progressive and of transient hypoxia on upper airway resistance in normal humans

In order to evaluate the influence of hypoxia on upper airway patency, we measured the response of upper airway resistance (UAR) to progressive (P) normocapnic hypoxia (Rebuck's method) and transient (T) hypoxia (three to five breaths to 100% N2) in 11 normal men. Breath-by-breath inspiratory UAR was calculated at isoflow during exclusive nasal breathing. The UAR response to hypoxia was characterized by the changes in nasal resistance and pharyngeal resistance (PR) as a function of SaO2, mean inspiratory flow (VT/Tl), and changes in the end-expiratory lung volume (EELV) measured with an inductance vest. The ventilatory response to hypoxia was greater during T (-0.31 +/- 0.03 L/min/%SaO2; mean +/- SEM) than during P (-0.27 +/- 0.03 L/min/%SaO2, p = 0.05). UAR decreased as SaO2 decreased; this decrease was steeper during T than during P hypoxia (delta PR/%SaO2: 3.9 +/- 0.5 during P and 2.5 +/- 0.2 during T, p = 0.05). For the whole group, there was no difference in the slope of the decrease in UAR with increasing VT/Tl between the two hypoxic tests (delta PR/delta VT/Tl: -0.85 +/- 0.1 during P and -0.70 +/- 0.1 during T, p greater than 0.05). However, in four subjects, the slope of the relationship PR/VT/Tl during T remained steeper than during P. EELV increased as SaO2 decreased, with a greater increase during progressive than during transient hypoxia.(ABSTRACT TRUNCATED AT 250 WORDS)

Changes in upper airway resistance during progressive normocapnic hypoxia in normal men

The effects of normocapnic progressive hypoxia on nasal and pharyngeal resistances were evaluated in nine normal men. To calculate resistances, upper airway pressures were measured with two low-bias flow catheters; one was placed at the tip of the epiglottis and the other in the posterior nasopharynx, and we measured flow with a Fleish no. 3 pneumotachograph connected to a tightly fitting mask. Both resistances were obtained during a baseline period and during progressive normocapnic hypoxia achieved by a rebreathing method. We collected the breath-by-breath values of upper airway resistances, minute ventilation, O2 and CO2 fractions, arterial O2 saturation (SaO2), and changes in functional residual capacity (inductance vest). The central respiratory drive was evaluated by the mouth occlusion pressure 0.1 s after the onset of inspiration (P0.1), and breath-by-breath P0.1 values were estimated by intrapolation from the linear relationship between P0.1 and SaO2. In each subject both resistances decreased during the hypoxic test. The slope of the decrease in resistance with decreasing SaO2 (%baseline/%SaO2) was steeper for pharyngeal resistance than for nasal resistance [2.67 +/- 0.29 and 1.61 +/- 0.25 (SE), respectively; P less than 0.05]. The slope of the decrease in resistance with increasing P0.1 (%baseline/cmH2O) was -0.24 +/- 0.05 for nasal resistance and -0.39 +/- 0.07 for pharyngeal resistance (P less than 0.05). Functional residual capacity progressively increased during the test, but the decrease in resistance was greater than expected from an isolated increase in lung volume. We conclude that nasal and pharyngeal resistances decrease during progressive normocapnic hypoxia.(ABSTRACT TRUNCATED AT 250 WORDS)