ESTIMATION OF BLOOD VOLUME FROM CHANGE IN BLOOD SPECIFIC GRAVITY FOLLOWING A PLASMA INFUSION

Assessment of venous hemodynamics and volume homeostasis during pregnancy: recommendations of the International Working Group on Maternal Hemodynamics

Venous hemodynamics and volume homeostasis are important aspects of cardiovascular physiology. However, today their relevance is still very much underappreciated. Their most important role is maintenance and control of venous return and, as such, cardiac output. A high-flow/low-resistance circulation, remaining constant under physiological circumstances, is mandatory for an uncomplicated course of pregnancy. In this article, characteristics of normal and abnormal venous and volume regulating functions are discussed with respect to normal and pathologic outcomes of pregnancy, and current (non-invasive) methods to assess these functions are summarized. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

Novel Structural Modification Based on Evans Blue Dye to Improve Pharmacokinetics of a Somastostatin-Receptor-Based Theranostic Agent

The development of somastatin (SS) peptide analogues for the detection and treatment of neuroendocrine tumors has been successful with the recent FDA approval of ⁶⁸Ga-DOTA-TATE and ¹⁷⁷Lu-DOTA-TATE. The structure of these peptide constructs contains the peptide binding motif that binds to the receptor with high affinity, a chelator to complex the radioactive metal, and a linker between the peptide and chelator. However, these constructs suffer from rapid blood clearance, which limits their tumor uptake. In this study, this design has been further improved by incorporating a modification to control the in vivo pharmacokinetics. Adding a truncated Evans Blue (EB) dye molecule into the construct provides a prolonged half-life in blood as a result of its low micromolar affinity to albumin. We compared ¹⁷⁷Lu-DOTA-TATE to the modified ¹⁷⁷Lu Evans Blue compound (¹⁷⁷Lu-DMEB-TATE), in vitro and in vivo in mice bearing A427-7 xenografts. The tumor uptake of ¹⁷⁷Lu-DMEB-TATE was significantly greater than the uptake of ¹⁷⁷Lu-DOTA-TATE in the biodistribution and SPECT-imaging studies. The therapeutic effect of the ¹⁷⁷Lu-DMEB-TATE construct was superior to the that of the ¹⁷⁷Lu-DOTA-TATE construct at the doses evaluated.

In Vivo Labeling of Serum Albumin for PET

The purpose of this study was to develop a novel in vivo albumin-labeling method to allow PET of cardiac function after myocardial infarction and vascular leakage and increased permeability in inflammatory diseases and malignant tumors.

METHODS

To label albumin in vivo, we synthesized a NOTA (1,4,7-triazacyclononane-N,N',N″-triacetic acid)-conjugated truncated form of Evans blue (NEB). (18)F labeling was achieved by the formation of an (18)F-aluminum fluoride ((18)F-AlF) complex, and (64)Cu labeling was obtained by a standard chelation method. Sixty-minute dynamic PET imaging was performed on normal mice to evaluate the distribution of (18)F-AlF-NEB, which was compared with in vitro-labeled mouse serum albumin ((18)F-fluorobenzyl-MSA). Electrocardiography-gated PET imaging was performed in a mouse model of myocardial infarction. Both dynamic and static PET scans were obtained in a mouse inflammation model induced by local injection of turpentine to evaluate vascular leakage. Tumor permeability was studied by dynamic and late-point static PET using (64)Cu-NEB in a UM-22B xenograft model.

RESULTS

NEB was successfully synthesized, and (18)F labeling including work-up took about 20-30 min, with a radiochemical purity greater than 95% without the need for high-performance liquid chromatography purification. Most of the radioactivity was retained in the circulation system at 60 min after injection (26.35 ± 1.52 percentage injected dose per gram [%ID/g]). With electrocardiography-gated PET, ventricles of the heart and major arteries were clearly visualized. The myocardial infarction mice showed much lower left ventricular ejection fraction than the control mice. Inflammatory muscles showed significantly higher tracer accumulation than the contralateral healthy ones. UM-22B tumor uptake of (64)Cu-NEB gradually increased with time (5.73 ± 1.11 %ID/g at 1 h and 8.03 ± 0.77 %ID/g at 2 h after injection).

CONCLUSION

The distribution and local accumulation of serum albumin can be noninvasively visualized and quantified by (18)F-AlF-NEB and (64)Cu-NEB PET. The simple labeling and broad applications make these imaging probes attractive for clinical translation.

The determination of the concentration of the dye T-1824 in normal and lipemic plasmas

A method is presented for estimating the concentration of T-1824 in lipemic plasma. The plasma is mixed with acetone, which precipitates the proteins, dissolves or precipitates the lipids, and yields a clear solution for photometric measurement of the dye. The method is not sensitive to changes in the degree of lipemia and is relatively insensitive to hemolysis.

A legacy in 20th-century medicine: Robert Allan Phillips and the taming of cholera

The legacy of Captain Robert Allan Phillips (1906-1976) was to establish effective, evidence-based rehydration methods for the treatment of cholera. As a Navy Lieutenant at the Rockefeller Institute for Medical Research (New York, New York) during World War II, Phillips developed a field method for the rapid assessment of fluid loss in wounded servicemen. After the war, he championed the establishment of United States Naval Medical Research Unit (NAMRU)-3 (Cairo; 1946) and NAMRU-2 (Taipei; 1955), serving at the helm of both units. Phillips embarked on cholera studies during the 1947 Egyptian cholera epidemic and brought them to maturity at NAMRU-2 (1958-1965), elucidating the pathophysiologic derangements induced by cholera and developing highly efficacious methods of intravenous rehydration. His conception of a simpler cholera treatment was realized in the late 1960s with the development of glucose-based oral rehydration therapy, a monumental breakthrough to which many other investigators made vital contributions. Today, these simple advances have been integrated into everyday medical practice across the globe, saving millions of lives annually.