A pharmacokinetic-pharmacodynamic (PKPD) model-based analysis of tedizolid against enterococci using the hollow-fibre infection model

BACKGROUND

Tedizolid is a novel oxazolidinone antibiotic. Considering the higher antibacterial effect in immunocompetent compared with immunosuppressed animals, it is not recommended in immunocompromised patients.

OBJECTIVES

In this study, we assessed the 'pure' pharmacokinetic-pharmacodynamic (PKPD) relationship for tedizolid against Enterococcus in the hollow-fibre infection model (HFIM).

METHODS

Unbound plasma concentration time profiles (200-5000 mg/day IV) were simulated in the HFIM over 120 h against an Enterococcus faecalis strain and two clinical isolates of Enterococcus faecium (VRE-vanB and VRE-vanA). Next, a PKPD model describing tedizolid efficacy against bacterial isolates was developed. A population PK model was linked to the developed PKPD model and utilized to predict the bacterial kinetics in plasma and in target tissues [adipose, muscle, epithelial lining fluid (ELF) and sputum] over 120 h of therapy.

RESULTS

The PKPD model adequately described the bacterial kill kinetics for all bacterial populations. At the human recommended dose of 200 mg/day, bacterial growth was predicted in plasma and all tissues, except for ELF. Bacteriostasis was observed only at a higher dose of 1200 mg/day over 120 h. An fAUC/MIC of 80 related to stasis over 120 h. Subpopulations resistant to 3 × MIC were amplified in plasma and target tissues, except for ELF, at doses of 200-800 mg/day.

CONCLUSIONS

The human dose of 200 mg/day was insufficient to suppress bacterial growth in the HFIM, indicating that further components contribute to the clinical effect of tedizolid. This study supports the warning/precaution for tedizolid to limit its use in immunocompromised patients.

Investigation of Power Specific Motor Primitives in an Upper Limb Rotational Motion

The purpose of this study was to investigate muscle synergies (MS) during upper limb cycling motion across power levels (20, 40, 60, 80, 100, and 120 watts). The MS hypothesis is important to the understanding of modular control for human movements. In this study, we explore its importance in execution of phasic movements at various power levels. Electromyographic (EMG) signals were recorded from 7 upper limb muscles during cycling for 30s on a hand-cycle ergometer. A Non-Negative Matrix factorization (NNMF) algorithm was used to extract MS. Cosine similarity was used to compare the MS and cross-correlation was used to compare activation coefficients. We found that the number and structure of synergies were consistent across power levels while admitting modulation in their activation coefficients. A total of three shared MS explaining ≥95% of the variance accounted for (VAF) represented push and pull mechanism during cyclic motion.

OP0078 HIGH MEDIAN NERVE LESION SECONDARY TO SEVERE GIANT CELL ARTERITIS (GCA)

Background:

Giant cell arteritis (GCA) is a systemic vasculitis affecting large to medium-sized vessels. Cranial nerve lesions are frequently documented secondary to GCA, however peripheral nerves are rarely involved.

Objectives:

We present an unusual case of a GCA-associated isolated high median nerve palsy.

Methods:

Case report.

Results:

A 76 year old white British female presented in Spain with three weeks of frontotemporal headaches, mandibular claudication, photopsia and constitutional symptoms, followed by acute-onset right hand paresis and dysaesthesia. Acute-phase reactants were elevated. COVID-19 PCR was negative. Shortly after admission she developed acute bilateral anterior ischaemic optic neuropathy and tongue necrosis with autoamputation. Temporal artery ultrasound and biopsy confirmed GCA. PET-CT showed no evidence of a diffuse large-vessel vasculitis. She was repatriated to the UK for ongoing inpatient care. Upper limb neurophysiology two months later demonstrated an isolated right high median nerve lesion, with reduced median motor responses and absent sensory responses with denervation in extensor carpi radialis. Imaging excluded a central lesion. The timing of her symptoms suggested the lesion was secondary to GCA. Treatment was with tocilizumab, methotrexate and tapering corticosteroids, alongside PEG feeding and careful multi-disciplinary rehabilitation.

Conclusion:

We suggest there are two important learning points from this complex case. Firstly, peripheral nerve lesions can occur in GCA, although they are rare. A literature search identified a modest number of case reports of brachial plexus or lower cervical nerve lesions1,2. Neurologic manifestations in GCA are attributed to vasculitis of the vasa nervorum, or extension of inflammation from arteries to contiguous nerves1,2. The restriction of clinical involvement to the median nerve alone would appear to favour the former mechanism. Functional recovery of neurological deficits is typically partial at best.

Secondly, this case highlights the difficulty faced by clinicians in recognising GCA and the importance of urgent treatment with glucocorticoids. The patient developed GCA during the ongoing COVID-19 pandemic when Spain was the second-worst affected European country (5% seroprevalence; 95% CI 4.7-5.4)3. The partial overlap in symptoms between GCA and COVID-19 (e.g. headache, pyrexia, malaise, elevated acute-phase reactants) can cause diagnostic confusion and treatment delay4. GCA should be considered in the differential diagnosis of older patients with suspected COVID-19, or the non-specifically unwell elderly patient.

References:

[1]Blaise S, et al. Horton’s disease revealed by brachial C5 plexopathy [French]. Rev Med Interne. 2005;26(7):578-82.

[2]Merianos P, et al. Giant cell arteritis of the median nerve simulating carpal tunnel syndrome. Hand. 1983;15(3): 249-251.

[3]Pollán M, et al. Prevalence of SARS-CoV-2 in Spain (ENE-COVID): a nationwide, population-based seroepidemiological study. Lancet. 2020; 396(10250): 535-544.

[4]Monti S, Delvino P, et al. Impact of delayed diagnoses at the time of COVID-19: increased rate of preventable bilateral blindness in giant cell arteritis. Ann Rheum Dis. 2020;79:1658-1659.

Table 1.Area/movementResultAbductor pollicis brevisGrade 2 weaknessOpponens pollicisGrade 4 weaknessPronator teres/quadratusGrade 4 weaknessFlexor pollicis longusGrade 1-2 weaknessFlexor digitorum profundus (digit 2 and 3)Grade 1-2 weaknessFinger abductionPreservedFinger extensionPreservedOther commentsDysaesthesia in distribution of median nerve

Disclosure of Interests:

Kundan Iqbal: None declared, James Miller Speakers bureau: Dr Miller has participated in pharmaceutical-sponsored symposiums previously but not in last five years., Consultant of: Dr Miller has participated in pharmaceutical-sponsored consultancy previously but not in last five years., Ming Lai: None declared, Mia Charnley: None declared, Muhammad Meraj: None declared, Ben Thompson Speakers bureau: Dr Thompson has participated in educational talks for Roche, Novartis, Lilly and UCB., Consultant of: Dr Thompson has participated in advisory boards for Roche, Novartis, Lilly, Gilead, Abbvie and UCB.

649 COVID BOAST In Practice: Our Experience Implementing BOA Recommendations During the UK Coronavirus Pandemic Peak

Background

In anticipation of the UK coronavirus pandemic peak, BOA published new pandemic-specific guidance (“COVID BOAST”) in April 2020. We describe our experience implementing this restructured T&O service in a busy DGH setting during the pandemic peak.

Method

A rapid retrospective audit was conducted of all patients presenting to our T&O service in April 2020, with particular emphasis compliance with COVID BOAST.

Results

Our service conducted 511 outpatient reviews, and 95 operative procedures. 94% of outpatients were treated non-operatively. We provided telephone appointments to 12.8% of follow-up patients, and 39% of new patients. 82% of patients were treated with removable casts/splints/boots. 23% of patients were discharged direct from VFC or after one face-to-face fracture clinic review. Residual deformity was consciously accepted in 13% of patients. Theatre throughput fell significantly due to pandemic precautions however, femoral neck fracture volumes remained constant.

Conclusions

We demonstrate broad compliance with COVID BOAST guidance. The majority of patients were treated non-operatively, including conscious acceptance of residual deformity. Our pre-existing VFC allowed us to provide a significant number of telephone consultations, although despite the practice shift towards removable splintage, face-to-face consultations were required for clinical and/or radiological assessment. The impact of increased conservative management on patients’ long-term outcomes needs further evaluation.

Biomedical soft robots: current status and perspective

This paper reviews the current status of soft robots in biomedical field. Soft robots are made of materials that have comparable modulus of elasticity to that of biological systems. Several advantages of soft robots over rigid robots are safe human interaction, ease of adaptation with wearable electronics and simpler gripping. We review design factors of soft robots including modeling, controls, actuation, fabrication and application, as well as their limitations and future work. For modeling, we survey kinematic, multibody and numerical finite element methods. Finite element methods are better suited for the analysis of soft robots, since they can accurately model nonlinearities in geometry and materials. However, their real-time integration with controls is challenging. We categorize the controls of soft robots as model-based and model-free. Model-free controllers do not rely on an explicit analytical or numerical model of the soft robot to perform actuation. Actuation is the ability to exert a force using actuators such as shape memory alloys, fluid gels, elastomers and piezoelectrics. Nonlinear geometry and materials of soft robots restrict using conventional rigid body controls. The fabrication techniques used for soft robots differ significantly from that of rigid robots. We survey a wide range of techniques used for fabrication of soft robots from simple molding to more advanced additive manufacturing methods such as 3D printing. We discuss the applications and limitations of biomedical soft robots covering aspects such as functionality, ease of use and cost. The paper concludes with the future discoveries in the emerging field of soft robots.

Evaluation of dose conformity and coverage of target volume for intensity-modulated radiotherapy of pelvic cancer treatment

BACKGROUND

Better conformity may help in delivering minimum dose to organs at risk (OARs) and maximum dose to planning target volume (PTV). As per the requirements of modern radiotherapy, 95% isodose should cover the PTV, so conformity indices (CIs) are used for evaluating quality of conformation of treatment plans.

AIM

This study aimed to investigate degree of conformity for pelvic patients using intensity-modulated radiotherapy (IMRT) technique. Three formulas of CIs described in literature were analyzed in this study.

SETTINGS AND DESIGN

This study was performed to evaluate degree of conformity of 18 patients treated with radiotherapy treatment plan using cumulative dose volume histogram. Effectiveness of different CIs was explored for IMRT plans using 15 MV photon beam. Doses delivered to OAR were also studied.

STATISTICAL ANALYSIS USED

CI suggested by the International Commission on Radiation Units and Measurements, radiation CI and CI prescription isodose to target volume (PITV) had mean ± standard deviation values of 1.02 ± 0.018, 0.98 ± 0.017, and 1.63 ± 0.333, respectively.

RESULTS AND CONCLUSION

Dose distribution for all patients was highly conformal and clinically acceptable. Values of CI PITV exceeded acceptable value for 27% patients with minor deviation. No statistically significant differences were observed for three CIs reported. Target volume lies between 95% and 107% of prescribed dose which shows ideal target coverage. This simple parameter is advantageous since it is easy to interpret and helped determine quality of treatment plan. This study clearly demonstrated that favorable dose distribution in PTV and OARs is achieved using IMRT technique, and hence, the risk of damage to normal tissues is reduced.

Synchronic inverse seasonal rhythmus of energy density of food intake and sleep quality: a contribution to chrono-nutrition from a Polish adult population

BACKGROUND/OBJECTIVES

There is evidence which suggests that sleep behavior and dietary intake are interlinked. Thus, we investigated whether a seasonal rhythm in food-energy density exists, and how this relates to quality of sleep.

SUBJECTS/METHODS

Two hundred and thirty adult volunteers were investigated across the four seasons. Anthropometrical measurements were obtained and The Pittsburgh Sleep Quality Index was used for an assessment of sleep quality and disturbances. The dietary intake was evaluated using a 24 h dietary recall. Generalized estimating equations were used to estimate seasonal changes in energy density and sleep quality, as well as the association of energy density with sleep quality. All analyses were adjusted for age, sex, education, occupation and shift-work.

RESULTS

Mean food energy density was significantly higher in winter as compared with other seasons (P<0.05), although no seasonal variations were observed in macronutrient intake (fat and protein). Overall, the sleep quality was low (score value >5) in all seasons, with the lowest quality occurring in winter and the highest in spring (P<0.05). The components of sleep quality score showed that winter had statistically (P<0.05) poorer subjective sleep quality, sleep latency and sleep disturbances, but lower daytime dysfunction compared with spring and summer. After adjusting for seasonal effects (correlated outcome data) and shift-work, energy density was found to be inversely associated (P<0.0001) with sleep quality.

CONCLUSIONS

An inverse association between seasonal fluctuation of food energy density and sleep quality was found with winter time, associated with the intake of higher energy dense food products and the lowest sleep quality.

Factors associated with poor outcomes in patients with lupus nephritis

The objective of this study was to identify the factors associated with important clinical outcomes in a case-control study of 213 patients with lupus nephritis. Included were 47% Hispanics, 44% African Americans and 9% Caucasians with a mean age of 28 years. Fifty-four (25%) patients reached the primary composite outcome of doubling serum creatinine, end-stage renal disease or death during a mean follow-up of 37 months. Thirty-four percent African Americans, 20% Hispanics and 10% Caucasians reached the primary composite outcome ( P < 0.05). Patients reaching the composite outcome had predominantly proliferative lupus nephritis (WHO classes: 30% III, 32% IV, 18% V and 5% II, P < 0.025) with higher activity index score (7 ± 6 versus 5 ± 5, P<0.05), chronicity index (CI) score (4 ± 3 versus 2 ± 2 unit, P<0.025), higher baseline mean arterial pressure (MAP) (111 ± 21 versus 102 ± 14 mmHg, P<0.025) and serum creatinine (1.9 ± 1.3 versus 1.3 ± 1.0 mg/dL, P<0.025), but lower baseline hematocrit (29 ± 6 versus 31 + 5%, P<0.025) and complement C3 (54 ± 26 versus 65 + 33 mg/dL, P<0.025) compared to controls. More patients reaching the composite outcome had nephrotic range proteinuria compared to controls (74% versus 56%, P<0.025). By multivariate analysis, CI (hazard ratio [95% CI] 1.18 [1.07-1.30] per point), MAP (HR 1.02 [1.00-1.03] per mmHg), and baseline serum creatinine (HR 1.26 [1.04-1.54] per mg/dL) were independently associated with the composite outcome. We concluded that hypertension and elevated serum creatinine at the time of the kidney biopsy as well as a high CI are associated with an increased the risk for chronic renal failure or death in patients with lupus nephritis.

Performance of select color-difference formulas in the blue region

The main objective of this work was to test the performance of major formulas for assessment of small suprathreshold color differences in the blue region. The models examined include CIELAB color space based equations, including CIELAB, CIE94, CIEDE2000, CMC (l:c), BFD (l:c), and formulas based on more uniform color spaces, such as DIN99d, CAM02-SCD, CAM02-UCS, OSA-GP, and OSA-Eu in comparison against data obtained via visual assessments. For this purpose, a dataset around the CIE high-chroma blue color center, hereafter called NCSU-B2, was developed. The NCSU-B2 dataset comprised 65 textile substrates and a standard, with a mean ΔE(ab)* color difference of 2.72, ranging from 0.54-5.72. Samples were visually assessed by 26 subjects against the reference gray scale in three separate trials with at least 24 h between assessments. A total of 5070 assessments were obtained. The standardized residual sum of squares (STRESS) index was used to examine the performance of various formulas for this dataset, as well as a previously developed NCSU-B1 low-chroma blue dataset [Color Res. Appl. 36, 27, 2011], and blue centers from other established visual datasets. Results show that formulas based on more recent uniform color spaces provide better agreement with perceptual data compared with models based on CIELAB space.

Quality assurance evaluation of spot scanning beam proton therapy with an anthropomorphic prostate phantom

OBJECTIVE

The purpose of this study was to evaluate spot scanning proton therapy with an anthropomorphic prostate phantom at the Proton Therapy Center of The University of Texas MD Anderson Cancer Center at Houston, TX (PTCH).

METHODS

An anthropomorphic prostate phantom from the Radiological Physics Center (RPC), The University of Texas MD Anderson Cancer Center, Houston, TX, was used, which contained thermoluminescent dosemeters and GAFCHROMIC(®) EBT2 film (ISP Technologies, Wayne, NJ). The phantom was irradiated by the Hitachi synchrotron (Hitachi America, Ltd, Tarrytown, NY), and the results were compared between the treatment planning system (TPS) and RPC measurements.

RESULTS

RPC results show that the right/left, inferior/superior and posterior/anterior aspects of the coronal/sagittal and EBT2 film measurements were within ±7%/±4 mm of the TPS. The RPC thermoluminescent dosemeter measurements of the prostate and femoral heads were within 3% of the TPS.

CONCLUSION

The RPC prostate phantom is a useful mechanism to evaluate spot scanning beam proton therapy within certain confidence levels.

ADVANCES IN KNOWLEDGE

The RPC anthropomorphic prostate phantom could be used to establish quality assurance of spot scanning proton beam for patients with prostate cancer.

Characterization of riboflavin-modified dentin collagen matrix

Crosslinking is considered a possible approach to increasing the mechanical and structural stability and biodegradation resistance of the dentin collagen matrix. The aim of this study was to investigate the mechanical and chemical variations and collagen degradation resistance associated with crosslinking of the dentin collagen matrix with UVA-activated riboflavin. Dentin collagen matrix specimens were treated with 0.1 and 1% riboflavin for 2 min and photo-activated with 7 mW/cm(2) UVA (368 nm) for 2 min. The structural change of the dentin collagen network with collagenase exposure was investigated by AFM and SEM at different time-points. The variations in surface/bulk mechanical properties and biodegradation resistance were characterized by nano-indentation, conventional mechanical testing, and hydroxyproline liberation at different time-points. Chemical changes associated with riboflavin/collagen-matrix interaction were analyzed by micro-Raman spectroscopy. UVA-activated riboflavin increased the mechanical properties, mechanical stability, and biodegradation resistance of the dentin collagen matrix. Higher collagen-network structural resistance against collagenolytic challenges was found with crosslinking. micro-Raman spectroscopy showed a strong dependency, in both intensity and wave-number, of certain Raman bands (1242-1667 cm(-1)) with crosslinking indicating the collagen/riboflavin interactions. UVA-activated riboflavin (1%) more efficiently crosslinked the dentin collagen matrix within a relatively clinically acceptable time-frame compared with 0.1% riboflavin.

Tau in Alzheimer disease and related tauopathies

Tau is the major microtubule associated protein (MAP) of a mature neuron. The other two neuronal MAPs are MAP1 and MAP2. An established function of MAPs is their interaction with tubulin and promotion of its assembly into microtubules and stabilization of the microtubule network. The microtubule assembly promoting activity of tau, a phosphoprotein, is regulated by its degree of phosphorylation. Normal adult human brain tau contains 2-3 moles phosphate/mole of tau protein. Hyperphosphorylation of tau depresses this biological activity of tau. In Alzheimer disease (AD) brain tau is ~three to four-fold more hyperphosphorylated than the normal adult brain tau and in this hyperphosphorylated state it is polymerized into paired helical filaments ([PHF) admixed with straight filaments (SF) forming neurofibrillary tangles. Tau is transiently hyperphosphorylated during development and during anesthesia and hypothermia but not to the same state as in AD brain. The abnormally hyperphosphorylated tau in AD brain is distinguished from transiently hyperphosphorylated tau by its ability (1) to sequester normal tau, MAP1 and MAP2 and disrupt microtubules, and (2) to self-assemble into PHF/SF. The cytosolic abnormally hyperphosphorylated tau, because of oligomerization, unlike normal tau, is sedimentable and on self-assembly into PHF/SF, loses its ability to sequester normal MAPs. Some of the tau in AD brain is truncated which also promotes its self-assembly. Tau mutations found in frontotemporal dementia apparently promote its abnormal hyperphosphorylation. Thus, the AD abnormally hyperphosphorylated tau (1) is distinguishable from both normal and transiently hyperphosphorylated taus, and (2) is inhibitory when in a cytosolic/oligomeric state but not when it is self-assembled into PHF/SF. Inhibition of abnormal hyperphosphorylation of tau offers a promising therapeutic target for AD and related tauopathies.

Patent ductus arteriosus device embolization

Nonsurgical closure of patent ductus arteriosus (PDA) using a duct occluder placed percutaneously is currently the first line of therapy and the success rate is quite high. Several devices are currently available. An eight year child underwent device closure of the ductus. However after deployment of the device it, became dislodged into the left pulmonary artery. Several attempts at catheter retrieval failed. The child underwent successful surgical removal of the device without cardiopulmonary bypass.

Stability analysis and breast tumor classification from 2D ARMA models of ultrasound images

Two-dimensional (2D) autoregressive moving average (ARMA) random fields have been proven to be accurate models of ultrasound breast images. However, the stability properties of these models have not been examined. In this paper, we investigate the stability of 2D ARMA models in ultrasound breast images, and use the estimated 2D ARMA coefficients as a basis for statistical inference using artificial neural networks. Specifically, we use the estimated 2D ARMA coefficients as inputs to a Multi layer perceptron (MLP) neural network to classify the ultrasound breast image into three regions: healthy tissue, benign tumor, and cancerous tumor. Our simulation results on various cancerous and benign ultrasound breast images illustrate the power of the proposed algorithm as attested by different learning algorithms and classification accuracy measures.

Positive expression and correlation of chemokine receptor CXCR4 with nodal metastasis and prognosis in colorectal cancer

e15128

Background: Colorectal cancer is one of the leading causes of cancer related deaths,with recurrence and metastasis as the primary reasons for mortality. New evidence hasimplicated Chemokines as the likely cause. We studied the positive expression of CXCR4 chemokine receptors in colorectal carcinoma and investigated its correlations to clinicpathologic characteristics and prognosis. Methods: Tumor tissue specimens of patients with colorectalcarcinoma (n = 67) who underwent surgery from January 2003 to December 2004 at the Department of Surgery, Tongji Hospital were collected. CXCR4 expression levels and tumor micro vessel density were evaluated by immunohistochemistry. Specimens were immunostained using formalin-fixed, paraffin-embedded tissues. The correlation between the CXCR4 expression and clinicopathological factors was evaluated Results: In 67 cancer tissue specimens, CXCR4 was positively expressed in 38 cases; positive rate being 56.7%. Positive expression of CXCR4 is associated with an increase incidence of nodal involvement, higher clinic stage, higher tumor micro vessel density and a lower 3-year disease free survival rate as compared to those with negative CXCR4 expression (P<0.05). Conclusions: Positive CXCR4 expression and high tumor micro vessel density are associated with poor prognosis and could be a potential predictive factor for recurrence or metastasis of colorectal cancer patients. So CXCR4 may be a potential target for specific therapeutic interventions in the future.

No significant financial relationships to disclose.

305 REPROGRAMMING EVENTS IN EARLY BOVINE AND MURINE EMBRYOS ARE MIRRORED BY PLASMID-ENCODED MARKER CONSTRUCTS

Episomal plasmids have emerged as useful tools to achieve stable transgenesis in mammalian cell cultures. Here, the suitability of scaffold/matrix attachment region (S/MAR) carrying episomal plasmids and conventional plasmids for the generation of transgenic murine and bovine embryos was assessed. Bovine zygotes were produced from slaughterhouse ovaries, and murine zygotes were isolated from superovulated and mated NMRI females. Zygote stages were microinjected with approximately 10 pl of plasmid solution. The S/MAR encoding plasmids pEPI or minicircle preparations (gift of J. Bode, Braunschweig, Germany), devoid of most of the plasmid backbone, were used as episomal plasmids. Both plasmids carry an enhanced green fluorescent protein (EGFP) gene driven by the cytomegalovirus promoter (CMV). The plasmids peGFP (CMV-eGFP), pdsRED encoding red fluorescent protein (CMV-RFP), pOct4-GFP (germ line-specific Oct-4 promoter-EGFP), and pgAChR-GFP (muscle-specific γAChR promoter) were used as conventional plasmids. To study the effects of DNA methylation at cytosine/guanine dinucleotids (CpG), plasmid DNA was treated with CpG-methylase in the presence of S-adenosyl-methionin, and in some experiments, completeness of DNA methylation was verified by methylation-sensitive restriction endonucleases. Embryos were analyzed during in vitro culture up to blastocyst stage by fluorescence microscopy, and selected stages were harvested for RT-PCR analysis or DNA recovery. Microinjection of circular plasmids with ubiquitous CMV (n = 505) or germ line-specific Oct-4 promoter (n = 176) driven transcription in bovine zygotes resulted in 159 and 44 blastocysts, of which 94 and 27 showed expression of EGFP. Microinjection of bovine zyotes (n = 179) with S/MAR plasmids yielded a total of 18 blastocysts of which 12 were green fluorescent protein-positive. On average, >50% of the blastocysts were EGFP-positive, irrespective of whether S/MAR carrying episomal plasmids or conventional plasmids had been injected. In contrast, injection of the γAChR (muscle-specific) driven construct did not give rise to EGFP expression (n = 20), suggesting that promoter specificity was maintained. Injection of murine zygotes (n = 126) with CMV or Oct-4 promoter constructs was less successful, about 10 to 20% of the obtained blastocysts expressed EGFP. In the case of unmethylated pOct4-GFP plasmid, the onset of EGFP expression was found to coincide with the time point of major embryonic genome activation [i.e. late 1-cell stage in murine (n = 25) and 4- to 8-cell stages in bovine (n = 75) embryos]. In contrast, injection of CpG-methylated plasmids (murine n = 33; bovine n = 101) delayed the onset of EGFP expression for a further 30 to 40 h. Recovery of plasmid sequences from blastocyst stages and bisulfite sequencing indicated that the majority of plasmids are maintained in an episomal status. Thus, plasmid-mediated transgenesis is a robust method to express foreign DNA in a promoter-specific manner in mammalian embryos and can be employed to analyze reprogramming events. The excellent technical support by E. Lemme and K. Korsawe is acknowledged. Funded by DFG.

277 PLASMID MEDIATED EXPERIMENTAL TELOMERE EXTENSION IN BOVINE EMBRYOS BY ECTOPIC EXPRESSION OF HUMAN TERT

Telomeres are composed of repetitive hexanucleotide sequences, (TTAGGG)n, encompassing several kilobase pairs, and protecting the ends of eukaryotic chromosomes. In somatic cells, the telomeres are eroded with each cell division and may reach a critical length at which viability becomes compromised. In germ cells, expression of the enzyme telomerase leads to restoration of telomere length. During early cleavage and up to the morula stage, telomerase is not active or is found only at low levels, but high telomerase activity is detectable at the blastocyst stage in bovine and human embryos. The goal of this study was to unravel the physiological consequences of an ectopic overexpression of the catalytic subunit of telomerase (TERT) in early bovine embryos. Human TERT (hTERT) has 80% sequence homology with bovine TERT. Oocytes were collected by slicing ovaries obtained from a local abattoir, followed by maturation in TCM-199 supplemented with eCG and hCG. The IVF of matured oocytes was carried out in Fert-TALP supplemented with hypotaurine, heparin, and epinephrine. Fertilized oocytes were used for DNA microinjection experiments; injected zygotes and nontreated controls were cultured in modified synthetic oviduct fluid medium (SOF) in reduced oxygen concentration. Two plasmid encoding CMV promoter-driven sequences of hTERT and green fluorescent protein (GFP) were coinjected in bovine zygotes, and GFP driven by a muscle specific promoter was injected for mock experiments. The hTERT and GFP were co-injected to allow live separation of embryos. A total of 768 bovine embryos were injected; 468 (61%) of the treated embryos showed specific GFP-fluorescence. Of a total of 132 blastocysts (17%), 45 showed GFP fluorescence (34%). The GFP-expressing embryos were selected at various developmental stages and were analyzed for hTERT expression. Both endogenous TERT and ectopic hTERT mRNA levels were assessed by RT-PCR from zygote to blastocyst. The mRNA level of the ectopic hTERT began to increase from the 4- to the 8-cell stage and remained high up to the morula stage. Embryos at the morula and blastocyst stages were spread on slides and analyzed by quantitative fluorescence in situ hybridization (qFISH). A Cy3-labeled 18-mer peptide nucleic acid (PNA) probe was used to hybridize the telomeres. The resulting spot intensities were quantified by using TFL-Telo software and were statistically analyzed. A modest increase in telomere length was observed in hTERT injected [775 ± 69 fluorescence unit (fu)] group compared to uninjected control (679 ± 75 fu) group at blastocyst stage. In conclusion, this study demonstrates that the ectopic expression of hTERT in embryos results in telomere elongation; overexpression of TERT may facilitate the derivation of bovine embryonic stem cells. Supported by DFG and Goyaike SAACIYF.

Hyperphosphorylation of microtubule-associated protein tau: a promising therapeutic target for Alzheimer disease

Alzheimer disease (AD) is the most common cause of dementia in adults. The current therapy for AD has only moderate efficacy in controlling symptoms, and it does not cure the disease. Recent studies have suggested that abnormal hyperphosphorylation of tau in the brain plays a vital role in the molecular pathogenesis of AD and in neurodegeneration. This article reviews the current advances in understanding of tau protein, regulation of tau phosphorylation, and the role of its abnormal hyperphosphorylation in neurofibrillary degeneration. Furthermore, several therapeutic strategies for treating AD on the basis of the important role of tau hyperphosphorylation in the pathogenesis of the disease are described. These strategies include (1) inhibition of glycogen synthase kinase-3beta (GSK-3beta), cyclin-dependent kinase 5 (cdk5), and other tau kinases; (2) restoration of PP2A activity; and (3) targeting tau O-GlcNAcylation. Development of drugs on the basis of these strategies is likely to lead to disease-modifying therapies for AD.

103 ECTOPIC EXPRESSION OF TELOMERASE IN BOVINE PREIMPLANTATION EMBRYOS

Recently, we have demonstrated a stage-specific increase of telomere length at morula-blastocyst transition in bovine and murine embryos (Schaetzlein et al. 2004 PNAS 101, 8034–8038). Telomeres are composed of repetitive hexanucleotide sequences (TTAGGG) encompassing several kilobasepairs and protecting the ends of eukaryotic chromosomes. In somatic cells, the telomeres are eroded with each cell division and may reach a critical length at which viability becomes compromised. In germ cells, expression of the enzyme telomerase leads to restoration of telomere length. During early cleavage up to the morula stage, telomerase is not active or only found at low levels, but high telomerase activity is detectable at the blastocyst stage in bovine and human embryos. The goal of this study was to unravel the physiological consequences of an ectopic overexpression of the catalytic subunit of telomerase (TERT) in early bovine embryos. Human TERT (hTERT) was selected as the target molecule due to its 80% sequence homology with bovine TERT. Oocytes were collected by slicing ovaries obtained from local abattoir followed by maturation in TCM-199 supplemented with eCG and hCG. The IVF of matured oocytes was carried out in Fert-TALP supplemented with hypotaurine, heparin, and epinephrine. Fertilized oocytes were used for DNA microinjection experiments; injected zygotes and nontreated controls were cultured in modified synthetic oviduct fluid medium (SOF) in reduced oxygen concentration. In preliminary tests, it was shown that co-injection of green fluorescent protein (GFP) and red fluorescent protein (dsRed) constructs resulted in the simultaneous expression of the 2 proteins. The onset of fluorescent protein expression was recorded 30 to 40 hours after injection by fluorescence microscopy. Because all cDNA were driven by the cytomegalovirus (CMV) promoter, it was assumed that hTERT is expressed in parallel. In the main experiment, 2 constructs encoding human TERT and GFP were co-injected to allow live separation of embryos. A total of 400 bovine embryos were injected, 209 (53%) of the treated embryos showed specific GFP fluorescence; out of a total of 104 blastocysts (26%), 55 showed GFP fluorescence (53%). The GFP-expressing embryos were selected at various developmental stages and were analyzed for hTERT expression. Both endogenous TERT and ectopic human TERT mRNA levels were assessed by RT-PCR from zygote to blastocyst. Surprisingly, expression pattern of the endogenous TERT revealed a transient increase at the 2–4 cell stage and a major increase at the blastocyst stage. The mRNA level of the ectopic hTERT started to rise from 4 to 8 cell stage and remained high up to the morula stage. Currently, qFISH and TRAP techniques are being employed to assess enzymatic activity of hTERT and to quantitatively determine telomere length. In conclusion, this study demonstrates the ectopic expression of TERT and fluorescent proteins in early embryos; overexpression of TERT may facilitate the derivation of bovine ES cells. Supported by DFG and Goyaike S.A.A.C.I. Y.F.

Alzheimer neurofibrillary degeneration: significance, etiopathogenesis, therapeutics and prevention

Alzheimer disease (AD) is multi-factorial and heterogeneous. Independent of the aetiology, this disease is characterized clinically by chronic and progressive dementia and histopathologically by neurofibrillary degeneration of abnormally hyperphosphorylated tau seen as intraneuronal neurofibrillary tangles, neuropil threads and dystrophic neurites, and by neuritic (senile) plaques of beta-amyloid. The neurofibrillary degeneration is apparently required for the clinical expression of AD, and in related tauopathies it leads to dementia in the absence of amyloid plaques. While normal tau promotes assembly and stabilizes microtubules, the abnormally hyperphosphorylated tau sequesters normal tau, MAP1 and MAP2, and disrupts microtubules. The abnormal hyperphosphorylation of tau also promotes its self-assembly into tangles of paired helical and or straight filaments. Tau is phosphorylated by a number of protein kinases. Glycogen synthase kinase-3 (GSK-3) and cyclin dependent protein kinase 5 (cdk5) are among the kinases most implicated in the abnormal hyperphosphorylation of tau. Among the phosphatases which regulate the phosphorylation of tau, protein phosphatase-2A (PP-2A), the activity of which is down-regulated in AD brain, is by far the major enzyme. The inhibition of abnormal hyperphosphorylation of tau is one of the most promising therapeutic targets for the development of disease modifying drugs. A great advantage of inhibiting neurofibrillary degeneration is that it can be monitored by evaluating the levels of total tau and tau phosphorylated at various known abnormally hyperphosphorylated sites in the cerebrospinal fluid of patients, obtained by lumbar puncture. There are at least five subgroups of AD, each is probably caused by a different etiopathogenic mechanism. The AD subgroup identification of patients can help increase the success of clinical trials and the development of specific and potent disease modifying drugs.

Developing pharmacological therapies for Alzheimer disease

Alzheimer disease (AD), while chronic and progressive with an average progression of 7 - 10 years, is both multifactorial and heterogeneous. Thus, AD offers a large window of opportunity and a large number of therapeutic targets to inhibit it. The selection of a therapeutic target, however, is one of the biggest challenges in developing a pharmacological treatment of this multifactorial disease. Inhibition of a pivotal downstream event is likely to benefit more patients than inhibition of an upstream event in AD pathogenesis. Neurofibrillary degeneration of abnormally hyperphosphorylated tau offers such a pivotal therapeutic target. Abnormal hyperphosphorylation of tau and not its aggregation into filaments appears to be the most deleterious step in neurofibrillary degeneration. Tau can be abnormally hyperphosphorylated by downregulation of protein phosphatase-2A activity or by upregulation of more than one tau kinase. Restoration of the phosphatase activity which is downregulated in AD brain or inhibition of GSK-3beta and cdk5, which are required for AD-type abnormal hyperphosphorylation of tau, are among the most promising therapeutic strategies.

Can acoustic vowel space predict the habitual speech rate of the speaker?

This study aims to find whether the acoustic vowel space reflect the habitual speaking rate of the speaker. The vowel space is defined as the area of the quadrilateral formed by the four corner vowels (i.e.,/i/,/&#230;/,/u/,/&#945;) in the F1F2- 2 plane. The study compares the acoustic vowel space in the speech of habitually slow and fast talkers and further analyzes them by gender. In addition to the measurement of vowel duration and midpoint frequencies of F1 and F2, the F1/F2 vowel space areas were measured and compared across speakers. The results indicate substantial overlap in vowel space area functions between slow and fast talkers, though the slow speakers were found to have larger vowel spaces. Furthermore, large variability in vowel space area functions was noted among interspeakers in each group. Both F1 and F2 formant frequencies were found to be gender sensitive in consistence with the existing data. No predictive relation between vowel duration and formant frequencies was observed among speakers.

Optimization of goal-oriented voluntary movements

A four-segment biomechanical model and a control characterizing the action of the central nervous system (CNS) are used to investigate optimization of the postural stabilization process and the execution of voluntary movement. The point-to-point voluntary movement is optimized using different measures of performance (cost functions) in the time- and frequency domains. In particular kinematic measure (jerk) and an LQ-type measure are considered and compared. The results of the study show that jerk optimization is better suited for musculoskeletal systems in synthesis of voluntary movement. These results are consistent with the existing literature.

Biodynamic modeling and simulation of multistage carcinogenesis

We present a mathematical model of multistage carcinogenesis. The population genetic model is developed based on the reaction diffusion, logistic behavior, and Hollings Type II interactions between normal, benign, and premalignant mutant cells. Computer simulations are used to observe the behavior, stability, and traveling wave solution of the premalignant stage mutation as well as its survival under natural selection pressure. As a simple application of the model, the interaction between normal and tumor cells with one or two stages of mutation is analyzed.

147 GENE KNOCKDOWN OF MATERNAL- AND EMBRYONIC-EXPRESSED GREEN FLUORESCENT PROTEIN IN MURINE EMBRYOS BY THE INJECTION OF A SHORT INTERFERING RNA (siRNA)

RNA interference (RNAi) is now widely used for gene silencing in various biological systems. Injection of long double-stranded RNAs has been shown to specifically knock down gene expression in mammalian embryos. The utilization of short interfering RNAs (siRNA) to target specific embryonic genes would make this approach flexible and efficient enough for studying physiological functions in development. To demonstrate the feasibility of a single class of siRNA molecules for achieving long-lasting effects after injection into mammalian zygotes, we used siRNAs to knock down expression of the green fluorescent protein (GFP) in transgenic murine embryos of the OG2 transgenic line. Homozygous OG2-animals, carrying the Oct4-GFP transgene, were mated with NMRI animals to produce OG2 hemizygous zygotes, which show a parentally dependent expression pattern of the marker gene. Hemizygous zygotes with a maternally inherited Oct4-GFP gene continuously express the GFP marker; hemizygous zygotes with a paternally inherited Oct4-GFP start transcription of the GFP gene at the 4–8 cell stage, i.e., after onset of embryonic genomic activation. Thus efficacy and duration of gene silencing could be tested under 2 different conditions where (i) GFP mRNA was already present at the time point of injection, and (ii) GFP transcription started 2–3 cell cycles after siRNA injection. Zygotes were microinjected with either a 22-basepair GFP-siRNA or a control siRNA and then cultured in vitro. The siRNAs were conjugated with the fluorochome rhodamine to allow monitoring of injection and subsequent degradation of siRNAs. At the end of the in vitro culture, the developmental stage, the number of nuclei, GFP fluorescence (Table 1), and the GFP mRNA levels were determined by RT-PCR. In conclusion, results demonstrate that injection of a synthetic siRNA is sufficient to knock down a target gene transcript with either maternal or embryonic expression in mammalian embryos. Importantly, maternally derived GFP proteins showed a delayed functional knockdown of GFP for 2 days. The advantages of this approach are that (i) off-target effects of long double-stranded RNAs can be avoided, (ii) siRNAs against any known transcript can be rapidly designed and synthesized, and (iii) developmentally important genes can be silenced in embryos for at least 5 days following injection. Table 1.siRNA microinjection into zygotes with maternally and paternally inherited GFP

Outcomes in African Americans and Hispanics with lupus nephritis

Poor outcomes have been reported in African Americans and Hispanics compared to Caucasians with lupus nephritis. The purpose of this retrospective analysis was to identify independent predictors of outcomes in African Americans and Hispanics with lupus nephritis. In total, 93 African Americans, 100 Hispanics, and 20 Caucasians with a mean age of 28 +/- 13 years and an annual household income of 32.9 +/- 17.3 (in 1000 US dollars) were studied. World Health Organization (WHO) lupus nephritis classes II, III, IV, and V were seen in 9, 13, 52, and 26%, respectively. Important baseline differences were higher mean arterial pressure (MAP) in African Americans compared to Hispanics and Caucasians (107 +/- 19, 102 +/- 15, and 99 +/- 13 mmHg, P < 0.05), and higher serum creatinine (1.66 +/- 1.3, 1.25 +/- 1.0, and 1.31 +/- 1.0 mg/dl, P < 0.025). African Americans had lower hematocrit compared to Hispanics and Caucasians (29 +/- 5, and 31 +/- 6, and 32 +/- 7%, P < 0.05), and lower annual household income (30.8 +/- 14.9, 33.1 +/- 15.9, and 42.2 +/- 29.3 in 1000 US dollars; P < 0.05). Lower prevalence of WHO class IV was seen in Caucasians (30%) compared to Hispanics (57%, P = 0.03) and African Americans (51%, P = 0.09). Development of doubling creatinine or end-stage renal disease was higher in African Americans and Hispanics than in Caucasians (31, 18, and 10%; P < 0.05), as was the development of renal events or death (34, 20, and 10%; P < 0.025). Our results suggest that both biological factors indicating an aggressive disease and low household income are common in African Americans and Hispanics with lupus nephritis, and outcomes in these groups are worse than in Caucasians.