Sensitivity volume as figure-of-merit for maximizing data importance in electrical impedance tomography

Objective.Electrical impedance tomography (EIT) is a noninvasive imaging method whereby electrical measurements on the periphery of a heterogeneous conductor are inverted to map its internal conductivity. The EIT method proposed here aims to improve computational speed and noise tolerance by introducing sensitivity volume as a figure-of-merit for comparing EIT measurement protocols.Approach.Each measurement is shown to correspond to a sensitivity vector in model space, such that the set of measurements, in turn, corresponds to a set of vectors that subtend a sensitivity volume in model space. A maximal sensitivity volume identifies the measurement protocol with the greatest sensitivity and greatest mutual orthogonality. A distinguishability criterion is generalized to quantify the increased noise tolerance of high sensitivity measurements.Main result.The sensitivity volume method allows the model space dimension to be minimized to match that of the data space, and the data importance to be increased within an expanded space of measurements defined by an increased number of contacts.Significance.The reduction in model space dimension is shown to increasecomputational efficiency, accelerating tomographic inversion by several orders of magnitude, while the enhanced sensitivitytolerates higher noiselevels up to several orders of magnitude larger than standard methods.

Establishing Foundational Nonarbitrary Distinctive and Categorical Relational Responding in Children with Autism

The present study sought to evaluate a sequence of training procedures on the emergence of foundational relational responses that underly more complex distinctive (i.e., difference) and hierarchical (i.e., categorical) relational frames. In a multiple baseline design, an initial baseline period with three children with autism showed that the participants did not select nonidentical stimuli from an array when presented the contextual cue "different." Simple discrimination training was efficacious in establishing this response and the skill transferred to a novel set of stimuli without reinforcement. In a second baseline period, participants did not demonstrate conditional identical/nonidentical relational responses when provided the contextual cues "same" and "different." Conditional discrimination training with all three participants was again efficacious in establishing the conditional reflexive and distinctive responses and the skill transferred to untrained stimuli. In a third baseline period, participants did not demonstrate correct conditional categorization/sorting. Like in the prior two training conditions, training was efficacious in establishing the target response with a generalized transfer to untrained stimuli.

APSIC dental infection prevention and control (IPC) guidelines

BACKGROUND

The Asia Pacific Society of Infection Control launched the Infection Prevention and Control Guidelines in July 2022. This document describes the guidelines and recommendations for safe practices in dental setting. It aims to highlight practical recommendations in a concise format designed to assist dental facilities at Asia Pacific region in achieving high standards in infection prevention and control practices, staff and patient safety.

METHOD

The guidelines were developed by an appointed workgroup comprising experts in the Asia Pacific region, following reviews of previously published international guidelines and recommendations relevant to each section.

RESULTS

It recommends standard precautions as a minimal set of preventive measures to protect staff and prevent cross transmission. Surgical aseptic technique is recommended when procedures are technically complex and longer in duration. Only trained staff are eligible to conduct reprocessing of dental instruments. The design, layout of the dental facility are important factors for successful infection prevention. The facility should also have a Pandemic Preparedness Plan.

CONCLUSIONS

Dental facilities should aim for excellence in infection prevention and control practices as this is part of patient safety. The guidelines that come with a checklist help dental facilities to identify gaps for improvement to reach this goal.

Mice deficient in endothelial cell-selective adhesion molecule develop left ventricle diastolic dysfunction

Funding Acknowledgements

Type of funding sources: Public Institution(s). Main funding source(s): American Heart Association

Background

Dysfunction of vascular endothelium plays a key role in the development of left ventricular diastolic dysfunction (LVDD) in patients with heart failure with preserved left ventricular ejection fraction (HFpEF). Recently, Endothelial Cell-Selective Adhesion Molecule (ESAM) was proposed as a novel biomarker in HFpEF.

Hypothesis. ESAM plays a mechanistic role in the development of both microvascular dysfunction and LVDD.

Methods

Animals: The study was performed utilizing ESAM knockout and wild type (WT) mice. Echocardiography: Left ventricular (LV) systolic and diastolic function and LV wall thickness were assessed by small animal ultrasound imaging (Vevo3100). Blood pressure measurement: Performed with tail-cuff plethysmography method. Vascular reactivity: Pulmonary arteries (2nd and 3rd order) were isolated from ESAM KO and WT mice, vascular reactivity was assessed with wire myography method. Evaluation of myocardial vascular density: Paraformaldehyde fixed paraffin embedded heart section (40 µm thick) from WT and ESAM KO mice stained with Tomato Lectin (Lycopersicon esculentum) DyLight594 to label vasculature were used. Unbiased automated tracing of the microvasculature was performed using the VesseLucida360 software (MBF), followed by a morphometric analysis (VesseLucida Explorer).

Results

Transthoracic echocardiography analysis showed that ESAM knockout mice displayed LV diastolic dysfunction, as indicated by a significantly reduced E/A ratio (E=early, A=late mitral inflow peak velocities), increased E/e’ ratio, isovolumic relaxation time (IVRT) and increased E wave deceleration time, with no change in the ejection fraction. The systolic blood pressure was not different between ESAM knockout and WT mice. Heart weight, related to body weight is increased in ESAM-deficient mice, pointing towards cardiac hypertrophy in these animals. Meanwhile, the analysis of the cardiac tissue vascularization with unbiased automated tracing of the microvasculature, reveals the decreased total vascular length per volume of the tissue in ESAM knockout mice. Using wire myography of the pulmonary artery vasodilator function we found that the endothelium-dependent, acetylcholine-induced relaxation of these arteries was significantly reduced in ESAM knockout mice, whereas endothelium-independent, nitric oxide donor, sodium nitroprusside-induced relaxation was similar in the two groups.

Conclusion

ESAM deficiency in mice resembles a HFpEF phenotype, in that ESAM knockout mice develop endothelial dysfunction and LVDD.

51-W average power, 169-fs pulses from an ultrafast non-collinear optical parametric oscillator

We present a high power optical parametric oscillator (OPO) synchronously pumped by the second-harmonic of a modelocked 1030-nm thin-disk laser (TDL) oscillator. The OPO delivers an average power of 51.1 W around degeneracy (1030 nm) with a 10.2-MHz repetition-rate. After extra-cavity dispersion compensation using dispersive mirrors, we obtain a pulse duration of 169 fs, which is 4.6× shorter than the TDL pulse duration of 770 fs. The TDL has 250 W average power, which is converted to 215 W at the second-harmonic. Hence, the OPO exhibits a high photon conversion efficiency of 47% (ratio of signal photons to 515-nm pump photons). Moreover, the OPO generates a peak power of 26.2 MW, which is very similar to the 28.0-MW peak power of the TDL. To facilitate continuous tuning around degeneracy and convenient extraction of the pump and idler beams, the OPO is operated in a noncollinear configuration. A linear cavity configuration was chosen since it offers easy alignment and straightforward cavity length tuning. To the best of our knowledge, this source has the highest average power generated by any ultrafast OPO, and the shortest pulse duration for any >5-W OPO. This result is an important step to adding wavelength tunability to high power Yb-based laser sources without the complexity of either laser or parametric amplifier systems.

Silicate bonding of sapphire to SESAMs: adjustable thermal lensing for high-power lasers

Silicate bonding is a flexible bonding method that enables room-temperature bonding of many types of materials with only moderate flatness constraints. It is a promising approach for bonding components in high power laser systems, since it results in a thin and low-absorption interface layer between the bonded materials. Here we demonstrate for the first time silicate bonding of a sapphire window to a SEmiconductor Saturable Absorber Mirror (SESAM) and use the composite structure to mode-lock a high-power thin-disk laser. We characterize the fabricated devices both theoretically and experimentally and show how the thermally induced lens of the composite structure can be tuned both in magnitude and sign via the thickness of the sapphire window. We demonstrate mode-locking of a high-power thin-disk laser oscillator with these devices. The altered thermal lens allows us to increase the output power to 233 W, a 70-W-improvement compared to the results achieved with a state-of-the-art SESAM in the same cavity.

Power scaling of ultrafast oscillators: 350-W average-power sub-picosecond thin-disk laser

We report a semiconductor saturable absorber mirror (SESAM)-modelocked thin-disk laser oscillator delivering a record 350-W average output power with 940-fs, 39-µJ pulses at 8.88-MHz repetition rate and 37-MW peak power. This oscillator is based on the Yb:YAG gain material and has a large pump spot on the disk. The cavity design includes an imaging scheme, which results in multiple reflections on the disk gain medium to enable a larger output coupling rate compared to those used in thin-disk oscillators with a single reflection on the disk. This reduces the intracavity power for a given output power, thus decreasing the stress on the intracavity components. We operate the laser in a low-pressure environment in order to limit the disk's thermal lensing and drastically reduce the nonlinearity picked up in the intracavity air medium. The combination of the imaging scheme and low-pressure operation paves the way to further power scaling of ultrafast thin-disk oscillators toward the kW milestone.

P2561Withdrawal of simulated obstructive sleep apnea partially reverses atrial arrhythmogenic substrate in rats

Background

Obstructive sleep apnea (OSA) is associated with structural alterations of the left atria (LA) and increased occurrence of atrial fibrillation (AF). Obstructive respiratory events lead to intermittent hypoxia (IH) and ineffective inspiration against the occluded upper airways, which result in intrathoracic and cardiac transmural pressure changes. Data on reversibility of LA-structural remodeling processes after withdrawal of OSA are still missing.

Objectives

Aim of the study was to develop a novel AF animal model mimicking intrathoracic pressure changes in addition to IH and to analyze the effect of OSA-withdrawal on atrial remodeling reversibility.

Method

In sedated rats (2% isoflurane), IH (n=9) was applied by intermittent increase in the respiratory dead volume. Standardized obstructive respiratory events were induced by defined intermittent negative upper airway pressure (INAP = inverse CPAP) applied via a customized mask connected to a negative pressure device (n=9). One minute of IH or INAP was followed by a rest period of nine minutes for four hours every second day. Rats with comparable anesthesia were used as controls (CTR). After three weeks, the animals were sacrificed. To analyze atrial structural remodeling reversibility, additional INAP-rats (n=5) were sacrificed after INAP-withdrawal of three weeks and compared to respective CTR (n=7).

Result

Blood pressure was not affected by IH or INAP. Intermittent desaturation and post-apneic hyperventilation were comparable in INAP- and IH-rats, but INAP-rats showed significantly higher breathing efforts during apneas compared to IH-rats. LA connexin43 (Cx43) protein expression assessed by quantitative immunofluorescence was reduced in both groups compared to CTR (0.77±0.07% in CTR vs. 0.45±0.06% in IH, p=0.02; CTR vs. 0.39±0.06% in INAP, p=0.005). However, LA interstitial fibrosis content (7.03±0.58% vs. CTR, p=0.01) and LA myocyte diameters (13.23±0.34μm vs. CTR, p=0.03) were increased in INAP-rats, but not in IH-rats. This was associated with longer inducible AF-durations in INAP-rats (11.65±4.43s vs. 0.72±0.33s in CTR, p=0.03) but not in IH-rats (1.28±0.33s vs. CTR, p=0.31). Three weeks of INAP-withdrawal (INAP-W) normalized interstitial fibrosis content (INAP-W vs. CTR, p=0.50) and LA-myocyte diameter (INAP-W vs. CTR, p=0.31). However, LA Cx43 protein expression remained low after three weeks of INAP withdrawal and inducible AF-episodes were still prolonged compared to respective CTR.

Conclusion

Application of INAP in rats mimics important components of OSA beyond IH and allows the study of an arrhythmogenic substrate in the atrium independent of the development of risk factors. In our model, withdrawal of INAP resulted in partial reversibility of structural LA remodeling but was not sufficient to abolish inducible AF-episodes completely. Future clinical studies are warranted to determine the anti-arrhythmic effect of isolated sleep apnea treatment in AF-patients.

Acknowledgement/Funding

Else Kröner-Fresenius-Stiftung, SFB-TRR219-M02/S-02

Abstract P5-13-19: Addressing non-adherence for breast cancer screening across ethnicity in southern Arizona

Background In Arizona, female breast cancer has the highest incidence rate and the second highest death rate compared to all other cancers. This ongoing single arm intervention study investigates non-adherence with recommended annual mammography or follow-up breast imaging. Data collected for this study is both retrospective, using the university Electronic Health Record (EHR) system (January 1, 2014 to September 30, 2017), and prospective, implementing a questionnaire during the intervention phase. Potential study participants were identified using EHR and categorized by BI-RADS (Breast Imaging-Reporting and Data System) 0 to 5. With IRB approval from University of Arizona, we designed a questionnaire to measure barriers to adherence and we navigate participants to schedule and attend follow-up appointments. This study's overall specific aims are to increase first time mammography screening by 25% among women in Southern Arizona; increase adherence or repeat screening rate by 20% among women lost to follow-up; establish the framework for a community- academic partnership in ethnically diverse areas. Women, age 40 and older who are not compliant with recommended annual mammograms or recommended follow-up screenings after a suspicious finding are eligible to participate in this study. Men and children, as well as women for whom breast imaging is not recommended are excluded from participating in this study. Results Patient's age was summarized by mean ± standard deviation for continuous variables and frequency and the associated percentage for categorical variables. BI-RADS scores were classified into Negative, Benign, Possible Malignancy and Proven Malignancy and compared between ethnic and racial groups using Fisher's exact test. Of 8823 non-compliant woman over nearly 4 years of data, 0.2% are BI-RADS 4 and 5, 2.2% are BI-RADS 3, 96% are BI-RADS 1 and 2, and 0.3% are BI-RADS 0. The mean age is 61.59 years, with 25% reporting as Hispanic, 66% reporting as non-Hispanic women (NHW), and 10% preferring to receive care in Spanish. Initial data shows only .24% with proven malignancies. Further, the data reveals that Hispanics have a slightly higher rate of possible malignancy (.36%) than NHW (.18%); however, NHW show a slightly higher rate of proven malignancy (.27% compared to .18%, respectively). Discussion These data provide valuable information for the direction of this study; in particular, understanding the disparity between Hispanic and NHW malignancies and developing culturally competent interventions and education materials to increase compliance with breast cancer screening recommendations. Further, these data indicate our focus should be on screening compliance for BI-RADS 1 and 2. These data also point to a possible high non-compliance issue. Comparing non-compliance data from other regional clinics will continue to shape this study's direction. The target sample size for this study is 300 participants. We accept a 95% confidence level and a 5% margin of error. Out of 420 recruitment letters mailed, the navigators have reached 152 potential participants by phone and have a 26% study recruitment rate (n=40).

Citation Format: Huff AJ, Gomez J, Calhoun E, Hsu C-H, Chalasani P, Fitzpatrick K, Borders M, Lang L, Prado Y. Addressing non-adherence for breast cancer screening across ethnicity in southern Arizona [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-13-19.

Towards Implementation of OMOP in a German University Hospital Consortium

Background  In 2015, the German Federal Ministry of Education and Research initiated a large data integration and data sharing research initiative to improve the reuse of data from patient care and translational research. The Observational Medical Outcomes Partnership (OMOP) common data model and the Observational Health Data Sciences and Informatics (OHDSI) tools could be used as a core element in this initiative for harmonizing the terminologies used as well as facilitating the federation of research analyses across institutions.

Objective  To realize an OMOP/OHDSI-based pilot implementation within a consortium of eight German university hospitals, evaluate the applicability to support data harmonization and sharing among them, and identify potential enhancement requirements.

Methods  The vocabularies and terminological mapping required for importing the fact data were prepared, and the process for importing the data from the source files was designed. For eight German university hospitals, a virtual machine preconfigured with the OMOP database and the OHDSI tools as well as the jobs to import the data and conduct the analysis was provided. Last, a federated/distributed query to test the approach was executed.

Results  While the mapping of ICD-10 German Modification succeeded with a rate of 98.8% of all terms for diagnoses, the procedures could not be mapped and hence an extension to the OMOP standard terminologies had to be made.

Overall, the data of 3 million inpatients with approximately 26 million conditions, 21 million procedures, and 23 million observations have been imported.

A federated query to identify a cohort of colorectal cancer patients was successfully executed and yielded 16,701 patient cases visualized in a Sunburst plot.

Conclusion  OMOP/OHDSI is a viable open source solution for data integration in a German research consortium. Once the terminology problems can be solved, researchers can build on an active community for further development.

Atf3 deficiency promotes genome instability and spontaneous tumorigenesis in mice

Mice lacking genes involving in the DNA damage response (DDR) are often tumor prone owing to genome instability caused by oncogenic challenges. Previous studies demonstrate that activating transcription factor 3 (ATF3), a common stress sensor, can activate the tumor suppressor p53 and regulate expression of p53 target genes upon DNA damage. However, whether ATF3 contributes to the maintenance of genome stability and tumor suppression remains unknown. Here we report that Atf3-deficient (Atf3^-/-) mice developed spontaneous tumors, and died significantly earlier than wild-type (Atf3^+/+) mice. Consistent with these results, Atf3^-/- mouse embryonic fibroblasts (MEFs) had more aberrant chromosomes and micronuclei, and were genetically unstable. Whereas we demonstrated that ATF3 activated p53 and promoted its pro-apoptotic activity in mouse thymi and small intestines, the chromosomal instability caused by Atf3 deficiency was largely dependent on the regulation of p53 by ATF3. Interestingly, loss of Atf3 also promoted spontaneous tumorigenesis in Trp53^+/- mice, but did not affect tumor formation in Trp53^-/- mice. Our results thus provide the first genetic evidence linking ATF3 to the suppression of the early development of cancer, and underscore the importance of ATF3 in the maintenance of genome integrity.

[Field investigation of occupational disease diagnosis in Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment from 2009 to 2014: an analysis of 136 cases]

OBJECTIVE

To investigate the characteristics of 136 patients with occupational diseases, to summarize key techniques used in field investigation, and to provide a scientific basis for the development of standard operating procedures for field investigation of occupational disease diagnosis.

METHODS

Field investigation and routine data analysis were performed to analyze the cases diagnosed by Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment from January 2009 to December 2014.

RESULTS

A total of 136 cases of occupational diseases were diagnosed by Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment from 2009 to 2014, and there were 66 cases of leukemia, 18 cases of suspected occupational benzene poisoning, 12 cases of suspected occupational handarm vibration disease, and 11 cases of suspected pneumoconiosis. Of all these patients, 41.91% were engaged in at least three types of work, 70.59% were exposed to at least three types of chemicals, 25.74% experienced changes in technical processes and chemicals, and 47.06% had disputes on the chemicals they were exposed to during verification by both parties. Occupational hazard factors were detected. Most samples (358)were used to measure benzene concentration in workplace air, among which 11.7% had a benzene concentration of >6.00 mg/m(3)(exceeding standard), 13.41% had a benzene concentration of 3.26~6.00 mg/m(3), 75.42% had a benzene concentration of<0.03 to <3.25 mg/m(3). The samples of suspected occupational hand-arm vibration disease, suspected pneumoconiosis, and suspected occupational noiseinduced hearing loss had high overstandard rates (100%, 93.8%, and 83.3%, respectively).

CONCLUSION

Field investigation of occupational disease diagnosis reveals large numbers of cases of leukemia, suspected occupational benzene poisoning, suspected occupational hand-arm vibration disease, and suspected pneumoconiosis. The key aspects of field investigation include confirmation of the history of occupational exposure, identification of occupational hazard factors, confirmation of the changes in technical processes and chemicals, detection of occupational hazard factors, sampling and analysis of raw materials, and epidemiological investigation of workers with the same type of work.

Evaluation of effectiveness and satisfaction outcomes of a mental health screening and referral clinical pathway for community nursing care

The study aimed to explore the effectiveness of a mental health screening and referral clinical pathway for generalist community nursing care of war veterans and war widow(er)s in Australia on outcomes of client self-reported mental health, quality of life, and client and carer satisfaction. The pathway was developed by literature review and consultation, then trialled and evaluated. Validated screening tools were embedded within the pathway to support generalist nurses' mental health decision making. Pre- and post-measures were applied. Clients on whom the pathway was trialled were invited to complete an evaluation survey questionnaire, as were their informal carers. Most clients and carers who responded to these questionnaires were highly satisfied or satisfied with care provided through application of the pathway. This study adds understanding about one way that community nurses might identify people with mental health difficulties. The trialled pathway, which was modified and refined following the study, is now available on the Internet as an evidence-based resource for community nurses in Australia to guide practice and maximize holistic care for war veterans and war widow(er)s where that care is funded by Department of Veterans' Affairs.

Semi-remote production of Br-76 and preparation of high specific activity radiobrominated pharmaceuticals for PET studies

The PET radionuclide 76Br (t1/2=16.2 h) can be easily produced utilizing the nuclear reaction As(3He,2n)76Br. We use high-purity arsenic targets and isolate radioactive bromide by chromic acid oxidation followed by simple distillation of [76Br] hydrogen bromide using a semi-remote apparatus. Use of reagents with little or no carrier bromine yields high specific activity radiobrominated pharmaceuticals prepared from the distilled [76Br] hydrogen bromide.

PET imaging of 5-HT1A receptor binding in patients with temporal lobe epilepsy

BACKGROUND

Activation of central serotonin (5-HT)1A receptors, found in high density in brainstem raphe, hippocampus, and temporal neocortex, exerts an anticonvulsant effect in various experimental seizure models. To test the hypothesis that 5-HT1A receptor binding is reduced in human epileptic foci, PET imaging was performed using the radioligand [18F]trans-4-fluoro-N-2-[4-(2-methoxyphenyl)piperazin-1-yl]ethyl]-N-(2-pyridyl)cyclohexanecarboxamide ([18F]FCWAY), a selective 5-HT1A receptor antagonist, in patients with temporal lobe epilepsy and normal controls.

METHODS

MRI and PET were performed using [15O]water and [18F]FCWAY in 10 controls and in 12 patients with temporal lobe epilepsy confirmed on ictal video-EEG; patients also underwent [18F]fluorodeoxyglucose PET. Using quantitative PET image analysis, regional values were obtained for [18F]FCWAY volume of distribution (V), cerebral blood flow (CBF), and glucose cerebral metabolic rate (CMRglc). Hippocampal volume (HV) was also measured with MRI. [18F]FCWAY V PET and MR measures were compared within patients and controls using paired t-tests; grouped comparisons were made with two sample t-tests.

RESULTS

Lower [18F]FCWAY V was found ipsilateral than contralateral to the epileptic focus in inferior medial (IMT) and lateral (ILT) temporal regions of patients (ILT 47.4 +/- 6.1 vs 61.8 +/- 6.1, p < 0.01; IMT 52 +/- 4.6 vs 67.0 +/- 6.0, p < 0.01). [18F]FCWAY V was 29% lower in raphe and 34% lower in the ipsilateral thalamic region of patients than controls. In ILT, mean [18F]FCWAY V asymmetry index (AI) was significantly greater than mean CBF and mean CMRglc AI. Mean [18F]FCWAY V AI in IMT was greater than mean HV AI, but the difference was not significant.

CONCLUSION

These findings support the hypothesis of reduced serotonin receptor binding in temporal lobe epileptic foci.

Liquid chromatography-tandem mass spectrometry identification of metabolites of two 5-HT1A antagonists, N-[2-[4-(2-methoxylphenyl)piperazino]ethyl]-N-(2-pyridyl) trans- and cis-4-fluorocyclohexanecarboxamide, produced by human and rat hepatocytes

Two 5-HT1A antagonists, t-FCWAY and c-FCWAY, were developed as imaging agents for positron emission tomography (PET). In order to evaluate these compounds, hepatocytes from both human and rat were utilized to produce metabolites and LC-MS-MS was used to identify metabolites. These in vitro metabolism studies indicate that hydrolysis of the amide linkage is the major metabolism pathway for humans, whereas aromatic ring-oxidation is the major metabolism pathway for rat. The rat hepatocyte results correlate well with in vivo rat metabolism studies. Based on the structures of the metabolites, we have developed an extraction procedure to determine the concentration of the parent compound in plasma.

PET evaluation of [(18)F]FCWAY, an analog of the 5-HT(1A) receptor antagonist, WAY-100635

We synthesized [(18)F]FCWAY, an analog of [carbonyl-(11)C]WAY-100635 ¿[(11)C]N-(2-(1-(4-(2-methoxyphenyl)-piperazinyl)ethyl))-N-(2-(pyridi nyl))cyclohexanecarboxamide¿, by replacing the cyclohexanecarbonyl group acid with a trans-4-fluorocyclohexanecarbonyl group (FC). Control and preblocking studies were performed in anesthetized monkeys. Plasma radioactive metabolite analysis showed the presence of [(18)F]FC and [(18)F]fluoride. Tissue time-radioactivity curves were corrected for metabolite contamination based on separate positron-emission tomography studies of these two labeled metabolites. Analysis using a two-tissue compartment model gave distribution volume (V) estimates (mL/mL) ranging from 33 in frontal cortex to 4 in cerebellum. Preblocking data showed uniform V of 2-3 mL/mL. These studies demonstrate that [(18)F]FCWAY has very similar kinetic characteristics to [(11)C]WAY-100635.

Fluoro analogs of WAY-100635 with varying pharmacokinetics properties

Radiolabeled derivatives of WAY-100635 have been shown to be important for imaging in vivo because of their antagonist properties and their specificity for the 5-hydroxytryptamine(1A) (5-HT(1A)) receptor. Our goal is to prepare a series of radiofluorinated derivatives of WAY-100635 that, in the rat, range in pharmacokinetic properties from nearly irreversible to reversible in their behavior. It appears that derivatives containing a cyclohexanecarboxylic acid (e.g., FCWAY) with its high affinity and high target to nontarget contrast, has properties suited to measure receptor concentration. Derivatives based on phenylcarboxamide (e.g., FBWAY and MeFBAWAY) have properties more suited to the measurement of changes in endogenous serotonin. The compound containing the pyrimidine moiety in place of the pyridine moeity in FBWAY (FBWAY 1,3N) appears to have intermediate properties.

Stress-induced, tissue-specific enrichment of hsp70 mRNA accumulation in Xenopus laevis embryos

In this study, we have employed whole-mount, in situ hybridization to study the spatial pattern of hsc70 and hsp70 mRNA accumulation in normal and heat shocked embryos during Xenopus laevis development. Our findings revealed that hsc70 mRNA was constitutively present in a global fashion throughout the embryo and was not heat inducible. Accumulation of hsp70 mRNA, however, was detected only in heat shocked embryos. Furthermore, hsp70 mRNA accumulation was enriched in a tissue-specific manner in X. laevis tailbud embryos within 15 minutes of a 33 degrees C heat shock. Abundant levels of heat shock-induced hsp70 mRNA were detected in the head region, including the lens placode, the cement gland, and in the somitic region and proctodeum. Preferential heat-induced accumulation of hsp70 mRNA was first detected at a heat shock temperature of 30 degrees C. Placement of embryos at 22 degrees C after a 1-hour, 33 degrees C heat shock resulted in decreased hsp70 mRNA with time, but the message persisted in selected tissues, including the lens placode and somites. Treatment of tailbud embryos with either sodium arsenite or zinc chloride induced a tissue-specific enrichment of hsp70 mRNA in the lens placode and somitic region. These studies reveal the complex nature of the heat shock response in different embryonic tissues and suggest the presence of regulatory mechanisms that lead to a stressor-induced, tissue-specific enrichment of hsp70 mRNA.

Biologically stable [(18)F]-labeled benzylfluoride derivatives

Use of the [(18)F]-fluoromethyl phenyl group is an attractive alternative to direct fluorination of phenyl groups because the fluorination of the methyl group takes place under milder reaction conditions. However, we have found that 4-FMeBWAY showed femur uptake equal to that of fluoride up to 30 min in rat whereas 4-FMeQNB had a significantly lower percent injected dose per gram in femur up to 120 min. For these and other benzylfluoride derivatives, there was no clear in vivo structure-defluorination relationship. Because benzylchlorides (BzCls) are known alkylating agents, benzylfluorides may be alkylating agents as well, which may be the mechanism of defluorination. On this basis, the effects of substitution on chemical stability were evaluated by the 4-(4-nitro-benzyl)-pyridine (NBP) test, which is used to estimate alkylating activity with NBP. The effect of substitution on the alkylating activity was evaluated for nine BzCl derivatives: BzCl; 3- or 4-methoxy (electron donation) substituted BzCl; 2-, 3-, or 4-nitro (electron withdrawing) substituted BzCl; and 2-, 3-, or 4-chloro (electron withdrawing) substituted BzCl. Taken together, the alkylating reactivity of 3-chloro-BzCl was the weakest. This result was then applied to [(18)F]-benzylfluoride derivatives and in vivo and in vitro stability were evaluated. Consequently, 3-chloro-[(18)F]-benzylfluoride showed a 70-80% decrease of defluorination in both experiments in comparison with [(18)F]-benzylfluoride, as expected. Moreover, a good linear relationship between in vivo femur uptake and in vitro hepatocyte metabolism was observed with seven (18)F-labeled radiopharmaceuticals, which were benzylfluorides, alkylfluorides, and arylfluorides. Apparently, the [(18)F]-fluoride ion is released by metabolism in the liver in vivo. In conclusion, 3-chloro substituted BzCls are the most stable, which suggests that 3-chloro benzylfluorides will be the most chemically stable compound. This result should be important in future design of radioligands labeled with a benzylfluoride moiety.

Spatial pattern of constitutive and heat shock-induced expression of the small heat shock protein gene family, Hsp30, in Xenopus laevis tailbud embryos

We employed whole-mount in situ hybridization and immunohistochemistry to study the spatial pattern of hsp30 gene expression in normal and heatshocked embryos during Xenopus laevis development. Our findings revealed that hsp30 mRNA accumulation was present constitutively only in the cement gland of early and midtailbud embryos, while hsp30 protein was detected until at least the early tadpole stage. Heat shock-induced accumulation of hsp30 mRNA and protein was first observed in early and midtailbud embryos with preferential enrichment in the cement gland, somitic region, lens placode, and proctodeum. In contrast, cytoskeletal actin mRNA displayed a more generalized pattern of accumulation which did not change following heat shock. In heat shocked midtailbud embryos the enrichment of hsp30 mRNA in lens placode and somitic region was first detectable after 15 min of a 33 degrees C heatshock. The lowest temperature capable of inducing this pattern was 30 degrees C. Placement of embryos at 22 degrees C following a 1-h 33 degrees C heat shock resulted in decreased hsp30 mRNA in all regions with time, although enhanced hsp30 mRNA accumulation still persisted in the cement gland after 11 h compared to control. In late tailbud embryos the basic midtailbud pattern of hsp30 mRNA accumulation was enhanced with additional localization to the spinal cord as well as enrichment across the embryo surface. These studies demonstrate that hsp30 gene expression can be detected constitutively in the cement gland of tailbud embryos and that heat shock results in a preferential accumulation of hsp30 mRNA and protein in certain tissues.

Targeting of transferrin receptors in nude mice bearing A431 and LS174T xenografts with [18F]holo-transferrin: permeability and receptor dependence

The goal of this study was to investigate whether 18F-labeled transferrin (Tf), which has a molecular weight (Mr) of approximately 79,000, binds to Tf receptor sites in tumors in a specific manner within the time frame commensurate with the half-life of 18F (109.7 min). We have previously shown that [18F]holo-Tf ([18F]Tf) maintains all properties of native Tf in vitro and that it can specifically target liver Tf receptor sites in vivo.

METHODS

The distribution of [18F]Tf, using [18F]albumin (Alb) or [14C]Alb as a control, was studied over a 6-h period in nude mice bearing LS174T and A431 xenografts of a high- and low-permeability tumor, respectively.

RESULTS

Measurements of Tf receptor concentration in the tumor extracts suggest similar binding capacities. In vivo, liver uptake values were higher for [18F]Tf than for both [18F]Alb and [14C]Alb throughout the study, indicating specific binding. In contrast, tumor Tf uptake values remained below those of the Alb tracers, and tumor-to-blood ratios of [18F]Tf in each xenograft increased in parallel with those of the Alb tracers. The permeabilities of [14C]Alb and [18F]Tf in LS174T were calculated to be 1.29+/-0.49 and 1.03+/-0.38 microL/min/g (mean +/- SD), respectively, whereas the permeabilities of the two tracers in A431 were 0.79+/-0.24 and 0.44+/-0.04 microL/min/g. Pharmacokinetic modeling of the data using these permeabilities and the high plasma and extracellular concentrations of endogenous Tf showed that the observed uptake values in the two xenografts are consistent with a non-receptor-mediated distribution. In the liver, the absence of permeability barriers yields specific [18F]Tf binding to receptors compared with the [14C]Alb control, within 5 min after injection.

CONCLUSION

Receptor-mediated accumulation of [18F]Tf in tumor xenografts is impaired by rate-determining permeability and competition from endogenous Tf and is not achieved in a time frame of 6 h.

Development of fluorine-18-labeled 5-HT1A antagonists

We have synthesized five fluorinated derivatives of WAY 100635, N-{2-[4-(2-methoxyphenyl)piperazino]ethyl}-N-(2-pyridyl)cyclohe xaneca rboxamide (4a), using various acids in place of the cyclohexanecarboxylic acid (CHCA, 2a) in the reaction scheme. The five acids are 4-fluorobenzoic acid (FB, 2b), 4-fluoro-3-methylbenzoic acid (MeFB, 2c), trans-4-fluorocyclohexanecarboxylic acid (FC, 2d), 4-(fluoromethyl)benzoic acid (FMeB, 2e), and 3-nitro-4-(fluoromethyl)benzoic acid (NFMeB, 2f) (see Scheme 1). These compounds were radiolabeled with fluorine-18, and their biological properties were evaluated in rats and compared with those of [11C]carbonyl WAY 100635 ([carbonyl-11C]4a). [Carbonyl-11C]4a cleared the brain with a biological half-life averaging 41 min. The metabolite-corrected blood radioactivity had a half-life of 29 min. [18F]FCWAY ([18F]4d) gave half-lives and intercepts comparable to [carbonyl-11C]4a in the brain, but the blood clearance was faster. [18F]FBWAY ([18F]4b) showed an early rapid net efflux from the whole brain, clearing with a biological half-life of 35 min. The metabolite-corrected blood half-life was 41 min. The comparable whole brain and blood half-lives for Me[18F]FBWAY ([18F]4c) were 16 and 18 min, respectively. For each compound, the corresponding carboxylic acid was identified as a major metabolite in blood. Fluoride was also found after injection of [18F]4d. However, for all compounds there was a good correlation (R > 0.97) between the differential uptake ratio (DUR, (%ID/g) x body weight (g)/100) in individual rat brain regions at 30 min after injection and the concentration of receptors as determined by in vitro quantitative autoradiography in rat. Specific binding ratios [region of interest (ROI)/cerebellum-1] in control studies for cortex (Ctx) and hippocampus (H) were higher for [carbonyl-11C]4a and [18F]4d compared to [18F]4b and [18F]4c. [18F]4d has similar pharmacokinetic properties and comparable specific binding ratios to [carbonyl-11C]4a. Fifty nanomoles of 4a blocked only 30% of the specific binding of [18F]4d, while complete blockade was obtained from co-injection of 200 nmol of 4a (H/Cb-1 from 17.2 to 0.6). [18F]4b and [18F]4c showed lower specific binding ratios than [carbonyl-11C]4a and [18F]4d. [18F]4c was superior to [18F]4b since its specific binding was more readily blocked by 4a. These studies suggest that [18F]4c should be a useful compound to assess dynamic changes in serotonin levels while [18F]4d, with its high contrast and F-18 label, should provide better statistics and quantification for static measurement of 5-HT1A receptor distribution.

HOLON/CADSE: integrating open software standards and formal methods to generate guideline-based decision support agents

This paper describes the efforts of a consortium that is trying to develop and validate formal methods and a meta-environment for authoring, checking, and maintaining a large repository of machine executable practice guidelines. The goal is to integrate and extend a number of open software standards so that guidelines in the meta-environment become a resource that any vendor can plug their applications into and run in their proprietary environment provided they conform to the interface standards.

VIP and breast cancer

VIP1 receptors are present in breast cancer cells. VIP elevates the cAMP and stimulates nuclear oncogene expression in MCF-7 cells. VIPhybrid is a VIP receptor antagonist that inhibits breast cancer proliferation. A VIP analog has been developed for imaging breast tumors. Therefore VIP1 receptors may be utilized for the early detection and treatment of breast cancer.

Aminosyn II effectively blocks renal uptake of 18F-labeled anti-tac disulfide-stabilized Fv

Because intact IgG has limitations as a tumor-imaging agent, radiolabeled Fv fragments are being evaluated. Due to the high renal accumulation of Fv fragments, methods to block renal uptake are being sought. This study evaluated how well Aminosyn II, a Food and Drug Administration-approved 15% amino acid solution, would block the renal accumulation of 18F anti-Tac disulfide-stabilized Fv (dsFv) fragments (small fragments with high renal uptake). The anti-Tac dsFv is directed against the alpha subunit of the interleukin 2 receptor. It was labeled at specific activities of 1.1-2.7 mCi/mg using N-succinimidyl 4-[18F]fluoromethyl benzoate. Four adult baboons were injected i.v. with 0.7-1.9 mCi and 150 microg of dsFv. Each baboon was preinjected with Aminosyn II i.v. and, on a separate occasion, with a control solution. Thirty min before injection of 18F-labeled anti-Tac dsFv, a bolus of either solution was given, followed by a constant infusion of 13.3 ml/kg/h. Quantitative positron emission tomography imaging was performed. The amino acid levels in serum were measured serially. The baseline levels of lysine (and other amino acids) in plasma were not significantly different in either the Aminosyn II or control infusion group and did not change during the control infusion. In the Aminosyn II group, lysine levels in plasma 5 min before anti-Tac dsFv infusion were 5-15 times higher than the baseline value and continued to rise during the infusion. The areas under the curve in blood of the 18F-labeled anti-Tac dsFv, from time of injection to end of imaging, expressed as percentage injected dose (%ID), were 28.94 +/- 4.05%ID x h/liter (mean +/- SD) for the control group and 32.09 +/- 11.15%ID x h/liter for the Aminosyn II group (P = 0.54). The peak concentration of 18F-labeled anti-Tac dsFv in the kidney of the controls was 24.53 +/- 4.34%ID; the value in the Aminosyn II group was 5.39 +/- 1.89%ID, representing a mean decrease of 78.5%. The times to reach 90% of the peak levels of 18F in the kidney were 5.6 +/- 3.0 min for the Aminosyn II group and 33.8 +/- 4.8 min for the control group. The amounts excreted in urine by 90 min were 47.7 +/- 8.55%ID and 78.5 +/- 12.8%ID (P = 0.01) for the controls and Aminosyn II group, respectively. In conclusion, Aminosyn II effectively blocks the renal accumulation of 18F-labeled anti-Tac dsFv. Use of Aminosyn II should allow much higher tracer administration for the same radiation exposure to the target organ (kidney).