Amide proton transfer-weighted imaging with a short acquisition time based on a self B0 correction using the turbo spin echo-Dixon method: A phantom study

PURPOSE

Conventional amide proton transfer (APT)-weighted imaging requires a chemical exchange saturation transfer (CEST) sequence with multiple saturation frequency offsets and a B0 correction sequence, plus a long acquisition time that can be reduced by applying the conventional method using CEST images with seven radiation pulses (i.e., the seven-points method). For a further reduction of acquisition times, we propose fast two-dimensional (2D) APT-weighted imaging based on a self B0 correction using the turbo spin echo (TSE)-Dixon method. We conducted a phantom study to investigate the accuracy of TSE-Dixon APT-weighted imaging.

METHODS

We prepared two types of phantoms with six samples for a concentrationdependent evaluation and a pH-dependent evaluation. APT-weighted images were acquired by the conventional, seven-points, and TSE-Dixon methods. Linear regression analyses assessed the dependence between each method's APT signal intensities (SIs) and the concentration or pH. We performed a one-way analysis of variance with Tukey's honestly significant difference post hoc test to compare the APT SIs among the three methods. The agreement of the APT SIs between the conventional and seven-points or TSE-Dixon methods was assessed by a Bland- Altman plot analysis.

RESULTS

The APT SIs of all three acquisition methods showed positive concentration dependence and pH dependence. No significant differences were observed in the APT SIs between the conventional and TSE-Dixon methods at each concentration. The Bland-Altman plot analyses showed that the APT SIs measured with the seven-points method resulted in 0.42% bias and narrow 95% limits of agreement (LOA) (0.93%-0.09%) compared to the conventional method. The APT SIs measured using the TSE-Dixon method showed 0.14% bias and similar 95% LOA (-0.33% to 0.61%) compared with the seven-points method. The APT SIs of all three methods showed positive pH dependence. At each pH, no significant differences in the APT SIs were observed among the methods. Bland-Altman plot analyses showed that the APT SIs measured with the seven-points method resulted in low bias (0.03%) and narrow 95% LOA (-0.30% to 0.36%) compared to the conventional method. The APT SIs measured by the TSE-Dixon method showed slightly larger bias (0.29%) and similar 95% LOA (from -0.15% to 0.72%) compared to those measured by the seven-points method.

CONCLUSION

These results demonstrated that our proposed method has the same concentration dependence and pH dependence as the conventional method and the seven-points method. We thus expect that APT-weighted imaging with less influence of motion can be obtained in clinical examinations.

Effect of Saturation Pulse Duration and Power on pH-weighted Amide Proton Transfer Imaging: A Phantom Study

PURPOSE

Amide proton transfer (APT) imaging may detect changes in tissues' pH based on the chemical exchange saturation transfer (CEST) phenomenon, and thus it may be useful for identifying the penumbra in ischemic stroke patients. We investigated the effect of saturation pulse duration and power on the APT effect in phantoms with different pH values.

METHODS

Five samples were prepared from a 1:10 solution of egg-white albumin in phosphate-buffered saline at pH 6.53-7.65. The APT signal intensity (SI) was defined as asymmetry of the magnetization transfer ratio at 3.5 ppm. We measured the APT SIs in the egg-white albumin samples of different pH values with saturation pulse durations of 0.5, 1.0, 2.0, and 3.0 sec and saturation pulse powers of 0.5, 1.5, and 2.5 μT. The relative change in the APT SI in relation to the saturation duration and power at different pH values was defined as follows: (APT SI each saturation pulse - APT SI shortest or weakest pulse)/APT SIshortest or weakest pulse. The dependence of the APT SI on pH and the relative change in the APT SI were calculated as the slope of the linear regression.

RESULTS

The lower the pH, the larger the relative change in the APT SI, due to the change in saturation pulse duration and power. The APT SI was highly correlated with the pH at all saturation pulse durations and powers.

CONCLUSION

The influence of saturation duration and power on the APT effect was greater at lower pH than higher pH. The combination of saturation pulse ≥ 1.0 s and power ≥ 1.5 μT was useful for the sensitive detection of changes in APT effects in the egg-white albumin samples with different pH values.

Grading of gliomas using 3D CEST imaging with compressed sensing and sensitivity encoding

PURPOSE

We evaluated the usefulness of three-dimensional (3D) chemical exchange saturation transfer (CEST) imaging with compressed sensing and sensitivity encoding (CS-SENSE) for differentiating low-grade gliomas (LGGs) from high-grade gliomas (HGGs).

METHODS

We evaluated 28 patients (mean age 51.0 ± 13.9 years, 13 males, 15 females) including 12 with LGGs and 16 with HGGs, all acquired using a 3 T magnetic resonance (MR) scanner. Nine slices were acquired for 3D CEST imaging, and one slice was acquired for two-dimensional (2D) CEST imaging. Two radiological technologists each drew a region of interest (ROI) surrounding the high-signal-intensity area(s) on the fluid-attenuated inversion recovery image of each patient. We compared the magnetization transfer ratio asymmetry (MTRasym) at 3.5 ppm in the tumors among the (i) single-slice 2D CEST imaging ("2D"), (ii) all tumor slices of the 3D CEST imaging (3D_all), and (iii) a representative tumor slice of 3D CEST imaging (maximum signal intensity [3D_max]). The relationship between the MTRasym at 3.5 ppm values measured by these three methods and the Ki-67 labeling index (LI) of the tumors was assessed. Diagnostic performance was evaluated with a receiver operating characteristic analysis. The Ki-67LI and MTRasym at 3.5 ppm values were compared between the LGGs and HGGs.

RESULTS

A moderate positive correlation between the MTRasym at 3.5 ppm and the Ki-67LI was observed with all three methods. All methods proved a significantly larger MTRasym at 3.5 ppm for the HGGs compared to the LGGs. All methods showed equivalent diagnostic performance. The signal intensity varied depending on the slice position in each case.

CONCLUSIONS

The 3D CEST imaging provided the MTRasym at 3.5 ppm for each slice cross-section; its diagnostic performance was also equivalent to that of 2D CEST imaging.

Optimization of the refocusing flip angle in the characterization of cerebrospinal fluid dynamics using multi-spin echo acquisition cine imaging (MUSACI)

PURPOSE

Multi-spin echo acquisition cine imaging (MUSACI) is a method used for cerebrospinal fluid (CSF) dynamics imaging based on the proton phase dispersion and flow void using 3D multi-spin echo imaging. In a previous study, the refocusing flip angle of MUSACI was set at a constant 80°. We conducted the present study to investigate the preservation the CSF signal intensity even in a long echo train and improve the ability to visualize CSF movement by modifying the refocusing flip angle in MUSACI.

METHODS

The MUSACI images were acquired in 10 healthy volunteers (7 men and 3 women; age range 24-44 years; mean age 29.4 ± 6.2 years) with a 3.0 Tesla MR scanner. Five refocusing flip angle sets were applied: constant 30°, constant 50°, constant 80°, pseudo-steady state (PSS) 50°-70°-100° (PSS50°), and PSS80°-100°-130° (PSS80°). In all sequences, the in-plane spatial resolution was 0.58 × 0.58 mm², and the CSF movement for one heartbeat was drawn at 80-msec intervals. The signal intensity (SI) of CSF in the lateral ventricle, the foramen of Monro, the third ventricle, the fourth ventricle, and the pons was measured on MUSACI. Pearson's correlation coefficient was calculated between the CSF SI and effective echo time (TE; TE_eff) in the lateral ventricle.

RESULTS

Both antegrade and retrograde CSF movements on the midsagittal MUSACI images and the retrograde CSF movement in the foramen of Monro was observed in all sequences with the constant flip angles. A strong reverse correlation between the CSF SI in the lateral ventricle and TE_eff values was observed with constant 30° (r = -0.96, p < 0.01), constant 50° (r = -0.97, p < 0.01) and constant 80° (r = -0.88, p < 0.01). A weak positive correlation was observed with PSS50° (r = 0.28, p = 0.43), and a moderate reverse correlation was observed at PSS80° (r = -0.60, p = 0.07). The SI values of the foramen of Monro, the third ventricle, and the fourth ventricle were significantly lower than that of the lateral ventricle, and those values were higher than that of the pons in both the constant 80° sequence and the PSS 50° sequence.

CONCLUSION

PSS50° could be the optimal flip angle scheme for MUSACI, because the SI changes due to CSF movement and the SI preservation due to a long echo train were large due to the use of the refocusing flip angle method.

A Qualitative and Quantitative Correlation Study of Lumbar Intervertebral Disc Degeneration Using Glycosaminoglycan Chemical Exchange Saturation Transfer, Pfirrmann Grade, and T1-ρ

BACKGROUND AND PURPOSE

Glycosaminoglycan chemical exchange saturation transfer (gagCEST) imaging allows the direct measurement and mapping of glycosaminoglycans. In this study, we aimed to evaluate the usefulness of gagCEST imaging in the quantitative assessment of intervertebral disc degeneration in a comparison with Pfirrmann grade and T1-ρ measurements.

MATERIALS AND METHODS

Ninety-six lumbar intervertebral discs in 24 volunteers (36.0 ± 8.5 years of age, 21 men and 3 women) were examined with both gagCEST imaging and T1-ρ measurements. The gagCEST imaging was performed at 3T with a saturation pulse with 1.0-second duration and the B₁ amplitude of 0.8 μT followed by imaging by a 2D fast spin-echo sequence. The Z-spectra were obtained at 25 frequency offsets from -3 to +3 ppm (step, 0.25 ppm). A point-by-point B₀ correction was performed with a B₀ map. The gagCEST signal and T1-ρ values were measured in the nucleus pulposus in each intervertebral disc. The Pfirrmann grades were assessed on T2-weighted images.

RESULTS

The gagCEST signal at grade I (5.36% ± 2.79%) was significantly higher than those at Pfirrmann grade II (3.15% ± 1.40%, P = .0006), grade III (0.14% ± 1.03%, P < .0001), grade IV (-1.75% ± 2.82%, P < .0001), and grade V (-1.47% ± 0.36%, P < .0001). The gagCEST signal at grade II was significantly higher than those of grade III (P < .0001), grade IV (P < .0001), and grade V (P < .0001). The gagCEST signal was significantly correlated negatively with Pfirrmann grade (P < .0001) and positively correlated with T1-ρ (P < .0001).

CONCLUSIONS

GagCEST imaging could be a reliable and quantitative technique for assessing intervertebral disc degeneration.

Impact of pixel-based machine-learning techniques on automated frameworks for delineation of gross tumor volume regions for stereotactic body radiation therapy

The aim of this study was to investigate the impact of pixel-based machine learning (ML) techniques, i.e., fuzzy-c-means clustering method (FCM), and the artificial neural network (ANN) and support vector machine (SVM), on an automated framework for delineation of gross tumor volume (GTV) regions of lung cancer for stereotactic body radiation therapy. The morphological and metabolic features for GTV regions, which were determined based on the knowledge of radiation oncologists, were fed on a pixel-by-pixel basis into the respective FCM, ANN, and SVM ML techniques. Then, the ML techniques were incorporated into the automated delineation framework of GTVs followed by an optimum contour selection (OCS) method, which we proposed in a previous study. The three-ML-based frameworks were evaluated for 16 lung cancer cases (six solid, four ground glass opacity (GGO), six part-solid GGO) with the datasets of planning computed tomography (CT) and ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT images using the three-dimensional Dice similarity coefficient (DSC). DSC denotes the degree of region similarity between the GTVs contoured by radiation oncologists and those estimated using the automated framework. The FCM-based framework achieved the highest DSCs of 0.79±0.06, whereas DSCs of the ANN-based and SVM-based frameworks were 0.76±0.14 and 0.73±0.14, respectively. The FCM-based framework provided the highest segmentation accuracy and precision without a learning process (lowest calculation cost). Therefore, the FCM-based framework can be useful for delineation of tumor regions in practical treatment planning.

Glycosaminoglycan chemical exchange saturation transfer in human lumbar intervertebral discs: Effect of saturation pulse and relationship with low back pain

PURPOSE

To evaluate the dependence of saturation pulse power and duration on glycosaminoglycan chemical exchange saturation transfer (gagCEST) imaging and assess the degeneration of human lumbar intervertebral discs (IVDs) using this method.

MATERIALS AND METHODS

All images were acquired on a 3T magnetic resonance imaging (MRI) scanner. The CEST effects were measured in the glycosaminoglycan (GAG) phantoms with different concentrations. In the human study, CEST effects were measured in the nucleus pulposus of IVD. We compared the CEST effects among the different saturation pulse powers (0.4, 0.8, and 1.6 μT) or durations (0.5, 1.0, and 2.0 sec) at each Pfirrmann grade (I-V). The relationship between the CEST effects and low back pain was also evaluated.

RESULTS

The phantom study showed high correlations between the CEST effects and GAG concentration (R²  = 0.863, P < 0.0001, linear regression). In the human study, the CEST effect obtained with the 0.8 μT power was significantly greater than those obtained with 0.4 (P < 0.01) and 1.6 μT power (P < 0.05) at Pfirrmann grade I. The CEST effect obtained with a 1.0-sec duration was significantly greater than those derived with 0.5 and 2.0 sec (P < 0.01) durations at Pfirrmann grades I and II. The CEST effects in the group with moderate low back pain were significantly lower than those in the groups without pain (P < 0.001) and with mild pain (P = 0.0216).

CONCLUSION

The contrast of gagCEST imaging in the lumbar IVDs varied with saturation pulse power and duration. GagCEST imaging may serve as a tool for evaluating IVD degeneration in the lumbar spine.

LEVEL OF EVIDENCE

2 J. Magn. Reson. Imaging 2017;45:863-871.

Effect of the saturation pulse duration on chemical exchange saturation transfer in amide proton transfer MR imaging: a phantom study

Amide proton transfer (APT) contrast imaging is based on the chemical exchange saturation transfer (CEST) of protons between the amide groups and bulk water. Here, we demonstrate the effect of the saturation pulse duration on CEST in APT imaging with use of a clinical MR scanner. Four samples were prepared from chicken egg white diluted with H2O. Experiments were performed on a 3T clinical MR scanner with use of a body coil for two-channel parallel radiofrequency transmission. APT images were acquired at six frequency offsets (± 3.0, ± 3.5, ± 4.0 ppm) with respect to the water resonance as well as one far off-resonant frequency (-160 ppm) for signal normalization. The CEST effect was defined as asymmetry of the magnetization transfer ratio at 3.5 ppm. We measured the CEST effects in the egg white samples with different concentrations at seven saturation pulse durations. The influence of the extension of repetition time (TR) on the CEST effect was also evaluated. The CEST effect was not influenced by the change in TR. The CEST effect was increased significantly with the concentration when the duration was ≥1.0 s (P < 0.01). The CEST effect was highly correlated with the concentration at all saturation pulse durations, and its increase ratio was higher at longer saturation pulse durations. In conclusion, a long saturation pulse duration is useful for the sensitive detection of mobile proteins and peptides in APT imaging.

Automated measurement of cerebral cortical thickness based on fuzzy membership map derived from MR images for evaluation of Alzheimer's disease

We have proposed an automated method for three-dimensional (3D) measurement of cerebral cortical thicknesses based on fuzzy membership maps derived from magnetic resonance (MR) images for evaluation of Alzheimer's disease (AD). The cerebral cortical thickness was three-dimensionally measured on each cortical surface voxel by using a localized gradient vector trajectory in a fuzzy membership map. The proposed method could be useful for the 3D measurement of the cerebral cortical thickness on individual cortical surface voxels as an atrophy feature in AD.

Computer-aided beam arrangement based on similar cases in radiation treatment-planning databases for stereotactic lung radiation therapy

The purpose of this study was to develop a computer-aided method for determination of beam arrangements based on similar cases in a radiotherapy treatment-planning database for stereotactic lung radiation therapy. Similar-case-based beam arrangements were automatically determined based on the following two steps. First, the five most similar cases were searched, based on geometrical features related to the location, size and shape of the planning target volume, lung and spinal cord. Second, five beam arrangements of an objective case were automatically determined by registering five similar cases with the objective case, with respect to lung regions, by means of a linear registration technique. For evaluation of the beam arrangements five treatment plans were manually created by applying the beam arrangements determined in the second step to the objective case. The most usable beam arrangement was selected by sorting the five treatment plans based on eight plan evaluation indices, including the D95, mean lung dose and spinal cord maximum dose. We applied the proposed method to 10 test cases, by using an RTP database of 81 cases with lung cancer, and compared the eight plan evaluation indices between the original treatment plan and the corresponding most usable similar-case-based treatment plan. As a result, the proposed method may provide usable beam arrangements, which have no statistically significant differences from the original beam arrangements (P > 0.05) in terms of the eight plan evaluation indices. Therefore, the proposed method could be employed as an educational tool for less experienced treatment planners.

Magnetic Resonance Image Analysis for Brain CAD Systems with Machine Learning

This chapter describes the image analysis for brain Computer-Aided Diagnosis (CAD) systems with machine learning techniques, which could assist radiologists in the detection of such brain diseases as asymptomatic unruptured aneurysms, Alzheimer’s Disease (AD), vascular dementia, and Multiple Sclerosis (MS) by magnetic resonance imaging. Image analysis in CAD systems consists of image enhancement, initial detection, and image feature extraction, including segmentation. In addition, the authors review the classification of true and false positives using machine learning techniques, as well as the evaluation methods and development cycle for CAD systems.

Changes in chemical and sensory properties of migaki-nishin (dried herring fillet) during drying

Migaki-nishin is a Japanese term that refers to dried herring fillets. It is widely consumed in Japan due to its characteristic flavor enhancing properties. This study was conducted to investigate the changes in chemical and sensory properties of migaki-nishin during drying. Chemical analyses showed that extractive nitrogen and amount of peptides increased significantly (P < 0.05) up to the 8th day of drying and then slightly decreased by the 10th day. Glutamic acid, alanine, glycine, and histidine were the most abundant free amino acids and the largest increase was found in samples dried for 10 d. A decrease in Hunter's L* value (lightness) and increase in b* value (yellowness) as well as browning intensity suggested that nonenzymatic browning occurred in migaki-nishin during drying. Fluorescence spectrophotometric determination also revealed that Maillard reactions progressed throughout the drying period. In addition, available lysine content and free amino groups decreased significantly (P < 0.05) as drying progressed. Sensory evaluation showed that addition of water-soluble extracts to Japanese noodle soup (mentsuyu) linearly enhanced the flavor characteristics such as thickness, mouthfulness, and continuity with the increased length of drying time. These results suggest that during the drying period, proteolysis as well as Maillard reaction products increased markedly, which might contribute to the characteristic taste and flavor of migaki-nishin.

Evidence for impaired gluconeogenesis in very long-chain acyl-CoA dehydrogenase-deficient mice

Hypoketotic hypoglycaemia is a characteristic feature of fatty acid oxidation (FAO) defects. Although the underlying pathogenic mechanism is unknown, one hypothesis points to an impairment in gluconeogenesis. To study hepatic glucose production in FAO defects, we used the knockout mouse model of very long-chain acyl-CoA dehydrogenase (VLCAD) deficiency presenting with stress-induced hypoglycaemia. We analysed metabolites of hepatic glucose production under non-stressed conditions and after stress in comparison to wildtype controls. Analysis included glycogen, glucose-6-phosphate (G6P), fructose-6-phosphate (F6P), glycerol-3-phosphate (G3P) and dihydroxyacetone-phosphate (DHAP). We also measured the activity of the key enzyme glucose-6-phosphatase. Blood and liver glucose were found to be low after stress, and liver glycogen was depleted. In addition, hepatic G6P and F6P were significantly reduced, especially during hypoglycaemia. Importantly, the activity of the enzyme converting G6P into glucose was not impaired. These data indicate a reduced rate of gluconeogenesis. The levels of DHAP and G3P were significantly lower suggesting decreased availability of glucose precursors from glycerol. This study gives biochemical evidence of impaired gluconeogenesis as one of the causes for hypoglycaemia observed in VLCAD deficiency. Whether this is due to lack of a substrate, inhibitory effects on other gluconeogenic enzymes or impaired transcription of gluconeogenic enzymes needs to be resolved in the future.

[Cor triatriatum diagnosed in adulthood; report of a case]

Cor triatriatum is a rare congenital cardiac anomaly especially in adulthood. A 68-year-old female was diagnosed as a cor triatriatum classified to Lucas-Schmidt IA, severe degree of mitral regurgitation and atrial fibrillation. Resection of the abnormal diaphragm in the left atrium and miral valve replacement were performed. Although the reason of sudden death of this patient after discharge is unknown, surgical intervention for atrial fibrillation should have performed to prevent a thromboembolism in such cases.

[Delayed onset malignant hyperthermia after a closure of ventricular septal defect]

An 18 month-old girl was diagnosed as ventricular septal defect (VSD) with mild aortic valve prolapse. She underwent a closure of VSD. Intra-and early postoperative course was uneventful. However, 20 hours after surgery, sudden bradycardia led to cardiac arrest and strong muscle rigidity was seen. Hyperkalemia and metabolic acidosis rapidly progressed and resuscitation was failed. Extracorporeal life support and continuous hemodialysis were initiated, but the patient died with multiple organ failure on 5th postoperative day. Her clinical course supported the diagnosis of delayed onset malignant hyperthermia. Histopathological findings of muscle biopsy were consistent with rhabdomyolysis, and immunopathological stains demonstrated changes as in a Duchenne type muscular dystrophy carrier. Delayed onset malignant hyperthermia is an extremely rare complication of general anesthesia. We should be aware of this lethal condition, which occurs with a certain time lag after surgery, especially when the patient has possible background of myopathy.

[Asplenia syndrome with total anomalous pulmonary venous connection]

Three patients of asplenia syndrome with total anomalous pulmonary venous connection (TAPVC) were reported. Case 1 with exceeding pulmonary blood flow, underwent TAPVC repair and pulmonary artery banding as a first palliation before bi-directional Glenn shunt. Case 2 did not require any surgery to control the pulmonary blood flow before the simultaneous procedure of TAPVC repair and bi-directional Glenn shunt. Case 3 with decreased pulmonary blood flow underwent a complicated course with 3 times of Blalock-Taussig shunts and the repair of TAPVC to prepare for bi-directional Glenn shunt. Simultaneous repair of TAPVC with the procedure which aimed to control the pulmonary blood flow at the first palliation surgery will simplify the control of pulmonary blood flow and prepare good condition of the lung for the Fontan operation in the future.

Changes in blood carnitine and acylcarnitine profiles of very long-chain acyl-CoA dehydrogenase-deficient mice subjected to stress

BACKGROUND

In humans with deficiency of the very long-chain acyl-CoA dehydrogenase (VLCAD), C14-C18 acylcarnitines accumulate. In this paper we have used the VLCAD knockout mouse as a model to study changes in blood carnitine and acylcarnitine profiles under stress.

DESIGN

VLCAD knockout mice exhibit stress-induced hypoglycaemia and skeletal myopathy; symptoms resembling human VLCADD. To study the extent of biochemical derangement in response to different stressors, we determined blood carnitine and acylcarnitine profiles after exercise on a treadmill, fasting, or exposure to cold.

RESULTS

Even in a nonstressed, well-fed state, knockout mice presented twofold higher C14-C18 acylcarnitines and a lower free carnitine of 72% as compared to wild-type littermates. After 1 h of intense exercise, the C14-C18 acylcarnitines in blood significantly increased, but free carnitine remained unchanged. After 8 h of fasting at 4 degrees C, the long-chain acylcarnitines were elevated 5-fold in knockout mice in comparison with concentrations in unstressed wild-type mice (P < 0.05), and four out of 12 knockout mice died. Free carnitine decreased to 44% as compared with unstressed wild-type mice. An increase in C14-C18 acylcarnitines and a decrease of free carnitine were also observed in fasted heterozygous and wild-type mice.

CONCLUSIONS

Long-chain acylcarnitines in blood increase in knockout mice in response to different stressors and concentrations correlate with the clinical condition. A decrease in blood free carnitine in response to severe stress is observed in knockout mice but also in wild-type littermates. Monitoring blood acylcarnitine profiles in response to different stressors may allow systematic analysis of therapeutic interventions in VLCAD knockout mice.

[Leaflet extension technique in a congenital aortic valve regurgitation]

A 17-year-old boy who was diagnosed as congenital aortic valve regurgitation underwent the leaflet extension technique in 3 aortic leaflets using glutaraldehyde-preserved autologous pericardium. Intraoperative transesophageal echocardiography and postoperative cardiac catheter revealed grade I regurgitation and the patient has been doing well for more than 4 months after the surgery. The leaflet extension technique is considered to be an acceptable surgical treatment for aortic valve disease especially in young patients to whom valve replacement or Ross procedure might not be suitable. A careful long-term follow-up will be necessary to evaluate the durability of the leaflet extension technique with autologous pericardium.

Kinase activities associated with mTOR

Although mTOR is a member of the PI-kinase-related kinase family, mTOR possesses serine-threonine protein kinase activities, which phosphorylate itself and exogenous substrates. mTOR autophosphorylates in vitro and is phosphorylated in vivo on serine residues. Ser2481, which is located in a His-Ser-Phe motif near the conserved carboxyl-terminal mTOR tail, has been reported as an autophosphorylation site in vivo and in vitro. The significance of the autophosphorylation remains unclear. Another phosphorylation site on mTOR in vivo is Ser2448. This site appears not to be an autophosphorylation site but a site potentially phosphorylated by protein kinase B (PKB). mTOR immunopurified from culture cells or tissues phosphorylates in vitro p70 S6 kinase (p70) alpha and p70beta, mainly on Thr412 or Thr401, respectively, located in a Phe-Thr-Tyr motif. Another exogenous substrate phosphorylated by immunopurified mTOR in vitro is eIF4E-binding protein 1 (4E-BP1) at sites corresponding to those phosphorylated in vivo during insulin stimulation in a Ser/Thr-Pro motif. Recently, raptor, a 150-kDa TOR-binding protein that contains a carboxyl-terminal WD-repeat domain, was discovered as a scaffold for the mTOR-catalyzed phosphorylation of 4E-BP1 and for the mTOR-mediated phosphorylation and activation of p70alpha. Other potential substrates phosphorylated by mTOR are nPKCdelta, nPKCepsilon, STAT3, and p53. The requirement of raptor for binding to and phosphorylation by mTOR of these potential substrates would clarify their physiological importance in the mTOR signaling pathway.

[Management of mediastinitis after pediatric cardiac surgery with continuous closed irrigation method]

Two cases are presented as a successful management for mediastinitis with the continuous closed irrigation method after pediatric cardiac surgery. The continuous closed irrigation method has significant advantages over conventional open irrigation method or muscle flap in pediatric cases, because the system is simple to handle and easy to wash out any infectious tissue debris without additional invasive intervention. However, adequate duration of the irrigation and subsequent antibiotic regimen is still unclear. We conclude that the continuous closed irrigation method is an effective management which is applicable to most of mediastinitis cases after pediatric cardiac surgery.

Distinct regulatory mechanism for p70 S6 kinase beta from that for p70 S6 kinase alpha

BACKGROUND

A novel ribosomal S6 kinase, termed p70 S6 kinase beta (p70beta), has a highly homologous amino acid sequence to that of p70/p85 S6 kinase (p70alpha). This includes the critical phosphorylation sites, Thr252, Ser394 and Thr412 in p70alpha1, which correspond to Thr241, Ser383 and Thr401 in p70beta1, respectively. However, the regulatory mechanism for p70beta remains to be elucidated.

RESULTS

We report here the expression and the mechanism of in vivo regulation of p70beta. Two isoforms, p70beta1 and p70beta2, were expressed in a variety of tissues at a different level. p70beta1 was mainly targeted to the nucleus, whereas p70beta2 dispersed throughout the cytoplasm including nucleoplasm. The kinase activity of p70beta1 was less sensitive to the inhibition induced by rapamycin, wortmannin and amino acid withdrawal than that of p70alpha. The portion of p70beta activity inhibited by rapamycin was rescued by the rapamycin-resistant mutant of the mammalian target of rapamycin (mTOR). Mutational analysis revealed that the phosphorylation of Thr241 and Thr401 in p70beta1 was indispensable for the kinase activity. In contrast, a p70beta1 mutant in which Ser383 was substituted with Gly (S383G) still retained nearly the half maximal activity. Sequential phosphorylation of wild-type and S383G mutant of p70beta1 with mTOR and 3-phosphoinositide-dependent protein kinase 1 (PDK1) in vitro synergistically activated their kinase activities.

CONCLUSION

These results indicate that p70beta is regulated by the mTOR- and PDK1-signalling pathways through a synergistic interaction between phosphorylated Thr241 and Thr401, while Ser383 plays minor role in their activation mechanism. Activated p70beta may be less sensitive to dephosphorylation mediated by putative phosphatases activated by rapamycin, amino acid withdrawal, and probably wortmannin.

Carboxyl-terminal region conserved among phosphoinositide-kinase-related kinases is indispensable for mTOR function in vivo and in vitro

BACKGROUND

The mammalian target of rapamycin (mTOR) belongs to the family of phosphoinositide (PI)-kinase-related kinases that includes the ataxia-telangiectasia gene product (ATM). mTOR plays a critical role in controlling translational effectors such as p70 S6 kinase alpha (p70 alpha) and eukaryotic initiation factor 4E binding protein 1 (4EBP1).

RESULTS

We show that the C-terminal region of mTOR, which is highly conserved among the PI-kinase-related kinases, plays a critical role in the mTOR protein kinase activity. Deletion of the C-terminal residues did not adversely affect the expression of mTOR, but caused a nearly complete loss of the mTOR protein kinase activity toward both 4EBP1 and p70 alpha in vitro. These deletions also abolished the ability of a rapamycin-resistant mTOR mutant to rescue the activity of p70 alpha from inhibition induced by rapamycin in vivo. Furthermore, replacement of Trp2545, a conserved residue in the C-terminal region throughout the PI-kinase-related kinase family, abolished the function of the mTOR kinase, both in vivo and in vitro. However, substitution of 32 C-terminal residues of mTOR with those of ATM did not restore the mTOR function.

CONCLUSIONS

These findings define an indispensable role for the noncatalytic C-terminal region of mTOR and indicate that, although this highly conserved region may be important throughout the PI-kinase-related kinase family, it is not functionally interchangeable within the family.

Immunopurified mammalian target of rapamycin phosphorylates and activates p70 S6 kinase alpha in vitro

p70 S6 kinase alpha (p70alpha) is activated in vivo through a multisite phosphorylation in response to mitogens if a sufficient supply of amino acids is available or to high concentrations of amino acids per se. The immunosuppressant drug rapamycin inhibits p70alpha activation in a manner that can be overcome by coexpression of p70alpha with a rapamycin-resistant mutant of the mammalian target of rapamycin (mTOR) but only if the mTOR kinase domain is intact. We report here that a mammalian recombinant p70alpha polypeptide, extracted in an inactive form from rapamycin-treated cells, can be directly phosphorylated by the mTOR kinase in vitro predominantly at the rapamycin-sensitive site Thr-412. mTOR-catalyzed p70alpha phosphorylation in vitro is accompanied by a substantial restoration in p70alpha kinase activity toward its physiologic substrate, the 40 S ribosomal protein S6. Moreover, sequential phosphorylation of p70alpha by mTOR and 3-phosphoinositide-dependent protein kinase 1 in vitro resulted in a synergistic stimulation of p70alpha activity to levels similar to that attained by serum stimulation in vivo. These results indicate that mTOR is likely to function as a direct activator of p70 in vivo, although the relative contribution of mTOR-catalyzed p70 phosphorylation in each of the many circumstances that engender p70 activation remains to be defined.

Alpha4 protein as a common regulator of type 2A-related serine/threonine protein phosphatases

The catalytic activity of the C subunit of serine/threonine phosphatase 2A is regulated by the association with A (PR65) and B subunits. It has been reported that the alpha4 protein, a yeast homolog of the Tap42 protein, binds the C subunit of serine/threonine phosphatase 2A and protein phosphatase 2A-related protein phosphatases such as protein phosphatase 4 and protein phosphatase 6. In the present study, we showed that alpha4 binds these three phosphatases and the association of alpha4 reduces the activities of these phosphatases in vitro. In contrast, PR65 binds to the C subunit of serine/threonine phosphatase 2A but not to protein phosphatase 4 and protein phosphatase 6. These results suggest that the alpha4 protein is a common regulator of the C subunit of serine/threonine phosphatase 2A and protein phosphatase 2A-related protein phosphatases.

Mammalian homologue of the Caenorhabditis elegans UNC-76 protein involved in axonal outgrowth is a protein kinase C zeta-interacting protein

By the yeast two-hybrid screening of a rat brain cDNA library with the regulatory domain of protein kinase C zeta (PKCzeta) as a bait, we have cloned a gene coding for a novel PKCzeta-interacting protein homologous to the Caenorhabditis elegans UNC-76 protein involved in axonal outgrowth and fasciculation. The protein designated FEZ1 (fasciculation and elongation protein zeta-1) consisting of 393 amino acid residues shows a high Asp/Glu content and contains several regions predicted to form amphipathic helices. Northern blot analysis has revealed that FEZ1 mRNA is abundantly expressed in adult rat brain and throughout the developmental stages of mouse embryo. By the yeast two-hybrid assay with various deletion mutants of PKC, FEZ1 was shown to interact with the NH2-terminal variable region (V1) of PKCzeta and weakly with that of PKCepsilon. In the COS-7 cells coexpressing FEZ1 and PKCzeta, FEZ1 was present mainly in the plasma membrane, associating with PKCzeta and being phosphorylated. These results indicate that FEZ1 is a novel substrate of PKCzeta. When the constitutively active mutant of PKCzeta was used, FEZ1 was found in the cytoplasm of COS-7 cells. Upon treatment of the cells with a PKC inhibitor, staurosporin, FEZ1 was translocated from the cytoplasm to the plasma membrane, suggesting that the cytoplasmic translocation of FEZ1 is directly regulated by the PKCzeta activity. Although expression of FEZ1 alone had no effect on PC12 cells, coexpression of FEZ1 and constitutively active PKCzeta stimulated the neuronal differentiation of PC12 cells. Combined with the recent finding that a human FEZ1 protein is able to complement the function of UNC-76 necessary for normal axonal bundling and elongation within axon bundles in the nematode, these results suggest that FEZ1 plays a crucial role in the axon guidance machinery in mammals by interacting with PKCzeta.

Molecular cloning and characterization of RBCK2, a splicing variant of a RBCC family protein, RBCK1

RBCK1 (RBCC protein interacting with PKC 1) has two coiled-coil regions, a RING finger, a B-box and a B-box-like motif. RBCK2, a cDNA fragment related to RBCK1 was obtained, that lacks the 161-bp sequence of RBCK1 and encodes 260 amino acid residues. The 240-amino acid sequence in the NH2-terminal of RBCK2 is identical with RBCK1 and contains two coiled-coil regions but no other structural motifs, whereas the 20-amino acid sequence in the COOH-terminal is distinct from RBCK1. The analysis of genomic DNA revealed that RBCK1 and RBCK2 are generated from a single gene by alternative splicing. The RBCK1 protein interacted with the RBCK1 and RBCK2 proteins, but the RBCK2 protein did not interact with itself, in vitro. The RBCK2 protein fused with the DNA-binding domain of yeast GAL4 (GAL4DBD) did not show a transcriptional activity, but the RBCK2 protein inhibited the transcriptional activity of the RBCK1 protein fused with GAL4DBD. These results suggest that RBCK2 may inhibit the transcriptional activity of RBCK1 probably through complex formation with RBCK1.

Transcriptional activity of RBCK1 protein (RBCC protein interacting with PKC 1): requirement of RING-finger and B-Box motifs and regulation by protein kinases

The RBCK1 protein was recently identified as a protein kinase C-interacting protein with a new type of RBCC (RING-B-Box-Coiled-coil) region, possessing both DNA-binding and transcriptional activities unlike other proteins in the RBCC protein family (Tokunaga et al. Biochem. Biophys. Res. Commun. 244, 353-359, 1998). To identify protein motifs in the RBCC region of RBCK1 essential for the transcriptional activity, RBCK1 mutant proteins have been constructed and analyzed by using the GAL4 chimeric transcription regulator system. We have found that both of the RING-finger and the B-Box motifs are indispensable for the transcriptional activity of RBCK1. This is the first observation that these protein motifs of the RBCC protein family play a crucial role in transcriptional activation. In addition, we have examined the effect of co-expression of several protein kinases on the transcriptional activity of RBCK1. Protein kinase A (PKA) was found to enhance the activity by about eightfold, whereas both ERK (extracellular signal-regulated kinase) activator kinase 1 (MEK1) and MEK kinase 1 (MEKK1) significantly repressed the activity. Because RBCC proteins are presumed to act as a proto-oncoprotein, these results suggest that the RBCK1 protein is involved in the intracellular signaling cascades along with PKA, MEK1, and MEKK1 and mediates cell growth and differentiation.

Molecular cloning and characterization of a novel protein kinase C-interacting protein with structural motifs related to RBCC family proteins

A novel protein kinase C (PKC)-interacting protein was identified by the yeast two-hybrid screening using the regulatory domain of PKC beta I as a bait. The protein contained several structural motifs such as two putative coiled-coil regions, a RING-finger, a B-box, and a B-box-like motif in the order from NH2- to COOH-terminals. The molecular organization of the protein resembles the structure of the RBCC protein family proteins which usually have a RING-finger, a B-box, and a coiled-coil region. Therefore, the protein identified was designated as RBCK1 (RBCC protein interacting with PKC 1). Northern blot analysis showed that RBCK1 gene is expressed ubiquitously among rat tissues. RBCK1 protein associated with PKC beta I and PKC zeta when coexpressed in cultured mammalian cells. By the polymerase chain reaction-assisted DNA-binding site selection and the electrophoretic mobility shift assay, RBCK1 protein was shown to bind to several DNA fragments containing TGG-rich sequences. When the yeast GAL4 DNA-binding domain fused RBCK1 protein was expressed in COS-7 cells harboring the luciferase gene placed under a synthetic promoter containing GAL4-binding sites, the fusion protein showed enhanced transcriptional activity comparing with the GAL4 DNA-binding domain. These results suggest that RBCK1 protein might be a transcription factor that has a role in the signaling pathway through PKC.

Protein-protein interaction of zinc finger LIM domains with protein kinase C

The LIM domain comprising two zinc-finger motifs is found in a variety of proteins and has been proposed to direct protein-protein interactions. During the identification of protein kinase C (PKC)-interacting proteins by a yeast two-hybrid assay, a novel protein containing three LIM domains, designated ENH, was shown to associate with PKC in an isoform-specific manner. Deletion analysis demonstrated that any single LIM domain of ENH associates with the NH2-terminal region of PKC. ENH associated with PKC in COS-7 cells and was phosphorylated by PKC in vitro. Upon treatment of the cells with phorbol ester, ENH in the membrane fraction was translocated to the cytosol fraction in vivo. Other LIM domain-containing proteins, such as Enigma and LIM-kinase 1, also interacted with PKC through their LIM domains. These results suggest that the LIM domain is one of the targets of PKC and that the LIM-PKC interaction may shed light on undefined roles of LIM domain-containing proteins.

Activation of RAC-protein kinase by heat shock and hyperosmolarity stress through a pathway independent of phosphatidylinositol 3-kinase

RAC protein kinase (RAC-PK), a serine/threonine protein kinase containing a pleckstrin homology (PH) domain, was activated by cellular stress such as heat shock and hyperosmolarity. Wortmannin, which is known as a potent inhibitor of phosphatidylinositol 3-kinase and normally inhibits growth factor-induced activation of RAC-PK, did not suppress heat-shock induced activation of RAC-PK, indicating that this stress-induced activation of the kinase is not mediated by phosphatidylinositol 3-kinase. The PH domain was indispensable for stress-induced activation of RAC PK. In heat-treated cells, PKC delta, a member of the protein kinase C family, was found to associate with the PH domain of RAC-PK. This PKC subspecies was phosphorylated in vitro by RAC-PK. The results suggest that RAC-PK may play a role in the cellular response to stress through its PH domain.

The effect of growth and joint formation on bristle pattern in D. melanogaster

Dependence of bristle pattern on size and joint formation was studied for male first leg tarsi of fj (four jointed) and d (dachs) mutants in homozygotes and in mosaics resulting from X-ray induced mitotic recombination. Homozygotes have four tarsal segments, lacking a third tarsal joint in most cases. The two proximal segments are shortened, the first by one-third, and altered in bristle pattern, whereas the distal two segments are little affected. Expressivity of fj is high, and of d is low, for the extent and frequency of joint failure. The longer the second segment, the more complete the third joint and the greater the bristle number. Only the jointed side of the segment approximates two segments in its bristle pattern. Mosaic studies show that joint failure occurs autonomously in fj, or in the majority of d clones, and that joint formation by heterozygous clones is autonomous except in the border area contacting a fj or d spot lacking a joint, in which are a joint failure occurs. Bristle pattern in this jointless heterozygous area switches to that of a single segment. Localized non-autonomy also occurs in the t-rows of heterozygous tissue contacting a fj or d spot. Both mutant genes are interpreted as reducing longitudinal growth of the proximal tarsi, with joint failure as a consequence, and with alterations of bristle pattern resulting directly from size reduction, or indirectly through joint failure.

Autonomy or nonautonomy of gene effects in mosaics

The dominant autosomal gene Msc (Multiple sex combs) of Drosophila causes the appearance of sex combs on the second and third legs and a reduction of size of sex combs on first legs. The effect of Msc was studied in mosaic flies in which non-Msc spots were present on a Msc background. Mosaics were due to somatic crossing-over induced by x-rays. Analysis of mosaics suggested autonomy of the action of Msc, provided that the somatic crossing-over occurs less frequently proximally to the Msc locus than distally. This unusual ratio of somatic crossing-over was confirmed by a separate experiment with the gene Kinked, whose locus is very close to Msc.

On cell lethals in Drosophila

Somatic crossing over in flies heterozygous for a dominant Minute mutant may result in two cells, homozygous for wild type and Minute, respectively. If both cells took part in development, a twin spot of two genotypes, different from the rest of the body, would result. Two-hundred wild type spots were found, none of which was accompanied by an adjacent twin spot homozygous for Minute. The absence of these spots shows that their cell lethality is not overcome by transport, including diffusion, across a few cells of gene-dependent material from the neighboring cells which carry one or two wild type alleles of Minute.