Fluorescent Guided Sentinel Lymph Mapping of the Oral Cavity with Fluorescent-Labeled Tilmanocept

OBJECTIVE

With the shift toward utilization of sentinel lymph node biopsy (SLNB) in oral cavity cancer, improved techniques for intraoperative sentinel node identification are needed. This study investigates the feasibility of fluorescently labeled tilmanoscept in SLNB in an oral cancer rabbit model.

METHODS

An animal study was designed using 21 healthy male New Zealand rabbits. Gallium-68-labeled tilmanocept labeled with IRDye800CW was injected submucosally into the buccal mucosa (n = 6) or lateral tongue (n = 7) followed by PET imaging. One hour after injection, SLNB was performed using fluorescence imaging followed by a bilateral neck dissection and sampling of non-nodal surrounding tissue. All tissues were measured for radioactivity and fluorescence. In addition, eight rabbits were injected with delayed SLNB performed 48 h after injection.

RESULTS

Buccal injections all had ipsilateral SLN drainage and tongue injections exhibited 18.2% contralateral drainage. An average of 1.9 ± 1.0 SLN (range 1-5) were identified. In addition, an average of 16.9 ± 3.3 non-sentinel lymph nodes were removed per animal. SLNs had an average of 0.69 ± 0.60 percent-of-injected dose (%ID) compared with non-sentinel nodes with 0.012 ± 0.025 %ID and surrounding tissue with 0.0067 ± 0.015 %ID. There was 98.0% agreement between sentinel lymph nodes identified using fluorescence compared to radioactivity with Cohen's kappa coefficient of 0.879. In 48-h delayed SLNB, results were consistent with 97.8% agreement with radioactivity and Cohen's Kappa coefficient of 0.884. Fluorescence identified additional lymph nodes that were not identified by radioactivity, and with one false negative.

CONCLUSION

Fluorescent-labeled Tc-99 m-tilmanocept represents a highly accurate adjunct to enhance SLNB for oral cavity cancer.

LEVEL OF EVIDENCE

N/A Laryngoscope, 134:1299-1307, 2024.

Post-exercise, passive heat acclimation with sauna or hot-water immersion provide comparable adaptations to performance in the heat in a military context

To mitigate the effects of heat during operations in hot environments, military personnel will likely benefit from heat acclimation (HA) conducted prior to deployment. Using post-exercise, passive heating, 25 participants completed a 5 d HA regime in sauna (70 °C, 18% RH) or hot-water immersion (HWI) (40 °C) for ≤40 min, preceded and followed by a heat stress test (1-h walking at 5 km.h^-1 in 33 °C, 77% RH in military uniform (20 kg) before an incremental ramp to exhaustion). Fifteen completed both regimes in a randomised, cross-over manner. While performance did not significantly improve (+14%, [-1, 29], p = .079), beneficial adaptations were observed for mean exercising core temperature (-0.2 °C, [-0.2, -0.2], p <.001), skin temperature (-0.2 °C, [-0.2, -0.2], p = 035) and heart rate (-8 bpm, [-6, -10], p<.001) in both conditions. Post-exercise, passive HA of either modality may benefit military units operating in the heat.Practitioner summary: Strategies are required to prevent health and performance impairments during military operations upon arrival in hot environments. Using a randomised, cross-over design, participants completed five-day passive, post-exercise heat acclimation using sauna or hot-water immersion. Both regimes elicited beneficial albeit modest heat adaptations.Abbreviations: HA: heat acclimation; HST: heat stress test; HWI: hot-water immersion; RH: relative humidity.

Seasonal regulation of a 24-kDa protein from red-osier dogwood (Cornus sericea) xylem

Previously, we showed that an apparent cell wall-plasma membrane interaction in xylem ray parenchyma differed between cold acclimated and non-acclimated red-osier dogwood (Cornus sericea L.) (Ristic and Ashworth 1994). For the present study, a calcium chloride extraction method was used to identify cell-wall-associated xylem proteins that accumulated during periods of cold acclimation. A 24-kDa protein represented the predominant protein in both total protein and CaCl2 extracts during cold acclimation of field-grown plants. Two-dimensional gel electrophoresis separated the 24-kDa protein into four basic isoforms. The most abundant and basic isoform had a high glycine content. In-gel digestion of this basic 24-kDa isoform generated three partial peptide fragments, of which one exhibited homology to the dehydrin protein family. An anti-dehydrin polyclonal antibody cross-reacted with the 24-kDa protein, providing further evidence that this protein is related to dehydrins. The 24-kDa protein began to accumulate in late August, reached a maximum in midwinter, declined during the spring months and was absent in early summer.

Fundamental cryobiology of selected African mammalian spermatozoa and its role in biodiversity preservation through the development of genome resource banking

Fundamental cryobiological characteristics of spermatozoa from threatened or endangered species must be determined for successful cryopreservation techniques to be established. In this study, spermatozoa from four diverse species, impala (Aepyceros melampus), wart hog (Phacochoerus aethiopicus), elephant (Loxodonta africana), and lion (Panthera leo), were collected by electroejaculation or epididymal aspiration. Spermatozoal plasma membrane permeability to water (hydraulic conductivity, Lp) and the osmotically inactive fraction of the sperm cell (Vb) were determined from each species. Changes in cell volume were measured over time using an electronic particle counter. A Kedem-Katchalsky membrane transport model was used to theoretically characterize the data to determine Lp and Vb for each species. In addition to determining plasma membrane characteristics, spermatozoa were also studied to determine their sensitivity to low temperatures and to permeating cryoprotectant solutes. Cells maintained at room temperature (20-22 degrees C) were slowly or rapidly exposed to cold temperatures (1-4 degrees C), and percent motility was estimated to determine the sensitivity of the cells to cooling. Spermatozoa were also in media containing 1 M glycerol, dimethyl sulfoxide or ethylene glycol, and percent motility was measured at 15, 30 and 60 min intervals to determine the sensitivity of the cells to the cryoprotectant agent over time. Results indicate that sperm motility is significantly effected by decreased temperatures and the presence of cryoprotectant agents.

Hyperosmotic tolerance of human spermatozoa: separate effects of glycerol, sodium chloride, and sucrose on spermolysis

Hyperosmotic stress, which cells experience during the freezing process, and its release during the warming process are both related to cryoinjury. To define optimal cooling or warming rates and prevent osmotic injury to human sperm, information is required regarding the osmotic tolerance of the cells as a function of 1) time, 2) temperature, 3) type of solute, and 4) solute concentration. Human sperm samples were divided into three aliquots. The aliquots were equilibrated at 0, 8, and 22 degrees C, respectively. Different hyperosmotic solutions were prepared by addition of either a permeating cryoprotective agent (glycerol) or nonpermeating solutes (sucrose, non-ionic; or NaCl, ionic) to isotonic Mann's Ringer solution. Aliquots of the prepared solutions were equilibrated at 0, 8, and 22 degrees C, respectively. A small volume (2.5 microliters) of each sperm aliquot was quickly mixed with 50 microliters of each hyperosmotic solution at the corresponding temperature. After times ranging from 5 s to 5 min, 10 microliters of each hyperosmotic cell suspension was abruptly returned to an isosmotic environment by mixing with 500 microliters of Mann's Ringer solution at the corresponding temperature. The plasma membrane integrity of cells after exposure to hyperosmotic stress and after return to isosmotic conditions was measured by a dual staining (carboxyfluoroscein diacetate and propidium iodide) technique and flow cytometry. The morphology of the treated cells was observed by scanning electron microscopy of freeze-substituted sperm. The results indicate that human spermatozoa exhibited a significant posthypertonic lysis/injury, i.e., loss of membrane integrity, when returned to isosmotic conditions after exposure to hyperosmotic solutions of NaCl or sucrose. The higher the hyperosmolality, the more serious the cell injury. The majority of the cells (> 50%) lost membrane integrity when the osmolality was > or = 2000 mOsm. In contrast, if the sperm were not returned to isosmotic conditions, the majority of the sperm in the hyperosmotic solutions appeared to maintain membrane integrity. For a given higher hyperosmolality (> 1000 mOsm), posthypertonic spermolysis was reduced with a decrease of temperature. Cell survival was also affected by time of cell exposure to hyperosmotic environments before cells were returned to the isotonic condition. The shorter the time, the higher the cell survival. When exposed to hyperosmotic glycerol solutions that were isotonic with respect to electrolytes, few cells lost their membrane integrity if the osmolality of glycerol was < 3000 mOsm. For a fixed high osmolality (> 3000 mOsm), the lower the temperature, the higher the percentage spermolysis.(ABSTRACT TRUNCATED AT 400 WORDS)