Effect of vitamin D source and amount on vitamin D status and response to endotoxin challenge

The objectives were to test the effects of dietary vitamin D₃ [cholecalciferol (CHOL)] compared with 25-hydroxyvitamin D₃ [calcidiol (CAL)] on vitamin D status and response to an endotoxin challenge. Forty-five Holstein bull calves (5 ± 2 d of age) were blocked into weekly cohorts, fed a basal diet that provided 0.25 µg/kg body weight (BW) CHOL, and assigned randomly to 1 of 5 treatments: control [(CON) no additional vitamin D], 1.5 µg/kg BW CHOL (CHOL1.5), 3 µg/kg BW CHOL (CHOL3), 1.5 µg/kg BW CAL (CAL1.5), or 3 µg/kg BW CAL (CAL3). Calves were fed milk replacer until weaning at 56 d of age and had ad libitum access to water and starter grain throughout the experiment. Treatments were added daily to the diet of milk replacer until weaning and starter grain after weaning. Measures of growth, dry matter intake, and serum concentrations of vitamin D, Ca, Mg, and P were collected from 0 to 91 d of the experiment. At 91 d of the experiment, calves received an intravenous injection of 0.1 µg/kg BW lipopolysaccharide (LPS). Clinical and physiological responses were measured from 0 to 72 h relative to LPS injection. Data were analyzed with mixed models that included fixed effects of treatment and time, and random effect of block. Orthogonal contrasts evaluated the effects of (1) source (CAL vs. CHOL), (2) dose (1.5 vs. 3.0 µg/kg BW), (3) interaction between source and dose, and (4) supplementation (CON vs. all other treatments) of vitamin D. From 21 to 91 d of the experiment, mean BW of supplemented calves was less compared with CON calves, but the effect was predominantly a result of the CHOL calves, which tended to weigh less than the CAL calves. Supplementing vitamin D increased concentrations of 25-hydroxyvitamin D in serum compared with CON, but the increment from increasing the dose from 1.5 to 3.0 µg/kg BW was greater for CAL compared with CHOL (CON = 18.9, CHOL = 24.7 and 29.6, CAL = 35.6 and 65.7 ± 3.2 ng/mL, respectively). Feeding CAL also increased serum Ca and P compared with CHOL. An interaction between source and dose of treatment was observed for rectal temperature and derivatives of reactive metabolites after LPS challenge because calves receiving CHOL3 and CAL1.5 had lower rectal temperatures and plasma derivatives of reactive metabolites compared with calves receiving CHOL1.5 and CAL3. Supplementing vitamin D increased plasma P concentrations post-LPS challenge compared with CON, but plasma concentrations of Ca, Mg, fatty acids, glucose, β-hydroxybutyrate, haptoglobin, tumor necrosis factor-α, and antioxidant potential did not differ among treatments post-LPS challenge. Last, supplementing vitamin D increased granulocytes as a percentage of blood leukocytes post-LPS challenge compared with CON. Supplementing CAL as a source of vitamin D to dairy calves was more effective at increasing serum 25-hydroxyvitamin D, Ca, and P concentrations compared with feeding CHOL. Supplemental source and dose of vitamin D also influenced responses to the LPS challenge.

Role of the Δ Resonance in the Population of a Four-Nucleon State in the ^{56}Fe→^{54}Fe Reaction at Relativistic Energies

The ^{54}Fe nucleus was populated from a ^{56}Fe beam impinging on a Be target with an energy of E/A=500  MeV. The internal decay via γ-ray emission of the 10^{+} metastable state was observed. As the structure of this isomeric state has to involve at least four unpaired nucleons, it cannot be populated in a simple two-neutron removal reaction from the ^{56}Fe ground state. The isomeric state was produced in the low-momentum (-energy) tail of the parallel momentum (energy) distribution of ^{54}Fe, suggesting that it was populated via the decay of the Δ^{0} resonance into a proton. This process allows the population of four-nucleon states, such as the observed isomer. Therefore, it is concluded that the observation of this 10^{+} metastable state in ^{54}Fe is a consequence of the quark structure of the nucleons.

Isolation of oligodendrocyte-like cells from human umbilical cord blood

BACKGROUND

As human umbilical cord blood (UCB) is known to be a rich source of progenitor cells, the prospect of isolating a subset of these cells that could differentiate into cells of non-hematopoietic lineages suggests a therapeutic use for patients with inherited lysosomal and peroxisomal storage diseases currently treated with UCB transplantation.

METHODS

Oligodendrocyte-like cells were isolated from UCB by density-gradient centrifugation and expanded using selective media. We then characterized this population of cells using standard immunohistochemical staining methods for neural cell proteins and polymerase chain reaction (PCR) to detect RNA sequences for myelin basic protein (MBP). We also developed a functional assay demonstrating myelination of neurons in vitro.

RESULTS

Cells with oligodendrocyte-like morphology were reproducibly cultured ex vivo from fresh human UCB. Cells stained positively for multiple oligodendria cell markers (O1, MBP and CNPase) via immunohistochemical staining and flow cytometry. PCR confirmed the presence of MBP and CNPase mRNA. A further in vitro functional assay demonstrated the myelination of mature neuronal cells from the brain of a myelin-deficient murine model co-cultured with the oligodendrocyte-like cells.

DISCUSSION

After human UCB transplant, donor-derived cells have been noted to migrate to the brain over time. Although is not known whether these cells solely deliver enzyme replacement or a subset engrafts and differentiates into mature neural cells, the clinical improvements noted in these patients suggest a potential role for targeted cellular therapy. Oligodendrocyte-like cells isolated ex vivo and expanded from human UCB could provide a potential cellular therapy for patients with demyelinating or dismyelinating diseases.

Impact of direct physician-to-physician contact on accelerating oncology clinical trial accrual

6613

Background: The development of more effective oncology agents is critically dependent on the completion of clinical trials; currently, >4000 oncology trials listed in www.clinicaltrials.gov are accruing pts in the US. Unfortunately, only 3–5% of new cancer pts participate in clinical trials and most trials do not meet their projected accrual timelines. Barriers to pt accrual include physician awareness & attitudes, access to protocols, administrative burdens to conduct clinical trials, cost to physicians and pts, and pt concerns about participation in research trials. To overcome at least some of these barriers, we investigated a strategy to improve clinical trial accrual that optimizes trial placement and awareness through a direct physician to physician intervention. Methods: For each site, a customized enrollment plan is established after initial assessment of interest and accrual potential. Implementation of the enrollment plan includes clinical communications and medical support delivered through direct physician to physician interactions. From Feb 2008 to December 2008, we implemented this strategy to increase accrual to 5 oncology trials (2 placebo controlled randomized trials and 3 phase II trials in breast cancer, non-Hodgkin's lymphoma and soft tissue sarcoma). Results: The implementation of direct physician to physician intervention resulted in a measurable improvement of between 50 - 300% in the monthly accrual to each of these 5 trials. Despite being significantly behind projections, 2 of the trials have now completed accrual on schedule. In the ongoing phase III study, accrual has improved from an average of 3.8 pts/mo to 13.5 pts/mo. Conclusions: The use of our current model of optimizing trial placement and awareness through a direct physician to physician intervention has been successful in significantly accelerating clinical trial accrual in 5/5 trials initiated to date.

[Table: see text]

[Table: see text]

Modification of a commercial cell sorter to support efficient and reliable preparation of ALDH-bright cells for clinical use

BACKGROUND

Cell populations manufactured by conventional commercial cell sorters have been safely infused into patients, but reliably sterilizing these instruments remains challenging. We are developing clinical protocols involving use of ALDH bright cells manufactured by cell sorting in patients. However, we encountered problems when we attempted to reliably sterilize the FACSAria cell sorter using standard methods.

RESULTS

We have identified and modified potential sources of microbial contamination in several FACSAria systems. We added new filter systems to the sheath and sample air lines, to the wet cart fluid supply, and to the sample line. Sheath was provided from an external sterile, disposable bag through sterile disposable tubing sets. The plenum reservoirs were modified in several ways to allow efficient decontamination of internal surfaces. A new bubble filter assembly was added and one valve was eliminated from the sample pathway to improve flow cell sterilization. A new cleaning and sterilization protocol was developed and validated. All cell products manufactured using the modified instrument and validated cleaning protocol have met lot release criteria for prevention of microbial contamination and safe clinical use.

DISCUSSION

The instrument modification and cleaning protocol described enable reliable manufacture of ALDH bright cell populations that are suitable for clinical trials. We have manufactured nineteen consecutive samples that meet all clinical release criteria in an on-going Phase 1 human trial.

Combination treatment of bullous pemphigoid with anti-CD20 and anti-CD25 antibodies in a patient with chronic graft-versus-host disease

In this case report we describe a novel treatment with two chimeric monoclonal antibodies (MoAb) targeting the autoimmune B cell clone responsible for bullous pemphigoid (BP) as a manifestation of steroid refractory chronic graft-versus-host disease (GVHD) that developed after unrelated cord blood transplantation. Monitoring the BP-specific circulating antibodies and CD25-expressing activated T lymphocyte subset led us to combine anti-CD20 (Rituximab) mediated B cell ablation with anti-CD25 (Daclizumab) therapy to block CD4(+) T cell help. Complete clinical and serologic response was achieved within 4 weeks of initiation of therapy allowing global immunosuppression to be dramatically reduced.

[Radiocarpal fracture dislocation]

Radiocarpal fracture dislocation is a very rare, often complex injury and the result of high energy trauma. We present a retrospective review of four patients. The injury in our series was characterized by a complete dorsal dislocation of the radiocarpal joint with fracture of the radial styloid, associated with avulsion of the palmar and dorsal cortical margin of the distal radius (radiotriquetral ligament included). One case presented a die punch fracture, another case a partial lesion of the scapholunate ligament. All injuries were immediately treated by closed reduction in local anaesthesia. All patients underwent operative treatment with a dorsal approach within seven days. The radial styloid was fixed with screws or Kirschner-wire, the impaction of the dorsoulnar aspect of the radius with elevation and fixation with a 2.7 mm plate. The tear of the scapholunate ligament was sutured and stabilized with Kirschner-wire between scaphoid and lunatum. All wrists were immobilized with a forearm cast for four weeks. The mean follow-up was 25 months. At the time of follow-up all patients showed a very good functional outcome, although the radiographic analysis revealed some osteoarthrotic changes.

Use of a biodegradable chlorhexidine chip in the treatment of adult periodontitis: clinical and radiographic findings

BACKGROUND

Previous multi-center trials demonstrated the efficacy of a biodegradable chlorhexidine-gelatin chip (CHX) in reducing probing depth in patients with periodontitis. The present study utilized a subset of subjects from the parent study to determine if the CHX chip was effective in maintaining alveolar bone over a 9-month period.

METHODS

Forty-five subjects with at least four 5 to 8 mm pockets, stratified by smoking status, were enrolled in this double-blind controlled, placebo-controlled trial. Control groups received either placebo chip plus scaling and root planing (SRP) or SRP alone. Test group subjects received active CHX chip or SRP alone (to maintain the blind). Standardized radiographs were taken for quantitative digital subtraction radiography at baseline and 9 months.

RESULTS

At 9 months, 15% of SRP treated subjects experienced loss of bone in 1 or more sites, no subject treated with active chip plus SRP lost bone (P <0.01). At 9 months, significant differences in the change in probing depth and clinical attachment levels favoring the active chip over SRP alone or SRP plus CHX chip were also observed (P <0.05).

CONCLUSIONS

These data indicate that the CHX chip, when used as an adjunct to scaling and root planing, significantly reduces loss of alveolar bone.

Focus on communication: improving interaction between staff and residents who have severe or profound mental retardation

The purpose of the present research project was to examine change in interactive behaviors between staff and residents of facilities that serve individuals with mental retardation. Twelve staff members were trained using an adapted component of the Nursing Child Assessment Satellite Training model, the Mental Retardation/Developmental Disabilities Adaptation of the Nursing Child Assessment Feeding Scale. Data indicated some slight increases in positive interactive staff behaviors with some small indications of generalization to another task and maintenance over a 6-month period in one setting. Little or inconsistent change was indicated in resident behaviors. Recommendations are made for further investigation of factors related to behavior change in staff and residents.

Cascade blue derivatives: water soluble, reactive, blue emission dyes evaluated as fluorescent labels and tracers

Fluorescent dyes based on the pyrenyloxytrisulfonic acid (Cascade Blue) structure were prepared and evaluated. The dyes contain functional groups that react with amines, thiols, acids, aldehydes, and ketones, forming covalently bonded, fluorescent derivatives of molecules with broad biological interest. Reactive groups in the Cascade Blue dyes include carboxylic acids and activated esters, amines, hydrazides, alcohols, photoaffinity reagents, acrylamides, and haloacetamides. The dyes exhibited absorption maxima at 374-378 nm and 399-403 nm, with extinction coefficients in the range of 1.9 x 10(4)-2.4 x 10(4) M-1cm-1 and 2.3 x 10(4)-3.0 x 10(4) M-1cm-1, respectively. Emission maxima ranged from 422-430 nm. The spectral properties of the fluorescent dyes are sufficiently different from fluorescein to permit simultaneous use of both dyes with minimum spectral interference. The Cascade Blue derivatives have narrower spectral bandwidths and smaller Stokes' shifts than other reactive dyes with similar spectral properties, do not show appreciable sensitivity to pH, have higher solubilities in aqueous solution, and have good to excellent quantum yields. Cascade Blue conjugates of a number of histochemically and biologically useful molecules were prepared, including dextrans, albumins, Fc receptor binding proteins, antibodies, lectins, membrane receptor binding proteins, and biotin binding proteins, as well as biological particles and bacteria. Cascade Blue conjugates of secondary and tertiary labels yielded specific fluorescence localization in the indirect immunofluorescent staining of human epithelial cell (HEp-2) nuclei.

A comparison of five methods for monitoring the precision of automated x-ray film processors

Five different methods for preparing sensitometric strips used to monitor the precision of automated film processors are compared. A method for determining the sensitivity of each system to processor variations is presented; the observed statistical variability is multiplied by the system response to temperature or chemical changes. Pre-exposed sensitometric strips required the use of accurate densitometers and stringent control limits to be effective. X-ray exposed sensitometric strips demonstrated large variations in the x-ray output (2 omega approximately equal to 8.0%) over a period of one month. Some light sensitometers were capable of detecting +/- 1.0 degrees F (+/- 0.6 degrees C) variations in developer temperature in the processor and/or about 10.0 ml of chemical contamination in the processor. Nevertheless, even the light sensitometers were susceptible to problems, e.g. film emulsion selection, line voltage variations, and latent image fading. Advantages and disadvantages of the various sensitometric methods are discussed.