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1.
Inorg Chem ; 56(17): 10452-10457, 2017 Sep 05.
Artículo en Inglés | MEDLINE | ID: mdl-28809550

RESUMEN

Magnetization measurements under pressure reveal that the external hydrostatic pressure significantly increases in the ferrimagnetic transition temperature, Tc, for A2Mn[Mn(CN)6] (A = K, Rb, Cs). In the case of monoclinic A = K and Rb, dTc/dp values are 21.2 and 14.6 K GPa-1, respectively, and Tc increases by 53 and 39%, respectively, from ambient pressure to 1.0 GPa. The cubic A = Cs compound also shows a monotonous increase with an initial rate of 4.22 K GPa-1 and about 11.4 K GPa-1 above 0.6 GPa, and an overall Tc increase by 26% at 1.0 GPa. The increase in Tc is attributed to deformation of the structure such that the MnII-N≡C angle decreases with increasing pressure. The smaller the alkali cation, the greater the decrease in the MnII-N≡C angle induced by pressure and the larger the increase of dTc/dp. This is in accordance with the ambient-pressure structures for A2Mn[Mn(CN)6] (A = K, Rb, Cs), which have decreasing MnII-N≡C angles that correlate to the observed increasing Tcs as K > Rb > Cs. The large increase in Tc for the A = K compound is the highest class among several cyano-bridged metal complexes. The tuning of the transition temperature by such a weak pressure may lead to additional applications such as switching devices.

2.
J Nucl Cardiol ; 20(2): 297-306, 2013 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-23288545

RESUMEN

Cardiac sarcoidosis (CS) has gained significant interest in recent years with the emergence of advanced imaging modalities such as MRI and F(18)-fluorodeoxyglucose-positron emission tomography (FDG-PET) as modalities to aid in the diagnosis of this condition. CS remains a difficult condition to diagnose, particularly in cases of isolated cardiac involvement and it can present with a broad spectrum of clinical syndromes. Furthermore, the appropriate management of these patients remains controversial. FDG-PET has a potential role not only in diagnosis of CS but also in directing further therapies, facilitating the decision to start immunosuppression and monitoring the response to it. In this article, we discuss when to consider FDG-PET, outline the current optimal patient preparation and scanning protocols and then, using case examples, discuss the use of FDG-PET in follow-up of patients with known or suspected CS. We also outline how PET can influence management decisions in these patients.


Asunto(s)
Cardiomiopatías/diagnóstico por imagen , Cardiomiopatías/terapia , Fluorodesoxiglucosa F18 , Tomografía de Emisión de Positrones/métodos , Sarcoidosis/diagnóstico por imagen , Sarcoidosis/terapia , Diagnóstico Diferencial , Humanos , Pronóstico , Radiofármacos
3.
Semin Dial ; 26(5): 616-23, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23106607

RESUMEN

Acute kidney injury (AKI) is characterized by deterioration in kidney function resulting in multisystem abnormalities. Much of the morbidity and mortality associated with AKI result from a systemic inflammatory response syndrome (SIRS). This study described herein is a prospective, single-arm, multicenter US study designed to evaluate the safety and efficacy of the Selective Cytopheretic Device (SCD) treatment on AKI requiring continuous renal replacement therapy (CRRT) in the ICU. The study enrolled 35 subjects. The mean age was 56.3±15. With regard to race, 71.4% of the subjects were Caucasian, 22.9% were Black, and 5.7% were Hispanic. Average SOFA score was 11.3±3.6. Death from any cause at Day 60 was 31.4%. Renal recovery, defined as dialysis independence, was observed in all of the surviving subjects at Day 60. The results of this pilot study indicate the potential for a substantial improvement in patient outcomes over standard of care therapy, which is associated with a greater than 50% 60-day mortality in the literature. The SCD warrants further study in scientifically sound, pivotal trial to demonstrate reasonable assurance of safety and effectiveness.


Asunto(s)
Lesión Renal Aguda/terapia , Terapia de Reemplazo Renal , Lesión Renal Aguda/mortalidad , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Mortalidad Hospitalaria , Humanos , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Método Simple Ciego , Tasa de Supervivencia , Resultado del Tratamiento , Estados Unidos , Adulto Joven
4.
J Frailty Aging ; 11(1): 18-25, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35122086

RESUMEN

BACKGROUND: Frailty is a geriatric syndrome associated with multiple negative health outcomes. However, its prevalence varies by population and instrument used. We investigated frailty and pre-frailty prevalence by 5 instruments in community-dwelling older adults enrolled to a randomized-controlled trial in 5 European countries. METHODS: Cross-sectional baseline analysis in 2,144 DO-HEALTH participants recruited from Switzerland, Austria, France, Germany, and Portugal with complete data for frailty. Frailty status was assessed by the Physical Frailty Phenotype [PFP], SOF-Frailty Index [SOF-FI], FRAIL-Scale, SHARE-Frailty Instrument [SHARE-FI], and a modified SHARE-FI, and compared by country, age, and gender. Logistic regression was used to determine relevant factors associated with frailty and pre-frailty. RESULTS: Mean age was 74.9 (±4.4) years, 61.6% were women. Based on the PFP, overall frailty and pre-frailty prevalence was 3.0% and 43.0%. By country, frailty prevalence was highest in Portugal (13.7%) and lowest in Austria (0%), and pre-frailty prevalence was highest in Portugal (57.3%) and lowest in Germany (37.1%). By instrument and overall, frailty and pre-frailty prevalence was highest based on SHARE-FI (7.0% / 43.7%) and lowest based on SOF-FI (1.0% / 25.9%). Frailty associated factors were residing in Coimbra (Portugal) [OR 12.0, CI 5.30-27.21], age above 75 years [OR 2.0, CI 1.17-3.45], and female gender [OR 2.8, CI 1.48-5.44]. The same three factors predicted pre-frailty. CONCLUSIONS: Among relatively healthy adults age 70 and older enroled to DO-HEALTH, prevalence of frailty and pre-frailty differed significantly by instrument, country, gender, and age. Among instruments, the highest prevalence of frailty and pre-frailty was documented by the SHARE-FI and the lowest by the SOF-FI.


Asunto(s)
Fragilidad , Anciano , Estudios Transversales , Femenino , Anciano Frágil , Fragilidad/diagnóstico , Fragilidad/epidemiología , Evaluación Geriátrica , Humanos , Prevalencia
5.
Diabetologia ; 53(9): 1986-97, 2010 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-20473479

RESUMEN

AIMS/HYPOTHESIS: AMP-activated protein kinase (AMPK) has a broad role in the regulation of glucose and lipid metabolism making it a promising target in the treatment of type 2 diabetes mellitus. We therefore sought to characterise for the first time the effects of chronic AMPK activation on skeletal muscle carbohydrate metabolism in carriers of the rare gain-of-function mutation of the gene encoding AMPKgamma(3) subunit, PRKAG3 R225W. METHODS: Aspects of fuel metabolism were studied in vitro in myocytes isolated from vastus lateralis of PRKAG3 R225W carriers and matched control participants. In vivo, muscular strength and fatigue were evaluated by isokinetic dynamometer and surface electromyography, respectively. Glucose uptake in exercising quadriceps was determined using [(18)F]fluorodeoxyglucose and positron emission tomography. RESULTS: Myotubes from PRKAG3 R225W carriers had threefold higher mitochondrial content (p < 0.01) and oxidative capacity, higher leak-dependent respiration (1.6-fold, p < 0.05), higher basal glucose uptake (twofold, p < 0.01) and higher glycogen synthesis rates (twofold, p < 0.05) than control myotubes. They also had higher levels of intracellular glycogen (p < 0.01) and a trend for lower intramuscular triacylglycerol stores. R225W carriers showed remarkable resistance to muscular fatigue and a trend for increased glucose uptake in exercising muscle in vivo. CONCLUSIONS/INTERPRETATION: Through the enhancement of skeletal muscle glucose uptake and increased mitochondrial content, the R225W mutation may significantly enhance exercise performance. These findings are also consistent with the hypothesis that the gamma(3) subunit of AMPK is a promising tissue-specific target for the treatment of type 2 diabetes mellitus, a condition in which glucose uptake and mitochondrial function are impaired.


Asunto(s)
Proteínas Quinasas Activadas por AMP/genética , Proteínas Quinasas Activadas por AMP/metabolismo , Glucosa/metabolismo , Fibras Musculares Esqueléticas/metabolismo , Adulto , Transporte Biológico/genética , Transporte Biológico/fisiología , Western Blotting , Células Cultivadas , Ácidos Grasos/metabolismo , Glucógeno/metabolismo , Humanos , Técnicas In Vitro , Persona de Mediana Edad , Músculo Esquelético/metabolismo , Mutación , Consumo de Oxígeno/genética , Consumo de Oxígeno/fisiología , Tomografía de Emisión de Positrones , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa
6.
Med Phys ; 37(8): 3995-4010, 2010 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-20879561

RESUMEN

PURPOSE: Factor analysis has been pursued as a means to decompose dynamic cardiac PET images into different tissue types based on their unique temporal signatures to improve quantification of physiological function. In this work, the authors present a novel kinetic model-based (MB) method that includes physiological models of factor relationships within the decomposition process. The physiological accuracy of MB decomposed (82)Rb cardiac PET images is evaluated using simulated and experimental data. Precision of myocardial blood flow (MBF) measurement is also evaluated. METHODS: A gamma-variate model was used to describe the transport of (82)Rb in arterial blood from the right to left ventricle, and a one-compartment model to describe the exchange between blood and myocardium. Simulations of canine and rat heart imaging were performed to evaluate parameter estimation errors. Arterial blood sampling in rats and (11)CO blood pool imaging in dogs were used to evaluate factor and structure accuracy. Variable infusion duration studies in canine were used to evaluate MB structure and global MBF reproducibility. All results were compared to a previously published minimal structure overlap (MSO) method. RESULTS: Canine heart simulations demonstrated that MB has lower root-mean-square error (RMSE) than MSO for both factor (0.2% vs 0.5%, p < 0.001 MB vs MSO, respectively) and structure (3.0% vs 4.7%, p < 0.001) estimations, as with rat heart simulations (factors: 0.2% vs 0.9%, p < 0.001 and structures: 3.0% vs 6.7%, p < 0.001). MB blood factors compared to arterial blood samples in rats had lower RMSE than MSO (1.6% vs 2.2%, p =0.025). There was no difference in the RMSE of blood structures compared to a (11)CO blood pool image in dogs (8.5% vs 8.8%, p =0.23). Myocardial structures were more reproducible with MB than with MSO (RMSE=3.9% vs 6.2%, p < 0.001), as were blood structures (RMSE=4.9% vs 5.6%, p =0.006). Finally, MBF values tended to be more reproducible with MB compared to MSO (CV= 10% vs 18%, p =0.16). The execution time of MB was, on average, 2.4 times shorter than MSO (p < 0.001) due to fewer free parameters. CONCLUSIONS: Kinetic model-based factor analysis can be used to provide physiologically accurate decomposition of (82)Rb dynamic PET images, and may improve the precision of MBF quantification.


Asunto(s)
Circulación Coronaria/fisiología , Corazón/fisiología , Modelos Cardiovasculares , Miocardio/metabolismo , Imagen de Perfusión/métodos , Tomografía de Emisión de Positrones/métodos , Radioisótopos/farmacocinética , Rubidio/farmacocinética , Animales , Velocidad del Flujo Sanguíneo/fisiología , Simulación por Computador , Perros , Corazón/diagnóstico por imagen , Cinética , Tasa de Depuración Metabólica , Radiofármacos/farmacocinética , Ratas
7.
PLoS One ; 10(8): e0132482, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26244978

RESUMEN

OBJECTIVE: Acute kidney injury (AKI) is a highly morbid condition in critically ill patients that is associated with high mortality. Previous clinical studies have demonstrated the safety and efficacy of the Selective Cytopheretic Device (SCD) in the treatment of AKI requiring continuous renal replacement therapy in the intensive care unit (ICU). DESIGN, SETTING, PATIENTS: A randomized, controlled trial of 134 ICU patients with AKI, 69 received continuous renal replacement therapy (CRRT) alone and 65 received SCD therapy. RESULTS: No significant difference in 60-day mortality was observed between the treated (27/69; 39%) and control patients (21/59; 36%, with six patients lost to follow up) in the intention to treat (ITT) analysis. Of the 19 SCD subjects (CRRT+SCD) and 31 control subjects (CRRT alone) who maintained a post-filter ionized calcium (iCa) level in the protocol's recommended range (≤ 0.4 mmol/L) for greater or equal to 90% of the therapy time, 60-day mortality was 16% (3/19) in the SCD group compared to 41% (11/27) in the CRRT alone group (p = 0.11). Dialysis dependency showed a borderline statistically significant difference between the SCD treated versus control CRRT alone patients maintained for ≥ 90% of the treatment in the protocol's recommended (r) iCa target range of ≤ 0.4 mmol/L with values of, 0% (0/16) and 25% (4/16), respectively (P = 0.10). When the riCa treated and control subgroups were compared for a composite index of 60 day mortality and dialysis dependency, the percentage of SCD treated subjects was 16% versus 58% in the control subjects (p<0.01). The incidence of serious adverse events did not differ between the treated (45/69; 65%) and control groups (40/65; 63%; p = 0·86). CONCLUSION: SCD therapy may improve mortality and reduce dialysis dependency in a tightly controlled regional hypocalcaemic environment in the perfusion circuit. TRIAL REGISTRATION: ClinicalTrials.gov NCT01400893 http://clinicaltrials.gov/ct2/show/NCT01400893.


Asunto(s)
Lesión Renal Aguda/terapia , Diálisis Renal , Terapia de Reemplazo Renal/instrumentación , Adulto , Anciano , Cuidados Críticos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Terapia de Reemplazo Renal/métodos , Resultado del Tratamiento
8.
Am J Psychiatry ; 155(7): 921-8, 1998 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-9659858

RESUMEN

OBJECTIVE: Olanzapine is a new atypical antipsychotic recently introduced for the treatment of schizophrenia. The purpose of this study was to investigate olanzapine's binding to the serotonin 5-HT2 and dopamine D2 receptors in schizophrenic patients being treated with clinically relevant doses. METHOD: Twelve patients with schizophrenia were randomly assigned to 5, 10, 15, or 20 mg/day of olanzapine in a prospective fashion. Three other subjects taking 30-40 mg/day were also included. Once steady-state plasma levels were achieved, dopamine D2 and serotonin 5-HT2 receptors were assessed by using [11C]raclopride and [18F]setoperone positron emission tomography imaging, respectively. Ratings of clinical status, extrapyramidal side effects, and prolactin levels were also obtained. RESULTS: Olanzapine induced near saturation of the 5-HT2 receptors, even at 5 mg/day. Its D2 occupancy increased with dose: patients taking 5-20 mg/day showed 43%-80% D2 occupancy, while patients taking 30-40 mg/day showed 83%-88%. CONCLUSIONS: Olanzapine is a potent 5-HT2 blocker and shows a higher 5-HT2 than D2 occupancy at all doses. However, its D2 occupancy is higher than that of clozapine and similar to that of risperidone. In the usual clinical dose range of 10-20 mg/day, its occupancy varies from 71% to 80%, and this restricted range may explain its freedom from extrapyramidal side effects and prolactin elevation. However, doses of 30 mg/day and higher are associated with more than 80% D2 occupancy and may have a higher likelihood of prolactin elevation and extrapyramidal side effects.


Asunto(s)
Antipsicóticos/farmacocinética , Antipsicóticos/uso terapéutico , Pirenzepina/análogos & derivados , Receptores de Dopamina D2/metabolismo , Receptores de Serotonina/metabolismo , Esquizofrenia/tratamiento farmacológico , Tomografía Computarizada de Emisión , Adulto , Benzodiazepinas , Radioisótopos de Carbono , Relación Dosis-Respuesta a Droga , Esquema de Medicación , Femenino , Radioisótopos de Flúor , Humanos , Masculino , Olanzapina , Pirenzepina/farmacocinética , Pirenzepina/uso terapéutico , Prolactina/sangre , Pirimidinonas , Racloprida , Receptores de Dopamina D2/efectos de los fármacos , Receptores de Serotonina/efectos de los fármacos , Salicilamidas , Esquizofrenia/diagnóstico por imagen , Esquizofrenia/metabolismo , Resultado del Tratamiento
9.
Am J Psychiatry ; 153(7): 948-50, 1996 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-8659621

RESUMEN

OBJECTIVE: The purpose of this study was to determine the dopamine D2 receptor occupancy induced by low-dose haloperidol treatment in a prospective trial. METHOD: Seven patients with schizophrenia were treated with 2 mg/day of haloperidol for 2 weeks, and D2 receptor occupancy was measured by [11C]raclopride and positron emission tomography. RESULTS: The patients showed high levels of D2 occupancy (53%-74%); five of them showed substantial clinical improvement, and none showed important side effects. CONCLUSIONS: The findings demonstrate that low doses of haloperidol induce D2 receptor occupancies that are in the putative therapeutic range. In combination with recent empirical trials, these findings should encourage clinicians to initiate treatment of psychotic episodes with low (2-4 mg haloperidol equivalent) doses of typical neuroleptics, particularly for first-episode patients.


Asunto(s)
Encéfalo/diagnóstico por imagen , Haloperidol/administración & dosificación , Haloperidol/farmacocinética , Receptores de Dopamina D2/metabolismo , Esquizofrenia/tratamiento farmacológico , Tomografía Computarizada de Emisión , Adulto , Encéfalo/efectos de los fármacos , Encéfalo/metabolismo , Radioisótopos de Carbono , Relación Dosis-Respuesta a Droga , Femenino , Haloperidol/farmacología , Humanos , Masculino , Estudios Prospectivos , Escalas de Valoración Psiquiátrica , Racloprida , Receptores de Dopamina D2/efectos de los fármacos , Salicilamidas , Esquizofrenia/metabolismo , Psicología del Esquizofrénico
10.
Am J Psychiatry ; 156(7): 1029-34, 1999 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-10401447

RESUMEN

OBJECTIVE: Widespread disturbances of serotonin (5-HT) are implicated in the pathophysiology of depression. Of 5-HT receptor abnormalities reported, the most replicated finding is increased 5-HT2 receptor binding in the postmortem prefrontal cortex of depressed suicide victims. The extent to which these findings exist in depressed persons without recent suicide attempts is uncertain. The objective of this study was to evaluate 5-HT2 receptors in depressed patients who were medication-free and who had not made recent suicide attempts. METHOD: With the use of [18F]setoperone and positron emission tomography (PET), 5-HT2 receptor binding potential was assessed in 14 depressed and 19 healthy subjects. Exclusion criteria for depressed patients included use of antidepressant medication within the past 6 months, a history of suicide attempts within the past 5 years, other current axis I disorders including bipolar disorder, and the presence of psychotic symptoms. The 5-HT2 (setoperone) binding potential in the two groups of subjects was compared by analysis of covariance with age as the covariate. RESULTS: Age had a significant effect on 5-HT2 binding potential, but depression did not. The interaction of age and depression was not significant. CONCLUSIONS: The 5-HT2 binding potential is not increased in untreated depressed subjects who have not made recent suicide attempts. This negative finding does not rule out the possibility that there is a role for 5-HT2 receptors in treatment or that 5-HT2 receptors are increased in highly suicidal states.


Asunto(s)
Trastorno Depresivo/diagnóstico , Radioisótopos de Flúor , Corteza Prefrontal/diagnóstico por imagen , Pirimidinonas , Receptores de Serotonina/metabolismo , Tomografía Computarizada de Emisión , Adolescente , Adulto , Factores de Edad , Trastorno Depresivo/metabolismo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Corteza Prefrontal/metabolismo , Proyectos de Investigación , Intento de Suicidio/estadística & datos numéricos
11.
Am J Psychiatry ; 156(1): 72-8, 1999 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-9892300

RESUMEN

OBJECTIVE: Several postmortem studies have reported a decreased density of serotonin 5-HT2 receptors in the prefrontal cortex in schizophrenia. The purpose of this study was to investigate this in patients with schizophrenia by means of [18F]setoperone and positron emission tomography (PET) imaging. METHOD: Thirteen neuroleptic-free patients with schizophrenia, 10 of whom were also neuroleptic-naive, were compared with a group of 26 normal subjects in the same age range. The density of 5-HT2 receptors was assessed with the use of [18F]setoperone and PET in standardized cortical regions of interest. RESULTS: Increasing age was associated with similar declines in 5-HT2 receptors in all cortical regions in the patient group and in the normal comparison group. After control for the effect of age, there was no statistically significant difference between the patients and the comparison subjects in 5-HT2 receptor density in any of the cortical regions. CONCLUSIONS: This study failed to find the decrease in 5-HT2 receptors reported in postmortem studies of schizophrenia. The study had the power to detect a decrease of 25% or more in 5-HT2 receptors, which was anticipated on the basis of the previous postmortem studies. Thus, a primary serotonergic abnormality in schizophrenia, if one exists, is either small or unlikely to be at the level of the 5-HT2 receptors. This finding does not rule out a therapeutic role for 5-HT2 antagonists in schizophrenia, but it does suggest that the therapeutic contribution is likely to be an indirect one.


Asunto(s)
Radioisótopos de Flúor , Corteza Prefrontal/química , Receptores de Serotonina/análisis , Esquizofrenia/diagnóstico , Tomografía Computarizada de Emisión , Antipsicóticos/uso terapéutico , Química Encefálica , Corteza Cerebral/química , Corteza Cerebral/diagnóstico por imagen , Medios de Contraste , Humanos , Corteza Prefrontal/diagnóstico por imagen , Pirimidinonas , Esquizofrenia/diagnóstico por imagen , Esquizofrenia/tratamiento farmacológico
12.
Am J Psychiatry ; 158(1): 78-85, 2001 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-11136637

RESUMEN

OBJECTIVE: In the cortex of animals, serotonin (5-HT) levels increase after several weeks of treatment with selective serotonin reuptake inhibitors (SSRIs). Studies using an intrasubject design to examine the effects of SSRI treatment on 5-HT(2A) receptors in the cortex of drug-free depressed patients are needed. In theory, agonist stimulation of 5-HT(2A) receptors could be relevant to SSRI treatment by promoting neuronal growth and survival as well as direct elevation of mood. The objective of this study was to evaluate the effect of 6 weeks of paroxetine treatment on 5-HT(2A) receptors in depressed patients. METHOD: After a medication-free period of at least 3 months, 19 depressed patients were treated for 6 weeks with paroxetine, 20 mg/day. The authors used [(18)F]setoperone and positron emission tomography to assess 5-HT(2A) receptor binding potential in the patients before and after treatment and in 19 age-matched healthy subjects. RESULTS: 5-HT(2A) binding potential declined with age in all cortical regions in the depressed and healthy subjects. There was a significant interaction between age and treatment effect on 5-HT(2A) binding potential in all cortical regions. Subjects aged 20 to 30 years had a 10% decrease in 5-HT(2A) binding potential after treatment, whereas subjects aged 30 to 40 had no change. No regional differences in 5-HT(2A) binding potential between depressed and healthy subjects were found. CONCLUSIONS: 5-HT(2A) receptors down-regulate in young depressed subjects after treatment with paroxetine, but this down-regulation attenuates with age. This suggests that over 6 weeks paroxetine treatment increases 5-HT agonism on 5-HT(2A) receptors in the cortex of young patients with depression.


Asunto(s)
Corteza Cerebral/efectos de los fármacos , Corteza Cerebral/diagnóstico por imagen , Trastorno Depresivo/tratamiento farmacológico , Paroxetina/uso terapéutico , Receptores de Serotonina/efectos de los fármacos , Inhibidores Selectivos de la Recaptación de Serotonina/uso terapéutico , Tomografía Computarizada de Emisión , Adolescente , Adulto , Factores de Edad , Corteza Cerebral/metabolismo , Trastorno Depresivo/diagnóstico por imagen , Regulación hacia Abajo/efectos de los fármacos , Femenino , Radioisótopos de Flúor , Humanos , Masculino , Paroxetina/farmacología , Pirimidinonas , Receptor de Serotonina 5-HT2A , Receptores de Serotonina/metabolismo , Inhibidores Selectivos de la Recaptación de Serotonina/farmacología , Tomografía Computarizada de Emisión/estadística & datos numéricos , Resultado del Tratamiento
13.
Neurology ; 48(6): 1578-83, 1997 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-9191769

RESUMEN

To estimate the threshold of nigrostriatal dysfunction required for symptomatic Parkinson's disease (PD), we employed [11C]RTI-32 and PET to study the dopamine transporter in striatal subdivisions of 11 L-dopa-naive patients with very early parkinsonism. As compared with the controls (N = 10), the PD group had on the side contralateral to the maximal clinical symptoms, significantly reduced binding in the posterior putamen (-56%) and anterior putamen (-28%), with the reduction in caudate (-12%) not significantly different. To the extent that dopamine transporter binding accurately reflects the number of nigrostriatal dopamine nerve terminals, these findings suggest that the clinical threshold for PD in the middle-age human is approximately 50% loss of dopaminergic innervation to the posterior putamen. Our data also suggest that damage to the putamen component of the striatum is sufficient for the clinical expression of PD.


Asunto(s)
Proteínas Portadoras/análisis , Glicoproteínas de Membrana , Proteínas de Transporte de Membrana , Enfermedad de Parkinson/metabolismo , Sustancia Negra/química , Adulto , Radioisótopos de Carbono , Progresión de la Enfermedad , Proteínas de Transporte de Dopamina a través de la Membrana Plasmática , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proteínas del Tejido Nervioso/análisis , Enfermedad de Parkinson/diagnóstico por imagen , Enfermedad de Parkinson/fisiopatología , Sustancia Negra/fisiopatología , Factores de Tiempo , Tomografía Computarizada de Emisión
14.
Neuropsychopharmacology ; 15(6): 562-6, 1996 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-8946430

RESUMEN

Positron emission tomography (PET) studies of typical neuroleptics suggest that 60% to 80% of striatal D2 occupancy may be sufficient for optimal clinical treatment of psychosis. Therefore, striatal D2 occupancy may be used as an index to determine the optimal dose range. Toward this end, we determined the in vivo D2 profile of loxapine, using [11C]-raclopride and PET. Seven patients selected from a clinical population were scanned while taking steady-state oral loxapine from 10 to 100 mg/day. Their D2 receptor occupancy was estimated by comparing them to age-matched data from neuroleptic-naive patients. The D2 receptor occupancy ranged from 52% to 90%, and there was a very strong relationship between dose and D2 occupancy, suggesting that 15 to 30 mg/day of loxapine would produce, the putatively optimal, 60% to 80% striatal D2 blockade. This dose range is much lower than that used in most clinical settings and points to the potential efficacy of loxapine at lower doses.


Asunto(s)
Antipsicóticos/metabolismo , Antagonistas de Dopamina/metabolismo , Loxapina/metabolismo , Trastornos Psicóticos/metabolismo , Receptores de Dopamina D2/efectos de los fármacos , Tomografía Computarizada de Emisión , Administración Oral , Adulto , Antipsicóticos/administración & dosificación , Radioisótopos de Carbono , Cuerpo Estriado/metabolismo , Estudios Transversales , Antagonistas de Dopamina/administración & dosificación , Femenino , Humanos , Loxapina/administración & dosificación , Masculino , Trastornos Psicóticos/diagnóstico por imagen , Trastornos Psicóticos/tratamiento farmacológico , Racloprida , Salicilamidas , Tomografía Computarizada de Emisión/métodos
15.
J Med Chem ; 33(1): 430-4, 1990 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-2296033

RESUMEN

A series of 7 alpha-undecylestradiol derivatives, featuring various substituents at the end of the undecyl spacer chain, were synthesized and evaluated for their interaction with the estrogen receptor and nonreceptor sites. Their relative binding affinities (RBA) for calf uterine estrogen receptors were measured by competitive binding assays and varied between 0.5 and 8.4% of that of unlabeled 17 beta-estradiol. Enhanced lipophilicity and steric hindrance of the substituent on the end of the spacer chain resulted in decreased binding affinity for the estrogen receptor, while interactions with nonreceptor sites increased. RBA values were not affected by prolonged incubation times, suggesting a stable ligand-receptor complex. The potential to use the 7 alpha-undecylestradiol as a vector for site-selective delivery of diagnostic and therapeutic moieties to estrogen-receptor-positive human cancers is discussed.


Asunto(s)
Neoplasias de la Mama/análisis , Estradiol/análogos & derivados , Receptores de Estrógenos/metabolismo , Ácidos Undecilénicos/metabolismo , Animales , Unión Competitiva , Neoplasias de la Mama/tratamiento farmacológico , Bovinos , Fenómenos Químicos , Química , Estradiol/síntesis química , Estradiol/metabolismo , Estradiol/uso terapéutico , Femenino , Estructura Molecular , Receptores de Estrógenos/análisis , Relación Estructura-Actividad , Ácidos Undecilénicos/síntesis química , Ácidos Undecilénicos/uso terapéutico , Útero/metabolismo
16.
J Nucl Med ; 36(12): 2252-60, 1995 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-8523116

RESUMEN

UNLABELLED: In the search for an in vivo marker of monoamine nerve terminal integrity, we investigated methoxytetrabenazine (MTBZ) as a tracer of the brain synaptic vesicular monoamine transporter (VMAT2). METHODS: The biodistribution, metabolism and in vivo specificity of MTBZ binding were first evaluated in rodents and the human dosimetry was estimated. Subsequently, the human brain distribution of VMAT2 binding was determined in normal volunteers following administration of [11C]MTBZ. Brain regional time-activity curves were obtained, and parametric transport and binding images were calculated using arterial blood sampling and a two-compartment tracer kinetic model. RESULTS: Regional rat brain localization of [3H]MTBZ 15 min postinjection was consistent with the known monoamine nerve terminal density, which demonstrated the highest activity in the striatum, lateral septum, substantia nigra pars compacta, the raphe nuclei and the locus coeruleus. At this time, chromatography revealed over 82% of brain activity, but less than 47% of plasma activity corresponded to authentic MTBZ. In vivo [11C]MTBZ binding in the mouse brain was inhibited by coinjection of excess unlabeled dihydrotetrabenazine. In humans [11C]MTBZ had high initial brain uptake and rapid clearance from all regions, with longest retention in areas of high VMAT2 concentration. Parametric quantification of VMAT2 density revealed the highest distribution volume in the putamen and caudate with lower values in cerebral cortex and cerebellum. CONCLUSION: Carbon-11-MTBZ is a suitable ligand for PET quantification of the vesicular monoamine transporter in the human brain.


Asunto(s)
Encéfalo/diagnóstico por imagen , Glicoproteínas/análisis , Glicoproteínas de Membrana , Proteínas de Transporte de Membrana , Neuropéptidos , Neurotransmisores/análisis , Tetrabenazina/análogos & derivados , Tomografía Computarizada de Emisión , Adulto , Animales , Transporte Biológico , Química Encefálica , Radioisótopos de Carbono , Femenino , Humanos , Ligandos , Masculino , Ratones , Ratas , Ratas Sprague-Dawley , Distribución Tisular , Proteínas de Transporte Vesicular de Aminas Biógenas , Proteínas de Transporte Vesicular de Monoaminas
17.
J Steroid Biochem Mol Biol ; 37(1): 77-83, 1990 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-2242354

RESUMEN

7 alpha-[11-(4-[125I]Iodophenoxy)undecyl]-17 beta-estradiol ([125I]IPUE2) was synthesized and its tissue distribution studied in immature female Fischer rats. Upon intravenous administration, [125I]IPUE2 was shown to accumulate in the adrenals and, to some extent, in the uterus and the ovaries. Coinjection with estrogen receptor (ER)-saturating quantities of unlabeled 17 beta-estradiol did not significantly reduce the uptake of [125I]IPUE2 in these tissues. The high adrenal uptake of [125I]IPUE2 is most likely associated with the lipophilic nature of the 7 alpha-substituted estradiol. The potential to use the 7 alpha-undecylestradiol as a vector to direct therapeutic groups to adrenal and ER-positive cancers is discussed.


Asunto(s)
Neoplasias de las Glándulas Suprarrenales/tratamiento farmacológico , Estradiol/análogos & derivados , Receptores de Estrógenos/efectos de los fármacos , Neoplasias de las Glándulas Suprarrenales/metabolismo , Animales , Estradiol/síntesis química , Estradiol/metabolismo , Estradiol/farmacocinética , Estradiol/uso terapéutico , Femenino , Humanos , Radioisótopos de Yodo , Ratas , Ratas Endogámicas , Distribución Tisular
18.
J Control Release ; 75(1-2): 199-210, 2001 Jul 10.
Artículo en Inglés | MEDLINE | ID: mdl-11451510

RESUMEN

A novel and highly efficient method of in vitro gene transfection has been developed. This method employs direct intracytoplasmic gene delivery into embryonic cardiocytes using neutral cytoskeletal-antigen specific immunoliposomes (CSIL). These immunoliposomes target cardiocytes specifically under reversible hypoxic conditions. Two independent reporter genes, pGL2 and pSV-beta-galactosidase, were used to verify CSIL-transfection (CSIL-fection). The efficiency of CSIL-fection with firefly luciferase pGL2 vector was 30+ times greater than controls consisting of hypoxic cardiocytes treated with plain liposomes (PL) or normoxic cardiocytes treated with CSIL, PL or naked DNA. CSIL-fection was also compared to cationic liposome transfection. Net cationic liposome transfection appeared to be more efficient than CSIL-fection for pGL2 vectors. However, a smaller number of viable cells was observed in the cationic liposome treated cultures than in the CSIL treated cultures. Therefore, to determine whether more cells were transfected with cationic liposomes or CSIL, pSV-beta-galactosidase vector was used. CSIL-fection with pSV-beta-galactosidase vector produced at least 40 times more transfected cells than those transfected with cationic liposomes. No transfection with pSV-beta-galactosidase vectors was obtained with IgG-liposome, PL or naked DNA treatments. Targeted enhanced efficiency of transfection by this novel method could have practical therapeutic applications in the genetic modification of cells ex vivo that could then be reimplanted into patients for gene therapy.


Asunto(s)
Citoplasma/metabolismo , Citoesqueleto/metabolismo , Marcación de Gen/métodos , Transfección/métodos , Animales , Células Cultivadas , ADN/administración & dosificación , ADN/análisis , ADN/farmacocinética , Portadores de Fármacos , Excipientes , Genes Reporteros , Liposomas , Luciferasas/genética , Microscopía Confocal , Microscopía Electrónica , Microscopía Fluorescente , Miocardio/citología , Miocardio/metabolismo , Miosinas/inmunología , Tamaño de la Partícula , Ratas , beta-Galactosidasa/genética
19.
Neurosci Lett ; 207(1): 25-8, 1996 Mar 22.
Artículo en Inglés | MEDLINE | ID: mdl-8710201

RESUMEN

This study assessed the modulatory effect of a serotonergic agonist, d-fenfluramine, on localized neuronal firing as indexed by changes in regional cerebral blood flow (rCBF). Previously, we reported the effect of oral d, l-fenfluramine on neuronal activity as measured by change in [18F]fluorodeoxyglucose uptake. Improvements in the current study include: a more specific serotonin agonist, d-fenfluramine; a more reliable administration route, intravenous; and a one session paradigm made possible with the radiotracer [15O]H2O. Changes in relative rCBF (P < 0.001) were observed: increases within the frontal cortex bilaterally and decreases within the temporal cortex bilaterally, and left thalamus. Other significant findings were elevated cortisol and growth hormone; increased euphoria and panic symptoms and decreased tiredness. These results support further investigation with intravenous d-fenfluramine to study the net functional effects of serotonergic stimulation in health and illness.


Asunto(s)
Conducta/efectos de los fármacos , Fenfluramina/farmacología , Lóbulo Frontal/efectos de los fármacos , Serotoninérgicos/farmacología , Lóbulo Temporal/efectos de los fármacos , Adulto , Animales , Femenino , Lóbulo Frontal/irrigación sanguínea , Lóbulo Frontal/diagnóstico por imagen , Hormona del Crecimiento/sangre , Humanos , Hidrocortisona/sangre , Radioisótopos de Oxígeno , Lóbulo Temporal/irrigación sanguínea , Lóbulo Temporal/diagnóstico por imagen , Tomografía Computarizada de Emisión
20.
Nucl Med Biol ; 27(5): 463-6, 2000 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-10962251

RESUMEN

This paper summarizes our work on WAY-100635 and analogues, labeled either with carbon-11 or fluorine-18, as potential radioligands for the 5-hydroxytryptamine(1A) (5-HT(1A)) neuroreceptors. Other facets of our work include: (1) human studies with [O-methyl-(11)C]WAY-100634, the major radioactive metabolite of [O-methyl-(11)C]WAY-100635, and with [(11)C]CPC 222; (2) use of a human liver metabolism model to screen in vitro potential metabolic problems in humans; (3) modification of the "dry method" to prepare [carbonyl-(11)C]WAY-100635; and (4) validation studies in humans with [carbonyl-(11)C]WAY-100635.


Asunto(s)
Piperazinas/metabolismo , Piridinas/metabolismo , Receptores de Serotonina/análisis , Antagonistas de la Serotonina/metabolismo , Tomografía Computarizada de Emisión , Animales , Humanos , Hígado/metabolismo , Piperidinas/metabolismo , Receptores de Serotonina 5-HT1
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