Technetium-99m-labeled lapachol as an imaging probe for breast tumor identification. / Lapachol marcado con tecnecio 99m como sonda de imágenes para la identificación de tumores de mama.

OBJECTIVE: Breast cancer is a health problem worldwide with high incidence and mortality rates. It is well known that the development of more sensitive and specific diagnostic methods is of great importance since an early diagnosis is essential to successfully treat tumors. Lapachol is a natural compound, belonging to the naphthoquinone group that has been widely used in traditional medicine to treat various illnesses, including cancer. The aim of this study was to evaluate technetium-99m (99mTc) labeled lapachol as an imaging probe for breast cancer identification. METHODS: To achieve this purpose, lapachol was labeled with 99mTc, radiochemical purity and in vitro stability were determined. Blood clearance, in healthy mice, and biodistribution, in 4T1 tumor-bearing mice, were also evaluated. RESULTS: Lapachol was successfully labeled with 99mTc, with high values of radiochemical yield (95.9±3.4%). In vitro stability showed that the radiolabeled complex remained stable for up to 24h, with values above 90% for both saline and plasma (95.6±3.6% and 96.4±1.7%, respectively). The radiolabeled complex decays in a biphasic manner, with a half-life of distribution and elimination equal to 3.3 and 50.0min, respectively. Biodistribution and scintigraphic images showed high uptake in organs of excretion (kidneys, liver, and intestine). It could be also noted that tumor uptake was higher than the muscle at all time points. Tumor-to-muscle ratio reaches ∼4.5 at 24h after administration. CONCLUSION: These findings suggest that 99mTc-lapachol can be a potential diagnostic agent for breast tumors.

Re-revision of a patellar tendon rupture in a young professional martial arts athlete.

A 27-year-old professional martial arts athlete experienced recurrent right knee patellar tendon rupture on three occasions. He underwent two operations for complete patellar tendon rupture: an end-to-end tenorrhaphy the first time, and revision with a bone-patellar-tendon (BPT) allograft. After the third episode, he was referred to our department, where we performed a surgical reconstruction with the use of hamstring pro-patellar tendon, in a figure-of-eight configuration, followed by a careful rehabilitation protocol. Clinical and radiological follow-ups were realized at 1, 3, and 6 months and 1 and 2 years postop, with an accurate physical examination, the use of recognized international outcome scores, and radiograph and MRI studies. As far as we know, this is the first paper to report a re-revision of a patellar tendon rupture.

Pharmacological functional MRI assessment of the effect of ibuprofen-arginine in painful conditions.

Pharmacological functional magnetic resonance imaging (phMRI) is a valuable tool for the investigation of pharmacological effects of a drug on pain processing. We hypothesized that the ibuprofen-arginine combination, in line with its characteristic analgesic properties, may influence the phMRI response at the central level, as compared to placebo. Ten healthy subjects underwent a double-blind, placebo-controlled, randomized, cross-over phFMRI study with somatosensory painful stimulation of the right median nerve. We measured the blood oxygen level dependent (BOLD) signal variations induced in conditions of pain after oral administration of either ibuprofen-arginine or placebo formulations. Independent component analysis (ICA) was used for the analysis of the fMRI data, without assuming a specific hemodynamic response function (HRF), which may be altered by drug administration. Median nerve electrical painful stimulation mainly activated the primary contralateral and the secondary somatosensory cortices, the insula, the supplementary motor area, and the middle frontal gyrus. Placebo and ibuprofen-arginine administration induced activation bilaterally in the premotor cortex, and an overall reduction in the other pain-related areas, which was more prominent in the left hemisphere. A task-related increase of BOLD signal between drug and placebo was observed bilaterally in the primary somatosensory area and the middle frontal gyrus without any changes in subjective pain scores. Overall, our findings show that ibuprofen-arginine, in line with the characteristic analgesic properties of ibuprofen, influences the BOLD response in specific pain-related brain areas with respect to placebo, with a vasoactive effect possibly due to arginine.

An fMRI investigation on image generation in different sensory modalities: the influence of vividness.

In the present fMRI study the issue of the specific cortices activation during imagery generation in different sensory modalities is addressed. In particular, we tested whether the vividness variability of imagery was reflected in the BOLD signal within specific sensory cortices. Subjects were asked to generate a mental image for each auditory presented sentence. Each imagery modality was contrasted with an abstract sentence condition. In addition, subjects were asked to fill the Italian version of the Questionnaire Upon Mental Imagery (QMI) prior to each neuroimaging session. In general, greater involvement of sensory specific cortices in high-vivid versus low-vivid subjects was found for visual (occipital), gustatory (anterior insula), kinaesthetic (pre-motor), and tactile and for somatic (post-central parietal) imagery modalities. These results support the hypothesis that vividness is related to image format: high-vivid subjects would create more analogical representations relying on the same specific neural substrates active during perception with respect to low-vivid subjects. Results are also discussed according to the simulation perspective.

Hypothalamus, sexual arousal and psychosexual identity in human males: a functional magnetic resonance imaging study.

In a recent functional magnetic resonance imaging study, a complex neural circuit was shown to be involved in human males during sexual arousal [A. Ferretti et al. (2005) Neuroimage, 26, 1086]. At group level, there was a specific correlation between penile erection and activations in anterior cingulate, insula, amygdala, hypothalamus and secondary somatosensory regions. However, it is well known that there are remarkable inter-individual differences in the psychological view and attitude to sex of human males. Therefore, a crucial issue is the relationship among cerebral responses, sexual arousal and psychosexual identity at individual level. To address this issue, 18 healthy male subjects were recruited. Their deep sexual identity (DSI) was assessed following the construct revalidation by M. Olivetti Belardinelli [(1994) Sci. Contrib. Gen. Psychol., 11, 131] of the Franck drawing completion test, a projective test providing, according to this revalidation, quantitative scores on 'accordance/non-accordance' between self-reported and psychological sexual identity. Cerebral activity was evaluated by means of functional magnetic resonance imaging during hard-core erotic movies and sport movies. Results showed a statistically significant positive correlation between the blood oxygen level-dependent signal in bilateral hypothalamus and the Franck drawing completion test score during erotic movies. The higher the blood oxygen level-dependent activation in bilateral hypothalamus, the higher the male DSI profile. These results suggest that, in male subjects, inter-individual differences in the DSI are strongly correlated with blood flow to the bilateral hypothalamus, a dimorphic brain region deeply implicated in instinctual drives including reproduction.

A frontoparietal network for spatial attention reorienting in the auditory domain: a human fMRI/MEG study of functional and temporal dynamics.

Several studies have identified a supramodal network critical to the reorienting of attention toward stimuli at novel locations and which involves the right temporoparietal junction and the inferior frontal areas. The present functional magnetic resonance imaging (fMRI)\magnetoencephalography (MEG) study investigates: 1) the cerebral circuit underlying attentional reorienting to spatially varying sound locations; 2) the circuit related to the regular change of sound location in the same hemifield, the change of sound location across hemifields, or sounds presented randomly at different locations on the azimuth plane; 3) functional temporal dynamics of the observed cortical areas exploiting the complementary characteristics of the fMRI and MEG paradigms. fMRI results suggest 3 distinct roles: the supratemporal plane appears modulated by variations of sound location; the inferior parietal lobule is modulated by the cross-meridian effect; and the inferior frontal cortex is engaged by the inhibition of a motor response. MEG data help to elucidate the temporal dynamics of this network by providing high-resolution time series with which to measure latency of neural activation manipulated by the reorienting of attention.

"What" versus "where" in the audiovisual domain: an fMRI study.

Similar "what/where" functional segregations have been proposed for both visual and auditory cortical processing. In this fMRI study, we investigated if the same segregation exists in the crossmodal domain, when visual and auditory stimuli have to be matched in order to perform either a recognition or a localization task. Recent neuroimaging research highlighted the contribution of different heteromodal cortical regions during various forms of crossmodal binding. Interestingly, crossmodal effects during audiovisual speech and object recognition have been found in the superior temporal sulcus, while crossmodal effects during the execution of spatial tasks have been found over the intraparietal sulcus, suggesting an underlying "what/where" segregation. In order to directly compare the specific involvement of these two heteromodal regions, we scanned ten male right-handed subjects during the execution of two crossmodal matching tasks. Participants were simultaneously presented with a picture and an environmental sound, coming from either the same or the opposite hemifield and representing either the same or a different object. The two tasks required a manual YES/NO response respectively about location or semantic matching of the presented stimuli. Both group and individual subject analysis were performed. Task-related differences in BOLD response were observed in the right intraparietal sulcus and in the left superior temporal sulcus, providing a direct confirmation of the "what-where" functional segregation in the crossmodal audiovisual domain.

Human brain activation during passive listening to sounds from different locations: an fMRI and MEG study.

Recent animal and human studies indicate the existence of a neural pathway for sound localization, which is similar to the "where" pathway of the visual system and distinct from the sound identification pathway. This study sought to highlight this pathway using a passive listening protocol. We employed fMRI to study cortical areas, activated during the processing of sounds coming from different locations, and MEG to disclose the temporal dynamics of these areas. In addition, the hypothesis of different activation levels in the right and in the left hemispheres, due to hemispheric specialization of the human brain, was investigated. The fMRI results indicate that the processing of sound, coming from different locations, activates a complex neuronal circuit, similar to the sound localization system described in monkeys known as the auditory "where" pathway. This system includes Heschl's gyrus, the superior temporal gyrus, the supramarginal gyrus, and the inferior and middle frontal lobe. The MEG analysis allowed assessment of the timing of this circuit: the activation of Heschl's gyrus was observed 139 ms after the auditory stimulus, the peak latency of the source located in the superior temporal gyrus was at 156 ms, and the inferior parietal lobule and the supramarginal gyrus peaked at 162 ms. Both hemispheres were found to be involved in the processing of sounds coming from different locations, but a stronger activation was observed in the right hemisphere.

Docosahexaenoic acid ingestion inhibits natural killer cell activity and production of inflammatory mediators in young healthy men.

The purpose of this study was to examine the effects of feeding docosahexaenoic acid (DHA) as triacylglycerol on the fatty acid composition, eicosanoid production, and select activities of human peripheral blood mononuclear cells (PBMNC). A 120-d study with 11 healthy men was conducted at the Metabolic Research Unit of Western Human Nutrition Reach Center. Four subjects (control group) were fed the stabilization diet throughout the study; the remaining seven subjects were fed the basal diet for the first 30 d, followed by 6 g DHA/d for the next 90 d. DHA replaced an equivalent amount of linoleic acid; the two diets were comparable in their total fat and all other nutrients. Both diets were supplemented with 20 mg D alpha-tocopherol acetate per day. PBMNC fatty acid composition and eicosanoid production were examined on day 30 and 113; immune cell functions were tested on day 22, 30, 78, 85, 106, and 113. DHA feeding increased its concentration from 2.3 to 7.4 wt% in the PBMNC total lipids, and decreased arachidonic acid concentration from 19.8 to 10.7 wt%. It also lowered prostaglandin E2 (PGE2) and leukotriene B4 (LTB4) production, in response to lipopolysaccharide, by 60-75%. Natural killer cell activity and in vitro secretion of interleukin-1beta and tumor necrosis factor alpha were significantly reduced by DHA feeding. These parameters remained unchanged in the subjects fed the control diet. B-cell functions as reported here and T-cell functions that we reported previously were not altered by DHA feeding. Our results show that inhibitory effects of DHA on immune cell functions varied with the cell type, and that the inhibitory effects are not mediated through increased production of PGE2 and LTB4.

A human dietary arachidonic acid supplementation study conducted in a metabolic research unit: rationale and design.

While there are many reports of studies that fed arachidonic acid (AA) to animals, there are very few reports of AA feeding to humans under controlled conditions. This 130-d study was conceived as a controlled, symmetrical crossover design with healthy, adult male volunteers. They lived in the metabolic research unit (MRU) of the Western Human Nutrition Research (WHNRC) for the entire study. All food was prepared by the WHNRC kitchen. The basal (low-AA) diet consisted of natural foods (30 en% fat, 15 en% protein, and 55 en% carbohydrate), containing 210 mg/d of AA, and met the recommended daily allowance for all nutrients. The high-AA (intervention) diet was similar except that 1.5 g/d of AA in the form of a triglyceride containing 50% AA replaced an equal amount of high-oleic safflower oil in the basal diet. The subjects (ages 20 to 39) were within -10 to +20% of ideal body weight, nonsmoking, and not allowed alcohol in the MRU. Their exercise level was constant, and their body weights were maintained within 2% of entry level. Subjects were initially fed the low-AA diet for 15 d. On day 16, half of the subjects (group A) wee placed on the high-AA diet, and the other group (B) remained on the low-AA diets. On day 65, the two groups switched diets. On day 115, group B returned to the low-AA diet. This design, assuming no carryover effect, allowed us to merge the data from the two groups, with the data comparison days being 65 (low-AA) and 115 (high-AA) for group B and 130 (low-AA) and 65 (high-AA) for group A. The main indices studied were the fatty acid composition of the plasma, red blood cells, platelets, and adipose tissue; in vitro platelet aggregation, bleeding times, clotting factors; immune response as measured by delayed hypersensitivity skin tests, cellular proliferation of peripheral blood mononuclear cells in response to various mitogens and antigens, natural killer cell activity, and response to measles/mumps/rubella and influenza vaccines; the metabolic conversion of deuterated linoleic acid to AA and the metabolic fate of deuterated AA in the subjects on and off the high-AA diet; and the production of eicosanoids as measured by excretion of 11-DTXB2 and PGI2-M in urine. The results of these studies will be presented in the next five papers from this symposium.

Increased dietary arachidonic acid enhances the synthesis of vasoactive eicosanoids in humans.

Data on the effect of dietary arachidonic acid (AA) (20:4n-6) on the synthesis of thromboxane and prostacyclin (PGI2) in humans are lacking. We measured the effect of 1.5 g/d (ca. 0.5 en%) of 20:4n-6 added isocalorically to a stabilization (low-AA) diet on the excretion of 11-dehydrothromboxane B2 (11-DTXB2) and 2,3-dinor-6-oxo-PGF1 alpha (PGI2-M). In a crossover design, 10 healthy men, living in a metabolic unit, were fed a diet (low-AA) containing 210 mg/d of 20:4n-6 for 65 d and an identical diet (high-AA) that contained 1.5 g/d of additional 20:4n-6 for 50 d. Three-day urine pools were collected at the end of each dietary period and analyzed for eicosanoids by gas chromatography-electron capture negative ion-tandem mass spectrometry. Mean excretion of 11-dehydrothromboxane B2 was 515 +/- 76, 493 +/- 154, and 696 +/- 144 ng/d (SD; n = 10) during the acclimation (15 d) low-AA diet and high-AA diet periods, respectively (41% increase from low-AA to high-AA diet, P = 0.0037); mean excretion of PGI2-M was 125 +/- 40, 151 +/- 36, and 192 +/- 55 ng/d (SD; n = 10) during acclimation (15 d) low-AA and high-AA diets; P = 0.0143). Thus both the metabolites of thromboxane and PGI2 increase on the high-AA diet. Furthermore, both indicated changes in metabolite excretion may be associated with measurable effects on several physiologically significant cellular functions, such as platelet aggregation in vivo and inflammation in response to immune challenges.

Antithromboxane activity of dietary alpha-linolenic acid: a pilot study.

Two decades of research conclusively demonstrated the antithrombotic properties of the long-chain n-3 polyunsaturated fatty acids (PUFA) present in lipids from marine fishes. Most American consumers, however, given their preference for meat, will not realize the benefits of a fish-rich diet. Could alpha-linolenic acid (18:3, n-3) be similarly effective via modulation of the synthesis of vasoactive eicosanoids, i.e., thromboxane and prostacyclin? The present pilot study is a contribution toward answering this question. We determined that the urinary excretion of 11-dehydrothromboxane B2 declined by 34% from baseline level 7 weeks after the n-6/n-3 ratio of dietary PUFA was reduced from 28:1 to 1:1. The excretion of 2,3-dinor-6-oxo-prostaglandin F1 alpha was similarly affected. The dietary adjustment was brought about by substituting measured amounts of canola and flaxseed oils (3:1) for measured amounts of olive and corn oils (3:1) in an otherwise fat-free basal diet. This study demonstrates that dietary alpha-linolenic acid is an effective modulator of thromboxane and prostacyclin biosynthesis. Therefore, we can expect that the eicosanoid-mediated effects of alpha-linolenic acid are similar to those elicited by marine lipids.

Pentose phosphate pathway alterations in multi-drug resistant leukemic T-cells: 31P NMR and enzymatic studies.

31P NMR studies were carried out on the parental drug-sensitive human T-lymphoblastoid cell line CCRI-CEM (CEM) and its multi-drug-resistant (MDR) CEM-VBL100 variants, to assess the role of the pentose phosphate (PP) in MDR expression. CEM and CEM-VBL100 were incubated in the presence of 2-deoxyglucose, as recently proposed by our group (Clin. Chim. Acta 208: 39, 1992). Accumulation of 2-deoxyglucose 6-phosphate was much lower in the drug-resistant than in sensitive cells, indicating PP shunt activation in the MDR variants. This result was confirmed by enzymatic analyses, which demonstrated that, with respect to the parental line, the MDR variant was characterized by a) unaltered hexokinase activity; b) higher glucose 6-phosphate dehydrogenase activity; c) increased levels of reduced glutathione and marked increase of glutathione peroxidase activity after cell exposure to an oxidizing agent (tert-butylhydroperoxide). These results support the view that cell detoxification mechanisms mediated by the pentose phosphate pathway may contribute to the expression of MDR in tumours.

Ingestion of marine oil reduces excretion of 11-dehydrothromboxane B2, an index of intravascular production of thromboxane A2.

We evaluated the effect of anchovy oil supplementation on the endogenous production of thromboxane A2 by measuring the excretion of its stable metabolite, 11-dehydrothromboxane B2 (11-DTXB2), in 24-h urine. In a longitudinal study, 35 male volunteers consumed a controlled basal diet for two experimental periods lasting a total of 20 weeks. During period 1 (10 weeks) the diet was supplemented with placebo (PO) capsules (15 x 1 g/d) consisting of a blend of fats approaching the fatty acid profile of the basal diet. During period 2 the subjects received 15 x 1 g/d capsules of fish oil concentrate (FOC). PO and FOC capsules contained 1 mg alpha-tocopherol per gram of fat as antioxidant. A 38% reduction of 11-DTXB2 excretion was observed after 10 weeks of FOC supplementation (period 2, n-6/n-3 PUFA ratio = 2.3), compared to an identical period of PO supplementation (period 1, n-6/n-3 = 12.5), p = 0.0001. The 11-DTXB2 excretion reduction (delta) fits the quadratic equation delta = 136.0038-0.3178(tx1)-0.0002(tx1)2, (R2 = 0.8944), where tx1 is the excretion rate at the end of period 1. This finding supports the hypothesis that the antithrombotic effect of marine oil is mediated, at least in part, by diet-induced shifts in the eicosanoid system.

13C and 31P NMR studies of glucose and 2-deoxyglucose metabolism in normal and enzyme-deficient human erythrocytes.

The flux of 13C-labeled glucose through the Embden-Meyerhof and pentose phosphate pathways was studied by 13C NMR in intact erythrocytes isolated from normal subjects or from patients suffering of glucose-6-phosphate dehydrogenase (G6PD, EC 1.1.1.49) deficiency. Similar rates of glucose catabolism and similar fluxes of the 13C-label into 2,3-bisphosphoglycerate and lactate were found, under basal conditions, in normal and in G6PD-deficient erythrocytes incubated in the presence of either [1-13C]- or D[6-13C]glucose. Exposure to oxidative stress by preincubation with tert-butylhydroperoxide induced in normal, but not in G6PD-deficient erythrocytes, a significant enhancement of glucose consumption, as well as a substantial reduction in 13C-label transfer from C1-glucose into lactate. It was also possible, by 31P NMR, to evaluate the conversion of 2-deoxyglucose to its phosphate-containing metabolites. The oxidation and subsequent decarboxylation of 2-deoxyglucose-6-phosphate was assessed in reconstituted systems and could subsequently be evidenced also in ethanolic extracts from normal (but not from G6PD-deficient) erythrocytes which had been exposed to oxidative stress. The results indicate that, in terms of glucose flux through the glycolytic pathway, there is little or no difference between normal and G6PD-deficient erythrocytes, regardless of previous exposure to oxidative stress. Faster consumption of either glucose or 2-deoxyglucose is induced, only in normal cells, by treatment with tert-butylhydroperoxide, essentially as a consequence of the activation of the pentose-phosphate pathway.

Effect of fish oil supplementation on the excretion of the major metabolite of prostaglandin E in healthy male subjects.

We investigated the effect of fish oil supplementation on the synthesis of prostaglandin E (PGE) in vivo by measuring the excretion of its catabolite, PGE-M, in 24-hr urine by gas chromatography/mass spectrometry. Forty healthy male volunteers (24-57 years of age) consumed a controlled basal diet providing 40% of energy from fat (P/S ratio about 0.8:1), 130 mg/1000 kcal cholesterol, and a minimum of 22 mg/day of alpha-tocopherol (alpha-T), for three experimental periods lasting a total of 28 weeks. During period 1 (10 weeks) the diet was supplemented with placebo (PO) capsules (15 X 1 g/day) consisting of a blend of fats approaching the fatty acid profile of the basal diet. This was followed by a second 10-week period during which the subjects received 15 X 1 g/day capsules of fish oil concentrate (FOC). During period 3 (8 weeks) they continued the 15 g/day intake of FOC but received an additional 200 mg/day of alpha-T. PO and FOC capsules contained 1 mg alpha-T/g fat as antioxidant. A 14% reduction of PGE-M excretion was observed after 10 weeks of FOC supplementation (period 2), compared to an identical period of placebo supplementation (period 1), P = 0.009. PGE-M excretion during the last week of period 3 was not significantly different from that at the end of period 2. The reduction in PGE synthesis in response to the relatively high marine oil supplementation was large in many subjects participating in this study.

Occurrence of prostaglandin E3 in human urine as a result of marine oil ingestion: gas chromatographic-mass spectrometric evidence.

This pilot study is an effort to elucidate the metabolic fate of dietary eicosapentaenoate in vivo and its influence on arachidonate cyclooxygenation at the renal level. The ultimate objective is to shed light on the biochemical mechanisms responsible for the physiologic effects of marine oil on humans. We found prostaglandin E3 (PGE3) in urine of a female volunteer who ingested 10-50 g/day of MaxEPA fish oil concentrate for 4 years. PGE3, a cyclooxygenase metabolite of eicosapentaenoate, could not be detected in 24-h urine pools from the same subject 16 weeks after fish oil supplementation ended. The appearance of PGE3 was concurrent with a reduction of urinary PGE2. Identification of the trienoic prostaglandin was based on comparison of chromatographic behavior of three distinct derivatives of endogenous PGE3 with that of authentic material, and on selected ion monitoring mass spectrometry.

A fish oil diet rich in eicosapentaenoic acid reduces cyclooxygenase metabolites, and suppresses lupus in MRL-lpr mice.

Dietary supplementation of fish oil as the exclusive source of lipid suppresses autoimmune lupus in MRL-lpr mice. This marine oil diet decreases the lymphoid hyperplasia regulated by the lpr gene, prevents an increase in macrophage surface Ia expression, reduces the formation of circulating retroviral gp70 immune complexes, delays the onset of renal disease, and prolongs survival. We show that a fatty acid component uniquely present in fish oil but not in vegetable oil decreases the quantity of dienoic prostaglandin E, thromboxane B, and prostacyclin normally synthesized by multiple tissues, including kidney, lung, and macrophages, and promotes the synthesis of small amounts of trienoic prostaglandin in autoimmune mice. We suggest that this change in endogenous cyclooxygenase metabolite synthesis directly suppresses immunologic and/or inflammatory mediators of murine lupus.