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1.
Eur J Neurol ; 24(9): 1140-1147, 2017 09.
Artículo en Inglés | MEDLINE | ID: mdl-28661018

RESUMEN

BACKGROUND AND PURPOSE: Huntington's disease (HD) is an autosomal dominant, neurodegenerative movement disorder, typically characterized by chorea. Dystonia is also recognized as part of the HD motor phenotype, although little work detailing its prevalence, distribution, severity and impact on functional capacity has been published to date. METHODS: Patients (>18 years of age) were recruited from the Cardiff (UK) HD clinic, each undergoing a standardized videotaped clinical examination and series of functional assessment questionnaires (Unified Huntington's Disease Rating Scale, Burke-Fahn-Marsden Dystonia Rating Scale and modified version of the Toronto Western Spasmodic Torticollis Rating Scale). The presence and severity of dystonia were scored by four independent neurologists using the Burke-Fahn-Marsden Dystonia Rating Scale and Unified Huntington's Disease Rating Scale. Statistical analysis included Fisher's exact test, Wilcoxon test, anova and calculation of correlation coefficients where appropriate. RESULTS: Forty-eight patients [91% (48/53)] demonstrated evidence of dystonia, with the highest prevalence in the left upper limb (n = 44, 83%), right upper limb most severely affected and eyes least affected. Statistically significant positive correlations (P < 0.05) were observed between dystonia severity and increasing HD disease stage and motor disease duration. Deterioration in functional capacity also correlated with increasing dystonia severity. No significant relationship was observed with age at motor symptom onset or CAG repeat length. CONCLUSIONS: We report a high prevalence of dystonia in adult patients with HD, with worsening dystonia severity with increasing HD disease stage and motor disease duration. The recognition and management of dystonic symptoms in routine clinical practice will aid overall symptomatic treatment and functional improvement.


Asunto(s)
Distonía/fisiopatología , Enfermedad de Huntington/fisiopatología , Actividades Cotidianas , Adulto , Edad de Inicio , Anciano , Estudios de Cohortes , Progresión de la Enfermedad , Femenino , Lateralidad Funcional , Humanos , Proteína Huntingtina/genética , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Fenotipo , Expansión de Repetición de Trinucleótido , Extremidad Superior/fisiopatología , Grabación en Video , Adulto Joven
2.
NMR Biomed ; 29(10): 1420-6, 2016 10.
Artículo en Inglés | MEDLINE | ID: mdl-27514007

RESUMEN

(1) H MRS measurements of lactate are often confounded by overlapping lipid signals. Double-quantum (DQ) filtering eliminates lipid signals and permits single-shot measurements, which avoid subtraction artefacts in moving tissues. This study evaluated a single-voxel-localized DQ filtering method qualitatively and quantitatively for measuring lactate concentrations in the presence of lipid, using high-grade brain tumours in which the results could be compared with standard acquisition as a reference. Paired standard acquisition and DQ-filtered (1) H MR spectra were acquired at 3T from patients receiving treatment for glioblastoma, using fLASER (localization by adiabatic selective refocusing using frequency offset corrected inversion pulses) single-voxel localization. Data were acquired from 2 × 2 × 2 cm(3) voxels, with a repetition time of 1 s and 128 averages (standard acquisition) or 256 averages (DQ-filtered acquisition), requiring 2.15 and 4.3 min respectively. Of 37 evaluated data pairs, 20 cases (54%) had measureable lactate (fitted Cramér-Rao lower bounds ≤ 20%) in either the DQ-filtered or the standard acquisition spectra. The measured DQ-filtered lactate signal was consistently downfield of lipid (1.33 ± 0.03 ppm vs 1.22 ± 0.08 ppm; p = 0.002), showing that it was not caused by lipid breakthrough, and that it matched the lactate signal seen in standard measurements (1.36 ± 0.02 ppm). In the absence of lipid, similar lactate concentrations were measured by the two methods (mean ratio DQ filtered/standard acquisition = 1.10 ± 0.21). In 7/20 cases with measurable lactate, signal was not measureable in the standard acquisition owing to lipid overlap but was quantified in the DQ-filtered acquisition. Conversely, lactate was undetected in seven DQ-filtered acquisitions but visible using the standard acquisition. In conclusion, the DQ filtering method has proven robust in eliminating lipid and permits uncontaminated measurement of lactate. This is important validation prior to use in tissues outside the brain, which contain large amounts of lipid and which are often susceptible to motion.


Asunto(s)
Biomarcadores de Tumor/metabolismo , Neoplasias Encefálicas/metabolismo , Neoplasias Encefálicas/patología , Ácido Láctico/metabolismo , Imagen Molecular/métodos , Espectroscopía de Protones por Resonancia Magnética/métodos , Procesamiento de Señales Asistido por Computador , Algoritmos , Humanos , Imagen por Resonancia Magnética/métodos , Clasificación del Tumor , Reproducibilidad de los Resultados , Sensibilidad y Especificidad
3.
NMR Biomed ; 28(3): 338-43, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25586623

RESUMEN

Lactate is a product of glucose metabolism. In tumour tissues, which exhibit enhanced glycolytic metabolism, lactate signals may be elevated, making lactate a potential useful tumour biomarker. Methods of lactate quantitation are complicated because of overlap between the lactate methyl doublet CH3 resonance and a lipid resonance at 1.3 ppm. This study presents the use of a selective homonuclear multiple quantum coherence transfer sequence (SelMQC-CSI), at 1.5 T, to better quantify lactate in the presence of lipids. Work performed on phantoms showed good lactate detection (49%) and lipid suppression (98%) efficiencies. To evaluate the method in the brain, the sequence was tested on a group of 23 patients with treated brain tumours, either glioma (N=20) or secondary metastases in the brain (N=3). Here it was proved to be of use in determining lactate concentrations in vivo. Lactate was clearly seen in SelMQC spectra of glioma, even in the presence of lipids, with high grade glioma (7.3 ± 1.9 mM, mean ± standard deviation) having higher concentrations than low grade glioma (1.9 ± 1.5 mM, p=0.048). Lactate was not seen in secondary metastases in the brain. SelMQC-CSI is shown to be a useful technique for measuring lactate in tumours whose signals are otherwise contaminated by lipid.


Asunto(s)
Neoplasias Encefálicas/metabolismo , Ácido Láctico/análisis , Fantasmas de Imagen , Teoría Cuántica , Encéfalo/metabolismo , Encéfalo/patología , Humanos , Ácido Láctico/metabolismo , Lípidos/química , Imagen por Resonancia Magnética , Metaboloma
4.
Eur J Nucl Med Mol Imaging ; 42(4): 562-78, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25578953

RESUMEN

Imaging biomarkers derived from MRI or CT describe functional properties of tumours and normal tissues. They are finding increasing numbers of applications in diagnosis, monitoring of response to treatment and assessment of progression or recurrence. Imaging biomarkers also provide scope for assessment of heterogeneity within and between lesions. A wide variety of functional parameters have been investigated for use as biomarkers in oncology. Some imaging techniques are used routinely in clinical applications while others are currently restricted to clinical trials or preclinical studies. Apparent diffusion coefficient, magnetization transfer ratio and native T1 relaxation time provide information about structure and organization of tissues. Vascular properties may be described using parameters derived from dynamic contrast-enhanced MRI, dynamic contrast-enhanced CT, transverse relaxation rate (R2*), vessel size index and relative blood volume, while magnetic resonance spectroscopy may be used to probe the metabolic profile of tumours. This review describes the mechanisms of contrast underpinning each technique and the technical requirements for robust and reproducible imaging. The current status of each biomarker is described in terms of its validation, qualification and clinical applications, followed by a discussion of the current limitations and future perspectives.


Asunto(s)
Biomarcadores de Tumor/metabolismo , Imagen por Resonancia Magnética/métodos , Neoplasias/diagnóstico por imagen , Tomografía Computarizada de Emisión/métodos , Animales , Humanos , Neoplasias/diagnóstico , Radiofármacos/farmacocinética
5.
Eur Radiol ; 25(5): 1247-56, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25749786

RESUMEN

OBJECTIVES: The objectives are determine the optimal combination of MR parameters for discriminating tumour within the prostate using linear discriminant analysis (LDA) and to compare model accuracy with that of an experienced radiologist. METHODS: Multiparameter MRIs in 24 patients before prostatectomy were acquired. Tumour outlines from whole-mount histology, T2-defined peripheral zone (PZ), and central gland (CG) were superimposed onto slice-matched parametric maps. T2, Apparent Diffusion Coefficient, initial area under the gadolinium curve, vascular parameters (K(trans),Kep,Ve), and (choline+polyamines+creatine)/citrate were compared between tumour and non-tumour tissues. Receiver operating characteristic (ROC) curves determined sensitivity and specificity at spectroscopic voxel resolution and per lesion, and LDA determined the optimal multiparametric model for identifying tumours. Accuracy was compared with an expert observer. RESULTS: Tumours were significantly different from PZ and CG for all parameters (all p < 0.001). Area under the ROC curve for discriminating tumour from non-tumour was significantly greater (p < 0.001) for the multiparametric model than for individual parameters; at 90 % specificity, sensitivity was 41 % (MRSI voxel resolution) and 59 % per lesion. At this specificity, an expert observer achieved 28 % and 49 % sensitivity, respectively. CONCLUSION: The model was more accurate when parameters from all techniques were included and performed better than an expert observer evaluating these data. KEY POINTS: • The combined model increases diagnostic accuracy in prostate cancer compared with individual parameters • The optimal combined model includes parameters from diffusion, spectroscopy, perfusion, and anatominal MRI • The computed model improves tumour detection compared to an expert viewing parametric maps.


Asunto(s)
Medios de Contraste , Imagen por Resonancia Magnética/métodos , Espectroscopía de Resonancia Magnética/métodos , Neoplasias de la Próstata/patología , Anciano , Imagen de Difusión por Resonancia Magnética/métodos , Humanos , Aumento de la Imagen/métodos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Próstata/patología , Curva ROC , Sensibilidad y Especificidad
6.
NMR Biomed ; 26(9): 1096-102, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-23417787

RESUMEN

The aims of this study were to characterise the major saturated and unsaturated lipid peaks in histologically normal cervical epithelium and stroma, dysplastic epithelium (low-grade cervical intraepithelial neoplasia, CIN) and cancer-containing tissue samples from patients with cervical cancer using diffusion-weighted (1) H high-resolution magic angle spinning MRS, to determine whether mobile lipid resonances (MLRs) distinguish tissue types and to test for a correlation between MLRs and the number of cytoplasmic lipid droplets. Diffusion-weighted spectra of tissue biopsies were acquired using a stimulated echo sequence with bipolar gradients. Major saturated and unsaturated MLRs were identified and multivariate analysis of peak combinations was used to determine the best separation between tissue classes. Lipid droplets were visualised with Nile red staining and fluorescence microscopy. Correlations of saturated lipid resonances (0.9 and 1.3 ppm), polyunsaturated resonances (2.8 ppm), triglycerides (4.3 ppm) and unsaturated resonances (5.3 ppm) with average droplet number (per image) were investigated using a Spearman rank test. A large heterogeneity in lipid content among samples was observed, resulting in no significant differences in MLR intensities of individual peaks between the three tissue classes. Linear discriminant analysis separated 'no cancer' from 'cancer' based on the intensities at 0.9, 1.3, 2.2 and 2.8 ppm [area under the curve (AUC) = 0.939, p < 0.001], 'low-grade CIN' from 'cancer' based on the intensities at 0.9, 4.1, 4.3 and 5.3 ppm (AUC = 0.987, p < 0.001) and 'no cancer' from 'low-grade CIN' based on intensities at 0.9, 2.2 and 4.3 ppm (AUC = 0.984, p < 0.001). The distribution of cytoplasmic lipid droplets was nonuniform and was not related to the presence of epithelial or stromal components. On average, there were more droplets visible in low-grade CIN and cancer-containing tissues. Significant correlations between MLR peaks and lipid droplet number were seen for 0.9 (p = 0.002), 1.3 (p = 0.003) and 2.8 ppm (p = 0.018). MLR combinations indicative of average lipid structure efficiently separated tissue classes. Increased lipid resonances correlated with increased numbers of cytoplasmic lipid droplets.


Asunto(s)
Cuello del Útero/patología , Lípidos/química , Espectroscopía de Resonancia Magnética , Neoplasias del Cuello Uterino/metabolismo , Biopsia , Imagen de Difusión Tensora , Femenino , Humanos , Microscopía Confocal
7.
Eur Radiol ; 23(6): 1537-45, 2013 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-23242002

RESUMEN

OBJECTIVES: To investigate the effect of magnetic field heterogeneity in breast dynamic contrast-enhanced examinations with fat saturation (DCE-FS). METHODS: The magnetic field was mapped over the breasts in ten patients. DCE-FS was undertaken at 1.5 T with fast spoiled gradient echoes and spectrally selective fat saturation. Signal intensity was calculated for T1 values 25-1,200 ms both on and off resonance, and results were verified with a test object. Clinical examinations were evaluated for the predicted effects of field heterogeneity. RESULTS: Magnetic field was found to vary by 3.6 ± 1.2 ppm over the central transaxial slice and 5.1 ± 1.5 over the whole breast volume (mean ± standard deviation). Computer simulations predict a reduction in the dynamic range if field heterogeneity leads to unintended water suppression, and distortion to CA uptake curves due to fat suppression failure (for fat containing pixels). A compromise between dynamic range and fat saturation performance is required. Both water suppression and fat suppression failure are apparent in clinical examinations. CONCLUSION: Magnetic field heterogeneity is likely to reduce the sensitivity of DCE-FS by distorting the CA uptake curves because of fat suppression failure (for fat containing pixels) and by reducing the dynamic range because of unintended water suppression. KEY POINTS: • Magnetic field heterogeneity is significant in breast magnetic resonance. • Contrast-agent uptake curves are distorted by a non-uniform magnetic field. • Radiologist must be aware of possibility of distortion to interpret uptake curves correctly. • Compromise between fat suppression and dynamic range is required.


Asunto(s)
Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/patología , Mama/patología , Medios de Contraste/farmacocinética , Tejido Adiposo/patología , Algoritmos , Simulación por Computador , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Imagenología Tridimensional , Campos Magnéticos , Reproducibilidad de los Resultados , Agua/química
8.
NMR Biomed ; 25(6): 859-65, 2012 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-22190219

RESUMEN

Increased expression of choline kinase has frequently been shown in tumours and is thought to be associated with disease progression. Studies using magnetic resonance spectroscopy have shown an increase in total choline-containing metabolites (tCho) in tumour compared with healthy tissue. Subsequent reductions in tCho following successful treatment support the use of tCho as a biomarker of disease and response. However, accurate measurement of tCho using MRS in abdominal tumours is complicated by respiratory motion, blurring the acquisition volume and degrading the lineshape and signal-to-noise ratio (SNR) of metabolites. Motion compensation using prospectively gated acquisitions or offline correction of phase and frequency distortions can help restore the SNR and linewidth of metabolites. Prospectively gated acquisitions have the advantage of confining the volume of acquisition to the prescribed volume but are constrained by the repetition time (TR) of the respiratory motion. In contrast, data acquired for offline correction may use a shorter repetition time and therefore yield an increased SNR per unit time. In this study abdominal spectra acquired from single-voxel 'free-breathing' measurements in liver of healthy volunteers and in abdominal tumours of cancer patients were compared with those of prospective gating and with an implementation of offline correction. The two motion compensation methodologies were assessed in terms of SNR, linewidth and repeatability. Our experiments show that prospective gating and offline correction result in a 12-22% reduction in median tCho linewidth, while offline correction also provides a significant increase in SNR. The repeatability coefficient (the expected interval for 95% of repeat measurements) for tCho/water ratio was reduced by 37% (prospective gating) and 41% (offline correction). Both methods of motion compensation substantially improved the reproducibility of the tCho/water measurement and the tCho linewidth. While offline correction also leads to a significant improvement in SNR, it may suffer more from out-of-voxel contamination.


Asunto(s)
Neoplasias Abdominales/química , Neoplasias Abdominales/diagnóstico , Artefactos , Biomarcadores de Tumor/análisis , Colina/análisis , Espectroscopía de Resonancia Magnética/métodos , Técnicas de Imagen Sincronizada Respiratorias/métodos , Ensayos Clínicos como Asunto , Diagnóstico por Computador/métodos , Humanos , Aumento de la Imagen/métodos , Imagen por Resonancia Magnética/métodos , Protones , Reproducibilidad de los Resultados , Sensibilidad y Especificidad
9.
Nat Cell Biol ; 2(12): 958-63, 2000 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-11146663

RESUMEN

Clathrin-coated vesicles mediate diverse processes such as nutrient uptake, downregulation of hormone receptors, formation of synaptic vesicles, virus entry, and transport of biosynthetic proteins to lysosomes. Cycles of coat assembly and disassembly are integral features of clathrin-mediated vesicular transport (Fig. 1a). Coat assembly involves recruitment of clathrin triskelia, adaptor complexes and other factors that influence coat assembly, cargo sequestration, membrane invagination and scission (Fig. 1a). Coat disassembly is thought to be essential for fusion of vesicles with target membranes and for recycling components of clathrin coats to the cytoplasm for further rounds of vesicle formation. In vitro, cytosolic heat-shock protein 70 (Hsp70) and the J-domain co-chaperone auxilin catalyse coat disassembly. However, a specific function of these factors in uncoating in vivo has not been demonstrated, leaving the physiological mechanism and significance of uncoating unclear. Here we report the identification and characterization of a Saccharomyces cerevisiae J-domain protein, Aux1. Inactivation of Aux1 results in accumulation of clathrin-coated vesicles, impaired cargo delivery, and an increased ratio of vesicle-associated to cytoplasmic clathrin. Our results demonstrate an in vivo uncoating function of a J domain co-chaperone and establish the physiological significance of uncoating in transport mediated by clathrin-coated vesicles.


Asunto(s)
Vesículas Cubiertas por Clatrina/metabolismo , Clatrina/metabolismo , ADN de Hongos/metabolismo , Proteínas Fúngicas/metabolismo , Proteínas del Tejido Nervioso/metabolismo , Fosfoproteínas/metabolismo , Saccharomyces cerevisiae/metabolismo , Proteínas Adaptadoras del Transporte Vesicular , Secuencia de Aminoácidos , Animales , Transporte Biológico Activo , Proteínas Fúngicas/genética , Proteínas HSP70 de Choque Térmico/metabolismo , Humanos , Modelos Biológicos , Chaperonas Moleculares/genética , Chaperonas Moleculares/metabolismo , Datos de Secuencia Molecular , Proteínas del Tejido Nervioso/genética , Fosfoproteínas/genética , Proteínas Recombinantes de Fusión/genética , Proteínas Recombinantes de Fusión/metabolismo , Saccharomyces cerevisiae/genética , Homología de Secuencia de Aminoácido
10.
Aerosol Sci Technol ; 56(1): 63-74, 2021 Nov 08.
Artículo en Inglés | MEDLINE | ID: mdl-35602286

RESUMEN

A sampling system for measuring emissions of nonvolatile particulate matter (nvPM) from aircraft gas turbine engines has been developed to replace the use of smoke number and is used for international regulatory purposes. This sampling system can be up to 35 m in length. The sampling system length in addition to the volatile particle remover (VPR) and other sampling system components lead to substantial particle losses, which are a function of the particle size distribution, ranging from 50 to 90% for particle number concentrations and 10-50% for particle mass concentrations. The particle size distribution is dependent on engine technology, operating point, and fuel composition. Any nvPM emissions measurement bias caused by the sampling system will lead to unrepresentative emissions measurements which limit the method as a universal metric. Hence, a method to estimate size dependent sampling system losses using the system parameters and the measured mass and number concentrations was also developed (SAE 2017; SAE 2019). An assessment of the particle losses in two principal components used in ARP6481 (SAE 2019) was conducted during the VAriable Response In Aircraft nvPM Testing (VARIAnT) 2 campaign. Measurements were made on the 25-meter sample line portion of the system using multiple, well characterized particle sizing instruments to obtain the penetration efficiencies. An agreement of ± 15% was obtained between the measured and the ARP6481 method penetrations for the 25-meter sample line portion of the system. Measurements of VPR penetration efficiency were also made to verify its performance for aviation nvPM number. The research also demonstrated the difficulty of making system loss measurements and substantiates the E-31 decision to predict rather than measure system losses.

11.
Lab Chip ; 10(22): 3026-42, 2010 Nov 21.
Artículo en Inglés | MEDLINE | ID: mdl-20877781

RESUMEN

Chitosan is a naturally derived polymer with applications in a variety of industrial and biomedical fields. Recently, it has emerged as a promising material for biological functionalization of microelectromechanical systems (bioMEMS). Due to its unique chemical properties and film forming ability, chitosan serves as a matrix for the assembly of biomolecules, cells, nanoparticles, and other substances. The addition of these components to bioMEMS devices enables them to perform functions such as specific biorecognition, enzymatic catalysis, and controlled drug release. The chitosan film can be integrated in the device by several methods compatible with standard microfabrication technology, including solution casting, spin casting, electrodeposition, and nanoimprinting. This article surveys the usage of chitosan in bioMEMS to date. We discuss the common methods for fabrication, modification, and characterization of chitosan films, and we review a number of demonstrated chitosan-based microdevices. We also highlight the advantages of chitosan over some other functionalization materials for micro-scale devices.


Asunto(s)
Quitosano , Dispositivos Laboratorio en un Chip , Sistemas Microelectromecánicos
12.
NMR Biomed ; 23(4): 382-90, 2010 May.
Artículo en Inglés | MEDLINE | ID: mdl-20014336

RESUMEN

The purpose of this study was to implement a diffusion-weighted sequence for visualisation of mobile lipid resonances (MLR) using high resolution magic angle spinning (HR-MAS) (1)H MRS and to evaluate its use in establishing differences between tissues from patients with cervical carcinoma that contain cancer from those that do not. A stimulated echo sequence with bipolar gradients was modified to allow T(1) and T(2) measurements and optimised by recording signal loss in HR-MAS spectra as a function of gradient strength in model lipids and tissues. Diffusion coefficients, T(1) and apparent T(2) relaxation times were measured in model lipid systems. MLR profiles were characterised in relation to T(1) and apparent T(2) relaxation in human cervical cancer tissue samples. Diffusion-weighted (DW) spectra of cervical biopsies were quantified and peak areas analysed using linear discriminant analysis (LDA). The optimised sequence reduced spectral overlap by suppressing signals originating from low molecular weight metabolites and non-lipid contributions. Significantly improved MLR visualisation allowed visualisation of peaks at 0.9, 1.3, 1.6, 2.0, 2.3, 2.8, 4.3 and 5.3 ppm. MLR analysis of DW spectra showed at least six peaks arising from saturated and unsaturated lipids and those arising from triglycerides. Significant differences in samples containing histologically confirmed cancer were seen for peaks at 0.9 (p < 0.006), 1.3 (p < 0.04), 2.0 (p < 0.03), 2.8 (p < 0.003) and 4.3 ppm (p < 0.0002). LDA analysis of MLR peaks from DW spectra almost completely separated two clusters of cervical biopsies (cancer, 'no-cancer'), reflecting underlying differences in MLR composition. Generated Receiver Operating Characteristic (ROC) curves and calculated area under the curve (0.962) validated high sensitivity and specificity of the technique. Diffusion-weighting of HR-MAS spectroscopic sequences is a useful method for characterising MLR in cancer tissues and displays an accumulation of lipids arising during tumourigenesis and an increase in the unsaturated lipid and triglyceride peaks with respect to saturated MLR.


Asunto(s)
Biopsia , Cuello del Útero/patología , Imagen de Difusión por Resonancia Magnética/métodos , Lípidos/análisis , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/patología , Cuello del Útero/química , Femenino , Humanos , Curva ROC
13.
BMJ Mil Health ; 166(2): 103-104, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32086275

RESUMEN

Clinical decision support and e-learning will be essential if we are to achieve the goal of preventing outbreaks of infectious diseases caused by extremely dangerous pathogens. However, these resources on their own will not be enough to achieve this outcome. To achieve this outcome, resources must be integrated into undergraduate and postgraduate educational curricula, accredited as part of continuous professional development programmes, built around the knowledge and skills gaps of learners and developed using an evidence-based methodology that will enable healthcare professionals to put their learning into action for the benefit of both patients and populations. This article describes and contextualises the personal views discussed at a workshop on education and clinical decision support for healthcare professionals reacting to an infectious disease outbreak from extremely dangerous pathogens.


Asunto(s)
Defensa Civil/educación , Sistemas de Apoyo a Decisiones Clínicas , Educación Médica , Curriculum , Humanos , Reino Unido
14.
Br J Cancer ; 101(11): 1860-8, 2009 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-19935799

RESUMEN

BACKGROUND: SR4554 is a fluorine-containing 2-nitroimidazole, designed as a hypoxia marker detectable with 19F magnetic resonance spectroscopy (MRS). In an initial phase I study of SR4554, nausea/vomiting was found to be dose-limiting, and 1400 mg m(-2) was established as MTD. Preliminary MRS studies demonstrated some evidence of 19F retention in tumour. In this study we investigated higher doses of SR4554 and intratumoral localisation of the 19F MRS signal. METHODS: Patients had tumours > or = 3 cm in diameter and < or = 4 cm deep. Measurements were performed using 1H/19F surface coils and localised 19F MRS acquisition. SR4554 was administered at 1400 mg m(-2), with subsequent increase to 2600 mg m(-2) using prophylactic metoclopramide. Spectra were obtained immediately post infusion (MRS no. 1), at 16 h (MRS no. 2) and 20 h (MRS no. 3), based on the SR4554 half-life of 3.5 h determined from a previous study. 19Fluorine retention index (%) was defined as (MRS no. 2/MRS no. 1)*100. RESULTS: A total of 26 patients enrolled at: 1400 (n=16), 1800 (n=1), 2200 (n=1) and 2600 mg m(-2) (n=8). SR4554 was well tolerated and toxicities were all < or = grade 1; mean plasma elimination half-life was 3.7+/-0.9 h. SR4554 signal was seen on both unlocalised and localised MRS no. 1 in all patients. Localised 19F signals were detected at MRS no. 2 in 5 out of 9 patients and 4 out of 5 patients at MRS no. 3. The mean retention index in tumour was 13.6 (range 0.6-43.7) compared with 4.1 (range 0.6-7.3) for plasma samples taken at the same times (P=0.001) suggesting (19)F retention in tumour and, therefore, the presence of hypoxia. CONCLUSION: We have demonstrated the feasibility of using 19F MRS with SR4554 as a potential method of detecting hypoxia. Certain patients showed evidence of 19F retention in tumour, supporting further development of this technique for detection of tumour hypoxia.


Asunto(s)
Espectroscopía de Resonancia Magnética/métodos , Neoplasias/metabolismo , Nitroimidazoles/farmacocinética , Adulto , Anciano , Anciano de 80 o más Años , Hipoxia de la Célula/fisiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nitroimidazoles/efectos adversos , Oxígeno/metabolismo , Presión Parcial , Adulto Joven
15.
Trends Cell Biol ; 3(12): 426-32, 1993 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-14731888

RESUMEN

In a secretory pathway organelle like the Golgi complex, resident proteins are retained in the face of substantial protein flux to subsequent destinations. Recently, molecular genetic strategies have been used to study membrane protein retention in a compartment of the yeast Saccharomyces cerevisiae that is analogous to the trans Golgi network (TGN) of mammalian cells. These studies have defined retention signals containing aromatic amino acids in the TGN proteins' cytoplasmic domains. The identification of mutants that fail to retain TGN proteins has offered the first glimpse into the components involved in retention. The phenotypes of these mutants suggest that retention involves retrieval of TGN proteins from an endosomal compartment.

16.
J Cell Biol ; 118(3): 531-40, 1992 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-1322413

RESUMEN

The role of clathrin in retention of Golgi membrane proteins has been investigated. Prior work showed that a precursor form of the peptide mating pheromone alpha-factor is secreted by Saccharomyces cerevisiae cells which lack the clathrin heavy chain gene (CHC1). This defect can be accounted for by the observation that the Golgi membrane protein Kex2p, which initiates maturation of alpha-factor precursor, is mislocalized to the cell surface of mutant cells. We have examined the localization of two additional Golgi membrane proteins, dipeptidyl aminopeptidase A (DPAP A) and guanosine diphosphatase (GDPase) in clathrin-deficient yeast strains. Our findings indicate that DPAP A is aberrantly transported to the cell surface but GDPase is not. In mutant cells carrying a temperature-sensitive allele of CHC1 (chc1-ts), alpha-factor precursor appears in the culture medium within 15 min, and Kex2p and DPAP A reach the cell surface within 30 min, after imposing the nonpermissive temperature. In contrast to these immediate effects, a growth defect is apparent only after 2 h at the nonpermissive temperature. Also, sorting of the vacuolar membrane protein, alkaline phosphatase, is not affected in chc1-ts cells until 2 h after the temperature shift. A temperature-sensitive mutation which blocks a late stage of the secretory pathway, sec1, prevents the appearance of mislocalized Kex2p at the cell surface of chc1-ts cells. We propose that clathrin plays a direct role in the retention of specific proteins in the yeast Golgi apparatus, thereby preventing their transport to the cell surface.


Asunto(s)
Clatrina/fisiología , Aparato de Golgi/metabolismo , Proteínas de la Membrana/metabolismo , Proproteína Convertasas , Pirofosfatasas , Proteínas de Saccharomyces cerevisiae , Saccharomyces cerevisiae/metabolismo , Subtilisinas , Alelos , Clatrina/química , Clatrina/genética , Dipeptidil-Peptidasas y Tripeptidil-Peptidasas/metabolismo , Proteínas Fúngicas/metabolismo , Membranas Intracelulares/metabolismo , Factor de Apareamiento , Mutación , Péptidos/metabolismo , Monoéster Fosfórico Hidrolasas/metabolismo , Pruebas de Precipitina , Saccharomyces cerevisiae/enzimología , Saccharomyces cerevisiae/genética , Saccharomyces cerevisiae/crecimiento & desarrollo , Serina Endopeptidasas/metabolismo , Temperatura , Vacuolas/metabolismo
17.
J Cell Biol ; 106(5): 1453-61, 1988 May.
Artículo en Inglés | MEDLINE | ID: mdl-2836429

RESUMEN

Clathrin heavy chain-deficient mutants (chcl) of Saccharomyces cerevisiae are viable but exhibit compromised growth rates. To investigate the role of clathrin in intercompartmental protein transport, two pathways have been monitored in chcl cells: transport of newly synthesized vacuolar proteins to the vacuole and receptor-mediated uptake of mating pheromone. Newly synthesized precursors of the vacuolar protease carboxypeptidase Y (CPY) were converted to mature CPY with similar kinetics in mutant and wild-type cells. chcl cells did not aberrantly secrete CPY and immunolocalization techniques revealed most of the CPY in chcl cells within morphologically identifiable vacuolar structures. Receptor-mediated internalization of the mating pheromone alpha-factor occurred in chcl cells at 36-50% wild-type levels. The mutant cells were fully competent to respond to pheromone-induced cell-cycle arrest. These results argue that in yeast, clathrin may not play an essential role either in vacuolar protein sorting and delivery or in receptor-mediated endocytosis of alpha-factor. Alternative mechanisms ordinarily may execute these pathways, or be activated in clathrin-deficient cells.


Asunto(s)
Clatrina/fisiología , Endocitosis , Proteínas Fúngicas/metabolismo , Organoides/metabolismo , Receptores de Péptidos , Saccharomyces cerevisiae/metabolismo , Factores de Transcripción , Vacuolas/metabolismo , Animales , Autorradiografía , Transporte Biológico , Carboxipeptidasas/metabolismo , Catepsina A , Clatrina/genética , Densitometría , Electroforesis en Gel de Poliacrilamida , Precursores Enzimáticos/metabolismo , Inmunohistoquímica , Cinética , Factor de Apareamiento , Microscopía Electrónica , Mutación , Péptidos/metabolismo , Feromonas/metabolismo , Receptores de Superficie Celular/metabolismo , Receptores del Factor de Conjugación , Saccharomyces cerevisiae/genética , Saccharomyces cerevisiae/ultraestructura , Proteínas de Saccharomyces cerevisiae
18.
J Cell Biol ; 135(6 Pt 2): 1789-800, 1996 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-8991091

RESUMEN

The yeast membrane protein Kex2p uses a tyrosine-containing motif within the cytoplasmic domain for localization to a late Golgi compartment. Because Golgi membrane proteins mislocalized to the plasma membrane in yeast can undergo endocytosis, we examined whether the Golgi localization sequence or other sequences in the Kex2p cytoplasmic domain mediate endocytosis. To assess endocytic function, the Kex2p cytoplasmic domain was fused to an endocytosis-defective form of the alpha-factor receptor. Ste2p. Like intact Ste2p, the chimeric protein, Stex22p, undergoes rapid endocytosis that is dependent on clathrin and End3p. Uptake of Stex22p does not require the Kex2p Golgi localization motif. Instead, the sequence NPFSD, located 37 amino acids from the COOH terminus, is essential for Stex22p endocytosis. Internalization was abolished when the N, P, or F residues were converted to alanine and severely impaired upon conversion of D to A. NPFSD restored uptake when added to the COOH terminus of an endocytosis-defective Ste2p chimera lacking lysine-based endocytosis signals present in wild-type Ste2p. An NPF sequence is present in the cytoplasmic domain of the a-factor receptor, Ste3p. Mutation of this sequence prevented pheromone-stimulated endocytosis of a truncated form of Ste3p. Our results identify NPFSD as a clathrin-dependent endocytosis signal that is distinct from the aromatic amino acid-containing Golgi localization motif and lysine-based, ubiquitin-dependent endocytosis signals in yeast.


Asunto(s)
Proteínas Bacterianas , Proteínas del Citoesqueleto , Endocitosis/fisiología , Proproteína Convertasas , Señales de Clasificación de Proteína/fisiología , Proteínas de Saccharomyces cerevisiae , Saccharomyces cerevisiae/química , Secuencia de Aminoácidos , Transporte Biológico/fisiología , Clatrina/fisiología , Proteínas de Unión al ADN/química , Proteínas de Unión al ADN/fisiología , Proteínas Fúngicas/química , Proteínas Fúngicas/fisiología , Aparato de Golgi/química , Aparato de Golgi/fisiología , Secuencias Hélice-Asa-Hélice/fisiología , Inmunohistoquímica , Lipoproteínas/química , Lipoproteínas/fisiología , Lisina/fisiología , Feromonas/química , Feromonas/metabolismo , Señales de Clasificación de Proteína/análisis , Receptores del Factor de Conjugación , Receptores de Péptidos/química , Receptores de Péptidos/genética , Proteínas Recombinantes de Fusión/análisis , Proteínas Recombinantes de Fusión/fisiología , Proteínas Represoras/química , Proteínas Represoras/fisiología , Saccharomyces cerevisiae/citología , Saccharomyces cerevisiae/fisiología , Subtilisinas/química , Subtilisinas/genética , Factores de Transcripción/química , Factores de Transcripción/genética , Tirosina/fisiología
19.
J Cell Biol ; 102(5): 1551-7, 1986 May.
Artículo en Inglés | MEDLINE | ID: mdl-3517002

RESUMEN

The structural gene for yeast vacuolar carboxypeptidase Y (PRC1) has been cloned by complementation of the prc1-1 mutation. As much as an eightfold elevation in the level of carboxypeptidase Y (CPY) results when a multiple-copy plasmid containing the PRC1 gene is introduced into yeast. Unlike the situation with a single copy of PRC1 in which newly synthesized CPY is efficiently localized to the vacuole, plasmid-directed overproduction results in secretion of greater than 50% of the protein as the precursor form. Secretion is blocked in a mutant that is defective at a late stage in the transport of periplasmic proteins. Unlike normal cell surface glycoproteins, secreted CPY precursor acquires no additional oligosaccharide modifications beyond those that accompany normal transport to the vacuole. In the periplasm, the CPY precursor is proteolytically activated to an enzymatically active form by an enzyme that is unrelated to the vacuolar processing enzyme. These findings suggest that proper sorting and transport of CPY is saturable. This may reflect limiting amounts of a CPY-sorting receptor, or of CPY-modifying machinery that is essential for recognition by such a receptor.


Asunto(s)
Carboxipeptidasas/metabolismo , Carboxipeptidasas/genética , Catepsina A , Clonación Molecular , Regulación de la Expresión Génica , Genes Fúngicos , Glicoproteínas/genética , Glicoproteínas/metabolismo , Peso Molecular , Plásmidos , Precursores de Proteínas/metabolismo , Saccharomyces cerevisiae/enzimología , Saccharomyces cerevisiae/genética , Proteínas de Saccharomyces cerevisiae , Vacuolas/enzimología
20.
J Cell Biol ; 123(6 Pt 2): 1707-16, 1993 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-8276891

RESUMEN

The role of clathrin in endocytosis of the yeast phermone receptors was examined using strains expressing a temperature-sensitive clathrin heavy chain. The yeast phermone receptors belong to the family of seven transmembrane segment, G-protein-coupled receptors. A rapid and reversible defect in uptake of radiolabeled alpha-factor pheromone occurred when the cells were transferred to the nonpermissive temperature. Constitutive, pheromone-independent internalization of newly synthesized a-factor phermone receptor was also rapidly inhibited in mutant strains at the nonpermissive temperature. In both cases residual endocytosis, 30-50% of wild-type levels, was detected in the absence of functional clathrin heavy chain. Once internalized, the a-factor receptor was delivered to the vacuole at comparable rates in chc1-ts and wild-type cells at the nonpermissive temperature. Clathrin heavy chain was also required for maximal uptake of a mutant a-factor receptor which is dependent on pheromone for internalization. In the presence of a-factor, the internalization rate of the mutant receptor in chc1-ts cells at the nonpermissive temperature was 2.5 times slower than the rate observed for endocytosis of the mutant receptor in wild-type cells. These experiments provide in vivo evidence that clathrin plays an important role in the endocytosis of the seven trans-membrane segment pheromone receptors in yeast.


Asunto(s)
Clatrina/metabolismo , Genes Fúngicos , Péptidos/metabolismo , Feromonas/metabolismo , Receptores de Péptidos/metabolismo , Saccharomyces cerevisiae/metabolismo , Factores de Transcripción , Transporte Biológico , Clatrina/biosíntesis , Clatrina/genética , Endocitosis , Proteínas de Unión al GTP/metabolismo , Genotipo , Cinética , Factor de Apareamiento , Pronasa , Receptores del Factor de Conjugación , Receptores de Péptidos/genética , Saccharomyces cerevisiae/genética , Temperatura , Vacuolas/metabolismo
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