Using Z and age-equivalent scores to address WISC-IV floor effects for children with intellectual disability.

BACKGROUND: The Wechsler Intelligence Scale for Children - Fourth Edition often produces floor effects in individuals with intellectual disability. Calculating respondents' Z or age-equivalent scores has been claimed to remedy this problem. METHOD: The present study applied these methods to the Wechsler Intelligence Scale for Children - Fourth Edition scores of 198 individuals diagnosed with intellectual disability. Confirmatory factor analysis and profile analysis were conducted using a Bayesian approach. RESULTS: The intelligence structure in intellectual disability resembled the one previously reported for typical development, suggesting configural but not metric invariance. When Z or age-equivalent scores (but not traditional scaled scores) were used, the average profile resembled the one previously reported for other neurodevelopmental disorders. CONCLUSIONS: Both methods avoided any floor effects, generating similar but not identical profiles. Despite some practical and conceptual limitations, age-equivalent scores may be easier to interpret. This was true even for a subgroup of individuals with more severe disabilities (mean IQ < 43).

Multispectral retinal image analysis: a novel non-invasive tool for retinal imaging.

PURPOSE: To develop a non-invasive method for quantification of blood and pigment distributions across the posterior pole of the fundus from multispectral images using a computer-generated reflectance model of the fundus. METHODS: A computer model was developed to simulate light interaction with the fundus at different wavelengths. The distribution of macular pigment (MP) and retinal haemoglobins in the fundus was obtained by comparing the model predictions with multispectral image data at each pixel. Fundus images were acquired from 16 healthy subjects from various ethnic backgrounds and parametric maps showing the distribution of MP and of retinal haemoglobins throughout the posterior pole were computed. RESULTS: The relative distributions of MP and retinal haemoglobins in the subjects were successfully derived from multispectral images acquired at wavelengths 507, 525, 552, 585, 596, and 611 nm, providing certain conditions were met and eye movement between exposures was minimal. Recovery of other fundus pigments was not feasible and further development of the imaging technique and refinement of the software are necessary to understand the full potential of multispectral retinal image analysis. CONCLUSION: The distributions of MP and retinal haemoglobins obtained in this preliminary investigation are in good agreement with published data on normal subjects. The ongoing development of the imaging system should allow for absolute parameter values to be computed. A further study will investigate subjects with known pathologies to determine the effectiveness of the method as a screening and diagnostic tool.

Multispectral imaging of the ocular fundus using light emitting diode illumination.

We present an imaging system based on light emitting diode (LED) illumination that produces multispectral optical images of the human ocular fundus. It uses a conventional fundus camera equipped with a high power LED light source and a highly sensitive electron-multiplying charge coupled device camera. It is able to take pictures at a series of wavelengths in rapid succession at short exposure times, thereby eliminating the image shift introduced by natural eye movements (saccades). In contrast with snapshot systems the images retain full spatial resolution. The system is not suitable for applications where the full spectral resolution is required as it uses discrete wavebands for illumination. This is not a problem in retinal imaging where the use of selected wavelengths is common. The modular nature of the light source allows new wavelengths to be introduced easily and at low cost. The use of wavelength-specific LEDs as a source is preferable to white light illumination and subsequent filtering of the remitted light as it minimizes the total light exposure of the subject. The system is controlled via a graphical user interface that enables flexible control of intensity, duration, and sequencing of sources in synchrony with the camera. Our initial experiments indicate that the system can acquire multispectral image sequences of the human retina at exposure times of 0.05 s in the range of 500-620 nm with mean signal to noise ratio of 17 dB (min 11, std 4.5), making it suitable for quantitative analysis with application to the diagnosis and screening of eye diseases such as diabetic retinopathy and age-related macular degeneration.

Quantitative analysis of multi-spectral fundus images.

We have developed a new technique for extracting histological parameters from multi-spectral images of the ocular fundus. The new method uses a Monte Carlo simulation of the reflectance of the fundus to model how the spectral reflectance of the tissue varies with differing tissue histology. The model is parameterised by the concentrations of the five main absorbers found in the fundus: retinal haemoglobins, choroidal haemoglobins, choroidal melanin, RPE melanin and macular pigment. These parameters are shown to give rise to distinct variations in the tissue colouration. We use the results of the Monte Carlo simulations to construct an inverse model which maps tissue colouration onto the model parameters. This allows the concentration and distribution of the five main absorbers to be determined from suitable multi-spectral images. We propose the use of "image quotients" to allow this information to be extracted from uncalibrated image data. The filters used to acquire the images are selected to ensure a one-to-one mapping between model parameters and image quotients. To recover five model parameters uniquely, images must be acquired in six distinct spectral bands. Theoretical investigations suggest that retinal haemoglobins and macular pigment can be recovered with RMS errors of less than 10%. We present parametric maps showing the variation of these parameters across the posterior pole of the fundus. The results are in agreement with known tissue histology for normal healthy subjects. We also present an early result which suggests that, with further development, the technique could be used to successfully detect retinal haemorrhages.

The in vitro plasma distribution of a novel cholesteryl ester transfer protein inhibitor, torcetrapib, is influenced by differences in plasma lipid concentrations.

PURPOSE: To determine the lipoprotein distribution of Torcetrapib in normolipidemic or hyperlipidemic human plasma and assess any changes in distribution due to lipid profile. METHODS: Torcetrapib was incubated with human plasma samples, and the distribution was measured across four fractions: triglyceride-rich lipoprotein (TRL), low-density lipoprotein, high-density lipoprotein, and lipoprotein-deficient plasma fraction. Two stocks of human plasma were used, one considered normolipidemic (total cholesterol concentration = 164 mg/dL, triglycerides concentration = 139 mg/dL, protein concentration = 912 mg/dL), the other hyperlipidemic (total cholesterol = 260 mg/dL, triglycerides = 775 mg/dL, protein = 917 mg/dL). The plasma samples were incubated with Torcetrapib at 37 degrees C, and the incubation was stopped with the addition of sodium bromide and cooling to 4 degrees C. The plasma samples were then separated by density gradient ultracentrifugation to their lipoprotein fractions. The resulting lipoprotein fractions and an aliquot of incubated plasma were analyzed by a validated gas chromatography/tandem mass spectrometry analytical method. The distribution of Torcetrapib was determined first with varying incubation times, then with several concentrations. RESULTS: At concentrations of 250 and 500 ng/mL, Torcetrapib distributed evenly across the four fractions in normolipidemic plasma. At the same concentrations in hyperlipidemic plasma, approximately 84% of Torcetrapib was found in the TRL fraction, with the remaining 16% evenly partitioned between the low-density lipoprotein, high-density lipoprotein, and lipoprotein-deficient plasma fractions. CONCLUSIONS: The results suggest that lipid profile affects the distribution of Torcetrapib in hyperlipidemic human plasma lipoprotein fractions. The preferential distribution of Torcetrapib into the TRL fraction in hyperlipidemic plasma needs to be investigated to see if it will affect the pharmacological effect of Torcetrapib in vivo.

Unilateral electronegative ERG of non-vascular aetiology.

BACKGROUND: Full field and pattern electroretinograms (ERG, PERG) are performed to assess generalised retinal function and macular function, respectively. An (electro) negative full field ERG usually describes an ISCEV standard maximal response in which the b-wave is smaller than a normal or minimally reduced a-wave and indicates dysfunction that is post-phototransduction. The most common cause of a unilateral negative ERG is central retinal artery occlusion (CRAO) or birdshot chorioretinopathy (BCR). This study examines the clinical and electrophysiological features of patients with unilateral negative ERG who do not have CRAO or BCR. METHODS: 12 patients were ascertained with a unilateral negative ERG in whom a vascular aetiology and BCR were excluded. Most presented with symptoms of central retinal dysfunction. In 11 of the 12 patients additional long duration photopic stimuli were used to test cone system ON and OFF responses. RESULTS: All 12 patients had unilateral electronegative bright flash full field ERGs indicating total or relative preservation of rod photoreceptor function, but dysfunction post-phototransduction. Seven of these patients had non-specific inflammatory changes in the eye with the negative ERG. Six patients, including five with inflammatory signs, had involvement of the cone ON response with complete preservation of cone OFF responses. A further three patients showed evidence of cone ON response abnormality with less severe OFF response involvement. CONCLUSION: The ERGs in this heterogeneous group of patients predominantly showed post-phototransduction involvement of the ON pathways. Sparing of the cone OFF response was often observed. The majority of patients had signs of previous inflammation and it is speculated that these highly unusual unilateral changes may be mediated via an autoimmune mechanism.

Model-based parameter recovery from uncalibrated optical images.

We propose a novel method for quantitative interpretation of uncalibrated optical images which is derived explicitly from an analysis of the image formation model. Parameters characterising the tissue are recovered from images acquired using filters optimised to minimise the error. Preliminary results are shown for the skin, where the technique was successfully applied to aid the diagnosis and interpretation of non-melanocytic skin cancers and acne; and for the more challenging ocular fundus, for mapping of the pigment xanthophyll.

Peptides containing the sulfonamide junction. 2. Structure and conformation of Z-Tau-Pro-D-Phe-NHiPr.

The taurine (Tau) containing N-protected pseudotripeptide isopropylamide Z-Tau-Pro-D-Phe-NHiPr (1) has been specifically designed and synthesized as suitable model to test the ability of the sulfonamido group to participate as H-bond acceptor to a type II beta-turn and to get information on the preferred rotameric conformation around the S-N bond and the hybridization state of the nitrogen atom. The present structural investigation reveals that, although the sulfonamide junction is invariably folded in a gauche mode, the beta-turn structure, stabilized by the 4 --> 1 hydrogen bond, is not found in the crystal and the sulfonamido oxygen atoms are not involved in any intra- or intermolecular hydrogen-bond interaction. More than one conformer populates the CDCl(3) solution with only a minor contribution by the expected beta-turn. The Pro nitrogen is significantly pyramidalized and the nitrogen lone pair points in opposite direction to that of the Pro C(alpha)H bond thus adopting R chirality, in an arrangement practically identical to that found in the previously studied homochiral analogue Z-Tau-Pro-Phe-NHiPr.

Novel glutathione analogues containing the dithiol and disulfide form of the Cys-Cys dyad.

The glutathione analogue gamma-(H-Glu-OH)-Cys-Cys-OH (5), containing the 8-membered disulfide ring -Cys-Cys replacing the native-Cys-Gly fragment, has been synthesized and characterized together with its reduced dithiol form gamma-(H-Glu-OH)-Cys-Cys-OH (6).

N-acetylcysteine reduces the exacerbation rate in patients with moderate to severe COPD.

OBJECTIVE: This study was performed to confirm the efficacy of a 6-month therapy with a formulation of N-acetylcysteine (NAC; 600 mg/day p.o.) on frequency and severity of exacerbations in patients suffering from chronic obstructive pulmonary disease (COPD). METHODS: One hundred sixty-nine patients attending five Italian centres were recruited in an open, randomized, controlled study. The patients were randomly allocated to standard therapy plus NAC 600 mg once a day or standard therapy alone over a 6-month period. At baseline, medical history was evaluated, and physical examination was performed; occurrence and severity of exacerbations and side effects of NAC were analyzed after 3 and 6 months. RESULTS: The results showed a decreased number of exacerbations (by 41%) in the group of patients treated with NAC and standard treatment: 46 patients had at least one exacerbation as compared with 63 patients of the group treated with standard therapy alone. Also the number of the patients with two or more exacerbations was lower in the NAC group (26%) than in the standard-therapy group (49%). The number of sick days was less (82) in the NAC group as compared with the standard-therapy group (155). There was a small but significant improvement in FEV(1) and MEF(50) in the NAC group. NAC once a day was well tolerated. There were no differences in the number of side effects reported in both groups. CONCLUSIONS: These data confirm results of previous studies which reported a reduction in the number of exacerbations in patients having moderate to severe COPD treated with the antioxidant NAC. Further, the once-daily formulation is well tolerated and is likely to improve patient compliance with the prescribed regimen.

psi(SO2NH) transition state isosteres of peptides. Synthesis and bioactivity of sulfonamido pseudopeptides related to carnosine.

This paper reports the synthesis of tauryl dipeptides related to carnosine. In particular H-Tau-His-OH (5), H-Tau-His(pi-Me)-OH (6) and H-Tau-His(tau-Me)-OH (9) are described. The enzyme carnosinase has been isolated from pig kidney and after purification has been used to test the stability and the inhibitory activity of the three new analogues. H-Tau-His-OH (5) and H-Tau-His(tau-Me)-OH (9) were found to possess weak inhibitory properties towards carnosinase, while H-Tau-His(pi-Me)-OH (6) proved to be devoid of any significant activity. All the three sulfonamido pseudopeptides 5, 6 and 9 show stability to carnosinase activity.

Synthesis and activity of the glutathione analogue gamma-(L-gamma-oxaglutamyl)-L-cysteinyl-glycine.

An efficient synthesis of the backbone modified glutathione analogue gamma-(L-gamma-oxaglutamyl)-L-cysteinyl-glycine (7), characterized by the presence of an urethane O-CO-NH linkage replacing the gamma-glutamylic CH2CO-NH fragment is described. The new analogue has been fully characterized by 1H- and 13C-NMR, and FAB-MS. Compound 7 was tested for inhibition of gamma-glutamyl-transferase activity and was found to be a non-competitive inhibitor of hog kidney gamma-glutamyltransferase (EC 2.3.2.2).

Synthesis and activity of the glutathione analogue gamma-(L-gamma-azaglutamyl)-L-cysteinyl-glycine.

The backbone-modified glutathione analogue gamma-(L-gamma-azaglutamyl)-L-cysteinyl-glycine 7, characterized by the presence of a NHCONH urea linkage deriving from the replacement of the native Glu gamma-CH2 with the aza (NH) group, was synthesized and fully characterized by FAB-MS, 1H- and 13C-NMR. Potential of 7 and its oxidized form 6 as gamma-glutamyltransferase inhibitors was investigated. Both compounds 7 and 6 were found to be competitive inhibitors of hog kidney gamma-glutamyltransferase (EC 2.3.2.2.) by binding at the donor site: the reduced analogue is a more efficient inhibitor than glutathione of the gamma-glutamyl transfer reaction. Inhibition at the acceptor site, which is also present, appears to be more complex. In particular, un-competitive inhibition is observed for compound 7. The results indicate that gamma-azapeptides of type 7 may represent interesting targets in the search for stable inhibitors of gamma-glutamyltransferases.

Determination of semduramicin sodium in poultry liver by liquid chromatography with vanillin postcolumn derivatization.

A liquid chromatographic (LC) method is described for the quantitative determination of semduramicin sodium in broiler liver when administered under projected use conditions. For this procedure, semduramicin sodium is extracted from liver with methanolic ammonium hydroxide, separated and concentrated by solid-phase extraction steps, and determined by LC with postcolumn derivatization with vanillin. The mean recovery of drug was 95% over the 40-320 ng/g range, the coefficient of variation was +/- 10% or better, and no interference was observed from commercial polyether ionophores. The minimum level of detection for semduramicin sodium in broiler liver is 25 ng/g.

Inhibitors of Zn-dependent metallopeptidases: synthesis and activity of N-(2-furoyl)-(Z)-alpha, beta-didehydroleucyl-L-tryptophan.

In order to gain information on structure activity relationships of peptidic inhibitors of Zn-dependent metalloproteinases "hemorrhagins", the conformationally restricted model N-(2-furoyl)-(Z)-alpha,beta-didehydroleucyl-L-tryptophan 2 was synthesized and its activity compared to that of related previously studied substrates. The new model 2 exhibits an inhibitory activity on proteinase II from Crotalus Adamanteus snake venom, sensibly lower than that of related substrates. This result indicates that the reduction of the conformational space due to the presence of the alpha,beta-didehydro-amino acid residue in 2 does not favour the fitting and binding at the enzyme active site.

Nine-membered cyclodepsitripeptides containing the retroisomeric sequence of ergot peptides.

In order to examine factors influencing cyclodepsitripeptide formation and stability, three cyclic peptide models containing the alpha-hydroxyacyl-alpha-aminoacylprolyl sequence, corresponding to the peptide lactone cyclo(-Xha-Pro-Xaa-) (Xha = Hiv, Lac; Xaa = Phe, DPhe, DAla), retroisomeric with respect to the ergot oxa-cyclolic peptide moiety, have been considered. Starting from 2,5-dioxomorpholines, aminoacyl incorporation reaction led, through intermediate tetrahedral adducts (aza-cyclols), to the corresponding nine-membered cyclodepsitripeptides cyclo(-Hiv-Pro-DPhe-) 4a, cyclo(-Lac-Pro-DPhe-) 4b, and cyclo (-Hiv-Pro-DAla-) 4c. Compounds 4a-c contain a CONH peptide bond in the nine-membered ring and are stable on standing. Solution conformations of 4a-c, as inferred by NMR spectra and NOE experiments, have been studied. A cis-cis-trans backbone conformation, analogous to that observed in the case of previously studied nine-membered cyclodepsitripeptides containing two proline residues in the ring, is proposed for 4a-c.

Structure and conformation of peptides containing the sulphonamide junction. III. Synthesis, crystal and molecular structure of a taurine containing peptidic oxa-cyclol.

The insertion of the (S)-lactyl residue into the cyclodipeptide cyclo (-Tau-Pro-) 3 leads in good yields to the first example of a stable tetrahedral adduct (oxa-cyclol) 5 containing the sulphonamide junction. Compound 5 does not show a significant tendency towards tautomeric equilibria and possesses an unexpected syn-orientation involving the hydroxyl group and the Pro-H alpha. The crystal structure and molecular conformation of 5 has been determined. Crystals are orthorhombic, s.g. P2(1)2(1)2(1), with a = 6.607, b = 12.297, c = 16.622 A. The cisoidal conformation around the S-N bond is very similar to that found in the previously studied linear and cyclic peptides containing a sulphonamide junction. The taurine nitrogen is practically planar whereas the proline nitrogen, bound to the SO2 group, is highly pyramidal. In the tricyclic system of 5 the seven-membered ring adopts a twist-chair conformation while the pyrrolidine and oxazolidinone rings show an envelope conformation. The crystal packing is characterized by three hydrogen bonds all formed by means of a water molecule.

Cyclization under mild conditions of salicyloyl-dipeptides.

Carboxy-activated linear peptides 6(a-c) of general formula Sal-Xaa-Pro-ONp (Xaa = Phe: Gly; Aib) were synthesized and treated at room temperature with 1,8-diazabicyclo [5,4,0] undec-7-ene (DBU) in benzene solution. The tetrahedral adducts (oxa-cyclols) 7, 11 and 12, tautomeric forms of the corresponding 10-membered cyclodepsitripeptides, have been isolated in each of the three models examined. These adducts, which contain the hydroxylated carbon atom located at the junction between two 6-membered rings, do not show a tendency to isomerize into the corresponding macrocyclic lactones, regardless of the nature of the substituents on the C alpha carbon atom of the central residue. Partially cyclized dimeric products 8 and 13, identified as N-(Sal-Xaa-Pro)-dioxopiperazines (Xaa = Phe;Aib), have been also isolated from the cyclization reactions.