A receptor-targeted fluorescent radiopharmaceutical for multireporter sentinel lymph node imaging.

PURPOSE: To determine the imaging and receptor-binding properties of a multireporter probe designed for sentinel lymph node (SLN) mapping via nuclear and fluorescence detection. MATERIALS AND METHODS: The animal experiments were approved by the institutional animal care and use committee. A multireporter probe was synthesized by covalently attaching cyanine 7 (Cy7), a near-infrared cyanine dye, to tilmanocept, a radiopharmaceutical that binds to a receptor specific to recticuloendothelial cells. In vitro binding assays of technetium 99m (99mTc)-labeled Cy7 tilmanocept were conducted at 4°C by using receptor-bearing macrophages. Optical SLN imaging after foot pad administration was performed by using two molar doses of Cy7 tilmanocept. Six mice were injected with 0.11 nmol of 99mTc-labeled Cy7 tilmanocept (low-dose group); an additional six mice were injected with 31 nmol of 99mTc-labeled Cy7 tilmanocept (high-dose group) to saturate the receptor sites within the SLN. After 2.5 hours of imaging, the mice were euthanized, and the sentinel and distal lymph nodes were excised and assayed for radioactivity for calculation of SLN percentage of injected dose and extraction. Four mice were used as controls for autofluorescence. Standard optical imaging software was used to plot integrated fluorescence intensity against time for calculation of the SLN uptake rate constant and scaled peak intensity. Significance was calculated by using the Student t test. RESULTS: In vitro binding assays showed subnanomolar affinity (mean dissociation constant, 0.25 nmol/L±0.10 [standard deviation]). Fluorescence imaging showed a detection sensitivity of 1.6×10(3) counts·sec(-1)·µW(-1) per picomole of Cy7. All four imaging metrics (percentage of injected dose, SLN extraction, SLN uptake rate constant, and expected peak fluorescence intensity) exhibited higher values (P=.005 to P=.042) in the low-dose group than in the high-dose group; this finding was consistent with receptor-mediated image formation. CONCLUSION: The multireporter probe 99mTc-labeled Cy7 tilmanocept exhibits in vitro and in vivo receptor-binding properties for successful receptor-targeted SLN mapping with nuclear and optical imaging.

Dynamic optical imaging of metabolic and NADPH oxidase-derived superoxide in live mouse brain using fluorescence lifetime unmixing.

Superoxide is the single-electron reduction product of molecular oxygen generated by mitochondria and the innate immune enzyme complex, nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (Nox), and its isoforms. Initially identified as critical to the host defense against infection, superoxide has recently emerged as an important signaling molecule and as a proposed mediator of central nervous system injury in stroke, neurodegenerative conditions, and aging itself. Complete understanding of superoxide in central nervous system disease has been hampered by lack of noninvasive imaging techniques to evaluate this highly reactive, short-lived molecule in vivo. Here we describe a novel optical imaging technique to monitor superoxide real time in intact animals using a fluorescent probe compound and fluorescence lifetime contrast-based unmixing. Specificity for superoxide was confirmed using validated mouse models with enhanced or attenuated brain superoxide production. Application of fluorescence lifetime unmixing removed autofluorescence, further enhanced sensitivity and specificity of the technique, permitted visualization of physiologically relevant levels of superoxide, and allowed superoxide in specific brain regions (e.g., hippocampus) to be mapped. Lifetime contrast-based unmixing permitted disease model-specific and brain region-specific differences in superoxide levels to be observed, suggesting this approach may provide valuable information on the role of mitochondrial and Nox-derived superoxide in both normal function and pathologic conditions in the central nervous system.

Generalized infection following facet joint injection -A case report-.

Facet joints have been shown to be a source of chronic low back pain, and it is generally accepted in clinical practice that diagnostic and therapeutic facet joint injections are the most reliable technique for the treatment of facet joint pain, which is considered to be an easy and safe procedure. Serious complications and side effects are uncommon after facet joint injection. However, infectious complications including septic arthritis, epidural abscess, meningitis and endocarditis have been reported following facet joint injections. We report here the first case of death following lumbar facet joint injection due to generalized infection.

Analytical method for the fast time-domain reconstruction of fluorescent inclusions in vitro and in vivo.

A novel time-domain optical method to reconstruct the relative concentration, lifetime, and depth of a fluorescent inclusion is described. We establish an analytical method for the estimations of these parameters for a localized fluorescent object directly from the simple evaluations of continuous wave intensity, exponential decay, and temporal position of the maximum of the fluorescence temporal point-spread function. Since the more complex full inversion process is not involved, this method permits a robust and fast processing in exploring the properties of a fluorescent inclusion. This method is confirmed by in vitro and in vivo experiments.

In vivo simultaneous monitoring of two fluorophores with lifetime contrast using a full-field time domain system.

Optical molecular imaging of small animals in vivo has witnessed dramatic growth during the past decade. Most commercial systems are based on continuous wave technology and measure solely bioluminescence or fluorescence intensity. Time domain (TD) technology enables the measurement of both intensity and fluorescence lifetime as an additional imaging metric. We have developed a novel, in-house, full-field TD system with dramatically faster acquisition times than available from a commercial TD system. Recent in vivo data from a mouse imaged with the full-field TD system has demonstrated the potential to monitor and discriminate two fluorophores injected simultaneously based on their fluorescence lifetime contrast.

Estimating the depth and lifetime of a fluorescent inclusion in a turbid medium using a simple time-domain optical method.

A simple time-domain optical method for estimating the depth (d) and lifetime (tau) of fluorescent inclusions in a turbid medium is described. We demonstrate the method for depth and lifetime estimation of a fluorescent inclusion directly by fitting a monoexponential decay (tau(eff)) of the temporal position of the temporal point-spread function and the measurement of its maximum temporal position (t(max)). Since both of these measurements are intensity independent, this method provides a robust and efficient approach. This method is validated with experimental data.

Analysis of the fluorescence temporal point-spread function in a turbid medium and its application to optical imaging.

A time-domain optical method to evaluate the concentration (n), lifetime (tau), and depth (d) of a fluorescent inclusion is described by the complete analysis of the fluorescence temporal point-spread function (TPSF). The behavior of parameters in the fluorescence TPSF is explored, and we demonstrate the method with experimental data from a localized fluorescent inclusion in scattering media to recover images of n, tau, and d. The method has potential application for in vivo fluorescence imaging.

Radiological analysis on a mummy from a medieval tomb in Korea.

Although naturally mummified corpses have frequently been found in medieval tombs of Korea, there have been no scientific reports on the physical status of the mummies. In this study, we first tried to investigate the mummy using radiological methods. On physical examination, there were no findings suggestive of the cause of the death. From the radiological studies, we found that some internal organs were well preserved, while the bones showed similar appearances to those of living cases. From the stage of development of the teeth and carpal bones, the age of the mummy was estimated to be 4.5 to 6.6 years old. Although the exact cause of the mummification could not be clearly elucidated, it may be due to the lime-soil mixture outside the outer coffin, completely sealing the inner coffin from the outer spaces. In this study, as the mummy in the medieval tomb has proved to be well preserved over the last 400 years, similar cases could give invaluable clues to the physical status of medieval Koreans.

Differential post-transcriptional regulation of p21WAF1/Cip1 levels in the developing nervous system following gamma-irradiation.

Radiation-induced death in the developing brain is p53-dependent. However, genetic studies indicate that the signalling pathways that couple irradiation to p53 expression can vary between different developing neural populations [Herzog et al. (1998) Science, 280, 1089-1091]. Here we establish that signalling downstream of p53 also exhibits brain region-specific differences that are associated with the relative vulnerability of some cell populations to radiation-induced killing in the mouse. Following gamma-irradiation, p53 and p21WAF1/cip1, but not Bax, protein levels increased in the developing cerebellum. In contrast, neither p21WAF1/cip1 nor Bax protein levels were elevated in the retina following irradiation, despite increased p53 expression. In the retina, p53 expression was associated with cells destined to die, whereas in the cerebellum, p53 was expressed in both radiation-sensitive and radiation-resistant neuroblasts of the external granule cell layer. Although p21WAF1/cip1 mRNA was expressed in all p53-positive neuroblasts after irradiation, p21WAF1/cip1 protein was only detected in radiation-resistant neuroblasts of the cerebellum. Thus, p21WAF1/cip1 was subject to post-transcriptional regulation with p21WAF1/cip1 protein only accumulating in cells destined to survive irradiation. Nevertheless, p21WAF1/cip1 function was not essential for radiation resistance, as postmitotic neuroblasts in the external granule cell layer were spared in p21WAF1/cip1 knockout mice.