An update survey of UK in vivo radiotherapy dosimetry practice.

A questionnaire was distributed in 2004 to 59 radiotherapy physics departments in the UK to determine whether in vivo dosimetry practice had changed since a similar survey conducted 10 years earlier. The number of centres carrying out central axis dosimetry had increased slightly from 17 centres in 1994 to 22 centres in 2004, with a diode alone being the most commonly used detector. Twice as many centres (43) carried out critical organ dosimetry compared with those carrying out central axis measurements, and this number had also increased slightly above the 1994 value (38). A diode was used by most centres carrying out central axis dosimetry and by about 50% of centres carrying out critical organ dosimetry. The action level adopted by each centre for central axis measurements varied from >+/-3% to >+/-10% difference between the measured and the prescribed dose, with >+/-5% being the most frequent value. It was concluded that there had been little change in in vivo dosimetry practice during the time between the two surveys, and that guidance on the method and applications for in vivo dosimetry is required before recent recommendations for its widespread adoption for routine use can be satisfied.

Comparison of two fluorescent whiteners, Calcofluor and Blankophor, for the detection of fungal elements in clinical specimens in the diagnostic laboratory.

Fluorescent whiteners, such as Blankophor and Calcofluor white, bind to chitin and cellulose, and fluoresce when exposed to UV light. Detection of fungal elements from skin and nail samples was faster and more accurate using Blankophor compared with potassium hydroxide preparations and Calcofluor (sensitivity and specificity 100% and 86% vs. 83-90% and 84-88%, or 80% and 84%, respectively). Visibility was improved, and the procedures were simple, inexpensive and rapid, all of which are important considerations in a busy diagnostic laboratory.

Affinity labelling with MgATP analogues reveals coexisting Na+ and K+ forms of the alpha-subunits of Na+/K+-ATPase.

To test the hypothesis that Na+/K+-ATPase works as an (alpha beta)2-diprotomer with interacting catalytic alpha-subunits, tryptic digestion of pig kidney enzyme, that had been inactivated with substitution-inert MgATP complex analogues, was performed. This led to the demonstration of coexisting C-terminal Na+-like 80-kDa as well as K+-like 60-kDa peptides and N-terminal 40-kDa peptides of the alpha-subunit. To localize the ATP binding sites on tryptic peptides, studies with radioactive MgATP complex analogues were performed: Co(NH3)4-8-N3-ATP specifically modified the E2ATP (low affinity) binding site of Na+/K+-ATPase with an inactivation rate constant (k2) of 12 x 10-3.min-1 at 37 degrees C and a dissociation constant (Kd) of 207 +/- 28 microm. Tryptic digestion of the [gamma32P]Co(NH3)4-8-N3-ATP-inactivated and photolabelled alpha-subunit (Mr = 100 kDa) led, in the absence of univalent cations, to a K+-like C-terminal 60-kDa fragment which was labelled in addition to an unlabelled Na+-like C-terminal 80-kDa fragment. Tryptic digestion of [alpha32P]-or [gamma32P]Cr(H2O)4ATP - bound to the E1ATP (high affinity) site - led to the labelling of a Na+-like 80-kDa fragment besides the immediate formation of an unlabelled K+-like N-terminal 40-kDa fragment and a C-terminal 60-kDa fragment. Because a labelled Na+-like 80-kDa fragment cannot result from an unlabelled K+-like 60-kDa fragment, and because unlabelled alpha-subunits did not show any catalytic activity, the findings are consistent with a situation in which Na+- and K+-like conformations are stabilized by tight binding of substitution-inert MgATP complex analogues to the E1ATP and E2ATP sites. Hence, all data are consistent with the hypothesis that ATP binding induces coexisting Na+ and K+ conformations within an (alphabeta)2-diprotomeric Na+/K+-ATPase.

In vitro radioautographic studies of the biodistribution of radiopharmaceuticals on blood elements.

In the present study we evaluated the binding of the radiopharmaceuticals sodium pertechnetate (Na 99mTcO4), methylenediphosphonic acid (99mTc-MDP) and glucoheptonate acid (99mTc-GHA) to blood elements using centrifugation and radioautographic techniques. Heparinized blood was incubated with the labelled compounds for 0, 1, 2, 3, 4, 6 and 24 h. Plasma (P) and blood cells (BC) were isolated and precipitated with 5% trichloroacetic acid (TCA), and soluble (SF) and insoluble fractions (IF) were separated. Blood samples were prepared (0 and 24 h) and coated with LM-1 radioautographic emulsions and percent radioactivity (%rad) in P and BC was determined. The binding of Na 99mTcO4 (%rad) to P was 61.2% (0 h) and 46.0% (24 h), and radioautography showed 63.7% (0 h) and 43.3% (24 h). The binding to BC was 38.8% (0 h) and 54.0% (24 h), and radioautography showed 36.3% (0 h) and 56.7% (24 h). 99mTc-MDP study presented 91.1% (0 h) to P and 87.2% (24 h), and radioautography showed 67.9% (0 h) and 67.4% (24 h). The binding to BC was 8.9% (0 h) and 12.8% (24 h), and radioautography showed 32.1% (0 h) and 32.6% (24 h). 99mTc-GHA study was 90.1% (0 h) to P and 79.9% (24 h), and radioautography showed 67.2% (0 h) and 60.1% (24 h). The binding to BC was 9.9% (0 h) and 20.1% (24 h), and radioautography showed 32.8% (0 h) and 39.9% (24 h). The comparison of the obtained results suggests that the binding to plasma and blood cells in the two techniques used (radioautography and centrifugation) is qualitatively in accordance.

In vitro effect of cyclophosphamide on the binding of radiopharmaceuticals (99mTcO4- and 99mTc-MDP) to blood elements.

Sodium pertechnetate (99mTcO4-) and many 99mTc-products are the radiopharmaceuticals most frequently used in nuclear medicine. Using an in vitro model, we evaluated the effect of cyclophosphamide on percent radioactivity of 99mTcO4- and methylenediphosphonic acid (99mTc-MDP) bound to isolated blood elements. Blood samples were incubated with the two radiopharmaceuticals, plasma and blood cells were separated and precipitated, and soluble and insoluble fractions were separated. To evaluate the effect of cyclophosphamide, blood was incubated with this drug 1 h prior to the addition of the radiopharmaceuticals. The fraction of 99mTcO4- radioactivity was slightly higher in plasma (61.2 to 53.8%) than in blood cells (38.8 to 46.2%) up to 6 h and cyclophosphamide did not interfere with this distribution. The amount of 99mTc-MDP radioactivity was higher in plasma (91.1 to 87.2%) than in blood cells (8.9 to 12.8%) up to 24 h and cyclophosphamide did not modify it. The binding of 99mTcO4- to the insoluble fraction of plasma (4.9 to 6.1%) was low and cyclophosphamide did not interfere with it up to 6 h, but a small blockade (9.8 to 4.8%) was observed at 24 h. From 3 h on, cyclophosphamide slightly inhibited 99mTcO4- binding to blood cells (23.1 to 16.6%) and increased it at 24 h (31.2 to 14.3%). Cyclophosphamide did not alter 99mTc-MDP binding to the insoluble fraction of blood cells and slightly decreased 99mTc-MDP binding to the insoluble fraction of plasma (29.8 to 23.6%) up to 6 h.(ABSTRACT TRUNCATED AT 250 WORDS)

In vitro effect of cyclophosphamide on the binding of radiopharmaceuticals (99mTcO4 and 99mTc-MDP) to blood elements

Sodium pertechnetate (99mTcO4) and many99m Tc-products are the radiopharmaceuticals most frequently used in nuclear medicine. Using an in vitro model, we evaluated the effect of cyclophosphamide on per cent radioactivity of 99mTcO4 and methylenedi-phosphonic acid (99mTc-MDP) bound toi isolated blood elements. Blood samples were incubated with the two radiopharmaceuticals, plasma and blood cells were separated and precipitated, and soluble and insoluble fractions were separated. To evaluate the effect of cyclophosphamide, blood was incubated with this drug 1h prior to the addition of the radiopharmaceuticals. The fraction of 99mTcO4 radioactivity was slightly higher in plasma (61.2 to 53.8 per cent) than in blood cells (38.8 to 46.2 per cent) up to 6 h and cyclophosphamide did not interfere with this distribution. The amount of 99mTc-mdp radioactivity was higher in plasma (91.1 to 87.2 per cent) than in blood cells 8.9 to 12.9 per cent) up to 24 h and cyclophosphamide did not modify it. The binding of 99mTcO4 to the insoluble fraction of plasma (4.9 to 6.1 per cent) was low and cyclophosphamide did not interfere with it up to 6h, but a small blockade (9.8 to 4.8 per cent) was observed at 24 h. From 3 h on, cyclophosphamide slightly inhibited 99mTcO4 binding to blood cells (23.1 to 16.6 per cent) and increased it at 24h (31.2 to 14.3 per cent). Cyclophosphamide did not alter 99mTc-MDP binding to the insoluble fraction of blood cells and slightly decreased 99mTc-MDP binding to the insoluble fraction of plasma (29.8 to 23.6 per cent) up to 6 h. The effect of cyclophosphamide was strongest at 24 h, with decreased radioactivity binding to the insoluble fraction of plasma (47.6 to 27.0 per cent) and blood cells (51.2 to 23.2 per cent). The fact that cyclophosphamide can bind to plasma proteins and/or cross the cell membrne explains in part the results obtained. Studies using other chemotherapeutic drugs may lead to the development of an in vitro model for the evaluation of drug interaction with radiopharmaceutical substances

Modification of the E1ATP binding site of Na+/K(+)-ATPase by the chromium complex of adenosine 5'-[beta,gamma-methylene]triphosphate blocks the overall reaction but not the partial activities of the E2 conformation.

The chromium complex of adenosine 5'-[beta,gamma-methylene]triphosphate, Cr(H2O)4AdoPP[CH2]P, inactivates Na+/K(+)-ATPase from pig kidney at 37 degrees C with an inactivation velocity constant of 7.1 x 10(-3) min-1 by binding to the high-affinity ATP site (E1ATP site). The dissociation constant (Kd) of the analogue at this site is 26 microM, and of ATP 0.8 microM. Inactivation of the overall reaction of Na+/K(+)-ATPase by Cr(H2O)4AdoPP[CH2]P did not alter the activities of the E2 conformational state such as K(+)-activated p-nitrophenylphosphatase, 86Rb+ occlusion and [3H]ouabain binding by the 'backdoor' phosphorylation. However, [3H]ouabain binding via the forwards reaction from E1ATP in the presence of Na+ + Mg2+ is inhibited. K(+)-activated p-nitrophenylphosphatase activity of the Cr(H2O)4AdoPP[CH2]P-inactivated enzyme decreases when an MgATP analogue, the tetraammine cobalt complex of ATP, Co(NH3)4ATP, is used additionally to inactivate the E2ATP site. The enzyme activity of K(+)-activated phosphatase is also lost if the beta,gamma-bidentate chromium(III) complex of ATP, Cr(H2O)4ATP, which may form a stable E1-chromo-phosphointermediate, is used for the inactivation of Na+/K(+)-ATPase. We conclude that the phenomenon of a blockade of the overall reaction of Na+/K(+)-ATPase by the formation of a stable E1.CrAdoPP[CH2]P complex, leading thereby to a loss of the partial activities of the E1 conformation, but not of the E2 conformation, is consistent with the postulate of an (alpha beta)2 diprotomeric nature of the sodium pump. The observation, moreover, that treatment of the sodium pump with Cr(H2O)4ATP but not with Cr(H2O)4AdoPP[CH2]P leads to an inactivation of K(+)-activated phosphatase seems to indicate that the formation of a E1-phosphointermediate affects the E2ATP site.