Targeted and oxygen-enriched polymeric micelles for enhancing photodynamic therapy.

Photodynamic therapy (PDT) has been emerged as an alternative therapeutic modality in treatment of several malignant tumors. However, the therapeutic efficacy of PDT is often limited by the solubility of photosensitizers, tumor hypoxia and lack of target specificity to cancer cells. In this study, we developed a folate-conjugated fluorinated polymeric micelle (PFFA) to deliver the hydrophobic photosensitizer (chlorin e6, Ce6) to overcome these limitations. The fluorinated micelles exhibit the low critical micelle concentration, good long-term stability, higher oxygen-carrying capacity and better singlet oxygen generation efficiency compared to non-fluorinated micelles, indicating the potential to improve the PDT efficacy in hypoxic conditions. Cytotoxicity of PDT effect and cellular uptake demonstrate the higher cell growth inhibition to HeLa cells upon irradiation attributed to the selective internalization of Ce6-loaded PFFA micelles (PFFA-Ce6). All results demonstrate the PFFA-Ce6 micelles with targeting function and oxygen-carrying capacity can serve as a promising drug delivery system for hydrophobic photosensitizers and improvement on PDT efficacy.

Folate-Conjugated and Dual Stimuli-Responsive Mixed Micelles Loading Indocyanine Green for Photothermal and Photodynamic Therapy.

A folic acid targeted mixed micelle system based on co-assembly of poly(ε-caprolactone)-b-poly(methoxytri(ethylene glycol) methacrylate-co-N-(2-methacrylamido)ethyl folatic amide) and poly(ε-caprolactone)-b-poly(diethylene glycol monomethyl ether methacrylate) is developed to encapsulate indocyanine green (ICG) for photothermal therapy and photodynamic therapy. In this study, the use of folic acid is not only for specific cancer cell recognition, but also in virtue of the carboxylic acid on folic acid to regulate the pH-dependent thermal phase transition of polymeric micelles for controlled drug release. The prepared ICG-loaded mixed micelles possess several superior properties such as a preferable thermoresponsive behavior, excellent storage stability, and good local hyperthermia and reactive oxygen species generation under near-infrared (NIR) irradiation. The photototoxicity induced by the ICG-loaded micelles has efficiently suppressed the growth of HeLa cells (folate receptor positive cells) under NIR irradiation compared to that of HT-29, which has low folate receptor expression. Hence, this new type of mixed micelles with excellent features could be a promising delivery system for controlled drug release, effective cancer cell targeting, and photoactivated therapy.

Glycine hydroxamate inhibits tyrosinase activity and melanin contents through downregulating cAMP/PKA signaling pathways.

Among the eight amino acid hydroxamates tested, Glycine hydroxamate (GH) was the best inhibitor of mushroom tyrosinase (TYR). With L-tyrosine as substrate, the GH inhibition of the monophenolase activity of the mushroom TYR was noncompetitive. GH decreased not only TYR protein expression, but also melanin content, tyrosinase-related protein (TRP)-1, TRP-2, and microphthalmia-associated transcription factor (MITF) expression in B16F10 melanoma cells while in the presence of α-melanocyte-stimulating hormone (α-MSH). GH also significantly decreased the isobutylmethylxanthine (IBMX)-induced increase in melanin content, which was not prevented by the ERK inhibitor PD98059. These results suggest GH has the potential for use in cosmetic hypopigmentation.

Fluorescent polymeric micelles with aggregation-induced emission properties for monitoring the encapsulation of doxorubicin.

A new type of fluorescent polymeric micelles is developed by self-assembly from a series of amphiphilic block copolymers, poly(ethylene glycol)-b-poly[styrene-co-(2-(1,2,3,4,5-pentaphenyl-1H-silol-1-yloxy)ethyl methacrylate)] [PEG-b-P(S-co-PPSEMA)]. Their capability of loading doxorubicin (DOX) is investigated by monitoring the loading content, encapsulation efficiency, and photophysical properties of micelles. Förster resonance energy transfer from PPSEMA to DOX is observed in DOX-loaded micelles, which can serve as an indication of successful encapsulation of DOX in these micelles. The application of this new type of fluorescent polymeric micelles as a fluorescent probe and an anticancer drug carrier simultaneously is explored by studying the intracellular uptake of DOX-loaded micelles.

pH-dependent, thermosensitive polymeric nanocarriers for drug delivery to solid tumors.

Polymeric micelles are promising carriers for anti-cancer agents due to their small size, ease of assembly, and versatility for functionalization. A current challenge in the use of polymeric micelles is the sensitive balance that must be achieved between stability during prolonged blood circulation and release of active drug at the tumor site. Stimuli-responsive materials provide a mechanism for triggered drug release in the acidic tumor and intracellular microenvironments. In this work, we synthesized a series of dual pH- and temperature-responsive block copolymers containing a poly(ε-caprolactone) (PCL) hydrophobic block with a poly(triethylene glycol) block that were copolymerized with an amino acid-functionalized monomer. The block copolymers formed micellar structures in aqueous solutions. An optimized polymer that was functionalized with 6-aminocaproic acid (ACA) possessed pH-sensitive phase transitions at mildly acidic pH and body temperature. Doxorubicin-loaded micelles formed from these polymers were stable at blood pH (~7.4) and showed increased drug release at acidic pH. In addition, these micelles displayed more potent anti-cancer activity than free doxorubicin when tested in a tumor xenograft model in mice.

Effect of diuretic use on 30-day postdialysis mortality in critically ill patients receiving acute dialysis.

BACKGROUND: The impact of diuretic usage and dosage on the mortality of critically ill patients with acute kidney injury is still unclear. METHODS AND RESULTS: In this prospective, multicenter, observational study, 572 patients with postsurgical acute kidney injury receiving hemodialysis were recruited and followed daily. Thirty-day postdialysis mortality was analyzed using Cox's proportional hazards model with time-dependent covariates. The mean age of the 572 patients was 60.8±16.6 years. Patients with lower serum creatinine (p = 0.031) and blood lactate (p = 0.033) at ICU admission, lower predialysis urine output (p = 0.001) and PaO(2)/FiO(2) (p = 0.039), as well as diabetes (p = 0.037) and heart failure (p = 0.049) were more likely to receive diuretics. A total of 280 (49.0%) patients died within 30 days after acute dialysis initiation. The analysis of 30-day postdialysis mortality by fitting propensity score-adjusted Cox's proportional hazards models with time-dependent covariates showed that higher 3-day accumulated diuretic doses after dialysis initiation (HR = 1.449, p = 0.021) could increase the hazard rate of death. Moreover, higher time-varying 3-day accumulative diuretic doses were associated with hypotension (p<0.001) and less intense hemodialysis (p<0.001) during the acute dialysis period. BACKGROUND AND SIGNIFICANCE: Higher time-varying 3-day accumulative diuretic dose predicts mortality in postsurgical critically ill patients requiring acute dialysis. Higher diuretic doses are associated with hypotension and a lower intensity of dialysis. Caution should be employed before loop diuretics are administered to postsurgical patients during the acute dialysis period.

2,1,3-Benzothiadiazole (BTD)-moiety-containing red emitter conjugated amphiphilic poly(ethylene glycol)-block-poly(epsilon-caprolactone) copolymers for bioimaging.

2,1,3-Benzothiadiazole (BTD)-containing red emitter was chemically conjugated onto amphiphilic poly(ethylene glycol)-block-poly(epsilon-caprolactone) (PEG-b-PCL) copolymers to form two new fluorophore-conjugated block copolymers (P5 and P7). P5 is a cationic amino group-containing polymer, whereas, P7 is a neutral polymer. The polymers formed micelles in aqueous solution with average diameters of 45 nm (P7) and 78 nm (P5), which were characterized using dynamic light scattering (DLS) and atomic force microscopy (AFM). Cell internalization of the micelles using mouse macrophage RAW 264.7 was investigated. The micelles formed from P5 were endocytosed into the cell's cytoplasm through a non-specific endocytosis process, which was affected by temperature and calcium ions. Micelles formed from P7 could not be endocytosed. The dramatic difference of cell uptake between P5 and P7 indicated the cationic amino groups had a strong influence on the cell internalization to enhance the endocytosis pathway. 3-(4,5-Dimethyl thiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) viability assay was used to evaluate the cytotoxicity of the P5 micelle and no significant toxicity was observed. This study is the first report regarding the synthesis of BTD-conjugated block copolymers and the application of the biomacromolecules for bioimaging.

Utilization of micelles formed from poly(ethylene glycol)-block-poly(epsilon-caprolactone) block copolymers as nanocarriers to enable hydrophobic red two-photon absorbing emitters for cells imaging.

A hydrophobic two-photon absorbing (2PA) red emitter (R) was successfully incorporated into micelles formed from two block copolymers, poly(epsilon-caprolactone)-block-poly(ethylene glycol)s, for imaging and toxicity studies. In micelles, the chromophore R exhibits a 2PA cross-section of 400 GM (1 GM = 1 x 10(-50) cm(4) s photon(-1) molecule(-1)) at 820 nm, which is among the highest values reported for red 2PA emitters. The micelles with a cationic amino moiety-containing poly(ethylene glycol) corona showed an enhancement of cell internalization and delivered the dye into the cytoplasmic regions of the mouse macrophage RAW 264.7 cells. In comparison, the dye in micelles with neutral poly(ethylene glycol) as corona could not be delivered into the cells. Cytotoxicity of the micelle-R constructs was studied using a 3-(4,5-dimethyl thiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. More than 90% of the cells were viable after they were stained with the dye-containing micelles at different concentrations (dye concentrations of 2-6 muM and polymer concentrations of 0.05-0.15 mg/mL) for 16 h. This is the first reported application of a hydrophobic 2,1,3-benzothiadiazole-containing 2PA red emitter delivered into the cytoplasm of cells for bioimaging and toxicity assessment.

Effects of chain architectures on the surface structures of conjugated rod-coil block copolymer brushes.

Rod-coil block copolymers are of unique and interesting characteristics since their physical properties can be reversibly tuned in response to the external stimuli, such as change in solvent quality. In this study, dissipative particle dynamics is used to investigate the surface structures of rod-coil polymer brushes tethered onto a surface. When immersed in the selective solvent for the coil blocks, rod blocks tend to form aggregates. Our results show that linear and Y-shaped polymer brushes exhibit similar aggregative behavior. However, some of the surface structures can be acquired within experimentally attainable surface grafting density only for Y-shaped polymer brushes. On the other hand, comblike polymer brushes are found to possess more diverse aggregative manners than linear brushes. Surface structures with aggregates taking the forms of cones, cylinders, or layers of spheres are found. By controlling the aggregative structures, it is possible for us to adjust the physical properties, such as optical function, of the material.

Impact of spiritual and religious activity on quality of sleep in hemodialysis patients.

BACKGROUND: Sleep disorders are common in hemodialysis (HD) patients. This study examined the relationship between quality of sleep (QoS) and religious/spiritual activity in HD patients. METHODS: The study subjects were 861 HD patients from 14 dialysis clinics in Taiwan. QoS and religious/spiritual activity were evaluated by the Pittsburgh Sleep Quality Index (PSQI) questionnaire and the Royal Free Questionnaire respectively. RESULTS: There was no difference in clinical parameters between the good and poor sleepers. Although total scores of religious and spiritual activity did not correlate with global PSQI score, patients who held strong 'spiritual' beliefs reported more problems in 'sleep disturbances', while those who exercised religious beliefs more strongly reported less trouble in 'daytime dysfunction'. CONCLUSION: There is no significant correlation between QoS and religious/spiritual activity globally. However, the spiritual and religious activity did associate with different components of QoS.

Theoretical and experimental studies on the surface structures of conjugated rod-coil block copolymer brushes.

A combined theoretical and experimental investigation of conjugated rod-coil block copolymer brushes is reported. The theoretical study for the surface structures of rod-coil block copolymer brushes was established based on the simulation method of dissipative particle dynamics. The effects of solvent stimuli, grafting density, and rod-coil block ratio of the polymer brushes on the surface structures were examined. The rod blocks of polymer brushes were found to be well-dispersed on the surface in their good solvents. On the other hand, aggregative domains of the rod blocks were formed in their poor solvents with the conformations of isolated islands or worm-like structures depending on the grafting density of the polymer brushes. The aggregative domains tend to stay on top of the coil blocks for small rod-to-coil block ratio. However, the submergence of the aggregative domains into the coil blocks is thermodynamically preferred for large enough rod-to-coil block ratio. New multifunctional amphiphilic rod-coil block copolymers, poly-[2,7-(9,9-di-n-hexylfluorene)]-block-poly-[poly(ethylene glycol) methyl ether methacrylate]-block-poly-[3(tripropoxysilyl)propyl methacrylate] (PF-b-PPEGMA-b-PPOPS), with two different block ratios were synthesized and used to prepare the corresponding polymer brushes via the grafting- method. The effects of stimuli factors on the surface structures characterized by the atomic force microscopy images were consistent with the theoretical results. Furthermore, the photophysical properties of PF-b-PPEGMA-b-PPOPS brushes were significantly varied by the solvent stimuli. The emission peaks originated from the aggregation and/or excimer formation of PF blocks were observed after methanol treatment. The photoluminescence intensity and its efficiency were well correlated to the surface structure and the methanol content in mixed solvents. Our study demonstrates how the surface structures and photophysical properties of rod-coil block copolymer brushes response to environmental stimuli.

Comparison of phacoemulsification and planned extracapsular cataract extraction in combined pars plana vitrectomy and posterior chamber intraocular lens implantation.

BACKGROUND AND OBJECTIVE: To compare two kinds of cataract removal methods combined with pars plana vitrectomy and posterior chamber intraocular lens (PC-IOL) implantation. PATIENTS AND METHODS: Cataract removal was performed by either phacoemulsification or extracapsular cataract extraction (ECCE) and followed by pars plana vitrectomy and PC-IOL implantation. Between May 1996 and June 2001, 31 and 22 patients with cataract and vitreoretinal disease were treated by phacoemulsification and ECCE, respectively, combined with pars plana vitrectomy and PC-IOL implantation. Preoperative demographic data and postoperative vision, astigmatism change, and complications were analyzed. RESULTS: The mean age of patients in the phacoemulsification and ECCE groups was 62.5 and 63.4 years, respectively. Diabetes mellitus was the most common underlying disease resulting in vitreous opacity. Vision improved in 87.1% of the phacoemulsification group and 59.1% of the ECCE group. The change in astigmatism after surgery was 0.92+/-1.08 D (P = .001) in the ECCE group and 0.25+/-0.74 D (P = .087) in the phacoemulsification group. There were fewer postoperative complications, including recurrent vitreous hemorrhage, increased intraocular pressure, and iris changes in the phacoemulsification group than in the ECCE group. CONCLUSION: Phacoemulsification and ECCE combined with pars plana vitrectomy and PC-IOL implantation are both effective surgical methods to achieve better and more rapid visual rehabilitation for patients with combined cataract and vitreoretinal disease. In this study, phacoemulsification combined with pars plana vitrectomy and PC-IOL implantation resulted in greater improvement in vision, less astigmatism change, and fewer postoperative complications.