Halogen-Kupfer-Austausch mit Kupferhypersilanid und Organylhalogeniden

Die Reaktion von Kupfertris(trimathylsilyl)silan (= Hypersilylkupfer, CuHyp) mit Iodoorganylverbindungen sollte analog zum Ullmann-Protokoll zum Halogen-Nukleophil-Austausch führen. Tatsächlich beobachteten wir zumeist die Bildung von Cuprio-Organylen, isolierbar in Form von mehrkernigen Neutralkomplexen aus dem Produkt und weiteren Äquivalenten von Hypersilylkupfer. Nach Zugabe von (weichen) Basen wie Trimethylphosphan kam es zur Auflösung dieser Komplexe und zur Bildung der erwarteten Silylorganyle. Von der systematischen Variation der eingesetzten Arene, Alkene und Alkine sowie ihrer Liganden versprachen wir uns tiefere Einsicht in die mechanistischen Zusammenhänge. Neben dem üblichen Halogen-Kupfer-Autausch konnten wir bei orthosubstituierten, bzw. zusätzlich tetramethylsubstituierten Diiodarenen einen einfachen Iod-Siyl-Autausch beobachten (vermutlich über Arinzwischenstufen), für Alkinedukte sogar eine doppelte Silylierung. Tatsächlich zeigen quantenchemische Berechnungen für CuHyp-Iodoorganyl-Systeme eine klare Präferenz von ullmannartigen Verläufen; andererseits führte Basenzugabe erst nachträglich zur Bildung von Ullmann-Produkten über die Auflösung der primären Komplexe. Innerhalb der üblicherweise gebildeten mehrkernigen Komplexe kommen Bindungen durch die Wechselwirkung unbesetzter σ*-Molekülorbitalee am Kupferzentrum von CuHyp und elektronenreichen bindenden Orbitalen in den Kupferorganyleinheiten zustande. Freie Elektronenpaare am Phosphor bei PMe3 könnten analog die Auflösung der Neutralkomplexe und die Bildung von vierkernigen Kupfer(III)-Intermediaten zwischen den Kupferorganyleinheiten und Iodsilan in der Lösung bewirken, die aufgrund ihrer strukturellen und energetischen Besonderheiten zu den erwarteten Ullmann-Produkten weiterreagieren würden. Die beobachteten Primärreaktionen verliefen dann offensichtlich über vergleichbare, aber unterschiedlich strukturierte Intermediate, vermutlich aufgrund der Tatsache, dass das eingesetzte CuHyp als Trimer vorliegt. Diese Annahme wird durch die direkte Silylierung von Iodalkinen gestützt, deren Dreifachbindungen möglicherweise als interne Base die trimeren in monomere CuHyp-Einheiten überführen. In eine ähnliche Richtung wäre die jüngst berichtete direkte Silylierung von Allylen bei Anwesenheit von elektronenreichen CN-Gruppen zu deuten.

From defined polymer architectures to structure-property relationships in vivo

Makromolekulare Wirkstoffträgersysteme sind von starkem Interesse bezüglich der klinischen Anwendung chemotherapeutischer Agenzien. Um ihr klinisches Potential zu untersuchen ist es von besonderer Bedeutung das pharmakokinetische Profil in vivo zu bestimmen. Jede Veränderung der Polymerstruktur beeinflusst die Körperverteilung des entsprechenden Makromoleküls. Aufgrund dessen benötigt man detailliertes Wissen über Struktur-Eigenschaftsbeziehungen im lebenden Organismus, um das Nanocarrier System für zukünftige Anwendungen einzustellen. In dieser Beziehung stellt das präklinische Screening mittels radioaktiver Markierung und Positronen-Emissions-Tomographie eine nützliche Methode für schnelle sowie quantitative Beobachtung von Wirkstoffträgerkandidaten dar. Insbesondere poly(HPMA) und PEG sind im Arbeitsgebiet Polymer-basierter Therapeutika stark verbreitet und von ihnen abgeleitete Strukturen könnten neue Generationen in diesem Forschungsbereich bieten.rnDie vorliegende Arbeit beschreibt die erfolgreiche Synthese verschiedener HPMA und PEG basierter Polymer-Architekturen – Homopolymere, Statistische und Block copolymere – die mittels RAFT und Reaktivesterchemie durchgeführt wurde. Des Weiteren wurden die genannten Polymere mit Fluor-18 und Iod-131 radioaktiv markiert und mit Hilfe von microPET und ex vivo Biodistributionsstudien in tumortragenden Ratten biologisch evaluiert. Die Variation in Polymer-Architektur und darauffolgende Analyse in vivo resultierte in wichtige Schlussfolgerungen. Das hydrophile / lipophile Gleichgewicht hatte einen bedeutenden Einfluss auf das pharmakokinetische Profil, mit besten in vivo Eigenschaften (geringe Aufnahme in Leber und Milz sowie verlängerte Blutzirkulationszeit) für statistische HPMA-LMA copolymere mit steigendem hydrophoben Anteil. Außerdem zeigten Langzeitstudien mit Iod-131 eine verstärkte Retention von hochmolekularen, HPMA basierten statistischen Copolymeren im Tumorgewebe. Diese Beobachtung bestätigte den bekannten EPR-Effekt. Hinzukommend stellen Überstrukturbildung und damit Polymergröße Schlüsselfaktoren für effizientes Tumor-Targeting dar, da Polymerstrukturen über 200 nm in Durchmesser schnell vom MPS erkannt und vom Blutkreislauf eliminiert werden. Aufgrund dessen wurden die hier synthetisierten HPMA Block copolymere mit PEG Seitengruppen chemisch modifiziert, um eine Verminderung in Größe sowie eine Reduktion in Blutausscheidung zu induzieren. Dieser Ansatz führte zu einer erhöhten Tumoranreicherung im Walker 256 Karzinom Modell. Generell wird die Körperverteilung von HPMA und PEG basierten Polymeren stark durch die Polymer-Architektur sowie das Molekulargewicht beeinflusst. Außerdem hängt ihre Effizienz hinsichtlich Tumorbehandlung deutlich von den individuellen Charakteristika des einzelnen Tumors ab. Aufgrund dieser Beobachtungen betont die hier vorgestellte Dissertation die Notwendigkeit einer detaillierten Polymer-Charakterisierung, kombiniert mit präklinischem Screening, um polymere Wirkstoffträgersysteme für individualisierte Patienten-Therapie in der Zukunft maßzuschneidern.rn

Methodenentwicklung zur Charakterisierung von metallischen Nanopartikeln und deren potentieller Einsatz bei der Analyse von Biomolekülen mittels ICP-MS Kopplungstechniken

Die qualitative und quantitative Analyse von Biomolekülen hat in den letzten Jahren und Jahrzehnten immer mehr an Bedeutung gewonnen. Durch das Aufkommen und die kontinuierliche Weiterentwicklung neuer Separations- und Detektionsmethoden und deren Verbindung miteinander zu leistungsfähigen Einheiten, erlangte man Schritt für Schritt neue Erkenntnisse bei ihrer Untersuchung. Die Elementmassenspektrometrie als nachweisstarke Detektionsmethode wird von vielen wissenschaftlichen Arbeitsgruppen bei der Trennung und Quantifizierung von Proteinen und Metalloproteinen mittels Detektion der in den Biomolekülen vorkommenden Metalle und Heteroatome angewendet. Heteroatome (z.B. Schwefel, Phosphor) haben im Plasma des ICP-MS (inductively coupled plasma - mass spectrometer) schlechte Ionisationseigenschaften und dementsprechend deutlich höhere Nachweisgrenzen als Metalle. Ein Ansatz, schlecht oder nicht detektierbare Verbindungen (also solche, die keine Metalle oder Heteroatome enthalten) mit dem ICP-MS sichtbar zu machen, ist die Markierung der selbigen mit Metallionen oder -cluster. rnIn dieser Arbeit ist es gelungen, der Analyse ganz unterschiedlicher Substanzklassen, zum einen metallische Nanopartikel und zum anderen Proteine, neue Impulse zu geben und zukünftiges Potential bei der Anwendung gekoppelter Techniken zur Separation und Detektion aufzuzeigen. Durch die Verwendung einer alten, aber neu konzipierten Trenntechnik, der Gelelektrophorese (GE), und deren Kopplung an einen modernen Detektor, dem ICP-MS, kann die für die Proteinanalytik weit verbreitete Gelelektrophorese ihr enormes Potential bei der Trennung verschiedenster Verbindungsklassen mit der exzellenten Nachweisstärke und Elementspezifität des ICP-MS verbinden und dadurch mit deutlich weniger Arbeitsaufwand als bisher qualitative und auch quantitative Ergebnisse produzieren. Bisher war dies nur mit großem präparativem Aufwand unter Verwendung der laser ablation möglich. Bei der Analyse von Nanopartikeln konnte aufgezeigt werden, dass durch die GE-ICP-MS-Kopplung aufgrund der guten Trenneigenschaften der GE vorhandene Spezies bzw. Fraktionen voneinander separiert werden und mit Hilfe des ICP-MS Informationen auf atomarem Niveau gewonnen werden können. Es war möglich, das atomare Verhältnis der Metallatome im Kern und der Schwefelatome in der Ligandenhülle eines Nanopartikels zu bestimmen und damit die Größe des Partikels abzuschätzen. Auch konnte die Anzahl der Goldatome in einem dem Schmid-Cluster ähnlichen Nanopartikel bestimmt werden, was vorher nur mit Hilfe von MALDI-TOF möglich war. Bei der Analyse von Biomolekülen konnte auf einfache Weise der Phosphorylierungsgrad verschiedener Proteine bestimmt werden. Auch bei kleinen Molekülen erzielt die Gelelektrophorese ausgezeichnete Trennergebnisse, wie z. B. bei der Analyse verschiedener Brom- und Iodspezies.rnDie stöchiometrische Kopplung eines Proteins an einen Nanopartikel, ohne eine der beiden Verbindungen in einem größeren Maße zu verändern, stellte jedoch eine Herausforderung dar, die im Rahmen dieser Arbeit nicht vollständig gelöst werden konnte. Verschiedene Ansätze zur Kopplung der beiden Substanzen wurden erprobt, jedoch führte keine zu dem gewünschten Ergebnis einer stöchiometrisch vollständigen und spezifischen Modifikation eines Proteins mit einem Nanopartikel. Durch das Potential der GE-ICP-MS-Kopplung bei der Analyse beider Substanz-klassen und dem Beweis der Praktikabilität und Zuverlässigkeit der Methode ist jedoch der Grundstein für weitere Forschungen auf diesem Gebiet gelegt worden. Ist eine geeignete chemische Kopplung der beiden Substanzklassen gefunden und beherrscht, steht auf analytischer Seite eine leistungsstarke Kombination aus Trennung und Detektion zur Verfügung, um die Quantifizierung von Proteinen entscheidend zu verbessern.rn

Dual-energy multidetector CT: how does it work, what can it tell us, and when can we use it in abdominopelvic imaging?

Dual-energy CT provides information about how substances behave at different energies, the ability to generate virtual unenhanced datasets, and improved detection of iodine-containing substances on low-energy images. Knowing how a substance behaves at two different energies can provide information about tissue composition beyond that obtainable with single-energy techniques. The term K edge refers to the spike in attenuation that occurs at energy levels just greater than that of the K-shell binding because of the increased photoelectric absorption at these energy levels. K-edge values vary for each element, and they increase as the atomic number increases. The energy dependence of the photoelectric effect and the variability of K edges form the basis of dual-energy techniques, which may be used to detect substances such as iodine, calcium, and uric acid crystals. The closer the energy level used in imaging is to the K edge of a substance such as iodine, the more the substance attenuates. In the abdomen and pelvis, dual-energy CT may be used in the liver to increase conspicuity of hypervascular lesions; in the kidneys, to distinguish hyperattenuating cysts from enhancing renal masses and to characterize renal stone composition; in the adrenal glands, to characterize adrenal nodules; and in the pancreas, to differentiate between normal and abnormal parenchyma.

Dual-energy CT-cholangiography in potential donors for living-related liver transplantation: Improved biliary visualization by intravenous morphine co-medication

PURPOSE: To prospectively evaluate whether intravenous morphine co-medication improves bile duct visualization of dual-energy CT-cholangiography. MATERIALS AND METHODS: Forty potential donors for living-related liver transplantation underwent CT-cholangiography with infusion of a hepatobiliary contrast agent over 40min. Twenty minutes after the beginning of the contrast agent infusion, either normal saline (n=20 patients; control group [CG]) or morphine sulfate (n=20 patients; morphine group [MG]) was injected. Forty-five minutes after initiation of the contrast agent, a dual-energy CT acquisition of the liver was performed. Applying dual-energy post-processing, pure iodine images were generated. Primary study goals were determination of bile duct diameters and visualization scores (on a scale of 0 to 3: 0-not visualized; 3-excellent visualization). RESULTS: Bile duct visualization scores for second-order and third-order branch ducts were significantly higher in the MG compared to the CG (2.9±0.1 versus 2.6±0.2 [P<0.001] and 2.7±0.3 versus 2.1±0.6 [P<0.01], respectively). Bile duct diameters for the common duct and main ducts were significantly higher in the MG compared to the CG (5.9±1.3mm versus 4.9±1.3mm [P<0.05] and 3.7±1.3mm versus 2.6±0.5mm [P<0.01], respectively). CONCLUSION: Intravenous morphine co-medication significantly improved biliary visualization on dual-energy CT-cholangiography in potential donors for living-related liver transplantation.

[Pharmacotherapy of hyperthyreosis--adverse drug reactions]

The antithyroid drugs mainly include thioimidazole (carbimazole, methimazole=thiamazole) and propylthiouracil. After absorption, carbimazole is rapidly metabolized to methimazole and thus switching between these two drugs should not be considered in case of side effects. Furthermore, in case of side effects, sometimes even cross reactions between thioimidazoles and propylthiouracil occur. Common and typical adverse reactions of antithyroid drugs include dose dependent hypothyroidism and thus thyroid function should be repeatedly checked while the patient is on antithyroid drugs. Furthermore, pruritus and rash may develop. In this case, one might try to switch from thioimidazoles to propylthiouracil or vice versa. Antithyroid drugs may cause mild dose dependent neutropenia or severe allergy-mediated agranulocytosis, which typically occurs during the first three months of treatment, has an incidence of 3 per 10,000 patients and cross reactivity between thioimidazoles to propylthiouracil may occur. Rarely, antithyroid drugs can cause aplastic anemia. Mainly propylthiouracil, but sometimes also methimazole may lead to an asymptomatic transient increase in liver enzymes or to severe, even lethal liver injury of cholestatic or hepatocellular pattern. Since propylthiouracil associated liver injury was observed increasingly among children and adolescent, it has been suggested to prefer thioimidazoles for these patients. Because of these potential serious adverse effects, physicians should advise patients to immediately seek medical help if they get a fever or sore throat or malaise, abdominal complaints or jaundice, respectively. Furthermore, arthralgias may develop in 1-5% of patients under both antithyroid drugs. Since arthralgias may be the first symptom of more serious immunologic side effects, it is recommended to stop the antithyroid drug in this case. Drug induced polyarthritis mainly develops during the first month of therapy, whereas ANCA-positive vasculitis is generally observed only after long term exposure to propylthiouracil or very rarely with the thioimidazoles. The teratogenic risk of the thioimidazoles is somewhat higher (Aplasia cutis congenita), that is why one generally recommends preferring propylthiouracil during pregnancy. During breast feeding both, thioimidazoles or propylthiouracil, may be administered. Nowadays, perchlorate is only used short term in case of latent hyperthyroidism before administering iodine-containing contrast agents. Therefore, the known side effects, which usually are only observed after long term treatment, are not an issue any more.

Iodide interaction with natural pyrite

29I is one of the major dose-determining nuclides in the safety analysis of deep storage of radioactive waste. Iodine forms anionic species that hardly sorb on the surfaces of common host-rock minerals. Recently, interest has arisen on the role of pyrite, an accessory mineral capable of binding anionic selenium. Whereas the interaction of selenium with pyrite is well documented, corresponding results on iodine sorption are still scarce and controversial. Pyrite is present in argicilleous rocks which are being considered in many countries as potential host rocks for a radioactive waste repository. The uptake of iodide (I−) on natural pyrite was investigated under nearly anoxic conditions (O2 < 5 ppm) over a wide concentration range (10−11–10−3 M total I−) using 125I as the radioactive tracer. Weak but measurable sorption was observed; distribution coefficients (R d) were less than 0.002 m3 kg−1 and decreased with increasing total iodide concentration. Iodide sorption was connected to the presence of oxidized clusters on the pyrite surface, which were presumably formed by reaction with limited amounts of dissolved oxygen. The results obtained indicated that pyrite cannot be considered as an effective scavenger of 129I under the geochemical conditions prevailing in underground radioactive waste geologic storage.

Cohort study of somatostatin-based radiopeptide therapy with [(90)Y-DOTA]-TOC versus [(90)Y-DOTA]-TOC plus [(177)Lu-DOTA]-TOC in neuroendocrine cancers

Radiopeptide therapy is commonly performed with a single radioisotope. We aimed to compare the effectiveness of somatostatin-based radiopeptide therapy with a single versus a combination of radioisotopes.

Whole-body computed tomography for multiple traumas using a triphasic injection protocol

To evaluate a triphasic injection protocol for whole-body multidetector computed tomography (MDCT) in patients with multiple trauma. Fifty consecutive patients (41 men) were examined. Contrast medium (300 mg/mL iodine) was injected starting with 70 mL at 3 mL/s, followed by 0.1 mL/s for 8 s, and by another bolus of 75 mL at 4 mL/s. CT data acquisition started 50 s after the beginning of the first injection. Two experienced, blinded readers independently measured the density in all major arteries, veins, and parenchymatous organs. Image quality was assessed using a five-point ordinal rating scale and compared to standard injection protocols [n = 25 each for late arterial chest, portovenous abdomen, and MDCT angiography (CTA)]. With the exception of the infrarenal inferior caval vein, all blood vessels were depicted with diagnostic image quality using the multiple-trauma protocol. Arterial luminal density was slightly but significantly smaller compared to CTA (P < 0.01). Veins and parenchymatous organs were opacified significantly better compared to all other protocols (P < 0.01). Arm artifacts reduced the density of spleen and liver parenchyma significantly (P < 0.01). Similarly high image quality is achieved for arteries using the multiple-trauma protocol compared to CTA, and parenchymatous organs are depicted with better image quality compared to specialized protocols. Arm artifacts should be avoided.

Sympathetic nervous system activity in rat thyroid: potential role in goitrogenesis

The role of sympathetic innervation in regulation of thyroid function is incompletely understood. We, therefore, carried out studies in rats utilizing techniques of norepinephrine turnover to assess thyroid sympathetic activity in vivo. Thyroidal sympathetic activity was increased 95% by exposure to cold (4 degrees C), 42% by chronic ingestion of an iodine-deficient diet, and 32% in rats fed a goitrogenic diet (low-iodine diet supplemented with propylthiouracil). In addition, fasting for 2 days reduced sympathetic nervous system activity in thyroid by 38%. Thyroid growth and 125I uptake were also compared in intact and decentralized hemithyroids obtained from animals subjected to unilateral superior cervical ganglion decentralization. Unilateral superior cervical ganglion decentralization led to a reduction in thyroid weight, in 125I uptake by thyroid tissue, and in TSH-induced stimulation of 125I uptake in decentralized hemithyroids. These results suggest that sympathetic activity in thyroid contributes to gland enlargement and may modulate tissue responsiveness to TSH.

Patient exposure and image quality of low-dose pulmonary computed tomography angiography: comparison of 100- and 80-kVp protocols

OBJECTIVE: Measures to reduce radiation exposure and injected iodine mass are becoming more important with the widespread and often repetitive use of pulmonary CT angiography (CTA) in patients with suspected pulmonary embolism. In this retrospective study, we analyzed the capability of 2 low-kilovoltage CTA-protocols to achieve these goals. MATERIALS AND METHODS: Ninety patients weighing less than 100 kg were examined by a pulmonary CTA protocol using either 100 kVp (group A) or 80 kVp (group B). Volume and flow rate of contrast medium were reduced in group B (75 mL at 3 mL/s) compared with group A (100 mL at 4 mL/s). Attenuation was measured in the central and peripheral pulmonary arteries, and the contrast-to-noise ratios (CNR) were calculated. Entrance skin dose was estimated by measuring the surface dose in an ovoid-cylindrical polymethyl methacrylate chest phantom with 2 various dimensions corresponding to the range of chest diameters in our patients. Quantitative image parameters, estimated effective dose, and skin dose in both groups were compared by the t test. Arterial enhancement, noise, and overall quality were independently assessed by 3 radiologists, and results were compared between the groups using nonparametric tests. RESULTS: Mean attenuation in the pulmonary arteries in group B (427.6 +/- 116 HU) was significantly higher than in group A (342.1 +/- 87.7 HU; P < 0.001), whereas CNR showed no difference (group A, 20.6 +/- 7.3 and group B, 22.2 +/- 7.1; P = 0.302). Effective dose was lower by more than 40% with 80 kVp (1.68 +/- 0.23 mSv) compared with 100 kVp (2.87 +/- 0.88 mSv) (P < 0.001). Surface dose was significantly lower at 80 kVp compared with 100 kVp at both phantom dimensions (2.75 vs. 3.22 mGy; P = 0.027 and 2.22 vs. 2.73 mGy; P = 0.005, respectively). Image quality did not differ significantly between the groups (P = 0.151). CONCLUSIONS: Using 80 kVp in pulmonary CTA permits reduced patient exposure by 40% and CM volume by 25% compared with 100 kVp without deterioration of image quality in patients weighing less than 100 kg.

Study of particle movement in the nearshore region of Lake Superior with radioisotope tracers

Biogeochemical processes in the coastal region, including the coastal area of the Great Lakes, are of great importance due to the complex physical, chemical and biological characteristics that differ from those on either the adjoining land or open water systems. Particle-reactive radioisotopes, both naturally occurring (210Pb, 210Po and 7Be) and man-made (137Cs), have proven to be useful tracers for these processes in many systems. However, a systematic isotope study on the northwest coast of the Keweenaw Peninsula in Lake Superior has not yet been performed. In this dissertation research, field sampling, laboratory measurements and numerical modeling were conducted to understand the biogeochemistry of the radioisotope tracers and some particulate-related coastal processes. In the first part of the dissertation, radioisotope activities of 210Po and 210Pb in a variability of samples (dissolved, suspended particle, sediment trap materials, surficial sediment) were measured. A completed picture of the distribution and disequilibrium of this pair of isotopes was drawn. The application of a simple box model utilizing these field observations reveals short isotope residence times in the water column and a significant contribution of sediment resuspension (for both particles and isotopes). The results imply a highly dynamic coastal region. In the second part of this dissertation, this conclusion is examined further. Based on intensive sediment coring, the spatial distribution of isotope inventories (mainly 210Pb, 137Cs and 7Be) in the nearshore region was determined. Isotope-based focusing factors categorized most of the sampling sites as non- or temporary depositional zones. A twodimensional steady-state box-in-series model was developed and applied to individual transects with the 210Pb inventories as model input. The modeling framework included both water column and upper sediments down to the depth of unsupported 210Pb penetration. The model was used to predict isotope residence times and cross-margin fluxes of sediments and isotopes at different locations along each transect. The time scale for sediment focusing from the nearshore to offshore regions of the transect was on the order of 10 years. The possibility of sediment longshore movement was indicated by high inventory ratios of 137Cs: 210Pb. Local deposition of fine particles, including fresh organic carbon, may explain the observed distribution of benthic organisms such as Diporeia. In the last part of this dissertation, isotope tracers, 210Pb and 210Po, were coupled into a hydrodynamic model for Lake Superior. The model was modified from an existing 2-D finite difference physical-biological model which has previously been successfully applied on Lake Superior. Using the field results from part one of this dissertation as initial conditions, the model was used to predict the isotope distribution in the water column; reasonable results were achieved. The modeling experiments demonstrated the potential for using a hydrodynamic model to study radioisotope biogeochemistry in the lake, although further refinements are necessary.

Detection of pulmonary emboli with CT angiography at reduced radiation exposure and contrast material volume: comparison of 80 kVp and 120 kVp protocols in a matched cohort

The detection rate of pulmonary emboli (PE) with computed tomography angiography (CTA) using either a standard or a low-dose protocol, combining reduced radiation exposure and iodine delivery rate, was retrospectively analyzed in a matched cohort of 120 patients.

Central venous catheter integrity during mechanical power injection of iodinated contrast medium

PURPOSE: To evaluate a widely used nontunneled triple-lumen central venous catheter in order to determine whether the largest of the three lumina (16 gauge) can tolerate high flow rates, such as those required for computed tomographic angiography. MATERIALS AND METHODS: Forty-two catheters were tested in vitro, including 10 new and 32 used catheters (median indwelling time, 5 days). Injection pressures were continuously monitored at the site of the 16-gauge central venous catheter hub. Catheters were injected with 300 and 370 mg of iodine per milliliter of iopamidol by using a mechanical injector at increasing flow rates until the catheter failed. The infusion rate, hub pressure, and location were documented for each failure event. The catheter pressures generated during hand injection by five operators were also analyzed. Mean flow rates and pressures at failure were compared by means of two-tailed Student t test, with differences considered significant at P < .05. RESULTS: Injections of iopamidol with 370 mg of iodine per milliliter generate more pressure than injections of iopamidol with 300 mg of iodine per milliliter at the same injection rate. All catheters failed in the tubing external to the patient. The lowest flow rate at which catheter failure occurred was 9 mL/sec. The lowest hub pressure at failure was 262 pounds per square inch gauge (psig) for new and 213 psig for used catheters. Hand injection of iopamidol with 300 mg of iodine per milliliter generated peak hub pressures ranging from 35 to 72 psig, corresponding to flow rates ranging from 2.5 to 5.0 mL/sec. CONCLUSION: Indwelling use has an effect on catheter material property, but even for used catheters there is a substantial safety margin for power injection with the particular triple-lumen central venous catheter tested in this study, as the manufacturer's recommendation for maximum pressure is 15 psig.

Transport of prion protein across the blood-brain barrier.

The cellular form of the prion protein (PrP(c)) is necessary for the development of prion diseases and is a highly conserved protein that may play a role in neuroprotection. PrP(c) is found in both blood and cerebrospinal fluid and is likely produced by both peripheral tissues and the central nervous system (CNS). Exchange of PrP(c) between the brain and peripheral tissues could have important pathophysiologic and therapeutic implications, but it is unknown whether PrP(c) can cross the blood-brain barrier (BBB). Here, we found that radioactively labeled PrP(c) crossed the BBB in both the brain-to-blood and blood-to-brain directions. PrP(c) was enzymatically stable in blood and in brain, was cleared by liver and kidney, and was sequestered by spleen and the cervical lymph nodes. Circulating PrP(c) entered all regions of the CNS, but uptake by the lumbar and cervical spinal cord, hypothalamus, thalamus, and striatum was particularly high. These results show that PrP(c) has bidirectional, saturable transport across the BBB and selectively targets some CNS regions. Such transport may play a role in PrP(c) function and prion replication.