PubMed Health⌕ Search

Biomedical subjects

William H Martin

Publications and source records attributed to William H Martin.

At least 19 recordsLinked to original sources

A novel series of non-carboxylic acid, non-hydantoin inhibitors of aldose reductase with potent oral activity in diabetic rat models: 6-(5-chloro-3-methylbenzofuran-2-sulfonyl)-2H-pyridazin-3-one and congeners.

Discovery of a highly selective, potent, and safe non-carboxylic acid, non-hydantoin inhibitor of aldose reductase (AR) capable of potently blocking the excess glucose flux through the polyol pathway that prevails under diabetic conditions has been a long-standing challenge. In response, we did high-throughput screening of our internal libraries of compounds and identified 6-phenylsulfonylpyridazin-2H-3-one, 8, which showed modest inhibition of AR, both in vitro and in vivo. Initial structure-activity relationships concentrated on phenyl substituents and led to 6-(2,4-dichlorophenylsulfonyl)-2H-pyridazin-3-one, 8l, which was more potent than 8, both in vitro and in vivo. Incorporation of extant literature findings with other aldose reductase inhibitors, including zopolrestat, resulted in the title inhibitor, 19m, which is one of the most potent and highly selective non-carboxylic acid, non-hydantoin inhibitors of AR yet described (IC50, 1 nM; ED90 vs sciatic nerve sorbitol and fructose, respectively, 0.8 and 4.0 mg/kg). In rats, its oral bioavailability is 98% and it has a favorable plasma t(1/2) (26 +/- 3 h).

Administration, Oral↗

NanoStore: a concept for logistical improvements of compound handling in high-throughput screening.

Small molecule screening, the systematic encounter of biology space with chemical space, has provoked the emergence of a whole industry that recreates itself by constant iterative improvements to this process. The authors describe an approach to tackle the problem for one of the most time-consuming steps in the execution of a screening campaign, namely, the reformatting of high-throughput screening test compounds from master plates to daughter assay plates used in the execution of the screen. Through an engineered storage procedure, they prepare plates ahead of the screening process with the respective compounds in a ready-to-use format. They show the biological inertness of the method and how it facilitates efficient recovery of compound activity. This uncoupling of normally interconnected processes provides time and compound savings, avoids repeated freeze-thaw cycles of compound solutions, and removes the problems associated with the DMSO sensitivity of certain assays types.

Automation↗

Identification of an infected left ventricular assist device after cardiac transplant by indium-111 WBC scintigraphy.

PURPOSE: The purpose of this case report is to demonstrate the utility of multimodality imaging in the diagnosis of infection within a retained prosthetic device in the posttransplant setting. MATERIAL AND METHODS: Autologous leukocytes were labeled in vitro with indium-111 oxine and were reinjected. Whole-body and SPECT images were acquired at 24 hours and correlated with contemporary CT images. RESULTS: Through the use of combined indium-labeled WBC scintigraphy and CT we were able to identify infection within retained left ventricular assist device tubing status postcardiac transplantation in a patient with a diagnosis of fever of unknown origin. CONCLUSION: Localization of possible infectious etiologies within the transplant population is of utmost concern. Multimodality imaging, often utilizing scintigraphic techniques, is recommended.

Heart Ventricles↗

Incremental value of fusion imaging with integrated PET-CT in oncology.

PURPOSE: The purpose of this study was to assess the incremental value of integrated F-18 FDG PET-CT imaging compared with either alone for evaluation of patients with body malignancies. MATERIALS AND METHODS: Images from 173 consecutive patients with body malignancies referred for integrated PET-CT imaging were reviewed. A CT with contrast performed within 2 months of PET-CT was available for 74 patients. RESULTS: There was agreement between the transmission CT (TrCT) and PET interpreted separately in 65% (112 of 173) of patients. Interpretation of integrated PET-CT had an incremental diagnostic value in 17.9% (31 of 173) of the total patient population. Data was analyzed further excluding patients for whom further analysis was not relevant: 1) 20% (34 of 173) of patients with normal TrCT and PET and 2) 11% (19 of 173) of patients with disseminated metastases (too numerous to count) on both TrCT and PET. Among the 120 other patients, PET interpreted alone was positive in 195 body regions and CT-positive in 178 body regions with agreement for all regions in 49% (59 of 120) of patients and discordance or equivocal lesions in 51% (61 of 120) of patients. Integrated PET-CT had an incremental diagnostic value in 27% (31 of 120) of patients. Contrasted CT scan demonstrated hepatic lesions in 5 and extrahepatic lesions in 3 patients overlooked on TrCT; all 8 of these lesions were PET-positive. There was incremental impact on the management of 12.5% (15 of 120) of patients. CONCLUSIONS: After excluding patients with a normal PET-CT or disseminated disease, there was an incremental diagnostic value of integrated PET-CT imaging in 27% (31 of 120) and incremental impact on management in 12.5% (15 of 120) of patients. CT with contrast did not demonstrate lesions not appreciated by PET-CT.

Fluorodeoxyglucose F18↗

The discovery of structurally novel CCR1 antagonists derived from a hydroxyethylene peptide isostere template.

The present manuscript details the discovery and early fundamental structure-activity relationship studies involving compound 3, a novel hydroxyethylene peptide isostere derived molecule that provides micromolar inhibition of CCL3 binding to its receptor CCR1. Initial studies established this screening hit as a legitimate lead for further medicinal chemistry optimization.

Crystallography, X-Ray↗

Potent small molecule CCR1 antagonists.

The present manuscript details structure-activity relationship studies of lead structure 1, which led to the discovery of CCR1 antagonists >100-fold more potent than 1.

Cell Line↗

Benzimidazolone p38 inhibitors.

The synthesis and in vitro p38 alpha activity of a novel series of benzimidazolone inhibitors is described. The p38 alpha SAR is consistent with a mode of binding wherein the benzimidazolone carbonyl serves as the H-bond acceptor to Met109 of p38 alpha in a manner analogous to the pyridine nitrogen of prototypical pyridylimidazole p38 inhibitors. Potent p38 alpha activity comparable to that of several previously reported p38 inhibitors is observed for this novel chemotype.

Benzimidazoles↗

PET and PET-CT for evaluation of colorectal carcinoma.

The evaluation of patients with known or suspected recurrent colorectal carcinoma is now an accepted indication for positron emission tomography using (18)F-fluorodeoxyglucose (FDG-PET) imaging. FDG-PET does not replace imaging modalities such as computed tomography (CT) for preoperative anatomic evaluation but is indicated as the initial test for diagnosis and staging of recurrence and for preoperative staging (N and M) of known recurrence that is considered to be resectable. FDG-PET imaging is valuable for the differentiation of posttreatment changes from recurrent tumor, differentiation of benign from malignant lesions (indeterminate lymph nodes, hepatic and pulmonary lesions), and the evaluation of patients with rising tumor markers in the absence of a known source. The addition of FDG-PET to the evaluation of these patients reduces overall treatment costs by accurately identifying patients who will and will not benefit from surgical procedures. Although initial staging at the time of diagnosis is often performed during colectomy, FDG-PET imaging is recommended for a subgroup of patients at high risk (with elevated CEA levels) and normal CT and for whom surgery can be avoided if FDG-PET shows metastases. Screening for recurrence in patients at high risk has also been advocated. FDG-PET imaging seems promising for monitoring patient response to therapy but larger studies are necessary. The diagnostic implications of integrated PET-CT imaging include improved detection of lesions on both the CT and FDG-PET images, better differentiation of physiologic from pathologic foci of metabolism, and better localization of the pathologic foci. This new powerful technology provides more accurate interpretation of both CT and FDG-PET images and therefore more optimal patient care. PET-CT fusion images affect the clinical management by guiding further procedures (biopsy, surgery, radiation therapy), excluding the need for additional procedures, and changing both inter- and intramodality therapy.

Colorectal Neoplasms↗

Value of FDG PET imaging in the management of patients with thyroid, neuroendocrine, and neural crest tumors.

OBJECTIVES: The purpose of this study was to evaluate the value and impact on management of FDG PET imaging in patients with biopsy-proved neuroendocrine and neural crest tumors, as well as thyroid carcinoma of various types. MATERIALS AND METHODS: This is a retrospective review of imaging and clinical data of 60 consecutive patients presenting for evaluation of suspected recurrence who underwent FDG PET imaging between August 1993 and February 2002. All patients were referred for PET because of equivocal findings on conventional evaluation (most often increasing tumor markers and negative conventional workup) or for restaging. The final diagnosis was established with pathology (n = 19) or at least 6 months of follow-up (n = 41). The FDG images were acquired 1 hour after the intravenous administration of 10 mCi FDG with 1 of 2 dedicated PET tomographs (Siemens ECAT 933, CTI, Knoxville, TN; and GE Advance, General Electric Medical Systems, Milwaukee, WI). RESULTS: Thirty-four patients had recurrent disease and 26 had no evidence of recurrence. FDG PET imaging revealed at least as many focal abnormalities as concurrent CT, magnetic resonance, or other nuclear imaging modalities in 46 of 60 patients (77%). There were 17 patients (28%) in whom FDG PET found abnormalities not seen with other modalities. In the small group (n = 18) of cases of carcinoid, pheochromocytoma, Merkel cell tumor, and neuroblastoma, all cases were true positive (T+) or true negative (T-). In the group of 42 cases of thyroid carcinoma, the sensitivity was 67%. There were 16 T+, 18 T-, and 8 false-negative (F-) cases. Six F- cases presented with increasing thyroglobulin levels and negative whole-body I-131 scans. Four of these 6 F- cases were proved by surgery, 1 by a positive post I-131 therapy scan, and 1 by normalization of thyroglobulin levels after I-131 therapy. Two of the 8 F- PET cases had a positive I-131 scan. FDG PET imaging had an impact on the management of 13 of 60 of these patients (22%) by demonstrating extensive metastases and cancelling surgery (n = 2), and by detecting recurrence and guiding surgery (n = 5) or radiation therapy (n = 6). CONCLUSIONS: FDG PET is helpful in the evaluation of thyroid, neuroendocrine, and neural crest tumors. Although the sensitivity was only 76%, there were no false-positive findings, and FDG PET findings changed the management of 22% of the patients.

Fluorodeoxyglucose F18↗

Prospective feasibility trial of radiotherapy target definition for head and neck cancer using 3-dimensional PET and CT imaging.

UNLABELLED: The aim of this investigation was to evaluate the influence and accuracy of (18)F-FDG PET in target volume definition as a complementary modality to CT for patients with head and neck cancer (HNC) using dedicated PET and CT scanners. METHODS: Six HNC patients were custom fitted with head and neck and upper body immobilization devices, and conventional radiotherapy CT simulation was performed together with (18)F-FDG PET imaging. Gross target volume (GTV) and pathologic nodal volumes were first defined in the conventional manner based on CT. A segmentation and surface-rendering registration technique was then used to coregister the (18)F-FDG PET and CT planning image datasets. (18)F-FDG PET GTVs were determined and displayed simultaneously with the CT contours. CT GTVs were then modified based on the PET data to form final PET/CT treatment volumes. Five-field intensity-modulated radiation therapy (IMRT) was then used to demonstrate dose targeting to the CT GTV or the PET/CT GTV. RESULTS: One patient was PET-negative after induction chemotherapy. The CT GTV was modified in all remaining patients based on (18)F-FDG PET data. The resulting PET/CT GTV was larger than the original CT volume by an average of 15%. In 5 cases, (18)F-FDG PET identified active lymph nodes that corresponded to lymph nodes contoured on CT. The pathologically enlarged CT lymph nodes were modified to create final lymph node volumes in 3 of 5 cases. In 1 of 6 patients, (18)F-FDG-avid lymph nodes were not identified as pathologic on CT. In 2 of 6 patients, registration of the independently acquired PET and CT data using segmentation and surface rendering resulted in a suboptimal alignment and, therefore, had to be repeated. Radiotherapy planning using IMRT demonstrated the capability of this technique to target anatomic or anatomic/physiologic target volumes. In this manner, metabolically active sites can be intensified to greater daily doses. CONCLUSION: Inclusion of (18)F-FDG PET data resulted in modified target volumes in radiotherapy planning for HNC. PET and CT data acquired on separate, dedicated scanners may be coregistered for therapy planning; however, dual-acquisition PET/CT systems may be considered to reduce the need for reregistrations. It is possible to use IMRT to target dose to metabolically active sites based on coregistered PET/CT data.

Adult↗

Prevention of organ allograft rejection by a specific Janus kinase 3 inhibitor.

Because of its requirement for signaling by multiple cytokines, Janus kinase 3 (JAK3) is an excellent target for clinical immunosuppression. We report the development of a specific, orally active inhibitor of JAK3, CP-690,550, that significantly prolonged survival in a murine model of heart transplantation and in cynomolgus monkeys receiving kidney transplants. CP-690,550 treatment was not associated with hypertension, hyperlipidemia, or lymphoproliferative disease. On the basis of these preclinical results, we believe JAK3 blockade by CP-690,550 has potential for therapeutically desirable immunosuppression in human organ transplantation and in other clinical settings.

Animals↗

CP-481,715, a potent and selective CCR1 antagonist with potential therapeutic implications for inflammatory diseases.

The chemokines CCL3 and CCL5, as well as their shared receptor CCR1, are believed to play a role in the pathogenesis of several inflammatory diseases including rheumatoid arthritis, multiple sclerosis, and transplant rejection. In this study we describe the pharmacological properties of a novel small molecular weight CCR1 antagonist, CP-481,715 (quinoxaline-2-carboxylic acid [4(R)-carbamoyl-1(S)-(3-fluorobenzyl)-2(S),7-dihydroxy-7-methyloctyl]amide). Radiolabeled binding studies indicate that CP-481,715 binds to human CCR1 with a Kd of 9.2 nm and displaces 125I-labeled CCL3 from CCR1-transfected cells with an IC50 of 74 nm. CP-481,715 lacks intrinsic agonist activity but fully blocks the ability of CCL3 and CCL5 to stimulate receptor signaling (guanosine 5'-O-(thiotriphosphate) incorporation; IC50 = 210 nm), calcium mobilization (IC50 = 71 nm), monocyte chemotaxis (IC50 = 55 nm), and matrix metalloproteinase 9 release (IC50 = 54 nm). CP-481,715 retains activity in human whole blood, inhibiting CCL3-induced CD11b up-regulation and actin polymerization (IC50 = 165 and 57 nm, respectively) on monocytes. Furthermore, it behaves as a competitive and reversible antagonist. CP-481,715 is >100-fold selective for CCR1 as compared with a panel of G-protein-coupled receptors including related chemokine receptors. Evidence for its potential use in human disease is suggested by its ability to inhibit 90% of the monocyte chemotactic activity present in 11/15 rheumatoid arthritis synovial fluid samples. These data illustrate that CP-481,715 is a potent and selective antagonist for CCR1 with therapeutic potential for rheumatoid arthritis and other inflammatory diseases.

Actins↗

Isozyme-nonselective N-substituted bipiperidylcarboxamide acetyl-CoA carboxylase inhibitors reduce tissue malonyl-CoA concentrations, inhibit fatty acid synthesis, and increase fatty acid oxidation in cultured cells and in experimental animals.

Inhibition of acetyl-CoA carboxylase (ACC), with its resultant inhibition of fatty acid synthesis and stimulation of fatty acid oxidation, has the potential to favorably affect the multitude of cardiovascular risk factors associated with the metabolic syndrome. To achieve maximal effectiveness, an ACC inhibitor should inhibit both the lipogenic tissue isozyme (ACC1) and the oxidative tissue isozyme (ACC2). Herein, we describe the biochemical and acute physiological properties of CP-610431, an isozyme-nonselective ACC inhibitor identified through high throughput inhibition screening, and CP-640186, an analog with improved metabolic stability. CP-610431 inhibited ACC1 and ACC2 with IC50s of approximately 50 nm. Inhibition was reversible, uncompetitive with respect to ATP, and non-competitive with respect to bicarbonate, acetyl-CoA, and citrate, indicating interaction with the enzymatic carboxyl transfer reaction. CP-610431 also inhibited fatty acid synthesis, triglyceride (TG) synthesis, TG secretion, and apolipoprotein B secretion in HepG2 cells (ACC1) with EC50s of 1.6, 1.8, 3.0, and 5.7 microm, without affecting either cholesterol synthesis or apolipoprotein CIII secretion. CP-640186, also inhibited both isozymes with IC50sof approximately 55 nm but was 2-3 times more potent than CP-610431 in inhibiting HepG2 cell fatty acid and TG synthesis. CP-640186 also stimulated fatty acid oxidation in C2C12 cells (ACC2) and in rat epitrochlearis muscle strips with EC50s of 57 nm and 1.3 microm. In rats, CP-640186 lowered hepatic, soleus muscle, quadriceps muscle, and cardiac muscle malonyl-CoA with ED50s of 55, 6, 15, and 8 mg/kg. Consequently, CP-640186 inhibited fatty acid synthesis in rats, CD1 mice, and ob/ob mice with ED50s of 13, 11, and 4 mg/kg, and stimulated rat whole body fatty acid oxidation with an ED50 of approximately 30 mg/kg. Taken together, These observations indicate that isozyme-nonselective ACC inhibition has the potential to favorably affect risk factors associated with the metabolic syndrome.

Acetyl-CoA Carboxylase↗

A highly selective, non-hydantoin, non-carboxylic acid inhibitor of aldose reductase with potent oral activity in diabetic rat models: 6-(5-chloro-3-methylbenzofuran- 2-sulfonyl)-2-H-pyridazin-3-one.

We report here on the discovery path that led to a structurally unprecedented non-hydantoin, non-carboxylic acid aldose reductase inhibitor, 24, which shows remarkably potent oral activity in normalizing elevated sorbitol levels and, more significantly, fructose levels in the sciatic nerve of chronically diabetic rats, with ED(90) values of 0.8 and 3 mpk, respectively. It is well absorbed in rats (oral bioavailability, 98%) and has a long plasma t(1/2) (26 +/- 3 h).

Administration, Oral↗

Electrical stimulation for intraoperative evaluation of thoracic pedicle screw placement.

STUDY DESIGN: Thoracic pedicle screws were stimulated electrically while recording electromyography (EMG) activity in associated muscle groups intraoperatively. Screw position was then evaluated after surgery using computed tomography (CT). The CT results were compared with evoked EMG threshold values. OBJECTIVE: To report our experience with pedicle screw stimulation in thoracic vertebrae in 22 patients who underwent thoracic level spinal instrumentation from May 1999 to March 2001. SUMMARY OF BACKGROUND DATA: Pedicle screw stimulation for intraoperative assessment of screw placement has been reported in lumbosacral spinal procedures. Evoked EMG thresholds >10 or 11 mA are associated with increased probability of vertebral cortex violation and postoperative complications. Thresholds >15 mA provide a 98% confidence of accurate screw positioning on postoperative CT scans. METHODS: Evoked EMG activity was recorded from ulnar carpal flexors, intercostals, or abdominal muscle groups, depending on the level of screw placement. Postoperative CT scans were read by a staff orthopedic spine surgeon, a senior resident in orthopedics, and a musculoskeletal radiologist. RESULTS: Results of 87 screws are reported. Five screws (5.7%) showed penetration on postoperative CT scans. Six screws (6.9%) had stimulation thresholds < or =11 mA, of which three showed cortical breakthrough. Of the 81 screws with thresholds >11 mA, 79 (97.5%) were within the vertebra. No postoperative neurologic complications were noted in any of the 22 patients. CONCLUSION: These results are consistent with previous studies of lumbosacral pedicle screws. In this series, stimulation thresholds >11 mA have a 97.5% negative predictive value, suggesting that cortical violation is highly unlikely. Although judgment of screw placement should not depend solely on stimulation thresholds, pedicle screw stimulation may provide rapid and useful intraoperative information on screw placement during procedures involving the use of thoracic pedicle screws.

Bone Screws↗

Calcium channel blockers: a potential cause of false-positive captopril renography.

PURPOSE: The purpose of the study was to review the causes of false-positive and false-negative captopril Tc-99m MAG3 renograms performed to evaluate renovascular hypertension at the authors' institution. METHODS: From May 2000 to January 2002, 77 patients were referred for evaluation of possible renovascular hypertension with captopril Tc-99m MAG3 renography. If the findings of the captopril study were abnormal, a baseline study was performed 3 days later. The captopril studies were retrospectively reviewed and correlated with available renal arteriography, magnetic resonance angiography, and duplex Doppler sonography studies and clinical follow-up. Renal artery stenosis greater than 70% on an arteriogram and 60% on Doppler studies or magnetic resonance angiography was considered positive for renovascular hypertension. RESULTS: There were five false-negative and four false-positive studies. The five patients who had the false-negative captopril studies underwent arteriography, which showed renal artery stenosis, and a stent was placed in two of them. The four false-positive captopril studies were proved by negative arteriograms in three and negative magnetic resonance angiography in one. Three patients with false-positive studies had bilateral renal function impairment after captopril and were taking calcium channel blockers at the time of the captopril study. One patient had a left nephrectomy and was also taking calcium channel blockers. CONCLUSION: Chronic intake of calcium channels blockers is a potential cause of bilateral symmetric false-positive captopril renography.

Adult↗

Unsuspected skeletal sarcoidosis mimicking metastatic disease on FDG positron emission tomography and bone scintigraphy.

Sarcoidosis is a disease process of unknown cause that exhibits heterogeneous clinical manifestations. Although the mediastinum and lungs are most commonly involved, the granulomatous process may also affect the skeleton, skin, eyes, kidneys, spleen, and liver. A 51-year-old woman with low back pain and no history of cancer was found to have a suspicious lesion at L4 on magnetic resonance imaging. Findings of bone scintigraphy were consistent with multiple metastases, and computed tomography of the chest identified two small indeterminate pulmonary nodules. Similarly, findings of fluorodeoxyglucose positron emission tomography were consistent with widespread skeletal metastases, but a primary tumor was not identified. Biopsy of a left femur lesion was diagnostic of active sarcoidosis with no evidence of cancer.

Bone Diseases↗

Sestamibi scanning and minimally invasive radioguided parathyroidectomy without intraoperative parathyroid hormone measurement.

OBJECTIVE: To evaluate the results of a large series of patients undergoing minimally invasive radioguided parathyroidectomy (MIRP) in which routine use of the intraoperative parathyroid hormone assay was not used, and to investigate characteristics between patients who had positive preoperative parathyroid scans versus those with negative scans. SUMMARY BACKGROUND DATA: The technique of parathyroidectomy has traditionally involved bilateral exploration of the neck under general endotracheal anesthesia. Parathyroid imaging using technetium-99m sestamibi (MIBI) has evolved and can localize the adenomas in 80% to 90% of patients. The MIRP technique combines parathyroid scintigraphy with a hand-held gamma detector used intraoperatively to guide the surgeon to the adenoma in patients with positive MIBI scans. Central to this technique or other unilateral approaches is a positive MIBI scan. METHODS: One hundred seventy-three patients with primary hyperparathyroidism operated on by a single surgeon between January 1998 and July 2002 were included. One hundred twelve patients underwent the MIRP procedure and by definition had a positive preoperative parathyroid scan. The technique involved injecting 20 mCi MIBI 1 hour before the surgical procedure in patients who preoperatively had positive MIBI imaging. Patients had the choice of general or MAC anesthesia. Using an incision of less than 4 cm, the dissection to the adenoma was guided by the Navigator 11-mm probe. These 112 patients and 4 additional patients who for various reasons did not have the MIRP procedure yet had positive MIBI scans were compared to 57 patients who had clearly negative MIBI parathyroid imaging. RESULTS: Follow-up data were available for 108 of 112 patients who underwent MIRP. No patients had persistent hypercalcemia. The long-term success rate for the MIRP group was 98%. Fifty-two percent of the MIRP procedures were performed using MAC anesthesia. Overall, gland weight and serum PTH were related to the probability of a positive MIBI scan. Multiple logistic regression revealed that females were more likely to exhibit positive scans than were males for any fixed serum PTH level. For females, there was a significant relationship between increasing serum parathyroid hormone and a positive MIBI scan. Conversely, in males, the relationship between scan positivity and serum parathyroid hormone was weaker. CONCLUSIONS: The MIRP technique without routine intraoperative serum parathyroid hormone measurement resulted in an excellent cure rate for primary hyperparathyroidism. As the MIRP technique as well as other techniques for unilateral cervical exploration are predicated on a positive parathyroid scan, the possible effect of gender on the sensitivity of MIBI scintigraphy for the detection of parathyroid adenomas warrants further investigation.

Adenoma↗