Denervation induces a rapid nuclear accumulation of MRF4 in mature myofibers

Muscle regulatory factor 4 (MRF4) is a member of the family of myogenic transcription factors, including MyoD, myogenin, and myf-5, that are necessary for the commitment and differentiation of mesoderm to skeletal muscle. Although the function of these transcription factors during embryonic development has been demonstrated, their role in adult muscle has remained elusive. Regulation of the MRF4 gene differs from the genes encoding the other myogenic factors in that its transcripts accumulate in neonatal muscle during maturation and continue to be expressed at relatively high levels in the adult. On the basis of its mRNA expression pattern, MRF4 has been suggested to regulate genes encoding adult contractile proteins and acetylcholine receptor subunits. To test this hypothesis, a specific antiserum was developed to study MRF4 protein expression in adult innervated and denervated muscle, because MRF4 mRNA levels increase by approximately threefold 1 day after nerve resection. By using three different immunohistochemical methods that vary widely in sensitivity, we were unable to detect MRF4 immunoreactivity in adult innervated muscles. The same results were obtained with another MRF4 antiserum generated independently. In contrast, any of these three immunologic techniques readily detected MRF4 immunoreactivity in myofiber and satellite cell nuclei of muscles denervated for 24 hours. The highest proportion of immunopositive nuclei (80%) was found 2-3 days after denervation. Immunoreactivity was no longer detectable by 14 days. There was no differential accumulation of MRF4 protein in the nuclei of satellite cells nor in sole plate (synaptic) nuclei at any time after denervation. No differences were found in the temporal accumulation of MRF4 in nuclei of type I and type II denervated myofibers, consistent with the similar distribution of MRF4 mRNAs in slow- and fast-twitch muscles. Our results are consistent with the lack of phenotype observed in the adult muscles of MRF4-null mutant mice observed by others and suggest that MRF4 may have important roles in the gene programs activated after denervation and during muscle regeneration.

Absence of odd-even parity behavior for Kondo resonances in quantum dots

Zero-bias anomalies in the conductance through quantum dots have recently been identified as Kondo resonances and explained in terms of the Anderson impurity model. The effect requires a degeneracy and it has been proposed that this should occur for odd electron numbers on the dot. In this paper we present data, obtained on a split-gate quantum dot with a small number of electrons, which are in disagreement with this expectation. The mapping of the Anderson model on the quantum dot is discussed in terms of an interacting N electron system demonstrating why this expectation can fail.

The influence of sound stimulation during hatching on the mortality of ducks

In the work the influence of the artificial sound stimulation during incubation on the speed of the Pekin duck breed hatching as well as on their mortality during that period was observed. The set eggs were hatched in four hatcheries. The eggs of the first two hatcheries (control groups Ka and Kb) were not sound stimulated. In the other two groups the set eggs were, from the very first hour of hatching, stimulated by the "knocking" sound from an electronic sound generator (experimental groups "a" and "b"). For the stimulation, the acoustic signal with intensity of 25 dB and frequency 5.68 Hz was applied. The fastest hatching process was recorded in the groups with sound stimulation. The "a" experimental group was the fastest, the ducks were hatched after 640.75+/-10.15 hours, in the "b" experimental group the ducks were hatched after 656.50+/-1.70 hours of incubation. In both sound stimulated experimental groups (a, b) the increased embryonic mortality resulted in the decrease of the percentage of hatchability--to 68.09+/-1.77% and 76.44+/-2.68%, respectively. This is statistically evident (P<0.01) when compared with the respective control groups which reached the 88.81+/-1.86% and 89.35+/-0.81% hatchability.

CNTF and its receptor subunits in human gliomas

Ciliary neurotrophic factor (CNTF) promotes the survival of various neuronal cell populations. It is produced by astrocytes and influences the development and differentiation of glial cells. CNTF and related neuropoietic cytokines affect growth and differentiation of various neoplasms. Moreover, they induce the reactive transformation of astrocytes (gliosis) and influence growth and differentiation of neuroectodermal tumor cell lines in vitro. However, their role in gliomas is largely unknown. We studied the expression of CNTF and its receptor subunits in human astrocytomas and glioblastomas. In more than 95% of the tumors, CNTF transcripts were found by RNAase protection assay; in more than 80% of the cases, tumor cells were CNTF immunoreactive. CNTF receptor alpha (CNTFR alpha), the specific component of the tripartite CNTF receptor system, was detectable by Northern blot analysis in 80% of the cases. In situ hybridization revealed CNTFR alpha mRNA in the cytoplasm of neoplastic cells. Transcripts of the remaining two components of the CNTF receptor system, gp130 and LIFR beta, were found by Northern blotting in 83% and 70% of the tumors, respectively. Simultaneous expression of CNTF and all its receptor components was detected in approximately half of the tumors. These results indicate that CNTF and its receptor components are expressed by human glioma cells. The simultaneous expression of ligands and receptor subunits suggests that CNTF might act on human glioma cells via an auto- or paracrine mechanism.

Pleomorphic xanthoastrocytoma derived from glioneuronal malformation in a child with intractable epilepsy

Malformative lesions as well as neoplasms can cause intractable epilepsy in childhood. Even though the neoplastic nature of a lesion is evident in most cases, the distinction can be difficult in some patients. We present the case of a child with intractable epilepsy caused primarily by a glioneuronal malformation. Years after the first surgical intervention, a pleomorphic xanthoastrocytoma evolved from remnants of this lesion. This case suggests that glioneuronal malformations might be precursor lesions of pleomorphic xanthoastrocytomas.

Tanztherapie in der onkologischen Rehabilitation: Konzepte und empirische Ergebnisse zu Auswirkungen auf die Lebensqualität

Zusammenfassung. Die Tanztherapie kann ein wesentliches Element innerhalb der psychoonkologischen Behandlung und Betreuung von Krebspatienten sein und hat sich in den letzten Jahren zusehends, insbesondere in der Nachsorge und in stationären Rehabilitationsprogrammen, etabliert. Mit hoher Akzeptanz wird diese Form der Kunsttherapie in der Klinik für Tumorbiologie seit vielen Jahren eingesetzt. Aufgabe einer ersten Pilotstudie war es, die Auswirkungen der Tanztherapie auf die Lebensqualität von Krebspatienten zu untersuchen und hierbei methodische Untersuchungsansätze im Bereich qualitativer und quantitativer Methodik im Hinblick auf ihre Adäquatheit für die Fragestellungen zu überprüfen. Das Konzept der Tanztherapie in der Klinik für Tumorbiologie verbindet psychoonkologische Arbeitsansätze mit Prinzipien der Salutogenese und Gesundheitsförderung. Die Ergebnisse der Pilotstudie zeigen, daß sich die Lebensqualität durch das Tanztherapieprogramm signifikant verbessern, wenngleich die Effekte nicht allein auf die Tanztherapie zurückgeführt werden können. Ergänzend zeigten die Ergebnisse der Interviews, daß die Tanztherapie in der Lage ist, Krankheitsverarbeitungsprozesse zu unterstützen. Ebenso können aus den Interviews erste Hinweise auf Wirkparameter der Tanztherapie identifiziert werden. Abschließend werden die Ergebnisse im Zusammenhang mit dem Konzept der Tanztherapie diskutiert und der zukünftige Forschungsbedarf in diesem Bereich skizziert.

[Not Available]

Epidemiological data show that 40-50% of all cancer patients develop some kind of psychosocial disturbancy during the course of their illness and about 30% will require professional support. Even if there exists a considerable body of knowledge and a differentiated health care System, the vast majority of cancer patients have no chance to receive any proper psychosocial care due to the lack of facilities like psychosocial outpatient Services in the communities and specifically trained psychooncologists on oncology wards, whereas the number of psychooncologists in rehabilitation-clinics seems to be sufficient. Psychooncological societies have established training courses and formulated guidelines relating to some important aspects of psychosocial research and practice, in order to promote good quality in the psychosocial care of cancer patients.

Expression of matrix metalloproteinase-2 in glial and neuronal tumor cell lines: inverse correlation with proliferation rate

The expression of matrix metalloproteinases (MMPs) has been found to be positively correlated to the degree of malignancy in gliomas, indicating that poorly differentiated brain tumor cells produce more MMPs than differentiated ones. We determined the production of active MMP-2 in five glial (U138MG, U373MG, A172, C6, GOS-3), two neuronal (SK-N-SH, SK-N-MC), and two pluripotent cell lines with facultative neuronal and glial differentiation (P19 and NT2) by gelatin zymography. The MMP-2 activity profiles were compared to the proliferative activities of the cell lines. MMP-2 expression varied from barely existent (P19 cells) to strong (U138MG and SK-N-SH). Interestingly, for the cell lines with high MMP-2 expression levels, low proliferative activities were recorded, and vice versa. Retinoic acid induced neuronal differentiation and a reduction of proliferation of P19 cells; the differentiated cells produced significantly more MMP-2 than untreated cells. Upon confluency, GOS-3 cells showed reduced proliferation, but increased MMP expression. Thus, proliferative activity was inversely correlated to MMP-2 expression in the tumor cell lines analyzed.

Mitochondrial complex I deficiency in a female with multiplex arthrogryposis congenita

A 10-year-old female with arthrogryposis multiplex congenita is presented. Clinical, neurophysiologic, and histologic findings suggested a mild myopathy. The analysis of enzymatic activity in the homogenate and of mitochondrial function in saponin-permeabilized fibers from the muscle biopsy revealed an approximately twofold-decreased specific activity of the NADH:CoQ oxidoreductase (complex I of the mitochondrial respiratory chain) that was compensated for by an increased number of mitochondria. The complex I deficiency was also detected in cultivated skin fibroblasts of the patient. The observed defect of mitochondrial oxidative phosphorylation in arthrogryposis multiplex congenita may be of pathogenetic relevance.

[Pseudoarthrosis in neurofibromatosis type 1]

Neurofibromatosis type 1 (NF1) is the most common neurocutaneous disease. The clinical manifestations are diverse. Some of the skeletal changes are most relevant to the patient. We report on 9 patients with NF1 who presented with typical pseudarthrosis. In 8 of these children the lower extremity was involved. In 2 cases lesions of both tibia and fibula were found, in one case even over long segments with a fully instable leg. One child had a complete pseudarthrosis of the radius and ulna. This report analyses the bony changes, the operations performed and the possible technical improvements to be made. The present study as well as other recent studies suggest that bony lesions should be operated early using microsurgical methods.

[Headache, painful eyes, fever and weight loss]

A 64-year-old patient with herpetic keratouveitis was hospitalized because of fatigue, fever, headache and confusion. Three days before admittance keratouveitis was diagnosed. He reported a recent onset of aversion against meat consumption and weight loss of 11 kg over the last 4 months. Clinical investigation revealed a slightly confused patient with conjunctivitis and reduced vision of the left eye. Laboratory tests showed anemia, hyponatremia, and increased carcinoembryonic antigen (CEA). In the cerebrospinal fluid examination protein concentration was increased, glucose concentration was decreased. CT-scan of the brain revealed multiple, hyperintense, circular lesions. Biopsy showed lymphoplasmacellular infiltration with increased number of glial and oligodendroglial cells with central necrosis. Despite therapy with tuberculostatic and antiviral drugs and corticosteroids the condition of the patient progressively deteriorated. The patient died 42 days after admission. Autopsy revealed a high grade B-cell non-Hodgkin's lymphoma of the jejunum. Septic shock was the cause of death with the lymphoma of the jejunum as a possible nidus of infection. The multiple brain lesions with central necrosis were probably caused by thromboembolization or by a previous viral meningoencephalitis.

Autosomal dominant burning feet syndrome

Familial burning feet syndrome inherited as an autosomal dominant trait has been described in only one family. Due to an associated sensory neuropathy the autosomal dominant burning feet syndrome was suggested to represent a variant form of hereditary sensory and autonomic neuropathy type I (HSAN I). Clinical, histopathological, and molecular genetic studies were performed in a large German kindred with autosomal dominant burning feet syndrome. The autosomal dominant burning feet syndrome was associated with a neuropathy predominantly affecting small unmyelinated nerve fibres. Linkage to the HSAN I locus on chromosome 9q22 and to the Charcot-Marie-Tooth disease type 2B (CMT 2B) locus on chromosome 3q13-q22 was excluded. The autosomal dominant burning feet syndrome is neither allelic to HSAN I nor to CMT 2B and thus represents a distinct genetic entity.

Timing adjustment in gadolinium MR angiography by raw data recombination. Technical note

To solve the problem of injection timing in gadolinium MR angiography, a simple procedure is proposed which allows the acquisition interval to be chosen after injection. Starting simultaneously with the injection, several consecutive acquisitions are made, after which raw data acquired in a contiguous interval with a variable starting time are recombined to one data set, which is then used for delayed image reconstruction.

Migratory potential of transplantable neural tumor cell lines

Experimentally induced primitive neuroectodermal tumor (PNET) cell lines were transplanted into neonatal and adult rat brain and examined neuropathologically for their tumorigenic potential. Both cell lines showed a striking migratory behavior in both neonatal and adult brain. Migration of tumor cells was found in host brain parenchyma, along white matter tracts and associated with CSF pathways. These neural tumor cell lines provide a valuable tool for the development of strategies against strongly migrating neural tumors.

Chemical shift artifact-free microscopy: spectroscopic microimaging of the human skin

A spectroscopic imaging technique with high spatial resolution was used for the study of human skin in vivo. The measurements were performed using a whole-body magnetic resonance system (1.5 T) with standard gradients and a standard 8-cm diameter circular surface coil. A decisive gain in signal-to-noise ratio was achieved by reducing the receiver bandwidth of the imaging system to values less than +/-5 kHz. The chemical shift misregistration was eliminated by post-detection data processing. The method was tested on different kinds of skin, on the foot sole and head. Water, fat, and chemical shift artifact-free images were obtained with resolution 0.107 x 0.143 mm in plane and slice thickness 1 mm. A major advantage of the spectroscopic imaging procedure is that the pulse sequence can be optimized for the maximum signal-to-noise ratio. There is no need for special modification of the sequence to circumvent the chemical shift artifacts (water, fat suppression, etc.).

Characterization of human head vasculature by percolation parameters

A data reduction procedure, originally proposed for characterization of fractals and random percolation clusters, has been used to evaluate the vascular system of the human head. The motivation behind this study arose from the wish to study empirically transport properties of vascular systems and to find a suitable formalism for their description. MR angiographic data acquired by a standard 3D inflow method were used. The evaluated parameters refer to the backbone fractal dimensionality and the correlation length. The fractal dimensionality of the backbone was found to be 1.71 for the human head vasculature. This value fits the theoretical range of random percolation networks. It is concluded that concepts of percolation theory might have some value for characterizing the structure and transport properties of the vascular system.

Interleukin-6 (IL-6) and its soluble receptor support survival of sensory neurons

The cytokine interleukin-6 (IL-6) has multiple functions in the immune and hematopoietic systems. IL-6 is related to ciliary neurotrophic factor (CNTF), a trophic factor for motoneurons, sensory dorsal root ganglion (DRG) neurons, and other neuronal subpopulations. Both act via related receptor complexes, consisting of one ligand-specific alpha-receptor subunit (IL-6R and CNTFR, respectively) and two signal-transducing receptor components. Even though IL-6 is expressed by neurons and glia, the functions of IL-6 in the nervous system are poorly understood. Here, we report that exogenous human IL-6 promotes the survival of dissociated newborn rat DRG neurons in vitro if supplemented with soluble human IL-6-alpha-receptor. The dosages of human IL-6 and soluble human IL-6R necessary to achieve neurotrophic effects could be reduced markedly by linking ligand and alpha-receptor component in a designer cytokine. Furthermore, we show that newborn rat DRG neurons express and secrete bioactive IL-6. Endogenously secreted IL-6 does not enhance survival of these neurons in vitro, suggesting that DRG neurons do not sufficiently express cell surface IL-6R. Exogenously added soluble rat IL-6R rendered DRG neurons responsive to secreted IL-6. Our results indicate an autocrine function of IL-6 in DRG neuron survival which depends on membrane-bound or soluble IL-6R as a neurotrophic cofactor.

Trophic effects of cardiotrophin-1 and interleukin-11 on rat dorsal root ganglion neurons in vitro

Cardiotrophin-1 (CT-1) was originally isolated for its hypertrophy inducing effects on cardiac myocytes whereas interleukin-11 (IL-11) was identified due to its ability to stimulate an interleukin-6 (IL-6) dependent plasmocytoma cell line. Both cytokines are structurally and functionally related to a group of factors called neuropoietic cytokines, which also includes IL-6, ciliary neurotrophic factor (CNTF), leukemia inhibitory factor (LIF), and oncostatin M. These factors have trophic effects on subsets of neurons. In the present study we examined the influence of CT-1 and IL-11 on newborn rat dorsal root ganglion neuron survival in vitro. Mouse CT-1 showed prominent trophic effects that were comparable to those of CNTF and LIF. Mouse IL-11 alone did not enhance neuronal survival, but soluble mouse IL-11 receptor alpha rendered neurons sensitive to IL-11. Surprisingly, soluble IL-11 receptor alpha even had slight neurotrophic effects by itself. These results suggest that CT-1 and IL-11 might also be involved in the physiological regulation of sensory neuron survival. Thus, they might, like CNTF, become tools for the therapeutic intervention in neurodegeneration due to disease, toxicity, and trauma.

Magnetic resonance spectroscopic imaging for visualization and correction of distortions in MRI: high precision applications in neurosurgery

We present a method for the quantification and correction of geometrical/intensity distortions of magnetic resonance images predominantly caused by bulk magnetic susceptibility shifts due to susceptibility heterogeneities of measured biologic tissues and shape of the object under investigation. The method includes precise and fast measurements of the static magnetic-field distribution inside the measured object and automated data processing. Magnetic-field deviations in the range (-2.4; 2.6) ppm were found in the human brain at B0 = 1.5 T. For routinely used imaging parameters, with a read gradient strength of about approximately 1 mT/m, the magnetic-field perturbations in the human brain can cause geometrical distortions up to +/-4 mm and intensity changes up to +/-50%. MR images corrected by the described method are suitable for planning high precision applications in neurosurgery.

Increased expression of CNTF receptor alpha in denervated human skeletal muscle

The functional receptor for ciliary neurotrophic factor (CNTF) is comprised of a CNTF binding entity termed CNTF receptor alpha (CNTFRalpha), and 2 signaling molecules called LIF receptor beta and gp130. CNTFRalpha can be released from the cell surface; the soluble form can confer CNTF responsiveness to cells. CNTFRalpha has recently been localized to several nonneuronal cell types including rat skeletal muscle fibers. In this study we examined the expression pattern of CNTFRalpha in normal, denervated and dystrophic human muscle. In muscle biopsies from 12 normal subjects, 16 cases of neurogenic muscular atrophy, 4 cases of Duchenne muscular dystrophy, and 4 cases of limb girdle dystrophy, CNTFRalpha mRNA levels were determined by Northern blotting. Transcript levels were significantly increased in cases of neurogenic atrophy compared to normal controls and dystrophic muscle. By nonradioactive in situ hybridization, CNTFRalpha transcripts were detected in the sarcoplasm of both normal sized and atrophic muscle fibers. In addition, soluble CNTFRalpha was elevated 4.4-fold in the urine of ALS patients compared to normal adults. These results suggest that the expression of CNTFRalpha in human skeletal muscle fibers is regulated by innervation. This regulation appears to be selective, because CNTFRalpha mRNA was not increased in dystrophic human muscle. Increased CNTFRalpha could confer higher sensitivity to CNTF during neurodegeneration or nerve fiber regeneration.

[Psychological problems and treatment possibilities in intensive care medicine exemplified by bone marrow transplantation]

Bone Marrow resp. Peripheral Blood Stem Cell Transplantation (BMT/PBSCT) represents the only chance of cure for many patients with haematological diseases. Treatment and convalescence place significant stress not only on patients but on partners, siblings (who are frequently donors) and medical staff. Stressors are the high risk of mortality and chronic disabilities, acute treatment side-effects and multiple psychological and social demands. This requires support during longt-term psychosocial sequelae. We present problems and possible interventions in an acute and a rehabilitative medical setting, discussing recent findings in respect of donors' motivations, social support and quality of life. Psychosocial support in BMT should be given in a process perspective systematically combining and assessing in- and outpatient interventions.

Chemical shift artifact-free imaging: a new option in MRI?

A high-speed proton spectroscopic imaging method with high spatial resolution was used for obtaining water, fat, and chemical shift artifact-free images on a 1.5 T MR scanner. The technique is based on a fast radiofrequency (RF) spoiled gradient-echo sequence. The chemical shift information is encoded by incrementing the echo time in a series of image records. Suppression of water or fat signals is not used. The technique does not require a highly homogeneous magnetic field. Spectroscopic images of a human volunteer were compared with corresponding conventional images obtained using the short inversion time inversion recovery (STIR) and the selective partial inversion recovery (SPIR) methods. The results demonstrate that it is possible to produce images entirely free from chemical shift artifacts using only a few chemical shift encoding steps. The technique also produces pure water and fat images which are significantly better than those produced by using the conventional methods STIR and selective partial inversion recovery. The described method appears to be promising for routine clinical applications because it can be fully automated.

[Need for psycho-oncologic management in Germany--a comparison of present status and future needs]

A comparison of acute care, inpatient rehabilitation and outpatient aftercare in Germany reveals significant differences in the quality and spreading of psychosocial services for cancer patients. Planning psychosocial care for cancer patients, we have to consider patients' need for psychosocial care as well as the health professionals' estimation of patients' needs and the demand for health care services. Analyses of patients' requirements have shown that the needs which patients defined themselves differ from the needs estimated by experts. Therefore, decisions made in health care must be based on systematic data acquired by various approaches. Within the frame of evaluation performed in the research program "Rehabilitation of Cancer Patients" funded by the German Ministry of Research (the former BMFT), data from two studies are presented investigating the need for psychosocial care in oncology using two different approaches. In one study we investigated the status quo of psychosocial care for cancer patients in acute hospitals (n = 585) and rehabilitation centers (n = 42). By use of the Delphi technique, the second study focuses on an analysis of patients' need estimated by health professionals (n = 34). Comparing both studies, deficits in psychosocial care for cancer patients were found especially in acute hospitals and outpatient aftercare services. Methodological problems of the two approaches are discussed and further research strategies are suggested.

GDNF expression is increased in denervated human skeletal muscle

Glial cell line derived neurotrophic factor (GDNF) is a potent trophic factor for several subpopulations of neurons including motor neurons. Two different transcripts of the GDNF gene (GDNF633 and GDNF555) have been detected in various tissues, including skeletal muscle. Denervation leads to an upregulation of GDNF633 in rat skeletal muscle, indicating that GDNF is involved in the response of skeletal muscle to denervation and possibly in reinnervation. To determine the role of GDNF in human neuromuscular disease, we investigated the expression of both transcripts in normal and denervated muscle and in muscle biopsies from Duchenne muscular dystrophy patients. GDNF expression levels were analyzed by competitive RT-PCR in 38 muscle specimens. Levels of both transcripts were significantly elevated in denervated muscle compared to normal and dystrophic muscle. Morphometric analysis of muscle-fiber calibers and its correlation to GDNF expression revealed that higher levels of GDNF were expressed in rapidly-progressive neurogenic atrophy, including four amyotrophic lateral sclerosis (ALS) cases, compared to cases of chronic atrophy. In dystrophic muscle, transcript levels were not significantly altered compared to normal controls. These data indicate that denervation, but not dystrophy, enhances GDNF expression in human skeletal muscle. Thus, the increase of GDNF expression is part of the reaction of human skeletal muscle to denervation caused by motor nerve lesion. GDNF might act on regenerating nerve fibers during muscle fiber reinnervation.

Endovascular coil embolization of microsurgically produced experimental bifurcation aneurysms in rabbits

BACKGROUND

Endovascular treatment of cerebral aneurysms is a relatively new method, since only a few animal models and data are available. The present experimental study was performed in order to establish an appropriate aneurysm animal model, to determine the rate of permanent occlusion, and to correlate radiologic and morphologic findings.

METHODS

End-to-side anastomoses of both common carotid arteries were performed microsurgically in 53 chinchilla rabbits. Venous pouches were adapted into the newly created bifurcation, resulting in berry-shaped aneurysms comparable to those in humans with regard to size and hemodynamics. Platinum and tungsten coils were used for endovascular embolization. The embolized aneurysms were investigated radiologically and morphologically.

RESULTS

Twenty-three carotid bifurcation aneurysms remained for testing endovascular therapeutic approaches. The morphologic examinations of 13 embolized aneurysms revealed in no instance a complete obliteration, even in the three cases that were considered completely embolized according to angiographic criteria.

CONCLUSIONS

The present animal model is an optimal tool for endovascular research. Analysis of the results of coil obliteration revealed a considerable discrepancy between radiologic and pathologic findings. The radiologic degree of aneurysm occlusion was overestimated.

Distribution of B-50(GAP-43) mRNA and protein in the normal adult human spinal cord

B-50(GAP-43) is a phosphoprotein mainly found in the nervous system which plays a major role in neurite growth during development and regeneration as well as in synaptic remodelling. In the mature intact central nervous system, intense B-50 immunoreactivity (B-50-IR) can still be detected in regions which maintain residual capacity for structural re-organization. B-50 expression has been studied extensively in laboratory animals; however, its distribution and regulation in the human spinal cord is largely unknown. As a first step to analyze lesion-induced structural alterations, we investigated the distribution of B-50 protein and mRNA in the normal adult human spinal cord and dorsal root ganglia. Intense B-50-IR was localized to the superficial laminae of the dorsal horn at all segmental levels, the intermediolateral nucleus at thoracic levels and Onuf's nucleus at sacral levels. Scattered neurons, particularly in the ventral horn of lumbar and sacral segmental levels (and occasionally also in Clarke's nucleus) displayed intense B-50-IR in close apposition to the perikaryal and proximal dendritic surfaces. Nonradioactive in situ hybridization indicated that B-50 mRNA could also be detected in neurons of the ventral horn and also in the intermediolateral nucleus. The distribution of B-50 mRNA and protein in the normal human spinal cord shows a marked similarity to that reported in experimental animals, including the selective labelling of Onuf's nucleus. However, the strong B-50-IR on the surface of some large anterior horn motor neurons has not been observed in other mammals. This finding might reflect a particular state of readiness for synaptic plasticity.

Phrenic nerves and diaphragms in sudden infant death syndrome

Disturbances of the respiratory system may be an important factor in the cascade of events leading to sudden infant death syndrome (SIDS). Even though the diaphragm is the major respiratory muscle in infants, little is known about alterations of this muscle and of the phrenic nerve in SIDS. In the present study, diaphragms and phrenic nerves of 24 SIDS infants and seven controls were analyzed. Morphometric analysis revealed only slightly larger cross sectional areas of phrenic nerve axons but no increase in myelin sheath thickness in SIDS cases. However, in one SIDS case, myelinated nerve fibre density was severely reduced. Using electron microscopy, several nerve fibres of SIDS infants showed focal accumulations of neurofilaments. Muscle fibre diameters in SIDS diaphragms were significantly larger compared to controls (P < 0.0001). However, in almost all SIDS and control cases, axons and myelin sheaths were artificially swollen, and acute segmental muscle fibre ruptures and contracture bands were found. These prominent nonspecific ultrastructural alterations should advise caution in the interpretation of morphometric data. Thus, in some cases exemplified by one case of the present series, decreased density of phrenic nerve myelinated axons might contribute to SIDS. Still, the present results indicate that development of phrenic nerves and diaphragms is not delayed in most SIDS infants.

A case of primary progressive aphasia. A 14-year follow-up study with neuropathological findings

Primary progressive aphasia has been clinically defined as a progressive language deficit leading to the dissolution of almost all language functions with relative preservation of other cognitive functions until late in the course of the disease. Two types of language impairment have been described for primary progressive aphasia, which differ with respect to the degree of fluency of spontaneous speech. Whereas some authors have emphasized non-fluency as a defining characteristic of primary progressive aphasia, others have proposed that phonemic rather than semantic paraphasias in naming, both in the fluent and the non-fluent subtype, should be used as a criterion to distinguish primary progressive aphasia from slowly progressive aphasia in other forms of degenerative brain disease. Patients with fluent speech and semantic dementia, as typically seen in Alzheimer's disease, produce semantic paraphasias and circumlocutions rather than phonemic errors in naming. This paper reports the long-term follow-up of a patient with fluent aphasic speech, whose language profile over a decade was similar to that of patients with semantic dementia. Neuropathological examination revealed no evidence of Alzheimer's disease. Pick's disease or Pick variant, but showed spongiform changes of cortical layers (II and III) in temporal and, less severely, in frontal gyri. The present case indicates that semantic dementia is not a reliable indicator of probable Alzheimer's disease and supports the notion that there are different subtypes of primary progressive aphasia which cannot be defined by fluency or by the presence of phonemic paraphasia. Progress in identifying the neuropathological correlates of these subtypes in cases with lobar atrophy and spongiform changes should be expected from hereditary variants of progressive disorder.

29Si chemical shift tensors of silyl silicate cages

Static and 29Si CP MAS spectra (spinning rates of 2000 and 500 Hz) of six silyl silicate cages are analyzed by deconvolution and simulation. The principal values of the various 29Si chemical shift tensors provide information about the point symmetry of the Si sites. The intensities of the signals correspond sufficiently well with the stoichiometries.

Endovascular occlusion of experimental aneurysms with detachable coils: influence of packing density and perioperative anticoagulation

OBJECTIVE

This study was designed to assess the intraluminal biological changes after endovascular coil occlusion of arterial aneurysms with detachable coils, to analyze the relationship between histological occlusion and mechanical packing density, and to evaluate the influence of perioperative anticoagulation on the occlusion rate.

METHODS

In rabbits, 30 microsurgically produced arterial bifurcation aneurysms were occluded with coils (18 with platinum coils, electrically detached; 12 with tungsten coils, mechanically detached). Coils were placed until no further coils fit into the aneurysmal lumen and it was no longer filled with radiographic contrast material. The individual degree of occlusion was then determined by the "packing density" on the angiograms. Complete occlusion was considered only if no neck remnant was visible on the films. Anticoagulation during and 2 days after the treatment was performed in 11 cases. After an observation period ranging from 3 to 6 months, angiographic and histological analyses were performed to obtain control data.

RESULTS

Complete occlusion was achieved in 9 cases, subtotal occlusion (i.e., > 95% occlusion, residual filling at the neck of the aneurysm) in 10 cases, and partial occlusion in 11 cases. Angiographically documented recanalization was detected in 14 aneurysms. In the remaining 16 aneurysms, the initially documented angiographic results were unchanged. A discrepancy between angiographic and pathological findings was frequently observed. Five of nine angiographically completely occluded aneurysms were recanalized. Endothelial-like tissue at the orifice of the aneurysm was able to be observed in only four of the nine initially completely occluded aneurysms.

CONCLUSION

The results suggest that even dense packing does not always guarantee permanent occlusion, although there was a positive relationship between packing density and occlusion rate. Anticoagulation did not have any negative effect on the results.

1H-spectroscopic imaging with read gradient during acquisition in inhomogeneous fields: analysis, measurement strategy, and data processing

The proton magnetic resonance spectroscopic imaging techniques that use read gradient during acquisition produce proton spectra with high spatial and moderately high spectroscopic resolution in a reasonable time for in vivo applications. These techniques suffer mainly from the spatial and spectral distortions caused by the convolution of spectral/spatial information (chemical-shift artifacts) and from the spectral shifts caused by static magnetic field inhomogeneities. The investigators analyze the chemical-shift artifacts in the presence of nonnegligible static magnetic field inhomogeneities and propose a postdetection processing scheme to correct for such effects. Spectral artifacts caused by chemical shifts, spectral line overlapping, streak broadening, and magnetic field inhomogeneities are discussed. The postdetection data processing scheme is demonstrated on measurements of a phantom as well as a human leg.

Enhanced apoptotic cell death of renal epithelial cells in mice lacking transcription factor AP-2beta

Expression of AP-2 transcription factors has been detected previously in embryonic renal tissues. We show here that AP-2beta -/- mice complete embryonic development and die at postnatal days 1 and 2 because of polycystic kidney disease. Analyses of kidney development revealed that induction of epithelial conversion, mesenchyme condensation, and further glomerular and tubular differentiation occur normally in AP-2beta-deficient mice. At the end of embryonic development expression of bcl-X(L), bcl-w, and bcl-2 is down-regulated in parallel to massive apoptotic death of collecting duct and distal tubular epithelia. Addressing the molecular mechanism we show that transfection of AP-2 into cell lines in vitro strongly suppresses c-myc-induced apoptosis pointing to a function of AP-2 in programming cell survival during embryogenesis. The position of the human AP-2beta gene was identified at chromosome 6p12-p21.1, within a region that has been mapped for autosomal recessive polycystic kidney disease (ARPKD). Sequence analyses of ARPKD patients and linkage analyses using intragenic polymorphic markers indicate that the AP-2beta gene is located in close proximity to but distinct from the ARPKD gene.

Isolated cerebral aspergilloma--long-term survival of a renal transplant recipient

A renal transplant recipient with isolated cerebral aspergilloma 4 months after allograft transplantation is reported. On admission cerebral computed tomography showed a ring-enhancing mass in the left frontal hemisphere and aspirated purulent material revealed A. fumigatus hyphae. He was cured by short-term antifungal therapy and neurosurgical removal of the well demarcated lesion. He is still alive more than two years later and the renal transplant is well functioning. This is the first report of a renal transplant recipient with isolated cerebral aspergillosis without any relapse and only the third patient who has survived longer than 3 months. Early diagnostic procedures with rapid confirmation of aspergillus infection are pivotal for a benign clinical course.

A cystic lesion within the dural sinuses: a rare cause of increased intracranial pressure

We present a rare cause of intracranial hypertension in a 19-year-old woman. The torcular was obstructed by a cystic developmental lesion, thought preoperatively to be an epidermoid. The patient also had a second lesion of possibly developmental origin, a cerebral cavernous haemangioma.

Ventricular dilatation in experimental intraventricular hemorrhage in pigs. Characterization of cerebrospinal fluid dynamics and the effects of fibrinolytic treatment

BACKGROUND AND PURPOSE

Hemorrhagic ventricular dilatation (HVD) is a prominent feature of human intraventricular hemorrhage (IVH) and a strong indicator for poor outcome. We developed an IVH model to define the mechanisms responsible for HVD and to test the efficacy of intraventricular administration of tissue plasminogen activator (TPA) in the treatment of HVD.

METHODS

Isolated IVH was produced in pigs by injecting 10 mL of blood simultaneously with thrombin into the right lateral ventricle. The treatment group received 1.5 mg of TPA after induction of IVH. Intraventricular blood volume and the volume of the lateral ventricles were assessed by CT after 90 minutes, 7 days, and 42 days. Intracranial pressure, the pressure-volume index, and the resistance to outflow of cerebrospinal fluid (R(out)) were measured 30 minutes and 7 days after IVH.

RESULTS

After IVH, the volume of the lateral ventricles increased from 1.98 +/- 0.69 to 6.43 +/- 1.23 mL (P < .001). There was a linear relationship between ventricular and clot volume (P = .014). Initially, R(out) increased from 24.34 +/- 7.13 to 63.56 +/- 64.91 mm Hg/mL per minute (P < .001). After 7 days, restoration of normal cerebrospinal fluid circulation occurred, but the ventricles were still significantly enlarged (5.24 +/- 1.76 mL, P < .001) and filled with blood. Within 6 weeks, ventricular volume had returned to normal values, paralleled by complete clot resolution. Intraventricular administration of TPA significantly accelerated clot clearance and restoration of normal ventricle volume.

CONCLUSIONS

These results suggest that intraventricular bleeding may cause impairment of cerebrospinal fluid circulation but that the mass effect of clots distending the ventricle walls is the most important mechanism responsible for HVD. This model closely imitates several prominent features of human IVH and may therefore be a useful tool for preclinical assessment of the efficacy and safety of treatment with TPA.

Fasting improves discrimination of grade 1 and atypical or malignant meningioma in FDG-PET

We investigated the use of PET with 2[18F]fluoro-2-deoxy-D-glucose (FDG) to discriminate between atypical or malignant and grade 1 meningiomas. The influence of fasting state and high-dose corticosteroid medication was analyzed retrospectively.

METHODS

Preoperative PET scans of 75 patients with suspected diagnosis of intracranial meningioma were evaluated using standardized uptake values (SUV) and tumor-to-contralateral gray matter ratios (TGR) of FDG uptake. Fifty-one of 75 patients fasted before the PET scan, and 27 of 75 patients were studied under high-dose corticosteroid medication. Eighteen tumors had recurred. PET results were compared to histopathological grading.

RESULTS

PET correctly identified 8/9 atypical or malignant meningiomas and 58/66 grade 1 meningiomas using TGR and a threshold of 1.05 in primary meningioma and 0.85 in tumor recurrence. This corresponds to a specificity of 0.88 for the detection of higher tumor grading. Specificity was significantly higher in fasting compared to nonfasting subjects (0.96 versus 0.73; p < 0.025). SUV quantification lead to a reduced specificity of 0.77 at the same level of sensitivity. The only false-negative PET finding occurred in a recurrent meningioma, which had been operated on four times before.

CONCLUSION

Overnight fasting before injection is needed to improve the diagnostic accuracy of FDG-PET for noninvasive metabolic grading of meningioma. Hyperglycemia in nonfasting patients and in diabetic patients may lead to overestimation of meningioma grading.

Cytogenetic analysis of gliomas by in situ hybridization of stereotactic biopsy material

Chromosome analysis of brain tumours can provide important pathobiological data; however, cytogenetic tools are so far not routinely applied for diagnosis. In the present study 25 paraffin embedded stereotactic biopsies from 19 glioma patients were studied using in situ hybridization of chromosome #10 and #15 using biotinylated pericentromeric probes. Numerical changes of chromosome #10 are frequent alterations in glioblastoma. Quantification of chromosome #15 served as a control in order to exclude artificial monosomies or nonspecific changes. The number of chromosomes in at least 200 cells were counted for each specimen. 18 of 25 biopsies could be evaluated quantitatively. The small volume of probes was not a limiting factor for analysis. Quantification of "nonspecific" chromosome #15 revealed single spots in 22-41% of all cells in the 18 biopsies. Chromosome #10 showed single spots in a range between 34 and 44% of counted nuclei in 13/18 biopsies. In 5 out of 18 biopsies 51-60% monosomies were found: in this subgroup were 4 high grade gliomas. These cases were interpreted as monosomy of chromosome #10. The results demonstrate feasibility and quantitative evaluability of cytogenetic analysis in stereotactic biopsy material using in situ hybridization.

Long-term angiographic and histopathologic findings in experimental aneurysms of the carotid bifurcation embolized with platinum and tungsten coils

PURPOSE

To evaluate the long-term outcome of endovascular occlusion of arterial aneurysms effected with metal coils.

METHODS

Microsurgical methods were used to produce carotid bifurcation aneurysms in 20 rabbits and the radiologic and histologic changes were examined. Eight of these aneurysms were occluded with electrically detachable platinum coils (Guglielmi detachable coils [GDCs] and nine were treated with mechanically detachable tungsten coils (mechanical detachable system [MDS]). Three aneurysms remained untreated and served as controls. One animal died of embolic complications 12 hours after endovascular treatment. After observation periods of 3 to 6 months, the remaining animals were examined by intraarterial digital subtraction angiography and subsequent fixation and light and electron microscopy.

RESULTS

Large open spaces without signs of thrombosis were found between the loops of the coil baskets in 12 aneurysms (six treated with GDCs and six treated with MDS) regardless of the observation period. In very densely packed aneurysms (four cases with complete occlusion as determined by angiographic criteria), the coil surfaces were for the most part covered by thin cell layers; however, complete endothelialization was never seen. In aneurysms with an initial partial occlusion of 70% to 90%, coil compaction and/or recanalization was a consistent finding. A comparison of the radiologic findings with the histologic aspect revealed that the degree of occlusion was often overrated on the radiographs (in eight of 17 cases). In general, the fibrous tissue reaction appeared to be slightly more pronounced in aneurysms occluded with tungsten coils.

CONCLUSIONS

Platinum and tungsten coils were not always effective in causing endoluminal thrombosis leading to long-term occlusion by organized thrombus.

Duplication of a vertebral artery associated with epidermoid cyst of the posterior fossa

A case of a duplication of the left vertebral artery associated with a premedullary epidermoid cyst at the level of the foramen magnum is described. The close proximity of the two malformative lesions in the present case and the overlap of the periods when such developmental abnormalities can arise suggest that they might be causally linked.

[Sensory Jacksonian seizures as initial manifestation of sarcoidosis]

A 46-year old patient is reported presenting with somatosensory focal seizures of either arm as the only manifestation of an otherwise clinically inapparent sarcoidosis. MRI showed signs of a granulomatous leptomeningeal affection. Histological examination of a meningeal biopsy proved the diagnosis of sarcoidosis by demonstrating noncaseating granulomas. There was no other clinical manifestation of sarcoidosis. Chest X-ray was normal and the serum level of angiotensin-converting-enzyme was only slightly elevated. The CD4/CD8 ratio in the bronchoalveolar lavage cell population, however, was clearly abnormal, supporting the role of this diagnostic tool in the diagnosis of sarcoidosis.