Detection of SARS-CoV-2 IgG antibodies and inflammatory cytokines in saliva-a pilot study

Objective

The pandemic caused by SARS-CoV-2 virus continues to have a profound effect worldwide. However, COVID-19 induced oral facial manifestations have not been fully described. We conducted a prospective study to demonstrate feasibility of anti-SARS-CoV-2 IgG and inflammatory cytokine detection in saliva. Our primary objective was to determine whether COVID-19 PCR positive patients with xerostomia or loss of taste had altered serum or saliva cytokine levels compared to COVID-19 PCR positive patients without those oral symptoms. Our secondary objective was to determine the correlation between serum and saliva COVID-19 antibody levels.

Materials and methods

For cytokine analysis, saliva and serum were obtained from 17 participants with PCR-confirmed COVID-19 infection at three sequential time points, yielding 48 saliva samples and 19 paired saliva-serum samples from 14 of the 17 patients. For COVID-19 antibody analyses, an additional 27 paired saliva-serum samples from 22 patients were purchased.

Results

The saliva antibody assay had 88.64% sensitivity [95% Confidence Interval (CI) 75.44%, 96.21%] to detect SARS-CoV-2 IgG antibodies compared to serum antibody. Among the inflammatory cytokines assessed - IL-6, TNF-α, IFN-γ, IL-10, IL-12p70, IL-1β, IL-8, IL-13, IL-2, IL-5, IL-7 and IL-17A, xerostomia correlated with lower levels of saliva IL-2 and TNF-α, and elevated levels of serum IL-12p70 and IL-10 (p < 0.05). Loss of taste was observed in patients with elevated serum IL-8 (p < 0.05).

Conclusions

Further studies are needed to construct a robust saliva-based COVID-19 assay to assess antibody and inflammatory cytokine response, which has potential utility as a non-invasive monitoring modality during COVID-19 convalescence.

The Role of Oral Health in the Acquisition and Severity of SARS-CoV-2: A Retrospective Chart Review

Objective

Studies have shown that gingival crevices may be a significant route for SARS-CoV-2 entry. However, the role of oral health in the acquisition and severity of COVID-19 is not known.

Design

A retrospective analysis was performed using electronic health record data from a large urban academic medical center between 12/1/2019 and 8/24/2020. A total of 387 COVID-19 positive cases were identified and matched 1:1 by age, sex, and race to 387 controls without COVID-19 diagnoses. Demographics, number of missing teeth and alveolar crestal height were determined from radiographs and medical/dental charts. In a subgroup of 107 cases and controls, we also examined the rate of change in alveolar crestal height. A conditional logistic regression model was utilized to assess association between alveolar crestal height and missing teeth with COVID-19 status and with hospitalization status among COVID-19 cases.

Results

Increased alveolar bone loss, OR = 4.302 (2.510 - 7.376), fewer missing teeth, OR = 0.897 (0.835-0.965) and lack of smoking history distinguished COVID-19 cases from controls. After adjusting for time between examinations, cases with COVID-19 had greater alveolar bone loss compared to controls (0.641 ± 0.613 mm vs 0.260 ± 0.631 mm, p < 0.01.) Among cases with COVID-19, increased number of missing teeth OR = 2.1871 (1.146- 4.174) was significantly associated with hospitalization.

Conclusions

Alveolar bone loss and missing teeth are positively associated with the acquisition and severity of COVID-19 disease, respectively.

Estrogen receptor alpha mediates mandibular condylar cartilage growth in male mice

OBJECTIVES

In the appendicular skeleton, estrogen via ERα signalling has been shown to mediate endochondral growth plate fusion in both males and females. However, the role of ERα in mediating growth of the mandibular condylar cartilage is unknown. Thus, this study focuses on the characterization of the mandibular condylar cartilage phenotype in young and adult male ERαKO mice.

SETTING

Columbia University Medical Center.

MATERIAL AND METHODS

WT and ERαKO C57BL/6 male mice were sacrificed at 49 days or 9 months for phenotypic analysis. Changes to MCC thickness, cell number and cell density were measured using histomorphometric methods. Cartilage-specific gene expression and OARSI scores were investigated for 49-day and 9-month-old male ERαKO and WT mice.

RESULTS

In young mice, a significant increase in the number of mandibular condylar cartilage cells and a significant decrease in the expression of Col10, Runx2 and DMP1 were observed in the male ERαKO mice compared to WT. In 9-month-old mice, we found a similar increase in the number of cells but no change in osteoarthritic histological scoring in ERαKO mice compared to WT mice.

CONCLUSION

In summary, estrogen plays a role in mediating mandibular condylar maturation in young male mice. However, according to this study, it does not play a role in mediating long-term growth or age-related mandibular condylar cartilage degeneration in males.

Estrogen via estrogen receptor beta partially inhibits mandibular condylar cartilage growth

OBJECTIVE

Temporomandibular joint (TMJ) diseases predominantly afflict women, suggesting a role for female hormones in the disease process. However, little is known about the role of estrogen receptor (ER) signaling in regulating mandibular condylar cartilage growth. Therefore, the goal of this study was to examine the effects of altered estrogen levels on the mandibular condylar cartilage in wild type (WT) and ER beta Knockout (KO) mice.

MATERIALS AND METHODS

21-day-old female WT (n = 37) and ER beta KO mice (n = 36) were either sham operated or ovariectomized, and treated with either placebo or estradiol. The mandibular condylar cartilage was evaluated by histomorphometry, proliferation was analyzed by double ethynyl-2'-deoxyuridine/bromodeoxyuridine (EdU/BrdU) labeling, and assays on gene and protein expression of chondrocyte maturation markers were performed.

RESULTS

In WT mice, ovariectomy caused a significant increase in mandibular condylar cartilage cell numbers, a significant increase in Sox9 expression and a significant increase in proliferation compared with sham operated WT mice. In contrast, ovariectomy did not cause any of these effects in the ER beta KO mice. Estrogen replacement treatment in ovariectomized WT mice caused a significant decrease in ER alpha expression and a significant increase in Sost expression compared with ovariectomized mice treated with placebo. Estrogen replacement treatment in ovariectomized ER beta KO mice caused a significant increase in Col2 expression, no change in ER alpha expression, and a significant increase in Sost expression.

CONCLUSION

Estrogen via ER beta inhibits proliferation and ER alpha expression while estrogen independent of ER beta induces Col2 and Sost expression.

Evaluation of BSP expression and apoptosis in the periodontal ligament during orthodontic relapse: a preliminary study

OBJECTIVE

To examine the expression of bone sialoprotein (BSP) and apoptosis in an in vivo orthodontic relapse model.

MATERIALS AND METHODS

Male mice (10-12 weeks old), either transgenic [green fluorescent protein (GFP) driven by the BSP promoter] or wild type, were used in this study. To achieve orthodontic tooth movement (OTM), maxillary right first molars were moved mesially using closed-coil springs. Animals were divided into an OTM group (14 days continuous orthodontic force - 11 animals) or Relapse group (10 days of force application followed by 4 days of relapse - 8 animals). The control group was comprised of the contralateral maxillary molars. The periodontal ligament (PDL) was analyzed in areas of compression and tension for transgenic expression, osteoclast localization, and the presence of apoptotic cells.

RESULTS

There was a significant decrease in GFP-labeled cells on the compression and tension sides of the PDL in the OTM group compared with control. In the relapse group, GFP-labeled cells were significantly decreased only on the old compression side. Osteoclasts were localized on the compression side of the OTM group, whereas in the Relapse group, they were present on both sides. PDL apoptosis significantly increased on the compression side in OTM and Relapse groups.

CONCLUSION

Both OTM and Relapse groups exhibited a decreased number of GFP-labeled cells in areas of compression and tension. There was significant PDL apoptosis in regions under compressive forces following OTM and to a lesser extent following relapse.

Orthodontic tooth movement causes decreased promoter expression of collagen type 1, bone sialoprotein and alpha-smooth muscle actin in the periodontal ligament

OBJECTIVE

To evaluate the effects of orthodontic tooth movement on the promoter expression of collagen type 1 (3.6Col1), bone sialoprotein (BSP) and alpha-smooth muscle actin (αSMA) in the periodontal ligament (PDL) using transgenic mice containing transgenes of these promoters fused to green fluorescent proteins (GFP).

MATERIALS AND METHODS

The maxillary first molars of 10-12 week-old transgenic mice were loaded with 10-12 g of force for 12, 48 h, or 7 days. Mice were transgenic for one of the following GFP-tagged bone markers of osteoblast lineage cells: 3.6-kb fragment of the rat collagen type 1 promoter (3.6Col1), BSP or α-smooth muscle actin (αSMA). Loaded molars under compression and tension were compared with contra-lateral unloaded controls.

RESULTS

On the compression side of the PDL, orthodontic tooth movement caused a significant decrease in GFP expression of all the promoters at each time point. On the tension side, there was a significant increase in BSP-GFP expression, 12 h following loading compared to the contralateral unloaded controls.

CONCLUSIONS

An in vivo tooth movement model using transgenic mice with promoter-GFP constructs provides an efficient and effective way of investigating the cellular events underlying orthodontic tooth movement. PDL cells may undergo decreased differentiation in response to the compressive force.

Sex differences in chondrocyte maturation in the mandibular condyle from a decreased occlusal loading model

Temporomandibular joint disorders (TMDs) predominantly afflict women of childbearing age. Defects in mechanical loading-induced temporomandibular joint (TMJ) remodeling are believed to be a major etiological factor in the development of TMD. The goal of this study was to determine if there are sex differences in CD-1 and C57BL/6 mice exposed to a decreased occlusal loading TMJ remodeling model. Male and female CD-1 and C57BL/6 mice, 21 days old, were each divided into two groups. They were fed either a normal pellet diet (normal loading) or a soft diet and had their incisors trimmed out of occlusion (decreased occlusal loading) for 4 weeks. The mandibular condylar cartilage was evaluated by histology, and the subchondral bone was evaluated by micro-CT analysis. Gene expression from both was evaluated by real-time PCR analysis. In both strains and sexes of mice, decreased occlusal loading caused similar effects in the subchondral bone, decreases in bone volume and total volume compared with their normal loading controls. However, in both strains, decreased occlusal loading caused a significant decrease in the expression of collagen type II (Col2) and Sox9 only in female mice, but not in male mice, compared with their normal loading controls. Decreased occlusal loading causes decreased bone volume in both sexes and a decrease in early chondrocyte maturation exclusively in female mice.

Comparative in vitro cytotoxicity study of carbon nanotubes and titania nanostructures on human lung epithelial cells

The aim of this study is to assess in vitro cytotoxic effects of titania nanostructures and carbon nanotubes (CNTs) by exposing A549 lung epithelial cell line to these materials. Titania nanotubes (TiNTs) were grown by hydrothermal treatment of TiO(2) nanoparticles, followed by annealing them at 400°C. The titania nanostructures obtained on annealing (mixture of nanotubes and nanorods) were hollow and open ended, containing 3-5 layers of titania sheets, with an internal diameter ∼3-5 nm and external diameter ∼8-10 nm, and a specific surface area of 265 m(2)/g. As-supplied single walled (SWCNTs) and microwave plasma enhanced chemical vapour deposition (MPCVD) grown multi walled carbon nanotubes (MWCNTs) were used in this study. The lengths and diameters of the SWCNTs were 5-10nm and 0.5-3 nm respectively. The lengths and diameters of the MWCNTs were 25-30 μm and 10-30 nm respectively. The cell viability was evaluated using the MTT (3-(4,-dimethylthiazol-2-yl)-2, 5-diphenyl-tetrazolium) assay. No significant cytotoxic effects of titania nanostructures were observed over a period of a week of testing time, while the presence of CNTs in some cases demonstrated significant cytotoxic effects. Finally, possible reason of cytotoxicity is discussed in the light of microstructures of materials.

Isolation and characterization of murine mandibular condylar cartilage cell populations

OBJECTIVES

The mandibular condylar cartilage is a heterogeneous tissue containing cells at various stages of chondrocyte maturation organized into 4 zones: superficial, polymorphic, flattened, and hypertrophic. The goal of this study was to use transgenic mice containing chondrocyte maturation markers fused to fluorescent protein transgenes to isolate and characterize homogenous cell populations of the mandibular condylar cartilage.

METHODS

Fluorescent reporter expression in the mandibular condylar cartilage of transgenic mice containing the 3.6-kb fragment of the rat collagen type 1 promoter fused to a topaz-fluorescent protein (Col3.6-tpz), collagen type 2 promoter fused to a cyan-fluorescent protein (Col2-cyan), and/or collagen type 10 promoter fused to cherry-fluorescent protein (Col10-cherry) was examined. Mandibular condylar cartilage cells were analyzed by fluorescence-activated cell sorting (FACS) and either used for gene expression analysis or plated in cell cultures and exposed to adipogenic, osteogenic, or chondrogenic conditions. To determine cell fate, transgenic mice containing the Col3.6-cre recombinase were bred with cre reporter mice.

RESULTS

Localization and analysis of gene expression revealed that Col3.6-tpz-positive cells corresponded to the polymorphic/flattened zones and Col2-cyan-positive cells corresponded to the flattened/hypertrophic zones of the mandibular condylar cartilage. Mandibular condylar cartilage FACS-sorted Col3.6-tpz-positive cells have the potential to differentiate into bone, cartilage, and fat. Cell fate mapping revealed that Col3.6 cells are precursors of some of the hypertrophic chondrocytes in the mandibular condylar cartilage.

CONCLUSION

Col3.6-tpz cells represent an earlier stage of the mandibular condylar cartilage maturation pathway.

Murine TMJ loading causes increased proliferation and chondrocyte maturation

The purpose of this study was to examine the effects of forced mouth opening on murine mandibular condylar head remodeling. We hypothesized that forced mouth opening would cause an anabolic response in the mandibular condylar cartilage. Six-week-old female C57BL/6 mice were divided into 3 groups: (1) control, (2) 0.25 N, and (3) 0.50 N of forced mouth opening. Gene expression, micro-CT, and proliferation were analyzed. 0.5 N of forced mouth opening caused a significant increase in mRNA expression of Pthrp, Sox9, and Collagen2a1, a significant increase in proliferation, and a significant increase in trabecular spacing in the subchondral bone, whereas 0.25 N of forced mouth opening did not cause any significant changes in any of the parameters examined. Forced mouth opening causes an increase in the expression of chondrocyte maturation markers and an increase in subchondral trabecular spacing.

Prenatal complex rhythmic music sound stimulation facilitates postnatal spatial learning but transiently impairs memory in the domestic chick

Early experience has a profound influence on brain development, and the modulation of prenatal perceptual learning by external environmental stimuli has been shown in birds, rodents and mammals. In the present study, the effect of prenatal complex rhythmic music sound stimulation on postnatal spatial learning, memory and isolation stress was observed. Auditory stimulation with either music or species-specific sounds or no stimulation (control) was provided to separate sets of fertilized eggs from day 10 of incubation. Following hatching, the chicks at age 24, 72 and 120 h were tested on a T-maze for spatial learning and the memory of the learnt task was assessed 24 h after training. In the posthatch chicks at all ages, the plasma corticosterone levels were estimated following 10 min of isolation. The chicks of all ages in the three groups took less (p < 0.001) time to navigate the maze over the three trials thereby showing an improvement with training. In both sound-stimulated groups, the total time taken to reach the target decreased significantly (p < 0.01) in comparison to the unstimulated control group, indicating the facilitation of spatial learning. However, this decline was more at 24 h than at later posthatch ages. When tested for memory after 24 h of training, only the music-stimulated chicks at posthatch age 24 h took a significantly longer (p < 0.001) time to traverse the maze, suggesting a temporary impairment in their retention of the learnt task. In both sound-stimulated groups at 24 h, the plasma corticosterone levels were significantly decreased (p < 0.001) and increased thereafter at 72 h (p < 0.001) and 120 h which may contribute to the differential response in spatial learning. Thus, prenatal auditory stimulation with either species-specific or complex rhythmic music sounds facilitates spatial learning, though the music stimulation transiently impairs postnatal memory.

Analysis of microarchitectural changes in a mouse temporomandibular joint osteoarthritis model

OBJECTIVE

Little is known about the natural progression of the disease process of temporomandibular joint (TMJ) osteoarthritis (OA), which affects approximately 1% of the US population. The goal of this study was to examine the early microarchitectural and molecular changes in the condylar cartilage and subchondral bone in biglycan/fibromodulin (Bgn/Fmod) double-deficient mice, which develop TMJ-OA at 6 months.

METHODS

TMJs from 3-month-old (n=44) and 9-month-old (n=52) wild-type (WT n=46) and Bgn/Fmod (n=50) double-deficient mice were evaluated. Micro-CT analysis of the subchondral bone (n=24), transmission electron microscopy for condylar cartilage fibril diameters (n=26), and real-time PCR analysis for gene expression for bone and cartilage maturation markers (n=45) was performed.

RESULTS

A statistically significant increase in collagen fibril diameter of the condylar cartilage and a decrease in expression of Parathyroid related protein in the mandibular condylar head were observed in the 3-month Bgn/Fmod double-deficient mice compared to WT controls. The 9-month Bgn/Fmod double-deficient mouse demonstrated an increase in bone volume and total volume in subchondral bone, and an increase in the expression of Collagen Type X and Aggrecan in the mandibular condylar head compared to the WT controls.

CONCLUSION

We found that changes in the microarchitecture of the condylar cartilage preceded changes in the subchondral bone during OA in the TMJ in Bgn/Fmod double-deficient mice.

Altered functional loading causes differential effects in the subchondral bone and condylar cartilage in the temporomandibular joint from young mice

OBJECTIVE

Altered loading is an important etiological factor for temporomandibular joint (TMJ) disorders. Studies examining altered loading of the TMJ have been done in rats but the response of the TMJ to altered loading in mice is largely unknown. Therefore, due to the potential usefulness of genetically engineered mice, the goal of this study was to develop a mouse TMJ altered functional loading model.

METHODS

One hundred and thirty four, 21-day-old CD-1 female mice were divided into two groups: (1) normal loading (hard pellet diet) for 2-6 weeks and (2) altered functional loading (incisor trimming every other day and soft dough diet) for 2-6 weeks. The mandibular condylar cartilage was evaluated by histology, the subchondral bone was evaluated by microcomputed tomography (micro-CT) analysis and gene expression was evaluated by real time polymerase chain reaction (PCR) analysis.

RESULTS

Altered functional loading for 2-6 weeks caused significant reduction in the thickness of the condylar cartilage whereas, only at 4 weeks was there a significant decrease in the bone volume fraction and trabecular thickness of the subchondral bone. Gene expression analysis showed that altered functional loading for 4 weeks caused a significant reduction in the expression of SRY-box containing gene 9 (Sox9), Collagen type X (Col X), Indian hedgehog (Ihh), Collagen type II (Col II) and Vascular endothelial growth factor (Vegf) and altered loading for 6 weeks caused a significant decrease in the expression of Sox9, Col II, Vegf and Receptor activator of NF-kappaB ligand (Rankl) compared to the normal loading group.

CONCLUSION

Altered functional TMJ loading in mice for 2-6 weeks leads to a loss of the condylar cartilage and a transient loss in the density of the mandibular condylar subchondral bone.

Age-related decrease in rod bipolar cell density of the human retina: an immunohistochemical study

During normal ageing, the rods (and other neurones) undergo a significant decrease in density in the human retina from the fourth decade of life onward.Since the rods synapse with the rod bipolar cells in the outer plexiform layer, a decline in rod density (mainly due to death)may ultimately cause an associated decline of the neurones which,like the rod bipolar cells,are connected to them.The rod bipolar cells are selectively stained with antibodies to protein kinase C-alpha.This study examined if rod bipolar cell density changes with ageing of the retina, utilizing donor human eyes (age: 6-91 years).The retinas were fixed and their temporal parts from the macula to the mid-periphery sectioned and processed for protein kinase C-alpha immunohistochemistry.The density of the immunopositive rod bipolar cells was estimated in the mid-peripheral retina (eccentricity: 3-5 mm)along the horizontal temporal axis.The results show that while there is little change in the density of the rod bipolar cells from 6 to 35 years (2.2%), the decline during the period from 35 to 62 years is about 21% and between seventh and tenth decades,it is approximately 27%.

A rare constellation of multiple upper limb anomalies

We describe an unusual combination of unilateral upper limb variations, including an axillary arch, absence of a "typical" musculocutaneous nerve, direct lateral cord innervation of the muscles usually supplied by the musculocutaneous nerve, variant superficial brachial artery, a high anomalous origin of the common interosseous artery and a superficial ulnar artery noted during routine cadaver dissection. The embryological basis, recent molecular insights concerning such a constellation of anomalies and its clinical relevance are discussed.

Hospital information management system: an evolutionary knowledge management perspective

The evolving paradigm shift resulting from IT, social and technological changes has created a need for developing an innovative knowledge-based healthcare system, which can effectively meet global healthcare system demands and also cater to future trends. The Hospital Information Management System (HIMS) is developed with this sole aim in mind, which helps in processing and management of hospital information not only inside the boundary, but also beyond the hospital boundary, e.g., telemedicine or e-healthcare. The purpose of this paper is to present such kind of functional HIMS, which can efficiently satisfy the current and future system requirements by using Knowledge Management (KM) and data management systems. The HIMS is developed in a KM context, wherein users can share and use the knowledge more effectively. The proposed system is fully compatible with future technical, social, managerial and economical requirements.

Small leucine-rich proteoglycans in the aging skeleton

Small Leucine-Rich Proteoglyans (SLRPs) are major skeletal extracellular matrix (ECM) components that comprise a family of 13 members containing repeats of a leucine-rich motif. To examine SLRP function, we generated mice deficient in one or more member and analyzed them at the tissue, cell and molecular levels. This review outlines the novel research findings uncovered using these new animal models.

Morphological and Neurochemical Development of the Human Neural Retina

The human retina, a derivative of the diencephalon, differentiates into its components in sequential patterns following a spatiotemporal order. The neuronal differentiation in the fovea and central retina begins earlier than that occurring elsewhere, completes by midgestation (19–21 weeks) and continues in the periphery until 30 weeks of gestation. By birth, all retinal layers and neurons are mature over its entire extent, except at the fovea, where photoreceptor differentiation (outer segments) continues up to 5 months postnatally. During differentiation, the neurons express an array of marker molecules, such as amino acid neurotransmitters, neuropeptides, calcium-binding proteins, nitric oxide and proteins of phototransduction pathways. Although their precise involvement in retinal development is unclear, their patterns of expression indicate that many of them may be necessary for neuronal differentiation. In order to gain knowledge on this issue, future studies utilizing embryonic human retinal culture and transplantation of the tissue into suitable hosts and characterization of the role of neurochemicals involved in retinal development appears to be worthwhile. This approach may highlight novel information about the specific neurochemical requirements for the adult retina in normal and pathological states.

Accelerated osteoarthritis in the temporomandibular joint of biglycan/fibromodulin double-deficient mice

OBJECTIVE

To investigate whether the absence of biglycan and fibromodulin, two proteoglycans expressed in cartilage, bone and tendon, resulted in accelerated osteoarthritis in the temporomandibular joint (TMJ).

METHODS

Histological sections of TMJ from 3-, 6-, 9- and 18-month-old wild-type (WT) and biglycan/fibromodulin double-deficient (DKO) mice were compared. Immuno-stainings for biglycan, fibromodulin and proliferating cell nuclear antigen (PCNA) were performed.

RESULTS

Biglycan and fibromodulin were highly expressed in the disc and articular cartilage of the TMJ. At 3 months of age, both WT and DKO presented early signs of cartilage degeneration visible as small acellular areas under the articular surfaces and superficial waving. From 6 months of age, DKOs developed accelerated osteoarthritis compared to WT. At 6 months, small vertical clefts in the condylar cartilage and partial disruption of the disk were visible in the DKO. In addition, chondrocytes had lost their regular columnar organization to form clusters. At 9 months, these differences were even more pronounced. At 18 months, extended cartilage erosion was visible in DKOs when by comparison the thickness of the articular cartilage in WT controls was basically intact. PCNA staining was stronger in 3-month-old WT TMJ fibrocartilage than in 3-month-old DKO TMJ fibrocartilage suggesting that chondrocyte proliferation might be impaired in DKOs.

CONCLUSION

The biglycan/fibromodulin double knock-out mouse constitutes a useful animal model to decipher the pathobiology of osteoarthritis in the TMJ.

Histopathological changes in the eyes in systemic lupus erythematosus: an electron microscope and immunohistochemical study

This paper reports the histopathological findings in the eyes of a 26-year-old female patient diagnosed with systemic lupus erythematosus (SLE) with peripheral neuropathy. The patient had no significant ocular problems. She died of pneumonia after two years of suffering. The eyeballs were procured at autopsy and the retina, choroid and optic nerve processed for light and electron microscopy, and immunohistochemistry for immunoglobulin G (IgG), glial fibrillary acidic protein (GFAP), calbindin and parvalbumin. Histologically, there was haemorrhaging in the retinal nerve fibre layer. Ultrastructurally, the axons of this layer were swollen, and contained an unusual accumulation of microtubules and smooth endoplasmic reticulum. There were degenerative changes in the pericytes and smooth muscle cells of blood vessels. The capillary lumen was partially obliterated, and contained IgG, which was also detected throughout the choroid and wall of choroidal arterioles. The latter and Bruch's membrane showed fibrin deposits. The optic nerve showed infiltrated mononuclear cells near the degenerated axons, these axons lacked immunoreactivity to calbindin and parvalbumin. Compared to the control, the connective tissue sheaths of the central retinal vessels possessed a vast number of proliferated fibroblast cells, and trichrome staining showed transmural vessel scarring. Dense GFAP immunoreactivity was observed surrounding the vessel wall. These pathological changes are due to impaired blood circulation caused by haemorrhaging and vasculitis, and vessel occlusion by fibrin. The nature of the changes observed tends to indicate that a regular, thorough ophthalmic examination should be conducted even in the absence of significant ocular symptoms in SLE.

A recombinant luteinising-hormone-releasing-hormone immunogen bioeffective in causing prostatic atrophy

Previous studies with a semi-synthetic vaccine indicated the utility of immunization against luteinising-hormone-releasing-hormone (LHRH) in prostate cancers. To overcome the limitations of the previous vaccine, which caused carrier induced suppression of antibody response on repeated immunizations and was costly to synthesize, two recombinant vaccines were designed, in which diptheria or tetanus toxoid used as carriers were replaced by 4-5 T non B peptides. The paper reports the immunogenecity, efficacy and safety of these multimer vaccines in rats, a homologous experimental animal. All animals generated anti-LHRH antibodies, which caused the decline of testosterone to castration levels at and above 0.15 OD units of antibody titres. The prostate was significantly atrophied in all animals immunized with these vaccines.

Comparison of new clinical and scintigraphic algorithms for the diagnosis of pulmonary embolism

Since the publication of the modified Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) criteria for the diagnosis of pulmonary embolism (PE), new clinical and scintigraphic diagnostic algorithms (the McMaster clinical criteria, the PisaPED simplified scintigraphic grading and the Miettinen logistic regression analysis) have been reported although the results have not been reproduced in other sites. Ventilation-perfusion lung scintigraphy was performed in 238 consecutive patients with a provisional diagnosis of PE. Scans were reported as normal/very low, low, intermediate or high probability for PE using standardized criteria. Each patient received a clinical grading of probability of PE as low, moderate or high using the McMaster clinical criteria. Using the PisaPED criteria (an alternate simplified scintigraphic grading system using the perfusion scan alone) each scan was also graded as normal/near normal, abnormal but not PE, or abnormal and PE. Using the logistic regression algorithm of Miettinen each scan received a numerical probability of PE. Frequencies for differing levels of probability of PE varied widely between the various algorithms. Cross tabulations revealed correlation of the standardized criteria with the Miettinen grading but not with the McMaster or the PisaPED gradings. We were unable to reproduce similar results using the McMaster clinical grading or the PisaPED simplified scintigraphic grading although the Miettinen logistic regression formula gave comparable results. New algorithms are not automatically transferable to new environments.

Abnormal musculoaponeurotic tunnel in the arm: possible entrapment of the median nerve and brachial artery with high origin of nerve to pronator teres within the tunnel

Median nerve and brachial artery in the arm are not usually overlapped by any structure. Connective tissue bands and muscular slips draping or enclosing this neurovascular bundle have been reported, however, which may produce clinical symptoms of nerve compression and vascular changes. We report an unusual musculoaponeurotic band that originates as the ligament of Struthers but terminates as the brachiofascialis muscle of Wood and in the process may have entrapped both the median nerve and brachial artery. The nerve to pronator teres originates from the median nerve within this tunnel. On histological examination the nerve was flattened and showed some perineurial thickening. In view of the flexor function of brachialis muscle, this anomalous musculoaponeurotic band may be considered a clinically important entity in the causation of idiopathic neurovasculopathy in the hand.

Effect of prenatal auditory enrichment on developmental expression of synaptophysin and syntaxin 1 in chick brainstem auditory nuclei

Neural activity plays an important role in shaping the developing brain. We have determined the consequence of increased auditory stimulation on the developmental profile of synaptic proteins, synaptophysin and syntaxin 1, in the chick brainstem auditory nuclei, nucleus magnocellularis and nucleus laminaris, by immunohistochemistry and western blotting techniques. The chick embryos were provided with patterned sounds of species-specific calls or musical notes of a sitar, a stringed instrument, in a graded manner from embryonic day 10 (E10) through hatching, for 15 min every hour. During normal synaptogenesis of nucleus magnocellularis and nucleus laminaris, synaptophysin immunoreactivity increased significantly from E8 to E20, in parallel with synapse formation, and reduced at hatching. The embryos receiving species-specific sound stimuli exhibited a similar pattern with higher levels of immunoreactivity, though the difference between the study groups was not statistically significant. The music stimulated embryos showed an earlier peak at E16, followed by a gradual decline until hatching. In all three groups studied, syntaxin immunoreactivity showed a surge at E12, followed by a decline at E16 and subsequent stabilization. The stimulated groups continually expressed higher amounts of syntaxin immunoreactivity. The results suggest that prenatal sound stimulation enhances the normal pattern of synaptic protein expression in these auditory nuclei.

Thoracoabdominal intestinal duplication with absent inferior vena cava

We report a rare case of thoracoabdominal intestinal duplication with absent inferior vena cava (IVC). The patient was initially explored with a mistaken diagnosis of diaphragmatic hernia on the basis of a chest radiograph and barium meal. However, a subsequent computed tomography scan revealed a mediastinal mass with an air-fluid level, a hugely dilated azygos vein, and an absent IVC. Thoracoabdominal exploration was required to excise the duplication cyst arising from the jejunum. We believe that this is the first report of this association.

Differential expression of syntaxin-1 and synaptophysin in the developing and adult human retina

Synaptophysin and syntaxin-1 are membrane proteins that associate with synaptic vesicles and presynaptic active zones at nerve endings, respectively. The former is known to be a good marker of synaptogenesis; this aspect, however, is not clear with syntaxin-1. In this study, the expression of both proteins was examined in the developing human retina and compared with their distribution in postnatal to adult retinas, by immunohistochemistry. In the inner plexiform layer, both were expressed simultaneously at 11-12 weeks of gestation, when synaptogenesis reportedly begins in the central retina. In the outer plexiform layer, however, the immunoreactivities were prominent by 16 weeks of gestation. Their expression in both plexiform layers followed a centre-to-periphery gradient. The immunoreactivities for both proteins were found in the immature photoreceptor, amacrine and ganglion cells; however, synaptophysin was differentially localized in bipolar cells and their axons, and syntaxin was present in some horizontal cells. In postnatal-to-adult retinas, synaptophysin immunoreactivity was prominent in photo-receptor terminals lying in the outer plexiform layer; on the contrary, syntaxin-1 was present in a thin immunoreactive band in this layer. In the inner plexiform layer, however, both were homogeneously distributed. Our study suggests that (i) syntaxin-1 appears in parallel with synapse formation; (ii) synaptogenesis in the human retina might follow a centre-to-periphery gradient; (iii) syntaxin-1 is likely to be absent from ribbon synapses of the outer plexiform layer, but may occur at presynaptic terminals of photoreceptor and horizontal cells, as is apparent from its localization in these cells, which is hitherto unreported for any vertebrate retina.