3D-printed digital pneumatic logic for the control of soft robotic actuators

Soft robots are paving their way to catch up with the application range of metal-based machines and to occupy fields that are challenging for traditional machines. Pneumatic actuators play an important role in this development, allowing the construction of bioinspired motion systems. Pneumatic logic gates provide a powerful alternative for controlling pressure-activated soft robots, which are often controlled by metallic valves and electric circuits. Many existing approaches for fully compliant pneumatic control logic suffer from high manual effort and low pressure tolerance. In our work, we invented three-dimensional (3D) printable, pneumatic logic gates that perform Boolean operations and imitate electric circuits. Within 7 hours, a filament printer is able to produce a module that serves as an OR, AND, or NOT gate; the logic function is defined by the assigned input signals. The gate contains two alternately acting pneumatic valves, whose work principle is based on the interaction of pressurized chambers and a 3D-printed 1-millimeter tube inside. The gate design does not require any kind of support material for its hollow parts, which makes the modules ready to use directly after printing. Depending on the chosen material, the modules can operate on a pressure supply between 80 and more than 750 kilopascals. The capabilities of the invented gates were verified by implementing an electronics-free drink dispenser based on a pneumatic ring oscillator and a 1-bit memory. Their high compliance is demonstrated by driving a car over a fully flexible, 3D-printed robotic walker controlled by an integrated circuit.

The impact of marker selection, in-line near-infrared spectroscopy (NIR), and feed mix time on the coefficient of variation (mix uniformity), body weight uniformity and broiler growth performance during the starter, grower, and finisher periods

Most feed manufacturers in the United States use the same mixing time (and thus mix uniformity) throughout the growing period regardless of age and consumption patterns. However, research evaluating the optimum mixing time requirements and novel analysis methods, such as in-line near-infrared (NIR) spectroscopy, on the coefficient of variation (CV) and growth performance of broilers throughout the production phases is sparse. Two experiments were conducted to determine the effects of marker selection, in-line NIR, and varying mix times on mix uniformity, broiler growth performance, and body weight uniformity from 1 to 42 d of age. Feed was manufactured utilizing a 1,815-kg counterpoise ribbon mixer. In both experiments, feed was mixed for 4.5 min (3 min dry mix and 90 s of wet mix) and 30 s (0 s dry mix and 30 s wet mix) to obtain a standard mix (SM) and an abbreviated mix (AM), respectively. Experiment 1 constituted a 2 × 2 × 4 factorial arrangement of 2 mix times, (4.5 and 0.5 min), 2 batch sizes (908 and 1,815 kg), and 4 methodologies to evaluate mixer performance (sodium chloride, Microtracers (Red#40 and Blue#40), and in-line NIR). In experiment 2, broilers received different mix time combinations: 1) SM from 1 to 42 d, 2) SM from 1 to 28 d and AM from 28 to 42 d, 3) SM from 1 to 14 d and AM from 14 to 42 d, and 4) AM from 1 to 42 d. In both experiments, selecting a single source marker provided a more accurate estimation of mixer CV in SM and AM diets (P < 0.05). In experiment 2, mix time did not influence BW, feed intake (FI), FCR, or individual bird BW CV from 1 to 42 d of age (P > 0.05). These data indicated that mixer CV differed depending on total mix time and methodology used and diets with a reduced mix time may not necessarily influence growth performance and BW uniformity during the starter, grower, and finisher periods of broilers.

Toward indicators of the performance of US Infrastructures under climate change risks

Built infrastructures are increasingly disrupted by climate-related extreme events. Being able to monitor what climate change implies for US infrastructures is of considerable importance to all levels of decision-makers. A capacity to develop cross-cutting, widely applicable indicators for more than a dozen different kinds of infrastructure, however, is severely limited at present. The development of such indicators must be considered an ongoing activity that will require expansion and refinement. A number of recent consensus reports suggest four priorities for indicators that portray the impacts of climate change, climate-related extreme events, and other driving forces on infrastructure. These are changes in the reliability of infrastructure services and the implications for costs; changes in the resilience of infrastructures to climate and other stresses; impacts due to the interdependencies of infrastructures; and ongoing adaptation in infrastructures.

Epidemiology of depression and distress in patients with inflammatory bowel disease (IBD) and validation of an indicator scale of perceived stress for psychosocial impairments

Background

Previous studies showed associations of stress and episodes of active disease [1,2]. We reported survey data on psychosocial problems of IBD patients [3]. This study investigates associations of stress with health impairments and analyses a scale of perceived stress as an indicator for psychosocial impairments (construct/criterion validity) [4].

Methods

In a multiregional German survey in 2005, 1083 patients with Crohn's disease (CD) and ulcerative colitis were recruited (gastroenterological practices, university outpatient clinics, patient organization). The questionnaire incorporated WHO's ICF [5] and established items and scales (i.a. HADS [6]). Scale construction followed item response theory analysing psychometric properties.

Results

Of the survey responders (58% CD, 65% female, mean age 42yrs), ⅓ reported severe fatigue. Clinically relevant anxiety was observed in 24%, depression in 29% of men and 21% of women. With three items we constructed a scale with good psychometric properties. Three groups (low, moderate, high perceived stress) were identified, differing substantially in reported anxiety/depression and the GIBDI disease activity score.

Conclusions

IBD patients report multiple psychosocial impairments. The scale of perceived stress may identify IBD patients with high demand for psychosocial attendance, if confirmed in independent samples. For enhanced secondary prevention [7] we propose integration of this psychosocial indicator into the diagnostic process.

Stem Cell Therapy for Tendon Regeneration: Current Status and Future Directions

In adults the healing tendon generates fibrovascular scar tissue and recovers never histologically, mechanically, and functionally which leads to chronic and to degenerative diseases. In this review, the processes and mechanisms of tendon development and fetal regeneration in comparison to adult defect repair and degeneration are discussed in relation to regenerative therapeutic options. We focused on the application of stem cells, growth factors, transcription factors, and gene therapy in tendon injury therapies in order to intervene the scarring process and to induce functional regeneration of the lesioned tissue. Outlines for future therapeutic approaches for tendon injuries will be provided.

Continued Validation of Ultrasound Guidance Targeting Tasks: Assessment of Internal Structure

RATIONALE AND OBJECTIVES

We previously demonstrated validity evidence for our novel ultrasound-guided invasive procedure targeting tasks in the content, response process, relations with other variables, and consequences validity domains. Here, we investigate their internal structure by assessing their interrater, intrarater, and test-retest reliability.

METHODS

In this Institutional Review Board approved nonrandomized interventional trial first year medical students performed our previously described dowel and straw ultrasound guidance targeting tasks as a pretest. Afterward, the training group had four weekly 1-hour training sessions. The control group had no further training. Both groups then had a posttest for both tasks. The training group was re-evaluated 2 and 5 months later. Completion time in seconds, errors, and error adjusted time (5 seconds penalty/error) were recorded. Pretest and posttest performance was compared within groups, and the amount of improvement from pretest to posttest was compared between groups. Interrater, intrarater, and test-retest interclass correlation coefficients (ICC) were calculated.

RESULTS

Although some improvements from pretest to posttest were seen in both groups, greater improvements were seen in the training group. This skill was retained for at least several months. The interrater and intrarater ICCs were excellent (range 0.83-0.93). The test-retest ICCs were good to excellent in all but one performance measure (0.50-0.78).

CONCLUSION

Student performance on the targeting tasks improved markedly after training and persisted for several months. The interrater and intrarater reliability were excellent, while the test-retest reliability was good. This provides additional validity evidence for our novel ultrasound-guided invasive procedure targeting curriculum.

Cell-Biological Requirements for the Generation of Dentate Gyrus Granule Neurons

The dentate gyrus (DG) receives highly processed information from the associative cortices functionally integrated in the trisynaptic hippocampal circuit, which contributes to the formation of new episodic memories and the spontaneous exploration of novel environments. Remarkably, the DG is the only brain region currently known to have high rates of neurogenesis in adults (Andersen et al., 1966, 1971). The DG is involved in several neurodegenerative disorders, including clinical dementia, schizophrenia, depression, bipolar disorder and temporal lobe epilepsy. The principal neurons of the DG are the granule cells. DG granule cells generated in culture would be an ideal model to investigate their normal development and the causes of the pathologies in which they are involved and as well as possible therapies. Essential to establish such in vitro models is the precise definition of the most important cell-biological requirements for the differentiation of DG granule cells. This requires a deeper understanding of the precise molecular and functional attributes of the DG granule cells in vivo as well as the DG cells derived in vitro. In this review we outline the neuroanatomical, molecular and cell-biological components of the granule cell differentiation pathway, including some growth- and transcription factors essential for their development. We summarize the functional characteristics of DG granule neurons, including the electrophysiological features of immature and mature granule cells and the axonal pathfinding characteristics of DG neurons. Additionally, we discuss landmark studies on the generation of dorsal telencephalic precursors from pluripotent stem cells (PSCs) as well as DG neuron differentiation in culture. Finally, we provide an outlook and comment critical aspects.

Effect of single intralesional treatment of surgically induced equine superficial digital flexor tendon core lesions with adipose-derived mesenchymal stromal cells: a controlled experimental trial

Background

Adipose tissue is a promising source of mesenchymal stromal cells (MSCs) for the treatment of tendon disease. The goal of this study was to assess the effect of a single intralesional implantation of adipose tissue-derived mesenchymal stromal cells (AT-MSCs) on artificial lesions in equine superficial digital flexor tendons (SDFTs).

Methods

During this randomized, controlled, blinded experimental study, either autologous cultured AT-MSCs suspended in autologous inactivated serum (AT-MSC-serum) or autologous inactivated serum (serum) were injected intralesionally 2 weeks after surgical creation of centrally located SDFT lesions in both forelimbs of nine horses. Healing was assessed clinically and with ultrasound (standard B-mode and ultrasound tissue characterization) at regular intervals over 24 weeks. After euthanasia of the horses the SDFTs were examined histologically, biochemically and by means of biomechanical testing.

Results

AT-MSC implantation did not substantially influence clinical and ultrasonographic parameters. Histology, biochemical and biomechanical characteristics of the repair tissue did not differ significantly between treatment modalities after 24 weeks. Compared with macroscopically normal tendon tissue, the content of the mature collagen crosslink hydroxylysylpyridinoline did not differ after AT-MSC-serum treatment (p = 0.074) while it was significantly lower (p = 0.027) in lesions treated with serum alone. Stress at failure (p = 0.048) and the modulus of elasticity (p = 0.001) were significantly lower after AT-MSC-serum treatment than in normal tendon tissue.

Conclusions

The effect of a single intralesional injection of cultured AT-MSCs suspended in autologous inactivated serum was not superior to treatment of surgically created SDFT lesions with autologous inactivated serum alone in a surgical model of tendinopathy over an observation period of 22 weeks. AT-MSC treatment might have a positive influence on collagen crosslinking of remodelling scar tissue. Controlled long-term studies including naturally occurring tendinopathies are necessary to verify the effects of AT-MSCs on tendon disease.

Electronic supplementary material

The online version of this article (doi:10.1186/s13287-017-0564-8) contains supplementary material, which is available to authorized users.

Tracking of autologous adipose tissue-derived mesenchymal stromal cells with in vivo magnetic resonance imaging and histology after intralesional treatment of artificial equine tendon lesions--a pilot study

BACKGROUND

Adipose tissue-derived mesenchymal stromal cells (AT-MSCs) are frequently used to treat equine tendinopathies. Up to now, knowledge about the fate of autologous AT-MSCs after intralesional injection into equine superficial digital flexor tendons (SDFTs) is very limited. The purpose of this study was to monitor the presence of intralesionally injected autologous AT-MSCs labelled with superparamagnetic iron oxide (SPIO) nanoparticles and green fluorescent protein (GFP) over a staggered period of 3 to 9 weeks with standing magnetic resonance imaging (MRI) and histology.

METHODS

Four adult warmblood horses received a unilateral injection of 10 × 10(6) autologous AT-MSCs into surgically created front-limb SDFT lesions. Administered AT-MSCs expressed lentivirally transduced reporter genes for GFP and were co-labelled with SPIO particles in three horses. The presence of AT-MSCs in SDFTs was evaluated by repeated examinations with standing low-field MRI in two horses and post-mortem in all horses with Prussian blue staining, fluorescence microscopy and with immunofluorescence and immunohistochemistry using anti-GFP antibodies at 3, 5, 7 and 9 weeks after treatment.

RESULTS

AT-MSCs labelled with SPIO particles were detectable in treated SDFTs during each MRI in T2*- and T1-weighted sequences until the end of the observation period. Post-mortem examinations revealed that all treated tendons contained high numbers of SPIO- and GFP-labelled cells.

CONCLUSIONS

Standing low-field MRI has the potential to track SPIO-labelled AT-MSCs successfully. Histology, fluorescence microscopy, immunofluorescence and immunohistochemistry are efficient tools to detect labelled AT-MSCs after intralesional injection into surgically created equine SDFT lesions. Intralesional injection of 10 × 10(6) AT-MSCs leads to the presence of high numbers of AT-MSCs in and around surgically created tendon lesions for up to 9 weeks. Integration of injected AT-MSCs into healing tendon tissue is an essential pathway after intralesional administration. Injection techniques have to be chosen deliberately to avoid reflux of the cell substrate injected. In vivo low-field MRI may be used as a non-invasive tool to monitor homing and engraftment of AT-MSCs in horses with tendinopathy of the SDFT.

Local and Systemic Therapies for Breast Cancer Patients: Reducing Short-term Symptoms with the Methods of Integrative Medicine

With improved prognosis due to advances in the diagnosis and therapy of breast cancer, physicians and therapists now focus on aspects such as quality of life and the management of side effects from breast cancer treatment. Therapy- and disease-related side effects often reduce the patient's quality of life and can place a further burden on patients, with non-compliance or discontinuation of therapy a potential consequence. Study data have shown that therapy- and disease-related side effects can be reduced using the methods of integrative medicine. Reported benefits include improving patients' wellbeing and quality of life, reducing stress, and improving patients' mood, sleeping patterns and capacity to cope with disease. Examining the impact of integrative medicine on the side effects of cancer treatment would be beyond the scope of this review. This article therefore looks at short-term side effects of cancer treatment which are usually temporary and occur during or after local and systemic therapy. The focus is on mind-body medicine, acupuncture and classic naturopathic treatments developed by Sebastian Kneipp as complementary therapies. The latter includes hydrotherapy, phytotherapy, nutritional therapy, exercise therapy and a balanced lifestyle.

Effect of autologous adipose tissue-derived mesenchymal stem cells on neovascularization of artificial equine tendon lesions

AIMS

To investigate whether autologous adipose tissue-derived mesenchymal stem cells (AT-MSCs) treatment of tendon lesions increases neovascularization during tendon healing.

MATERIALS & METHODS

A standardized surgical model was used to create lesions in both front limb superficial digital flexor tendons (SDFTs) of nine horses. Either AT-MSCs or control substance was injected intralesionally 2 weeks post-surgery. Color Doppler ultrasonography of SDFTs was performed at regular intervals. Horses were euthanized 22 weeks post-treatment and SDFTs were harvested for histology.

RESULTS

The color Doppler ultrasonography signal was significantly more extensive at 2 weeks post-treatment and the number of vessels counted on histologic slides was significantly higher at 22 weeks post-treatment in AT-MSC-treated SDFTs.

CONCLUSION

Our findings indicate that AT-MSC treatment has a beneficial effect on neovascularization of healing tendons.

Clinical status, psychosocial impairments, medical treatment and health care costs for patients with inflammatory bowel disease (IBD) in Germany: an online IBD registry

BACKGROUND

The aim of this cross-sectional study was to establish an online inflammatory bowel disease (IBD) registry for a first picture of the situation of IBD outpatients' treatment in Germany.

METHODS

Between March 2006 and July 2007 IBD outpatients from 24 gastroenterological specialist practices and two hospitals in Germany were enrolled in an Internet-based registry to evaluate the outpatients' clinical status, psychological impairments, provided health care, as well as medical treatment and medication costs.

RESULTS

1032 IBD patients (ulcerative colitis/UC: 519; Crohn's disease/CD: 511; indeterminate colitis: 2) were enrolled in the study (age: 43 ± 14 years/M ± SD). Disease duration of all patients averaged 10 ± 8.5 years. In 519 UC-patients (49% male; 33% pancolitis), 66% were in remission as were 55% of CD patients (37 % male; 41 % active smokers). Associated with higher rates of disease activity (CDAI ≥ 150; CAI>4) were corticosteroids (CD, UC), topical medication (UC), relevant reported depressive symptoms (15%; 6-31%) and impairments in sexuality (21%; 9-42%). Relevant medication groups prescribed were oral aminosalicylates (UC: 70%; CD: 47%); immunosuppressive therapy - mostly azathioprine/6 MP (CD: 47%; UC: 26%), and Infliximab (CD: 8%; UC: 3%). Strongly associated with their clinical disease activity in UC as well as CD patients, 15% (6-31%) reported relevant depressive symptoms and 21% (9-42%) relevant impairments in sexuality.

CONCLUSIONS

The registry constitutes a large complemental database for the patient population in Germany. About one third of the IBD patients were not in clinical remission (CDAI ≥150/CAI >4) (CD: 45%; UC: 27%), although high rates of immunosuppressive drugs (CD: 47%; UC 26%) were administered. This study shows a large burden of active disease associated with an unexpectedly high (co)morbidity and high psychosocial impairments, indicating a reduced health state in IBD patients.

[Preference of patients with inflammatory bowel disease regarding information and shared decision-making: results from a cross-sectional survey in Germany]

BACKGROUND

Evidence-based and consented pathways for patients with inflammatory bowel diseases (IBD, Crohn's disease, ulcerative colitis) call for tailored education programmes to foster shared decision-making and patient self-management. Their preferences should be taken into account.

METHODS

In 2005 a cross-sectional postal questionnaire survey was conducted in different regions of Germany. Adult patients with ulcerative colitis (UC) or Crohn's disease (CD) were recruited from specialised gastroenterological practices, university outpatient clinics and the member registry of the relevant patient organisation DCCV. They returned a questionnaire including (inter)nationally established scales (e. g., HADS) as well as questions on their information needs, preferred information sources and their role in decision-making.

RESULTS

Data of 1056 responders could be analysed (65 % female; CD: 58 %; DCCV member: 71 %). The mean age of the patients was 42 (SD 12,8) years. Almost all patients wanted more information on "treatment alternatives" (83 %), "causes of disease" (80 %) and "what can I (still) do by myself" (79 %). 27 % of the patients asked for more information on 15 or more of overall 19 topics. The high information need was significantly associated with HADS potential depressive disorder (score > 8) and HADS probable anxiety disorder (score > 10). Most IBD patients (70 %) obviously regard their physicians as the most desirable source of information, 67 % prefer an active involvement in clinical decision-making.

CONCLUSIONS

The data demonstrate high information needs of IBD patients and may serve in the planning of future educational programmes.

[Cerebral vasculitis associated with gemcitabine]

Neoadjuvant chemotherapy consisting of cisplatin and gemcitabine was given to a 50-year-old woman suffering from transitional cell carcinoma of the bladder. Whereas the first cycle was administered without major side effects, the patient experienced a generalized tonic-clonic seizure and a prolonged cognitive deficit with the second cycle. Magnetic resonance imaging of the brain was consistent with cerebral vasculitis. The short interval between the application of gemcitabine and the neurological deterioration suggests a causal relationship. Although recent reports have linked this drug with leukoencephalopathy and vasculitis in various localizations, this is the first case of cerebral vasculitis associated with gemcitabine.

RGMa inhibits neurite outgrowth of neuronal progenitors from murine enteric nervous system via the neogenin receptor in vitro

The enteric nervous system (ENS) in vertebrate embryos is formed by neural crest-derived cells. During development, these cells undergo extensive migration from the vagal and sacral regions to colonize the entire gut, where they differentiate into neurons and glial cells. Guidance molecules like netrins, semaphorins, slits, and ephrins are known to be involved in neuronal migration and axon guidance. In the CNS, the repulsive guidance molecule (RGMa) has been implicated in neuronal differentiation, migration, and apoptosis. Recently, we described the expression of the subtypes RGMa and RGMb and their receptor neogenin during murine gut development. In the present study, we investigated the influence of RGMa on neurosphere cultures derived from fetal ENS. In functional in vitro assays, RGMa strongly inhibited neurite outgrowth of differentiating progenitors via the receptor neogenin. The repulsive effect of RGMa on processes of differentiated enteric neural progenitors could be demonstrated by collapse assay. The influence of the RGM receptor on ENS was also analyzed in neogenin knockout mice. In the adult large intestine of mutants we observed disturbed ganglia formation in the myenteric plexus. Our data indicate that RGMa may be involved in differentiation processes of enteric neurons in the murine gut.

RGMb controls aggregation and migration of Neogenin-positive cells in vitro and in vivo

The proliferation, migration and differentiation of dentate gyrus stem and precursor cells have aroused keen interest. Neogenin and RGMb are expressed in non-overlapping compartments of the developing dentate gyrus. While Neogenin is expressed in migrating and proliferating dentate precursors, RGMb is localized in structures bordering the developing dentate, such as cornus ammonis cells and Cajal-Retzius cells in the marginal zone including the hippocampal fissure. Co-immunoprecipitation and binding assays indicate a strong physical interaction. In vitro and in vivo migration of dentate neuroepithelial cells is abolished by RGMb, and cell adhesion is reduced when cells expressing Neogenin comes into contact with cells expressing RGMb. Ectopic expression of RGMb in organotypic slice cultures and after in utero electroporation in the hippocampus modifies precursor cell migration. Our results imply that Neogenin-RGMb interaction might be involved in neuronal migration in the dentate gyrus.

[Intratesticular metastasis of renal cancer]

We report on a 66-year-old man after nephrectomy of the right kidney because of renal cell carcinoma. One year after diagnosis, an osseous metastasis of the right femur occurred and was resected. The following investigations, including positron emission tomography/computed tomography, showed no relapse. Three and a half years after diagnosis, the patient developed a testicular tumor of the right hemiscrotum, which was treated by testicular ablation. The histological investigation showed a testicular metastasis of renal cancer. This case represents one of the unusual forms of metastatic invasion of renal cell cancer.

Immune depression syndrome following human spinal cord injury (SCI): a pilot study

Experimental spinal cord injury (SCI) has been identified to trigger a systemic, neurogenic immune depression syndrome. Here, we have analyzed fluctuations of immune cell populations following human SCI by FACS analysis. In humans, a rapid and drastic decrease of CD14+ monocytes (<50% of control level), CD3+ T-lymphocytes (<20%, P<0.0001) and CD19+ B-lymphocytes (<30%, P=0.0009) and MHC class II (HLA-DR)+ cells (<30%, P<0.0001) is evident within 24 h after spinal cord injury reaching minimum levels within the first week. CD15+ granulocytes were the only leukocyte subpopulation not decreasing after SCI. A contributing, worsening effect of high dose methylprednisolone cannot be excluded with this pilot study. We demonstrate that spinal cord injury is associated with an early onset of immune suppression and secondary immune deficiency syndrome (SCI-IDS). Identification of patients suffering spinal cord injury as immune compromised is a clinically relevant, yet widely underappreciated finding.

The Use of Clinically Approved Small Particles of Iron Oxide (SPIO) for Labeling of Mesenchymal Stem Cells Aggravates Clinical Symptoms in Experimental Autoimmune Encephalomyelitis and Influences Their In Vivo Distribution

Multiple sclerosis (MS) is an inflammatory and demyelinating disease of the central nervous system (CNS). Mesenchymal stem cells (MSC) have been shown to ameliorate symptoms in experimental autoimmune encephalomyelitis (EAE), a model of MS. Using cloned MSC labeled with clinically approved small particles of iron oxide (SPIO) for treatment of EAE we analyzed the tissue localization of transferred cells. Treatment with unlabeled MSC led to disease amelioration compared to controls. In contrast, treatment with SPIO-labeled MSC lead to increase in disease severity. Treatment with SPIO alone did not alter disease course. After transplantation labeled and nonlabeled MSC were detected in the CNS and the liver with significantly more SPIO-labeled cells present in the CNS. Iron deposition was present in the group treated with SPIO-labeled MSC, indicating that in vivo the initially cell surface-bound iron detached from the MSC. These results could be of great importance for imaging of patients in the clinical setting, indicating that in vivo application of SPIO-labeled MSC needs to be performed with caution because the cell-derived exposure of iron can lead to disease aggravation.

Gene expression of the repulsive guidance molecules/neogenin in the developing and mature mouse visual system: C57BL/6J vs. the glaucoma model DBA/2J

We used in-situ hybridization to analyze the expression patterns of three known members (a, b and c) of the RGM ("repulsive guidance molecule") gene family and of the RGMa receptor neogenin in a glaucoma mouse model (DBA/2J strain) and the C57BL/6J strain, which served as a control. In order to understand the role of the RGMs and neogenin in glaucoma, we characterized their expression patterns in the developing and mature mouse retina and in the optic nerve. In all investigated stages from post-natal day (P) 0 to 15 months (M) RGMa, RGMb and neogenin expression was detected in the ganglion cell layer (GCL). From P10 to 15M, we found RGMa, RGMb and neogenin expression in the inner nuclear layer (INL) and the outer nuclear layer (ONL). In P10- and older mice, the expression patterns of RGMa and its receptor neogenin were similar, while that of RGMb differed from both. As expected, no specific retinal expression of RGMc was detected in any of the age groups investigated. C57BL/6J mice and DBA/2J mice displayed no differences in the expression pattern of RGMa, RGMb, RGMc and neogenin in the developing retina (gestational age 14.5 days (E14.5), P0 & P10). Interestingly, we found a higher expression of RGMa, RGMb and neogenin in the retinas of all glaucoma-affected mice than in the age-matched control strain. Furthermore, we detected a higher RGMa and RGMb expression in the optic nerves of glaucoma-affected DBA/2J-mice older than 11M than in C57BL/6J mice of the same age.

Spinal cord injury-induced expression of the antiangiogenic endostatin/collagen XVIII in areas of vascular remodelling

OBJECT

Spinal cord injury (SCI) induces the disruption of neural and vascular structures. In contrast to the emerging knowledge of mechanisms regulating the onset of the postinjury angiogenic response, little is known about counterregulatory signals.

METHODS

Using immunohistochemical methods, the authors investigated the expression of the endogenous angiogenic inhibitor endostatin/collagen XVIII during the tissue remodeling response to SCI.

RESULTS

After SCI, endostatin/collagen XVIII+ cells accumulated at the lesion site, in pannecrotic regions (especially in areas of cavity formation), at the lesion margin/areas of ongoing secondary damage, and in perivascular Virchow-Robin spaces. In remote areas (> 0.75 cm from the epicenter) a more modest accumulation of endostatin/collagen XVIII+ cells was observed, especially in areas of pronounced Wallerian degeneration. The numbers of endostatin/collagen XVIII+ cells reached their maximum on Day 7 after SCI. The cell numbers remained elevated in both, the lesion and remote regions, compared with control spinal cords for 4 weeks afterwards. In addition to being predominantly confined to ED1+-activated microglia/macrophages within the pannecrotic lesion core, endostatin/collagen XVIII expression was frequently detected by the endothelium/vessel walls. Numbers of lesional endostatin/collagen XVIII+ endothelium/vessel walls were found to increase early by Day 1 postinjury, reaching their maximum on Day 3 and declining subsequently to enhanced (above control) levels 30 days after SCI.

CONCLUSIONS

The authors detected that in comparison to the early expression of neoangiogenic factors, there was a postponed lesional expression of the antiangiogenic endostatin/collagen XVIII. Furthermore, the expression of endostatin/collagen XVIII was localized to areas of neovascular pruning and retraction (cavity formation). The expression of endostatin/collagen XVIII by macrophages in a "late" activated phagocytic mode suggests that this factor plays a role in counteracting the preceding "early" neoangiogenic response after SCI.

„Tissue engineering“ und Stammzellforschung in der Urologie für den rekonstruktiven bzw. regenerativen Therapieansatz

With the involvement of clinical reconstructive urology in the field of tissue engineering, outstanding results have been achieved in basic research as well as in some clinics. Stem cell research has even opened up possibilities for regenerative aspects. In close cooperation with various disciplines, the Department of Urology at the University of Tübingen investigates different clinical aspects with regard to reconstructive and regenerative urology. The regeneration of the external urethral sphincter requires functionally integrated muscle cells. In addition stricture reconstruction with multilayer urothelium should become less invasive and the re-stricture rate reduced. After the application of differentiating stem cells was proven, the clinical setting needed to be set for legal issues. In addition to the specification of culture media and verification in the animal model, the possibility to harvest omnipotent stem cells out of human testis and to differentiate those into the three germ layers was demonstrated. With the reduced invasiveness of harvesting the urothelium cells by a bladder wash using specific culture fluids, the cell culture was significantly improved enabling successful creation of urothelium by stratification. In addition urothelial cells in a matrix are further improved for endoscopic application. The close cooperation of different disciplines shortens the time to develop therapeutic approaches with a close clinical relationship in reconstructive and regenerative urology.

Spinal cord injury-induced immune depression syndrome (SCI-IDS)

Infections are among the leading causes of death in spinal cord-injured patients, and are associated with hampered wound healing, prolonged hospitalization and impaired neurological recovery. We have analysed fluctuations of immune cell populations in an experimental rat model of spinal cord injury (SCI) by FACS analysis compared with sham-operated controls to detect the responses specifically induced by SCI. Further, to illustrate the impact of SCI only animals did not receive methylprednisolone in order to exclude confounding iatrogenic factors. Experimental SCI of rats induced a depletion of ED9(+) monocytes (< 45%, P < 0.01), CD3(+) T-lymphocytes (< 35%, P < 0.01), CD45 RA(+) B-lymphocytes (< 25%, P < 0.01), MHC class II(+) (< 40%, P < 0.01) and OX-62(+) dendritic cells (< 50%, P = 0.032) within the first week after SCI. HIS 48(+) granulocytes remained on levels similar to sham-operated controls. Our data suggest that experimental SCI induces early onset of an immune suppression that we refer to as SCI-immune depression syndrome. Iatrogenic application of methylprednisolone in patients suffering may worsen the immune suppression. A deeper understanding of the underlying mechanisms of this novel syndrome might be essential to decrease mortality, costs (time of hospitalization) and to protect the intrinsic neurological recovery potential following SCI.

Neogenin-RGMa Signaling at the Growth Cone Is Bone Morphogenetic Protein-independent and Involves RhoA, ROCK, and PKC

The repulsive guidance molecule RGMa has been shown to induce outgrowth inhibition of neurites by interacting with the transmembrane receptor neogenin. Here we show that RGMa-induced growth cone collapse is mediated by activation of the small GTPase RhoA, its downstream effector Rho kinase and PKC. In contrast to DRG cultures from neogenin-/- mice, in which no RGMa-mediated growth cone collapse and activation of RhoA occurred, treatment of wild type DRG neurites with soluble RGMa led to a marked activation of RhoA within 3 min followed by collapse, but left Rac1 and Cdc42 unaffected. Furthermore, preincubation of DRG axons with the bone morphogenetic protein (BMP) antagonist noggin had no effect on RGMa-mediated growth cone collapse, implying that the role of RGM in axonal guidance is neogenin- and not BMP receptor-dependent. Pretreatment with 1) C3-transferase, a specific inhibitor of the Rho GTPase; 2) Y-27632, a specific inhibitor of Rho kinase; and 3) Gö6976, the general PKC inhibitor, strongly inhibited the collapse rate of PC12 neurites. Growth cone collapse induced by RGMa was abolished by the expression of dominant negative RhoA, but not by dominant negative Rac1. In contrast to RGMa, netrin-1 induced no growth cone retraction but instead reduced RGMa-mediated growth cone collapse. These results suggest that activation of RhoA, Rho kinase, and PKC are physiologically relevant and important elements of the RGMa-mediated neogenin signal transduction pathway involved in axonal guidance.

[Prognostic markers for congenital hydronephroses]

Watchful waiting has become the standard therapy in most cases of asymptomatic unilateral congenital hydronephroses with normal renal function. Simple, reliable, and noninvasive prognostic parameters that predict an increased risk of functional deterioration either at the initial evaluation or during follow-up would be most useful. At the moment the diameter of the renal pelvis and especially its increase is the most useful prognostic parameter, while an "obstructed" washout at furosemide isotope renography is of limited prognostic value. Preclinical and preliminary clinical studies indicate that the measurement of molecules in the urine of affected children such as TGF-31 and MCP-1 that are involved in the signal transduction during hydronephrotic atrophy might become well accepted as useful prognostic parameters in the near future.