Articulating polymethylmethacrylate (PMMA) spacers may have an immunomodulating effect on synovial tissue

AIMS

Tissue responses to debris formed by abrasion of polymethylmethacrylate (PMMA) spacers at two-stage revision arthroplasty for prosthetic joint infection are not well described. We hypothesised that PMMA debris induces immunomodulation in periprosthetic tissues.

PATIENTS AND METHODS

Samples of tissue were taken during 35 two-stage revision arthroplasties (nine total hip and 26 total knee arthroplasties) in patients whose mean age was 67 years (44 to 85). Fourier transform infrared microscopy was used to confirm the presence of PMMA particles. Histomorphometry was performed using Sudan Red and Haematoxylin-Eosin staining. CD-68, CD-20, CD-11(c), CD-3 and IL-17 antibodies were used to immunophenotype the inflammatory cells. All slides were scored semi-quantitatively using the modified Willert scoring system.

RESULTS

The mean CD-68 scores did not show any significant change during the six weeks between the stages. Perivascular and diffuse scores showed significant difference in CD-3, CD-20, CD-11(c) and IL-17. At the time of re-implantation, a shift in the pattern of the expression of dendritic cells towards a perivascular arrangement and towards the periphery of PMMA particles was observed. Positive microbiological cultures were found at the time of re-implantation in three patients. Five further revisions were required for other reasons.

CONCLUSION

Our results represent a biological reaction of the synovial tissues to spacers with a less diffuse expression of dendritic cells and an increased expression of perivascular lymphocytes. The use of spacers in two-stage revision for infection probably induces an immunomodulation of synovial tissues. Cite this article: Bone Joint J 2016;98-B:1062-8.

Correlated two-electron momentum spectra for strong-field nonsequential double ionization of He at 800 nm

We report on a kinematically complete experiment on nonsequential double ionization of He by 25 fs 800 nm laser pulses at 1.5 PW/cm;{2}. The suppression of the recollision-induced excitation at this high intensity allows us to address in a clean way direct (e,2e) ionization by the recolliding electron. In contrast with earlier experimental results, but in agreement with various theoretical predictions, the two-electron momentum distributions along the laser polarization axis exhibit a pronounced V-shaped structure, which can be explained by the role of Coulomb repulsion and typical (e,2e) kinematics.

Complete characterization of molecular dynamics in ultrashort laser fields

Reaction Microscope-based, complete, and time-resolved Coulomb explosion imaging of vibrating and dissociating D(2)(+) molecules with femtosecond time-resolution allowed us to perform an internuclear distance (R-)dependent Fourier analysis of the corresponding wave packets. Calculations demonstrate that the obtained two-dimensional R-dependent frequency spectra enable the complete characterization of the wave packet dynamics and directly visualize the field-modified molecular potential curves in intense, ultrashort laser pulses.

Spatiotemporal imaging of ultrafast molecular motion: collapse and revival of the D+2 nuclear wave packet

We report on a real-time imaging of the ultrafast D(+)2 rovibrational nuclear wave-packet motion performed using a combination of a pump-probe setup with 7 fs laser pulses and a "reaction-microscope" spectrometer. We observe fast dephasing (collapse) of the vibrational wave packet and its subsequent revival and prove rotational excitation in ultrashort laser pulses. Channel-selective Fourier analysis of the wave packet's long-term (approximately 3000 fs) evolution allows us to resolve its individual constituents, revealing unique information on the mechanisms of strong-field ionization and dissociation.

Quantum-phase resolved mapping of ground-state vibrational D2 wave packets via selective depletion in intense laser pulses

Applying 7 fs pump-probe pulses (780 nm, 4 x 10(14) W/cm2) we observe electronic ground-state vibrational wave packets in neutral D2 with a period of T=11.101(70) fs by following the internuclear separation (R-)dependent ionization with a sensitivity of Delta<R><or=0.02 A. The absolute phase of the wave packet's motion provides evidence for R-dependent depletion of the ground state by nonlinear ionization, to be the dominant preparation mechanism. A phase shift of about pi found between pure ionization (D2+) and dissociation (D+ + D) channels opens a pathway of quantum control.

Time-resolved imaging and manipulation of H2 fragmentation in intense laser fields

We report on the experimental realization of time-resolved coincident Coulomb explosion imaging of H2 fragmentation in 10(14) W/cm(2) laser fields. Combining a high-resolution "reaction microscope" and a fs pump-probe setup, we map the motion of wave packets dissociating via one- or two-photon channels, respectively, and observe a new region of enhanced ionization. The long-term interferometric stability of our system allows us to extend pump-probe experiments into the region of overlapping pulses, which offers new possibilities for the manipulation of ultrafast molecular fragmentation dynamics.

Correlated multielectron dynamics in ultrafast laser pulse interactions with atoms

We present the results of the detailed experimental study of multiple ionization of Ne and Ar by 25 and 7 fs laser pulses. Whereas in multiple ionization of Ar different mechanisms, involving field ionization steps and recollision-induced excitations, play a role, for Ne only one channel, where the highly correlated instantaneous emission of up to four electrons is triggered by a recollisional electron impact, is found to be important. Using few-cycle pulses we are able to suppress those processes that occur on time scales longer than one laser cycle.

Rescattering of ultralow-energy electrons for single ionization of Ne in the tunneling regime

Electron emission for single ionization of Ne by 25 fs, 1.0 PW/cm(2) laser pulses at 800 nm has been investigated in a kinematically complete experiment using a "reaction microscope." Mapping the complete final state momentum space with high resolution, a distinct local minimum is observed at P(e parallel )=0, where P(e parallel ) is the electron momentum parallel to the laser polarization. Whereas tunneling theory predicts a maximum at zero momentum, our findings are in good agreement with recent semiclassical predictions which were interpreted to be due to "recollision."

Projectile-charge sign dependence of four-particle dynamics in helium double ionization

Double ionization of helium by 6 MeV proton impact has been explored in a kinematically complete experiment using a "reaction microscope." For the first time, fully differential cross sections for positively charged projectiles have been obtained and compared with data from 2 keV electron impact. The significant differences observed in the angular distribution of the ejected electrons are attributed to the charge sign of the projectile, resulting in different dynamics of the four-particle Coulomb system, which is not considered in the first Born approximation.

Coincident fragment detection in strong field photoionization and dissociation of H2

Electron-ion momentum spectroscopy is used to investigate the correlated electronic and nuclear motion in fragmentation of H2 in 4 x 10(14) W/cm(2), 25 fs laser pulses at 795 nm. Reaction channel dependent photoelectron spectra indicate that besides the main, stepwise H2 ionization H2(+) dissociation mechanism resulting in the products H(1s) + H(+) + e(-) a second new mechanism has to be assumed. The momentum distribution of H(+) ions in the dissociation channels H(1s) + H(+) + e(-) and 2H(+) + 2e(-) is found to be independent of the kinetic energy of the photoelectrons.

Separation of recollision mechanisms in nonsequential strong field double ionization of Ar: the role of excitation tunneling

Vector momentum distributions of two electrons created in double ionization of Ar by 25 fs, 0.25 PW/cm(2) laser pulses at 795 nm have been measured using a "reaction microscope." At this intensity, where nonsequential ionization dominates, distinct correlation patterns are observed in the two-electron momentum distributions. A kinematical analysis of these spectra within the classical "recollision model" revealed an (e,2e)-like process and excitation with subsequent tunneling of the second electron as two different ionization mechanisms. This allows a qualitative separation of the two mechanisms demonstrating that excitation-tunneling is the dominant contribution to the total double ionization yield.

Non-sequential double ionization of Ne in intense laser pulses: a coincidence experiment

The dynamics of Neon double ionization by 25 fs, 1.0 PW/cm 2 laser pulses at 795 nm has been studied in a many particle coincidence experiment. The momentum vectors of all ejected atomic fragments (electrons and ions) have been measured using combined electron and recoil-ion momentum spectroscopy. Electron emission spectra for double and single ionization will be discussed. In both processes the mean electron energies differ considerably and high energetic electrons with energies of more than 120 eV have been observed for double ionization. The experimental results are in qualitative agreement with the rescattering model.

Collection of MNCs with two cell separators for adoptive immunotherapy in patients with stage IV melanoma

BACKGROUND

MNCs for adoptive immunotherapy may be collected by leukocytapheresis with a cell separator.

STUDY DESIGN AND METHODS

Six healthy cytapheresis donors donated two MNC concentrates on a cell separator (AS.TEC 204, Fresenius): one on the standard MNC program and one on a modified MNC program with reduced centrifuge velocity that leads to a lower platelet contamination. Seventeen patients with malignant melanoma donated 26 MNC concentrates: 5 on the AS.TEC 204 MNC program, 9 on the modified AS.TEC 204 MNC program, and 12 on another modified MNC program (Spectra, COBE).

RESULTS

In the course of cultivation of MNCs to dendritic cells (DCs), the donor MNC concentrates with the lower platelet contamination (475 +/- 85 x 10(9)/L) had a significantly higher relative DC yield (low platelet contamination: 3.9 +/- 1.6% of the plated cells; high platelet contamination: 2.5 +/- 1.8% of the plated cells; p = 0.019) than the concentrates with the higher platelet contamination (2364 +/- 448 x 10(9)/L). No significant difference was found in the yields of MNCs and CD14+ cells in the three protocols used for the collection of MNCs from patients with melanoma. The components obtained by the standard AS.TEC 204 MNC program had a significantly higher platelet contamination (1768 +/- 994 x 10(9)/L) than the components obtained by the modified AS.TEC MNC program (360 +/- 98 x 10(9)/L; p<0.05) and the modified Spectra MNC program (636 +/- 266 x 10(9)/L); p<0.05). Because of the low number of investigated components, no significant difference in the DC yield of the three protocols could be detected (mean DC yield after cultivation: 746 +/- 429 x 10(6)).

CONCLUSION

A high platelet contamination of MNC concentrates intended for adoptive immunotherapy can lead to a significant impairment of the DC yield after cultivation. Both the modified AS.TEC 204 and the modified Spectra MNC programs are well suited for collecting MNC concentrates with high MNC yields and low platelet contamination from patients with malignant melanoma.

A method for the production of cryopreserved aliquots of antigen-preloaded, mature dendritic cells ready for clinical use

Dendritic cells (DC) are increasingly used as a vaccine. Unfortunately, a satisfactory cryopreservation of DC in the absence of FCS is not yet available, so that laborious repeated generation of DC from fresh blood or frozen peripheral blood mononuclear cells for each vaccination has been required to date. We now aimed at developing an effective cryopreservation method, and by testing several variables found that it was crucial to combine the most advantageous maturation stimulus with an improved freezing procedure. We generated monocyte-derived DC from leukapheresis products by using GM-CSF and IL-4 and showed that amongst several known maturation stimuli the cocktail consisting of TNF-alpha+IL-1 beta+IL-6+PGE(2) achieved the highest survival of mature DC. We then systematically explored cryopreservation conditions, and found that freezing matured DC at 1 degrees C/min in pure autologous serum+10% DMSO+5% glucose at a cell density of 10x10(6) DC/ml gave the best results. Using this approach 85-100% of the frozen DC could be recovered in a viable state after thawing (Table 1). The morphology, phenotype, survival as well as functional properties (allogeneic mixed leukocyte reaction, induction of influenza matrix or melan A peptide-specific cytotoxic T cells) of these thawed DC were equivalent to freshly prepared ones. The addition of CD40L or TRANCE/RANKL further improved DC survival. Importantly, we demonstrate that DC can effectively be loaded with antigens (such as Tetanus Toxoid, influenza matrix and melan A peptides) before cryopreservation so that it is now possible to generate antigen-preloaded, frozen DC aliquots that after thawing can be used right away. This is an important advance as both the generation of a standardized DC vaccine under GMP conditions and the carrying out of clinical trials are greatly facilitated.

[Cowpox and catpox infection. 2 Clinical case reports]

In patients with painful, possibly hemorrhagic vesicles or black crusts, especially on hands/fingers or face/neck with typical history (contact to cows or feral/cats) the possibility of a cowpox/catpox infection has to be considered. The clinical diagnosis can be confirmed with the electron microscopy; cytoplasmic inclusions may be detected histologically. Further useful diagnostic tools are the identification of the cowpox/catpox virus by PCR or in cell culture as well as serological tests to detect virus specific antibodies. We report the development of typical skin lesions of a cowpox/catpox infection in two female patients who had contact with cows or cats. Recent diagnostic and therapeutic approaches are also discussed.

Electron correlations observed through intensity interferometry

Intensity interferometry was applied to study electron correlations in doubly ionizing ion-atom collisions. In this method, the probability to find two electrons emitted in the same double ionization event with a certain momentum difference is compared to the corresponding probability for two uncorrelated electrons from two independent events. The ratio of both probabilities, the so-called correlation function, is found to sensitively reveal electron correlation effects, but it is rather insensitive to the collision dynamics.

Momentum distributions of ne(n+) ions created by an intense ultrashort laser pulse

Vector momentum distributions of Ne(n+) (n = 1,2,3) ions created by 30 fs, approximately 1 PW/cm(2) laser pulses at 795 nm have been measured using recoil-ion momentum spectroscopy. Distinct maxima along the light polarization axis are observed at 4.0 and 7.5 a.u. for Ne2+ and Ne3+ production, respectively. Hence, mechanisms based on an instantaneous release of two (or more) electrons can be ruled out as a dominant contribution to nonsequential strong-field multiple ionization. The positions of the maxima are in accord with kinematical constraints set by the classical "rescattering model."

Laparoscopic cholecystectomy during pregnancy: three case reports

OBJECTIVE

The purpose of this presentation is to investigate the effects and feasibility of laparoscopic cholecystectomy during pregnancy.

METHODS AND PROCEDURES

We present three pregnant patients who underwent a laparoscopic cholecystectomy for biliary colic during the early second and early third trimester of pregnancy. We also reviewed the literature regarding this topic.

RESULTS

All three pregnant patients had uneventful hospital courses after their procedures and delivered full-term babies without complications. Laparoscopic cholecystectomy during the first trimester of pregnancy is contraindicated due to the ongoing fetal organogenesis and during the third trimester is not technically feasible due to the large uterine size.

CONCLUSIONS

We conclude that laparoscopic cholecystectomy during the second and very early third trimester of pregnancy is safe and feasible.

Cellular analysis of the mode of action of methyl-3,5-diiodo-4-(4'-methoxyphenoxy) benzoate (DIME) on tumor cells

The hormonally inactive methyl-3,5-diiodo-4-(4'-methoxyphenoxy) benzoate (DIME) at 1-4 mu M concentration induces morphologic changes in E-ras 20 and MDA-MB-231 and other human cancer cells such as multinucleation and enlargement and arrests the cell cycle in the M phase without affecting interphase. Time-lapse videomicroscopy allowed us to follow individual cells. Cells exposed to DIME divided in an abnormal manner, leading to 20% cell fusion and multinucleation. Chromosome painting demonstrated a large accumulation of chromosomes after 5 days of treatment with DIME, consistent with the failure of cells to divide normally. Chromosome breakage was not observed. On the other hand, highly abnormal tubulin-containing structures ensue upon exposure to DIME (1 mu M for 18 h) treatment, indicating an early biochemical action of DIME on the spindle assembly system.

The peripheral myelin protein 22 kDa (PMP22) gene is amplified in cell lines derived from glioma and osteogenic sarcoma

Two glioma (SF188, SF763) and two osteogenic sarcoma cell lines (RH30, SA1) were examined for the presence of an amplification of the PMP22 gene by means of fluorescence in situ hybridization (FISH). In one cell line of both cell types, we found about 10 copies of the PMP22 (peripheral myelin protein 22 kDa) gene, located on different marker chromosomes within homogeneously staining regions. Surrounding chromosome 17p material was found to be coamplified, but coamplification of TP53 (17p13) and erbB2/Her2 (17q11.12) were excluded by FISH for both cell lines, SF763 and RH30. This is the first report of a PMP22 amplification in cell lines derived from human tumors.

Heterotypic cell-cell adhesion of human mast cells to fibroblasts

Skin mast cells are typically located in the perivascular or perineural connective tissue. We observed that HMC-1 mast cells growing in suspension adhered efficiently to (> 90% of cells) and spread on top of fibroblast monolayers and to a lesser degree on purified extracellular matrix proteins. Since adhesive interactions determine cell migration and tissue localization we studied the mechanism. It was found that HMC-1 cells attach to collagen I and fibronectin, laminin, collagen IV and vitronectin, but not to collagens III and VI or hyaluronic acid. Adhesion to fibronectin, collagen I and laminin was completely inhibited by mAbs blocking beta 1-integrins, whereas adhesion of HMC-1 cells to vitronectin was inhibited by anti-alpha v-chain mAbs. However, attachment of HMC-1 cells to fibroblasts was not influenced by mAbs blocking beta 1- or alpha v-chain function, by RGD peptides or by mAbs interfering with other receptors, most notably c-kit. Identical results were obtained with normal mast cells isolated from human foreskin. These results indicate that human mast cells attach to fibroblasts independently of beta 1- or alpha v-integrins as well as of c-kit receptor-mediated mechanisms. The functional characteristics observed (i.e. only partial sensitivity to trypsin and EDTA, no increase in trypsin sensitivity by pretreatment with EDTA) suggest that cadherin receptors were not involved, and it is likely that the adhesion process observed involved not-yet-defined heterotypic cell-cell adhesion receptors.

Scrapie prions alter receptor-mediated calcium responses in cultured cells

The molecular basis of neurologic dysfunction in prion diseases is unknown. Spongiform degeneration of neurons is the most characteristic neuropathologic change which raises the possibility of abnormal ion channel function. Here we examined the regulation of Ca2+ fluxes in two cell lines chronically infected with scrapie prions, designated ScN2a (scrapie-infected mouse neuroblatoma) and ScHaB (scrapie-infected hamster brain) cells. In uninfected HaB cells, bradykinin caused increases in intracellular Ca2+ concentration ([Ca2+]i) by release of Ca2+ from internal stores and influx of extracellular Ca2+ whereas, in N2a cells, bradykinin increased [Ca2+]i exclusively from internal stores. Prion infection of both cell lines markedly reduced or eliminated bradykinin-activated increases in [Ca2+]i, whether driven by internal or extracellular sources. Stressing the cells with high extracellular [Ca2+], 8 to 20 mM, led to cytopathologic changes in ScHaB but not in ScN2a cells. Cytopathology was not preceded by an increase in [Ca2+]i. These findings indicate that scrapie infection induces abnormalities in receptor-mediated Ca2+ responses and raise the possibility that nerve cell dysfunction and degeneration in prion diseases is related to ion channel aberrations.

A selective effect of methylglyoxal-bis(guanylhydrazone) on the synthesis of mitochondrial DNA of cultured L1210 leukemia cells

Methylglyoxal-bis(guanylhydrazone) (MGBG) is a polycationic drug which is useful in the chemotherapy of lymphoid and myeloid proliferative disorders. The drug has recently been shown to produce selective ultrastructural damage to the mitochondria of proliferating cell populations. It is important to understand the molecular basis for this action, since it may be related to the known ability of MGBG to block polyamine biosynthesis. Accordingly, the effect of MGBG treatment on the incorporation of [3H]thymidine into both mitochondrial and nuclear DNA has been examined. Exponentially growing L1210 leukemia cells were prelabeled with [14C]thymidine, treated with MGBG for 1.5 to 16 hr, and then pulse labeled with [3H]-thymidine. Incorporation of [3H]thymidine into mitochondrial DNA was selectively inhibited at 5 hr with concentrations of 1 to 10 microM MGBG. Nuclear DNA, however, was not similarly affected until 8 to 11 hr of drug treatment. Dye-CsCl gradients of mitochondrial DNA indicated that the inhibition of synthesis occurred in replicative forms of circular DNA. Uptake studies excluded the possibility of drug interference with cellular uptake of thymidine. Ultrastructural studies revealed a very close correlation between the dose-response curve for mitochondrial damage and that for MGBG inhibition of mitochondrial DNA synthesis. This correlation suggests a direct cause-and-effect relationship between inhibition of mitochondrial DNA synthesis and ultrastructural damage, but the possibility of both phenomena being related to another action by the drug, such as inhibition of polyamine biosynthesis, or a drug effect on mitochondrial function, must also be considered.