Collaboration Around Rare Bone Diseases Leads to the Unique Organizational Incentive of the Amsterdam Bone Center

In the field of rare bone diseases in particular, a broad care team of specialists embedded in multidisciplinary clinical and research environment is essential to generate new therapeutic solutions and approaches to care. Collaboration among clinical and research departments within a University Medical Center is often difficult to establish, and may be hindered by competition and non-equivalent cooperation inherent in a hierarchical structure. Here we describe the "collaborative organizational model" of the Amsterdam Bone Center (ABC), which emerged from and benefited the rare bone disease team. This team is often confronted with pathologically complex and under-investigated diseases. We describe the benefits of this model that still guarantees the autonomy of each team member, but combines and focuses our collective expertise on a clear shared goal, enabling us to capture synergistic and innovative opportunities for the patient, while avoiding self-interest and possible harmful competition.

The effects of posterior continuous curvilinear capsulorhexis on contrast sensitivity

PURPOSE

We aimed at evaluating the effects of posterior continuous curvilinear capsulorhexis (PCCC) on contrast sensitivity.

MATERIALS AND METHODS

In this prospective, randomized, bilateral clinical study, 40 eyes of 20 patients who underwent bilateral cataract surgery were included. The phacoemulsification machine, viscoelastic substances, surgical tools, and intraocular lenses (IOLs) were the same for both eyes. The only difference was that we conducted the PCCC procedure before IOL implantation to one of the eyes of the patients. The selection of the eye that underwent the PCCC procedure was decided randomly.

RESULTS

The mean photopic contrast sensitivity values at spatial frequencies of 1.5, 3, 6, 12, and 18 cpd (cycles per degree) were 41.55, 59.90, 61.25, 32.35, and 9.75, respectively, and for the control group these values were 39.05, 56.60, 57.95, 29.80, and 8.75, respectively. The mean mesopic contrast sensitivity values at special frequencies of 1.5, 3, 6, 12, and 18 cpd were 41.20, 54.75, 55.55, 31.70, and 9.00, respectively, and for the control group these values were 38.35, 51.70, 52.15, 30.05, and 8.00, respectively. The mean contrast sensitivity values of the eyes that underwent the PCCC procedure were slightly better than the fellow eyes at all spatial frequencies, but the difference was statistically insignificant (P>0.05).

CONCLUSIONS

In early post-operative period, the PCCC procedure exerts some positive effects on contrast sensitivity although these effects are statistically insignificant.

Chorionic gonadotrophin beta subunit mRNA but not luteinising hormone beta subunit mRNA is expressed in the pituitary of the common marmoset (Callithrix jacchus)

The pituitary gonadotrophins LH and FSH are responsible for regulation of gametogenesis in the testis and ovary. Chorionic gonadotrophin (CG), a third closely related glycoprotein hormone derived by gene duplication of the LHbeta gene and secreted by the placenta in primates, is essential for the rescue of the corpus luteum and maintenance of pregnancy. We have recently shown that marmoset (m) CGbeta mRNA is highly expressed in the pituitary of the common marmoset (Callithrix jacchus) and that LH is less active than human CG in activating the human LH receptor lacking exon 10. To investigate further which gonadotrophin is the actual ligand of the LH receptor (LHR) of the marmoset monkey that naturally lacks exon 10, we identified and characterised the genomic organisation of the mLHbeta gene and its expression. Intergenic PCR amplification of the region encompassing the mLHbeta and the mCGbeta genes revealed that, surprisingly, mCGbeta is located 20 kbp upstream of the LHbeta gene, whereas in other species the intergenic distance is approximately 2-3 kbp. Sequence analysis of the mLHbeta coding region showed 70% identity to mCGbeta and 90% identity to human LHbeta at the amino acid level. Both gonadotrophin beta subunits are present at the genomic level, but RT-PCR of pituitary and placental total RNA using specific oligonucleotides for mCGbeta and mLHbeta showed high expression of mCGbeta mRNA in both tissues, whereas LHbeta was expressed neither in the pituitary nor in the placenta. Thus mLHbeta mRNA is lacking in the marmoset pituitary. Immunohistochemistry of marmoset pituitaries showed that mCG was confined to the gonadotrophes, and partly co-localised in cells stained positively for FSH. Western blot analysis confirmed the presence of mCG in the pituitary. Northern blot analysis using mCGbeta as a probe displayed one transcript of 0.7 kb in the pituitary and detected two transcripts of 1.1 kb and 2 kb in the marmoset placenta. Our results suggest that, in the common marmoset, CG is the only gonadotrophin with luteinising function that is present in the pituitary. We postulate that, owing to an unknown mutational event in evolution, expression of mLH was completely abolished, and CG - which, unlike LH, acts normally even when exon 10 is missing from the LHR - took over its function.

The structure and organization of the human follicle-stimulating hormone receptor (FSHR) gene

The structure and organization of the human follicle-stimulating hormone receptor (FSHR) gene were determined by either screening a phage library of human genomic DNA or applying the long PCR technique to amplify different exon pairs with their corresponding introns. The FSHR gene spans a region of 54 kb and consists of 10 exons and 9 introns. Most of the extracellular domain is encoded by 9 exons, ranging in length between 69 and 251 bp; the C-terminal part of the extracellular domain, the transmembrane domain, and the intracellular domain are encoded by the large exon 10 (1234 bp). Overall the gene encodes 695 amino acids. The structure of the human FSHR displays striking similarity to that of the previously characterized rat FSHR gene, with a high degree of conservation in exon sizes and exon/intron junctions.

Altered transferrin gene expression in preneoplastic and neoplastic liver lesions induced in rats with N-nitrosomorpholine

The expression of the gene for the iron transport protein transferrin was found to be altered in preneoplastic and neoplastic lesions induced in the rat liver by N-nitrosomorpholine. The total RNA of ten hepatocellular carcinomas (HCC) was investigated by Northern blot analysis using a cDNA-probe comprising 150 bp of the 3' region and compared with the total hepatic RNA in untreated rats. Seven hepatocellular carcinomas showed slight or pronounced reduction in transferrin expression. In situ hybridization of two additional hepatocellular carcinomas revealed marked reduction in the mRNA level for the transferrin gene compared with the surrounding tissue. In contrast, the majority of early preneoplastic lesions storing excess glycogen and tigroid cell foci expressed increased levels of transferrin mRNA. The loss of glycogen in mixed cell foci, which represent a later stage of hepatocarcinogenesis, was usually accompanied by a decrease in transferrin mRNA suggesting a close relationship between this change in gene expression and cellular dedifferentiation emerging during hepatocarcinogenesis.

The nucleotide sequence of rat liver glycogen phosphorylase cDNA

The nucleotide sequence of a cDNA coding for rat liver glycogen phosphorylase has been determined. The 2715 base pairs of the cDNA are sufficient to encode the total protein as determined by comparison with the liver type of glycogen phosphorylase of man. Human and rat liver glycogen phosphorylase showed 86% homology at the DNA level whereas the deduced amino acid sequence has 93.5% identity.