North Atlantic ocean circulation and abrupt climate change during the last glaciation.

The most recent ice age was characterized by rapid and hemispherically asynchronous climate oscillations, whose origin remains unresolved. Variations in oceanic meridional heat transport may contribute to these repeated climate changes, which were most pronounced during marine isotope stage 3, the glacial interval 25 thousand to 60 thousand years ago. We examined climate and ocean circulation proxies throughout this interval at high resolution in a deep North Atlantic sediment core, combining the kinematic tracer protactinium/thorium (Pa/Th) with the deep water-mass tracer, epibenthic δ(13)C. These indicators suggest reduced Atlantic overturning circulation during every cool northern stadial, with the greatest reductions during episodic Hudson Strait iceberg discharges, while sharp northern warming followed reinvigorated overturning. These results provide direct evidence for the ocean's persistent, central role in abrupt glacial climate change.

Proteomic profiling of human retinal pigment epithelium exposed to an advanced glycation-modified substrate.

PURPOSE: The retinal pigment epithelium (RPE) and underlying Bruch's membrane undergo significant modulation during ageing. Progressive, age-related modifications of lipids and proteins by advanced glycation end products (AGEs) at this cell-substrate interface have been implicated in RPE dysfunction and the progression to age-related macular degeneration (AMD). The pathogenic nature of these adducts in Bruch's membrane and their influence on the overlying RPE remains unclear. This study aimed to identify alterations in RPE protein expression in cells exposed to AGE-modified basement membrane (AGE-BM), to determine how this "aged" substrate impacts RPE function and to map the localisation of identified proteins in ageing retina. METHODS: Confluent ARPE-19 monolayers were cultured on AGE-BM and native, non-modified BM (BM). Following 28-day incubation, the proteome was profiled using 2-dimensional gel electrophoresis (2D), densitometry and image analysis was employed to map proteins of interest that were identified by electrospray ionisation mass spectrometry (ESI MS/MS). Immunocytochemistry was employed to localise identified proteins in ARPE-19 monolayers cultured on unmodified and AGE-BM and to analyze aged human retina. RESULTS: Image analysis detected altered protein spot densities between treatment groups, and proteins of interest were identified by LC ESI MS/MS which included heat-shock proteins, cytoskeletal and metabolic regulators. Immunocytochemistry revealed deubiquitinating enzyme ubiquitin carboxyterminal hydrolase-1 (UCH-L1), which was upregulated in AGE-exposed RPE and was also localised to RPE in human retinal sections. CONCLUSIONS: This study has demonstrated that AGE-modification of basement membrane alters the RPE proteome. Many proteins are changed in this ageing model, including UCHL-1, which could impact upon RPE degradative capacity. Accumulation of AGEs at Bruch"s membrane could play a significant role in age-related dysfunction of the RPE.

Transient simulation of last deglaciation with a new mechanism for Bolling-Allerod warming.

We conducted the first synchronously coupled atmosphere-ocean general circulation model simulation from the Last Glacial Maximum to the Bølling-Allerød (BA) warming. Our model reproduces several major features of the deglacial climate evolution, suggesting a good agreement in climate sensitivity between the model and observations. In particular, our model simulates the abrupt BA warming as a transient response of the Atlantic meridional overturning circulation (AMOC) to a sudden termination of freshwater discharge to the North Atlantic before the BA. In contrast to previous mechanisms that invoke AMOC multiple equilibrium and Southern Hemisphere climate forcing, we propose that the BA transition is caused by the superposition of climatic responses to the transient CO(2) forcing, the AMOC recovery from Heinrich Event 1, and an AMOC overshoot.

Isolation of retinal progenitor and stem cells from the porcine eye.

PURPOSE: Retinal progenitor cells (RPCs) and retinal stem cells (RSCs) from rodents and humans have been isolated and characterized in vitro. Transplantation experiments have confirmed their potential as tools for cell replacement in retinal degenerative diseases. The pig represents an ideal pre-clinical animal model to study the impact of transplantation because of the similarity of its eye to the human eye. However, little is known about porcine RPCs and RSCs. We aimed to identify and characterize in vitro RPCs and RSCs from porcine ocular tissues. METHODS: Cells from different subregions of embryonic, postnatal and adult porcine eyes were grown in suspension sphere culture in serum-free medium containing basic fibroblast growth factor (bFGF) and epidermal growth factor (EGF). Growth curves and BrdU incorporation assays were performed to establish the proliferative capacity of isolated porcine retina-derived RPCs and ciliary epithelium (CE)-derived RSCs. Self-renewal potential was investigated by subsphere formation assays. Changes in gene expression were assayed by reverse transcription polymerase chain reaction (RT-PCR) at different passages in culture. Finally, differentiation was induced by addition of serum to the cultures and expression of markers for retinal cell types was detected by immunohistochemical staining with specific antibodies. RESULTS: Dissociated cells from embryonic retina and CE at different postnatal ages generated primary nestin- and Pax6-immunoreactive neurosphere colonies in vitro in numbers that decreased with age. Embryonic and postnatal retina-derived RPCs and young CE-derived RSCs displayed self-renewal capacity, generating secondary neurosphere colonies. However, their self-renewal and proliferation capacity gradually decreased and they became more committed to differentiated states with subsequent passages. The expansion capacity of RPCs and RSCs was higher when they were maintained in monolayer culture. Porcine RPCs and RSCs could be induced to differentiate in vitro to express markers of retinal neurons and glia. CONCLUSIONS: Porcine retina and CE contain RPCs and RSCs which are undifferentiated, self-renewing and multipotent and which show characteristics similar to their human counterparts. Therefore, the pig could be a useful source of cells to further investigate the cell biology of RPCs and RSCs and it could be used as a non-primate large animal model for pre-clinical studies on stem cell-based approaches to regenerative medicine in the retina.

The use of Raman microscopy to determine and localize vitamin E in biological samples.

Alpha-tocopherol (aT), the predominant form of vitamin E in mammals, is thought to prevent oxidation of polyunsaturated fatty acids. In the lung, aT is perceived to be accumulated in alveolar type II cells and secreted together with surfactant into the epithelial lining fluid. Conventionally, determination of aT and related compounds requires extraction with organic solvents. This study describes a new method to determine and image the distribution of aT and related compounds within cells and tissue sections using the light-scattering technique of Raman microscopy to enable high spatial as well as spectral resolution. This study compared the nondestructive analysis by Raman microscopy of vitamin E, in particular aT, in biological samples with data obtained using conventional HPLC analysis. Raman spectra were acquired at spatial resolutions of 2-0.8 microm. Multivariate analysis techniques were used for analyses and construction of corresponding maps showing the distribution of aT, alpha-tocopherol quinone (aTQ), and other constituents (hemes, proteins, DNA, and surfactant lipids). A combination of images enabled identification of colocalized constituents (heme/aTQ and aT/surfactant lipids). Our data demonstrate the ability of Raman microscopy to discriminate between different tocopherols and oxidation products in biological specimens without sample destruction. By enabling the visualization of lipid-protein interactions, Raman microscopy offers a novel method of investigating biological characterization of lipid-soluble compounds, including those that may be embedded in biological membranes such as aT.

Effect of reserpine on the generation of the chromogranin A-derived neuropeptide WE-14 in rat oxyntic mucosa.

WE-14, a post-translational product of the neuroendocrine protein chromogranin A (CgA), is generated in distinct subpopulations of endocrine cells. The objective of this study was to investigate the generation of WE-14 in the endocrine cell types of the oxyntic mucosa of the stomach, after treatment with reserpine, an irreversible inhibitor of vesicular monoamine uptake 2 (VMAT2). Reserpine (10 mg/kg) was administered subcutaneously and tissue analysed 1, 3, 5 and 18 h following treatment. The oxyntic mucosa was analysed immunohistochemically employing a site-specific WE-14 antiserum, a region-specific CgA antiserum and an antiserum against histidine decarboxylase (HDC), a marker of the histamine-producing ECL cells in the oxyntic mucosa. The number of oxyntic endocrine cells exhibiting WE-14 immunostaining increased more than 100-fold 18 h after reserpine administration relative to vehicle treated controls. Double immunostaining with HDC revealed that most, but not all, of the WE-14 positive cells were ECL cells. These results suggest that reserpine has the ability to influence the post-translational processing of CgA to generate WE-14 in rat stomach ECL cells, presumably as a consequence of reduced VMAT2-driven accumulation of histamine.

Computed tomographic demonstrated infarcts after surgical and endovascular treatment of aneurysmal subarachnoid hemorrhage.

BACKGROUND: Cerebral infarction is a sequela of vasospasm. Other etiologies for infarction after subarachnoid hemorrhage (SAH), however, have not been well-studied. To determine the incidence and etiologies for infarction after SAH, we reviewed the head CT scans of all SAH patients at our center from 1993-2000. METHODS: From 1993-2000, 679 consecutive patients were admitted with SAH, of which 619 patients underwent surgical or endovascular treatment. Two reviewers examined the head CT scans of all 619 patients for new infarct. Clinical outcome was collected from a prospective database. FINDINGS: 505 patients were treated with surgical clipping; 114 with endovascular coiling. There were CT findings of new infarct in 189 patients (30%): 140 in the surgical group (28%) and 49 in the endovascular group (43%). The etiologies for infarct in the surgical group were vasospasm 79 (15%), perforator occlusion 40 (8%), large vessel occlusion 14 (3%), elevated intracranial pressure 4 (1%), thromboembolism 2 (0.4%), and systemic hypotension 1 (0.2%). Infarcts in the endovascular group were due to vasospasm 20 (18%), thromboembolism 12 (11%), large vessel occlusion/dissection 9 (8%), elevated intracranial pressure 4 (4%), perforator occlusion 3 (3%), and systemic hypotension 1 (1%). Hunt Hess Grade (P < 0.001), Fisher Score (P < 0.0001), and MGH Grade (P < 0.001) were significantly associated with CT-demonstrated infarct. There was no significant difference in incidence of CT-infarcts when the period 1993-1996 was compared to 1997-2000. CONCLUSIONS: Despite advances in the treatment of SAH, there is still a significant incidence of associated radiographic infarcts. Hunt Hess Grade, Fisher Score, and MGH Grade were significantly associated with CT-demonstrated infarct.

Characterisation of WE-14 in porcine ocular tissue.

WE-14 is derived from the cell-specific posttranslational processing of chromogranin A (CgA) in subpopulations of neuroendocrine cells and neurons. Region- and site-specific chromogranin A, pancreastatin and WE-14 antisera were employed to study the generation of WE-14 in porcine ocular tissues. No chromogranin A or pancreastatin immunostaining was detected in ocular tissue. Immunohistochemistry detected WE-14 immunostaining in a network of nerve fibre bundles and nerve fibres throughout the limbus, cornea, iris and ciliary body with sparse nerve fibres detected throughout the choroid and sclera. Retinal analysis detected intense WE-14 immunostaining in large ovoid cells in the ganglion cell layer with weak immunostaining in a population of small cells in the inner nuclear layer; weak immunostaining was detected within the fibre layers in the inner plexiform layer. Quantitatively, the highest WE-14 tissue concentration was recorded in aqueous retinal and corneal extracts with lower concentrations in the sclera, choroid and anterior uveal tissues. Chromatographic profiling resolved a minor chromogranin A-like immunoreactant and a predominant immunoreactant co-eluting with synthetic human WE-14. This is the first study to demonstrate that WE-14 is generated in neuronal fibres primarily innervating the anterior chamber and in select cell populations in the retina.

Gene organization and expression of a neuropeptide Y homolog from the land planarian Arthurdendyus triangulatus.

Neuropeptide Y is one of the most widespread regulatory peptides within the vertebrate nervous system and shares the C-terminal motif [FY]-x(3)-[LIVM]-x(2)-Y-x(3)-[LIVMFY]-x-R-x-R-[YF] with pancreatic polypeptide, peptide YY, and fish pancreatic peptide Y. All four peptides are believed to have arisen from a single ancestral gene through successive gene duplication events in vertebrates. The origin of this peptide family may date back further still; similarly sized peptide transmitters with an identical C-terminal motif have been identified in molluscs and flatworms and designated neuropeptide F (NPF). Cloning of the npf gene from the parasitic flatworm Moniezia expansa identified some unusual features within the peptide precursor organization but, at the same time, provided support for an evolutionary relationship of npf and npy genes through the presence of a single intron at a conserved position. To extend the analysis of the evolutionary relationships between invertebrate NPF and vertebrate NPY family peptides, the NPF precursor from the turbellarian Arthurdendyus triangulatus was characterized. Sequence analysis revealed the npf transcript to be 362 base pairs in length encoding a single open reading frame of 81 amino acids. The precursor comprises a signal peptide followed by the mature peptide of 36 amino acids in length, terminating in the typical invertebrate GRPRF motif, followed by a carboxyterminal glycyl extension. The NPF precursor of A. triangulatus shows significant similarities to the vertebrate NPY peptides. Indeed, the N-terminus of A. triangulatus prepro-NPF corresponds more closely to that of the vertebrate peptide homologs than to that of other invertebrate NPFs isolated to date. Immunocytochemical localization studies have demonstrated NPF immunoreactivity throughout the nervous system of A. triangulatus, particularly in association with muscular structures. The data support an early evolutionary origin for this peptide transmitter family within the nervous system of basal bilaterians.

WE-14, a chromogranin a-derived neuropeptide.

The neuropeptide WE-14 is derived from the posttranslational processing of chromogranin A (CgA). While CgA is expressed in a preponderance of neuroendocrine cells, WE-14 is generated in a distinct subpopulation of CgA-immunopositive cells, most notably in the adrenal, pituitary, and parathyroid glands. Physiological and pharmacological studies have demonstrated that CgA is cleaved to generate WE-14 in the adrenal chromaffin cell population and in the enterochromaffin-like (ECL) cells of the oxyntic mucosa. Pathological analyses of neuroendocrine tumors have revealed a heterogeneous pattern of WE-14 immunostaining, with variable concentrations quantified and chromatographically resolved in tissue extracts. Phylogenetic surveys have demonstrated that WE-14 exhibits an ancient lineage, while ontogenetic examination has shown that it is generated at an early stage during fetal development. Putative WE-14 receptor binding sites have been identified in several tissues; however, the physiological role of WE-14 remains enigmatic.

Immunohistochemical localization of WE-14 in the developing porcine sympathoadrenal cell lineage.

Immunohistochemical investigation of the post-translational processing of chromogranin A (CgA) to generate WE-14 in the sympathoadrenal cell lineage of the developing porcine fetus (F) detected intense CgA and weak WE-14 immunoreactivity in migrating neuroblast cells of the diffuse sympathetic ganglia adjacent to the dorsal aorta and projecting toward the cortical mass at F24-27. F37-42; WE-14 immunoreactivity was detected in chromaffinoblasts at the periphery of the developing cortex and at F54-56 days gestation WE-14 immunoreactivity was detected in a large population of central medullary cells. From F74 to F76 days and thereafter the number of cells exhibiting intense WE-14 immunostaining decreased, and the majority of chromaffin cells exhibited uniform weak WE-14 immunostaining. At postnatal day 1 (P1) intense WE-14 immunoreactivity was primarily confined to clusters of chromaffin cells with weak immunostaining in the general population. The transitory neuroblasts, chromaffinoblasts, and maturing chromaffin cell population exhibited uniform intense CgA immunostaining through gestation and after birth. Additional observations detected intense CgA and WE-14 immunostaining in extrachromaffin tissue at P1 and in neuronal-like cells in vessels of the aortic arch at F37. This study has demonstrated that CgA is post-translationally processed to generate WE-14 during early fetal development in the migrating progenitor cells of the porcine sympathoadrenal lineage.

Analysis of the post-translational processing of chromogranin A in rat neuroendocrine tissue employing an N-terminal site-specific antiserum.

Chromogranin A (CgA) is a complex prohormone expressed as a constituent of the regulated secretory pathway of numerous neuroendocrine cells. Recent investigations have demonstrated that CgA is selectively cleaved to generate distinct peptides in different neuroendocrine tissues. This investigation employed a site-specific antiserum that detects residues 98-106 rat CgA to examine the amino-terminal processing of CgA to generate beta-granin and related peptides in rat neuroendocrine tissues. Immunohistochemistry revealed moderate to intense beta-granin-like immunostaining in cells scattered throughout the anterior pituitary, thyroid, in the islets of Langerhans and in the mucosa of the gastrointestinal tract. Variable intensities of immunostaining were observed in distinct clusters of chromaffin cells. Quantitatively, the highest concentration of beta-granin-like immunoreactivity was detected in pituitary extracts. Significantly lower concentrations were detected in adrenal and thyroid glands, brain, ventral and dorsal pancreatic lobes and gastrointestinal tissue extracts. Chromatography resolved three distinct beta-granin-like immunoreactants; a large CgA-like form, an intermediate molecular form presumably corresponding to beta-granin (rat CgA1-128) and small immunoreactants that coeluted with the synthetic peptide. Two beta-granin-like immunoreactants, 21 and 22 kDa, were detected following immunoblot analysis of pituitary extracts. This study has demonstrated that chromogranin A is subject to distinct amino-terminal patterns of tissue-and cell-specific processing to generate a beta-granin-like immunoreactant which is additionally cleaved in pancreatic, fundic and colonic tissue to generate previously unidentified peptides.

Cell-specific processing of chromogranin A in endocrine cells of the rat stomach.

The rat stomach is rich in endocrine cells. The acid-producing (oxyntic) mucosa contains ECL cells, A-like cells, and somatostatin (D) cells, and the antrum harbours gastrin (G) cells, enterochromaffin (EC) cells and D cells. Although chromogranin A (CgA) occurs in all these cells, its processing appears to differ from one cell type to another. Eleven antisera generated to different regions of rat CgA, two antisera generated to a human (h) CgA sequences, and one to a bovine (b) CgA sequence, respectively, were employed together with antisera directed towards cell-specific markers such as gastrin (G cells), serotonin (EC cells), histidine decarboxylase (ECL cells) and somatostatin (D cells) to characterize the expression of CgA and CgA-derived peptides in the various endocrine cell populations of the rat stomach. In the oxyntic mucosa, antisera raised against CgA(291-319) and CGA(316-321) immunostained D cells exclusively, whereas antisera raised against bCgA(82-91) and CgA(121-128) immunostained A-like cells and D cells. Antisera raised against CgA(318-349) and CgA(437-448) immunostained ECL cells and A-like cells, but not D cells. In the antrum, antisera against CgA(291-319) immunostained D cells, and antisera against CgA(351-356) immunostained G cells. Our observations suggest that each individual endocrine cell type in the rat stomach generates a unique mixture of CgA-derived peptides, probably reflecting cell-specific differences in the post-translational processing of CgA and its peptide products. A panel of antisera that recognize specific domains of CgA may help to identify individual endocrine cell populations.

Resection of a dominant-hemisphere intraventricular meningioma facilitated by functional magnetic resonance imaging. Case report.

Intraventricular meningiomas of the lateral ventricle occur relatively rarely, but they are often large at the time of detection and present more commonly on the left side. Although the ability to resect these tumors safely has greatly improved over time, standard surgical approaches often traverse cortex close to areas of specific cortical function. Precise cortical mapping of language and sensorimotor cortices can be accomplished noninvasively by using functional magnetic resonance (fMR) imaging. The authors used fMR imaging in planning the cortical incision for resection of a large intraventricular trigone meningioma in the dominant hemisphere of a patient who, postoperatively, suffered no aphasia or hemiparesis. The authors discuss the advantages of mapping cortical function preoperatively with fMR imaging when approaching intraventricular lesions.

Immunohistochemical evaluation of the post-translational processing of chromogranin A in human pituitary adenomas.

Chromogranin A (CgA), pancreastatin (PST), intervening-peptide (IP) and WE-14 antisera were employed to investigate the proteolysis of CgA in 50 pituitary adenomas. All non-functioning (NF) pituitary tumours (n = 28) exhibited CgA immunoreactivity. PST, IP and WE-14 immunostaining was observed in 85%, 89% and 67%, respectively. CgA, PST and IP immunostaining were comparable in the majority of NF tumours, while less intense WE-14 immunoreactivity was detected in a subpopulation of NF tumour cells. Approximately half of the functioning pituitary tumours expressed CgA immunoreactivity. Six of nine ACTH-secreting tumours displayed CgA and IP immunostaining; four of these tumours displayed PST immunoreactivity. WE-14 immunoreactivity was detected in one corticotroph tumour. Three of six growth hormone (GH) secreting tumours displayed CgA immunostaining, two exhibited PST and IP, and one exhibited WE-14 immunoreactivity. Clusters of WE-14 immunopositive cells were detected in one GH tumour. One of seven prolactinomas exhibited weak CgA immunostaining, while weak IP and WE-14 immunostaining was detected in an additional tumour. No PST immunostaining was detected in prolactinomas. Therefore CgA is a valuable marker of NF pituitary tumours, however it is a more sporadic marker of functioning adenomas. In general, the cellular pattern and intensities of CgA, PST and IP immunoreactivity were comparable in the majority of pituitary adenomas. In contrast, WE-14 immunostaining was observed in a subpopulation of tumour cells. The pathophysiological significance of the proteolysis of CgA to generate bioactive peptides in both NF and functioning pituitary adenomas remains to be established.

Immunostaining for vasostatin I distinguishes between ileal and lung carcinoids.

Although chromogranin A (CgA) is a recognized marker of neuroendocrine tumours, little is known about the distribution of the CgA-derived peptides, vasostatin (VST) I or II, in these tumours. Rabbit polyclonal antiserum was raised to a fragment of VST I and used to immunostain sections (5 microns) of wax-embedded tumour tissue. Immunoreactivity (IR) was detected using swine anti-rabbit fluorescein secondary antibody and sections were viewed by fluorescence microscopy. Of 24 tumours from patients with lung carcinoids, one was weakly positive, while 23 of 26 ileal carcinoid tumours were immunoreactive. Metastatic deposits from patients with ileal carcinoids also tended to be immunoreactive (9/10). The difference in IR between lung and ileal carcinoid primary tumours did not appear to be related to the metastatic potential, since appendiceal tumours, which seldom metastasize, also tended to be immunoreactive (4/6) for VST I. The strongest IR was recorded in two patients with flushing as a result of ileal carcinoids; five other 'flushers' with ileal carcinoids were also immunopositive for VST I-like IR. By contrast, patients with flushing as a result of lung carcinoids were immunonegative for VST. In conclusion, VST I-like IR may assist in the identification of a secondary deposit from an unknown primary site.

The new management team.

There is no better place to instill the necessary sense of cooperation and collaboration than the top. If top management, both physician and nonphysician, can establish a suitable working relationship, and communicate both the necessity for and success of the relationship throughout the organization, breakdowns in cooperation and collaboration are far less likely to occur. Shared responsibility and decision-making at the upper levels can be a laboratory for their use in other organizational locations. The partnership between clinical and administrative leadership is more important now than ever before. Medical group practices are an ideal setting for testing a new form of shared management that will help to rid organizations of the confrontational and adversarial attitudes that have too long characterized relationships among managers and clinicians in our health care organizations and institutions.

Newer antiepileptic drugs: gabapentin, lamotrigine, felbamate, topiramate and fosphenytoin.

Twenty-five to 40 percent of patients with epilepsy continue to have seizures despite optimal treatment with traditional antiepileptic drugs. Treatment with standard anticonvulsants such as phenytoin, carbamazepine, valproic acid and phenobarbital is often complicated by side effects and by failure to adequately control seizures. Up to 61 percent of patients with seizures report having side effects with antiepileptic drugs. After a 15-year hiatus since the last new antiepileptic drug was marketed, five new drugs have been approved by the U.S. Food and Drug Administration for the control of seizures. Three of these, gabapentin, lamotrigine and topiramate, are approved for use in adults with partial seizures with or without generalization. Felbamate is approved for the above indication and also for use in children with Lennox-Gastaut syndrome, a rare childhood seizure disorder. Felbamate and lamotrigine have the potential of significant side effects and should be prescribed by physicians experienced in managing patients with complicated epilepsy. Fosphenytoin is a parenteral prodrug of phenytoin that is more tolerable than parenteral phenytoin.