Lysosomal dysfunction in the brain of a mouse model with intraneuronal accumulation of carboxyl terminal fragments of the amyloid precursor protein.

Recent data suggest that intraneuronal accumulation of metabolites of the amyloid-ß-precursor protein (APP) is neurotoxic. We observed that transgenic mice overexpressing in neurons a human APP gene harboring the APPE693Q (Dutch) mutation have intraneuronal lysosomal accumulation of APP carboxylterminal fragments (APP-CTFs) and oligomeric amyloid ß (oAß) but no histological evidence of amyloid deposition. Morphometric quantification using the lysosomal marker protein 2 (LAMP-2) immunolabeling showed higher neuronal lysosomal counts in brain of 12-months-old APPE693Q as compared with age-matched non-transgenic littermates, and western blots showed increased lysosomal proteins including LAMP-2, cathepsin D and LC3. At 24 months of age, these mice also exhibited an accumulation of α-synuclein in the brain, along with increased conversion of LC3-I to LC3-II, an autophagosomal/autolysosomal marker. In addition to lysosomal changes at 12 months of age, these mice developed cholinergic neuronal loss in the basal forebrain, GABAergic neuronal loss in the cortex, hippocampus and basal forebrain and gliosis and microgliosis in the hippocampus. These findings suggest a role for the intraneuronal accumulation of oAß and APP-CTFs and resultant lysosomal pathology at early stages of Alzheimer's disease-related pathology.

Somatostatin neuron contributions to cortical slow wave dysfunction in adult mice exposed to developmental ethanol.

Introduction: Transitions between sleep and waking and sleep-dependent cortical oscillations are heavily dependent on GABAergic neurons. Importantly, GABAergic neurons are especially sensitive to developmental ethanol exposure, suggesting a potential unique vulnerability of sleep circuits to early ethanol. In fact, developmental ethanol exposure can produce long-lasting impairments in sleep, including increased sleep fragmentation and decreased delta wave amplitude. Here, we assessed the efficacy of optogenetic manipulations of somatostatin (SST) GABAergic neurons in the neocortex of adult mice exposed to saline or ethanol on P7, to modulate cortical slow-wave physiology. Methods: SST-cre × Ai32 mice, which selectively express channel rhodopsin in SST neurons, were exposed to ethanol or saline on P7. This line expressed similar developmental ethanol induced loss of SST cortical neurons and sleep impairments as C57BL/6By mice. As adults, optical fibers were implanted targeting the prefrontal cortex (PFC) and telemetry electrodes were implanted in the neocortex to monitor slow-wave activity and sleep-wake states. Results: Optical stimulation of PFC SST neurons evoked slow-wave potentials and long-latency single-unit excitation in saline treated mice but not in ethanol mice. Closed-loop optogenetic stimulation of PFC SST neuron activation on spontaneous slow-waves enhanced cortical delta oscillations, and this manipulation was more effective in saline mice than P7 ethanol mice. Discussion: Together, these results suggest that SST cortical neurons may contribute to slow-wave impairment after developmental ethanol.

Mesencephalic dopamine neuron number and tyrosine hydroxylase content: Genetic control and candidate genes.

The mesotelencephalic dopamine system shows substantial genetic variation which fundamentally affects normal and pathological behaviors related to motor function, motivation, and learning. Our earlier radioenzyme assay studies demonstrated significantly higher activity of tyrosine hydroxylase (TH), the first and rate limiting enzyme in the biosynthesis of catecholamine neurotransmitters, in the substantia nigra-ventral tegmental area of BALB/cJ mice in comparison with that of C57BL/6ByJ mice. Here, using quantitative immunoblotting and immunocytochemistry, we tested the hypothesis that mesencephalic TH protein content and number of nigral TH-positive neurons show strain-dependent differences in C57BL/6ByJ and BALB/cJ parallel to those observed in the TH activity studies. Immunoblotting experiments detected significantly higher mesencephalic TH protein content in BALB/cJ in comparison to C57BL/6ByJ (P<0.05). Immunocytochemical studies demonstrated that the number of TH-positive cells in substantia nigra was 31.3% higher in BALB/cJ than that in C57BL/6ByJ (P<0.01), while the average dopamine neuron volume was not significantly different. In a search for candidate genes that modulate TH content and the size of mesencephalic dopamine neuron populations we also studied near-isogenic mouse sublines derived from the C57BL/6ByJ and BALB/cJ progenitor strains. A whole-genome scan with 768 single nucleotide polymorphism markers indicated that two sublines, C4A6/N and C4A6/B, were genetically very similar (98.3%). We found significantly higher mesencephalic TH protein content in C4A6/B in comparison to C4A6/N (P=0.01), and a tendency for higher number of dopamine neurons in the substantia nigra in C4A6/B in comparison to C4A6/N, which, however, did not reach statistical significance. To identify the genetic source of the TH content difference we analyzed the single nucleotide polymorphism (SNP) genotype data of the whole-genome scan, and detected two small differential chromosome segments on chr. 13 and chr. 14. Microarray gene expression studies and bioinformatic analysis of the two differential regions implicated two cis-regulated genes (Spock1 and Cxcl14, chr. 13), and two growth factor genes [bone morphogenetic protein 6 (Bmp6) (chr. 13), and fibroblast growth factor 14 (Fgf14) (chr. 14)]. Taken together, the results suggest that (1) nigral dopamine neuron number and TH protein content may be genetically associated but further studies are needed to establish unequivocally this linkage, and (2) Spock1, Cxcl14, Bmp6, and Fgf14 are novel candidates for modulating the expression and maintenance of TH content in mesencephalic dopamine neurons in vivo.

Developmental ethanol exposure-induced sleep fragmentation predicts adult cognitive impairment.

Developmental ethanol (EtOH) exposure can lead to long-lasting cognitive impairment, hyperactivity, and emotional dysregulation among other problems. In healthy adults, sleep plays an important role in each of these behavioral manifestations. Here we explored circadian rhythms (activity, temperature) and slow-wave sleep (SWS) in adult mice that had received a single day of EtOH exposure on postnatal day 7 and saline littermate controls. We tested for correlations between slow-wave activity and both contextual fear conditioning and hyperactivity. Developmental EtOH resulted in adult hyperactivity within the home cage compared to controls but did not significantly modify circadian cycles in activity or temperature. It also resulted in reduced and fragmented SWS, including reduced slow-wave bout duration and increased slow-wave/fast-wave transitions over 24-h periods. In the same animals, developmental EtOH exposure also resulted in impaired contextual fear conditioning memory. The impairment in memory was significantly correlated with SWS fragmentation. Furthermore, EtOH-treated animals did not display a post-training modification in SWS which occurred in controls. In contrast to the memory impairment, sleep fragmentation was not correlated with the developmental EtOH-induced hyperactivity. Together these results suggest that disruption of SWS and its plasticity are a secondary contributor to a subset of developmental EtOH exposure's long-lasting consequences.

Somatostatin-like immunoreactivity and glycine high-affinity uptake colocalize to an interplexiform cell of the Xenopus laevis retina.

Antibodies directed against somatostatin have been used to label a population of interplexiform cells (IPCs) in the Xenopus laevis retina. These cells have spherical soma which lie in the inner nuclear layer (INL), adjacent to or one cell distal to the inner plexiform layer (IPL). Processes from these cells project throughout the IPL, with a fairly dense accumulation of labeled dendrites in the upper two-fifths of the IPL and a dense, narrow band of labeled dendrites adjacent to the ganglion cell layer. These cells also have finer processes, originating at the cell body, that traverse the INL and ramify in the outer plexiform layer (OPL). Double label experiments show that all of the cells that contain somatostatin-like immunoreactivity (SOM-LI) in the INL are also labeled by high-affinity uptake with 3H-glycine. Immunocytochemistry of retinal whole mounts shows that these cells are evenly distributed across the retina at a density of 542 +/- 65 cells/mm2. On the basis of the colocalization experiments and the morphological homogeneity of these cells, we suggest that they represent a single cell type. Interplexiform cell processes were further characterized by electron microscopy after immunocytochemistry or 3H-glycine autoradiography. In the IPL, IPC processes are seen to be postsynaptic at both ribbon and conventional synapses. This input is found almost entirely in the distal two-fifths of the IPL. Interplexiform cell processes are presynaptic to unlabeled processes in both the distal and proximal IPL. In the OPL, labeled processes are found near or contiguous with photoreceptor bases, and are often presynaptic to small-diameter processes. The postsynaptic processes have been identified as bipolar cell dendrites in six cases. Interplexiform cell processes may also contact horizontal cell processes in the OPL.

Glycinergic contacts in the outer plexiform layer of the Xenopus laevis retina characterized by antibodies to glycine, GABA and glycine receptors.

Electrophysiological experiments have predicted a direct synaptic input from glycinergic interplexiform cells (IPCs) to GABAergic horizontal cells in the Xenopus retina. However, previous ultrastructural studies failed to demonstrate this input. Here, we used three immunocytochemical approaches to investigate this issue. First, double-label postembedding immunocytochemistry with GABA- and glycine-like immunoreactivity (GABA-LI and glycine-LI) was used to study possible interactions of the glycinergic IPC with GABAergic horizontal cells. Processes postsynaptic to glycine-LI IPC terminals in the outer plexiform layer (OPL) fell into two groups, small microtubule-filled processes and larger electron-lucent processes with sparse microtubules and occasional mitochondria. In no case did we find glycine-LI synapses onto GABA-LI cells or processes. Second, pre-embedding immunocytochemistry was used to label GABA-LI cells and processes in the OPL. GABA-LI was sparse in horizontal cell axons and more intense in horizontal cell somas and in small processes. In agreement with our first set of experiments, GABA-LI profiles did not receive input from conventional synapses. Third, we localized glycine-receptor-like immunoreactivity (GlyR-LI) to several types of apparent synapses in the OPL. As expected, it was found at IPC synapses. Unexpectedly, GlyR-LI was also subsynaptic at photoreceptor synapses onto second order neurons, both at ribbon and basal junction type synapses. At least some of the GlyR-LI photoreceptor synapses were from cones. Also, GlyR-LI was apposed to photoreceptors and to unidentified small diameter processes, where no other indication of synaptic input was evident. Because glycine-LI is not found in photoreceptors, we suggest that glycine receptors at photoreceptor synapses are stimulated by glycine that diffuses from other sites, possibly from IPCs. This interpretation is consistent with available physiological studies of glycinergic effects in this retina.

Serotonergic axons in monkey prefrontal cerebral cortex synapse predominantly on interneurons as demonstrated by serial section electron microscopy.

Anatomical approaches were used to describe the distribution, appearance, and synaptic interactions of serotonin (5-HT)-immunoreactive axons in monkey prefrontal cortex. A plexus of 5-HT axons was found throughout the gray matter, with an especially high density in layer I and a slight increase in layer IV. They were strikingly heterogeneous, with a gradient of morphologies ranging from fine and nonvaricose to highly varicose or thick and nonvaricose. Electron microscopy showed that both varicose and nonvaricose axons were typically filled with clear vesicles and less abundant dense core vesicles. A serial section analysis of 5-HT varicosities in layers I, III, and V showed consistent results across layers. Only about 23% of labeled varicosities formed identifiable synapses. These synapses were consistently asymmetric and were 2-5 serial sections (or 0.08-0.38 mu) in diameter. Targets of identified 5-HT synapses were dendritic shafts with the exception of one cell soma. Followed in serial sections, postsynaptic dendrites typically had morphological features of interneurons, i.e. they lacked spines, had a high density of synaptic inputs, and often had a varicose morphology. Only 8% of postsynaptic shafts were classified as pyramidal dendrites. This is in striking contrast to our previous study in this cortex of dopamine axons, which synapsed predominantly on pyramidal dendrites. These are the first results to indicate that interneurons are the major recipient of identifiable 5-HT synapses in the monkey prefrontal cortex.

Light and electron microscopic characterization of dopamine-immunoreactive axons in human cerebral cortex.

The distribution and synaptic connections of dopamine axons were studied by light and electron microscopy in human cerebral cortex. For this purpose, dopamine immunoreactivity was characterized in apparently normal anteriolateral temporal cortex, which was removed to gain access to the medial temporal lobe during tumor excision or treatment of epilepsy. Nissl sections showed this to be granular neocortex. Dopamine fibers were distributed throughout this cortex, although there were relatively more fibers in layers I-II and in layers V-VIa, compared to layers III-IV and VIb, resulting in a bilaminar pattern of labeling. In all layers, fibers were seen to form numerous varicosities, and to vary in size from thick to very fine. Fibers were relatively straight, sparsely branched and were oriented in various planes within the cortex. However, in layer I, they often ran parallel to the pial surface. In order to analyze the functional interactions of dopamine fibers, individual cortical layers were surveyed for dopamine synapses. These were usually symmetrical (Gray's type II), although 13% of them were asymmetrical. Approximately 60% of dopamine synapses were made with dendritic spines, and 40% with dendritic shafts, and this ratio was similar in all layers. On both spines and shafts, it was common to see dopamine synapses closely apposed to an unlabeled asymmetric input, suggesting a dopamine modulation of excitatory input. Some postsynaptic dendritic shafts had features of pyramidal cells, including formation of spines. Since pyramidal cells are the major type of cortical spiny neuron, they probably represent the main target of dopamine synapses in this cortex. There were also dopamine profiles apposed to membrane densities on unlabeled axon terminals, suggesting another type of synaptic interaction. These findings provide the first documentation of dopamine synapses in the human cortex, and show that they form classical synaptic junctions. The location of these synapses on spines and distal dendrites, and their proximity to asymmetric synapses, suggest a modulatory role on excitatory input to pyramidal cells.

Cholinergic neurons of the nucleus basalis of Meynert receive cholinergic, catecholaminergic and GABAergic synapses: an electron microscopic investigation in the monkey.

An electron microscopic analysis of the nucleus basalis in the macaque monkey was carried out following the immunohistochemical labeling of choline acetyltransferase, either by itself or in conjunction with glutamate decarboxylase or tyrosine hydroxylase. Cholinergic axon varicosities were frequently encountered, and formed large, usually asymmetric, synapses on both choline acetyltransferase-immunopositive and -immunonegative dendrites of nucleus basalis neurons. Catecholaminergic (tyrosine hydroxylase-immunoreactive) axon varicosities formed synapses which in most cases were classified as asymmetric, and glutamate decarboxylase-immunoreactive (GABAergic) axons formed clearly symmetric synapses, each on to choline acetyltransferase-immunopositive or -immunonegative dendrites. These findings indicate that cholinergic cells in the nucleus basalis of the monkey, also known as Ch4 neurons, receive numerous synaptic inputs from cholinergic, catecholaminergic and GABAergic axons.

Monoaminergic-cholinergic interactions in the primate basal forebrain.

Anatomical studies in the rat have shown that the cholinergic cells of the nucleus basalis receive synapses from monoamine axons, but similar evidence is lacking in primates. We used single- and double-labeling immunocytochemistry to visualize monoamine axons and their relationship with the cholinergic cells of the basal forebrain of the monkey. Norepinephrine axons, labeled with dopamine-beta-hydroxylase antibodies, formed a bed of fine varicose axons that co-distributed with the cholinergic cells. Tyrosine hydroxylase-immunoreactive axons, presumed to be mainly dopaminergic, were 10-20 times more abundant than dopamine-beta-hydroxylase axons throughout the basal forebrain, except in the medial septal area, where their density was lower. Serotonin-immunoreactive axons formed a dense axon plexus throughout the basal forebrain. Double-labeling light microscopy demonstrated that each of the three types of monoamine axons formed frequent direct contacts with the cholinergic cells. Electron microscopy showed that the noradrenergic and the putative dopaminergic axons synapsed on the cholinergic cells. In the human brain, immunolabeling with antibodies to dopamine-beta-hydroxylase, tyrosine hydroxylase and tryptophan hydroxylase (for serotonin axons) showed axon densities in the nucleus basalis comparable to those of the monkey brain. The data demonstrate that all three of these monoamine systems innervate the cholinergic and possibly also the non-cholinergic cells of the nucleus basalis, and therefore affect the release of acetylcholine in the cerebral cortex.

m2 muscarinic receptor immunolocalization in cholinergic cells of the monkey basal forebrain and striatum.

Pharmacological studies have suggested that the m2 muscarinic receptor functions as an autoreceptor in the cholinergic axons which innervate the cerebral cortex and striatum. To test this hypothesis in the macaque monkey, we used a subtype-specific antibody to the m2 muscarinic receptor. Immunoreactive cells were well visualized in the nucleus basalis, where some of these cells displayed dense m2 immunoreactivity, while others were lightly labeled. This heterogeneity of labeling intensity was not based on peculiarities of the methodology, because cholinergic cells of the striatum expressed uniformly dense m2 immunoreactivity. Concurrent labeling with choline acetyltransferase immunoreactivity proved that most of the heavily m2-labeled cells in the nucleus basalis were also choline acetyl-transferase positive. The findings demonstrate that at least 10-25% of the cholinergic neurons in the nucleus basalis of the monkey are densely m2 immunoreactive. In the striatum, concurrent labeling demonstrated that the majority, if not all, choline acetyltransferase-positive cells also contained m2 immunoreactivity. In addition, these experiments identified a population of smaller striatal cells which were m2 immunoreactive and choline acetyltransferase negative. Consecutive labeling with m2 immunoreactivity and NADPH-diaphorase histochemistry demonstrated that many of these m2-immunoreactive non-cholinergic neurons belonged to the population of nitric oxide-synthesizing medium aspiny neurons. The findings indicate that the m2 muscarinic receptor may be expressed at high levels in only a subset of cholinergic basal forebrain neurons. In contrast, m2 receptors appear to be expressed by all cholinergic cells of the striatum.

Infracortical interstitial cells concurrently expressing m2-muscarinic receptors, acetylcholinesterase and nicotinamide adenine dinucleotide phosphate-diaphorase in the human and monkey cerebral cortex.

Intense immunoreactivity for the m2-muscarinic receptor was found in a population of interstitial polymorphic neurons embedded within the infracortical white matter and the adjacent deep layers of the cerebral cortex. These infracortical neurons were evenly distributed throughout architectonic subdivisions of the monkey cortex except for parts of primary visual cortex where they were less numerous. A similar set of m2-immunoreactive interstitial cells was also detected in the human lateral temporal neocortex obtained at surgery. Upon electron microscopic examination, they were found to receive unlabelled synaptic inputs and displayed abundant rough endoplasmic reticulum, a prominent nucleolus, and invaginations of the nuclear membrane. Double labelling of m2 immunoreactivity and acetylcholinesterase histochemistry demonstrated that approximately 90% of the m2-positive infracortical cells were acetylcholinesterase-rich in the monkey and human brains. Conversely, the proportion of acetylcholinesterase-rich infracortical neurons that were m2-immunoreactive was over 90% in the monkey and at least 50% in the human. The concurrent visualization of nicotinamide adenine dinucleotide phosphate diaphorase (NADPH-d) enzyme activity with m2 immunoreactivity in the monkey and human brain showed that 85-95% of m2-immunoreactive infracortical cells were NADPH-d positive. Conversely, about 70% of NADPH-d cells contained m2 immunoreactivity. These observations provide the most convincing information to date that many of the acetylcholinesterase-rich neurons located in the infracortical white matter of the cerebral cortex are likely to be cholinoceptive. The expression of NADPH-d by these neurons suggests that they may also provide a relay through which cholinergic innervation, originating predominantly from the nucleus basalis of Meynert, could regulate the release of nitric oxide in the cerebral cortex and subjacent white matter. The degeneration of these neurons may account for at least some of the depletion of m2 receptors that has been reported in Alzheimer's disease.

Silver-enhanced diaminobenzidine-sulfide (SEDS): a technique for high-resolution immunoelectron microscopy demonstrated with monoamine immunoreactivity in monkey cerebral cortex and caudate.

A common frustration of immunoelectron microscopy (IEM) is the density of the 3,3'-diaminobenzidine (DAB) label, which obscures intracellular details of labeled structures. To overcome this problem, a silver enhancement protocol was developed which leaves silver deposits on very low levels of DAB. The resulting label is composed of easily visualized punctate silver deposits, localized in processes with little or no detectable DAB. This technique incorporates several modifications into previously described methods for silver enhancement of DAB. The principal innovation is to pretreat the DAB label with sodium sulfide before silver enhancement, which substantially increases the sensitivity of the silver enhancement. In addition, cysteine was used in place of thioglycolic acid to suppress tissue argyrophilia, allowing use of both glutaraldehyde- and paraformaldehyde-fixed tissue without degradation of ultrastructure. We demonstrate this technique with dopamine, norepinephrine (NE), and serotonin (5HT) immunoreactivity in monkey prefrontal cerebral cortex and with dopamine immunoreactivity in the anterior caudate. The punctate label allows essentially unobscured visualization of the intracellular details and cell membranes of these monoamine axons. Whereas 5HT axons formed small asymmetric synapses, dopamine and NE axons typically formed small symmetric synapses with notably subtle membrane specializations. It is likely that these are often obscured by conventional DAB labeling. The use of several preparations indicates that this technique will be useful with a variety of antibodies. It might also provide an attractive alternative to colloidal gold, especially with glutaraldehyde-fixed tissue which is not easily penetrated by gold particles.

Glycine high-affinity uptake labels a subpopulation of somatostatin-like immunoreactive cells in the Rana pipiens retina.

Somatostatin-like immunoreactivity (Som-LI) and glycine high-affinity uptake have been characterized in the Rana pipiens retina. These labels are found in both the outer and inner plexiform layers (OPL and IPL), suggesting that interplexiform cells (IPCs) contain both Som and glycine in this retina. In double-label experiments these labels colocalize to an abundant population of cells in the mid-inner nuclear layer (INL), in the second or third cell layer distal from the IPL. These cells have medium sized spherical or oval somas, each with a single thin descending dendrite which ramifies in the distal IPL. Processes ascending from cells at this location were not visualized by immunocytochemistry, but could be seen by autoradiography of tissue processed for glycine high-affinity uptake. In autoradiographs apparent IPCs were the most intensely labeled cell type in this retina. Som-LI is also found in two types of probable amacrine cells in the proximal INL adjacent to the IPL, neither of which is labeled by glycine high-affinity uptake. One of these is rare (about 10 cells/mm2), and has a large pyriform soma with a thick dendrite that branches in the proximal IPL. The other type is more common (324 +/- 20 cells/mm2), has medium-sized spherical or horizontally elongated elliptical somas, and has multiple thin dendrites projecting into the distal IPL. In addition to the above cell types, faint Som-LI was seen in cells of the ganglion cell layer, possibly indicating the presence of somatostatinergic ganglion cells or displaced amacrine cells.

Nitric oxide synthase interneurons in the monkey cerebral cortex are subsets of the somatostatin, neuropeptide Y, and calbindin cells.

99%) immunoreactive for somatostatin and neuropeptide Y, but did not express calbindin. The LNOS cells comprised about 30% of the somatostatin cells and about 60% of the neuropeptide Y cells. The SNOS cells were nearly always (87-98%) calbindin-immunoreactive, and were rarely or never labeled with antibodies to somatostatin or neuropeptide Y. The SNOS cells accounted for about 20% of all of the calbindin cells. The findings demonstrate that the two types of nNOS cells can be distinguished by antibodies to calbindin, somatostatin and neuropeptide Y, but none of these markers is found exclusively in nNOS cells. Nevertheless, neuropeptide Y-immunoreactivity provides a useful marker for LNOS cells, because it is very dense in these cells and only light in the interneurons that lack nNOS.

The anatomy of dopamine in monkey and human prefrontal cortex.

This chapter reviews recent evidence establishing the comparable organization of dopamine afferents and dopaminergic receptors in the human and monkey prefrontal cortex. Light microscopy using a dopamine-specific antibody reveals that the dopamine innervation in the human prefrontal cortex exhibits a distinct bilaminar distribution with dense bands of fibers in the upper and deeper strata of the cortex, closely resembling the patterning of dopamine fibers in the monkey prefrontal cortex. Also, EM-immunohistochemistry has now revealed identical synaptic complexes both in human and monkey. In both species, dopamine axons from symmetric synapses predominantly on the spines of pyramidal cells. In many cases, the same spine is apposed by an asymmetric, putatively excitatory synapse. Finally, both in human and monkey prefrontal cortex, the dopamine D1-specific ligand, 3H-SCH23390, and the D2-specific ligand, H3-raclopride, label binding sites in laminar positions which match the location of the densest dopamine innervation. These results indicate that the organization of the cortical dopamine system is essentially the same in macaque monkey and human and that the nonhuman primate is a suitable animal model for analysis of dopamine function in prefrontal cortex.

Relationship between dipstick positive proteinuria and albumin:creatinine ratios.

Currently, neither the American Diabetes Association nor the Kidney Foundation consider the results of a positive dipstick urine test for protein, a semi-quantitative measurement, in the final evaluation of diabetic nephropathy. Instead, they require a quantitative test. The object of this study was to assess whether a positive semi-quantitative test could accurately substitute for a quantitative one to evaluate renal disease. We determined the proportion of urine samples dipstick positive for protein that had an albumin:creatinine ratio of 30 microg/mg or more, the recommended value for the diagnosis of microalbuminuria (incipient nephropathy). Albumin:creatinine ratios were measured in urine samples from 19 diabetic and 51 nondiabetic patients in which the dipstick test for protein was positive. Twelve of 24 (50%) urine samples trace positive for protein by a dipstick method had albumin:creatinine ratios of 30 microg/mg or more, whereas 42 of 46 (91%) urine samples greater than or equal to 1+ for protein exceeded that ratio. The results were similar in the two groups of patients. The positive predictive value for a test result more than or equal to 1+ for protein was 91%. We conclude that in contrast to the recommendations of the American Diabetes Association and the National Kidney Foundation, dipstick positive proteinuria of more than or equal to 1+ can substitute for an albumin:creatinine ratio. An algorithm for this more cost-effective approach to the diagnosis of diabetic nephropathy is suggested.

Monoamines and acetylcholine in primate cerebral cortex: what anatomy tells us about function.

In primates, cholinergic and monoaminergic axons that innervate the cerebral cortex originate almost exclusively from subcortical nuclei in the brainstem and basal forebrain. These projections are thought to modulate cortical activity during arousal, attention and memory formation. Physiological and anatomical evaluations of these ascending projections suggest that they have overlapping but somewhat distinctive synaptic targets in the cortex. This review compares the anatomical organization of acetylcholine-, dopamine-, norepinephrine-, and serotonin-containing axon systems in the monkey and human cerebral cortex. Analysis of the distributions of axons, receptors, and synapses suggests that each system is likely to have a differential role in modulating cortical function.

Glycine stimulates calcium-independent release of 3H-GABA from isolated retinas of Xenopus laevis.

A perfusion system was used to monitor the release of [3H]-GABA from isolated retinas of Xenopus laevis. Measurable release was stimulated by glycine at concentrations as low as 200 microM. Glycine-stimulated release was blocked by strychnine, and was not reduced in "calcium-free" Ringer's solution (0 Ca2+/20 mM Mg2+). Glutamate also stimulated calcium-independent release, using concentrations as low as 100 microM. In contrast, release stimulated by 25 mM potassium was reduced by 80% in calcium-free medium. In most experiments, agonists were applied in six consecutive 4-min pulses separated by 10-min washes with Ringer's solution. Under these conditions, the release stimulated by 0.5 mM glutamate or 25 mM potassium decreased by at least 50% from the first to the second pulse, and then gradually decreased with successive applications. In contrast, the response to 0.5 mM glycine at first increased and then only gradually decreased with successive pulses. These patterns of response to different agonists were similar in calcium-free medium. Somatostatin (-14 or -28) also stimulated release, and this effect was inhibited by AOAA, an inhibitor of GABA degradation. In the presence of AOAA, somatostatin had little effect, except at high concentrations of somatostatin (5 microM), which increased both basal and glycine-stimulated release. In contrast to somatostatin, glycine-stimulated release was much larger in the presence of AOAA. Autoradiography was used to investigate which cell types released [3H]-GABA under our conditions. Autoradiograms showed that horizontal cells and a population of apparent "off" bipolar cells were well-labeled by [3H]-GABA high-affinity uptake. In addition, light labeling was seen over numerous amacrine cells. After application of glycine, glutamate, or potassium, there was a decrease in label density over horizontal cells.