Detection of medullary thyroid microcarcinoma using ultrasound-guided fine needle aspiration cytology.

OBJECTIVE: Compared with incidental papillary thyroid microcarcinoma (microPTC), incidental medullary thyroid microcarcinoma (microMTC) is clinically more significant. The objective of the present study was to summarize our experience in detecting microMTCs. METHODS: From 1995 to 2011, there were 10825 thyroid fine needle aspirates (FNAs) guided using high-resolution ultrasound with on-site preparation and evaluation by a cytopathologist. Of the 140 microcarcinomas detected, 132 were microPTCs and eight were microMTCs, which are the subject of the present study. RESULTS: All eight cases were incidentalomas and none of the five women and three men, age 37-70 years, had a family history of MTC. One patient had two FNAs at an interval of 10 months, two had a single lymph node metastasis and one had a 0.1-cm tumour nodule near the main tumour. Four of five plasmacytoid cell microMCTs had irregular borders; two round cell and one rectangular cell tumours had smooth borders. In contrast, 17 larger MTCs diagnosed in the same period included seven plasmacytoid, four giant cell and six spindle cell types. All five plasmacytoid microMTCs were correctly diagnosed on FNA, but the round cell and rectangular cell tumours were undercalled as follicular lesions. Sampling of colloid from adjacent follicles was noted in microMTCs. Two were diagnosed on histology following recommended surgery and one was diagnosed on recommended repeat FNA. CONCLUSIONS: US-guided FNA of thyroid lesions is a powerful tool in the detection of microMTCs, provided that cytopathologists are alerted to the pitfalls described in the present study.

Plasticity of Dental Cell Types in Development, Regeneration, and Evolution.

Recent years have improved our understanding of the plasticity of cell types behind inducing, building, and maintaining different types of teeth. The latest efforts were aided by progress in single-cell transcriptomics, which helped to define not only cell states with mathematical precision but also transitions between them. This includes new aspects of dental epithelial and mesenchymal stem cell niches and beyond. These recent efforts revealed continuous and fluid trajectories connecting cell states during dental development and exposed the natural plasticity of tooth-building progenitors. Such "developmental" plasticity seems to be employed for organizing stem cell niches in adult continuously growing teeth. Furthermore, transitions between mature cell types elicited by trauma might represent a replay of embryonic continuous cell states. Alternatively, they could constitute transitions that evolved de novo, not known from the developmental paradigm. In this review, we discuss and exemplify how dental cell types exhibit plasticity during dynamic processes such as development, self-renewal, repair, and dental replacement. Hypothetically, minor plasticity of cell phenotypes and greater plasticity of transitions between cell subtypes might provide a better response to lifetime challenges, such as damage or dental loss. This plasticity might be additionally harnessed by the evolutionary process during the elaboration of dental cell subtypes in different animal lineages. In turn, the diversification of cell subtypes building teeth brings a diversity of their shape, structural properties, and functions.

Short-day photoperiod increases milk yield in cows with a reduced dry period length.

Exposure of cows to a short-day photoperiod (SDPP; 8 h light:16 h dark) during a 60-d dry period increases milk yield in the subsequent lactation compared with cows exposed to a long-day photoperiod (LDPP; 16 h light:8 h dark). Whereas the traditional recommendation for dry period length is 60 d, recent studies indicate that the dry period length can be reduced without depressing the yield in the next lactation. However, the optimal duration of the dry period appears to be between 40 and 60 d, because fewer than 30 d could result in a significant loss of milk production. Our main objective was to determine whether treatment with SDPP combined with a reduced dry period length of 42 d would increase milk yield in the next lactation relative to treatment with LDPP, even though SDPP exposure was limited to 42 d. Multiparous Holstein cows (n = 40) were randomly assigned to 1 of 2 treatments during the dry period: LDPP or SDPP. Each treatment group (n = 20) was balanced according to the previous 305-d mature equivalent milk yield. To quantify plasma prolactin (PRL) concentration, blood samples were collected weekly during the dry period. Dry matter intake (DMI) was recorded during the dry period. Health was monitored weekly during the dry period and at calving. During lactation, milk yield and DMI were recorded for 120 and 42 d, respectively. Cows exposed to SDPP calved 4.8 d earlier than cows exposed to LDPP and days dry averaged 37 and 42 d for cows exposed to SDPP and LDPP, respectively. Cows on SDPP consumed more dry matter (17.0 +/- 1.1 kg/d) during the dry period than did cows on LDPP (15.9 +/- 1.1 kg/d), but DMI after parturition did not differ. In the first 42 d of lactation, cows exposed to SDPP and LDPP consumed 18.0 and 17.7 +/- 1.4 kg/d, respectively. The periparturient PRL surge was greater in cows exposed to LDPP (22.6 +/- 3.2 ng/mL) than in those exposed to SDPP (17.1 +/- 4.1 ng/mL). Milk yield was inversely related to the magnitude of the periparturient PRL surge, but was directly related to the expression of PRL-receptor mRNA in lymphocytes during the dry period. Through 120 d of lactation, cows exposed to SDPP when dry produced more milk (40.4 +/- 1.1 kg/d) than cows exposed to LDPP (36.8 +/- 1.1 kg/d). These results support the concept that SDPP, combined with a targeted 42-d dry period, increases milk yield in the subsequent lactation, relative to a 42-d dry period combined with LDPP, and that exposure to 42 d of SDPP in the dry period is sufficient to increase milk yield in the next lactation.

Teeth and tooth nerves.

(1) Although our knowledge on teeth and tooth nerves has increased substantially during the past 25 years, several important issues remain to be fully elucidated. As a result of the work now going on at many laboratories over the world, we can expect exciting new findings and major break-throughs in these and other areas in a near future. (2) Dentin-like and enamel-like hard tissues evolved as components of the exoskeletal bony armor of early vertebrates, 500 million years ago, long before the first appearance of teeth. It is possible that teeth developed from tubercles (odontodes) in the bony armor. The presence of a canal system in the bony plates, of tubular dentin, of external pores in the enamel layer and of a link to the lateral line system promoted hypotheses that the bony plates and tooth precursors may have had a sensory function. The evolution of an efficient brain, of a head with paired sense organs and of toothed jaws concurred with a shift from a sessile filter-feeding life to active prey hunting. (3) The wide spectrum of feeding behaviors exhibited by modern vertebrates is reflected by a variety of dentition types. While the teeth are continuously renewed in toothed non-mammalian vertebrates, tooth turnover is highly restricted in mammals. As a rule, one set of primary teeth is replaced by one set of permanent teeth. Since teeth are richly innervated, the turnover necessitates a local neural plasticity. Another factor calling for a local plasticity is the relatively frequent occurrence of age-related and pathological dental changes. (4) Tooth development is initiated through interactions between the oral epithelium and underlying neural crest-derived mesenchymal cells. The interactions are mediated by cell surface molecules, extracellular matrix molecules and soluble molecules. The possibility that the initiating events might involve a neural component has been much discussed. With respect to mammals, the experimental evidence available does not support this hypothesis. In the teleost Tilapia mariae, on the other hand, tooth germ formation is interrupted, and tooth turnover ceases after local denervation. (5) Prospective dental nerves enter the jaws well before onset of tooth development. When a dental lamina has formed, a plexus of nerve branches is seen in the subepithelial mesenchyme. Shortly thereafter, specific branches to individual tooth primordia can be distinguished. In bud stage tooth germs, axon terminals surround the condensed mesenchyme and in cap stage primordia axons grow into the dental follicle.(ABSTRACT TRUNCATED AT 400 WORDS)

Use of intravenous tigecycline in patients with severe Clostridium difficile infection: a retrospective observational cohort study.

There are only a limited number of antimicrobials for treating severe Clostridium difficile infection (sCDI). Tigecycline shows significant in vitro effect against C. difficile and is approved for management of complicated intra-abdominal infections. Our aim was to analyse the efficacy of tigecycline compared with standard therapy (oral vancomycin plus intravenous metronidazole) in adults treated for sCDI. A retrospective cohort study of such patients hospitalized at our department from January 2014 to December 2015 was performed. Patients receiving tigecycline monotherapy were compared with patients treated with standard therapy alone. Diagnosis and severity of CDI were determined according to guidelines of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID). Primary outcome was clinical recovery, secondary outcomes were in-hospital and 90-day all-cause mortality and relapse, colectomy, and complication rates. Of the 359 patients hospitalized for sCDI, 90 (25.0%) were included, 45 in each group. Patients treated with tigecycline had significantly better outcomes of clinical cure (34/45, 75.6% vs. 24/45, 53.3%; p 0.02), less complicated disease course (13/45, 28.9% vs. 24/45, 53.3%; p 0.02), and less CDI sepsis (7/45, 15.6% vs. 18/45, 40.0%; p 0.009) compared with patients receiving standard therapy. Tigecycline usage was not associated with adverse drug reactions or need for colectomy. Rates of ileus, toxic megacolon, mortality, and relapse were similar between the two groups. Favourable outcomes suggest that tigecycline might be considered as a potential candidate for therapeutic use in cases of sCDI refractory to standard treatment.

Combinatorial expression patterns of the connexins 26, 32, and 43 during development, homeostasis, and regeneration of rat teeth.

Gap junctions permit the exchange of regulatory molecules between cells and play important roles during organogenesis. The expression pattern of the gap junction proteins connexin 26, 32, and 43 was studied by immunohistochemistry in the developing, adult, and injured rat teeth. Connexins 32 and 43, but not the connexin 26, were detected during the late stages of embryonic tooth development (bell stage). Expression of connexin 32 was predominant in epithelial cells, whereas connexin 43 was more widely distributed and found in both epithelial and mesenchymal cells. During cytodifferentiation (early postnatal stages), both connexin 32 and 43 were expressed in the epithelial-derived ameloblasts, synthesizing and secreting the enamel matrix proteins. In mesenchyme, connexin 32 was observed only in differentiating odontoblasts, while connexin 43 was expressed in both differentiating and functional odontoblasts, which secrete the dentin matrix. In adult rat teeth, connexin 26 and 43 were expressed in the odontoblastic layer at low and high levels, respectively, while connexin 32 was absent from odontoblasts. Electron microscopy showed that connexin 43 was distributed exclusively at sites of contacts between odontoblasts. However, double immunostaining combined with confocal microscopy suggested an occasional overlap between odontoblasts and calcitonin gene-related peptide-positive nerve fibers. Denervation experiments showed that the expression of connexins in dental pulp was independent of innervation, whereas in injured teeth connexin 43 was upregulated in pulpal fibroblasts. Finally, cultured dental epithelial cells expressed both connexin 32 and 43, and connexin 43 was detected in cultured pulp fibroblasts in vitro, thus mimicking the in vivo distribution pattern of connexins. These results demonstrate that connexins are involved in tooth development and suggest that a given connexin may have distinct roles during odontogenesis and tooth homeostasis.

Expression of the intermediate filament nestin during rodent tooth development.

The developing tooth represents a suitable model for understanding the molecular mechanisms involved in induction, morphogenesis and differentiation of organs. It is conceivable that the developmental changes could be reflected in the distribution of different cytoskeletal components and in this report we analyze the expression of the intermediate filament nestin during rodent tooth development at the protein and mRNA levels (by immuno light and electron microscopy, and by in situ hybridization). Nestin is expressed at all stages of tooth development, but the expression levels increase after birth in both ectodermal and ectomesenchymal derivatives. The shift in nestin distribution, from the proliferating dental lamina to the dental mesenchyme, indicates that nestin may be involved in inductive phenomena. At early stages of mineralization, nestin is seen within the apical parts of the presecretory ameloblasts. Nestin is also expressed in odontoblasts, both during odontogenesis and after tooth eruption. The increase in nestin expression from early to late developmental stages and sustained expression in a differentiated cell type contrasts with previously observed patterns of nestin expression during nerve and muscle development. This suggests that nestin could be used as a specific marker for the odontoblast.

Three-dimensional Imaging Reveals New Compartments and Structural Adaptations in Odontoblasts.

In organized tissues, the precise geometry and the overall shape are critical for the specialized functions that the cells carry out. Odontoblasts are major matrix-producing cells of the tooth and have also been suggested to participate in sensory transmission. However, refined morphologic data on these important cells are limited, which hampers the analysis and understanding of their cellular functions. We took advantage of fluorescent color-coding genetic tracing to visualize and reconstruct in 3 dimensions single odontoblasts, pulp cells, and their assemblages. Our results show distinct structural features and compartments of odontoblasts at different stages of maturation, with regard to overall cellular shape, formation of the main process, orientation, and matrix deposition. We demonstrate previously unanticipated contacts between the processes of pulp cells and odontoblasts. All reported data are related to mouse incisor tooth. We also show that odontoblasts express TRPM5 and Piezo2 ion channels. Piezo2 is expressed ubiquitously, while TRPM5 is asymmetrically distributed with distinct localization to regions proximal to and within odontoblast processes.

Nerve injury-induced pain in the trigeminal system.

This article reviews some recent findings on peripheral mechanisms related to the development of oro-facial pain after trigeminal nerve injury. Chronic injury-induced oro-facial pain is not in itself a life-threatening condition, but patients suffering from this disorder undoubtedly have a reduced quality of life. The vast majority of the work on pain mechanisms has been carried out in spinal nerve systems. Those studies have provided great insight into mechanisms of neuropathic spinal pain, and much of the data from them is obviously relevant to studies of trigeminal pain. However, it is now clear that the pathophysiology of the trigeminal nerve (a cranial nerve) is in many ways different to that found in spinal nerves. Whereas some of the changes seen in animal models of trigeminal nerve injury mimic those occurring after spinal nerve injury (e.g., the development of spontaneous activity from the damaged axons), others are different, such as the time-course of the spontaneous activity, some of the neuropeptide changes in the trigeminal ganglion, and the lack of sprouting of sympathetic terminals in the ganglion. Recent findings provide new insights that help our understanding of the etiology of chronic injury-induced oro-facial pain. Future investigations will hopefully explain how data gained from these studies relate to clinical pain experience in man and should enable the rapid development of new therapeutic regimes.

Pulpal axons in developing, mature, and aging feline permanent incisors. A study by electron microscopy.

The ingrowth, maturation, and aging of pulpal axons was followed by electron microscopy in permanent mandibular incisors of 44 cats aged 35 days-11 years. The first axons entered the incisor pulps about 2 months after birth. Cells resembling Schwann cells, but lacking an axonal relation, were also observed at this time. Axonal ingrowth and maturation continued until 7 months, when the pulps contained 92-394 axons, 81-88% of which were unmyelinated. Between month 7 and 20 months the character of the incisor pulpal axons remained largely unchanged. In adult cats the myelinated pulpal axons had diameters of 1-6 micrometer. The relation between the number of myelin lamellae and the axon size correlated better with linear + logarithmic than linear functions. The g-ratios were higher than in most peripheral nerves, and tended to increase with axon diameter. In the old adult this tendency was more evident and the g-ratios were generally lower. From 3 years on the incisors displayed various age-related or pathological alterations. These were accompanied by axonal changes and axon loss. In contrast to earlier stages perineuriumlike sheaths were frequent in old teeth. The findings are discussed in relation to axon development in the inferior alveolar nerve and in primary incisor pulps.

Developmental growth and degeneration of pulpal axons in feline primary incisors.

The life history of pulpal axons in primary mandibular incisors was examined by light and electron microscopy in 56 kittens aged from 25 days postconception to 120 days after birth. Cells resembling Schwann cells preceded the first arrival of pulpal axons, 1 week postnatally. myelination was initiated during the second week. Two months after birth the incisors were fully grown and each pulp contained about 100 axons. Between 10 and 20% of these were myelinated and ranged in size from 1 to 5 micrometer. The relation between number of myelin lamellae and axon size appeared nonlinear and differed markedly from that in similarly sized inferior alveolar nerve axons. During the third month many unmyelinated axons showed signs of degeneration. With progress of root resorption an increasing proportion of both unmyelinated and myelinated axons degenerated. In highly resorbed incisors necrotic Schwann cells were associated with degenerating axons and there was a generalized pulpal tissue reaction. In some teeth with advanced root resorption pulpal axons were lacking. A progressive derangement of all pulpal tissue elements continued until shedding during the second half of the fourth month. In incisor nerve branches below the incisor teeth axon degeneration was very limited.

Substance P-, calcitonin gene-related peptide, growth-associated protein-43, and neurotrophin receptor-like immunoreactivity associated with unmyelinated axons in feline ventral roots and pia mater.

The spinal pia mater receives a rich innervation of small sensory axons via the ventral roots. Other sensory axons enter the ventral roots but end blindly or turn abruptly in hairpin loop-like formations and continue in a distal direction. In the present study, the content of substance P (SP)-, calcitonin gene-related peptide (CGRP)-, growth-associated protein (GAP-43)-, and low-affinity neurotrophin receptor protein (p75NGFr)-like immunoreactivity (-LI) associated with these different types of sensory axons was assessed with light and electron microscopic immunohistochemical techniques. In addition, the binding of antibodies against synthetic peptides representing unique sequences of residues in the products of the trk and trkB protooncogenes was analyzed. These genes encode membrane spanning proteins, which have been shown to constitute specific high affinity binding sites for several members of the nerve growth factor family of neurotrophic factors. The results of the present study imply that the ventral root afferents comprise several different types of sensory axons, which all contain SP-, CGRP-, GAP-43-, and p75NGFr-like immunoreactivities. In addition, at least some of the presumed sensory fiber bundles in ventral roots and the pia mater were immunoreactive for the trkB gene product. Moreover, leptomeningeal cells and nonneuronal cells of the ventral roots were shown to bind antibodies to both the trk and trkB gene products. The ventral root afferents seem to share their immunohistochemical pattern with pain-transducing axons at some other locations, such as the tooth pulp. The contents of SP- and CGRP-LI in sensory axons that reach the central nervous system (CNS) through the ventral root indicate that ventral root afferents may be involved in sensory mechanisms, such as the ventral root pain reaction, as well as in the control of the pial blood vessels. The demonstration of GAP-43 and neurotrophin receptor-immunoreactivities associated with unmyelinated fibers in ventral roots and the pia mater is discussed in relation to previous reports on postnatal plasticity in these axonal populations.

De- and regeneration of axons after minor lesions in the rat sciatic nerve. Effects of microneurography electrode penetrations.

The structural effects of microneurography electrode penetrations were examined in the rat sciatic nerve. Such penetrations always produced restricted peri- and endoneurial lesions, resulting in degeneration of myelinated and unmyelinated axons, as well as in demyelination. The regenerative response was vigorous, and the regenerating axons usually formed a separate region of fascicle. However, restitution was not complete after 9 weeks survival, and in some cases not even after 16 weeks.

Sympathetic nerve sprouting fails to occur in the trigeminal ganglion after peripheral nerve injury in the rat.

Peripheral nerve injury induces sprouting of sympathetic nerve fibers in dorsal root ganglia after spinal nerve injury. In the present study, we sought to determine the extent of intraganglionic noradrenergic sprouting in the trigeminal system. The inferior alveolar nerve, a major branch of the mandibular division, or the infraorbital nerve of the maxillary division was either ligated or chronically constricted in Sprague-Dawley rats and recovery permitted for either 2-3 or 6-9 weeks. In some animals both nerves were injured. Using immunohistochemistry with tyrosine hydroxylase antibodies, we found no signs of sympathetic nerve fiber sprouting in the trigeminal ganglion after injury. In contrast, sciatic nerve injury in rat littermates induced a widespread autonomic nerve outgrowth in affected DRGs. Thus, sensory ganglion sympathetic nerve sprouting does not seem to be a general outcome of PNS injury, but is restricted to certain specific locations. Sympathetic nerve fiber networks that surround primary sensory neurons have been suggested to form a structural basis for interactions between the sympathetic and sensory nervous systems after PNS injury. Such interactions, sometimes resulting in paraesthesia or dysaesthesia in patients, appear to be less common in territories innervated by the trigeminal nerve than in spinal nerve regions. The lack of injury-induced intraganglionic sympathetic sprouting in the trigeminal ganglion may help to explain this observation.

Neurites from trigeminal ganglion explants grown in vitro are repelled or attracted by tooth-related tissues depending on developmental stage.

Although neurite attracting factors are present in the developing dental pulp and trigeminal ganglion (TG) axons can respond to such factors, nerve fibres do not enter the tooth pulp until a late developmental stage compared with surrounding tissues supplied by the TG. This suggests that the dental pulp secretes neurite growth inhibitory molecules. Semaphorins represent one group of substances, which can inhibit/repel growing neurites. The aims of the present study were to investigate if dental tissue explants inhibit/repel neurite growth from TGs at some developmental stages in vitro, and if so, to seek evidence for or against a participation of semaphorins in that interaction. By co-culturing mandibular or dental epithelial and mesenchymal tissue explants and TGs in collagen gels, we found that embryonic day 11 (E11) mandibular and E13 dental mesenchymal explants repel neurites from corresponding TGs. Repulsion was replaced by attraction if tissues from late embryonic or early postnatal mice (E17-postnatal day 5) were used. Using semi-quantitative reverse transcription/polymerase chain reaction we showed that a number of semaphorins were expressed by tooth-related mesenchyme collected from embryonic and postnatal mice. The expression of some semaphorins (3A, 3C, 3F, 4F, 5B, 6A, 6B and 6C) was high early in development and then decreased in a temporal pattern that correlated with neurite inhibitory/repulsive effects of dental mesenchyme observed in co-cultures. The expression of other semaphorins increased with development (3B, 4A and 7A), whilst others varied irregularly or remained at a fairly constant level (3E, 4B, 4C, 4D, 4G and 5A). Immunohistochemistry was used to determine if tooth-related nerve fibres possess neuropilins. This revealed that axons surrounding embryonic tooth buds express neuropilin-1, but not neuropilin-2. In postnatal teeth, nerve fibres located within the tooth pulp were immunonegative for neuropilin-1 and neuropilin-2. We conclude that developing mandibular/dental mesenchyme can inhibit/repel neurite growth in vitro. Our results support the hypothesis that semaphorins may be involved in this interaction.

Distribution and axonal relations of macrophages in a neuroma.

After axotomy in the peripheral nervous system, most axons regrow and re-establish contact with their targets. Depending on the type of lesion, a varying number of nerve fibers fail to regenerate and terminate far from the target, forming a neuroma. Sensory axons trapped in a neuroma show abnormal sensitivity to various stimuli, and often fire spontaneously. In this study we have examined the distribution and axonal relations of macrophages in rat sciatic neuromas three days to one year after cutting and ligating the nerve. ED1-immunoreactive macrophages migrated into the neuroma in large numbers within the two first weeks after the injury. Most cells were at that time located 0.5-1 mm proximal to the ligature. From three weeks on, a majority of the ED1-immunoreactive cells contained numerous large vacuoles filled with myelin fragments. At sites of focal demyelination, macrophages often had direct contact with axonal membranes. At later survival stages (three months to one year) ED1-immunoreactive cells were seen not only in the area just proximal to the ligature, but also several millimeters proximal to this. Macrophages persisted in considerable numbers in the neuroma for at least one year. These data suggest that neuroma macrophages may participate in the genesis of electrophysiological abnormalities thought to underly chronic pain after neuroma formation, possibly by creating demyelinated axonal regions susceptible to external stimuli from e.g. neighboring nerve fibers, by releasing substances which influence regeneration and remodelling of axonal growth cones, or by direct actions on the denuded axonal membranes.

Anterograde horseradish peroxidase tracing and immunohistochemistry of trigeminal ganglion tooth pulp neurons after dental nerve lesions in the rat.

The peripheral reorganization of pulpal nerves after tooth injury was studied, in the rat, with anterograde horseradish peroxidase tracing techniques, and combined retrograde Fluorogold tracing and immunohistochemistry was employed to examine the effects of inferior alveolar nerve lesions or tooth injury on some cytochemical characteristics of pulpal trigeminal ganglion nerve cells, namely content of substance P, calcitonin gene-related peptide and the ganglioside GM1 (binding subunit of cholera toxin), as well as affinity to RT 97 (antibody to neurofilament protein) and the lectin Griffonia simplicifolia isolectin I-B4. Anterograde horseradish peroxidase tracing demonstrated that pulpal nerves either disappear or reinnervate novel targets after loss of pulpal tissue. There were no obvious signs of neuroma formation. Retrograde Fluorogold labelling with immunohistochemistry showed that after inferior alveolar nerve lesions with subsequent regeneration, a much higher proportion of Fluorogold cells (15%) were substance P-positive compared to normal (2%). In addition, 3% of the cells were Griffonia simplicifolia isolectin I-B4-positive. Such cells were very rare in controls. Proportions of calcitonin gene-related peptide-, GM1- and RT-97-positive cells were normal. After tooth lesions, the proportions of Fluorogold-positive substance P-, Griffonia simplicifolia isolectin I-B4-, GM1- and RT 97-labelled cells were similar to controls, while the proportion of calcitonin gene-related peptide-positive neurons was reduced. The results show that pulpal deafferentation may change the long-term cytochemical characteristics of affected trigeminal ganglion neurons.

Responses of rat trigeminal neurones to dental pulp cells or fibroblasts overexpressing neurotrophic factors in vitro.

The adult dental pulp is innervated by sensory trigeminal axons and efferent sympathetic axons. Rat trigeminal ganglia extend neurites when co-cultivated in vitro with pulpal tissue explants, suggesting that pulpal cells secrete soluble molecules that stimulate the growth of trigeminal ganglion axons. In addition, cultured pulpal cells produce mRNAs for neurotrophins and glial cell line-derived neurotrophic factor-family members. These data suggest that neurotrophic factors are involved in the formation of a pulpal innervation. Here, we examine how pulpal cells and 3T3 fibroblasts overexpressing certain neurotrophic factors (nerve growth factor, brain-derived neurotrophic factor, neurotrophin-3, neurotrophin-4, glial cell line-derived neurotrophic factor or neurturin) influence survival and growth of single trigeminal ganglion neurones in vitro in quantitative terms. The results show that most of the neurotrophic factor-overexpressing fibroblasts induce similar neuronal soma diameters, but higher survival rates and neurite lengths compared with pulpal cells. With respect to neurite growth pattern, trigeminal ganglion neurones co-cultured with fibroblasts overexpressing nerve growth factor develop a geometry that is most similar to that seen in co-cultures with pulpal cells. We conclude that none of the fibroblasts overexpressing neurotrophic factors can fully mimic the effects of pulpal cells on trigeminal ganglion neurones, and that nerve growth factor promotes a neurite growth pattern most similar to the picture seen in co-cultures with pulpal cells.

Combined retrograde tracing and enzyme/immunohistochemistry of trigeminal ganglion cell bodies innervating tooth pulps in the rat.

Rat trigeminal neurons innervating tooth pulps were retrogradely labelled with fluorogold and analysed enzyme- and immunohistochemically for their content of substance P, calcitonin gene-related peptide, fluoride-resistant acid phosphatase, GM 1 ganglioside, carbonic anhydrase and neurofilament protein. The data showed that both small, medium-sized and large trigeminal neurons were labelled after fluorogold deposition in maxillary molar pulps, with a majority of the cells being medium-sized and large. Less than 2% of the pulpal neurons showed substance P-like immunoreactivity. Fifty-six per cent of the pulpal nerve cells were calcitonin gene-related peptide-positive. These cells were small, medium-sized and large. Only 1% of the fluorogold-labelled cells contained fluoride-resistant acid phosphatase enzyme activity. This paralleled the finding that the pulpal neurons were unstained by Griffonia simplicifolia isolectin I-B4, a plant lectin which preferentially binds to fluoride-resistant acid phosphatase-positive cells. Choleragenoid-like immunoreactivity, which identifies cells with the GM 1 ganglioside receptor, was found in 70% of the fluorogold-labelled pulpal neurons. Approximately 80% of the fluorogold-labelled cells showed RT 97-immunoreactivity. RT 97 labels neurofilament protein and is present in large light primary sensory neurons. No pulpal neurons appeared to contain carbonic anhydrase, as judged from both enzyme- and immunocytochemical observations. The findings suggest that, in the rat, trigeminal tooth pulp neurons, which according to the classical view are nociceptive, form a heterogeneous group of neurons with a minority of small cells which may contain calcitonin gene-related peptide but rarely either substance P or fluoride-resistant acid phosphatase. However, the vast majority of pulpal nerve cells appear to have sizes and cytochemical characteristics which are not generally associated with nociceptive primary sensory neurons.

The effect of selective serotonergic neurotoxin treatment on tachykinin levels in the rat ventral spinal cord.

The levels of 5-hydroxytryptamine and tachykinin neuropeptides substance P, neurokinin A, neurokinin B and neuropeptide K were measured in the spinal cord of rats treated by intraventricular injection of the selective serotonergic neurotoxin 5,7-dihydroxytryptamine. The spinal cord levels of 5-hydroxytryptamine as measured by high performance liquid chromatography with electrochemical detection decreased by more than 90% in the ventral and dorsal cord compared to controls. The levels of substance P as measured by radioimmunoassay were significantly reduced (66%, P less than 0.01) in the ventral lumbar cord only. In this region, neurokinin A, neurokinin B and neuropeptide K levels were determined by combined high performance liquid chromatography and radioimmunoassay. The neurotoxin treatment also caused a significant reduction of neurokinin A (72% reduction, P less than 0.01) and a non-significant reduction of neuropeptide K, but virtually no change in the neurokinin B level. Immunohistochemical studies of the ventral lumbar cord of sham-operated animals showed immunoreactivity for 5-hydroxytryptamine as well as for substance P and neurokinin A in nerve fibres around motor neurons. In neurotoxin-treated rats this region was devoid of immunohistochemically detectable substance P- and neurokinin A-positive fibres and showed very sparse or no 5-hydroxytryptamine immunoreactivity. We conclude that among the tachykinins both neurokinin A and substance P, but probably not neurokinin B, co-exist with 5-hydroxytryptamine in nerve terminals in the rat ventral spinal cord.