Biopsia esterotáxica de lesiones intracraneanas en niños: reporte de los 10 primeros casos de la literatura con control tomográfico del procedimiento / Stereotactic biopsy of intracraneal lesions in children

La biopsia esterotáxica (BE) es un método adecuado para la tipificación histológica de cualquier patología intracraneana. Todos los sistemas de BE utilizados en la actualidad permiten el cálculo de las cordenadas cartesianas de la lesión utilizando las imágenes obtenidas con la tomografía axial computarizada (TAC). El marco esterotáxico Patil II (Westco Co.). Permite el control tomográfico de la posición del instrumento de biopsia en el punto elegido para la obtención de la muestra de tejido. El aprovechamiento de esta característica requiere que todo el procedimiento quirúrgico se realice en el gabinete de la TAC. Se reportan los 10 primeros pacientes de la literatura pediátrica en quienes se realizó BE intracraneanas utilizando el sistema Patil II. Los diagnósticos incluyeron siete neoplasias, una enfermedad degenerativa y una lesión por radionecrosis. No se observaron complicaciones relacionadas con el procedimiento quirúrgico. Se concluye que la BE en el gabinete de la TAC debe de ser considerada en pacientes pediátricos con lesiones encefálicas profundas.

Modulation of osteogenesis by isolated calvaria cells: a model for tissue interactions.

Dispersed cells from calvaria fetuses when suspended in agarose deposit a metachromic matrix. Anchorage independence is a requirement for these cells to express type II collagen. Type I collagen is preferentially expressed by cells in monolayer cultures. Cell separation by isopycnic percoll gradient showed that cells recovered from densities 1.04 g ml-1 or higher synthesized type II collagen when suspended in agarose. These cells cultured on a plastic surface expressed type I collagen. Endothelial cells isolated from rat liver or bovine aorta when implanted in diffusion chambers together with dispersed calvaria cells enhanced the formation of bone. The calcium content was 70 times higher than in chambers containing either endothelial or calvaria cells alone. The former cells developed no bone at all when implanted alone, even in the presence of demineralized bone matrix, but some isolated islands of cartilage could be seen.

Immunolocalization of collagenase and tissue inhibitor of metalloproteinases (TIMP) in mechanically deformed fibrous joints.

To investigate the effects of mechanical deformation on matrix degradation in fibrous joints, coronal suture explants from neonatal rabbits were stressed in vitro for 24 hours in an established tooth-movement model system. The metalloproteinase collagenase (CL) and its inhibitor, TIMP (tissue inhibitor of metalloproteinases), were immunolocalized in two ways by a two-step indirect technique: (1) extracellularly by immunoprecipitation at the site of secretion, and (2) intracellularly by incubation of the explants with the ionophore monensin. Immunoprecipitates of CL and TIMP were distributed throughout the sutural and periosteal tissues of nonstressed explants. In stressed explants, however, CL immunoprecipitates were predominantly associated with an area of rounded cells between the bone ends. In explants treated with monensin a significant increase in the number of CL-positive cells was observed in this cellular area; active enzyme was suggested by the demonstration of CL bound to collagen. Extracellular TIMP was not seen within the area of rounded cells of stressed explants, but intracellular TIMP was detectable; this suggests that insufficient TIMP was available to immunoprecipitate with anti-TIMP, probably because it had become irreversibly complexed with active CL. Since the area of rounded cells corresponds to the site of increased cell proliferation in this and other animal models of tooth movement, these data suggest that collagenase production and cell proliferation might be correlated. We speculate that matrix degradation is an essential prerequisite for cell proliferation as it creates room to accommodate an increase in cell population.

Observations on pigment granules in the bones of silky fowls.

The distribution of melanin pigment-containing cells in the bones of both young and adult silky fowls was observed. Melanin pigment was detected not only in melanocytes which were mainly distributed in the periosteum, but also in all the other types of cells in the periosteum and bone. The continuity of the number of pigment granules in melanocytes and that in the other pigment-containing cells could not be recognized because the granules in the latter cells were much fewer than those in the former. In young fowls, the pigment-containing cells were distributed in all layers of the periosteum and bone, but their number was low. On the other hand, in aged fowls, most of the cells in the periosteum had pigment granules. In the bone, however, pigment granules were observed only in osteocyte situated near the surface. These findings suggest that the pigment granules which are observed in osteocytes have been transferred from melanocytes to osteogenic cells or osteoblasts before they differentiate to osteocytes, where they are presumed to be digested.

Prenatal protein-energy malnutrition alters various biochemical components of the membranous bones in fetal rats.

The effects of prenatal protein-energy malnutrition on the biochemical parameters of the membranous bone were studied using fetal rats. Timed pregnant rats were fed a protein-deficient diet as an experimental group from day 13 of gestation, whereas control dams were fed a normal protein diet. By day 15, radioactive Na2SO4 was injected. On day 22, all fetuses were delivered by cesarean section. The hexosamine content per milligram dry tissue, and the protein and hexosamine contents per guanidine-HCl extract were greater in the mandibles but less in the calvaria of the malnourished group than in those of the controls. Calcium content per gram dry tissue was lower in both bones of the malnourished group. 35S-sulfate uptake per milligram dry tissue or milligram proteoglycan was greater in the malnourished group than in the controls in both bones. The mandible in the malnourished group had less lower-weight molecular proteoglycan subunits in the dissociative condition. Protein-energy malnutrition affects the mandible and calvaria in different ways, although both bones originate from membranous bone. Insufficient degradation of proteoglycan could be the reason for the delay of mineralization in the malnourished bones.

Ultrastructural immunocytochemical localization of endogenous 1,25-dihydroxyvitamin D3 and its receptors in osteoblasts and osteocytes from neonatal mouse and rat calvaria.

Immunoreactivity to 1,25-dihydroxyvitamin D3 receptors and endogenous 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) were studied in osteoblasts and osteocytes from calvaria of neonatal mice and rats by immunocytochemistry with the use of ultrathin sections obtained by cryo-ultramicrotomy. Tissue samples were fixed in glutaraldehyde, postfixed in osmium tetroxide and frozen under liquid nitrogen. 1,25(OH)2D3 and 1,25(OH)2D3 receptor-like immunoreactivities were observed in osteoblasts and osteocytes. In both types of cell, 1,25(OH)2D3 and its receptors were similarly located in the cytoplasmic matrix but not in organelles, and mainly in the nucleus (primarily in the chromatin and sometimes near the nuclear membrane or in the nucleolus). Reaction products, however, were never seen at the plasma membrane level. These results provide immunocytological evidence for the presence of 1,25(OH)2D3 and its receptors in osteoblasts and osteocytes. The similar localization of the hormone and its receptors in osteoblasts and osteocytes supports the hypothesis of a direct action of 1,25(OH)2D3 in these bone cells. The fact that the main localization of 1,25(OH)2D3 receptors was nuclear, implies, as postulated for other steroid receptors, that 1,25(OH)2D3 receptors occur primarily in the nucleus.

Distribution of uranium in human bones.

Uranium and calcium contents in human bones (skull, rib and femur) were determined by the fission track method and the inductively coupled plasma-atomic emission spectroscopic method (ICP-AES), respectively. The U/Ca concentration ratio in the bones was found to decrease in the order of rib greater than femur greater than skull, which is in accordance with the decreasing order of the mean annual replacement percentage of bone components. Several femur bones were cut into several longitudinal segments, and uranium and calcium contents in each segment were determined. Among these, the U/Ca ratio in the epiphysis was higher than those in the diaphysis.

Identification of calmodulin in new-born rat calvaria.

The extract of new-born rat calvaria was chromatographed on DEAE-cellulose. Calmodulin activity was eluted at 0.3 and 0.4 M NaCl and markedly inhibited by trifluoperazine and W-7, calmodulin antagonists. The fractions with calmodulin activity contained a protein the electrophoretic migration of which on sodium dodecyl sulfate-polyacrylamide gel was accelerated by Ca2+. Its apparent molecular weight was about 18 or 20K in the presence or absence of Ca2+, respectively. With 45Ca-autoradiography, the protein was shown to have a high affinity for Ca2+. Thus calmodulin could be readily identified in new-born rat calvaria.

Identification of glycosaminoglycans in the chondrocranium of the chick embryo before and at the onset of chondrogenesis.

It appears that hyaluronate is associated with cell migration and the chondroitin sulphates with differentiation during morphogenesis of the chick embryo. The aim of this study was to see if such a correlation could be made for chondrocranium morphogenesis. Specifically, the purpose of this study was to determine the proportion of extracellular matrix (ECM) to cell area and total head mesenchymal area during chondrocranium morphogenesis; and to identify the location, types, and relative amounts of glycosaminoglycans (GAG) being synthesized in the presumptive chondrocranium at the onset of chondrogenesis and prior to this time. Morphometric analyses were made on median and parasagittal sections of heads of stage-24 and -33 embryos in order to determine relative contributions of cells and ECM to the total area of head mesenchyme at these stages. Presumptive chondrocrania (heads minus eyes) of these stage embryos were also analysed histochemically and biochemically in order to identify the GAGs present in the ECM. Sections of whole heads were stained with alcian blue at low and high pH as well as digested prior to staining with hyaluronidase (Streptomyces and testicular). Identification of GAGs was done by pulse labelling embryos with [3H]glucosamine, digesting homogenates with hyaluronidase (Streptomyces or testicular), precipitating the undigested GAGs with cetylpyridinium chloride and counting the dissolved precipitates using scintillation spectrophotometry. The types and relative amounts of GAGs present in the presumptive chondrocranium were determined by comparing the amount of radioactivity in the precipitates of the non-digested GAG with the counts in the precipitates of the predigested GAGs. This study reports that chondrogenesis begins in the presumptive chondrocranium of the chick embryo at stage 33 and that the area of the head mesenchyme increases 60-fold between stages 24 and 33. Little change in cell density and individual cell area as well as in the relative proportion of total area allocated to cells and ECM occurs. GAGs are localized exclusively in the presumptive chondrocranium. These GAGs are restricted to the ventral half of the presumptive chondrocranium. Within this region, the GAGs are further localized to the presumptive facial area, perichordal region, ethmoid, sphenoid and periotic regions. The types of GAG being synthesized in the head mesenchyme of both stage-24 and -33 embryos are hyaluronate, the chondroitins and unidentified sulphated GAGs (dermatan, keratin, heparin and heparan sulphate).(ABSTRACT TRUNCATED AT 400 WORDS)

Change in facial shape in micro-, macro- and normocephalics.

In view of the dubious scientific validity of traditional cephalometric analyses, the more accurate technique of biorthogonal analysis was used in this study. Developed from D'Arcy Thompson's transformation grids, this technique showed similar craniofacial shape changes in micro-, macro- and normocephalics between the ages of 12 and 16 years, implying the contrasts in facial form between these 3 samples predominantly reflect size rather than shape differences.

Transforming and nontransforming growth factors are present in medium conditioned by fetal rat calvariae.

Conditioned medium recovered from fetal rat calvarial cultures contains an autocrine factor termed bone-derived growth factor (BDGF); this factor has been purified by acid extraction, gel-permeation chromatography, and two reversed-phase HPLC steps and examined for mitogenicity on normal rat kidney fibroblasts (NRK, clone 49F). HPLC-purified BDGF caused a dose-related increase in cell number, DNA content, and [3H]thymidine incorporation into acid-insoluble material. Since highly purified BDGF appeared less mitogenic than cruder preparations, the latter were tested for additional growth factors, with particular attention to those required for anchorage-independent colony formation in soft agar. BDGF did not displace 125I-labeled epidermal growth factor (EGF) in a radioligand-receptor assay, indicating the absence of EGF and transforming growth factor alpha (TGF-alpha). Without EGF, no BDGF preparation induced NRK cells to form soft agar colonies. However, calvarial conditioned medium contained a factor which, like TGF-beta, induced large soft-agar colonies in the presence of EGF; this TGF-beta-like factor did not copurify with BDGF. Polyclonal antibodies against platelet-derived growth factor did not neutralize the effects of BDGF on NRK cells. BDGF is a potent mitogen for nonskeletal-tissue-derived fibroblasts. Although crude BDGF preparations do contain TGF-beta, BDGF is distinct from this factor and others necessary for NRK cell transformation to anchorage-independent growth.

The U.S. Transuranium Registry report on the 241Am content of a whole body. Part III: Gamma-ray measurements.

The 241Am measurements on the donor's body, followed by an analysis of each bone of the skeleton, have provided the best available calibration factors for measuring the 241Am content in the skeletons of the living. These calibration factors have already been useful in measuring the skeletal burden of several workers in the nuclear industry. This study has shown that differential linear scanning provides good results on the content of various parts of the skeleton. Previously used methods of head or leg counting for estimating total skeletal content of 241Am were also found to provide good results. These studies confirm previous recommendations that in-vivo measurement of the skull probably provides the best estimate of 241Am in the skeleton; however, other positions such as the knee are also found to be bilaterally symmetrical for identical bones on the right and left sides of the body. A comparison of measurements on the donor's body with those of other people with skeletal burdens of 241Am shows that differences in skeletal distribution do exist and are probably due to the age of the person, the duration of the skeletal 241Am burden,and perhaps the physical activity of the person. Additional measurements and studies are planned on the remaining half of the skeleton and they should further improve the accuracy of in-vivo measurements of 241Am in the human skeleton.

The U.S. Transuranium Registry report of the 241Am content of a whole body. Part IV: Preparation and analysis of the tissues and bones.

Los Alamos National Laboratory has analyzed autopsy tissue for the USTR, as a part of its study of the uptake, distribution and retention of Pu and other transuranic elements in occupationally exposed workers since 1978. In April 1979, Los Alamos received the internal organs and bone samples from the first whole-body donation to the USTR. The donor was known to have an internal deposition of 241Am. All soft tissue, the bones from the right half of the skeleton, and the odd-numbered vertebrae were received at Los Alamos in February 1980. The bones were subdivided along anatomical areas of interest. All soft tissues and bone specimens were analyzed for their 241Am content. A total deposition of 147.4 nCi 241Am was measured. Approximately 18% of the 241Am remaining in the body (disregarding that in the left hand), was found in the soft tissues, and 82% was in the bones and teeth. The soft tissues and organs containing the largest amounts of 241Am were the combined soft tissue (striated muscle, connective tissue and skin) 8.8%; liver, 6.4% and respiratory tract, 1.5%. The remaining organs accounted for 0.9% of the systemic burden.

Bone-derived macrophage chemotactic factors: methods of extraction and further characterization.

Mononuclear phagocytes have been implicated as important cellular elements in the process of bone resorption. We have postulated that the recruitment and migration of mononuclear phagocytes to bone occurs via a mechanism(s) in which bone-derived chemotactic factors (BDCF) are released from foci undergoing resorption. In the experiments presented here we have used newborn mouse calvaria and examined a variety of extraction protocols, both dissociative and non-dissociative, as means of obtaining stable and reproducible chemotactic activity for mouse peritoneal macrophages. Chemotaxis and chemokinesis were assessed using a multi-well chamber modification of the Boyden transfilter method. Further, we have attempted to purify the BDCF by both molecular sieve and anion exchange chromatography. Our results indicated that non-dissociative extraction with 0.5 M EDTA in the presence of 1% DMSO yielded the most potent and reproducible chemotactic activity. The results of molecular sieve and anion exchange chromatography suggested that there were several BDCF activities in these preparations and that their molecular weights were probably in the range of from 14,000-67,000 daltons. Anion exchange chromatography also demonstrated the presence of a fraction, eluted with 2 M NaCl, with high chemotactic activity and minimal protein concentration. These observations confirmed the suggestion that there are several macrophage chemotactic factors in bone which have as yet to be identified, and suggest methods for pursuing their isolation.

SEM localization of cell-surface-associated fibronectin in the cranium of chick embryos utilizing immunolatex microspheres.

Fibronectin has been localized to basement membranes and cell surfaces with the light microscope by fluorescent staining of thick sections, and with the TEM by immunoperoxidase reaction. However, these methods are limited because it is difficult to appreciate the patterned distribution of fibronectin from sectioned material. We have developed a probe for fibronectin that facilitates its identification with the SEM. Our probe consists of two parts; the first component is a derivatized methacrylate microsphere 90 nm in diameter, linked to purified sheep anti-rabbit IgG. The second component is anti-fibronectin IgG raised in rabbits. Stage-3 to -12 chick embryos were fixed and the ectoderm covering the cranial mesoderm was removed. Embryos were treated with testicular hyaluronidase, exposed to rabbit anti-fibronectin IgG and finally to sheep anti-rabbit IgG conjugated microspheres. As expected, the basal lamina of surface and neural ectoderm as well as the remaining fibrous ECM were heavily decorated with microspheres, whereas control embryos treated with preimmune serum were beadless. Fibronectin was localized on the cell soma and processes of primary mesenchyme as early as stage 3. In addition, it was possible to decorate to various extents, populations of prosencephalic, mesencephalic, and rhombencephalic cranial neural crest cells. Our studies suggest that fibronectin is present in the cranium of chick embryos at earlier times than heretofore realized, and that fibronectin accumulates in a cranial to caudal gradient that reflects the sequential differentiation of the embryonic axis.

Matrix constituents of early developing bone examined by freeze fracture.

Specimens of aldehyde-fixed and glycerol-impregnated early developing bone matrix, obtained from rat calvaria, were examined by the freeze-fracture method. The developing bone matrix reveals collagen fibrils, numerous membranous structures and a granular background. The collagen fibrils, when viewed longitudinally, exhibit a substructure of thinner filaments (microfibrils) which appear to follow a twisted course along the fibril-axis. Some of the membranous structures are readily identified as osteoblast processes. Others, which are round, ovoid or irregular in shape, were found either with or without intramembrane particles (IMPs). It is concluded that the round or ovoid IMP-containing membranous structures correspond to matrix-vesicles. The nature of the IMP-free bodies, however, is uncertain. They may be artefacts or genuine matrix-vesicles deriving from unstable membrane domains which have a propensity for blebbing or budding off. Confirmation of the latter possibility might come from examination of directly frozen specimens.