Mechanisms regulating spill-over of synaptic glutamate to extrasynaptic NMDA receptors in mouse substantia nigra dopaminergic neurons.

N-Methyl-D-aspartate glutamate receptors (NMDARs) contribute to neural development, plasticity and survival, but they are also linked with neurodegeneration. NMDARs at synapses are activated by coincident glutamate release and depolarization. NMDARs distal to synapses can sometimes be recruited by 'spill-over' of glutamate during high-frequency synaptic stimulation or when glutamate uptake is compromised, and this influences the shape of NMDAR-mediated postsynaptic responses. In substantia nigra dopamine neurons, activation of NMDARs beyond the synapse during different frequencies of presynaptic stimulation has not been explored, even though excitatory afferents from the subthalamic nucleus show a range of firing frequencies, and these frequencies change in human and experimental Parkinson's disease. This study reports that high-frequency stimulation (80 Hz/200 ms) evoked NMDAR-excitatory postsynaptic currents (EPSCs) that were larger and longer lasting than those evoked by single stimuli at low frequency (0.1 Hz). MK-801, which irreversibly blocked NMDAR-EPSCs activated during 0.1-Hz stimulation, left a proportion of NMDAR-EPSCs that could be activated by 80-Hz stimulation and that may represent activity of NMDARs distal to synapses. TBOA, which blocks glutamate transporters, significantly increased NMDAR-EPSCs in response to 80-Hz stimulation, particularly when metabotropic glutamate receptors (mGluRs) were also blocked, indicating that recruitment of NMDARs distal to synapses is regulated by glutamate transporters and mGluRs. These regulatory mechanisms may be essential in the substantia nigra for restricting glutamate diffusion from synaptic sites and keeping NMDAR-EPSCs in dopamine neurons relatively small and fast. Failure of glutamate transporters may contribute to the declining health of dopamine neurons during pathological conditions.

Quasi-exact solutions for guided modes in two-dimensional materials with tilted Dirac cones.

We show that if the solutions to the (2+1)-dimensional massless Dirac equation for a given one-dimensional (1D) potential are known, then they can be used to obtain the eigenvalues and eigenfunctions for the same potential, orientated at an arbitrary angle, in a 2D Dirac material possessing tilted, anisotropic Dirac cones. This simple set of transformations enables all the exact and quasi-exact solutions associated with 1D quantum wells in graphene to be applied to the confinement problem in tilted Dirac materials such as 8-Pmmn borophene. We also show that smooth electron waveguides in tilted Dirac materials can be used to manipulate the degree of valley polarization of quasiparticles travelling along a particular direction of the channel. We examine the particular case of the hyperbolic secant potential to model realistic top-gated structures for valleytronic applications.

Surgical treatment of congenital pseudarthrosis of the clavicle: a report of three cases and review of the literature.

Congenital pseudarthrosis of the clavicle is a rare entity of unknown aetiology with predominance of the right side. Our therapeutic concept is discussed with special reference to surgical therapy, histopathological findings and the most recent literature. Two girls and one boy, aged 4, 6, and 8 years, presenting with congenital pseudarthrosis of the clavicle were surgically treated between 1994 and 2000. A resection of the pseudarthrosis and internal fixation with a small reconstruction plate was performed. A bone graft from the iliac crest was used for restoration of clavicular length. Histological examination revealed a false joint with the ends of the clavicle covered by hyaline cartilage. The patients showed radiographic healing after 12 weeks. At follow-up (mean 44 months), all patients showed excellent clinical and radiological results without functional impairment. The clinical features and histological examination of the resected pseudarthroses clearly proved the diagnosis of a true congenital pseudarthrosis of the clavicle. According to our clinical and radiological results and considering the recent literature, we recommend surgical therapy with resection, bone grafting, and osteosynthesis with a reconstruction plate around the age of 4 - 6 years.

[Prospective screw misplacement analysis after conventional and navigated pedicle screw implantation]. / Prospektive Schraubenfehllagenanalyse nach konventioneller und navigierter Pedikelschraubenimplantation.

BACKGROUND: [corrected] The aim of this prospective study was (1) to evaluate the accuracy of pedicle screw placement using Computer - Assisted Orthopedic - Surgery (CAOS) in comparison to conventionelly image intensifier controlled pedicle screw instrumentation, (2) to compare our results with data from literature and (3) report our experiences with this technique. PATIENTS AND METHODS: Between 11/00 and 11/01 sixteen patients planned for spine surgery were subsequently recruited. Pedicle screw instrumentation was done in each patient as well with computer aided surgery (CAOS, SurgiGate-System, Medivision, Stratec Medical, Swiss) as also with image intensifier control, allowing for intraindividual comparison. Evaluation of pedicle screw placement was carried out with postoperative computed tomography (CT) or magnetic resonance imaging (MRI). RESULTS: 33 of altogether 36 pedicle screws inserted with Computer-Assistance (CAOS) were correctly placed (91,7%), however only 17 of altogether 24 pedicle screws inserted under image intensifier control (70,8%). The difference of frequency of screw misplacement between Computer-aided and image intensifier controlled instrumentation was statistically significant (p<0.05; chi-square test). CONCLUSION: Computer assisted surgery reduces significantly the misplacement rate of pedicle screws and remains for experienced spine surgeons an important support in the operative treatment of complex spinal deformities in future. Additionally it can be expected that Computer-Navigation will also spread out in the field of minimal-invasive spinal surgery, e.g. the kyphoplasty. The use of this technique supports beside the medical-technical knowledge an improved three-dimensional orientation in the education of spine surgeons.

[Retransfusion of unwashed drainage blood after total hip and knee arthroplasty]. / Retransfusion ungewaschenen Drainageblutes nach Hüft- und Knieendoprothesenimplantationen.

The method of retransfusion of drainage blood as known from the literature was investigated in a prospectiv study regarding effectivness and rate of side effects. 200 patients who underwent total hip and knee arthroplasty were investigated concerning hemoglobin, hematocrit, amount and quality of the retransfused drainage blood, the amount of autologous and homologous transfusions as well as complications and costs. 100 of these patients were selected as the control group. The amount of the retransfused drainage blood after hip arthroplasty amounted an average of 387 +/- 194 ml and after knee arthroplasty 595 +/- 250 ml. The retransfused blood had an average hemoglobin of 5,2 +/- 0,9mmol/l with a hematocrit of 0,24 0,05. No complications directly associated to the retransfusion were found. The need of transfusion was reduced for patients with knee arthroplasty about 30% and for hip arthroplasty about 25%. The retransfusion of unwashed drainage blood is a sufficient method to reduce perioperative homologous blood transfusion in patients with arthroplasty of hip and knee. Substantial complications were not observed, so that this method seems to be save enough for clinical usage. The method is easy to handle and usable without special technical devices. The autologous retransfusion of drainage blood can contribute to lower costs in patients treatement.

Preclinical assessment of human hematopoietic progenitor cell transduction in long-term marrow cultures.

Long-term marrow cultures (LTMCs) were established from 27 human marrows. Hematopoietic cells were subjected to multiple rounds of exposure to retroviral vectors during 3 weeks of culture. Seven different retroviral vectors were evaluated. LTMCs were assessed for viability, replication-competent retrovirus, progenitors capable of proliferating in immune-deficient mice, and gene transfer. The average number of adherent cells and committed granulocyte-macrophage progenitors (CFU-GM) recovered from LTMCs was 28% and 11% of the input totals, respectively. There was no evidence by marker rescue assay or polymerase chain reaction (PCR) of replication-competent virus production during LTMC. No toxicity to cellular proliferation due to the transduction procedure was observed. The adherent layers of LTMCs exposed to retroviral vectors were positive for proviral DNA by PCR and by Southern blot analysis. Fifty-three percent of 1,427 individual CFU-GM from transduced LTMC adherent layers were positive for vector-derived DNA. For neocontaining vectors, the average G418 resistance was 28% of 1,393 LTMC-derived CFU-GM. Forty percent of 187 tissues from 30 immune-deficient mice injected with human LTMC cells were positive for human DNA 4-5 weeks after adoptive transfer. These studies indicate that multiple exposures of human LTMCs to retroviral vectors result in consistent and reproducible LTMC viability and gene transfer into committed progenitors. Our results further support the use of transduced LTMC cells in clinical trials of hematopoietic stem cell gene transfer.

A novel insulinoma tumor suppressor gene locus on chromosome 22q with potential prognostic implications.

The molecular mechanisms contributing to the tumorigenesis of insulinomas are still poorly understood. As moderate to high rates of LOH have been found on chromosome 22q in gastrinomas, we performed a finer deletion mapping study of chromosome 22q with 8 microsatellite markers in 15 insulinomas (4 malignant and 11 benign). Fourteen of 15 (93%) insulinomas revealed LOH on chromosome 22q, whereas the shortest region of overlap implicated a deletion of approximately 700 kb at 22q12.1-q12.2 with an LOH rate of up to 57% (8 of 14). Although the expressed sequence tag marker A006E25 that is localized in the hSNF5/INI1 gene on 22q11.2 revealed LOH in 50% of informative cases (7 of 14), no alterations in this gene could be identified by single strand conformational polymorphism analysis, direct DNA sequencing, or RNA expression analysis. Remarkably, the four malignant tumors showed a common deleted region between markers D22S345 and D22S1144 compared with none of the 11 benign insulinomas. The observed high frequency of chromosome 22q12 deletions in insulinomas is suggestive for a region compatible with harboring a tumor suppressor gene. The hSNF5/INI1 gene is most likely not the candidate gene, because no alterations could be identified. The distinct pattern of allelic loss identified in this chromosomal region appears to be an attractive candidate marker for further evaluation with regard to the discrimination between benign and malignant insulinomas.

Fc receptor-mediated transcytosis of IgG-coated liposomes across epithelial barriers.

Drug carriers such as liposomes are not readily transported across cellular barriers that constitute epithelia. However, certain epithelia (rabbit yolk sac endoderm and enterocytes of suckling rat gut proximal small intestine) are well known to transcytose maternal IgG by Fc receptor-mediated endocytic events. We have shown that coating liposomes with appropriate IgG enhances their transport across these epithelia, as measured both by radioactivity indicative of liposomal membrane or entrapped 125I-PVP and [3H]inulin, and by the hypoglycemic effect of entrapped insulin. It is suggested that these transported liposomes follow a pathway of transcytosis in clathrin-coated vesicles, thus escaping lysosomal degradation.

Monoclonal antibodies directed against surface and intracellular antigens of mouse granulated metrial gland cells.

Rat monoclonal antibodies with reactivity directed against mouse GMG cells have been produced. One of the antibodies (GMG-1) reacts with a surface antigen of GMG cells and cross-reacts with T lymphocytes. Another (GMG-2) reacts with an intracellular antigen in GMG cells and with asialo-GM1 positive cells in the spleen. Three antibodies (GMG-3, -4, -5) bind to intracellular antigens in GMG cells. The cross-reactivity of these antibodies is discussed with reference to the lineage relationship of GMG cells to NK cells and T cells and the recent suggestion that NK cells and T cells have a common progenitor cell. It is proposed that GMG cells share this common progenitor cell but are otherwise independent of the NK or T cell lineages.

Activation of nicotinic acetylcholine receptors expressed in quail fibroblasts: effects on intracellular calcium.

1. The aim of these experiments was to determine the ability of the muscle-type nicotinic acetylcholine receptor (AChR) stably expressed in quail fibroblasts (QF18 cells) to elevate intracellular calcium ([Ca2+]i) upon activation. Ratiometric confocal microscopy, with the calcium-sensitive fluorescent dye Indo-1 was used. 2. Application of the nicotine agonist, suberyldicholine (SDC), to the transfected QF18 cells caused an increase in [Ca2+]i. Control [Ca2+]i levels in QF18 cells were found to be 164 +/- 22 nM (mean +/- s.e. mean; n = 40 cells) rising to 600 +/- 81 nM on addition of SDC (10 microM; n = 15 cells), whereas no increase in [Ca2+]i was seen in non-transfected control QT6 fibroblasts (before: 128 +/- 9 nM, n = 40; after; 113 +/- 13 nM, n = 15). 3. The increase in [Ca2+]i caused by application of SDC was dose-dependent, with an EC50 value of 12.7 +/- 5.9 microM (n = 14). 4. The responses to SDC in QF18 cells were blocked by prior application of alpha-bungarotoxin (200 nM), by the addition of Ca2+ (100 microM), by removal of Na+ ions from the extracellular solution, or by the voltage-sensitive calcium channel blockers nifedipine and omega-conotoxin, which act with IC50 values of 100 nM and 100 pM respectively. 5. We conclude that activation of the nicotinic AChRs leads to a Na(+)-dependent depolarization and hence activation of endogenous voltage-sensitive Ca2+ channels in the plasma membrane and an increase in [Ca2+]i. There is no significant entry of Ca2+ through the nicotinic receptor itself.

IgG transport across the gut of the suckling opossum (Monodelphis domestica).

We investigated IgG transport across the gut of suckling opossums to see whether it is likely to be Fc gamma R-mediated. Enterocytes isolated from the proximal and distal regions of the small intestine of suckling aged 12-52 days, and reacted with indicator SRBC at pH 6.0 or 7.2, bound opossum IgG in rosette assays. Considerable overall variation was observed in the numbers of enterocytes forming rosettes. No binding was seen with rabbit IgG at these ages, or with opossum and rabbit IgG when enterocytes were obtained from opossums aged 55-73 days. Opossum anti-SRBC antibody (IgG) fed to sucklings at 52 days and earlier (but not later) could subsequently be detected in the serum. However, rabbit anti-SRBC antibody (IgG) could not be detected in the blood serum when fed to sucklings of any age. Fluorescent tracing of FITC-labelled opossum and rabbit IgG fed to suckling opossums, and of endogenous opossum IgG, pointed to transport of the homologous IgG occurring across gut enterocytes of the proximal region. These results suggest that IgG is recognised and transcytosed by specific Fc gamma Rs present on opossum enterocytes prior to weaning.

Evidence that Fc gamma receptors in rabbit yolk sac endoderm do not depend upon an acid pH to effect IgG binding and transcytosis in vitro.

An in vitro culture system has been devised creating apical and basal compartments separated by rabbit visceral yolk sac (VYS) with an intact epithelium. Selective transcytosis and binding of heterologous IgG applied to the apical yolk sac endoderm (YSE) was demonstrated in vitro using double label immunofluorescence. Thus, whilst both human and bovine IgG could be detected in endosomes in YSE, only human IgG could be detected in the basement membrane and vascular mesenchyme. This mirrors what is found in vivo. The Fc fragment of human Ig was transcytosed but not the Fab fragment, indicating that Fc receptors were expressed in the cultured YSE. When VYS was previously chilled to 4 degrees C to prevent endocytosis and treated with rabbit serum albumin to prevent non-specific binding, human IgG, but not bovine IgG, became specifically bound to YSE apical plasma membrane; comparison of binding at pH 6.0, 7.3 (the average pH of rabbit uterine fluid) and 8.0 revealed no obvious difference. Pre-exposure of VYS for up to 5 min in monensin, followed by culture in monensin and immunoglobulin-containing medium, did not prevent the selective transcystosis of human IgG, suggesting that an acidic compartment may not be needed for transcytosis. An acid pH dependent Fc gamma receptor equivalent to that on suckling rat gut jejunal enterocyte plasma membranes could not be isolated from rabbit YSE following exposure of solubilized membrane to affinity matrix bound IgG at pH 6.0 and elution at pH 8.0. These results contradict a recent suggestion that Fc receptors on all IgG transcytosing epithelia require an acid pH to effect IgG binding and selective transcytosis.

The route of maternal IgM transport to the rabbit fetus.

The route of IgM transport to the rabbit fetus was investigated by comparing its localization with that of IgG in the yolk sac splanchnopleure and uterine tissues using direct immunofluorescence and immunodiffusion analysis. IgM was first detected in fetal serum at 20 days of gestation but was present in uterine fluid at 18 days, the earliest stage tissues and fluids were examined. IgM was co-localized with IgG in the yolk sac endoderm basement membrane and in the vascular mesenchyme of the yolk sac splanchnopleure providing evidence of its transport to fetal blood; it was also present in vesicles in the yolk sac endoderm. IgM could not be detected in uterine fluid of nonpregnant uterine horns of rabbits unilaterally pregnant. Human IgM injected into the maternal circulation was readily transported to the uterine fluid and across the yolk sac splanchnopleure to fetal blood indicating that IgM secreting plasma cells, found to be present in the uterine stroma, contributed little towards IgM in the uterine fluid. Degenerating paraplacental decidual tissue, a feature of rabbit pregnancy, is suggested to be a major route for maternal immunoglobulin transport to the uterine fluid.

Multiple primaries in pancreatic cancer patients: indicator of a genetic predisposition?

BACKGROUND: The genetic basis of several familial cancers including breast and colon cancers has been identified recently. The occurrence of multiple cancers in one individual is also suggestive of a genetic predisposition. To evaluate inherited predisposition in pancreatic cancer we compared the clinical data of pancreatic cancer patients with and without multiple primaries as well as the frequency of malignancies among their relatives. METHODS: Detailed data on 69 pancreatic cancer patients included survival time and TNM-classification. Index case data were separated into two groups. The first group (group 1) developed only pancreatic cancer during their lifetime, whereas the second group (group 2) developed additional primary tumours. A systematic family history was taken from 59 of these pancreatic cancer patients using a standardized questionnaire. The pancreatic cancers and the multiple primaries of the 59 patients were histologically proven. RESULTS: Of the 69 pancreatic cancer patients, 13 (18.8%) had multiple primaries. Neither the clinical data nor the survival data of the index cases revealed differences between the two groups (all nominal P-values >0.05). In the family history study blood relatives developed a malignancy in 51% (24 of 47) of the families in group 1 compared to 75% (9 of 12) in group 2. The risk of relatives in group 2 of developing a malignant tumour was significantly higher (P = 0.034) than in group 1 after adjustments for family size and age of disease onset of the index case. The cancer spectrum of the 59 families mainly included tumours of the digestive tract and the reproductive organs. CONCLUSIONS: A multiple primary cancer history is a common condition among pancreatic cancer patients. Relatives of these patients seem to have an increased risk for the development of distinct malignant solid tumours, which might be caused by an inherited predisposition. Clinical and genetic investigation of pancreatic cancer patients with multiple primaries and their families might lead to the identification of predisposing gene defects providing a new goal for the understanding of a shared genetic basis of different solid tumours.

Distribution of Fc gamma receptors on isolated gut enterocytes of the suckling rat.

An erythrocyte-antibody rosette assay has been used to study the presence and distribution of Fc gamma receptors on enterocytes isolated from 12-day-old suckling rat gut by means of a buffer medium containing EGTA. Such receptors were found to be restricted to enterocytes in the proximal region (duodenum and jejunum) of the small intestine and to be acid-pH dependent. For the majority of enterocytes indicator red cells bound in high density to the abluminal plasmalemma but not to the apical microvillous brush border. Since immunofluorescence studies revealed strong binding of added IgG to the microvillous region, a likely explanation is that there is a paucity of Fc gamma receptors from the tips of microvilli (at least under the conditions of the rosette assay) and that receptors more deeply situated as inaccessible to indicator red cells. Binding of indicator red cells was readily inhibited by rabbit, human, guinea pig and rat IgG but less so by bovine IgG, and of the two sub-classes, bovine IgG2 inhibited much more readily than bovine IgG1. Cortisone acetate injection virtually abolished Fc gamma receptor expression on isolated enterocytes within three days. These findings correlate both with selective transport of IgG of different species in vivo and the known effect of cortisone acetate to terminate such transport.

Ontogeny of the Fc gamma receptor in rat small intestine.

The time course of Fc gamma receptor expression on isolated enterocytes of the small intestine of rat fetuses and sucklings has been studied. This was achieved principally using indicator sheep red blood cells (SRBC) sensitized with rabbit IgG in an erythrocyte-antibody rosette assay which detects receptors located mainly on the lateral and basal plasma membrane, and in a more limited way using binding of rabbit IgG to metabolically inhibited gut as detected by immunofluorescence and which detects receptors located on the apical brush border. From the time they were first detectable in the rosette assay (20-day-old fetuses) to the time they disappeared (22-day-old sucklings) such receptors were found always to be acid pH dependent and restricted to enterocytes from the proximal region. Acid pH, Fc-dependent binding of rabbit IgG to metabolically inhibited gut was first detectable at 21 days gestation and there were indications that receptors differentiate on enterocytes in a proximal to distal direction. This was also indicated by electron microscope studies using rabbit PAP injected into the duodenum of 21-day-old fetuses. Such studies also provided evidence for the receptor-mediated translocation of IgG across the duodenum of the fetal rat in a manner similar to that described for older sucklings.

Apical expression of an antigen common to rabbit yolk sac endoderm and kidney proximal tubule epithelium.

The tissue distribution, molecular weight, and biochemical nature of an antigen detected by a mouse monoclonal antibody designated 283D3 and raised against rabbit visceral yolk sac endodermal cells, has been investigated. The antigen is located on the luminal side of apical tubules and large sub-apical vesicles in rabbit yolk sac endoderm and proximal kidney tubule epithelial cells. It is expressed in a similar polarised fashion in epithelial cells lining the epididymis. Western blotting showed the antigen to comprise proteins of molecular weight 330-380 kDa. The antigen has been affinity purified from yolk sac and kidney and is predominantly protein in nature with a small percentage of N-linked carbohydrate. In terms of tissue distribution and molecular weight it has close similarity to Heymann nephritis antigen but differs in not being confined to coated pits. Its function is not known, but the association with endocytic elements implies a possible role in non-specific protein absorption.

Receptors for IgG2b on cells of the mouse metrial gland.

Single cells prepared from metrial glands of mice killed at days 10, 13 and 17 of pregnancy were assayed for the expression of Fc gamma receptors in a standard rosetting assay using sheep red blood cells sensitised with a mouse monoclonal IgG2b antibody. Rosettes, indicating Fc gamma receptors, were found on both granulated metrial gland (GMG) cells and non-GMG cells, comprising mainly stromal cells, from each stage of pregnancy. Some animals were given an intravenous injection of horseradish peroxidase 2 h before they were killed in order to identify endocytic cells. No GMG cells were found to have endocytosed the horseradish peroxidase. Non-GMG cells which showed endocytic activity all expressed Fc gamma receptors but these receptors were also found on some of the non-GMG cells which had not exhibited endocytosis. The finding of Fc gamma receptors on GMG cells provides further evidence that these cells may be related to NK cells.

Pancreaticoduodenal endocrine tumors in multiple endocrine neoplasia type 1: surgery or surveillance?

BACKGROUND: The management of pancreaticoduodenal endocrine tumors (PETs) remains controversial in multiple endocrine neoplasia type 1 (MEN 1). METHODS: Twenty-one patients with MEN 1 and PETs were analyzed for outcome of surgery and surveillance with special regard to the genotype based on MEN1 gene mutation analysis. RESULTS: Nine patients had gastrinomas, 5 had nonfunctioning tumors, 4 had insulinomas, 2 had insulinomas and gastrinomas, and 1 had a VIPoma. Seven patients (33%) had malignant tumors. Sixteen patients (76%) were initially treated by pancreatic resections or tumor enucleations or both. Six patients underwent reoperations for recurrences or lymph node metastases or both. Fifteen of the 16 operated patients are alive, and 12 have no evidence of disease after a median follow-up of 78 months (range, 1-198 months). Five patients with gastrinomas or nonfunctioning tumors, but no symptoms, underwent surveillance; 1 of them developed lymph node metastases. Patients with truncating mutations in the N- or C-terminal region (exons 2, 9, or 10) of the MEN1 gene had a significantly higher rate of malignant tumors (55% vs 10%; P <.05) than patients with other mutations. CONCLUSIONS: An aggressive surgical approach is justified for PETs in patients with MEN 1. However, MEN1 gene mutations in exons 3 to 8 seem to be associated with mild behavior of PETs, possibly allowing surveillance in asymptomatic patients.