SPECT-Befunde bei Hemiparkinson-Syndrom mit 99mTc-HMPAO

The symptoms of Parkinson’s disease often begin on one side of the body and continue to do so as the disease progresses. First SPECT results in 4 patients with hemiparkinsonism using 99mTc-HMPAO as perfusion marker are reported. Three patients exhibited reduced tracer uptake in the contralateral basal ganglia One patient who was under therapy for 1 year, showed a different perfusion pattern with reduced uptake in both basal ganglia. These results might indicate reduced perfusion secondary to reduced striatal neuronal activity.

Picosecond activation of the DEACM photocage unravelled by VIS-pump-IR-probe spectroscopy

The light-induced ultrafast uncaging process of the [7-(diethylamino)coumarin-4-yl]methyl (DEACM) cage is measured by time-resolved visible-pump-infrared-probe spectroscopy, and supported by steady-state absorption spectroscopy in the visible and infrared spectral regions. Understanding the uncaging process is important because its favorable properties make DEACM an interesting case for chemical and biological applications. It has a convenient absorption in the visible spectral range, and is relatively easily modified to carry leaving groups (LGs) such as nucleotides, substrates or inhibitors, which are inactive when bound and active when released. Previous work suggested a lower limit for the uncaging rate, which places it among the fastest available cages. Here, we determine the photodissociation directly to occur on the picosecond time scale by monitoring the appearance of the released LG in the infrared spectral region. In the present study, azide (N₃) is chosen as an LG to monitor photodissociation because its vibrational mode is spectrally isolated (hence easy to follow) and its absorption wavenumber is sensitive to local structural rearrangements. The uncaging process is recorded up to 3 nanoseconds and compared to the collected steady-state spectra. The free LG appears on a picosecond time scale, rendering this one of the fastest known cages. No evidence is found for a tight-ion pair (TIP) preceding the free LG. The uncaging mechanism is found to be slowed down upon the addition of water to acetonitrile.

Effects of ketamine on brain function during smooth pursuit eye movements

The uncompetitive NMDA receptor antagonist ketamine has been proposed to model symptoms of psychosis. Smooth pursuit eye movements (SPEM) are an established biomarker of schizophrenia. SPEM performance has been shown to be impaired in the schizophrenia spectrum and during ketamine administration in healthy volunteers. However, the neural mechanisms mediating SPEM impairments during ketamine administration are unknown. In a counter-balanced, placebo-controlled, double-blind, within-subjects design, 27 healthy participants received intravenous racemic ketamine (100 ng/mL target plasma concentration) on one of two assessment days and placebo (intravenous saline) on the other. Participants performed a block-design SPEM task during functional magnetic resonance imaging (fMRI) at 3 Tesla field strength. Self-ratings of psychosis-like experiences were obtained using the Psychotomimetic States Inventory (PSI). Ketamine administration induced psychosis-like symptoms, during ketamine infusion, participants showed increased ratings on the PSI dimensions cognitive disorganization, delusional thinking, perceptual distortion and mania. Ketamine led to robust deficits in SPEM performance, which were accompanied by reduced blood oxygen level dependent (BOLD) signal in the SPEM network including primary visual cortex, area V5 and the right frontal eye field (FEF), compared to placebo. A measure of connectivity with V5 and FEF as seed regions, however, was not significantly affected by ketamine. These results are similar to the deviations found in schizophrenia patients. Our findings support the role of glutamate dysfunction in impaired smooth pursuit performance and the use of ketamine as a pharmacological model of psychosis, especially when combined with oculomotor biomarkers. Hum Brain Mapp 37:4047-4060, 2016. © 2016 Wiley Periodicals, Inc.

Structural differences between glycosylated, disulfide-linked heterodimeric Knob-into-Hole Fc fragment and its homodimeric Knob-Knob and Hole-Hole side products

An increasing number of bispecific therapeutic antibodies are progressing through clinical development. The Knob-into-Hole (KiH) technology uses complementary mutations in the CH3 region of the antibody Fc fragment to achieve heavy chain heterodimerization. Here we describe the X-ray crystal structures of glycosylated and disulfide-engineered heterodimeric KiH Fc fragment and its homodimeric Knob-Knob and Hole-Hole side products. The heterodimer structure confirms the KiH design principle and supports the hypothesis that glycosylation stabilizes a closed Fc conformation. Both homodimer structures show parallel Fc fragment architectures, in contrast to recently reported crystal structures of the corresponding aglycosylated Fc fragments which in the absence of disulfide mutations show an unexpected antiparallel arrangement. The glycosylated Knob-Knob Fc fragment is destabilized as indicated by variability in the relative orientation of its CH3 domains. The glycosylated Hole-Hole Fc fragment shows an unexpected intermolecular disulfide bond via the introduced Y349C Hole mutation which results in a large CH3 domain shift and a new CH3-CH3 interface. The crystal structures of glycosylated, disulfide-linked KiH Fc fragment and its Knob-Knob and Hole-Hole side products reported here will facilitate further design of highly efficient antibody heterodimerization strategies.

[Dacryoliths and Iatrogenic Foreign Bodies as Classical Triggers for Inflammatory Pseudotumors of the Lacrimal Drainage System]

BACKGROUND

Tumors of the lacrimal duct are rare. Inflammatory pseudotumors do not represent neoplasias as such. Chronic inflammation may lead to an angiomatous granulation tissue.

PATIENTS

The first case presents a 53-year-old male patient suffering a mass of the mediocaudal orbit after an acute dacryocystitis has been cured. Using diagnostic dacryoendoscopy, a large dacryolith was detected. Removing the concrement, via external dacryocystorhinostomy, a polypous tissue appeared which was resected as well. The second case concerns a 29-year-old female patient. She had a lacrimal surgery with stenting seven years prior to surgery. The patient's history revealed recurrent mucous secretion of the tear duct and tenderness of the lacrimal sac. An intrasaccal silicon foreign body could be confirmed by dacryoendoscopy. An external dacryocystorhinostomy was performed and the material was extracted. Hereby, an inflammatory tissue mass filling the whole efferent tear duct was removed.

RESULTS

In both patients, external dacryocystorhinostomy was performed complication-free. Surgery enabled the reconstruction of the nasolacrimal duct. Temporary autostable silicon intubation was inserted into the nasolacrimal duct (case 1 and 2), as well into osteotomy (case 2). Histologically, reactive granulation tissue was confirmed. During the follow-up of 9 months (patient 1) and 12 months (patient 2), patients were free of complaints. Lacrimal stentings were removed uneventfully and completely.

CONCLUSIONS

Dacryoliths and intrasaccal foreign bodies may cause a chronic dacryocystitis. Due to inflammation, reactive tissue proliferation can be initiated. In these cases, a hypertrophic granulation arose. Endogenous (dacryoliths) and exogenous (iatrogenic foreign bodies) triggers may be underlying reasons. Histological examination is essential for differentiating other inflammatory pathologies or tumors.

Caregiver Child Interaction Patterns in Two Cultures in Relation to Nutritional Intake

The major focus of the present project was the relation between caregiver behaviour towards toddlers, and caregiver and toddler nutritional intake across two cultures. Kenyan subjects were 110 toddlers, 18-30 months of age and their caregivers; Egyptian subjects were 153 toddlers, 18-30 months of age and their caregivers. Based on monthly observations and maternal report, food intake values were calculated for both mothers and toddlers in both countries. In Kenya, based on bimonthly observations, five measures of caregiver behaviour were collected; based on monthly observations, nine measures of caregiver behaviour were collected in Egypt. Results indicated that in both countries caregiver behaviours toward their toddlers were driven primarily by toddler rather than by maternal intake. However, the specific pattern of relations differed across each culture. Specifically, in Egypt, more adequately nourished toddlers received more appropriate stimulation from caregivers. In Kenya, more adequately nourished toddlers had less physical contact with their caregivers and their caregivers responded verbally to their vocalisations less than they did for poorly nourished toddlers.

Exploring photochemistry of p-bromophenylsulfonyl, p-tolylsulfonyl and methylsulfonyl azides by ultrafast UV-pump–IR-probe spectroscopy and computations

The photochemistry of three sulfonylazides was studied by femtosecond time-resolved infrared (TRIR) spectroscopy and quantum chemical computations.

Raman spectroscopy as probe of nanometre-scale strain variations in graphene

Confocal Raman spectroscopy has emerged as a major, versatile workhorse for the non-invasive characterization of graphene. Although it is successfully used to determine the number of layers, the quality of edges, and the effects of strain, doping and disorder, the nature of the experimentally observed broadening of the most prominent Raman 2D line has remained unclear. Here we show that the observed 2D line width contains valuable information on strain variations in graphene on length scales far below the laser spot size, that is, on the nanometre-scale. This finding is highly relevant as it has been shown recently that such nanometre-scaled strain variations limit the carrier mobility in high-quality graphene devices. Consequently, the 2D line width is a good and easily accessible quantity for classifying the crystalline quality, nanometre-scale flatness as well as local electronic properties of graphene, all important for future scientific and industrial applications.

Raman spectroscopy has become an invaluable tool for graphene characterisation, yet the nature of the broadening of the Raman 2D line remains unclear. Here, Stampfer et al. show that the Raman 2D line width is a measure of nanometre-scale strain variations in graphene on insulating substrates.

[The relevant axial deviation: Diagnostics and therapy for correction osteotomies of the femur]

Intraoperative assessment of the femoral axis, length and torsion can be difficult. A postoperative torsional discrepancy is a common but rarely diagnosed condition. A clinical evaluation of femoral torsion is limited, especially in the early postoperative period. Conventional radiographs are a reliable diagnostic tool for evaluation of discrepancies of leg length and axis. Computed tomography remains the gold standard for assessment of torsional discrepancies. Because of the wide variability of the physiological femoral torsion, the clinical impact of a torsional discrepancy in individual cases remains unclear. There is a general recommendation for revision in cases of intraindividual deviations of more than 15°; however, most patients with deviations even greater than 15° are asymptomatic. Therefore, the indications for correction should be carefully considered in each individual case. The patient level of activity is a crucial point in decision-making for correction osteotomy. Before correction osteotomy, the surgeon has to make a detailed biomechanical analysis of the leg. Early correction is recommended in most cases. Detailed knowledge of the patient medical history is needed for preoperative planning. Prior surgeries can have a significant impact on the choice of the surgical approach and stabilization technique.

Posterolateral fusion in acute traumatic thoracolumbar fractures: a comparison of demineralized bone matrix and autologous bone graft

INTRODUCTION Alternative fusion expanders are in clinical use for instrumented posterolateral fusion (PLF) to avoid donor site morbidity in autologous bone graft (ABG) harvesting. Purpose of this study was to evaluate demineralized bone matrix (DBM) in PLF as alternative to the gold standard of ABG in acute traumatic vertebral body fractures of the thoracolumbar spine. MATERIAL AND METHODS We retrospectively identified 101 patients with acute traumatic vertebral body fractures of the thoracic and lumbar spine who were treated with instrumented PLF in our level one trauma center between 2005 and 2011. Patients with a primary paraplegia, osteodepriving disease or loss to follow-up had been excluded. Until August 2008, autologous bone graft harvested from the posterior iliac crest was used in PLF (control group n = 46). Starting September 2008, DBM was used as fusion expander in PLF (study group n = 16). Clinical and radiological evaluation was performed with a minimum followup of 18 months to assess the clinical and radiological outcome. RESULTS We found a fusion rate of 94% in patients undergoing PLF with the use of DBM and 100% with the use of ABG. There was one major complication of deep infection in the DBM group and two cases of superficial wound infection in the ABG group. We discovered a trend of reduced operating time with the use of DBM. CONCLUSIONS DBM leads to a similar fusion rate as the use of ABG in patients undergoing PLF for acute traumatic vertebral body fractures of the thoracic and lumbar spine. DBM is associated with reduced operating time.

LEVEL OF EVIDENCE III

case-control study Key words: demineralized bone matrix instrumented posterolateral fusion, acute traumatic vertebral body fracture, thoracolumbar spine, autologous bone graft.

Carbapenem-resistant Enterobacteriaceae and the correlation between carbapenem and fluoroquinolone usage and resistance in the US military health system

Whether carbapenem or fluoroquinolone usage is correlated with carbapenem-resistant Enterobacteriaceae (CRE) has not been investigated at the level of an entire US nationwide managed health care system. We analyzed 75 million person-years of surveillance and 1,969,315 cultures from all 266 hospitals in the geographically dispersed US military health system. Incidences of CRE remained under 1 case per 100,000 person-years. Incidences of CRE increased relative to 2005 baseline levels in 3 of 7 subsequent years, then decreased in 2012 (P<0.05). Incident proportions of carbapenem resistance (CR) differed significantly among years, geographical regions, and bacterial species. Although use and resistance strongly correlated (R>0.80) for several "drug-bug" combinations, none were significant at the national or facility level. One exception was that inpatient consumption of fluoroquinolones was significantly correlated (P=0.0007) with CR in Escherichia coli when data from the major referral centers of the Southern and Northern regions were combined.

Activation of the δ-opioid receptor promotes cutaneous wound healing by affecting keratinocyte intercellular adhesion and migration

BACKGROUND AND PURPOSE

In addition to its analgesic functions, the peripheral opioid receptor system affects skin homeostasis by influencing cell differentiation, migration and adhesion; also, wound healing is altered in δ-opioid receptor knockout mice (DOPr^–/–). Hence, we investigated δ-opioid receptor effects on the expression of several proteins of the desmosomal junction complex and on the migratory behaviour of keratinocytes.

EXPERIMENTAL APPROACH

Expression levels of desmosomal cadherins in wild-type and DOPr^–/– mice, and the morphology of intercellular adhesion in human keratinocytes were analysed by immunofluorescence. To investigate the δ-opioid receptor activation pathway, protein expression was studied using Western blot and its effect on cellular migration determined by in vitro live cell migration recordings from human keratinocytes.

KEY RESULTS

Expression of the desmosomal cadherins, desmogleins 1 and 4, was up-regulated in skin from DOPr^–/– mice, and down-regulated in δ-opioid receptor-overexpressing human keratinocytes. The localization of desmoplakin expression was rearranged from linear arrays emanating from cell borders to puncta in cell periphery, resulting in less stable intercellular adhesion. Migration and wound recovery were enhanced in human keratinocyte monolayers overexpressing δ-opioid receptors in vitro. These δ-opioid receptor effects were antagonized by specific PKCα/β inhibition indicating they were mediated through the PKC signalling pathway. Finally, cells overexpressing δ-opioid receptors developed characteristically long but undirected protrusions containing filamentous actin and δ-opioid receptors, indicating an enhanced migratory phenotype.

CONCLUSION AND IMPLICATIONS

Opioid receptors affect intercellular adhesion and wound healing mechanisms, underlining the importance of a cutaneous neuroendocrine system in wound healing and skin homeostasis.

LINKED ARTICLES

This article is part of a themed section on Opioids: New Pathways to Functional Selectivity. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2015.172.issue-2