Feasibility study to evaluate the correlation between results of a candidate in vitro assay and established in vivo assays for potency determination of Newcastle disease vaccines

A Newcastle disease virus antigen quantification assay has been developed at CIDC-Lelystad as a candidate in vitro potency test for inactivated Newcastle disease vaccines. In studies performed at CIDC-Lelystad, a high correlation was demonstrated between the results of this candidate in vitro potency assay and the results of the serological potency assay (European Pharmacopoeia monograph 0870; test A). Furthermore, a high correlation between the serological data (Haemagglutination Inhibition-antibody titres) and clinical protection after challenge was demonstrated. The aim of the feasibility study was to confirm the correlation between the results obtained using the candidate in vitro potency assay and the results from both the in vivo potency assays currently prescribed in Ph Eur monograph 0870, in different laboratories and to determine whether a large-scale validation study of the in vitro method should ensue. In the feasibility study three Official Medicines Control Laboratories tested the potency of 5 different inactivated Newcastle disease vaccines and one experimental vaccine, using both of the in vivo methods described in the European Pharmacopoeia and the candidate in vitro method. The 6 vaccine batches represented a quantitative range of Newcastle disease virus antigen content and were produced by different manufacturers. Statistical evaluation of all results indicated that a satisfactory correlation was found in all laboratories between the two types of in vivo tests currently in place, and the candidate in vitro test. An excellent reproducibility of the proposed in vitro method was observed with respect to the ranking of the vaccines included in this study. It is concluded that the results of this feasibility study indicate that a large-scale collaborative study can be organised to validate the in vitro method and the suitability of the reference preparation.

Low-dose gadobenate dimeglumine versus standard dose gadopentetate dimeglumine for contrast-enhanced magnetic resonance imaging of the liver: an intra-individual crossover comparison

RATIONALE AND OBJECTIVES

Gadobenate dimeglumine (Gd-BOPTA) has a two-fold higher T1 relaxivity compared with gadopentetate dimeglumine (Gd-DTPA) and can be used for both dynamic and delayed liver MRI. This intraindividual, crossover study was conducted to compare 0.05 mmol/kg Gd-BOPTA with 0.1 mmol/kg Gd-DTPA for liver MRI.

MATERIALS AND METHODS

Forty-one patients underwent two identical MR examinations separated by >or= 72 hours. Precontrast T1-FLASH-2D and T2-TSE sequences and postcontrast T1-FLASH-2D sequences were acquired during the dynamic and delayed (1-2 hours) phases after each contrast injection. Images were evaluated on-site by two independent, blinded off-site readers in terms of confidence for lesion detection, lesion number, character and diagnosis, enhancement pattern, lesion-to-liver contrast, and benefit of dynamic and delayed scans. Additional on-site evaluation was performed of the overall diagnostic value of each agent.

RESULTS

Superior diagnostic confidence was noted by on-site investigators and off-site assessors 1 and 2 for 6, 4 and 2 patients with Gd-BOPTA, and for 3, 1 and 2 patients with Gd-DTPA, respectively. No consistent differences were noted for other parameters on dynamic phase images whereas greater lesion-to-liver contrast was noted for more patients on delayed images after Gd-BOPTA. More correct diagnoses of histologically confirmed lesions (n = 26) were made with the complete Gd-BOPTA image set than with the complete Gd-DTPA set (reader 1: 68% vs. 59%; reader 2: 78% vs. 68%). The overall diagnostic value was considered superior after Gd-BOPTA in seven patients and after Gd-DTPA in one patient.

CONCLUSION

The additional diagnostic information on delayed imaging, combined with the possibility to use a lower overall dose to obtain similar diagnostic information on dynamic imaging, offers a distinct clinical advantage for Gd-BOPTA for liver MRI.

Low-dose gadobenate dimeglumine versus standard dose gadopentetate dimeglumine for contrast-enhanced magnetic resonance imaging of the liver: an intra-individual crossover comparison

RATIONALE AND OBJECTIVES

Gadobenate dimeglumine (Gd-BOPTA) has a two-fold higher T1 relaxivity compared with gadopentetate dimeglumine (Gd-DTPA) and can be used for both dynamic and delayed liver MRI. This intraindividual, crossover study was conducted to compare 0.05 mmol/kg Gd-BOPTA with 0.1 mmol/kg Gd-DTPA for liver MRI.

MATERIALS AND METHODS

Forty-one patients underwent two identical MR examinations separated by >or= 72 hours. Precontrast T1-FLASH-2D and T2-TSE sequences and postcontrast T1-FLASH-2D sequences were acquired during the dynamic and delayed (1-2 hours) phases after each contrast injection. Images were evaluated on-site by two independent, blinded off-site readers in terms of confidence for lesion detection, lesion number, character and diagnosis, enhancement pattern, lesion-to-liver contrast, and benefit of dynamic and delayed scans. Additional on-site evaluation was performed of the overall diagnostic value of each agent.

RESULTS

Superior diagnostic confidence was noted by on-site investigators and off-site assessors 1 and 2 for 6, 4 and 2 patients with Gd-BOPTA, and for 3, 1 and 2 patients with Gd-DTPA, respectively. No consistent differences were noted for other parameters on dynamic phase images whereas greater lesion-to-liver contrast was noted for more patients on delayed images after Gd-BOPTA. More correct diagnoses of histologically confirmed lesions (n = 26) were made with the complete Gd-BOPTA image set than with the complete Gd-DTPA set (reader 1: 68% vs. 59%; reader 2: 78% vs. 68%). The overall diagnostic value was considered superior after Gd-BOPTA in seven patients and after Gd-DTPA in one patient.

CONCLUSION

The additional diagnostic information on delayed imaging, combined with the possibility to use a lower overall dose to obtain similar diagnostic information on dynamic imaging, offers a distinct clinical advantage for Gd-BOPTA for liver MRI.

Osteosarcoma of the pelvis: experience of the Cooperative Osteosarcoma Study Group

PURPOSE

To define patients and tumor characteristics as well as therapy results, patients with pelvic osteosarcoma who were registered in the Cooperative Osteosarcoma Study Group (COSS) were analyzed.

PATIENTS AND METHODS

Sixty-seven patients with a high-grade pelvic osteosarcoma were eligible for this analysis. Fifteen patients had primary metastases. All patients received chemotherapy according to COSS protocols. Thirty-eight patients underwent limb-sparing surgery, 12 patients underwent hemipelvectomy, and 17 patients did not undergo definitive surgery. Eleven patients received irradiation to the primary tumor site: four postoperatively and seven as the only form of local therapy.

RESULTS

Local failure occurred in 47 of all 67 patients (70%) and in 31 of 50 patients (62%) who underwent definitive surgery. Five-year overall survival (OS) and progression-free survival rates were 27% and 19%, respectively. Large tumor size (P =.0137), primary metastases (P =.0001), and no or intralesional surgery (P <.0001) were poor prognostic factors. In 30 patients with no or intralesional surgery, 11 patients with radiotherapy had better OS than 19 patients without radiotherapy (P =.0033). Among the variables, primary metastasis, large tumor, no or intralesional surgery, no radiotherapy, existence of primary metastasis (relative risk [RR] = 3.456; P =.0009), surgical margin (intralesional or no surgical excision; RR = 5.619; P <.0001), and no radiotherapy (RR = 4.196; P =.0059) were independent poor prognostic factors.

CONCLUSION

An operative approach with wide or marginal margins improves local control and OS. If the surgical margin is intralesional or excision is impossible, additional radiotherapy has a positive influence on prognosis.

Estrogen receptor-alpha knockout mice exhibit resistance to the developmental effects of neonatal diethylstilbestrol exposure on the female reproductive tract

Data indicate that estrogen-dependent and -independent pathways are involved in the teratogenic/carcinogenic syndrome that follows developmental exposure to 17beta-estradiol or diethylstilbestrol (DES), a synthetic estrogen. However, the exact role and extent to which each pathway contributes to the resulting pathology remain unknown. We employed the alphaERKO mouse, which lacks estrogen receptor-alpha (ERalpha), to discern the role of ERalpha and estrogen signaling in mediating the effects of neonatal DES exposure. The alphaERKO provides the potential to expose DES actions mediated by the second known ER, ERbeta, and those that are ER-independent. Wild-type and alphaERKO females were treated with vehicle or DES (2 microg/pup/day for Days 1-5) and terminated after 5 days and 2, 4, 8, 12, and 20 months for biochemical and histomorphological analyses. Assays for uterine expression of the genes Hoxa10, Hoxa11, and Wnt7a shortly after treatment indicated significant decreases in DES-treated wild-type but no effect in the alphaERKO. In contrast, the DES effect on uterine expression of Wnt4 and Wnt5a was preserved in both genotypes, suggesting a developmental role for ERbeta. Adult alphaERKO mice exhibited complete resistance to the chronic effects of neonatal DES exposure exhibited in treated wild-type animals, including atrophy, decreased weight, smooth muscle disorganization, and epithelial squamous metaplasia in the uterus; proliferative lesions of the oviduct; and persistent vaginal cornification. Therefore, the lack of DES effects on gene expression and tissue differentiation in the alphaERKO provides unequivocal evidence of an obligatory role for ERalpha in mediating the detrimental actions of neonatal DES exposure in the murine reproductive tract.

Psychiatric conditions in patients with recurrent unexplained syncope

AIMS

The relationship between syncope and psychiatric disorders is little investigated. This study evaluated the prevalence of psychiatric diseases and prognostic outcome in patients with recurrent unexplained syncope.

METHODS AND RESULTS

After an inconclusive standard diagnostic work-up for syncope, including head-up tilt testing, a psychiatric evaluation was offered to 50 consecutive patients with recurrent syncope. The evaluation was accepted by 26 patients (77% females, 36 +/- 16 years) and refused by 24 (63% females, 50 +/- 19 years). A psychiatric disorder was diagnosed in 21 (81%) patients: 12 had depression, four panic attacks, two general anxiety, and three a somatization disorder. Only five patients showed normal psychosocial function. Of the patients with psychiatric disorders four accepted psychiatric care, such as psychotherapy and/or pharmacotherapy; 17 patients refused treatment. During 6 months of follow-up no patient under psychiatric care had syncope, while all patients without psycho- or pharmacotherapy had recurrent syncopal events. In these patients the median of syncopal episodes was three in a 6 months interval before and after clinical assessment. Patients who refused both psychiatric evaluation and therapy continued to experience syncope as before.

CONCLUSIONS

In patients with recurrent unexplained syncope psychiatric alteration is common. However, patients seldom accepted a psychiatric evaluation and treatment.

Expression, cellular distribution and protein binding of the glioma amplified sequence (GAS41), a highly conserved putative transcription factor

The glioma amplified sequence 41 (GAS41) was previously isolated by microdissection mediated cDNA capture from the glioblastoma multiforme cell line TX3868 and shown to be frequently amplified in human gliomas. We determined the complete cDNA sequence of the GAS41 gene, demonstrated that the GAS41 protein is evolutionarily conserved, specifically at the N-terminus, and identified the yeast transcription factor tf2f domain within the GAS41 sequence. A human multiple-tissue Northern blot revealed ubiquitous expression of GAS41 with the highest expression in human brain. After generating polyclonal antibodies we found GAS41 protein expression in the nucleus of the TX3868 cell line by Western blot analysis and immunofluorescence microscopy. The nuclear localization was confirmed for several human tumors including gliomas of different grades of malignancy. In neuroblastoma however, GAS41 was found in the nucleoli but not in the nucleoplasm. Yeast two-hybrid screening of the TX3868 cell line identified the nuclear mitotic apparatus protein (NuMA), the KIAA1009 protein, and prefoldin subunit 1 (PFDN1) as potential interacting partners of GAS41. We generated a polyclonal antibody against the KIAA1009 protein and we demonstrated that the KIAA1009 protein is a nuclear protein, which appears to be co-localized with the GAS41 protein and NuMA.

Change of plasmid DNA structure, hypermethylation, and Lon-proteolysis as steps in a replicative cascade

I have defined conditions under which RepFIC plasmid DNA can be maintained in a state of lowered helical density. In exponentially growing cultures, the DNA of lowered helical density is present in small amounts but never totally absent, suggesting that it is a normal variant of plasmid maintenance. It is fully methylated at frequent sites by dam-methyltransferase, some not previously recognized, further suggesting that the variant is a precursor of replication. The low-helical density plasmid is present in dam hosts, indicating that methylation is not essential for the change in helical density. The lowered helical density is stabilized in lon hosts, suggesting that Lon-protease may remove both the protein(s) that lower the helical density and the dam-methyltransferase after each round of replication.

Dach1 mutant mice bear no gross abnormalities in eye, limb, and brain development and exhibit postnatal lethality

Drosophila dachshund is necessary and sufficient for compound eye development and is required for normal leg and brain development. A mouse homologue of dachshund, Dach1, is expressed in the developing retina and limbs, suggesting functional conservation of this gene. We have generated a loss-of-function mutation in Dach1 that results in the abrogation of the wild-type RNA and protein expression pattern in embryos. Homozygous mutants survive to birth but exhibit postnatal lethality associated with a failure to suckle, cyanosis, and respiratory distress. The heart, lungs, kidneys, liver, and skeleton were examined to identify factors involved in postnatal lethality, but these organs appeared to be normal. In addition, blood chemistry tests failed to reveal differences that might explain the lethal phenotype. Gross examination and histological analyses of newborn eyes, limbs, and brains revealed no detectable abnormalities. Since Dach1 mutants die shortly after birth, it remains possible that Dach1 is required for postnatal development of these structures. Alternatively, an additional Dach homologue may functionally compensate for Dach1 loss of function.

Sonic hedgehog regulates growth and morphogenesis of the tooth

During mammalian tooth development, the oral ectoderm and mesenchyme coordinate their growth and differentiation to give rise to organs with precise shapes, sizes and functions. The initial ingrowth of the dental epithelium and its associated dental mesenchyme gives rise to the tooth bud. Next, the epithelial component folds to give the tooth its shape. Coincident with this process, adjacent epithelial and mesenchymal cells differentiate into enamel-secreting ameloblasts and dentin-secreting odontoblasts, respectively. Growth, morphogenesis and differentiation of the epithelium and mesenchyme are coordinated by secreted signaling proteins. Sonic hedgehog (Shh) encodes a signaling peptide which is present in the oral epithelium prior to invagination and in the tooth epithelium throughout its development. We have addressed the role of Shh in the developing tooth in mouse by using a conditional allele to remove Shh activity shortly after ingrowth of the dental epithelium. Reduction and then loss of Shh function results in a cap stage tooth rudiment in which the morphology is severely disrupted. The overall size of the tooth is reduced and both the lingual epithelial invagination and the dental cord are absent. However, the enamel knot, a putative organizer of crown formation, is present and expresses Fgf4, Wnt10b, Bmp2 and Lef1, as in the wild type. At birth, the size and the shape of the teeth are severely affected and the polarity and organization of the ameloblast and odontoblast layers is disrupted. However, both dentin- and enamel-specific markers are expressed and a large amount of tooth-specific extracellular matrix is produced. This observation was confirmed by grafting studies in which tooth rudiments were cultured for several days under kidney capsules. Under these conditions, both enamel and dentin were deposited even though the enamel and dentin layers remained disorganized. These studies demonstrate that Shh regulates growth and determines the shape of the tooth. However, Shh signaling is not essential for differentiation of ameloblasts or odontoblasts.

The polyurethane nasolacrimal duct stent for lower tear duct obstruction: long-term success rate and complications

BACKGROUND

The polyurethane nasolacrimal duct stent is used as an alternative to conventional techniques for treatment of lower tear duct obstruction. The aim of this study was to evaluate the clinical success rate after a follow-up of 2 years.

METHODS

Nasolacrimal duct stent implantation was attempted in 19 patients with nasolacrimal duct obstruction proven by digital substraction dacryocystography. The median age of the patients was 50 years, and the minimum duration of symptoms was 3 months. Patients were followed up 1 week, 6 months, 1 year and 2 years after the procedure.

RESULTS

Eighteen stents were implanted in 17 patients without surgical complications. All stents were proven to be patent at the end of the procedure. Success rate, defined as proportion of patients free of symptoms, was 66.6%, 55.5% and 50% after 1 week, 6 months and I year, respectively, and remained unchanged thereafter. Three stents had to be removed between 6 months and 2 years after implantation. Histological examination showed granulation tissue growing into the opening and obstructing the stent in one case.

CONCLUSION

Implantation of a polyurethane nasolacrimal duct stent is an alternative to conventional techniques in lower tear duct obstruction. Its overall success rate is lower than that reported after conventional dacryocystorhinostomy, but the procedure is fast, safe and reversible. Refinement of the surface and stent design may improve results in the future.

Conservation of early odontogenic signaling pathways in Aves

Teeth have been missing from birds (Aves) for at least 60 million years. However, in the chick oral cavity a rudiment forms that resembles the lamina stage of the mammalian molar tooth germ. We have addressed the molecular basis for this secondary loss of tooth formation in Aves by analyzing in chick embryos the status of molecular pathways known to regulate mouse tooth development. Similar to the mouse dental lamina, expression of Fgf8, Pitx2, Barx1, and Pax9 defines a potential chick odontogenic region. However, the expression of three molecules involved in tooth initiation, Bmp4, Msx1, and Msx2, are absent from the presumptive chick dental lamina. In chick mandibles, exogenous bone morphogenetic protein (BMP) induces Msx expression and together with fibroblast growth factor promotes the development of Sonic hedgehog expressing epithelial structures. Distinct epithelial appendages also were induced when chick mandibular epithelium was recombined with a tissue source of BMPs and fibroblast growth factors, chick skin mesenchyme. These results show that, although latent, the early signaling pathways involved in odontogenesis remain inducible in Aves and suggest that loss of odontogenic Bmp4 expression may be responsible for the early arrest of tooth development in living birds.

Msx2 deficiency in mice causes pleiotropic defects in bone growth and ectodermal organ formation

The composite structure of the mammalian skull, which forms predominantly via intramembranous ossification, requires precise pre- and post-natal growth regulation of individual calvarial elements. Disturbances of this process frequently cause severe clinical manifestations in humans. Enhanced DNA binding by a mutant MSX2 homeodomain results in a gain of function and produces craniosynostosis in humans. Here we show that Msx2-deficient mice have defects of skull ossification and persistent calvarial foramen. This phenotype results from defective proliferation of osteoprogenitors at the osteogenic front during calvarial morphogenesis, and closely resembles that associated with human MSX2 haploinsufficiency in parietal foramina (PFM). Msx2-/- mice also have defects in endochondral bone formation. In the axial and appendicular skeleton, post-natal deficits in Pth/Pthrp receptor (Pthr) signalling and in expression of marker genes for bone differentiation indicate that Msx2 is required for both chondrogenesis and osteogenesis. Consistent with phenotypes associated with PFM, Msx2-mutant mice also display defective tooth, hair follicle and mammary gland development, and seizures, the latter accompanied by abnormal development of the cerebellum. Most Msx2-mutant phenotypes, including calvarial defects, are enhanced by genetic combination with Msx1 loss of function, indicating that Msx gene dosage can modify expression of the PFM phenotype. Our results provide a developmental basis for PFM and demonstrate that Msx2 is essential at multiple sites during organogenesis.

Pax1 and Pax9 synergistically regulate vertebral column development

The paralogous genes Pax1 and Pax9 constitute one group within the vertebrate Pax gene family. They encode closely related transcription factors and are expressed in similar patterns during mouse embryogenesis, suggesting that Pax1 and Pax9 act in similar developmental pathways. We have recently shown that mice homozygous for a defined Pax1 null allele exhibit morphological abnormalities of the axial skeleton, which is not affected in homozygous Pax9 mutants. To investigate a potential interaction of the two genes, we analysed Pax1/Pax9 double mutant mice. These mutants completely lack the medial derivatives of the sclerotomes, the vertebral bodies, intervertebral discs and the proximal parts of the ribs. This phenotype is much more severe than that of Pax1 single homozygous mutants. In contrast, the neural arches, which are derived from the lateral regions of the sclerotomes, are formed. The analysis of Pax9 expression in compound mutants indicates that both spatial expansion and upregulation of Pax9 expression account for its compensatory function during sclerotome development in the absence of Pax1. In Pax1/Pax9 double homozygous mutants, formation and anteroposterior polarity of sclerotomes, as well as induction of a chondrocyte-specific cell lineage, appear normal. However, instead of a segmental arrangement of vertebrae and intervertebral disc anlagen, a loose mesenchyme surrounding the notochord is formed. The gradual loss of Sox9 and Collagen II expression in this mesenchyme indicates that the sclerotomes are prevented from undergoing chondrogenesis. The first detectable defect is a low rate of cell proliferation in the ventromedial regions of the sclerotomes after sclerotome formation but before mesenchymal condensation normally occurs. At later stages, an increased number of cells undergoing apoptosis further reduces the area normally forming vertebrae and intervertebral discs. Our results reveal functional redundancy between Pax1 and Pax9 during vertebral column development and identify an early role of Pax1 and Pax9 in the control of cell proliferation during early sclerotome development. In addition, our data indicate that the development of medial and lateral elements of vertebrae is regulated by distinct genetic pathways.

[Importance of digital thoracic radiography in the diagnosis of pulmonary infiltrates in patients with bone marrow transplantation during aplasia]

PURPOSE

Evaluation of digitized chest x-ray for the detection of pulmonary infiltrations in bone marrow transplant patients during aplasia.

METHODS

Digitized chest x-rays of 40 patients (21 female, 19 male) with "Fever of unknown origin" (FUO) were evaluated concerning radiological signs of pulmonary infiltrations and correlated to clinical findings, blood chemistry, microbiology and bronchoscopy. Additionally, an individual risk profile was established.

RESULTS

In 11/40 patients pulmonary infiltrations were detected in digitized chest x-rays (group 1). 10/11 developed an infectious pulmonary infiltration. 29/40 patients developed no pulmonary infiltration (group 2). When fever increased for the first time (initial chest x-ray) a sensitivity, specificity, positive and negative predictive value of 46%, 86%, 56%, 81% and for the chest x-rays in progress of 61%, 79% 68% and 73% was found. C-reactive protein and temperature increase occurred statistically significantly earlier (p < 0.05) in group 1 compared to group 2. The average latency of digital chest x-rays in comparison to c-reactive protein and temperature increase was 6 days. The incidence of risk factors was significantly higher in group 1 in comparison to group 2 (p < 0.05).

CONCLUSION

Digitized chest x-rays are not a reliable method for primary detection of pulmonary infiltrations after bone marrow transplantation. Individual risk factors have to be taken into consideration to indicate further diagnostic methods such as computed tomography at an earlier time.

Eya1-deficient mice lack ears and kidneys and show abnormal apoptosis of organ primordia

Haploinsufficiency for human EYA1, a homologue of the Drosophila melanogaster gene eyes absent (eya), results in the dominantly inherited disorders branchio-oto-renal (BOR) syndrome and branchio-oto (BO) syndrome, which are characterized by craniofacial abnormalities and hearing loss with (BOR) or without (BO) kidney defects. To understand the developmental pathogenesis of organs affected in these syndromes, we inactivated the gene Eya1 in mice. Eya1 heterozygotes show renal abnormalities and a conductive hearing loss similar to BOR syndrome, whereas Eya1 homozygotes lack ears and kidneys due to defective inductive tissue interactions and apoptotic regression of the organ primordia. Inner ear development in Eya1 homozygotes arrests at the otic vesicle stage and all components of the inner ear and specific cranial sensory ganglia fail to form. In the kidney, Eya1 homozygosity results in an absence of ureteric bud outgrowth and a subsequent failure of metanephric induction. Gdnf expression, which is required to direct ureteric bud outgrowth via activation of the c-ret Rtk (refs 5, 6, 7, 8), is not detected in Eya1-/- metanephric mesenchyme. In Eya1-/- ear and kidney development, Six but not Pax expression is Eya1 dependent, similar to a genetic pathway elucidated in the Drosophila eye imaginal disc. Our results indicate that Eya1 controls critical early inductive signalling events involved in ear and kidney formation and integrate Eya1 into the genetic regulatory cascade controlling kidney formation upstream of Gdnf. In addition, our results suggest that an evolutionarily conserved Pax-Eya-Six regulatory hierarchy is used in mammalian ear and kidney development.

[Ultra-small superparamagnetic iron oxide particles: the signal behavior and relaxation times of the bone marrow after repeated i.v. application in the pig model at 1.5 tesla]

PURPOSE

Evaluation of the influence of an iron-containing MR contrast agent on the signal behaviour and the relaxation time of the bone marrow at 1.5 tesla after repeated doses.

ANIMALS AND METHODS

14 pigs received i.v. on days 1, 9, and 15 ultra-small (core diameter 6-8 nm) superparamagnetic iron oxide particles at doses of 20 (low dose = LD) or 200 mumol/kg body weight (high dose = HD).

RESULTS

Following the first administration a dose-independent reduction in the bone-marrow signal intensity in the T2-weighted gradient-echo sequence (FFE) was observed together with a reduction in the T1 and T2 relaxation times. Following the second application there were no further signal-reductions in the HD-group; in contrast, there was a signal reduction in the LD-group, made possible by a signal recovery in the meantime. On the other hand, the relaxation times T1 and T2 were shortened after each administration of contrast medium.

CONCLUSION

Nano-SIPS result at both doses in a signal reduction in the bone marrow. Only in the LD-group may repeated examinations with new contrast agent offer diagnostically sufficient images. Relaxometry shows a shortening of T1 as well as T2. This effect could be summed up after repeated doses. Almost no iron remained in the medullary space three weeks after i.v. administration of the contrast agent, which suggests mobilization and metabolization.

Isolation and characterization of Methanomethylovorans hollandica gen. nov., sp. nov., isolated from freshwater sediment, a methylotrophic methanogen able to grow on dimethyl sulfide and methanethiol

A newly isolated methanogen, strain DMS1(T), is the first obligately anaerobic archaeon which was directly enriched and isolated from a freshwater sediment in defined minimal medium containing dimethyl sulfide (DMS) as the sole carbon and energy source. The use of a chemostat with a continuous DMS-containing gas stream as a method of enrichment, followed by cultivation in deep agar tubes, resulted in a pure culture. Since the only substrates utilized by strain DMS1(T) are methanol, methylamines, methanethiol (MT), and DMS, this organism is considered an obligately methylotrophic methanogen like most other DMS-degrading methanogens. Strain DMS1(T) differs from all other DMS-degrading methanogens, since it was isolated from a freshwater pond and requires NaCl concentrations (0 to 0.04 M) typical of the NaCl concentrations required by freshwater microorganisms for growth. DMS was degraded effectively only in a chemostat culture in the presence of low hydrogen sulfide and MT concentrations. Addition of MT or sulfide to the chemostat significantly decreased degradation of DMS. Transient accumulation of DMS in MT-amended cultures indicated that transfer of the first methyl group during DMS degradation is a reversible process. On the basis of its low level of homology with the most closely related methanogen, Methanococcoides burtonii (94.5%), its position on the phylogenetic tree, its morphology (which is different from that of members of the genera Methanolobus, Methanococcoides, and Methanohalophilus), and its salt tolerance and optimum (which are characteristic of freshwater bacteria), we propose that strain DMS1(T) is a representative of a novel genus. This isolate was named Methanomethylovorans hollandica. Analysis of DMS-amended sediment slurries with a fluorescence microscope revealed the presence of methanogens which were morphologically identical to M. hollandica, as described in this study. Considering its physiological properties, M. hollandica DMS1(T) is probably responsible for degradation of MT and DMS in freshwater sediments in situ. Due to the reversibility of the DMS conversion, methanogens like strain DMS1(T) can also be involved in the formation of DMS through methylation of MT. This phenomenon, which previously has been shown to occur in sediment slurries of freshwater origin, might affect the steady-state concentrations and, consequently, the total flux of DMS and MT in these systems.

Middle ear defects associated with the double knock out mutation of murine goosecoid and Msx1 genes

A number of developmental regulatory genes, including homeobox genes, are dynamically expressed in the mammalian cephalic ectomesenchyme during craniofacial morphogenesis. Owing to the vast amount of gene knock out experiments, functions of such genes are now being revealed in the mammalian skeletal patterning process. The murine goosecoid (Gsc) and Msx1 genes are expressed during craniofacial development and each mutant mouse displays intriguing facial abnormalities including those of middle ear ossicles, suggesting that both genes play roles in spatial programming of craniofacial regions. In order to examine whether these genes could function in concert to direct particular craniofacial morphogenesis, double knock out mice were analyzed. The phenotype of the double mutant mice was restricted to the first arch derivatives and was apparently additive of the single gene mutant mice, implying region specific genetic interactions of these homeobox genes expressed in overlapping regions of middle ear forming ectomesenchyme. Our results also suggested that the patterning of distal portions of the malleus depends on the tympanic membrane, for which normal expressions of both the genes are prerequisite.

[Neoadjuvant therapy for localized osteosarcoma of extremities. Results from the Cooperative osteosarcoma study group COSS of 925 patients]

BACKGROUND

Owing to twenty years of multicentric interdisciplinary cooperation, the COSS group has been able to collect data on a large group of osteosarcoma patients treated by neoadjuvant therapy. This paper reviews results achieved in patients with localized extremity tumors.

PATIENTS AND METHODS

INCLUSION CRITERIA

Registration into a completed neoadjuvant COSS-Study. Histologically confirmed, primary, localized, high-grade, central osteosarcoma of an extremity; age < 40 years; no pretreatment; interval diagnosis to chemotherapy < or = 3 weeks; no severe comorbidity. Chemotherapy: HD-methotrexate +/- doxorubicin +/- cisplatin +/- ifosfamide +/- BCD. Scheduled local therapy: Surgery.

RESULTS

925 evaluable patients from 101 institutions. Median age 15 years, m:f 1.4:1. Primary site: femur 510, tibia 251, humerus 100, fibula 51, other 13. Tumor-size < 1/3 of the involved bone 616, > or = 1/3 304. Definitive surgery in 903/925 cases, 443 limb salvage procedures. Good response (> 90% necrosis) in 469/806 (58.2%) evaluated tumors. Median follow-up for surviving patients: 5.42 years. Actuarial survival after 5 and 10 years: 72.5% (95%-CI 69.3-75.7) and 66.3% (62.5-70.0), relapse-free 62.1% (58.7-65.4) and 59.4% (55.8-63.0). 683/925 alive (601 first remission), 242 deceased (212 tumor progression, 30 other causes). 66.2% (97.3%) of all relapses within 2 (5) years. Prognosis correlates with tumor-size (< vs. > or = 1/3: 69.9% vs. 58.3% at 10 years) and -site (tibia: 74.2%, humerus: 54.5%) and -response (good vs. poor: 78.2% vs. 52.5%) (all p < 0.01). Actuarial 10-year survival by response grading I-VI according to Salzer-Kuntschik 80.9%, 82.8%, 71.1%, 60.7%, 47.7%, 27.3%. COSS-studies with preoperative 4-drug therapy more efficacious than less aggressive protocols. No impact of doxorubicin scheduling (sequential: rapid vs. 48 h-continuous infusion) or cisplatin scheduling (randomized: 5 h vs. 72 h-infusion) on prognosis detected.

CONCLUSIONS

Intensive multiagent chemotherapy and delayed surgery for localized extremity osteosarcoma led to excellent oncologic results in the COSS-studies. Tumor-size, -site, and -response as well as the intensity of upfront chemotherapy correlated with outcome. Giving doxorubicin and cisplatin by continuous infusions did not result in discernible prognostic disadvantages.

Pharmacological characterization of protein phosphatase activities in preparations from failing human hearts

beta-Adrenoceptor stimulation acts in the heart in part by increasing the phosphorylation state of phospholamban and phospholemman. There is evidence that the beta-adrenoceptor-mediated increase in phospholamban phosphorylation is in part due to inhibition of type 1 phosphatases. The aim of the present study was to elucidate which phosphatases dephosphorylate phospholamban and phospholemman in the human heart. In the past, cardiac serine/threonine phosphatases have been studied using phosphorylase a as substrate. Here, type 1 and type 2A phosphatase activities were studied in preparations from failing human hearts using phosphorylated phospholamban and phospholemman as substrates. Phospholamban and phospholemman phosphatase activity was detectable in human cardiac homogenates. Moreover, using a heparin-Sepharose column, the catalytic subunits of type 1 and type 2A phosphatases could be separated from human ventricles. Okadaic acid and cantharidin inhibited phosphatase activities dephosphorylating phospholamban, phospholemman, and phosphorylase a in homogenates in a concentration-dependent manner. However, okadaic acid was more potent. Cantharidin inhibited type 2A and type 1 activities against all substrates studied with IC50 values <15 nM and >290 nM, respectively. Okadaic acid inhibited type 1 and type 2A phosphatase activities as effectively but 10-30 times more potently than cantharidin. This work provides evidence that in the human heart, type 1 and 2A phosphatases are involved in the dephosphorylation of phospholamban and phospholemman and could play a role in the effects of beta-adrenergic stimulation in the heart.

BMP7 acts in murine lens placode development

Targeted inactivation of the Bmp7 gene in mouse leads to eye defects with late onset and variable penetrance (A. T. Dudley et al., 1995, Genes Dev. 9, 2795-2807; G. Luo et al., 1995, Genes Dev. 9, 2808-2820). Here we report that the expressivity of the Bmp7 mutant phenotype markedly increases in a C3H/He genetic background and that the phenotype implicates Bmp7 in the early stages of lens development. Immunolocalization experiments show that BMP7 protein is present in the head ectoderm at the time of lens placode induction. Using an in vitro culture system, we demonstrate that addition of BMP7 antagonists during the period of lens placode induction inhibits lens formation, indicating a role for BMP7 in lens placode development. Next, to integrate Bmp7 into a developmental pathway controlling formation of the lens placode, we examined the expression of several early lens placode-specific markers in Bmp7 mutant embryos. In these embryos, Pax6 head ectoderm expression is lost just prior to the time when the lens placode should appear, while in Pax6-deficient (Sey/Sey) embryos, Bmp7 expression is maintained. These results could suggest a simple linear pathway in placode induction in which Bmp7 functions upstream of Pax6 and regulates lens placode induction. At odds with this interpretation, however, is the finding that expression of secreted Frizzled Related Protein-2 (sFRP-2), a component of the Wnt signaling pathway which is expressed in prospective lens placode, is absent in Sey/Sey embryos but initially present in Bmp7 mutants. This suggests a different model in which Bmp7 function is required to maintain Pax6 expression after induction, during a preplacodal stage of lens development. We conclude that Bmp7 is a critical component of the genetic mechanism(s) controlling lens placode formation.

[MRI diagnosis of a female urethral diverticulum]

Magnetic resonance tomography reliably provides all anatomic information necessary for the differential diagnosis of a urethral diverticulum even when other imaging procedures cannot provide conclusive evidence. In general, the methodological limitations concern only the less important detail findings such as representation of the neck of the diverticulum or the distinction between septated and multiple diverticula. In addition, possible complications and the pelvic anatomy are shown in one examination. Thus magnetic resonance tomography has a key position among the imaging processes and should be used as the imaging procedure of choice for diagnostically doubtful cases.

FGFs and BMP4 induce both Msx1-independent and Msx1-dependent signaling pathways in early tooth development

During early tooth development, multiple signaling molecules are expressed in the dental lamina epithelium and induce the dental mesenchyme. One signal, BMP4, has been shown to induce morphologic changes in dental mesenchyme and mesenchymal gene expression via Msx1, but BMP4 cannot substitute for all the inductive functions of the dental epithelium. To investigate the role of FGFs during early tooth development, we examined the expression of epithelial and mesenchymal Fgfs in wild-type and Msx1 mutant tooth germs and tested the ability of FGFs to induce Fgf3 and Bmp4 expression in wild-type and Msx1 mutant dental mesenchymal explants. Fgf8 expression is preserved in Msx1 mutant epithelium while that of Fgf3 is not detected in Msx1 mutant dental mesenchyme. Moreover, dental epithelium as well as beads soaked in FGF1, FGF2 or FGF8 induce Fgf3 expression in dental mesenchyme in an Msx1-dependent manner. These results indicate that, like BMP4, FGF8 constitutes an epithelial inductive signal capable of inducing the expression of downstream signaling molecules in dental mesenchyme via Msx1. However, the BMP4 and FGF8 signaling pathways are distinct. BMP4 cannot induce Fgf3 nor can FGFs induce Bmp4 expression in dental mesenchyme, even though both signaling molecules can induce Msx1 and Msx1 is necessary for Fgf3 and Bmp4 expression in dental mesenchyme. In addition, we have investigated the effects of FGFs and BMP4 on the distal-less homeobox genes Dlx1 and Dlx2 and we have clarified the relationship between Msx and Dlx gene function in the developing tooth. Dlx1,Dlx2 double mutants exhibit a lamina stage arrest in maxillary molar tooth development (Thomas B. L., Tucker A. S., Qiu M., Ferguson C. A., Hardcastle Z., Rubenstein J. L. R. and Sharpe P. T. (1997) Development 124, 4811–4818). Although the maintenance of molar mesenchymal Dlx2 expression at the bud stage is Msx1-dependent, both the maintenance of Dlx1 expression and the initial activation of mesenchymal Dlx1 and Dlx2 expression during the lamina stage are not. Moreover, in contrast to the tooth bud stage arrest observed in Msx1 mutants, Msx1,Msx2 double mutants exhibit an earlier phenotype closely resembling the lamina stage arrest observed in Dlx1,Dlx2 double mutants. These results are consistent with functional redundancy between Msx1 and Msx2 in dental mesenchyme and support a model whereby Msx and Dlx genes function in parallel within the dental mesenchyme during tooth initiation. Indeed, as predicted by such a model, BMP4 and FGF8, epithelial signals that induce differential Msx1 and Msx2 expression in dental mesenchyme, also differentially induce Dlx1 and Dlx2 expression, and do so in an Msx1-independent manner. These results integrate Dlx1, Dlx2 and Fgf3 and Fgf8 into the odontogenic regulatory hierarchy along with Msx1, Msx2 and Bmp4, and provide a basis for interpreting tooth induction in terms of transcription factors which, individually, are necessary but not sufficient for the expression of downstream signals and therefore must act in specific combinations.

[Transmyocardial laser revascularization--the initial experiences of imaging in MRT]

PURPOSE

Imaging of myocardial signal alteration and perfusion differences after transmyocardial laser revascularization (TMLR).

METHODS AND MATERIAL

5 patients suffering from coronary vessel disease underwent MRI (0.5 T) pre- and 4-7 d post-TMLR. T1-weighted spin echo sequences were acquired ECG-triggered native and after injection of gadolinium. Qualitative analysis was performed on both native and contrast-enhanced images. Myocardial signal alterations and wall changes were evaluated. Qualitative and quantitative analyses of contrast-enhanced images were performed with regard of post-therapeutic perfusion differences. Analysis was based on contrast-to-noise (C/N) data obtained from operator defined "regions of interest".

RESULTS

Visualization of laser-induced channels was not possible. Native scans obtained before and after TMLR revealed no significant change with regard to the qualitative analysis. Both qualitative and quantitative analyses demonstrated a posttherapeutic increase of C/N in both the left ventricular myocardium (64.4 pre-TMLR; 89.1 post-TMLR; p = 0.06) and the septum in the majority of cases. No significant difference between laser-treated left myocardium and untreated septum was observed (p > 0.05).

DISCUSSION

Single myocardial laser channels could not be visualized with a 0.5-T MRI. However, visualization of increased myocardial contrast enhancement in laser-treated left ventricular myocardium was evident in the majority of cases on the basis of qualitative and quantitative analyses.

CONCLUSIONS

The MRI technique used enabled a first, limited depiction of TMLR-induced myocardial changes. The clinical value and impact still have to be defined.

Pancreaticoduodenal artery aneurysm--a life-threatening cause of gastrointestinal hemorrhage: case report and review of the literature

Gastrointestinal bleeding caused by erosion of a pancreaticoduodenal artery aneurysm in patients with pancreatitis is a rare but potentially life threatening disease. In this case report, the successful treatment of a patient bleeding from a ruptured pancreaticoduodenal artery aneurysm is described. A review of the literature of reported cases discusses the value of early angiographic intervention in patients with unexplained gastrointestinal hemorrhage and suspected rupture of an aneurysm.

[Haemosuccus pancreaticus as a rare initial manifestation of chronic pancreatitis]

Haemosuccus pancreaticus is an unfrequent but known cause of an upper gastrointestinal bleeding. Pathogenesis of spontaneous severe hemorrhage of the pancreatic duct includes chronic pancreatitis generated pseudocysts or aneurysms of the visceral arteries. We present two cases of severe spontaneous gastrointestinal bleeding as a first manifestation of chronic pancreatitis, in which the diagnosis chronic pancreatitis was not known and the patients denied any gastrointestinal symptoms in their medical history at the time of hemorrhage.

[Pleural drainage in acute thoracic trauma. Comparison of the radiologic image and computer tomography]

PURPOSE

Estimation of chest tube placement in patients with thoracic trauma with regard to chest tube malposition in chest radiography in the supine position compared to additional computed tomography of the thorax.

MATERIAL AND METHODS

Apart from compulsory chest radiography after one or multiple chest tube insertions, 31 severely injured patients with thoracic trauma underwent a CT scan of the thorax. These 31 patients with 40 chest tubes constituted the basis for the present analysis.

RESULTS

In chest radiography in the supine position there were no chest tube malpositions (n = 40); In the CT scans 25 correct positions, 7 pseudo-malpositions, 6 intrafissural and 2 intrapulmonary malpositions were identified. Moreover 16 sufficient, 18 insufficient and 6 indifferent functions of the chest tubes were seen.

CONCLUSION

In case of lasting clinical problems and questionable function of the chest tube, chest radiography should be supplemented by a CT scan of the thorax in order to estimate the position of the chest tube.

[Liver tumors in children: spiral CT findings and differential diagnostic classification]

Liver tumors in childhood are rare. They can be subdivided in benign or primary and secondary malignant liver tumors. The prognosis of malignant liver disease has improved due to extended therapy in the past few years. Thus, diagnosis of liver tumors in childhood gains in significance. After a suspect ultrasound diagnosis, usually computed tomography (CT) is used as a radiologic sectioning method. Guided by a retrospective analysis of 15 cases, the importance of the Helical-CT is presented. Helical-CT is a good diagnostic method for pediatric cases due to reduced scan times. By the basis of clinical data, distribution, and density, various differential diagnoses can be made. Benign liver tumors, especially cysts and frequently haemangioma, can easily be diagnosed and controlled because of their typical echogenicity and contrast visualisation. In cases of hamartoma, focal nodal hyperplasia, and adenoma computed tomography diagnosis is often necessary. Primary malignant liver tumors can prove to be unilocular hepatoblastomas or hepatocellular carcinomas, while disseminated liver invasions usually are considered as metastatic liver tumors of kidney or adrenal cancer.

[Quantitative morphology of vertebral body cortical bone. Building block for noninvasive calculation of fracture threshold in osteoporosis]

The vertebral bodies consist of two main structures, trabecular and cortical bone. The histological changes within the spine, especially in cortical bone, leading to osteoporotic fractures remain, however, poorly understood. Therefore, the complete front column of the spine was removed in 26 autopsy cases without skeletal diseases and in 11 cases with proven osteoporosis. A sagittal segment prepared through the center of all vertebral bodies was undecalcified embedded in plastic, ground to a 1-mm-thick block and stained using a modification of the von Kossa method. The analysis included measurement of the mean cortical thickness of both ventral and dorsal shell (from C3 to L5). The qualitative investigation of the structure of the cortical ring completed the analysis. The skeletally intact specimens had high cortical thickness values in the cervical spine (285 +/- 22 microns), a decrease in the thoracic spine (244 +/- 14 microns) and an increase in the lumbar spine (290 +/- 15 microns). The mean thickness of the ventral shell is in general higher than the thickness of the dorsal shell. The cortical thickness of the spine showed no gender-specific differences (P = n.s.). There was a slight decrease in the cortical thickness with age; however, this decrease and the correlation of cortical thickness to age was only significant below vertebral body T8 (r = 0.225 to 0.574; Pr < 0.05 to Pr < 0.005). Most interestingly, osteoporosis is characterized by a significant decrease in cortical thickness throughout the whole spine. This decrease in cortical thickness was more marked in the dorsal shell (P < 0.05) than in the ventral shell (ventral from C3 to T6 (P < 0.05) below T6 (P = n.s.). We therefore conclude that in osteoporosis, biomechanical competence is affected by both trabecular bone loss and decrease of cortical thickness. This suggests that, in addition to trabecular bone measurements, the cortical thickness is of special interest for diagnostic radiological examinations (CT) to yield clues about the risk of vertebral fractures.

Lens-specific gene recruitment of zeta-crystallin through Pax6, Nrl-Maf, and brain suppressor sites

Zeta-Crystallin is a taxon-specific crystallin, an enzyme which has undergone direct gene recruitment as a structural component of the guinea pig lens through a Pax6-dependent mechanism. Tissue specificity arises through a combination of effects involving three sites in the lens promoter. The Pax6 site (ZPE) itself shows specificity for an isoform of Pax6 preferentially expressed in lens cells. High-level expression of the promoter requires a second site, identical to an alphaCE2 site or half Maf response element (MARE), adjacent to the Pax6 site. A promoter fragment containing Pax6 and MARE sites gives lens-preferred induction of a heterologous promoter. Complexes binding the MARE in lens nuclear extracts are antigenically related to Nrl, and cotransfection with Nrl elevates zeta-crystallin promoter activity in lens cells. A truncated zeta promoter containing Nrl-MARE and Pax6 sites has a high level of expression in lens cells in transgenic mice but is also active in the brain. Suppression of the promoter in the brain requires sequences between -498 and -385, and a site in this region forms specific complexes in brain extract. A three-level model for lens-specific Pax6-dependent expression and gene recruitment is suggested: (i) binding of a specific isoform of Pax6; (ii) augmentation of expression through binding of Nrl or a related factor; and (iii) suppression of promoter activity in the central nervous system by an upstream negative element in the brain but not in the lens.

[The significance of the arterial vascular supply of segment IV in living liver donation]

PURPOSE

Postoperative CT's in living liver donors were analysed retrospectively to examine whether atrophies of segment IV occur after procurement depending on arterial vascular supply.

PATIENTS AND METHODS

Postoperative CT's from 19 living donors were retrospectively analysed. DSA of the upper abdomen had been performed on all donors prior to donation.

RESULTS

The pre-operative DSA images demonstrated an arterial vascular supply of segment IV from the right hepatic artery in 10/19 cases, from the left hepatic artery in 7/19 cases and from both, left and right hepatic artery, in 2/19 cases. Atrophies were seen in 3/7 patients in which segment IV was perfused via left hepatic artery, in further two patients with perfusion from the right hepatic artery or from both sides respectively. Clinically only one patient presented with an abscess.

CONCLUSIONS

The patterns of vascular supply to segment IV seen in our patients differ from those published by Couinaud. Since only 3/7 patients with an arterial supply from the left hepatic artery developed a segmental atrophy, we conclude that there must be additional, radiologically not identifiable portal venous branches or collaterals from the right portal vein that maintain perfusion of segment IV.

Interactions of the RepA1 protein with its replicon targets: two opposing roles in control of plasmid replication

By studying the interaction of derivatives of RepFIC miniplasmids, we were able to demonstrate that under certain conditions the RepA1 initiator protein inhibits plasmid replication. An analysis of cloned derivatives whose replication is inhibited by the RepA1 protein revealed the existence of two areas of the RepFIC genome that interact with RepA1 in the inhibition reaction. One of these areas, which occurs in the origin region, was explored by in vivo methylation protection footprinting studies. The protected area was 200 bp long and showed a definite periodicity of protected and hypersensitive sites, suggesting that RepA1 promotes a topological change in the RepFIC genome. The significance of our results is discussed in the context of plasmid replication control.

Role of the RepA1 protein in RepFIC plasmid replication

Using a sensitive primer extension technique, we have carried out studies to localize the start site of replication of the replicon RepFIC. In the course of these studies, we have found evidence that supports the hypothesis that transcription is an integral component of the initiation of replication. On the basis of our findings, we suggest that the transcript is processed to act as a primer, and therefore we propose that the transcript has a dual role as primer of replication and mRNA for the RepA1 protein. We present a model, based on our evidence, for the initiation of replication of the replicon RepFIC. This model provides as well an alternative explanation for what has been called the cis action of RepA1, and we show that RepA1 may act in trans as well as in cis.

The genetic control of early tooth development

Most vertebrate organs begin their initial formation by a common, developmentally conserved pattern of inductive tissue interactions between two tissues. The developing tooth germ is a prototype for such inductive tissue interactions and provides a powerful experimental system for elucidation of the genetic pathways involved in organogenesis. Members of the Msx homeobox gene family are expressed at sites of epithelial-mesenchymal interaction during embryogenesis, including the tooth. The important role that Msx genes play in tooth development is exemplified by mice lacking Msx gene function. Msxl-deficient mice exhibit an arrest in tooth development at the bud stage, while Msx2-deficient mice exhibit late defects in tooth development. The co-expression of Msx, Bmp, Lefl, and Activin beta A genes and the coincidence of tooth phenotypes in the various knockout mice suggest that these genes reside within a common genetic pathway. Results summarized here indicate that Msxl is required for the transmission of Bmp4 expression from dental epithelium to mesenchyme and also for Lefl expression. In addition, we consider the role of other signaling molecules in the epithelial-mesenchymal interactions leading to tooth formation, the role that transcription factors such as Msx play in the propagation of inductive signals, and the role of extracellular matrix. Last, as a unifying mechanism to explain the disparate tooth phenotypes in Msxl- and Msx2-deficient mice, we propose that later steps in tooth morphogenesis molecularly resemble those in early tooth development.

[Osteoblastoma simulating osteosarcoma of the petrous bone]

The case of a 25-year-old patient with a rare osteoblastoma-like osteosarcoma of the pars petrosa is discussed. CT scans (thin layers) showed a lytic, the skull basis-resorbing tumor with slight matrix calcification. MRI demonstrated a mainly signal intense tumor in T1-weighted images with less signal intensity at its borders which showed an enhancing peripheral zone after use of a gadolinium-containing medium.

Mechanisms of the contractile effects of 2,3-butanedione-monoxime in the mammalian heart

We studied the mechanisms of action of a negative inotropic compound, 2,3-butanedione-monoxime (BDM), which has been suggested to be a cardioprotective agent. In guinea-pig papillary muscles the negative inotropic effect of BDM start at 100 mumol/l amounting to 18.32 +/- 2.09% of predrug value at 10 mmol/l without any effects on time parameters (n = 12, each). 30 mmol/l BDM totally abolished force of contraction; this effect was reversible after washout. In the presence of the phosphatase-inhibitor cantharidin (30 mumol/l) the concentration response curve on force of contraction was shifted to higher concentrations of BDM. 100 mmol/l BDM decreased the phosphorylation state of the inhibitory subunit of troponin (TnI) and phospholamban (PLB) in [32P]-labeled guinea-pig ventricular myocytes to 76.5 +/- 4.7% and 49.7 +/- 4.2%, respectively (n = 7). Furthermore, BDM enhanced the activity of phosphorylase phosphatases in guinea-pig ventricular homogenates amounting to a stimulation to 203.5 +/- 10.4% at 100 mmol/l whereas type 1 phosphorylase phosphatase activity increased only by 24.5% (n = 5). PLB phosphatase activity was enhanced to 155.9 +/- 11.7% by 100 mmol/l BDM (n = 5). It is concluded that the effects of BDM on contractile parameters are accompanied by decreased phosphorylation of the cardiac regulatory proteins TnI and PLB which could in part be due to activation of type 1 or 2A phosphatase activity. Hence, it is suggested that BDM affects the phosphorylation state of TnI and PLB not directly, but via activation of their phosphatases.

Msx1 controls inductive signaling in mammalian tooth morphogenesis

Members of the Msx homeobox family are thought to play important roles in inductive tissue interactions during vertebrate organogenesis, but their precise developmental function has been unclear. Mice deficient for Msx1 exhibit defects in craniofacial development and a failure of tooth morphogenesis, with an arrest in molar tooth development at the E13.5 bud stage. Because of its potential for experimental manipulation, the murine molar tooth germ provides a powerful system for studying the role of Msx genes in inductive signaling during organogenesis. To further analyze the role of Msx1 in regulating epithelial-mesenchymal interactions during tooth morphogenesis, we have examined the expression of several potential Msx1 downstream genes in Msx1 mutant tooth germs and we have performed functional experiments designed to order these genes into a pathway. Our results show that expression of Bone Morphogenetic Protein 4 (BMP4), the HMG box gene Lef1 and the heparan sulfate proteoglycan syndecan-1 is specifically reduced in Msx1 mutant dental mesenchyme, while expression of the extracellular matrix protein tenascin is unaffected. BMP4 soaked beads can induce Bmp4 and Lef1 expression in explanted wild-type dental mesenchymes, but only Lef1 expression in Msx1 mutant dental mesenchyme. We thus conclude that epithelial BMP4 induces its own expression in dental mesenchyme in a manner that requires Msx1. In turn, we show that addition of BMP4 to Msx1 deficient tooth germs bypasses the requirement for Msx1 and rescues epithelial development from the bud stage to the E14.5 cap stage. Lastly, we show that FGFs induce syndecan-1 expression in dental mesenchyme in a manner that also requires Msx-1. These results integrate Msx1 into a regulatory hierarchy in early tooth morphogenesis and demonstrate that Msx1 is not only expressed in dental mesenchyme in response to epithelial signals, but also in turn regulates the reciprocal expression of inductive signals in the mesenchyme which then act back upon the dental epithelium. We propose that Msx genes function repetitively during vertebrate organogenesis to permit inductive signaling to occur back and forth between tissue layers.

Regulation of Msx-1, Msx-2, Bmp-2 and Bmp-4 during foetal and postnatal mammary gland development

Expression of the Msx-1 and Msx-2 homeobox genes have been shown to be coordinately regulated with the Bmp-2 and Bmp-4 ligands in a variety of developing tissues. Here we report that transcripts from all four genes are developmentally regulated during both foetal and postnatal mammary gland development. The location and time-course of the Bmp and Msx expression point to a role for Msx and Bmp gene products in the control of epithelial-mesenchymal interactions. Expression of Msx-2, but not Msx-1, Bmp-2 or Bmp-4 was decreased following ovariectomy, while expression of the human Msx-2 homologue was regulated by 17beta-oestradiol in the MCF-7 breast cancer cell line. The regulation of Msx-2 expression by oestrogen raises the possibility that hormonal regulation of mammary development is mediated through the control of epithelial-mesenchymal interactions.

[Tuberculous pseudotumor of the omentum]

The abdomen is one of the most common extrathoracic manifestation sites for tuberculosis. The constellation of ascites, fatigue, fever, weight loss and ileus in younger patients should lead to the diagnosis, particularly in times when immunosuppression appears more frequently associated with AIDS. Using modern imaging techniques like CT and ultrasound and in combination with interventional procedures (guided paracentesis or biopsy) the number of diagnostic laparotomies and laparoscopies, like in the case presented could be reduced. In this context the radiologist should include tuberculosis in the differential diagnosis.