[Joint presentation of facial hemangioma, posterior fossa malformation, and carotid-vertebral hypoplasia (Pascual-Castroviejo syndrome II): report of 2 new cases]

INTRODUCTION

The association of external capillary hemangiomas with intracranial malformations (vascular or nonvascular) was first described by Pascual-Castroviejo in 1978. The commonest anomalies found included: Dandy-Walker syndrome, cerebellar hypoplasia, arterial angiomas and alterations in the origin or distribution of the main cerebral arteries. In 1996 the same author named it the 'hemangiovascular complex syndrome'. The syndrome association is very similar, perhaps even identical, to that recently described in the English literature under the heading of PHACE.

CLINICAL CASES

We describe two new cases of facial hemangioma, Dandy-Walker type posterior fossa malformation and hypoplasia of the carotid-vertebral trunk ipsilateral to the facial hemangioma. The first patient, a three year old girl had needed a ventriculo-peritoneal shunt for hydrocephalus secondary to a Dandy-Walker malformation. During the third month she had severe symptoms of laryngeal obstruction due to the angiomatous lesion and was satisfactorily treated with corticosteroids. At the present time her psychomotor development seems normal on neurological examination and evaluation. The second patient, a thirteen year old boy, besides showing the characteristic features of this syndrome also had attention-deficit hyperactivity and clumsy movements. In both cases the facial hemangioma was present at birth and gradually became smaller although it did not disappear completely.

CONCLUSION

It is important to know about this neurocutaneous syndrome to avoid confusion with similar conditions such as the Sturge-Weber syndrome, so as to carry out suitable clinical investigations: cerebral magnetic resonance, angio-resonance of the intracranial vessels and supra-aortic trunks, arteriography, echocardiography and ophthalmological assessment and to prevent signs of upper respiratory tract obstruction which may be very serious.

Distribution of the mRNA encoding the four dopamine D(1) receptor subtypes in the brain of the european eel (Anguilla anguilla): comparative approach to the function of D(1) receptors in vertebrates

Four subtypes of D(1) dopamine receptors are expressed in the brain of the European eel (Anguilla anguilla), an elopomorph teleost. To correlate this molecular multiplicity with specific localisation and functions, the distribution of the D(1) receptor transcripts was analysed by in situ hybridisation. The four D(1) receptor transcripts exhibit largely overlapping expression territories. In telencephalon, they are found in the olfactory bulb and the dorsal telencephalon (except its lateral part) but are most abundant in the subpallial areas. More caudally, the entopeduncular nucleus, preoptic nuclei, preglomerular nuclear complex, ventral thalamus, periventricular hypothalamus, optic tectum and cerebellum, all contain various amounts of D(1) receptor transcripts. Finally, D(1) receptor mRNAs are present in nuclei associated with the cranial nerves. The two D(1A) receptor subtypes are generally the most abundant and present a different distribution in several areas. The D(1B) mRNA, although present in fewer areas than D(1A) transcripts, is the most abundant in ventrolateral telencephalon and torus semicircularis. The D(1C) receptor transcript, which has not been found in mammals, is restricted to diencephalon and cerebellum. In view of the expression territories of D(1) receptor transcripts and previous data, some areas of the everted telencephalon of teleost may be homologous to regions of the tetrapod brain. In particular, D(1) expression territories of the ventral telencephalon are likely to be equivalent to striatal areas. These observations suggest an evolutionary scenario in which the D(1A) receptor subtype was highly conserved after the first gene duplication during the evolution of craniates, whereas D(1B) and D(1C), and their associated specific characteristics, appeared later, probably in the gnathostome lineage.

Insulin-like growth factor-I stimulates gonadotrophin production from eel pituitary cells: a possible metabolic signal for induction of puberty

Insulin-like growth factor (IGF)-I has been suggested as a potential signal linking growth and puberty in mammals. Using the juvenile European eel as a model, we employed a long-term, serum-free primary culture of pituitary cells to study the direct effect of IGF-I on gonadotrophin (GtH-II=LH) production. IGF-I increased both cell content and release of GtH-II in a time- and dose-dependent manner. IGF-I and IGF-II had similar potencies but insulin was 100-fold less effective, suggesting the implication of an IGF type 1 receptor. Other growth and metabolic factors, such as basic fibroblast growth factor and thyroid hormones, had no effect on GtH-II production. IGF-I did not significantly increase the number of GtH-II immunoreactive cells, indicating that its stimulatory effect on GtH-II production does not result from gonadotroph proliferation. Comparison of IGF-I and somatostatin (SRIH-14) effects showed that both factors inhibited growth hormone (GH) release but only IGF-I stimulated GtH-II production by eel pituitary cells. This indicates that the effect of IGF-I on gonadotrophs is not mediated by the reduction of GH released by somatotrophs into the culture medium. This study demonstrates a specific stimulatory effect of IGF-I on eel GtH-II production, played out directly at the pituitary level. These data obtained in a primitive teleost suggest that the role of IGF-I as a link between body growth and puberty may have been established early in the evolution of vertebrates.

Tyrosine hydroxylase in the european eel (Anguilla anguilla): cDNA cloning, brain distribution, and phylogenetic analysis

We report the isolation of a full-length eel tyrosine hydroxylase (TH) cDNA that is characterized by a long 3' untranslated region and by a diversity restricted to the 3' end owing to the differential use of three polyadenylation signals. The longest eel TH mRNA was distinctive in the presence of four pentameric elements (AUUUA) in the AU-rich 3' noncoding region. Such a diversity could provide the basis of posttranscriptional or translational regulation of eel TH gene expression. Comparison of the eel TH sequence with those of other aromatic amino acid hydroxylases (TH, tryptophan hydroxylase, and phenylalanine hydroxylase) and phylogenetic analysis confirmed that the N-terminal regulatory domain is highly divergent, contrasting with the conservation of the catalytic core of the enzyme. Molecular phylogenies including the available sequences of the three hydroxylase genes suggested that the duplication of their common ancestor occurred before the emergence of arthropods. The regional expression of the eel TH mRNA was studied by semiquantitative PCR, northern blots, and in situ hybridization and compared with the immunocytochemical localization of TH protein. The data showed that TH mRNA is mostly expressed in the olfactory and hypothalamic areas, whereas sparse TH-expressing cell bodies are present in the telencephalic region and brainstem. No labeling was detected in the mesencephalic area, in striking contrast with that found in amphibians and amniotes.

Graded X-ray Optics for Synchrotron Radiation Applications

Using X-ray diffractometry and spectral measurements, the structure and properties of graded X-ray optical elements have been examined. Experimental and theoretical data on X-ray supermirrors, which were prepared by the magnetron sputtering technique using precise thickness control, are reported. Measurements on graded aperiodic Si(1-x)Ge(x) single crystals, which were grown by the Czochralski technique, are also presented. The lattice parameter of such a crystal changes almost linearly with increasing Ge concentration. The measurements indicate that Si(1-x)Ge(x) crystals with concentrations up to 7 at.% Ge can be grown with a quality comparable to that of pure Si crystals.

Long-term inhibitory effects of somatostatin and insulin-like growth factor 1 on growth hormone release by serum-free primary culture of pituitary cells from European eel (Anguilla anguilla)

To investigate the ability of hypothalamic and peripheral factors to directly regulate growth hormone (GH) release in a primitive teleost, the European eel (Anguilla anguilla L.), we used primary cultures of dispersed pituitary cells. When cultured for 12 days in a serum-free medium, pituitary cells continuously released large amounts of GH, which exceeded the initial cellular content. Somatotropin-release inhibiting hormone (SRIH-14) dose-dependently inhibited GH release (EC50 0.75 nM) up to a maximal inhibitory effect of 95%. No desensitization of somatotropes to SRIH was observed over the 12 days of culture. Use of receptor subtype-selective SRIH agonists suggests the existence on eel somatotropes of SRIH receptor(s) related to the mammalian sst2/sst3/sst5 class rather than to the sst1/sst4 class. Insulin-like growth factor 1 (IGF1) dose-dependently inhibited GH release (EC50 0.03 nM) up to a maximal inhibitory effect of 85%, without desensitization. IGF1 and IGF2 were equipotent in inhibiting GH release, whereas insulin was 1,000 times less active, suggesting the implication of a receptor related to the mammalian IGF type 1 receptor. These results indicate that eel somatotropes are active in vitro without any specific additional factors, and suggest the existence of a dominant inhibitory control of GH release in vivo. Two potential candidates for this chronic negative regulation are a neurohormone, SRIH and a circulating factor, IGF1. These data underline the early evolutionary origin of the molecular and functional SRIH-GH-IGF1 neuroendocrine axis in vertebrates.

[Solitary crossed renal ectopia and congenital vertebral anomalies]

OBJECTIVE

To describe a case of solitary crossed renal ectopia that had been incidentally discovered in a healthy male with a previous history of spinal surgery.

METHODS/RESULTS

A 43-year-old male who had undergone two surgical procedures for severe scoliosis of the thoracic spine when he was 7 years of age, consulted for symptoms of unspecific urethritis that had just remitted. Abdominal ultrasound and excretory urography revealed a solitary crossed ectopia on the right side and the spinal x-ray showed congenital fusion of the cervical vertebrae (Klippel-Feil syndrome).

CONCLUSIONS

Crossed ectopia of a solitary kidney is an exceedingly rare anomaly of the urinary tract (about 30 cases have been reported) combining renal agenesia of one side, contralateral displacement of the ureter draining the only kidney and agenesia or hypoplasia of the other ureter. It is frequently an incidental finding, although it may be associated with congenital spinal anomalies and even severe genital and anal anomalies.

Reconstruction of human maxillary defects with nacre powder: histological evidence for bone regeneration

The defective areas in the premolar-molar region of maxillary alveolar bone of eight patients were reconstructed using powdered nacre from the giant oyster Pinctada maxima. Histological, microradiographic and polarized light studies of drill biopsies taken 6 months postoperatively showed that nacre was tightly bound to newly-formed bone. The nacre was gradually and centripetally biodissolved and replaced with immature and then mature lamellar bone. These results are in agreement with our previous experimental in vitro data indicating that nacre has good osteogenic properties.

[Scrotal granuloma caused by oil migrating from the hip in 2 transsexual males (scrotal sclerosing lipogranuloma)]

OBJECTIVE

To describe two patients with scrotal granuloma due to silicone oil migrated from the hip.

METHODS/RESULTS

Two male transsexuals without genitoplasty developed scrotal inflammatory masses after subcutaneous injection of silicone oil to remodel the hip contour. Imaging studies and pathologic examination disclosed lesions similar to those encountered in ruptured silicone breast implants.

CONCLUSIONS

Silicone migration to the scrotum through subdermal fascial planes can cause a granulomatous lesion similar to that of ruptured breast implants. The migratory pathway is similar to that of scrotal emphysema and, inversely, the dissemination of necrotizing fasciitis of the genitalia.

Primary cultures of dispersed pituitary cells from estradiol-pretreated female silver eels (Anguilla anguilla L.): immunocytochemical characterization of gonadotropic cells and stimulation of gonadotropin release

To analyze the multihormonal control mechanisms of GTH secretion in the eel, primary culture of pituitary cells from control or estradiol-treated female silver eels, a treatment known to stimulate in vivo GTH synthesis, was developed. Dispersed eel pituitary cells obtained by enzymatic (trypsin/DNAse) and mechanical dispersion were cultured in Earles M199, at 18 degrees. Immunoreactive GTH (ir-GTH) cells were characterized by the immunoperoxidase method, using antiserum to carp GTH beta subunit. Ir-GTH cells from control silver eels were small and represented 14% of the dispersed pituitary cells. In contrast, ir-GTH cells from estradiol-treated eels were larger (cell area x 2.5) and represented a higher proportion (21%) of the pituitary cells. Intracellular and medium contents of GTH were measured by radioimmunoassay for the GTH beta subunit. In vivo estradiol-treatment increased more than 100-fold the GTH content of cell cultures. GTH release, studied over 1 to 4 hr, was undetectable in cultures from normal eels. In contrast, GTH release was low (less than 2% of cell content) but measurable in cultures from estradiol-treated eels. Subsequent experiments examined effects of various secretagogues on GTH release from primary cultures of pituitary cells from estradiol-pretreated eels. GTH release was significantly increased (x1.5 to x3 basal release) by 10(-6) M GnRH-A as well as by both native GnRHs in the eel (mammalian GnRH, mGnRH, and chicken GnRH-II, cGnRH-II), at the same concentration. Lower GnRH concentrations had no significant effect, indicating a low sensitivity of gonadotrophs to GnRH, likely to be related to their immature state at the silver stage. The similar efficacy of mGnRH and cGnRH-II suggested that the pituitary GnRH receptor had a low specificity toward various molecular forms, in the eel as in the other nonmammalian species. The protein kinase C (PKC) activator (phorbol ester: PMA) also stimulated GTH secretion, with a maximal effect at 10(-8) M, indicating that the PKC pathway was functional. In contrast, a depolarizing agent (50 mM KCl) had no significant effect on GTH release, suggesting lack of a functional voltagesensitive calcium channel (VSCC) secretory pathway. Perifusion experiments on whole pituitary confirmed the lack of effect of KCl on gonadotrophs from E2-pretreated eels and indicated that an additional in vivo treatment with GnRH agonist and dopamine antagonist could induce the differentiation of a functional VSCC pathway. These characteristics of the transduction mechanisms may be related to the immature state of the eel gonadotrophs at the silver stage.

Development of a radioimmunoassay for European eel growth hormone and application to the study of silvering and experimental fasting

A specific and sensitive homologous radioimmunoassay for eel (Anguilla anguilla L.) growth hormone (angGH) has been developed. The antiserum, raised against purified angGH and used at 1:20,000 final dilution, did not cross-react with eel prolactin or thyrotropin, carp gonadotropin II, bovine GH, or serum from hypophysectornized eel. The inhibition curves for eel pituitary extracts and serum were parallel to that of angGH standard. The ED50 value was between 1 and 2 ng/tube and the recovery of purified angGH added to the serum was about 100%. In immunocytochemical studies, the antiserum, used at 1:1000 dilution, specifically labeled the somatotrophs in the pituitaries of the glass, yellow, and silver eels. The GH contents were determined in the pituitaries of glass, yellow, and silver eels and in the serum at the yellow and silver stages. GH variations during the transformation of the yellow to silver eel were examined. The results indicated a decrease in GH production between the yellow and the silver eels, possibly related to the cessation of growth at the silver stage. In contrast to the situation in the naturally fasting silver eel, submitting yellow eels to 3 months of starvation (experimental fasting) greatly increased GH production. This suggests a variation in the regulation of GH according to the type of fasting (natural or experimental) and/or the stage of the fish (yellow or silver).

Immunocytochemical localization of mammalian GnRH (gonadotropin-releasing hormone) and chicken GnRH-II in the brain of the European silver eel (Anguilla anguilla L.)

Using specific antibodies for the two molecular forms of gonadotropin-releasing hormone (GnRH) present in the European eel, Anguilla anguilla, (mammalian GnRH, mGnRH, and chicken GnRH II, cGnRH-II), we employed immunocytochemistry to determine the distribution of these two peptides in the brain and in the pituitary. The results indicate that mGnRH and cGnRH-II are localized in different neurons: mGnRH-immunoreactive (ir) perikaria were observed in the olfactory bulbs, the junction between olfactory bulbs and telencephalon (nucleus olfactoretinalis), the telencephalon, the preoptic region and the mediobasal hypothalamus. These cell bodies are located along a continuum of ir-fibers that could be traced from the olfactory nerve to the pituitary. Mammalian GnRH-ir fibers were detected in many parts of the brain (olfactory bulbs, ventral telencephalon, hypothalamus, optic tectum, mesencephalon) and in the pituitary. Chicken GnRH-II-ir cell bodies were detected in the nucleus of the medial longitudinal fasciculus of the midbrain tegmentum, but only scattered fibers could be detected in different parts of the brain. The pituitary exhibited very few cGnRH-II-ir fibers, contrasting with an extensive mGnRH innervation. These results are in agreement with our previous data obtained in the same species using specific radioimmunoassays for mGnRH and cGnRH-II. They demonstrate a differential distribution of the two forms of GnRH in the brain of the eel, as in the brain of some other vertebrate species, and suggest differential physiological roles for the two GnRH forms in the eel. They also provide information concerning the evolution of the GnRH systems in vertebrates.

Sequence and regulation of European eel prolactin mRNA

cDNA clones encoding the European eel (Anguilla anguilla L.) prolactin were isolated from a pituitary cDNA library constructed in gamma gt10, using a rainbow trout Prl cDNA fragment as a probe. Four different inserts were subcloned into the pGEM 3Z plasmid after PCR amplification. The 1082 bp-long nucleotide sequence revealed an open reading frame of 627 bp encoding a 24 amino acid-long signal peptide followed by a 185 amino acid-long mature protein. Comparison studies showed 60-70% homology with other known teleost fish prolactins and 30-45% with non-teleost fish, amphibian, reptilian, avian and mammalian prolactins. In situ hybridization studies using labelled prolactin RNA probe showed a strong signal in the rostral pars distalis of the pituitary gland. We next examined the physiological regulation of this prolactin synthesis in vivo using Northern blot analysis and prolactin cDNA probe labelled by random priming. The pituitary prolactin mRNA level was markedly decreased 3 weeks after transfer of eels from freshwater to sea water. Implants of thyroid hormones left for up to three weeks were ineffective on prolactin mRNA. Estradiol administered as implant, alone or in combination with 500 micrograms testosterone, was also unable to significantly alter the pituitary mRNA level for prolactin in the freshwater silver eels whatever the dose used (20-500 micrograms) and whatever the duration of treatment (from 4 days to 10 weeks).