Development of a frameless and armless stereotactic neuronavigation system with ultrasonographic registration

OBJECTIVE

We have developed a frameless stereotactic neuronavigation system that allows navigation during neurosurgical procedures through an image formed from integrating ultrasonography and preoperative magnetic resonance (MR) imaging and/or x-ray computed tomography.

METHODS

The system consists of a ultrasound imaging scanner, a workstation with an image capture board, and an ultrasonic tracking sensor with a 5-MHz ultrasonographic transducer. The ultrasonic tracking sensor measures the position and orientation of the ultrasonographic transducer. The oblique plane of the MR/computed tomographic image corresponding to the ultrasound image is then displayed on the workstation monitor. A three-dimensional computer graphic representation of the integrated image is also reported as a preliminary test. For the patient-image registration, the coordinates of digitized and imaged markers on a specifically developed reference frame are used. The reference frame is noninvasive because it is not bolted but only fastened to the patient's head with silicon.

RESULTS

Based on the findings from the clinical application of the system in three cases, the system was advantageous because of the surgical procedures could be controlled by intraoperative ultrasonography as well as by preoperative MR/computed tomographic images. Missing parts in the ultrasonogram were supplemented with preoperative MR/computed tomographic images. At other times, spatial positioning and visualization by ultrasonography were useful for identifying anatomical objects in the image.

CONCLUSION

This preliminary study of the frameless integration of ultrasonography into stereotactic space demonstrated its clinical usefulness. We believe that the concept of pre- and intraoperative image-guided surgery presented here will find increasing use in the future.

Comparison of the closing dynamics of mechanical prosthetic heart valves

To compare the closing dynamics of mechanical tilting disk prosthetic heart valves (OmniScience 25 [OS25], Medtronic-Hall 25 [MH25], Bjork-Shiley Monostrut 29 [BS29]) and bileaflet valves (CarboMedics 29 [CM29]) in the mitral position, an x-ray high speed video camera (XHVC) and a mechanical mock circulator were used. From the continuous images taken with the XHVC, the starting point of closing and the period during closing (PDC) were measured. Pressures and flow rate were recorded at 500 Hz synchronously with the XHVC. A pressure difference across the valves at the onset of closing (dpc) was newly introduced to compare the closing response. Using 60 and 100 bpm, the following results were obtained: 1) the CM29 had less PDC and maximum backflow rate than the BS29; 2) the dpc and the PDC at 100 bpm were larger than those at 60 bpm; 3) the dpc of the MH25 was the lowest; and 4) the PDC of the CM29 was the shortest. With regard to the effect of valve design on closing dynamics, it was shown that: 1) less momentum of inertia of the occluder and disk traveling angle resulted in lower dpc and shorter PDC, and 2) the higher the dpc and the PDC became, the larger the maximum backflow rate that was generated, and 3) low final closing speed will be achieved for small disk travelling angle.

Stimulation of cyclic ADP-ribose synthesis by acetylcholine and its role in catecholamine release in bovine adrenal chromaffin cells

Cyclic ADP-ribose (cADPR) is suggested to be a novel messenger of ryanodine receptors in various cellular systems. However, the regulation of its synthesis in response to cell stimulation and its functional roles are still unclear. We examined the physiological relevance of cADPR to the messenger role in stimulation-secretion coupling in cultured bovine adrenal chromaffin cells. Sensitization of Ca2+-induced Ca2+ release (CICR) and stimulation of catecholamine release by cADPR in permeabilized cells were demonstrated along with the contribution of CICR to intracellular Ca2+ dynamics and secretory response during stimulation of intact chromaffin cells. ADP-ribosyl cyclase was activated in the membrane preparation from chromaffin cells stimulated with acetylcholine (ACh), excess KCl depolarization, and 8-bromo-cyclic-AMP. ACh-induced activation of ADP-ribosyl cyclase was dependent on the influx of Ca2+ into cells and on the activation of cyclic AMP-dependent protein kinase. These and previous findings that ACh activates adenylate cyclase by Ca2+ influx in chromaffin cells suggested that ACh induces activation of ADP-ribosyl cyclase through Ca2+ influx and cyclic AMP-mediated pathways. These results provide evidence that the synthesis of cADPR is regulated by cell stimulation, and the cADPR/CICR pathway forms a significant signal transduction for secretion.

Nonsymmetric leaflet motion of St. Jude Medical mitral valves simulated with a computer-controlled hydraulic mock circulator

Since the introduction of high-performance prosthetic heart valves, particularly bileaflet valves and monoleaflet valves with larger opening angles, we have observed in vivo complex leaflet motion which has not been experimentally confirmed yet. We developed a computer-controlled hydraulic mock circulator to study the motion of in vivo leaflets. A high speed CCD camera recorded the valve movement. In the mitral position, a standard St. Jude Medical valve was tilted to be horizontal or vertical. The test valve was driven with single- or double-peaked flow. The flow rate was set to 5.0 L/min at 70 bpm with a systole/diastole ratio of 0.3. We found the following results: independent of valve orientation, the valve showed a nonsymmetric leaflet motion; the valve showed unpredictable leaflet position during decreasing flow or absence of flow; and the disc closed temporarily at the lower inflow rate between the 2 flow peaks.

Study of the effect of atrial contraction on mitral prosthetic valve by high speed video camera

To clarify the effect of atrial contraction on the dynamic behavior of mitral prosthetic valves, a mechanical mock circulatory system has been developed. It is able to simulate the inflow characteristics during diastole. The disc motions of Björk-Shiley Monostrut (BSM29) and CarboMedics (CM29) valves (both with an annulus diameter of 29 mm) were measured and compared with a high speed video camera. After contraction of the artificial atrium (100 ms), there was a delay of 75 ms before the onset of the ventricular contraction. Mitral flow similar to physiological conditions could be achieved. The BSM29 was tested in the anterior position (a) and the posterior position (p). Under the condition of active atrial contraction (AC), we confirmed that the closing motion was initiated and the period during closing motion (PDCM) was prolonged (BSM29[a]: 22.4 +/- 3.4-->63 +/- 3.2; BSM29[p]: 71.2 +/- 38-->94.2 +/- 11; and CM29: 14 +/- 0.0-->28.4 +/- 2.3 [unit: ms]), the prolongation of the PDCM of the CM29 due to the AC being smaller than that of the BSM29. We also confirmed that the closing volume (CV) increased slightly (BSM29 [a]: 7.8 +/- 0.4-->8.5 +/- 0.8; BSM29[p]: 6.9 +/- 0.6-->7.0 +/- 0.5; and CM29: 3.6 +/- 0.6-->4.1 +/- 0.6 [unit: ml]). The CM29 had a shorter PDCM, less prolongation of the PDCM due to the AC, and less CV than the BSM29. Thus, we confirmed that the CM29 produced better response at valve closure than the BSM29.

Increased sialyl Lewis A expression and fucosyltransferase activity with acquisition of a high metastatic capacity in a colon cancer cell line

A human colon cancer cell line, OCUC-LM1(LM), was established from a liver metastasis in our laboratory. Intrasplenic injection of LM into nude mice was repeated three and five times, and the daughter cell lines were designated as LM-H3 and LM-H5 respectively. The level of sialyl Lewis A (SLA) in the supernatant of LM-H3 and LM-H5 was 3 and 4.5 times higher than that of LM respectively. Flow cytometric analysis of SLA expression showed that the peak channel for LM was 113; for LM-H3, 126; and for LM-H5, 146. The mean fluorescence intensity of LM was 102.3 +/- 43.5; for LM-H3, 126.2 +/- 28.4; and for LM-H5, 144.8 +/- 23.4. In endothelial cell adhesion assays, the percentages of adherent LM-H3 and LM-H5 cells were significantly higher than for LM. The activity of alpha1-->4 fucosyltransferase was higher in LM-H3 and LM-H5 than in LM, but there was no difference in alpha2-->3 sialyltransferase activities for type 1 chain among the cell lines. Our results suggest that SLA expression is associated with acquisition of a high capacity for liver metastasis of colon cancer; increased SLA expression is due mainly to increased fucosyltransferase activity.

Stimulation of platelet-activating factor synthesis by neurotransmitters in salivary glands

Platelet-activating factor (PAF), a phospholipid mediator exhibiting potent biological activities, has been shown to stimulate amylase release from the pancreas and salivary glands. The capacity of salivary glands for PAF biosynthesis in response to stimulation has also been demonstrated. To elucidate the role of PAF in salivary glands, we studied the regulation of platelet-activating factor synthesis by the autonomic nervous system in canine salivary glands. Acetylcholine and ionomycin stimulated PAF production in dispersed cells from parotid, submandibular, and sublingual glands of dogs. Norepinephrine and phenylephrine, but not isoproterenol, also stimulated PAF production in submandibular gland cells. Norepinephrine-induced PAF production was blocked by phentolamine but not by propranolol. Acetylcholine and norepinephrine increased both the PAF production and liberation of [14C]arachidonic acid from cells pre-labeled with [14C]arachidonic acid in the presence of Ca2+ in the medium. These stimulants increased [14C]arachidonic acid liberation without the accompanying production of PAF in Ca(2+)-deprived medium. No activators or inhibitors of protein kinase C produced or affected acetylcholine-induced PAF production. Lyso-PAF:acetyl-CoA acetyltransferase was activated in the cells treated with acetylcholine, norepinephrine, isoproterenol, and 8Br-cyclic AMP. Deprivation of Ca2+ in the medium markedly reduced acetylcholine-induced activation of the transferase, but little affected norepinephrine-, isoproterenol-, and 8Br-cyclic AMP-induced activation. Dithiothreitol-insensitive cholinephosphotransferase activity was also increased by acetylcholine, norepinephrine, isoproterenol, and 8Br-cyclic AMP, and the deprivation of Ca2+ in the medium further increased the activation of the enzyme activity by these agents. These results suggest that PAF synthesis in canine salivary glands is under the control of muscarinic cholinergic and alpha-adrenergic systems via Ca(2+)-dependent remodeling pathways, and that the independent activation of either phospholipase A2 or acetyltransferase is insufficient for PAF production in submandibular gland cells, i.e., the concurrent activation of these enzymes is required.

Suppression of sialyl Lewis X expression and E-selectin-mediated cell adhesion in cultured human lymphoid cells by transfection of antisense cDNA of an alpha1-->3 fucosyltransferase (Fuc-T VII)

The antisense cDNA approach was used to identify the endogenous fucosyltransferase species responsible for synthesis of the sialyl Lewis X (NeuAcalpha2-->3 Galbeta1-->4[Fucalpha1-->3]GlcNAcbeta1-->R) determinant in human lymphoid cells. The cultured human adult T-cell leukemia cell line, ED40515-N, expressed the message of alpha1-->3 fucosyltransferase (Fuc-T) IV and VII, with a low level of the Fuc-T III and VI message, and manifested the sialyl Lewis X as well as Lewis X (Galbeta1-->4 [Fucalpha1-->3]GlcNAcbeta1-->R) determinant at the cell surface. Transfection of this cell line with the pRc/CMV vector containing an antisense human Fuc-T VII construct (pRc/CMV/5'FT7AS) resulted in a significant decrease of endogenous Fuc-T VII message and a marked reduction in the cell surface expression of sialyl Lewis X determinant as well as a reduction in the enzymatic activity of alpha1-->3 fucosyltransferase against sialylated type 2 chain substrate. This was accompanied by diminution of cell adhesive activity toward E-selectin on interleukin-1beta-treated endothelial cells. These results indicated that the synthesis of the sialyl Lewis X determinants that were functionally active as E-selectin ligands was mainly mediated by Fuc-T VII in these lymphoid cells. On the other hand, the message of Fuc-T IV showed no significant change in the transfectant clones, and the surface expression of the Lewis X antigen as well as the enzymatic activity of alpha1-->3 fucosyltransferase against non-sialylated type 2 chain substrate was well preserved. The clear contrast between the diminished expression of sialyl Lewis X and the conserved manifestation of Lewis X in the transfectant clones suggested that the synthesis of sialyl Lewis X and that of Lewis X are independently regulated by different fucosyltransferases in human lymphoid cells. Fuc-T VII must be involved in the synthesis of sialyl Lewis X, while the synthesis of Lewis X is mediated by an enzyme other than Fuc-T VII, most probably Fuc-T IV.

Cellular and molecular aspects of monoamine neurotransmitter transporters

Neurotransmitter transporters terminate synaptic neurotransmission by accumulating neurotransmitters once again after release in a sodium- and chloride-dependent fashion. The availability of the cloned neurotransmitter transporters has allowed investigation into the roles of these transporters in neuronal function. Molecular biological and protein engineering studies including in vitro site-directed mutagenesis, chimera formation of several transporter clones, or epitope-tagging various regions of transporter proteins, have revealed the topology and functionally mapped the transporter proteins. Monoamine neurotransmitter transporters such as those for dopamine, norepinephrine and serotonin are of interest, since they are a target of drugs of abuse and are involved in neuronal disorders including Parkinson's disease and depression. Therefore, elucidating the molecular basis of these transporters may clarify these problems and help develop treatments with which to combat these disorders and drug abuse.

Detection of N-acetylgalactosaminyltransferase mRNA which determines expression of Sda blood group carbohydrate structure in human gastrointestinal mucosa and cancer

The Sda blood group carbohydrate structure, GalNAcbeta1-4[NeuAcalpha2-3]Galbeta1-4GlcNAc-R, is expressed on glycolipid and glycoprotein in human gastrointestinal mucosa. The expression of the Sda determinant dramatically decreases in cancer tissue. The activity of the beta1,4N-acetylgalactosaminyltransferase (Sda-GalNAcT), which transfers GalNAc to NeuAcalpha2-3Galbeta1-4Glc(NAc)-R, correlates with the expression of the Sda immuno-epitope. From the total RNA fraction of human gastric mucosa, we have amplified a cDNA segment by reverse-transcription-polymerase-chain reaction (RT-PCR), using primers designed according to the cDNA sequence of a murine beta1,4GalNAcT which synthesizes the Sda determinant. An RT-PCR product of 390 bp shared 85% nucleotide identity with the murine Sda-related beta1,4GalNAcT. This RT-PCR product hybridized to a transcript in mRNA prepared from human gastric mucosa. In RT-PCR using specific primers to this PCR product, Sda-GalNAcT mRNA was detected in all samples of normal stomach and small intestine examined and the majority of normal colonic specimens. Six out of nine cases of gastric cancer, and 9 out of 13 cases of colonic cancer failed to produce the target DNA. These results correlate with the beta1,4GalNAcT activity measured in the same samples. In conclusion, a segment of the cDNA for betal,4GalNAcT which determines expression of the Sda carbohydrate structure was obtained, and reduced transcription of this beta 1,4GalNAcT resulted in the disappearance of the Sda epitope in gastrointestinal cancer.

Cocaine inhibits the release of MPP+ but not dopamine through the rat dopamine transporter

Transporter-mediated release of dopamine and the parkinsonism-inducing neurotoxin 1-methyl-4-phenylpyridinium (MPP+) was examined in COS cells, a cell line derived from monkey kidney, expressing the rat dopamine transporter. The release of preloaded [3H]MPP+ but not [3H]dopamine was dose-dependently inhibited by cocaine and other compounds known as dopamine uptake inhibitor, 1-[2-(diphenylmethoxy)ethyl]-4-(3-phenylpropyl)-piperazine (GBR12,935) and nomifensine, although the uptake of both [3H]dopamine and [3H]MPP+ was sensitive to these compounds. The different sensitivity of the outward transport of dopamine and MPP+ to the uptake inhibitors might provide a clue to the identity of the specific site(s) for cocaine on the transporter.

Ca2+ entry induced by calcium influx factor and its regulation by protein kinase C in rabbit neutrophils

Extracellular application of acid extract from platelet-activating factor- or thapsigargin-treated rabbit neutrophils induced a rise of cytosolic free calcium concentration ([Ca2+]i) in neutrophils and adrenal chromaffin cells suspended in Ca(2+)-containing, but not in Ca(2+)-deficient, medium. The ability of the extract to selectively induce Ca2+ entry was also confirmed by the increase in 45Ca2+ uptake and failure to stimulate Ca2+ release in digitonin-permeabilized neutrophils. 12-O-tetradecanoylphorbol-13-acetate (TPA) inhibited the extract-induced [Ca2+]i rise in a staurosporine (ST)-sensitive fashion, neither of which had any effect on its production. SK&F 96365 and econazole also reduced extract-induced Ca2+ entry. These results suggest that a Ca2+ entry-inducible substrate (calcium influx factor) is extracted from Ca2+ store-depleted neutrophils, and that its action may be regulated by protein kinase C and certain pharmacological agents.

Activation of mitogen activated protein kinase in dolichyl phosphate-induced apoptosis in U937 cells

Exogenous dolichyl phosphate (Dol-P) induced apoptosis in the human monoblastic leukemia cell line U937 within 4 hours. Phosphorylation of p42 mitogen-activated protein kinase (MAP kinase) increased prior to DNA fragmentation. MAP kinase activation occurred within 5 min, and the maximum response was observed at 30 min. Inhibition of tyrosine phosphorylation of MAP kinase by herbimycin A resulted in complete inhibition of DNA fragmentation and partial inhibition of cell death. These results suggested that Dol-P-induced apoptosis is mediated by the MAP kinase cascade.

Uptake and release of dopamine through the rat dopamine transporter expressed in Xenopus laevis oocyte: evaluation by voltammetric measurement of intracellular dopamine concentration

An attempt was made to evaluate the uptake and release of dopamine (DA) through the rat dopamine transporter (DAT) expressed in Xenopus laevis oocytes. A carbon electrode was placed intracellularly into the oocyte to measure directly the intracellular concentration of DA ([DA]i) by voltammetric analyzer. Oocytes injected with the rat DAT cRNA showed a rapid rise and fall of [DA]i in response to the perfusion solution in the presence and absence of DA. In the control experiment, oocytes injected with water showed no response to external DA. An increase in [DA]i which was induced in control oocytes injected with DA into cytosol was not affected by DA-free perfusion solution, suggesting that in the absence of the transporter the accumulated DA never leaked out from the cell. Thus, the bi-directional DA fluxes through the transporter were demonstrated electrochemically in real time on-line mode.

Study of secondary flow in centrifugal blood pumps using a flow visualization method with a high-speed video camera

Four pump models with different vane configurations were evaluated with flow visualization techniques using a high-speed video camera. These models also were evaluated through in vivo hemolysis tests using bovine blood. The impeller having the greatest fluid velocity relative to the impeller, the largest velocity variance, and the most irregular local flow patterns in the flow passage caused the most hemolysis. Even if the pumps were operated at almost the same speed (rpm) at the same output, the impeller showing more irregular flow patterns had a statistically greater rate of hemolysis. This fact confirms that the existence of local irregular flow patterns in a centrifugal blood pump deteriorates its hemolytic performance. Thus, to optimize the design of the pump, it is very important to examine the secondary flow patterns in the centrifugal blood pump in detail using flow visualization with a high-speed video camera.

Biochemical bases in differentiation of a mouse cell line GSM06 to gastric surface cells

A mouse gastric surface cell line GSM06 established from a transgenic mouse harboring temperature-sensitive simian virus 40 large T-antigen gene was subjected to the lipid and glycoprotein analysis. When GSM06 cells were cultured for a long time after formation of a confluent monolayer, they differentiated to resemble foveolar epithelial cells morphologically. Biochemical changes during culture were studied in cells harvested just when a monolayer had formed (day 0), on day 7, and on day 21. Content of total phospholipids, cholesterol, cholesterol sulfate, total sugar and sialic acid increased about 1.5-fold from day 0 to 7 and remained elevated till day 21. The fatty acid composition of phospholipids revealed increased relative levels of oleic acid in phosphatidylcholine and phosphatidylethanolamine, and an increased level of plasmenylethanolamine from day 0 to 7. The level of dolichylphosphate continued to increase in a time-dependent manner. Glycosylation of various proteins, detected with lectins, was enhanced from day 7. In addition, greater resistance to taurodeoxycholate and acetylsalicylic acid was observed on days 7 and 21 than on day 0. Thus, enhanced glycosylation of proteins and an overall increase in the area of cellular membranes were the major changes in GSM06 cells during culture, and they were accompanied by an enhancement of cytoprotective potential.

Flow visualization study on centrifugal blood pump using a high speed video camera

Flow visualization is widely applied to evaluate rotary blood pumps; however, it is very difficult to visualize flow near the vanes of centrifugal blood pumps because the rotational speed of the impeller is usually several thousand rpm. In this study, a tracer method with a high speed video camera that can take more than 2,000 frames/s was utilized for flow visualization together with computer-assisted image measurement. This method visualized the complex secondary flow pattern near the vanes of the impeller, such as the vortex and recirculation. It also visualized the enhanced washout effect by the secondary washout vanes on the backside of the impeller. The proposed method was effective to analyze the flow pattern in the centrifugal blood pump by providing useful information for better design of the pump hemolysis and thrombus formation.

[Fucosyltransferase producing sialyl Le(a) and sialyl Le(x) carbohydrate antigen in gastrointestinal cancer]

Sialyl Lea and sialyl Lex are cancer-associated carbohydrate antigens. The biosynthesis of these antigens is completed by fucosyltransferases. We measured the activity of alpha 1-->4 fucosyltransferase (sialyl Lea synthase) and alpha 1-->3 fucosyltransferase (sialyl Lex synthase) in gastrointestinal cancer tissues. alpha 1-->4 fucosyltransferase activity was similarly detected in most normal or malignant tissues. alpha 1-->3 fucosyltransferase activity in gastric cancer was higher than in the normal mucosa. In colonic cancer, although the enhanced expression of sialyl Lex was observed in 86% of cases, the elevated activity of alpha 1-->3 fucosyltransferase was observed in only 58%. In conclusion, the expression of sialyl Lea and sialyl Lex antigens in the stomach and colon was not controlled solely by fucosyltransferases.

Platelet-activating factor mediated potentiation of stimulation-evoked catecholamine release and the rise in intracellular free Ca2+ concentration in adrenal chromaffin cells

The effects of platelet-activating factor (PAF) on catecholamine (CA) release and intracellular free Ca2+ concentration ([Ca2+]i) were studied in cultured bovine adrenal chromaffin cells. PAF (1 nM-1 micron) alone had no effect on [Ca2+]i and basal CA release, but potentiated the [Ca2+]i rise and CA release evoked by acetylcholine (ACh) and by elevated extracellular K+. PAF did not potentiate the responses to caffeine in Ca(2+)-deficient medium or to Bay K 8644. In chromaffin cells pretreated with either BN 50739, tetrodotoxin and amiloride or in Na(+)-deficient medium, PAF failed to potentiate the stimulation-evoked [Ca2+]i rise and CA release. In contrast, neomycin, U 73122, 5-(N-ethyl-N-isopropyl)amiloride or pertussis toxin were ineffective in blocking the potentiating effect of PAF. In a membrane fraction prepared from fresh bovine adrenal medulla, ligand-binding studies using [3H]WEB 2086 identified a PAF-displaceable binding site. These results are consistent with a model in which PAF modulates CA release by activating plasma membrane receptors that can enhance the [Ca2+]i rise via an Na(+)-dependent mechanism.

Enhanced expression of GM2/GD2 synthase mRNA in human gastrointestinal cancer

BACKGROUND

The content of the GM2 ganglioside and the activity of UDP-GalNAc: GM3 beta-1,4N-acetylgalactosaminyltransferase (beta-1,4GalNAcT), which synthesizes GM2, increased in gastric cancer tissues and gastric cancer cell lines as compared with that in normal gastric mucosa.

METHODS

Expression of beta-1,4GalNAcT mRNA and a concentration of GM2 in the human gastrointestinal tissues were examined. Beta-1,4GalNAcT mRNA in human surgical specimens, which was not detectable with Northern blotting because of the paucity of absolute amounts expressed, was detected with competitive reverse transcription-polymerase chain reaction (PCR) method using an internal standard cRNA that could be amplified by the same primers as target mRNA in PCR. The quantification of GM2 was examined using immunostaining of thin-layer chromatography.

RESULTS

In 10 of 10 gastric carcinomas and 6 of 13 colonic carcinomas, mRNA expression was more enhanced than that in the normal mucosa of each patient. The alteration of GM2 content in carcinoma from normal tissue generally was correlated to the change in the expression of beta-1,4GalNAcT mRNA with a few exceptions. One gastric cancer sample had a higher level of mRNA with a lower GM2 content than the corresponding normal tissue, and two colonic carcinoma tissue specimens had a lower level of mRNA with a higher GM2 content.

CONCLUSIONS

These results suggest that expression of the beta-1,4GalNAcT gene is a key step in the molecular mechanisms underlying the regulation of cancer-associated GM2 expression in the stomach and the colon.