Topographic localization of neuropeptide Y mRNA in the monkey brainstem

Neuropeptide Y (NPY) modulates cardiovascular, feeding and reproductive functions. Peripheral neurohumoral inputs from these systems are integrated and transformed into efferent signals in the brainstem. Detailed mapping of NPY-expressing cells in the brainstem has not been established in primates. In this report we utilized the in situ hybridization (ISH) method to identify brainstem areas that contain NPY mRNA in four ovariectomized rhesus macaques treated with estradiol-17beta. A 35S-labeled human NPY cRNA probe was used for ISH in paraformaldehyde-fixed brainstem blocks that were sectioned at 20 microm thickness. In the upper cervical spinal cord, NPY mRNA signals were confined to the substantia gelatinosa along the spinal tract of the trigeminal nerve. In the medulla, NPY images were found in the nucleus of solitary tract, dorsal motor nucleus of vagus nerve, nucleus of the spinal tract of trigeminal nerve, lateral reticular nucleus and the reticular formation. In the pons, NPY mRNA was confined to cells in the locus coeruleus and the nucleus of raphe. NPY signals were observed in the ventral portion of the periaqueductal grey, the dorsal nucleus of raphe and the reticular formation of mesencephalon in the midbrain. Whereas the brainstem distribution of NPY-containing cells in the rhesus macaque overlap those regions that are rich in catecholamines, NPY perikarya were also present in 'noncatecholaminergic' areas. For example, the reticular formation of both the medulla and mesencephalon abundantly expressed NPY mRNA. The functional significance of, and the effects of estrogen on, these patterns in NPY expression is unknown.

Enhanced hippocampal CA1 LTP but normal spatial learning in inositol 1,4,5-trisphosphate 3-kinase(A)-deficient mice

To define the physiological role of IP(3)3-kinase(A) in vivo, we have generated a mouse strain with a null mutation of the IP(3)3-kinase(A) locus by gene targeting. Homozygous mutant mice were fully viable, fertile, apparently normal, and did not show any morphological anomaly in brain sections. In the mutant brain, the IP4 level was significantly decreased whereas the IP3 level did not change, demonstrating a major role of IP(3)3-kinase(A) in the generation of IP4. Nevertheless, no significant difference was detected in the hippocampal neuronal cells of the wild-type and the mutant mice in the kinetics of Ca2+ regulation after glutamate stimulation. Electrophysiological analyses carried out in hippocampal slices showed that the mutation significantly enhanced the LTP in the hippocampal CA1 region, but had no effect on the LTP in dentate gyrus (DG). No difference was noted, however, between the mutant and the wild-type mice in the Morris water maze task. Our results indicate that IP(3)3-kinase(A) may play an important role in the regulation of LTP in hippocampal CA1 region through the generation of IP4, but the enhanced LTP in the hippocampal CA1 does not affect spatial learning and memory.

The preliminary study and tentative animal study on the sintered PDLLA/TCP composites as bone fracture internal fixation

Polyesters based on the lactic acid have been reported safety and biodegradation in the human beings for two decades. The greatest advantage of the material is its degradation only conducted by the hydrolysis, where the ester backbones are supposed to be unchained in the aqueous condition. The final degradable products are carbon dioxide and water which can be metabolized and digested in the physiological environment. The goal of this study was aimed to develop a composite sintered with poly-DL-lactide (PDLLA) and tricalcium phosphate (TCP) ceramic particles as orthopedic application. The TCP particles in a range of 30-60 wt% (with 5 wt% increment) were doped into the PDLLA matrix for the reinforcement, which were prepared by the melting and hot pressing techniques. The basic mechanical strength, biodegradable behavior, and biological response of the composites will be investigated in the study. Various techniques, such as pH meter, UV, FTIR, XRD ect., were used to examine and record the degradable process of the composites soaked in the saline for 1-16 weeks. The rabbit femur condyle fracture fixation test was used to evaluate the tissue compatibility and the effects of bone fracture fixation of the composites. The histological observation and x-ray photography were applied for investigating assistance. In the histological evaluation of rabbit femur condyle fracture fixation test, the surface of the composite with 50 wt% TCP addition was attached by the new generated bone without fibrous tissue around after 8 weeks implantation. The fracture bone was gradually healing and the composite always firmly and properly fixed on the fracture area during the implanted period, which provided a breeding environment for normal bone remodeling. The developed composite was thought to be an alternative material for orthopedic application in the future, especially in bone screw and bone plate.

The role of Müller's muscle reconsidered

It is a traditional teaching that the levator aponeurosis is the main transmitter of the levator palpebrae muscle. However, there are several points that raise doubts in this fundamental concept of the levator aponeurosis as being the primary interconnecting mechanism in upper lid elevation. Despite the structural integrity of the levator complex, drooping of the upper eyelids is seen to develop in situations such as Horner's syndrome and in times of excessive fatigue and sleepiness. Amid the controversy in the literature regarding the specific role of the levator aponeurosis in the lid-elevating mechanism, we have observed that the levator aponeurosis fails to make constant attachment to the tarsal plate. This has led us to speculate on the possible role of the posterior lamella - Müller's muscle - as the primary transmitter of the levator muscle action to the tarsal plate.

Possible involvement of norepinephrine transporter activity in the pulsatility of hypothalamic gonadotropin-releasing hormone release: influence of the gonad

Pulsatile secretion of hypothalamic gonadotropin-releasing hormone (GnRH) is suppressed by alpha-adrenergic antagonists in ovariectomized (OVX) rabbits, thus suggesting that initiation of GnRH pulses requires the presence of norepinephrine (NE) stimulation. Terminals of NE neurons are located in proximity with GnRH cells in the hypothalamus, including the arcuate nucleus-median eminence (AME) region. Synaptic NE molecules may be catabolized or transported back to NE terminals (i.e. reuptake) via specific NE transporter proteins (NET). Thus, the amount of synaptic NE acting on GnRH cells is a function of the rate of NE release, metabolism and reuptake. Hypothetically, the rise and fall of a GnRH pulse may be associated with the similar fluctuations of synaptic NE release and/or NET activity. To test this hypothesis, we examined the effects of AME administration of desipramine (DMI, a specific NET blocking drug) on GnRH release. First, we delivered 0.2-10 mM doses of DMI continuously for 1 h via an AME microdialysis (microD) system into intact male rabbits. We found that each AME-DMI infusion, between dosages of 1 mM and 10 mM, stimulated a GnRH pulse, and that the size of these GnRH pulses were proportional to the dosage of DMI. To confirm the specificity of DMI on NET, we measured catecholamine content in microD samples by HPLC. The temporal (60 min) DMI induced a pattern of NE release that included a rising limb within the first 20-30 min; although NE returned to baseline values within the period of DMI treatment. Neither epinephrine nor dopamine levels were changed by DMI. Second, a median dose of DMI (5 mM) was given by microD for 60 min in four separate rabbit models: gonadal intact females (F-INT), intact males (M-INT), gonadectomized females (F-GDX) and castrated males (M-GDX). Individual microD samples were measured for NE and GnRH. Regardless of gender or gonadal status, 5 mM of DMI concomitantly induced a pulse-like release of NE and GnRH. Furthermore, the response of GnRH to DMI was greater in GDX rabbits than in INT animals of both genders. Third, we administered DMI (5 mM) for 30 min via a push-pull perfusion (PPP) system during four repeated 90 min intervals, in either F-INT or ovariectomized (F-GDX) females, and measured GnRH in PPP samples. In both F-INT and F-GDX, each DMI challenge induced a GnRH pulse. In F-INT, all sequential DMI-induced GnRH pulses were nearly equal in size. In contrast, in F-GDX, the first DMI-induced GnRH pulse was greater than subsequent ones. Collectively, these observations are consistent with the concept of noradrenergic regulation of pulsatile GnRH release, and we conclude that the temporal activity of NET may be an integral part of the mechanism by which GnRH pulses operate.

Airway goblet cell mucin: its structure and regulation of secretion

Mucociliary clearance is a major function of the airway epithelium. This important function depends both on the physicochemical properties of the airway mucus and on the activity of the cilia. The former, in turn, is dependent mainly on the quality and quantity of mucous glycoproteins or mucins, which are produced by two different cell types, namely, goblet cells of the epithelium and mucous cells of the submucosal gland. Neither the structural nor the functional differences of mucins produced by these two cell types are yet known. The availability of primary airway epithelial cell culture systems, however, has made it possible to study the structure and regulation of airway goblet cells to some extent. The epithelial mucins are extremely hydrophobic and are associated with various macromolecules, the quality and quantity of which may also affect the physicochemical properties of the mucus. Secretion of epithelial mucins is stimulated by various factors, including a number of inflammatory agents. The recent progress in mucin molecular biological research will allow us to identify different mucin core proteins produced by those different cell types, and, hopefully, the differential functions of these mucins in health and disease.

Performance characteristics of combined haemodialysis/haemoperfusion system for removal of blood toxins

The application of high clearance haemodialysis (HD) for removal of small molecules of waste metabolites, has been practised for many years. Haemoperfusion (HP) is capable of effective removal of middle and protein-bound molecules. The combined HD/HP system is thought to give a more effective treatment for patients of renal failure or drug intoxication. This paper discusses the performance characteristics of removal of toxic substances (e.g. paraquat and creatinine), using the combined HD/HP recycled system in two different arrangements (HD-HP and HP-HD). The results demonstrate that for most favourable adsorbing solutes, the HD-HP arrangement gives higher performance whereas, HP-HD arrangement is more suitable and gives more effective detoxication characteristics for unfavourable adsorbing solutes.

Anesthetic management in parturients with uterine rupture preoperatively--report of two cases

Uterine rupture is a rare obstetric emergency, and the diagnosis of rupture is not always obvious. High surgical delivery rate today which tends to increase the incidence of the disaster urged us to present this report. Two cases of spontaneous rupture of uterus are described. Case 1 concerns spontaneous rupture of a previously intact uterus; case 2 is a rupture due to placenta percreta. A review relevant to its incidence, risk factors, clinical characteristics, and anesthetic managements is given.

ATP P2X receptors mediate fast synaptic transmission in the dorsal horn of the rat spinal cord

ATP has been proposed to mediate synaptic transmission in the spinal cord dorsal horn, particularly in the pathway carrying nociceptive information. Using transverse spinal cord slices from postnatal rats, we show that EPSCs mediated by P2X receptors, and presumably activated by synaptically released ATP, are evoked in a subpopulation of spinal cord lamina II neurons, a region known to receive strong input from nociceptive primary afferents. The P2X receptors on acutely dissociated dorsal horn neurons are nondesensitizing, insensitive to alphabeta methylene ATP, and show strong but variable sensitivity to the antagonists suramin and pyridoxal-phosphate-6-azophenyl-2',4'-disulfonic acid (PPADS). These characteristics are consistent with a heterogeneous population of P2X receptors, the composition of which includes P2X2, P2X4, and P2X6 receptor subtypes. Our results suggest that ATP-activated P2X receptors in lamina II of the rat spinal cord may play a role in transmitting or modulating nociceptive information.

Characterization of hemin binding activity of Streptococcus pneumoniae

Streptococcus pneumoniae is a causative agent of bacterial pneumonia, otitis media, meningitis, and bacteremia. It causes considerable morbidity and mortality throughout the world, especially among children, the elderly, and immunocompromised individuals. We have demonstrated previously that the growth of S. pneumoniae is limited under iron-depleted conditions and can be restored by the addition of either hemin or hemoglobin. In the present study, we showed that S. pneumoniae had the ability to bind hemin and that the level of hemin binding activity was not affected by supplementation of the growth medium with iron. Approximately 70 to 80% of the hemin binding activity was mediated by proteinase-resistant components, and the remainder was mediated by proteins. Hemin binding proteins were located in both soluble extract and envelope fractions of pneumococcal cells. By batch affinity chromatography, a major hemin binding polypeptide with an apparent molecular mass of 43 kDa was identified in the cell lysate of S. pneumoniae. Polyclonal antibodies against this polypeptide were raised. By immunoblot analysis, this hemin binding polypeptide was localized in the envelope and did not exhibit any variation in molecular weight among all serotypes tested. The subcellular distribution of hemin binding activity may have functional implications.

Immunologic epitope, gene, and immunity involved in pneumococcal glycoconjugate

Pneumococcal infection persists as a major cause of pneumonia, otitis media, and meningitis in infants. Children less than 2 years of age show the highest incidence of pneumococcal diseases. Production of monoclonal antibody (MAb) to polysaccharide (PS) and binding characteristics to PS epitopes were studied. Removal of the O-acetyl group from 9V PS by alkali hydrolysis resulted in a decreased binding with rabbit 9V antiserum (AS). However, the binding reaction with 9V MAb was less affected by the loss of O-acetyl content. Type 9V IgG MAb provided passive protection and enhanced the opsonophagocytic activity of polymorphonuclear (PMN) leukocytes to kill type 9V pneumococci. The pathogenecity of pneumococci is attributed to various virulence factors distributed on the cell surface, including capsular polysaccharide and protein antigens, for example, pneumolysin, autolysin, pneumococcal surface protein A (PspA), pneumococcal surface adhesion (PsaA), and hemin binding protein. Some of these protein antigens may be used as a component to combine with pneumococcal PS vaccine or as a carrier of conjugate vaccine. Clinical trials of pneumococcal conjugate vaccines showed that covalent linkage of capsular PS to protein carriers improved the immunogenicity of the PS. Development of glycoconjugate vaccine for selected pneumococcal types will help solve the problem of poor immunogenecity of PS vaccine in young children used for prevention of pneumococcal infection.

Nitric oxide acts directly in the presynaptic neuron to produce long-term potentiation in cultured hippocampal neurons

Nitric oxide (NO) has been proposed to act as a retrograde messenger during long-term potentiation (LTP) in the CA1 region of hippocampus, but the inaccessibility of the presynaptic terminal has prevented a definitive test of this hypothesis. Because both sides of the synapse are accessible in cultured hippocampal neurons, we have used this preparation to investigate the role of NO. We examined LTP following intra- or extracellular application of an NO scavenger, an inhibitor of NO synthase, and a membrane-impermeant NO donor that releases NO only upon photolysis with UV light. Our results indicate that NO is produced in the postsynaptic neuron, travels through the extracellular space, and acts directly in the presynaptic neuron to produce long-term potentiation, supporting the hypothesis that NO acts as a retrograde messenger during LTP.

The optimal tidal volume delivered by ventilator after pulmonary resection: its effect on cardiopulmonary hemodynamics

Pulmonary function and gas exchange deteriorate after pulmonary resection. The vital capacity, tidal volume, and functional capacity decrease after pulmonary resection because of loss of effective lung volume and, therefore, affect the setting of the ventilator. Nineteen patients undergoing pulmonary resection were included in this study on the optimal tidal volume delivered by a ventilator. Five patients received mediastinal surgery or wedge resection of the lung, 4 had pneumonectomy, and 10 had lobectomy. Immediately after the pulmonary surgery, they were maintained with ventilatory support. Subsequently, a different setting of tidal volume on the ventilator was given for each patient, i.e., 6 ml/kg, 8 ml/kg, 10 mg/kg, and 14 ml/kg. For each setting of tidal volume, a hemodynamic study was performed including cardiac output and other parameters. With the examination of Wilk's Lambda test, there was no difference in association with different settings of tidal volume on blood pressure (F = 0.92, p = 0.51), pulmonary artery pressure (F = 0.95, p = 0.43), pulmonary vascular resistance (F = 0.24, p = 0.97), systemic vascular resistance (F = 0.42, p = 0.78), and cardiac output (F = 0.35, p = 0.93) in 3 different groups of patients. It is concluded that after pulmonary resection a patient's lungs can be inflated with a tidal volume to 14 ml/kg during ventilatory support without compromise of cardiovascular performance.

Organ transplantation in Taiwan

We performed the first successful kidney transplantation in Taiwan on May 27, 1968. Since then, kidney, heart, lung, pancreas, liver, and heart-kidney transplantations have been increasingly successful in restoring lives of otherwise dying patients with organ failure. The first successful kidney, liver, and heart transplantations in Asia were achieved in Taiwan in 1968, 1984, and 1987. respectively. Individual organ transplantation, organ transplant recipient survival, graft survival, and problems and pitfalls encountered in the care of organ transplantation recipients are analyzed. Using polymerase chain reaction amplification with sequence-specific primers, donor-specific DNA was detected in the peripheral blood of the patient who survived the longest (26 years) in this series. Interestingly enough, recently, we had a patient undergoing cadaveric renal transplantation in whom chimerism was detected in her lymph nodes and skin only 3 years after transplantation. Organ procurement in Taiwan is the greatest problem, and we have been exerting our maximal effort to establish a transplantation coordination team to create a central network and to educate, procure, preserve, distribute, and increase the availability of organs and tissues for transplantation.

Using titanium plate or meshplate for chest wall reconstruction: report of 6 cases and literature review

Titanium plate has been widely used in several surgical fields, such as craniofacial reconstruction and orthopedic prosthesis. This prosthesis has been proved not only with good biocompatibility and mechanical strength, but also with light weight and low radiological interference. From October 1991 to May 1995, 6 patients underwent thoracic cage reconstruction with titanium plate in our hospital. They included 5 females and 1 male, with ages ranging from 26 to 62 years. Four of them suffered from primary chest wall tumors (2 desmoid tumors, a chondrosarcoma, and 1 hemangioma), one had a recurrent chest wall tumor from breast carcinoma, and one had thoracic hypoplasia. The thoracic cage defect ranged from 5 x 6 cm to 10 x 15 cm, and 1 to 3 titanium plates were used for the reconstruction. No paradoxical movement or other prosthesis-related complications have occurred during the follow-up period. We conclude that titanium plate is a good material for thoracic cage reconstruction.

Production, binding characteristics and protective immunity of monoclonal antibody to pneumococcal type-9V conjugate

A monoclonal antibody (MAb) to pneumococcal type-9V polysaccharide (PS) was produced using PS conjugated to inactivated pneumolysin as the immunogen. The MAb to 9V PS was of the IgG1 subclass. The antigen-antibody reaction increased rapidly at low concentrations and reached a plateau at 10 micrograms PS/ml as measured by nephelometry of the group 9 PS against 9V MAb binding. In contrast, the binding of group 9 PS against rabbit 9V antiserum (AS) increased proportionally and continued to increase up to the highest concentration of PS tested (20 micrograms PS/ml). The 9V MAb reacted with all group 9 PSs (9A, 9L, 9N and 9V) by immunodiffusion. In the homologous 9V Ag-MAb reaction, there were marked differences in the inhibition of binding by the cross-reactive 9L PS (19.2% inhibition) and the 9N PS (0.2%). In contrast, inhibition of the homologous 9V Ag-rabbit AS binding by cross-reactive 9L and 9N PSs ranged from 57.8 to 62.7%. Removal of the O-acetyl group from 9V PS by alkali hydrolysis resulted in decreased binding with rabbit 9V AS. However, the binding reaction with 9V MAb was less affected by the loss of O-acetyl content. The 9V MAb was both opsonic and passively protected young mice against challenge with type-9V pneumococci.

The role of video-assisted thoracic surgery in the diagnosis and treatment of indeterminate pulmonary lesion

Patients with indeterminate pulmonary lesions usually require a definite diagnosis for proper management. The conventional diagnostic procedures such as bronchoscopy and transthoracic needle biopsy sometimes fail to obtain a decisive answer, thus a more aggressive diagnostic procedure will be needed. Video-assisted thoracic surgery (VATS) has provided an alternative for open thoracotomy for definite diagnosis in these conditions. Thirty-three patients with indeterminate pulmonary lesions received VATS in National Taiwan University Hospital. Of these patients, twenty-eight manifested with coin lesion and five had diffuse pulmonary infiltration before operation. Traditional diagnostic procedures, i.e. bronchoscopy or transthoracic needle biopsy, could not give a definite diagnosis for these patients. A definite diagnosis was obtained after thoracoscopy in all of these patients. The mean operation time was 129 minutes (range, 180 to 45 minutes). The mean duration of chest tube drainage was 4.1 days (range, 1 to 7 days). The mean postoperative hospital stay of elective surgery without subsequent chemotherapy or radiotherapy was 9.5 days (range, 5 to 14 days). The patients received 2.4 times parental narcotics injection for analgesia on average (range, 0 to 6 times). There is no operation-related death in this series. Three patients had prolonged air leak with seven days of chest tube drainage. Two patients, with CMV and chronic interstitial pneumonia, have mortality from their underlying disease later. VATS is a safe and effective procedure not only for diagnosis, but also for treatment in the management of indeterminate pulmonary lesions.

Videothoracoscopic treatment of spontaneous pneumothorax

Thoracoscopic surgery has been well accepted as a treatment for spontaneous pneumothorax and other intrathoracic diseases. Seventy-four patients with primary or secondary pneumothorax underwent thoracoscopic operation in this hospital. There was no postoperative mortality or major morbidity. Only two (2.7%) patients developed recurrent pneumothorax postoperatively, but this never reappeared after using bullae resection and mechanical pleurodesis in place of electroablation only at an earlier period. Three patients had residual pleural effusion or air space, and two patients had persistent air-leak postoperatively; all of them recovered after conservative treatment. The mean operation time, intensive care unit stay, and total hospital stay were decreased significantly when compared with open thoracotomy. The low recurrence rate and shorter hospital stay also made this procedure much superior to tube thoracostomy and chemical pleurodesis only. Approaches to make working ports, bullectomy, and pleurodesis are also discussed here. We concluded that thoracoscopic surgery is highly effective and minimally invasive for patients with spontaneous pneumothorax, but may not be suitable for patients with generalized emphysematous change of lungs or dense adhesion of the pleural spaces.

Nucleolar organizer regions as a prognostic factor in surgically treated lung cancer patients

The prognostic value of the number of nucleolar organizer regions (NORs) (DNA loops in the nucleus) in tumor cells from various kinds of malignancies has been widely studied in recent years. During the period 1989 to 1992, a total of 73 primary lung tumors was examined for the number of NORs by silver staining AgNOR proteins on the stump smear of resected specimens in this hospital. The relations of the mean number of AgNOR per cell with other factors such as sex, age, habit of smoking, performance status, tumor location, tumor size, pathological stage, histological type, degree of differentiation, and whether histologically vascular or lymphatic invasion were analysed. It was found that the mean number of AgNOR was significantly different between positives and negatives of histologically vascular or lymphatic invasion (6.4 +/- 0.4 vs 5.5 +/- 0.2) (p < 0.05). Both single and multiple-variate analysis of patient survival revealed that the mean number of AgNOR was a significant prognostic factor, as were pathological stage, histological type, and performance status of the patient. Patients with a higher mean number of AgNOR (> 7) had a significantly worse prognosis compared with those with less AgNOR (< or = 7) (median survival 28 versus 43 months) (p < 0.05). It was concluded that the mean number of AgNOR of tumor cells is a significant prognostic factor in surgically treated lung cancer patients.

Synaptic strengthening through activation of Ca2+-permeable AMPA receptors

Postsynaptic Ca2+ elevation during synaptic transmission is an important trigger for short- and long-term changes in synaptic strength in the vertebrate central nervous system. The AMPA (alpha-amino-3-hydroxy-5-methyl-4-isoxazoleproprionate) receptors, a subfamily of glutamate receptors, mediate much of the excitatory synaptic transmission in the brain and spinal cord. It has been shown that a subtype of the AMPA receptor is Ca2+-permeable and is present in the subpopulations of neurons. When synaptically localized, these receptors should mediate postsynaptic Ca2+ influx, providing a trigger for changes in synaptic strength. Here we show that Ca2+-permeable AMPA receptors are synaptically localized on a subpopulation of dorsal horn neurons, and that they provide a synaptically gated route of Ca2+ entry, and that activation of these receptors strengthens synaptic transmission mediated by AMPA receptors. This pathway for postsynaptic Ca2+ influx may provide a new form of activity-dependent modulation of synaptic strength.