In vitro investigation of calcium distribution and tissue thickness in the human thoracic aorta

Atherosclerosis represents a significant cause of morbidity and mortality in the western world. Manifestations of atherosclerotic disease among the elderly include the development of raised lesions that often include calcified regions with material properties similar to bone. There is little information available about the amount and distribution of these calcified plaques within the human aorta, partly due to the difficulty in obtaining this information during in vivo studies. We report the results of a cadaveric investigation of thoracic aortic wall thickness, diameter and calcium content. A non-destructive x-ray imaging technique was used to obtain two-dimensional maps of total thickness and mineral content in excised thoracic aortic specimens. In a study of 39 individuals (23 male and 16 female, aged 20-92 years) we report a significant non-linear correlation between calcium burden and age, with calcium deposition most commonly occurring proximal to the ostia of major branching vessels. We also found a significant linear correlation between age and both total aortic wall thickness and aortic diameter. An improved understanding of the pathological changes in the ageing thoracic aorta may be useful in the development of strategies to reduce the undesirable vessel calcification associated with atherosclerosis.

[Calcium and bioluminescent probes]

Ca2+ is an universal second messenger in numerous cell physiological processes. Aequorin, a bioluminescent calcium-binding protein is used today as a cellular probe to measure and image variations in calcium concentrations. The paper describes the characteristics and the use of aequorin as a luminescent calcium probe, and the future in the use of this protein for calcium imaging.

[HIV-1 Tat protein induces IL-10 production by human monocytes: implications of the PKC and calcium pathway]

In asymptomatic patients infected by HIV-1, the level of IL-10, a cytokine with immunosuppressive activity, is associated with the course of HIV infection towards AIDS. We show that HIV-1 Tat, a viral protein secreted by infected cells, induces IL-10 production by human peripheral blood monocytes. The analysis of the signal transduction pathways strongly suggests that the protein kinase C may play an essential role in this induction. Stimulation by Tat induces nuclear translocation of the transcription factor NFkB the activation of which seems to be necessary for IL-10 production. Using microspectrofluorimetry and confocal microscopy, we also show that Tat induces a calcium influx.

[Calcium-dependent pathways involved in the production of cytokines in lymphocytes]

CD4+ T lymphocytes are divided in Th1 cells producing IFN gamma and Th2 cells that synthetize IL-4. This paper describes signaling pathways activated following T cell receptor (TCR) engagement and emphasizes differences that can account for differential cytokine production. This paper focuses on a new signaling pathway involved in IL-4 synthesis. This pathway couples the TCR to PKC that controls a calcium entry through dihydropyridine sensitive calcium channels. The calcium response is sufficient to initiate IL-4 gene transcription. Differing from that of IL-4, IFN gamma gene expression always requires MAP-kinase activation in addition to a calcium signal.

[Neural determination in Xenopus laevis embryos: control of early neural gene expression by calcium]

In amphibian embryos the central nervous system derives from the dorsal region of the ectoderm. Molecular studies led to the formulation of the "neural default model" in which neural development is under the inhibitory control of members of the BMP family. These growth factors also act as epidermis inducers. The neural fate is revealed by factors secreted by the Spemann Organizer such as noggin, chordin, follistatin, Xnr3 and cerberus which act by blocking BMP signalling. We propose a new model for neural cell determination in which a signalling pathway controlled by an increase in intracellular calcium suppresses the epidermis fate and activates the neural fate instead. This increase in calcium is due to an influx through calcium channels of the L-type, expressed in ectodermal cells during gastrulation. The possible involvement of a calcium-dependent phosphatase (calcineurin) to inhibit the epidermis fate and a calcium-calmodulin kinase (CaMkinase II) which activates the neural fate is discussed.

The components of the magnetic resonance image of the neurocentral junction

The neurocentral junction (NCJ) is a cartilaginous growth plate located between the vertebral centrurn and the neural arch. In characterizing the age of closure of this growth plate, anatomic studies have suggested that the NCJ closes before age 10, whereas MRI studies have suggested that the NCJ does not fuse until adolescence In this study, gross anatomic and histologic sections were correlated with MR images to determine the components of the NCJ image. The NCJ image appeared as a thick white line that was shown to encompass the cartilage of the growth plate, the surrounding woven bone and a portion of the trabecular bone of the vertebra. Although the MR pixels were too large to completely resolve the tissues that surround the growth plate, MRI was shown to be a valuable technique of visualizing the NCJ cartilage and further MRI studies of the human NCJ are needed.

Assessing the impact of pelvic obliquity in post-operative neuromuscular scoliosis

The goal of this pilot study was to explore the relationship between pelvic obliquity and patient pain, sitting tolerance, pressure sores, and function. Five neuromuscular patients who underwent spinal surgery 6-26 weeks prior to assessment took part in this on-going study (4F; 1M); age at surgery (14.6 +/- 2.6 years). Pelvic obliquity was measured from pre- and post-operative anterior-posterior radiographs. A force-sensing pad with a grid of sensors was placed on a flat surface and the weight distribution pattern was recorded. The pressures were divided into left and right sides and peak levels were noted on each side. The parents or caregivers completed a questionnaire on their child's pain, sitting tolerance, pressure sores, and functional abilities. Pelvic obliquity was reduced after surgery by approximately 50% depending on the method used to assess pelvic obliquity. The major curve was reduced from 64 degrees(10 degrees) to 39 degrees (10 degrees). Post operatively, the average pressure (left/right side) ranged from 1.2 to 2.0 (average 1.6). The peak pressure ratio ranged from 1.1 to 1.9 (average 1.4). The ratio of left/right pressure correlated with improvement in pelvic obliquity (r2=0.9). Pain was moderate/severe in the 2 patients with the least correction as measured with the Cobb angle from surgery; both improved following surgery. Two patients suffered pressure sores pre-operatively and one post-operatively. Only 3/5 felt sitting endurance had increased. All parents felt their child sat straighter after surgery. The outcome measures of pain, pressure sores, sitting tolerance, and function were not well related to the amount of pelvic obliquity. More candidates and a longer follow-up may shed light on the many relationships.

Development of the neurocentral junction as seen on magnetic resonance images

The neurocentral junction (NCJ) is a cartilaginous growth plate in the vertebra that has been implicated as a potential cause of adolescent idiopathic scoliosis (AIS) since the early 1900s. Studies to date have focused on the age of closure without characterizing normal NCJ development. Using MRI, the normal development of the NCJ image can be determined and the stages preceding the disappearance of the NCJ image can be characterized. 405 NCJs from 11 pediatric patients were examined using MRI and the various images were categorized. NCJ development encompassed five stages, with a specific pattern of absence of the NCJ image noted in each vertebra and in the vertebral column as a whole. The image of the NCJ first became absent in the cervical region (age 6), then in the lumbar region (age 12) and finally in the thoracic region (age 14). These patterns of development serve as a baseline to evaluate NCJ pathology in conditions such as adolescent idiopathic scoliosis (AIS).

The development of scoliosis following pinealectomy in young chickens is not the result of an artifact of the surgical procedure

Pinealectomy in young chickens consistently results in scoliosis which has many characteristics similar to those seen in adolescent idiopathic scoliosis. The mechanism underlying this phenomenon remains a mystery and it is not yet entirely clear whether some unidentified aspect of the extensive surgery is the major factor rather than the removal of the pineal gland. Four different types of pinealectomy surgery were performed on young chickens as well as deliberate damage to the cerebral cortex which simulated the extreme of any accidental damage that might occur during surgery. Scoliosis was assessed from weekly radiographs. No differences in incidence of scoliosis, degree of severity or pattern of curve development were observed for any of the experimental groups when compared with controls. In all groups approximately 55% of the chickens developed scoliosis that progressed rapidly. Different pinealectomy procedures and deliberate damage to the cerebral cortex produce scoliosis in young chickens with the same incidence and characteristics. This suggests strongly that the mechanism behind the phenomenon is due to the removal of the pineal gland and not some artifact of the extensive surgery. The pinealectomy model in young chickens is proving to be a good model for studying AIS in humans. An understanding of the mechanism underlying this phenomenon has the potential to provide further insights into the aetiology of AIS and can lead to the development of novel treatement methods.

Brace monitoring system for the treatment of scoliosis

Determining the efficacy of brace treatment for AIS has been hampered by poor data on the wear pattern of those children prescribed this treatment. Although there is some information on brace compliance, there is very little on how well the brace is secured and the resulting loads imposed on the trunk. The purpose of this study was to determine the daily brace wear pattern of adolescents prescribed Boston braces. The brace monitoring system consists of a force transducer and a microcomputer unit. A force transducer was placed in the lining of the Boston brace. The microcomputer unit was carried while the brace was worn. The force imposed by the brace pad during daily activity was recorded at 1 minute intervals over a period of 3 to 14 days. The samples were stored by the microcomputer. Five subjects (3F;2M; age: 14+/-2 years) who were to wear the brace full time were studied. The subjects adjusted their braces to a prescribed level of tightness as indicated by a light on the microcomputer. Overall compliance, compliance during school days, and forces imposed by the brace were analysed. The force provided by the Boston brace varies considerably during daily activity. Overall brace compliance was lower than expected, with 2 of 5 subjects wearing their brace infrequently. The compliance rate during school time was not different than during the rest of the study period. Peer pressure at school did not appear to affect brace compliance.

Spine-Straight device for the treatment of kyphosis

Kyphosis is an excessive rounding of the upper spine. Its treatment depends upon the severity, the age of the patient and the levels of the spine that are affected. Early diagnosis is a key to providing optimal treatment. In a skeletally immature patient, an exercise program or bracing is the most commonly used treatment. However, the compliance of bracing for adolescents is poor and exercise training is labor intensive. The purpose of this study is to determine whether a Spine-Straight device can help patients to correct their kyphosis themselves and there by reduce back pain without the biomechanical support of a brace. The Spine-Straight device consists of an accelerometer and a microcomputer unit. The accelerometer is used to measure the kyphotic angle and the microcomputer unit controls a pager vibrator to alert patients when their posture exceeds personalized thresholds. The system was tested in the laboratory before used by subjects. The results were compared to back data obtained from a laser scanner imaging system. The maximum angle deviation between the laser scanner and the Spine-Straight device was 1.5 degrees. Two volunteers tested the systems for 2 days. The accelerometer was placed at the T3 location and the microcomputer unit was carried during daily activities. The angle measurement was recorded at 1 minute intervals during daily activity over a period of 2 days. The preliminary trials demonstrate subjects can improve their posture when feedback signals were provided.

Long-term follow-up of surgically treated AIS patients

The aim of this study was to determine the long-term changes in spine and trunk alignment in patients who have undergone scoliosis surgery. Twenty-three (16F; 7M; at age of surgery 15.7 +/- 4.9 years) patients with adolescent idiopathic scoliosis agreed to participate and had posterior-anterior radiographs and surface topography prior to derotation surgery, within 6 months of surgery, at 2 years post-operatively and 5-10 years (mean follow-up period 6.11 +/- 1.6 years) after surgery. Cobb angles, surface trunk rotations, and cosmetic scores were measured at each visit. A questionnaire assessed back appearance and pain at the 5-10 year follow-up. The results of the questionnaire were compared to 25 patients with idiopathic scoliosis who had recently undergone surgery. A paired two-tailed Student's t-test with p=0.05 was used to compare the deformity between visits. The Cobb angle and cosmetic score improved after surgery while the change in trunk rotation was insignificant (p=0.37). Between the two-year and 5-10 year review, the Cobb angle, cosmetic score, and surface trunk rotation significantly increased. Self-perception of appearance and pain were similar to the control group. Surgical correction of scoliosis is not completely maintained during adulthood although the radiographic and surface deterioration does not appear to be clinically significant.

Weak TCR stimulation induces a calcium signal that triggers IL-4 synthesis, stronger TCR stimulation induces MAP kinases that control IFN-gamma production

Th1 and Th2 cells produce different cytokines and have distinct functions. Th1/Th2 cell differentiation is influenced, among other factors, by the nature of TCR-MHC interactions. However, how the TCR transduces a signal resulting in IFN-gamma or IL-4 production is a matter of debate. For example, some authors reported a loss of calcium signaling pathway in Th2 cells. We used a T cell hybridoma producing IL-4 upon weak TCR stimulation and both IL-4 and IFN-gamma for strong TCR engagement as a model to study how TCR signaling pathways are differentially activated in both conditions of stimulation and how this influences the production of cytokines. We show that: (1) the calcium response is identical following weak and strong TCR stimulation; (2) mitogen-activated protein kinase(MAPK) activation is a gradual phenomenon depending upon the strength of TCR activation; (3) a calcium response, even weak, triggers IL-4 expression; (4) IFN-gamma synthesis requires not only a calcium response but also MAPK activation. The MAPK pathway is dispensable for IL-4 production, although it amplifies IL-4 synthesis upon strong TCR stimulation; (5) TCR-induced IL-4 production also depends on calcium signaling in Th2 cells, while IFN-gamma synthesis is dependent, in addition, on MAPK activation in Th1 cells.

Evaluation of contraceptive efficacy and cycle control of a transdermal contraceptive patch vs an oral contraceptive: a randomized controlled trial

CONTEXT

Oral contraceptive (OC) pills are effective, but poor compliance increases rates of pregnancy during treatment.

OBJECTIVE

To compare the contraceptive efficacy, cycle control, compliance, and safety of a transdermal contraceptive patch and an OC.

DESIGN

Randomized, open-label, parallel-group trial conducted October 1997 to June 1999.

SETTING

Forty-five clinics in the United States and Canada.

PARTICIPANTS

A total of 1417 healthy adult women of child-bearing potential.

INTERVENTIONS

Participants were randomly assigned to receive a transdermal contraceptive patch (n = 812) vs an OC (n = 605) for 6 or 13 cycles. Patch treatment consisted of application of 3 consecutive 7-day patches followed by 1 patch-free week.

MAIN OUTCOME MEASURES

Overall and method-failure Pearl Indexes (number of pregnancies/100 person-years of use) and life-table estimates of the probability of pregnancy were calculated. Cycle control, compliance, patch adhesion, and adverse events were also assessed.

RESULTS

Overall and method-failure Pearl Indexes were numerically lower with the patch (1.24 and 0.99, respectively) vs the OC (2.18 and 1.25, respectively); this difference was not statistically significant (P =.57 and.80, respectively). The incidence of breakthrough bleeding and/or spotting was significantly higher only in the first 2 cycles in the patch group, but the incidence of breakthrough bleeding alone was comparable between treatments in all cycles. The mean proportion of participants' cycles with perfect compliance was 88.2% (811 total participants, 5141 total cycles) with the patch and 77.7% (605 total participants, 4134 total cycles) with the OC (P <.001). Only 1.8% (300/16 673) of patches completely detached. Both treatments were similarly well tolerated; however, application site reactions, breast discomfort, and dysmenorrhea were significantly more common in the patch group.

CONCLUSION

The contraceptive patch is comparable to a combination OC in contraceptive efficacy and cycle control. Compliance was better with the weekly contraceptive patch than with the OC.

Improved methods for the quantification of free and linked spacer in conjugate vaccine process

In polysaccharide (PS)-protein conjugate vaccine process, indirect coupling via derivatization of the antigenic PS by diamino spacer molecules is widely used. Such a conjugation technology requires the accurate determination of both the degree of PS-amino substitution (linked spacer) and the removal of residual unlinked (free) diamino spacer. We report two methods for the microdetermination of the spacer primary amino groups, based on their fluorescent labelling. In the first developed assay, activated PS is derivatized with 6-aminoquinolyl-N-hydroxysuccinimidyl carbamate (AQC) and the free spacer is separated and detected as its AQC derivative by RP-HPLC with fluorescence detection (lambda(Ex,Em) 246/396 nm). In the second assay, activated PS is derivatized with 3-(2-furoyl)quinoline-2-carboxaldehyde (FQ) and its FQ derivative is separated by capillary zone electrophoresis (CZE) with laser-induced-fluorescence (LIF) detection (lambda(Ex/Em) 488/590 nm). Compared to the traditional gel filtration and colorimetric assays, these two methods show major advances in terms of sensitivity, reduced analysis time and small sample requirements.

Quantification of C-polysaccharide in Streptococcus pneumoniae polysaccharides by high-performance anion-exchange chromatography with pulsed amperometric detection

A sensitive method, using high-performance anion-exchange chromatography with pulsed amperometric detection (HPAEC-PAD) has been developed for measurement of the C-polysaccharide contamination in Streptococcus pneumoniae capsular polysaccharides, which are part of the polysaccharides based vaccines for the prevention of pneumococcal infections. This method, based on the quantification by HPAEC-PAD of the ribitol released by aqueous hydrofluoric acid (HF) followed by trifluoro acid hydrolysis (TFA) of the pneumococcal polysaccharides is simple and provides both a qualitative and quantitative method for control of the polysaccharides.

Pineal transplantation after pinealectomy in young chickens has no effect on the development of scoliosis

STUDY DESIGN

Three experimental groups and one control group of chickens underwent different surgical procedures to determine the effects of pineal gland transplantation on the development of scoliosis.

OBJECTIVE

To determine whether transplantation of the pineal gland to the body wall musculature maintains serum melatonin levels at normal values and prevents the development of scoliosis.

SUMMARY OF BACKGROUND DATA

Scoliosis occurs consistently after pinealectomy in young chickens. Many characteristics of this scoliosis are similar to those seen in patients with adolescent idiopathic scoliosis. It is not clear whether the underlying mechanism is dependent on reduced levels of serum melatonin or some other aspect of the extensive surgery.

METHODS

Four groups of chickens were selected: normal chickens, pinealectomized chickens, chickens that underwent simple cutting of the pineal stalk, and chickens that underwent transplantation of the pineal gland into the body wall. Development of scoliosis was determined from measurement of the Cobb angle from weekly radiographs.

RESULTS

All of the experimental groups showed the same levels of incidence and the same patterns of scoliosis development. Serum melatonin levels were reduced to nearly zero in all the experimental groups for the duration of the experiment. Scoliosis developed in none of the normal chickens.

CONCLUSIONS

Neither transplantation of the pineal gland into the body wall musculature nor simple cutting of the pineal stalk was able to maintain normal levels of serum melatonin because both procedures reduced levels to nearly zero. The incidence and pattern of scoliosis development in these groups were the same as those for the pinealectomized group. Reduction of serum melatonin levels remains a prerequisite for scoliosis development in young chickens.