Relationships between gastric slow wave frequency, velocity, and extracellular amplitude studied by a joint experimental-theoretical approach

BACKGROUND

Gastric slow wave dysrhythmias are accompanied by deviations in frequency, velocity, and extracellular amplitude, but the inherent association between these parameters in normal activity still requires clarification. This study quantified these associations using a joint experimental-theoretical approach.

METHODS

Gastric pacing was conducted in pigs with simultaneous high-resolution slow wave mapping (32-256 electrodes; 4-7.6 mm spacing). Relationships between period, velocity, and amplitude were quantified and correlated for each wavefront. Human data from two existing mapping control cohorts were analyzed to extract and correlate these same parameters. A validated biophysically based ICC model was also applied in silico to quantify velocity-period relationships during entrainment simulations and velocity-amplitude relationships from membrane potential equations.

KEY RESULTS

Porcine pacing studies identified positive correlations for velocity-period (0.13 mm s^-1 per 1 s, r² =.63, P<.001) and amplitude-velocity (74 μV per 1 mm s^-1 , r² =.21, P=.002). In humans, positive correlations were also quantified for velocity-period (corpus: 0.11 mm s^-1 per 1 s, r² =.16, P<.001; antrum: 0.23 mm s^-1 per 1 s, r² =.55; P<.001), and amplitude-velocity (94 μV per 1 mm s^-1 , r² =.56; P<.001). Entrainment simulations matched the experimental velocity-period relationships and demonstrated dependence on the slow wave recovery phase. Simulated membrane potential relationships were close to these experimental results (100 μV per 1 mm s^-1 ).

CONCLUSIONS AND INFERENCES

These data quantify the relationships between slow wave frequency, velocity, and extracellular amplitude. The results from both human and porcine studies were in keeping with biophysical models, demonstrating concordance with ICC biophysics. These relationships are important in the regulation of gastric motility and will help to guide interpretations of dysrhythmias.

Diabetic gastroparesis alters the biomagnetic signature of the gastric slow wave

BACKGROUND

Gastroparesis is characterized by delayed gastric emptying without mechanical obstruction, but remains difficult to diagnose and distinguish from other gastrointestinal (GI) disorders. Gastroparesis affects the gastric slow wave, but non-invasive assessment has been limited to the electrogastrogram (EGG), which reliably characterizes temporal dynamics but does not provide spatial information.

METHODS

We measured gastric slow wave parameters from the EGG and magnetogastrogram (MGG) in patients with gastroparesis and in healthy controls. In addition to dominant frequency (DF) and percentage power distribution (PPD), we measured the propagation velocity from MGG spatiotemporal patterns and the percentage of slow wave coupling (%SWC) from EGG.

KEY RESULTS

No significant difference in DF was found between patients and controls. Gastroparesis patients had lower percentages of normogastric frequencies (60 ± 6% vs 78 ± 4%, p < 0.05), and higher brady (9 ± 2% vs 2 ± 1%, p < 0.05) and tachygastric (31 ± 2% vs 19 ± 1%, p < 0.05) frequency content postprandial, indicative of uncoupling. Propagation patterns were substantially different in patients and longitudinal propagation velocity was retrograde at 4.3 ± 2.9 mm/s vs anterograde at 7.4 ± 1.0 mm/s for controls (p < 0.01). No difference was found in %SWC from EGG.

CONCLUSIONS & INFERENCES

Gastric slow wave parameters obtained from MGG recordings distinguish gastroparesis patients from controls. Assessment of slow wave propagation may prove critical to characterization of underlying disease processes. Future studies should determine pathologic indicators from MGG associated with other functional gastric disorders, and whether multichannel EGG with appropriate signal processing also reveals pathology.

Life without neuropeptide Y

Neuropeptide Y (NPY), a 36 amino acid neuromodulator that is secreted by neurons throughout the peripheral and central nervous system, has been implicated in the control of many physiological processes. We have begun to examine its role in regulation of appetite, behavior, and excitotoxicity by examining mice that are unable to produce NPY as a consequence of gene inactivation. These mutant mice are remarkably normal when reared under standard vivarium conditions. Despite considerable evidence that NPY plays a central role in stimulating appetite, NPY-deficient mice eat normally, grow normally, and refeed after a fast normally. Furthermore, all of their endocrine responses to fasting are normal. The response of NPY-null mice to diet-induced obesity, chemically induced obesity (monosodium glutamate and gold thioglucose), and genetic-based obesity (lethal yellow agouti, Ay; uncoupling protein-diphtheria toxin transgenics, UCP-DT) were all normal. However, NPY deficiency does partially ameliorate the obesity and all of the adverse endocrine effects of leptin deficiency in ob/ob mice. NPY-null mice as well as mice deficient in both NPY and leptin are more sensitive to leptin, suggesting that NPY may normally have a tonic inhibitory action on leptin-mediated satiety signals. NPY-null mice display the normal voracious feeding response to injected NPY. Thus, the only condition where we have observed a role for NPY in body-weight regulation is in the context of complete leptin deficiency--where absence of NPY is beneficial. The activity and general behavior of NPY-null mice are normal. They appear to have normal spatial and contextual learning ability; however, they manifest more anxiety under some conditions. NPY-null mice occasionally display spontaneous, seizure-like events. They also are less able to terminate seizures induced by GABA receptor antagonists or glutamate receptor agonists. These observations are consistent with previous data suggesting that NPY plays an important role in dampening excitotoxicity.

Response of neuropeptide Y-deficient mice to feeding effectors

Neuropeptide Y (NPY) is thought to be an important central regulator of feeding behavior and body weight. However, mice lacking NPY due to targeted genetic deletion do not display abnormalities in food intake or body weight with ad libitum access to food or in response to fasting. In this study, we investigate the response of NPY-deficient (NPY-/-) mice to anorexic and orexigenic treatments. The dose-dependent stimulation of food intake by central NPY administration was unaltered in NPY-/- mice. Peripheral administration of various doses of leptin for 2 days elicited a two-fold greater inhibition of food intake in NPY-/- mice than in wildtype (NPY+/+) mice. In addition, lateral ventricular administration of leptin (1 microg) suppressed refeeding in NPY-/- mice after a 24 h fast, but had little effect in NPY+/+ mice. However, the response to other feeding inhibitors such as corticotrophin releasing factor (CRF), dexfenfluramine, and a melanocortin 4 receptor (MC4R) agonist, MTII, was unaltered in NPY-/- mice. These results indicate that the appetite-suppressant action of exogenous leptin is uniquely amplified in NPY-/- mice, and suggest that NPY may tonically antagonize leptin action.

Effect of peripheral axotomy on dorsal root ganglion neuron phenotype and autonomy behaviour in neuropeptide Y-deficient mice

The lumbar 5 (L5) dorsal root ganglia (DRGs) were studied in neuropeptide tyrosine (NPY)-deficient (-/-) and wild type (+/+) mice after unilateral sciatic nerve transection using in situ hybridization and immunohistochemistry. NPY, galanin and two NPY receptors (Y-Rs) were analyzed as well as self-mutilation behaviour (autotomy) and nociceptive thresholds. No difference between wild type and NPY-deficient mice was seen in the tail-flick or hot plate test. However, -/- mice showed a much stronger autotomy behaviour than wild type mice. NPY was not found in L5 DRGs in -/- mice, not even after axotomy. Galanin was upregulated to the same extent after axotomy in NPY-deficient and wild type mice. Y1- and Y2-R mRNAs were found mainly in small DRG neuron profiles. Both receptor mRNAs were downregulated after axotomy, to about the same extent in NPY-deficient as in wild type mice. In control and contralateral ganglia the mRNA levels of both receptors were lower in NPY-deficient mice than in wild type mice. The contralateral Y2-R mRNA levels did not reach control values in the NPY-deficient mice, as they did in the wild type mice. In both strains the Y1-R protein was decorating the somatic plasmalemma. The present results suggest that lack of NPY may cause exaggerated autotomy, a self-mutilation behaviour possibly related to pain sensation, in agreement with the described analgesic effect of NPY. Although significant differences in levels of Y1- and especially Y2-R mRNAs were observed between wild type and NPY-deficient mice, they were only moderate. These findings suggest that expression, regulation, localization and possible function of Y1- and Y2-Rs are not dependent on presence of the endogenous ligand. Also, deletion of NPY does not seem to influence the expression of the partly coexisting peptide galanin.

Role of neuropeptide Y in diet-, chemical- and genetic-induced obesity of mice

OBJECTIVE

The goal of this study was to ascertain whether neuropeptide Y (NPY) is required in mice for the development of obesity induced by a high-fat diet (HFD), chemical lesions of the hypothalamus caused by monosodium glutamate (MSG) or gold thioglucose (GTG), impaired brown adipose tissue (BAT) due to a diphtheria toxin transgene driven by the uncoupling protein 1 promoter (UCP-DTA) or the lethal yellow agouti mutation (Ay).

BACKGROUND

The obesity syndrome of the leptin-deficient (ob/ob) mouse can be partially reversed by the genetic removal of NPY. In the murine models of obesity examined in this study, the animals become obese despite increased serum leptin levels, indicating that they are resistant to the weight-limiting actions of leptin. The role of NPY in these obesity models with elevated leptin levels is unknown.

EXPERIMENTAL DESIGN

Mice lacking NPY due to genetic disruption of the gene and wildtype littermates were made obese by allowing them access to a highly palatable HFD, by treatment with MSG, or GTG, or by inheriting the dominant UCP-DTA or Ay alleles. Food consumption, body weight and dissectable fat pad weights were measured and compared to values obtained from non-obese littermates.

RESULTS

In each model of obesity tested, NPY-deficient mice achieved the same food intake, body weight and fat content as wildtype littermates.

CONCLUSION

NPY is not necessary for the progressive development of obesity exhibited by multiple murine models with leptin resistance.

Effect of fasting and leptin deficiency on hypothalamic neuropeptide Y gene transcription in vivo revealed by expression of a lacZ reporter gene

Neuropeptide Y (NPY), a peptide synthesized in the hypothalamic arcuate nucleus, is implicated in the physiologic control of food intake and body weight. Because both genetic (e.g. in obese ob/ob mice) and acquired leptin deficiency (e.g. fasting in normal mice) increase hypothalamic NPY accumulation, and as leptin administration reverses this effect, we hypothesized that leptin inhibits transcription of the NPY gene by arcuate nucleus neurons. To test this hypothesis, we studied mice with a targeted mutation of the NPY gene (NPY knockout mice), in which the lacZ reporter gene was inserted into the first exon of the NPY gene. As a result, these mice express beta-galactosidase (beta gal; the enzyme encoded by lacZ) in neurons that normally express the NPY gene. To determine whether beta gal staining provides a valid measure of lacZ expression, we used a histochemical method to count the number of beta gal+ neurons in coronal sections of brain tissue from mice bearing either one (NPY+/-) or two (NPY-/-) mutant alleles. In both the arcuate nucleus and the thalamic reticular nucleus, beta gal+ cell number was 260% higher in NPY-/- than in NPY+/- mice (P < 0.05). Fasting for 48 h also increased the mean beta gal+ cell number in the arcuate nucleus of NPY+/- mice by 260% (P < 0.001), but had no effect in the thalamic reticular nucleus. Similarly, obese leptin-deficient ob/ob, NPY+/- mice had a 67.3% increase in arcuate nucleus beta gal+ cell number compared with lean ob/+, NPY+/- littermates (P < 0.05), and this effect was attenuated 36.6% (P < 0.05) by leptin administration (70 microg/day, i.p., for 4 days). Based on the results of this novel method for measuring NPY gene transcription in vivo, we conclude that both fasting and genetic leptin deficiency increase NPY gene transcription in the arcuate nucleus and that this transcriptional response is attenuated by leptin administration in ob/ob, NPY+/- mice.

Increased expression of mRNA for the long form of the leptin receptor in the hypothalamus is associated with leptin hypersensitivity and fasting

The responsiveness of the hypothalamus to the inhibitory effects of leptin on food intake and body weight is influenced by multiple factors, including deficiency of either leptin or leptin receptors (Ob-R). To investigate whether altered expression of Ob-R in the hypothalamus could potentially contribute to altered leptin sensitivity, we performed in situ hybridization with riboprobes that detected either mRNAs encoding both the long (Ob-Rb) and short (Ob-Ra) splice variants or mRNA encoding only Ob-Rb. In the arcuate nucleus, mRNA encoding Ob-Rb, the predominant signaling form of the receptor, was 2.3 times greater in obese db/db and ob/ob mice than in lean +/ob controls (P < 0.01). In ob/ob mice, systemic administration of leptin reduced Ob-Rb mRNA content of the arcuate nucleus by 30% compared with saline-treated, pair-fed controls (P < 0.05). A 48-h fast increased Ob-Rb mRNA levels in the arcuate nucleus of normal and neuropeptide Y (NPY)-knockout mice (P < 0.01), although the effect was greater in the NPY-knockout mice (400 vs. 247%, P < 0.05). In addition, Ob-Rb mRNA hybridization was elevated by 40% in the arcuate nucleus (P < 0.05) and by 75% in the ventromedial nucleus (P < 0.05) of rats fasted 48 h. The results suggest that expression of Ob-Rb mRNA in the hypothalamus is sensitive to genetic and physiological interventions that alter circulating leptin levels, and that overexpression of Ob-Rb in the hypothalamus may contribute to increased leptin sensitivity.

Knock-out mice reveal a critical antiepileptic role for neuropeptide Y

Neuropeptide Y (NPY) inhibits excitatory synaptic transmission in the hippocampus and is implicated in control of limbic seizures. In the present study, we examined hippocampal function and the response to pharmacologically induced seizures in mutant mice lacking this peptide. In slice electrophysiology studies, no change in normal hippocampal function was observed in NPY-deficient mice compared with normal wild-type littermates. Kainic acid (KA) produced limbic seizures at a comparable latency and concentration in NPY-deficient mice compared with littermates. However, KA-induced seizures progressed uncontrollably and ultimately produced death in 93% of NPY-deficient mice, whereas death was rarely observed in wild-type littermates. Intracerebroventricular NPY infusion, before KA administration, prevented death in NPY-deficient mice. These results suggest a critical role for endogenous NPY in seizure control.

Endocrine function of neuropeptide Y knockout mice

Among its many proposed functions, neuropeptide Y (NPY) is thought to modulate the hypothalamic-pituitary axis. Specifically, increased hypothalamic NPY signaling may be critical in mediating the neuroendocrine response to fasting. To determine the consequences of NPY deficiency on endocrine physiology, multiple hormones were quantitated in wildtype and NPY-knockout mice under fed and fasted conditions. Serum concentrations of leptin, corticosterone, thyroxine, and testosterone were normal in NPY-knockout males fed ad libitum. A 48-hour fast resulted in a 50% reduction in leptin, a 60% reduction in thyroxine, a 75% reduction in testosterone, and a 12-fold increase in corticosterone in both wildtype and NPY-knockout mice. Fasting also increased the estrous cycle length by 3 days in both wildtype and NPY-deficient female mice. We conclude that NPY is not essential for appropriate function of the gonadotropic, thyrotropic, or corticotropic axes under ad lib fed conditions or in response to acute fasting.

EMG analysis of lower extremity muscle recruitment patterns during an unloaded squat

During an unloaded squat, hamstring and quadriceps co-contraction has been documented and explained via a co-contraction hypothesis. This hypothesis suggests that the hamstrings provide a stabilizing force at the knee by producing a posteriorly-directed force on the tibia to counteract the anterior tibial force imparted by the quadriceps. Research support for this hypothesis, however, is equivocal. Therefore, the purposes of this study were 1) to determine muscle recruitment patterns of the gluteus maximus, hamstrings, quadriceps, and gastrocnemius during an unloaded squat exercise via EMG and 2) to describe the amount of hamstring-quadriceps co-contraction during an unloaded squat. Surface electrodes were used to monitor the EMG activity of six muscles of 41 healthy subjects during an unloaded squat. Each subject performed three 4-s maximal voluntary isometric contractions (MVIC) for each of the six muscles. Electrogoniometers were applied to the knee and hip to monitor joint angles, and each subject performed three series of four complete squats in cadence with a metronome (50 beats.min-1). Each squat consisted of a 1.2-s eccentric, hold, and concentric phase. A two-way repeated measures ANOVA (6 muscles x 7 arcs) was used to compare normalized EMG (percent MVIC) values during each arc of motion (0-30 degrees, 30-60 degrees, 60-90 degrees, hold, 90-60 degrees, 60-30 degrees, 30-0 degrees) of the squat. Tukey post-hoc analyses were used to quantify and interpret the significant two-way interactions. Results revealed minimal hamstring activity (4-12% MVIC) as compared with quadriceps activity (VMO: 22-68%, VL: 21-63% of MVIC) during an unloaded squat in healthy subjects. This low level of hamstring EMG activity was interpreted to reflect the low demand placed on the hamstring muscles to counter anterior shear forces acting at the proximal tibia.

Disruption of the metallothionein-III gene in mice: analysis of brain zinc, behavior, and neuron vulnerability to metals, aging, and seizures

Metallothionein-III (MT-III), a brain-specific member of the metallothionein family of metal-binding proteins, is abundant in glutamatergic neurons that release zinc from their synaptic terminals, such as hippocampal pyramidal neurons and dentate granule cells. MT-III may be an important regulator of zinc in the nervous system, and its absence has been implicated in the development of Alzheimer's disease. However, the roles of MT-III in brain physiology and pathophysiology have not been elucidated. Mice lacking MT-III because of targeted gene inactivation were generated to evaluate the neurobiological significance of MT-III. MT-III-deficient mice had decreased concentrations of zinc in several brain regions, including hippocampus, but the pool of histochemically reactive zinc was not disturbed. Mutant mice exhibited normal spatial learning in the Morris water maze and were not sensitive to systemic zinc or cadmium exposure. No neuropathology or behavioral deficits were detected in 2-year-old MT-III-deficient mice, but the age-related increase in glial fibrillary acidic protein expression was more pronounced in mutant brain. MT-III-deficient mice were more susceptible to seizures induced by kainic acid and subsequently exhibited greater neuron injury in the CA3 field of hippocampus. Conversely, transgenic mice containing elevated levels of MT-III were more resistant to CA3 neuron injury induced by seizures. These observations suggest a potential role for MT-III in zinc regulation during neural stimulation.

Metallothioneins in brain--the role in physiology and pathology

A symposium on the role of brain metallothioneins (MTs) in physiology and pathology was held at the 1996 Annual Society of Toxicology Meeting in Anaheim, California. The objectives of this symposium were to: (1) review the physiologic function of MTs, (2) examine the distribution of brain MTs with particular emphasis on cell-specific localization (neurons vs neuroglia), (3) discuss MT gene responsiveness upon toxic insult with metals, and (4) discuss the potential role of MTs in the etiology of neurodegenerative disorders. Dr. Cherian discussed the biochemical properties of the MTs, emphasizing structural similarities and differences between the MTs. Dr. Klaassen addressed the expression and distribution of the MTs in brains with special reference to the cell-specific localization of MTs. Dr. Aschner provided data illustrating a potential role for MTs in attenuating the cytotoxicity caused by methylmercury (MeHg) in cultured neonatal astrocytes. Dr. Palmiter discussed the properties of MT-III and the increased sensitivity of MT-III knockout mice to kainate-induced seizures. Cerebral zinc metabolism, its relationship to MT homeostasis, and its pathogenic potential in Alzheimer's disease was addressed by Dr. Bush.

Attenuation of the obesity syndrome of ob/ob mice by the loss of neuropeptide Y

The obesity syndrome of ob/ob mice results from lack of leptin, a hormone released by fat cells that acts in the brain to suppress feeding and stimulate metabolism. Neuropeptide Y (NPY) is a neuromodulator implicated in the control of energy balance and is overproduced in the hypothalamus of ob/ob mice. To determine the role of NPY in the response to leptin deficiency, ob/ob mice deficient for NPY were generated. In the absence of NPY, ob/ob mice are less obese because of reduced food intake and increased energy expenditure, and are less severely affected by diabetes, sterility, and somatotropic defects. These results suggest that NPY is a central effector of leptin deficiency.

Sensitivity to leptin and susceptibility to seizures of mice lacking neuropeptide Y

Neuropeptide Y (NPY), a 36-amino-acid transmitter distributed throughout the nervous system, is thought to function as a central stimulator of feeding behaviour. NPY has also been implicated in the modulation of mood, cerebrocortical excitability, hypothalamic-pituitary signalling, cardiovascular physiology and sympathetic function. However, the biological significance of NPY has been difficult to establish owing to a lack of pharmacological antagonists. We report here that mice deficient for NPY have normal food intake and body weight, and become hyperphagic following food deprivation. Mutant mice decrease their food intake and lose weight, initially to a greater extent than controls, when treated with recombinant leptin. Occasional, mild seizures occur in NPY-deficient mice and mutants are more susceptible to seizures induced by a GABA (gamma-aminobutyric acid) antagonist. These results indicate that NPY is not essential for certain feeding responses or leptin actions but is an important modulator of excitability in the central nervous system.

Selective block of the brachialis motor point. An anatomic investigation of musculocutaneous nerve branching

BACKGROUND AND OBJECTIVES

Injections of neurolytic agents designed to block the musculocutaneous nerve often eliminate all elbow flexion movements, leaving the patient with a flail arm. In such patients, motor point blocks of the biceps brachii or brachialis muscle, or both, may be indicated. By virtue of its relative cross-section area, the brachialis is the largest contributor to elbow flexion. This factor, together with this muscle's lack of a role in supination, makes it the target of choice for controlling flexion spasticity. There are few descriptions of brachialis motor point blocks, and they fail to provide satisfactory instructions for the procedure. The goal of this study was to determine the brachialis motor point site and to quantitatively describe its location.

METHODS

In this prospective, randomized study of 26 cadaver arms, the innervation site of the brachialis muscle from the musculocutaneous nerve was measured. Measurements were taken from the lateral epicondyle and were compared with the distance to the biceps motor point. These lengths were normalized across subjects by dividing by the arm length (from lateral epicondyle to the acromion).

RESULTS

The brachialis was found to be innervated at approximately one third of the distance from the elbow to the acromion. This site is significantly different (P < .05) from that of the biceps brachii, which was found to be located at approximately half of the distance from the elbow to the acromion.

CONCLUSIONS

An injection one third of the distance from the lateral epicondyle to the acromion along the medial aspect is recommended to provide best access to the brachialis motor point. By injecting from the medial aspect, one avoids the humerus (encountered in a lateral approach) and the need to pass through the biceps brachii (as in an anterior approach).

Expression of human metallothionein-III in transgenic mice

Transgenic mice that express human metallothionein-III (hMT-III) were generated. Human MT-III mRNA expression was prominent in brain, resulting in a 9-fold elevation of MT-III mRNA in cortex, a 3-5-fold elevation in hippocampus, thalamus, brainstem, and olfactory bulb, and a 1.4-fold elevation in cerebellum. Human MT-III protein was detected biochemically and accounted for a 3.4-fold increase in total brain MT. The concentration of zinc (but not copper) was elevated in those brain regions that expressed the most hMT-III mRNA. The histochemically reactive pool of zinc, as measured by Timm's stain or TS-Q histofluorescence, was not appreciably altered. No changes in brain weight, morphology or histology have been noted; the mice breed normally and appear to have normal behavior.

Bioactivity of metallothionein-3 correlates with its novel beta domain sequence rather than metal binding properties

Human and mouse metallothionein-3 (MT-3) molecules exhibit the same metal binding stoichiometry with Zn(II), Cd(II), or Cu(I) as MT-1 or MT-2 molecules, suggesting that MT-3 consists of two domains enfolding separate polymetallic clusters. The kinetic reactivities of Zn(II) complexes of MT-3 with the chelator ethylenediaminetetraacetic acid (EDTA) or the thiol reagent dithiobis(2-nitrobenzoic acid) (DTNB) resembles the reactivity of ZnMT-1. Furthermore, the candidate alpha and beta domain peptides of human MT-3 are very similar to MT-1 domain peptides in the reactivity of Zn(II) complexes. Zn(II) complexes of human and mouse MT-3 inhibit the survival of rat cortical neurons cultured in the presence of an Alzheimer's disease brain extract. Inhibitory activity is unique to the MT-3 isoform and is a property of the N-terminal beta domain. The inhibitory activity of the 32-residue MT-3 beta domain is abolished by a double mutation within the beta domain resulting in the conversion of the C-P-C-P sequence to either C-S-C-A or C-T-C-T. Thus, the bioactivity arises from a novel structure of the N-terminal beta domain of MT-3 and not any unusual metal-binding properties.

Metallothionein III is expressed in neurons that sequester zinc in synaptic vesicles

MT-III, a brain-specific member of the metallothionein gene family, binds zinc and may facilitate the storage of zinc in neurons. The distribution of MT-III mRNA within the adult brain was determined by solution and in situ hybridization and compared to that of MT-I mRNA. MT-III mRNA is particularly abundant within the cerebral cortex, hippocampus, amygdala, and nuclei at base of the cerebellum. Transgenic mice generated using 11.5 kb of the mouse MT-III 5' flanking region fused to the E. coli lacZ gene express beta-galactosidase in many of the same regions identified by in situ hybridization. MT-III mRNA was present in readily identifiable neurons within the olfactory bulb, hippocampus, and cerebellum, and beta-galactosidase activity was localized to neurons throughout the brain, but not to glia, as determined by costaining with X-Gal and neural- and glia-specific antibodies. There is marked correspondence between the neurons that are rich in MT-III mRNA and those neurons that store zinc in their terminal vesicles. MT-III is found complexed with zinc in vivo and its expression in cultured cells leads to the intracellular accumulation of zinc and enhanced histochemical detection of zinc. These results are discussed in light of the possibility that MT-III may participate in the utilization of zinc as a neuromodulator.

Enhanced neurotrophic activity in Alzheimer's disease cortex is not associated with down-regulation of metallothionein-III (GIF)

Alzheimer's disease (AD) is a chronic neurodegenerative disorder for which the pathogenic mechanisms are not well understood. Previous studies demonstrated that extracts prepared from AD brains could increase the survival of rat cortical neurons in vitro. Additional studies indicated that this enhanced neurotrophic activity of AD brain was due to a reduction of a growth inhibitory factor (GIF) that was subsequently shown to be a new member of the metallothionein (MT) gene family, and designated MT-III. The study presented here examined the association between neurotrophic activity and MT-III expression in frontal cortices from eight AD and five control brains, and further characterized the inhibitory activity of MT-III. On average, AD extracts stimulated the survival of approximately 2-fold more rat cortical neurons than control extracts, demonstrating that AD brain possesses elevated neurotrophic activity. When recombinant MTs were added to cultures grown in the presence of brain extract, MT-III but not MT-I had an inhibitory effect on neuron survival, confirming that MT-III is a specific inhibitory factor in this assay. However, in contrast to previous reports, neither MT-III mRNA nor MT-III protein levels were significantly decreased in the AD group. Therefore, the difference in neurotrophic activity between the AD and control brain samples examined in this study is probably not directly mediated by MT-III. These results suggest that MT-III down-regulation is not an important pathogenic event in some cases of AD.

Induction of a new metallothionein isoform (MT-IV) occurs during differentiation of stratified squamous epithelia

A new member of the metallothionein (MT) gene family was discovered that lies about 20 kb 5' of the MT-III gene in both mouse and human. The MT-IV proteins are highly conserved in both species and have a glutamate insertion at position 5 relative to the classical MT-I and MT-II proteins. Murine MT-IV mRNA appears to be expressed exclusively in stratified squamous epithelia associated with oral epithelia, esophagus, upper stomach, tail, footpads, and neonatal skin. The MT derived from tongue epithelium contains both zinc and copper. Many of these epithelia develop parakeratosis during zinc deficiency in the rat. In situ hybridization reveals intense labeling of MT-IV mRNA in the differentiating spinous layer of cornified epithelia, whereas MT-I is expressed predominantly in the basal, proliferative layer; thus, there is a switch in MT isoform synthesis during differentiation of these epithelia. We suggest that MT-IV plays a special role in regulating zinc metabolism during the differentiation of stratified epithelia.

The use of hypnosis in anesthesia: a master class commentary

There are unequivocal benefits derived from the use of positive suggestion and hypnotic techniques in all patients who must submit to surgical and obstetrical procedures with modern general or regional anesthesia. We must learn, and we must teach our colleagues, the advantages of consistent use of the semantics of positive suggestion. When we help patients focus on the desired comfort, safety, and satisfaction obtained with well-managed modern anesthesia and surgery, they will enjoy great benefit, especially when we use the auditory perception that often exists during general anesthesia. Rather than regarding hypnotic suggestion as a mere adjunct to anesthesia, it should be regarded as an integral part of surgical and obstetrical care.

Psychological interventions in the pre-surgical period

The literature on pre-surgical psychological interventions designed to improve psychological adjustment to and recovery from surgery, as well as increase cost-effectiveness, is reviewed. Three broad classifications of interventions (information-based interventions, behaviorally-oriented interventions, and insight-oriented interventions) are discussed based on previous studies aimed at demonstrating the utility of each approach. Limitations of the research in this area are presented and recommendations are made for effective implementation of pre-surgical interventions.

Catalysis of peptide bond formation by histidyl-histidine in a fluctuating clay environment

The condensation of glycine to form oligoglycines during wet-dry fluctuations on clay surfaces was enhanced up to threefold or greater by small amounts of histidyl-histidine. In addition, higher relative yields of the longer oligomers were produced. Other specific dipeptides tested gave no enhancement, and imidazole, histidine, and N-acetylhistidine gave only slight enhancements. Histidyl-histidine apparently acts as a true catalyst (in the sense of repeatedly catalyzing the reaction), since up to 52 nmol of additional glycine were incorporated into oligoglycine for each nmol of catalyst added. This is the first known instance of a peptide or similar molecule demonstrating a catalytic turnover number greater than unity in a prebiotic oligomer synthesis reaction, and suggests that histidyl-histidine is a model for a primitive prebiotic protoenzyme. Catalysis of peptide bond synthesis by a molecule which is itself a peptide implies that related systems may be capable of exhibiting autocatalytic growth.