Laparoscopic versus hybrid approach for treatment of incisional ventral hernia: a 5-10-year follow-up of the randomized controlled multicenter study

PURPOSE

In this long-term follow-up of a prospective, randomized, and multicenter study, we compare the results of a group receiving laparoscopic incisional ventral hernia repair using intraperitoneal onlay mesh (LG) to a group receiving a hybrid hernia repair where open closure of fascial defect was added to intraperitoneal mesh placement (HG).

METHODS

Originally, 193 patients with 2-7 cm incisional hernias were randomly assigned to either the LG or HG during the 30-month recruitment period in 2012 to 2015. Long-term follow-up was conducted 5-10 years after surgery to evaluate hernia recurrence rate and quality of life (QoL).

RESULTS

In all, 65 patients in the LG and 60 in the HG completed the long-term follow-up with a median follow-up period of 87 months. Recurrent hernia was detected in 11 of 65 patients (16.9%) in the LG and 10 of 60 patients (16.7%) in the HG (p  >  0.9). Kaplan-Meier analysis demonstrated a recurrence rate approaching 20% in both groups, with similar curves. Three patients in the LG (4.6% and five patients in the HG (8.1%) had undergone re-operation due to recurrence (p  = 0.48). There was no difference in patient-reported QoL measured using the SF-36 questionnaire. Mean pain scores were similar between groups, mean numeric rating scale (NRS) 0 to 10 being 1.1 in the LG and 0.7 in the HG (p  = 0.43).

CONCLUSION

Fascial closure did not reduce hernia recurrence rate in this study population, even though it has been shown to be beneficial and recommended in surgery guidelines. In the long term, recurrence rate for both groups is similar.

Correlations between different protein species of oral rinse MMP-8 and patient-related factors

OBJECTIVES

The aim of this study is to examine correlations between different oral rinse matrix metalloproteinase (MMP)-8 protein species in western blot (WB) analysis, quantitative MMP-8 measurements, and patient-related factors. Elevated activated MMP-8 (aMMP-8) associate with periodontitis and a diagnostic point-of-care technology has been developed based on aMMP-8. In WB, different MMP-8 protein species can be analyzed. Relative abundancy of fragmented 20-25 kDa forms in WB has been associated with and reflects MMP-8 activation and related fragmentation and elevated quantitative aMMP-8 measurements.

MATERIAL AND METHODS

A random sample of 192 participants from a periodontal disease screening study was used for this study. Oral rinse samples for biomarker analyses were collected before clinical periodontal examinations. aMMP-8 immunofluorometric (IFMA) and WB analysis (utilizing the same monoclonal antibody, 8708), polymorphonuclear leukocyte (PMN) elastase activity test and tissue inhibitor of metalloproteinases (TIMP)-1 ELISA levels were performed from the oral rinse samples. Distinct MMP-8 protein species were differentiated in the WB analysis. Principal component (PC) analysis was conducted to explore correlation patterns between the different species. Adjusted correlation analysis between the extracted PCs of WB and aMMP-8 IFMA levels and multilevel regression analysis were conducted to explore if the other periodontal disease-related biomarkers and clinical surrogate measures and patient-related factors are co-variating with the extracted components.

RESULTS

Distinct correlation patterns between the MMP-8 protein species were observed. The first four PCs explained 89% of the whole variance in PC analysis. Statistically significant correlation (p < 0.05) were observed as follows: PC1 positively with 21 kDa (r = .69) and 25 kDa fragments (r = .55) and negatively with 150 kDa complexes (r = -.46). PC2 correlated with 45 (r = .70) and 55 kDa (r = .65) activated forms, PC3 with 70-80 kDa latent proforms (r = .63) and 90-100 kDa complexes (r = .67), and PC4 with 35 kDa fragments (r = .81). There were significant correlations between quantitative (IFMA) aMMP-8 measurements and PC1 (p < 0.001), PC2 (<0.05) and PC3 (<0.05) but not with PC4. In multilevel regression models age, PMN elastase activity, TIMP-1 levels, and a number of 4-5 mm periodontal pockets were associated with PC1, nonsmoking with PC2, age and PMN elastase activity with PC3, and age and smoking with PC4.

CONCLUSIONS

Relative abundancy of fragmented 21-25 kDa protein species was correlated with the quantitative aMMP-8 (IFMA) measurements, which is in line with previous results. Different patient-related factors (smoking, age, proteolytic activity) may modify the formation of different MMP-8 protein species in oral rinse samples and may cause variability in quantitative aMMP-8 measurement.

Reduced Number of Pediatric Orthopedic Trauma Requiring Operative Treatment during COVID-19 Restrictions: A Nationwide Cohort Study

Background and Aims:

The coronavirus outbreak significantly changed the need of healthcare services. We hypothesized that the COVID-19 pandemic decreased the frequency of pediatric fracture operations. We also hypothesized that the frequency of emergency pediatric surgical operations decreased as well, as a result of patient-related reasons, such as neglecting or underestimating the symptoms, to avoid hospital admission.

Materials and Methods:

Nationwide data were individually collected and analyzed in all five tertiary pediatric surgical/trauma centers in Finland. Operations related to fractures, appendicitis, and acute scrotum in children aged above 16 years between March 1 and May 31 from 2017 to 2020 were identified. The monthly frequencies of operations and type of traumas were compared between prepandemic 3 years and 2020.

Results:

Altogether, 1755 patients were identified in five tertiary hospitals who had an emergency operation during the investigation period. There was a significant decrease (31%, p = 0.03) in trauma operations. It was mostly due to reduction in lower limb trauma operations (32%, p = 0.006). Daycare, school, and organized sports–related injuries decreased significantly during the pandemic. These reductions were observed in March and in April. The frequencies of appendectomies and scrotal explorations remained constant.

Conclusion:

According to the postulation, a great decrease in the need of trauma operations was observed during the peak of COVID-19 pandemic. In the future, in case similar public restrictions are ordered, the spared resources could be deployed to other clinical areas. However, the need of pediatric surgical emergencies held stable during the COVID-19 restrictions.

Selection of resistance by antimicrobial coatings in the healthcare setting

Antimicrobial touch surfaces have been introduced in healthcare settings with the aim of supporting existing hygiene procedures, and to help combat the increasing threat of antimicrobial resistance. However, concerns have been raised over the potential selection pressure exerted by such surfaces, which may drive the evolution and spread of antimicrobial resistance. This review highlights studies that indicate risks associated with resistance on antimicrobial surfaces by different processes, including evolution by de-novo mutation and horizontal gene transfer, and species sorting of inherently resistant bacteria dispersed on to antimicrobial surfaces. The review focuses on antimicrobial surfaces made of copper, silver and antimicrobial peptides because of the practical application of copper and silver, and the promising characteristics of antimicrobial peptides. The available data point to a potential for resistance selection and a subsequent increase in resistant strains via cross-resistance and co-resistance conferred by metal and antibiotic resistance traits. However, translational studies describing the development of resistance to antimicrobial touch surfaces in healthcare-related environments are rare, and will be needed to assess whether and how antimicrobial surfaces lead to resistance selection in these settings. Such studies will need to consider numerous variables, including the antimicrobial concentrations present in coatings, the occurrence of biofilms on surfaces, and the humidity relevant to dry-surface environments. On-site tests on the efficacy of antimicrobial coatings should routinely evaluate the risk of selection associated with their use.

Specialized cleaning associated with antimicrobial coatings for reduction of hospital-acquired infection: opinion of the COST Action Network AMiCI (CA15114)

Recognized issues with poor hand hygiene compliance among healthcare workers and reports of recontamination of previously chemically disinfected surfaces through hand contact emphasize the need for novel hygiene methods in addition to those currently available. One such approach involves antimicrobial (nano) coatings (AMCs), whereby integrated active ingredients are responsible for elimination of micro-organisms that come into contact with treated surfaces. While widely studied under laboratory conditions with promising results, studies under real-life healthcare conditions are scarce. The views of 75 contributors from 30 European countries were collated regarding specialized cleaning associated with AMCs for reduction of healthcare-associated infection. There was unanimous agreement that generation of scientific guidelines for cleaning of AMCs, using traditional or new processes, is needed. Specific topics included: understanding mechanisms of action of cleaning materials and their physical interactions with conventional coatings and AMCs; that assessments mimic the life cycle of coatings to determine the impact of repetitive cleaning and other aspects of ageing (e.g. exposure to sunlight); determining concentrations of AMC-derived biocides in effluents; and development of effective de-activation and sterilization treatments for cleaning effluents. Further, the consensus opinion was that, prior to widespread implementation of AMCs, there is a need for clarification of the varying responsibilities of involved clinical, healthcare management, cleaning services and environmental safety stakeholders.

Spinal canal dimensions affect outcome of adolescent disc herniation

PURPOSE

Small spinal canal dimensions play a role in symptomatic adult disc herniation, but its role in adolescent disc herniation has not been investigated with MRI. The goal of this study was to examine retrospectively if there is a correlation with dimensions of osseous spinal canal and need of discectomy in an adolescent population suffering from disc herniation.

METHODS

A retrospective review of child and adolescent patients who were treated in our institution for back or back--related leg pain was conducted. Patients were divided in three groups; group 1: lumbar disc herniation requiring operative treatment; group 2: lumbar disc herniation treated with observation; and group 3: back pain and no disc herniation on MRI. MRI images and radiographs were studied for spinal canal dimensions and compared between groups.

RESULTS

The discectomy group presented considerably smaller spinal canal dimensions measured from the MRI images than the two other groups.

CONCLUSION

Adolescent patients requiring operative treatment for symptomatic disc herniation have smaller osseous spinal canals than patients who are managed non-operatively.

Copper as an antibacterial material in different facilities

The present study was performed in real life settings in different facilities (hospital, kindergarten, retirement home, office building) with copper and copper alloy touch surface products (floor drain lids, toilet flush buttons, door handles, light switches, closet touch surfaces, corridor hand rails, front door handles and toilet support rails) in parallel to reference products. Pure copper surfaces supported lower total bacterial counts (16 ± 45 vs 105 ± 430 CFU cm^-2 , n = 214, P < 0·001) and a lower occurrence of Staphylococcus aureus (2·6 vs 14%, n = 157, P < 0·01) and Gram-negatives (21 vs 34%, n = 214, P < 0·05) respectively than did reference surfaces, whereas the occurrence of enterococci (15%, n = 214, P > 0·05) was similar. The studied products could be assigned to three categories according to their bacterial loads as follows (P < 0·001): floor drain lids (300 ± 730 CFU cm^-2 , n = 32), small area touch surfaces (8·0 ± 7·1 to 62 ± 160 CFU cm^-2 , n = 90) and large area touch surfaces (1·1 ± 1·1 to 1·7 ± 2·4 CFU cm^-2 , n = 92). In conclusion, copper touch surface products can function as antibacterial materials to reduce the bacterial load, especially on frequently touched small surfaces.

SIGNIFICANCE AND IMPACT OF THE STUDY

The efficiency of copper as an antimicrobial material has been noted in laboratory studies and in the hospital environment. The present study further shows that copper exerted an antibacterial effect in different facilities, i.e. in a hospital, a kindergarten, an office building and in a retirement home for the elderly. The study suggests that copper has potential use as an antibacterial material and therefore might serve as a means to lower the incidence of transmission of infectious agents from inanimate surfaces in different facilities, with everyday functions.

Anti-tumour activity of oncolytic Western Reserve vaccinia viruses in canine tumour cell lines, xenografts, and fresh tumour biopsies

Cancer is one of the most common reasons for death in dogs. One promising approach is oncolytic virotherapy. We assessed the oncolytic effect of genetically modified vaccinia viruses in canine cancer cells, in freshly excised tumour biopsies, and in mice harbouring canine tumour xenografts. Tumour transduction efficacy was assessed using virus expressing luciferase or fluorescent marker genes and oncolysis was quantified by a colorimetric cell viability assay. Oncolytic efficacy in vivo was evaluated in a nude mouse xenograft model. Vaccinia virus was shown to infect most tested canine cancer cell lines and primary surgical tumour tissues. Virus infection significantly reduced tumour growth in the xenograft model. Oncolytic vaccinia virus has antitumour effects against canine cancer cells and experimental tumours and is able to replicate in freshly excised patient tumour tissue. Our results suggest that oncolytic vaccinia virus may offer an effective treatment option for otherwise incurable canine tumours.

CD40 ligand and tdTomato-armed vaccinia virus for induction of antitumor immune response and tumor imaging

Oncolytic vaccinia virus is an attractive platform for immunotherapy. Oncolysis releases tumor antigens and provides co-stimulatory danger signals. However, arming the virus can improve efficacy further. CD40 ligand (CD40L, CD154) can induce apoptosis of tumor cells and it also triggers several immune mechanisms. One of these is a T-helper type 1 (Th1) response that leads to activation of cytotoxic T-cells and reduction of immune suppression. Therefore, we constructed an oncolytic vaccinia virus expressing hCD40L (vvdd-hCD40L-tdTomato), which in addition features a cDNA expressing the tdTomato fluorochrome for detection of virus, potentially important for biosafety evaluation. We show effective expression of functional CD40L both in vitro and in vivo. In a xenograft model of bladder carcinoma sensitive to CD40L treatment, we show that growth of tumors was significantly inhibited by the oncolysis and apoptosis following both intravenous and intratumoral administration. In a CD40-negative model, CD40L expression did not add potency to vaccinia oncolysis. Tumors treated with vvdd-mCD40L-tdtomato showed enhanced efficacy in a syngenic mouse model and induced recruitment of antigen-presenting cells and lymphocytes at the tumor site. In summary, oncolytic vaccinia virus coding for CD40L mediates multiple antitumor effects including oncolysis, apoptosis and induction of Th1 type T-cell responses.

The effect of chemical inhibition of matrix metalloproteinases on the size of experimentally induced apical periodontitis

AIM

To determine the effect of matrix metalloproteinase (MMP) inhibition on periapical lesion formation in a rat model.

METHODOLOGY

The pulp chambers of mandibular fist molars of adult SD rats were exposed to be infected by oral microbes. The experimental group was fed 20 mg kg(-1) MMP-inhibitor chemically modified tetracycline-3 (CMT-3) daily in an oral gavage and the controls were fed the vehicle. After 2 and 4 weeks, the mandibles (n = 10 in both groups at both times) were radiographed, decalcified and subjected to histological analysis. Extension of necrosis in first molar distal root canals was measured from the histological sections, and periapical lesion sizes in the same roots were determined from radiographs and histological sections. Mann-Whitney U-test was used for the statistical analysis.

RESULTS

There was a statistically significant difference in the extension of necrosis in root canals between 2 and 4 weeks in the control group (P < 0.05), but not with MMP inhibition. Radiographically, MMP inhibition increased the periapical lesion size by 70% and 34% after 2 and 4 weeks respectively (P < 0.05 in after 2 weeks). In histological measurements, lesion size increased with MMP inhibition by 26% and 8% after 2 and 4 weeks respectively.

CONCLUSIONS

MMP inhibition affects pulpal and periapical inflammation, increasing the rate of spreading of necrosis in root canals and the rate of periapical lesion formation.

[AIDS prevention in austrian schools]

Prevention campaigns and new antiretroviral therapies caused a decline in HIV-infections as well as mortality from HIV/AIDS in industrialised countries. Despite this development AIDS is one of the ten mean causes of death worldwide, with 3,1 million deaths in 2002. Hence there is an urgent need for prevention and information campaigns, which ideally should start in early childhood or at school age. It is well known that preventive strategies start at a time when the risk or the possibility of a risky behaviour does not yet exist. A WHO-report in 1993 showed, that sex education often comes too late, as sexual activity of adolescents is already on its way. Persons who are already sexually active can be influenced to have fewer sexual partners and to increase safer sex methods. There is no evidence for causing a higher risk by sex education of adolescents. In Austrian schools numerous experts and organisations cooperate in the sphere of sex education and STD-prevention. School children in Vienna are confronted with this topic by the schools they attend according to the Sex Education-Act of 1970 on a voluntary basis. Various examples of effective teaching models prove intensive efforts and successful interdisciplinary cooperation. This study analyses common risk-reduction-methods and describes the Austrian way of HIV/AIDS/STD prevention in school children, although there is no obligation for sex education in schools, according to the School Teaching-Act of 1986, which leads to better knowledge and subsequent risk behaviour of adolescents in the same geographical area.

Accelerated up-regulation of L-Sox5, Sox6, and Sox9 by BMP-2 gene transfer during murine fracture healing

Fracture repair is the best-characterized situation in which activation of chondrogenesis takes place in an adult organism. To better understand the mechanisms that regulate chondrogenic differentiation of mesenchymal progenitor cells during fracture repair, we have investigated the participation of transcription factors L-Sox5, Sox6, and Sox9 in this process. Marked up-regulation of L-Sox5 and Sox9 messenger RNA (mRNA) and smaller changes in Sox6 mRNA levels were observed in RNAse protection assays during early stages of callus formation, followed by up-regulation of type II collagen production. During cartilage expansion, the colocalization of L-Sox5, Sox6, and Sox9 by immunohistochemistry and type II collagen transcripts by in situ hybridization confirmed a close relationship of these transcription factors with the chondrocyte phenotype and cartilage production. On chondrocyte hypertrophy, production of L-Sox5, Sox9 and type II collagen were down-regulated markedly and that of type X collagen was up-regulated. Finally, using adenovirus mediated bone morphogenetic protein 2 (BMP-2) gene transfer into fracture site we showed accelerated up-regulation of the genes for all three Sox proteins and type II collagen in fractures treated with BMP-2 when compared with control fractures. These data suggest that L-Sox5, Sox6, and Sox9 are involved in the activation and maintenance of chondrogenesis during fracture healing and that enhancement of chondrogenesis by BMP-2 is mediated via an L-Sox5/Sox6/Sox9-dependent pathway.

MAPK/ERK overrides the apoptotic signaling from Fas, TNF, and TRAIL receptors

The tumor necrosis factor (TNF), Fas, and TNF-related apoptosis-inducing ligand (TRAIL) receptors (R) are highly specific physiological mediators of apoptotic signaling. We observed earlier that a number of FasR-insensitive cell lines could redirect the proapoptotic signal to an anti-apoptotic ERK1/2 signal resulting in inhibition of caspase activation. Here we determine that similar mechanisms are operational in regulating the apoptotic signaling of other death receptors. Activation of the FasR, TNF-R1, and TRAIL-R, respectively, rapidly induced subsequent ERK1/2 activation, an event independent from caspase activity. Whereas inhibition of the death receptor-mediated ERK1/2 activation was sufficient to sensitize the cells to apoptotic signaling from FasR and TRAIL-R, cells were still protected from apoptotic TNF-R1 signaling. The latter seemed to be due to the strong activation of the anti-apoptotic factor NF-kappaB, which remained inactive in FasR or TRAIL-R signaling. However, when the cells were sensitized with cycloheximide, which is sufficient to sensitize the cells also to apoptosis by TNF-R1 stimulation, we noticed that adenovirus-mediated expression of constitutively active MKK1 could rescue the cells from apoptosis induced by the respective receptors by preventing caspase-8 activation. Taken together, our results show that ERK1/2 has a dominant protecting effect over apoptotic signaling from the death receptors. This protection, which is independent of newly synthesized proteins, acts in all cases by suppressing activation of the caspase effector machinery.

Induction of periosteal callus formation by bone morphogenetic protein-2 employing adenovirus-mediated gene delivery

Although the chondrogenic response of periosteum is well established in healing fractures, the mechanisms mediating the proliferation and differentiation of periosteal chondroprogenitor cells are poorly understood. In the present study we demonstrate that bone morphogenetic protein-2 (BMP-2), introduced by adenovirus-mediated gene transfer, alone is capable of inducing callus formation at the site of periosteal injection. Both immunohistochemistry and Northern analysis demonstrated activation of type II collagen production between days 4 and 7 after the injection, followed by activation of type X collagen expression. The activation of chondrogenesis was associated with increased expression of L-Sox5 and Sox9, suggesting that the BMP-2 effect is mediated via Sox proteins. This capacity of adenovirus-mediated overproduction of BMP-2 to induce chondrogenesis (and subsequent endochondral ossification) should be useful for tissue engineering of cartilage and bone.

Expression of matrix metalloproteinases and tissue inhibitors of metalloproteinases in human chondrosarcomas

The aim of the present study was to characterise the ability of malignant chondrosarcomas to invade normal bone by analysing their production of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs). For this purpose 12 chondrosarcomas were investigated for the expression of mRNAs for several MMPs and all 4 TIMPs by Northern hybridisation, and for immunohistochemical localisation of the proteins. A characteristic finding of these analyses was increased expression of MMP-13, MMP-14 and TIMP-2 mRNAs in chondrosarcomas when compared with nonmalignant control samples. Individual chondrosarcomas also exhibited elevated levels of MMP-1, MMP-7 and MMP-9 mRNAs. The results of Northern hybridisations were supported by immunohistochemical stainings of the corresponding tumour areas for MMP-2, MMP-14 and TIMP-2, further suggesting that these may have prognostic value for determining whether individual chondrosarcomas are locally aggressive or have a probability of recurrence. Another finding of the present study was a marked heterogeneity in histologic appearance and gene expression of the chondrosarcomas, emphasising the importance of analysing several areas of these tumours to get representative results. These findings suggest that analysis of MMPs could be a useful diagnostic indicator in patients with cartilaginous tumours and could help in differentiating between a low-grade malignant chondrosarcoma and a benign growing enchondroma.

A metaphyseal defect model of the femur for studies of murine bone healing

A bone defect model was developed in the distal metaphysis of the femur for studies on bone healing in the mouse. The circular defect involving 20% of the bone circumference resulted in a 34% reduction in the bending moment compared to intact bone. The healing process was followed using histomorphometry, peripheral quantitative computed tomography (pQCT), biomechanical testing, and molecular biological analyses. Histologically, healing of the defect was characterized by filling of the medullary cavity with trabecular new bone during the first week of healing, and by closing of the cortical window by 6 weeks. Small areas of periosteal chondrogenesis were frequently observed during defect healing. In pQCT, bone mineral content (BMC) of the defect area approached that of intact control bone already by 3 weeks, reflecting the production of trabecular bone. Similarly, the bending strength and stiffness of the healing femur reached the level of intact control femur already at 3 weeks. Bone formation and remodeling was followed by Northern analyses, which demonstrated elevated mRNA levels for bone components (type I collagen and osteocalcin), and for osteoclastic enzymes (cathepsin K, matrix metalloproteinase-9, and tartrate-resistant acid phosphatase) throughout the healing period. Finally, the applicability of the defect model for gene therapy experiments was tested using adenovirus-mediated transfer of the LacZ reporter gene. Both histochemistry and mRNA analyses demonstrated that the gene was expressed in the repair tissue with the highest expression during the first week of healing. The present model thus provides a standardized environment for studies on induction and remodeling of trabecular new bone in normal and genetically engineered mice.

Vitamin D and prostate cancer

Our recent epidemiological study (Ahonen et al., Cancer Causes Control 11(2000) (847-852)) suggests that vitamin D deficiency may increase the risk of initiation and progression of prostate cancer. The nested case-control study was based on a 13-year follow-up of about 19000 middle-aged men free of clinically verified prostate cancer. More than one-half of the serum samples had 25OH-vitamin D (25-VD) levels below 50 nmol/l, suggesting VD deficiency. Prostate cancer risk was highest among the group of younger men (40-51 years) with low serum 25-VD, whereas low serum 25-VD appeared not to increase the risk of prostate cancer in older men (>51 years). This suggests that VD has a protective role against prostate cancer only before the andropause, when serum androgen concentrations are higher. The lowest 25-VD concentrations in the younger men were associated with more aggressive prostate cancer. Furthermore, the high 25-VD levels delayed the appearance of clinically verified prostate cancer by 1.8 years. Since these results suggest that vitamin D has a protective role against prostate cancer, we tried to determine whether full spectrum lighting (FSL) during working hours could increase serum 25-VD concentrations. After 1-month exposure, there was no significant increase in the serum 25-VD level, although there was a bias towards slightly increasing values in the test group as opposed to decreasing values in controls. There was no significant change in the skin urocanic acid production. The possibility to use FSL in cancer prevention is discussed. In order to clarify the mechanism of VD action on cell proliferation and differentiation, we performed studies with the rat and human prostates as well prostate cancer cell lines. It is possible that 25-VD may have a direct role in the host anticancer defence activity, but the metabolism of vitamin D in the prostate may also play an important role in its action. We raised antibodies against human 1alpha-hydroxylase and 24-hydroxylase. Our preliminary results suggest that vitamin D is actively metabolised in the prostate. Vitamin D appears to upregulate androgen receptor expression, whereas androgens seem to upregulate vitamin D receptor (VDR). This may at least partially explain the androgen dependence of VD action. VD alone or administered with androgen causes a suppression of epithelial cell proliferation. VD can activate mitogen-activated kinases, erk-1 and erk-2, within minutes and p38 within hours. Also, auto/paracrine regulation might be involved, since keratinocyte growth factor (mRNA and protein) was clearly induced by VD. Based on these studies, a putative model for VD action on cell proliferation and differentiation is presented.

Transcriptional targeting of adenoviral gene delivery into migrating wound keratinocytes using FiRE, a growth factor-inducible regulatory element

Impaired cutaneous wound healing is a common complication in diabetes, ischemia and venous insufficiency of lower extremities, and in long-term treatment with corticosteroids or other immunosuppressive agents. In development of gene therapy for wound repair, expression of therapeutic transgenes should be precisely targeted and controlled. Here, we describe a recombinant adenovirus RAdFiRE-EGFP, in which a growth factor inducible element (FiRE) of the murine syndecan-1 gene controls the expression of enhanced green fluorescent protein (EGFP) reporter gene. Treatment of RAdFiRE-EGFP-transduced murine epidermal keratinocytes in culture with FiRE-activating growth factor markedly enhanced the expression of EGFP. In ex vivo organ culture of wounded murine skin transduced with RAdFiRE-EGFP, the EGFP expression was specifically detected in wound margin keratinocytes, but not in intact skin. Activity of EGFP was first detected 2 days after a single application of RAdFiRE-EGFP and persisted up to 10 days. Similarly, FiRE-driven EGFP expression was detected specifically in epidermal keratinocytes in the edge of incisional wounds in murine skin transduced with RAdFiRE-EGFP. In contrast, adenovirus-mediated lacZ expression driven by CMV promoter was detected scattered in epidermal, dermal and subcutaneous layers in ex vivo and in vivo wounds, as well as in intact skin. These data demonstrate the feasibility of FiRE as a tool for transcriptional targeting of adenovirus-mediated transgene expression to cutaneous wound edge keratinocytes.

Matrix metalloproteinases in tumor invasion

Controlled degradation of extracellular matrix (ECM) is essential for the growth, invasion, and metastasis of malignant tumors, and for tumor-induced angiogenesis. Matrix metalloproteinases (MMPs) are a family of zinc-dependent neutral endopeptidases collectively capable of degrading essentially all ECM components and they apparently play an important role in all these aspects of tumor development. Furthermore, recent evidence suggests that MMPs also play a role in tumor cell survival. In this review, we discuss the current concept concerning the role of MMPs and their inhibitors in tumor invasion, as a basis for prognosis and targeted therapeutic intervention in cancer.

Enhancement of fibroblast collagenase-1 (MMP-1) gene expression by tumor promoter okadaic acid is mediated by stress-activated protein kinases Jun N-terminal kinase and p38

Collagenase-1 (matrix metalloproteinase-1, MMP-1) is expressed by several types of cells, including fibroblasts, and apparently plays an important role in the remodeling of collagenous extracellular matrix in various physiologic and pathologic situations. Here, we have examined the molecular mechanisms of the activation of fibroblast MMP-1 gene expression by a naturally occurring non-phorbol ester type tumor promoter okadaic acid (OA), a potent inhibitor of serine/threonine protein phosphatase 2A. We show that in fibroblasts OA activates three distinct subgroups of mitogen activated protein kinases (MAPKs): extracellular signal-regulated kinase1,2 (ERK1,2), c-Jun N-terminal-kinase/stress-activated protein kinase (JNK/SAPK) and p38. Activation of MMP-1 promoter by OA is entirely blocked by overexpression of dual-specificity MAPK phosphatase CL100. In addition, expression of kinase-deficient forms of ERK1,2, SAPKbeta, p38, or JNK/SAPK kinase SEK1 strongly inhibited OA-elicited activation of MMP-1 promoter. OA-elicited enhancement of MMP-1 mRNA abundance was also strongly prevented by two chemical MAPK inhibitors: PD 98059, a specific inhibitor of the activation of ERK1,2 kinases MEK1,2; and SB 203580, a selective inhibitor of p38 activity. Results of this study show that MMP-1 gene expression in fibroblasts is coordinately regulated by ERK1,2, JNK/SAPK, and p38 MAPKs and suggest an important role for the stress-activated MAPKs JNK/SAPK and p38 in the activation of MMP-1 gene expression. Based on these observations, it is conceivable that specific inhibition of stress-activated MAPK pathways may serve as a novel therapeutic target for inhibiting degradation of collagenous extracellular matrix.

Adenovirus-mediated gene delivery of tissue inhibitor of metalloproteinases-3 inhibits invasion and induces apoptosis in melanoma cells

We have used adenovirus-mediated gene delivery of tissue inhibitor of metalloproteinase (TIMP)-1, -2, and -3 to examine their effect on the invasion capacity of metastatic melanoma cell lines SK-Mel-5 and A2058. Infection of melanoma cells with recombinant replication-deficient adenoviruses coding for TIMP-1, TIMP-2, and TIMP-3 resulted in marked secretion of TIMP-1 and TIMP-2 to culture medium and accumulation of TIMP-3 to matrix. Overexpression of TIMP-3 inhibited invasion of SK-Mel-5 and A2058 cells through reconstituted basement membrane (Matrigel) even more potently than TIMP-1 and TIMP-2. In addition, overproduction of TIMP-3 reduced attachment of melanoma cells to type I and IV collagen and fibronectin and resulted in apoptosis in both SK-Mel-5 and A2058 cells. These results propose a novel role for TIMP-3 in regulation of invasion and survival of malignant cells and suggest potential use for TIMP-3 in adenovirus-mediated gene therapy of malignant melanoma.

Human TIMP-3 is expressed during fetal development, hair growth cycle, and cancer progression

We studied the expression and regulation of TIMP-3, a recently cloned member of the tissue inhibitor of the metalloproteinase family, during human fetal development and in various human tissues, with emphasis on epithelial structures. Expression of TIMP-3 mRNA was detected by in situ hybridization in developing bone, kidney, and various mesenchymal structures. At 16 weeks of gestation, ectoderm-derived cells of hair germs expressed TIMP-3 mRNA, and beginning from the twentieth week consistent expression was detected in epithelial outer root sheath cells of growing hair follicles. In normal adult human skin, expression of TIMP-3 mRNA was limited to hair follicles, starting at the early anagen (growing) phase and vanishing at the catagen (regressing) phase. TIMP-3 mRNA was not detected in benign hair follicle-derived tumors but was present in tumor cells of infiltrative basal cell carcinomas and in surrounding stromal cells in squamous cell carcinomas. Human primary keratinocytes in culture expressed TIMP-3 mRNAs, the levels of which were upregulated by transforming growth factor-beta (TGF-beta), whereas interleukin-1beta (IL-1beta) and tumor necrosis factor-alpha (TNF-alpha) had no effect. Our results suggest a role for TIMP-3 in connective tissue remodeling during fetal development, hair growth cycle, and cancer progression.

Activation of tissue inhibitor of metalloproteinases-3 (TIMP-3) mRNA expression in scleroderma skin fibroblasts

Excessive accumulation of fibrillar collagens is a hallmark of the cutaneous fibrosis in both systemic and localized scleroderma. Turnover of the collagenous extracellular matrix is dependent on the balance between collagenolytic matrix metalloproteinases and their specific inhibitors. We have examined the expression of the novel, matrix associated tissue inhibitor of metalloproteinases-3 (TIMP-3) in normal and scleroderma skin fibroblasts in culture and in vivo. The levels of TIMP-3 mRNA were elevated up to 2.5-fold in five of seven systemic sclerosis fibroblast strains, whereas TIMP-1 mRNA expression was elevated up to 1.8-fold in two and TIMP-2 mRNA expression up to 1.8-fold in two systemic sclerosis strains. Using in situ hybridization, TIMP-3 mRNA was detected in seven of 12 localized scleroderma skin samples, specifically in fibroblasts within fibrotic collagen fibers or in the vicinity of inflammatory cells. TIMP-1 mRNA was detected in three of eight scleroderma skin samples in fibroblasts adjacent to inflammatory cells. The expression of TIMP-3 mRNA by systemic sclerosis and normal skin fibroblasts was enhanced to a similar extent (by 8.6- and 8.1-fold, respectively) by transforming growth factor-beta, and suppressed down to 34 and 54%, respectively, by tumor necrosis factor-alpha. Specific activation of TIMP-3 gene expression in scleroderma skin fibroblasts in culture and in vivo suggests a role for TIMP-3 in the pathogenesis of dermal fibrosis via inhibition of turnover of fibrotic dermal extracellular matrix, possibly due to upregulation of TIMP-3 expression by transforming growth factor-beta.

Catecholamine-synthesizing enzymes in the rat stomach

Local production of catecholamines in the stomach of the rat was studied by immunohistochemical demonstration of tyrosine hydroxylase (TH), dopamine-beta-hydroxylase (DBH) and phenylethanolamine-N-methyltransferase (PNMT), the enzymes catalyzing the formation of dopamine, noradrenaline and adrenaline, respectively. A rich innervation of TH- and DBH-immunoreactive nerve fibers was seen in the muscular layers and the myenteric plexus, in the submucosa and in the walls of submucosal blood vessels and in the lamina propria at the base of the epithelial layer. In addition, TH-, but not DBH-immunoreactive nerve fiber networks surrounding ganglion cells in the myenteric plexus were frequently observed, indicating dopaminergic preganglionic innervation of the myenteric plexus. In the oxyntic epithelium, single TH- and DBH-immunoreactive fibers extended in the strands of lamina propria as far as the middle portion of the gastric glands. A small population of single angulate cells in the oxyntic epithelium showed TH-, but not DBH-immunoreactivity. No specific PNMT immunoreactivity was observed.

Analysis of chromosomal aberrations, sister-chromatid exchanges and micronuclei in peripheral lymphocytes of pharmacists before and after working with cytostatic drugs

The frequencies of chromosome aberrations, SCEs and micronuclei (cytokinesis-block method) in blood lymphocytes were compared among six nonsmoking female pharmacists before and after 1 year of working with cytostatic drugs. All possible precautions were taken to avoid exposure to cytostatics, including proper protective clothing and a monitored, negative-pressured working environment with vertical laminar flow cabinet. As referents, an age-matched group of six nonsmoking female hospital workers not dealing with cytostatics was simultaneously sampled twice with the same time interval. The pharmacists showed a marginally higher mean frequency of SCEs/cell (6.3; P = 0.049) after the working period than 1 year earlier (5.8). On the other hand, the referents, with no obvious exposure, had a higher mean number of cells with chromatid-type aberrations, gaps excluded, in the second sampling (2.0%; P = 0.048) than in the first one (0.5%). In addition, a slight (P = 0.055) trend towards a higher frequency of micronucleated binucleate cells was observed in the second sampling for both the exposed and control subjects. As such findings suggest technical variation in the cytogenetic parameters, the small difference observed in SCEs for the pharmacists between the two samplings was probably not related to the cytostatics exposure. No statistically significant differences were observed for any of the cytogenetic parameters in comparisons between the pharmacists and the referents. The findings suggest that caution should be exercised in comparing results obtained from two different samplings in prospective cytogenetic studies.

Effect of vagotomy on expression of neuropeptides and histamine in rat oxyntic mucosa

The effect of vagotomy and pyloroplasty on the density of nerve fibers containing bombesin/gastrin-releasing peptide (GRP), calcitonin gene-related peptide (CGRP), and galanin as well as histamine-, 5-hydroxytryptamine (5-HT)-, and somatostatin-containing cells in the oxyntic mucosa of the rat stomach was studied. Ten days after vagotomy and pyloroplasty the density of histamine-containing cells in the oxyntic mucosa was increased by 70% (P < 0.05), and these cells were larger and showed more extensive cell processes than in control animals. The density of 5-HT-immunoreactive (IR) cells and somatostatin-IR cells were not affected. A marked decrease in the density of CGRP-IR nerve fibers and a slighter decrease in the density of GRP-IR nerve fibers was observed in the mucosal layer, while only a minor reduction of CGRP-IR fibers, and no reduction of GRP-IR fibers was seen in the muscular layer. The density of galanin-IR nerve fibers was not affected. The height of the oxyntic mucosa was reduced by about 25% (P < 0.05). Thus, a striking effect on the histamine-IR cells was seen, supporting the view that these cells are regulated by the vagus nerve. The study also indicates that a major portion of the CGRP-IR nerve fibers, and part of the GRP-IR nerve fibers, in the mucosal layer of the fundic region are of vagal origin or regulated by normal vagus nerve activity.

Preepithelial mucus-HCO-3 layer protects against intracellular acidosis in acid-exposed gastric mucosa

The role of the preepithelial mucus-HCO-3 layer in protection against intracellular acidosis was investigated in isolated Necturus gastric antral mucosa exposed to luminal acid by simultaneous measurement of intracellular pH (pH(i)) and extracellular surface pH (pHs) in surface epithelium with microelectrode technique. Acidification of the luminal perfusate to pH 2.5 acidified pH(i) in surface epithelial cells from 7.33 +/- 0.02 to 7.20 +/- 0.04, whereas pHs fell from 6.75 +/- 0.21 to 5.20 +/- 0.25 (P < 0.01; n = 9), followed by a steady state for at least 2 h. Inhibition of epithelial HCO-3 secretion and transport by removal of serosal HCO-3 and CO2 (HEPES and O2 substitution) during acid exposure provoked a progressive acidification of pHs from 5.60 +/- 0.41 to 2.74 +/- 0.14 in 30 min (P < 0.01; n = 9), which was accompanied, after a 5- to 10-min delay, by acidification of pH(i) from 7.21 +/- 0.03 to 5.68 +/- 0.26 (P < 0.01). Digestion of the surface mucus gel by pepsin (5% wt/vol) at pH 2.5 caused a slow acidification of pHs from 5.22 +/- 0.59 to 3.60 +/- 0.46 within 2 h. This was followed by a more rapid acidification to 2.53 +/- 0.38 (P < 0.01; n = 7), with concomitant acidification of pH(i) from 7.19 +/- 0.05 to 6.03 +/- 0.33 (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Neurofilament immunoreactivity and acetylcholinesterase activity in the developing sympathetic tissues of the rat

In this study, the ontogenetic appearance of three neuronal markers, tyrosine hydroxylase (TH), neurofilament (NF) proteins and acetylcholinesterase (AChE), have been compared in the neural tube and derivatives of the neural crest with special consideration on developing rat sympathetic tissues. The tree markers appeared for the first time on embryonic day E 12.5. At this age, NF immunoreactivity was located in the cells on the ventro- and dorsolateral edges of the neural tube, i.e., in the regions where the cells had reached the postmitotic stage. In addition, on day E 12.5, NF-immunoreactive fibers were located in the dorsal and ventral roots and the spinal and sympathetic ganglia. This suggests rapid extension of neurites. In contrast to NF, AChE first appeared on day E 12.5 in cell somata of spinal and sympathetic ganglia and only after that in axons. Thus, it can be considered as a marker of differentiating neuronal cell bodies. In the developing sympathoadrenal cells, TH is expressed before NF and AChE. However, the migrating TH immunoreactive sympathetic cells are constantly followed by NF immunoreactive fibers, suggesting that sympathetic tissues may receive innervation from preganglionic axons at the very beginning of their ontogeny. During the later development, all sympathetic tissues contain two major cell groups: 1) one with a moderate TH immunoreactivity, NF immunoreactivity and AChE activity and 2) the other with an intense TH immunoreactivity but lacking NF immunoreactivity or AChE activity. The former includes principal neurons, neuron-like cells of the paraganglia and noradrenaline cells of the adrenal medullae, and the latter includes ganglionic small intensely fluorescent (SIF) cells, paraganglionic cells and medullary adrenaline cells.

Distribution of histamine in the developing peripheral nervous system

The presence and ontogenetic distribution of histamine was studied in the developing peripheral nervous system of the rat by using an indirect immunofluorescence technique and a specific rabbit anti-histamine antiserum. Histamine immunoreactivity (IR) first appeared in peripheral nerves on embryonic day 14. The number and intensity of histamine-immunoreactive nerves was highest on embryonic days 16-18. During development starting from embryonic day 14, motoneurones in ventral horns of the spinal cord at cervical, thoracic and lumbar levels contained histamine IR. A subpopulation of sensory neurones in dorsal root ganglia exhibited histamine IR. Histamine IR was also present in nerve fibres of ventral and dorsal roots of spinal cord, as well as in spinal nerves. Population of neurons and nerve fibres in sympathetic and pelvic ganglia as well as in myenteric ganglia of the intestine were also labelled with the histamine antiserum. In peripheral target organs, histamine IR was observed in nerve fibres around bronchi of the lungs, in the atria of the heart, in the adrenal gland, in the intestinal wall, in muscular tissues and in subepithelial tissue of the skin. The results of this study indicate that histamine is widely distributed in different types of neurons and nerve fibers of the developing peripheral nervous system.

Histamine in the developing sympathoadrenal system

The ontogenetic distribution of histamine in correlation with catecholamines in the developing rat sympathoadrenal system was analyzed by using an indirect immunohistochemical method and a specific rabbit anti-histamine antiserum. Tyrosine hydroxylase (TH) immunoreactivity was used as a marker of catecholamine synthesis. TH immunoreactivity appeared in retroperitoneal sympathetic tissues on embryonic day 12.5 (E 12.5) when it was found in cells of lumbar chain ganglia. In preaortic sympathetic tissue. TH immunoreactivity was observed on day E 13.5 and in adrenal medullae on day E 14.5. Histamine immunoreactivity was expressed in all of these tissues beginning from day E 14.5. First it was found mainly in nerve fibers, but also in some cells. During the embryonic development the number of histamine-immunoreactive cells increased in all sympathetic tissues studied. In newborn rats, histamine immunoreactivity was restricted to a subpopulation of sympathetic cells, i.e. small intensely fluorescent (SIF) cells of sympathetic ganglia, paraganglion-type cells and some adrenaline-synthesizing cells of the adrenal medulla.

L-glutamate decarboxylase immunoreactivity in developing sympathetic tissues of the rat

An indirect immunofluorescence method was used to study the appearance and distribution of L-glutamate decarboxylase (GAD), the enzyme synthesizing gamma-aminobutyric acid, in developing rat retroperitoneal sympathetic tissues. GAD immunoreactivity was analyzed in correlation with immunoreactivity to the catecholamine-synthesizing enzyme, tyrosine hydroxylase (TH), in the main retroperitoneal paraganglion, adrenal medullae and abdominal sympathetic ganglia. In different abdominal sympathetic tissues TH-immunoreactive cells first appeared on embryonic days 12.5-14.5, while GAD immunoreactivity was first observed in all these tissues in 14.5-day-old embryos (E 14.5). This suggests that the first expression of GAD is not coupled to the onset of catecholamine synthesis. In developing chain ganglia, GAD immunoreactivity was localized prenatally only in cell clusters with bright TH immunoreactivity, suggesting that GAD is expressed only in the cell lineage leading to ganglionic small intensely fluorescent (SIF) cells. The coeliac-superior mesenteric ganglion complex developed from the preaortic sympathetic tissue, starting from E 16.5 embryos, when the cranial, moderately TH-immunoreactive cells of this tissue were seen to form compact cell islets around the branches of the abdominal aorta. The caudal, intensely TH-immunoreactive cells of preaortic sympathetic tissue were seen to form the main retroperitoneal paraganglion from day E 15.5. During the prenatal period GAD immunoreactivity in preaortic sympathetic tissue was present caudally only in these paraganglionic cells and cranially in some brightly TH-immunoreactive cells, representing SIF and/or paraganglionic cells. In the adrenal medulla, only some of the TH-immunoreactive cells showed GAD immunoreactivity during early developmental stages. The moderately TH-immunoreactive, noradrenaline-synthesizing, cell clusters were seen for the first time in E 16.5 embryos, and they exhibited no GAD immunoreactivity. Thereafter, GAD was expressed only in the intensely TH-immunoreactive, adrenaline-synthesizing, cell clusters. The results of this study indicate that in the developing rat sympathetic tissues GAD is present only in the cell lineages which differentiate into SIF cells of abdominal sympathetic ganglia, preaortic paraganglionic cells and adrenaline cells of the adrenal medulla.

Immunocytochemical localization of L-glutamate decarboxylase and catecholamine-synthesizing enzymes in the retroperitoneal sympathetic tissue of the newborn rat

The localization of L-glutamate decarboxylase (GAD), the enzyme synthesizing gamma-aminobutyric acid, was studied in newborn rat retroperitoneal sympathetic tissue, i.e. the main retroperitoneal paraganglion, adrenal medullae and abdominal sympathetic ganglia using the indirect immunofluorescence method. The coexistence of GAD with the catecholamine-synthesizing enzymes tyrosine hydroxylase (TH) and phenylethanolamine N-methyltransferase (PNMT) was analyzed in consecutive sections or by staining one section consecutively with different antisera. GAD immunoreactivity was observed only in some cell types of each organ studied. In the main retroperitoneal paraganglion, the small, intensely TH-immunoreactive, paraganglion-type cells were GAD-immunoreactive, while the larger moderately TH-immunoreactive, neuron-like cells were non-reactive for GAD. In the adrenal medulla, GAD immunoreactivity was localized only in the adrenaline-synthesizing, PNMT-immunoreactive chromaffin cells. The noradrenaline-synthesizing, i.e. the TH-immunoreactive cells with no PNMT immunoreactivity, were non-reactive for GAD. In the abdominal sympathetic ganglia, some small intensely TH-immunoreactive cells were GAD-immunoreactive, while the principal neurons were non-reactive for GAD. These results provide immunohistochemical evidence that GAD is present and is colocalized with catecholamine-synthesizing enzymes in various sympathetic tissues of the newborn rat. The present results indicate that GAD is localized in adrenaline-synthesizing cells of all the sympathetic tissues studied. A fraction of noradrenaline-synthesizing cells of retroperitoneal sympathetic tissues, excluding the adrenal medulla, also contains GAD.

Developmental changes in 5-hydroxytryptamine immunoreactivity of sympathetic cells

5-Hydroxytryptamine was demonstrated immunohistochemically in developing sympathetic chain ganglia, adrenal medullae and retroperitoneal paraganglionic tissue. Initially, all catecholamine-synthesizing cells were immunoreactive to 5-hydroxytryptamine, but during the maturation some sympathetic cell types lose this property. In the ganglia, small intensely fluorescent cells retain their 5-hydroxytryptamine content throughout maturation. This property is expressed transitionally in some neonatal principal neurons, but can be triggered even in adult neurons, e.g. after loading with L-tryptophan. In the adrenal medulla, immunoreactivity to 5-hydroxytryptamine is carried over to the adrenaline-synthesizing cells, while in the main retroperitoneal paraganglion it is observed in both adrenaline and noradrenaline cells. These results suggest that initial expression of 5-hydroxytryptamine immunoreactivity is coupled to the onset of catecholamine synthesis, but is regulated differently in each mature sympathetic organ.

5-Hydroxytryptamine and catecholamines in developing sympathetic cells of the rat

Appearance of 5-hydroxytryptamine (5-HT) in developing sympathetic cells of prenatal rats was studied using the indirect immunofluorescence method. In consecutive sections, tyrosine hydroxylase (TH) immunoreactivity was considered as a marker for catecholamine-synthesizing cells in general, while phenylethanolamine N-methyltransferase (PNMT) immunoreactivity was used as an indicator of adrenaline synthesis. 5-HT immunoreactivity was observed for the first time in 12.5-day-old embryos in developing sympathetic chain ganglia. On day 13.5, 5-HT-immunoreactive cells were first seen on the preaortic region and on day 14.5 in the developing adrenal gland. Comparison with consecutive sections stained for TH revealed that all TH-immunoreactive cells were also 5-HT-immunoreactive. During later development, however, 5-HT immunoreactivity was retained by some cell types in each sympathetic tissue. In the ganglia, most developing principal nerve cells gradually lost their 5-HT immunoreactivity, while all so-called small intensely fluorescent (SIF) cells remained intensely 5-HT-immunoreactive. In the adrenal medulla, all catecholamine-containing cells showed 5-HT immunoreactivity until day 16.5. The first adrenaline-synthesizing cells appeared at this stage. Occasionally on day 16.5 and constantly on day 17.5 noradrenaline cell islets were distinguished among adrenaline cells. The adrenaline cells retained intense 5-HT immunoreactivity, while the noradrenaline cells were non-reactive to it. In the main retroperitoneal paraganglion, two noradrenaline cell populations were distinguished from day 15.5, one being 5-HT-immunoreactive and the other non-reactive. A third population appeared in this tissue at the time of birth, consisting of adrenaline-synthesizing cells which were also 5-HT-immunoreactive. These results indicate that the 3 sympathetic tissues undergo similar developmental changes: 5-HT immunoreactivity occurs in conjunction with the initiation of catecholamine synthesis and appears first in all catecholamine cells. During maturation it is confined to certain subpopulations in each tissue, i.e. the SIF cells and some principal nerve cells of the ganglion, the adrenaline cells of the adrenal medulla, the adrenaline cells and some noradrenaline cells of the paraganglionic tissue.

Pre- and postnatal development of rat retroperitoneal paraganglia

The prenatal and postnatal development of the rat retroperitoneal paraganglia were studied using the formaldehyde-induced catecholamine fluorescence (FIF) method. In addition, the transmitter composition of the paraganglionic cells of the newborn rat was analyzed by immunohistochemical demonstration of the catecholamine-synthesizing enzymes. The first fluorescent preaortic cells were detected in the 13.5-day-old embryos. One day later these cells constituted a distinct organ with moderately fluorescent cells, and in 15.5-day-old embryos this organ consisted cranially of moderately fluorescent and caudally of brightly fluorescent cells. The organ reached its largest size at birth and afterwards fibrous material increased between the fluorescent cells. In 4-week-old animals, only small clusters of fluorescent cells were observed in the preaortic area although many small paraganglia were situated cranially near the coeliac ganglion. In the organ of the newborn rat, many cells showed bright FIF. In addition, some cells with only slight or moderate fluorescence as well as non-fluorescent cells were detected. The analysis of immunoreactivity to the catecholamine-synthesizing enzymes showed that there was a cell population with intense reactivity to both tyrosine hydroxylase (TH) and dopamine beta-hydroxylase (DBH). These cells were considered as paraganglion-type cells. Some of them were also immunoreactive to phenylethanolamine N-methyltransferase (PNMT). In addition, there were cells with weak to moderate reactivity to TH and DBH but not to PNMT. Also totally negative cells were constantly seen. These findings were confirmed by using consecutive sections for the localization of different enzymes and by using the Tramu method to elute previous staining and by restaining the same sections with the other antibodies. It is concluded that the retroperitoneal paraganglia of newborn rat consist of many paraganglion-type cells containing noradrenaline, some of them containing also adrenaline, a few neuron-like cells with TH and DBH immunoreactivity, and cells containing no catecholamines.