Drosophila atypical protein kinase C associates with Bazooka and controls polarity of epithelia and neuroblasts

The establishment and maintenance of polarity is of fundamental importance for the function of epithelial and neuronal cells. In Drosophila, the multi-PDZ domain protein Bazooka (Baz) is required for establishment of apico-basal polarity in epithelia and in neuroblasts, the stem cells of the central nervous system. In the latter, Baz anchors Inscuteable in the apical cytocortex, which is essential for asymmetric localization of cell fate determinants and for proper orientation of the mitotic spindle. Here we show that Baz directly binds to the Drosophila atypical isoform of protein kinase C and that both proteins are mutually dependent on each other for correct apical localization. Loss-of-function mutants of the Drosophila atypical isoform of PKC show loss of apico-basal polarity, multilayering of epithelia, mislocalization of Inscuteable and abnormal spindle orientation in neuroblasts. Together, these data provide strong evidence for the existence of an evolutionary conserved mechanism that controls apico-basal polarity in epithelia and neuronal stem cells. This study is the first functional analysis of an atypical protein kinase C isoform using a loss-of-function allele in a genetically tractable organism.

Characterization of the Streptomyces peucetius ATCC 29050 genes encoding doxorubicin polyketide synthase

The dps genes of Streptomyces peucetius, encoding daunorubicin (DNR)-doxorubicin (DXR) polyketide synthase (PKS), are largely within an 8.7-kb region of DNA that has been characterized by Southern analysis, and gene sequencing, mutagenesis and expression experiments. This region contains nine ORFs, many of whose predicted products are homologous to known PKS enzymes. Surprisingly, the gene encoding the DXR PKS acyl carrier protein is not in this region, but is located about 10 kb distant from the position it usually occupies in other gene clusters encoding type-II PKS. An in-frame deletion in the dpsB gene, encoding a putative subunit of the DXR PKS, resulted in loss of production of DXR and the known intermediates of its biosynthetic pathway, confirming that this gene and, by implication, the adjacent dps genes are required for DXR biosynthesis. This was verified by expression of the dps genes in the heterologous host, Streptomyces lividans, which resulted in the production of aklanonic acid, an early intermediate of DXR biosynthesis.

Reducing chimera formation during PCR amplification to ensure accurate genotyping

Measurements of population diversity are fundamental to the reconstruction of the evolutionary and epidemiological history of organisms. Commonly used protocols to measure population diversity using the polymerase chain reaction (PCR) are prone to the introduction of artificial chimeras. These are often difficult to detect and can confound the correct interpretation of results due to the false generation of recombinants when the underlying DNA sample contains multiple distinct templates. This study presents a standardised procedure to suppress the formation of artificial chimeras during PCR amplification. The solution is based on the accurate determination of the efficiency and end point of the log-linear phase of a PCR. This procedure will facilitate the generation of data sets that more accurately reflect the underlying population diversity rather than artifacts introduced by the process itself.

Purification and characterization of the DNA-binding protein DnrI, a transcriptional factor of daunorubicin biosynthesis in Streptomyces peucetius

The DnrI protein, essential for the biosynthesis of daunorubicin in Streptomyces peucetius, was purified almost to homogeneity from dnrI expression strains of Escherichia coll and S. peucetius through several steps of chromatography. The proteins purified from both organisms had identical chromatographic and electrophoretic behaviour. Purified Histagged or native DnrI was used to conduct DNA-binding assays by gel mobility-shift analysis, and the results showed no significant difference in the DNA-binding activity of native or His-tagged proteins. DnrI binds specifically to DNA segments containing the intergenic regions separating the putative dnrG-dpsABCD and dpsEF operons, and the dnrC gene and dnrDKPSQ operon. DNase I footprinting assays indicated that the DNA-binding sites for DnrI extended from upstream of the -10 to -35 regions of the dnrG or dpsE promoters to include about 65 bp of the dnrG-dpsE intergenic region and about 80 bp of the dnrC-dnrD intergenic region. Both binding sites contain imperfect inverted repeat sequences of 6-10 bp with a 5'-TCGAG-3' consensus sequence that was present in 4 out of 10 other promoter regions in the cluster of daunorubicin biosynthesis genes.

Islet glutathione and insulin release

In isolated rat pancreatic islets, glucose (5.6, 11.1, and 16.7 mM) significantly increased reduced glutathione (GSH) and decreased oxidized glutathione (GSSG) levels in a dose-related manner. This was paralleled by a concomitant increase of NADPH and a decrease of NADP. The change of the GSH level occurred as quickly as one minute after addition of glucose. Exogenous insulin (200, 400, and 800 microU/ml) significantly decreased islet GSH levels in the presence of 5.6 and 16.7 mM glucose and significantly inhibited the insulin-releasing effect of the thiol reagent parachloromercuribenzoate (p-CMB) and tolbutamide. These data, together with earlier observations, suggest that GSH levels in pancreatic islets are increased by glucose and decreased by exogenous insulin via their effects on the pentose phosphate shunt and NADPH. Our results are compatible with the hypothesis that glucose and exogenous insulin, by modifying the redox state of the NADPH/NADP and GSH/GSSG systems, modulate the sensitivity of the beta-cell to the insulin-triggering actions of glucose, p-CMB, and tolbutamide.

Nerve ultrasound as follow-up tool in treated multifocal motor neuropathy

BACKGROUND AND PURPOSE

High-resolution ultrasound is a valuable tool in supporting the diagnosis of multifocal motor neuropathy (MMN) but longitudinal data under therapy are lacking.

METHODS

The change in peripheral nerve ultrasound pattern in patients with MMN was assessed over time. Patients with MMN received a thorough initial examination and follow-up over a period of 6-12 months using high-resolution ultrasound of the cervical roots and the nerves of the arms and legs, nerve conduction studies, Medical Research Council Sum Score (MRCSS) and Rotterdam Inflammatory Neuropathy Cause and Treatment Group (INCAT) score to evaluate changes under treatment. The Ultrasound Pattern Sum Score (UPSS) was used as standardized peripheral nerve ultrasound protocol.

RESULTS

Seventeen patients with MMN received initial examinations of whom 12 were successfully followed up. All patients with MMN showed at least localized but often multifocal peripheral nerve enlargement. An enlarged overall cross-sectional area as well as enlarged single fascicles (>3 mm²) in clinically and electrophysiologically affected (>90%) and unaffected (>70%) nerves were found. The UPSS did not correlate with clinical disability at both visits. However, the change in clinical disability (evaluated as difference in MRCSS) and the change in UPSS correlated significantly inversely (P = 0.004).

CONCLUSIONS

High-resolution sonography of peripheral nerves revealed multifocal nerve enlargement in MMN. Distinct enlargement patterns may support the diagnosis. Ultrasound findings did not correlate well with clinical severity or electrophysiological findings at initial presentation. As changes in UPSS correlated significantly with the clinical course in terms of muscle strength (MRCSS), sonographic assessment may represent a useful tool for therapeutic monitoring.

Effect of methylene blue and thiol oxidants on pancreatic islet GSH/GSSG ratios and tolbutamide mediated insulin release in vitro

Methylene blue (an oxidant of NADPH), diamide (an oxidant of glutathion-SH [GSH]) and tertbutyl hydroperoxide (a substrate of glutathione peroxidase) significantly decreased the GSH content of pancreatic rat islets and decreased their GSH/GSSG ratio. They also significantly depressed the single peak insulin response to tolbutamide by the isolated perfused pancreas as well as its synergistic action with glucose in isolated pancreatic islets. These results suggest that the effect of tolbutamide alone and its synergistic action with glucose could depend on the islet NADPH and GSH. In addition it appears that augmentation of tolbutamide action by glucose in insulin release is mediated by the provision of additional NADPH and GSH through glucose metabolism.

Analysis of Zinc Compound Buffer Layers in Cu(In, Ga)(S, Se)2 Thin Film Solar Cells by Synchrotron-Based Soft X-Ray Spectroscopy

Zinc-based buffer layers like ZnSe, ZnS, or wet-chemically deposited ZnO on Cu(In, Ga)(S, Se)2 absorber materials (CIGSSe) have yielded thin film solar cell efficiencies comparable to or even higher than standard CdS/CIGSSe cells. However, little is known about surface and interface properties of these novel buffer layers. In this contribution we characterize the specific chemical environment at the absorber/buffer-interface using X-ray Emission Spectroscopy (XES) and Photoelectron Spectroscopy (PES) in a complementary way. Evidence of intermixing and chemical reactions is found for different buffer materials and deposition methods.

Influence of volatile and intravenous anesthetics on the threshold of the acoustically evoked stapedius reflex

The influence of volatile and intravenous anesthetics on the threshold of the acoustically evoked stapedius reflex (SR) was studied prospectively in 45 patients undergoing elective ENT surgical procedures. After premedication with flunitrazepam the patients were randomly assigned to one of nine groups. Group I: 70% nitrous oxide (N2O) in oxygen (O2); Groups II-VII: induction of anesthesia with intravenous thiopental, followed by mask inhalation with 100% O2 and 1.13% halothane (Group II), 2.52% enflurane (Group III) or 1.73% isoflurane (Group IV); or 70% N2O in oxygen, and 0.44% halothane (Group V), 0.86% enflurane (Group VI) or 0.75% isoflurane (Group VII): Group VIII: intravenous midazolam and ketamine; and Group IX: intravenous midazolam and alfentanil. Tympanometry and ipsilateral and contralateral SR measurements were performed when the effects of the anesthetics had achieved a steady state. Flunitrazepam raised the SR threshold only slightly. Substances applied during inhalation anesthesia either markedly increased the threshold contralaterally more than ipsilaterally (thiopental, N2O), or suppressed the reflex completely (thiopental, all volatile anesthetics with or without N2O). Under intravenous anesthesia the reflex was always present. The midazolam-ketamine combination influenced the threshold bilaterally only slightly, while the midazolam-alfentanil combination led to a pronounced, contralaterally significant elevation of the threshold. Based on its minimal influence on the SR threshold, flunitrazepam is especially suitable for sedation and the midazolam-ketamine combination for anesthesia in audiological diagnostic procedures.

Endovascular Treatment of Dural Arteriovenous Fistulas of the Anterior or Posterior Condylar Vein : A Cadaveric and Clinical Study and Literature Review

Dural arteriovenous fistulas (DAVF) involving the anterior and posterior condylar vein at the skull base are rare but important to recognize. Due to the highly variable anatomy of the venous system of the skull base, detailed anatomical knowledge is essential for correct diagnosis and appropriate treatment of these lesions. In this report we review the normal anatomy of the condylar veins and describe rare and, to our knowledge, not previously reported anatomical variants. We also highlight the treatment modalities for these lesions with focus on the endovascular transvenous occlusion based on four consecutive cases from our center.

A Comparison between 6-point Dixon MRI and MR Spectroscopy to Quantify Muscle Fat in the Thigh of Subjects with Sarcopenia

BACKGROUND

Changes in muscle fat composition as for example observed in sarcopenia, affect physical performance and muscular function, like strength and power.

OBJECTIVES

The purpose of this study was to compare 6-point Dixon magnetic resonance imaging and multi-echo magnetic resonance spectroscopy sequences to quantify muscle fat. Setting, participants and measurements: Two groups were recruited (G1: 23 healthy young men (28 ± 4 years), G2: 56 men with sarcopenia (80 ± 5 years)). Proton density fat fraction was measured with a 6-point product and a 6-point prototype Dixon sequence in the left thigh muscle and with a high-speed multi-echo T2*-corrected H1 magnetic resonance spectroscopy sequence within the semitendinosus muscle of the left thigh. To evaluate the comparability among the different methods, Bland-Altman and linear regression analyses of the proton density fat fraction results were performed.

RESULTS

Mean differences ± 1.96 * standard deviation between spectroscopy and 6pt Dixon sequences were 1.9 ± 3.3% and 1.5 ± 3.6% for the product and prototype sequences, respectively. High correlations were measured between the proton density fat fraction results of the 6-point Dixon sequences and spectroscopy (R = 0.95 for the product sequence and R = 0.97 for the prototype sequence).

CONCLUSIONS

Dixon imaging and spectroscopy sequences show comparable accuracy for fat measurements in the thigh. Spectroscopy is a local measurement, whereas Dixon sequences provide maps of the fat distribution. The high correlations of the 6-point Dixon sequences with spectroscopy support their clinical use. They provide higher spatial resolution than spectroscopy, but are not suitable for a more complicated spectral analysis to separate extra- and intramyocellular lipids.

Spectroscopic investigation of the deeply buried Cu(In,Ga)(S,Se)2∕Mo interface in thin-film solar cells

The Cu(In,Ga)(S,Se)(2)Mo interface in thin-film solar cells has been investigated by surface-sensitive photoelectron spectroscopy, bulk-sensitive x-ray emission spectroscopy, and atomic force microscopy. It is possible to access this deeply buried interface by using a suitable lift-off technique, which allows us to investigate the back side of the absorber layer as well as the front side of the Mo back contact. We find a layer of Mo(S,Se)(2) on the surface of the Mo back contact and a copper-poor stoichiometry at the back side of the Cu(In,Ga)(S,Se)(2) absorber. Furthermore, we observe that the Na content at the Cu(In,Ga)(S,Se)(2)Mo interface as well as at the inner grain boundaries in the back contact region is significantly lower than at the absorber front surface.

[Diagnostic nerve ultrasonography]

CLINICAL/METHODICAL ISSUE

For the diagnostics of nerve lesions an imaging method is necessary to visualize peripheral nerves and their surrounding structures for an etiological classification.

STANDARD RADIOLOGICAL METHODS

Clinical neurological and electrophysiological investigations provide functional information about nerve lesions. The information provided by a standard magnetic resonance imaging (MRI) examination is inadequate for peripheral nerve diagnostics; however, MRI neurography is suitable but on the other hand a resource and time-consuming method.

METHODICAL INNOVATIONS

Using ultrasonography for peripheral nerve diagnostics.

PERFORMANCE

With ultrasonography reliable diagnostics of entrapment neuropathies and traumatic nerve lesions are possible. The use of ultrasonography for neuropathies shows that a differentiation between different forms is possible.

ACHIEVEMENTS

Nerve ultrasonography is an established diagnostic tool. In addition to the clinical examination and clinical electrophysiology, structural information can be obtained, which results in a clear improvement in the diagnostics. Ultrasonography has become an integral part of the diagnostic work-up of peripheral nerve lesions in neurophysiological departments.

PRACTICAL RECOMMENDATIONS

Nerve ultrasonography is recommended for the diagnostic work-up of peripheral nerve lesions in addition to clinical and electrophysiological investigations. It should be used in the clinical work-up of entrapment neuropathies, traumatic nerve lesions and spacy-occupying lesions of nerves.

Donor Dopamine Does Not Affect Liver Graft Survival: Evidence of Safety From a Randomized Controlled Trial

Treatment of donation after brain death (DBD) donors with low-dose dopamine improves the outcomes after kidney and heart transplantation. This study investigates the course of liver allografts from multiorgan donors enrolled in the randomized dopamine trial between 2004 and 2007 (clinicaltrials.gov identifier: NCT00115115). There were 264 hemodynamically stable DBDs who were randomly assigned to receive low-dose dopamine. Dopamine was infused at 4 μg/kg/minute for a median duration of 6.0 hours (interquartile range, 4.4-7.5 hours). We assessed the outcomes of 212 liver transplantations (LTs) performed at 32 European centers. Donors and recipients of both groups were very similar in baseline characteristics. Pretransplant laboratory Model for End-Stage Liver Disease score was not different in recipients of a dopamine-treated versus untreated graft (18 ± 8 versus 20 ± 8; P = 0.12). Mean cold ischemia time was 10.6 ± 2.9 versus 10.1 ± 2.8 hours (P = 0.24). No differences occurred in biopsy-proven rejection episodes (14.4% versus 15.7%; P = 0.85), requirement of hemofiltration (27.9% versus 31.5%; P = 0.65), the need for early retransplantation (5.8% versus 6.5%; P > 0.99), the incidence of primary nonfunction (7.7% versus 8.3%; P > 0.99), and in-hospital mortality (15.4% versus 14.8%; P > 0.99). Graft survival was 71.2% versus 73.2% and 59.6% versus 62.0% at 2 and 3 years (log-rank P = 0.71). Patient survival was 76.0% versus 78.7% and 65.4% versus 69.4% at 1 and 3 years (log-rank P = 0.50). In conclusion, donor pretreatment with dopamine has no short-term or longterm effects on outcome after LT. Therefore, low-dose dopamine pretreatment can safely be implemented as the standard of care in hemodynamically stable DBDs.

[Surgical anatomy of the maxillary sinus]

BACKGROUND

Improved understanding of the microanatomy of the paranasal sinuses, including its individual variations, makes a substantial contribution to current progress in endonasal endoscopic microsurgery. Microanatomy of the sinuses is an active field of present scientific investitations.

MATERIALS AND METHODS

A comprehensive review on microanatomy of the maxillary sinus is presented from the perspective of contemporary endonasal endoscopic microsurgery.

RESULTS

The range of variation of the individual microanatomy of all sections of the maxillary sinus is presented, in particular to minimize secondary sugical tissue trauma, to avoid complications (e.g. on orbital tissues) and as a basis for the prelacrimal access to the maxillary sinus.

CONCLUSION

Improved understanding of the range of microanatomical variations reduced the burden on the patient while opimizing the effectiveness of the necessary surgical manipulations.

[Critical illness polyneuropathy and critical illness myopathy]

Critical illness polyneuropathy (CIP) and critical illness myopathy (CIM) are frequent complications in critically ill patients and both are associated with sepsis, systemic inflammatory response syndrome (SIRS) and multiorgan failure. Major signs are muscle weakness and problems of weaning from the ventilator. Both CIP and CIM lead to elongated times of ventilation, elongated hospital stay, elongated times of rehabilitation and increased mortality. Electrophysiological measurements help to detect CIP and CIM early in the course of the disease. State of the art sepsis therapy is the major target to prevent the development of CIP and CIM. Although no specific therapy of CIP and CIM has been established in the past, the diagnosis generally improves the therapeutic management (weaning from the ventilator, early physiotherapy, etc.). This review provides an overview of clinical and diagnostic features of CIP and CIM and summarizes current pathophysiological and therapeutic concepts.

Gated Conditional Displacement Readout of Superconducting Qubits

We have realized a new interaction between superconducting qubits and a readout cavity that results in the displacement of a coherent state in the cavity, conditioned on the state of the qubit. This conditional state, when it reaches the cavity-following, phase-sensitive amplifier, matches its measured observable, namely, the in phase quadrature. In a setup where several qubits are coupled to the same readout resonator, we show it is possible to measure the state of a target qubit with minimal dephasing of the other qubits. Our results suggest novel directions for faster readout of superconducting qubits and implementations of bosonic quantum error-correcting codes.

Major complications after intraoperative radiotherapy with low-energy x-rays in early breast cancer

PURPOSE

To describe and analyze major local complications after intraoperative radiotherapy (IORT) with low-energy x‑rays during breast-conserving surgery (BCS) in early breast cancer.

METHODS

Ten women out of 408 who were treated with IORT between 2002 and 2017 and subsequently developed a severe local complication requiring surgical intervention were retrospectively identified and analyzed. Demographic, clinical, and surgical parameters as well as complication characteristics and treatment methods were evaluated.

RESULTS

At initial presentation, eight patients (80%) showed redness, six (60%) seroma, six (60%) wound infection, six (60%) suture dehiscence, and four (40%) induration of the former surgical area. Hematoma and necrosis were observed in one case (10%) each. Time interval until appearance of the first symptoms ranged from directly postoperative until 15 years postoperatively (median 3.1 months). Initial treatment modalities comprised antibiotic therapy (n = 8/80%) and transcutaneous aspiration of seroma (n = 3/30%). In the majority of patients, smaller surgical interventions (excision of a necrotic area/fistula [n = 6/60%] or secondary suture [n = 5/50%]) were sufficient to overcome the complication, yet larger interventions such as complex flap surgery and mastectomy were necessary in one patient each.

CONCLUSION

IORT is an efficient and safe treatment method as < 2.5% of all IORT patients experienced major local complications. However, it seems to pose the risk of causing severe local complications that may require lengthy and burdensome treatment. Thorough preoperative counseling, implementation of recommended intraoperative precautions, and high vigilance for first symptoms of complications during follow-up appointments are necessary measures.

Anatomy of the sphenopalatine artery and its implications for transnasal neurosurgery

BACKGROUND

The knowledge of sinonasal vasculature is inevitable in transnasal neurosurgery. We performed an anatomical study on the sphenopalatine artery from the perspective of skull base procedures.

METHODOLOGY

To analyse the anatomical landmarks of the sphenopalatine artery, arterial skull corrosion casts (26 head halves) underwent endoscopic transnasal phantom surgery. Furthermore, we performed microsurgical dissection on formaldehyde-fixated cadavers with arterial perfusion (14 head halves) as well as studied Cone Beam CT-scans of anonymised patients and cadavers (115 head sides).

RESULTS

In our cadaveric material, the sphenopalatine foramen is located at the transition of the superior and middle nasal meatus (95.0%) or in the superior nasal meatus (5.0%). It is the main entry point of the branches of the sphenopalatine artery into the nasal cavity. In most cadaveric cases (25.0%), at this level there are 2 branches superiorly and 1 vessel inferiorly to the ethmoid crest. An average of 2.4 vessels leave the sphenopalatine foramen superiorly to the ethmoid crest, 97.8% of them belong to the sphenopalatine arterys posterior septal branches. An average of 2.1 branches leave the sphenopalatine foramen inferiorly to the ethmoid crest; all of them belong to the posterior lateral nasal branches. There are no cases with a single artery at the plane of the sphenopalatine foramen. We describe a triangular bony structure bordering the sphenopalatine foramen anteriorly which is built up by the palatine and ethmoid bone as well as the maxilla. According to the radiographic studies, this triangular prominence is surrounded superiorly by a posterior ethmoid cell (57.4%), the sphenoid sinus (41.7%) or the orbit (0.9%) with a varying contribution of the superior nasal meatus; inferolaterally by the maxillary sinus (98.3%) or the pterygopalatine and infratemporal fossa (1.7%) and inferomedially by the middle nasal meatus. The medial vertex of the bony triangle corresponds to the ethmoid crest of the palatine bone. In transnasal endoscopic surgery, the posterior lateral nasal branches of the sphenopalatine artery appear at the triangle's inferomedial edge, the posterior septal branches emerge at its superior edge.

CONCLUSIONS

The triangular bony structure is a landmark to find and differentiate the posterior lateral nasal and posterior septal branches of the sphenopalatine artery and to identify the sphenoid sinus.

The breast care nurse: the care specialist in breast centres

BACKGROUND

In Europe, breast cancer is the most common form of cancer in women; 26.5 per cent of all new malignant diseases and 17.5 per cent of all cancer deaths are due to this type of cancer. In Germany, approximately every tenth woman is diagnosed with breast cancer during her lifetime.

OBJECTIVE

In order to increase the quality of life of breast cancer patients, the European Society of Mastology (EUSOMA) requires the availability of, and an integration of qualified and specialized care into the interdisciplinary team. Thus, in Germany, a new type of job profile for 'breast nurse' as a qualified care specialist has to be established and has to be oriented towards the international standards of a breast care nurse (BCN).

METHODS

The Charité's Academy of Health--in cooperation with the Interdisciplinary Breast Centre of the Charité--has offered a career advisory service curriculum for the BCN since 2006 in accordance with the EUSOMA guidelines.

RESULTS

In three courses, 45 BCNs have been trained. In the first refresher seminar in May 2009, the BCNs were given an opportunity to exchange with fellow BCNs their experiences.

CONCLUSION

We were able to set up a new curriculum to train nurses as BCNs as to improve the quality of care for breast cancer patients and to orientate the training towards the international standards of a BCN qualification.