Outcomes of transperineal and transrectal ultrasound-guided prostate biopsy

OBJECTIVE

To compare the clinical outcomes and pathological findings of transperineal ultrasound-guided prostate biopsy (TPUSPB) and transrectal ultrasound-guided prostate biopsy (TRUSPB) in a secondary referral hospital.

METHODS

This was a retrospective study of 100 TPUSPBs and 100 TRUSPBs performed in our centre. Pre-biopsy patient parameters (eg, patient age, clinical staging, serum prostate-specific antigen [PSA] level, prostate size, and PSA density), as well as pathological results and 30-day complication and readmission rates, were retrieved from the patients' medical records and compared between the two groups.

RESULTS

One hundred TPUSPBs performed from January 2018 to May 2018 and 100 TRUSPBs performed from January 2016 to April 2016 were included for analysis. Mean age did not significantly differ between the groups. The TPUSPB group had a higher mean PSA level, smaller prostate size, and higher PSA density, compared with the TRUSPB group. The overall prostate cancer detection rate was similar between the TPUSPB and TRUSPB groups (35% vs 25%, P=0.123). There were no significant differences between the groups in prostate cancer detection rates after stratification according to PSA density and clinical staging. With respect to complications, no patients developed fever in the TPUSPB group, while 4% of patients in the TRUSPB group had fever and required at least 1-week admission for intravenous antibiotic administration.

CONCLUSION

For prostate biopsy, TPUSPB is safer, with no infection complications, and has similar prostate cancer detection rate compared with TRUSPB.

Phenotypic and genotypic characterization of Chinese children diagnosed with tuberous sclerosis complex

We investigated the clinical phenotypes and genetic mutations in Chinese children diagnosed with tuberous sclerosis complex (TSC). Sequencing of TSC1 and TSC2 genes was performed in 117 children with TSC and their parents. Association of TSC gene mutations with clinical manifestations was investigated. All gene mutations were heterozygous including in 16 patients (13.7%) with mutations in TSC1 gene and 101 patients (86.3%) with mutations in TSC2 gene. Among the 16 patients with TSC1 gene mutations, 15 different types of mutations were found, which included 5 novel mutations; all patients had skin manifestations and epilepsy. Among the 101 patients with TSC2 mutations, 85 different types of mutations were found, which included 25 novel mutations; 97 patients (96.0%) had skin manifestations; 97 (96.0%) had epilepsy; 74 (73.3%) had intellectual disability and 25 patients (24.8%) were autistic. The clinical phenotype of the 14 children with familial TSC was more severe than that of their parents.

[Investigation on immunization program coverage rate and its safety in children with tuberous sclerosis]

Objective: To investigate the status of immunization of National Immunization Program (NIP) and its adverse reaction rate in children with tuberous sclerosis. Method: Questionnaire survey was adopted to identify the vaccination coverage and its adverse events; 72 cases of children with tuberous sclerosis and 78 normal controls (healthy children completing age-appropriate NIP) admitted to Chinese People's Liberation Army General Hospital from December 2014 to November 2015 were involved into this study. Result: The age-appropriate NIP coverage rate of tuberous sclerosis was 36%(26/72). The coverage rate of bacillus calmette-guerin (BCG), hepatitis B vaccine 1^st to 3^rd doses (HepB1-3), oral poliovaccine 1^st dose (OPV1), diphtheria, pertussis and tetanus 1^st dose (DPT1), DPT1-3, meningococcal polysaccharide vaccine group A (MPVA), measles amd rubella vaccine/measles vaccine 1^st dose (MRV/MCV1), and Japanese encephalitis vaccine 1^st dose (JEV1) were 100%(72 cases), 75%(51 cases), 97%(66 cases), 91%(62 cases), 82%(56 cases), 66%(45 cases), 69%(42 cases), and 61%(37 cases) respectively. The reasons why the children did not complete the vaccination plan were that parents were concerned about vaccination-induced seizures or seizures had not been controlled. Among 72 children with TSC, the rate of adverse events or suspected adverse events after vaccination was 17% (12 cases), which was higher than the normal control children (2 cases, 3%) (χ²=8.799, P<0.05). The main adverse events were seizure events, which accounted for 92%(11 cases). Conclusion: The age-appropriate NIP coverage rate among children with tuberous sclerosis is low. The high incidence of adverse events may be associated with a fact that there are some nervous system abnormalities in cases with tuberous sclerosis. TSC children vaccination is relatively safe, with no serious adverse events.

[Rapamycin in the treatment of cardiac rhabdomyoma associated with tuberous sclerosis complex]

OBJECTIVE

To assess the efficacy and safety of mammalian target of rapamycin (mTOR) inhibitor rapamycin in treatment of children with cardiac rhabdomyoma, associated with tuberous sclerosis complex (TSC).

METHOD

The clinical data of children with cardiac rhabdomyomas, who had received a diagnosis of TSC previously, were collected between September 2011 and November 2015 from Pediatric Department of the People's Liberation Army General Hospital.Patients in line with the inclusion criteria received long-term treatment with sirolimus.The starting doses of sirolimus was 1 mg/ (m(2)·d), and the plasma concentration was maintained at 5-10 μg/L.The size and number of cardiac rhabdomyomas were analyzed after treatment with rapamycin, and the efficacy and safety were assessed. The Wilcoxon test was used to analyze data.

RESULT

All the 51 children met the inclusion and exclusion criteria, including 30 males and 21 females.The median age for rapamycin treatment was 15.0 months (7.0-35.0 months). Tumors disappeared in 26 (51%) children, decreased by more than 50%(including 50%) in 15 (29%) children, decreased by less than 50% in 5 (12%) children, and had no change or progressed in 4 (8%) children.The number of tumors decreased by 77(72%). The median maximum diameter of tumor was 8.7 (5.9-11.3) mm before treatment, 0.0 (0.0-4.0) mm after treatment, and the median decrease of tumor size were 6.7 (3.9-10.0) mm (Z=-8.817, P<0.01). The median disappearance time was 3.26 (2.92-5.37) months.Among different age groups, after treatment by rapamycin, the rate of tumor's disappearance was 50% (12/24) in 0-1 years group.Tumors disappeared in 10 of 16 patients in >1-3 years group and in 4 of 11 patients in >3 years group.The rate of tumor's disappearance was the highest after 3 months of treatment as compared with 6 and 12 months of treatment.Ten children had adverse event that was related to rapamycin.Canker sore was reported in one child and dyslipidemia was reported in 9 children.

CONCLUSION

Rapamycin is efficacious and well tolerate in treatment of cardiac rhabdomyomas associate with TSC, and lead to a reduction in tumor size and number, in addition, significantly shorten the duration of cardiac rhabdomyoma.

[Analysis of community composition in dental plaque of elder people with root caries]

OBJECTIVE

To analyze the community in dental plaque of elder people with root caries.

METHODS

Total DNAs were extracted from the root caries dental plaques of nine elders over 60 years of age. Polymerase chaid reaction-based denaturing gradient gel electrophoresis (PCR-DGGE) was used to analyze the microbial composition, DGGE bands were excised from the gels for sequencing and identification.

RESULTS

The dominant genus in root caries dental plaque of elder people were: Acinetobacte [0.9% (1/114)], Actinobaculum [1.8% (2/114)], Actinomyces [15.8% (18/114)], Aggregatibacter [0.9% (1/114)], Capnocytophaga [14.0% (16/114)], Corynebacterium [0.9% (1/114)], Haemophilus [0.9% (1/114)], Mobiluncus [0.9% (1/114)], Naxibacter [0.9% (1/114)], Neisseriaceae [10.5% (12/114)], Porphyromonas [0.9% (1/114)], Prevotella [12.3% (14/114)], Selenomonas [6.1% (7/114)], Staphylococcus [1.8% (2/114)], Oralis streptococcus [6.1% (7/114)], Mutans streptococcu [7.9% (9/114)], Tannerella [0.9% (1/114)], Treponema [1.8% (2/114)], Veillonella [10.5% (12/114)] and two uncultured unknown genus [1.8% (2/114)]. Uncultred genotypes accounted for 19.30% of the total. Gram-positive bacteria genotype accounted for 31.6% (36/114), and Gram-negative bacteria genotype accounted for 66.7% (76/114).

CONCLUSIONS

There were many bacteria genotypes in root caries dental plaque in the elderly, which were widely distributed. Gram-negative bacteria accounted for the majority. Genotype-specific pathogenic bacteria were not found.

[Observation of genetic diversity in dental plaque of elder people with root caries]

PURPOSE

Bacterial community in dental plaque of elder people was analyzed to learn about the microhabitat composition and diversity.

METHODS

Dental plaque samples were collected from 25 elders. PCR-based denaturing gradient gel electrophoresis (PCR-DGGE) was used to evaluate the microbial diversity by displaying PCR-generated 16SrDNA fragments that migrate at different distances, reflecting the different sequence of fragment. SPSS12.0 software was used to analyze the variance of genotypes between different groups of bacteria.

RESULTS

Genotypes of bacteria in dental plaques in the root caries group was significantly more than the other two groups. Crown caries group and caries-free group had no significant difference.

CONCLUSIONS

The genetic diversity of the dental plaque microflora in the root caries group is significantly higher than coronal caries group and caries-free group.

[Quantitative evaluation of residual endodontic microorganisms after mechanical root canal preparation different chemical preparations by real-time PCR]

PURPOSE

To establish a quick, sensitive method for quantifying root canal flora and investigate the effects of different root canal preparations on the pathogenic bacteria at RNA level.

METHODS

A total of 24 single-rooted teeth with chronic apical periodontitis were selected and prepared using 3% H2O2 combined with 1% NaClO, EDTA combined with 3% H(2)O(2),1% NaClO, respectively,the samples were taken before and after root canal preparation. After isolation of total RNA from the root canal samples, cDNA was synthesized by reverse transcription, and detected by real-time PCR. The data were analyzed with SAS 6.12 software package.

RESULTS

The number of bacteria in the root canal reduced dramatically after mechanical preparation and irrigated using 3% H(2)O(2) and 1% NaClO(P<0.01). Further combined with EDTA, its effect was better than that of simply irrigated using 3% H(2)O(2) and 1% NaClO(P<0.05).

CONCLUSIONS

Real-time PCR can be employed in the identification of bacteria flora in the root canal, both methods of root canal preparation can effectively reduce the number of bacteria flora.

[Comparison of the sucrose dependent cell adherence of Streptococcus mutans isolates from caries-active and caries-free children]

PURPOSE

To study the sucrose dependent cell adhesive ability of Streptococcus mutans islolated from the caries-active and caries-free children.

METHODS

60 isolated Streptococcus mutans strains were selected and identified from the dental plaque of 10 caries-active children and 10 caries-free children (3 to 5 years), in which 39 strains were from caries-active group(dmfs>or=6) and 21 strains from caries-free group(dmfs=0). With the use of ultraviolet spectrophotometer, the sucrose dependent cell adherence to glass wall of the sucrose-containing testing tubes was analyzed. One-way ANOVA was used by SPSS12.0 software package to determine the statistical difference of the adhesive ability between the two groups.

RESULTS

The average adhesive ratio of the Streptococcus mutans strains isolated from caries-active group was 55.49%+26.16% in the 1% sucrose-containing culture medium, while the average adhesive ratio of the Streptococcus mutans strains isolated from caries-free group was 27.01%+18.39%. The difference between the two groups was statistically significant (P<0.01).

CONCLUSION

In the sucrose-containing circumstance, the sucrose dependent cell adhesive ability of the Streptococcus mutans isolated from the caries-active children was significantly higher than that from the caries-free children. This indicated that the adhesive ability may be related to the caries-causing tendency.

[In vitro evaluation of the sealing ability of an iodoform-calcium phosphorate cement root canal filler]

PURPOSE

To evaluate the sealing ability of an injectable iodoform-calcium phosphate cement(CPC) root canal filler in vitro.

METHODS

Sixty-two single-rooted human extracted teeth were selected and root canals were instrumented to 40# with K file. Fifty-eight teeth were randomly divided into two experimental groups. The root canals were filled by lateral condensation of gutta-purcha with iodoform-CPC or zinc-oxide-eugenol-iodoform paste used as sealer respectively. Other four teeth were used as control. When the sealer was solidified, the apical portion of tooth was soaked into 2% methylene blue for 6 days. After the tooth was longitudinally sectioned, the dye length was measured for apical microleakage.The data obtained were analysed with group t test.

RESULTS

The average microleakage in iodoform-CPC group(8.400mm) was significantly larger than that in the control group(5.300mm), P=0.021.

CONCLUSIONS

We conclude that iodoform-CPC does not provide a sealing ability as good as zinc-oxide-eugenol-iodoform paste in vitro.

[Preliminary evaluation of the clinical results of calcium phosphorate cement root canal sealer]

PURPOSE

To investigate the clinic effect of calcium phosphorate cement as a root canal sealer-filler material.

METHODS

136 teeth with chronic periapical disease were instrumented and obturated with laterally condensed gutta-percha and either calcium phosphate cement(CPC) or iodoform paste. The patients were recalled and observed according to the clinic symptom and radiography after 1 week,3 months, 6 months and 1 year. The data was processed using SAS6.2 software package for Chi-square test and Wilcoxon rank test.

RESULTS

The patients of CPC group had mild reaction after treatment and the successful rate of 3-month was higher compared with the control group(with iodoform paste), however there was no different clinical effects between the two groups after one year.

CONCLUSION

Calcium phosphate cement root canal sealer can be acceptable for root canal filling , but the long term clinical results are needed be investigated.

Effects of pregnant mare serum gonadotropin (eCG) on follicle development and granulosa-cell apoptosis in the pig

The effect of eCG on follicular development and granulosa-cell apoptosis in sexually mature and immature gilts and on granulosa-cell apoptosis in vitro were studied. The sexually mature gilts were treated with eCG on Day 11 of the estrous cycle, and effects were analyzed at different times after treatment with untreated animals at corresponding stages of the cycle as controls. Apoptosis was determined by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL), hematoxylin and eosin staining, and DNA ladder. The proportion of apoptotic cells in atretic follicles (39%) was significantly higher (P<0.01) than that in healthy follicles (9%). At 24h after eCG treatment in mature gilts, the total number of follicles visible on the ovarian surface (57 per ovary), the number of small (<3mm) follicles (31.5 per ovary) and the number of medium-sized (3-5mm) follicles (23 per ovary) were significantly higher (P<0.05) than those of control animals (28, 20 and 6.5 per ovary, respectively), and declined gradually thereafter to below the level of control animals. The number of large (>or=5mm) follicles began to show a marked increase at 72h after eCG (8.5 versus 2.5, P<0.05). At 24h after eCG treatment, the proportions of apoptotic cells in small (7.2%) and medium-sized follicles (7.4%) were markedly lower (P<0.01) than those in controls (21.5 and 21%, respectively) and increased gradually thereafter to approach the level in controls. The percentage of apoptotic cells in large follicles (10% at 24h post-eCG) did not change significantly. Before eCG treatment, there were markedly fewer follicles of all types on ovaries of immature gilts than of mature gilts (9 versus 25 per ovary) and the proportion of apoptotic cells in small and medium follicles was high (25 and 34%, respectively). After eCG treatment, the changes in follicle number and proportion of apoptotic cells in the immature gilts followed a similar pattern to that of the mature gilts. Equine chorion gonadotropin inhibited apoptosis of granulosa cells cultured either in vitro or in intact follicles in a dose-dependent manner. Thus, follicular atresia in the pig, as in other animals, was characterized by apoptosis of large numbers of granulosa cells, and eCG promoted follicular development by inhibition of granulosa-cell apoptosis.

Specificity of reinnervation and motor recovery after interposition of an artificial barrier between transected and repaired nerves in adjacency--an experimental study in the rat

Non-specific re-innervation of target organs caused by misdirected axonal growth at the repair site is regarded as one reason for a poor functional outcome after peripheral nerve transsection and repair. This study investigates the rate of aberrant re-innervation and its influence on motor recovery in the rat sciatic nerve using artificial sheets as barrier between tibial and peroneal nerves. The sciatic nerve was transsected and repaired as follows: epineural sutures (A x 6), fascicular repair of tibial and peroneal nerves respectively (B x 8), and the same as in group B, but separating both nerves using an Integra-sheet with silicone (C x 8), or Integra without silicone (D x 8). As control, solely the tibial nerve was transsected and repaired (E x 5). Final investigations after 4 months revealed that in group C, 50% of the Integra-silicone sheets were dislocated. No dislocation was found in group D. Muscle contraction force of the gastrocnemius muscle was significantly higher in group E as compared to all other groups. However although not significant, group D showed a consistently higher muscle contraction force than groups A, B, and C. Histology in groups A, B, and C with dislocated sheets demonstrated multiple axons growing from the tibial to the peroneal nerve and vice versa. In groups D and E, no such axonal growth was visible. These findings were confirmed by a significantly higher rate of specific reinnervation of the soleus muscle using sequential retrograde double labelling technique. Results of this study suggest that an artificial sheet such as Integra bears the potential of preventing aberrant re-innervation between repaired adjacent nerves resulting in improved motor recovery. Clinically, this technique may be of importance for brachial plexus, sciatic nerve, and facial nerve repair.

Differential regulation of alternatively spliced endothelial cell myosin light chain kinase isoforms by p60(Src)

The Ca(2+)/calmodulin-dependent endothelial cell myosin light chain kinase (MLCK) triggers actomyosin contraction essential for vascular barrier regulation and leukocyte diapedesis. Two high molecular weight MLCK splice variants, EC MLCK-1 and EC MLCK-2 (210-214 kDa), in human endothelium are identical except for a deleted single exon in MLCK-2 encoding a 69-amino acid stretch (amino acids 436-505) that contains potentially important consensus sites for phosphorylation by p60(Src) kinase (Lazar, V., and Garcia, J. G. (1999) Genomics 57, 256-267). We have now found that both recombinant EC MLCK splice variants exhibit comparable enzymatic activities but a 2-fold reduction of V(max), and a 2-fold increase in K(0.5 CaM) when compared with the SM MLCK isoform, whereas K(m) was similar in the three isoforms. However, only EC MLCK-1 is readily phosphorylated by purified p60(Src) in vitro, resulting in a 2- to 3-fold increase in EC MLCK-1 enzymatic activity (compared with EC MLCK-2 and SM MLCK). This increased activity of phospho-MLCK-1 was observed over a broad range of submaximal [Ca(2+)] levels with comparable EC(50) [Ca(2+)] for both phosphorylated and unphosphorylated EC MLCK-1. The sites of tyrosine phosphorylation catalyzed by p60(Src) are Tyr(464) and Tyr(471) within the 69-residue stretch deleted in the MLCK-2 splice variant. These results demonstrate for the first time that p60(Src)-mediated tyrosine phosphorylation represents an important mechanism for splice variant-specific regulation of nonmuscle MLCK and vascular cell function.

Interposition of a pedicle fat flap significantly improves specificity of reinnervation and motor recovery after repair of transected nerves in adjacency in rats

Despite highest standards in nerve repair, functional recovery following nerve transection still remains unsatisfactory. Nonspecific reinnervation of target organs caused by misdirected axonal growth at the repair site is regarded as one reason for a poor functional outcome. This study was conducted to establish a method for preventing aberrant reinnervation between transected and repaired nerves in adjacency. Rat sciatic nerve was transected and repaired as follows: epineural sutures of the sciatic nerve (group A, n = 6), fascicular repair of tibial and peroneal nerves respectively (group B, n = 8), and, as in group B, separating both nerves using a pedicle fat flap as barrier (group C, n = 8). As control only, the tibial nerve was transected and repaired (group D, n = 5). Muscle contraction force of the gastrocnemius muscle was significantly higher in group C as compared with groups A and B after 4 months. Muscle weight showed significantly lower values in group A as compared with groups B, C, and D. Histologic examination in group C revealed little growth of axons from the tibial to the peroneal nerve and vice versa. This axon crossing was observed only when gaps between the fat cells were available. These findings were confirmed by a significantly lower rate of misdirected axonal growth as compared with groups A and B using sequential retrograde double labeling technique of the soleus motoneuron pool. We conclude that a pedicle fat flap significantly prevents aberrant reinnervation between repaired adjacent nerves resulting in significantly improved motor recovery in rats. Clinically, this is of importance for brachial plexus, sciatic nerve, and facial nerve repair.

Role of the target in end-to-side neurorrhaphy: reinnervation of a single muscle vs. multiple muscles

The authors examined the effects of end-to-side neurorrhaphy for reinnervation of the musculocutaneous nerve (Group A) which innervates the biceps muscle, compared to reinnervation of the median nerve which innervates multiple muscles in a rat model. Additionally, end-to-end neurorrhaphy to the musculocutaneous nerve using one-third of the median nerve (Group B) was investigated. End-to-end coaptation of the musculocutaneous nerve served as a control (Group C). In a grooming test, the biceps muscle function in Group A animals demonstrated a slower but nearly similar good recovery to Groups B and C. Biceps muscle contraction force investigated after 24 weeks demonstrated no statistically significant differences among all groups. In Groups A and B, no significant impairment of the donor median nerve function was found in a grasping test and the muscle contraction force of the flexor carpi radialis muscle, and histologic evaluation of the musculocutaneous nerve showed multiple regenerated axons distal to the coaptation site. Retrograde double-labeling in Group A animals showed reinnervation of the musculocutaneous nerve by median nerve axons located at the coaptation site. These results validate that end-to-side neurorrhaphy to a nerve innervating a single muscle is more efficient than to a nerve innervating multiple muscles, as demonstrated in an earlier study. The reason for this phenomenon is most likely that all sprouting axons are directed toward one target rather than toward multiple targets, with the latter situation resulting in a smaller number of axons and a variable distribution of axons per target. Since donor nerve sprouting axons were observed at the coaptation site, a relevance of the selected site for end-to-side neurorrhaphy is suggested. Both end-to-side neurorrhaphy and end-to-end neurorrhaphy, using one-third of the median nerve, led to useful functional recovery in this rat model, if an agonistic donor nerve is employed.

Nerve transfer to the median nerve using parts of the ulnar and radial nerves in the rabbit--effects on motor recovery of the median nerve and donor nerve morbidity

In this study, motor re-innervation of the median nerve by transfer of one-third, one-half, and two-thirds of either the agonistic ulnar nerve or the antagonistic radial nerve was investigated in both extremities of 20 rabbits. Recipient median nerve: Muscle contraction force of the flexor digitorum sublimus muscle after a one-third and a one-half of the ulnar nerve transfer achieved an average of 75 and 97% muscle power respectively as compared to conventional end-to-end neurorrhaphy. Muscle contraction force after one-third or one-half of the radial nerve transfer was significantly lower (36%). Donor nerves: Extensor carpi radialis muscle or flexor carpi ulnaris muscle contraction force 6 months postoperatively demonstrated a significant decrease after a one-half ulnar nerve and a two-thirds ulnar or radial nerve transfer, but not after a one-third transfer of either radial or ulnar nerves. Histologically, the number of axons in the re-innervated median nerve and both donor nerves distal to the coaptation site seemed to follow variable patterns. It was concluded that in the rabbit use of one-third of the agonistic ulnar nerve for re-innervation of the median nerve results in useful motor recovery with negligible donor site morbidity. Clinically, this technique may offer an alternative option for proximal nerve injuries or for free functioning muscle transplantations.

Selection of donor nerves--an important factor in end-to-side neurorrhaphy

We have examined the effects of end-to-side neurorrhaphy on peripheral nerve regeneration using the median nerve as recipient nerve and either the antagonistic radial nerve or the agonistic ulnar nerve as donor nerves in rat upper limbs. A perineural window was created in all cases. Motor recovery up to 16 weeks postoperation was tested with the grasping test. No recovery of motor function was evident after end-to-side neurorrhaphy of the median nerve to the antagonistic radial nerve, whereas six of eight rats with end-to-side neurorrhaphy to the agonistic ulnar nerve achieved 367 g +/- 47 g grasping power as compared to 526 g +/- 6 g in end-to-end coapted control animals. No significant difference in flexor digitorum sublimus-motor nerve conduction velocity was found among all three groups. Radial nerve stimulation produced simultaneous contraction of both extensor and flexor muscles of the lower arm that disabled any coordinated movement of the paw. Histology (toluidine blue, acetylcholinesterase-stain) showed multiple regenerated (motor)-axons distal to the coaptation site in the median nerve. Reinnervation of the median nerve solely by the respective donor nerve was demonstrated by a retrograde double labelling technique. These results show that averaged 70% muscle power as compared to end-to-end neurorrhaphy with well coordinated muscle function can be achieved by axonal sprouting through end-to-side neurorrhaphy if an agonistic nerve is used as donor nerve. However, satisfying results are unpredictable. Antagonistic nerves show the ability to induce axonal regeneration, but no useful function can be expected.

Effects of Systemically Applied IGF-1 on Motor Nerve Recovery After Peripheral Nerve Transection and Repair in the Rat - A Functional Study

The trophic effects of systemically applied Rh insulin-like growth factor-1 (rhIGF-1) on peripheral motor nerve regeneration following transection and epineural repair in rats median nerve have been examined. RhIGF-1 (0.5 mg/kg/rat) was administered subcutaneously to the neck region of the repaired side for 14 days post-operation. Motor recovery was tested with the grasping test that is an objective quantitative behavioural assessment of regeneration of the rats median nerve. Muscle twitch tension and muscle weight were measured in the flexor digitorum sublimus muscle. No significant differences between experimental and control animals regarding onset of muscle function, recovery of muscle power, and muscle weight were found. These results demonstrate that subcutaneously applied rhIGF-1 cannot improve functional motor recovery after nerve transection and repair in the rat as has been demonstrated after nerve crushing injury. This is regarded as a consequence of specificity failure during reinnervation, which occurs after nerve transection and repair, whereas after crushing injury specific reinnervation is a common feature.

Effects of insulin-like growth factor-1 in motor nerve regeneration after nerve transection and repair vs. nerve crushing injury in the rat

Despite highest standards in nerve repair, functional recovery following nerve transection still remains unsatisfactory. Non-specific re-innervation of target organs are regarded as one reason for a poor functional outcome. Insulin-like growth factor-1 (IGF-1) has demonstrated promoting effects on sciatic nerve regeneration after crushing injury. Similarly, IGF-1 has shown a direct inductive effect on motoneuron growth associated protein-43 (GAP-43) which is believed to play a role in axon guidance during development. Based on this fact we have examined the trophic effects of recombinant human IGF-1 on peripheral motor nerve regeneration following transection and epineural repair in rats median nerve. RhIGF-1 (0.5 mg/kg/rat) was administered subcutaneously to the neck of the repaired side for 14 days postoperation. Accuracy of re-innervation of the flexor carpi radialis muscle motoneuron pool was studied by sequential retrograde double labelling technique. Motor recovery was tested with the grasping test. No significant differences between experimental and control animals in accuracy of re-innervation and in recovery of muscle power could be demonstrated. Non-specific re-innervation of the flexor carpi radialis muscle was found in 23.2% in the experimental group and in 24.2% in the control group. These results demonstrate that systemically applied rhIGF-1 failed to improve functional motor recovery after nerve transection and repair in the rat as it was demonstrated after nerve crushing injury in several studies. Furthermore, systemically applied IGF-1 did not improve accuracy of re-innervation after axotomy and repair in adult rats.

In vitro and in vivo photosensitizing capabilities of 5-ALA in vascular endothelial cells

BACKGROUND

The object of our study is to evaluate the feasibility of photodynamic therapy for complicated hemangiomas. We studied the effect of the photosensitizing agent 5-aminolevulinic acid (5-ALA) in both in vitro and in vivo models.

METHODS

The in vitro photosensitizing activity of 5-ALA was examined in a microvascular endothelial cell (MEC) culture system. 5-ALA was added in various concentrations and the cells were illuminated at 630 nm. The percentage of MEC killed was measured by either a Live/Dead assay or an lactate dehydrogenase (LDH) assay. The effect of varying the light energy dose delivered at 630 nm after the administration of 5-ALA was studied by determining the amount of necrosis produced in chicken combs.

RESULTS

The combination of 5-ALA at a concentration of 35 micrograms/ml, and illumination by 100 mW/cm2 of laser light at 630 nm wavelength, caused 50% cell kill in the MEC culture system. Chicken combs of animals that received 200 mg/kg of 5-ALA and illumination at a power density of 80 mW/cm2 had a depth of injury of 362.5 +/- 27.6 microns upon histological examination. Those combs that received 100 or 120 mW/cm2 showed a depth of injury of 732.5 +/- 29.1 and 792.5 +/- 36.0 microns respectively.

CONCLUSION

5-ALA is effective in sensitizing human MEC to laser illumination. However, the degree of absorption and tissue destruction in different anatomical structures should be considered in future clinical studies.

Thrombin induces thrombomodulin mRNA expression via the proteolytically activated thrombin receptor in cultured bovine smooth muscle cells

Thrombin, an important mitogen governing smooth muscle cell proliferation, binds to cultured bovine aortic smooth muscle cells (BASMCs) via both the proteolytically activated thrombin receptor (PATR) and thrombomodulin (TM). Although TM mRNA expression and functional activity is regulated by thrombin in human endothelial cells and mouse hemangioma cells, it remains unclear in those models whether the increased TM mRNA expression observed upon thrombin stimulation is mediated through the activation of PATR or via TM occupancy. We observed in cultured BASMCs that TM mRNA is increased threefold to sixfold by either thrombin, basic fibroblast growth factor (bFGF), or platelet-derived growth factor (PDGF). The increase in TM mRNA with thrombin is time dependent (maximal at 3 hours), a consequence of increased mRNA stability, and accompanied by increases in cell surface TM functional activity. Thrombin-induced TM mRNA was reproduced by the hexameric thrombin receptor-activating peptide (TRAP6) and augmented by a TM-specific antibody. Together, these data suggest that up-regulation of TM mRNA by thrombin is mediated via the PATR. We speculate that increases in BASMC TM mRNA and activity after thrombin may contribute to the impaired thrombus formation observed after atherosclerotic vascular injury.

Detection of human papillomavirus DNA in biopsy-proven cervical squamous intraepithelial lesions in pregnant women

This study analyzed cervical squamous intraepithelial lesions (SILs) in pregnant women for human papillomavirus (HPV) using in situ hybridization analysis. HPV DNA was detected in 77% (23/30) of low-grade SILs as compared to 89% of such lesions in nonpregnant women. The detection rate in high-grade SILs was 41% (9/22) compared to 70% in nonpregnant women. Analysis by the polymerase chain reaction showed that the detection rates were similar (96-100%) for low- and high-grade lesions in pregnant and nonpregnant women, which demonstrates that in situ negative tissues indeed contained HPV DNA. Low-grade SILs contained a heterogeneous group of at least 14 different HPV types, whereas most high-grade SILs contained HPV 16. We concluded that cervical SILs in pregnant women are invariably associated with HPV. Further study is needed to determine which of several possible variables, such as the age of the lesion and the viral copy number, may explain the apparent decreased detection rate of HPV by in situ hybridization in SILs during pregnancy.

The distribution of serum albumin in the rat testis, studied by electron microscope immunocytochemistry on ultrathin frozen sections

The distribution of serum albumin is of interest in the rat testis because this protein is the principal carrier for testosterone in the plasma and interstitial fluid of this species. We have localized extravascular serum albumin in the rat testis at the electron microscope level, using gold particle immunocytochemistry on ultrathin frozen sections of tissue fixed lightly by perfusion. The same localization was obtained with three different antisera. Preabsorption and normal rabbit serum controls were negative, and Western blots of testis extracts showed major activity only at the molecular weight of albumin. Serum albumin occurred in substantial concentration throughout extracellular space in the interstitial tissue, as well as in the space between the boundary layer and the base of the seminiferous epithelium. Immunoreactivity extended between Sertoli cells, as well as around spermatogonia and early primary spermatocytes (to stage 11), but did not traverse the Sertoli-Sertoli junctions that comprise the blood-testis barrier. Macrophages in the interstitial tissue showed some endocytic activity. If perfusion fixation was carried out in a manner that flushed most of the albumin from the interstitial space, then a layer of albumin remained on the surface of Leydig cells and many macrophages but was minimal or absent on the surface of other cell types that are normally in contact with albumin, such as Sertoli cells, spermatogonia, myoid cells, lymphatic endothelium, fibroblasts, or cells of blood vessels.

Time-lapse microcinematographic and phase contrast studies on the cell reformation of Chirocephalus yolk granules in vitro

In this article we report on a time-lapse microcinematographic and phase contrast study of the cell reformation of yolk granules which were isolated from mature oocytes in the genital sac of the middle female intersex of Chirocephalus nankinensis. The observations on yolk granules were made in fixed positions and the morphological changes of cell reformation were continuously recorded in vitro. The transformation of yolk granules into cellular structures may be tentatively described as follows: At the early stages in culture, it can be seen that the granular or bubbly structures gradually appear within the hyaloid and homogeneous yolk granules; the appearance of yolk granules gradually changes from elliptical into round shape. With further transformation, their appearances in general take the shape of oblate spheroids, their size is smaller than before and inside the yolk granules their granular and bubbly structures become more and more obvious. Finally, the nuclear and cellular structures can be seen in these transforming yolks. By means of time-lapse microcinematographic and phase contrast examinations in fixed positions, single yolk granules obtained from the mature oocyte with little amounts of adhering cytoplasm are continuously recorded and have been shown to occur, steadily and gradually build up cellular structures by self-organization and self-assembly. Up to the present, we have cultured these kinds of cellular organizations repeatedly. Therefore, it can be concluded that the existence of cell reformation on the basis of yolk granules according to the dynamic morphological changes is an objective reality.