Effective reduction of neuronal death by inhibiting gap junctional intercellular communication in a rodent model of global transient cerebral ischemia

Gap junctions assemble astrocytes into syncytia, allowing exchange of metabolites, catabolites, and second-messenger molecules. Connexin43 is the predominant connexin of astrocytic gap junctions. The distribution of gap junction protein connexin43 was analyzed in different subfields of the hippocampal formation as a function of time after transient forebrain ischemia. One decisive key step in understanding why an ischemic insult gradually expands may be to establish how gap junction channels permit dying cells in the ischemic focus to communicate, in particular, with viable cells. The role of gap junctional intercellular communication in the hippocampus under ischemic conditions could be decisive for cell death propagation. We found that the vulnerable CA1/CA2 subfields have a higher density of gap junctions than the resistant CA3/CA4 areas, that changes in the distribution of connexin43 immunoreactivity may correlate with the phenomenon of selective vulnerability, and that inhibition of astrocytic gap junction permeability by octanol restricts the flow of undesirable neurotoxins that could potentially exacerbate neuronal damage. This provides a novel perspective for analysis of the pathophysiology of cerebral ischemia.     

Safety and efficacy of pallidal or subthalamic nucleus stimulation in advanced PD

The authors retrospectively compared 1-year results of bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN; n = 16) and internal pallidum (GPi) (n = 11) in advanced PD and found about equal improvements in "off" period motor symptoms, dyskinesias, and fluctuations. STN stimulation reduced medication requirements by 65% and required significantly less electrical power. These advantages contrasted with a need for more intensive postoperative monitoring and a higher incidence of adverse events related to levodopa withdrawal.     

Geschwisterpaar italienischer Abstammung mit Hyperferritinämie und Katarakt

Zusammenfassung Ein beschwerdefreies Geschwisterpaar italienischer Abstammung wurde zum Ausschluss einer H?mochromatose bei erh?hten Serumferritinspiegeln vorgestellt. Bei beiden war bereits eine Kataraktoperation durchgeführt worden, wie auch bei der Mutter. Die augen?rztliche Untersuchung ergab auch bei 2 der 5 Kindern der betroffenen Geschwister eine Katarakt. K?rperliche Untersuchung und Laborbefund waren bis auf eine deutliche Hyperferritin?mie unauff?llig, histologisch wurde eine H?mochromatose ausgeschlossen. Die PCR-Amplifikation und -Sequenzierung des „Iron responsive element” (IRE) im 5′ regulatorischen Bereich des Ferritin-Leichtkettengens ergab eine Punktmutation im „Stamm” des IRE als molekulare Grundlage des dominant vererbten „heredit?ren Hyperferritin-Kataraktsyndroms”. Die Kasuistik soll diese Differentialdiagnose der heredit?ren Hyperferritin?mie exemplarisch darstellen. Das Hyperferritin-Kataraktsyndrom konnte bisher in einzelnen Familien italienischer, franz?sischer aber auch englischer Herkunft nachgewiesen werden. Aufgrund der Kontraindikation einer Aderlasstherapie und zur Füherkennung der Kataraktbildung in den betroffenen Familien hat sie jedoch als Differentialdiagnose Bedeutung. Die Diagnose kann durch Anamnese, Bestimmung des Serumferritins und augen?rztliche Untersuchung gestellt und durch molekulargenetische Untersuchung, also ohne invasive Ma?nahmen gesichert werden. Ferner stellt sich im Hyperferritin-Kataraktsyndrom exemplarisch ein neuer Pathomechanismus dar, der in Zukunft an Bedeutung gewinnen k?nnte.     

Computer graphics for digitally formatted images

The increasing use of digitally formatted imaging systems requires high-quality interactive gray-scale computer raster graphics systems for the management, display, and analog film recording of digital image and alphanumeric information. These systems are a combination of computer hardware and software and implement a set of graphics protocols. This paper describes a set of interactive graphics protocols that has been developed for clinical use.     

Parathyroid adenomas evaluated by Tl-201/Tc-99m pertechnetate subtraction scintigraphy and high-resolution ultrasonography

Thallium-201/technetium-99m pertechnetate subtraction scintigraphy of the parathyroid glands was performed in a prospective study of 33 patients who had undergone bilateral neck exploration for elevated serum calcium and serum parathyroid hormone levels. In 31 cases, the Tl-201/Tc-99m subtraction technique yielded an overall sensitivity of 81%, specificity of 99%, and accuracy of 94% for identifying solitary parathyroid adenomas. Tl-201/Tc-99m subtraction scintigraphy correctly identified 73% of parathyroid adenomas weighing less than 499 mg, 79% of those weighing 500-1,499 mg, and 100% of adenomas weighing more than 1,500 mg. In a subgroup of 24 patients with solitary parathyroid adenomas who underwent both scintigraphy and high-resolution sonography, the sensitivity, specificity, and accuracy of both procedures were similar.     

Effect of subthalamic deep brain stimulation on the function of the urinary bladder

Detrusor hyperreflexia is a relevant clinical symptom for patients suffering from Parkinson's disease. In a series of 16 patients, we demonstrated that subthalamic deep brain stimulation has a significant and urodynamically recordable effect leading to a normalization of pathologically increased bladder sensibility.     

Long-term results of bilateral pallidal stimulation in Parkinson's disease

We followed up 11 patients for up to 5 years after bilateral pallidal deep brain stimulation for advanced Parkinson's disease. Dyskinesias remained significantly reduced until the last assessment. The initial improvement of off-period motor symptoms and fluctuations, however, was not sustained and gradually declined. Beneficial effects of pallidal deep brain stimulation on activities of daily living in the on- and off-period were lost after the first year. Replacement of pallidal electrodes into the subthalamic nucleus in four patients could restore the initial benefit of deep brain stimulation and allowed a significant reduction of dopaminergic drug therapy.     

Prognostic value of antibodies against p53 in patients with oral squamous cell carcinoma--five years survival rate

BACKGROUND: p53 gene aberrations are the most common genetic changes seen in human carcinogenesis. Frequently, single point mutations are detected, resulting in increased levels of (an aberrant) p53 protein in tumor cells. The cellular protein produced appears to become immunogenic during tumor development, inducing the production of circulating antibodies against p53. METHODS: For this study, sera from 126 patients with oral squamous cell carcinomas (102 primary tumours and 24 recurrent/secondary tumours) were examined for p53 autoantibodies and their further clinical course was followed up for more than 5 years. 80 sera from internal medicine patients without known or suspected neoplasm served as control. A sandwich ELISA (enzyme linked immuno sorbent assay) designed by Dianova, Hamburg was used to detect p53 autoantibodies. RESULTS: In 18.6 % of the patients with primary oral squamous cell carcinomas, p53 autoantibodies were detected, and also in 50 % of the patients with recurrent or local secondary carcinomas. None of the sera of the control group was positive. Patients with anti-p53 have noticeably poorer prognosis (Log Rank Test, p < 0.005). After a period of 5 years, the overall survival rate of the p53-positive group was 24 % - less than half of that of the p53-negative group with a survival rate of 51 %. CONCLUSIONS:: The detection of p53 autoantibodies definitely permits a clearer prognostic assessment, which in turn influences clinical procedures. If p53 autoantibodies are detected in a patient during therapy, the applied therapeutic method should be reconsidered and the patient be more closely observed than other, p53 negative patients.