Experience with the iodine-123 and technetium-99m labelled anti-granulocyte antibody MAb47: a comparison of labelling methods

Four different methods of radiolabelling the anti-granulocyte monoclonal antibody MAW were compared and their influence on diagnostic value studied. The best clinical images were obtained following labelling with iodine-123 by the Iodogen method and direct labelling with technetium-99m after tris-(carboxyethyl)-phosphine treatment of MAW to achieve disulphide bridge reduction.^99mTc labelling using a specific ligand (MAb47-mtp), or a second method involving direct reduction with mercaptoethanol, led to an increased background activity in clinical studies, thus impeding the diagnosis of chronic disease. Fresh infections were clearly localized by all four preparations. The elimination of the activity from the blood was slower in the case of the iodinated MAb47, while the collected urine samples showed an excrection of about 10% of the injected activity per day independent of the labelling method. The results in terms of sensitivity and specificity were rather similar for all labelling methods and ranged from 90% to 99%.     

Cluster headache. Local anesthetic abortive agents

Cocainization of the sphenopalatine fossa region has been shown to abort acute cluster headaches rapidly. Whether this response occurs by sympathomimetic action or via local anesthetic effect has been unknown. In this study, lidocaine hydrochloride was given as a therapeutic abortive agent to patients with cluster headache to elucidate cocaine's mechanism of action in relieving symptoms and to search for a safe, nonaddicting agent for self-administration. Using a 4% lidocaine solution applied to the sphenopalatine fossa, four of five patients obtained rapid relief of nitrate-induced cluster headaches and associated signs. Lidocaine was also effective in relieving spontaneous attacks. These results indicated that anesthetic rather than sympathomimetic effects are responsible for cocaine-medicated abortion of cluster headache, that transmission of pain in cluster headache likely occurs via the sphenopalatine fossa, and that topical lidocaine is effective in rapidly aborting acute cluster headache.     

Brain gangliosides in birds with different types of postnatal development (nidifugous and nidicolous type)

Developmental profiles of 14 different brain gangliosides were followed from the first day after hatching to the adult stage in two bird species representing different strategies of posthatch development: the nidifugous type (leaving the nest directly post-hatch, e.g. quail) and the nidicolous type (remaining for longer period in the nest, e.g. finch). In the zebra finch, parallel with a striking increase in ganglioside concentration, two main postnatal changes in the ganglioside composition occurred: after hatching, concomittantly to an increased outgrowth of nerve fibers and synaptogenesis, the polysialogangliosides GQ1b and GP decreased in favour of the less polar fractions GD1b, GD1a and GT1b. The second period of changes started with the onset of myelination and was characterized by an increase of GM1 and GM1'. The results obtained for quails were in close agreement with those of chicken, showing only slight postnatal changes due to the nearly completed morphological differentiation. These data show that gangliosides are useful biochemical markers for brain development, indicating successive periods of brain maturation by means of preferential biosynthesis of specific fractions regardless of the type of development.     

Lumbar dorsal root ganglia of the cat: a quantitative study of peptide immunoreactivity and cell size

The purpose of the present study was to quantify the extent to which several peptides and serotonin coexist with substance P or somatostatin in selected lumbar dorsal root ganglia of the cat. The technique for the simultaneous visualization of two antigens by immunofluorescence was used to investigate the coexistence of neuropeptides in the lumbar dorsal root ganglia of colchicine-treated cats. Perikarya immunoreactive for calcitonin gene-related peptide, galanin, leu-enkephalin, somatostatin, and substance P were visualized in both the lumbar 5 and 6 dorsal root ganglia. In contrast, no immunoreactivity was observed for adipokinetic hormone, bombesin, dynorphin A, met-enkephalin, oxytocin, tyrosine hydroxylase, thyrotropin-releasing hormone, vasopressin, vasoactive intestinal peptide, or serotonin in either ganglion examined. Substance P coexisted with calcitonin-gene-related peptide, somatostatin, and leu-enkephalin. Somatostatin was colocalized with calcitonin gene-related peptide, leu-enkephalin, and substance P but coexisted with galanin minimally. The cell area of immunoreactive perikarya was also examined. Data concerning the cross-sectional area of immunoreactive cells indicated that somatostatin-immunoreactive perikarya were generally the largest population observed (up to approximately 6,000 microns2). Somatostatin and calcitonin gene-related peptide, as well as substance P and calcitonin gene-related peptide, coexisted in populations of cell bodies that had a smaller size (less than 2,000 microns2). These results suggest that certain peptides which coexist in the dorsal root ganglia may provide histochemical markers for functional groups of primary afferent neurons.     

Schwerwiegende Komplikation nach perkutan-transaxillärer Verschraubung einer Glenoidfraktur

The common treatment for glenoid rim fractures has been open reduction and internal fixation by a deltopectoral approach. Minimally invasive procedures with percutaneous transaxillary manipulation have a high risk for neurovascular damage. In a single case we demonstrate the possible complications associated with percutaneous refixation of a glenoid rim fracture. A 34-year-old patient with an anterior glenoid rim fracture was referred to our shoulder service after percutaneous transaxillary fixation of the fracture of the glenoid. He presented a dislocated fracture with joint infection and damage of the axillary nerve and artery. During revision surgery, joint infection with Staphylococcus aureus, dislocation of the fracture, aneurysm of the axillary artery, and a lesion in continuity of the axillary nerve were diagnosed. The fragment was excised and the capsule reattached to the remaining glenoid rim. The aneurysm was resected with an end-to-end anastomosis. The outcome was a noninfected and stable shoulder with a limited range of motion. In patients with a glenoid rim fracture with more then 21% of the glenoid fossa involved, refixation of the fracture is recommended. Open reduction and internal fixation is the gold standard. In some cases arthroscopic repair is possible. Percutaneous transaxillary manipulation is not recommended.     

Effect of norepinephrine on insulin, glucagon, and somatostatin secretion in isolated perifused rat islets.

The rate of insulin, glucagon, and somatostatin secretion was measured from isolated rat islets maintained in a perifusion system. The effect of norepinephrine (NE) was simultaneously determined on the release rate of all three hormones. Norepinephrine was employed at an acute dose of 10 micrometers and in graded doses from 1 nM to 10 micrometers in the presence of high (22 mM) and low (1.4 mM) glucose conditions, insulin secretion was maximally inhibited at 10 micrometers NE concentration and was significantly depressed at 100 mM NE concentration. Under both high and low glucose conditions, glucagon release was maximally stimulated at 10 micrometers NE concentration and was significantly elevated at 10 nM NE concentration. Under high and low glucose conditions, somatostatin release was inhibited by 10 micrometers NE concentration and was significantly depressed at 100 nM NE concentration. During the initial maximal stimulation of glucagon, NE inhibition of somatostatin and insulin was prevented, possibly by the high level of glucagon released. A paracrine effect of glucagon on beta and delta cells is proposed.