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Spine pain (SP) is the most common musculoskeletal disorder that causes transitional forms of motor disability. Considering its affordability and safety, manipulative therapy (MT) stands as one of the primary therapeutic approaches for SP and the related dysfunctional consequences. However, it is still difficult to assess and quantify the results of this treatment since there is a lack of objective evaluation tools in the available scientific literature. Thus, the purpose of this comprehensive review is to summarize the main outcomes used to evaluate the effectiveness of spine manipulations, focusing on their strengths and weaknesses. An extensive review of the PubMed, Cochrane, and Embase databases was performed to identify the literature of the last ten years regarding MT and the related assessment tools. A total of 12 studies met the inclusion criteria. The analyzed literature indicates that a wide range of outcome measures have been used to assess the effectiveness of spine MT. Pain is the main aspect to be investigated but it remains difficult to elucidate since it is strongly linked to various dimensions such as self-perception and psychological aspects. Therefore, it seems necessary to include new tools for evaluating the effects of spine MT, with the aim of exploiting new technologies and taking into consideration the SP biomechanical and biopsychosocial aspects.

Background: Vertebral arthrodesis for degenerative pathology of the lumbar spine still remains burdened by clinical problems with significant negative results. The introduction of the sagittal balance assessment with the evaluation of the meaning of pelvic parameters and spinopelvic (PI-LL) mismatch offered new evaluation criteria for this widespread pathology, but there is a lack of consistent evidence on long-term outcome., Methods: The authors performed an extensive systematic review of literature, with the aim to identify all potentially relevant studies about the role and usefulness of the restoration or the assessment of Sagittal balance in lumbar degenerative disease. They present the study protocol RELApSE (NCT05448092 ID) and discuss the rationale through a comprehensive literature review., Results: From the 237 papers on this topic, a total of 176 articles were selected in this review. The analysis of these literature data shows sparse and variable evidence. There are no observations or guidelines about the value of lordosis restoration or PI-LL mismatch. Most of the works in the literature are retrospective, monocentric, based on small populations, and often address the topic evaluation partially., Conclusions: The RELApSE study is based on the possibility of comparing a heterogeneous population by pathology and different surgical technical options on some homogeneous clinical and anatomic-radiological measures aiming to understanding the value that global lumbar and segmental lordosis, distribution of lordosis, pelvic tilt, and PI-LL mismatch may have on clinical outcome in lumbar degenerative pathology and on the occurrence of adjacent segment disease., (© 2023 The Authors.)

Cystic fibrosis (CF) is an autosomal recessive disease resulting from mutations on both copies of the CFTR gene. Phenylalanine deletion at position 508 of the CFTR protein (F508del-CFTR) is the most frequent mutation in CF patients. Currently, the most effective treatments of CF use a dual or triple combination of CFTR correctors and potentiators. In triple therapy, two correctors (C1 and C2) and a potentiator are employed. Herein, we describe the identification and exploration of the SAR of a series of 4-aminopyrrolidine-2-carboxylic acid C2 correctors of CFTR to be used in conjunction with our existing C1 corrector series for the treatment of CF., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: Autosomal dominant polycystic kidney disease (ADPKD) is the most common form of inherited kidney disease worldwide. Over the past five years, the therapeutic pipeline for ADPKD has expanded, leading to a growing need for patient enrollment in clinical trials and improved understanding of patient-centered outcomes that can be used in trial design. To advance these goals, the Polycystic Kidney Disease Foundation (PKDF) established a national web-based ADPKD Registry., Methods: The ADPKD Registry is hosted on a secure, HIPAA-compliant, online platform (IQVIA, oc-meridian.com/pkdcure). Participants are consented through the online system and complete a series of modules. The Core Questionnaire includes patient-reported diagnosis, latest creatinine values, and comorbidities. Additional modules include surveys of family history, diet, quality of life, extrarenal manifestations, and attitudes surrounding research participation., Results: As of October 2021, 1563 ADPKD patients across the United States have registered and completed the Core Questionnaire. Participants have a median age of 44 years and are 72% women, 93% White, with 4% self-identifying as Hispanic/Latino and 2% as Black. All CKD stages are present, including post kidney transplant. To date, seven clinical studies have used the Registry as a recruitment tool. Additionally, quality-of-life burden scores revealed a correlation with disease stage as determined by kidney function., Conclusions: The Registry described here is the only one of its kind and is a valuable longitudinal research tool encompassing all stages of ADPKD. The registry will allow investigators to pursue a range of research questions related to the management of ADPKD, including definition of health-related quality of life (HRQoL) outcomes and recruitment for a variety of observational and therapeutic clinical protocols., Competing Interests: B. Benson reports being a member of the Polycystic Kidney Disease Foundation (PKDF) Board of Directors (unpaid position) and the Northeastern University Biotechnology Center of Excellence Scientific Advisory Board. N.K. Dahl reports consultancy for Otsuka Pharmaceuticals and Vertex; research funding as a PI for clinical trials sponsored by Allena, Kadmon, Reata, Regulus, and Sanofi; honoraria from AstraZeneca, the National Kidney Foundation, and Otsuka Pharmaceutical; an advisory or leadership role for the Natera Scientific Advisory Board and the PKDF; participation in a speakers’ bureau for Otsuka; and other interests or relationships with the Medical Advisory Board, NKF NE Chapter. B. Gitomer reports honoraria from the Department of Defense UD study section and the National Institute of Diabetes and Digestive and Kidney Diseases for study section participation; and an advisory or leadership role for CJASN (editorial board member) and the PKDF (member of the Scientific Advisory Council). E. Hoover reports being an employee of the PKDF. M. Mrug reports consultancy for Caraway Therapeutics, Chinook, Goldilocks Therapeutics, Natera, Otsuka Corp., Reata, and Sanofi; research funding from Chinook, Goldilocks Therapeutics, Otsuka Corp., Palladio, and Sanofi; honoraria from Chinook, Natera, Otsuka Corp., Reata, and Sanofi; and an advisory or leadership role for Carraway Therapeutics (advisory board), Goldilocks Therapeutics (advisory board), the PKDF, Sanofi (STAGED-PKD steering committee), and Santa Barbara Nutrients (advisory board). M. Park reports consultancy for Abalone Bio and Acelink Therapeutics; ownership interest in Merck (spouse); honoraria from Grand Rounds and Healthcare Consultancy Group; and other interests or relationships with Kadmon (site PI for tesevatinib trial), Reata (site PI for bardoxolone FALCON trial), Sanofi (site PI for venglustat SAVEPKD trial [now terminated]), and being an advisory board participant for Otsuka, Reata, and Sanofi. R.D. Perrone reports consultancy for Caraway, Navitor, Otsuka, Palladiobio, Reata, Sanofi-Genzyme; research funding from Kadmon, Palladiobio, Reata, and Sanofi; honoraria from Otsuka, Reata, and Sanofi-Genzyme; an advisory or leadership role for Otsuka, PalladioBio, and Sanofi-Genzyme; participation in a speakers’ bureau for Haymarket Media; and other interests or relationships with the Critical Path Institute, the PKDF, and UpToDate. C. Rusconi reports being an employee of the PKDF. S.L. Seliger reports consultancy for Tricida, Inc. (Endpoint Adjudication Committee); research funding from Kadmon Pharmaceuticals, Palladio Biosciences, Reata, Roche Diagnostics, Inc., and Sanofi US; patents or royalties from the University of Maryland, Baltimore, and University of Texas, Southwestern (Methods for Assessing Differential Risk for Developing Heart Failure); and an advisory or leadership role for Circulation (member of the editorial board), CJASN (associate editor), Endpoint Adjudication Committee (member), ESRD Network 5 (member), the Medical Review Board (member), and Tricida, Inc. (VALOR-CKD trial). T.J. Watnick reports research funding for clinical trials sponsored by Palladio Biosciences and from Reata (study site for the Falcon Study); patents or royalties from AThena Diagnostics (PKD DNA testing) and UpToDate (royalties declined); an advisory or leadership role for JASN (editorial board) and the PKDF Registry (Scientific Advisory Committee); and serving on advisory committees for the PKDF. All remaining authors have nothing to disclose., (Copyright © 2022 by the American Society of Nephrology.)

Aim Posture requires fine integrative elaboration, performed by the central nervous system, of neurosensory information originated from the visual, vestibular and spinal circuit. Many perturbing agents can influence this elaboration and then the postural stability. Several studies have evaluated only the effect of a single agent on the postural control. The study analysed the perturbing effect of several external agents on the different sensorial circuits in terms of postural balance loss in orthostatism. Methods The postural stability of 31 patients was evaluated with a static posturography platform in basal conditions and after exposure to an external agent in the following order: stroboscopic light projecting, mechanical rotations on a swivel chair, feet desensitization through ice, administration of an alcoholic drink at intervals which depended on the participant return to basic posturographic values. Tests were performed with open eyes (OE), closed eyes (CE) and reducing plantar perception through the use of a rubber pillow. Results The stroboscopic light altered the postural control. The swivel chair disturbed only with CE. Ice and alcohol increased the oscillation area. The alcohol test had a significant reduction in postural control with OE compared to CE. The rubber cushion increased the oscillation area in all OE tests and with CE in alcohol and ice tests. Conclusion The different agents did not trigger postural control deficits in the same way. A cold environment with psychedelic lights and the use of alcoholic beverages altered significantly the postural stability by influencing simultaneously all perceptions (visual, vestibular and somatosensory feedback)., (Copyright© by the Medical Assotiation of Zenica-Doboj Canton.)

The novel coronavirus (COVID-19) began in China in early December 2019 and rapidly has spread to many countries around the globe, with the number of confirmed cases increasing every day. An epidemic has been recorded since February 20 in a middle province in Northern Italy (Lodi province, in the low Po Valley). The first line hospital had to redesign its logistical and departmental structure to respond to the influx of COVID-19-positive patients who needed hospitalization. Logistical and structural strategies were guided by the crisis unit, managing in 8 days from the beginning of the epidemic to prepare the hospital to be ready to welcome more than 200 COVID-19-positive patients with different ventilatory requirements, keeping clean emergency access lines, and restoring surgical interventions and deferred urgent, routine activity.

Cystic fibrosis (CF) is a genetic disorder that affects multiple tissues and organs. CF is caused by mutations in the CFTR gene, resulting in insufficient or impaired cystic fibrosis transmembrane conductance regulator (CFTR) protein. The deletion of phenylalanine at position 508 of the protein (F508del-CFTR) is the most common mutation observed in CF patients. The most effective treatments of these patients employ two CFTR modulator classes, correctors and potentiators. CFTR correctors increase protein levels at the cell surface; CFTR potentiators enable the functional opening of CFTR channels at the cell surface. Triple-combination therapies utilize two distinct corrector molecules (C1 and C2) to further improve the overall efficacy. We identified the need to develop a C2 corrector series that had the potential to be used in conjunction with our existing C1 corrector series and provide robust clinical efficacy for CF patients. The identification of a pyrrolidine series of CFTR C2 correctors and the structure-activity relationship of this series is described. This work resulted in the discovery and selection of (2 S ,3 R ,4 S ,5 S )-3-( tert -butyl)-4-((2-methoxy-5-(trifluoromethyl)pyridin-3-yl)methoxy)-1-(( S )-tetrahydro-2 H -pyran-2-carbonyl)-5-( o -tolyl)pyrrolidine-2-carboxylic acid (ABBV/GLPG-3221), which was advanced to clinical trials., Competing Interests: The authors declare the following competing financial interest(s): All authors are current AbbVie employees., (Copyright © 2019 American Chemical Society.)

Objective: The present study reports the on-field screening of a population of young soccer players in the pursuit of alterations in gait using a portable and low-cost gait analysis system composed of a Wii Balance Board and a webcam., Results: Recordings of motion of the lower extremities along with vertical ground reaction force (GRF) were used to quantify coefficients of symmetry for the overall GRF and the forces exerted by the quadriceps femori and acting on the anterior cruciate ligament (ACL). Data show that, in face of a quite homogeneous symmetry of GRF during left and right stance phases of gait, quadriceps and ACL exert and are subjected to left-right asymmetrical forces that might prelude, especially in young athletes, later alterations of gait.

Morphological analyses of cerebral vascularization are not only important for the characterization of the anatomical and physiological relationships between vascular and nervous tissue, but also required to understand structural modifications that occur in many pathological conditions affecting the brain. The aim of this study was to generate a three-dimensional vascular map of the cerebral hemispheres in the nude mouse brain, a widely used animal model for studying tumour biology. We used the corrosion casting (CC) technique to isolate blood vessels from 30 nude mouse brains. All casts were analysed using scanning electron microscopy (SEM), which generated quantitative data regarding vessel length and diameter as well as inter-vascular and inter-branching distances. We identified three different topographical regions: (i) the cortical region, characterized by a superficial wide sheet of vessels giving rise to terminal perforant vessels that penetrate the grey matter; (ii) the inner part of the grey matter, in which dense capillary nets form many flake-like structures extending towards the grey-white matter boundary, where perforant vessels finally change direction and form a well-defined vascular sheet; and (iii) the white matter layer, characterized by a more disorganized vascular architecture. In this study, we demonstrate the accuracy of the CC-SEM method in revealing the 3D-topographical organization of the vascular network of the normal nude mouse brain. These baseline data will serve as a reference for future anatomical investigations of pathological alterations, such as tumour infiltrations, using the nude mouse model., (© 2018 Anatomical Society.)

Unlabelled: Background: Metformin is a biguanide antihyperglycemic agent that decreases insulin resistance. It is removed through renal mechanisms and its clearance is reduced in renal failure. Metformin ingestion should always be considered in the differential diagnosis of any patient with metabolic acidosis and increased lactate level. Hemodialysis and continuous veno-venous hemofiltration (CVVH) are both efficient methods to treat metformin intoxication and correct metabolic abnormalities., Methods: Patient 1: A 63-year-old man with type 2 diabetes mellitus presented to emergency department (ED) of Lodi (Italy) for dyspnea. He also reported having diarrhea for 10 days. Initial investigations revealed metabolic acidosis with hyperlactatemia and hypoglycemia (54 mg/dL), metformin concentration was 41 μg/mL (normal value <4 μg/mL). His hemodynamic condition became rapidly unstable and hypotension worsened despite CVVH being performed. Death occurred in 24 h. Patient 2: A 76-year-old man with type 2 diabetes mellitus presented to ED of Lodi for dyspnea. He referred a recent surgery amputation of the left foot's fifth phalanx for osteomyelitis, in levofloxacin therapy. Initial investigations revealed metabolic acidosis with hyperlactatemia and severe hypoglycemia (20 mg/dL). Two hemodialysis sessions were performed with complete normalization of the serum concentration of metformin., Results and Conclusions: In our two cases the genesis of metformin intoxication was clear, powered by acute renal failure, but less obvious was the etiology of acute renal damage responsible for metformin accumulation. Damage due to renal hypoperfusion or the direct toxic effect of metformin should be considered. Additionally, for the second patient, we can also hypothesize that interstitial nephritis was exacerbated by levofloxacin.

Object: This study was performed to study the microvascular changes that occur during the first 12 hours after traumatic brain injury (TBI) using the corrosion casting technique., Methods: The authors performed a qualitative and quantitative morphological study of the changes in cerebral vessels at acute (3 hours) and subacute (12 hours) stages after experimental TBI. They used a model of controlled cortical impact (CCI) injury induced by a recently developed electromagnetic device (impactor), focusing their observations mainly on the microvascular alterations responsible for the formation and maintenance of tissue edema and consequent brain swelling during the first hours after TBI. They used corrosion casting, scanning electron microscopy (SEM), light microscopy, and transmission electron microscopy (TEM) to obtain a morphological qualitative map with both 2D and 3D details., Results: Scanning electron microscopy analysis of vascular casts documented in 3 dimensions the typical injuries occurring after a TBI: subdural, subarachnoid, and intraparenchymal hemorrhages, along with alterations of the morphological characteristics and architecture of both medium-sized and capillary vessels, including ectasia of pial vessels, sphincter constrictions at the origin of the perforating vessels, focal swelling of perforating vessels, widening of intercellular junctions, and some indirect evidence of structural impairment of endothelial cells. All of these vascular alterations were confirmed in 2D analyses using light microscopy and TEM., Conclusions: The corrosion casting-SEM technique applied to a CCI experimental model proved to be a reliable method for studying the pathophysiology of the vascular alterations occurring at acute and subacute stages after CCI injury. It was also possible to obtain topographical localization of the vascular and cellular events that usually lead to hyperemia, edema, and brain swelling. Moreover, by applying informatic software to anatomical images it was possible to perform quantification and statistical analysis of the observed events.

Histamine H(3) receptor antagonists have been widely reported to improve performance in preclinical models of cognition, but more recently efficacy in pain models has also been described. Here, A-960656 ((R)-2-(2-(3-(piperidin-1-yl)pyrrolidin-1-yl)benzo[d]thiazol-6-yl)pyridazin-3(2H)-one) was profiled as a new structural chemotype. A-960656 was potent in vitro in histamine H(3) receptor binding assays (rat K(i)=76 nM, human K(i)=21 nM), and exhibited functional antagonism in blocking agonist-induced [(35)S]GTPγS binding (rat H(3) K(b)=107 nM, human H(3) K(b)=22 nM), and was highly specific for H(3) receptors in broad screens for non-H(3) sites. In a spinal nerve ligation model of neuropathic pain in rat, oral doses of 1 and 3mg/kg were effective 60 min post dosing with an ED(50) of 2.17 mg/kg and a blood EC(50) of 639 ng/ml. In a model of osteoarthritis pain, oral doses of 0.1, 0.3, and 1mg/kg were effective 1h post dosing with an ED(50) of 0.52 mg/kg and a blood EC(50) of 233 ng/ml. The antinociceptive effect of A-960656 in both pain models was maintained after sub-chronic dosing up to 12 days. A-960656 had excellent rat pharmacokinetics (t(1/2)=1.9h, 84% oral bioavailability) with rapid and efficient brain penetration, and was well tolerated in CNS behavioral safety screens. In summary, A-960656 has properties well suited to probe the pharmacology of histamine H(3) receptors in pain. Its potency and efficacy in animal pain models provide support to the notion that histamine H(3) receptor antagonists are effective in attenuating nociceptive processes., (Copyright © 2012 Elsevier B.V. All rights reserved.)

In this morphological study, we report on the three-dimensional microvascular architecture constituting the toes of a patient affected by diabetic microangiopathy. We applied corrosion casting (CC) technique to the toes of a patient affected by Type 2 diabetes, who underwent surgery for explantation of inferior left limb due to necrotic processes of soft tissues. The toes of a foot traumatically explanted in a motorcycle accident were kept as controls. According to technical protocols, toes were injected with a low-viscosity acrylic resin (Mercox) through the major digital artery, tissues were corroded in KOH solution (8%), and resulting casts processed for SEM observations. Already at low magnification, in diabetic toes, we found an impairment of the linear track-like disposition of the vessels of plantar side, with signs of vascular disruption and obliterations, stopped resin, and leakages. Capillaries under the nail and a lot of vascular villi in eponychium and nail borders were damaged, and vascular regression phenomena acting on them were clearly visible. Resin leakages and impairment of normal vascular architecture were also observed in the root of the nail. This preliminary report represents only the first step for further investigations regarding morphological three-dimensional appearance of diabetic microangiopathy. CC and scanning electron microscopy technique well documented these morphological modifications, highlighting on both structural and ultrastructural features of diabetic toes microvessels. In conclusion, our qualitative data try to better focus on the pathophysiological mechanisms involved in diabetic dermopathy and microangiopathy, proposing CC as useful method to investigate on them., (Copyright © 2010 Wiley-Liss, Inc.)

Background and Purpose: The histamine H4 receptor is widely expressed in cells of immune origin and has been shown to play a role in a variety of inflammatory processes mediated by histamine. In this report, we describe the in vitro and in vivo anti-inflammatory properties of a potent histamine H4 receptor antagonist, A-940894 (4-piperazin-1-yl-6,7-dihydro-5H-benzo[6,7]cyclohepta[1,2-d]pyrimidin-2-ylamine)., Experimental Approach: We have analysed the pharmacological profile of A-940894 at mouse native, rat recombinant and human recombinant and native, histamine H4 receptors by radioligand binding, calcium mobilization, mast cell shape change, eosinophil chemotaxis assays and in the mouse model of zymosan-induced peritonitis., Key Results: A-940894 potently binds to both human and rat histamine H4 receptors and exhibits considerably lower affinity for the human histamine H1, H2 or H3 receptors. It potently blocked histamine-evoked calcium mobilization in the fluorometric imaging plate reader assays and inhibited histamine-induced shape change of mouse bone marrow-derived mast cells and chemotaxis of human eosinophils in vitro. In a mouse mast cell-dependent model of zymosan-induced peritonitis, A-940894 significantly blocked neutrophil influx and reduced intraperitoneal prostaglandin D2 levels. Finally, A-940894 has good pharmacokinetic properties, including half-life and oral bioavailability in rats and mice., Conclusions and Implications: These data suggest that A-940894 is a potent and selective histamine H4 receptor antagonist with pharmacokinetic properties suitable for long-term in vivo testing and could serve as a useful tool for the further characterization of histamine H4 receptor pharmacology.

Degenerative changes in the knee joint after meniscectomy are well known. Although likely to be due to changed biomechanics, there is no evidence in the literature to identify the underlying biomechanical alterations. The aim of this study was to analyse lower limb gait biomechanics before and after meniscectomy. Ten patients who required partial medial meniscectomy for irreparable meniscal tear took part in motion analysis before surgery, then at 6 and 12 months post-operatively. A control group was also set up consisting of 10 healthy volunteers. Joint kinematics did not show significant alterations between pre-operative and 6 month post-operative evaluations. However flexion increases at the hip, knee and ankle joint were observed in late swing and early stance phase 12 months after surgery. Hip and knee flexion-extension moments were affected with knee moment altered both before and after surgery. Before surgery and at 6 months after, the changes occurred mainly at the point of push off, while at 12 months they occurred during the swing phase. Hip flexion-extension moment had also changed 12 months after surgery. When examining symmetry of gait patterns prior to surgery, there were differences between the flexion-extension moments of the healthy and of the injured knee at first impact and during late stance. After surgery, asymmetries were not more apparent at first impact, but in late stance phase a reduced knee extension moment in the injured limb was still present. Before surgery, the joint kinematics were not greatly altered and changes were mainly due to pain. After partial meniscectomy, the pain disappeared and new joint responses were observed. These could be caused by the altered mechanics and/or through proprioceptive mechanisms.

The corrosion casting method represents one of the most widely used technique to study the 3D microvascularization of many tissues, both in their normal and pathological conditions. For a long time this technique was used only to perform a qualitative evaluation of the images obtained by scanning electron microscopy (SEM). A quantitative evaluation of vascular parameters (e.g., interbranching and intervascular distances, angle measurements, lengths and diameters) was lacking, mainly because of the difficulties found in the measurement performed on 2D SEM images. Then, some authors reported a quantitative method based on the analyses of stereo-pair images that allowed precise morphometric measurements. To visualize the specimens in 3D, it was necessary to use red-green glasses. In this article we describe a new approach by which we can automatically obtain a 3D reconstruction of vascular cast specimen's surface directly from stereo-images. Moreover, we developed a software that performed micrometric measurements on the 3D construct generated from the stereo-pictures. In conclusion, implementing together these two softwares and applying them to corrosion casting samples made it possible to render in 3D the surface of corrosion cast as well as make quantitative measurements on the corrosion casts.

Oculomotor dysfunctions are hidden causes of invalidity following whiplash injury. Many patients with whiplash injury grade II present oculomotor dysfunctions related to input disturbances of cervical or vestibular afferents. We used static posturography to investigate 40 consecutive patients with whiplash injury grade II and oculomotor dysfunctions. We demonstrated a relation between length and surface of body sway: the surface value (A) was higher than the length value (L) and this led to an open graph of body sway in the statokinesigram. Oculomotor rehabilitation can resolve the impairment of vestibular function but if therapy is delayed or the patient has been wearing an orthopaedic neck collar, more therapeutic sessions are required. In conclusion, without rehabilitation of the oculomotor muscles other therapies are not sufficient to recover the impairment caused by whiplash injury.

Corrosion casting combined with scanning electron microscopy (SEM) has been widely used to study the morphofunctional aspects of microcirculation in many organs. In this study, we present an optimization of the corrosion casting (CC) technique associating it with NaOH 1 N maceration method to obtain a clear visualization of the relationships existing between the microvascular architecture of an organ and its extracellular matrix. Briefly, experiments were performed macerating the tissue previously injected with a low viscosity acrylic resin in 1 N NaOH and then observing it at SEM. In this study, we present an application of this technique to better evaluate the extracellular components of the vascular wall in medium-sized and capillary vessels both in skin and in kidney. The results obtained yielded clear images of the three-dimensional layout of medium-sized and capillary vessels in comparison with the extracellular environment. Furthermore, detailed information was obtained on the three-dimensional layout of fibers constituting the walls of venules, arterioles, and capillaries. In addition, the tubular collagenic structures surrounding the excretory tubules of the kidney and the dermal glands of the skin were depicted and their relationships with their vascular supply described in detail., ((c) 2006 Wiley-Liss, Inc.)

The human Kaposi sarcoma represents one of the most common skin lesions associated with AIDS. Its clinical presentation and anatomopathological structure seem to demonstrate a particularly rich vascularity. The latest therapies aim to limit its intrinsic angiogenic activity in an attempt to reduce vascular density and the formation of new vessels. For these reasons, we decided to study the microvascular architecture of Kaposi sarcoma in three dimensions. We used a corrosion casting technique applied to nude mice previously transplanted subcutaneously with human modified neoplastic Kaposi sarcoma cells. The cooption of host vessels made by the tumor was demonstrated by three-dimensional scanning electron microscopy (SEM) images. At high magnification several angiogenic patterns were observed in the form of potato-shaped vessels, sprouts, intussusceptions and mouse tailed end tipped capillaries along with some ultrastructural features such as intercellular extravasations and endothelial cell modifications. Our investigation allowed us to build a detailed map of tumor vasculature in human Kaposi sarcoma. Furthermore, this study want to shed light on the sharp morphological three-dimensional conformation of angiogenic sprouts so to be able to better understand their modifications occurred during time and after antiangiogenic experimental therapies, by now observed only by immunohistochemical or immunofluorescent assays.

We report and discuss the use of and rationale for tissue engineering techniques in a 40-year-old sportsman who suffered simultaneous anterior cruciate ligament (ACL) rupture, irreparable medial meniscal tear, and chondral lesion of the medial femoral condyle. A 2-step treatment was adopted to address all lesions. The first procedures consisted of ACL reconstruction and collagen meniscus implant (CMI), followed 6 months later by autologous chondrocyte implantation on a collagen membrane (MACI). A CMI biopsy was performed 6 months after implantation. Histologic and ultrastructural analysis documented scaffold invasion by cells and newly synthesized connective tissue. At 2-year follow up, the clinical and functional results were good and magnetic resonance imaging showed integration of the meniscal and cartilage implants. In this patient, each lesion needed to be addressed to achieve an optimal outcome. The primary goal was to restore normal joint biomechanics by performing CMI and ACL reconstruction. MACI was an adequate solution for the management of the large (5 cm(2)) chondral defect.

Fragments of human ascending aorta harvested during heart surgery were cryofractured and observed by scanning electron microscopy (SEM) and atomic force microscopy (AFM). Elastic fibers appear as irregular, undulated laminae of variable size and shape. Their surface shows an evident fibrous texture suggestive of a criss-crossed, delicate filamentous scaffold and is marked by a number of features such as ridges, holes and protruding ribs. At higher magnification, both SEM and AFM show the surface composed of a finely granular material, with a bead size of approximately 20 nm. However, the thickness of the metal coating in one case, and the tip convolution effect on the other, may equally result in an artifactual enlargement of the structures, so that the beads may be significantly smaller. The surfaces created by the fracture always appear smooth and compact and with this technique do not reveal significant detail. The collagen component is mostly represented by small, uniform fibrils gathered in flexuous bundles and following a wavy course not unlike that of the elastic laminae. An orthogonal lattice of small proteoglycans is readily evident even without a specific treatment. Occasionally, the fibrils appear encrusted or engulfed in a grainy matrix reminiscent of the elastic fiber surface. Fluid Tapping-Mode Atomic Force Microscopy simultaneously reveals the surface-bound proteoglycans and the inner architecture of the fibrils, composed of smaller subunits following a spiral course with a winding angle of approximately 17 degrees.

The ultrastructure of crimps of the Achilles tendon of rat, excised and processed in a slack condition, was investigated by atomic force microscopy in air, in fluid and by scanning electron microscopy and stereo reconstruction. The tendon was made of distinct fascicles, each comprising a succession of straight segments connected by sharp angles. The length of the segments and the interposed angles varied widely. In particular, the angles ranged from almost zero to over 135 degrees . We did not observe a unique structure for the hinge regions, but rather a variety of gradations of buckling and/or torsion with no evident correlation with other features of tendon. A constant hallmark was the local loss of regular molecular packing, as revealed by the disappearance of the D-banding. Our results do not support recent reports of a helical structure or smooth sinusoidal waves in tendons. Such structures may nonetheless exist in other non-tensile structures whose collagen fibrils exhibit a helical inner architecture and are able to follow a highly convoluted course without buckling or crimping.

This study aimed to describe the impressive diversity of vascular plexiform structures of the hypodermal layer of human skin. We chose the human body site with the highest concentration of dermal corpuscles, the human digit, and processed it with the corrosion casting technique and scanning electron microscopy analysis (SEM). This approach proved to be the best tool to study these microvascular architectures, free from any interference by surrounding tissues. We took high-definition pictures of the vascular network of sweat glands, thermoreceptorial and tactile corpuscles, the vessels constituting the glomic bodies and those feeding the hair follicles. We observed that the three-dimensional disposition of these vessels strictly depends on the shape of the corpuscles supplied. We could see the tubular vascularization of the excretory duct of sweat glands and the ovoid one feeding their bodies, sometimes made up of two lobes. In some cases, knowledge of these morphological data regarding the normal disposition in space and intrinsic vascularization structure of the dermal corpuscles can help to explain many of the physiopathological changes occurring during chronic microangiopathic diseases.

The collagen meniscus implant (CMI) is a tissue-engineering technique designed to stimulate regeneration of meniscus-like tissue in cases of irreparable tears or previous meniscectomy. CMI morphology was investigated before and after implantation by light microscopy, scanning electron microscopy (SEM), and transmission electron microscopy (TEM). In a case series biopsy specimens were harvested from four patients who underwent a second arthroscopic look 6 months after placement of the CMI. CMI sections appeared composed of parallel connective laminae of 10-30 microm, connected by smaller bundles (5-10 microm). This connective network formed lacunae with diameters between 40 and 60 microm. At greater magnification, the walls of the lacunae demonstrated tightly packed and randomly distributed collagen fibrils, with diameters ranging from 73 to 439 nm. In the biopsy specimens, the lacunae were filled with connective tissue that contained newly formed vessels and fibroblast-like cells, presenting an abundant rough endoplasmic reticulum and several mitochondria. In the extracellular matrix, the collagen fibrils showed uniform diameters (126 nm +/- 32 nm). The original structure of CMI was still recognizable, and no inflammatory cells were detected within the implant. The morphological findings of this case series demonstrate that CMI provides a three-dimensional scaffold suitable for colonization by precursor cells and vessels and leading to the formation of a fully functional tissue., (Copyright 2005 Wiley Periodicals, Inc.)

The hybridization site of a DNA probe was detected using a scanning electron microscope (SEM), modifying the standard in situ hybridization (ISH) method. The experiments were performed on human metaphases obtained from lymphocyte cultures of human peripheral blood. The libraries and probes used were: 1-chromosome library for the painting of chromosome 1 (wcp 1), an alphoid centromere-specific probe of chromosome 8 (pZ8.4), and the yeast artificial chromosome (YAC) 964-C10 mapped at band p13 on chromosome 12. These probes were labeled by nick translation with biotin and displayed with a gold-conjugated anti biotin goat antibody. The gold signal was amplified by silver enhancement. The chromatides appeared as packages of thin filaments 120 nm high; some of them collapsed, probably due to ISH procedures. All the probes were clearly detected as small gold particles grouped on the surface of the target chromosomes and chromosome sites. Thus, this procedure is useful to clarify the positional relationship between the chromatin filaments and the probe.

High-resolution, detailed 3D reconstructions of biological specimens obtained from scanning electron microscopy stereo-micrographs and proprietary software were compared with Tapping-Mode AFM datasets of the same fields. The reconstruction software implements several original solutions including a neural adaptive point-matching technique, the ability to build an irregular triangulated mesh rather than a regular orthogonal grid, and the ability to re-map one of the original images exactly onto the reconstructed surface. The technique was applied to human nerve tissue to obtain 1,424 x 968-pixel, texture-mapped datasets, which were subsequently compared against 512 x 512-pixel AFM datasets from the same viewfields. Accounting for the inherent differences of the two techniques, direct comparison revealed an excellent visual match. The correspondence was also quantified by calculating the cross-correlation coefficient between corresponding altimetric profiles in SEM and AFM data, which consistently exceeded a figure of 0.9, with a rate of point mismatch in the order of 0.01%. Research is still underway to improve the robustness of the technique when applied to arbitrary images, (Copyright 2005 Wiley-Liss, Inc.)

We performed a morphological scanning electron microscope (SEM) study to describe the fine structure and disposition of collagenous tissue in the human toe. After therapeutic amputation of a human right leg, we applied the Othani maceration technique to the skin of three toes surgically explanted from the foot. We distinguished eight cutaneous regions and focused on some specialized collagenous structures differing in the thickness of the skin. The eight areas investigated were: the dorsal skin, the eponychium, the perionychium, the hyponychium, the region under the visible nail, the nail root, the plantar skin and finally the toe tip. Each of these areas is characterized by a distinctive collagenous surface disposition, with some peculiar features mostly related to dermal papillae. At high magnification, we observed the spatial arrangement of the collagen fibers constituting the top of the dermal papillae that represents the attachment site of the proliferative basal layer of the epidermis. We also noted an impressive density of collagen fibers throughout the thickness of the dermal layer, organized in specialized structures and constituting the skeleton of dermal thermoreceptorial corpuscles or sweat glands. A combination of SEM and Ohtani technique disclosed the three-dimensional architecture of the collagenous matrix of tarsal skin under physiologic conditions, giving a detailed description of the most reactive tissue during pathologic processes.

Amyloid-beta1-42 (Abeta1-42) is crucial to Alzheimer disease (AD) pathogenesis but the conformation of the toxic Abeta species remains uncertain. AD risk is increased by apolipoprotein E4 (apoE4) and decreased by apoE2 compared with the apoE3 isoform, but whether inheritance of apoE4 represents a gain of negative or a loss of protective function is also unresolved. Using hippocampal slices from apoE knockout (apoE-KO) and human apoE2, E3, and E4 targeted replacement (apoE-TR) mice, we found that oligomeric Abeta1-42 inhibited long-term potentiation (LTP) with a hierarchy of susceptibility mirroring clinical AD risk (apoE4-TR > apoE3-TR = apoE-KO > apoE2-TR), and that comparable doses of unaggregated Abeta1-42 did not affect LTP. These data provide a novel link among apoE isoform, Abeta1-42, and a functional cellular model of memory. In this model, apoE4 confers a gain of negative function synergistic with Abeta1-42, apoE2 is protective, and the apoE-Abeta interaction is specific to oligomeric Abeta1-42.

Inflammation mediated by activated microglia cells has been shown to contribute to the pathogenesis of Alzheimer disease (AD) [1]. Microglia are the immune cells in the central nervous system, and when activated they secrete the lipid-derived mediator prostaglandin E2 (PGE2), the cytokine interleukin-1beta (IL-1beta), and other inflammatory mediators. Apolipoprotein E isoform 4 (apoE4), coded for by the gene APOE4 (epsilon4), has been shown to correlate with higher risk of onset of AD, as well as with increased severity of other diseases with a neuroinflammatory component. This study investigated isoform-specific effects of apoE on the regulation of PGE2, COX2, and IL-1beta expression. Two physiologically relevant preparations of apoE displayed an isoform-specific effect on inflammation in primary adult microglia cultured from adult rat brain cortex. Specifically, apoE4 alone, but not the more common isoform apoE3, stimulated secretion of PGE2 and IL-1beta. The increase in PGE2 release stimulated by apoE4 was not accompanied by the upregulation of the COX-2 enzyme in microglia.

Polymorphisms in the apolipoprotein E (APOE) gene affect the risk of Alzheimer disease and the amount of amyloid beta-protein (Abeta) deposited in the brain. The apoE protein reduces Abeta levels in conditioned media from cells in culture, possibly through Abeta clearance mechanisms. To explore this effect, we treated multiple neural and non-neural cell lines for 24 h with apoE at concentrations similar to those found in the cerebrospinal fluid (1-5 microg/mL). The apoE treatment reduced Abeta40 by 60-80% and Abeta42 to a lesser extent (20-30%) in the conditioned media. Surprisingly, apoE treatment resulted in an accumulation of amyloid precursor protein (APP)-C-terminal fragments in cell extracts and a marked reduction of APP intracellular domain-mediated signaling, consistent with diminished gamma-secretase processing of APP. All three isoforms of apoE, E2, E3 and E4, had similar effects on Abeta and APP-C-terminal fragments, and the effects were independent of the low-density lipoprotein receptor family. Apolipoprotein E had minimal effects on Notch cleavage and signaling in cell-based assays. These data suggest that apoE reduces gamma-secretase cleavage of APP, lowering secreted Abeta levels, with stronger effects on Abeta40. The apoE modulation of Abeta production and APP signaling is a potential mechanism affecting Alzheimer disease risk., (Copyright 2004 International Society for Neurochemistry)

The aim of this study was to describe microcirculation in the human digit, focusing on the vascular patterns of its cutaneous and subcutaneous areas. We injected a functional supranumerary human thumb (Wassel type IV) with a low-viscosity acrylic resin through its digital artery. The tissues around the vessels were then digested in hot alkali and the resulting casts treated for scanning electron microscopy. We concentrated on six different areas: the palmar and dorsal side of the skin, the eponychium, the perionychium, the nail bed and the nail root. On the palmar side, many vascular villi were evident: these capillaries followed the arrangement of the fingerprint lines, whereas on the dorsal side they were scattered irregularly inside the dermal papillae. In the hypodermal layer of the palmar area, vascular supports of sweat glands and many arteriovenous anastomoses were visible, along with glomerular-shaped vessels involved in thermic regulation and tactile function. In the eponychium and perionychium, the vascular villi followed the direction of nail growth. In the face of the eponychium in contact with the nail, a wide-mesh net of capillaries was evident. In the nail bed, the vessels were arranged in many longitudinal trabeculae parallel to the major axis of the digit. In the root of the nail, we found many columnar vessels characterized by multiple angiogenic buttons on their surface.

Scanning electron microscopic observation of corrosion casts is the finest technique to describe spatial patterns of microvessels in many organs, giving a readily interpreted representation of their vascular architecture without interference from surrounding tissues. We focused on the renal cortex of guinea pigs to make an in-depth morphological analysis of structural and ultrastructural details left by the cells on the resin cast. In addition, we made a qualitative description of normal variants usually observed in glomerular disposition, arteriolar morphology or capillary arrangement in the space to shed more light on the relationship between vascular tissue and surrounding cells. The study also disclosed some examples of vascular adaption to physiological and pathological conditions occurring in renal microvessels such as many systems essential to flow regulation, filtration and excretory processes. At lower magnification, all major vessels can be readily distinguished: interlobar, arciform and interlobular arteries and veins, along with a web of peritubular and capsular capillaries. At higher magnification, the glomeruli become visible and the afferent and efferent arteries and the tortuosity the inner vessels can be distinguished. In some of them, the resin, due to the narrowing sizes, suddenly stopped leaving a half-casted glomerulus. This helped to reveal its internal circulation characterized by thin capillaries with a high degree of bi or trifurcation. In addition, we confirmed the close correspondence between cellular ultrastructural detail (pores, corrugations of cellular membrane, perivascular cell branches) and the impressions left on the resin visible only at high magnifications.

The three-dimensional microvascular structure of many organs can be adequately investigated only using the corrosion casting technique. We applied this method, consisting of an injection of low viscosity acrylic resin through the major vessels and the subsequent digestion of the organic component with strong alkali or acids, to the choroid plexus of the lateral ventricles in the rat, focusing on its structural vascular features. This approach allowed a qualitative morphological description of the choroid plexus of the lateral ventricles, revealing several aspects of their capillary architecture as well as the morphological details underlying its main functional activity, essential to cerebrospinal fluid turnover. Observation of the casts with scanning electron microscopy gave a detailed picture of the choroid plexus of the lateral ventricles of the rat and enabled us to distinguish four different regions, depending on the site that the lateral ventricles occupied: the anterior olfactory region, the main central region, the longer branch and the inferior horn. Each region mostly consisted of spiral capillaries and had specific characteristics. At high magnification, the casts revealed distinctive vascular specializations, such as numerous bulges regularly placed on the capillaries. This morphological investigation underpins a better comprehension of the pathological mechanisms involving the choroid plexus in the lateral ventricles.

Vascular and bronchial endocasts represent a useful instrument to study the ramification pattern of these structures. Casts have been made from different materials, such as waxes in ancient times and, more recently, silicon-like compounds or resins (see e.g. Mercox) to study the finest details. These techniques are valuable for small specimens, whereas they are inadequate for very large organs, where technical difficulties require the development of specific instrumentation. In this study we present a new simple injection technique, based on expanded polyurethane, which allows preparing vascular and bronchial trees for macroscopic and microscopic studies. The new injection technique is very easy to carry out, since the propulsion is provided by compressed air, and it does not require special instrumentation. To this aim, endocasts of the entire tracheal-bronchial tree and casts of vascular kidney from different animals were prepared. The specimens have a very low weight, show the finest ramifications, and are very stable and resistant to mechanical stress. To examine microscopically the details of the casts, specimens from the kidney cast were also analyzed by scanning electron microscopy, revealing good preservation of microcirculatory structures, functional sphincters and endothelial cell impressions. Therefore, the technique may be useful for macroscopic studies of large specimens, retaining sufficiently fine details.

Background: The present paper considers the technique of CT scan maps of pulmonary isodensity, examining lung density differences as a function of the type of disease and considering their significance for the purposes of refined, useful diagnosis in a surgical context. METHODS. The method is used to examine 3 groups of subjects selected on a clinical/anamnestic basis and a further group already admitted for surgery. For each patient we obtained 2 thoracic density scans during the phase of maximum inspiration and expiration. On each scan we constructed 50 isodensity maps, the equivalent of more than 2500 measurements: the preliminary standard was represented by 100 wide windows to produce total "illumination" of the pulmonary fields. The isodensity windows were then codified differently. Subsequently, the density scans were analysed with the technique of scalar decomposition., Results: The CT scan maps of lung isodensity proved useful for certain lung diseases in which early diagnosis, topographic extent of the pathology and the refined definition of the pathological picture provide important solutions as regards the indication and planning of surgical treatment and for the evaluation of the operative risk and prognosis., Conclusions: We consider that the technique is rapidly performed, not complex and inexpensive and is able to supply detailed information on the lung parenchyma such as to be used not only as a routine technique but also in emergencies.

Following a review of international literature, AA report main results and refer their opinion about the correlation of hemorrhoidal disease with constipation, considering some variants as well as age, sex, breed, social-economic condition and geographic distribution in USA, England and Wales. Epidemiologically ten millions of people, in USA, are affected by hemorrhoidal disease; the incidence rate is 4.4% with an age distribution that shows a prevalence between 45-65 years old subject while constipation has an exponential increase with aging. Hemorrhoidal disease is significantly influenced by sex and geographic distribution that is in white breed more than in black, in social high class and in men more than women. In black breed constipation and hemorrhoidal disease present especially in lower social classes. Based on these results hemorrhoidal disease shows on epidemiological pattern that differ from constipation's one. Many questions are still present about correlations between hemorrhoidal disease and chronic constipation regarding etiopathogenesis. Only future case-control studies will solve the problem.

The authors report a number of cases of hemorrhoid disease and describe the therapeutic iter followed with particular reference to the surgical approach used. After a description of the physiopathological aspects linked to the disease, bearing in mind the use of electromanometry and electromyography in diagnosis, the authors underline the contemporary presence of varices in the lower limbs and hemorrhoid disease, as well as the frequent finding of hemorrhoids in a syndrome of portal hypertension. They then affirm how it is impossible to establish the causes of this pathology with any certainty and how a single standardised treatment plan is untenable. The authors then indicate the guidelines used to choose the most appropriate form of surgery rather than pharmacological treatment, based on the ideal cases and conditions for surgery. The ultimate goals of surgery are also outlined. The study compares four possible surgical techniques, providing synthetic information regarding their adaptability to the various cases treated and the characteristics of their use. This means that, once decided, surgery must successfully resolve the patient's problems. In conclusion, once hemorrhoid disease has been diagnosed, it is important to intervene with appropriate medical treatment to control the evolution of the pathology; if this is not sufficient, surgery becomes an inevitable choice.

F11 cells are a dorsal root ganglion (DRG) cell line used to model the function of authentic type C, peptidergic, nociceptive neurons. The cellular events underlying the antinociceptive effects of (+/-)-epibatidine, a nicotinic acetylcholine receptor (nAChR) ligand that is 200-fold more potent than morphine, is unknown. The present study investigated the ability of cholinergic channel activators (ChCAs) to effect nAChR-gated ion flux and modulate the release of substance P (SP), a neuropeptide identified to play a critical role in nociception. The prototypical agonists (-)-nicotine and (-)-cytisine, the ganglionic stimulant 1,1-dimethyl-4-phenylpiperazinium, the novel ChCA ABT-418 [(S)-3-methyl-5-(-1-methyl-2-pyrrolidinyl)isoxazole], and (+/-)-epibatidine evoked a concentration-dependent stimulation of rubidium (86Rb+) efflux with EC50 values of 14.2 +/- 1.6, 63.4 +/- 24, 3.8 +/- 2.0, 29.8 +/- 2.6, and 0.019 +/- 0.001 microM as well as maximal intrinsic activities of 100, 97, 69, 75, and 102%, respectively. The noncompetitive nAChR antagonist mecamylamine potently antagonized (-)-nicotine-evoked ion flux, whereas the competitive antagonist dihydro-beta-erythroidine was a weak antagonist, giving support to an alpha3beta4 nAChR subtype. In addition, concentrations of (+/-)-epibatidine, similar to those necessary to induce maximal 86Rb+ efflux, evoked spontaneous release of SP from these cells, which was blocked by mecamylamine. Furthermore, prolonged exposure to (+/-)-epibatidine desensitized the functional response of the nAChR in this cell line (IC50 = 12 +/- 9 nM). These findings in F11 cells provide a model to investigate the role nAChRs play in modulating DRG cell function, and may lead to insights into the role these receptors have in modulating nociceptive transmission.

The correlation between the epsilon 4 allele of apolipoprotein E (apoE) and Alzheimer's disease is well established. However, the role of apoE in normal as well as pathological brain processes remains unclear. We evaluated the effect of apoE treatment on development and beta-amyloid (A beta)-induced toxicity using primary cultures of developing rat hippocampal neurons. The source of apoE was conditioned media from HEK cells stably transfected with human apoE3 or apoE4 cDNA, a preparation where apoE is lipid-associated. Morphological and biochemical changes in the cultures were assessed at 1 and 3 days following low- and high-density plating with either apoE3 or E4 with or without A beta. Both apoE isoforms were neurotrophic, as measured by increased neurite length. Aged A beta(1-42), a peptide preparation exhibiting extensive fibril and aggregate formation, is toxic to these cultures. Addition of apoE3 and E4 significantly and comparably attenuated the A beta-induced reduction in both neurite length and cell viability. The level of protection against this toxicity was proportional to the neurotrophic actions of the two apoE isoforms. Thus, apoE acts as a potent growth factor in both the absence and the presence of A beta, supporting a potentially important role for apoE in neurobiology.

To investigate the consequences of complement activation on neuronal viability, the effects of serum treatment on neuron-rich and mixed neuronal/glial cultures were evaluated. The neurotoxicity observed following treatment with either human or rat serum was variable and did not appear to be mediated through a complement-mediated mechanism. Serum lots lacking CH50 activity induced neurotoxicity, and heat treatment of toxic lots of either human or rat sera did not abolish toxicity. In cases where serum treatment did not induce cell death, treatment with PIPLC to remove endogenous membrane-bound complement inhibitors prior to serum exposure, did not result in cell death.

The conditions under which beta-amyloid (Abeta) is toxic to primary rat hippocampal neurons were investigated. Synthetic Abeta(1-42) peptide was neurotoxic following "aging" for 7 to 14 days at 37 degrees C in modified Eagle's media. Neurotoxicity included decreases in neurite length, cell number, and metabolic state. In contrast, aging Abeta(1-42) in the presence of the media supplement B27 inhibited Abeta (1-42) induced neurotoxicity. Differences in the aggregation state of the two preparations did not account for differences in the biological activities elicited by each peptide. Since components of B27 include antioxidants as well as other agents that provide protection against oxidative damage, we suggest that free radicals may be responsible, in part, for the toxicity that occurs following the aging of the peptide.

We have considered a 1 year first-aid survey and focused a 6 checked mesentery vascular traumatic tearing cases. We have valued some hypotheses on pathogenic mechanism assumptions about these vascular injuries in abdomen trauma. Among these, we have focused our attention on the relationship between visceral stretching from alimentary bolus and abdominal vascular trauma. During diagnosis, we valued the importance of abdominal sounding, of echotomography and Computerized Tomography; the first one seems to be remarkable for reliability and quickness of accomplishment. In one case we have performed laparoscopic diagnostic-therapeutic approach. We suggested some standards for surgery choice related to injury amount. Monitoring is particularly important for those patients it can performed by invasive or image means seen that the unacknowledged endo-abdominal injury increases mortality by about 5-65%.

Dopamine (DA) D1 receptors are generally known to couple only to Gs and cAMP production. Recently, D1 receptors expressed in mouse Ltk- cells have been shown to induce cAMP production, phosphoinositide (PI) hydrolysis, and calcium mobilization [Mol. Endocrinol. 6: 1815-1824 (1992)]. To further evaluate second messenger systems that could be activated by the D1 receptor, we examined the effects of DA, (R)-(+)-SKF-38393, and DA antagonists on cAMP production and calcium release in human embryonic kidney 293 cells stably expressing three different levels (Bmax = 0.12, 1.4, and 23 pmol/mg of protein) of the human D1 receptor. DA and (R)-(+)-SKF-38393 activated cAMP production and calcium release in all three D1-293 clones, and their potency was proportional to receptor density. The efficacy of SKF-38393 was also increased with receptor density in both cAMP and calcium studies. The effect of DA on calcium release consisted of a transient peak response (< 20 sec) that declined to an ethylene glycol bis(beta-aminoethyl ether)-N,N,N',N'-tetraacetic acid-sensitive plateau level above the base-line (>5 min). The effect of DA on cAMP and calcium release was selectively inhibited by SCH23390, a selective D1 antagonist, and not by spiperone, a selective D2 antagonist. DA did not induce PI hydrolysis in any of the three receptor-expressing clones. A 24-hr pretreatment with cholera toxin (2 micrograms/ml) greatly attenuated the effect of DA on cAMP formation and calcium release. To address how DA could activate calcium release without enhancing PI hydrolysis, the effects of forskolin, thapsigargin, and isoproterenol (Iso) were studied. Similarly to the effects of DA, forskolin and Iso stimulated cAMP production and calcium release from D1-293 cells. Cells that were stimulated with Iso or forskolin showed a reduced response to subsequent addition of DA. Pretreatment of D1-293 cells with thapsigargin, a selective Ca2+-ATPase inhibitor, elicited calcium release from the inositol-1, 4, 5-trisphosphate-sensitive calcium store and attenuated the response to subsequent addition of DA. Carbachol stimulated PI hydrolysis and calcium release but had little effect on cAMP production. Prestimulation with carbachol abolished the calcium response to DA, Iso, or forskolin. These studies indicate that D1 receptor-mediated calcium mobilization in 293 cells is dependent on cAMP production and the cAMP-dependent calcium store is part of the inositol-1,4,5-trisphosphate-sensitive calcium pool.

The conditions under which amyloid is toxic to primary rat hippocampal neurons were investigated. Synthetic A beta (1-42) peptide elicited neurotoxic activity following "aging" for 7 to 14 days at 37 degrees C in Modified Eagles Media. Neurotoxicity included decreases in neurite length, cell number, and a loss in 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide reduction. In contrast, the addition of the media supplement B27, during the aging process, promoted the neurotrophic actions of aged A beta (1-42), as indicated by an increase in neurite length and the number of cells possessing neurites, and attenuated toxicity. The differences in the biological actions elicited by these two preparations of aged peptide were attributed to the presence of the B27 components. B27 consists of a mixture of agents that provide protection against oxidative damage. In support, aging A beta (1-42) in the presence of superoxide dismutase and catalase, two components of B27, significantly reduced the toxic actions of peptide; hence, suggesting that free radicals may be required for the toxicity that accumulates during the aging of the peptide. To determine the contribution of particular amino acid residues in amyloid toxicity, studies were carried out with an aged preparation of the A beta (1-42) analog, A beta (1-42)Nle35. Findings from these studies suggest that the methionine residue may play a part, but is not required, for amyloid toxicity to occur.

The effect of the Kunitz proteinase inhibitor (KPI) on potential beta-amyloid precursor protein (beta PP)-processing activities from control and Alzheimer's disease (AD) brains was examined using fluorogenic substrates designed to mimic the secretory and amyloidogenic cleavages in beta PP. In addition, the level of secretion of KPI-containing beta PP751 and KPI-lacking beta PP695 from transfected cells was examined to assess the effect of the KPI on beta PP secretion. beta PP751 and beta PP695, obtained from conditioned media of transfected cells, had no effect on proteinase activities against the secretory and amyloidogenic substrates in extracts from control and AD brains. At similar concentrations beta PP751, but not beta PP695, completely inhibited the activity of trypsin against these substrates. Serine proteinase inhibitors had only modest effects on activities from brain, whereas cysteine modification completely inhibited them, indicating that these proteinase activities were not of the serine type. Thus, the results do not support a role for the KPI in the secretion of beta PP or in the amyloidogenic cleavage of beta PP. The amounts of beta PP695 and beta PP751 collected from the media of transfected cells after 48 h of growth were similar, indicating an equal rate of secretion. This result suggests that the KPI domain in beta PP751 did not inhibit the secretory cleavage in transfected cells.

Apolipoprotein E (apoE), particularly the e4 allele, is genetically linked to the incidence of Alzheimer's disease. ApoE is present in the extracellular senile plaques and intracellular neurofibrillary tangles associated with Alzheimer's disease. In vitro, apoE has been shown to bind beta-amyloid (A beta), an amyloidogenic proteolytic product of amyloid precursor protein. To analyze the interaction of A beta and apoE, we used Western immunoblotting of human A beta-(1-40)-peptide incubated with conditioned medium from HEK-293 cells transfected with either human apoE3 or apoE4 (products of the e3 and e4 alleles, respectively) cDNA. Nonreducing SDS-polyacrylamide gel electrophoresis revealed the presence of an approximately 45-kDa complex with both A beta and apoE immunoreactivity. The level of the apoE3.A beta complex was approximately 20-fold greater than that of the apoE4.A beta complex. This apoE isoform-specific binding pattern was maintained from pH 5.0 to 9.0, from 2 min to 24 h of peptide incubation, and at concentrations of apoE from 5 to 100 micrograms/ml and of A beta from 10 microM to 1 mM. The higher level of apoE3 binding to A beta is in contrast to previously published data using purified apoE (Strittmatter, W. J., Weisgraber, K.H., Huang, D. Y., Dong, L.-M., Salvesen, G. S., Pericak-Vance, M., Schmechel, D., Saunders, A. M., Goldgaber, D., and Roses, A.D. (1993) Proc. Natl. Acad. Sci. U. S. A. 90, 8098-8102). Factors responsible for the isoform-specific interactions between apoE and A beta will require further study before the apparent discrepancy between these data can be reconciled.

Receptors for dopamine are present on horizontal cells of fish retina that are linked to the activation of adenylate cyclase. In the present study, the goldfish (Carassius auratus) gene that encodes these receptors, referred to as gfD1, was isolated and analyzed. A single open reading frame within the gfD1 gene encodes a protein of 363 amino acids that is highly homologous with dopamine D1 receptors from rats and humans. Interestingly, the carboxyl terminus of gfD1 lacks 80 amino acids that are present in the mammalian receptor sequences. RNA analysis using the polymerase chain reaction demonstrated that the gene is expressed in the goldfish retina and is intronless within the coding region. The fact that gfD1 encodes a dopamine D1 receptor was demonstrated through pharmacological analysis of transfected cells. Both the gfD1 receptor and the human D1 receptor expressed in mammalian cells had high affinity for SCH-23390 and other D1-specific ligands. In addition, the gfD1 receptor and the human D1 receptor were able to stimulate the accumulation of cAMP in response to SKF-38393 or dopamine. Interestingly, stimulation of both the gfD1 and human receptors with dopamine also resulted in an increase in intracellular Ca2+. Finally, long term pretreatment of transfected cells with dopamine resulted in the desensitization and down-regulation of both the goldfish and human receptors.

D1 and D2 dopamine receptors are G-protein coupled receptors and have seven transmembrane spanning regions (TM) typical of this receptor superfamily. Although dopamine binds equally to D1 and D2 receptors, many compounds are highly selective. To probe the receptors for regions that determine subtype specificity, plasmid constructs coding for the D1 or a D1/D2 chimeric receptor were made and transfected into cells to study the binding and agonist properties of non-selective or subtype-selective compounds. The results suggest that the D2-selective agonist, quinpirole, gains much of its selectivity by binding to within TM VI and VII of the D2 receptor.

Several serines present in transmembrane domain V are conserved among members of the G-protein-coupled receptor family that bind catecholamines. Two of these serines that are present in the beta-adrenergic receptor were previously shown by site-directed mutagenesis to affect agonist binding and receptor activation (Strader, C. D., Candelore, M. R., Hill, W. S., Sigal, I. S., and Dixon, R. A. F. (1989) J. Biol. Chem. 264, 13572-13578). We investigated the role of the serines present in transmembrane V of another catecholamine receptor, the dopamine D1 receptor, by site-directed mutagenesis, and the results show that mutations at serines 198, 199, and 202 affect dopamine binding. The substitution of serine 198 or serine 199 by an alanine also affects the binding of several other agonist and antagonist dopaminergic compounds while an alanine substitution at serine 202 has no effect on the binding of these compounds. Moreover, each single serine mutation decreased the maximal cAMP accumulation elicited by a dopamine D1 partial agonist. These results suggest that serines present in transmembrane V of the D1 receptor affect ligand interactions and receptor signal transduction, but not entirely in the manner that would be predicted from the model proposed for the beta-adrenergic receptor.

The 6-substituted 2-(3',4'-dichlorophenoxy)-2H-pyrano[2,3-b]pyridines MDL 20,610 (6-SO2CH3), MDL 20,646 (6-Br), and MDL 20,957 (6-Cl) are potent antirhinovirus compounds with median plaque 50% inhibitory concentrations (IC1/2s) of 0.03, 0.006, and 0.006 micrograms/ml, respectively, against the 32 serotypes evaluated. The 6-halogenated analogs produced 99% reductions in progeny virion yields at concentrations as low as 0.004 micrograms/ml. However, these analogs perturbated HeLa cell metabolism at lower concentrations (at or above 5 micrograms/ml) than did the 6-methylsulfonyl analog (at or above 20 micrograms/ml). Compound MDL 20,610 was also active against human, simian, and bovine rotaviruses (cytopathic effect IC1/2s of 0.8 to 1.5 micrograms/ml) and possessed variable enterovirus and paramyxovirus activity.