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Expression pattern of the mouse ortholog of the Pendred's syndrome gene (Pds) suggests a key role for pendrin in the inner ear.

Pendred's syndrome is an autosomal-recessive disorder characterized by deafness and goiter. After our recent identification of the human gene mutated in Pendred's syndrome (PDS), we sought to investigate in greater detail the expression of the gene and the function of its encoded protein (pendrin). Toward that end, we isolated the corresponding mouse ortholog (Pds) and performed RNA in situ hybridization on mouse inner ears (from 8 days postcoitum to postnatal day 5) to establish the expression pattern of Pds in the developing auditory and vestibular systems. Pds expression was detected throughout the endolymphatic duct and sac, in distinct areas of the utricle and saccule, and in the external sulcus region within the cochlea. This highly discrete expression pattern is unlike that of any other known gene and involves several regions thought to be important for endolymphatic fluid resorption in the inner ear, consistent with the putative functioning of pendrin as an anion transporter. These studies provide key first steps toward defining the precise role of pendrin in inner ear development and elucidating the pathogenic mechanism for the deafness seen in Pendred's syndrome.

Amino Acid Sequence↗

Mutations of the Pendred syndrome gene (PDS) in patients with large vestibular aqueduct.

A recent report demonstrated the presence of a mutation in the Pendred syndrome gene (PDS) of patients with large vestibular aqueducts but without goitre. We studied PDS mutations in members of four Japanese families, among which five affected members showed bilateral enlarged vestibular aqueducts. All affected members exhibited moderate to severe bilateral fluctuating sensorineural hearing loss and the absence of goitre. Three members also suffered from recurrent episodic vertiginous spells. Analysis of PDS mutation revealed two single base changes (mis-sense mutations) in exons 19 and 10. The first was an A-->G transition at nucleotide position 2168, resulting in a predicted His-->Arg substitution at position 723 (H723R), whereas the second was a C-->T transition at nucleotide position 1229, resulting in a predicted Thr-->Met substitution at position 410 (T410M). Both mutations are situated in the extracellular domain close to the C terminal. It thus appears that PDS mutations can lead not only to classic Pendred syndrome, but also to large vestibular aqueduct syndrome.

Adolescent↗

The bedfordshire PDS orthodontic pilot.

Throughout the 50-year history of the NHS, the Government has sought to cash limit the GDS. PDS (Personal Dental Services) pilots represent another attempt at cash limiting and a new system for delivering dental services in NHS practice. The development of the Bedfordshire Orthodontic PDS pilot is described. The basis is the prioritization of orthodontic services to child patients with the greatest oral health need through a cost and volume contract with the local Health Authority. A brief outline of the Bedfordshire PDS contract is given. The experiences of the first 9 months of the PDS pilot are related.

Child↗

Subclavian flap angioplasty with absorbable suture polydioxanone (PDS). An experimental study in growing piglets.

The fate of the subclavian flap in aortoplasty was studied and a new synthetic monofilament, absorbable vascular suture (polydioxanone, PDS) was evaluated. In 11 piglets submitted to the aortic repair, the diameter of the aortic arch and descending aorta and the length and width of the subclavian flap were measured. The aortoplasty was performed with a continuous running suture of 6/0 PDS. All the animals survived and grew normally. They were sacrificed 6-26 weeks postoperatively, when the mentioned variables were reestimated. No aortic narrowing was found and no suture material was detectable in the lumen. The subclavian flap had grown uniformly in length and width. Histologic examination showed evening of the inner surface by intimal proliferation and healing of the anastomoses. There was no sign of flap destruction and tissue reaction to PDS suture was minimal, indicating normal growth and viability in all parts of the flap. The suture material was absorbed 26 weeks postoperatively. Continuous suture with absorbable PDS seems to be a good alternative for repair of aortic coarctation in early infancy.

Animals↗

[Ligament repair with PDS (polydioxanone) in chronic insufficiency of the fibular ligament of the upper ankle joint: experimental and clinical experiences].

From September 1988 till February 1989, 14 patients with chronic ligamentous rupture of the ankle had been operated on using PDS-plasty. Of 12 patients checked in follow-up examination (mean postoperative period 45 weeks), only two showed good or very good results. Most patients had the same signs of chronic instability as preoperatively. Two patients had been reoperated on. Intraoperatively we did not find a biological substitute along the PDS guide line. In an experiment on the rat we examined histological changes and tensile strength at appointed times. Histological data showed no biological substitute of PDS. We also found residues of PDS even after 300 days. After a short time loss of tensile strength occurred. In view of an aseptical necrosis that occurred in our experiments, we must point out the risk of foreign body granulomas.

Adolescent↗

Growth of tracheal anastomoses in lambs. Comparison of PDS and Vicryl suture material and interrupted and continuous techniques.

Tracheal anastomoses were performed in 19 lambs (mean age 4 weeks, mean weight 9.8 kg) to compare polydioxanone (PDS) and polyglactin 910 (Vicryl) suture material (Ethicon, Inc., Somerville, N.J.) and simple continuous and simple interrupted suture technique. Each animal had two anastomoses with full-thickness bites for both suture techniques. Animals were killed at 4 months (n = 6) or 8 months (n = 5). Eight animals died before they were scheduled to be put to death (mean 6 weeks postoperatively). Transverse sections of the trachea were taken at the level of the anastomoses and three tracheal rings above and below each anastomosis. The cross-sectional area of the tracheal lumen of these transverse sections was measured with a computerized digitizing tablet. A percent luminal area for each anastomosis was calculated relative to the mean tracheal area three rings above and three rings below the anastomosis. There was little difference between interrupted and continuous technique with either suture material (p = 0.94). In 10 animals that each served as its own control for suture material, PDS anastomotic area was 55.0% +/- 4.1% of mean tracheal luminal area compared with 45.4% +/- 7.1% for Vicryl anastomoses (p = 0.06). Histologic analysis revealed a more intense inflammatory reaction surrounding multifilament Vicryl sutures with more rapid resorption and greater subsequent fibrosis relative to the reaction seen with PDS sutures. A small clinical experience with seven infants has confirmed short-term satisfactory clinical performance of continuous PDS suture for tracheal anastomosis.

Anastomosis, Surgical↗

[Augmentation of the coraco-clavicular ligament suture. Comparison between wire cerclage, vicryl tape and PDS cord].

A total of 71 patients (average age 32 years) with acute grade III acromio-clavicular dislocation were all treated with the same surgical procedure: open reduction, transfixation of the acromio-clavicular joint with a Kirschner wire and suture of the coraco-clavicular ligaments with augmentation. The augmentation was done with a 1.2-mm wire cerclage in the first group (22 patients), a 3-mm wide Vicryl tape in the second group (30 patients) and a 1.5-mm PDS cord in the third group (19 patients). At follow-up (average time 4.4 years) the patients were questioned as well as being examined radiologically and clinically. Only two patients were not satisfied with the outcome of surgery. On clinical evaluation after wire cerclage augmentation of the suture, the distal end of the clavicle was found to be dislocated in 23% of cases. The incidence was 20% after Vicryl taping and 58% after PDS cord augmentation. At X-ray examination with 8 kg suspended from the wrist acromio-clavicular dislocation was found in 45% after wire cerclage, 23% after Vicryl taping and 58% after PDS cord augmentation of the suture. The results show that dislocation is more likely to persist after augmentation of the suture of the coraco-clavicular ligaments with wire cerclage or PDS cord than when the suture is augmented with a Vicryl tape. We conclude that a resorbable material is suitable for augmenting the suture of the coraco-clavicular ligaments, but that a filiform augmentation is less appropriate than a band.

Acromioclavicular Joint↗

Comparison of Maxon suture with Vicryl, chromic catgut, and PDS sutures in fascial closure in rats.

Two hundred ten rats were randomized into one of five study groups to compare standard absorbable sutures with a new synthetic absorbable suture. We evaluated Maxon (polyglyconate), Vicryl (polyglactin), chromic catgut (catgut), and PDS (polydioxanone) with respect to tissue inflammatory reaction, knot security, suture tensile strength, and suture absorption. The results indicate that Maxon and PDS elicited a lower degree of chronic inflammation when compared with Vicryl and chromic catgut. The tensile strengths of Maxon and Vicryl significantly exceeded those of PDS and chromic catgut during the critical period of wound healing. Maxon and PDS retained a larger percentage of tensile strength during the long postoperative period, whereas Vicryl and chromic catgut were mostly absorbed. Maxon is an excellent addition to the armamentarium of the gynecologic surgeon.

Absorption↗

[Effect of panaxadiol saponin (PDS) on phorbol ester induced change of protein kinase C activity in cardiomyocytes].

Partially purified protein kinase C and protein kinase A were separately incubated with various concentrations of PDS (1-1000 micrograms.ml-1) for 10 min in vitro. The results indicate that protein kinase C activity was inhibited in a dose-dependent manner by PDS, but type I and type II protein kinase A were not. In cardiomyocytes preincubated with PDS (250, 500, 1000 micrograms.ml-1) for 10 min, PMA-induced decrease of cytosol protein kinase C activity and increase of membrane protein kinase C activity were greatly inhibited in the same manner. These results suggest that PDS not only inhibited protein kinase C in vitro, but also inhibited activation of protein kinase C in cardiomyocytes.

Animals↗

[Resorbable synthetics (PDS foils) for bridging extensive orbital wall defects in an animal experiment comparison].

In a long term animal study (min 2 weeks; max 48 weeks) on 6 minipigs, clinical related defects of the medial orbital wall extending in the orbital roof (2.5 cm x 3.5 cm) were created. The defects were bridged by slowly resorbable polydioxanon implants (so called PDS-foils, Ethicon) of different thickness (0.25/0.50 mm) and compared to control defects of identical size. The histological findings reveal: 1. After 29 weeks the resorption of both PDS-implants had been completely finished. Only the morphological intact implants had osteoconductive capabilities. 2. The osseous regeneration of the orbital defects started from the osteotomized margins of the orbital wall. The regenerates were covered by unaffected mucosa. 3. The bony regeneration was supported by the activated periosteal membrane. 4. The resorbed PDS-implants were being replaced by a tight scar tissue, which did not had any adjection to the orbital content. 5. The control defects showed a prolapse of the soft tissue with resulting enophthalmos. 6. According to the material specific characteristics, PDS-foils allow a sufficient bridging of even great and anatomically demanding orbital defects. 7. Notice: The hydrolytical broken down implant material may produce an irritation of the surrounding tissue causing a foreign body granuloma.

Animals↗

[Histologic studies of replacement of the anterior cruciate ligament with PDS-augmented patellar tendon transplants].

The bone-patellar tendon-bone graft is currently the best substitute for the anterior cruciate ligament (ACL). To improve the results we compared a modified Jones procedure with an additional PDS augmentation. In 25 sheep the ACL was reconstructed in the left knee after total resection. The only resection of the ACL was done in all right knees. One year postoperative 21 sheep remained in the experiment and came to evaluation. There were 10 modified Jones procedures and 11 PDS augmentations. In both groups, the central one-third of the patellar tendon was implanted through a femoral and tibial drill hole for reconstruction of the anterior cruciate ligament. The transplants were fixed on both ends with a 1-mm cord of polydioxanon (PDS), a soft preload of 50 N was given with a spring balance and the ends of the cords were fixed with a screw and a washer. In the second group we did an additional augmentation with a doubled cord of 2 mm PDS. Early mobilization and weight-bearing was allowed. Throughout the observation period all animals were labelled for fluorescence microscopy. One year after resection of the ACL without reconstruction there were totally destroyed joints. Histology showed damaged menisci and joint surfaces without any cartilage as a sign of severe arthrosis. The macroscopic aspect of the transplants showed strong ligaments coated totally by a synovial membrane with good vascularization. Only little signs of degeneration were to be seen.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

[Ligament replacement with polydioxanone (PDS)].

Experimentations on animals have been performed in order to verify the applicability of the slowly resorbable suturing material Polydioxanon (PDS) in the transposition of ligaments in general and the transposition of cruciate ligaments in particular. After six weeks, the absorption of a twisted cord of 2 mm diameter still has a traction tolerance of 58%. The experimentations made on rabbits and sheep suggest that PDS can be used to fasten ligament sutures and to reinforce ligament grafts. Under extremely favorable soft tissue conditions, the substance can even be used as ligament substitute. Good clinical results can be achieved in the problematic plastic surgery of the anterior cruciate ligament if the reinforcement of the autologous transplant is performed with PDS in the sense of an augmentation graft.

Animals↗

[Septum reconstruction with PDS implant].

To achieve septoplasty without compromising the surgical goal of attaining a straight and solid septum, even in cases of marked deviations or severe post-traumatic deformities, we now use a new technique in which the septal reconstruction includes the placement of a resorbable implant as a "compound graft." For this purpose the entire septal cartilage is removed, and the severely deviated part is divided into straight sections that are reconnected to each other to form a straight and solid plate. As connecting material we use a polydioxanon (PDS) foil. The sections of cartilage are sutured to the foil with PDS suture material. The compound graft thus constructed consists of the septal cartilage and resorbable alloplastic material and is reimplanted into the nose. The PDS and suture material are usually resorbed within 8 months, excluding long-term complications. During the past 2 years this method was used in treating 38 patients. The surgical goal was attained in every case, and no immediate or long-term complications occurred. This method of combining septal cartilage with a resorbable implant leads to a better, significant correction of even severe septal deviations.

Adult↗

Non-syndromic hearing loss associated with enlarged vestibular aqueduct is caused by PDS mutations.

Enlarged vestibular aqueduct (EVA), known as the most common form of inner ear abnormality, has recently been of particular genetic interest because this anomaly is inherited in a recessive manner. The locus for non-syndromic sensorineural hearing loss with EVA has been mapped to the same chromosomal region, 7q31, as the Pendred syndrome locus. In the present study, seven mutations in the PDS gene (PDS), the gene responsible for Pendred syndrome, have been found in families of non-syndromic sensorineural hearing loss with EVA. One family is homozygous, three families are compound heterozygotes, and two families are heterozygous but with no other mutation detected. The present results provide evidence that mutations in PDS cause both syndromic and non-syndromic hearing loss.

Carrier Proteins↗

Evaluation of expanded polytetrafluoroethylene (ePTFE) versus polydioxanone (PDS) for the repair of dura mater defects.

A comparative animal experimental study was performed to test the potential application of expanded polytetrafluoroethylene (ePTFE) vs. polydioxanone (PDS) as dural substitutes. Sixty male Sprague-Dawley rats underwent a right frontoparietal craniotomy, opening of the dura mater, and a small cortical lesion. The dural defect was covered with a piece of ePTFE or PDS. Animals were sacrificed at 30 days or 90 days. Following decalcification, heads including scalp, skull, and underlying brain were sectioned, stained with hematoxylin-eosin, and histologically analyzed. Dural defects repaired with ePTFE, showed minimal reactive changes and no adhesions to the brain surface. No foreign body type giant cell reaction was seen, and the graft became enclosed in a thin sheet of connective tissue. Dural defects repaired with PDS, showed some giant cell infiltration and ingrowth of collagen fibers. Both substitutes provided satisfactory biological function and biocompatibility. Expanded PTFE advantages included relative suppression of tissue ingrowth, ensheathment by connective tissue, and a high tearing strength. Although both materials show promise for use in dural grafting, further clinical studies are necessary to determine their potential applications as a human dural substitute.

Animals↗

PDS (polydioxanone suture): a new synthetic absorbable suture in cataract surgery. A preliminary study.

PDS (polydioxanone suture), a new synthetic absorbable suture, was used in 21 patients undergoing cataract surgery. It still retains 25% of its tensile strength at 42 days but absorption takes 130-180 days. 1 braided coated and 1 monofilament PDS were adequate as conjunctival sutures but offered no advantage over available materials. 0.5 monofilament PDS was superior in handling qualities to 0.4 virgin silk. It does not need to be removed but retains tensile strength for longer than other absorbable sutures.

Aged↗

PDS is a new susceptibility gene to autoimmune thyroid diseases: association and linkage study.

Autoimmune thyroid disease (AITD), including Graves' disease (GD), Hashimoto thyroiditis (HT), and primary idiopathic myxedema, is caused by multiple genetic and environmental factors. Genes involved in immune response and/or thyroid physiology appear to influence susceptibility to disease. The PDS gene (7q31), responsible for Pendred syndrome (congenital sensorineural hearing loss and goiter), encodes a transmembrane protein known as pendrin. Pendrin is an apical porter of iodide in the thyroid. To evaluate the contribution of PDS gene in the genetic susceptibility of AITD, we examined four microsatellite markers in the gene region. Two hundred thirty-three unrelated patients (GD,141; HT, 54; primary idiopathic myxedema, 38), 15 multiplex AITD families (104 individuals/46 patients) and 154 normal controls were genotyped. Analysis of case-control data showed a significant association of D7S496 and D7S2459 with GD (P = 10(-3)) and HT (P = 1.07 10(-24)), respectively. The family-based association test showed significant association and linkage between AITDs and alleles 121 bp of D7S496 and 173 bp of D7S501. Results obtained by transmission disequilibrium test are in good agreement with those obtained by the family-based association test. Indeed, evidence for linkage and association of allele 121 bp of D7S496 with AITD was confirmed (P = 0.0114). Multipoint nonparametric linkage analysis using MERLIN showed intriguing evidence for linkage with marker D7S496 in families with only GD patients [Z = 2.12, LOD = 0.81, P = 0.026]. Single-point and multipoint parametric LOD score linkage analysis was also performed. Again, the highest multipoint parametric LOD score was found for marker D7S496 (LOD = 1.23; P = 0.0086) in families segregating for GD under a dominant model. This work suggests that the PDS gene should be considered a new susceptibility gene to AITDs with varying contributions in each pathology.

Alleles↗

Sociodemography of borderline personality disorder (PD): a comparison with Axis II PDs and psychiatric symptom disorders convergent validation.

A theoretical objective of the present meta-analysis based upon data derived from a previously reported review (Taub, 1995), was to test two inductive hypotheses empirically regarding educational background and social class across different criteria for the DSM-III diagnosis of borderline personality disorder (PD). A secondary purpose was to determine whether comorbidity of borderline PD with other Axis II PDs would significantly delineate socioeducational variables. Across 7/8 pairwise contrasts which represented five studies, distribution of Hollingshead Redlich (H-R) social classes II-IV borderline PD (N = 326) significantly exceeded that in 457 diagnostic controls with Axis II PDs and psychiatric symptom disorders. Although average differences, as well as, interactions reflected by values of the H-R two-factor scale attained statistical significance these were were less consistent in magnitude and direction versus outcomes yielded by distribution of social classes. For the borderline PD diagnosis, the inductive hypotheses were substantiated by findings of significantly advanced scholastic achievement, as well as the younger age of most cohorts versus diagnostic controls with Axis II PDs and psychiatric symptom disorders; and in pairwise contrasts of outpatients with hospitalized cohorts. Comorbidity of the borderline PD diagnosis was associated with significantly lower social class, scholastic achievement and to a lesser extent, more severe psychopathology. Evidence for predominantly convergent validation relative to the socioeducational variables was substantiated by comparisons with (a) cohorts selected by criteria of the DSM-III-R, Gunderson's DIB and Borderline Personality Scale: (b) Norwegian females admitted to Gaustad Hospital and (c) patients with the DSM-III diagnosis of borderline PD attending an outpatient clinic in Norway.

Adult↗