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Integrated evaluation of central nervous system lesions: stains for neurons, astrocytes, and microglia reveal the spatial and temporal features of MK-801-induced neuronal necrosis in the rat cerebral cortex.

Routinely processed, hematoxylin and eosin (H&E)-stained slides are typically used to assess the morphologic integrity of the central nervous system in neurotoxicity safety studies. However, the value of special stains for improving neuropathologic evaluations during the assessment of neurotoxicity has been emphasized in the neuroscience literature and by regulatory agencies. The primary objective of the present study was to characterize the spatial and temporal changes in neurons, astrocytes, and microglia after dizocilpine maleate (MK-801)-induced focal neuronal necrosis in the posterior cingulate/retrosplenial (PC/RS) cortex of the rat. A secondary objective was to evaluate the application of special stains and a novel sectioning procedure for detecting neurotoxicity. Sixty adult male Sprague-Dawley rats were treated with sterile water vehicle or 10 mg/kg MK-801 and perfused through the left ventricle (pumped at 65 mm Hg pressure) with 10% neutral buffered formalin or 4% paraformaldehyde at 4 hr and on days 1, 3, 7, 14, and 28 after treatment. For light microscopic evaluation, brain sections were stained with H&E, a special cupric-silver (CS) stain that selectively impregnates degenerating neurons and makes them readily evident, glial fibrillary acidic protein (GFAP) immunohistochemistry for astrocytes, and Griffonia simplicifolia isolectin B4(GSA) histochemistry for microglia. Brains perfusion-fixed with 4% paraformaldehyde were prepared for CS staining with a novel frozen-sectioning procedure for multiple embedding in a composite gelatin block. In H&E sections from treated rats, necrotic nerve cell bodies were observed in PC/RS cortical layers 3 and 4 on days 1, 3, 7, and 14, but not on day 28. These necrotic neurons required high magnification for detection (x20 objective, x10 ocular). In contrast, degenerating neurons selectively stained with CS were observed in the same location as necrotic neurons seen with H&E but at low magnification (x2 objective, x10 ocular). Cupric-silver staining showed details not seen with H&E, including dendritic and axonal degeneration with progressive fragmentation. Beginning on day 3, GFAP immunohistochemistry revealed hypertrophic astrocytes in a diffuse pattern throughout the region of cell body necrosis, a change that persisted throughout the study. However, GSA lectin histochemistry identified a few reactive microglia on day 1 in a multifocal pattern throughout the region of cell body necrosis. Reactive microglia were observed on days 3, 7, and 14, but not on day 28. Glial changes observed with H&E staining were limited to an increase in the cellularity of glial cell nuclei in the area of neuronal necrosis. This study provides a comprehensive and integrated view of the temporal changes occurring in neurons, astrocytes, and microglia during acute neurotoxic injury. Moreover, advantages for using new staining and sectioning methodologies to enhance the toxicologic evaluation of the central nervous system are demonstrated.

Animals↗

Detection and quantification of embolic particles during percutaneous coronary intervention to stable plaque: it correlates to coronary flow dynamics and myocardial damage.

OBJECTIVES: We detected embolic particles liberated from plaque during percutaneous coronary intervention (PCI) as high-intensity transient signals (HITS) with a Doppler guidewire and studied their impact on coronary flow dynamics and the myocardium in patients with stable angina pectoris. BACKGROUND: These embolic particles during PCI may cause myocardial injury. However, this was difficult to confirm because it was impossible to detect embolic particles. METHODS: We performed balloon angioplasty followed by stenting in 31 patients while monitoring coronary flow velocity. After PCI, we measured average peak velocity at baseline and after infusion of adenosine 5'-triphosphate to calculate coronary flow velocity reserve (CFVR) and coronary resistance index (CRI). In patients with PCI to the left coronary artery (n = 21), we calculated relative CFVR as the ratio of CFVR in the target vessel to that in the reference vessel. We measured cardiac troponin T (cTnT) the day after PCI. RESULTS: HITS were detected in 27 (87%) of 31 patients and the majority were observed after stenting. The total number of HITS was correlated with CRI (r = 0.36, P = 0.049) or relative CFVR (r = 0.65, P = 0.0036) but not with CFVR (r = 0.048, P = 0.82). Thirteen patients showed elevated cTnT (range, 0.05-0.31 ng/ml) and the total number of HITS was greater in those with elevated cTnT than in those without elevated cTnT (24 +/- 9 vs. 10 +/- 7, P = 0.0007). CONCLUSIONS: Embolic particles are frequently observed during PCI to stable plaque and the majority are liberated after stenting. There appears to be a quantitative relationship between amounts of HITS and coronary microvessel dysfunction and minor myocardial injury.

Aged↗

Automatic spike detection via an artificial neural network using raw EEG data: effects of data preparation and implications in the limitations of online recognition.

OBJECTIVE: Automatic detection of epileptic EEG spikes via an artificial neural network has been reported to be feasible using raw EEG data as input. This study re-investigated its suitability by further exploring the effects of data preparation on classification performance testing. METHODS: Six hundred EEG files (300 spikes and 300 non-spikes) taken from 20 patients were included in this study. Raw EEG data were sent to the neural network using the architecture reported to give best performance (30 input-layer and 6 hidden-layer neurons). RESULTS: Significantly larger weighting of the 10th input-layer neuron was found after training with prepared raw EEG data. The classification process was thus dominated by the peak location. Subsequent analysis showed that online spike detection with an erroneously trained network yielded an area less than 0.5 under the receiver-operating-characteristic curve, and hence performed inferiorly to random assignments. Networks trained and tested using the same unprepared EEG data achieved no better than about 87% true classification rate at equal sensitivity and specificity. CONCLUSIONS: The high true classification rate reported previously is believed to be an artifact arising from erroneous data preparation and off-line validation. Spike detection using raw EEG data as input is unlikely to be feasible under current computer technology.

Brain↗

[Early detection of profound hearing loss in children. Results of screening students in Rhine schools for the deaf and hearing impaired in Cologne].

OBJECTIVE: Early detection and adequate and timely rehabilitation of profound deafness in children is accepted as an important aim of preventive child health care. Ideally, rehabilitation of congenital deafness should not be delayed beyond the age of six months. The present study seeks to determine whether this goal has been achieved in Germany in the 1990s. PATIENTS AND METHODS: The medical charts of 314 profoundly hearing impaired pupils at the schools for the hearing impaired in Cologne, Germany, were reviewed. All available data on the time of first suspicion and the final diagnosis were collected. In addition, the families of these children were interviewed using a standardized questionnaire. RESULTS: The mean age at first suspicion was 2.1 years, the mean age at the time of final diagnosis was 2.6 years (median: 2.0 years). Breaking down the whole cohort into three subgroups according to the year of birth revealed obvious differences between these subgroups. The final diagnosis for those born from 1974 to 1979 (n = 70) was confirmed in 48.6% at the age of two years, in 46.3% for those born from 1980 to 1985 (n = 121), and in 65.8% for those born from 1986 to 1991 (n = 114) at the age of two. The diagnosis was significantly delayed for children of immigrants (n = 96), where the mean age at diagnosis was 3.7 years as opposed to 2.0 years for the native German population. Of the 314 children, 304 where supplied with hearing aids and five with cochlear implants. Once the audiological diagnosis had been established, no further delay in rehabilitation was noticed. CONCLUSION: Although highly sensitive, cost effective, and non-invasive screening methods (transient evoked otoacoustic emissions and auditory brainstem response audiometry) for the early detection of profound inborn hearing impairment are now available, the current state of early identification of these disorders is inadequate. The reason for this is the lack of a universal and nationwide neonatal screening program. The results of this study indicate that the pure availability of sophisticated screening methods is insufficient if they are not included in a universal screening program.

Child↗

[Detection of mutations in exon 7 of p53 from fresh tumor samples by single-strand conformation polymorphism and direct DNA sequencing].

OBJECTIVE: To detect mutations of exon 7 of p53 gene in laryngeal squamous cell carcinoma (LSCC) and analyze the relationship between the mutation and LSCC. METHODS: Fresh tumor samples from 60 LSCC patients were examined using polymerase chain reaction-single-strand conformation polymorphism (PCR-SSCP) and direct DNA sequencing. RESULTS: An extra band in SSCP 3 was shown in 25 out of 60 samples. Exon 7 of p53 were detected by direct DNA sequencing in 8 samples taken at random from 25 cases. In 8 cases, 1 base pair deletion CCC-->CC in 250 codon which may result in frame shift mutation was shown. Simultaneously, in 3 cases, transversion AGT-->GGG in 261 codon which may bring out missense mutation was found. In 2 cases, 1 base pair deletion CGG-->GG in 248 codon was detected. In another case, 1 base pair deletion AGG-->AG in 249 codon was detected. Transversion ATC-->TTC in 254 codon was found in one of the cases. Transversion GGT-->TCA in 262 codon was found in another case. CONCLUSION: The codon 248, 250, 261 may be "hot spots" in LSCC. Mutations and deletions in exon 7 of p53 gene occurred frequently in LSCC.

Adult↗

Ontogeny of spatial discrimination in mice: a longitudinal analysis in the modified open-field with objects.

The present longitudinal study investigated the emergence of spatial discrimination and reaction to novelty in CD-1 mice, using a modified open-field test with four objects, a test in which responses to both spatial rearrangement of familiar objects and object novelty are assessed. Male and female mice were tested on postnatal days (pnd) 18, 28, 46 and 90. Locomotor activity was highest on pnd 90, whereas time spent on objects before rearrangement was highest on pnd 46. Eighteen-day old mice were unable to detect both object rearrangement and object novelty, suggesting immaturity in processing spatial information. On days 28 and 46 mice showed a clear response to object novelty, actively exploring the unfamiliar object placed in the arena, while at these ages object displacement elicited a generalized increase of exploration, not directed towards the displaced objects. A clear and selective response to object displacement emerged only at adulthood (day 90).

Animals↗

In vivo, real-time confocal imaging.

We have adapted a tandem scanning confocal microscope for real-time, non-invasive imaging of cells under in vivo conditions. This form of in vivo confocal imaging relies on the optical sectioning abilities of the confocal microscope to obtain en face, sequential, reflected light images of cells at various depths, up to 1 mm, within opaque organs in living animals. Of major consideration in the design of an in vivo confocal microscope is maximizing the real-time detection of signals reflected from low contrast structures which can be affected by the microscope design, objective, and image detector systems. Using an in vivo confocal microscope design with a 20 x BioOptics surface contact objective we have obtained live cellular images from selected tissues including cornea, kidney, liver, adrenal, thyroid, epididymis, and muscle and connective tissue of rabbits and rats. Images were captured, digitized, and processed using a DAGE Mti low light level SIT camera coupled to a Gould IP9527 image processor. In vivo images were also compared with conventional bright field light and scanning electron microscopic images of "dead," fixed tissues. Overall, in vivo confocal imaging can provide remarkable detail of living cells comparable to that of conventional microscopic images of "dead," fixed, and stained tissue. A more unique feature of in vivo confocal imaging is the ability to study cellular structure and function sequentially over time in the same organ or tissue and represents a fundamentally new paradigm in microscopy. With continued refinements in the microscope, objective and detection system designs and their consequent improvements in lateral and axial resolution, in vivo confocal microscopy will enable us as observers to see what no one has been able to see before.

Animals↗

Differential effects of retinal target displacement, changing size and changing disparity in the control of anterior/posterior and lateral body sway.

When visual information is provided in addition to input from other sensory systems, normal body sway can be attenuated by about 50%. The essential visual cue is retinal target displacement, which increases as eye-target distance is reduced. As a result, both lateral and anterior/posterior (A-P) sway decrease as eye/target distance decreases. We have investigated the geometrical basis of lateral and fore-aft sway detection by vision, the latter provided by detection of change in disparity of the visual axis of both eyes and change in target size. Using known movement detection thresholds the largest possible distance for visual stabilization of posture can be calculated to be 34 m for lateral sway, and for fore-aft sway 1.50 m for change in disparity and 3.20 m for change in size. Visual stimuli were designed to selectively stabilize fore-aft sway either by change in size or by change in disparity. The experiments revealed that the theoretical prediction overestimates the efficacy of visual stabilization of lateral sway and underestimates the efficacy of fore-aft sway stabilization. It is proposed that microoscillations of the eye increase the threshold for detection of retinal target displacements, leading to less efficient lateral sway stabilization than expected, and that the threshold for detection of self motion in the A-P direction is lower than the threshold for object motion detection used in the calculations, leading to more efficient stabilization of A-P sway.

Form Perception↗

Fluorescence tomographic imaging in turbid media using early-arriving photons and Laplace transforms.

We present a multichannel tomographic technique to detect fluorescent objects embedded in thick (6.4 cm) tissue-like turbid media using early-arriving photons. The experiments use picosecond laser pulses and a streak camera with single photon counting capability to provide short time resolution and high signal-to-noise ratio. The tomographic algorithm is based on the Laplace transform of an analytical diffusion approximation of the photon migration process and provides excellent agreement between the actual positions of the fluorescent objects and the experimental estimates. Submillimeter localization accuracy and 4- to 5-mm resolution are demonstrated. Moreover, objects can be accurately localized when fluorescence background is present. The results show the feasibility of using early-arriving photons to image fluorescent objects embedded in a turbid medium and its potential in clinical applications such as breast tumor detection.

Algorithms↗

Blind robust watermarking schemes for copyright protection of 3D mesh objects.

In this paper, two novel methods suitable for blind 3D mesh object watermarking applications are proposed. The first method is robust against 3D rotation, translation, and uniform scaling. The second one is robust against both geometric and mesh simplification attacks. A pseudorandom watermarking signal is cast in the 3D mesh object by deforming its vertices geometrically, without altering the vertex topology. Prior to watermark embedding and detection, the object is rotated and translated so that its center of mass and its principal component coincide with the origin and the z-axis of the Cartesian coordinate system. This geometrical transformation ensures watermark robustness to translation and rotation. Robustness to uniform scaling is achieved by restricting the vertex deformations to occur only along the r coordinate of the corresponding (r, theta, phi) spherical coordinate system. In the first method, a set of vertices that correspond to specific angles theta is used for watermark embedding. In the second method, the samples of the watermark sequence are embedded in a set of vertices that correspond to a range of angles in the theta domain in order to achieve robustness against mesh simplifications. Experimental results indicate the ability of the proposed method to deal with the aforementioned attacks.

Algorithms↗

Detection of micrometastatic tumor cells in pN0 lymph nodes of patients with completely resected nonsmall cell lung cancer: impact on recurrence and Survival.

OBJECTIVE: To detect occult micrometastatic tumor cells in pN0 lymph nodes of nonsmall cell lung cancer (NSCLC) by a combination of cytokeratin and p53 immunohistochemistry staining, and to evaluate the relation between the micrometastasis in pN0 lymph nodes and the prognosis of patients with completely resected stage 1 NSCLC. SUMMARY BACKGROUND DATA: The average 5-year survival rate for patients with completely resected stage 1 NSCLC is only about 70%; thus, about 30% of these patients have recurrent disease. This suggests that occult micrometastasis may exist at the time of surgery; the rate is clearly underestimated by current clinical staging examinations and conventional histopathologic methods. METHODS: A total of 474 hilar and mediastinal lymph nodes were removed during surgery from 49 patients with completely resected stage 1 NSCLC. The lymph nodes analyzed for micrometastasis using immunohistochemical staining with the biclonal anticytokeratin antibody, AE1/AE3. Of these 474 lymph nodes from 49 patients, 263 lymph nodes from 25 patients, whose primary tumors were positive for the p53 protein, were subjected to immunohistochemical staining with the monoclonal anti-p53 protein antibody DO-1. RESULTS: Cells positive for cytokeratin and p53 protein were found in 35 (7.4%) of 474 and 20 (7.6%) of 263 lymph nodes, respectively; 17 (34.7%) of 49 patients had cytokeratin-positive cells and 10 (40.0%) of 25 patients had p53-positive cells in their pN0 lymph nodes. By a combination of cytokeratin and p53 protein immunohistochemical staining, micrometastatic tumor cells were identified in pN0 lymph nodes in 22 (44.9%) of 49 patients. The patients with lymph node micrometastasis identified by a combination of cytokeratin and p53 protein immunohistochemical staining had a poorer prognosis than those without micrometastasis on both univariate and multivariate analyses (overall survival, P =.0003 and 0.013, respectively). CONCLUSIONS: The detection of lymph nodal micrometastasis by cytokeratin and p53 protein immunohistochemical staining will be helpful to predict the recurrence and prognosis of patients with completely resected stage 1 NSCLC.

Carcinoma, Non-Small-Cell Lung↗

[Detection of expression of heat shock protein 47 mRNA in pathological scar tissue by using real-time fluorescent quantitative RT-PCR].

OBJECTIVE: To detect the expression of heat shock protein 47 mRNA in pathological scar tissue by using real-time fluorescent quantitative reverse transcription-polymerase chain reaction (RT-PCR). METHODS: The tissues of normal skin (n = 6), hypertrophic scar (n = 6) and keloid (n = 6) were adopted, which were diagnosed by Pathology Department. Based on fluorescent TaqMan methodology, the real-time fluorescent quantitative RT-PCR were adopted to detect the expression of heat shock protein 47 mRNA. RESULTS: Compared with normal skin tissue (0.019 +/- 0.021) x 10(5), the expressions of heat shock protein 47 cDNA of hypertrophic scar tissue (1.233 +/- 1.039) x 10(5) and keloid tissue (1.222 +/- 0.707) x 10(5) were higher, being significant differences (P < 0.05). CONCLUSION: A fluorescent quantitative method was successfully applied to detecting the expression of heat shock protein 47 mRNA. Heat shock protein 47 may play an important role in promoting the formation of pathological scar tissue.

Adolescent↗

The use of objective structured clinical examination (OSCE) for detecting and correcting teaching-learning errors in physical examination.

The innovative use of Objective Structured Clinical Examination (OSCE) to detect and correct teaching-learning (T-L) errors in clinical skills is described. The group performance errors could be classified as Type I (faulty performance or omission of a step), Type II (failure to recognize or correctly interpret a clinical sign) or combined (Type I & II) errors. Type I errors were due to ineffective or absent T-L experiences. Type II errors were due to poor concept attainment or inability to discriminate between the differences in a clinical sign. Clinical demonstration during feedback was effective in eliminating Type I errors. Correcting Type II errors of the group needed more time and effort and was only partially effective.

Clinical Competence↗

Women's response to fetal choroid plexus cysts detected by prenatal ultrasound.

OBJECTIVES: To determine maternal responses to detection of a minor structural variant, the choroid plexus cyst (CPC), in their fetus on prenatal ultrasound. STUDY DESIGN: We interviewed 34 pregnant women with an isolated CPC detected on mid-pregnancy ultrasound about their objective experience at diagnosis, emotional response and subsequent reactions. Audiotaped, transcribed responses were evaluated by two independent raters and analyzed qualitatively and quantitatively. RESULTS: All women reported negative emotional responses including shock, distress, fear and decreased attachment, despite counseling by 82% of providers that the CPC was probably benign. Three women underwent amniocentesis purely for reassurance after CPC detection. Most (79%) sought information beyond what their physician provided, frequently on the internet. One half of women reported that intense negative responses were temporary. However, weeks after diagnosis, 62% continued to believe that the CPC presented some danger to their baby. CONCLUSIONS: Detection of CPC prenatally can evoke profound, negative maternal emotional responses despite accurate provider counseling. Practitioners should consider these responses when counseling parents about these and other structural variants of unclear functional significance.

Adaptation, Psychological↗

Interexaminer variability of digital rectal examination in detecting prostate cancer.

OBJECTIVES: Digital rectal examination (DRE) is an important method of prostate cancer detection used by primary care physicians and medical specialists to identify patients in whom a prostatic biopsy is warranted. However, there is little empirical evidence assessing the degree of interexaminer variability in the use of DRE for the detection of prostate cancer. We addressed this issue within the framework of a prostate cancer screening study. METHODS: We performed DRE examinations in 116 consecutive volunteers twice on the same day, with different urologists performing the examinations. The urologists were blinded to the results of the other examination and to the subject's serum prostate-specific antigen (PSA) level. DRE results were coded as being benign or sufficiently suspicious for cancer to warrant a prostatic biopsy. RESULTS: Examiners independently agreed on the DRE findings in 98 of the 116 (84%) subjects. However, when adjusted for chance agreement, the interexaminer agreement among urologists was only fair (ie, kappa = 0.22, P = 0.009). Interexaminer variability was greater between faculty and resident examiners than among faculty examiners. CONCLUSIONS: Our results suggest that the reproducibility of DRE for detecting prostate cancer is only fair among urologists. Further studies are indicated to evaluate interexaminer variability between primary care physicians and urologists.

Aged↗

Detection of the cervical gland area in threatened preterm labor using transvaginal sonography in the assessment of cervical maturation and the outcome of pregnancy.

OBJECTIVES: To detect the cervical gland area in threatened preterm labor, and to determine its detection rate and relationship with cervical maturation and outcome of pregnancy in preterm labor. METHODS: This was a mixed longitudinal and cross-sectional study involving 615 transvaginal scans performed to detect the cervical gland area and measure cervical length in 101 singleton pregnancies with threatened preterm labor. The patients were treated with intravenous administration of ritodrine chloride for regular uterine contractions at 16-35 weeks of gestation. 260 normal singleton pregnancies served as controls. Simultaneously conventional digital examination was used to assess the cervical maturation index. The detection rates of the cervical gland area, measurements of cervical length by sonography, and assessment of the cervical maturation index by digital examination in threatened preterm labor were compared with those of normal singleton pregnancies. In the threatened labor group, the outcome of pregnancy was assessed according to the sonographic absence or presence of the cervical gland area. RESULTS: In the normal pregnancy group, the detection rate of the cervical gland area remained practically constant until the 31st week of pregnancy (97%), but substantially decreased thereafter (70.2% in gestational weeks 32-35). In the threatened preterm labor group, the detection rate of the cervical gland area was constantly lower (44.5%) and the cervical maturation index was higher (4.65 score) than in the normal pregnancy group (83.1% and 1.80 score, respectively). The outcome of pregnancy in the threatened preterm labor group was poorer in the subgroup with the absence of a cervical gland area than in the subgroup with the presence of a cervical gland area (duration of pregnancy 257.0 vs. 271.0 days, birth weight 2,597.2 vs. 2,990.0 g, and admission to delivery interval 38.8 vs. 60.8 days). Highly significant correlations were noted among the detection rates of a cervical gland area and cervical length, cervical maturation index, and outcome of pregnancy. CONCLUSIONS: This study demonstrates for the first time that the sonographic absence of the cervical gland area reflects cervical maturation and could be considered as a predictor of threatened preterm labor and a sign of poor outcome of pregnancy in this condition.

Adolescent↗

Properties of structured association approaches to detecting population stratification.

OBJECTIVE: To examine the properties of the structured association approach for the detection and correction of population stratification. METHOD: A method is developed, within a latent class analysis framework, similar to the methods proposed by Satten et al. (2001) and Pritchard et al. (2000). A series of simulations illustrate the relative impact of number and type of loci, sample size and population structure. RESULTS: The ability to detect stratification and assign individuals to population strata is determined for a number of different scenarios. CONCLUSION: The results underline the importance of careful marker selection.

Algorithms↗

Fluorescence in situ hybridization (FISH) as a method to detect aneuploid cells.

OBJECTIVES: To test the sensitivity and specificity of various FISH probes for detecting male and aneuploid cells and to determine the percentage of fetal cells that must be present in a sample in order to use the probes for prenatal diagnosis. METHODS: Adult human lymphocytes were cultured and harvested. Twelve different proportions of male to female cells and 5 different proportions of trisomy 21 cells and trisomy 18 cells in euploid cells were prepared for FISH. Alpha-satellite DYZ1 was applied to detect the male cells. Chromosome 21/Down syndrome critical region cosmid and D13Z1/D21Z1 alpha-satellite probes were applied to detect trisomy 21 cells. The D18Z1 alpha-satellite probe was used to detect trisomy 18 cells. RESULTS: DYZ1 detected male cells reliably in concentrations as low as 2%. Both D18Z1 and chromosome 21/Down syndrome critical region cosmid probes could detect aneuploid cells at reasonably achievable concentrations. However, the D13Z1/D21Z1 probe was not sensitive below concentrations of 50%. CONCLUSIONS: FISH is an alternative technique for noninvasive prenatal diagnosis. The sensitivity and specificity of FISH probes may play a crucial role in the accuracy of prenatal diagnosis.

Adult↗