Visual symptoms in Parkinson's disease and Parkinson's disease dementia

Visual symptoms are common in PD and PD dementia and include difficulty reading, double vision, illusions, feelings of presence and passage, and complex visual hallucinations. Despite the established prognostic implications of complex visual hallucinations, the interaction between cognitive decline, visual impairment, and other visual symptoms remains poorly understood. Our aim was to characterize the spectrum of visual symptomatology in PD and examine clinical predictors for their occurrence. Sixty-four subjects with PD, 26 with PD dementia, and 32 age-matched controls were assessed for visual symptoms, cognitive impairment, and ocular pathology. Complex visual hallucinations were common in PD (17%) and PD dementia (89%). Dementia subjects reported illusions (65%) and presence (62%) more frequently than PD or control subjects, but the frequency of passage hallucinations in PD and PD dementia groups was equivalent (48% versus 69%, respectively; P = 0.102). Visual acuity and contrast sensitivity was impaired in parkinsonian subjects, with disease severity and age emerging as the key predictors. Regression analysis identified a variety of factors independently predictive of complex visual hallucinations (e.g., dementia, visual acuity, and depression), illusions (e.g., excessive daytime somnolence and disease severity), and presence (e.g., rapid eye movement sleep behavior disorder and excessive daytime somnolence). Our results demonstrate that different "hallucinatory" experiences in PD do not necessarily share common disease predictors and may, therefore, be driven by different pathophysiological mechanisms. If confirmed, such a finding will have important implications for future studies of visual symptoms and cognitive decline in PD and PD dementia.

Stable N isotope composition of nitrate reflects N transformations during the passage of water through a montane rain forest in Ecuador

Knowledge of the fate of deposited N in the possibly N-limited, highly biodiverse north Andean forests is important because of the possible effects of N inputs on plant performance and species composition. We analyzed concentrations and fluxes of NO3 −–N, NH4 +–N and dissolved organic N (DON) in rainfall, throughfall, litter leachate, mineral soil solutions (0.15–0.30 m depths) and stream water in a montane forest in Ecuador during four consecutive quarters and used the natural 15N abundance in NO3 − during the passage of rain water through the ecosystem and bulk δ15N values in soil to detect N transformations. Depletion of 15N in NO3 − and increased NO3 −–N fluxes during the passage through the canopy and the organic layer indicated nitrification in these compartments. During leaching from the organic layer to mineral soil and stream, NO3 − concentrations progressively decreased and were enriched in 15N but did not reach the δ15N values of solid phase organic matter (δ15N = 5.6–6.7‰). This suggested a combination of nitrification and denitrification in mineral soil. In the wettest quarter, the δ15N value of NO3 − in litter leachate was smaller (δ15N = −1.58‰) than in the other quarters (δ15N = −9.38 ± SE 0.46‰) probably because of reduced mineralization and associated fractionation against 15N. Nitrogen isotope fractionation of NO3 − between litter leachate and stream water was smaller in the wettest period than in the other periods probably because of a higher rate of denitrification and continuous dilution by isotopically lighter NO3 −–N from throughfall and nitrification in the organic layer during the wettest period. The stable N isotope composition of NO3 − gave valuable indications of N transformations during the passage of water through the forest ecosystem from rainfall to the stream.

The contribution of glacial archaeology to our knowledge of alpine passages - L'apport de l'archéologie des glaciers dans la connaissance des voies de passage alpins

Die europäischen Alpen sind in den Hochlagen trotz einem immensen Rückgang in den letzten Jahrzehnten immer noch stark vergletschert. Früher dachte man, dass die alpine Zone über rund 2000 m über Meer vom prähistorischen Menschen nicht begangen wurde. 1991 zeigte die Entdeckung des Mannes aus dem Eis beim Tisenjoch („Ötzi“) in über 3000 m Höhe, dass schon im Neolithikum Vorstösse bis in die vergletscherten Gebiete der Alpen stattgefunden haben. Die ältesten Spuren am Schnidejoch, einem Pass in den Berner Alpen der Schweiz, reichen bis in die Zeit zwischen 4800 und 4500 v.Chr. zurück. Der Pass wurde auch in der Frühen Bronzezeit benutzt, wie zahlreiche Objekte aus der Zeit zwischen etwa 2200 und 1600 v.Chr. belegen. Frühbronzezeitliche Funde liegen auch vom Lötschenpass, einem zweiten Passübergang in den Berner Alpen vor. Nördlich dieser Übergänge befinden sich die bekannten frühbronzezeitlichen Gräber des Berner Oberlandes (Region des unteren Thunersees), südlich davon stammen zahlreiche frühbronzezeitliche Funde aus Gräbern und Nekropolen im Rhonetal. Dank der Erhaltung von organischem Material bieten die Eisfundstellen wertvolle Einblicke zur Frequentierung der Hochalpen. Neben Bohlenwegen, Strassen und Brücken bilden Pässe wichtige Elemente des prähistorischen terrestrischen Transportsystems.

Influence of the Central American Seaway and Drake Passage on ocean circulation and neodymium isotopes: A model study

The sensitivity of the neodymium isotopic composition (ϵNd) to tectonic rearrangements of seaways is investigated using an Earth System Model of Intermediate Complexity. The shoaling and closure of the Central American Seaway (CAS) is simulated, as well as the opening and deepening of Drake Passage (DP). Multiple series of equilibrium simulations with various intermediate depths are performed for both seaways, providing insight into ϵNd and circulation responses to progressive throughflow evolutions. Furthermore, the sensitivity of these responses to the Atlantic Meridional Overturning Circulation (AMOC) and the neodymium boundary source is examined. Modeled ϵNd changes are compared to sediment core and ferromanganese (Fe-Mn) crust data. The model results indicate that the North Atlantic ϵNd response to the CAS shoaling is highly dependent on the AMOC state, i.e., on the AMOC strength before the shoaling to shallow depths (preclosure). Three scenarios based on different AMOC forcings are discussed, of which the model-data agreement favors a shallow preclosure (Miocene) AMOC (∼6 Sv). The DP opening causes a rather complex circulation response, resulting in an initial South Atlantic ϵNd decrease preceding a larger increase. This feature may be specific to our model setup, which induces a vigorous CAS throughflow that is strongly anticorrelated to the DP throughflow. In freshwater experiments following the DP deepening, ODP Site 1090 is mainly influenced by AMOC and DP throughflow changes, while ODP Site 689 is more strongly influenced by Southern Ocean Meridional Overturning Circulation and CAS throughflow changes. The boundary source uncertainty is largest for shallow seaways and at shallow sites.

In Vitro and In Vivo Validation of Human and Goat Chondrocyte Labeling by Green Fluorescent Protein Lentivirus Transduction

We investigated whether human articular chondrocytes can be labeled efficiently and for long-term with a green fluorescent protein (GFP) lentivirus and whether the viral transduction would influence cell proliferation and tissue-forming capacity. The method was then applied to track goat articular chondrocytes after autologous implantation in cartilage defects. Expression of GFP in transduced chondrocytes was detected cytofluorimetrically and immunohistochemically. Chondrogenic capacity of chondrocytes was assessed by Safranin-O staining, immunostaining for type II collagen, and glycosaminoglycan content. Human articular chondrocytes were efficiently transduced with GFP lentivirus (73.4 +/- 0.5% at passage 1) and maintained the expression of GFP up to 22 weeks of in vitro culture after transduction. Upon implantation in nude mice, 12 weeks after transduction, the percentage of labeled cells (73.6 +/- 3.3%) was similar to the initial one. Importantly, viral transduction of chondrocytes did not affect the cell proliferation rate, chondrogenic differentiation, or tissue-forming capacity, either in vitro or in vivo. Goat articular chondrocytes were also efficiently transduced with GFP lentivirus (78.3 +/- 3.2%) and maintained the expression of GFP in the reparative tissue after orthotopic implantation. This study demonstrates the feasibility of efficient and relatively long-term labeling of human chondrocytes for co-culture on integration studies, and indicates the potential of this stable labeling technique for tracking animal chondrocytes for in cartilage repair studies.

DNase 2 is the main DNA-degrading enzyme of the stratum corneum

The cornified layer, the stratum corneum, of the epidermis is an efficient barrier to the passage of genetic material, i.e. nucleic acids. It contains enzymes that degrade RNA and DNA which originate from either the living part of the epidermis or from infectious agents of the environment. However, the molecular identities of these nucleases are only incompletely known at present. Here we performed biochemical and genetic experiments to determine the main DNase activity of the stratum corneum. DNA degradation assays and zymographic analyses identified the acid endonucleases L-DNase II, which is derived from serpinB1, and DNase 2 as candidate DNases of the cornified layer of the epidermis. siRNA-mediated knockdown of serpinB1 in human in vitro skin models and the investigation of mice deficient in serpinB1a demonstrated that serpinB1-derived L-DNase II is dispensable for epidermal DNase activity. By contrast, knockdown of DNase 2, also known as DNase 2a, reduced DNase activity in human in vitro skin models. Moreover, the genetic ablation of DNase 2a in the mouse was associated with the lack of acid DNase activity in the stratum corneum in vivo. The degradation of endogenous DNA in the course of cornification of keratinocytes was not impaired by the absence of DNase 2. Taken together, these data identify DNase 2 as the predominant DNase on the mammalian skin surface and indicate that its activity is primarily targeted to exogenous DNA.

Passing the thrombus in endovascular treatment of acute ischemic stroke: Do we penetrate the thrombus?

Mechanical thrombectomy is increasingly applied during the treatment of acute stroke. Various devices have been advocated with different sites of force effect at the thrombus. The purpose of this study was to evaluate the angiographic route of passing systematically and therefore to assess the site of deployment of mechanical devices in correlation to the thrombus in interventional stroke treatment. Twenty-one consecutive patients with endovascular treatment for acute ischemic stroke with 26 passing procedures were evaluated prospectively. Occlusion site was the M1-segment in 17 cases (65.4%), ICA termination in five cases (19.2%), M2-segment in two cases (7.7%), the A2-segment in one case (3.8%) and basilar artery in one case (3.8%). On angiographic images the microwire and microcatheter passage was evaluated by illustrating the entry point and course across the occlusion site in relation to the thrombus in different projections and in correlation to the recanalisation result. Results were correlated to the origin of the thrombi according to the TOAST criteria. In all cases the point of entry to the occlusion site was delineated laterally to the thrombus in at least one projection. The course of the wire across the occluded segment in relation to the thrombus was found to be laterally in 22 procedures (84.6%). In the majority of M1-occlusions (12/17, 70.6%) the passage was found in the cranial aspect of the thrombus. In four procedures (15.4%) angiograms in different projections did not unequivocally confirm a passage laterally to the thrombus. The route of passing the thrombus was independent of thrombus origin according to the TOAST criteria. In the majority of cases the complete route of passing the occlusion site was visualized angiographically. Entrance of the microwire and microcatheter at proximal surface of the thrombus takes place laterally to the thrombus and accordingly the passage takes place between the thrombus and the vessel wall independent of thrombus origin. A penetration of the thrombus was not observed. This route of passing has implications on deployment and transmission of force in relation to the thrombus in mechanical approaches and consequently on the development of retrieval devices.

Eluding oblivion with smart stochastic selection of synaptic updates

The variables involved in the equations that describe realistic synaptic dynamics always vary in a limited range. Their boundedness makes the synapses forgetful, not for the mere passage of time, but because new experiences overwrite old memories. The forgetting rate depends on how many synapses are modified by each new experience: many changes means fast learning and fast forgetting, whereas few changes means slow learning and long memory retention. Reducing the average number of modified synapses can extend the memory span at the price of a reduced amount of information stored when a new experience is memorized. Every trick which allows to slow down the learning process in a smart way can improve the memory performance. We review some of the tricks that allow to elude fast forgetting (oblivion). They are based on the stochastic selection of the synapses whose modifications are actually consolidated following each new experience. In practice only a randomly selected, small fraction of the synapses eligible for an update are actually modified. This allows to acquire the amount of information necessary to retrieve the memory without compromising the retention of old experiences. The fraction of modified synapses can be further reduced in a smart way by changing synapses only when it is really necessary, i.e. when the post-synaptic neuron does not respond as desired. Finally we show that such a stochastic selection emerges naturally from spike driven synaptic dynamics which read noisy pre and post-synaptic neural activities. These activities can actually be generated by a chaotic system.

[The incidence of Dicrocoelium dendriticum in Emmental]

A cross-sectional field study on the prevalence of Dicrocoelium dendriticum was performed in the Emmental. The study included 211 bovines, 170 equines, 20 ovines, 46 caprines and 23 rabbits (from 119 farms). In addition, laboratory routine diagnostic data obtained from 2.840 animals--all originating from the same area of investigation--were assessed in the same way. The infection extent concerning the different animal species were the following: bovines 46%, equines 12%, ovines 30%, caprines 48% and rabbits 9%. Univariate analyses of baseline epidemiological data identified no significant risk factors, with the exception of the type of stable used. Bovines kept in a modern free ranging stable had a significantly lower chance of infection with D. dendriticum than cattle in conventional tie stalls. The epidemiological data characterizing the area of investigation suggest the following procedure to reduce the problem of dicrocoeliosis: Pasturing animals of all ages should be regularly dewormed (e.g. every six week during pasture) using a compound effective against D. dendriticum. A treatment is especially indicated at the time after pasture in autumn or before housing the animals in winter. In spring, only animals having pastured the year before need to be treated prior to pasture in the new year. However, it is recommended to perform an economic analysis comparing costs of treatment versus putative costs of damage prior to the initiation of a strategic campaign: animal welfare aspects have to be considered. The laboratory routine diagnostic data showed infection extent similar to those of the cross-sectional study: bovines 60%, equines 24%, ovines 26%, caprines 31%, rabbits 32%. Atypical hosts such as dogs and cats exhibited low infection extent (3% and 1%, respectively), rather reflecting a gastro-intestinal passage of parasite eggs ingested by consumption of infected livers or by coprophagy of ruminant faeces.

Immunophenotypic changes of human articular chondrocytes during monolayer culture reflect bona fide dedifferentiation rather than amplification of progenitor cells

In this study, a time-course comparison of human articular chondrocytes (HAC) and bone marrow-derived mesenchymal stem cells (MSC) immunophenotype was performed in order to determine similarities/differences between both cell types during monolayer culture, and to identify HAC surface markers indicative of dedifferentiation. Our results show that dedifferentiated HAC can be distinguished from MSC by combining CD14, CD90, and CD105 expression, with dedifferentiated HAC being CD14+/CD90bright/CD105dim and MSC being CD14-/CD90dim/CD105bright. Surface markers on MSC showed little variation during the culture, whereas HAC showed upregulation of CD90, CD166, CD49c, CD44, CD10, CD26, CD49e, CD151, CD51/61, and CD81, and downregulation of CD49a, CD54, and CD14. Thus, dedifferentiated HAC appear as a bona fide cell population rather than a small population of MSC amplified during monolayer culture. While most of the HAC surface markers showed major changes at the beginning of the culture period (Passage 1-2), CD26 was upregulated and CD49a downregulated at later stages of the culture (Passage 3-4). To correlate changes in HAC surface markers with changes in extracellular matrix gene expression during monolayer culture, CD14 and CD90 mRNA levels were combined into a new differentiation index and compared with the established differentiation indices based on the ratios of mRNA levels of collagen type II to I (COL2/COL1) and of aggrecan to versican (AGG/VER). A correlation of CD14/CD90 ratio at the mRNA and protein level with the AGG/VER ratio during HAC dedifferentiation in monolayer culture validated CD14/CD90 as a new membrane and mRNA based HAC differentiation index.

Enhancement of titanium implants via bioengineered periodontal tissues

Osseointegration of titanium dental implants into the jaw bone, which is required for maintenance of the implant in the jaw, results in ankylosis. Dental implants are therefore very unlike natural teeth, which exhibit significant movement in response to mechanical forces. The ability to generate periodontal ligament (PDL) tissues onto dental implants would better mimic the functional characteristics of natural teeth, and would likely improve implant duration and function. OBJECTIVES: The objective of this study was to investigate the feasibility of bioengineering PDL tissues onto titanium implant surfaces. METHODS: Bilateral maxillary first and second molars of 8-week old rats were extracted and used to generate single cell suspensions of PDL tissues, which were expanded in culture. Immunohistochemistry and RT-PCR were used to identify putative PDL progenitor/stem cell populations and characterize stem cell properties, including self-renewal, multipotency and stem cell maker expression. Cultured rPDL cells were harvested at third passage, seeded onto Matrigel-coated titanium implants (1.75 mm x 1 mm), and placed into healed M1/M2 extraction sites. Non-cell seeded Matrigel-coated titanium implants served as negative controls. Implants were harvested after 8, 12, or 18 weeks. RESULTS: Cultured rPDL cells expressed the mesenchymal stem-cell marker STRO-1. Under defined culture conditions, PDL cells differentiated into adipogenic, neurogenic and osteogenic lineages. While control implants were largely surrounded by alveolar bone, experimental samples exhibited fibrous PDL-like tissues, and perhaps cementum, on the surface of experimental implants. CONCLUSIONS: PDL contains stem cells that can generate cementum/PDL-like tissue in vivo. Transplantation of these cells might hold promise as a therapeutic approach for the bioengineering of PDL tissues onto titanium implant. Further refinement of this method will likely result in improved dental implant strategies for use of autologous PDL tissue regeneration in humans. This research was supported by CIMIT, and NIH/NIDCR grant DE016132 (PCY), and TEACRS (YL).

Safety of prolonged sacral neuromodulation tined lead testing

OBJECTIVE: Prolonged sacral neuromodulation (SNM) testing is more reliable for accurate patient selection than the usual test period of 4-7 days. However, prolonged testing was suspected to result in a higher complication rate due to infection via the percutaneous passage of the extension wire. Therefore, we prospectively assessed the complications associated with prolonged tined lead testing. PATIENTS AND METHODS: A consecutive series of 44 patients who underwent prolonged tined lead testing for at least 14 days between May 2002 and April 2007 were evaluated. Complications during prolonged tined lead testing, during and after tined lead explantation and during follow-up after implantation of the implantable pulse generator (IPG) were registered prospectively. RESULTS: Four patients suffered from urgency-frequency syndrome, 13 from urge incontinence, 18 from non-obstructive chronic urinary retention and nine from chronic pelvic pain syndrome. The median test phase was 30 days (interquartile range [IQR] 21-36). Thirty-two of the 44 patients (73%) had successful prolonged tined lead testing and 31 of these (97%) underwent the implantation of the IPG. The median follow-up of the IPG implanted patients was 31 months (IQR 20-41). The complication rate was 5% (2/44) during prolonged tined lead testing and 16% (5/31) during follow-up of the IPG implanted patients, respectively. None of the complications could be attributed to prolonged testing. No infections were observed during the study period. CONCLUSIONS: This prospective, observational non-randomised study suggests prolonged SNM tined lead testing is a safe procedure. Based on the low complication rate and the increased reliability for accurate patient selection, this method is proposed as a possible standard test procedure, subject to confirmation by further randomised, controlled clinical studies.