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Biomedical subjects

D C Anthony

Publications and source records attributed to D C Anthony.

At least 19 recordsLinked to original sources
PubMed1998

Matrix metalloproteinase expression in an experimentally-induced DTH model of multiple sclerosis in the rat CNS.

In an experimentally-induced DTH model of MS, we examined mRNA and protein expression of a range of MMPs and of TNFalpha to establish the contribution that individual MMPs might make to the pathogenesis. In control rat brain, mRNA for all of the MMPs examined was detectable. However, by immunohistochemistry, only MMP-2 could be detected. In the DTH lesions, significant increases in the level of mRNA expression were observed for MMP-7, MMP-8, MMP-12, and TNFalpha. Where expression of MMP mRNA was increased, there was a corresponding increase in protein expression detected by immunohistochemistry. To determine whether the upregulated MMPs could invoke destructive events in the CNS, highly purified activated MMP-7, MMP-8, and MMP-9 were stereotaxically injected into the brain parenchyma. All provoked recruitment of leukocytes and BBB breakdown. In addition, MMPs 7 and 9 induced loss of myelin staining. In conclusion, specific MMPs are upregulated in DTH lesions; for the most part, measurement of mRNA was a predictor of increased protein expression. From our injections of MMPs, it is clear that the upregulated MMPs in the DTH lesions could participate in the disruption of the BBB, leukocyte recruitment, and tissue damage.

Animals↗
PubMed1998

Stroke: a double-edged sword for cleaving clots?

The discovery that tissue plasminogen activator can promote neuronal degeneration has uncovered a novel pathway leading to neuronal cell death and raises important issues concerning the use of tissue plasminogen activator as a thrombolytic therapy for stroke.

Animals↗
PubMed1998

Mutilating hand syndrome in an infant with familial carpal tunnel syndrome.

A 7-month-old infant, son of consanguinous Indian parents, presented with recurrent chewing of his digits in a median nerve distribution as the primary manifestation of carpal tunnel syndrome, in conjunction with features consistent with congenital insensitivity to pain. Electromyography (EMG) demonstrated severe median nerve entrapment at the wrist bilaterally, but other nerves were normal. In spite of clinical evidence of diffuse pain insensitivity, sural nerve and skin biopsies were normal, and he had no evidence of autonomic dysfunction. Hand findings evolved with scarring and infection of median innervated digits and loss of fine motor skills. Carpal tunnel release resulted in complete clinical resolution and significant EMG improvement. Milder symptoms and EMG evidence of median nerve entrapment were demonstrated in both parents, paternal grandparents, and several of his father's siblings. We hypothesize this child may be homozygous for a mutant allele that in its heterozygous state predisposes to familial autosomal dominant carpal tunnel syndrome. Homozygosity for this or another mutant allele may be responsible for his congenital insensitivity to pain.

Action Potentials↗
PubMed1998

Loss of the tight junction proteins occludin and zonula occludens-1 from cerebral vascular endothelium during neutrophil-induced blood-brain barrier breakdown in vivo.

The tight junctions found between cerebral vascular endothelial cells form the basis of the blood-brain barrier. Breakdown of the blood-brain barrier is a feature of a variety of CNS pathologies that are characterized by extensive leucocyte recruitment, such as multiple sclerosis and stroke. The molecular mechanisms associated with opening of the blood-brain barrier and leucocyte recruitment in vivo are currently poorly understood. We have used an in vivo rat model to investigate the molecular response of the CNS endothelium to neutrophil adhesion and migration. Injection of interleukin-1 beta into the striatum of juvenile brains results in a neutrophil-dependent increase in vessel permeability at 4 h. Only a subset of blood vessels were associated with neutrophil recruitment. These particular vessels displayed an increase in phosphotyrosine staining, loss of the tight junctional proteins, occludin and zonula occludens-1, and apparent redistribution of the adherens junction protein vinculin. Examination of these vessels under the electron microscope indicated that the cell-cell adhesions in such vessels are morphologically different from normal junctions. This study provides the first direct evidence in vivo that leucocyte recruitment can trigger signal transduction cascades leading to junctional disorganization and blood-brain barrier breakdown. Our results have established an endothelial cell molecular profile associated with leucocyte-induced blood-brain barrier breakdown in vivo, and the relevance of different in vitro cell culture models may now be viewed more objectively.

Aging↗
PubMed1998

Childhood brain tumor: neuroimaging correlated with disease outcome.

The authors explored the hypothesis that functional behavior of childhood brain tumors can be estimated by serial analysis of imaging (thallium-201 [201Tl] single-photon emission computed tomography and magnetic resonance imaging [MRI]) examinations. Seventy-five patients diagnosed on clinical or histologic grounds were monitored for a period of 1 day to 3.9 years (mean +/- S.D. = 1.39 +/- 1.10 years). Abnormal 201Tl uptake appeared to denote a subgroup of lesions with distinctly greater mortality and morbidity. Of 201Tl-positive patients, 17% died within the course of this study; no deaths occurred among the 201Tl-negative group. Other parameters of disease outcome also clearly separated the 201Tl-positive and 201Tl-negative groups, with the former demonstrating a 50% shorter period of recurrence-free survival from the time of diagnosis (two-tailed t test, P < 0.01). Significant enhancement with paramagnetic contrast agents paralleled 201Tl positivity in correlating with greater mortality but failed to predict duration of recurrence-free survival. The authors conclude that 201Tl activity provides significant predictive information of the expected biologic behavior of childhood brain tumors, both for duration of recurrence-free survival and for estimated life expectancy. This information complements and extends data provided by MRI enhancement patterns.

Adolescent↗
PubMed1998

Nerve sheath tumours with hybrid features of neurofibroma and schwannoma: a conceptual challenge.

AIMS: To characterize and delineate a subset of rare nerve sheath tumours showing hybrid features of neurofibroma and schwannoma. METHODS AND RESULTS: Nine lesions were identified in the authors' files showing predominant features of neurofibroma with distinct, often nodular regions of classical schwannomatous differentiation. Most patients were adults, eight out of nine were male. Of the nine lesions, two were dermal, two were subcutaneous and five were subfascial. Five lesions had a plexiform architecture and one patient had overt neurofibromatosis. One out of six patients with follow-up developed local recurrence. Schwannoma-like regions displayed strong S100 staining, in contrast to more varied and limited S100 reactivity in neurofibromatous areas. The Antoni A areas could be quite cellular with high MIB-1 proliferation indices. No lesion underwent malignant change. CONCLUSIONS: Our results demonstrate that some nerve sheath tumours may contain histologically clear components of both neurofibroma and schwannoma, suggesting that (despite evident and well-defined clinicopathological differences) these two lesions may be even more closely related than previously recognized. Whether this phenomenon results from a localized microenvironmental change or from a clonal genetic alteration remains unknown.

Adolescent↗
PubMed1998

Papillary glioneuronal tumor: a new variant of mixed neuronal-glial neoplasm.

We describe the clinicopathologic features of nine cases of a unique papillary glioneuronal tumor (PGNT) exhibiting astrocytic as well as extensive and varied neuronal differentiation. The four male and five female patients studied ranged in age from 11 to 52 years (mean 27.7 years). They either presented with mild neurologic symptoms or were asymptomatic. Magnetic resonance imaging showed demarcated cystic, 1.5-cm to 7-cm contrast-enhancing masses; five involved the temporal lobe, two the parietal, and two the frontal. All but one were totally resected. No recurrence was noted despite a follow-up period of 3 years. Two microscopic components were evident: 1) compact pseudopapillae composed of hyalinized vessels covered by a single layer of glial fibrillary acid protein (GFAP)-positive astrocytes and 2) synaptophysin-positive neuronal cells of varying size, including neurocytes, ganglioid cells, and ganglion cells within neuropil. Immunostains for chromogranin-A were negative, as was in situ hybridization for chromogranin-A mRNA. Ultrastructurally, neuronal cells featured microtubule-containing processes and aberrant synaptic terminals, but dense core granules were rare. Overall, cellularity was moderate and atypia was minimal. No mitotic activity or necrosis was noted. The proportions of the two components varied, but essential morphologic findings were identical in all cases. In that the clinical, radiographic, and morphologic characteristics of PGNT are distinctive, it appears to represent a previously undescribed form of mixed neuronal-glial tumor of the central nervous system.

Adolescent↗
PubMed1998

Structure-activity relation of N-alkyl tetracaine derivatives as neurolytic agents for sciatic nerve lesions.

BACKGROUND: N-butyl tetracaine has local anesthetic and neurolytic properties. An injection of this drug at the rat sciatic notch produces rapid onset and nerve impairment lasting > 1 week. This study aimed to elucidate the structure-activity relation of various tetracaine derivatives to design better neurolytic agents. METHODS: N-alkyl tetracaine salts (n = 2-6) were synthesized, and their ability to elicit sciatic nerve impairment of sensory and motor functions in vivo was tested in rats. A single dose (0.1 ml at 37 mM) was administered close to the sciatic nerve at the sciatic notch. Regeneration was assessed morphologically in transverse sections of treated nerves. Finally, the drug potency in blocking Na+ currents was studied under voltage-clamp conditions. RESULTS: N-ethyl and N-propyl tetracaine derivatives were non-neurolytic and elicited complete sciatic nerve block lasting 3-7 h. In contrast, N-butyl, N-pentyl, and N-hexyl tetracaine derivatives were strong neurolytic agents and elicited functional impairment of sciatic nerve for > 1 week. All derivatives were strong Na+ channel blockers, more potent than tetracaine if applied intracellularly. External drug application showed marked differences in their wash-in rate: tetracaine > N-hexyl > N-butyl > N-ethyl tetracaine. All derivatives were trapped within the cytoplasm and showed little washout within 7 min. CONCLUSIONS: When n-alkylation is 4-6, n-alkyl tetracaine appeared as a strong neurolytic agent. Neurolytic derivatives retained their local anesthetic activity and elicited rapid onset of nerve block after injection. Such derivatives are potential local anesthetic-neurolytic dual agents for chemical lesions of the sciatic nerve.

Anesthetics, Local↗
PubMed1998

Telomerase activity in human gliomas.

OBJECTIVE: Telomerase activity, which is undetectable in most mature normal tissues, has been identified in many types of human cancers, including neuroblastomas and oligodendrogliomas. These findings suggest that a novel mechanism in addition to activation of oncogenes and inactivation of tumor suppressor genes may play an important role in tumorigenesis. The goal of the present study was to assess and correlate the telomerase activity in astrocytic gliomas of different grades. METHODS: Telomere repeat amplification protocol and Southern blot hybridization with telomere-specific probes were used to detect telomerase activity and to measure terminal restriction fragment length, respectively. RESULTS: Telomerase activity was detected in 3 of 9 (33%) low-grade astrocytomas (World Health Organization Grade II), 5 of 11 (45%) anaplastic astrocytomas (World Health Organization Grade III), 36 of 41 (89%) glioblastomas multiforme (World Health Organization Grade IV), 3 of 4 (75%) oligodendrogliomas, and none of 4 normal brain specimens. CONCLUSION: We demonstrated that telomerase activity is absent in normal brain tissues while present in most glioma samples (72%). The frequency of such activity increases with malignancy. These results suggest that telomerase activity may be used as a tumor marker and that the activation of telomerase may correlate with initiation and malignant progression of astrocytic tumors.

Astrocytoma↗
PubMed1998

Focal cortical dysplasia with glioproliferative changes causing seizures: report of 3 cases.

In contrast to neoplasia, lesions of focal cerebral dysplasia are thought to be completed developmental processes of abnormal neuronal migration. We present three children with seizures resulting from brain lesions which pathologically demonstrate regions of both clearcut focal cortical dysplasia and also hypercellularity and monomorphism typical of proliferative lesions such as low grade glial tumor. These cases suggest the existence of a distinct subgroup of patients with prominent glioproliferative changes in association with focal cortical dysplasia, challenging the conventional dichotomy between dysplastic and proliferative categories of brain lesions. Recognition of patients with dual pathology may be of practical as well as theoretical importance.

Brain Neoplasms↗
PubMed1998

Tectal tumors of childhood: clinical and imaging follow-up.

PURPOSE: This study was done to determine which clinical and imaging findings best correlate with outcome in children with tectal tumors. METHODS: A retrospective review was done of the medical records and imaging studies of 32 children (16 boys and 16 girls; mean age, 8 years) with tectal tumors. Eight children had CT, 11 had MR imaging, and 13 had both CT and MR studies. Findings from surgical and pathologic reports as well as from follow-up examinations (mean follow-up period, 5 years; range, 3.6 months to 17 years) were included in the review. RESULTS: All patients had hydrocephalus and all but one required CSF diversion. The tectum was the center of the tumor in all cases and the majority of the tumors appeared isodense on CT scans, isointense on T1-weighted MR images, and hyperintense on T2-weighted images. Twenty patients required no further treatment. In this group, the mean maximum tumor diameter was 1.8 cm and enhancement occurred in two cases. At follow-up, 18 patients had stable tumor size, one had an increase in tumor size with cyst formation but no worsening of symptoms, and one had a decrease in tumor size. Twelve patients required further treatment (excision and/or radiotherapy) because of progression as indicated by either increased tumor size or worsening of symptoms. In this group, the mean maximum tumor diameter was 2.5 cm and contrast enhancement occurred in nine cases. Further follow-up in this group showed decreased tumor size in eight and stable residual tumor in three. CONCLUSION: Tectal tumors in childhood have variable behavior. MR imaging assists in the clinical determination of which children need treatment beyond CSF diversion. Larger tumor size and enhancement are radiologic predictors of the need for further treatment.

Adolescent↗
PubMed1997

Gangliogliomas in adults.

BACKGROUND: Gangliogliomas are rare tumors occurring in both children and adults that are characterized by the presence of neoplastic cells resembling both neurons and glia. METHODS: The authors reviewed 18 adults patients with intracranial gangliogliomas treated at the study institutions between October 1987 and November 1995. RESULTS: The median age at diagnosis was 33.7 years, with a range of 21 to 55 years. Median follow-up was 37.7 months, with a range of 4 months to 13 years. Clinical manifestations among the patients included seizures (13), headache (2), ataxia (1), and hemiparesis and paresthesias (1 patient each). Tumors were located in the temporal lobe (6 patients), temporal lobe and thalamus (1 patient), frontal lobe (5 patients), cerebellum (4 patients), and insula or thalamus (1 patient each). Thirteen patients underwent gross total resection, 4 underwent incomplete resection, and 1 underwent only a stereotactic biopsy. Treatment modalities included surgery only, surgery plus radiation, and surgery plus radiation and chemotherapy. Median survival was 90.3 months, with a range of 14 months to 13 years. Three patients were dead at follow-up with a mean survival of 32.3 months. These patients showed anaplastic features in their pathology at initial surgery or surgery for recurrence. CONCLUSIONS: In adults, gangliogliomas have a relatively favorable prognosis; however, the presence of anaplastic features predicts a worse outcome.

Adult↗
PubMed1997

Matrix metalloproteinases, tumor necrosis factor and multiple sclerosis: an overview.

The matrix metalloproteinases (MMPs) are a family of at least 14 zinc-dependent enzymes which are known to degrade the protein components of extracellular matrix. In addition, MMPs and related enzymes can also process a number of cell surface cytokines, receptors, and other soluble proteins. In particular we have shown that the release of the pro-inflammatory cytokine, tumor necrosis factor-alpha, from its membrane-bound precursor is an MMP-dependent process. MMPs are expressed by the inflammatory cells which are associated with CNS lesions in animal models of multiple sclerosis (MS) and in tissue from patients with the disease. MMP expression will contribute to the tissue destruction and inflammation in MS. Drugs which inhibit MMP activity are effective in animal models of MS and may prove to be useful therapies in the clinic.

Animals↗
PubMed1997

The blood-brain barrier and the inflammatory response.

The environment of the brain is controlled by a sophisticated endothelial barrier that prevents the free entry of solutes from the blood. It is commonly assumed that this blood-brain barrier (BBB) also prevents the entry of leukocytes into the central nervous system. However, recent evidence in animal models shows that this is not the case, and leukocytes can cross an intact BBB during health and disease. Indeed, in many neurological diseases, including Alzheimer's disease, prion diseases and AIDS-related dementia, leukocytes enter the brain parenchyma without concomitant BBB breakdown. Current research is concentrating on factors that control the integrity of the BBB and the mechanisms that leukocytes use to enter the brain.

Animals↗
PubMed1997

Age-related effects of interleukin-1 beta on polymorphonuclear neutrophil-dependent increases in blood-brain barrier permeability in rats.

In adult rats, 50,000 units of recombinant interleukin-1 beta (IL-1 beta) injected into the brain parenchyma produced an intense meningitis and disruption of the blood-CSF barrier by 4 h. No increase in vascular permeability to horseradish peroxidase or leukocyte recruitment was observed at the site of injection. By contrast, in juvenile rats, 100 units of IL-1 beta injected into the striatum gave rise to a large increase in blood-brain barrier permeability and recruitment of polymorphonuclear neutrophils into the tissue around the injection site by 4 h. This effect was also accompanied by a marked meningitis. The injection of 100 units of IL-1 beta into neonatal (2-h-old) rats gave rise to an increase in permeability of vessels to serum proteins in the meninges, but no increase in vascular permeability was observed at the injection site. The IL-1 beta-induced increases in vessel permeability in the meninges, parenchyma, and choroid plexus were polymorphonuclear neutrophil dependent, since leukocyte depletion by irradiation or polymorphonuclear neutrophil anti-serum pre-treatment eliminated the response in the juvenile animals and in the adults. Seventy-five thousand units of murine tumour necrosis factor-alpha injected into the parenchyma of both adults and juvenile animals failed to induce an increase in blood-brain barrier permeability or polymorphonuclear neutrophil recruitment, but did give rise to a mild meningitis. These findings demonstrate clear differences in the responsiveness of different CNS compartments to IL-1 beta. Furthermore, while tumour necrosis factor-alpha and IL-1 beta might have been expected to exhibit similar proinflammatory effects in the CNS, this is not the case. We also show, for the first time, that age has a significant effect on the response to a cytokine. The "window of susceptibility' to an inflammatory stimulus in juvenile rats, if paralleled in humans, may be a major factor in the increased susceptibility of children to trauma or to infectious insults to the CNS.

Animals↗
PubMed1997

Congenital myotonic dystrophy pathology and somatic mosaicism.

We present the pathology and molecular genetic analysis of an infant with congenital myotonic dystrophy. The proband/infant, born at 35 weeks' gestational age to a mother with myotonic dystrophy and 750 CTG repeats, was markedly hypotonic and had severe cardiomyopathy. She died after 16 days of life. At autopsy, skeletal and heart muscles were immature and had a decrease in contractile elements. DNA CTG trinucleotide repeat analysis of the proband demonstrated 2,480 repeats in blood and a slightly greater number of repeats in skeletal muscles, viscera, and gray matter. Corresponding to the clinical course and pathology, cardiac tissues displayed somatic mosaicism, with repeats ranging from 2,760 to 3,220.

Adult↗
PubMed1997

Diencephalic syndrome: clinical features and imaging findings.

PURPOSE: To emphasize the importance of imaging in children with diencephalic syndrome due to hypothalamic/chiasmatic astrocytomas. METHODS: Findings in nine patients (mean age, 26 months) with diencephalic syndrome and hypothalamic/chiasmatic astrocytomas were analyzed retrospectively, including reviewing clinical records, imaging examinations, and follow-up studies. RESULTS: Symptoms and signs included failure to thrive (n = 9), nystagmus (n = 3), visual field defects (n = 1), optic pallor (n = 1), emesis (n = 2), and headache (n = 1). All patients had hypothalamic/chiasmatic masses. Five patients underwent biopsy, and, in all cases, specimens showed low-grade astrocytoma. Imaging studies were available in eight patients. All tumors were large (median maximum diameter, 3.5 cm), involved the chiasm and hypothalamus, and showed homogeneous enhancement. Three patients had hydrocephalus and two had metastases. At follow-up, five patients had recurrent disease and two had died. CONCLUSION: Diencephalic syndrome is a rare cause of failure to thrive in childhood, and diagnosis of a hypothalamic/ chiasmatic astrocytoma might therefore be delayed. The astrocytomas associated with this syndrome are larger, occur at a younger age, and are often more aggressive than other astrocytomas arising in this region.

Astrocytoma↗