Lumbar degenerative spondylolisthesis is not always unstable: clinicobiomechanical evidence.

STUDY DESIGN: A clinicobiomechanical study. OBJECTIVE: To clarify the clinicobiomechanical characteristics of a segment with lumbar degenerative spondylolisthesis (LDS) using an original intraoperative measurement system. SUMMARY OF BACKGROUND DATA: Although radiographical evaluation of LDS is extensively performed, the diagnosis of segmental instability remains controversial. The intraoperative measurement system used in this study is the first clinically available system that performs cyclic flexion-extension displacement of the segment with all ligamentous structures intact and can determine both the stiffness (N/mm) and neutral zone (NZ, [mm/N]). METHODS: Forty-eight patients with LDS (males/females = 19/29, 68.5 yr; group D) were compared with 48 patients with lumbar spinal stenosis without LDS (males/females = 33/15, 64.8 yr, group N) in terms of symptoms, radiological, and biomechanical results. Instability was defined as a segment with NZ more than 2 mm. Symptoms (36-Item Short Form Health Survey), radiographical findings (radiographs, magnetic resonance images, computed tomographic scans), stiffness, NZ, and frequency of instability were also compared. Risk factors for instability were analyzed by multivariate logistic regression with a forward stepwise procedure. RESULTS: None of the physical function categories or radiological findings of 36-Item Short Form Health Survey and low back pain (visual analogue scale) differed significantly between the groups. Although NZ was significantly greater in group D (1.97) than in group N (1.73) (P < 0.05), the frequency of instability did not differ significantly between groups. Facet opening (odds ratio, 11.0; P < 0.01) and facet type (odds ratio, 6.0; P < 0.05) were significant risk factors for instability. CONCLUSION: Neither the symptoms nor the frequency of instability differed significantly between groups. The radiological findings of spondylolisthesis did not indicate instability, but facet opening and sagittally oriented facets were indicative of instability. The results of this study demonstrated that LDS is not always unstable in the measurement setting, suggesting that the instability of LDS can stabilize spontaneously during the natural course. LEVEL OF EVIDENCE: N/A.

Selective gene transfer into neurons via Na,K-ATPase beta1. Targeting gene transfer with monoclonal antibody and adenovirus vector.

BACKGROUND: Neuron-selective gene transfer is an attractive therapeutic strategy for neurological disorders. However, optimal targets and gene delivery systems remain to be determined. METHODS: Following immunization of mice with PC12 cells, hybridomas were screened by beta-Gal reporter gene assay using FZ33 fiber-modified adenovirus vectors. Subsequently, the efficacy and specificity of monoclonal antibody (mAb)-mediated gene transfer via FZ33 and FdZ adenovirus vectors were evaluated by flow cytometry, chemiluminescent beta-Gal reporter gene assay, and immunocytochemistry. Finally, the antigen recognized by the mAb was identified by mass spectrometry and transfection analysis. RESULTS: A hybridoma clone 6E3 producing monoclonal antibody, mAb6E3, was screened. Flow cytometry, chemiluminescent beta-Gal reporter gene assay, and immunocytochemistry with mAb6E3 and the fiber mutant adenovirus demonstrated efficient gene transfer into the PC12 cells. Treatment of neuron-glia cocultures with mAb6E3 and FdZ adenovirus resulted in neuron-selective gene transfer. Immunohistochemical images of rat spinal cord tissue showed that mAb6E3 reacts specifically with neurons. Finally, Na,K-ATPase beta1 was identified as the antigen of mAb6E3. CONCLUSIONS: Hybridoma screening using FZ33 fiber-modified adenovirus vectors serves as an efficient approach to detect antigens in mAb-targeted gene transfer. Neuronal tropism in the central nervous system through mAb6E3 represents an important initial step towards neuron-selective gene transfer in the treatment of local neurological disorders, such as spinal cord injury.

Bcl-xL gene transfer inhibits Bax translocation and prolongs cardiac cold preservation time in rats.

BACKGROUND: Apoptosis is an important cause of early graft loss after heart transplantation. Bcl-xL was reported to protect the heart against normothermic ischemia and reperfusion injury. In this study, we determined whether overexpression of Bcl-xL could inhibit tissue injury resulting from prolonged cold preservation followed by warm reperfusion of heart transplants. METHODS AND RESULTS: Lewis rat hearts were transduced with an adenovirus vector harboring Bcl-xL cDNA (AxCAhBclxL) 4 days before collection of tissue. After preservation in University of Wisconsin solution at 4 degrees C for 24 hours, the heart was either perfused with a Langendorff device ex vivo or used for heterotopic heart transplantation in vivo. Bcl-xL gene transfer significantly reduced the infarct size (23.0+/-2.6% versus 47.7+/-7.0% in saline control and 48.6+/-6.1% in vector control, P<0.01) after 2-hour reperfusion at 37 degrees C with the Langendorff device and significantly decreased creatine kinase release (0.82+/-0.27 IU, versus 1.57+/-0.33 and 1.50+/-0.37 IU in saline and vector controls, respectively; P<0.05). In heart transplantation, overexpression of Bcl-xL inhibited Bax translocation from the cytosol to the mitochondria, resulting in decreased cytochrome c release from the mitochondria; it also significantly decreased cardiac cell apoptosis and improved graft survival rate after long cold preservation, followed by warm reperfusion. CONCLUSIONS: Bcl-xL gene transfer inhibited the translocation of Bax and prolonged the cold preservation time of cardiac transplants. This may be a potential therapeutic method in clinical practice.

Mesenchymal stem cells that produce neurotrophic factors reduce ischemic damage in the rat middle cerebral artery occlusion model.

Mesenchymal stem cells (MSC) were reported to ameliorate functional deficits after stroke in rats, with some of this improvement possibly resulting from the action of cytokines secreted by these cells. To enhance such cytokine effects, we previously transfected the telomerized human MSC with the BDNF gene using a fiber-mutant adenovirus vector and reported that such treatment contributed to improved ischemic recovery in a rat transient middle cerebral artery occlusion (MCAO) model. In the present study, we investigated whether other cytokines in addition to BDNF, i.e., GDNF, CNTF, or NT3, might have a similar or greater effect in this model. Rats that received MSC-BDNF (P < 0.05) or MSC-GDNF (P < 0.05) showed significantly more functional recovery as demonstrated by improved behavioral test results and reduced ischemic damage on MRI than did control rats 7 and 14 days following MCAO. On the other hand, rats that received MSC-CNTF or MSC-NT3 showed neither functional recovery nor ischemic damage reduction compared to control rats. Thus, MSC transfected with the BDNF or GDNF gene resulted in improved function and reduced ischemic damage in a rat model of MCAO. These data suggest that gene-modified cell therapy may be a useful approach for the treatment of stroke.

Role of the autonomic nervous system in emetic and cardiovascular responses in Suncus murinus.

To clarify the role of the autonomic nervous system in cardiovascular and emetic responses, we studied the influence of drugs that act on autonomic nervous function on emetic and cardiovascular responses induced by chemical or mechanical stimulation to the stomach in two strains of Suncus murinus, Jic:SUN-Her and Jic:SUN-Ler. Latency to the first retching in Jic:SUN-Her was significantly shorter than that in Jic:SUN-Ler to both mechanical and chemical stimulation. This result indicated that there are different sensitivities to mechanical and chemical stimulation to the stomach in these two strains of suncus. However, the numbers of emetic episodes were almost the same in these two strains. Mean blood pressure significantly increased from baseline prior to retching in both strains. Heart rate decreased in Jic:SUN-Her and increased in Jic:SUN-Ler prior to retching, suggesting that a different baroreflex responsiveness might exist in these two strains of suncus. Administration of acetylcholine and phenylephrine affected emetic response induced by mechanical and chemical stimulation. Although the baseline values of mean blood pressure and heart rate after administration of these drugs were different, changes in mean blood pressure and heart rate prior to retching were unaffected. This result suggested that the state of autonomic activity before the emetic response might be important in the development of the emetic response. Pretreatment with hexamethonium suppressed the cardiovascular response prior to retching and prolonged the latency to the first retching. This result indicated that there was an interaction between the mechanisms involved in cardiovascular and emetic responses. The change in autonomic function during the emetic response, especially enhancement of sympathetic activity prior to retching, may be relevant to emetic and cardiovascular responses. Moreover, these results suggest that different autonomic function or different baroreflex responsiveness in Jic:SUN-Her and Jic:SUN-Ler may be involved in emetic responses.

The daily pattern of cardiovascular parameters in Kurosawa and Kusanagi-Hypercholesterolemic (KHC) rabbits.

We studied characteristics of the daily pattern of heart rate (HR), blood pressure (BP), body temperature (BT), and locomotor activity (LA) in conscious and unrestrained Kurosawa and Kusanagi-Hypercholesterolemic (KHC) rabbits and age-matched normal Japanese white (JW) rabbits, using a telemetry system. In all JW rabbits, nocturnal patterns were observed in HR, BT and LA. In the 5 months group of KHC rabbits, however, diurnal rhythm was observed in HR, and in the 10 months group of KHC rabbits, it was also shown in LA. The nocturnal pattern was observed only in BT in 10 months KHC rabbits. Mean blood pressure (MBP) in JW and KHC rabbits showed no clear daily pattern. The mean daily values of HR and BT were not altered between the 5 months and 10 months groups in KHC rabbits, although those in JW were lower in the 10 months group than in the 5 months group. Moreover, the daily values of HR and MBP in KHC rabbits tended to be higher than those in the age-matched JW rabbits. The pulse pressure in the 10 months group of KHC rabbits tended to be greater than the 5 months groups of KHC and JW rabbits. Furthermore, short-term variabilities in BP in the 5 months KHC rabbits were significantly lower than those in the other groups. From these results, it is suggested that the cardiovascular function, including the autonomic nervous function is altered with the development of atherosclerosis in KHC rabbits.

Power spectral analysis of heart rate variability for assessment of diurnal variation of autonomic nervous activity in guinea pigs.

We established characteristics of power spectral analysis of heart rate variability, and assessed the diurnal variations of autonomic nervous function in guinea pigs. For this purpose, an electrocardiogram (ECG) was recorded for 24 hr from conscious and unrestrained guinea pigs using a telemetry system. There were two major spectral components, at low frequency (LF) and high frequency (HF) bands, in the power spectrum of HR variability. On the basis of these data, we defined two frequency bands of interest: LF (0.07-0.7 Hz) and HF (0.7-3.0 Hz). The power of LF was higher than that of HF in the normal guinea pigs. Atropine significantly reduced power at HF. Propranolol also significantly reduced power at LF. Furthermore, the decrease in the parasympathetic mechanism produced by atropine was reflected in a slight increase in the LF/HF ratio. The LF/HF ratio appeared to follow the reductions of sympathetic activity produced by propranolol. Autonomic blockade studies indicated that the HF component reflected parasympathetic activity and the LF/HF ratio seemed to be a convenient index of autonomic balance. Nocturnal patterns, in which the values of heart rate in the dark phase (20:00-06:00) were higher than those in the light phase (06:00-20:00), were observed. However, the HF, LF and the LF/HF ratio showed no daily pattern. These results suggest that the autonomic nervous function in guinea pigs has no clear circadian rhythmicity. Therefore, this information may be useful for future studies concerning the autonomic nervous function in this species.

Diurnal variation of heart rate, locomotor activity, and body temperature in interleukin-1 alpha/beta doubly deficient mice.

This study was investigated the roles of interleukin-1 (IL-1) on diurnal rhythms of heart rate (HR), locomotor activity (LA), and body temperature (BT). For this purpose, HR, LA, and BT were recorded from conscious and unrestrained IL-1 alpha/beta doubly deficient (KO) and normal C57BL/6J mice using a telemetry system. These parameters were continuously recorded from just after to 2 weeks after transmitter implantation, because we thought that the surgical stress-induced IL-1 might affect the biobehavioral activities of the animals. At 1 day after implantation, HR and LA in IL-1 alpha/beta KO mice were higher than those in C57BL/6J mice. While BT in IL-1 alpha/beta KO mice was lower than that in C57BL/6J mice. Moreover, diurnal rhythmicity in these parameters after implantation in IL-1 alpha/beta KO mice appeared earlier than in C57BL/6J mice. At 2 weeks after implantation, there were no significant differences in the light- and dark-phase values of each parameter between IL-1 alpha/beta KO and C57BL/6J mice, however, IL-1 alpha/beta KO mice showed clear ultradian rhythmicity. It is thought that a phenotypical difference in biobehavioral activities between IL-1 alpha/beta KO and C57BL/6J mice may reflect IL-1 induced febrile and behavioral responses. These results suggest that IL-1 may play important physiological and pathophysiological roles on biobehavioral activities.

Diurnal fluctuations of heart rate, body temperature and locomotor activity in the house musk shrew (Suncus murinus).

Diurnal fluctuations of heart rate (HR), body temperature (BT) and locomotor activity (LA) in the unanaesthetized and unrestrained house musk shrew (Suncus murinus) were studied using a telemetry system. Six adult male shrews (Jic:SUN) weighing 60-70 g were used in the present study. They were housed under conditions of 24 C and a 12/12-hr light-dark cycle. HR, BT and LA were recorded over 10 days, following the post-implantation period (10 days or more) of the telemetric transmitter. A clear nocturnal rhythm of LA was shown, while intermittent and short-term LA were shown during the light period. The mean HR was 323.5 +/- 8.8 bpm in the light period and 354.3 +/- 5.2 bpm in the dark period, and the fluctuation of HR showed a nocturnal pattern. A nocturnal pattern was also observed in BT fluctuation, and all animals lowered their body temperature from 35-37 C to approximately 30 C or below, mostly during the light period. The fall of body temperature progressed over 2-3 hr, and then rose to the baseline temperature rapidly within approximately 30 min. While the body temperature fell, HR markedly decreased to approximately 100 bpm. These results suggest that the shrew has unique physiological properties in maintaining metabolic balance which are anticipated to be caused by the dramatic alteration of the autonomic nervous function.