[Capillary hemangioma of the colon as a rare cause of intussusception in adults]. / Kapilläres Hämangiom des Kolon als seltene Ursache einer Invagination beim Erwachsenen.

HISTORY AND ADMISSION FINDINGS: A 39-year-old patient presented with a history of constipation, abdominal pain and nausea. Magnetic resonance imaging showed a colonic tumour. Biopsy of the tumour did not reveal the diagnosis. INVESTIGATION: The abdomen was tense on palpation and inflammation parameters were elevated. On abdominal x-ray signs of obstructive colonic ileus could be seen. Endoscopic investigation revealed a tumorous stricture of the transverse colon presenting as intussusception with cockade phenomenon during sonography. TREATMENT AND CLINICAL COURSE: Because of obstructive ileus laparotomy was performed with extended right hemicolectomy and end-to-end ileotransversostomy. Histology showed the rare finding of colonic intussusception due to a capillary hemangioma. Post-operative clinical course was normal without any further signs or symptoms of systemic disease. CONCLUSION: Intussusception in adult patients can be a rare complication due to gastrointestinal hemangioma. Endoscopy and radiologic imaging may help to establish diagnosis. Surgical resection of the involved bowel segment seems to be a safe and effective treatment. Nevertheless congenital disease must be excluded to prevent further complications.

Morphological development and neurochemical differentiation of cerebellar inhibitory interneurons in microexplant cultures.

The cerebellar cortex comprises a rather limited variety of interneurons, prominently among them inhibitory basket and stellate cells and Golgi neurons. To identify mechanisms subserving the positioning, morphogenesis, and neurochemical maturation of these inhibitory interneurons, we analyzed their development in primary microexplant cultures of the early postnatal cerebellar cortex. These provide a well-defined, patterned lattice within which the development of individual cells is readily accessible to experimental manipulation and observation. Pax-2-positive precursors of inhibitory interneurons were found to effectively segregate from granule cell perikarya. They emigrate from the core explant and avoid the vicinity of granule cells, which also emigrate and aggregate into small clusters around the explant proper. This contrasts with the behavior of Purkinje neurons, which remain within the explant proper. During migration, a subset of Pax-2-positive cells gradually acquires a GABAergic phenotype, and subsequently also expresses the type 2 metabotropic receptor for glutamate, or parvalbumin, markers for Golgi neurons and basket or stellate cells, respectively. The latter eventually orient their dendrites such that they take a preferentially perpendicular orientation relative to granule cell axons. Both the neurochemical maturation of basket/stellate cells and the specific orientation of their dendrites are independent of their continuous contact with radially oriented glia or Purkinje cell dendrites projecting from the core explant. Numbers of parvalbumin-positive basket/stellate cells and the prevalence of glutamate-positive neurites, which form a dense network preferentially within cell clusters containing granule cell perikarya and their dendrites, are subject to regulation by chronic depolarization. In contrast, brain-derived neurotrophic factor results in a drastic decrease of numbers of basket/stellate cells. These findings document that granule cell axons (parallel fibers) are the major determinant of basket/stellate cell dendritic orientation. They also show that the neurochemical maturation of cerebellar interneurons is sensitive to regulation by activity and neurotrophic factors.

Brain-derived neurotrophic factor modulates dendritic morphology of cerebellar basket and stellate cells: an in vitro study.

The dendrites of cerebellar basket/stellate cells show a highly stereotyped orientation relative to granule cell axons (parallel fibers) and Purkinje cell dendrites. This specific morphology is acquired during the early postnatal phase of cerebellar development, when basket/stellate cells become synaptically integrated with Purkinje neurons and granule cells. In the present study, we used primary cerebellar cultures to test how the spatial arrangement of granule cell axons affects basket/stellate cell dendritic morphology. In addition, we sought to determine whether active signals as might be provided by granule cells, i.e. synaptic input and the neurotrophin, brain-derived neurotrophic factor, affect basket/stellate cell development. Our results confirm the critical role of parallel fiber orientation for basket/stellate dendritic morphogenesis. Moreover, we found that both electrical activity and brain-derived neurotrophic factor increased basket and stellate cell dendritic arborization. Together with previously published findings, our data led to the conclusion that both structural cues and active interneuronal signaling collaborate to bring about the precise morphogenesis of cerebellar basket/stellate cells. The distinct responses of various cerebellar phenotypes towards the morphogenetic effects of brain-derived neurotrophic factor suggest that this neurotrophin, within the developing cerebellum, enhances synaptic connectivity by concerting the formation of appropriate pre- and postsynaptic structures.

Rat adjuvant arthritis: imaging with technetium-99m-anti-CD4 Fab' fragments.

UNLABELLED: The abundance of CD4 molecules on inflammatory cells in the synovial membrane renders anti-CD4 monoclonal antibodies (MAbs) or their fragments very promising for specific imaging of arthritic joints. METHODS: Joint uptake and body distribution of a 99mTc-labeled Fab', derived from the anti-rat CD4 MAb W3/25 (IgG1), were investigated following intravenous injection in normal and adjuvant arthritic rats. An isotype-matched Fab' (anti-human nonspecific crossreacting antigen-90) was used as control. RESULTS: A 14-hr sequential pinhole scan of the ankle joints revealed that both the anti-CD4 and the control Fab' accumulated to a higher degree in arthritic than in normal ankle joints; however, accumulation of the anti-CD4 Fab' in arthritic joints exceeded that of the control Fab' (approximate to 1.6 fold). Preferential joint accumulation of anti-CD4 Fab' was confirmed by whole-body scans at 14 hr and by direct well counter measurements of tissue samples at 16 hr following injection. Unlike the control Fab', the anti-CD4 Fab' preferentially accumulated in the liver and lymph nodes, organs rich in CD4-positive cells, as observed by direct tissue measurements. CONCLUSION: Despite its monovalency, the anti-CD4 Fab' retains the in vivo selectivity for CD4-positive cell-rich tissues, previously reported for the complete anti-CD4 MAb, and improves imaging of inflamed joints in experimental adjuvant arthritis.