Striatal cells containing aromatic L-amino acid decarboxylase: an immunohistochemical comparison with other classes of striatal neurons.

In a previous study, we described a population of striatal cells in the rat brain containing aromatic L-amino acid decarboxylase, the enzyme involved in the conversion of L-DOPA into dopamine. We have also presented evidence that these cells produce dopamine in the presence of exogenous L-DOPA. In this paper, we further characterize these striatal aromatic L-amino acid decarboxylase-containing cells in order to determine whether they form a subclass of one of the known categories of striatal neurons or if they represent a novel cell type. Using immunohistochemical methods, we compared the morphology and distribution of the aromatic L-amino acid decarboxylase-immunolabeled cells with those of other classes of striatal neurons. Our results show that both the morphology and distribution of aromatic L-amino acid decarboxylase-immunolabeled cells are very distinctive and do not resemble those of cells labeled for other striatal neuronal markers. Double-labeling procedures revealed that aromatic L-amino acid decarboxylase cells do not co-localize somatostatin or parvalbumin, and only a very small percentage of them co-localize calretinin. However, the population of aromatic L-amino acid decarboxylase cells label intensely for GABA.Overall, our results suggest that these aromatic L-amino acid decarboxylase-containing cells represent a class of striatal GABAergic neurons not described previously.

Electron microscopic evidence for neurotoxicity in the basal ganglia.

The dopaminergic projection from the substantia nigra to the neostriatum is vulnerable to several neurotoxins including 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), amphetamine, and 5-hydroxydopamine. We have treated rats or mice with these agents and examined various regions of their brains with a combination of Fink-Heimer, immunohistochemical, serial-section electron microscopic, and three-dimensional reconstruction methods. In addition to degenerating or swollen axons, we found darkened glial processes and some damage to postsynaptic cells and dendrites. The particular effects observed critically depend on experimental variables such as dose, time, species and strain and raise questions about the correlation of light and electron microscopic results. These studies provide the basis for a discussion of the advantages and disadvantages of an ultrastructural examination of the effects of neurotoxins.

5-hydroxydopamine-labeled dopaminergic axons: three-dimensional reconstructions of axons, synapses and postsynaptic targets in rat neostriatum.

Previous studies employing 5-hydroxydopamine to identify nigrostriatal dopaminergic axons and their synapses found that labeled axons made few synapses or that asymmetric contacts predominated. In contrast, recent studies using tyrosine hydroxylase or dopamine antibody techniques indicate that presumed dopaminergic axons form small symmetric contacts. We re-examined 5-hydroxydopamine-labeled material from the rat neostriatum using serial three-dimensional reconstruction techniques to characterize the morphology of labeled axons, synapses and postsynaptic targets. This ultrastructural analysis revealed a class of heavily labeled axons that are small (0.06-1.5 microns in diameter) and lack large varicosities. These axons form small (0.011-0.09 microns 2), en passant, symmetric synapses, mainly onto dendritic spines and spiny dendritic shafts and, in some cases, onto aspiny dendritic segments near branch points. The sites of these synapses along the axon appeared unrelated to the locations of axonal enlargements, suggesting that counting varicosities may not be an accurate indication of the extent of dopaminergic innervation in the neostriatum. The characteristics of these 5-hydroxydopamine-labeled elements correspond in all respects to axons and synapses identified as dopaminergic by immunohistochemistry in previous studies. In tissue in which all labeled and unlabeled synapses were classified, approximately 9% of all synapses were identified as dopaminergic by this type of label. Three-dimensional reconstructions provided additional insight concerning the interaction of dopaminergic afferents with postsynaptic striatal targets and their relation to other afferents to these neurons. They reveal that a short, unbranched dopaminergic axonal segment can make multiple synapses onto dendritic spines, shafts and branch points of one or more dendrites. In addition, one dendrite can receive contacts from several labeled axons. Dopamine synapses onto spines are always associated with unlabeled, asymmetric synapses onto the same spine. Synapses of various morphologies with a distinctly different, lighter form of labeling were much rarer, and may represent other aminergic afferents to the neostriatum. The presence of this second form of label in earlier 5-hydroxydopamine studies may have contributed to the long-standing controversy over the appearance of dopaminergic synapses examined by different techniques. Our results help to resolve this controversy and confirm that the nigrostriatal projection makes small symmetric synapses with a variety of striatal targets.

Outcomes measurement in hospitals: can the system change the organization?

The U.S. health care industry is in crisis--a crisis of accountability. Many believe that improved information, especially outcomes information, is at least part of the solution. If this assessment is accurate, outcomes measurement could offer a powerful opportunity to help mold our dysfunctional health care machinery into an effective infrastructure. This article explores whether implementing an outcomes measurement system in a hospital compels this kind of change. It examines the experiences of 31 hospitals that implemented a market-leading outcomes measurement system. Despite its potential, MedisGroups did not compel important improvements in hospitals' quality of care or their internal practices. Hospitals found it particularly difficult to maintain momentum throughout implementation and to structure the system as a supporting tool, rather than a driving influence, in their pursuit of operating improvements.

Outcomes measurement: compliance tool or strategic initiative?

This article explores how hospitals are using outcomes measurement to deal with their changing environment. Based on interviews at thirty-one hospitals, the study reveals three very different management approaches and three different uses of the same outcomes measurement tool.

Histological and ultrastructural evidence that D-amphetamine causes degeneration in neostriatum and frontal cortex of rats.

D-Amphetamine sulfate, continuously administered for 3 days subcutaneously via an implanted minipump, induced neural degeneration in Long-Evans and Sprague-Dawley rats at doses between 20 and 60 mg/kg/day. Using Fink-Heimer silver staining, axonal degeneration was detected in the neostriatum and the dorsal agranular insular cortex and degenerating pyramidal cells were observed in portions of the somatosensory neocortex in both strains. In contrast, dense axonal degeneration largely confined to layers 2 and 3 of frontal motor areas (Fr1, Fr2 and Fr3 of Zilles36) with occasional degenerating cells was seen reliably in Long-Evans rats but rarely in Sprague-Dawley rats. In the electron microscope, cortical degeneration consisted mainly of disrupted cell bodies and dark processes, including axons making asymmetric synapses. Damage in all cortical areas represents damage to non-monoamine neurons and processes since tyrosine hydroxylase and serotonin immunolabeling were normal. In contrast, the damage in neostriatum probably includes damage to dopamine axonal terminals since tyrosine hydroxylase immunolabeling was patchy with many swollen and distorted labeled axons. Serotonin and Leu-enkephalin labeling were normal. Electron microscopy confirmed that the neostriatum contained many tyrosine hydroxylase-labeled axons that were swollen and disrupted, although other labeled processes made normal symmetric synapses onto spines and dendrites. Additional degeneration found only in amphetamine-treated rats included many dark, shrunken profiles. Some of these appeared to be astrocytic processes and a few were myelinated axons, suggesting that some non-monoamine, possibly cortical afferents, are also degenerating in the neostriatum. Since similar degrees of behavioral activation, weight loss and lethality were seen in both strains, a genetic predisposition constrain amphetamine-induced motor cortex damage but not neostriatal damage.

Continuous amphetamine administration induces tyrosine hydroxylase immunoreactive patches in the adult rat neostriatum.

Continuous 3-day administration of d-amphetamine sulfate via a subcutaneous minipump induced the appearance of tyrosine hydroxylase immunoreactive patches in the neostriatum of adult Sprague-Dawley and Long-Evans rats at doses (greater than 20 mg/kg/day) that also produced axonal terminal degeneration as evidenced by Fink-Heimer silver grain deposition. The tyrosine hydroxylase patches coincided with striosomes identified by Leu-enkephalin immunoreactivity on adjacent sections. Sham-operated control, naive control, low dose amphetamine- (less than 15 mg/kg/day) and cocaine- (less than 125 mg/kg/day, IV) treated rats did not show tyrosine hydroxylase neostriatal patches nor axonal degeneration. These results suggest that the diffuse neostriatal dopamine system may be more susceptible to the neurotoxic, degenerative action of continuously administered amphetamine than is the islandic dopamine system.

Cocaine, in contrast to D-amphetamine, does not cause axonal terminal degeneration in neostriatum and agranular frontal cortex of Long-Evans rats.

Continuous three day administration via implanted minipumps of cocaine hydrochloride (50-450 mg/kg/day, sc and 100-250 mg/kg/day, iv) did not produce axonal degeneration in frontal agranular cortex or neostriatum that was detectable by Fink-Heimer silver staining or tyrosine hydroxylase immunolabeling. This is in contrast to the extensive axonal degeneration detectable in these regions following d-amphetamine sulfate (10-60 mg/kg/day) administered following an identical protocol. Doses of cocaine and amphetamine were equated using three measures: 1) weight loss, 2) lethality and 3) behavioral activation. Thus, cocaine resembles other catecholamine reuptake blockers and does not cause the neurodegenerative changes characteristic of other abused drugs that interact with the brain's dopamine systems.

Acute ultrastructural and behavioral effects of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) in mice.

Acute actions of MPTP on behavior and on neostriatal ultrastructure were examined in young C57 Black mice. Autonomic, motor, and toxic effects of MPTP exhibited dependence on dose (20-40 mg/kg) and time during the first 4 h after subcutaneous injection. The ultrastructure of the neostriatum was altered very quickly (2-24 h) after single injections of MPTP. Darkened glial processes were found within 2-8 h, followed by dark degeneration of synaptic boutons, especially those making small symmetric synapses. More rarely, swollen axons and postsynaptic degeneration were also observed.

Three-dimensional structure of dendritic spines in the rat neostriatum.

Dendritic spines of rat neostriatal neurons were examined by light microscopy and high voltage stereo electron microscopy (HVEM) following selective staining by intracellular microinjection of horseradish peroxidase. Conventionally prepared material also was used for quantitative analysis of dendritic spines from serial thin sections of neostriatum. Stereo electron microscopy of semithin sections from rat neostriatum fixed using a protocol designed to preserve cytoskeletal integrity was employed to examine the organization of the dendritic spine cytoplasm. Light microscopic and HVEM examination of spiny dendrites and quantitative analysis of serial thin sections from normal material revealed no distinct spine types but rather continuous and independent variation of spine head diameter, stalk diameter, and stalk length. Likewise, there was no systematic relationship between any of these spine dimensions and dendritic diameter. Spine head membrane surface area was directly related to the area of the synaptic junctional membrane of the spine head. In semithin sections, the cytoplasm of the spine contained membranous saccules of spine apparatus and a delicate cytoskeletal network composed of microfilaments and a set of finer and more variable cytoskeletal filaments. It is proposed that this cytoskeletal network together with the spine apparatus is responsible for the maintenance and alteration of spine shape and in this way controls the effectiveness of axospinous synapses.

Dendro-dendritic synapses in substantia nigra: descriptions based on analysis of serial sections.

Dendro-dendritic synapses were studied in serial sections of rat substantia nigra in subjects pretreated with intraventricularly administered 5-hydroxydopamine, a monoaminergic synaptic label. These synapses had symmetrical membrane thickenings and small clusters of heavily labeled pleomorphic vesicles in the presynaptic dendrites, which were assumed to extend from the dopaminergic cells of pars compacta. Dendro-dendritic synapses were seen in the pars compacta of the substantia nigra, but were not found in blocks trimmed to include only the nondopaminergic pars reticulata. The presynaptic dendrites did not receive other synapses near the sites of dendro-dendritic synapses. These dendrites were frequently apposed to other dendrites for long distances with no intervening glial processes. In many cases, several adjacent dendro-dendritic contacts were made by a single presynaptic dendrite onto several different postsynaptic dendrites. Presynaptic dendrites did not participate in reciprocal synapses, serial synapses, or dendro-axonic synapses. Presynaptic and postsynaptic dendrites engaged in dendro-dendritic synaptic contact were of similar appearance and both had cross-sectional diameters of 0.23-1.9 microns. In several cases, label could also be detected in the postsynaptic dendrite in cisternae of smooth endoplasmic reticulum, providing evidence for dendro-dendritic synapses between dopaminergic neurons. Release of dopamine from dopaminergic dendrites and their role in the control of neuronal activity in substantial nigra are discussed.

A novel model for fluid secretion by the trypanosomatid contractile vacuole apparatus.

We have studied fluid secretion by the contractile vacuole apparatuss of the trypanosomatid flagellate Leptomonas collosoma with thin sections and freeze-fracture replicas of cells stabilized by ultrarapid freezing without prior fixation or cryoprotection. The ultrarapid freezing has revealed membrane specializations related to fluid segregation and transport as well as membrane rearrangements which may accompany water expulsion at systole. This osmoregulatory apparatu consists of the spongiome, the contractile vacuole, and the fluid discharge site. The coated tubules of the spongiome converge on the contractile vacuole from all directions. These 60- to 70-nm tubules contain characteristic double rows of 11-nm intramembrane particles in a helical configuration which fracture predominantly with the E face. Short double rows of similar particles are also frequently found on both faces of the contractile vacuole itself, in addition to many smaller particles on the P face. The spongiome tubules fuse with the vacuole during the filling stage of each cycle and then detach before secretion. The contractile vacuole membrane is permanently attached to the plasma membrane of the flagellar pocket by a dense adhesion plaque. In some ultrarapidly frozen cells, 20- to 40-nm perforations can be visualized within the plaque and the adjacent membranes during the presumptive time of discharge. The formation of the plaque perforations and the membrane channels occurs without fusion of the vacuole and the plasma membrane and does not require extracellular calcium. On the basis of our results, we have developed a model for water secretion which suggests that the adhesion plaque may induce pore formation in the adjoining lipid bilayers, thereby allowing bulk expulsion of the fluid.