Prolonged MRI T2 times of the lentiform nucleus in idiopathic spasmodic torticollis.

Using high-field MRI, we investigated possible morphologic changes in the basal ganglia of 22 patients with clinically diagnosed idiopathic spasmodic torticollis (iTs) compared with 28 age-matched normal controls. Two patients were found to have distinct basal ganglia lesions and were excluded from further analysis. The frequency of gross morphologic changes (atrophy, enlarged Virchow-Robin spaces) in patients was not significantly higher than in controls. However, T2 values calculated for the putamen and pallidum on both sides were significantly higher in the lentiform nucleus of the patients compared with the controls. In contrast, other well-defined subcortical regions did not exhibit a similar abnormality, nor did the optical or quantified signal analysis of various regions of interest show any differences. This finding suggests a morphologic abnormality in iTs that is not associated with a gross structural lesion. It could reflect focal gliosis and might correspond to earlier sporadic pathoanatomic descriptions of gliosis in idiopathic dystonia.

Human complement factor H: molecular cloning and cDNA expression reveals variability in the factor H-related mRNA species of 1.4 kb.

Previously, we have shown that three different mRNA species of 4.3 kb, 1.8 kb and 1.4 kb, related to human complement factor H, are constitutively expressed in the human liver. Probing with our cDNA clone H-46 which represents 920 bp of the 3' end of the 4.3 kb mRNA of factor H on human liver RNA, we always detected the 4.3 kb and the additional, abundantly expressed mRNA species of 1.4 kb in length, indicating that the 1.4 kb transcript is highly homologous to the 3' end of the classical factor H mRNA of 4.3 kb. Using H-46 as a probe, several cDNA clones were isolated from a liver cDNA library and sequenced. The open reading frame of the novel mRNA species encodes a peptide consisting of five internal short consensus repeat motifs (SCR), identifying the translational product to be a member of the SCR family. Sequence comparison with cDNA clones derived from liver RNA of a different donor provided evidence for variability in the factor H related proteins encoded by the 1.4 kb mRNA species. Interestingly, this variability was found to be restricted to the three carboxyterminal SCR domains. Expression data indicate that our variant is not recognized by the monoclonal antibody 3D11.

[Functional spectroscopy: the limits and potentials of a new method for the study of brain activation with MR tomography]. / Funktionelle Spektroskopie: Grenzen und Möglichkeiten einer neuen Methode zur Untersuchung der Hirnaktivierung mit Kernspintomographie.

The possibility of examining brain activity by means of localised spectroscopy was studied in relation to its neurological basis. Measurements on 18 normals during optical stimulation showed an improvement in signal to noise ratio compared with functional imaging of almost one order of magnitude. Time dependent measurements during stimulation by a 500 ms light impulse showed definite delay of increased blood flow when compared with oxygen utilisation. The excellent signal to noise ratio and the inherent stability of the method permits reliable detection of weak effects such as are caused by finger tapping or electrical stimulation.

Constitutively active mutant of the mitogen-activated protein kinase kinase MEK1 induces epithelial dedifferentiation and growth inhibition in madin-darby canine kidney-C7 cells.

Overexpression of a constitutively active mitogen-activated protein kinase kinase (MAPKK or MEK) induces neuronal differentiation in adrenal pheochromocytoma 12 cells but transformation in fibroblasts. In the present study, we used a constitutively active MAPK/extracellular signal-regulated kinase (ERK) kinase 1 (MEK1) mutant to investigate the function of the highly conserved MEK1-ERK2 signaling module in renal epithelial cell differentiation and proliferation. Stable expression of constitutively active MEK1 (CA-MEK1) in epithelial MDCK-C7 cells led to an increased basal and serum-stimulated ERK1 and ERK2 phosphorylation as well as ERK2 activation when compared with mock-transfected cells. In both mock-transfected and CA-MEK1-transfected MDCK-C7 cells, basal and serum-stimulated ERK1 and ERK2 phosphorylation was almost abolished by the synthetic MEK inhibitor PD098059. Increased ERK2 activation due to stable expression of CA-MEK1 in MDCK-C7 cells was associated with epithelial dedifferentiation as shown by both a dramatic alteration in cell morphology and an abolished cytokeratin expression but increased vimentin expression. In addition, we obtained a delayed and reduced serum-stimulated cell proliferation in CA-MEK1-transfected cells (4.6-fold increase in cell number/cm2 after 5 days of serum stimulation) as compared with mock-transfected controls (12.9-fold increase in cell number/cm2 after 5 days). This result was confirmed by flow cytometric DNA analysis showing that stable expression of CA-MEK1 decreased the proportion of MDCK-C7 cells moving from G0/G1 to G2/M as compared with both untransfected and mock-transfected cells. Taken together, our data demonstrate an association of increased basal and serum-stimulated activity of the MEK1-ERK2 signaling module with epithelial dedifferentiation and growth inhibition in MDCK-C7 cells. Thus, the MEK1-ERK2 signaling pathway could act as a negative regulator of epithelial differentiation thereby leading to an attenuation of MDCK-C7 cell proliferation.

Hand muscle reflexes following air puff stimulation.

Hand muscle reflexes following muscle stretch and electrical nerve stimulation show a typical pattern consisting of short- and long-latency reflexes. The present investigation was designed to test reflexes following pure cutaneous stimulation. Air puffs were delivered to the palmar tip and the nail bed of the first, second and fifth fingers during isotonic contraction of hand muscles. The EMGs from the thenar muscles, the first dorsal interosseous muscle and the hypothenar muscles were recorded. Reflexes were obtained in all muscles, with a typical configuration consisting of a short-latency excitatory component (cutaneous long-latency reflex I, cLLR I) and a second excitatory component (cutaneous long-latency reflex II, cLLR II), with an inhibitory component between them. The size of cLLR II differed depending on the area stimulated and the muscle recorded. We found the largest responses always in the muscle acting on the stimulated finger. The reflex size depended on the strength of air puff stimulation. Allowing small displacements of the fingers led to an additional increase in the size of the reflex. The pattern of reflexes was identical independent of whether the finger tip or the nail bed was stimulated, but the size of the reflexes was smaller following nail bed stimulation. Following blockade of the cutaneous nerve branches of the thumb with local anaesthetics, air puff stimulation of the thumb no longer elicited this reflex pattern. Hence, under our experimental conditions, cutaneous receptors were the only source of afferent input for these reflexes.(ABSTRACT TRUNCATED AT 250 WORDS)

Differential activities of H+ extrusion systems in MDCK cells due to extracellular osmolality and pH.

The aim of the present study was to obtain detailed information on MDCK cell proton secretion characteristics under various growth conditions. Confluent monolayers cultured on glass coverslips were adapted over 48 h to media with different osmolality and pH (200 mosmol/kgH2O, pH 7.4; 300 mosmol/kgH2O, pH 7.4; and 600 mosmol/kgH2O, pH 6.8) corresponding to the luminal fluid composition of the collecting duct segments found in the in renal cortex, the outer stripe of outer medulla and inner medulla. Proton fluxes were determined from the recovery of intracellular pH following an acid load induced by an NH4Cl pulse times the corresponding intrinsic buffering power (beta(i)). The intracellular buffering power was found to change only with culture medium osmolality but not with culture medium pH. In addition to an amiloride and Hoe-694-sensitive Na+/H+ exchange, Madin-Darby canine kidney (MDCK) cells possess a Sch-28080-sensitive, K+-dependent H+ extrusion mechanism that is increased upon adaptation of monolayers to hyperosmotic-acidic culture conditions. A significant contribution of the bafilomycin A1-sensitive vacuolar H+-ATPase could be found only in cells adapted to hyposmotic culture conditions. Exposure of MDCK cells to 10(-5) or 10(-7) M aldosterone for either 1 or 18 h did not alter the H+ extrusion characteristics significantly. The results obtained show that different extracellular osmolality and pH induce different MDCK phenotypes with respect to their H+-secreting systems.

[Corticobasal degeneration. The significance of clinical criteria for establishing the diagnosis]. / Kortiko-basale Degeneration. Die Bedeutung klinischer Kriterien zur Diagnosestellung.

Neuropathological studies show that about 20% of all patients suffering from an acinetic-rigid syndrome can not be given the diagnosis of idiopathic Parkinson's disease. Among these non-idiopathic Parkinson-syndromes the corticobasal degeneration (CBD) can be regarded as a separate disease entity. The pathological findings of moderate predominantly frontal and parietal cerebral atrophy, cortical Pick-cells and specific corticobasal inclusion bodies are considered valuable features which support the diagnosis. The clinical Characteristics of CBD are demonstrated in 3 patients including an acinetic-rigid syndrome, limb apraxia and "alien limb"-syndrome, as well as reflex myoclonus. Eye movement disorders, dementia and other rare symptoms may also be present. Electrophysiological reflex-testing helps to corroborate diagnosis. These findings and a summary which includes the previously published cases of CBD show that CBD in most cases can be diagnosed intra vitam.

Detection of brain activation using oxygenation sensitive functional spectroscopy.

A nonwater-suppressed localized spectroscopy experiment using the PRESS-sequence has been used to study the signal changes of the water resonance during cortical activation. Significant effects with an effect-to-noise ratio up to 50:1 for a single shot experiment have been observed upon photic stimulation. The exceedingly high signal-to-noise ratio of the experiment was used to demonstrate signal changes as low as 0.1% after electrical stimulation of the median nerve.

A novel, complement factor H-related regulatory protein expressed on the surface of human B cell lines.

Complement regulatory proteins present on the surface of various mammalian cells play an important role in controlling homologous lysis, by interacting with C3 (and usually C4). These proteins have a similar structural motif ("short consensus repeat") (Reid, K.B.M., Bentley, R.D., Campbell, R.D., Chung, L.P., Sim, R.B., Kristensen, T. and Tack, B.F., Immunol. Today 1986. 7:230), and the genes encoding them are members of the family of regulators of complement activation. Here we describe a hitherto unknown member of this family, a molecule expressed by B lymphoblastoid cells. This protein is recognized by polyclonal antibodies to factor H and by MAH4, a monoclonal antibody reacting with the N-terminal portion of factor H. The cell surface protein is built up of two disulfide-linked chains of approximately 68 and 75 kDa. Biosynthetic labeling studies confirmed that it is synthesized by B cells only, but not by the investigated lines of other origin. When tested for its functional activity, this molecule was shown to act as cofactor for factor I-mediated cleavage of fluid-phase C3b to C3bi. The protein appears to be encoded by a 3.5-kb mRNA, hybridizing with a cDNA probe coding for the N-terminal portion of factor H. Due to its cross-reactivity with anti-H antibodies, cofactor activity for factor I and hybridization with factor H cDNA, despite its two-chain composition, it is considered a factor H-like protein.

Differential expression and acid-base regulation of glutaminase mRNAs in gluconeogenic LLC-PK(1)-FBPase(+) cells.

LLC-PK(1)-FBPase(+) cells, which are a gluconeogenic substrain of porcine renal LLC-PK(1) cells, exhibit enhanced oxidative metabolism and increased levels of phosphate-dependent glutaminase (PDG) activity. On adaptation to acidic medium (pH 6.9, 9 mM HCO(-)(3)), LLC-PK(1)-FBPase(+) cells also exhibit a greater increase in ammonia production and respond with an increase in assayable PDG activity. The changes in PDG mRNA levels were examined by using confluent cells grown on plastic dishes or on permeable membrane inserts. The latter condition increased the state of differentiation of the LLC-PK(1)-FBPase(+) cells. The levels of the primary porcine PDG mRNAs were analyzed by using probes that are specific for the 5.0-kb PDG mRNA (p2400) or that react equally with both the 4.5- and 5.0-kb PDG mRNAs (p930 and r1500). In confluent dish- and filter-grown LLC-PK(1)-FBPase(+) cells, the predominant 4.5-kb PDG mRNA is increased threefold after 18 h in acidic media. However, in filter-grown epithelia, which sustain an imposed pH and HCO(-)(3) gradient, this adaptive increase is observed only when acidic medium is applied to both the apical and the basolateral sides of the epithelia. Half-life experiments established that induction of the 4. 5-kb PDG mRNA was due to its stabilization. An identical pattern of adaptive increases was observed for the cytosolic PEPCK mRNA. In contrast, no adaptive changes were observed in the levels of the 5. 0-kb PDG mRNA in either cell culture system. Furthermore, cultures were incubated in low-potassium (0.7 mM) media for 24-72 h to decrease intracellular pH while maintaining normal extracellular pH. LLC-PK(1)-FBPase(+) cells again responded with increased rates of ammonia production and increased levels of the 4.5-kb PDG and PEPCK mRNAs, suggesting that an intracellular acidosis is the initiator of this adaptive response. Because all of the observed responses closely mimic those characterized in vivo, the LLC-PK(1)-FBPase(+) cells represent a valuable tissue culture model to study the molecular mechanisms that regulate renal gene expression in response to changes in acid-base balance.

Polymorphism and deficiency of human factor H-related proteins p39 and p37.

We described previously cDNA clones representing a novel factor H-related 1.4 kilobase mRNA. This mRNA species codes for a doublet of serum proteins of M(r) 39,000 and 37,000 (p39/p37). The respective recombinant proteins of the three clones H-69, pFH1.4a, and pFH1.4b differ in the expression of the epitope recognized by the monoclonal antibody (mAb) 3D11. This probably reflects the difference of three amino acid residues of the deduced protein sequence. Here we report evidence for corresponding alterations in the native proteins p39/p37 in human sera. Employing mAb 3D11 and a polyclonal factor H-specific antiserum we detected three different patterns in western blot analyses of human sera which we provisionally termed FH1.4p+m+, FH1.4p+m-, and FH1.4p-m-. In the first pattern, p39/p37 were recognized by both antibodies, while in the second pattern the two proteins reacted only with the polyclonal antiserum. Both antibodies failed to detect p39/p37 in the third pattern. These phenotypes are found in the healthy population with frequencies of 0.556, 0.40, and 0.044, respectively. The frequencies of the alleles FH1.4*p+m+, FH1.4*p+m-, and FH1.4*p-m- were estimated to be 0.33, 0.46, and 0.21, respectively, assuming the gene distribution to be in Hardy-Weinberg equilibrium. Studies of 98 members from 27 families revealed an autosomal Mendelian inheritance. Southern blot data support our assumption of a polymorphism of the factor H-related proteins p39 and p37.

Orellanine poisoning: rapid detection of the fungal toxin in renal biopsy material.

BACKGROUND: Mushroom poisoning by some species of the Cortinarius (Agaricales) often lead to irreversible renal failure caused by the nephrotoxin orellanine. In 1994 and 1995, six poisoning outbreaks involving ten individuals in Northern Italy and in Austria were investigated. METHODS: A total of 87 clinical samples (urine and blood samples including renal biopsy material of three patients) were examined for the presence of orellanine by thin layer chromatography. RESULTS: Orellanine can be detected after a relatively long period following poisoning by performing a simple thin layer chromatography technique using small quantities of renal biopsy material. No toxin was found in urine or blood samples. CONCLUSIONS: Orellanine is rapidly concentrated in the kidneys in a relatively soluble form and cannot be detected in urine, blood and dialysis fluids at the time when first symptoms appear.

PMA and staurosporine affect expression of the PCK gene in LLC-PK1-F+ cells.

The addition of phorbol 12-myristate 13-acetate (PMA) to renal LLC-PK1-F+ cells caused a rapid decrease in the level of phosphoenolpyruvate carboxykinase (PCK) mRNA and reversed the stimulatory effects of exposure to acidic medium (pH 6.9, 10 mM HCO-3) or cAMP. In contrast, prolonged treatment with PMA increased the levels of PCK mRNA. The two effects correlated with the membrane translocation and downregulation of the alpha-isozyme of protein kinase C and were blocked by pretreatment with specific inhibitors of protein kinase C. The rapid decrease in PCK mRNA caused by PMA occurred with a half-life (t1/2 = 1 h) that is significantly faster than that measured during recovery from acid medium or following inhibition of transcription (t1/2 = 4 h). The effect of PMA was reversed by staurosporine, which apparently acts by inhibiting a signaling pathway other than protein kinase C. Staurosporine had no effect on the half-life of the PCK mRNA, but it stimulated the activity of a chloramphenicol acetyltransferase gene that was driven by the initial 490 base pairs of the PCK promoter and transiently transfected into LLC-PK1-F+ cells. This effect was additive to that of cAMP, and neither stimulation was reversed by PMA. The stimulatory effect of staurosporine was mapped to the cAMP response element (CRE-1) and P3(II) element of the PCK promoter. The data indicate that, in LLC-PK1-F+ cells, activation of protein kinase C decreases the stability of the PCK mRNA, whereas transcription of the PCK gene may be suppressed by a kinase that is inhibited by staurosporine.

Topography and sources of electromagnetic cerebral responses to electrical and air-puff stimulation of the hand.

SEPs and SEFs after air-puff stimulation of index and little fingers have been studied and compared to the responses following electrical stimulation of the same digits and of the median nerve at the wrist in 5 subjects. The differences in morphology of the evoked signals are described and the generator characteristics are analysed for SEFs by means of a moving dipole model inside a homogeneous sphere. In our measurements the magnetic fields following electrical finger stimulation show a 30 msec component, which was absent following air-puff stimulation. This could not be seen in the electric field activity. The generators of the first component of SEFs after air-puff finger stimulation proved to be deeper (8 mm on average across all subjects and for both fingers) than in the case of electrically evoked SEFs. A similar behaviour was also observed for the second component of SEFs for the 2 stimulus modalities.

What is the optimal dose of botulinum toxin A in the treatment of cervical dystonia? Results of a double blind, placebo controlled, dose ranging study using Dysport. German Dystonia Study Group.

OBJECTIVES: Botulinum toxin injections have become a first line therapeutic approach in cervical dystonia. Nevertheless, published dosing schedules, responder rates, and frequency of adverse events vary widely. The present prospective multicentre placebo controlled double blind dose ranging study was performed in a homogenous group of previously untreated patients with rotational torticollis to obtain objective data on dose-response relations. METHODS: Seventy five patients were randomly assigned to receive treatment with placebo or total doses of 250, 500, and 1000 Dysport units divided between one splenius capitis (0, 175, 350, 700 units) and the contralateral sternocleidomastoid (0, 75, 150, 300 units) muscle. Assessments were obtained at baseline and weeks 2, 4, and 8 after treatment and comprised a modified Tsui scale, a four point pain scale, a checklist of adverse events, global assessment of improvement, and a global rating taking into account efficacy and adverse events. At week 8 the need for retreatment was assessed and then the code was unblinded. For those still responding, there was an open follow up until retreatment to assess the duration of effect. RESULTS: Seventy nine per cent reported subjective improvement at one or more follow up visits. Decreases in the modified Tsui score were significant at week 4 for the 500 and 1000 unit groups versus placebo (p<0.05). Additionally positive dose-response relations were found for the degree of subjective improvement, duration of improvement, improvement on clinical global rating, and need for reinjection at eight weeks. A significant dose relation was also established for the number of adverse events overall and for the incidence of neck muscle weakness and voice changes. CONCLUSION: Magnitude and duration of improvement was greatest after injections of 1000 units Dysport; however, at the cost of significantly more adverse events. Therefore a lower starting dose of 500 units Dysport is recommended in patients with cervical dystonia, with upward titration at subsequent injection sessions if clinically necessary.