Assessing IgG4-related ophthalmic disease and its mimics: a comparison of ACR/EULAR, organ-specific and revised comprehensive diagnostic criteria.

AIMS: Diagnosis of IgG4-related ophthalmic disease (IgG4-ROD) rests on the correlation of clinical features, serological testing and histopathology, using internationally accepted diagnostic criteria for objective interpretation; however, several mimickers of IgG4-RD overlap in clinical presentation and histopathology. We assess histopathological features in a series of presumptive IgG4-ROD cases, with emphasis on histopathological mimics and comparison of three IgG4-ROD diagnostic/classification criteria (organ-specific (OS), revised comprehensive diagnostic (RCD) and American College of Rheumatology/European Alliance of Associations for Rheumatology (ACR/EULAR) criteria). METHODS: The histopathology database was screened for cases with clinical/histopathological suspicion of IgG4-ROD. Slides were reviewed, OS, RCD and ACR/EULAR criteria were applied, and the final clinicopathological diagnosis was recorded. RESULTS: 37 patients (24 females, 13 males; 19-73 years) were diagnosed as either IgG4-ROD (n=18) or non-IgG4-related disease (n=19). Non-IgG4-related disease group showed elevated serum IgG4 (55.5%), fibrosis (100%), dense lymphoplasmacytic inflammation (92.8%), with an increase in tissue IgG4+plasma cells (57.1%) and elevated IgG4:IgG+plasma cell ratio (14.3%). ACR/EULAR missed 50% (9/18, sensitivity-52.8%) of true IgG4-ROD cases, while OS and RCD criteria missed 11.1% (2/18, sensitivity-88.9%) of IgG-ROD cases. ACR/EULAR criteria mislabelled 7.14% (1/14, specificity-90.9%) while OS and RCD criteria wrongly categorised 71.4% (10/14, specificity-47.4%) and 50% (7/14, specificity-63.2%) specific non-IgG4-ROD cases as IgG4-ROD. Storiform fibrosis, obliterative phlebitis, increased IgG4:IgG+plasma cell ratio and elevated serum IgG were statistically significant in distinguishing IgG4-ROD from its mimics. CONCLUSION: ACR/EULAR criteria showed high specificity but were cumbersome and sensitivity was low, while RCD and OS criteria showed low specificity. Stringent clinicopathological correlation to exclude mimics is critical in avoiding diagnostic errors in IgG4-ROD.

Eyelid nodule: a rare presentation of Langerhans cell histiocytosis.

Langerhans cell histiocytosis occurring as an isolated tumor of eyelid has rarely been reported. We report an unusual case of a 5-year-old boy who presented with a smooth nodular lesion over the right lower eyelid accompanied with hyperemia for a month. The biopsy and CD1a positivity confirmed it to be Langerhans cell histiocytosis. It was localized to the eyelid as no other organ was involved. Although Langerhans cell histiocytosis of the eyelid is exceptional, it must be included in the differential diagnosis of eyelid nodular lesions and the diagnostic and the subsequent management must be multidisciplinary.

Large low-frequency fluctuations in the velocity of a driven vortex lattice in a single crystal of 2H-NbSe2 superconductor.

The driven state of a well-ordered flux line lattice in a single crystal of 2H-NbSe2 in the time domain has revealed the presence of substantial fluctuations in velocity, with large and distinct time periods ( approximately seconds). A superposition of a periodic drive in the driven vortex lattice causes distinct changes in these fluctuations. We propose that prior to the onset of the peak effect there exists a heretofore unexplored regime of coherent dynamics, with unexpected behavior in velocity fluctuations.

Sodium-Calcium Exchanger in Pig Coronary Artery.

This review focuses on the sodium-calcium exchangers (NCX) in the left anterior descending coronary artery smooth muscle. Bathing tissues in Na+-substituted solutions caused them to contract. In cultured smooth muscle cells, it increased the cytosolic Ca2+ concentration and extracellular entry of 45Ca2+. All three activities were attributed to NCX since they were inhibited by NCX inhibitors. The tissues also expressed the sarco/endoplasmic reticulum (SER) Ca2+ pump SERCA2b whose activity was much greater than that of NCX. Inhibiting SERCA2b with thapsigargin decreased the NCX-mediated 45Ca2+ accumulation by the cells. The decrease was not observed in cells loaded with the Ca2+-chelator BAPTA. The results are consistent with a limited diffusional space model with a proximity between NCX and SERCA2b. NCX molecules appear to be colocalized with the subsarcolemmal SERCA2b based on studies on membrane flotation experiments and microscopic fluorescence imaging of antibody-labeled cells. Thapsigargin inhibition of SERCA2b moved NCX even closer to SER. This provides a model for the NCX-mediated Ca2+ refilling of SER in the arterial smooth muscle. The model for the NCX-mediated refilling of the depleted SER proposed for smooth muscle did not apply to endothelium in which NCX levels were greater and SERCA levels were lower than in smooth muscle. The effect of thapsigargin on the NCX-mediated Ca2+ accumulation which was observed in smooth muscle was absent in the endothelium. We propose that the coupling between NCX and smooth muscle may be tissue dependent.

Study of the sign change of exchange bias across the spin reorientation transition in Co(Cr1-x Fe x )2O4 (x = 0.00-0.125).

We present the evolution of novel phenomena of magnetic compensation effect, exchange bias (EB) effect and the field induced anomalies in '[Formula: see text]' substituted multiferroic compound [Formula: see text]. A few percent of '[Formula: see text]' substitution for '[Formula: see text]' in [Formula: see text] results in the reversal of field cooled magnetization under low applied fields below compensation temperature T comp. Further, increase in the field leads to the spin reorientation transition (T SR). Signature of EB in a narrow temperature window in the vicinity of T SR and its sign change across T SR is observed. Magnitude of EB depends on the amount of compensation and rigidity of the spin reorientation. We also notice the appearance of positive EB below the lock-in transition (T L). Presence of unidirectional anisotropy developed in the commensurate spin-spiral below T L could be responsible for the appearance of EB below T L.

Negative velocity fluctuations and non-equilibrium fluctuation relation for a driven high critical current vortex state.

Under the influence of a constant drive the moving vortex state in 2H-NbS2 superconductor exhibits a negative differential resistance (NDR) transition from a steady flow to an immobile state. This state possesses a high depinning current threshold ([Formula: see text]) with unconventional depinning characteristics. At currents well above [Formula: see text], the moving vortex state exhibits a multimodal velocity distribution which is characteristic of vortex flow instabilities in the NDR regime. However at lower currents which are just above [Formula: see text], the velocity distribution is non-Gaussian with a tail extending to significant negative velocity values. These unusual negative velocity events correspond to vortices drifting opposite to the driving force direction. We show that this distribution obeys the Gallavotti-Cohen Non-Equilibrium Fluctuation Relation (GC-NEFR). Just above [Formula: see text], we also find a high vortex density fluctuating driven state not obeying the conventional GC-NEFR. The GC-NEFR analysis provides a measure of an effective energy scale (E eff ) associated with the driven vortex state. The E eff corresponds to the average energy dissipated by the fluctuating vortex state above [Formula: see text]. We propose the high E eff value corresponds to the onset of high energy dynamic instabilities in this driven vortex state just above [Formula: see text].

Plasma membrane calcium pump activity in rat pancreatic islets: an accurate method to measure its calcium-dependent modulation.

The aim of this study was to quantify the glucose modulation of the plasma membrane calcium pump (PMCA) function in rat pancreatic islets. Ca2+-ATPase activity and levels of phosphorylated PMCA intermediates both transiently declined to a minimum in response to stimulation by glucose. Strictly dependent on Ca2+ concentration, this inhibitory effect was fully expressed at physiological concentrations of the cation (less than 0.5 muM), then progressively diminished at higher concentrations. These results, together with those previously reported on the effects of insulin secretagogues and blockers on the activity, expression and cellular distribution of the PMCA, support the concept that the PMCA plays a key role in the regulation of Ca2+ signaling and insulin secretion in pancreatic islets.

Studies on almond emulsin beta-D-glucosidase. II. Kinetic evidence for independent glucosidase and galactosidase sites.

A purified beta-D-glucosidase (beta-D-glucoside glucohydrolase, EC 3.2.1.21) isozyme isolated from almond emulsin was found to catalyze hydrolysis of beta-D-glucopyranosides and beta-D-galactopyranosides but not the corresponding alpha-D-derivatives. Hydrolysis of the corresponding beta-D-thioglycopyranosides at rates 10(3)--10(4) times lower than those for the hydrolysis of the beta-D-glycopyranosides was also noted. The enzyme does not exhibit any transferolytic activity using D-glucose or D-galactose as acceptors. D-glucose, p-nitrothiophenyl-beta-D-glucopyranoside, 5-deoxy-5-thio-D-glucose and D-glucono-delta-lactone are shown to exert mainly competitive inhibition on beta-D-galactopyranoside hydrolysis. D-galactose, p-nitrothiophenyl-beta-D-galactopyranside and methylthio-beta-D-galactopyranoside are shown to inhibit the glucopyranoside hydrolysis mainly non-competitively and to exert competitive inhibition of galactopyranoside hydrolysis. The inhibition caused by the antibiotic Nojirimycin (5-amino-5-deoxy-D-glucose) is shown to be more complex. Analysis of the kinetic data indicates that the catalytic site of the enzyme responsible for the beta-D-glucosidase activity is kinetically distinct from the beta-D-galactosidase site.

ESR studies on the orientation of cholesteryl ester in phosphatidylcholine multilayers.

The alignment of cholesteryl esters in multilayer phosphatidylcholine membranes was investigated using two spin-labelled cholesteryl esters: 10 : 3 ester (I) and 1 : 14 ester (II). The nitroxide label of I is aligned in the membrane with a very large angle of tilt (47 degrees +/- 1.5 degrees) with respect to the normal to the membrane surface; II does not show such a tilt. I gives spectra corresponding to immobilized label while II gives nearly isotropic spectra. Ascorbate treatment of the multilayers shows that the labels in I and II are not present at the phosphatidylcholine-water interphase. The data supports a 'horseshoe' configuration for the cholesteryl ester in the bilayer, with both the fatty acid chain and the cholesteryl moiety extending deep into the hydrophobic region of the membrane and with the ester linkage near the surface.

Studies on almond emulsin beta-D-glucosidase. I. Isolation and characterization of a bifunctional isozyme.

A beta-D-glucosidase (beta-D-glucoside glucohydrolase, EC 3.2.1.21) isozyme has been isolated from almond emulsin. The isolated enzyme is a glycoprotein and migrates as a single band on Sephadex G-200 filtration, CM 52 ion exchange chromatography, polyacrylamide gel electrophoresis, sodium dodecyl sulfate polyacrylamide gel electrophoresis and isoelectric focussing. The glucosidase and galactosidase activities traverse together during Sephadex G-200 gel filtration. Polyacrylamide gels stained specifically for the 2 enzymes reveal that the two activities comigrate. The molecular weight of the isozyme has been found to be 135 180 +/- 770, and that of its protomers to be 65 150 +/- 650.

Expression of isoforms of internal Ca2+ pump in cardiac, smooth muscle and non-muscle tissues.

Smooth muscle and several non-muscle tissues contain mRNA for an alternative splice of the mRNA for the cardiac sarcoplasmic reticulum (SR) Ca,Mg-ATPase. Based on amino acid composition deduced from cDNA sequences the cardiac isoform (Ic) is 110 kDa while the smooth muscle and the non-muscle isoform (Is) is 115 kDa. This prediction in their molecular masses was tested at the protein level in rabbit stomach, aorta, uterus and vas deferens smooth muscles; stomach mucosa, brain, liver, kidney and heart. The major species of the acylphosphates formed in the presence of Ca2+ and electrophoresed in acid SDS-acrylamide gels were 5 kDa smaller for the heart (Ic) than those for all the other tissues (Is). The size difference was also confirmed in Western blots using a monoclonal antibody which binds to both Is and Ic. Thus consistent with the mRNA splices for the internal Ca2+ pumps previously reported to be present in these tissues, rabbit heart expresses predominantly the Ca2+ pump protein Ic and the various smooth muscle, mucosa, brain, liver and kidney express mainly the isoform Is.

Subcellular fractionation of pig coronary artery smooth muscle.

A detailed procedure for subcellular fractionation of the smooth muscle from pig coronary arteries based on dissection of the proper tissue, homogenization, differential centrifugation and sucrose density gradient centrifugation is described. A number of marker enzymes and Ca2+ uptake in presence or absence of oxalate, ruthenium red and azide were studied. The ATP-dependent oxalate-independent azide- or ruthenium red-insensitive Ca2+ uptake, and the plasma membrane markers K+-activated ouabain-sensitive p-nitrophenylphosphatase, 5'-nucleotidase and Mg2+-ATPase showed maximum enrichment in the F2 fraction (15-28% sucrose) which was also contaminated with the endoplasmic reticulum marker NADPH: cytochrome c reductase, and to a small extent with the inner mitochondrial marker cytochrome c reductase, and also showed a small degree of oxalate stimulation of the Ca2+ uptake. F3 fraction (28-40% sucrose) was maximally enriched in the ATP- and oxalate-dependent azide-insensitive Ca2+ uptake and the endoplasmic reticulum marker NADPH: cytochrome c reductase but was heavily contaminated with the plasma membrane and the inner mitochondrial markers. The mitochondrial fraction was enriched in cytochrome c oxidase and azide- or ruthenium red-sensitive ATP-dependent Ca2+ uptake but was heavily contaminated with other membranes. Electron microscopy showed that F2 contained predominantly smooth surface vesicles and F3 contained smooth surface vesicles, rough endoplasmic reticulum and mitochondria. The ATP-dependent azide-insensitive oxalate-independent and oxalate-stimulated Ca2+ uptake comigrated with the plasma membrane and the endoplasmic reticulum markers, respectively, and were preferentially inhibited by digitonin and phosphatidylserine, respectively. This study establishes a basis for studies on receptor distribution and further Ca2+ uptake studies to understand the physiology of coronary artery vasodilation.

Leber's hereditary optic neuropathy with molecular characterization in two Indian families.

PURPOSE: Leber's hereditary optic neuropathy (LHON) presents in early adulthood with painless progressive blindness of one or both eyes. Usually there is a positive family history of similar disease on the maternal side. Definitive diagnosis can be established by finding the change in the mitochondrial gene. No molecular studies have been reported from India. MATERIAL AND METHODS: Clinical, ophthalmologic and molecular studies were carried out in two patients from different families and available first degree relatives. The subjects were tested for the three common mutations seen in LHON by molecular techniques of polymerase chain reaction using mutation specific primers. RESULTS: The mutations G3460A and G11778A in the mitochondrial genes MTND1 and MTND4, known to be causative for LHON, were found in one family each. CONCLUSION: Diagnosis of LHON should be considered in familial cases and in young adults with optic atrophy. Confirmation of diagnosis should be sought by molecular gene analysis. Genetic counselling should be offered to all 'at risk' relatives of a patient harbouring the mutation.

Paramagnetic magnetization signals and curious metastable behaviour in field-cooled magnetization of a single crystal of superconductor 2H-NbSe2.

We present here some newer characteristics pertaining to paramagnetic Meissner effect like response in a single crystal of the low [Formula: see text] superconducting compound 2H-[Formula: see text] via a detailed study of effects of perturbation on the field-cooled magnetization response. In the temperature range, where an anomalous paramagnetic magnetization occurs, the field-cooled magnetization response is found to be highly metastable: it displays a curious tendency to switch randomly from a given paramagnetic value to a diamagnetic or to a different paramagnetic value, when the system is perturbed by an impulse of an externally applied ac magnetic field. The new facets revealed in a single crystal of 2H-[Formula: see text] surprisingly bear a marked resemblance with the characteristics of magnetization behaviour anticipated for the giant vortex states with multiple flux quanta ([Formula: see text], [Formula: see text], [Formula: see text]) predicted to occur in mesoscopic-sized superconducting specimen and possible transitions amongst such states.

Ca-pumps in smooth muscle: one in plasma membrane and another in endoplasmic reticulum.

For several years it has been debated whether the Ca-pump in smooth muscle is located in the plasma membrane or in the endoplasmic reticulum (alias sarcoplasmic reticulum). Experimental evidence using skinned smooth muscle cells and subcellular membrane fractions isolated from a number of smooth muscles is reviewed here to hopefully resolve this issue. The inescapable conclusion is that there are two modes of nonmitochondrial ATP-dependent Ca-transport. The first one, unaffected by oxalate, is localized in the plasma membranes and the second, potentiated by oxalate, is localized in the endoplasmic reticulum. Clear experiments to delineate the roles of the two pumps in the excitation-contraction cycle of the smooth muscle remain to be conducted.

Calcium binding proteins in smooth muscle plasma membrane.

Rat myometrium plasma membrane showed a number of 45Ca-binding proteins as identified by gel electrophoresis. An attempt was made to identify these either by studying the inhibition of this binding by several ions or by studying binding of these proteins to calmodulin, A9 an antibody against skeletal muscle Ca-binding proteins and Stains-all. On the basis of the molecular weight, calmodulin binding and La-sensitivity of Ca-binding, the Ca-binding protein at 137 +/- 2 kDa has been identified as the Ca-pump. This protein as judged from Coomassie blue staining forms a very small percentage of the proteins present in the plasma membrane.

Characterization and solubilization of the nitrendipine binding protein from canine small intestinal circular smooth muscle.

The binding of nitrendipine, a calcium channel blocking agent, to the microsomes prepared from canine small intestinal circular smooth muscle was characterized. The binding of this 1,4-dihydropyridine to the membrane was reversible, saturable and of high affinity with a dissociation constant of 0.28 nM and a maximal binding of 91 fmol/mg microsomal protein. The binding occurred with an association rate constant of 0.094 nM-1 min-1 and dissociated at the rate of 0.0498 min-1. These rate constants gave a value of 0.52 nM for the dissociation constant of the binding. The binding was inhibited in a competitive fashion by other dihydropyridines (nifedipine, nimodipine, nisoldipine, PN200-110) with inhibition constants in the range of 0.1 to 1.0 nM. The binding was also inhibited by verapamil and D-600 but only at much higher concentrations. Diltiazem increased the nitrendipine binding to the membranes. The nitrendipine binding protein was solubilized using the detergent 3-[(3-cholamidopropyl)dimethyl-ammonio]-1-propanesulfonate (CHAPS). The solubilized material bound nitrendipine with a dissociation constant of 0.51 nM giving maximal binding of 70 fmol/mg protein. The binding of the solubilized material resembled the membrane bound material in inhibition by the dihydropyridines, verapamil and D-600 and in the increase by diltiazem. Thus we have solubilized the nitrendipine binding protein without changing its binding properties substantially.

High affinity Ca-binding to smooth muscle plasma membrane: inhibition by cations.

The effects of Mg2+, Na+ and K+ on the pH-dependent high affinity passive Ca-binding to sarcolemmal enriched membrane fractions from the smooth muscles of rat myometrium and gastric fundus were examined at 1 uM Ca2+-concentration. For the myometrial plasma membranes, these ions inhibited the passive Ca-binding with the following IC50 values: Mg2+: 1.75 mM; Na+: 19 mM; K+: 233 mM. Similarly, for the gastric fundus membranes, the IC50 values were Mg2+:1.6 mM, Na+:46 mM and K+:67 mM.

Abundance of heteronuclear and messenger RNA for internal Ca pump in stomach smooth muscle and myocardium.

The sarcoplasmic reticulum Ca pump gene SERCA2 is alternatively spliced to express mRNA encoding the protein SERCA2a in heart and SERCA2b in stomach smooth muscle. The expression of SERCA2 protein in heart is 70 +/- 10 fold that in stomach smooth muscle. To understand the mechanism underlying this tissue difference in the expression level, a comparison is made of their mRNA and heteronuclear RNA (hn-RNA) contents. A 72 bp intron present in the gene encoding SERCA2a/b was cloned and sequenced. By reverse transcription of total RNA followed by PCR using primers based on the sequence of this intron and the cDNA sequences flanking it, a value of 0.37 +/- 0.03 was obtained for the ratio heart hn-RNA/mRNA:stomach hn-RNA/mRNA. Similarly, a ratio of 3.4 +/- 0.5 was obtained for heart:stomach mRNA/28S values. This value was slightly lower but statistically similar to a value of 5.7 +/- 1.8 obtained for the heart:stomach mRNA/poly A+ RNA obtained by Northern blot analysis using a conserved region SERCA2 cDNA probe. Based on mRNA/28S ratio of 3.4 +/- 0.5 and hn/mRNA ratio of 0.37 +/- 0.03, the ratio of heart:stomach for hn-RNA/28S was 1.2 +/- 0.2. Thus, heart which expresses SERCA2a contains 70 +/- 10 times more protein, 3.4 +/- 0.5 times more mRNA and only 1.2 +/- 0.2 times more hn-RNA for this message than the stomach smooth muscle which expresses SERCA2b.

Calcium pump isoforms: diversity, selectivity and plasticity. Review article.

Ca2+ pumps are essential for removing cytosolic Ca2+ either across the plasma membrane (PM) or into internal organelles such as the sarcoplasmic reticulum (SR). Four genes (PMCA1, PMCA2, PMCA3 and PMCA4) have been reported to encode the PM Ca2+ pumps and three (SERCA1, SERCA2 and SERCA3) to encode the SR Ca2+ pumps. The PM Ca2+ pumps are stimulated by calmodulin, the SR Ca2+ pumps encoded by SERCA1 and SERCA2 are stimulated by phospholamban while the product of SERCA3 may be regulated directly by cAMP-dependent protein kinase. Alternative splicing of the primary transcripts of several of these genes has been reported to occur in a tissue selective manner and for others to alter during ontogeny. For the PM Ca2+ pump, alternative RNA splicing may result in isoforms with altered cyclic nucleotide dependent protein kinase sensitivity. The diversity in distribution of Ca2+ pump isoforms and their regulatory factors when coupled with different Ca2+ entry mechanisms allows for tissue selectivity and plasticity in stimulus-response coupling. The roles of various Ca2+ pump isoforms, the rationale behind their tissue selective expression and the plasticity in this expression are among the new challenges to researchers in this field.