Rapidly induced changes in neuromagnetic fields following repetitive hand movements.

Sensory feedback plays a major role in movement execution and motor learning, particularly in motor rehabilitation. Whilst elaborating therapeutic strategies, it is of interest to visualize the effect of a therapeutic intervention at the moment of its application. We analyzed the effect of repeated execution of a simple extension and flexion movement of the wrist on the sensorimotor cortex of seven healthy subjects using magnetoencephalography. Spatial filtering based on current dipoles was used to quantify the strength of cortical activation. Our results showed an increase of cortical activation reflecting activity of efferent neurons, whereas the activity of proprioceptive afferent neurons was not affected. Since only efferent activity increased, it is suggested that this reflects phenomena of long-term potentiation.

Progression of neurofibrillary changes and PHF-tau in end-stage Alzheimer's disease is different from plaque and cortical microglial pathology.

In terminal Alzheimer's disease (AD) the frequency of plaques was found to be reduced in single cases. To test this finding in a larger sample, and in order to determine whether the number of plaques labeled with different markers and the distribution of neurofibrillary tangles are correlated positively to each other and to the degree of dementia, a sample of 134 autopsy brains with and 15 without AD-related pathology has been examined. All of the cases were staged according to Braak and Braak. Both the frequency of plaques immunopositive for beta-amyloid, amyloid precursor protein, and apolipoprotein E and that of microglial cells in the cortex and in the white matter were determined semiquantitatively. The content and distribution of PHF-tau was ascertained by ELISA and immunohistochemistry. Both the clinical dementia rating and the global deterioration scale were used as clinical parameters retrospectively. Correlation coefficients were calculated for all parameters and differences were evaluated statistically. With progressive distribution of neurofibrillary tangles and increasing content of PHF-tau the plaque stages and the degree of cortical microglia reaction increased up to the Braak-stages IV and V, thereafter showing a slightly decreasing tendency in the investigated regions. In end-stage AD resorption of beta-amyloid seems to surpass its deposition. The microglial reaction in the white matter correlated neither with the Braak-stage nor with the accumulation of amyloid. With regard to the degree of dementia, both scales correlated well with the pathological changes. Our data show that neuronal cytoskeletal alterations progressively increase with progressive dementia until the end stage of AD in contrast to the frequencies of plaques and cortical microglial cells, and are therefore preferable for staging purposes.

[Patient-individual care pathways in phase D neurological rehabilitation]. / Patientenindividuelle Behandlungspfade in der neurologischen Rehabilitation der Phase D.

The "patient-individual neurological care pathways" are a concept for qualified decision-making about rational rehabilitative strategies in the treatment of neurological diseases. Such clinical pathways include available scientific evidence and treatment guidelines. In neurological rehabilitation all treatments have a decidedly interdisciplinary character. All members of the team need highly specialized knowledge, a high potential for teamwork, as well as efficient organisation of work time. Here, computer aided decision-making tools such as the "patient-individual neurological care pathways" facilitate rational decisions and reduce the need for reorganization of therapies. In rehabilitation of neurological patients a symptom-oriented and function-related perspective of the individual treatment goals is indispensable for optimal choice of therapy approaches. This function-oriented classification of patients and creation of individual treatment plans are realized within the Excel-based care pathways. This system has been proved on the one hand as an instrument for streamlining and optimisation and, on the other, as a useful tutoring tool in the medical rehabilitation process.

Studies on a new acute phase protein. I. Immunocytochemical demonstration of the origin.

Synovial fluid of patients with rheumatoid arthritis or traumatic arthritis contains an antigen which is thermostable to boiling temperature and insoluble in ethanol. The antigen was not found in sera of healthy subjects but it is present in numerous sera of patients with different inflammatory diseases. The partial purification of the antigen and the production of specific antisera are described. Immunofluorescent staining of tissue sections and blood smears indicates, that the antigen is a cytoplasmic protein of polymorphonuclear leucocytes. Monocytes contain the antigen to a lower degree, it was not found in eosinophils and lymphocytes. In addition, the influence of different fixing agents and of other pretreatment on the pattern of the cell fluorescence was studied. We propose to designate the antigen as thermostable granulocyte antigen (TSGA).

[Morphology and pathogenesis of penicillamine-induced nephropathy]. / Zur Morphologie und Pathogenese der Penicillamin-Nephropathie.

Histological, immunohistological and electron microscopical investigations on the glomerular renal lesions in penicillamine-induced nephropathy were carried out by studying biopsy material of eight patients with rheumatoid arthritis (4 cases), allergic alveolitis (3 cases) and systemic scleroderma (1 case) under the treatment with D-penicillamine. Summarizing all the findings, the characteristic pattern of immune complex nephritis as membranous type glomerulonephritis on the one hand and proliferative type glomerulonephritis (mesangioproliferative GN, focal proliferative GN or minimal proliferative GN) on the other hand could be demonstrated. The different types of glomerular alterations in penicillamine nephropathy obviously depend on the kind and duration of the primary main disease and on the individual immune reactivity of the body was a whole by this determined. The possible pathogenesis related to definite effects of the D-penicillamine is discussed and compared with the communications in the literature.

Assay for beta-ureidopropionase by high-performance liquid chromatography.

A sensitive assay for beta-ureidopropionase based on derivatization of the reaction product beta-alanine with phenylisothiocyanate has been developed. Purification of the resulting phenylthiocarbamoyl-beta-alanine is achieved on a LiChrospher 100 C18 reversed-phase high-performance liquid chromatography column using an isocratic elution system. Phenylthiocarbamoyl-beta-alanine is detected by its absorbance at 245 nm and quantitated by automatic peak integration referring to a calibration curve. This technique offers a high degree of sensitivity as beta-alanine quantities in the picomole range can be identified. N-Carbamoyl-beta-alanine, the natural substrate of beta-ureidopropionase, does not interfere with the described assay system. The enzymatic reaction is linear for an incubation time of 45 min with enzyme concentrations of 3.2 micrograms/ml.

[Morphology and pathogenesis of glomerular renal lesions in gold nephropathy]. / Zur Morphologie und Pathogenese glomerulärer Nierenveränderungen bei der Gold-Nephropathie.

Histological, immunofluorescent and electron microscopical investigations on the glomerular renal lesions in gold-induced nephropathy were performed by analyzing biopsy materials from 9 patients with rheumatoid arthritis treated by Sanocrysin (gold sodium thiosulfate). The morphological and immunofluorescent main changes consisted in the characteristic pattern of immune complex nephritis as membranous glomerulonephritis on the one hand (4 cases) and as mesangioproliferative glomerulonephritis (4 cases) on the other hand; in one case there could be demonstrated a focal proliferative glomerulonephritis similar to that observed as visceral manifestation of rheumatoid arthritis in the kidney. These different types of glomerular alterations in gold nephropathy evidently are related to th duration and immunological activity of the main disease and to the individual immune reactivity of the body as a whole determined by this, and not at all, by the combination of gold additionally with other antiinflammatory, especially antirheumatic drugs. The possible pathogenesis of nephropathy is discussed with special regard to definite effects of gold on the immune system.

Killing of untreated target cells by nonimmunized rat macrophages in vitro. II. Ultrastructural studies on the interaction of macrophages and rat liver cells.

The sequence of morphological changes following the interactions between macrophages of nonimmunized rats and allogeneic liver cells in vitro were examined by scanning and transmission electron microscopy. The effector cells could be identified as macrophages because of their morphologic characteristics and their ability of latex beads incorporation. The cytotoxic reactions required close contracts between the reactive cells. Effector membrane processes and microvilli attached the target cell surface. Broad contacts and, more frequent, point contacts were observed. After 4 to 5 hrs of incubation the target cells showed pinocytotic activities in the contact regions. Later on submembraneous cytoplasmatic leaks or defects indicated the increasing damage of the target cells. Finally, liver cell ghosts with degenerated organelles were found as morphologic expression of general target cell destruction whereas effector macrophages did not show any damage during the cytotoxic reaction.

Ultrastructural cytology of human osteosarcoma cells.

The cytology of 6 osteosarcomas was examined by electron microscopy. In keeping with the varied pattern of osteosarcomas seen by light microscopy several types of tumor cells could be differentiated: osteoblast-like, fibroblast-like, chondroblast-like, osteoclast-like and histiocyte-like cells. Moreover, atypical malignant mesenchymal cells and vascular spaces were present. The individual cytoplasmic organelles are not considered to be specific to particular types of cell as seen from the discussion of the significance of rough endoplasmic reticulum, microfilaments and lysosomes. Only examination of the composite pattern of subcellular organelles allows the differentiation of certain cell types. All tumor cells visible in osteosarcomas are considered as modifications of a transformed common progenitor cell. Because of the variegated cytological picture a multipotent mesenchymal cell rather than an osteoblastic cell is assumed to be the ancestor cell.

Immunocytochemical demonstration of Con A-receptors on the cell surface of guinea pig peritoneal macrophages.

By means of protein A-gold in combination with the replica technique the distribution of Con A-receptors on the surface of guinea pig peritoneal macrophages was investigated. In nonspecifically activated macrophages the arrangement of Con A-binding sites was demonstrated as homogeneous. It could be evidenced that by the combined technique the advantages of the high resolution of transmission electron microscopy could be joined with the possibility of the stereological demonstration of cell surface structures.

[Different antibody tests (IgG, IgM) from children with chronical recurrent urinary tract infections (author's tranls)]. / Differenzierte Antikörperbestimmungen (IgG, IgM) bei Kindern mit chronisch-rezidivierender Harnwegsinfektion

Different Antibody tests (IgG, IgM) were made from children with chronical and recurrent urinary tract infections with help of the indirect fluorescent method and were compared with the indirect hemagglutination test. The indirect hemagglutination gave absolutely higher antibody rest results, but the specifity of the immune fluorescence test is just as large. You can see the acute attacks of pyelonephritis in either the antibody response test or IHA test. It is quite important, in the beginning, to repeat the controlls of the antibody test, because the changes that could occure in the titer should be seen. The IgG antibody reactions rise slightly during the acute attacks of E. coli- and Enterococci reinfections.

[Heart wall rupture as a grave complication of acute myocardial infarct]. / Die Herzwandruptur als schwerwiegende Komplikation des akuten Herzinfarktes.

The rupture of the heart wall is a severe complication of the acute myocardial infarction. We found it in 3.5% of the deceased patients with an acute myocardial infarction. The average age of these patients was 71 years. 75% of the patients died during the first five days after the event of the myocardial infarction. Apart from elderly patients with myocardial infarction such ones with a transmural myocardial infarction in the region of the left ventricle, an enlargement of the heart and signs of an insufficiency of the left heart, with a hypertension and diabetes mellitus seemed to be endangered. These patients need the most exact control and observation and in case of suspicion (symptomatology of angina pectoris which is continuing to exist) of a developing rupture of the heart wall and aimed diagnostics (echocardiography) and therapy must be begun immediately.

Demonstration of lipopolysaccharide (LPS) binding sites on the cell surface of guinea pig peritoneal macrophages by means of immunogold technique.

Lipopolysaccharide binding sites of guinea pig peritoneal macrophages were demonstrated by means of immunogold technique. Resident peritoneal macrophages show a strong specific binding of bacterial lipopolysaccharides from E. coli to cell surface structures.

Killing of untreated target cells by nonimmunized rat macrophages in vitro. I. Studies on the type of effector cells and their capacity to destroy allogeneic target cells.

Spleen cells derived from unsensitized Wistar rats lysed untreated, allogeneic liver cells of high passages (93rd until 159th subculture) as well as allogeneic tumor cells in mixed cultures. On the other hand, rat liver cells between passages 42 and 56 and allogeneic or xenogeneic fibroblasts were not destroyed by rat spleen cells in vitro. The degree of target cell lysis was dependent on the incubation time and effector-target cell ratio. In the rat spleen, the macrophages were detected as effector cells. Rat peritoneal cells showed the same effects as rat spleen cells. Trypsin treatment caused no loss of cytotoxicity of rat macrophages. Thymocytes and blood lymphocytes of rats were not cytotoxic against allogeneic or xenogeneic target cells. The macrophages apparently destroyed target cells by a nonphagocytic form of cell contact. Unstimulated spleen cells of guinea pigs, Syrian hamsters, CBA mice and rabbits were not capable to destroy target cells in allogeneic and xenogeneic systems.

Thymocyte stimulating activity of the serum of rats in the early phase after 2-acetylaminofluorene (AAF)-treatment.

The serum of rats collected at various time intervals after application of a single dose of 2-acetylaminofluorene (AAF) stimulates the incorporation of 3H-thymidine into the DNA of cultured thymocytes of rats, mice and hamsters. This reaction shows a clear dose-response relationship. The serum activity is dialysable and relatively thermostable.

Stimulation of thymocytes in vitro by serum of 2-acetylaminofluorene (AAF)-treated rats.

The serum of rats obtained at various time intervals after administration of AAF was tested for its action on the 3H-thymidine incorporation into the DNA of thymocytes in vitro. In comparison with untreated or solvent-treated controls, the sera of animals in the early phase after the AAF-treatment stimulate the incorporation of the nucleotide into the thymocytes of rats, mice and hamsters. This reaction shows an unequivocal dose-response relationship. The serum activity is dialysable and relatively thermostable. Spleen lymphocytes and peritoneal cells of rats are insensitve to the AAF-serum. A possible relationship between growth-stimulating serum activities in liver regeneration and in early carcinogen action is discussed.

[Assessing functional health and sociability of aged persons: the development and validation of two guttman-scales (author's transl)]. / Die Erfassung von Rüstigkeit und Kontaktbereitschaft bei Betagten: Entwicklung und Validierung zweier Guttman-Skalen.

Studies to develop and validate two Guttman-scales are reported, which aim at measuring level of functional health and inclination to engage in social contacts in aged persons. A first scale analysis, based on the answers of 150 old persons, resulted in two, 12-item scales, which according to Guttman's criterion were fully satisfying. In two consecutive studies Guttman-selfratings of two other samples of old people were validated against ratings of experts, who disposed of profound knowledge of the sampled persons (a physician of a nursing home, managers of homes for the aged). A second scale analysis was performed, too. The results, especially the very significant correlations between expert ratings and selfassessments, suggest a broader application of at least the functional health scale. It is proposed to use the scales, if one aims at increasing the fit between individual needs and amount of services provided, and as instruments to control for sample characteristics, if different care programs are evaluated.