Cortical involvement in a gait-related imagery task: comparison between Parkinson's disease and normal aging.

PURPOSE: We employed imaginary tasks to investigate the neurophysiology of gait in patients with Parkinson's disease (PD) using functional magnetic resonance imaging (fMRI). METHODS: Cortical activation of gait-related imagery was explored in 13 PD patients, 13 age-matched controls (Old), and 14 young volunteers (Young) using fMRI. The tasks included gait initiation, stepping over an obstacle and gait termination using an event-related design. Subjects watched a video clip showing an actor walking and imagined the walking process. RESULTS: At gait initiation, no significant difference could be found between PD and the Old controls. Activation in the visual related areas in the Old subjects was increased compared to the Young subjects. While imagining stepping over obstacles, the right dorsal premotor area (PMd), precentral, right inferior parietal lobule, and bilateral precuneus were more activated in PD compared to the Old. An extensive network of bilateral SMA, PMd, posterior parietal lobe and visual association areas was activated in the Old versus the Young subjects. At gait termination, visual related areas were noted when PD was compared to the Old. In contrast, increased activation in bilateral pre-SMA, PMd, ventral premotor area, precentral, posterior parietal lobes and visual association areas were activated in the Old when compared to the Young. CONCLUSIONS: Our study provides image based evidence for gait disturbance in PD patients and during normal aging. The compensatory cortical mechanism in the findings could be a background resource for further therapeutic interventions.

Tuberculosis of the breast with erythema nodosum: a case report.

INTRODUCTION: There has been an increasing number of tuberculosis cases worldwide, but tuberculosis of the breast remains rare. In rare cases this is seen with a cutaneous manifestation of erythema nodosum. CASE PRESENTATION: We report the case of a 33-year-old Chinese woman with tuberculosis of the left breast accompanied by erythema nodosum on the anterior aspect of both lower legs. Due to her poor clinical response to conventional therapy, and the histopathological findings of fine needle aspiration cytology, there were strong indications of tuberculosis. Her clinical diagnosis was confirmed by molecular detection of Mycobacterium tuberculosis complex by polymerase chain reaction. The diagnosis was further confirmed by a second polymerase chain reaction test of erythema nodosum which tested positive for Mycobacterium tuberculosis complex. She received anti-tuberculous therapy for 18 months, and finally underwent residual lumpectomy. During her follow-up examination after 12 months, no evidence of either residual or recurrent disease was present. CONCLUSION: Histopathological features and a high index of clinical suspicion are necessary to confirm a diagnosis of tuberculosis of the breast. Anti-tuberculous therapy with or without simple surgical intervention is the core treatment.

Differential expression of a V-type ATPase C subunit gene, Atp6v1c2, during culture of rat lung type II pneumocytes.

The lung alveolar epithelium consists of type I and type II pneumocytes. In vivo, the type II cell is the progenitor cell from which the type I cell originates. When freshly-isolated type II cells are cultured under conventional conditions they rapidly lose their phenotypic properties and attain characteristics of type I cells. Taking advantage of this transdifferentiation, we sought to identify genes that are differentially expressed during culture of rat type II cells. Using suppression subtractive hybridization (SSH), a vacuolar-type H+-ATPase (V-ATPase) C2 subunit gene (Atp6v1c2) was found to be enriched in freshly isolated rat type II cells compared to those cultured for 4 days. Northern blotting and reverse-transcription polymerase chain reaction (RT-PCR) confirmed the differential expression of Atp6v1c2 during in vitro culture of isolated type II cells. Expression ofAtp6v1c2 was significantly reduced early during in vitro culture: almost 90% reduction was observed after 24 h of incubation as determined by real-time PCR. In situ hybridization showed that Atp6v1c2 is expressed in both bronchiolar and alveolar lung epithelial cells, an expression pattern similar to that of surfactant protein B (SP-B). Multi-tissue Northern blotting revealed a unique tissue distribution with Atp6v1c2 expression limited to lung, kidney and testis. The presence and expression of Atp6v1c2 gene transcript isoforms, resulting from alternative splicing, were also investigated. Elucidation of differential expression of Atp6v1c2 in type II cells and further studies of its regulation may provide information useful in understanding the molecular mechanism underlying phenotypic and functional changes during transdifferentiation of alveolar epithelial cells.