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Biomedical subjects

H Kalimo

Publications and source records attributed to H Kalimo.

At least 91 records · Page 5Linked to original sources

MR classification of brain gliomas: value of magnetization transfer and conventional imaging.

We compared quantitative analysis of conventional MR and magnetization transfer (MT) images with visual morphologic assessment of standard images in the classification of gliomas. Thirty-two patients with gliomas were imaged preoperatively. Relative signal intensities on T2- and T1-weighted images, Gd-enhancement, signal heterogeneity on T2-weighted and Gd-enhanced T1-weighted images and MT ratios were measured. In 16 astrocytomas, the MT ratios were correlated with the volume fraction of tumor cell nuclei in histological sections. Among the conventional sequences T2-weighted images were most accurate for quantitative classification; signal heterogeneity was more accurate than relative signal intensity. MT ratios were superior to quantitative analysis of conventional images and equal to visual morphologic evaluation in discriminating between low-grade and high-grade gliomas and correlated with the volume fraction of nuclei in the tumor tissue (r = 0.71, p < .01). The results indicate that quantitative analysis is generally of minor value in the grading of gliomas. In spite of sensitivity to tissue changes associated with malignancy MT imaging cannot significantly improve MR classification of gliomas.

Astrocytoma↗

Denervated segments of injured skeletal muscle fibers are reinnervated by newly formed neuromuscular junctions.

A muscle fiber normally receives its innervation at a single neuromuscular junction (NMJ). Transection of myofiber usually leaves one (abjunctional) stump denervated, while the other (adjunctional) remains innervated. To determine the mechanism of reinnervation of the abjunctional stumps, we transected the rat extensor digitorum muscle (EDL) below the site of the distalmost NMJ. Myofiber regeneration was followed for up to 56 days. Reinnervation began with the appearance of irregular acetylcholinesterase and alpha-bungarotoxin-positive deposits on abjunctional stumps after 10 to 15 days. These deposits later developed into more regular NMJ. The newly formed NMJ were innervated by sprouting axons which penetrated through the connective tissue scar separating the stumps. While denervated, the myofibers of the abjunctional segments underwent marked atrophy, which was reversed when reinnervation had ensued. In conclusion, we demonstrate for the first time that mature myofiber segments devoid of previous NMJ can induce both sprouting from intact axon terminals and formation of new "ectopic" NMJ on their own surface. This type of reinnervation is likely to occur only when myofibers are asymmetrically transected by a trauma. The signaling molecules possibly involved in this phenomenon are discussed.

Animals↗

Proliferative activity and DNA index do not significantly predict survival in primary central nervous system lymphoma.

Proliferative activity and DNA index were analyzed and correlated with histology and survival in 30 primary central nervous system lymphomas (PCNSL) in immunocompetent patients. Proliferative activity was determined using mitotic activity index and volume-corrected mitotic index, percentage of Ki-67 (MIB-1) immunopositive nuclei and flow cytometric S-phase fraction. Twenty-nine PCNSL were of B-cell origin and one of T-cell; by Kiel classification there were 23% low grade and 77% high grade and by Working Formulation there were 7%, 73% and 20% low, intermediate and high grade tumors, respectively. Mean survival time for non-survivors (n = 26) was 11.5 months and median 6.5 months. When indicators of proliferative activity were evaluated against histological grading, correlation existed only between mitotic activity index and Kiel classification. None of the proliferation markers or DNA index correlated significantly with survival, but there was a trend for patients with higher volume-corrected mitotic index to have shorter survival. In conclusion, most PCNSL have poor prognosis irrespective of their histological grade and proliferative activity. Furthermore, because at present stereotactic biopsy is recommended for establishing the diagnosis, exact histological subtyping and determination of proliferation activity in such small samples appears to be of only marginal significance.

Adult↗

Correlation between the clinical symptoms and the proportion of mitochondrial DNA carrying the 8993 point mutation in the NARP syndrome.

We describe a four-generation family with a maternally inherited mitochondrial disorder. The symptoms were restricted to the CNS and muscle, the most common features being subacute necrotizing encephalomyopathy, cognitive impairment, ataxia, retinitis pigmentosa, infantile spasms, and optic atrophy. A point mutation at the nucleotide 8993 of the gene encoding subunit 6 of the ATP synthase, associated with the neurogenic muscle weakness, ataxia, retinitis pigmentosa (NARP) syndrome, was shown to be inherited maternally in this family, and a clear correlation was found between the clinical severity of the disease and the proportion of mutant mtDNA. Analysis of oxidative phosphorylation in mitochondria carrying 80% mutant mitochondrial DNA showed a reduction of the ATP generation rate coupled to substrate oxidation.

Adolescent↗

Satellite cell proliferation and the expression of myogenin and desmin in regenerating skeletal muscle: evidence for two different populations of satellite cells.

BACKGROUND: Regeneration of mature skeletal muscle recapitulates closely fetal myogenesis. It is initiated by activation of the reserve myogenic precursor cells, the satellite cells, which proliferate, differentiate into myoblasts expressing muscle-specific proteins, fuse into myotubes, and finally mature into myofibers. The MyoD family of transcription factors participates in the regulation of the complex phenomenon of myogenic differentiation during development and in vitro. The function of these transcription factors in the regeneration of injured mature skeletal muscle in vivo is, however, still unclear. EXPERIMENTAL DESIGN: To clarify the primary events in myogenic precursor cell activation, the expression of myogenin was examined in rats 1 to 48 hours after either a contusion injury to the gastrocnemius or after toxic injury to the soleus muscle. Myogenin mRNA expression was studied by Northern blot hybridizations, and the results were correlated with the onsets of the mitotic activity (i.e., incorporation of bromodeoxyuridine) of the satellite cells and of the production of the myogenin and MyoD1 proteins, as well as muscle-specific intermediate filament protein, desmin. RESULTS: Both forms of muscle injury produced myofiber necrosis, followed by the activation of the satellite cells. The first sign of myogenic differentiation, an increase in myogenin mRNA expression, occurred between 4 and 8 hours after injury. The first desmin-, MyoD1- and myogenin-positive myoblasts were seen after 12 hours, but satellite cell proliferation was not seen until 24 hours after the injury. CONCLUSIONS: The schedule of the events in our study contradicts the general concept that differentiation should follow proliferation. To explain this discrepancy, we propose that there are two populations of precursor cells: committed satellite cells, which are ready for immediate differentiation without preceding cell division, and stem satellite cells, which undergo mitosis before providing one daughter cell for differentiation and another for future proliferation.

Animals↗

Lumbar muscle fiber size and type distribution in normal subjects.

The macroanatomy of the clinically important lumbar muscles has recently been investigated in detail, whereas the information about their microscopic structure in healthy persons is still scanty. In this study we have analysed lumbar multifidus and erector spinae muscles from 21 previously healthy persons who died suddenly and were of working age (range 23-65 years, mean 44.7 years). The microscopic structure of myofibers within the lumbar muscles was found to be regionally uniform, which renders in vivo biopsies representative of the whole muscle bulk. Somewhat surprisingly, age did not significantly influence fiber type composition, fiber size, or proportion of nonmuscular tissue. There was a slight predominance of type 1 fibers. The size of type 1 fibers (mean lesser diameter 54.0 microns) corresponded to that in other skeletal muscles, with no significant sex difference (55.1/51.6 microns male/female). Selective type 2 fiber atrophy was a common finding in both sexes, but significantly less so in men (mean diameter 38.8/28.4 microns male/female). We suggest that the values of fiber type proportions and fiber size in the deep multifidus presented in this study can be used as reference values for healthy adults in the present society with limited physical activity.

Adult↗

Differential expression of myc, max and RB1 genes in human gliomas and glioma cell lines.

Deregulated expression of myc proto-oncogenes is implicated in several human neoplasias. We analysed the expression of c-myc, N-myc, L-myc, max and RB1 mRNAs in a panel of human gliomas and glioma cell lines and compared the findings with normal neural cells. The max and RB1 genes were included in the study because their protein products can interact with the Myc proteins, being thus putative modulators of Myc activity. Several gliomas contained c/L-myc mRNAs at levels higher than those in fetal brain, L-myc predominantly in grade II/III and c-myc in grade III gliomas. High-level N-myc expression was detected. In one small-cell glioblastoma and lower levels in five other gliomas. In contrast, glioma cell lines totally lacked N/L-myc expression. The in situ hybridisations revealed mutually exclusive topographic distribution of myc and glial fibrillary acidic protein (GFAP) mRNAs, and a lack of correlation between myc expression and proliferative activity, max and RB1 mRNAs were detected in most tumours and cell lines. The glioma cells displayed interesting alternative splicing patterns of max mRNAs encoding Max proteins which either suppress (Max) or augment (delta Max) the transforming activity of Myc. We conclude that (1) glioma cells in vivo may coexpress several myc genes, thus resembling fetal neural cells; but (2) cultured glioma cells expression only c-myc; (3) myc, max and RB1 are regulated independently in glioma cells; and (4) alternative processing of max mRNA in some glioma cells results in delta Max encoding mRNAs not seen in normal fetal brain.

Adult↗

CD44-hyaluronate interaction mediates in vitro lymphocyte binding to the white matter of the central nervous system.

The cell adhesion molecule CD44 is expressed in the central nervous system, especially on glial cells in the white matter, the extracellular matrix of which also contains one of its ligands, hyaluronate. We investigated the role of CD44 and hyaluronate in the adhesion of human peripheral blood lymphocytes to myelinated areas of cerebellum by an in vitro binding assay. Hermes-1 epitope, which recognizes the hyaluronate binding site of CD44, and Hermes-3 epitope, involved in lymphocyte binding to mucosal high endothelial venules, were both immunohistochemically expressed in the white matter. No immunoreactivity was observed with mAb Var3.1, which sees variant forms of CD44 containing the exon v6 encoding region. The molecular weight analysis showed that CD44 of the white matter was identical to the major 90 kD form of CD44 present on lymphocytes. The binding of both T and B lymphocytes was significantly inhibited by pretreatment of both cells and sections with mAb Hermes-1 but not with Hermes-3. Digestion of the sections and/or lymphocytes with hyaluronidase also reduced lymphocyte binding. These findings implicate that CD44-hyaluronate mediates lymphocyte adhesion to the white matter and this interaction may be involved in the pathogenesis of inflammations and lymphomas of the central nervous system.

Antibodies, Monoclonal↗

Normal and hypertrophic scars: quantification and localization of messenger RNAs for type I, III and VI collagens.

The expression of type I, III and VI collagens was studied in nine normal and two hypertrophic scars using slot-blot and in situ hybridization techniques. Slot-blot hybridization indicated that the steady-state levels of pro alpha 1(I) and pro alpha 1(III) collagen chain mRNAs were moderately elevated in two of the nine normal scars, whereas the two hypertrophic scars analysed displayed markedly elevated mRNA levels when compared with normal skin. The mRNA levels of alpha 2(VI) collagen chain were only slightly elevated in both types of scars studied. In situ hybridization was most informative when applied to hypertrophic scars. These lesions were characterized by the presence of intense hybridization signals for type I and III collagen mRNAs, and a moderate signal for type VI collagen mRNA, in nodules which were located in the upper dermis on each side of the original wound. This may explain, in part, why hypertrophic scars rise above the level of the surrounding skin. The results of the present study are in marked contrast to our previous findings on collagen gene expression in keloids and neurofibromas, in which the steady-state levels of type VI and I collagen mRNAs in particular were shown to be elevated. Thus, our results emphasize that distinct molecular mechanisms are operative in the development of clinically different dermal fibrotic conditions, such as normal and hypertrophic scars, keloids and neurofibromas.

Adolescent↗

Spread of malignant lymphoid cells into rat central nervous system with intact and disrupted blood-brain barrier.

The pathways of spread of malignant lymphoid cells into the central nervous system (CNS) were studied using a T lymphoblastic leukaemia/lymphoma model of inbred PVG rats. The effects of intraperitoneal, intracarotid, intravenous, intrathecal and intracerebral routes of transplantation were analysed, and the significance of the blood-brain barrier (BBB) in preventing neoplastic cell invasion was studied by disrupting the BBB with focal cold injury. Extraneurally transplanted cells appeared first in the dura and subarachnoid space. From the latter they spread further into the perivascular space of penetrating cortical vessels. Parenchymal tumour cell foci were only seen in terminally ill rats, usually associated with damage to the vessel wall. Intrathecal transplantation did not accelerate the progression of the disease. Intracerebrally transplanted cells readily produced parenchymal infiltrates with diffuse invasion into the white matter, perivascular spreading into the cortex, and contralateral extension along the corpus callosum. Parenchymal invasion did not occur immediately after disruption of the BBB, but in the chronic phase neoplastic cells infiltrated the injured area. In conclusion, the model closely resembles human CNS leukaemia. Malignant cells appeared to enter the CNS through the deficient BBB of the subarachnoid vessels, whereas the BBB of the intracerebral vessels and perivascular glia limitans were very resistant to leukaemic cell invasion. This underlines the difference between the subarachnoid and perivascular v. intraparenchymal compartments. Preceding BBB damage may predispose to brain metastases. The parenchymal dissemination of malignant cells was similar to that in primary CNS lymphoma and it followed the same spreading pathways as the extracellular fluid.

Animals↗

Ultrasound, computed tomography and magnetic resonance imaging in myopathies: correlations with electromyography and histopathology.

Imaging of examinations by ultrasound (US), computerized tomography (CT) and low field magnetic resonance imaging (MRI) were compared with EMG and muscle biopsy findings in the same muscles of 33 patients with different neuromuscular diseases. None of the imaging methods revealed specific diagnostic details, but gave valuable information on the extent and distribution of muscle involvement. In myopathies all imaging modalities corresponded well with the EMG and histopathology findings, but in the neuropathies with minimal tissue destruction EMG was, understandably, more sensitive. The imaging characteristics of MR were as good as those of CT, but MRI has the advantage of not requiring ionizing radiation. US is the most economical method and it was found to be, despite its lower resolution, very informative in the hands of an experienced examiner, especially for the detection of fibrosis. The good agreement of histopathology with pathologic imaging and EMG findings implies that the accuracy of muscle biopsy increases, if its site is selected on the basis of imaging and/or EMG examination.

Adipocytes↗

Vascular changes and blood-brain barrier damage in the pathogenesis of polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy (membranous lipodystrophy).

The histopathological, immunohistochemical and electron microscopic findings in eight patients with polycystic lipomembranous osteodysplasia and sclerosing leukoencephalopathy (PLO-SL) are described. This autosomally recessively inherited disease is first manifested by multiple bone cysts, which are later followed around the age of 30 by severe neuropsychiatric syndrome. The pathogenesis of PLO-SL has not been established, and the search for the most suspected error in lipid metabolism has been unsuccessful. The typical macroscopic features were marked hydrocephalus ex vacuo due to severe destruction of the white matter (WM) with extensive secondary astrocytic gliosis, and with relatively better preserved gray matter (GM). The basement membranes of blood vessels with plump endothelium were thickened and often multiplied, most prominently in the WM. Extravasation of plasma constituents was demonstrated immunohistochemically. On the basis of the vascular changes, also present in bone lesions, it is proposed that severe chronic vasogenic brain edema is the main pathogenetic mechanism of the severe leukoencephalopathy in this disease entity.

Adult↗

DNA analysis in Finnish patients with hereditary neuropathy with liability to pressure palsies (HNPP).

Hereditary neuropathy with liability to pressure palsies (HNPP) is a dominantly inherited disorder that presents as recurrent mononeuropathies precipitated by apparently trivial traumas. The presence of a deletion in 17p11.2 was analysed in 13 Finnish families with HNPP. The deletion was found in all patients who were neurologically and neurophysiologically confirmed to have HNPP. In the problematic cases the detection of the gene defect is the method of choice in the diagnosis of HNPP. Analysis of DNA can also be used to detect clinically unaffected family members.

Chromosome Deletion↗

Sources of variation in the assessment of cell proliferation using proliferating cell nuclear antigen immunohistochemistry.

The reproducibility in quantitation of proliferation activity, determined using the monoclonal antibody 19A2 to proliferating cell nuclear antigen (PCNA), was tested in visual and computer-assisted analyses of brain tumor material. The PCNA labeling index was scored using count (PCNA-LI, visual and computer analyses) and area (PCNA-LIa, computer analysis) estimates of immunopositivity. The quality of immunostaining was the most important reason for variation in the assessment results. Other significant variation sources in the assessment were experience in selecting microscopic fields and distinguishing immunopositive nuclei from immunonegative ones. Computer-assisted analysis improved the reproducibility of quantitation between different observers (visual rPCNA-LI = 0.624 versus computer assisted rPCNA-LI = 0.904). Also, the use of PCNA-LIa improved the intraobserver and interobserver reproducibility in different stainings (observer 1:rPCNA-LI = 0.857 versus rPCNA-LIa = 0.874; observers 1 and 2: rPCNA-LI = 0.904 versus rPCNA-LIa = 0.927; observers 3 and 4: rPCNA-LI = 0.848 versus rPCNA-LIa = 0.906). PCNA-LIa by computerized image analysis improves accuracy in the evaluation of the granularly expressed PCNA level. Furthermore, the effect of tumor heterogeneity on the assessment results can be diminished with the computerized method because large tissue areas can be analyzed faster.

Astrocytoma↗