Biomedical subjects
M Haltia
Publications and source records attributed to M Haltia.
Spontaneous occlusion of the circle of Willis (moyamoya syndrome).
Three young autopsy and four temporal artery biopsy cases with an arteriographically typical moyamoya syndrome were studied by histologic, electron microscopic, and immunofluorescence methods. In all autopsy cases the intracranial segment of the internal carotid arteries showed concentric intimal thickening with severe stenosis or obstruction of the lumen, folding of the internal elastic lamina, and shrinkage of the external diameter of the vessel. Inflammatory infiltration was absent. Abnormal networks of thin-walled vessels, interpreted as secondary collaterals, were seen at the base and on the convexity of the brain. Degenerative changes, including a ruptured coronary aneurysm in one case, were also noted in the coronary and temporal arteries. In both the intra- and extracranial arteries repeated endothelial damage was indicated by the presence of redundant subendothelial basement membrane-like material. Lipid or calcium deposits were exceptional, and no evidence for the presence of immunoglobulins or components of the complement could be obtained by immunofluorescence. These pathologic alterations, distinct from atherosclerosis, fibromuscular dysplasia, and the established types of arteritis, seem to be identical in children and adults, in spite of different clinical manifestations of the moyamoya syndrome in these age groups. We suggest that a humoral factor, associated with infections, may induce repeated endothelial damage and intimal thickening in the intracranial arteries of genetically predisposed children in analogy with recent observations made in the coronary arteries of young subjects.
Regional distribution of glycoasparagine storage material in the brain in aspartylglycosaminuria.
We have studied the regional distribution of glycoasparagine storage material in the brain in aspartylglycosaminuria, a condition characterized by inherited deficiency of lysosomal N-aspartyl-beta-N-acetylglucosamine amidohydrolase. Gaschromatographic measurements of the main accumulating glycoprotein-derived metabolite, N-acetylglucosaminyl-asparagine (GlcNAc-Asn), in 12 defined cerebral areas showed that GlcNAc-Asn is rather evenly distributed in the brain. The mean concentrations ranged from 0.454 mg/g wet tissue (corpus callosum) to 0.0610 mg/g (pons). The GlcNAc-Asn concentrations tended to be higher in grey matter areas than in white matter areas. GlcNAc-Asn was identified in the isolated neuronal fraction, but not in the myelin fraction, by mass-fragmentographic techniques. Electron-microscopic reexamination of a brain biopsy specimen revealed, in addition to the abundant presence of storage lysosomes in the neuronal perikarya, numerous cytoplasmic inclusions in brain capillary endothelial cells and pericytes as well as in occasional macrophages. The results indicate that the glycoasparagine storage material is not limited to expected cortical areas in aspartylglycosaminuria, but is distributed in a rather constant fashion in all cerebral grey and white matter areas studied.
[Clinicopathological conference LXIII. Duodenal ulcer, papilledema and progressive neurological symptoms].
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[Normal and abnormal structural development of the central nervous system].
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Failure of interferon to modify Creutzfeldt-Jakob disease.
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Juvenile metachromatic leukodystrophy. Clinical, biochemical, and neuropathologic studies in nine new cases.
We describe nine patients with metachromatic leukodystrophy. Seven patients had the juvenile form; in two others, the age at onset was 1 year, but the clinical course was different from the late infantile form. The age at onset ranged from 1 to 18 years; the duration ranged from three to 17 years. Mental retardation associated with motor impairment and pathological EEG and electromyographic findings were the main clinical findings. In patients with early onset, mental retardation was almost the only symptom for the first ten years. Segmental demyelination, remyelination, onion bulb formation, and occasional perivascular macrophages containing metachromatic lipid were the main findings in sural nerves studied after biopsy. The mean arylsulfatase-A (ASA) activity was 1.3 nmoles of nitrocatechol sulfate per milligram of protein per 30 minutes in peripheral leukocytes of the patients, 62.0 in the heterozygotes, and 139.0 in the controls. The ASA band could not be detected in enzyme electrophoresis.
Herpes simplex virus encephalitis: new diagnostic and clinical features and results of therapy.
Six patients with herpes simplex virus (HSV) encephalitis underwent diagnostic and clinical evaluation. The HSV or its antigenic material was found in three brain biopsy specimens. In the remaining three cases, the diagnosis was supported by detection of HSV antibodies in the CSF. Cell count and total protein concentration in the CSF reached a maximum level at three weeks and two months, respectively. The IgG index and HSV antibody level in the CSF often remained constant after reaching maximal values. In three patients, a transient low serum sodium level was observed. Characteristic EEG changes were present five to 11 days after the onset of symptoms. Computerized tomographic scanning revealed a temporal low-density lesion. Three patients became deeply comatose and had respiratory failure. The patient without vidarabine therapy and one of the five patients treated with vidarabine died.
Distribution of a major connective tissue protein, fibronectin, in normal and neoplastic human nervous tissue.
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Mutually exclusive expression of fibronectin and glial fibrillary acidic protein in cultured brain cells.
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Histocompatibility antigens in familial Creutzfeldt-Jakob disease.
Histocompatibility antigens were defined in 25 members of a Finnish family in which Creutzfeldt-Jakob disease (CJD) was diagnosed clinically in 4 cases and neuropathologically in 3 cases; 3 further cases had a history of presenile dementia. 2 HLA haplotypes were defined in 3 patients and deduced in a further 3 cases; only one haplotype could be deduced in 2 patients. CJD was not linked with a single haplotype, but at least 7 out of 8 patients with this disease apparently shared the HLA antigens A28 and B8.
Creutzfeld-Jakob disease.
The eyes of two patients with Creutzfeld-Jakob disease were received at autopsy and examined for any specific changes. Previous clinical examination of one of the patients had failed to reveal any specific ocular changes. No evidence for an infectious agent was found in any portion of the eye. The cornea and the retinal were structurally intact. The axons and the glial elements of the optic nerve head were intact. However, increased cellularity, consisting mainly of astrocytes, was noted in the optic nerves in front of and behind the lamina cribrosa.
[Clinical pathological conference LX. Progressive neurological symptoms and changes shown by computerized tomography].
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Glial fibrillary acidic protein and intermediate filaments in human glioma cells.
Cultured human glioma cells were studied by double indirect immunofluorescence technique using antisera against intermediate filaments and glial fibrillary acidic protein. With both antisera cytoplasmic fibrillar fluorescence was seen. Perinuclear bundles of intermediate-sized filaments, induced by vinblastine treatment, were strongly stained with both antisera. The degree of codistribution of the two types of antigenic determinants varied considerably from cell to cell. The results suggest that two types of filament-related antigenic determinants can be present in the same cell, and also that glial fibrillary acidic protein-related filaments may possess functional similarities to the intermediate filaments found in other cells. Glial fibrillary acidic protein remains as a useful and specific antigenic marker for the study of glial cells in vitro.
Familial Creutzfeldt-Jakob disease.
A Finnish family is described with 9 cases of presenile dementia in 3 generations. The mean age at onset was 52 years (range 46--62 years). Progressive dementia, upper motor neuron signs, muscular rigidity, and twitching, irregular tremors were consistent features in the 6 clinically investigated patients and were associated with spongiform change in the cerebral cortex of one autopsy and two brain biopsy cases. The EEG showed progressive slowing without the occurrence of repetitive high-voltage complexes at any stage of the disease. The average duration of the disease (21 months, range 11--36 months) was longer than in the sporadic form of CJD. The occurrence of CJD within this family follows a pattern consistent with an autosomal dominant mode of inheritance, suggesting the possibility of vertical transmission of the presumptive causative agent for example by genomic integration or transplacental passage. However, the occurrence of the disease only through the paternal line of relationships and the presence of a discordant twin pair argue strongly against transplacental passage or transmission via mother's milk. Simple contact infection also seems unlikely, as conjugal cases were not found among the 7 married patients. The interval between the death of the last affected member in generation IV and the time of onset of the disease in the first affected member of generation V was 10 years. Thus setting a minimum incubation period if case-to-case transmission were occurring. To evaluate the role of a genetically determined susceptibility to infection studies on the HLA antigens and other genetic markers are in progress.
Infantile form of so-called neuronal ceroid lipofuscinosis: lipid biochemical studies, fatty acid analysis of cerebroside sulfatides and sphingomyelin, myelin density profile and lipid composition.
The biochemical analysis of a case of infantile neuronal ceroid lipofuscinosis, as determined by clinical and neuropathological findings, is presented. A diminished amount of solids is found, the amount of lipids is 30% of the normal as expressed in lyophilized tissue. The yield of myelin isolated by the density gradient is 1.8% of the normal. Phospholipid patterns show a reduction in ethanolamine phosphoglyceride, N-acetylneuraminic acid is extremely low and sphingolipids are largely reduced, cerebrosides being most affected (2.5% of the normal). In cerebrosides and sulfatides the decrease in very long chain fatty acids is important, but the deficiency in any type (including hydroxy compounds) is not too dramatic. According to the aspect under electron microscopy, the density profile, and the biochemical composition of the subfractions, isolated myelin is close to normal. The loss of the myelin sheath appears to reflect a Wallerian degeneration in the CNS: myelin loss is a secondary effect. This disease, from a biochemical point of view, seems to be the ideal control for leukodystrophies.
Fluoroangiographic picture of the acute stage in measles retinopathy.
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[Normal structure and histochemistry of muscle].
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