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Biomedical subjects

R Nass

Publications and source records attributed to R Nass.

At least 37 records · Page 2Linked to original sources

Intracellular sequestration of sodium by a novel Na+/H+ exchanger in yeast is enhanced by mutations in the plasma membrane H+-ATPase. Insights into mechanisms of sodium tolerance.

Sodium tolerance in yeast is disrupted by mutations in calcineurin, a Ca2+/calmodulin-dependent protein phosphatase, which is required for modulation of Na+ uptake and efflux mechanisms. Five Na+-tolerant mutants were isolated by selecting for suppressors of calcineurin mutations, and mapped to the PMA1 gene, encoding the plasma membrane H+-ATPase. One mutant, pma1-alpha4, which has the single amino acid change Glu367 --> Lys at a highly conserved site within the catalytic domain of the ATPase, was analyzed in detail to determine the mechanism of Na+ tolerance. After exposure to Na+ in the culture medium, 22Na influx in the pma1 mutant was reduced 2-fold relative to control, consistent with a similar decrease in ATPase activity. Efflux of 22Na from intact cells was relatively unchanged in the pma1 mutant. However, selective permeabilization of the plasma membrane revealed that mutant cells retained up to 80% of intracellular Na+ within a slowly exchanging pool. We show that NHX1, a novel gene homologous to the mammalian NHE family of Na+/H+ exchangers, is required for Na+ sequestration in yeast and contributes to the Na+-tolerant phenotype of pma1-alpha4.

Amino Acid Sequence↗

The development of drawing in children with congenital focal brain injury: evidence for limited functional recovery.

Children with pre- or perinatal injury to right hemisphere (RH) brain regions show impairment of spatial integrative functions similar to that observed among adults with comparable injury. Unlike adults, children show considerable improvement with development on a range of spatial construction tasks which require spatial integration. Such gains could reflect true recovery of spatial integrative abilities. Alternatively, the improvement could be more limited in scope, reflecting the development of compensatory strategies which are task specific and allow the children to circumvent, rather than overcome, their primary spatial disorders. The studies presented here examined this distinction within the context of drawing tasks in which the child was first asked to draw a house and then an impossible house. The impossible house task was designed to examine the extent to which children rely on graphic formulas in generating organized drawings. The results showed that while all of the children with RH injury make considerable progress in free drawing into the school age period, they are very reliant on the use of graphic formulas. When given a task which requires them to alter their drawings, they did not change the spatial configuration of the depicted object. Rather they found alternate ways to render the object 'impossible'.

Adolescent↗

Language development in children with congenital strokes.

The congenital lesion population provides an excellent forum to investigate the issues of innate specialization and plasticity. Effects of early lesions on left and right hemisphere function reflect both the cognitive process under study and biological/neurological factors of lesion parameters and hemispheric maturation rates. In general, toddlers with both congenital left and right lesions show mild to moderate delays in language acquisition. School-age children with left hemisphere lesions have more problems with language and language-based academic skills than those with right hemisphere lesions, but the problems are subtle and do occur in both groups. This pattern stands in sharp contrast with the adult, who shows striking language deficits with acquired lesions only in the left perisylvian region. Thus, there is evidence in these studies of the immature nervous system for both innate specialization and plasticity, as well as a right hemisphere contribution to language acquisition and verbal cognition.

Adult↗

Boys with Asperger's disorder, exceptional verbal intelligence, tics, and clumsiness.

Five boys with both Asperger's disorder and Tourette syndrome, exceptional verbal intelligence, and clumsiness are reported. Each presented at early elementary school age with a prominent complaint of social difficulties with peers. History was notable for a flapping stereotypy and the neurological examination revealed motor and/or vocal tics and numerous motor soft signs. Highly specialized interests were characteristics. Language prosody and/or pragmatics was impaired. Despite exceptional verbal intelligence, the children were not, according to their teachers and parents, faring well either socially or academically. Motor difficulties, manifested psychometrically as a significant performance IQ disadvantage, interfered with school performance and social adjustment. Tics, although not noted by parents in the clinical history, compounded their social difficulties. Asperger's disorder in these highly verbal children overlaps with pervasive developmental disorder (PDD) on account of the socioemotional difficulties and stereotypies seen in both. Asperger's disorder and Tourette syndrome overlap in these children on account of the tics. Finally, Asperger's disorder and the right-hemisphere-based learning disorders overlap on account of the visuoperceptual and attentional deficits that can occur in both.

Child, Preschool↗

Magnetic resonance imaging in the congenital adrenal hyperplasia population: increased frequency of white-matter abnormalities and temporal lobe atrophy.

Congenital adrenal hyperplasia results from an adrenal enzyme deficiency, that causes an underproduction of glucocorticoids and sometimes mineralocorticoids and a resultant overproduction of androgens, until treatment with replacement glucocorticoids is instituted. The goal of this study was to determine the frequency and etiology of white-matter changes and temporal lobe atrophy demonstrable on magnetic resonance imaging (MRI) in a group of children and young adults with congenital adrenal hyperplasia. About one third of the patients evidenced white-matter abnormalities or temporal lobe atrophy. All patients, except one with a known stroke, had normal neurologic examinations. Exposure to excess exogenous glucocorticoids in the process of being treated for congenital adrenal hyperplasia is the most theoretically appealing explanation for these MRI findings. However, the relationship of MRI findings to treatment status (over-versus under-suppressed) does not run in clear parallel.

Adolescent↗

[Growth hormone substitution in adulthood. Use of recombinant human GH--strict diagnostic criteria].

Human growth hormone (GH) is produced in the anterior lobe of the pituitary gland not only in childhood but also in the adult. It has an influence on the physical performance, composition and metabolism of the adult organism. A complex system of endocrine and paracrine factors mediate the influence of growth hormone, and its deficiency in the adult leads to such typical clinical symptoms as fatigue, a lack of drive, poor physical performance and truncal obesity. Since recombinant human growth hormone can now be produced by gene technology in unlimited amounts, it has become possible to investigate new indications for growth hormone therapy in adults. GH replacement has recently become an accepted form of treatment of patients with proven GH deficiency after controlled clinical trials had shown it to have beneficial results.

Adult↗

Developmental change in spatial grouping activity among children with early focal brain injury: evidence from a modeling task.

Spatial construction skills were assessed in children with left (LH) or right (RH) hemisphere focal brain injury and control children. Children copied simple and complex block models which were rated on accuracy and spatial strategy. The accuracy of simple and complex constructions for 4- to 5-year-old children with LH injury was indistinguishable from 4-year-old controls. However, although they were able to produce accurate complex constructions, the processes used by children with LH injury differed from those of normal children. On both simple and complex constructions, 4- to 5-year-old children with RH injury showed evidence of developmental delay. For both accuracy and process measures, children with RH injury performed at a level comparable to normal children at 3 years. A second group of children with LH and RH injury were tested at 5 to 6 years of age. Both lesion groups were indistinguishable from 4-year-old controls in terms of accuracy. However, both children with LH and RH injury used different spatial processes than did controls. This study emphasizes the importance of distinguishing between products of behavior and the processes which underlie them. It is in the dissociation of products and process of behavior that the subtle spatial construction deficits in this population of brain-injured subjects is revealed.

Brain Injuries↗

Specific cognitive abilities in 2-year-old children with subependymal and mild intraventricular hemorrhage.

Subependymal and mild intraventricular hemorrhages (S/IVH) are likely to affect the subcortical and frontal cortex regions of the brain in premature infants. Damage to the subcortical and frontal areas has been associated with poorer performance in certain abilities, including visual attention, memory for location, and ability to change response set. This study investigated whether S/IVH, occurring at birth, affect these abilities in young children. Two-year-old premature children with S/ IVH, premature children with normal neonatal head ultrasound scans, and full term children with normal births were evaluated on a series of tasks. These tasks were a habituation/novelty preference task (visual attention), Piaget's invisible displacement task (memory for location), an object discrimination reversal task (ability to change response set), and the Bayley Scales of Infant Development (traditional infant test). Premature children with hemorrhage performed significantly less well on the task of ability to remember the last location of a hidden object and on the task of ability to reverse response set. Both groups of premature children performed.

Cerebral Hemorrhage↗

Insulin-like growth factor I is an independent coregulatory modulator of natural killer (NK) cell activity.

We aimed to investigate the natural killer (NK) cell activity in hGH-deficient adults and to analyze the effect of insulin-like growth factor (IGF)-I in vivo and in vitro on NK cell activity. NK cell activity was measured in a 4-h nonisotopic assay with europium-labeled and cryopreserved K-562 cells. NK-cell numbers were measured after incubation with murine monoclonal CD3 and CD16 antibodies by flow cytometry analysis. In a cross-sectional study, the basal and interferon-beta (IFN-beta) stimulated (1000 IU/ml) NK cell activity of 15 hGH-deficient patients and 15 age- and sex-matched controls was measured. The percentages and absolute numbers of CD3-/16+ NK-cells were not significantly different in the patient vs. control group. The basal and IFN-beta stimulated NK cell activity however was significantly decreased in the patient vs. control group at all effector/target (E/T) cell ratios from 12.5-100 (e.g. 17 +/- 3 vs. 28 +/- 3% lysis without IFN-beta, P < 0.05, and 42 +/- 4 vs. 57 +/- 4% lysis with IFN-beta, P < 0.05; both at E/T 50). IGF-I levels of patients and controls showed a significant positive correlation with NK cell activity (r = 0.37; P < 0.05). In an IGF-I in vitro study (IGF-I in vitro 250-1250 microg/L), the basal and IFN-beta stimulated NK cell activity of 13 hGH-deficient patients and of 18 normal subjects was significantly enhanced by IGF-I in vitro (e.g. GH-deficient patients: 9 +/- 2 vs. 10 +/- 2% lysis without IFN-beta, P < 0.05 and 25 +/- 4 vs. 30 +/- 4% lysis with IFN-beta, P < 0.005; and normal subjects: 15 +/- 3 vs. 23 +/- 3% lysis without IFN-beta, P < 0.001 and 35 +/- 4 vs. 44 +/- 5% lysis with IFN-beta, P < 0.001; both at IGF-I 500 microg/L). In summary, in our cross-sectional study, adult GH-deficient patients showed a significantly lower basal and IFN-beta stimulated NK cell activity than matched controls, despite equal NK cell numbers. IGF-I levels of patients and controls showed a weak positive correlation with NK cell activity. In an in vitro study, IGF-I significantly enhanced basal and IFN-beta stimulated NK cell activity of hGH-deficient patients and also of normal subjects. The decreased NK cell activity in GH-deficient patients may be caused at least in part by low serum IGF-I levels. IGF-I appears to be an independent coregulatory modulator of NK cell activity.

Adult↗

Failure of steroid replacement to consistently normalize pituitary function in congenital adrenal hyperplasia: hormonal and MRI data.

Exogenous glucocorticoid replacement in patients with congenital adrenal hyperplasia (CAH), who due to an adrenal 21-hydroxylase enzyme deficiency are unable to produce endogenous glucocorticoids, is aimed at normalizing hypothalamic-pituitary-adrenal function. Excess androgen production by the adrenals is thus decreased. Despite standard glucocorticoid replacement doses (12.5-40 mg, 10.5-27 mg/m2/day hydrocortisone equivalents) 4 of 7 patients ranging in age from 14 to 33 years had abnormalities of the pituitary on MRI. Three appeared to have microadenomas and 1 had an empty sella. Five (3 salt wasters, 2 simple virilizers) of these 7 patients had 60-min p.m. ovine corticotropin-releasing hormone (oCRH) stimulation studies. The mean (logarithm) area under the ACTH curve for 0-60 min after oCRH stimulation was significantly greater in patients than controls (p < 0.0001). Mean ACTH at each time point before and after oCRH stimulation was similarly greater in patients than controls (p < 0.05). Two of these patients had pituitary microadenomas, 1 had an empty sella; all 3 were salt wasters. Despite standard glucocorticoid replacement, adolescent and young adult patients with CAH tend to have high basal ACTH and ACTH hyperresponsiveness to oCRH, as well as structural abnormalities of the pituitary. The inevitable periods of under- and overexposure to glucocorticoids in CAH patients may over time cause abnormalities of the hypothalamic-pituitary-adrenal axis.

17-alpha-Hydroxyprogesterone↗

Effect of growth hormone (hGH) replacement therapy on physical work capacity and cardiac and pulmonary function in patients with hGH deficiency acquired in adulthood.

The effects of 6 months of replacement therapy with recombinant human GH (hGH) on physical work capacity and cardiac structure and function were investigated in 20 patients with hGH deficiency of adult onset in a double blind, placebo-controlled trial. The GH dose of 12.5 micrograms/kg BW was self-administered daily sc. Oxygen consumption (VO2), CO2 production, and ventilatory volumes were measured during exercise on a bicycle spiroergometer. M-Mode echocardiography was performed using standard techniques. The VO2 max data, expressed per kg BW (mL/min.kg BW) showed a significant increase from 23.2 +/- 2.4 to 30.0 +/- 2.3 (P < 0.01) in the hGH-treated group, whereas the VO2 max data, expressed per lean body mass (milliliters per min/kg lean body mass) did not change significantly in either group. Maximal O2 pulse (milliliters per beat) increased significantly from 15.2 +/- 5.6 to 19.6 +/- 3.3 mL/beat (P < 0.01), but remained constant in the placebo group. The maximal power output (watts +/- SE) increased significantly (P < 0.01) from 192.5 +/- 13.5 to 227.5 +/- 11.5 in the hGH-treated group, but remained constant in the placebo group. Cardiac structure (left ventricular posterior wall, interventricular septum thickness, left ventricular mass, left ventricular end-systolic dimension, and left ventricular end-diastolic dimension) as well as echocardiographically assessed cardiac function did not change significantly after 6 months of treatment in either group. We conclude that hGH replacement in hGH-deficient adults improves oxygen uptake and exercise capacity. These improvements in pulmonary parameters might be due to an increase in respiratory muscle strength and partly to the changes in muscle volume per se observed during hGH replacement therapy. Furthermore, an increased cardiac output might contribute to the improvement in exercise performance during hGH treatment. According to our data, hGH replacement therapy leads to an improvement of exercise capacity and maximal oxygen uptake, but has no significant effect on cardiac structure.

Adult↗

Advances in learning disabilities.

This review reports recent findings about diagnostic criteria, epidemiology, genetics, neuropsychological underpinnings, neuroanatomy, etiology, outcome, and treatment for the following: pervasive developmental disorder, the developmental language disorders, dyslexia, and dyscalculia. In addition, recent findings about neurological correlates, medical causes, and gender effects of learning disabilities are discussed.

Brain↗

Acquired stuttering after a second stroke in a two-year-old.

An almost two-year-old left-handed girl with a history of a left-hemisphere stroke at the age of one year developed a transient stutter with newly acquired white matter infarctions. Her course suggests that developmental stuttering may reflect anomalous dominance and/or atypical interhemispheric connectivity.

Cerebral Infarction↗

Effect of aging on endogenous level of 5 alpha-dihydrotestosterone, testosterone, estradiol, and estrone in epithelium and stroma of normal and hyperplastic human prostate.

It is widely believed that benign prostatic hyperplasia (BPH) is associated with aging. Thus, the question arises whether or not a correlation exists between the well known prostatic androgen and estrogen accumulation and aging. To address this question, we measured 5 alpha-dihydrotestosterone (DHT), testosterone, estradiol, and estrone in epithelium and stroma of six normal (NPR) and 19 BPH and correlated the values with the age of the donors (26-87 yr). The mean DHT level in NPR epithelium was significantly higher than in NPR stroma, and also significantly higher than in epithelium and stroma of BPH. The epithelial DHT level of NPR and BPH decreased with age, the correlation being statistically significant. The stromal DHT level of NPR and BPH showed no correlation with age. Concerning testosterone, generally rather low values were found which showed no correlation with age. The mean levels of estradiol and estrone were significantly higher in BPH stroma as compared to BPH epithelium as well as to NPR epithelium and stroma. In NPR, the mean levels of estradiol and estrone were significantly higher in epithelium than stroma. In NPR and BPH, the stromal estradiol and estrone levels increased significantly with age. In epithelium such a correlation between the estrogen levels and age was not found. Our results indicate that the prostatic accumulation of DHT, estradiol, and estrone is in part intimately correlated with aging, leading with increasing age to a dramatic increase of the estrogen/androgen ratio particularly in stroma of BPH.

Adult↗

Differential effects of congenital versus acquired unilateral brain injury on dichotic listening performance: evidence for sparing and asymmetric crowding.

We assessed dichotic speech and complex-pitch discrimination in nine young patients with unilateral left-hemisphere injury and eight young patients with unilateral right-hemisphere injury incurred in the pre-perinatal (congenital) period. As in adults with acquired unilateral lesions, both congenital lesion groups demonstrated poor performance on stimuli presented to the ear contralateral to the lesion. In overall performance on speech discrimination, however, the left-hemisphere congenital lesion group performed significantly better than the acquired-lesion group did. On complex-pitch discrimination, the right-hemisphere congenital lesion group performed significantly better than did the acquired-lesion group, but both left- and right-hemisphere congenital lesion groups were significantly worse at complex-pitch discrimination than were their age- and gender-matched normal controls. These results indicate that although congenital damage produces a "lesion effect" in dichotic listening similar to that after damage acquired in adulthood, overall function is relatively spared. To the extent that complex-pitch discrimination is affected by congenital damage to either hemisphere but speech discrimination is not, the present results are consistent with an asymmetric form of crowding during reorganization after congenital unilateral brain damage.

Adolescent↗

Early lexical development in children with focal brain injury.

Early lexical development in 27 children with focal brain injury was studied cross-sectionally and longitudinally. Data were obtained from children between 12 and 35 months of age who acquired their lesion prenatally or within the first 6 months of life. Results for the group as a whole provide clear evidence for delays in lexical comprehension and production, and for a larger number of comprehension/production dissociations than would be expected by chance. In addition, a significant number of children were observed having unusual difficulty mastering predication and/or using an atypically high proportion of closed class words (suggesting reliance on holistic/formulaic speech). Analyses by lesion type revealed no effect of lesion size. Analyses according to side of lesion revealed that children with right-hemisphere damage produced a higher proportion of closed class words, suggesting heavy reliance on well-practiced but under-analyzed speech formulae. Children with left-hemisphere damage were slightly better in comprehension than children with right-hemisphere damage. In addition, left posterior lesions were associated with greater delays in expressive language, and delays were more protracted in children with left posterior damage. No differential effects of left posterior damage were found for lexical comprehension.

Brain Injuries↗

Spatial grouping activity in young children with congenital right or left hemisphere brain injury.

Spatial grouping abilities were examined in 20 preschool-aged children with right or left hemisphere congenital focal brain injury, and a group of age-matched normal control children. Children were presented with a series of spontaneous grouping tasks in which they were given small sets of blocks and asked to play with them. Although the children with focal brain injury played as actively with the blocks as normal children, the constructions they produced differed systematically. Across eight measures of spatial grouping both children with right and left hemisphere injury were delayed compared to normal children. In addition, the behavioral profiles for the two groups of children with focal brain injury were qualitatively different. Data for the children with RH injury suggested difficulty organizing objects into coherent spatial groupings, while data from the children with LH injury suggested difficulty with local relations within the spatial arrays. These findings are consistent with data reported for adults on spatial construction tasks. Developmental trajectories in the 3- to 4-year age period suggest, further, that the spatial integrative deficits observed in the children with RH injury are persistent. When the children began to produce spatial constructions using complex grouping procedures, those constructions were heaps or disordered clusters. In contrast, when children with LH injury began to use complex procedures, they generated the types of constructions usually associated with those procedures in normal children, e.g., arches, enclosures, and symmetries. These data were found within a cross-sectional study of 20 children and confirmed in a series of six longitudinal case study reports of three children with RH and three with LH injury. The data confirm our previous reports of spatial integrative deficit associated with early RH injury and present the first indication of spatial encoding deficits in children with LH injury.

Age Factors↗