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Biomedical subjects

C Mhiri

Publications and source records attributed to C Mhiri.

At least 19 recordsLinked to original sources

Stress activation and genomic impact of Tnt1 retrotransposons in Solanaceae.

Tnt1 elements are a superfamily of LTR-retrotransposons distributed in the Solanaceae plant family and represent good model systems for studying regulatory and evolutionary controls established between hosts and transposable elements. Tnt1 retrotransposons tightly control their activation, by restricting expression to specific conditions. The Tnt1A element, originally discovered in tobacco, is expressed in response to stress, and its activation by microbial factors is followed by amplification, demonstrating that factors of pathogen origin can generate genetic diversity in plants. The Tnt1A promoter has the potential to be activated by various biotic and abiotic stimuli but a number of these are specifically repressed in tobacco and are revealed only when the LTR promoter is placed in a heterologous context. We propose that a tobacco- and stimulus-specific repression has been established in order to minimize activation in conditions that might generate germinal transposition. In addition to tight transcriptional controls, Tnt1A retrotransposons self-regulate their activity through gradual generation of defective copies that have reduced transcriptional activity. Tnt1 retrotransposons found in various Solanaceae species are characterized by a high level of variability in the LTR sequences involved in transcription, and have evolved by gaining new expression patterns, mostly associated with responses to diverse stress conditions. Tnt1A insertions associated with genic regions are initially favored but seem subsequently counter-selected, while insertions in repetitive DNA are maintained. On the other hand, amplification and loss of insertions may result from more brutal occurrences, as suggested by the large restructuring of Tnt1 populations observed in tobacco compared to each of its parental species. The distribution of Tnt1 elements thus appears as a dynamic flux, with amplification counterbalanced by loss of insertions. Tnt1 insertion polymorphisms are too high to reveal species relationships in the Nicotiana genus, but can be used to evaluate species relationships in the Lycopersicon and Capsicum genera. This also demonstrates that the behavior of Tnt1 retrotransposons differs between host species, most probably in correlation to differences in expression conditions and in the evolutionary and environmental history of each host.

Base Sequence↗

[Subacute myelitis revealed by human immunodeficiency virus infection].

A 35 year-old heterosexual man had a six months history of cervical myelitis with progressive paraplegia, leg weakness and paresthesia of the four extremities. Spinal cord MRI showed a high T2 signal intramedullary lesion wide from the bulbo-medullary junction to D4. Post gadolinium T1 sequence revealed an enhancement in front of C3-C4 vertebrae. VIH serology was positive. Corticosteroid treatment achieved a marked improvement. In addition to vacuolar myelopathy, well-known at the advanced stages of the HIV infection (AIDS), myelitis and clinical pictures simulating multiple sclerosis were described during early stages of the infection. These inflammatory lesions of the central nervous system and sometimes of the peripheral nervous system seems to be related to the immune response dysfunction induced by the VIH.

Adult↗

[Syringomyelobulbia associated with cervical spondylosis. Pathophysiology and therapeutic implications].

Spinal spondylosis is rarely implicated in syringomyelia. We report the case of a 70-year-old patient with a 10-year history of gait disturbance; constrictive pain of lower limbs and urinary incontinance. Physical examination disclosed spastic tetraparesis. In the upper limbs, deep tendon reflexes were abolished, with hyposthesia and hands amyotrophy. Brain and cervical MRI showed syringomyelobulbia with cervical spondylotic myelopathy. Extensive cervical laminectomy induced a mild clinical improvement. A second MRI performed 6 months after surgery depicted a complete disappearance of the bulbo-medullar cavitation with secondary atrophy. Extradural spondylotic compression of the spinal cord should be firmly considered as an etiology of syringomyelia. A purely extradural decompression could be sufficient to induce regression of the medullary cavitation.

Aged↗

[Carcinomatous meningitis revealing a cancer: study of two cases].

Meningeal Carcinomatosis (MC) is rare (4 to 5% of patients with solid tumors). We report two cases. The first case is a 53 year-old man presenting flaccid paraplegia and the second is a 76 year-old man presenting a clinical picture suggestive of normal pressure hydrocephalus. In the two cases, the diagnosis of MC was achieved by the demonstration of malignant cells in the CSF. Prognosis was poor in the two cases. The clinical presentation of MC is non specific and the diagnosis is only confirmed by demonstrating carcinomatous cells in CSF.

Aged↗

[Hemichorea caused by striatal infarct in a young type 1 diabetic patient].

Movement disorders such as chorea and ballism rarely occur in diabetes mellitus. We report the case of 26-year-old man with a 13-year-history of type 1 diabetes mellitus. He presented with a right side hemichorea. Brain CT-scan and MRI showed an infarction of the head of the caudate nucleus and the anterior part of the putamen. Presence of microangiopathy affecting retina, kidneys and peripheral nerves suggest a similar involvement of the lenticulo-striatal arteries. Hemichorea and hemiballism usually occur in older patients presenting type 2 diabetes mellitus. Non-ketotic hyperglycaemia is the common cause in such situation. Striatal infarct, as seen in our patient, is rarely reported.

Adult↗

Sacral meningeal arteriovenous fistula supplied by branches of the hypogastric artery revealed by conus medullaris infarction.

OBJECTIVE: Spinal dural arteriovenous fistulas (DAVF), the most common vascular malformations of the spine, are usually supplied by branches of the intercostal or lumbar arteries. Rarely, the DAVF are fed by branches of the hypogastric artery. Only 12 such cases have been reported. CASE REPORT: A 28 year-old man presented with a 2-month history of micturition dysfunction and progressive weakness of the legs. Physical examination showed motor deficit of the lower limbs with brisk knee jerks, absent ankle reflexes and normal plantar reflexes. Cremasteric reflexes were absent. We noted hypoesthesia of the lower limbs with complete anesthesia of the perineum. MRI of the lumbo-sacral spine demonstrated an enlargement of the conus medullaris with high T2 signal intramedullary lesion. It showed also large intradural serpentine vessels. A left iliac angiogram disclosed a nidus of arteriovenous malformation (AVM) supplied by a lateral sacral artery and draining by two enlarged ascending perimedullary veins. No clinical improvement was observed after surgical removal of the AVM. CONCLUSION: The screening examination of choice for spinal DAVF remains MRI. When selective spinal arteriography is normal, we have to search for an unusual arterial supply particularly from the hypogastric artery.

Adult↗

[Clinical, biological and genetic study of 24 patients with ataxia telangiectasia from southern Tunisia].

Ataxia telangiectasia is a multisystem disease with an autosomal recessive inheritance. It is characterized by progressive cerebellar ataxia, oculocutaneous telangiectasia, humoral and cellular immunodeficiencies and high incidence of neoplasia and radiosensitivity. A 5 year retrospective survey included 24 patients belonging to 17 families. Cerebellar ataxia was the first clinical symptom and was usually noticed when the child began to walk. Mean age of onset was 2.9+/-1.8 years. Oculocutaneous telangiectasia was present in 17 cases and appeared between 2 and 8 years and then spread in a characteristic symmetrical pattern. When ocular telangiectasia was absent (6 cases), the diagnostic of ataxia telangiectasia was retained on oculomotor apraxia (2 cases), recurrent sinopulmonary infections (3 cases) and/or a sib with typical ataxia telangiectasia (1 case). Recurrent sinopulmonary infections, absence or low serum level of IgA (78 p.100) and lymphopenia revealed immunodeficiency. Among 12 patients, chromosomal instability was observed in 5. Balanced rearrangements involving chromosomes 2, 7, 14, 22, 1, 3 and 11. The responsible gene, ATM, encodes a large protein kinase with a phosphatidylinositol 3-kinase-like domain. Ataxia telangiectasia patients have a 100 fold higher risk of cancer than the general population. We reported, in the same family two patients who developed neoplasia, (lymphoma and leukemia). During follow-up, a progressive worsening was observed in all cases. Three patients have died.

Age of Onset↗

[Neurological manifestations indicative of brucellosis].

Eight patients presented neurological signs secondary to Brucella infection. The clinical presentation was a meningoencephalitis in three cases, a meningoencephalomyelitis in one case, an epiduritis with spinal cord compression in one case, an acute polyradiculoneuritis in two cases and a chronic polyradiculoneuritis in one case. Acoustic nerve was impaired in seven cases. Cerebrospinal fluid (CSF) analysis revealed a lymphocytic meningitis and a high protein concentration in all cases. The agglutination test titers were elevated in the serum and in the CSF of seven patients (> or = 1/80) and two patients respectively. Brucella melitensis culture was disclosed in the blood of one patient and in the CSF of two patients. Three patients were treated by the association cycline and rifampicin whereas a tritherapy including cycline, rifampicin and TMP-SMZ was used in the other cases. Outcome was favorable in seven cases. This study outlines the polymorphism of neurological manifestations due to brucellosis, even in familial cases and this diagnostic must be especially done in Middle East and South Mediterranean countries.

Acute Disease↗

[Hydatid cysts of the brain stem. Two cases].

Cerebral hydatid cysts represent 2-3% of all intracranial masses in endemic countries. Its incidence in posterior fossa is very rare. We report two cases of brainstem location. Clinically, the lesion exhibited signs of brainstem tumor. In two patients, CT scan showed a hypodense lesion. There was no enhancement after contrast administration. One patient was explored by MRI; on precontrast images, the lesion appeared homogeneous with hyposignal intensity and smooth limits. T2 weighted MRI and post contrast examination confirmed the cyst nature of the lesion. Surgery was performed in the two patients. The cyst was first aspirated and its membrane was then removed. Post operatively, one patient died, the other one is still alive but severely affected two years later. CT scan showed total disappearance of the cyst. The clinical presentation, radiological findings and surgical procedures are discussed.

Brain Stem Neoplasms↗

[Rett's syndrome: report of 5 cases in Tunisia].

We report 5 girls presenting Rett syndrome. All of them were from south Tunisia. They fulfilled the Rett syndrome diagnosis criteria (The Rett syndrome diagnosis criteria work group, 1988). Pregnancy, birth and psychomotor development during the first year of live were normal. The mean age at the onset was 19.8 +/- 2.5 months. The two revealing symptoms were psychomotor regression (3 cases) and epilepsy (2 cases). They were admitted to our ward at a mean age of 4.7 +/- 1.5 years. Clinical presentation was typical of Rett syndrome. Mental retardation, stereotypic hand movement (hand washing/wringing or clapping/tapping) and loss of purposeful manual skills were noted in all cases. Gait was apraxic and increase of head circumference was slowed. Additional features included, respiratory dysfunction (episodic hyperventilation and breath-holding), epilepsy, scoliosis (4 cases), growth retardation and spasticity (3 cases). Electroencephalography showed slow activity with multifocal epileptiform abnormalities. Sleep enhanced these EEG abnormalities. MRI and CT-scan disclosed non specific cortical and sub-cortical atrophy. All cases were isolated and parents were consanguineous in 3 cases. Rett syndrome is relatively frequent in Europe, but in Tunisia this disease remains rare and certainly underdiagnosed.

Brain↗

Interleukin-1 expression in normal motor endplates and muscle fibers showing neurogenic changes.

Histological features of neurogenic muscle involvement include type grouping, muscle fiber atrophy and target fibers. In zidovudine-induced myopathy and dermatomyositis, immunoreactivity for interleukin (IL)-1 has been reported in diseased muscle fibers involving myofibrillar breakdown and atrophy. Since IL-1 is a signal for muscle proteolysis, we studied myofiber expression of IL-1 in neurogenic muscle involvement, specially in atrophic myofibers and target fibers which are associated with myofilament breakdown. Muscle biopsy samples from patients with normal (5 cases) or neurogenic muscle involvement (25 cases) were studied by enzyme histochemistry and immunohistochemistry. In normal muscles, immunoreactivity for IL-1beta was restricted to the postsynaptic domain of motor endplates and that for IL-1alpha had a similar localization but was faint. Immunoreactivity for IL-1alpha and -beta was observed, respectively, in 42.5% and 75.5% of target fibers, in 8.5% and 10.4% of dark angulated fibers, in 0% and 0.3% of non-atrophic type-grouped fibers, in 14.2% and 16.5% of moderately atrophic fibers, and in 65% and 20.9% of severely atrophic fibers. Immunoblot study showed the presence of both proIL-1 (31 kDa) and mature IL-1 (17.5 kDa). From this study, we conclude that IL-1 is normally expressed in the muscular domain of neuromuscular junctions; that IL-1 is mainly expressed in neurogenic target fibers; and that IL-1 expression by muscle fibers in pathological conditions seems to be associated with myofibrillar protein breakdown and regeneration.

Adult↗

[Importance of electromyography in the diagnosis of botulism].

Botulism is a cause of neuromuscular transmission impairment. We report here an electrophysiological study of the neuromuscular junction in a patient presenting with botulism. Repetitive stimulation of a motor nerve showed a characteristic triad, indicating presynaptic block of neuromuscular transmission: the muscle action potential amplitude was low; repetitive high frequency stimulation (20 Hz) induced a more than 100% increment in the amplitude; low frequency repetitive stimulation (3 Hz) induced a more than 10% decrement in the amplitude. Progressive clinical improvement spontaneously occurred and the electrophysiological control recording that was done 1 month later was normal. Botulism toxin reduces acetylcholine quanta released in the autonomic and neuromuscular junction, causing presynaptic block. Electrophysiological recordings associated with clinical data contributed more to the diagnosis of botulism than serological analysis, which remained negative in this patients.

Adolescent↗

The promoter of the tobacco Tnt1 retrotransposon is induced by wounding and by abiotic stress.

The transcription of the tobacco Tnt1 retrotransposon was previously shown to be induced, in tobacco and in heterologous species, by microbial elicitors and by pathogen infections. We report here that the expression of the Tnt1 promoter is also activated in heterologous species such as tomato and Arabidopsis by wounding, freezing and by other abiotic factors known to induce the plant defence response, such as salicylic acid, CuCl2, or oxidative stress. A similar regulation is observed in tobacco for most treatments. The induction of the Tnt1 promoter expression by wounding remains localized around injury points. In CuCl2-treated Arabidopsis plants, the transcription of Tnt1 is correlated with accumulation of the phytoalexin camalexin and with the expression of the EL13 defence gene. The interest of the Tnt1 promoter as a sensitive indicator of the plant defence responses is discussed.

Arabidopsis↗

Interleukin-1 expression in inflammatory myopathies: evidence of marked immunoreactivity in sarcoid granulomas and muscle fibres showing ischaemic and regenerative changes.

The most frequent autoimmune adult inflammatory myopathies are dermatomyositis, polymyositis, inclusion body myositis, and sarcoid myopathy. Interleukin-1 (IL-1) is a pleiotropic molecule, implicated in the inflammatory process, but also in tissue protection and remodelling. We evaluated the immunocytochemical expression of [L,-1alpha and beta in frozen muscle biopsy specimens from patients with dermatomyositis (15 cases), polymyositis (five cases), inclusion body myositis (five cases) and sarcoid myopathy (five cases). Positive immunoreactivities, were observed in both inflammatory cells and muscle fibres. Specificity of the immunostaining was assessed by Western blot experiments. IL-1 positive inflammatory cells were rare in polymyositis and inclusion body myositis, moderately abundant in dermatomyositis, and prominent in sarcoid myopathy granulomas. In sarcoid myopathy, 24.6 +/- 4.1% inflammatory cells were IL-1alpha-positive and 45.2 +/- 2.6% were IL-1beta-positive. IL-1 positive muscle fibres were mainly observed in dermatomyositis, usually remote from inflammatory infiltrates. Positive immunostaining for IL-1 was observed in fibres showing ischaemic punched-out vacuoles, that correspond to areas of myosinolysis, in atrophic perifascicular fibres, and in fibres located within healing microinfarcts. All NCAM-positive regenerating fibres were IL-1 positive. We conclude that: (i) IL-1 is expressed in granulomas of sarcoid myopathy, which is in keeping with the role ascribed to IL-1 in the formation of granulomas: (ii) IL-1 is expressed by muscle fibres undergoing ischaemic damage: and (iii) IL-1 expression by muscle fibres is associated with myofibrillar protein breakdown and regeneration.

Adult↗

[Lupic spinal cord diseases and antiphospholipid antibodies].

Central nervous system involvement in systemic lupus erythematosus (SLE) is frequent and severe, however, myelopathy is rarely reported (0.8 p. 100 of SLE cases). We describe two SLE-young women. They were 21 and 37 year old, presented with acute paraplegia. CSF study showed pleocytosis and moderately elevated protein. Antinuclear, anti-DNA and anticardiolipin were positive. High dose steroids therapy induced marked improvement. The pathogenesis of myelopathy in SLE remains unclear. Anti-phospholipid antibodies may cause thrombosis and ischemic myelopathy. However, auto-antibodies directed against central nervous system constituents may be involved.

Adult↗

The expression of the tobacco Tnt1 retrotransposon is linked to plant defense responses.

Activation of retrotransposons by stresses and external changes is common in all eukaryotic systems, including plants. The transcription of the tobacco Tnt1 retrotransposon was studied in its natural host as well as in Arabidopsis and tomato. It is activated by factors of microbial origin, by external stresses, and by viral, bacterial, and fungal attacks. Tnt1 expression is linked with the biological responses of the plant to the elicitor or to the pathogen attack and in particular with the early steps of the metabolic pathways leading to the activation of plant defense genes. In most cases, the basic features of Tnt1 regulation in tobacco are maintained in tomato and Arabidopsis, but some host-specific regulations were shown. The U3 region of the Tnt1 LTR contains the major cis-acting components of Tnt1 transcriptional activation in association with the plant defense responses. Furthermore, the Tnt1 U3 region, and especially the tandemly repeated BII boxes, contains several sequences similar to well-characterized motifs involved in the activation of several plant defense genes. The possible origin of Tnt1 regulatory sequences as well as the biological implications of Tnt1 activation by pathogen attacks are discussed.

Arabidopsis↗