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Biomedical subjects

M Gahr

Publications and source records attributed to M Gahr.

At least 19 recordsLinked to original sources
PubMed2006

[Systemic lupus erythematosus in children and adolescents].

Children and adolescents represent 15-20% of all systemic lupus erythematosus (SLE) patients. Although the clinical presentation and immunological findings are similar to those of adult SLE, children usually have a more severe disease at onset with higher rates of organ involvement. Rapid diagnosis and subsequent therapy are necessary to prevent major organ damage. The survival of children with SLE has improved dramatically over the past decades due to the introduction of steroids and immunosuppressive drugs. New strategies to improve the long-term course of the disease and to reduce potential drug toxicities are necessary. A common concept does not exist. There are some promising new drugs. This review article summarizes the epidemiology, pathogenesis, clinical manifestations and therapy of childhood and adolescent-onset SLE.

Adolescent↗
PubMed2005

Hormonal influence on song structure and organization: the role of estrogen.

The development of song in songbirds is a complex phenomenon that involves memory and learning, sensorimotor integration, and neural and muscular maturation. Gonadal hormones are involved in each of these steps, as they influence the differentiation of the neural song system, the incorporation and survival of neurones, and the development of muscles used for song production. In young males the development of song, therefore, is closely linked to the secretion of testosterone by the testicles. Castration results in the development of incomplete or unstable songs, and hormone replacement leads to the development of crystallized or stable song. However, testosterone does not act solely as an androgen. The brain of songbirds contains high concentrations of the enzyme aromatase, which converts testosterone into estradiol. Estradiol then binds to estrogen receptors, which in the song system are found only in the nucleus HVC. This forebrain nucleus, also called the "master nucleus," codes for the syntactic structure of song, i.e. for the particular combination of simple elements-syllables-that characterize the song of an individual. In this paper, we will review our studies on the role of estrogen in guiding the organization of song in canaries.

Animals↗
PubMed2004

NADPH oxidase is not required for spontaneous and Staphylococcus aureus-induced apoptosis of monocytes.

Reactive oxygen intermediates (ROI) generated in the respiratory burst reaction are crucial for the killing of bacteria and fungi in phagocytes. The key enzyme for the respiratory burst reaction is the NADPH oxidase. Reactive oxygen intermediates have additionally been proposed to be of general importance for the expression of FAS and soluble FAS ligand (sFASL) and the subsequent induction of apoptosis. This conclusion has been drawn from the observation that neutrophils with an inborn lack of the NADPH oxidase as well as cell lines and monocytes with artificially blocked NADPH oxidase exhibit impaired apoptosis. Being one of the few centers caring for patients with chronic granulomatous disease (CGD) who exhibit an inborn lack of NADPH oxidase, we had the unique opportunity to determine the role of the NADPH oxidase for apoptosis in monocytes with otherwise unmanipulated cells of these patients (CGD monocytes). We compared the expression of FAS on monocytes and the concentration of sFASL in the supernatant between CGD monocytes and healthy donors undergoing spontaneous apoptosis. Neither the expression of FAS nor the concentration of sFASL was decreased in CGD monocytes. We further compared spontaneous apoptosis and apoptosis occurring after the phagocytosis of Staphylococcus aureus in CGD monocytes to monocytes of healthy controls. In these experiments we could not determine any significant impairment of apoptosis in CGD monocytes. Our data indicate for the first time that in an unmanipulated human model a functional NADPH oxidase is not crucial for the apoptosis of monocytes and disprove a general role of ROI for the induction of apoptosis in phagocytes.

Apoptosis↗
PubMed2004

Neonatal seizures in two sisters with incontinentia pigmenti.

Familial incontinentia pigmenti (IP) (OMIM #308300) is a rare genetic disorder which segregates in an X-linked dominant way. The female-to-male ratio ranges from 20 to 37 : 1. In affected females IP causes highly variable abnormalities of the skin, hair, nails, teeth, eyes, and central nervous system (CNS). Cardiovascular anomalies, cerebral infarction, and immune dysfunction are rare complications of IP. The pathogenesis of cerebral changes in IP remains elusive. We report the case of two IP-affected sisters who presented in each case with neonatal seizures on the fifth day of life. Via cranial magnetic resonance tomographic imaging (MRI) different types of lesions in both hemispheres were demonstrable in both patients. To date the pathogenetic mechanisms for the cerebral lesions are not fully understood. However, multiple microscopic infarcts could serve as a possible explanation. The clinical course and the neurological development of the older child are favorable and so far the younger sibling appears to be developing normally, which is uncommon for patients with early onset of neurological symptoms. Symptomatic seizures in IP are an important differential diagnosis in benign non-familial and familial neonatal seizures.

Brain↗
PubMed2003

Effects of unilateral lesions of HVC on song patterns of male domesticated canaries.

Bird song is a model for studying neural control and lateralization of a learned behavior. Adult male canary develops large and varied song repertoires. Particular features of the male are well known to stimulate the reproductive activities of the female. We report here on the effect of lesions of either the left or right HVC, a key nucleus of the descending vocal control network of songbirds, on different song parameters of common domesticated male canaries of an European outbred strain. These canaries are useful to evaluate the question of central versus peripheral lateralization because they do not show syringeal dominance for syllable production compared to the previously studied canary strains. Right-sided lesions reduced the highest frequency and the widest frequency band. Left-sided lesion increased the lowest frequency. The size of the left-sided lesions correlated with the reduction of the repertoire of simple syllables, of the total repertoire and of the highest repetition rate, and with the increase of the lowest frequency. These results suggest a lateralized specialization of both left and right vocal pathways for particular features of the song, especially those that are known to elicit a great number of copulation solicitation displays (CSD). Lesions of both left and right pathways affected, however, sound amplitude of all syllables. Because this effect was more sever following left-sided lesions, and because the syrinx morphology of canaries has a left-right asymmetry, we suggest a peripheral mechanism for the observed lateralized specializations.

Animals↗
PubMed2003

[Haematemesis and dysphagia in a 20-year-old woman with congenital spine malformation and situs inversus partialis].

A 20-year-old woman with a four-week history of dysphagia, weight loss of four kilograms and unspecific abdominal pain was admitted because of sudden haematemesis. The physical examination showed a patient with a prominent kyphoskoliosis. The patient reported of having a situs inversus abdominalis and a tethered cord syndrome. Bladder function disorders were present since childhood. Upper endoscopy demonstrated a 4 cm large, exophytically growing necrotic tumour of the oesophagus. The CT scan showed a space occupying tumour of the oesophagus and metastases in a size of 1.5 cm in both lungs. Further imaging revealed a UICC-Stadium IVB (T2NxMIb ). Histology of the tumour biopsies showed a poor differentiated squamous cell carcinoma. Staging after the 6 th dose cisplatin (100 mg/m2/die) and 5-fluorouracil (5 x 1000 mg/m2/die) showed a mild reduction of the tumour and the metastases. The patient died ten months later of multiorgan failure after severe progress of tumour and metastatic growth. The manifestation of squamous cell carcinoma of the oesophagus is unusual in people at the age of twenty. Genetic and chromosomal analysis of the patient gave no evidence for a hereditary disorder. Drug history revealed that the patient had been treated with the alpha-receptor blocking drug phenoxybenzamine over at least 12 years for bladder dysfunction. Animal experiments of rats with exposition of phenoxybenzamine over 24 months produced gastrointestinal malignomas. By the German admission board phenoxybenzamine is only recommended for short term therapy. It seems to be likely that even in humans phenoxybenzamine acts as a mutagenic substance and should be carefully used in long-term treatment.

Adrenergic alpha-Antagonists↗
PubMed2002

Recovery of song preferences after excitotoxic HVC lesion in female canaries.

The courtship solicitation display (CSD) of the female canary is a model to study estrogen dependent auditory preferences for male songs. The forebrain auditory-vocal nucleus, HVC, is part of the circuit that determines such preferences. To further develop this model we show that bilateral excitotoxic lesions of the medial part of HVC involving between 18-60% of the bilateral nucleus are behaviorally effective while complete unilateral lesions are not. Further, we show that animals recover their song preferences over a period of several months after the lesion. This functional recovery does not involve anatomical recovery of the HVC. Even 9 months after the lesion, the HVC size of these females was similar to that of females sacrificed 2 days after the lesion and thus was 40 +/- 8% smaller compared to normal females. Further, ipsilaterally, the lesion procedure transiently disturbed the neurochemistry, such as GAD-mRNA expression, in the part of HVC that did not undergo cell death. These results suggest that the integrity of the lateral part of at least one HVC is required to perform CSD in response to relevant auditory stimuli.

Animals↗
PubMed2001

Distribution of sex steroid hormone receptors in the avian brain: functional implications for neural sex differences and sexual behaviors.

Developmental and seasonal changes in the production of androgens, estrogens, and progestins seem to control sex-specific differentiation and seasonal changes in appetitive and consummatory sexual behaviors of birds. This results in profound sex differences in the quality (sex-specific) or quantity (sex-typical) of behaviors such as courtship, territoriality, or copulation. Steroids affect the brain by binding to intracellularly located receptors. The same brain areas express androgen, estrogen, and progesterone receptors in male and female brains. Sex differences in these genetically determined patterns occur in the size of neuron populations that intrinsically express sex steroid receptors. Further permanent sex differences are subsequent to degenerative fates of receptor expressing neuron populations during ontogeny. Transient sex differences in receptor expression appear to be due to area-specific up- and down-regulation of receptor levels, reflecting transient changes in the level of circulating steroids, changes in environmental conditions, or in the physiological status of the individuals. In particular, intrinsic sex differences in the expression pattern of sex steroid receptors and steroid-independent regulation of the expression level of these receptors in the brain are limiting mechanisms for gonad-dependent sexual development and activities.

Animals↗
PubMed2001

Evaluation of catecholamine metabolites, mIBG scan, and bone marrow cytology as response markers in stage 4 neuroblastoma.

BACKGROUND: The early biological response has been proved an excellent predictor in acute lymphoblastic leukemia and nephroblastoma. We asked whether catecholamine metabolites, mIBG scan, and bone marrow evaluation might be relevant response markers in disseminated neuroblastoma. PROCEDURE: Three hundred sixty-seven unselected stage 4 neuroblastoma patients treated according the German cooperative trial NB90 were entered into the study. Catecholamine plasma and urine levels were centrally determined by gas chromatography/ mass spectrometry. Bone marrow cytology and mIBG scans were evaluated by local investigators. RESULTS: At diagnosis, mIBG scan was positive in 306 patients (92%), borderline in seven patients (2%), and negative in 19 patients (6%). Bone marrow aspirates were cytologically positive in 292 patients (84%) and negative in 57 patients (16%). Plasma catecholamine levels were elevated in 79% (206 of 260 patients.), urinary levels in 91% (307 of 338 patients). The outcome of patients with normalized mIBG scan after four courses of chemotherapy [5 year EFS (event free survival) 0.22 +/- 0.07] was not superior to the outcome of patients with still abnormal uptake (5 year EFS 0.30 +/- 0.05). The event free survival of patients with still positive bone marrow aspirates after four courses (0.16 +/- 0.06) was inferior to the EFS of patients with negative bone marrow aspirates (0.26 +/- 0.04, P = 0.0054). Urinary catecholamine normalization after four cycles of chemotherapy (5 year EFS 0.35 +/- 0.06 versus 0.26 +/- 0.10) had no influence on outcome, whereas plasma catecholamine normalization after the first (5 year EFS 0.40 +/- 0.09 versus 0.14 +/- 0.07, P= 0.0364) or the fourth cycle (5 year EFS 0.35 +/- 0.06 versus 0.26 +/- 0.10, P = 0.0242) indicated a better outcome. CONCLUSIONS: These data show that serial plasma catecholamine levels and bone marrow aspirates in the course of the disease are useful tools in predicting outcome.

3-Iodobenzylguanidine↗
PubMed2001

Testosterone regulates the activity and expression of aromatase in the canary neostriatum.

The estrogen synthesizing enzyme, P450 aromatase, plays a critical role in the regulation of vertebrate sexual behavior. Songbirds differ from other avian species in the distribution and expression of aromatase in the telencephalon. The highest concentration of aromatase in the songbird brain is found in the caudomedial neostriatum (NCM). This area surrounds the only nucleus of the neural song system that contains estrogen receptors, the high vocal center (HVC). It has been suggested that estrogen produced in NCM via aromatization of circulating testosterone (T) is involved in song development and adult song plasticity. The modalities of regulation of aromatase in NCM are not well understood, and some studies suggest that in NCM, unlike in the preoptic-hypothalamic areas, aromatase is not regulated by androgen and/or estrogen. In this work, we studied whether the treatment of female canaries with T, which induces the development of malelike song and the masculinization of the song system, also induces an increase in the expression and activity of aromatase in NCM. Our results show that both the expression and activity of aromatase in NCM increase in female canaries following T treatment. This study provides the first direct evidence that T regulates telencephalic aromatase in songbirds, and suggests that an increase in estrogen production in NCM might be functional in neural and behavioral plasticity during phases of song organization.

Animals↗
PubMed2001

Aromatase inhibition reduces specifically one display of the ring dove courtship behavior.

The courtship behavior of the male ring dove (Streptopelia risoria) combines aggressive displays (chasing, bowing) and nest-oriented displays (nest soliciting). Aggressive displays depend on circulating testosterone, whereas nest soliciting is estrogen-dependent and appears to depend on the aromatization of androgen into estrogen within the brain. The present work tested the hypothesis that aromatase specifically modulates the nest soliciting display in intact male ring doves. Males were tested for courtship behavior with receptive females before and after being implanted with micro-osmotic pumps containing Fadrozole, a nonsteroidal aromatase inhibitor, or saline. Fadrozole at the higher dose reduced estrogen-dependent nest soliciting but did not affect androgen-dependent chasing and bowing. These results support the hypothesis that aromatase modulates nest soliciting in male ring doves, and provide further evidence for separate hormonal control of different courtship displays in this species.

Androgens↗
PubMed2001

Seasonal activation and inactivation of song motor memories in wild canaries is not reflected in neuroanatomical changes of forebrain song areas.

Seasonal, testosterone-dependent changes in sexual behaviors are common in male vertebrates. In songbirds such seasonal changes occur in a learned behavior--singing. Domesticated male canaries (Serinus canaria) appear to lose song units (syllables) after the breeding season and learn new ones until the next breeding season. Here we demonstrate in a longitudinal field study of individual, free-living nondomesticated (wild) canaries (S. canaria) a different mode of seasonal behavioral plasticity, seasonal activation, and inactivation of auditory-motor memories. The song repertoire composition of wild canaries changes seasonally: about 25% of the syllables are sung seasonally; the remainder occur year-round, despite seasonal changes in the temporal patterns of song. In the breeding season, males sing an increased number of fast frequency-modulated syllables, which are sexually attractive for females, in correlation with seasonally increased testosterone levels. About 50% of the syllables that were lost after one breeding season reappear in the following breeding season. Furthermore, some identical syllable sequences are reactivated on an annual basis. The seasonal plasticity in vocal behavior occurred despite the gross anatomical and ultrastructural stability of the forebrain song control areas HVc and RA that are involved in syllable motor control.

Animals↗
PubMed2001

Increased susceptibility of a carrier of X-linked chronic granulomatous disease (CGD) to Aspergillus fumigatus infection associated with age-related skewing of lyonization.

Chronic granulomatous disease (CGD) is an inherited disorder characterized by the inability of phagocytes to generate normal amounts of superoxide (O2-), leaving patients susceptible to life-threatening infections. It was previously assumed that once carriers of the X-linked form of CGD were found to have 30% or more of functionally normal neutrophils, they would be free of risk for infection because the lyonization ratio was believed to be constant. Our report strongly contradicts this assumption. A 45-year-old X-CGD carrier had approximately 40% of normal neutrophils in her peripheral blood at age 21 years. Recently, she contracted a life-threatening pulmonary infection with Aspergillus fumigatus. After recovery, the ratio of normal-to-nonfunctional neutrophils was re-evaluated. She was found to have only 6-8% of normal neutrophils, suggesting that a striking decrease in the number of normal cells over the past 25 years was the reason for an increased susceptibility to Aspergillus infection. We conclude that age-related acquired skewing of the lyonization ratio can result in an increased susceptibility to life-threatening infections in X-CGD carriers.

Aging↗
PubMed2001

Periodic fever (TRAPS) caused by mutations in the TNFalpha receptor 1 (TNFRSF1A) gene of three German patients.

TNF-receptor-associated periodic syndrome (TRAPS) is a recently recognized disorder characterized by prolonged attacks of high fever and severe localized inflammation. TRAPS is caused by dominant mutations in the 55 kDa TNF receptor gene (TNFRSF1A). We here describe three German TRAPS patients of two families with Cys30-->Arg and Thr50-->Met mutations, respectively. Both mutations have already been observed before in other nonrelated families. The Thr50-->Met amino acid exchange, caused by an ACG-->ATG transition, has been reported in two other families of different ethnic background. The possibility that the ACG-->ATG sequence alteration is a mutational hot spot causing TRAPS is discussed. Furthermore, we describe and discuss the symptoms of our patients, possible inducers of febrile attacks, and treatments which the patients had received when their diagnoses were still unknown.

Adult↗
PubMed2000

Neural song control system of hummingbirds: comparison to swifts, vocal learning (Songbirds) and nonlearning (Suboscines) passerines, and vocal learning (Budgerigars) and nonlearning (Dove, owl, gull, quail, chicken) nonpasserines.

Males of certain hummingbird species such as Anna's hummingbirds (Calypte anna) learn their song during postnatal development. Here we report that male Anna's hummingbirds and male Amazilia hummingbirds (Amazilia amazilia), two singing hummingbird species, possess forebrain areas that are similar in morphological appearance, location, and connectivity to the song control areas RA (nucleus robustus archistriatalis), HVC (nucleus hyperstriatalis ventrale, pars caudale, or higher vocal center), and LMAN (lateral part of nucleus mangnocellularis anterioris) of oscine passerines (songbirds). The vocal control areas of songbirds are further defined by the expression of androgen receptors. Similarly, the singing hummingbird species express androgen receptors in the LMAN-like area and in the HVC-like area. The hummingbird RA projects to the medullary syringeal motonucleus nXIIts (nucleus hypoglossus pars tracheosyringealis) and the respiratory premotonucleus RAm (nucleus retroambigualis). The HVC-, RA-, and LMAN-like areas are rudimentary in adult male ruby-throated hummingbirds (Archilochus colubris) and Allen's hummingbirds (Selasphorus sasin) and not distinguishable in female hummingbirds, none of which sing. Vocal-area-like forebrain areas (delineated by the cytoarchitecture or androgen receptor expression) were not found in vocal nonlearning swifts and suboscines, the taxonomic sister groups of hummingbirds and songbirds, respectively. These areas were also missing in owls, ring doves, gulls, and gallinaceous species, nonpasserines that do not learn vocalizations. Budgerigars (vocal learners) are known to have forebrain vocal areas, but these areas do not express sex steroid receptors. These data suggest that hummingbirds and songbirds belong to two groups of birds that have common forebrain circuits. Parts of this circuit are organized as nuclear-like structures (LMAN, HVC, RA) in species that learn to sing.

Animals↗
PubMed2000

Seasonal expression of androgen receptors, estrogen receptors, and aromatase in the canary brain in relation to circulating androgens and estrogens.

Songbirds have a complex neural network for learning and production of song, namely the neural song system. Several nuclei of the song system contain androgen receptors (AR), and the neostriatal nucleus HVc also contains alpha type estrogen receptors (ER). Many songbird species show seasonal changes in both song and the neural song system that are correlated with seasonal variations in the circulating levels of gonadal steroids. However, there is increasing evidence that the sensitivity of the song system to gonadal steroids also changes seasonally. This could involve changes in the expression and activity of steroid receptors and steroid-metabolizing enzymes, such as the estrogen-synthesizing enzyme aromatase (AROM). The seasonal regulation of brain AR, ER, and AROM has not been studied before in the same individual songbirds. In this work, we compared plasma levels of androgens and estrogens, the expression level of AR-, ER-, and AROM-mRNA in the telencephalon, and brain AROM activity in male canaries between autumn (November) and spring (April) periods of high singing activity. Plasma levels of androgens and estrogens were higher in April than in November. The expression level of ER in HVc was higher in November than in April. In contrast, the expression level of AROM in the caudomedial neostriatum was higher in April than in November. However, we found no seasonal differences in the level of expression of AR and the volume of HVc as delimited by AR expression. Thus, AR expression in HVc was not correlated with circulating androgen levels. This study shows that both steroid-dependent and -independent seasonal factors regulate the action of gonadal hormones on the song system. In addition, we report a new site of AROM expression in the songbird brain, the nucleus interfacialis.

Androgens↗