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Kinesin molecular motors: transport pathways, receptors, and human disease.

Kinesin molecular motor proteins are responsible for many of the major microtubule-dependent transport pathways in neuronal and non-neuronal cells. Elucidating the transport pathways mediated by kinesins, the identity of the cargoes moved, and the nature of the proteins that link kinesin motors to cargoes are areas of intense investigation. Kinesin-II recently was found to be required for transport in motile and nonmotile cilia and flagella where it is essential for proper left-right determination in mammalian development, sensory function in ciliated neurons, and opsin transport and viability in photoreceptors. Thus, these pathways and proteins may be prominent contributors to several human diseases including ciliary dyskinesias, situs inversus, and retinitis pigmentosa. Kinesin-I is needed to move many different types of cargoes in neuronal axons. Two candidates for receptor proteins that attach kinesin-I to vesicular cargoes were recently found. One candidate, sunday driver, is proposed to both link kinesin-I to an unknown vesicular cargo and to bind and organize the mitogen-activated protein kinase components of a c-Jun N-terminal kinase signaling module. A second candidate, amyloid precursor protein, is proposed to link kinesin-I to a different, also unknown, class of axonal vesicles. The finding of a possible functional interaction between kinesin-I and amyloid precursor protein may implicate kinesin-I based transport in the development of Alzheimer's disease.

Alzheimer Disease↗

Setae of the First Antennae of the Copepod Cyclops scutifer (Sars): Their Structure and Importance.

Ultrastructural studies of the setae of the first antennae of Cyclops scutifer (Sars) have revealed their sensory function. The setae are the extension of modified ciliary structures which function as mechanoreceptors. The setae apparently act to detect gravitational and inertial forces. This is of particular importance in sensing disturbances generated by prey or predators.

Journal Article↗

Multifocal stimulation techniques in ophthalmology -- Current knowledge and perspectives.

The purpose of this paper is to give a brief overview on the application of multifocal stimulation techniques in ophthalmology. The use of m-sequences as a stimulus sequence allows a high-resolution topographic mapping of sensory function. Outer retinal dysfunction can readily be detected with the multifocal ERG (mfERG). When the inner retinal contribution to the mfERG response is enhanced through adapting the stimulation sequence, the sensitivity of the mfERG to detect retinal dysfunction in glaucoma can be increased. Testing of the entire visual pathway with multifocal cortical evoked visual potentials is also possible and recent studies have focused on reducing interindividual variability. The use of m-sequence stimulation in magnetic encephalography offers new ways to study visual processing without the need to apply electrodes.

Electroretinography↗

Untreated congenital and posttraumatic high dislocation of the hip treated by replacement in adult age: 22 hips in 16 patients followed for 1-8 years.

Between 1993 and 2001, we replaced 22 hips in 16 patients with high dislocation of the hip. All but 1 case was due to congenital dislocation. In all cases the femur was osteotomized below the lesser trochanter and a straight uncemented stem inserted in the medullary canal. The acetabular prostheses were inserted at the site of the original acetabulum, usually after augmenting the acetabular rim by using the medial half of the resected proximal femur. The lateral part of the proximal femur with the intact attachment of the gluteus medius muscle was transposed and fixed to the femoral diaphysis thereby restoring direction of muscle pull. The HHS score increased from a median value of 42 points preoperatively to a median of 86 points after median 25 months of follow-up. Limp, which before surgery was severe in all cases, was less marked or had disappeared at follow-up. The legs had been lengthened median 2.5 (1.0-4.5) cm. No postoperative infections occurred. Palsy or loss of sensory function was not observed in any patient. Dislocation was the commonest complication. It occurred in 3 hips, 2 of which had to be revised to ensure stability.

Adult↗

The vomeronasal (Jacobson's) organ in adult humans: frequency of occurrence and enzymatic study.

The vomeronasal system in adult humans has commonly been regarded as absent or vestigial, but recently it was found to be more common than previously reported. In this study, a search for the frequency of occurrence of the vomeronasal organ (VNO) was performed by examining the nasal septae of 200 adult patients. The frequency of occurrence was found to vary according to the method of examination. By anterior rhinoscopy, large pits and even deep grooves lined by glistening mucosa were visible in 16% of the people examined. Using nasal endoscopes this ratio increased to 76%. After receiving informed, written consent, from 13 patients undergoing endonasal surgery under general anaesthesia, one VNO was dissected out. Specimens were examined histologically and histochemically for succinic dehydrogenase and alkaline phosphatase enzymes. One specimen was processed for transmission electron microscopy. Two morphologically distinct cell types were differentiated. One cell type was previously suggested to have some of the features associated with nerve cells and could have a sensory function. A possible function for the VNO is postulated.

Adult↗

Transient global amnesia: perplexing to patient and physician alike.

Transient global amnesia is a benign condition in which an isolated episode of amnesia occurs and then clears completely. No loss of motor or sensory function occurs and patients are not aphasic during the episodes. Neurologic workup is not likely to reveal any specific cause. It is necessary to eliminate treatable causes of transient ischemic attacks and also to rule out seizure disorders and brain tumors as a cause of this often unrecognized phenomenon. Cerebrovascular disease is often postulated as the underlying mechanism.

Aged↗

Diagnosis of esophageal motility disorders.

Esophageal motility disorders are now known to be a heterogeneous group of conditions that commonly cause dysphagia and chest pain. Motor dysphagia is usually provoked by solids and liquids (in contrast to mechanical dysphagia, which is usually provoked by solids only). Chest pain with these disorders is nonspecific and can mimic angina pectoris. In many patients with diffuse esophageal spasm or nutcracker esophagus, pain appears to be caused by abnormal sensory function rather than contraction abnormalities. Barium esophagography and esophageal manometry are complementary studies in the evaluation of motility disorders.

Barium Sulfate↗

The role of the barostat in human research and clinical practice.

BACKGROUND: The barostat is a recently developed device used to study the physiology and pathophysiology of the motor and sensory functions of the gastrointestinal tract. It can monitor volume changes while maintaining a set constant pressure and deliver controlled distensions of gastrointestinal organs. Simultaneously, motility and visceral perception may be assessed. The barostat has contributed to the understanding of physiological processes in the gastrointestinal tract with regard to regulation of tone, compliance, enteric reflexes, sensation and processing of signals to and from the gut. In addition, the barostat has been used to study various gastrointestinal disorders. In functional bowel disorders, objective abnormalities in visceral sensitivity and enteric reflexes have been demonstrated. Numerous other diseases, gastrointestinal in origin as well as systemic diseases affecting the gut, have been studied. In the near future, the barostat may become a clinically useful tool for the objective diagnosis of motor and sensitivity disorders of the gut and for monitoring the effectiveness of therapy.

Baroreflex↗

Brain injury following neuroleptic malignant syndrome: case report and review of the literature.

OBJECTIVE: To report a case of brain injury following neuroleptic malignant syndrome (NMS) and review the literature for similar documented cases. CASE REPORT: A 30-year old woman presented to the ER with psychotic features and was treated with several anti-psychotics. Subsequently, she developed neurological symptoms and was diagnosed with neuroleptic malignant syndrome. Following a prolonged course in an acute care facility, she was admitted to a rehabilitation ward, where cognitive and physical examinations revealed significant findings. These included marked dysarthria, difficulties comprehending commands, attention problems, as well as abnormalities in her muscle tone, power, reflexes, gait, co-ordination and sensory function. CONCLUSION: Literature reviews reveal few documented cases of brain injury following neuroleptic malignant syndrome. A further exploration of the effects of NMS on the brain is warranted to elicit whether cerebellar damage is indeed common following neuroleptic malignant syndrome. Such research could eventually lead to therapeutic interventions aimed at preventing permanent brain injury in persons with NMS.

Adult↗

Coverage of the median nerve with free and pedicled flaps for the treatment of recurrent severe carpal tunnel syndrome.

Fifteen patients (10 women and 5 men; median age 46 years; range 28-55), with recurrent severe carpal tunnel syndrome, were operated on with re-exploration and cover of the median nerve with free or pedicled flaps (five pedicled ulnar flaps, one pedicled dorsal forearm flap (served by the posterior interosseus artery), one groin flap, three free scapular flaps, and five free lateral arm flaps). The patients were followed up by a self-administered questionnaire at 3 months-14 years (median 8.5 years) after operation and replies were obtained from 14 patients. There was a significant improvement in pain (p = 0.01) and percussion tenderness at the wrist (p = 0.02), but no significant improvement in allodynia and cold intolerance in the hand as evaluated by the use of a visual analogue scale (VAS). Three of the 14 patients had less numbness/paraesthesiae and four had subjectively improved sensory function in the hand and fingers since the procedure. Ten patients had problems from the donor site, including a cosmetically unacceptable scar, allodynia, and itching. Four patients had worked before the operation and nine patients returned to ordinary or light work afterwards. In conclusion, 10/14 patients considered themselves as somewhat better, better, or cured, while four felt that they were unchanged or worse. We conclude that cover with vascularised fat may be worthwhile in some patients with recurrent severe carpal tunnel syndrome, preferably with a simple pedicled ulnar flap.

Adult↗

Dietary, anthropometric, hematological and biochemical assessment of the nutritional status of centenarians and elderly people in Okinawa, Japan.

OBJECTIVE: The population of old people has increased and nutritional disorders are common among them. The assessment of nutritional status and dietary intakes of this population is necessary in order to improve their nutritional status and reduce risk to infection and mortality. In the present study, data on the nutritional status of healthy elderly and centenarians is provided. SUBJECTS: Participants were free-living healthy volunteers (39 centenarians; 11 male and 28 female and 44 elderly in their 70s; 13 male and 31 female). METHODS: Their nutritional status was assessed by anthropometric measurements, hematological and biochemical variables. Activities of daily living (ADL) of 11 items were scored depending upon their activities with a maximum score of 5.0. Dietary survey by food recording was done for 2 days and food models were used to obtain the best estimate of food intake. Energy and nutrient intakes were compared with Japanese recommended dietary allowances (RDAs). RESULTS: The elderly had complete independence of physical activities, good sensory function and cognitive abilities. The physical activities of male centenarians were between the category of completely independent and independent but slow. In female centenarian participants, their physical activities were independent but slow or independent with difficulty. The functions of auditory acuity and eyesight of the centenarians were poor but their cognitive abilities were still good. The elderly subjects had short stature whereas their body weight and body mass index (BMI) were not low, especially among the women, compelling female elderly to reduce their food intake to control the weight. Energy intake of female centenarians was low. The ADL in the female centenarians was positively related to energy, suggesting that the low energy intake of the female centenarians was mainly due to their low ADL. Anthropometric, hematological and biochemical variables of the centenarians were lower or near the lower reference limit except serum lipids. All the hematological and biochemical variables were statistically lower (p < 0.05) in the centenarians than in the elderly particularly for females with some minor exceptions. CONCLUSION: The results of the present study showed that the nutritional status assessed by ADL and anthropometric, hematological and biochemical parameters was poor in the centenarian subjects but was maintained in the elderly subjects except height and that the diet was not the major factor of their problems in the nutritional status.

Activities of Daily Living↗

Neurological complications after 434 MHz microwave hyperthermia of the rat lumbar region including the spinal cord.

Hyperthermia was applied in the region of the vertebral column from the second to the fifth lumbar vertebra using a ring-shaped 434 MHz microwave radiator. In all experiments temperatures were measured at a 'reference' thermocouple which was placed against the fourth lumbar vertebra. After 60 min of heat treatment at 'reference' temperatures of 43.0 degrees C, 44.0 degrees C and 45.0 degrees C (+/- 0.05 degrees C) the average maximal temperature inside the vertebral canal were 42.6 degrees C, 43.0 degrees C and 43.8 degrees C (+/- 0.3 degrees C), respectively. At all 'reference' temperatures the maximal core temperature of the animal did not exceed 40.5 +/- 0.3 degrees C after 60 min of heat treatment. Dorsal skin and muscle temperatures in the treatment area reached 'reference' temperature, and transient skin and muscle necrosis was observed after treatment for 1 h at 'reference' temperatures at 44 degrees C and 45 degrees C. Temperatures in the peritoneal cavity approximately 1 mm ventrally of the vertebral column rose to 41.8 degrees C after 60 min at reference 43.0 degrees C. Treatment at spinal cord temperature 42.6 degrees C for 60 min did not induce any significant neurological effects. Motoric dysfunction of the hind legs, such as difficulties with walking, was observed after 60 min treatment at spinal cord temperatures of 43.0 degrees C or 43.8 degrees C. In addition, 24 h after treatment at 43.8 degrees C for 60 min loss of tail tonus was observed, as well as loss of sensory function in the hind limbs. Recovery from the neurological disorders, except for the loss of tail tonus, occurred within 2 weeks after treatment. Histopathological examination revealed necrosis in the central areas of the spinal cord at 3 days and complete necrosis at 7 days after treatment at 43.8 degrees C for 60 min.

Animals↗

Critical illness polyneuropathy: a summary of the literature on rehabilitation outcome.

PURPOSE: To evaluate the available literature on outcome of critical illness polyneuropathy (CIP) and to identify rehabilitation problems. METHODS OF STUDY SELECTION: A literature search in electronic databases. Primary articles on outcome in CIP using the classification of ICIDH or Quality of Life were enrolled in this study. Because of the types of study design, the lack of information regarding validity and the variability, a quantitative analysis was not possible. Instead, the overall results were evaluated in a qualitative approach. RESULTS: In the literature minimal attention was given to the rehabilitation aspects and long-term outcome of patients with CIP. Outcome measures were mainly used on the level of impairments and in lesser extent on the level of disabilities. One year after the onset of CIP, muscle weakness and decreased sensory function were frequently observed. Reported functional disabilities were dependency in Activities of Daily Living (ADL) and walking disabilities. CONCLUSION: The specific course and long-term outcome of CIP remains unclear. Research on the course and long-term functional outcome in CIP is necessary in order to identify rehabilitation problems and to formulate treatment strategies specifically directed towards the outcome of CIP.

Activities of Daily Living↗

Reduced pain after surgery for cervical disc protrusion/stenosis: a 2 year clinical follow-up.

PURPOSE: To follow the clinical outcome after surgery for cervical radiculopathy caused by degenerative cervical disc disease and to compare it with the outcome after conservative treatment. METHOD: Forty-three patients all awaiting surgery were studied prospectively. A control group of 39 conservatively treated patients were chosen, matched for gender and age. All patients rated their Sickness Impact Profile (SIP) and pain (VAS) and were clinically examined by unbiased observers initially and after 3, 9 and 24 months. RESULTS: Long-lasting pain reduction was noted both in the neck and in the arm for the operated patients, as well as improved sensory function and reduction of reflex disturbances. Their SIP showed a temporary improvement in the overall index, in the psychosocial dimension, in sleep/rest and home management, but only mobility remained improved. Among the operated patients referred directly to us, there was an improvement in SIP at the final follow-up. The control group's SIP indicated only a temporary improvement in sleep/rest. CONCLUSIONS: Surgically treated patients experienced pain reduction which was partially maintained for at least 24 months. A sustained improvement in the health status measured by SIP was observed only among operated patients that were not referred via the social insurance offices.

Adult↗

A memoir of olfaction.

Osphreiology, though beginning with Aristotle, and the title of a classical monograph from 1819 by Cloquet, has, like the human sense of smell itself, played a relatively modest role, compared to other sensory functions. The anatomical and physiological connections of the nose to the brain proved to be more complex than those of sight, hearing and even touch, and were therefore poorly understood before the second half of the 19th century. Moreover, the close association between smell and taste gave rise to much controversy regarding the respective roles of the first and the fifth cranial nerves. Next, came the unfolding of the evolutionary influence of cerebral structure and function--viz Broca's "limbic" concept, and the "olfactory desert" in the brains of "anosmatic" animals, Jackson's "uncinate" seizures featuring olfactory hallucinations brought the hippocampal formation into focus. Finally, there were the clinical manifestations of hyposmia and hyperosmia, from "coryza", the common cold, to injury or neoplasms causing hyposmia, as well as some endocrine alterations causing hyperosmia. (And let us not forget Charles Huysman's "Against the Grain" and Marcel Proust's evocative fragrant madeleine.).

Cranial Nerves↗

Age-related changes in event-cued visual and auditory prospective memory proper.

We rely upon prospective memory proper (ProMP) to bring back to awareness previously formed plans and intentions at the right place and time, and to enable us to act upon those plans and intentions. To examine age-related changes in ProMP, younger and older participants made decisions about simple stimuli (ongoing task) and at the same time were required to respond to a ProM cue, either a picture (visually cued ProM test) or a sound (auditorily cued ProM test), embedded in a simultaneously presented series of similar stimuli (either pictures or sounds). The cue display size or loudness increased across trials until a response was made. The cue size and cue loudness at the time of response indexed ProMP. The main results showed that both visual and auditory ProMP declined with age, and that such declines were mediated by age declines in sensory functions (visual acuity and hearing level), processing resources, working memory, intelligence, and ongoing task resource allocation.

Adolescent↗

Stress and combined exposure to low doses of pyridostigmine bromide, DEET, and permethrin produce neurochemical and neuropathological alterations in cerebral cortex, hippocampus, and cerebellum.

Exposure to a combination of stress and low doses of the chemicals pyridostigmine bromide (PB), DEET, and permethrin in adult rats, a model of Gulf War exposure, produces blood-brain barrier (BBB) disruption and neuronal cell death in the cingulate cortex, dentate gyrus, thalamus, and hypothalamus. In this study, neuropathological alterations in other areas of the brain where no apparent BBB disruption was observed was studied following such exposure. Animals exposed to both stress and chemical exhibited decreased brain acetylcholinesterase (AChE) activity in the midbrain, brainstem, and cerebellum and decreased m2 muscarinic acetylcholine (ACh) receptor ligand binding in the midbrain and cerebellum. These alterations were associated with significant neuronal cell death, reduced microtubule-associated protein (MAP-2) expression, and increased glial fibrillary acidic protein (GFAP) expression in the cerebral cortex and the hippocampal subfields CA1 and CA3. In the cerebellum, the neurochemical alterations were associated with Purkinje cell loss and increased GFAP immunoreactivity in the white matter. However, animals subjected to either stress or chemicals alone did not show any of these changes in comparison to vehicle-treated controls. Collectively, these results suggest that prolonged exposure to a combination of stress and the chemicals PB, DEET, and permethrin can produce significant damage to the cerebral cortex, hippocampus, and cerebellum, even in the absence of apparent BBB damage. As these areas of the brain are respectively important for the maintenance of motor and sensory functions, learning and memory, and gait and coordination of movements, such alterations could lead to many physiological, pharmacological, and behavioral abnormalities, particularly motor deficits and learning and memory dysfunction.

Animals↗

Assessment of the neurotoxic potential of chlorpyrifos relative to other organophosphorus compounds: a critical review of the literature.

Chlorpyrifos (diethyl 3,5,6-trichloro-2-pyridyl phosphorothionate) is a broad-spectrum organophosphorus (OP) insecticide. Anticipated increases in the already extensive use of this compound have prompted this reassessment of its neurotoxicity. Because chlorpyrifos and other OP insecticides are designed to produce acute cholinergic effects through inhibition of acetylcholinesterase (AChE) and some OP compounds can cause OP compound-induced delayed neurotoxicity (OPIDN) via chemical modification of neurotoxic esterase (neuropathy target esterase, NTE), this review focuses on the capacity of chlorpyrifos to precipitate these and other adverse neurological consequences. Chlorpyrifos exhibits only moderate acute toxicity in many mammalian species, due largely to detoxification of the active metabolite, chlorpyrifos oxon, by A-esterases. Rats given large doses of chlorpyrifos (sc in oil) have prolonged inhibition of brain AChE, possibly due to slow release of the parent compound from a depot. Associated cognitive and motor deficits return to normal well before recovery of AChE activity and muscarinic receptor down-regulation, as expected from classic tolerance. Controlled studies of OP compound exposures in humans also indicate that cognitive dysfunction requires substantial AChE inhibition. Information is relatively sparse on neurological dysfunction that is secondary to theoretical reproductive, developmental, or immunological effects, but the best available data indicate that such effects are unlikely to result from exposures to chlorpyrifos. In accord with the much greater inhibitory potency of chlorpyrifos oxon for AChE than for NTE, clinical reports and experimental studies indicate that OPIDN from acute exposures to chlorpyrifos requires doses well in excess of the LD50, even when followed by repeated doses of the OPIDN potentiator phenylmethanesulfonyl fluoride (PMSF). Likewise, studies in hens show that subchronic exposures at the maximum tolerated daily dose do not result in OPIDN. Although exposure to chlorpyrifos as a result of normal use is unlikely to produce classical OPIDN, a recent report stated that mild reversible sensory neuropathy had occurred in eight patients who had been exposed subchronically to unknown amounts of chlorpyrifos. It is not clear whether these cases represent an incorrect linkage of cause and effect, a newly disclosed reversible sensory component of OPIDN, or an entirely new phenomenon. The question of the potential for chlorpyrifos to cause this mild sensory neuropathy could be resolved by the use of quantitative tests of sensory function in animal experiments and/or prospective studies of humans with known exposures to chlorpyrifos.

Animals↗