Novel twelve-generation kindred of fatal familial insomnia from germany representing the entire spectrum of disease expression

We present a novel large German kindred of fatal familial insomnia (FFI) consisting of three branches and comprising more than 800 individuals of 12 generations, the largest pedigree of any familial prion disease known today. There is a wide spectrum of clinical presentations leading to misdiagnoses of Olivo-Ponto-Cerebellar Atrophy (OPCA), Parkinson's or Alzheimer's disease in addition to Creutzfeldt-Jakob disease (CJD) and Gerstmann-Str?ussler-Scheinker (GSS) syndrome. Molecular genetic analysis of the prion protein gene (PRNP) confirmed the mutation D178N segregating with methionine at the polymorphic codon 129 of PRNP in all 7 patients examined. This polymorphism at codon 129 is supposed to discriminate between familial CJD (fCJD) and FFI; the 129M allele determines FFI and 129V fCJD. Furthermore, heterozygosity at this site appears to induce prolonged disease duration as compared to the homozygous condition. The variability of the clinical and pathological findings documented for our patients indicates the difficulty in establishing the diagnosis of FFI on clinical and on pathological grounds alone. In three cases (IX-97, XI-21, V-2) followed up by us prospectively insomnia was an early and severe symptom; however, in case notes analyzed retrospectively this symptom was frequently missed. In contrast to previous reports and in agreement with recent studies we cannot confirm a clear relationship between the status of the M/V polymorphism at codon 129 and the age-of-onset of this disease.     

Zur Polypeptidketten-Struktur von Immunglobulinen

Zusammenfassung Individuelle normale IgG wurden isoelektrisch in eine Vielzahl von Komponenten getrennt, deren IP zwischen pH 5,5 und 9,5 lagen. Im Gegensatz dazu focussierten individuelle Myelom IgG einheitlich. Die isoelektrischen Punkte dieser Paraproteine unterschieden sich untereinander stark, verteilten sich alle zusammen jedoch ebenfalls über den pH-Bereich 5–9. Dieser Befund entspricht der Auffassung, daß diese Paraproteine normale Immunglobuline repräsentieren.Ähnliche Ergebnisse hatte die Fraktionierung der L- und H-Polypeptidketten. Während normale L- und H-Ketten eine ausgeprägte Heterogenität aufwiesen, waren die IgG-L- und H-Ketten von Myelomproteinen einheitlich. Mittels gleichzeitiger Anwendung der PAA-Elektrophorese, quantitativen Aminosäurenanalyse, Endgruppenbestimmung und anderer protein-chemischer Methoden konnte gezeigt werden, daß im Falle der L-Ketten sowohl die Aminosäureverteilung als auch die Konfiguration das unterschiedliche isoelektrische Verhalten bedingt. Die Anwendung der isoelektrischen Analyse für den Nachweis von Rekombinatbildungen aus L- und H-Ketten wurde gezeigt.

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Summary Myeloma IgG and its light and heavy polypeptide chains were subjected to isoelectric focusing in a vertical column containing a combined pH and density gradient. The results have been compared to those obtained by isoelectric separation of normal individual IgG and its polypeptide chains. In carrier ampholytes of two pH steps each individual myeloma globulin was focused in only one fraction, but the isoelectric points of all myeloma globulins were distributed between pH 5 and pH 9. In contrast to these results each normal individual IgG was electrofocused in a multiplicity of isoelectric fractions exhibiting the same pH range from pH 5 to pH 9. Similar results were obtained by the analysis of light and heavy polypeptide chains. A remarkable degree of heterogeneity could be demonstrated in normal and a homogenous isoelectric pattern in myeloma IgG polypepide chains. By polyacrylamide-gel-electrophoresis it could be demonstrated that a direct proportionality of isoelectric point and electrophoretic mobility in polyacrylamide-gel did'nt exist. By the quantitative aminoacid determination, endgroup analysis and other physico-chemical methods it could be shown, that differences in the isoelectric point of L-chains are not exclusively caused by differences in the amino acid composition. The use of isoelectric focusing for the analysis of L- and H-chains recombination has been demonstrated.

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Wir danken der Deutschen Forschungsgemeinschaft für ihre Unterstützung.     

Dose-response relationship for a positive inotropic effect of insulin on isolated papillary muscle

Summary Beneficial effect of glucose and insulin on the myocardium are still a matter of discussion. The influence of insulin on isometric force of contraction of right ventricular papillary muscles of guinea pigs war studied. The papillary muscles were mounted vertically in a 95% O₂, 5% CO₂ modified Krebs-Hensuleit solution (31.5° C, 5.5 mM glucose) and stimulated 1/s. A positive inotropic effect of insulin was dedectable at a concentration of 5×10^–4 IU/ml insulin, was half maximal (52% above controle force of contraction) at 8×10^–3 IU/ml and maximal at 10^–1 IU/ml. The maximal positive inotropic effect was observed 4.7±0.6 min after addition of insulin. After the maximum there was a decrease to a steady state level of 109.8±8.5% of control (p<0.05) in 14.6±1.3 min. Higher glucose (16.5 mM) only shifted the half maximal positive inotropic effect to 5.5×10^–3 IU/ml insulin (n.s.). Inhibition of glycolysis with hypoxia or jodoacetate (5×10^–5 M) did not prevent the positive inotropic effect as known as 75% of control force was retained. When glucose transport was blocked with phlorizin (5×10^–3 M) or phloritin (5×10^–4 M) no positive inotropic action of insulin was observed. Therefore we conclude that the positive inotropic effect of insulin in isolated papillary muscles is mediated by inhanced glucose transport.     

Artifact analysis of approximate helical cone-beam CT reconstruction algorithms

In this paper, four approximate cone-beam CT reconstruction algorithms are compared: Advanced single slice rebinning (ASSR) as a representative of algorithms employing a two dimensional approximation, PI, PI-SLANT, and 3-PI which all use a proper three dimensional back-projection. A detailed analysis of the image artifacts produced by these techniques shows that aliasing in the z-direction is the predominant source of artifacts for a 16-row scanner with 1.25 mm nominal slice thickness. For a detector with isotropic resolution of 0.5 mm, we found that ASSR and PI produce different kinds of artifacts which are almost at the same level, while PI-SLANT produces none of these artifacts. It is shown that the use of redundant data in the 3-PI method suppresses aliasing artifacts efficiently for both scanners.     

Ninth International Histocompatibility pre-workshop testing of Dw6 HTCs. Two subtypes of Dw6

In the scope of the cellular part of the 9th International Histocompatibility Workshop, the offered homozygous typing cells (HTCs) of several specificities have been screened in a pre-Workshop. In Leiden and Seattle all HTCs typing for "HLA-Dw6" have been tested. This implied that in both laboratories mixed lymphocyte culture (MLC) matrices were performed between the Dw6 HTCs and that all HTCs were tested as stimulator cells against a panel of heterozygous responder cells. The results clearly demonstrated that "HLA-Dw6" as defined by the different participating laboratories can be split into two major groups, Dw6.a and Dw6.b. This observation confirms and extends previous reports. None of the 9th Workshop B-cell sera could discriminate between the two presently described subgroups of HLA-Dw6.