Steroid‐responsive,progressive, focal measles virus brain infection

Chronic measles virus infection of the brain causes subacute sclerosing panencephalitis (SSPE), a progressive, relentless fatal disorder. We report a 52‐year‐old male who developed focal, chronic persistent measles virus infection of the brain following interferon and ribavirin therapy for hepatitis C, and who responded to steroid therapy. This case, diametrically different from SSPE, has 2 unique features, its focal nature and its permissive response to steroids, that may add to the understanding of the pathogenesis of SSPE and the mechanism enabling viruses to evade the immune response and establish persistent brain infection. Ann Neurol 2014;75:967–970     

Downregulation of GABAA Receptor Protein Subunits α6, β2, δ, ε, γ2, θ, and ρ2 in Superior Frontal Cortex of Subjects with Autism

We measured protein and mRNA levels for nine gamma-aminobutyric acid A (GABA_A) receptor subunits in three brain regions (cerebellum, superior frontal cortex, and parietal cortex) in subjects with autism versus matched controls. We observed changes in mRNA for a number of GABA_A and GABA_B subunits and overall reduced protein expression for GABA_A receptor alpha 6 (GABRα6), GABA_A receptor beta 2 (GABRβ2), GABA_A receptor delta (GABRδ), GABA_A receptor epsilon (GABRε), GABA_A receptor gamma 2 (GABRγ2), GABA_A receptor theta (GABRθ), and GABA_A receptor rho 2 (GABRρ2) in superior frontal cortex from subjects with autism. Our data demonstrate systematic changes in GABA_A&B subunit expression in brains of subjects with autism, which may help explain the presence of cognitive abnormalities in subjects with autism.     

Subsidized dental care for young men: Its impact on utilization and dental health

An important part of Norwegian welfare policy is provision of free dental care for children up to the age of 18. After that age some counties have introduced a public subsidy scheme for young people aged 19–20 years, where 75% of their dental care expenses are covered. After the age of 21, all patients have to pay the costs for dental care themselves. The focus of the present work was to examine the effect that the public subsidy scheme for young adults had on demand for dental care, and its effect on dental health. The analyses were performed on 2 extensive sets of survey data. The major finding was that the public subsidy scheme had no effect on demand for dental care. In addition, there was no relationship between whether these young adults were covered by the subsidy scheme and dental health.     

Endoscopic sphincterotomy and endoscopic fulguration in the management of adenoma of the papilla of Vater

Adenoma of the papilla of Vater is a rare premalignant lesion usually treated by local surgical resection. Five patients with adenomas of the papilla, presenting with obstructive jaundice, underwent endoscopic sphincterotomy with reversal of hepatic biochemistry to normal. Thereafter, four patients underwent local surgical excision. The adenoma recurred in all four patients within six to 18 months after the operation. The recurrent adenomas were eradicated by diathermic fulguration through the endoscope and were not found during a 12 to 24 month follow-up period. Snare polypectomy was performed upon one patient (who refused surgical treatment) who had a flat, broad-based adenoma, with an incomplete resection of the adenoma. This patient had adenocarcinoma of the head of the pancreas develop 40 months later. We conclude that endoscopic sphincterotomy is effective for biliary decompression of adenoma of the papilla of Vater presenting with acute obstructive jaundice. Endoscopic snare polypectomy of the adenoma combined with fulguration may be used as an alternative to surgical treatment in high risk patients.     

Mediation of calcium-independent contraction in trabecular meshwork through protein kinase C and rho-A

PURPOSE. Inhibition of protein kinase C (PKC) and rho-kinase (ROCK) may represent a new way of influencing outflow facility through isolated relaxation of the trabecular meshwork (TM). This work was performed to investigate the existence of calcium-independent contraction in this smooth-muscle-like tissue and its modulation by targeting the rho-guanosine triphosphatase (GTPase)-mediated pathway. METHODS. Isometric tension measurements of bovine TM and ciliary muscle (CM) were performed. Intra- and extracellular calcium buffering was accomplished with EGTA and 1, 2-bis(2-aminophenoxy)-ethane-N,N:,N:,N:',N:'-tetra-acetic acid tetrakis/acetoxymethhyl ester (BAPTA-AM) followed by stimulation of PKC with phorbolester (PMA) or 4alpha-phorbol. Calcium-independent contraction was blocked using the highly specific ROCK inhibitor Y-27632. Western blot analysis and immunoprecipitation was performed using human TM cells. RESULTS. In TM, carbachol induced partial contraction under conditions of extracellular calcium depletion (22. 1% +/- 2.3% versus 100%, n = 9). The membrane-permeable calcium chelator BAPTA-AM completely blocked this response (1.1% +/- 1.4% versus 100%, n = 9). When calcium was completely blocked, PMA induced contraction in TM (16.7% +/- 5.9% versus 100%, n = 9) but not in CM (1.8% +/- 2.5% versus 100%, n = 6). The inactive PMA analogue 4alpha-phorbol did not induce contraction, indicating that activation of PKC is involved in this contractile response. The ROCK inhibitor Y-27632 completely blocked the calcium-independent PMA-induced contraction in TM. Western blot analysis and immunoprecipitation revealed the expression of the rho-A protein in human TM cells. CONCLUSIONS. The data indicate that contrary to CM, the TM features calcium-independent contractile mechanisms linked to rho-A and PKC isoforms that do not require calcium for activation. ROCK inhibitors may allow specific modulation of the TM to enhance outflow facility, thus lowering intraocular pressure.