Myasthenia-like syndrome induced by cardiovascular agents. Report of a case

The case of a myasthenia-like syndrome induced by cardiovascular drugs is reported. The clinical and electrophysiological features of the case are discussed.

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Sommario Viene descritto il caso di una sindrome miastenica indotta da farmaci efficaci sul sistema cardiovascolare. Vengono analizzate e discusse le principali caratteristiche cliniche ed elettrofisiologiche del caso.

     

Oral tolerance impairment in mice with staphylococci-induced wasting syndrome.

The effects of staphylococci-induced experimental wasting disease on the immune response of 1 month old CD1 mice were investigated. Animals were separated into different subgroups in order to study their cellular immune competence. Malnutrition of wasted mice was associated with anorexia, diarrhea and weakness. Footpad-injected splenic cells produced normal graft vs. host (GvH) reactions in the popliteal lymph nodes of F1 hybrids. In other experiments, the SRBC intragastric feeding of wasted mice did not cause a tolerant anti-erythrocyte humoral immune response. Three weeks after the staphylococci injections, convalescent erythrocyte-fed wasted mice exhibited an anti-SRBC PFC production similar to that observed in non-tolerant immunized control healthy mice. In return, healthy SRBC-fed control mice showed the specific attenuation of antibody response characteristics of oral tolerance. Differences were found between the immune competence of the undernourished staphylococci-treated wasted mice and those shown by other authors in protein-depleted mice.     

F-wave study at different stimulation rates

In 50 ulnar nerves of healthy subjects, F-wave latency, duration, amplitude and persistence were determined at different frequencies of the antidromic impulse (0.2-0.5-1-2 Hz). The F amplitude and persistence were found significantly increased at higher stimulation rates, suggesting that the frequency of the antidromic impulse influences the motoneuron pool discharges. Individual cross-correlation values (r) obtained for latency and duration, latency and amplitude, amplitude and duration did not show any significant changes at different stimulation rates.     

Autonomously replicating plasmids carrying theAMA1 region inPenicillium chrysogenum

Plasmid vectors containing theAMA1 sequence transformed with high efficiency and replicated autonomously inPenicillium chrysogenum. The efficiency of transformation ofP. chrysogenum was related to the length of theAMA1 fragment used for constructing the different autonomously replicating plasmids. One of the two palindromic inverted repeats ofAMA1 (the 2.2-kbSalI-HindIII fragment) is sufficient to confer autonomous replication and a high transformation efficiency. Deletion of the 0.6-kb central fragment located between the inverted repeats did not affect either the ability of the plasmids to replicate autonomously or the efficiency of transformation, but did alter the mitotic stability and the plasmid copy number. Deletion of any fragment of the 2.2-kb repeat caused the loss of the ability to replicate autonomously and reduced the transformation efficiency. Most of the transformants retained the original plasmid configuration, as multimers and without reorganization, after several rounds of autonomous replication. TheAMA1 region works as an origin of replication inP. chrysogenum andA. nidulans but not apparently inAcremonium chrysogenum.     

Modulation of visual cortical excitability in migraine with aura: effects of 1 Hz repetitive transcranial magnetic stimulation

Recent studies showed hyperexcitability of the occipital cortex in subjects affected by migraine with aura. It has been shown that 1 Hz repetitive transcranial magnetic stimulation (rTMS) reduces excitability of visual cortex in normal subjects. The aim of the study was to investigate the effects of low frequency (1 Hz) rTMS on visual cortical excitability by measuring changes in phosphene threshold (PT) in subjects with migraine with aura. Thirteen patients with migraine with aura and 15 healthy controls were examined. Using a standardized transcranial magnetic stimulation protocol of the occipital cortex, we assessed the PT (the lowest magnetic stimulation intensity at which subjects just perceived phosphenes) before and after a 1-Hz rTMS train delivered at PT intensity for 15 min. The difference in the proportion of subjects reporting phosphenes in migrainer and control groups was significant (migrainers: 100% vs controls 47%; P<0.05), and 1 Hz rTMS over the occipital cortex led to a significantly increased visual cortex excitability expressed as a decrease in PT in subjects affected by migraine with aura. Conversely, after a 1-Hz TMS train normal subjects showed increased PT values, which suggests a decreased visual cortex excitability. Our findings confirm that the visual cortex is hyperexcitable in migrainers and suggest a failure of inhibitory circuits, which are unable to be upregulated by low frequency rTMS.     

Comparison of the activation of the Ca2+ release-activated Ca2+ current I CRAC to InsP3 in Jurkat T-lymphocytes, pulmonary artery endothelia and RBL-1 cells

In many electrically non-excitable cells, Ca2+ entry is mediated predominantly by the store-operated Ca2+ influx pathway. The best-characterised store-operated Ca2+ current is the Ca2+ release-activated Ca2+ current (ICRAC). It is generally believed that high concentrations of intracellular Ca2+ buffer are required to measure ICRAC, due to Ca2+-dependent inactivation of the channels. Recently, we have recorded robust ICRAC in rat basophilic leukaemia (RBL-1) cells at physiological levels of Ca2+ buffering when stores were depleted by inhibition of the sarcoplasmic/ endoplasmic reticulum Ca2+-activated adenosine triphosphatase (SERCA) pumps. However, the second messenger inositol 1,4,5-trisphosphate (InsP3) was not able to evoke the current under such conditions, despite inducing substantial Ca2+ release. We have therefore suggested that a threshold exists within the Ca2+ stores which has to be overcome for macroscopic ICRAC to activate. To establish whether this is a specific feature of ICRAC in RBL-1 cells or whether it is a more general phenomenon, we investigated whether a threshold is also seen in other cell-types used to study store-operated Ca2+ entry. In Jurkat-T lymphocytes, ICRAC is activated weakly by InsP3 in the presence of low concentrations of Ca2+ buffer, whereas the current is large when SERCA pumps are blocked simultaneously, as in RBL-1 cells. Although the electrophysiological properties of ICRAC in the Jurkat cell are very similar to those of RBL-1 cells, the Na+ conductance in the absence of external divalent cations is quite different. Unexpectedly, we failed consistently to record any store-operated Ca2+ current in macrovascular pulmonary artery endothelia whereas robust ICRAC was seen under the same conditions in RBL-1 cells. Our results show that ICRAC has a similar profile of activation in the presence of physiological levels of Ca2+ buffering for Jurkat T-lymphocytes and RBL-1 cells, indicating that the threshold mechanism may be a general feature of ICRAC activation. Because ICRAC in pulmonary artery endothelia is, at best, very small, additional Ca2+ influx pathways may also contribute to agonist-induced Ca2+ entry.     

Phenotypic and functional characterization of the circulating NK compartment in hairy cell leukaemia.

A phenotypic and functional analysis of the circulating natural killer (NK) cell population was carried out in a series of patients with hairy cell leukaemia (HCL). The overall mean NK activity of both the mononuclear and T cell fractions was reduced compared to that of normal controls (466 lytic units (lu) v 573 lu and 226 lu v 381 lu, respectively), though this difference did not reach statistical significance (P less than 0.05). Individual analysis of the data showed that in five out of 15 and in seven out of 16 cases the K562 killing by the mononuclear and T cells respectively was below the lowest s.d. limit for normal subjects. This reduced NK function was associated with a decreased ability of the effector cells to bind the target. The NK response to exogenous human leucocyte interferon was also generally depressed in cases with a low basal NK activity. The functional studies were complemented with the evaluation of the membrane expression of NK associated antigens. The percentage of circulating T cells recognized by the monoclonal antibody (MoAb) Leu-7 was significantly higher (P less than 0.001) in HCL than in normal blood (25.2% +/- 10.2 v 11.9 +/- 5.9 s.d.). However, the reactivity with two other NK-related MoAb, Leu-11 and AB8.28, was significantly lower (7.1% +/- 6.9 and 9.8% +/- 8.5; P less than 0.002) than with Leu-7 and moderately reduced compared with that of normal circulating T cells (11.7% + 6.1 & 12% + 5.5). These findings suggest that in a proportion of patients with HCL there is an impairment of the NK compartment, which may contribute towards the occurrence of the infective complications which are the primary cause of death in this disease.     

Seasonal dynamics of the fecal excretion of Elaphostrongylus cervi (Nematoda, Metastrongyloidea) first-stage larvae in Iberian red deer (Cervus elaphus hispanicus) from southern Spain

Elaphostrongylus cervi (Nematoda, Metastrongyloidea) is an extrapulmonary lungworm of red deer (Cervus elaphus) whose first-stage larvae (L1) require terrestrial gastropods as intermediate hosts. The seasonal pattern of fecal excretion of E. cervi L1 in Iberian red deer (Cervus elaphus hispanicus) was monitored during three annual periods (June 2000–May 2003) on a hunting estate from south-central Spain. The lowest rates of mean intensity of fecal L1 were found in summer, whereas no seasonal variation was found for prevalence. Monthly intensity of excretion was positively associated with early rainfall (the next month) rather than with rainfall of the same month. This seasonal rhythm of E. cervi L1 discharge may be the result of parasite adaptation to the seasonal Mediterranean climate and habitat constraints to improve the chance of parasite transmission. We have standardized the sampling period to compare E. cervi L1 infection rates of Iberian red deer populations in Mediterranean Spain, a natural limit of both the parasite and deer historical ranges, for potential use in the assessment of management strategies.