Rhythmic palatal myoclonus (RPM) is a rare movement disorder consisting of continuous synchronous jerks of the soft palate, muscles innervated by other cranial nerves and, rarely, trunk and limb muscles. It usually develops secondary to brainstem or cerebellar disease (symptomatic RPM). Some patients, however, fail to show evidence of a structural lesion (essential RPM). A total of 287 cases with RPM from the literature including 210 cases with symptomatic and 77 cases with essential RPM have been reviewed and analysed statistically to look for criteria separating the two conditions. Patients with essential RPM usually have objective earclicks as their typical complaint which is rare in the symptomatic form. Eye and extremity muscles are never involved. The jerk frequency is lower in essential than in symptomatic RPM. Patients with essential RPM are younger and have a balanced sex distribution as compared with a male preponderance in the symptomatic form. The rhythmicity of RPM seems to be more profoundly influenced by sleep, coma and general anaesthesia in essential than in symptomatic RPM. We conclude from these results that essential RPM should be separated as a distinct clinical entity. Symptomatic RPM is a rhythmic movement disorder whose pathogenesis is quite well established. The cells of the hypertrophied inferior olives are believed to represent the oscillator. Among other possibilities, essential RPM may represent its functional analogue, based on transmitter changes only. Such a relationship could be of theoretical interest for the understanding of rhythmic hyperkinesias in general.

Sesquiterpene lactones (SLs) are the active compounds of a variety of traditionally used medicinal plants from the Asteraceae family. They are known to possess a considerable antiinflammatory activity in different inflammation models. They inhibit the transcription factor NF-kappaB probably by alkylating cysteine38 in the DNA binding domain of the p65 subunit. Here we investigate a set of 103 different sesquiterpene lactones representing 6 structural groups (44 germacranolides, 16 heliangolides, 22 guaianolides, 9 pseudoguaianolides, 2 hypocretenolides, 10 eudesmanolides) for their NF-kappaB inhibiting properties and the resulting IC(100)-values were submitted to a QSAR study. Properties important for the inhibition potency are discussed for the whole data set and for subsets of the different structural classes.

No abstract

ObjectivesTo analyze risk factors for chylothorax in infants after congenital heart surgery and the efficacy of median chain triglyceride diet (MCT). To develop our therapeutic pathway for the management of chylothorax.Patients and methodsRetrospective review of the institutional surgical database and patient charts including detailed perioperative informations between 1/2000 and 10/2006. Data analyzing with an elimination regression analysis.ResultsTwenty six out of 282 patients had chylothorax (=9.2%). Secondary chest closure, low body weight, small size, longer cardiopulmonary bypass (242 ± 30 versus 129 ± 5 min) and x-clamp times (111 ± 15 versus 62 ± 3 min) were significantly associated with chylothorax (p < 0.05). One patient was cured with total parenteral nutrition (TPN) and one without any treatment. 24 patients received MCT-diet alone, which was successful in 17 patients within 10 days. After conversion to regular alimentation within one week only one chylothorax relapsed. Out of 7 patients primarily not responsive to MCT-diet, 2 were successfully treated by lysis of a caval vein thrombosis, 2 by TPN + pleurodesis + supradiaphragmatic thoracic duct ligation, one by octreotide treatment, and two patients finally died.ConclusionsChylothorax may appear due to injury of the thoracic duct, due to venous or lymphatic congestion, central vein thrombosis, or diffuse injury of mediastinal lymphatic tissue in association with secondary chest closure. Application of MCT alone was effective in 71%, and more invasive treatments like TPN should not be used in primary routine. After resolution of chylothorax, MCT-diet can be converted to regular milk formula within one week and with very low risk of relapse.

Individuals with Parkinson’s disease (PD) mainly suffer from motor impairments which increase the risk of falls and lead to a decline of quality of life. Several studies investigated the long-term effect of dance for people with PD. The aims of the present study were to investigate (i) the short-term effects of dance (i.e., the effect immediately after the dance class) on motor control in individuals with PD and (ii) the long-term effects of 8 months of participation in the weekly dance class on the quality of life of the PD patients and their caregivers. The dance lessons took place in a ballet studio and were led by a professional dancer. Eleven people with moderate to severe PD (58–85 years old) were subjected to a motor and quality of life assessments. With respect to the motor assessments the unified Parkinson disease rating scale III (UPDRS III), the timed up and go test (TUG), and the Semitandem test (SeTa) before and after the dance class were used. With respect to the quality of life and well-being we applied quality of life scale (QOLS) as well as the Westheimer questionnaire. Additionally, we asked the caregivers to fill out the Questionnaire for caregivers. We found a significant beneficial short-term effect for the total score of the UPDRS motor score. The strongest improvements were in rigidity scores followed by significant improvements in hand movements, finger taps, and facial expression. No significant changes were found for TUG and for SeTa. The results of the questionnaires showed positive effects of the dance class on social life, health, body-feeling and mobility, and on everyday life competences of the PD patients. Beneficial effect was also found for the caregivers. The findings demonstrate that dance has beneficial effect on the functional mobility of individuals with PD. Further, dance improves the quality of life of the patients and their caregivers. Dance may lead to better therapeutic strategies as it is engaging and enjoyable.

Ki-67 labeling was quantified in 37 nonmalignant breast tissues and in 63 breast carcinomas by counting ten random high-power fields each in three section planes (RC) or by evaluation of the area with the highest labeling density (HDC). Both procedures proved to be highly correlated (r, = 0.94). Ki-67-positive fractions of the nonmalignant tissues (mean, 2.1% for RC and 4.1% for HDC) were significantly lower as compared with the carcinomas (mean, 14.5% for RC and 17.5% for HDC). In carcinomas the Ki-67 labeling was significantly associated with pT stage, axillary lymph node status, and tumor grading and inversely related to progesterone receptor status. Using the medians of both counting methods (12% for RC and 17% for HDC) as cutoff points, significantly different curves for overall and disease-free survival (median follow-up, 37 months) were obtained. However, Cox multivariate analysis failed to demonstrate an independent effect of Ki-67 labeling. In contrast, Ki-67 reactivity seems to be of independent prognostic value if a higher cutoff level was selected. Cancer 67:421-428, 1991. HE BIOLOGICAL BEHAVIOR of human breast Carci

Chakarov V, Naranjo JR, Schulte-Mö nting J, Omlor W, Huethe F, Kristeva R. Beta-range EEG-EMG coherence with isometric compensation for increasing modulated low-level forces. J Neurophysiol 102: 1115-1120, 2009. First published May 20, 2009 doi:10.1152/jn.91095.2008. Corticomuscular synchronization has been shown to occur in beta (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) and gamma range (30 -45 Hz) during isometric compensation of static and dynamic (periodically modulated) low-level forces, respectively. However, it is still unknown to what extent these synchronization processes in beta and gamma range are modified with increasing modulated force. We addressed this question by investigating the corticomuscular coherence (CMC) between the electroencephalogram (EEG) and electromyogram (EMG) from the first dorsal interosseus muscle (FDI) as well as the cortical and muscular spectral power during a visuomotor task where different levels of a dynamic (modulated) force were used. Seven healthy right-handed female subjects compensated dynamic forces at 8, 16, and 24% of the maximal voluntary contraction (MVC) isometrically with their right index finger. Under the three conditions investigated, we found a broad-band CMC comprising both beta and gamma range and peaking at ϳ22 Hz within the beta band. This broad-band coherence increased linearly with higher force level. A separate analysis of the gamma range CMC did not show significant modulation of the CMC by the force levels. EEG and EMG spectral power did not show any significant difference among the three force conditions. Our results favor the view that the function of beta range CMC is not specific for low-level static forces only. The sensorimotor system may resort to stronger and also broader beta-range CMC to generate stable corticospinal interaction during increased force level, as well as when compensating for dynamic modulated forces. This finding re-enforces the importance of the beta-range EEG-EMG coherence in sensorimotor integration. I N T R O D U C T I O NMuch attention has been given to the functional organization of the corticospinal system and the mechanisms of muscle control by the CNS and in particular to the universal mechanism of neuronal interaction via synchronization, which plays a relevant role in the effective coordination between the cortical motor areas and the muscles. This synchronization mechanism can be described by the coherence function for different frequency ranges. During maintained motor contraction the cortical motor areas and the muscles are synchronized in beta-range as shown in monkeys (Baker et al. 1997(Baker et al. , 1999 Fetz 1992, 1996) (Perez et al. 2006). Based on the finding that increased beta-range CMC and better performance are correlated, we suggested the betarange CMC as a mechanism for effective corticospinal interaction during static forces .Because one of the main functions of the motor cortex is to control force output (Ashe 1997), modulation of the beta-range CMC by different stati...

No abstract