Phonetic tone signals quantity and word structure

Many languages exploit suprasegmental devices in signaling word meaning. Tone languages exploit fundamental frequency whereas quantity languages rely on segmental durations to distinguish otherwise similar words. Traditionally, duration and tone have been taken as mutually exclusive. However, some evidence suggests that, in addition to durational cues, phonological quantity is associated with and co-signaled by changes in fundamental frequency in quantity languages such as Finnish, Estonian, and Serbo-Croat. The results from the present experiment show that the structure of disyllabic word stems in Finnish are indeed signaled tonally and that the phonological length of the stressed syllable is further tonally distinguished within the disyllabic sequence. The results further indicate that the observed association of tone and duration in perception is systematically exploited in speech production in Finnish.

Quantity and tone in Finnish lexically stressed syllables

This paper presents results from a study on the tonal aspects of quantity in Finnish lexically stressed syllables. Fourteen speakers produced a set of 66 utterances where the quantity and structure of the lexically stressed syllable was system- atically varied. The tonal aspects of the syllable nucleus and nucleus and coda in case of closed syllables was stud- ied in the framework of the Target Approximation theory as formulated by Yi Xu. The results show a clear tendency to- wards the quantity distinction and bimoracity in general in Finnish to be signalled tonally by a dynamic falling tone as opposed to a static high tone in short (one mora) nuclei.

Preliminary Phonological Analysis of Denjongka of Sikkim

This thesis is a preliminary phonological description of the Tibetan-related Denjongka language of Sikkim, India. Because the language has not been much researched and the previous studies have focused on other issues than phonology, the present paper is the first of its kind. The data for this thesis was gathered in Gangtok, the capital of Sikkim, from March to May 2004. I had four language informants from four different locations in Sikkim who spoke different dialects of Denjongka. One of the informants, from whom I recorded c. 900 words and 530 sentences, was used as the main data source for the analysis. First, I will give some ethnographic background information on the people who speak Denjongka. Next, I will discuss first the segmental and then the suprasegmental phonology of the language, which were analysed much in line with American structuralism. I also used acoustic analysis enabled by the Praat-program. Eight vowel phonemes were found. The phonemic status of /E/, however, is still suspect. I present some preliminary evidence for roundedness, frontness and height assimilation among the vowels. In the interpretation adopted in this analysis, there are no diphthongs in Denjongka. Forty consonant phonemes were found: 17 plosives, 7 affricates, 5 fricatives, 5 nasals, 4 liquids and 2 approximants. Denjongka plosives and affricates have four-way aspiration/voicing distinction: voiceless aspirated, voiceless unaspirated, voiceless slightly aspirated (devoiced), and voiced unaspirated. Two voiceless nasals and two voiceless liquids were found. Two phonation types were found to be contrastive, lax/breathy and tense/creaky. Nasalisation and length in vowels are phonemic. Denjongka is an incipient tone language. Tonal phenomena, which involve mainly pitch and phonation type, are complex. Pitch is most of the time predictable from the initial consonant and the phonation type. In some cases, however, pitch is the only contrastive feature between words. The description of Denjongka in this paper differs from the traditional four-tone system, which has been used in many descriptions of Tibetan-related languages. In the four-tone system, pitch is contrastive both in the high and low register, whereas in the present analysis pitch has been established to contrast only in the high register. Lastly, the appendices include a comparative word list of the four Denjongka dialects studied in this thesis.

Pathet : Musiikin symboliikka jaavalaisessa varjoteatterissa

The aim of this study is to define and analyse the symbolism hidden in the gamelan music of the Central Javanese, especially in the Yogyakartanese wayang kulit shadow theatre. This dissertation is divided into two parts. The first part deals with the theory, history and practice of Central Javanese shadow theatre. It also presents the tone symbol theory on which this study is based of B. Y. H. Sastrapustaka, the court servant and musician of the sultan s palace of Yogyakarta. For historical comparison, other theories and phenomena that seem to have some connections with the previously mentioned tone symbol theory are presented here as well as the equipment of the shadow theatre, its music, musical instruments and the shadow theatre in general in literature. The theoretic-methodological basis of the study is an enlarged model of research of cultural music, in which a person in the centre of the model with his/her concepts and by his/her behaviour creates a work of art and receives criticism through feedback, while the process of reciprocal action dynamically affects the whole development of the culture in question. In connection with the concepts of the work of art, the manner of approach of this study is also semiotic as the tone symbol theory gives a particular meaning to each musical note. Thus the purpose of this study is to find answers to how the tone symbol theory manifests itself in practical music making, what its origin is, if it is well known or not, and whether shadow theatre music supports this theory. The second part of this dissertation deals with material collected through interviews and observations as well as representative samples of musical pieces for shadow theatre and their analyses. In relation to this a special tool for analysing gamelan music, developed for the purpose of this study, is also presented. Sufficiently versatile material on the essence and meaning of the shadow theatre collected from many puppet masters of an older generation, many of whom are no longer with us, constitutes an important part of this study. This study proves that the tone symbol theory of Sastrapustaka is of tantristic tradition from the Hindu-Javanese period before the 16th century and before the appearance of Islam in Java. The variants of the previously mentioned theory can be found also in other fields of Javanese advanced civilization, such as architecture and dance. But it seems that knowledge about the tone symbolism connected to the shadow theatre especially has only been preserved in the sultan s palace of Yogyakarta and its intimate circles. The outsider puppet masters surely follow the theory, but they do not necessarily know its origin. As a result of the musical analysis, it is obvious that the musical pieces used for the shadow theatre bear different kinds of symbolic meanings which only an initiated person can feel and understand. These meanings are closely related to the plot of the play at the moment.

A sequential analysis of "nú" and "núna" in Icelandic conversation

This thesis is an empirical study of how two words in Icelandic, "nú" and "núna", are used in contemporary Icelandic conversation. My aims in this study are, first, to explain the differences between the temporal functions of "nú" and "núna", and, second, to describe the non-temporal functions of "nú". In the analysis, a focus is placed on comparing the sequential placement of the two words, on their syntactical distribution, and on their prosodic realization. The empirical data comprise 14 hours and 11 minutes of naturally occurring conversation recorded between 1996 and 2003. The selected conversations represent a wide range of interactional contexts including informal dinner parties, institutional and non-institutional telephone conversations, radio programs for teenagers, phone-in programs, and, finally, a political debate on television. The theoretical and methodological framework is interactional linguistics, which can be described as linguistically oriented conversation analysis (CA). A comparison of "nú" and "núna" shows that the two words have different syntactic distributions. "Nú" has a clear tendency to occur in the front field, before the finite verb, while "núna" typically occurs in the end field, after the object. It is argued that this syntactic difference reflects a functional difference between "nú" and "núna". A sequential analysis of "núna" shows that the word refers to an unspecified period of time which includes the utterance time as well as some time in the past and in the future. This temporal relation is referred to as reference time. "Nú", by contrast, is mainly used in three different environments: a) in temporal comparisons, 2) in transitions, and 3) when the speaker is taking an affective stance. The non-temporal functions of "nú" are divided into three categories: a) "nú" as a tone particle, 2) "nú" as an utterance particle, and 3) "nú" as a dialogue particle. "Nú" as a tone particle is syntactically integrated and can occur in two syntactic positions: pre-verbally and post-verbally. I argue that these instances are employed in utterances in which a speaker is foregrounding information or marking it as particularly important. The study shows that, although these instances are typically prosodically non-prominent and unstressed, they are in some cases delivered with stress and with a higher pitch than the surrounding talk. "Nú" as an utterance particle occurs turn-initially and is syntactically non-integrated. By using "nú", speakers show continuity between turns and link new turns to prior ones. These instances initiate either continuations by the same speaker or new turns after speaker shifts. "Nú" as a dialogue particle occurs as a turn of its own. The study shows that these instances register informings in prior turns as unexpected or as a departure from the normal state of affairs. "Nú" as a dialogue particle is often delivered with a prolonged vowel and a recognizable intonation contour. A comparative sequential and prosodic analysis shows that in these cases there is a correlation between the function of "nú" and the intonation contour by which it is delivered. Finally, I argue that despite the many functions of "nú", all the instances can be said to have a common denominator, which is to display attention towards the present moment and the utterances which are produced prior or after the production of "nú". Instead of anchoring the utterances in external time or reference time, these instances position the utterance in discourse internal time, or discourse time.

Rauta ja Ristilukki : Vilho Helasen salapoliisiromaanisarja

Vilho Helanen (1899 1952) was a right-wing opinion leader in interwar Finland. But following the Second World War, the political situation in the country changed dramatically, and Helanen lost his job as well as his influential social station. He began to write detective fiction, and between 1946 and 1952 published seven novels (one had already been published in 1941). The novels protagonist is Kaarlo Rauta, a lawyer who acts as a private investigator. This doctoral dissertation analyzes the Rauta series from three different points of view. It investigates the extent to which the author s life and his strong political background appears in the series. The study also situates the series within Finnish society during and after the war. Finally, the study examines the Rauta series in terms of the genre conventions of detective fiction, that is, the study compares the Rauta series with other Finnish crime fiction and international crime fiction written during the 1940s. The Iron and The Cross Spider uses the term citizenship education when analyzing how Helanen implicitly continued his political teaching when writing crime fiction. The series includes a didactic register, which instructs the middle class in appropriate behaviour and manners, and the social roles entailed by gender. A special area of focus in this didacticism are norms of correct masculinity and femininity. The study devotes specific attention to the status of character in the series. The masculine detective and his beautiful wife are prominent, as is the fictive community and the tensions that criss-cross it. After the war, the Rauta series takes on a positive tone. Men can earn their place in society by fighting at the front, and after the war a homosocial bond exists between all the former soldiers. Women are shut out of the war experience. The detective hero has served in the war, but he is physically and psychologically untouched by it. The community is threatened by artists and immoral bohemians, but not the working class. Artists have affairs outside of marriage and abnormal sexual habits. The members of the upper class are also described as immoral in the series. Sadistic sexuality is often characteristic of the criminals, who are mostly femme fatales in the fashion of hard-boiled detective stories and film noir. Also, strong feelings have a negative connotation in the series, and showing them is forbidden behaviour. Men become criminals when they are insufficiently masculine or when they have not carried out their duty by fighting in the war. Helanen portrayed the communists, his political opponents from the 1930s, as criminals in his post-war series, but they were not openly represented as Russians or communists. Instead, Helanen used the cross spider as their symbol, a symbol which the readers of the time would recognize.

Aivojen jännitevasteiden rekisteröinti useaan äänen piirteeseen yhdellä mittauskerralla terveillä musiikkileikkikoulua käyvillä kaksivuotiailla

The early detection of hearing deficits is important to a child's development. However, examining small children with behavioural methods is often difficult. Research with ERPs (event-related potentials), recorded with EEG (electroencephalography), does not require attention or action from the child. Especially in children's ERP research, it is essential that the duration of a recording session is not too long. A new, faster optimum paradigm has been developed to record MMN (mismatch negativity), where ERPs to several sound features can be recorded in one recording session. This substantially shortens the time required for the experiment. So far, the new paradigm has been used in adult and school-aged children research. This study examines if MMN, LDN (late discriminative negativity) and P3a components can be recorded in two-year-olds with the new paradigm. The standard stimulus (p=0.50) was an 80 dB harmonic tone consisting of three harmonic frequencies (500 Hz, 1000 Hz and 1500 Hz) with a duration of 200 ms. The loudness deviants (p=0.067) were at a level of +6 dB or -6 dB compared to the standards. The frequency deviants (p=0.112) had a fundamental frequency of 550 or 454.4 Hz (small deviation), 625 or 400 Hz (medium deviation) or 750 or 333.3 Hz (large deviation). The duration deviants (p=0.112) had a duration of 175 ms (small deviation), 150 ms (medium deviation) or 100 ms (large deviation). The direction deviants (p=0.067) were presented from the left or right loudspeaker only. The gap deviant (p=0.067) included a 5-ms silent gap in the middle of the sound. Altogether 17 children participated in the experiment, of whom the data of 12 children was used in the analysis. ERP components were observed for all deviant types. The MMN was significant for duration and gap deviants. The LDN was significant for the large duration deviant and all other deviant types. No significant P3a was observed. These results indicate that the optimum paradigm can be used with two-year-olds. With this paradigm, data on several sound features can be recorded in a shorter time than with the previous paradigms used in ERP research.

Koko talo soi : Klemetti-Opisto suomalaisen musiikkikulttuurin kehittäjänä 1953-1968

This study aims to examine the operations and significance of the Klemetti Institute (Klemetti-Opisto) as a developer of Finnish music culture from 1953 to 1968 during the term of office of the Institute s founder and first director, Arvo Vainio. The Klemetti Institute was originally established as a choir institute, but soon expanded to offer a wide range of music courses. In addition to providing courses for choir leaders and singers, the Institute began its orchestral activities as early as the mid-1950s. Other courses included ear training seminars as well as courses for young people s music instructors and in playing the kantele (a Finnish string instrument) and solo singing. More than 20 types of courses were offered over the 16-year period. The Klemetti Institute s courses were incorporated into the folk high school courses offered by the Orivesi Institute (Oriveden Opisto) and were organised during the summer months of June and July. In addition to funding based on the Folk High School Act, financial assistance was obtained from various foundations and funds, such as the Wihuri Foundation. This study is linked to the context of historical research. I examine the Klemetti Institute s operations chronologically, classifying instruction into different course types, and analyse concert activities primarily in the section on the Institute s student union. The source material includes the Klemetti Institute archives, which consist of Arvo Vainio s correspondence, student applications, register books and cards, journals and student lists, course albums and nearly all issues of the Klemettiläinen bulletin. In addition, I have used focused interviews and essays to obtain extensive data from students and teachers. I concentrate on primary school teachers, who accounted for the majority of course participants. A total of more than 2,300 people participated in the courses, nearly half of whom took courses during at least two summers. Primary school teachers accounted for 50% to 70% of the participants in most courses and constituted an even larger share of participants in some courses, such as the music instructor course. The Klemetti Institute contributed to the expansion throughout Finland of a new ideal for choral tone. This involved delicate singing which strives for tonal purity and expressiveness. Chamber choirs had been virtually unheard of in Finland, but the Klemetti Institute Chamber Choir popularised them. Chamber choirs are characterised by an extensive singing repertoire ranging from the Middle Ages to the present. As the name suggests, chamber choirs were originally rather small mixed choirs. Delicate singing meant the avoidance of extensive vibrato techniques and strong, heavy forte sounds, which had previously been typical of Finnish choirs. Those opposing and shunning this new manner of singing called it ghost singing . The Klemetti Institute s teachers included Finland s most prominent pedagogues and artists. As the focused essays, or reminiscences as I call them, show, their significance for the students was central. I examine extensively the Klemetti Institute s enthusiastic atmosphere, which during the early years was characterised by what some writers described as a hunger for music . In addition to distributing a new tonal ideal and choir repertoire, the Klemetti Institute also distributed new methods of music education, thus affecting the music teaching of Finnish primary schools, in particular. The Orff approach, which included various instruments, became well known, although some of Orff s ideas, such as improvisation and physical exercise, were initially unfamiliar. More important than the Orff approach was the in-depth teaching at the Klemetti Institute of the Hungarian ear training method known as the Kodály method. Many course participants were among those launching specialist music classes in schools, and the method became the foundation for music teaching in many such schools. The Klemetti Institute was also a pioneer in organising orchestra camps for young people. The Klemetti Institute promoted Finnish music culture and played an important role in the continuing music education of primary school teachers. Keywords: adult education, Grundtvigian philosophy, popular enlightenment, Klemetti Institute, Kodály method, choir singing, choir conducting, music history, music education, music culture, music camp, Orff approach, Orff-Schulwerk, Orivesi Institute, instrument teaching, free popular education, communality, solo singing, voice production

The role of catechol-O-methyltransferase (COMT) and the effects of COMT inhibition in brain and in cardiovascular and renal pathophysiology

Catechol-O-methyltransferase (COMT) metabolizes catecholamines such as dopamine (DA), noradrenaline (NA) and adrenaline, which are vital neurotransmitters and hormones that play important roles in the regulation of physiological processes. COMT enzyme has a functional Val158Met polymorphism in humans, which affects the subjects COMT activity. Increasing evidence suggests that this functional polymorphism may play a role in the etiology of various diseases from schizophrenia to cancers. The aim of this project was to provide novel biochemical information on the physiological and especially pathophysiological roles of COMT enzyme as well as the effects of COMT inhibition in the brain and in the cardiovascular and renal system. To assess the roles of COMT and COMT inhibition in pathophysiology, we used four different study designs. The possible beneficial effects of COMT inhibition were studied in double-transgenic rats (dTGRs) harbouring human angiotensinogen and renin genes. Due to angiotensin II (Ang II) overexpression, these animals exhibit severe hypetension, cardiovascular and renal end-organ damage and mortality of approximately 25-40% at the age of 7-weeks. The dTGRs and their Sprague-Dawley controls tissue samples were assessed with light microscopy, immunohistochemistry, reverse transcriptase-polymerase chain reaction (RT-PCR) and high-pressure liquid chromatography (HPLC) to evaluate the tissue damages and the possible protective effects pharmacological intervention with COMT inhibitors. In a second study, the consequence of genetic and pharmacological COMT blockade in blood pressure regulation during normal and high-sodium was elucidated using COMT-deficient mice. The blood pressure and the heart rate were measured using direct radiotelemetric blood pressure surveillance. In a third study, the effects of acute and subchronic COMT inhibition during combined levodopa (L-DOPA) + dopa decarboxylase inhibitor treatment in homocysteine formation was evaluated. Finally, we assessed the COMT enzyme expression, activity and cellular localization in the CNS during inflammation-induced neurodegeneration using Western blotting, HPLC and various enzymatic assays. The effects of pharmacological COMT inhibition on neurodegeneration were also studied. The COMT inhibitor entacapone protected against the Ang II-induced perivascular inflammation, renal damage and cardiovascular mortality in dTGRs. COMT inhibitors reduced the albuminuria by 85% and prevented the cardiovascular mortality completely. Entacapone treatment was shown to ameliorate oxidative stress and inflammation. Furthermore, we established that the genetic and pharmacological COMT enzyme blockade protects against the blood pressure-elevating effects of high sodium intake in mice. These effects were mediated via enhanced renal dopaminergic tone and suggest an important role of COMT enzyme, especially in salt-sensitive hypertension. Entacapone also ameliorated the L-DOPA-induced hyperhomocysteinemia in rats. This is important, since decreased homocysteine levels may decrease the risk of cardiovascular diseases in Parkinson´s disease (PD) patients using L-DOPA. The Lipopolysaccharide (LPS)-induced inflammation and subsequent delayed dopaminergic neurodegeneration were accompanied by up-regulation of COMT expression and activity in microglial cells as well as in perivascular cells. Interestingly, similar perivascular up-regulation of COMT expression in inflamed renal tissue was previously noted in dTGRs. These results suggest that inflammation reactions may up-regulate COMT expression. Furthermore, this increased glial and perivascular COMT activity in the central nervous system (CNS) may decrease the bioavailability of L-DOPA and be related to the motor fluctuation noted during L-DOPA therapy in PD patients.

Der Prediger vom weißen Berg : Zur Rezeption der besseren Gerechtigkeit aus Mt 5 in Martin Luthers Predigtüberlieferung 1522 1546.

The purpose of this study is to examine the reception of Matthew 5 in Martin Luther s sermons; in other words to investigate how Luther interprets and applies Jesus teaching of the better righteousness and the law in Mt 5. The study applies the reception-historical approach and contributes to the history of effects and the history of interpretation in New Testament exegesis. The study shows that Luther understands the better righteousness of Mt 5 as good works and fulfillment of the law. Luther s interpretation coheres with the intention of the Evangelist, even if Luther s overall concept of righteousness is foreign to Matthew. In Luther s view righteousness is twofold: The greater righteousness of Mt 5 is the second and the actual righteousness (iustitia activa), which follows the first and the foreign righteousness (iustitia passiva). The first righteousness (faith) is for Luther the work of God, while the second righteousness (good works) is co-operation between a Christian and God. In this co-operation the law, as it is taught by Jesus, is not the opposite of the gospel, but the gospel itself in the sense of Christ as an example . The task of the law is to show the dependence of a Christian on God and to help one to love and to serve one s neighbour (brothers as well as enemies) properly. The study underlines a feature in Luther s thinking that has received little attention in Lutheran theology: Luther insists on preaching the law to Christians. In his view Mt 5 is directed to all Christians and particularly to pastors, for whom Jesus here gives an example of how to preach the law. Luther believes similarly to Matthew that Jesus reveals the real meaning of Mosaic Law and confirms its validity for Christians in Mt 5. Like Matthew, Luther insists on the practicability of the commandments of Mt 5 in his view Christians fulfil the law also with joy yet his interpretation of Mt 5 attenuates the radical nature of its commandments. Luther s reception of the individual pericopes of Mt 5 is considerably generative and occasionally contradictory, which is explained by the following factors, among others: Luther receives many ideas from tradition and reads them and his own theological concepts into Matthew s Gospel. He interprets Mt 5 through his understanding of some Old Testament passages as well as Paul. Most of all, Luther s reception of Mt 5 is shaped by his own experience as a preacher, by his relation to his religious enemies, rulers and to the congregation of Wittenberg. Here Luther shares with Matthew the experience of being opposed and concern about the upright living of the believers, which in both cases also explains the polemical tone of the paraenesis.

GDNF family receptors in peripheral target innervation and hormone production

Glial cell line-derived neurotrophic factor (GDNF) family ligands: GDNF, neurturin, persephin and artemin, signal through a receptor tyrosine kinase Ret by binding first to a co-receptor (GFRα1-4) that is attached to the plasma membrane. The GDNF family factors can support the survival of various peripheral and central neuronal populations and have important functions also outside the nervous system, especially in kidney development. Activating mutations in the RET gene cause tumours in neuroendocrine cells, whereas inactivating mutations in RET are found in patients with Hirschsprung s disease (HSCR) characterized by loss of ganglionic cells along the intestine. The aim of this study was to examine the in vivo functions of neurturin receptor GFRα2 and persephin receptor GFRα4 using knockout (KO) mice. Mice lacking GFRα2 grow poorly after weaning and have deficits in parasympathetic and enteric innervation. This study shows that impaired secretion of the salivary glands and exocrine pancreas contribute to growth retardation in GFRα2-KO mice. These mice have a reduced number of intrapancreatic neurons and decreased cholinergic innervation of the exocrine pancreas as well as reduced excitatory fibres in the myenteric plexus of the small intestine. This study also demonstrates that GFRα2-mediated Ret signalling is required for target innervation and maintenance of soma size of sympathetic cholinergic neurons and sensory nociceptive IB4-binding neurons. Furthermore, lack of GFRα2 in mice results in deficient perception of temperatures above and below thermoneutrality and in attenuated inflammatory pain response. GFRα4 is co-expressed with Ret predominantly in calcitonin-producing thyroid C-cells in the mouse. In this study GFRα4-deficient mice were generated. The mice show no gross developmental deficits and have a normal number of C-cells. However, young but not adult mice lacking GFRα4 have a lower production of calcitonin in thyroid tissue and consequently, an increased bone formation rate. Thus, GFRα4/Ret signalling may regulate calcitonin production. In conclusion, this study reveals that GFRα2/Ret signalling is crucial for the development and function of specific components of the peripheral nervous system and that GFRα4-mediated Ret signalling is required for controlling transmitter synthesis in thyroid C-cells.

CADASIL: molecular studies on the most common hereditary vascular dementing disorder

Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is the most common hereditary vascular dementia. CADASIL is a systemic disease of small and medium-sized arteries although the symptoms are almost exclusively neurological, including migraineous headache, recurrent ischemic episodes, cognitive impairment and, finally, subcortical dementia. CADASIL is caused by over 170 different mutations in the NOTCH3 gene, which encodes a receptor expressed in adults predominantly in the vascular smooth muscle cells. The function of NOTCH3 is not crucial for embryonic development but is needed after birth. NOTCH3 directs postnatal arterial maturation and helps to maintain arterial integrity. It is involved in regulation of vascular tone and in the wound healing of a vascular injury. In addition, NOTCH3 promotes cell survival by inducing expression of anti-apoptotic proteins. NOTCH3 is a membrane-spanning protein with a large extracellular domain (N3ECD) containing 34 epidermal growth factor-like (EGF) repeats and a smaller intracellular domain with six ankyrin repeats. All CADASIL mutations are located in the EGF repeats and the majority of the mutations cause gain or loss of one cysteine residue in one of these repeats leading to an odd number of cysteine residues, which in turn leads to misfolding of N3ECD. This misfolding most likely alters the maturation, targetting, degradation and/or function of the NOTCH3 receptor. CADASIL mutations do not seem to affect the canonical NOTCH3 signalling pathway. The main pathological findings are the accumulation of the NOTCH3 extracellular domain on degenerating vascular smooth muscle cells (VSMCs), accumulation of granular osmiophilic material (GOM) in the close vicinity of VSMCs as well as fibrosis and thickening of arterial walls. Narrowing of the arterial lumen and local thrombosis cause insufficient blood flow, mainly in small arteries of the cerebral white matter, resulting in tissue damage and lacunar infarcts. CADASIL is suspected in patients with a suggestive family history and clinical picture as well as characteristic white matter alterations in magnetic resonance imaging. A definitive verification of the diagnosis can be achieved by identifying a pathogenic mutation in the NOTCH3 gene or through the detection of GOM by electron microscopy. To understand the pathology underlying CADASIL, we have generated a unique set of cultured vascular smooth muscle cell (VSMC) lines from umbilical cord, placental, systemic and cerebral arteries of CADASIL patients and controls. Analyses of these VSMCs suggest that mutated NOTCH3 is misfolded, thus causing endoplasmic reticulum stress, activation of the unfolded protein response and increased production of reactive oxygen species. In addition, mutation in NOTCH3 causes alterations in actin cytoskeletal structures and protein expression, increased branching and abnormal node formation. These changes correlate with NOTCH3 expression levels within different VSMCs lines, suggesting that the phenotypic differences of SMCs may affect the vulnerability of the VSMCs and, therefore, the pathogenic impact of mutated NOTCH3 appears to vary in the arteries of different locations. Furthermore, we identified PDGFR- as an immediate downstream target gene of NOTCH3 signalling. Activation of NOTCH induces up-regulation of the PDGFR- expression in control VSMCs, whereas this up-regulation is impaired in CADASIL VSMCs and might thus serve as an alternative molecular mechanism that contributes to CADASIL pathology. In addition, we have established the congruence between NOTCH3 mutations and electron microscopic detection of GOM with a view to constructing a strategy for CADASIL diagnostics. In cases where the genetic analysis is not available or the mutation is difficult to identify, a skin biopsy is an easy-to-perform and highly reliable diagnostic method. Importantly, it is invaluable in setting guidelines concerning how far one should proceed with the genetic analyses.

Genotype-Phenotype Relationships in Long QT Syndrome: Role of Mental Stress, Adrenergic Activity and a Common KCNH2 Polymorphism

Long QT syndrome is a congenital or acquired arrhythmic disorder which manifests as a prolonged QT-interval on the electrocardiogram and as a tendency to develop ventricular arrhythmias which can lead to sudden death. Arrhythmias often occur during intense exercise and/or emotional stress. The two most common subtypes of LQTS are LQT1, caused by mutations in the KCNQ1 gene and LQT2, caused by mutations in the KCNH2 gene. LQT1 and LQT2 patients exhibit arrhythmias in different types of situations: in LQT1 the trigger is usually vigorous exercise whereas in LQT2 arrhythmia results from the patient being startled from rest. It is not clear why trigger factors and clinical outcome differ from each other in the different LQTS subtypes. It is possible that stress hormones such as catecholamines may show different effects depending on the exact nature of the genetic defect, or sensitivity to catecholamines varies from subject to subject. Furthermore, it is possible that subtle genetic variants of putative modifier genes, including those coding for ion channels and hormone receptors, play a role as determinants of individual sensitivity to life-threatening arrhythmias. The present study was designed to identify some of these risk modifiers. It was found that LQT1 and LQT2 patients show an abnormal QT-adaptation to both mental and physical stress. Furthermore, as studied with epinephrine infusion experiments while the heart was paced and action potentials were measured from the right ventricular septum, LQT1 patients showed repolarization abnormalities which were related to their propensity to develop arrhythmia during intense, prolonged sympathetic tone, such as exercise. In LQT2 patients, this repolarization abnormality was noted already at rest corresponding to their arrhythmic episodes as a result of intense, sudden surges in adrenergic tone, such as fright or rage. A common KCNH2 polymorphism was found to affect KCNH2 channel function as demonstrated by in vitro experiments utilizing mammalian cells transfected with the KCNH2 potassium channel as well as QT-dynamics in vivo. Finally, the present study identified a common β-1-adrenergic receptor genotype that is related a shorter QT-interval in LQT1 patients. Also, it was discovered that compound homozygosity for two common β-adrenergic polymorphisms was related to the occurrence of symptoms in the LQT1 type of long QT syndrome. The studies demonstrate important genotype-phenotype differences between different LQTS subtypes and suggest that common modifier gene polymorphisms may affect cardiac repolarization in LQTS. It will be important in the future to prospectively study whether variant gene polymorphisms will assist in clinical risk profiling of LQTS patients.