Peritoneal dialysis and neurological outcome in infants and small children

Although improved outcomes for children on peritoneal dialysis (PD) have been seen in recent years, the youngest patients continue to demonstrate inferior growth, more frequent infections, more neurological sequelae, and higher mortality compared to older children. Also, maintain-ing normal intravascular volume status, especially in anuric patients, has proven difficult. This study was designed to treat and monitor these youngest PD patients, which are relatively many due to the high prevalence of congenital nephrotic syndrome of the Finnish type (CNF, NPHS1) in Finland, with a strict protocol, to evaluate the results and to improve metabolic balance, growth, and development. A retrospective analysis of 23 children under two years of age at onset of PD, treated between 1995 and 2000, was performed to obtain a control population for our prospective PD study. Respectively, 21 patients less than two years of age at the beginning of PD were enrolled in prospective studies between 2001 and 2005. Medication for uremia and nutrition were care-fully adjusted during PD. Laboratory parameters and intravascular volume status were regu-larly analyzed. Growth was analyzed and compared with midparental height. In a prospective neurological study, the risk factors for development and the neurological development was determined. Brain images were surveyed. Hearing was tested. In a retrospective neurological study, the data of six NPHS1 patients with a congruent neurological syndrome was analyzed. All these patients had a serious dyskinetic cerebral palsy-like syndrome with muscular dysto-nia and athetosis (MDA). They also had a hearing defect. Metabolic control was mainly good in both PD patient groups. Hospitalization time shortened clearly. The peritonitis rate diminished. Hypertension was a common problem. Left ventricular hypertrophy decreased during the prospective study period. None of the patients in either PD group had pulmonary edema or dialysis-related seizures. Growth was good and catch-up growth was documented in most patients in both patient groups during PD. Mortality was low (5% in prospective and 9% in retrospective PD patients). In the prospective PD patient group 11 patients (52%) had some risk factor for their neuro-development originating from the predialysis period. The neurological problems, detected be-fore PD, did not worsen during PD and none of the patients developed new neurological com-plications during PD. Brain infarcts were detected in four (19%) and other ischemic lesions in three patients (14%). At the end of this study, 29% of the prospectively followed patients had a major impairment of their neurodevelopment and 43% only minor impairment. In the NPHS1+MDA patients, no clear explanation for the neurological syndrome was found. The brain MRI showed increased signal intensity in the globus pallidus area. Kernic-terus was contemplated to be causative in the hypoproteinemic newborns but it could not be proven. Mortality was as high as 67%. Our results for young PD patients were promising. Metabolic control was acceptable and growth was good. However, the children were significantly smaller when compared to their midparental height. Although many patients were found to have neurological impairment at the end of our follow-up period, PD was a safe treatment whereby the neurodevelopment did not worsen during PD.

Autoimmune Regulator (AIRE) in the Maintenance of Immunological Tolerance

Autoimmune regulator (AIRE) is the gene mutated in the human polyglandular autoimmune disease called Autoimmune polyendocrinopathy, candidiasis, and ectodermal dystrophy (APECED) that belongs to the Finnish disease heritage. Murine Aire has been shown to be important in the generation of the T cell central tolerance in the thymus by promoting the expression of ectopic tissue-specific antigens in the thymic medulla. Aire is also involved in the thymus tissue organization during organogenesis. In addition to the thymus, AIRE/Aire is expressed in the secondary lymphoid organs. Accordingly, a role for AIRE/Aire in the maintenance of peripheral tolerance has been suggested. Peripheral tolerance involves mechanisms that suppress immune responses in secondary lymphoid organs. Regulatory T cells (Tregs) are an important suppressive T cell population mediating the peripheral tolerance. Tregs are generated in the thymus but also in the peripheral immune system T cells can acquire the Treg-phenotype. The aim of this study was to characterize Tregs in APECED patients and in the APECED mouse model (Aire-deficient mice). In the mouse model, it was possible to separate Aire expression in the thymus and in the secondary lymphoid organs. The relative importance of thymic and peripheral Aire expression in the maintenance of immunological tolerance was studied in an experimental model that was strongly biased towards autoimmunity, i.e. lymphopenia-induced proliferation (LIP) of lymphocytes. This experimental model was also utilised to study the behaviour of T cells with dual-specific T cell receptors (TCR) during the proliferation. The Treg phenotype was studied by flow cytometry and relative gene expression with real-time polymerase chain reaction. TCR repertoires of the Tregs isolated from APECED patients and healthy controls were also compared. The dual-specific TCRs were studied with the TCR repertoire analysis that was followed with sequencing of the chosen TCR genes in order to estimate changes in the dual-specific TCR diversity. The Treg function was tested with an in vitro suppression assay. The APECED patients had normal numbers of Tregs but the phenotype and suppressive functions of the Tregs were impaired. In order to separate Aire functions in the thymus from its yet unknown role in the secondary lymphoid organs, the phenomenon of LIP was utilised. In this setting, the lymphocytes that are adoptively transferred to a lymphopenic recipient proliferate to stimuli from self-originating antigens. This proliferation can result in autoimmunity if peripheral tolerance is not fully functional. When lymphocytes that had matured without Aire in the thymus were transferred to lymphopenic Aire-sufficient recipients, no clinical autoimmunity followed. The Aire-deficient donor-originating lymphocytes hyperproliferated, and other signs of immune dysregulation were also found in the recipients. Overt autoimmunity, however, was prevented by the Aire-deficient donor-originating Tregs that hyperproliferated in the recipients. Aire-deficient lymphopenic mice were used to study whether peripheral loss of Aire had an impact on the maintenance of peripheral tolerance. When normal lymphocytes were transferred to these Aire-deficient lymphopenic recipients, the majority of recipients developed a clinically symptomatic colitis. The colitis was confirmed also by histological analysis of the colon tissue sections. In the Aire-deficient lymphopenic recipients Tregs were proliferating significantly less than in the control group s recipients that had normal Aire expression in their secondary lymphoid organs. This study shows that Aire is not only important in the central tolerance but is also has a significant role in the maintenance of the peripheral tolerance both in mice and men. Aire expressed in the secondary lymphoid organs is involved in the functions of Tregs during an immune response. This peripheral expression appears to be relatively more important in some situations since only those lymphopenic recipients that had lost peripheral expression of Aire developed a symptomatic autoimmune disease. This AIRE-related Treg defect could be clinically important in understanding the pathogenesis of APECED.

Dissection of the genetic background of childhood onset progressive myoclonic epilepsies

The progressive myoclonic epilepsies (PMEs) are a clinically and etiologically heterogeneous group of symptomatic epilepsies characterized by myoclonus, tonic-clonic seizures, psychomotor regression and ataxia. Different disorders have been classified as PMEs. Of these, the group of neuronal ceroid lipofuscinoses (NCLs) comprise an entity that has onset in childhood, being the most common cause of neurodegeneration in children. The primary aim of this thesis was to dissect the molecular genetic background of patients with childhood onset PME by studying candidate genes and attempting to identify novel PME-associated genes. Another specific aim was to study the primary protein properties of the most recently identified member of the NCL-causing proteins, MFSD8. To dissect the genetic background of a cohort of Turkish patients with childhood onset PME, a screen of the NCL-associated genes PPT1, TPP1, CLN3, CLN5, CLN6, MFSD8, CLN8 and CTSD was performed. Altogether 49 novel mutations were identified, which together with 56 mutations found by collaborators raised the total number of known NCL mutations to 364. Fourteen of the novel mutations affect the recently identified MFSD8 gene, which had originally been identified in a subset of mainly Turkish patients as the underlying cause of CLN7 disease. To investigate the distribution of MFSD8 defects, a total of 211 patients of different ethnic origins were evaluated for mutations in the gene. Altogether 45 patients from nine different countries were provided with a CLN7 molecular diagnosis, denoting the wide geographical occurrence of MFSD8 defects. The mutations are private with only one having been established by a founder-effect in the Roma population from the former Czechoslovakia. All mutations identified except one are associated with the typical clinical picture of variant late-infantile NCL. To address the trafficking properties of MFSD8, lysosomal targeting of the protein was confirmed in both neuronal and non-neuronal cells. The major determinant for this lysosomal sorting was identified to be an N-terminal dileucine based signal (9-EQEPLL-14), recognized by heterotetrameric AP-1 adaptor proteins, suggesting that MFSD8 takes the direct trafficking pathway en route to the lysosomes. Expression studies revealed the neurons as the primary cell-type and the hippocampus and cerebellar granular cell layer as the predominant regions in which MFSD8 is expressed. To identify novel genes associated with childhood onset PME, a single nucleotide polymorphism (SNP) genomewide scan was performed in three small families and 18 sporadic patients followed by homozygosity mapping to determine the candidate loci. One of the families and a sporadic patient were positive for mutations in PLA2G6, a gene that had previously been shown to cause infantile neuroaxonal dystrophy. Application of next-generation sequencing of candidate regions in the remaining two families led to identification of a homozygous missense mutation in USP19 for the first and TXNDC6 for the second family. Analysis of the 18 sporadic cases mapped the best candidate interval in a 1.5 Mb region on chromosome 7q21. Screening of the positional candidate KCTD7 revealed six mutations in seven unrelated families. All patients with mutations in KCTD7 were reported to have early onset PME, rapid disease progression leading to dementia and no pathologic hallmarks. The identification of KCTD7 mutations in nine patients and the clinical delineation of their phenotype establish KCTD7 as a gene for early onset PME. The findings presented in this thesis denote MFSD8 and KCTD7 as genes commonly associated with childhood onset symptomatic epilepsy. The disease-associated role of TXNDC6 awaits verification through identification of additional mutations in patients with similar phenotypes. Completion of the genetic spectrum underlying childhood onset PMEs and understanding of the gene products functions will comprise important steps towards understanding the underlying pathogenetic mechanisms, and will possibly shed light on the general processes of neurodegeneration and nervous system regulation, facilitating the diagnosis, classification and possibly treatment of the affected cases.

Classification of Myopathies on Molecular basis in Drosophila using Raman spectroscopy

Myopathies are muscular diseases in which muscle fibers degenerate due to many factors such as nutrient deficiency, infection and mutations in myofibrillar etc. The objective of this study is to identify the bio-markers to distinguish various muscle mutants in Drosophila (fruit fly) using Raman Spectroscopy. Principal Components based Linear Discriminant Analysis (PC-LDA) classification model yielding >95% accuracy was developed to classify such different mutants representing various myopathies according to their physiopathology.

Classification of Myopathies on Molecular basis in Drosophila using Raman spectroscopy

Myopathies are muscular diseases in which muscle fibers degenerate due to many factors such as nutrient deficiency, infection and mutations in myofibrillar etc. The objective of this study is to identify the bio-markers to distinguish various muscle mutants in Drosophila (fruit fly) using Raman Spectroscopy. Principal Components based Linear Discriminant Analysis (PC-LDA) classification model yielding >95% accuracy was developed to classify such different mutants representing various myopathies according to their physiopathology.

Intertwined vorticity and elastodynamics in flapping wing propulsion

We performed numerical experiments on a one-dimensional elastic solid oscillating in a two-dimensional viscous incompressible fluid with the intent of discerning the interplay of vorticity and elastodynamics in flapping wing propulsion. Perhaps for the first time, we have established the role of foil deflection topology and its influence on vorticity generation, through spatially and temporally evolving foil slope and curvature. Though the frequency of oscillation of the foil has a definite role, it is the phase relation between foil slope and pressure that determines thrust or drag. Similarly, the phase difference between flapping velocity, and pressure and inertial forces, determine the power input to the foil, and in turn drives propulsive efficiency. At low frequencies of oscillation, the sympathetic slope and curvature of deformation of the foil allow generation of leading-edge vortices that do not separate; they cause substantial rise in pressure between the leading edge and mid-chord. The circulatory component of pressure is determined primarily by the leading-edge vortex and therefore thrust too is predominantly circulatory in origin at low frequencies. In the intermediate and high-frequency range, thrust and drag on the foil spatially alternate and non-circulatory forces dominate over circulatory and viscous forces. For the mass ratios we simulated, thrust due to flapping varies quadratically as a function of Strouhal number or trailing-edge flapping velocity; further, the trailing edge flapping velocities peak at the same set of frequencies where the thrust is also a maximum. Propulsive efficiency, on the other hand, is roughly a mirror image of the thrust variation with respect to Strouhal number. Given that most instances of flapping propulsion in nature are primarily through distributed muscular actuation that enables precise control of deformation shape, leading to high thrust and efficiency, the results presented here are pointers towards understanding some of the mechanisms that drive thrust and propulsive efficiency.

Biotipos musculares en la raza criolla

En razón del crecimiento de pruebas funcionales que requieren fuerza explosiva en la Raza Criolla, se observa un creciente cambio en el biotipo muscular. Del tradicional biotipo muscular aeróbico se está cambiando progresivamente, y en forma acelerada hacia un biotipo muscular anaeróbico, mucho mas adaptado y eficiente para las pruebas funcionales selectivas / deportivas en constante expansión y con un número muy importante de participantes. Estos cambios traerán como consecuencia la adquisición de nuevas cualidades deseables, en desmedro de cualidades características de la Raza Criolla.

Phenotypic correlations of fatty acid composition among intramuscular, subcutaneous and intermuscular fat tissues in concentrate-fed beef cattle of differing genotypes

[EN]In an attempt to predict intramuscular fatty acid composition using easily accessible fat depots, between-tissue correlations were studied in 75 Asturiana de los Valles bulls with different levels of muscular hypertrophy, and 25 Asturiana de la Montan˜ a bulls. Trans-18:1 in intramuscular fat was highly and positively correlated with levels in subcutaneous and intermuscular fats, while levels of total n-3 were not correlated. Predicting intramuscular fatty acid composition using easily accessible depots is thus possible for some fatty acids exhibiting high between-tissue correlations (e.g., trans-18:1) but breed and tissue specific deposition may limit this for others (e.g., n-3 fatty acids).

Unlike Physical Exercise, Modified Environment Increases the Lifespan of SOD1(G93A) Mice However Both Conditions Induce Cellular Changes

8 p.

Jarduera fisikoak adineko pertsona autonomoen osasunean duen eragina

294 p. : il.

Muscle glycogen and blood lactate in yellowfin tuna, Thunnus albacares, and skipjack, Katsuwonus pelamis, following capture and tagging

ENGLISH: Tagging and the recovery of tagged yellowfin (Thunnus albacares) and skipjack (Katsuwonus pelamis) tunas are important aspects of the investigations conducted by the Inter-American Tropical Tuna Commission in the Eastern Tropical Pacific Ocean. The results of the tagging program provide information on population structures, migrations, mortality rates and growth rates of these two species. The present experimental program was undertaken to study the relationship between muscular fatigue and high tagging mortalities in yellowfin and skipjack. SPANISH: La marcación del atún aleta amarilla (Thunnus albacares) y del barrilete (Katsuwonus pelamis), y el recobro de estos atunes marcados, son aspectos importantes de la investigación que efectúa la Comisión Interamericana del Atún Tropical en el Océano Pacífico Oriental Tropical. Los resultados del programa de marcación proporcionan información sobre la estructura de las poblaciones, migraciones, tasas de mortalidad y tasas de crecimiento de estas dos especies. El programa experimental presente fue emprendido para estudiar la relación entre la fatiga muscular y la alta mortalidad causada por la marcación en el atún aleta amarilla y el barrilete. (PDF contains 52 pages.)

Características antropométricas, condición física y velocidad de lanzamiento en balonmano de élite y amateur

166 p.

Development of new applications of inductively coupled plasma mass spectrometry (ICP-MS) hyphenated with different sample introduction systems

225 p. : il. Texto en español con conclusiones en inglés

Diferencias fisiológicas entre futbolistas de categoría cadete y juvenil

Los objetivos de este estudio fueron analizar las diferencias en las características antropométricas, resistencia aeróbica, temperatura corporal y percepción subjetiva del esfuerzo en futbolistas de distintas categorías (cadete y juvenil), y examinar la relación existente entre las distintas variables analizadas. Para ello participaron 37 jóvenes futbolistas, 20 de ellos cadetes (15,12 ± 0,69 años) y 17 juveniles (16,94 ± 0,89 años). A los futbolistas se les midió la talla y la masa corporal, calculándose el índice de masa corporal (IMC). A su vez, para determinar su resistencia aeróbica, los jugadores realizaron el Yo-Yo Intermittent Recovery Level 1, registrándose la distancia total recorrida, la temperatura pre y post-test y la percepción subjetiva del esfuerzo (RPE). Los futbolistas de categoría juvenil obtuvieron mayores valores de masa corporal e IMC, obteniendo además mejores valores en el test de resistencia que los cadetes. Asimismo, se registraron diferencias en el RPEmus y RPEmus-TL, siendo mayor el de los juveniles en ambos casos. Para acabar, se observaron correlaciones altas entre los resultados del test de resistencia y el RPEres-TL, así como con el RPEmus-TL en los juveniles, mientras que en el caso de los cadetes solo correlacionó con el RPEres-TL. Se cree que dichas diferencias pueden ser debidas al mayor desarrollo muscular de los juveniles respecto a los cadetes, aunque se necesitan más estudios.

Autoefikazia bakarkako kiroletan: esku pelotako kirolari eta atleten arteko ezberdintasunak

Lan honen helburua eskuzko pilotarien eta atleten autoefikazia neurtu eta hauen arteko ezberdintasunak zein diren aztertzea zen autematen zuten abilezia fisikoaren inguruan. Honetarako, ???Perceived Physical Ability??? (PPA) eskala erabili zen. Lagina kategoria ezberdineko (kadete, jubenil eta senior) 37 kirolariz osatuta zegoen (24 pilotari eta 13 atleta) beraien bataz besteko adina, pilotariena 19,41 eta atletena 20,53 izanik. Lortutako emaitzek adierazten dute atletek balore altuagoak izan dituztela abiadura, azkartasuna, bizitasuna eta trebeziari erlazionatutako galderetan batez ere eta baita ere masa muskular tonuari dagokion galdera batean. Konklusiotzat, eskala honen bidez pilotari eta atleten arteko ezberdintasun orokorrak zein diren ikusi dira hautematen duten autoefikazia mailari dagokionez. Ezberdintasunak adierazgarriak aurkitu ziren abiadura, azkartasuna, trebezia, zalutasuna eta muskular tonuari zegozkien itemetan.