Rightward bisection errors for letter lines: The role of semantic information

When bisecting words in their middle, people reveal leftward bisection errors. This tendency might emerge from an attentional bias towards the beginning of the word. However, when longer meaningless letter strings are presented, people reveal a rightward bisection bias. To test the role of semantic information on leftward or rightward bisection biases, we tested letter line bisection performance in healthy right-handed students in four independent experiments. A third of the letter lines contained an embedded four-letter word to the left of true centre, another third contained an embedded four-letter word to the right of true centre, while the remaining lines contained no words. Half of these words were emotional words, the other half were neutral words. Results across experiments revealed a stronger rightward bisection bias: (i) for letter lines containing emotional as compared to neutral words, (ii) for letter lines containing words in the left as compared to right half of the lines, and (iii) for those experiments in which the spatial position of letter lines remained within a narrow body-centred space. Findings from this study suggest that letter line bisection performance might be only minimally determined by visuo-spatial attention. Rather, letter line perception might activate the left hemisphere more than the right hemisphere, shifting the subjective midpoint to the right of true centre. Leftward bisection biases for words only, as had been described in the literature, may thus have resulted from automated reading strategies rather than from attentional biases towards the left hemispace.

Cellular oxygen sensing: Crystal structure of hypoxia-inducible factor prolyl hydroxylase (PHD2)

Cellular and physiological responses to changes in dioxygen levels in metazoans are mediated via the posttranslational oxidation of hypoxia-inducible transcription factor (HIF). Hydroxylation of conserved prolyl residues in the HIF-alpha subunit, catalyzed by HIF prolyl-hydroxylases (PHDs), signals for its proteasomal degradation. The requirement of the PHDs for dioxygen links changes in dioxygen levels with the transcriptional regulation of the gene array that enables the cellular response to chronic hypoxia; the PHDs thus act as an oxygen-sensing component of the HIF system, and their inhibition mimics the hypoxic response. We describe crystal structures of the catalytic domain of human PHD2, an important prolyl-4-hydroxylase in the human hypoxic response in normal cells, in complex with Fe(II) and an inhibitor to 1.7 A resolution. PHD2 crystallizes as a homotrimer and contains a double-stranded beta-helix core fold common to the Fe(II) and 2-oxoglutarate-dependant dioxygenase family, the residues of which are well conserved in the three human PHD enzymes (PHD 1-3). The structure provides insights into the hypoxic response, helps to rationalize a clinically observed mutation leading to familial erythrocytosis, and will aid in the design of PHD selective inhibitors for the treatment of anemia and ischemic disease.

Perceptual aberrations impair mental own-body transformations

Dysfunctional self and bodily processing have been reported from the schizophrenia spectrum. Here, the authors tested 72 students (40 women) to determine whether performance in a mental own-body transformation task relates to self-rated frequency of spontaneously experienced schizotypal body schema alterations (perceptual aberration). Participants provided speeded left-right decisions concerning the body of a visually depicted human figure (front view vs. back view). For men, reaction times to disembodied perspectives increased with increasing scores on a validated perceptual aberration scale. This finding constitutes behavioral evidence for the clinically postulated association between aberrant bodily experiences during everyday life and aberrant processing in a mental own-body transformation task arguably reflecting mild dysfunction at the temporo-parietal junction.

Blinking and schizotypal thinking

Spontaneous eye blink rate (SBR) is thought to be a biological marker for cerebral dopamine (DA) activity. Accordingly, positive psychotic symptoms have been found to be associated with an increased SBR and negative psychotic symptoms with a decreased SBR. However, modulations of the DA system in patient populations also result from prior neuroleptic treatment. Here, we tested the possible relationship between SBR and positive and negative schizotypal thought. To test the direct influence of DA on SBR in general and as a function of schizotypy, half of a sample of 40 healthy men received levodopa and the other half placebo in a double-blind procedure. SBR did not differ between substance groups suggesting that a pharmacologically induced DA increase in healthy individuals does not generally increase SBR. However, in the levodopa group, increasing SBR correlated with increasing negative schizotypy scores, while no relationship was found between SBR and (1) negative schizotypy in the placebo group, or (2) positive schizotypy in either substance group. We conjecture that a pre-existing hypodopaminergic state in high negative schizotypy scorers, made these individuals susceptible to an increased DA concentration, as it has been observed in Parkinson's disease. Furthermore, the absence of any relationship in the placebo group might suggest that variations in DA concentration as a function of schizotypy are too subtle to influence SBR. Finally, the lack of any association of SBR with positive schizotypy might indicate that SBR and positive schizotypy are mediated by functionally distinct neural circuits.

Spheno-orbital meningiomas: interdisciplinary surgical approach, resectability and long-term results

OBJECTIVE

To describe the interdisciplinary surgical approach in spheno-orbital meningiomas and to evaluate the operative results regarding resectability and functional outcome.

PATIENTS AND METHODS

A series of 16 patients underwent surgical resection of spheno-orbital meningiomas followed by bony reconstruction. Four patients presented with a recurrent meningioma and had undergone surgical resection previously. Radical tumour removal was attempted in all cases, although no aggressive effort was made to remove tumour tissue infiltrating the cavernous sinus or soft tissues deep in the orbit to avoid severe functional disturbances. All patients but one were female (mean age 53 years). Mean follow-up period was 68 months (range 4-155 months).

RESULTS

The leading symptom was proptosis in 14 patients, accompanied in 7 cases by progressive visual impairment. Surgical resection was thought to have been complete in 11 patients (69%) and incomplete in 5 (31%). Residual tumour was deliberately left when there was infiltration of the cavernous sinus (n = 4), the pterygopalatine fossa (n = 2) and/or the deep intraorbital soft tissues (n = 1). Tumour recurrence was observed in 9 patients, among whom were 6 patients with an initially "completely" resected meningioma. Eight patients underwent re-operation. Complete resection was achieved in 3 of these latter patients with an isolated exclusively intraorbital tumour manifestation.

CONCLUSION

By means of combined skull base approaches, spheno-orbital meningiomas are grossly resected totally with a long-term survival free of recurrence and an acceptable quality of life. In some cases, deliberate subtotal tumour resection is useful to avoid severe neurological damage with sufficient tumour control and a valuable progression-free survival.

The development of a new measure for the assessment of psychopathology in adults with intellectual disability

BACKGROUND

People with intellectual disability (ID) and untreated psychiatric disorder lead unnecessarily difficult and unhappy lives. The prevalence of mental illness in children and adults with ID is greater than that found in the general population. A carer-completed checklist of psychopathology that could be used with both children and adults would help identify those individuals with ID most likely to have a mental health problem, help ensure that they receive the limited services that are usually available and also assist the process of clinical assessment, diagnosis and management.

METHOD

This research aimed to develop a reliable and valid carer-completed checklist of psychopathology for adults with ID by redeveloping an existing measure for children with ID, the Developmental Behaviour Checklist (DBC-P). The new checklist, The Developmental Behaviour Checklist for Adults (DBC-A) was devised by changing, deleting and adding to DBC-P items. Reliability studies were conducted with paid and family carers, and DBC-A scores were compared with the results from two other measures of psychopathology.

RESULTS

One DBC-P item was deleted, seven items changed and 12 items added. The psychometric properties of this new checklist, the DBC for Adults with ID (DBC-A), were investigated and found to be satisfactory. Intraclass correlations for test-retest and inter-rater reliability ranged from 0.72 to 0.85, and concurrent validity with two measures of emotional and behavioural disturbance was satisfactory.

CONCLUSIONS

The carer-completed DBC-A provides a broad and comprehensive survey of the emotional and behavioural problems of adults with ID. It has satisfactory psychometric properties and therefore can be used with confidence in clinical, research and service settings, and its development allows continuous assessment of psychopathology across the lifespan for all people with ID.

Oculo-auriculo-vertebral spectrum (OAVS): clinical evaluation and severity scoring of 53 patients and proposal for a new classification

Oculo-auriculo-vertebral spectrum (OMIM164210) is a phenotypically and probably also a genetically heterogeneous disorder, characterized by anomalies of the ear (mostly microtia), hemifacial microsomia, and defects of the vertebral column. Associated clinical findings include anomalies of the eye and brain, and developmental delay. We have evaluated the clinical data and photographs of 53 unrelated patients with OAVS, all presenting with either isolated microtia or preauricular tags in association with hemifacial microsomia as minimal diagnostic criteria; five had a positive family history for OAVS. Based on the main clinical findings and unilateral or bilateral involvement, we have developed a new classification system for OAVS, consisting of six subgroups. There is a statistically significant correlation between the subgroup and number of associated clinical findings, and a statistically significant difference regarding prognosis in uni- and bilaterally affected patients, suggesting that this classification is clinically relevant to the categorization of patients with OAVS. The newly developed scoring system (two points for each main clinical finding and one for each associated clinical finding) presented here, also aids prognosis, especially for delay of motor development and brain anomalies, and statistical analysis revealed significant clustering between different clinical findings of OAVS confirming the clinical impression previously published by several authors.

The anterior cingulate cortex contains distinct areas dissociating external from self-administered painful stimulation: a parametric fMRI study

The anterior cingulate cortex (ACC) has a pivotal role in human pain processing by integrating sensory, executive, attentional, emotional, and motivational components of pain. Cognitive modulation of pain-related ACC activation has been shown by hypnosis, illusion and anticipation. The expectation of a potentially noxious stimulus may not only differ as to when but also how the stimulus is applied. These combined properties led to our hypothesis that ACC is capable of distinguishing external from self-administered noxious tactile stimulation. Thermal contact stimuli with noxious and non-noxious temperatures were self-administered or externally applied at the resting right hand in a randomized order. Two additional conditions without any stimulus-eliciting movements served as control conditions to account for the certainty and uncertainty of the impending stimulus. Calculating the differences in the activation pattern between self-administered and externally generated stimuli revealed three distinct areas of activation that graded with perceived stimulus intensity: (i) in the posterior ACC with a linear increase during external but hardly any modulation for the self-administered stimulation, (ii) in the midcingulate cortex with activation patterns independent of the mode of application and (iii) in the perigenual ACC with increasing activation during self-administered but decreasing activation during externally applied stimulation. These data support the functional segregation of the human ACC: the posterior ACC may be involved in the prediction of the sensory consequences of pain-related action, the midcingulate cortex in pain intensity coding and the perigenual ACC is related to the onset uncertainty of the impending stimuli.

Compound measure of hand-foot-eye preference masked opposite turning behavior in healthy right-handers and non-right-handers: technical comment on Mohr et al. (2003)

A previous article reported opposite turning behavior in right-handers and non-right-handers (C. Mohr. T. Landis, H. S. Bracha, & P. Brugger, 2003). This observation appears contradictory to the 1st study on long-term spontaneous turning behavior in healthy participants (H. S. Bracha, D. J. Seitz, J. Otemaa, & S. D. Click, 1987). These latter authors found a complex interaction between hemispheric dominance, preferred turning side, and sex. C. Mohr et al. (2003) argued that the differentiation of the population in hemisphere-dominant groups by a compound measure of hand-foot-eye preference might have masked their recent finding. Thus, this commentary presents a reanalysis of the original data set (H. S. Bracha et al., 1987). Replicating recent observation, right-handers preferred left-sided turns; and non-righthanders, right-sided turns. This replication strengthens the proposition that handedness and turning behavior might depend on interhemispheric dopamine asymmetries.

Cerebellar neural responses related to actively and passively applied noxious thermal stimulation in human subjects: a parametric fMRI study

Cerebellar activation is consistently found during noxious stimulation but little is known about its pain-related specificity. Under natural circumstances noxious stimuli are actively or passively delivered with concomitant tactile sensory stimulation. Using fMRI we therefore studied pain-related cerebellar activation with innocuous and noxious thermal stimuli in a parametric design taking motor execution as confounding factor into account. With respect to psychophysical pain ratings anterior vermal and ipsilateral hemispheric lobule VI activation was parametrically modulated for stimulus intensity in actively but not in passively elicited thermal stimulation. The cerebellum seems to be capable of distinguishing active from passive painful stimuli.

(4-Piperidinylphenyl)aminoethyl amides as a novel class of non-covalent cathepsin K inhibitors

A series of (4-piperidinylphenyl)aminoethyl amides based on dipeptide anilines were synthesized and tested against cathepsin K, cathepsin L and cathepsin B. These new non-covalent inhibitors exhibited single-digit nM inhibition of the cysteine proteases. Compounds 3 and 7 demonstrated potency in both mouse and human osteoclast resorption assays.

[Quantitative ultrasound for the diagnosis of osteoporosis]

Quantitative ultrasound (QUS) methods are promising tools for the assessment of the bone status in osteoporosis. The techniques are based on changes in speed and amplitude of a broadband ultrasound signal propagating through the bone. However, ultrasound propagation through the anisotropic bone is complex and cannot be described in a simple way. The devices are easy to use, inexpensive, portable, do not use ionizing radiation, and therefore have advantages compared to conventional densitometry. This review discusses the technical basics, current research, clinical applications, points of weakness, and future prospects of QUS. For better understanding ultrasound propagation through bone is visualized with a simulation software.

Human side preferences in three different whole-body movement tasks☆

Animals turn away from the hemisphere with the more active dopamine (DA) system. For humans, a similar relationship has been assumed. However, results from independent studies were obtained from different tasks and indicated different side preferences. To investigate side preferences between different tasks within the same subject, we assessed in 36 healthy research participants (20 women) (1) long-term spontaneous turning (number of 360 degree turns during 20 h), (2) veering (lateral deviations during walking blindfolded straight forward) and (3) stepping (deviations while stepping blindfolded on a given spot) behavior. We observed a left-sided preference for long-term spontaneous turning behavior and no significant side preference for veering and stepping behavior. The absence of consistent side preferences suggests that DA does not equally control lateralized whole-body movements. We propose that visual control enhanced left-sided movement preferences, probably through an enhanced contribution of the right hemisphere to visuo-spatial behavior. Recently, we reported [Neurosci. Lett. 339 (2003) 115] that levodopa supplementation decreases right-sided veering tendencies, while stepping behavior was unaffected by substance intake. We suggest that veering tendencies, which appeared equally pronounced in either direction, are under dopaminergic control as long as attention is directed towards extrapersonal space. Side preferences in lateralized whole-body movement tasks are thus neither comparable between tasks nor within subjects. We conclude that experimental parameters such as visuo-spatial control and spatial task demands (veering is directed to extrapersonal space and stepping to peripersonal space) determine whether or not the DA system is involved.

3 Tesla-MRT: Der Erfolg h�herer Feldst�rken

The recent development of 3 Tesla MRI (3T MRI) has been fueled by promise of increased signal-to-noise ratio(SNR). Many are excited about the opportunity to not only use the increased SNR for clearer images, but also the chance to exchange it for better resolution or faster scans. These possibilities have caused a rapid increase in the market for 3T MRI, where the faster scanning tips an already advantageous economic outlook in favor of the user. As a result, the global market for 3T has grown from a research only market just a few years ago to an ever-increasing clinically oriented customer base. There are, however, significant obstacles to 3T MRI presented by the physics at higher field strengths. For example, the T1 relaxation times are prolonged with increasing magnet field strength. Further, the increased RF-energy deposition (SAR), the larger the chemical shift and the stronger susceptibility effect have to be considered as challenges. It is critical that one looks at both the advantages and disadvantages of using 3T. While there are many issues to address aand a number of different methods for doing so, to properly tackle each of these concerns will take time and effort on the part od researchers and clinicians. The optimization of 3T MRI scanning will have to be a combined effort, though much of the work to date has been in neuroimaging. Multiple applications have been explored in addition to clinical anatomical imaging, where resolution is improved showing structure in the brain never seen before in human MRI. Body and cardiac imaging provide a great challenge but are also achievable at 3T. As an example, the full range of clinical applications currently achieved on today's state-of-the-art 1.5T cardiac MR scanners has also been demonstrated at 3T. In the body, the full range of contrast is available over large fields of view allowing whole liver studies in the clinic or, as needed, one may choose a smaller field of view for high-resolution imaging of the pancreas. The ability to increase resolution for musculoskeletal imaging has provided previously unseen detail. Bone structure, cartilage, and tendons and ligaments can be clearly visualized and pathology more easily detected due to an increased image quality. As the increase in field strength continues, a push to look at 7T has begun. The design philosophy is to keep the system as similar as possible, while changing only the frequency-dependent components. To date, both animal and human imaging have been performed on a whole body 7T scanner. Results show promise for both detailed imaging and functional MRI, but the road ahead is too long to be able to predict where it will end. The move toward higher field strengths is an exciting adventure in which 3T plays the role of trailblazer.

Localisation of “unseen” visual stimuli: Blindsight in normal observers?

We developed two experiments on normal subjects to simulate “blindsight”, i.e., above chance localization performance of visual stimuli without phenomenal awareness. In both experiments, visual targets were presented on a computer screen at one of six possible locations, followed by a metacontrast mask. Subjects (1) indicated whether they had seen the target stimulus or not, and (2) guessed at which location the stimulus had been presented. Fifty percent were blank trials. We found that even when subjects did not acknowledge the presence of a stimulus, they nevertheless guessed its location with above chance accuracy. Apparent motion improved both detection and localization performance. Subjective confidence was related to stimulus presence and localisation performance. Thus, simulated blindsight appeared to be based on residual conscious awareness.

Characterization of the acute immune response in the retina of Borna disease virus infected Lewis rats

In Lewis rats infected intracerebrally with the highly neurotropic Borna disease virus (BDV), the retina is one of the most severely affected central nervous system (CNS) structures. While BDV-induced damage in the brain has been previously shown to be caused by a T-cell-dependent process, the immunopathological mechanisms leading to BDV-induced retinitis remain to be elucidated. RNA samples from retinae were subjected to RNase protection assays to detect transcripts of proinflammatory cytokines and chemokines known to be involved in the recruitment of T-cells and macrophages in the CNS. The observed expression profile of proinflammatory cytokines and chemokines, as well as the immunohistochemical detection of alpha beta TCR-positive, CD4- and CD8-positive T-cells in the BDV-infected retinae, is reminiscent of the situation observed in the brains of Lewis rats during the acute phase of Borna disease (BD). This suggests that similar immunopathological mechanisms are operating in retinae and brains of infected rats.

Differential cerebellar activation related to perceived pain intensity during noxious thermal stimulation in humans: a functional magnetic resonance imaging study

Little is known about the cerebellar involvement in pain processing in spite of the fact that the cerebellum probably plays a crucial role in pain-related behavior. Using functional magnetic resonance imaging we examined the differential cerebellar activation in 18 healthy subjects in relation to their perceived pain-intensity of noxious and non-noxious thermal stimuli. In contrast to non-noxious (40 degrees C) stimuli, noxious (48.5 degrees C) stimuli revealed activation in the deep cerebellar nuclei, anterior vermis and bilaterally in the cerebellar hemispheric lobule VI. With the same noxious stimulus (48.5 degrees C) there was differential cerebellar activation depending on the perceived pain intensity: high pain intensity ratings were associated with activation in ipsilateral hemispheric lobule III-VI, deep cerebellar nuclei and in the anterior vermis (lobule III). This differential cerebellar activation pattern probably reflects not only somatosensory processing but also perceived pain intensity that may be important for cerebellar modulation of nociceptive circuits.

Opposite Turning Behavior in Right-Handers and Non-Right-Handers Suggests a Link Between Handedness and Cerebral Dopamine Asymmetries

The strong right hand preference in humans remains a riddle; no lateralized behavior other than fine finger dexterity relates to it. The relation between handedness and language dominance may be far weaker than currently judged; after all, both right-handers and non-right-handers utilize the left brain for speech. There is, however, a lateralized motor preference in animals, turning behavior, that is strongly associated with hemispheric dopamine (DA) asymmetries. Turning consistently occurs towards the side with less DA. The authors tested 69 right-handers and 24 non-right-handers with a device recording spontaneous turning behavior for 20 hr within 3 days. Findings indicate that right-handers preferred left-sided turning and non-right-handers preferred right-sided turning. This result suggests a link between handedness and DA asymmetries.

Associative processing and paranormal belief

In the present study we introduce a novel task for the quantitative assessment of both originality and speed of individual associations. This 'BAG' (Bridge-the-Associative-Gap) task was used to investigate the relationships between creativity and paranormal belief. Twelve strong 'believers' and 12 strong 'skeptics' in paranormal phenomena were selected from a large student population (n > 350). Subjects were asked to produce single-word associations to word pairs. In 40 trials the two stimulus words were semantically indirectly related and in 40 other trials the words were semantically unrelated. Separately for these two stimulus types, response commonalities and association latencies were calculated. The main finding was that for unrelated stimuli, believers produced associations that were more original (had a lower frequency of occurrence in the group as a whole) than those of the skeptics. For the interpretation of the result we propose a model of association behavior that captures both 'positive' psychological aspects (i.e., verbal creativity) and 'negative' aspects (susceptibility to unfounded inferences), and outline its relevance for psychiatry. This model suggests that believers adopt a looser response criterion than skeptics when confronted with 'semantic noise'. Such a signal detection view of the presence/absence of judgments for loose semantic relations may help to elucidate the commonalities between creative thinking, paranormal belief and delusional ideation.

Electrophysiological alterations and upregulation of ATP receptors in retinal glial Müller cells from rats infected with the Borna disease virus

Infection with the neurotropic Borna disease virus (BDV) causes an immune-mediated neurological disease in a broad range of species. In addition to encephalitis, BDV-infected Lewis rats develop a retinitis histologically characterized by the loss of most retinal neurons. By contrast, the dominating retinal macroglia, the Müller cells, do not degenerate. It is known from several models of neurodegeneration that glial cells may survive but undergo significant alterations of their physiological parameters. This prompted us to study the electrophysiology and ATP-induced changes of intracellular Ca(2+)-concentration ([Ca(2+)](i)) in Müller cells from BDV-infected rat retinae. Freshly isolated cells were used for whole-cell patch-clamp recordings. Whereas neither zero current potentials nor membrane resistances showed significant alterations, the membrane capacitance increased in cells from BDV-infected rats during survival times of up to 8 months. This process was accompanied by a decrease in K(+) current densities. Müller cells from BDV-infected rats were characterized by expression of a prominent fast-inactivating A-type K(+) current which was rarely found in control cells. Moreover, the number of cells displaying Na(+) currents was slightly increased after BDV-infection. ATP evoked increases in [Ca(2+)](i) in Müller cells within retinal wholemounts of both control and BDV-infected animals. However, the number of ATP-responding isolated cells increased from 24% (age-matched controls) to 78% (cells from animals > or =18 weeks after infection). We conclude that in BDV-induced retinopathy, reactive rat Müller cells change their physiological parameters but these changes are different from those in Müller cells during proliferative vitreoretinopathy in man and rabbit.

Changes of the organotypic retinal organization in Borna virus-infected Lewis rats

Retinae of Borna disease virus (BDV)-infected Lewis rats were investigated with emphasis on long-term changes in organotypic tissue organization and glia-neuron relationship. Virus inoculation was attained via intracerebral BDV injection. Following survival times ranging between two and eight months, the retinal thickness was reduced up to one third of that of controls. Photoreceptor segments were completely extinguished and the number of neurons was dramatically reduced. The typical laminar organization of the retina was largely dissolved. Electron microscopy revealed severe spongy degeneration. Large numbers of activated microglia and macrophages were found, both cell types performing very active phagocytosis. The microglial cells expressed an extraordinary phenotype as characterized by large numbers of processes, with some of them penetrating the endfeet of Müller cells and others establishing highly complex interdigitations with vacuolized swellings and endings of neuronal processes. Müller cells were not reduced in number but displayed clear indications of gliosis such as alterations in the immunoreactivity for filament proteins and glutamine synthetase, significantly thickened stem processes, and an altered pattern of K(+) currents in patch-clamp recordings. These findings demonstrate for the first time long-term neuron-glia interactions in the retina of BDV-infected rats. Moreover, the data contribute to our knowledge on structural and functional alterations accompanying persisting virus infection in the central nervous system.

Loose but normal: a semantic association study

An abnormal facilitation of the spreading activation within semantic networks is thought to under-lie schizophrenics' remote associations and referential ideas. In normal subjects, elevated magical ideation (MI) has also been associated with a style of thinking similar to that of schizotypal subjects. We thus wondered whether normal subjects with a higher MI score would judge "loose associations" as being more closely related than do subjects with a lower MI score. In two experiments, we investigated whether judgments of the semantic distance between stimulus words varied as a function of MI. In the first experiment, random word pairs of two word classes, animals and fruits, were presented. Subjects had to judge the semantic distance between word pairs. In the second experiment, sets of three words were presented, consisting of a pair of indirectly related, or unrelated nouns plus a third noun. Subjects had to judge the semantic distance of the third noun to the word pair The results of both experiments showed that higher MI subjects considered unrelated words as more closely associated than did lower MI subjects. We conjecture that for normal subjects high on MI "loose associations" may not be loose after all. We also note that the tendency to link uncommon, nonobvious, percepts may not only be the basis of paranormal and paranoid ideas of reference, but also a prerequisite of creative thinking.

Associations to smell are more pleasant than to sound

To assess and compare the quantitive and qualitative aspects of verbal associations of olfaction and audition, we conducted two verbal category fluency tasks, one consisting of the generation of 'smelling' associations and the other of 'auditory' associations. The responses of the 40 subjects on these fluency tasks were rated as pleasant or unpleasant by themselves as well as by an independent group of 40 subjects. In addition, all 80 healthy, right-handed subjects rated their momentary emotional state on a visual analog scale. The mean number of words generated by the 40 subjects did not differ between the two tasks, and in both tasks pleasant associations were more frequent than unpleasant associations. However, for all subjects, the proportion of pleasant associations was significantly higher in the olfactory compared to the auditory fluency task. The finding of more pleasant associations in both tasks confirms previous reports, but the pronounced effect in the olfactory task suggests that odors may be more hedonically coded than other sensory modalities, i.e., audition. Although there is evidence that the majority of odors are initially perceived as unpleasant, when retrieved from memory, pleasant connotations seem to dominate. The possible mechanisms for this dissociation are discussed.

Implant-supported mandibular telescopic prostheses in oral cancer patients: an up to 9-year retrospective study

PURPOSE

The aim of this retrospective study was to present the results of implant-supported telescopic prostheses in the mandible after removal of malignant tumors.

MATERIALS AND METHODS

Between 1991 and 2000, 24 patients with squamous cell carcinoma (16 irradiated, eight nonirradiated) underwent mandibular rehabilitation with implant-supported telescopic prostheses. A total of 111 dental implants were placed. Treatment complications were observed. The cumulative survival rates of the implants and prostheses were evaluated by lifetable analysis.

RESULTS

Within a mean follow-up period of 30 months (1 to 108 months), only three implants failed. All other implants are still in function. Of 24 patients, 23 were satisfied with their implant-supported telescopic restorations. Soft tissue, implant, or prosthetic complications occurred very rarely. The cumulative implant survival rate was about 97% and the cumulative prosthesis survival rate was about 95% at 9 years.

CONCLUSION

Implants and implant-supported telescopic maxillofacial prostheses can successfully remain in function over a long period. Increased implant and prosthetic complications should not be expected. Therefore, telescopic implant attachments seem to be very useful as a treatment option for prosthetic restoration of the mandible in tumor patients.

Unilateral olfactory perception and magical ideation

We assessed olfactory detection thresholds and discrimination abilities in 40 healthy right-handers (20 women and 20 men). All subjects were also required to complete the Magical Ideation (MI) scale, a well-validated 30-item schizotypy inventory. Over both nostrils, we found elevated thresholds for subjects with high MI scores (at or above the median score of 9.0) compared with those with low scores. In men but not women, specifically left-nostril acuity was inversely correlated to MI raw scores. MI was unrelated to olfactory discrimination performance. These results suggest an association, at least in healthy men, between even moderate signs of schizotypy and deficits in odor detection. The selective impairment of left-nostril performance adds to the growing evidence for left temporal lobe functional abnormalities in people high on MI. This laterality effect is known from previous studies in patients with schizophrenia. However, as a rule, in psychiatric patients olfactory identification rather than simple detection performance was found to be impaired, indicating that the integration of odor information is affected at different levels of processing in schizotypy compared with schizophrenia. Work with completely normal subjects may reasonably complement clinical studies of olfactory perception. Among its advantages are the good subject compliance and the absence of medication effects.

Metabolic effects of HAY's diet

The aim of the study was, to evaluate the metabolic effect of HAY's diet on protein turnover, fat oxidation, respiratory quotient, body fat and weight loss. Twelve healthy adults received an individually regular diet and thereafter a corresponding isocaloric and isonitrogenous 10-day HAY-diet. Protein turnover and 13C-fat oxidation were investigated after administration of [15N]glycine and an [U-13C]algae lipid mixture. The 15N and 13C enrichment in urine and breath were measured by isotope ratio mass spectrometry. The respiratory quotient was measured by indirect calorimetry. Body fat, total body water and lean body mass were estimated by bio-electric impedance analysis. HAY's diet led to a significantly higher 13C-fat oxidation (15.4 vs. 22.0% P < 0.01), corresponding to a lower respiratory quotient (0.88 vs. 0.81; P < 0.01), whereas the protein turnover remained constant in both diets (3.06 vs. 3.05 g/kg/day). HAY's diet did not reduce total body water, lean body mass, body fat and body weight (72.2 vs. 71.4 kg).

[Therapeutic facial surgery possibilities for orbital tumors]

Based on a large experience of more than 400 orbital tumours which were treated operatively, the surgical strategies are described in detail. A surgical approach including the temporary removal of one or more bony orbital walls provided excellent exposure of the intraorbital structures. Using microsurgical techniques for tumour removal the surgical morbidity could be minimized. Subsequent refixation of the osteotomized orbital bones with microplates and screws and skin incisions within the hair bearing parts of the skull resulted in excellent postoperative function and cosmesis. For many malignant orbital tumours definitive cure can only be achieved by an orbital exenteration procedure. An individually tailored surgical and reconstructive strategy (if possible preservation of eyelid skin, tarsal and bulbar conjunctiva) gives a significant benefit, as well with respect to function as to the esthetic outcome of the patient.

A new application for craniofacial implants: wigs

PURPOSE

The purpose of this study was to describe a new application of craniofacial implants, as anchoring elements for wigs.

MATERIALS AND METHODS

In two patients, a split-skin graft was used to close a soft tissue defect in the occipital, parietal, temporal, and frontal region (defect size of 10 cm x 33 cm and 10 cm x 14 cm). Six titanium implants were placed in each patient. Six months after implant placement, abutment connection was performed and titanium magnets were adapted. Subsequently, an implant-retained wig was constructed.

RESULTS

In a follow-up period of between 10 and 22 months no implant failed. The incorporated wigs effectively retain a functionally and cosmetically successful craniofacial rehabilitation.

CONCLUSION

Despite these successful treatments, further research is needed before craniofacial implants as anchoring elements for wigs can be considered a standard option in the rehabilitation of craniofacial alopecic defects.

Clostridium innocuum: a glucoseureide-splitting inhabitant of the human intestinal tract

Glycosylureides were recently described as non-invasive markers of intestinal transit time. The underlying principle is an enzymatic splitting of (13)C-labelled ureides by intestinal bacteria. The (13)CO(2) released from the urea moiety of the glycosylureides can be measured in breath samples when the ingested tracer substrate reaches the caecum that is colonised with microbes. To date, the microbes that degrade glycosylureides are unknown. In order to identify the glucoseureide (GU)-splitting bacteria, 174 different strains of intestinal microbes obtained from five healthy adults were checked for their ability to degrade GU. The results of the microbial cultures and thin layer chromatography revealed that GU was exclusively degraded by Clostridium innocuum, belonging to the normal human intestinal microflora. C. innocuum probably synthesises a yet unknown enzyme that splits the glucose-urea bond. We suggest that the term glucoseureidehydrolase is the appropriate designation for this enzyme.

[Effects of oral administration of bifidobacteria on intestinal microflora in premature and newborn infants]

In a prospective, randomised study the effects of orally administered bifidobacteria on the intestinal microflora were investigated in 100 preterm and term neonates under intensive care conditions during the first 21 days of life. The 50 infants (group with bifidobacteria) received lyophilized bifidobacteria (Töpfer Bifidus) via nasogastral tube with an initial dosage of 3 times daily 1.25 x 10(8) bifidobacteria on day 2 of life and a daily dosage of 6 times 1.25 x 10(8) bifidobacteria on day 3 until day 21 of life. The other 50 infants (control group) did not receive bifidobacteria. The preterm and term neonates were fed either with pasteurized mother's milk or milk from healthy female donors (n = 79) or with an infant formula (Alfaré, n = 13) or initially with Alfaré and thereafter with mother's milk (n = 8). The intestinal microflora of preterm and term neonates under intensive care conditions could be influenced by the oral administration of bifidobacteria. The administration of bifidobacteria resulted in the group of inoculated infants in a significantly earlier colonization of bifidobacteria (8.1 +/- 3.9 days of life) than in the control group (11.3 +/- 4.7 days of life). On day 7 a bifidobacterial dominance (> 90% of the intestinal microflora) could be found in 26% of infants with inoculation of bifidobacteria and only in 2% of the control group (p < 0.001). These significant differences could be shown until day 21 of life. A difference in septicemia frequency between the two groups could not be demonstrated. At the beginning of the infection a bifidobacterial dominance was found in only one of 23 cases of septicemia.

Compact organization of rRNA genes in the filamentous fungus Ashbya gossypii

The rDNA cluster in the phytopathogenic fungus Ashbya gossypii consists of approximately 50 tandem repeat units of 8197 bp. Each unit carries a gene for the 35S pre-rRNA, processed into 18S, 5.8S and 25S rRNA, and a divergently transcribed gene for 5S rRNA. The well-characterized rDNA of the yeast Saccharomyces cerevisiae is the only other example of a completely sequenced rDNA unit (9137 bp) carrying both a 35S pre-rRNA and a 5S rRNA gene. The coding regions for the 5S, 5.8S, 18S and 25S rRNAs are 95-100% identical whereas transcribed and non-transcribed spacers show 43-66% sequence identity. Functionally characterized rDNA and rRNA elements of S. cerevisiae can be unambiguously recognized in the A. gossypii sequence, including the RNA polymerase-I transcription start site, two Reb1p enhancer binding sites and numerous recognition sequences for rRNA modification and processing. In addition to these functionally characterized sequences eight highly conserved elements from 10 to 71 bp were detected in the over 600-bp transcribed region upstream of the 18S rRNA gene which most likely play as yet uncharacterized functions at the DNA or RNA level. In addition to this work we started to identify A. gossypii homologs of S. cerevisiae nucleolar proteins involved in rDNA maturation.

Ten-year experience in oral implant rehabilitation of cancer patients: treatment concept and proposed criteria for success

Between 1988 and 1997, 18 irradiated patients (group 1, 83 implants) and 22 nonirradiated patients (group 2, 92 implants) received resection of the cancer-involved mandible and floor of the mouth and subsequently underwent mandibular rehabilitation with endosseous implants. Implant-supported prostheses were placed in 26 patients, while 13 patients received implant-tissue-supported prostheses. Between 1988 and 1991, patients were restored with implant-tissue-supported prostheses (based on 2 to 4 implants). This strategy was later changed because of the development of denture-related lesions. Since 1992, group 1 patients have been restored exclusively with implant-supported prostheses on 5 to 6 implants; group 2 patients have been rehabilitated alternatively with implant-tissue-supported prostheses on 4 implants. Special criteria for determining the success of implant-supported maxillofacial prostheses were developed. With a mean follow-up period of 37 months, 160 implants (91%) were clinically osseointegrated. Both types of restorations provided sufficient oral rehabilitation. However, only completely implant-supported prostheses avoided soft tissue ulcers. The cumulative success rate was approximately 75% after 7 years for group 1 patients and about 86% after 10 years for group 2 patients. The success rates for implants placed after the change in strategy were approximately 86% (group 1) and 94% (group 2) after 5 years. Based on these experiences, it is suggested that irradiated patients should be restored with exclusively implant-supported prostheses, without any mucosal contact.

Neural command of electromotor output in mormyrids

The electric discharge of mormyrid fish has an irregular pattern controlled by the electromotor command nucleus in the medulla. Anatomical studies suggest that much of the descending information integrated by the command nucleus comes from the diencephalic precommand nucleus. But field potentials related to the motor command occur later in the precommand nucleus than in the command nucleus, suggesting that they are a corollary rather than a cause of electromotor command initiation. Recorded extracellularly, certain precommand nucleus units fire spontaneously between electromotor commands but pause briefly following each command; others units fire a burst of spikes only during the post-command pause. The firing frequency of the former is correlated with the duration of the interval between successive electromotor commands when the fish is discharging at more than approximately 5 Hz. The post-command pause in spontaneous firing is due to corollary-discharge-mediated feedback inhibition, probably generated by the activity of the bursting units that fire only during this period. Precommand nucleus neurons are activated by electrosensory input, and stimulation of the precommand nucleus modulates the endogenous pattern of electromotor command. We propose that the irregular rhythm of the motor command depends largely on the integration of descending information of various origins, conveyed via the precommand nucleus to the command nucleus, and that this process is regulated by corollary discharge feedback inhibition to the precommand nucleus.

[Prosthetic-implantology defect treatment concept for oral rehabilitation of the mandibular area after tumor treatment]

Between 1988 and 1997, tumor resection was carried out in 18 irradiated patients group 1: 36-72 Gy. 83 implants) and 22 nonirradiated patients (group 2: 92 implants) in the mandible and floor of the mouth, and these patients subsequently underwent mandibular endosseous implant rehabilitation. A total of 23 patients were treated with exclusively implant-supported prostheses, and 16 with implant tissue-supported constructions. Between 1988 and 1991, group 1 and 2 patients received implant tissue-supported prostheses (using two to four implants). Due to prosthesis-related pressure lesions, the strategy has now been changed. Since 1992, group 1 patients have received exclusively implant-supported prostheses (using five to six implants), while group 2 patients have received implant tissue-supported constructions (using four implants). Special criteria for the success of implant-supported maxillofacial prosthetics were drawn up. With an average follow-up period of 37 months 160 fixtures (91%) were clinically osseointegrated. Both types of restoration provided sufficient oral rehabilitation. However, only completely implant-supported prostheses avoided soft tissue ulcers. The overall success rate was about 77% after 7 years in group 1 and about 87% after 9 years in group 2. With regard to implants placed after strategy change, the 5-year success rate was approximately 86% (group 1) and 94% (group 2). In irradiated patients, an exclusively implant-supported prosthesis without any mucosal contact (thus avoiding soft tissue ulcers with a potential to develop osteoradionecrosis) should therefore be fabricated. Implant tissue-supported restoration is also possible in nonirradiated oral cancer patients.

[Persistent Lactobacillus casei subspecies rhamnosus bacteremia in a 14 year old girl with acute myeloid leukemia. A case report]

The present clinical observation is related to a 14-year-old girl suffering from acute myeloid leukemia. The clinical course was complicated by episodes of severe enterocolitis, E. coli- septicemia, pancreatitis and pneumonia. In the course of continued cytostatic and antibiotic treatment a persistent asymptomatic Lactobacillus casei subsp. rhamnosus-bacteremia became detectable by a total of 18 blood cultures. Microbial cultures of the faeces revealed colony-forming unites of this germ in orders of 10(9)/g. Antibiotic eradication attempts according to the resistogram were not successful. The Lactobacillus-bacteremia disappeared only after 13 months when the cytostatic therapy was terminated. An adjuvant influence of the Lactobacillus infection on the outcome of the underlying disease cannot be excluded.

Breaking the bad news: dilemmas in shared decision-making in medical practice

In a review of the literature, very little empirically based research was uncovered to guide the practice of health professionals who need to tell their patients bad news and help them to decide on their preferred treatment option. Various practising styles and guidelines are presented, and ethical and crosscultural challenges discussed. An enormous amount of research still needs to be done to discover the least stressful ways of dealing with these issues in health care settings.

Potent dipeptide inhibitors of the pp60c-src SH2 domain

The design, synthesis, and evaluation of dipeptide analogues as ligands for the pp60c-src SH2 domain are described. The critical binding interactions between Ac-Tyr-Glu-N(n-C5H11)2 (2) and the protein are established and form the basis for our structure-based drug design efforts. The effects of changes in both the C-terminal (11-27) and N-terminal (51-69) portions of the dipeptide are explored. Analogues with reduced overall charge (92-95) are also investigated. We demonstrate the feasibility of pairing structurally diverse subunits in a modest dipeptide framework with the goal of increasing the druglike attributes without sacrificing binding affinity.