Time-frequency analysis of visual evoked potentials by means of matching pursuit with chirplet atoms

Detection of visual evoked potentials (VEP) elicited by repetitive stimuli is valuable in both laboratorial research and clinical practice. Therefore, knowing the characteristics of VEPs is of fundamental importance for adequate design of a signal detector. Usually, the signal is modeled as a steady-state VEP (ssVEP) consisting of the fundamental frequency and the higher harmonics, while ignoring the information contained in its transients (tVEP). We propose here to characterize both tVEP and ssVEP by chirplet time-frequency representation of VEP signal using a matching pursuit (MP) algorithm. Compared to the time-frequency analysis with short-time-Fourier-transform (STFT) and linear-prediction-coding (LPC) method, MP with chirplet shows not only clear characteristics of ssVEP, but a clear spindle-like time-frequency component of tVEP as well, which is not obvious in the other two methods.

Rapporteur's report

An international workshop was hosted by the Federal Office for Radiation Protection (BfS) on 25-26 July 2006 at its headquarters in Munich. Around 40 expert scientists attended in order to discuss the dosimetry work being carried out within the framework of the German Mobile Telecommunication Research Programme (DMF). There were three presentation sessions in the workshop, the first considering numerical models and computations, the second considering dosimetry in biological studies and the third considering exposure of the general public. The attendees discussed the projects in the context of four over-arching questions: what has been achieved by the projects, where do we still have gaps in knowledge, can minimum standards be defined for future work and do any of the findings impact on the setting of standards and guidelines. This report summarises the workshop outcomes under the four headings.

Image Transfer by Mobile Phones in Neurosurgery

Image transfer by mobile phones with built-in cameras (1 Megapixel CCD digital camera, 7 stage digital zoom, max. picture size 858 x 1 144 pixels, display resolution 240 x 320 dots, 262 K colour system CGS LCD) was introduced into clinical practice in the author's department in July 2004 to improve communication between neurosurgeons. During the first 12 months of use 13-72 images per month with an average of 1.4 images/case were transmitted via the regular German mobile phone net (GRPS standard, 40 KBit/s) among all neurosurgeons. Most images were transferred from the resident on call to the senior neurosurgeon backing him up. Overall, the system was extremely reliable, quick, and enabled immediate decisions in all emergency situations. In conclusion, image transfer by mobile phones has significantly improved communication within our department.

General versus locoregional anesthesia in carotid surgery: A prospective randomised trial

Background: To evaluate the influence of anesthetic technique on perioperative neurological and cardiopulmonary complication rates in patients undergoing carotid endarterectomy. Patients and methods: 186 patients with symptomatic internal carotid artery (ICA) stenosis > 70% or asymptomatic ICA stenosis > 80% were prospectively randomized for either locoregional (LA) or general anesthesia (GA). Results: Neurological complication rates were similar in both groups (GA 2% vs. LA 2%). Cardiopulmonary complication rates were not significantly different (GA 4% vs LA 1%).There were no stroke-related deaths, but one patient from the GA group died from severe postoperative pneumonia. Thus, a significant difference in combined stroke / cardiopulmonary related death between the two groups (GA 1% vs LA 0%) could not be found. However, perioperative cardiopulmonary monitoring showed that significantly more patients operated under general anesthesia had hypertensive events, with systolic blood pressure values greater than 180 mmHg on postoperative day one. There were no differences in the number of postoperatively hypotensive episodes (systolic blood pressure values < 100 mmHg) between the two groups. Conclusions: Significant differences in the perioperative neurological and cardiopulmonary complication rates between general and locoregional anesthesia in patients undergoing carotid endarterectomy could not be observed.

Extended flexible sigmoidoscopy performed by colonoscopists for colorectal cancer screening: a pilot study

BACKGROUND

Caecal intubation can be achieved by extended flexible sigmoidoscopy in 32% of patients.

AIM

To assess the feasibility of extended flexible sigmoidoscopy performed by colonoscopists for colorectal cancer screening.

METHODS

We enrolled 41 patients referred for screening flexible sigmoidoscopy. After purging, examination was performed with a colonoscope. All patients completed sigmoidoscopy (success in meeting referral goal); 93% and 71% had examination to the transverse or ascending colon, and caecum, respectively. Overall yield and right-sided polyps was 56% and 27%, respectively. Caecal intubation and complete examination with polypectomy took 6.0 +/- 2.5 and 18.3 +/- 5.1 min, respectively; with no complications. Twelve patients requested colonoscope withdrawal because of discomfort. Although 46% reported moderate to severe discomfort, 39% and 36%, respectively, were definitely or probably willing to repeat flexible sigmoidoscopy.

RESULTS

Unsedated colonoscopy introduced as extended flexible sigmoidoscopy emphasizes the benefits of added yield rather than the negative image of withholding of discomfort relief. The patient can choose to accept the equivalent of an unsedated colonoscopy or reject the option based on perceived discomfort during extended flexible sigmoidoscopy performed by the colonoscopist.

CONCLUSION

Extended flexible sigmoidoscopy is a feasible option in carefully selected patients, fully prepared and by an experienced colonoscopist.

Inhibition of 7,8-diaminopelargonic acid aminotransferase by amiclenomycin and analogues

Cis and trans stereoisomers of amiclenomycin, a natural L-amino acid antibiotic, have been prepared using unequivocal routes. By using 1H NMR spectroscopy, the configuration of the six-membered ring of natural amiclenomycin was shown to be cis and not trans as originally proposed. Amiclenomycin and some synthetic analogues with the cis configuration irreversibly inactivate DAPA AT (7,8-diaminopelargonic acid aminotransferase), an enzyme involved in biotin biosynthesis, by forming an aromatic PLP (pyridoxal-5'-phosphate)-inhibitor adduct that is tightly bound to the active site. The following kinetic parameters for the inactivation of Escherichia coli DAPA AT by amiclenomycin were derived: K(I)=2 microM and k(inact)=0.4 min(-1). The structure of the aromatic adduct formed upon inactivation was confirmed by UV-visible spectroscopy, X-ray crystal structure determination and MS. Because Mycobacterium tuberculosis DAPA AT is a potential drug target, this enzyme was cloned, overexpressed and purified to homogeneity for biochemical characterization.

Studies on thiamine diphosphate-dependent enzymes

The 3-deaza analogue of TPP (thiamine diphosphate), a close mimic of the ylid intermediate, has been synthesized and is an extremely potent inhibitor of a variety of TPP-dependent enzymes, binding much more tightly than TPP itself. Results using deazaTPP complexed with the E1 subunit of PDH (pyruvate dehydrogenase) have led to a novel proposal about the mechanism of this enzyme. The 2-substituted forms of deazaTPP, which mimic other intermediates in the catalytic mechanism, can also be synthesized and 2-(1-hydroxyethyl)deazaTPP is also an extremely potent inhibitor of PDC (pyruvate decarboxylase). Attachment of such 2-substituents is expected to be a way to introduce selectivity in the inhibition of various TPP-dependent enzymes.

Emotional labour and stress within mental health nursing

For many within the nursing profession, the work role involves a great deal of emotional work or 'emotional labour'. Such emotional work can be performed through 'surface acting' in which the individual simply feigns an appropriate emotion, or through 'deep acting' in which they actually try to feel the required emotion. The current study aims to aid understanding of the complex relationship between components of emotional labour and stress within the mental health nursing sector. Thirty-five mental health nurses completed questionnaires relating to a total of 122 nurse-patient interactions. Data were collected in relation to: (1) the duration and intensity of the interaction; (2) the variety of emotions expressed; (3) the degree of surface or deep acting the nurse performed; and (4) the perceived level of stress the interaction involved. Nurses also completed Daily Stress Indicators. Results suggest that: (1) emotional labour is positively correlated with both 'interaction stress' and daily stress levels; (2) the deeper the intensity of interactions and the more variety of emotions experienced, the more emotional labour was reported; and (3) surface acting was a more important predictor of emotional labour than deep acting. Implications for mental health nurses are outlined.

Identification of Chicken Transmembrane Channel-like (TMC) genes: Expression analysis in the cochlea

Mutations of the human gene encoding transmembrane channel-like protein (TMC)1 cause dominant and recessive nonsyndromic hearing disorders, suggesting that this protein plays an important role in the inner ear. In this study, we cloned chicken Tmc2 (GgTmc2) from a cochlear cDNA library and we annotated four additional TMC family members: GgTmc1, GgTmc3, GgTmc6, and GgTmc7. All chicken TMCs possess the defining TMC signature motif and display high conservation of their genomic structure when compared with other vertebrate TMC genes. GgTmc1 is localized on the chicken sex chromosome Z at a locus that displays conserved synteny with the loci of mammalian orthologues residing on autosomes. In contrast, the locus of GgTmc2 does not exhibit conserved synteny with its mammalian orthologues. Because murine TMC1 and TMC2 are restrictively expressed in cochlear hair cells, we determined the expression of the chicken orthologues in the basilar papilla, the avian equivalent of the organ of Corti. While GgTmc2 was present throughout the basilar papilla and in other tissues, GgTmc1 transcript was detected specifically in the basal portion of the basilar papilla and was not detectable in any other tissue or organ studied. GgTmc3 and GgTmc6 were detectable in all organs analyzed. Antibody labeling revealed that GgTmc2 is predominantly associated with the lateral membranes of hair and supporting cells. The expression of GgTmc2 by both cell types was further confirmed by RT-PCR using isolated cells. This expression and subcellular localization of GgTmc2 is in agreement with the proposed potential role of this novel class of transmembrane proteins in ion transport.

Seltene pulmonale Manifestation eines intrakraniellen meningothelialen Meningeoms

HISTORY AND CLINICAL FINDINGS

A 53-year-old sailor was admitted to our department with the history of severe headache, dysphasia and mild psychotic behavior. Routine chest X-rays several weeks before had shown a focal lung lesion in the lower lobe of the right lung. The patient was without pulmonary symptoms.

INVESTIGATIONS

Brain magnetic resonance imaging demonstrated a large intracranial extracerebral mass with perifocal brain edema in the right frontoparietal region.

THERAPY

The patient was suspected of having a metastasis of an unknown primary tumor. Craniotomy and total removal of the tumor was performed. Histological examination revealed a meningothelial meningioma without signs of malignancy. 6 weeks later thoracotomy and total removal of the lung tumor were performed. Histological examination revealed a meningioma with the same histological pattern as the intracranial lesion. Postoperatively there were no complications, the physical examination at discharge was normal without any pulmonary or neurological deficits. Two years later, we found no evidence of an intracranial or pulmonary tumor recurrence.

CONCLUSION

Pulmonary metastases of benign intracranial meningiomas are rare but should be considered in the differential diagnosis, especially in cases with an undiscovered primary tumor.

Developing clinically relevant and reproducible symptom-defined populations for cancer diagnostic research in general practice using a community survey

BACKGROUND

In developing cancer diagnostic studies, there is a particular need for the population of patients with symptoms of possible oncological significance who consult the GP in 'real life' to be comparable with the group of individuals with symptoms constructed as part of a research project.

OBJECTIVES

The objective of this study was to seek to assess whether a community-based symptom survey can be harnessed in order to produce clinically relevant and reproducible populations within which studies of more detailed indicants could be undertaken.

METHOD

A total of 3629 patients registered with a general practice at Winterton, UK, were sent a questionnaire enquiring about 10 symptoms of possible oncological significance together with their consultation intention in relation to these symptoms. Up to 1 month later, an identical questionnaire was applied to all patients reporting at least one symptom, and more detailed information was obtained by research nurses on each symptom.

RESULTS

The overall response rate was 64.4%, and 850 patients reported one or more symptoms. For the majority of symptom reports, there was moderate to substantial agreement between the two applications of the questionnaire. The question on blood in the motions/toilet pan or on the toilet paper demonstrated almost perfect agreement. Slight agreement was found for abdominal pain for longer than 4 weeks and for black/tarry motions. In relation to the reliability of the patient consultation intention, there was substantial/moderate agreement for actions related to the majority of symptoms. For all symptoms, there was also a greater level of agreement for past activity than future intent.

CONCLUSION

The results of the study provide some support for a community survey as a mechanism to develop 'clinically relevant' populations for the iatrotropic symptoms rectal bleeding or indigestion/heartburn within which studies of more detailed indicants could be undertaken. There is also consistency with the work of others in relation to the numbers and characteristics of patients within the 'clinically relevant' population.

[Contrast-enhanced MR angiography in the routine work-up of the lower extremity arteries]

PURPOSE

Prospective evaluation of the effectiveness of contrast-enhanced moving-table magnetic resonance angiography (CE-MRA) as the sole routine tool for the diagnosis of peripheral arterial occlusive disease and determination whether it can replace catheter arteriography.

SUBJECTS AND METHODS

In a time period of 23 weeks, 100 consecutive patients were evaluated. A total of 112 contrast-enhanced moving-table MR angiograms were performed at 1.5 Tesla. A dedicated vascular coil system was used. It was evaluated in which cases MR angiography was sufficient to determine the treatment plan and in which cases limited quality required additional examinations.

RESULTS

In 93.75 % (105/112) of all examinations, the treatment plan was determined by MRA as the sole diagnostic tool. Twenty-two patients underwent surgery or percutaneous angioplasty based on MRA findings. Additional examinations due to impaired quality were performed in seven (6.25 %) cases: two MR angiographies of the pelvic arteries, one MR angiography of the calf, and four selective arteriographies because of venous overlay at the calf.

CONCLUSION

Contrast-enhanced MR angiography can take the place of catheter angiography in the routine work-up of patients with peripheral arterial occlusive disease. Further assessment might be necessary in five to ten percent of the cases when the diagnostic quality is inadequate, mostly due to venous overlay in the lower leg.

The potential of biomimesis in bone tissue engineering: lessons from the design and synthesis of invertebrate skeletons

Synthetic bone replacement materials are now widely used in orthopedics. However, to date, replication of trabecular bone structure and mechanical competence has proved elusive. Maximization of bone tissue attachment to replacement materials requires a highly organized porous structure for tissue integration and a template for assembly, combined with structural properties analogous to living bone. Natural structural biomaterials provide an abundant source of novel bone replacements. Animal skeletons have been designed through optimization by natural selection to physically support and physiologically maintain diverse tissue types encompassing a variety of functions. These skeletons possess structural properties that provide support for the complete reconstruction and regeneration of ectodermal, mesodermal, and bone tissues derived from animal and human and are thus suited to a diversity of tissue engineering applications. Increased understanding of biomineralization has initiated developments in biomimetic synthesis with the generation of synthetic biomimetic materials fabricated according to biological principles and processes of self-assembly and self-organization. The synthesis of complex inorganic forms, which mimic natural structures, offers exciting avenues for the chemical construction of macrostructures and a new generation of biologically and structurally related bone analogs for tissue engineering.

Interfacial synthesis of hollow microspheres of mesostructured silica

Hollow microspheres with ordered mesoporous walls are synthesised under ambient conditions by a simple procedure involving dilution and neutralisation of an aqueous tetraethoxysilane/cetyltrimethylammonium bromide reaction mixture.

The effects of HDV-insulin on carbohydrate metabolism in Type 1 diabetic patients

The aim of this study was to compare the metabolic effects of a single equimolar subcutaneous injection of hepatic directed vesicle-insulin (HDV-insulin) and regular insulin on glucose levels and intermediary metabolism during a 75-g oral glucose tolerance test (OGTT). Nine Type 1 diabetic patients underwent two experiments separated by 4 weeks. Each experimental protocol consisted of an identical evening meal followed by overnight euglycemic control achieved by a continuous low-dose insulin infusion. The next morning a subcutaneous injection (0.1 U/kg) of HDV-insulin or regular insulin was administered 30 min before a 75-g OGTT. The overnight basal insulin infusion was maintained unaltered throughout the 150-min OGTT. Plasma glucose, glucoregulatory hormones (insulin, glucagon, cortisol), and intermediary metabolites (lactate, alanine, glycerol, NEFA, beta-hydroxybutyrate) were measured to assess the metabolic effects of the two insulin preparations. Compared to regular insulin, an equivalent subcutaneous dose of HDV-insulin significantly lowered glucose levels during OGTT (mean reduction 2.2+/-0.4 mmol/l; P<.005). Plasma levels of insulin and glucagon were equivalent during both series of experiments. Blood lactate, glycerol and plasma NEFA levels were not different during OGTT indicating similar peripheral action of the insulins. beta-Hydroxybutyrate levels were significantly reduced (P<.05) following HDV-insulin supporting a preferential hepatic action of the preparation. We conclude that HDV-insulin can significantly lower plasma glucose excursions compared to an equivalent dose of regular insulin during an OGTT in Type 1 diabetic patients. The metabolic profile of equivalent peripheral insulin, glucagon and glycerol levels but reduced beta-hydroxybutyrate values support a hepatospecific effect of HDV-insulin.

Loss of annexin II heavy and light chains in prostate cancer and its precursors

Annexin II mRNA coding for a calcium binding protein was found to be absent in prostate cancer by subtractive hybridization and Northern analysis. In contrast to high expression in normal and benign hyperplastic glandular and basal epithelium, Annexin II heavy (p36) and light (p11) chains in 31/31 prostate cancer specimens were lost immunohistochemically. In glands involved by prostate intraepithelial neoplasia, 65% lost both chains in glandular epithelial cells, whereas basal cells were all positively stained. Southern analysis of cancer DNA showed no noticeable deletion in p36 gene. LNCaP cells treated with 5-azacytidine re-expressed p36, suggesting methylation could be responsible for the silencing.

Formation of BaSO4 fibres with morphological complexity in aqueous polymer solutions

BaSO4 fibres with morphological complexity were formed in aqueous solution with polyacrylate and partially monophosphonated poly(ethyleneoxide)-block-poly(methacrylic acid) additives by a simple precipitation reaction. For polyacrylate, formation of the fibrous deposits was strongly dependent on the level of supersaturation (S) and Ba2+:polymer molar ratio (R). At S = 60 to 80, and R = 3 to 14, highly anisotropic crystalline fibres consisting of bundles of BaSO4 nanofilaments were formed after several weeks, although the yield was low. The nanofilaments were also organized into cone-shaped aggregates at S = 80, and at lower R values these formed higher-order structures that consisted of multiple cone-on-cone assemblies with remarkable self-similarity. Increasing the supersaturation produced ovoid or cross-shaped dendritic particles for the range of molar ratios studied. In contrast, BaSO4 crystallisation in the presence of a partially phosphonated block copolymer gave a high yield of BaSO4 fibres up to 100 microm in length, and consisting of co-aligned bundles of 30 nm-diameter defect-free single-crystal nanofilaments with a uniform growth tip. A model for the defect-free growth of BaSO4 nanofilaments in aqueous polymer solutions based on amorphous precursor particles, vectorially directing forces and van der Waals attraction is proposed.

New-onset palpitations in general practice: assessing the discriminant value of items within the clinical history

BACKGROUND

Palpitations are non-specific, with less than half of patients experiencing palpitations having a cardiac arrhythmia. Currently it seems that there is little evidence available to assist GPs in discriminating between patients complaining of palpitations who have significant cardiac arrhythmias and those who do not.

OBJECTIVES

Our aim was to estimate discriminant functions for specific items of clinical information in relation to the categorization of a patient (aged over 18 years) with a symptom of new-onset palpitations presenting to primary care.

METHODS

A network of 62 GPs spread amongst 36 practices agreed to recruit patients with new-onset palpitations over the course of a 9-month study period. Patients consenting to be involved in the study were asked a number of questions, focusing particularly on the medical history, and were requested to complete a Hospital Anxiety and Depression Scale. Each patient was also provided with a RhythmCard cardiac event recorder for up to 2 weeks and was asked to record their heart rhythm if they experienced palpitations. Odds ratios (adjusted for age and sex) were used to compare the clinical information obtained from patients with the final diagnosis.

RESULTS

Of the 139 patients with palpitations presenting to GPs, it would appear that males [odds ratio = 2.1 (1.0-4.5)], those with regular palpitations [odds ratio = 2.5 (1.0-5.8)], those experiencing palpitations at work [odds ratio = 3.0 (1.3-7.2)] and those experiencing palpitations affected by sleeping (odds ratio = 3.3 (1.4-7.7)] were more likely to have a cardiac cause for their palpitations. Similar findings were made in an analysis focusing solely on the 81 patients with a RhythmCard result. Furthermore, amongst this group, it is interesting to note that patients with regular palpitations were more than twice as likely to have a 'significant' cardiac arrhythmia as a cause for their palpitations. There were suggestions of dose-response effects between the rate of the palpitation, the duration of the palpitation and the likelihood of it being a 'significant' arrhythmia.

CONCLUSIONS

This study provides some information on the characteristics of patients reporting palpitations to GPs who may have 'significant' cardiac arrhythmias. Based on this work, we believe that a larger community-based study would be worthwhile and would provide useful and useable clinical discriminant information for GPs in the settings where they work and amongst the types of patients they encounter.

Effect of morning exercise on counterregulatory responses to subsequent, afternoon exercise

The aim of this study was to determine whether a bout of morning exercise (EXE(1)) can alter neuroendocrine and metabolic responses to subsequent afternoon exercise (EXE(2)) and whether these changes follow a gender-specific pattern. Sixteen healthy volunteers (8 men and 8 women, age 27 +/- 1 yr, body mass index 23 +/- 1 kg/m(2), maximal O(2) uptake 31 +/- 2 ml x kg(-1) x min(-1)) were studied after an overnight fast. EXE(1) and EXE(2) each consisted of 90 min of cycling on a stationary bike at 48 +/- 2% of maximal O(2) uptake separated by 3 h. To avoid the confounding effects of hypoglycemia and glycogen depletion, carbohydrate (1.5 g/kg body wt po) was given after EXE(1), and plasma glucose was maintained at euglycemia during both episodes of exercise by a modification of the glucose-clamp technique. Basal insulin levels (7 +/- 1 microU/ml) and exercise-induced insulin decreases (-3 microU/ml) were similar during EXE(1) and EXE(2). Plasma glucose was 5.2 +/- 0.1 and 5.2 +/- 0.1 mmol/l during EXE(1) and EXE(2), respectively. The glucose infusion rate needed to maintain euglycemia during the last 30 min of exercise was increased during EXE(2) compared with EXE(1) (32 +/- 4 vs. 7 +/- 2 micromol x kg(-1) x min(-1)). Although this increased need for exogenous glucose was similar in men and women, gender differences in counterregulatory responses were significant. Compared with EXE(1), epinephrine, norepinephrine, growth hormone, pancreatic polypeptide, and cortisol responses were blunted during EXE(2) in men, but neuroendocrine responses were preserved or increased in women. In summary, morning exercise significantly impaired the body's ability to maintain euglycemia during later exercise of similar intensity and duration. We conclude that antecedent exercise can significantly modify, in a gender-specific fashion, metabolic and neuroendocrine responses to subsequent exercise.

Potassium channel receptor site for the inactivation gate and quaternary amine inhibitors

Many voltage-dependent K+ channels open when the membrane is depolarized and then rapidly close by a process called inactivation. Neurons use inactivating K+ channels to modulate their firing frequency. In Shaker-type K+ channels, the inactivation gate, which is responsible for the closing of the channel, is formed by the channel's cytoplasmic amino terminus. Here we show that the central cavity and inner pore of the K+ channel form the receptor site for both the inactivation gate and small-molecule inhibitors. We propose that inactivation occurs by a sequential reaction in which the gate binds initially to the cytoplasmic channel surface and then enters the pore as an extended peptide. This mechanism accounts for the functional properties of K+ channel inactivation and indicates that the cavity may be the site of action for certain drugs that alter cation channel function.