The utility of an RDoC motor domain to understand psychomotor symptoms in depression

Despite the clinical impact of motor symptoms such as agitation or retardation on the course of depression, these symptoms are poorly understood. Novel developments in the field of instrumentation and mobile devices allow for dimensional and continuous recording of motor behavior in various settings, particularly outside the laboratory. Likewise, the use of novel assessments enables to combine multimodal neuroimaging with behavioral measures in order to investigate the neural correlates of motor dysfunction in depression. The research domain criteria (RDoC) framework will soon include a motor domain that will provide a framework for studying motor dysfunction in mood disorders. In addition, new studies within this framework will allow investigators to study motor symptoms across different stages of depression as well as other psychiatric diagnoses. Finally, the introduction of the RDoC motor domain will help test how motor symptoms integrate with the original five RDoC domains (negative valence, positive valence, cognitive, social processes, and arousal/regulation).

Alpha3 integrin receptors contribute to the consolidation of long-term potentiation

Several lines of evidence suggest that integrin receptors play a pivotal role in consolidation of long-term potentiation (LTP), but which of the many integrin dimers are involved remains to be discovered. The present study used an LTP reversal paradigm to test if alpha3 integrins make an important contribution. Function blocking alpha3 monoclonal antibodies or vehicle were locally infused into recording sites in field CA1 of rat hippocampal slices and LTP induced with theta burst stimulation. Low frequency trains of pulses were applied 30 min after the theta bursts. Previous work indicates that low frequency stimulation reverses LTP when applied immediately after induction but is largely ineffective after 30-45-min delays. If the antibodies were to block consolidation, then they should extend the period over which potentiation is vulnerable to disruption. There was no detectable difference between the two groups in the initial degree of LTP or within slice decay of potentiation 1-10 min after induction; a small but reliable decay occurred from 10 to 30 min with antibody treatment (P<0.01) but not in control slices. Percent potentiation was not statistically different for vehicle (55 +/- 19%, mean +/- S.D.) and anti-alpha3 (43 +/- 21%) slices at 30 min post-theta bursts. Five-Hz stimulation ("theta pulse" stimulation) 30 min after induction caused a reduction of LTP. The percent loss of potentiation after the 1-min trains was greater in the antibody-treated slices than in controls (98 +/- 4% vs. 62 +/- 28%, P<0.01, U-test) and correlated (r=0.84, alpha3 slices) with the percent LTP present prior to low frequency stimulation, as expected if the stimulation reversed potentiation. Recovery occurred in both groups but percent LTP was significantly smaller in experimental slices at 10 min post-theta pulses (5 +/- 11% vs. 36 +/- 15%, P<0.01). Recovery continued for 20 min after theta pulses and, in accordance with earlier work, was nearly complete for the control slices (50 +/- 19% vs 55 +/- 15%, 40 min post- vs. immediately pre-theta pulses). LTP remained depressed after 40 min of recovery in the anti-alpha3 slices (23 +/- 19% vs. 43 +/- 21%) at which point it was substantially less than that found in controls (P<0.01). Western blots with anti-alpha3 antibodies identified a polypeptide with the molecular mass (155 kDa) expected for the alpha3 subunit and further showed that it is broadly distributed in brain. Subcellular fractionation experiments demonstrated that alpha3 is concentrated in synaptic membranes over homogenates to about the same degree as the GluR1 subunit of the alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionate-type glutamate receptor. From these results we suggest that alpha3-containing integrins are localized to synapses and are needed to stabilize a slowly decaying form of LTP. The findings also show that vulnerability to reversal can be used in place of extended recording sessions in studying consolidation.

[Retinal lesion due to an obstetrical traumatism: a case report]

The authors report a case of unilateral, stable, localized, and well-circumscribed choriocapillaris atrophy associated with retinal pigment epithelium dispersion and atrophy. The anterior segment was normal. Facial examination revealed a homolateral malar hypoplasia. The other eye was normal. The electrophysiologic study did not confirm pigmentary degeneration of the retina. The patient's history included a difficult delivery using obstetrical forceps. The authors review the main ocular lesions secondary to birth trauma. In this case, they favored a traumatic chorioretinal lesion secondary to an obstetrical traumatism. In this context, progressive facial hemiatrophy is the main differential diagnosis.

[Excessive tearing in infants and young children. Questions? Answers]

Tearing in infants and young children is a subject of controversy. A logical succession of questions and answers is helpful in developing a consensual attitude.

Grid photocoagulation for focal diabetic macular edema with focal leaks and hard exsudates involving the peri-foveolar area

This study was conducted to determine whether indirect grid laser therapy is effective in reducing focal diabetic macular edema characterised by focal leaks and hard exsudates involving the para-foveal area (less than 300 microns from the center of the fovea). Since focal coagulation of microaneurysms in such a critical location can be deleterious, indirect grid pattern laser treatment may be used in such cases.

[Endonasal dacryocystorhinostomy (DCR) with protected drill]

PURPOSE

To analyze the interest of protected drills to perform endoscopic endonasal DCR.

MATERIAL AND METHODS

[corrected] Fifty patients suffering from chronic epiphora were operated successively. None of those patients had had prior nasal surgery. The same surgeons (BF and ER) did the surgical procedure for all the cases. The technical steps were: endoscopic visualization of the middle meatus and evaluation of the anatomic variations of the nose; identification of the lacrymal bag with a 1 mm light in the canaliculus; unciformectomy; the maxillary bone was drilled with a 3.2 mm bit (straightshot Xomed), protected and irrigated; the lacrymal bag was opened by cissors and the flap was pushed in the ethmoid and coagulated.

RESULTS

The suction-irrigation system was efficient to clean the surgical site, with a good endoscopic control. The protected bit didn't damage the 4-mm optics and the septal wall mucosa, even in narrow noses. The staightshot bit (Xomed) was tough enough to drill the maxillary bone in only 68 % of the surgical cases. In 28 % the drilling was unsatisfactory and in 4 % it was inefficient. The functional results at 6 month were good in 85 %. There was no difference between normal and narrow noses.

CONCLUSION

The concept of protected bits perfectly matches the endoscopic endonasal DCR. The visual comfort and security of the surgical procedure are increased. Short term results are equivalent to external DCR, but are rather inefficient and expensive.

[Eyelid and lacrimal abscesses]

Nonspecific eyelid abscesses are rare, whereas periorbital infections occur more frequently. Localisation of a maximum number of inflammatory signs is essential for diagnosis. A superior external localisation suggest dacryoadenitis or infection of a dermal cyst and the end of the eyebrow. An internal canthal localisation would reflect lacrimal disorder. In the adult, the main cause of infection is acute dacryocystitis. After antibiotic and anti-inflammatory drug treatment, dacryocystorhinotomy is necessary to preclude recurrence. In the newborn, bilateral forms of dilatation of the lacrimal sacs can lead to respiratory distress. The treatment of choice is resection of the endonasal pouches.

[A monocanalicular stent with self-stabilizing meatic fixation in surgery of excretory lacrimal ducts. Initial results]

Our experience of 49 cases with a new monocanalicular silicone stent is described. This is a stent with a "auto-stable" meatic plug which respects the canalicular anatomy. There is no stopping-knot, no palpebral ring as in the bicanaliculo-nasal-intubation. The risk of accidental exteriorization is less important, the risk of stricturotomy is absent. Two types of intubation can be used: monocanaliculo-nasal intubation: the way of putting it in place is the same as the bicanaliculo-nasal one, with a metallic probe. The range of it's use widdens from distal canalicular wounds (2 cases) to common canalicular stenosis (15 cases) and to lacrimo-nasal imperforations (12 cases). In the two last instances, the intubation is made through the superior canaliculus, so that the inferior one is left free. In 13 cases, an intubation was made bilaterally for the same disorder, and a comparison could be done between monocanalicular and bicanalicular intubation. The true monocanalicular intubation, for proximal injuries: grasping the metallic probe inside the nose is no longer necessary. The length of the silicone probe is adaptated intra-operatively. The functional results of monocanalicular intubation are comparable to the results of bicanalicular intubation, especially for monocanalicular injuries (in addition with canalicular sutures) and the lacrimo-nasal imperforation. Incidents were observed especially with the first patients; a strict method is mandatory for avoiding accidents. The use of monocanalicular intubation should be used only for short duration and monocanalicular disorders. In other cases, bicanalicular intubation remains the good choice.

Clinical considerations for neutron capture therapy of brain tumors

The radiotherapeutic management of primary brain tumors and metastatic melanoma in brain has had disappointing clinical results for many years. Although neutron capture therapy was tried in the United States in the 1950s and 1960s, the results were not as hoped. However, with the newly developed capability to measure boron concentrations in blood and tissue both quickly and accurately, and with the advent of epithermal neutron beams obviating the need for scalp and skull reflection, it should now be possible to mount such a clinical trial of NCT again and avoid serious complications. As a prerequisite, it will be important to demonstrate the differential uptake of boron compound in brain tumor as compared with normal brain and its blood supply. If this can be done, then a trial of boron neutron capture therapy for brain tumors should be feasible. Because boronated phenylalanine has been demonstrated to be preferentially taken up by melanoma cells through the biosynthetic pathway for melanin, there is special interest in a trial of boron neutron capture therapy for metastatic melanoma in brain. Again, the use of an epithermal beam would make this a practical possibility. However, because any epithermal (or thermal) beam must contain a certain contaminating level of gamma rays, and because even a pure neutron beam causes gamma rays to be generated when it interacts with tissue, we think that it is essential to deliver treatments with an epithermal beam for boron neutron capture therapy in fractions in order to minimize the late-effects of low-LET gamma rays in the normal tissue. I look forward to the remainder of this Workshop, which will detail recent progress in the development of epithermal, as well as thermal, beams and new methods for tracking and measuring the uptake of boron in normal and tumor tissues.

[Repair of recent canalicular wounds using a monocanalicular stent]

A new monocanalicular stent is described, which is used in cases of lacrimal canalicular injuries, associated with direct sutures of the canalicular wall. When injuries occur on proximal portion (2/3) of the canaliculus, a true monocanalicular stent is used, without intubation of the vertical part of lacrimal system. When the distal portion (1/3) of the canaliculus and/or the sac are involved, a complete monocanalicular probe is placed. First results of this method are exposed (5 cases) and are suggestively good.

[Follow-up care of a bilateral nasal catheter. Incident management]

A review of the follow-up care of the silicone intubation is analysed. Details are given for the management of complications such as: vanishing of the probe, exteriorization, splitting of the canaliculus... A scheme of post-operative history is given, with consideration of tentative treatments.

Post-separation detection of nucleic acids and proteins by neutron activation

We describe approaches to neutron activation analysis and their application to post-separation autoradiographic detection of biological compounds. Specifically, we have extended the use of a "direct-labeling" method to the post-separation detection of DNA after gel electrophoresis and to the detection of nucleotides separated by TLC. In addition, we describe a more generally applicable "indirect-labeling" method in which separated compounds of interest are selectively bound to ligands containing highly neutron-activatable elements, such as manganese (55Mn), europium (151Eu), or dysprosium (164Dy), and then irradiated with thermal neutrons. This method is illustrated with nucleotides separated by TLC and with proteins separated by polyacrylamide gel electrophoresis. In contrast to the direct-labeling approach, the indirect-labeling method can be adapted to detect any class of substances for which a highly neutron-activatable, selectively binding ligand is available. The theoretically achievable sensitivity of the indirect-labeling method is in the attomole (10(-18) mol) range.

Birdshot retinochoroidopathy and subretinal new vessels

Decrease of visual acuity in birdshot retinochoroidopathy is due either to optic atrophy or to 3 types of macular involvement: cystoid macular oedema, geographic atrophy, or macular serous detachment. We describe 3 cases of juxtapapillary subretinal neovascularisation occurring in long-standing birdshot retinochoroidopathy. The mechanism of the formation of the new vessels is discussed.

[Orange pigment and hyperfluorescent pin-point dots on the angiographic datas of malignant melanoma (author's transl)]

In a 65 year old woman, a melanoma has been diagnosed on the following angiographic datas: relief; irregular pigmentation; hyperpigmented border-line; leakage of the dye; orange pigment; hyperfluorescent pin-point dots over the tumor. These last two materials has been histologically studied. It is confirmed that lipofuscin could be the constituant of the orange pigment and that the hyperfluorescent points could correspond with exsudative, hyaline and glyco-lipido-proteic "blebs", in connection with the Bruch's membrane or in the subretinal space. This could be the expression of choriocapillaris and/or RPE suffering.