[Chimeric antigen receptors (CARs): universal tools in adoptive cell therapy]

BACKGROUND

The observation that tumor-infiltrating lymphocytes (TIL) after ex vivo amplification can control tumors in the long term led to the concept of redirecting patients' cytolytic T‑cells by a receptor with defined specificity against the tumor.

OBJECTIVES

Development of a recombinant receptor-signal molecule (chimeric antigen receptor, CAR) to increase selectivity and enhance anti-tumor immunity.

METHODS

Description of a prototype CAR, overview of the modular composition and further development of CAR technology for use in adoptive immune cell therapy.

RESULTS

Intensive research over the last two decades has shown how CAR-mediated T‑cell activation is influenced by factors such as binding affinity, the epitope of the target antigen, its expression density and accessibility on the tumor cells, as well as by the signaling domains and their combination to induce T‑cell activation. The quality and duration of the T‑cell response can be specifically modulated by modifying the modular composition of the CAR; CAR T‑cells can act as "biopharmaceutical factories" (T-cells redirected for unrestricted cytokine-mediated killing, TRUCK) in the tissue by CAR-mediated release of transgenic therapeutic proteins.

CONCLUSION

Adoptive CAR T‑cell therapy has shown clinical efficacy in the treatment of hematological malignancies; the treatment of solid tumors, however, is more challenging. Allogeneic CAR T‑cell technology is aimed at generating "off-the-shelf" CAR T‑cells that are accessible for a large number of patients. A further promising approach is the use of CAR T‑cells for other therapeutic applications such as the treatment of autoimmune diseases.

A new microscopic method to analyse desiccation-induced volume changes in aeroterrestrial green algae

Aeroterrestrial green algae are exposed to desiccation in their natural habitat, but their actual volume changes have not been investigated. Here, we measure the relative volume reduction (RVRED ) in Klebsormidium crenulatum and Zygnema sp. under different preset relative air humidities (RH). A new chamber allows monitoring RH during light microscopic observation of the desiccation process. The RHs were set in the range of ∼4 % to ∼95% in 10 steps. RVRED caused by the desiccation process was determined after full acclimation to the respective RHs. In K. crenulatum, RVRED (mean ± SE) was 46.4 ± 1.9%, in Zygnema sp. RVRED was only 34.3 ± 2.4% at the highest RH (∼95%) tested. This indicates a more pronounced water loss at higher RHs in K. crenulatum versus Zygnema sp. By contrast, at the lowest RH (∼4%) tested, RVRED ranged from 75.9 ± 2.7% in K. crenulatum to 83.9 ± 2.2% in Zygnema sp. The final volume reduction is therefore more drastic in Zygnema sp. These data contribute to our understanding of the desiccation process in streptophytic green algae, which are considered the closest ancestors of land plants.

Photosynthetic efficiency, desiccation tolerance and ultrastructure in two phylogenetically distinct strains of alpine Zygnema sp. (Zygnematophyceae, Streptophyta): role of pre-akinete formation

Two newly isolated strains of green algae from alpine regions were compared physiologically at different culture ages (1, 6, 9 and 15 months). The strains of Zygnema sp. were from different altitudes ('Saalach' (S), 440 m above sea level (a.s.l.), SAG 2419 and 'Elmau-Alm' (E-A), 1,500 m a.s.l., SAG 2418). Phylogenetic analysis of rbcL sequences grouped the strains into different major subclades of the genus. The mean diameters of the cells were 23.2 μm (Zygnema S) and 18.7 μm (Zygnema E-A) but were reduced significantly with culture age. The photophysiological response between the strains differed significantly; Zygnema S had a maximal relative electron transport rate (rETR max) of 103.4 μmol electrons m(-2) s(-1), Zygnema E-A only 61.7 μmol electrons m(-2) s(-1), and decreased significantly with culture age. Both strains showed a low-light adaption and the absence of strong photoinhibition up to 2,000 μmol photons m(-2) s(-1). Photosynthetic oxygen production showed similar results (P max Zygnema S, 527.2 μmol O2 h(-1) mg(-1) chlorophyll (chl.) a, Zygnema E-A, 390.7 μmol O2 h(-1) mg(-1) chl. a); the temperature optimum was at 35 °C for Zygnema S and 30 °C for Zygnema E-A. Increasing culture age moreover leads to the formation of pre-akinetes, which accumulate storage products as revealed by light and transmission electron microscopy. Desiccation at 84 % relative air humidity (RH) lead to a reduction of the effective quantum yield of photosystem II (PSII) (ΔFv/Fm') to zero between 90 to 120 min (Zygnema S) and between 30 to 60 min (Zygnema E-A), depending on the culture age. A partial recovery of ΔFv/Fm' was only observed in older cultures. We conclude that pre-akinetes are crucial for the aeroterrestrial lifestyle of Zygnema.

The weal and woe of costimulation in the adoptive therapy of cancer with chimeric antigen receptor (CAR)-redirected T cells

Adoptive cell therapy has shown impressive efficacy to combat cancer in early phase clinical trials, in particular when T cells engineered to specifically target tumor cells were applied. The patient's T cells are genetically equipped with a chimeric antigen receptor (CAR) which allows them to be redirected in a predefined manner towards virtually any target; by using an antibody-derived domain for binding, CAR T cells can be redirected in a major histocompatibility complex (MHC) dependent and independent fashion. The CAR also provides the stimuli required to induce and maintain T cell activation. Recent clinical data sustain the notion that strong costimulation in conjunction with the primary activation signal is crucial for lasting therapeutic efficacy of CAR T cells. However, costimulation is a double-edged sword and the impact of the individual costimuli to optimize T cell activation is still under debate; some general rules are emerging. The review summarizes how costimulation modulates, improves and prolongs the redirected anti-tumor T cell response and how the same costimulatory signals may contribute to unintended side effects including "cytokine storm" and T cell repression. Upcoming strategies to break the activation/repression circle by using CAR's with modified costimulatory signals are also discussed.

Spherical particles of halophilic archaea correlate with exposure to low water activity--implications for microbial survival in fluid inclusions of ancient halite

Viable extremely halophilic archaea (haloarchaea) have been isolated from million-year-old salt deposits around the world; however, an explanation of their supposed longevity remains a fundamental challenge. Recently small roundish particles in fluid inclusions of 22 000- to 34 000-year-old halite were identified as haloarchaea capable of proliferation (Schubert BA, Lowenstein TK, Timofeeff MN, Parker MA, 2010, Environmental Microbiology, 12, 440-454). Searching for a method to produce such particles in the laboratory, we exposed rod-shaped cells of Halobacterium species to reduced external water activity (a(w)). Gradual formation of spheres of about 0.4 μm diameter occurred in 4 M NaCl buffer of a(w) ≤ 0.75, but exposure to buffered 4 M LiCl (a(w) ≤ 0.73) split cells into spheres within seconds, with concomitant release of several proteins. From one rod, three or four spheres emerged, which re-grew to normal rods in nutrient media. Biochemical properties of rods and spheres were similar, except for a markedly reduced ATP content (about 50-fold) and an increased lag phase of spheres, as is known from dormant bacteria. The presence of viable particles of similar sizes in ancient fluid inclusions suggested that spheres might represent dormant states of haloarchaea. The easy production of spheres by lowering a(w) should facilitate their investigation and could help to understand the mechanisms for microbial survival over geological times.

Evolution of public attitudes about mental illness: a systematic review and meta-analysis

OBJECTIVE

To explore whether the increase in knowledge about the biological correlates of mental disorders over the last decades has translated into improved public understanding of mental illness, increased readiness to seek mental health care and more tolerant attitudes towards mentally ill persons.

METHOD

A systematic review of all studies on mental illness-related beliefs and attitudes in the general population published before 31 March 2011, examining the time trends of attitudes with a follow-up interval of at least 2 years and using national representative population samples. A subsample of methodologically homogeneous studies was further included in a meta-regression analysis of time trends.

RESULTS

Thirty-three reports on 16 studies on national time trends met our inclusion criteria, six of which were eligible for a meta-regression analysis. Two major trends emerged: there was a coherent trend to greater mental health literacy, in particular towards a biological model of mental illness, and greater acceptance of professional help for mental health problems. In contrast, however, no changes or even changes to the worse were observed regarding the attitudes towards people with mental illness.

CONCLUSION

Increasing public understanding of the biological correlates of mental illness seems not to result in better social acceptance of persons with mental illness.

239 A NOVEL PIG MODEL OF CYSTIC FIBROSIS GENERATED BY SEQUENTIAL TARGETING OF CFTR BY BACTERIAL ARTIFICIAL CHROMSOME VECTORS

Cystic fibrosis (CF), the most common inherited disease in the Caucasian population, is caused by mutations of the CFTR gene, coding for an anion channel responsible for chloride movement, determining transepithelial salt transport, fluid flow and ion concentrations. Cystic fibrosis is determined by chronic lung disease, marked by airway surface dehydration, reduced mucus clearance and increased mucus obstruction, impaired bacterial killing and inflammation and continuous destruction of the lung tissue. The lack of suitable CF mouse models has so far impeded the understanding of disease mechanisms and the development of novel therapies. Recently, a pig model reflecting the main hallmarks of the human disease in the respiratory, gastrointestinal and genital tracts has been reported (Rogers et al. 2008 Science 321, 1837–1841). In the present study, we generated a new CF pig model by disrupting the CFTR gene using an approach that differs in 3 major aspects from the previously published model: (1) gene targeting was achieved using a modified bacterial artificial chromosome (BAC) vector; (2) transcription of the CFTR gene was completely prevented; and (3) homozygous CFTR mutant pigs were derived by nuclear transfer from cells in which both alleles were inactivated by sequential BAC targeting. We characterised 2 cloned litters with a total of 13 piglets (including 4 stillborns). All piglets showed a characteristic CF multi-organ disease with severe meconium ileus, microcolon, microgallbladder, hypoplasia of the exocrine pancreas, congenital aplasia of the vas deferens and malformations of the trachea. In contrast to the recently published CF pig, where the majority of the intestinal obstructions occurred proximal to the ileocecal junction, we found obstructions exclusively distal to this site. We thus present a novel pig model for CF that reflects the main hallmarks of the human disease. It confirms the suitability of the CFTR mutant pig for cystic fibrosis research and increases the availability of CF models for molecular and translational CF research. The help by Prof. K. Heinritzi and his team from the Pig Clinic, LMU Munich, is gratefully acknowledged. This study was supported by Mukoviszidose e.V.

The loss of sadness: the public's view

OBJECTIVE

With the exception of bereavement, the diagnosis of major depressive disorder in the DSM-IV does not take into account the context in which the symptoms occur. Recent criticism has maintained that common sense suggests making a distinction between depression as mental disorder and sorrow as 'normal' reaction to social stress. This study sets out to investigate whether the public does in fact make this distinction.

METHOD

In spring 2009, a population-based survey was conducted by phone in the city of Vienna (n = 1205). A fully structured interview was carried out which began with the presentation of a vignette describing a diagnostically unlabeled case of depression, with or without provision of information about preceding stressful life events.

RESULTS

Respondents presented with vignettes containing information on loss events were less likely to define depressive symptoms as indication of mental illness. They were also not as willing to recommend professional help. And if they were, they tended to less frequently recommend seeking help from someone with a medical background.

CONCLUSION

In contrast to the conceptualization in the DSM-IV, the public tends to perceive depressive symptoms differently depending on the context in which they occur.

Cytoarchitecture of the desiccation-tolerant green alga Zygogonium ericetorum

In this study, the filamentous green alga Zygogonium ericetorum (Zygnematales, Chlorophyta), collected at its natural habitat in the high alps, was investigated by light, scanning, and transmission electron microscopy. The field samples were separated into a moist fraction when wetted by splattering water of a nearby spring or a desiccated one when visually dried out. Light microscopy demonstrated a purple pigmentation of the sun-exposed upper layers, the central position of the nucleus, and the starch content in the pyrenoids. The smooth surface of the cells occasionally covered with fungal hyphae was shown by scanning electron microscopy. The cytoarchitecture of moist cells revealed many vacuoles and only a thin cytoplasmic area surrounding the two chloroplasts. The secondary cell walls of older cells were up to 4 microm thick. Organelle membranes as well as thylakoid membranes occasionally showed an inversion of contrast. In the chloroplasts, distinct areas with granular content surrounding the pyrenoids were detected. Within the cytoplasm, electron-dense particles with electron-translucent crystalloid structures were observed. When desiccated samples were investigated, the vacuoles and cytoplasmatic portions appeared destroyed, whereas nucleus and chloroplasts generally remained intact. The thylakoid membranes of desiccated samples showed lumen dilatations and numerous plastoglobules. Water-soluble extracts were separated by high-pressure liquid chromatography that revealed two major compounds with UV-absorbing capacities.

Cell morphology, ultrastructure, and calcification pattern of Oocardium stratum, a peculiar lotic desmid

Cell morphology and ultrastructure of the desmid Oocardium stratum and its habitat conditions in two limestone-precipitating spring habitats in the Alps were studied. In spite of specific cell geometry, we found ultrastructural features (nucleus with nucleolus, Golgi apparatus, chloroplast structure, lipid bodies, cell wall texture) closely related to other desmids. The type of the mucilage pore apparatus perforating in high densities extended areas of the cell wall of Oocardium is of the Cosmarium type. Oocardium contrasts to Cosmarium by a peculiar bilateral cell geometry (lateral sphenoid shape) which is combined with a dislocated nucleus. Although the cell features of Oocardium did not differ between the two habitats, different calcification types (rhombohedral calcite versus fascicular-fibrous calcite) and calcification intensities were recorded. The spatial positioning and extension of the Oocardium niches differed considerably between the two springs in spite of high CO(2) oversaturation at both sites.

Extreme hyponatremia in an infant with congenital adrenal hypoplasia due to a novel NR0B1 (DAX-1) mutation

BACKGROUND

Extreme hyponatremia (<105 mmol/l) has rarely been reported in infants. It is potentially life-threatening and requires intensive care treatment.

PATIENT

We report on a male infant with absence of weight gain from birth to day 33 of life despite adequate nutrition. On admission serum sodium and potassium were 104 and 5.9 mmol/L respectively. The infant's physical status revealed dehydration, but normal activity with no apparent neurological, circulatory or respiratory impairment.

MAIN RESULTS

Global adrenocortical insufficiency was diagnosed and treated with hormonal substitution in addition to intravenous application of fluid, glucose and electrolytes. The rise of serum sodium was carefully monitored and adjusted to a target rate of 0.5 mmol/L/h. X-linked adrenal hypoplasia congenita (X-AHC) was confirmed by the identification of a novel nonsense NR0B1 (DAX-1) mutation (W236X).

CONCLUSIONS

X-AHC in infants may present as failure to thrive despite adequate nutrition. Extreme hyponatremia may be associated with little symptoms if developing slowly. Rehydration and slow correction of serum sodium with solutions containing less sodium than normal saline is essential.

[Malassezia furfur colonising the respiratory tract of mechanically ventilated neonates]

BACKGROUND

Ventilated neonates are prone to acquire ventilator-associated pneumonia (VAP). Consequently early diagnosis of pneumonia is required. Beside bacteria, fungi are suspected as a cause of VAP. However, fungal colonisation and infection of the lung have not been studied systematically. The purpose of this study was to evaluate pulmonary fungal colonisation in ventilated neonates and premature infants.

MATERIALS AND METHODS

187 tracheal aspirates (TA) from 29 ventilated neonates (23-35 weeks gestational age) were investigated. TAs were evaluated microscopically and by culture. Data were matched with clinical signs of VAP or sepsis.

RESULTS

Candida species were not detected in TA or culture. In contrast, Malassezia furfur (Mf), a lipophilic fungus, was detected from the 10th, 21st and 31st postnatal days onwards in TAs of 3 out of 17 extremely prematures (gestational age at birth < 25 weeks). The presence of Mf was associated with clinical deterioration either immediately or a few days after the first positive Mf smear. Topic steroids were more frequently applied to Mf-positive ELBW infants (p = 0.03). In vitro, natural surfactant was demonstrated to be a sufficient substrate for Mf in culture.

CONCLUSION AND DISCUSSION

This is the first report on Mf lung colonisation of ELBWI during mechanical ventilation. Because Mf is generally not detected in standard cultures it appears to be an overlooked, potentially pathogenic fungus in prematures. Mf must be considered in the differential diagnosis of VAP in ELBWI exposed to topical steroids, especially when natural surfactant was administered.

Investigating cytoskeletal function in chloroplast protrusion formation in the arctic-alpine plant Oxyria digyna

Arctic and alpine plants like Oxyria digyna have to face enhanced environmental stress. This study compared leaves from Oxyria digyna collected in the Arctic at Svalbard (78 degrees N) and in the Austrian Alps (47 degrees N) at cellular, subcellular, and ultrastructural levels. Oxyria digyna plants collected in Svalbard had significantly thicker leaves than the samples collected in the Austrian Alps. This difference was generated by increased thickness of the palisade and spongy mesophyll layers in the arctic plants, while epidermal cells had no significant size differences between the two habitats. A characteristic feature of arctic, alpine, and cultivated samples was the occurrence of broad stroma-filled chloroplast protrusions, 2 - 5 microm broad and up to 5 microm long. Chloroplast protrusions were in close spatial contact with other organelles including mitochondria and microbodies. Mitochondria were also present in invaginations of the chloroplasts. A dense network of cortical microtubules found in the mesophyll cells suggested a potential role for microtubules in the formation and function of chloroplast protrusions. No direct interactions between microtubules and chloroplasts, however, were observed and disruption of the microtubule arrays with the anti-microtubule agent oryzalin at 5 - 10 microM did not alter the appearance or dynamics of chloroplast protrusions. These observations suggest that, in contrast to studies on stromule formation in Nicotiana, microtubules are not involved in the formation and morphology of chloroplast protrusions in Oxyria digyna. The actin microfilament-disrupting drug latrunculin B (5 - 10 microM for 2 h) arrested cytoplasmic streaming and altered the cytoplasmic integrity of mesophyll cells. However, at the ultrastructural level, stroma-containing, thylakoid-free areas were still visible, mostly at the concave sides of the chloroplasts. As chloroplast protrusions were frequently found to be mitochondria-associated in Oxyria digyna, a role in metabolite exchange is possible, which may contribute to an adaptation to alpine and arctic conditions.

Design and construction of a new temperature-controlled chamber for light and confocal microscopy under monitored conditions: biological application for plant samples

A new light microscope-temperature-controlled chamber (LM-TCC) has been constructed. The special feature of the light microscope-temperature-controlled chamber is the Peltier-element temperature control of a specimen holder for biological samples, with a volume capacity of 1 mL. This system has marked advantages when compared to other approaches for temperature-controlled microscopy. It works in a temperature range of -10 degrees C to +95 degrees C with an accuracy of +/-0.1 degrees C in the stationary phase. The light microscope-temperature-controlled chamber allows rapid temperature shift rates. A maximum heating rate of 12.9 degrees C min(-1) and a maximum cooling rate of 6.0 degrees C min(-1) are achieved with minimized overshoots (<or=1.9 degrees C). This machinery operates at low cost and external coolants are not required. Especially with samples absorbing irradiation strongly, temperature control during microscopy is necessary to avoid overheating of samples. For example, leaf segments of Ficaria verna exposed to 4500 micromol photons m(-2) s(-1) in a standard microscopic preparation show a temperature increase (deltaT) of 18.0 degrees C, whereas in the light microscope-temperature-controlled chamber this is reduced to 4 degrees C. The kinetics of microscope-light induced deltaT are described and infrared thermography demonstrates the dissipation of the temperature. Chloroplasts of the cold adapted plant Ranunculus glacialis show the tendency to form stroma-filled protrusions in relation to the exposure temperature. The relative number of chloroplasts with protrusions is reduced at 5 degrees C when compared to 25 degrees C. This effect is reversible. The new light microscope-temperature-controlled chamber will be useful in a wide range of biological applications where a rapid change of temperature during microscopic observations is necessary or has to be avoided allowing a simulation of ecologically relevant temperature scenarios.

Temperature-sensitive formation of chloroplast protrusions and stromules in mesophyll cells of Arabidopsis thaliana

In leaf mesophyll cells of transgenic Arabidopsis thaliana plants expressing GFP in the chloroplast, stromules (stroma-filled tubules) with a length of up to 20 mum and a diameter of about 400-600 nm are observed in cells with spaces between the chloroplasts. They appear extremely dynamic, occasionally branched or polymorphic. In order to investigate the effect of temperature on chloroplasts, we have constructed a special temperature-controlled chamber for usage with a light microscope (LM-TCC). This LM-TCC enables presetting of the temperature for investigation directly at the microscope stage with an accuracy of +/-0.1 degrees C in a temperature range of 0 degrees C to +60 degrees C. With the LM-TCC a temperature-dependent appearance of chloroplast protrusions has been found. These structures have a considerably smaller length-to-diameter ratio than typical stromules and reach a length of 3-5 mum. At 5-15 degrees C (low temperatures), almost no chloroplast protrusions are observed, but they appear with increasing temperatures. At 35-45 degrees C (high temperatures), numerous chloroplast protrusions with a beaklike appearance extend from a single chloroplast. Interaction of stromules with other organelles has also been investigated by transmission electron microscopy. At 20 degrees C, transverse sections of stromules are frequently observed with a diameter of about 450 nm. A close membrane-to-membrane contact of stromules with the nucleus and mitochondria has been visualised. Golgi stacks and microbodies are found in the spatial vicinity of stromules. At 5 degrees C, virtually no chloroplast protrusions or stromules are observed. At 35 degrees C, chloroplast protrusions are present as broader thylakoid-free stroma-filled areas, resulting in an irregular chloroplast appearance.

The effect of ultraviolet radiation on ultrastructure and photosynthesis in the red macroalgae Palmaria palmata and Odonthalia dentata from Arctic waters

In radiation exposure experiments, the effects of mild artificial UV conditions (4.7 W m(-2) UV-A and 0.20 W m(-2) UV-B) plus PAR (25 - 30 micromol photons m(-2) s(-1)) on photosynthesis and ultrastructure of two red algal species from the Arctic have been investigated. While Palmaria palmata was collected from the upper sublittoral of the Kongsfjord (Spitsbergen, Norway), Odonthalia dentata represents a typical deepwater species at this high latitude. After 6 h and 24 h exposure to UV, chlorophyll fluorescence of photosystem II (PS II efficiency, F(v)/F(m)) was determined as an indicator for photosynthetic performance, and the relative electron transport rates in response to increasing photon fluence rates were recorded. In parallel, tissue samples were prepared for the transmission electron microscope (TEM). The presented data clearly demonstrate a significant influence of experimental UV on photosynthetic performance. Photochemical efficiency of PS II of both red algal species decreased to about one third of the initial value under UV. While the PI (photosynthesis-irradiance) curve parameter alpha (positive slope at limiting photon fluence rates) strongly decreased in both plants, the I(k) values (initial value of light-saturated photosynthetic rate) increased 3 - 5-fold. Palmaria palmata does not appear to become photoinhibited under these conditions, but O. dentata showed strong photoinhibition. The TEM results demonstrated that the photosynthetic apparatus was severely influenced by UV in both species, because thylakoid membranes appeared wrinkled, lumen dilatations occurred, and the outer membranes were altered. Moreover, mitochondria were damaged, and numerous plasma vesicles were observed. In conclusion, both red algal species are negatively affected by UV on the physiological and ultrastructural level. However, the differences in photoinhibitory responses correlate well with the vertical depth zonation of P. palmata and O. dentata in the Arctic Kongsfjord.

Stigmatisierungserfahrungen von Patienten mit Zwangserkrankungen

BACKGROUND

Only in recent years has research shown interest in stigma experiences of patients with mental disorders. However, subjective experiences of patients with OCD have not been published until now.

METHOD

Fifty-one patients with OCD were questioned about anticipated and actual stigmatization experiences as well as their stigma coping strategies, using a questionnaire especially developed for this study.

RESULTS

Most of the patients expected negative reactions from their environment. Eighty per cent of the respondents were convinced that they would be rejected at work when it became known that they are mentally ill. Two thirds of the respondents feared that they would be rejected in a partnership. Concrete stigmatization was rarely reported by patients with OCD. Contrary to patients with depression and schizophrenia, the group of patients with OCD showed some differences between anticipated and actually experienced stigmatization. Concealing is a relevant strategy for dealing with the illness for three quarters of the respondents.

CONCLUSION

Possibilities of reducing stigmatization and discrimination because of mental illness in general and OCD in particular are discussed.

Impairment of cytoskeleton-dependent vesicle and organelle translocation in green algae: combined use of a microfocused infrared laser as microbeam and optical tweezers

A Nd-YAG laser at 1064 nm is used as optical tweezers to move intracellular objects and a laser microbeam to cause impairment of cytoskeleton tracks and influence intracellular motions in desmidiaceaen green algae. Naturally occurring migrations of large nuclei are inhibited in Micrasterias denticulata and Pleurenterium tumidum when the responsible microtubules are targeted with a laser microbeam generating 180 mW power in the focal plane. Impairment of the microtubule tracks appears to be irreversible, as the nucleus cannot pass the former irradiated area in Pleurenterium or remains abnormally dislocated in Micrasterias. The actin filament-dependent movement of secretory vesicles and smaller particles can be manipulated by the same IR-laser at 90 mW when functioning as optical tweezers. In Closterium lunula particles are displaced from their cytoplasmic tracks for up to 10 micro m but return to their tracks immediately after removing the light pressure gained by the optical tweezers. The cytoplasmic tracks consist of actin filament cables running parallel to the longitudinal axis of Closterium cells as depicted by Alexa phalloidin staining and confocal laser scanning microscopy. Dynamics and extensibility of the cytoplasmic strands connecting particles to the tracks are also demonstrated in the area of large vacuoles which are surrounded by actin filament bundles. In Micrasterias trapping of secretory vesicles by the optical tweezers causes irreversible malformations of the cell shape. The vesicle accumulation itself dissipates within 30 s after removing the optical tweezers, also indicating reversibility of the effects induced, in the case of actin filament-mediated processes.

Depression and quality of life: results of a follow-up study

BACKGROUND

Although there is sufficient evidence that the quality of life of people suffering from depression is reduced hardly anything is known about their quality of life after the remission of a depressive episode.

AIMS

We therefore set out to study the quality of life of patients with depression (ICD-10 F32, F33) one, four and seven months after discharge from hospital. For comparison, a random sample of the general population was studied in addition.

METHOD

Quality of life was assessed by means of the WHOQOL-100, a self-administered questionnaire developed by WHO.

RESULTS

Although, shortly after discharge, quality of life of patients whose depression remitted was better than that of patients with persisting depression it was still slightly worse than that of the general population. During the subsequent six months, there was no further improvement of quality of life, i.e. even at the end of the follow-up period there was a slight lack of quality of life, especially as concerns the level of independence, spirituality/religion/personal beliefs and physical health.

CONCLUSIONS

Thus, what already had been reported based on the objective assessment of quality of life, namely that depression implies a persisting impairment of social functioning and living conditions, can be replicated to some extent from the point of view of the patients themselves.

[Causal beliefs of schizophrenic patients]

RESEARCH QUESTION

Aim of the study is to investigate whether the preference of schizophrenic patients for psychosocial causal explanations found in a previous study carried out in Hamburg can be observed elsewhere. Further aim of the study was to find out how stable patients' causal attributions are over time. Finally, we were interested to know to what degree patients' beliefs reflect those held by the general public.

METHOD

Using an inventory comprising 15 items, we inquired about 105 schizophrenic patient's aetiological ideas at the time of discharge from hospital from inpatient or daycare treatment at 4 psychiatric hospitals in Germany. Follow-ups were carried out 3 months and 6 months later.

RESULTS

Psychosocial factors, especially psychosocial stress, were most frequently held responsible for the onset of the illness. The possibility that biological factors might play a role in the causation of schizophrenia was considered more rarely by the patients. There were practically no regional variations as concerns aetiological beliefs. The tendency to endorse psychosocial stress factors was more pronounced among patients as compared with the general public. In total the causal beliefs proved to be quite stable over a time period of 6 months.

DISCUSSION

Patients' causal beliefs are compared with findings of psychiatric research, and possible ways to bridge the gap between the two are discussed.

["It may be somewhat more demanding sometimes, but also more interesting". Psychiatrists evaluate the impact of psychoeducation on outpatient treatment of schizophrenia]

PURPOSE

Aim of the study is the analysis of the psychiatrists' evaluation of the impact of a psychoeducative group programme on patients with schizophrenia and schizoaffective disorders, which was part of the project "Integrated Treatment of Schizophrenia".

METHOD

Semi-structured interviews were carried out with 20 psychiatrists involved in outpatient treatment of patients who participated in the psychoeducative programme. Interviews were analysed by means of qualitative content analysis.

RESULTS

For some patients psychiatrist noticed positive changes of the awareness for early signs of psychosis, the illness behaviour and their attitudes regarding their disorder. Although only some of the psychiatrists believe that psychoeducation has a direct impact on the reduction of relapse rates and the necessity of inpatient episodes, most of them regard the observed effects as an important improvement of the patients' ability to cope with their disorder.

CONCLUSIONS

The effectiveness of psychoeducational programmes should not only be assessed by their impact on the reduction of relapse rates and health service cost but also by its contribution to the patients' quality of life. The integration of psychoeducational programmes into existing outpatient services seems to be an important task of future service planning.