[Recurrent depressive disorder associated with an atypical CADASIL syndrome]. / Recidiverende depressieve stoornis bij een atypisch CADASIL-syndroom.

A 55-year-old man with recurrent depressive episodes, with onset at age 45, was admitted to hospital after a suicide attempt. Due to a recent stroke as well as a family history of stroke and depression, CADASIL (prevalence of 2-5 per 100.000) was considered as a possible diagnosis. Although depression is common in CADASIL, the initial presentation is not typically comprised of recurrent depressions. Brain MRI, however, did not show the characteristic white matter lesions in the anterior temporal lobe. Genetic analysis revealed a cysteine-sparing mutation (Arg61Trp) in the NOTCH3 gene. Recently, several such mutations have been associated with CADASIL presenting with an atypical phenotype including a lower prevalence of recurrent stroke. This suggests that the prevalence of CADASIL may be higher than estimated in depressed patients. This case demonstrates the importance of considering CADASIL as a possible etiology of depression as this has consequences for prognosis, treatment and genetic counseling.

[Autistic female with anxiety disorder and superior mesenteric artery syndrome]. / Autisme bij een jonge vrouw met een angststoornis en het A.-mesenterica-superiorsyndroom.

An anxiety disorder can manifest in multiple ways. We saw a 21-year-old woman with an anxiety disorder in combination with superior mesenteric artery syndrome. For we know, this is the first description of this combination. There was also hypersensitivity to certain foods and rigid thinking patterns, and an autism spectrum disorder was discovered later. The recognition of the influence of autism on comorbid disorders is important in order to create an individual adapted treatment protocol.

[Melatonin and sleep disorders: Overview of literature and testing in psychiatric practice]. / Melatonine en slaapstoornissen: literatuuroverzicht en toetsing aan de psychiatrische praktijk.

BACKGROUND: Sleep disorders are a frequent problem with an important impact on the quality of life. Given its physiological properties, melatonin is often associated with sleep disorders and their treatment. In addition, melatonin has been recognized by the European Medicines Agency (ema) since 2007 for primary insomnia in adults over 55 years of age for a maximum of 13 weeks.
AIM: Analysis of the international literature on the indication statements and effectiveness of melatonin for sleep disorders and their testing against practical use.
METHOD: A narrative literature study in PubMed, Cochrane and Web of Science, supplemented with a retrospective study of prescribing behavior within a university psychiatric hospital.
RESULTS: The current evidence for the use of melatonin for insomnia and circadian arrhythmias is low. We also noted that the effectiveness of melatonin for the recognized indication of primary insomnia was questioned by some guidelines and that the various studies were also heterogeneous in terms of outcome measures, indication statements and formulated advice. In addition, only 19.6% of the requirements in the retrospective study met the official ema indication.
CONCLUSION: This study shows that melatonin is mainly used off-label. Overall, there appears to be limited effectiveness of melatonin, which has an impact on the indication statements.

Floral ontogeny of the Afro-Madagascan genus Mitrasacmopsis with comments on the development of superior ovaries in Rubiaceae.

BACKGROUND AND AIMS: Members of Rubiaceae are generally characterized by an inferior ovary. However, Mitrasacmopsis is cited in the literature as having a semi-inferior to superior ovary. It has previously been hypothesized that the gynoecial development of Rubiaceae with semi-inferior to superior ovaries takes place in the same way as in Gaertnera, one of the most commonly cited rubiaceous genera with a superior ovary. To test this hypothesis, a floral ontogenetic study of Mitrasacmopsis was carried out with special attention paid to the gynoecial development. METHODS: Floral ontogeny and anatomy of Mitrasacmopsis were examined using scanning electron and light microscopy. KEY RESULTS: At an early developmental stage, a concavity becomes visible in the centre of the floral apex simultaneously with the perianth initiation. A ring primordium surrounding this concavity expands vertically forming the corolla tube (early sympetaly). Stamen primordia develop inside the corolla. From the bicarpellate gynoecium only two carpel tips are visible because the ovary is formed by a gynoecial hypanthium. In the basal part of each carpel, a placenta primordium is initiated. Two septa divide the ovary into two locules. In each locule, the placenta becomes mushroom shaped and distinctly stalked. Eventually, the inferior ovary of Mitrasacmopsis develops into a beaked capsule. Only very late in the fruiting stage, the continuously expanding ovary is raised above the insertion point of the persistent calyx, changing the ovary position of Mitrasacmopsis from basically inferior to secondarily semi-inferior. CONCLUSIONS: Mitrasacmopsis follows an epigynous pattern of floral development. However, the presence of a prominent beak in the fruiting stage gives the whole ovary a semi-inferior appearance. This kind of secondarily semi-inferior ovary is shown to be different from the secondarily superior ovary observed in Gaertnera.

The use of common elder Sambucus nigra to promote Aphidophagous syrphids in apple orchards.

Elder shrubs (Sambucus nigra L.) were planted in an experimental apple orchard as bordering hedgerow with the objective of rearing syrphids (Diptera: Syrphidae) and consequently enhancing the biological control of the rosy apple aphid Dysaphis plantaginea (Passerini). The inoculative introduction of the specific elder aphid Aphis sambuci L. (Homoptera: Aphididae) in late March 2002 and again in 2003 led to the complete hedgerow turning into an early and productive alternative prey reservoir for indigenous syrphids. The species Scaeva pyrastri (L.), S. selenetica (Meigen), Syrphus ribesii (L.), S. vitripennis Meigen, Epistrophe eligans (Harris), E. nitidicollis (Meigen), Platycheirus scutatus (Meigen), Eupeodes corollae (F.), Meligramma triangulifera (Zetterstedt) and Episyrphus balteatus (De Geer) developed on the elder hedgerow during the spring 2002 taking advantage of the aphid infestation. The season 2003 was characterised by a quite different species abundance pattern as, contrary to the previous year when both monovoltine and polyvoltine species were equally represented, the monovoltine syrphids (Epistrophe spp.) represented the dominant group exploiting the elder aphids. A parallel analysis showed that the faeces of the first adult syrphids observed ovipositing on the elder hedgerow in spring contained digested pollen of mainly apple. Our observations indicate the possibility of establishing a local population of monovoltine syrphids in apple orchards by managing an aphid-infested elder hedgerow, without any additional pollen or nectar producing plants.

The remarkable genus Coptosapelta (Rubiaceae): pollen and orbicule morphology and systematic implications.

The pollen morphology and distribution of orbicules were investigated in ten species of the genus Coptosapelta (Rubiaceae) using light, scanning electron and transmission electron microscopy. In general, Coptosapelta pollen is three- to five-pororate and suboblate to oblate-spheroidal. The sexine ornamentation varies from psilate to reticulate, and the pollen-wall stratification lacks columellae. 'Droplets' are observed on the inner nexine surface. Distinct orbicules are found in five species. Orbicules are often lobed and appear to be aggregated and embedded in the tapetal remnants of the locule wall. Ultrastructurally, a single, flattened core is frequently observed. Coptosapelta has a unique pollen type within Rubiaceae and does not resemble possibly related genera. Pollen characteristics provide additional evidence supporting earlier findings that Coptosapelta represents an isolated lineage in Rubiaceae.

Pollen development of Rondeletia odorata (Rubiaceae).

Pollen wall ontogeny of RONDELETIA: odorata was studied with transmission electron microscopy (TEM) and scanning electron microscopy (SEM) from tetrad stage until maturity. The ontogenetic sequence of wall development in RONDELETIA: follows, to some extent, the basic scheme in the angiosperms, i.e., development starts centripetally with the pro-columellae in a plasmalemma surface coating (primexine) at the early tetrad stage when the microspores are still enveloped by callose, until intine formation in young pollen grains. The main ontogenetical features of Rondeletia odorata pollen are (1) the very thin irregular foot layer, (2) development of a continuous layer of radially oriented membranous granular material under the thick endexine, (3) initiation of intine before first mitosis with characteristic radial plasmalemma invaginations, and (4) a strong stretching force upon engorgement just prior to dehiscence, which leads to reduction in thickness of all wall layers. The possible function of Golgi vesicles in the considerable increase in surface area of the plasmalemma at intine initiation is discussed. The endocingulum observed on acetolyzed and sectioned mature grains is explained ultrastructurally.

Morphology and ultrastructure of orbicules in the subfamily Ixoroideae (Rubiaceae).

Orbicules were studied in 43 species belonging to 32 genera of the five tribes of the Ixoroideae (Rubiaceae). The orbicules were investigated with scanning electron microscopy (SEM), light microscopy (LM), and transmission electron microscopy (TEM). Orbicules are present in all species investigated of the tribes Pavetteae, Octotropideae and Coffeeae. In the tribes Gardenieae and Aulacocalyceae orbicules were found in some species, while they were absent in others. 15 species out of 11 genera lack orbicules. Three orbicule types (III, V, and VI) could be distinguished, mainly on the basis of general morphological and ultrastructural variations. Orbicules that belong to type III (0.50-1.29µm) have perforations in their wall, a regular or irregular shape and two or three electron transparent cores. This orbicule type, exclusively found in all Pavetteae species investigated, can be divided into two subtypes. Orbicules of subtype IIIa are present in all genera related to Ixora, and orbicules of subtype IIIb in those genera related to Tarenna. Orbicules of type V (0.97-1.86µm) are present in Himalrandia tetrasperma (Aulacocalyceae), and in all Octotropideae genera investigated, except Feretia. Complexes of more than three individual orbicules characterize this type. They are irregularly shaped and have many perforations as well as sporopollenin granules on the orbicule wall. In all species investigated of tribe Coffeeae, type VI orbicules (0.56-1.60µm) are present. These orbicules are characterized by their embedded position towards the tapetal membrane, their aggregated form and by the presence of perforations as well as sporopollenin granules on their orbicule wall. In the tribe Gardenieae different types of orbicule were found (V, VI and orbicules that cannot be classified in our typology). Our results suggest that orbicule characters in the Ixoroideae may be systematically useful on tribal level.

Pollen morphological survey of Pentas (Rubiaceae-Rubioideae) and its closest allies.

Pollen descriptions, based on LM and SEM observations, are provided for the Pentas complex, an African alliance within the Hedyotideae-Spermacoceae alliance, which includes the genera Pentas, Otomeria, Batopedina, Parapentas, and Chamaepentas. The close relationship among these genera is confirmed by pollen morphological data. The observed variation in pollen character states agrees well with the existing genera and subgenera. The combination of small spheroidal pollen grains with narrow, acute endocolpi, and a small apocolpium index distinguishes Batopedina from Otomeria and Pentas. Parapentas differs from Batopedina in having broad endocolpi with vague ends.Two of the three subgenera of Otomeria, Neotomeria and Volubilis, are supported by pollen data. Pollen of the subgenus Otomeria, however, is less differentiated and is similar to pollen of Pentas subgenus Pentas. The exact relationship between the genera Otomeria and Pentas remains unclear, and molecular data are needed to interpret the observed morphological variation. Chamaepentas has pollen that is nearly identical to that of the Pentas subgenus Chamaepentadoides and of the subgenus Megapentas, i.e. large spheroidal pollen grains with three, medium-length colpi and endocolpi with acute ends. Pollen morphology provides additional support for a close affinity between Pentas subgenus Phyllopentas and Pentas subgenus Vignaldiopsis.