Female, but not male, nematodes evolve under experimental sexual coevolution.

Coevolution between the sexes is often considered to be male-driven: the male genome is constantly scanned by selection for traits that increase relative male fertilization success. Whenever these traits are harmful to females, the female genome is scanned for resistance traits. The resulting antagonistic coevolution between the sexes is analogous to Red Queen dynamics, where adaptation and counteradaptation keep each other in check. However, the underlying assumption that male trait evolution precedes female trait counteradaptation has received few empirical tests. Using the gonochoristic nematode Caenorhabditis remanei, we now show that 20 generations of relaxed versus increased sexual selection pressure lead to female, but not to male, trait evolution, questioning the generality of a male-driven process.

Sperm competition generates evolution of increased paternal investment in a sex role-reversed seed beetle.

When males provide females with resources at mating, they can become the limiting sex in reproduction, in extreme cases leading to the reversal of typical courtship roles. The evolution of male provisioning is thought to be driven by male reproductive competition and selection for female fecundity enhancement. We used experimental evolution under male- or female-biased sex ratios and limited or unlimited food regimes to investigate the relative roles of these routes to male provisioning in a sex role-reversed beetle, Megabruchidius tonkineus, where males provide females with nutritious ejaculates. Males evolving under male-biased sex ratios transferred larger ejaculates than did males from female-biased populations, demonstrating a sizeable role for reproductive competition in the evolution of male provisioning. Although larger ejaculates elevated female lifetime offspring production, we found little evidence of selection for larger ejaculates via fecundity enhancement: males evolving under resource-limited and unlimited conditions did not differ in mean ejaculate size. Resource limitation did, however, affect the evolution of conditional ejaculate allocation. Our results suggest that the resource provisioning that underpins sex role reversal in this system is the result of male-male reproductive competition rather than of direct selection for males to enhance female fecundity.

[Dissociative seizures: a manual for neurologists for communicating the diagnosis]. / Dissoziative Anfälle : Ein Manual für Neurologen zur Diagnosemitteilung.

The great physical resemblance between epileptic and dissociative seizures and a diagnosis of epilepsy that had been made years ago and usually had been treated unsuccessfully makes it difficult for both physician and patient to communicate the diagnosis of dissociative seizures. A direct referral to psychotherapy treatment is rarely accepted by patients. Intermediate steps, which are based on cooperation between neurologists and psychotherapists, are necessary. The approach that we use to communicate diagnosis and motivation for psychotherapeutic treatment includes eight steps: 1. Welcome and introduction; 2. Jointly watching a video of documented seizures; 3. The message that the seizures are not of epileptic origin, 4. Development of an alternative disease concept; 5. Motivation for a conversation with a representative from psychosomatics; 6. Responding to the fear of "going crazy"; 7. If necessary, briefly touching on the subject of sexual violence; 8. More recommendations and conclusion of the conversation. The manual was discussed and practiced with the attending neurologist in two sessions and is now being regularly used by two neurologists with concomitant supervision.

Disclosing information about randomised controlled trials in oncology: training concept and evaluation of an individualised communication skills training for physicians COM-ON-rct.

When physicians disclose information about randomised controlled trials, they have to balance the requirements of conducting high standard research and the respect for patients' rights. Physicians need training in this difficult matter. An individualised communication skills training (CST) about randomised controlled trials for oncologists has been developed. The aim of this publication is to describe the concept of our CST and present data of evaluation by the participants: First, a theoretical introduction about a communication model and important ethical and legal issues was presented. Individual learning goals of participants were then derived through video assessment with actor-patients. The learning goals were the basis for practicing in role play. Individual coaching helped physicians to transfer the made experience into their daily work. Forty physicians have been trained. The acceptance of the training concept was assessed by a questionnaire consisting of 14 items and using a 6-point scale from 1 (very best) to 6 (very bad): the individualised CST was highly accepted (mean = 1.33). Practicing with actor-patients (mean = 1.4), providing constructive feedback (mean = 1.3) and assessing individual learning goals (mean = 1.85) were seen as helpful. Our CST trains physicians to realise best research standards and incorporate patients' rights.

[Introduction to the basic principles and techniques of diffusion-weighted imaging]. / Einführung in die Grundlagen und Techniken der Diffusionsbildgebung.

This article gives an overview of the many different technical aspects of diffusion-weighted imaging and a review of the physical and mathematical background. Specific terms, such as free and restricted diffusion are introduced and elucidated. The measurement of diffusion by magnetic resonance imaging (MRI) and which phenomena can occur are described. Finally, an overview of current developments in diffusion imaging and its application in research is presented.

[Anesthetic management in laryngotracheal surgery. High-frequency jet ventilation as strategy for ventilation during general anesthesia]. / Anästhesiologische Besonderheiten bei der laryngotrachealen Chirurgie.

During surgical procedures of the upper respiratory tract anesthesiologists and surgeons are in a kind of competition situation because of the close spatial relationship between the airway of the patient and the surgical area. Especially in laryngeal surgery the use of high-frequency jet ventilation (HFJV) offers an alternative to the endotracheal tube. During HFJV the ventilation gas is intermittently administered by an injector with a high frequency into the airway which is open to the outside. Exhalation occurs passively in the area nearby the wall of the airway cross-section. According to the availability of the technique and the indications jet ventilation can be implemented in an infraglottic, supraglottic, transtracheal or transluminal manner. To exert influence on gas exchange of the patient the respiratory rate, driving pressure, oxygen concentration and inspiration time can be changed according to the needs. Severe tracheal stenosis, risk of excessive bleeding during the procedure, patients at risk for aspiration and exacerbation of lung diseases are depicted as contraindications for HFJV. Complications under HFJV are rare despite the limited conditions for monitoring gas exchange and mechanics of ventilation in contrast to conventional ventilation. A particular challenge for the anesthesiologist is the use of HFJV during laryngeal laser surgery.

[Anesthetic management in laryngotracheal surgery. High-frequency jet ventilation as strategy for ventilation during general anesthesia]. / Anästhesiologische Besonderheiten bei der laryngotrachealen Chirurgie. Hochfrequenzjetventilation als spezielle Beatmungsstrategie während der Narkose.

During surgical procedures of the upper respiratory tract anesthesiologists and surgeons are in a kind of competition situation because of the close spatial relationship between the airway of the patient and the surgical area. Especially in laryngeal surgery the use of high-frequency jet ventilation (HFJV) offers an alternative to the endotracheal tube. During HFJV the ventilation gas is intermittently administered by an injector with a high frequency into the airway which is open to the outside. Exhalation occurs passively in the area nearby the wall of the airway cross-section. According to the availability of the technique and the indications jet ventilation can be implemented in an infraglottic, supraglottic, transtracheal or transluminal manner. To exert influence on gas exchange of the patient the respiratory rate, driving pressure, oxygen concentration and inspiration time can be changed according to the needs. Severe tracheal stenosis, risk of excessive bleeding during the procedure, patients at risk for aspiration and exacerbation of lung diseases are depicted as contraindications for HFJV. Complications under HFJV are rare despite the limited conditions for monitoring gas exchange and mechanics of ventilation in contrast to conventional ventilation. A particular challenge for the anesthesiologist is the use of HFJV during laryngeal laser surgery.

[Patients with malignancies of the oro- and hypopharynx as well as the larynx. Significance/importance of oncological aftercare consultation]. / Patienten mit Malignomen des Oro- und Hypopharynx sowie Larynx. Stellenwert der onkologischen Nachsorgesprechstunde.

The necessity of a long-time, closely monitored, well-structured, personal and time-consuming aftercare consultation is still discussed controversially. Based on the analysis of our oncological patients with tumours of the pharynx and larynx in the period from 1999-2000 we want to emphasize that after treatment is of vital importance. Besides the main focus of oncology on the early detection of recurrent tumours, distant metastases and second primary tumours as well as a fast interdisciplinary and mostly multimodal treatment planning, consultation is also a central point of reference and coordination site for rehabilitation, psycho-oncology and quality assurance of treatment. Last but not least consultation serves for purposes of continuous data collection and oncological epidemiology.

Metabolic profile and nitric oxide synthase expression of skeletal muscle fibers are altered in patients with type 1 diabetes.

We investigate muscle fiber composition, fiber-specific glycolytic and oxidative enzyme capacity and nitric oxide synthase (NOS) expression in skeletal muscle of patients with type 1 diabetes (T1D) compared to individuals with normal glucose tolerance (NGT). Vastus lateralis muscle was obtained by percutaneous biopsy from 7 T1D patients and 10 healthy controls with similar characteristics. Using cytophotometry, muscle fiber composition and fiber type-specific glycolytic and oxidative enzyme activities were measured in slow oxidative (SO), fast oxidative glycolytic (FOG) and fast glycolytic (FG) fibers. In addition, NOS 1-3 protein expression was mea-sured. The glycolytic fiber fraction was 1.4 fold higher, whereas FOG and SO fiber fractions were significantly reduced by 13.5% and 6.2% in skeletal muscle from T1D patients. Glycolytic enzyme activities and fiber-specific ratio of glycolytic relative to oxidative enzyme activity were significantly higher in all fiber types of T1D patients and correlated with HbA (1c). Expression of NOS1-3 isoforms was reduced in skeletal muscle of T1D subjects. Increased glycolytic enzyme activity in muscle of T1D patients is most likely due to both a higher number of fast glycolytic fibers and a shift towards increased glycolytic metabolism in all fiber types. Alterations in muscle fiber distribution and enzyme activities seem to be due to impaired long-term glycemic control.

Perceptual phenomena after unilateral arm amputation: a pre-post-surgical comparison.

Painful and non-painful phantom phenomena occur frequently after amputations but are rarely investigated in the perioperative stage. The goal of the present study was the assessment of phantom phenomena, pain and changes in primary somatosensory cortex prior to and after upper limb amputation. Two patients who suffered from metastatic carcinoma were examined 2 days prior to and 7 days after the amputation of an arm using comprehensive psychometric assessments and neuroelectric source imaging. Both patients reported phantom limb pain that was similar to their pre-amputation pain. In one patient, reorganization of the mouth area into the deafferented hand area took place immediately after the amputation. In the other patient reorganization had occurred prior to the amputation possibly related to non-use of the arm several years prior to the amputation.

Production of unsaturated polyesters by Pseudomonas oleovorans.

Pseudomonas oleovorans was grown separately on 3-hydroxy-6-octenoic acid and 3-hydroxy-7-octenoic acid as the only carbon source and under ammonium nutrient-limiting conditions to produce storage polyesters. The polyesters produced contained mainly unsaturated C8 units. Small amounts of both the saturated and the unsaturated C6 units were also present, but only about 1% of the saturated 3-hydroxyoctanoate units was detected. The polyester obtained from 3-hydroxy-6-octenoic acid, which was a mixture of the cis and trans isomers, also contained units with cis and trans double bonds. The weight average molecular weights of the polymers produced were in the range of 339,000-383,000 as determined by g.p.c. relative to polystyrene, with Mw/Mn ratios of 1.8-2.1. The mechanism of PHA formation from n-octene previously reported is discussed in relation to the present results, and the two were found to be in good agreement.

Bacterial polyesters containing branched poly(beta-hydroxyalkanoate) units.

Pseudomonas oleovorans was grown on mixtures of methyloctanoates with n-octanoate. Polymers were also obtained from organisms grown on pure 7-methyloctanoate, but not from pure 5- or 6-methyloctanoate. The polyesters obtained from 7-methyloctanoate and from its mixtures with n-octanoate contained units with the methyl branches in the pendant group, as did the copolymers from the mixtures of 5- and 6-methyloctanoate with n-octanoate. The methyl branched repeating units contained two diastereomers, and the 13C-n.m.r. spectra of these polymers indicated that the 5-methyloctanoate units had a higher content of one of the two isomers, but not in the 6-methyloctanoate units. The weight average molecular weights of the copolyesters produced were in the range of 220,000 to 410,000, with Mw/Mn ratios of 1.7 to 1.9.

[Primary psychosomatic management in general practice. Results of a German nationwide demonstration project of quality assurance]. / Psychosomatische Grundversorgung in der Hausarztpraxis. Ergebnisse eines bundesweiten Demonstrationsprojektes zur Qualitätssicherung.

In the frame of a national demonstration program, psychosocial care of patients with psychological and psychosomatic problems were assessed. General practitioners (n = 191) from six regions participated in the study. 1341 treatment episodes of patients with predominately psychosocial symptoms were documented. Anxiety (62%), depression (51%) and marital/family conflicts (44%) were the most frequent symptoms. Somatic treatment and psychosocial intervention were offered equally. Patients with psychosocial treatment achieved better results. Partners and family members were rarely integrated into therapy. The procedures employed to improve outcome were quality circles, family-orientated case conferences, consultation services and collaborative groups.

[Pigeon coryza--ornithosis--pigeon breeder's lung]. / Taubenschnupfen--Ornithose--Taubenzüchterlunge.

The published informations on the entities pigeon coryza and ornithosis are reviewed. On the basis of own experiences and experimental data obtained in the Landesveterinäruntersuchungsamt Koblenz, pigeon coryza apparently is a symptom rather than a clearly defined disease. Finally pigeon breeder's lung is discussed in front of the background of own observations and recommendations to be of allergic origin.

[Somatisizing patients. Concrete recommendations for a stepwise therapy in general practice]. / Somatisierende Patienten. Konkrete Vorschläge für eine Stufentherapie in der Hausarztpraxis.

Patients with physical symptoms but no detectable organic substrate often present a challenge for the family doctor. The therapeutic approach discussed herein focuses on the development of a psychosomatic model of the problem. In this step-by-step approach, the patient's subjective understanding of, and attitude towards, his illness and its treatment are established, alternative psychosomatic models of disease based on a consideration of psychophysiological interactions are worked out jointly with the patient, and, finally, thought is given to the current complaints within the context of the patient's personality and life situation. The basis for successful treatment is an empathic and sound doctor-patient relationship based on trust that gives the patient the feeling that he and his problem are being taken seriously. The prerequisite for the use of such a program is appropriate training in basic psychosomatic care.

Diffusion-weighted imaging in rectal carcinoma patients without and after chemoradiotherapy: a comparative study with histology.

Diffusion-weighted imaging (DWI) can be used to quantitatively assess functional parameters in rectal carcinoma that are relevant for prognosis and treatment response assessment. However, there is no consensus on the histopathological background underlying the findings derived from DWI. The aim of this study was to perform a comparison of DWI and histologic parameters in two groups of rectal carcinoma patients without (n=12) and after (n=9) neoadjuvant chemoradiotherapy (CRT). The intravoxel incoherent motion (IVIM) model was used to calculate the diffusion coefficient D and the perfusion fraction f in rectal carcinoma, the adjacent rectum and fat in the two patient groups. Immunohistological analysis was performed to assess the cellularity, vascular area fraction and vessel diameter for comparison and correlation. Out of 36 correlations between parameters from DWI and histology, four were found to be significant. In rectal carcinoma of patients without CRT, the diffusion D and the perfusion f correlated with the vascular area fraction, respectively, which could not be found in the group of patients who received CRT. Further correlations were found for the rectum and fat. Histological evaluation revealed significant differences between the tissues on the microscopic level concerning the cellular and vascular environment that influence diffusion and perfusion. In conclusion, DWI produces valuable biomarkers for diffusion and perfusion in rectal carcinoma and adjacent tissues that are highly dependent of the underlying cellular microenvironment influenced by structural and functional changes as well as the administered treatment, and consequently can be beyond histological ascertainability.

MITK diffusion imaging.

BACKGROUND: Diffusion-MRI provides a unique window on brain anatomy and insights into aspects of tissue structure in living humans that could not be studied previously. There is a major effort in this rapidly evolving field of research to develop the algorithmic tools necessary to cope with the complexity of the datasets. OBJECTIVES: This work illustrates our strategy that encompasses the development of a modularized and open software tool for data processing, visualization and interactive exploration in diffusion imaging research and aims at reinforcing sustainable evaluation and progress in the field. METHODS: In this paper, the usability and capabilities of a new application and toolkit component of the Medical Imaging and Interaction Toolkit (MITK, www.mitk.org), MITK-DI, are demonstrated using in-vivo datasets. RESULTS: MITK-DI provides a comprehensive software framework for high-performance data processing, analysis and interactive data exploration, which is designed in a modular, extensible fashion (using CTK) and in adherence to widely accepted coding standards (e.g. ITK, VTK). MITK-DI is available both as an open source software development toolkit and as a ready-to-use installable application. CONCLUSIONS: The open source release of the modular MITK-DI tools will increase verifiability and comparability within the research community and will also be an important step towards bringing many of the current techniques towards clinical application.

The extensible open-source rigid and affine image registration module of the Medical Imaging Interaction Toolkit (MITK).

Although non-rigid registration methods are available or under development for many specific problems in medicine, rigid and affine registration is an important task that is often performed for pre-aligning images before using non-rigid registration. In this paper, we present a free and open-source application for rigid and affine image registration, which is designed both for developers and for end-users. The application is based on the Medical Imaging Interaction Toolkit (MITK) and allows for inter-modality and intra-modality rigid 2D-2D and 3D-3D registration of medical images such as CT, MRI, or ultrasound. The framework as well as the application can be easily extended by adding new transforms, metrics and optimizers. Thus, developers of new algorithms are enabled to test and use their algorithms more quickly, spending less work on user interfaces. Additionally, the framework provides the possibility to use image masks to restrict the evaluation of metric values by the optimizer on certain areas of the images.