Training emotion regulation through real-time fMRI neurofeedback of amygdala activity.

Being in control of one's emotions is not only desirable in many everyday situations but is also a great challenge in a variety of mental disorders. Successful intentional emotion regulation is related to down-regulation of amygdala activity. Training mental interventions supported by neurofeedback of one's own amygdala activity using real-time (rt-)fMRI might be beneficial for mental health and well-being. Rt-fMRI guided amygdala-downregulation using cognitive interventions such as a "reality check", however, have not been well-investigated. Fifteen healthy subjects underwent four rt-fMRI sessions with neurofeedback of their own amygdala activity while applying a reality check as an emotion regulation strategy in order to down-regulate their amygdala signal during a stimulation with emotional pictures. The Control group comprised of eleven subjects also trained emotion regulation but without obtaining feedback. We hypothesized more prominent down-regulation of amygdala activity at the end of the training in the Feedback group. We investigated effects over time and between groups and further task specific connectivity of the amygdala by using psychophysiological interaction analyses. Four weekly amygdala-based feedback sessions resulted in significantly decreased amygdala activity (p = 0.003, d = 0.93), also compared to the Control group (p = 0.014, d = 1.12). Task specific connectivity of the amygdala with the anterior cingulate cortex, hippocampus and distinct prefrontal areas was increased in the Feedback group. Training of emotion regulation supported by rt-fMRI neurofeedback resulted in a prominent amygdala down-regulation compared to training without feedback. The finding implicates successful emotion regulation, compliant with emotion control models, through an easily applicable reality check strategy. Rt-fMRI neurofeedback may support emotion regulation learning and bears clinical potential for psychotherapy.

Extravascular incidental findings in run-off CT angiography in patients with acute limb ischaemia: incidence and clinical relevance.

AIM: To evaluate the incidence and clinical relevance of extravascular incidental findings (EVIFs) in CT angiography of the abdominal aorta and lower extremities (run-off CTA) in patients presenting with acute limb ischaemia (ALI). MATERIALS AND METHODS: In this institutional review board-approved, retrospective study, 141 run-off CTA examinations conducted between 2005 and 2013 of patients (67 women, mean age 80 years; 74 men, mean age 69 years) presenting with clinical symptoms of ALI were re-evaluated by two radiologists (2 and 7 years of experience in interpreting run-off CTA). Imaging was conducted using 16- and 64-section CT systems. Image acquisition ranged from the costodiaphragmatic recess to the forefoot. The medical history form of each patient served as the standard of reference for assessment of incidence of EVIFs. CT morphology was assessed to assign EVIFs to one of three categories of clinical relevance: (I) immediate, (II) potential, and (III) no clinical relevance. RESULTS: Thirty-eight patients had category I findings, including four patients (2.8%) with previously unknown malignancy and 67 patients with category II EVIFs. In total 473 extravascular EVIFs were found in 141 patients: 52 category I, 163 category II and 258 category III. CONCLUSION: EVIFs with immediate clinical relevance are very common in run-off CTA in patients presenting with acute peripheral artery disease. Therefore, it is important to evaluate all body regions included in a CT examination carefully, even if the clinical focus is on vascular evaluation. The adequate classification of these EVIFs is required to avoid possible unnecessary diagnostic work-up with associated risks and costs.

Topographic analysis and evaluation of anatomical landmarks for placement of central venous catheters based on conventional chest X-ray and computed tomography.

BACKGROUND: Positioning central venous catheters (CVCs) in the proper part of the superior vena cava (SVC) is difficult. The aim of this exploratory study was to analyse topographic relationships of the extrapericardial SVC using chest X-ray (CXR) and computed tomography (CT). This included an appraisal of rules for optimal CVC tip placement. METHODS: We retrospectively evaluated 100 patients with CVCs who underwent bedside CXR and CT on the same day. Distances between the sternoclavicular joint (SCJ), tracheal carina, SVC origin, pericardial reflection, and CVC tip were analysed on CT and, if visible, on CXR. These measurements served to locate the extrapericardial SVC in relation to anatomical landmarks. Different strategies for CVC tip positioning were evaluated. RESULTS: The mean (standard deviation) extrapericardial length of the SVC was 26 (12) mm. The average position of the pericardial reflection was 5 mm below the carina (range, 29 mm below to 25 mm above). In our patient population, the best results in terms of tip positions in the extrapericardial SVC would have been achieved by using 85% of the SCJ-to-carina distance (in 86%) or by positioning the CVC tip 9 mm above the carina (in 84% of patients). CONCLUSIONS: The extrapericardial part of the SVC varies considerably in length and position, and rules of thumb based on anatomical landmarks should be used cautiously. In our series, using 85% of the SCJ-to-carina distance or placing the CVC tip 9 mm above the carina would have resulted in a high percentage of positions in the extrapericardial SVC.

Photoinactivation of Escherichia coli (SURE2) without intracellular uptake of the photosensitizer.

AIM: This study was performed to investigate the possibility to photodynamically inactivate Gram-negative bacteria without intracellular uptake of the photosensitizer. The efficiency of the photodynamic growth inhibition of Escherichia coli (SURE2) was proved in a comparative study of a neutral and a cationic photosensitizer. METHODS AND RESULTS: We used confocal laser scanning microscopy (CLSM) to investigate the uptake of the photosensitizer by the bacteria to show that both chlorin e(6) and TMPyP are not accumulated in the cells. Fluorescence lifetime imaging (FLIM) and phototoxicity experiments were used to investigate the photodynamic inactivation of the Gram-negative bacteria. The phototoxicity experiments were carried out using a white light LED-setup to irradiate the bacterial suspensions. The viability of the bacteria was obtained by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT)-assay. For the cationic TMPyP, photodynamic inactivation without intracellular uptake was observed, whereas for chlorin e(6) such behaviour was not found. CONCLUSIONS: It was proven that in general, it is possible to photodynamically inactivate Gram-negative bacteria without photosensitizer accumulation in the bacterial cells. This fact is especially interesting, considering that the development of resistances may be prevented, leaving the active components outside the bacterium. SIGNIFICANCE AND IMPACT OF THE STUDY: In a world with bacteria that gain the ability to withstand the effects of antibiotics and are able to transmit on these resistances to the next generation, it becomes necessary to develop new approaches to inhibit the growth of multi-resistant bacteria. The photodynamic inactivation of bacteria is based on a three-component system by which the growth of the bacterial cells is inhibited. The well-directed oxidative damage is initiated by visible light of a certain wavelength, which excites a nontoxic photoactive molecule, called photosensitizer. Its reaction with oxygen causes the generation of cytotoxic species like singlet oxygen, which is highly reactive and causes the inactivation of the growth of bacteria.

Long-term follow-up of standard microdiscectomy versus minimal access surgery for lumbar disc herniations.

BACKGROUND: Surgery of lumbar disc herniations is one of the most common neurosurgical procedures. New surgical approaches and techniques are constantly evolving. We present our long-term follow-up results comparing standard open microdiscectomy (SOMD) and minimal access microdiscectomy (MAMD) for single-level lumbar disc herniations. METHODS: Patients were randomized in two groups receiving either MAMD or SOMD. Physical and mental health and pain relief were assessed (ODI, SF-36 questionnaire, VAS leg and back pain). In addition, all patients received MR imaging for morphological evaluation of postoperative peridural scar tissue formation. RESULTS: Of the 60 initial patients (SOMD: 30 pts, MAMD: 30 pts), 38 were available for long-term follow-up. Mean follow-up time was 33 months. Long-term follow-up revealed significant postoperative pain relief in both groups. Good to excellent results concerning physical and mental health and pain relief were achieved in both groups. Significantly less peridural scar tissue formation was observed in the MAMD patients, but without clinical impact. CONCLUSION: MAMD is a feasible alternative to the standard open approach. Both groups show significant and long-lasting pain relief and good to excellent results regarding health-related quality of life. Congruent to our short-term results, we observed slightly but not statistically significant better clinical results in the MAMD group when compared to the SOMD group.

Serum concentrations, therapeutic response and side effects in children and adolescents with impulsive-aggressive symptoms during risperidone therapy.

INTRODUCTION: The aim of this prospective naturalistic study was to examine for the first time the relationship between dosage, serum concentration and clinical outcome in children and adolescents with impulsive-aggressive symptoms during risperidone therapy. METHODS: Steady state trough serum concentrations of risperidone and 9-hydroxyrisperidone (the active moiety) were measured in 103 subjects. The therapeutic effect was assessed by the clinical global impression improvement subscale and side effects by the Udvalg for Kliniske Undersogelser-side effect rating scale. RESULTS: We found a linear relationship between the risperidone dose and the serum concentration of the active moiety (Spearman rho=0.53) and no correlation between the serum concentration and either the therapeutic effect or side effects. There was no effect of gender and co-medication. DISCUSSION: This study has the typical limitations of naturalistic studies, therefore our results should be interpreted with caution. Based on the serum concentrations at the therapeutically effective dose range (0.25-1.5 mg/day) we obtained first information on a possibly appropriate therapeutic serum range for the risperidone treatment of children and adolescents with impulsive-aggressive symptoms. Further studies with greater sample sizes are needed to validate our results and to examine the influence of genetic polymorphisms on the serum concentration of risperidone.

Cobalt and manganese carboxylates for metal oxide thin film deposition by applying the atmospheric pressure combustion chemical vapour deposition process.

Coordination complexes [M(O2CCH2OC2H4OMe)2] (M = Co, 4; M = Mn, 5) are accessible by the anion exchange reaction between the corresponding metal acetates [M(OAc)2(H2O)4] (M = Co, 1; M = Mn, 2) and the carboxylic acid HO2CCH2OC2H4OMe (3). IR spectroscopy confirms the chelating or µ-bridging binding mode of the carboxylato ligands to M(ii). The molecular structure of 5 in the solid state confirms a distorted octahedral arrangement at Mn(ii), setup by the two carboxylato ligands including their α-ether oxygen atoms, resulting in an overall two-dimensional coordination network. The thermal decomposition behavior of 4 and 5 was studied by TG-MS, revealing that decarboxylation occurs initially giving [M(CH2OC2H4OMe)2], which further decomposes by M-C, C-O and C-C bond cleavages. Complexes 4 and 5 were used as CCVD (combustion chemical vapour deposition) precursors for the deposition of Co3O4, crystalline Mn3O4 and amorphous Mn2O3 thin films on silicon and glass substrates. The deposition experiments were carried out using three different precursor solutions (0.4, 0.6 and 0.8 M) at 400 °C. Depending on the precursor concentration, particulated layers were obtained as evidenced by SEM. The layer thicknesses range from 32 to 170 nm. The rms roughness of the respective films was determined by AFM, displaying that the higher the precursor concentration, the rougher the Co3O4 surface is (17.4-43.8 nm), while the manganese oxide films are almost similar (6.2-9.8 nm).

Replication of the single-stranded DNA of the male-specific bacteriophage M13: circular forms of the replicative DNA.

Equilibrium centrifugation in caesium chloride, band sedimentation in alkaline solutions and electron microscopy have been used to study purified preparations of the M13 replicative DNA. The buoyant density of the M13 replicative DNA in a CsCl density gradient is 1.701, compared to a density of 1-710 for Escherichia coli DNA. When the replicative DNA is sedimented in alkaline solutions of CsCl (p = 1.35), two components are observed with uncorrected s-values of 48.6 +/- 0.2 and 15.2 +/- 0.5. Treatment of the replicative DNA with pancreatic DNase reduces the relative amount of the fast component in alkaline CsCl and similarly increases the relative amount of the slow component. Electron microscopic observation of the replicative DNA also shows two different forms of DNA, extended circles and condensed forms of DNA. The relative amount of condensed forms of DNA in a preparation of replicative DNA is equal to the relative amount of the fast component in alkaline velocity sedimentation. The average contour length of the extended circles is 2.19 +/- 0.07 micro.

Uber infektiöse Substrukturen aus Escherichia coli Bakteriophagen. VIII. On the tertiary structure and biological properties of phiX174 replicative form.

As already known, phiX174 replicative-form DNA is separated into two components when sedimented in a sucrose gradient. The faster component, I, is not denatured by heat treatment, whereas the slower component, II, is converted to single strands. Only the infectivity of component II increases after heat denaturation. A quantitative comparison of data obtained by band centrifugation and by electron microscopy shows that the tertiary structure of component I is a highly twisted circle and that of component II an extended circle. By treatment with DNase, component I (as observed in band centrifugation) and twisted rings (as observed by electron microscopy) are converted at the same rate to component II and to extended circles and linear molecules. The plating efficiency of replicative-form DNA, in contrast to denatured component II replicative form and to phiX174 single-stranded DNA, is diminished by the addition of Escherichia coli DNA to the adsorption medium. The inhibition by E. coli DNA at concentrations above 0.5 microg/ml. is of first order. The lower the relative plating efficiency of native replicative-form DNA, the greater is the increase of infectivity for the denatured component II. The importance of these findings with respect to normal test conditions is discussed. Some observations suggest that under ideal test conditions the relative plating efficiency of the replicative-form DNA may rise to that of phiX174 single-stranded DNA.

Corticostriatal cells in comparison with pyramidal tract neurons: contrasting properties in the behaving monkey.

Antidromically identified neurons projecting to the putamen (CPNs) and pyramidal tract neurons (PTNs) were recorded from motor and premotor cortex of a monkey which performed a load-bearing task with the wrist. CPNs appeared as a uniform population with very slowly conducting axons and low spontaneous activity. In contrast to PTNs, they exhibited weak, mostly insignificant correlation with graded steady-state forces, responded to torque perturbations with remarkably long latency, and seemed to discharge much later with active movement. Collateral branching of PTNs to the putamen was found to be infrequent (1%). We suggest that the putamen receives a cortical message that is strikingly different from that sent down the pyramidal tract.

The kinetic of the oxidation of InSn48.

The oxidation of InSn48 has been investigated at partial pressures between 10(-8) Pa and 10(+4) Pa over a temperature range from 22 ( degrees )C to 250 ( degrees )C with different analytical methods. The oxide film contains a mixture of several oxides, although indium oxide forms preferentially. Below the melting point a logarithmic growth, and above this, a parabolic growth of the oxide film has been observed. The oxide film formed in air at 250 ( degrees )C does not become thicker than 50 nm in the first 5 min of oxidation.

[Ocular symptoms in pituitary adenomas (author's transl)]. / Manifestations ophtalmologiques des adénomes hypophysaires.

The study of 85 patients suffering from pituitary adenoma, amongst which 56 with a visual failure, allowed to show: 1) The importance of the functional loss a revealing sign of the disease (50% cases). 2) The importance of the ophthalmological examination as a diagnostic argument. The latter, however, needs an extremely methodical examination of the visual fields. The combinated use of the Goldman Perimeter, and the Amsler schemes gave us satisfactory results: 87.5% of patent bitemporal hemianopsiae. It has been useful, in several cases to enhance these methodes by using coloured indexes. All of the patients underwent surgery, with complementary radiotherapy. The functional recovery quality has been shown, in the majority of the cases, to be proportionnal to the operation precocity in relation to the first functional symptoms.

Processing of amplitude modulated sounds in the medial geniculate body of squirrel monkeys.

The responses of single and multi units in the medial geniculate body of the squirrel monkey (Saimiri sciureus) to modulation frequency, modulation depth and changes in absolute intensity of sinusoidally amplitude modulated (AM) sounds were studied. Both spike-frequency and spike rate modulation were used as a measure for neuronal response. Spike rate modulation was derived from FFT (Fast-Fourier-Transformation) analysis of the PSTHs. In all cases (N = 133) spike rate modulation was shown to be dependent on the stimulus modulation frequency: Most neurons responded best to one modulation frequency, i.e., they showed a modulation transfer function with bandpass characteristic; only a few displayed a low pass or multiple peaked transfer characteristic. The majority of the neurons responded best in a range from 4 to 64 Hz, with a peak at 32 Hz and a median at 16 Hz. Such modulation frequencies are common in parts of the species vocal repertoire.

Anaerobic transformation of 2,4,6-trinitrotoluene (TNT).

A sulfate-reducing bacterium using trinitrotoluene (TNT) as the sole nitrogen source was isolated with pyruvate and sulfate as the energy sources. The organism was able to reduce TNT to triaminotoluene (TAT) in growing cultures and cell suspensions and to further transform TAT to still unknown products. Pyruvate, H2, or carbon monoxide served as the electron donors for the reduction of TNT. The limiting step in TNT conversion to TAT was the reduction of 2,4-diamino-6-nitrotoluene (2,4-DANT) to triaminotoluene. The reduction proceeded via 2,4-diamino-6-hydroxylaminotoluene (DAHAT) as an intermediate. The intermediary formation of DAHAT was only observed in the presence of carbon monoxide or hydroxylamine, respectively. The reduction of DAHAT to triaminotoluene was inhibited by both CO and NH2OH. The inhibitors as well as DANT and DAHAT significantly inhibited sulfide formation from sulfite. The data were taken as evidence for the involvement of dissimilatory sulfite reductase in the reduction of DANT and/or DAHAT to triaminotoluene. Hydrogenase purified from Clostridium pasteurianum and carbon monoxide dehydrogenase partially purified from Clostridium thermoaceticum also catalyzed the reduction of DANT in the presence of methyl viologen or ferredoxin, however, as the main reduction product DAHAT rather than triaminotoluene was formed. The findings could explain the function of CO as an electron donor for the DANT reduction (to DAHAT) and the concomitant inhibitory effect of CO on triaminotoluene formation (from DAHAT) by the inhibition of sulfite reductase.(ABSTRACT TRUNCATED AT 250 WORDS)

Transient transfection induces different intracellular calcium signaling in CHO K1 versus HEK 293 cells.

For the controlled production of recombinant proteinsin mammalian cells by transient transfection, it maybe desirable not only to manipulate, but also todiagnose the expression success early. Here, weapplied laser scanning confocal microscopy to monitortransfection induced intracellular Ca(2+)responses. We compared Chinese hamster ovary (CHO K1)versus human embryo kidney (HEK) 293 cell lines, whichdiffer largely in their transfectability. An improvedcalcium phosphate transfection method was used for itssimplicity and its demonstrated upscale potential.Cytosolic Ca(2+) signaling appeared to inverselyreflect the cellular transfection fate. Virtually allCHO cells exhibited asynchronous, cytosolicCa(2+) oscillations, which peaked 4 h afteraddition of the transfecting solution. Yet, most ofthe HEK cells displayed a slow and continuousCa(2+) increase over the time of transfection. CHOcells, when exposed to a transfection-enhancingglycerol shock, strongly downregulated their Ca(2+)response, including its oscillations. When treatedwith thapsigargin, a Ca(2+) store depleting drug,the number of successfully transfected CHO cells was significantly reduced. Our result points tointracellular store release as a critical componentfor the transfection fate of CHO cells, and its early detection before product visualization.

Marker pattern instabilities as a major cause of reproducibility problems in two-dimensional DNA fingerprinting.

Two-dimensional (2-D) DNA fingerprinting is a promising technique for multilocus analysis of eukaryotic genomes. It has been successfully applied to the detection of DNA variation in tumors, to linkage analyses and to genomic comparisons of inbred mouse strains. However, there are still problems with inter-gel comparisons of 2-D DNA typing patterns as documented by the inter-gel reproducibility rates reported in the literature, which range from 84 to 98%. The basis for standardization in almost all of these studies has been a set of lambda fragments (digested separately with the restriction enzymes HaeIII, RsaI, Bg/I) that produces a spot pattern scattered across the gel. These spots are used as markers for gel comparisons. Since we noticed considerable variations in the marker spot patterns, we evaluated the properties of the lambda marker using both computer simulation and an empirical analysis of forty independent consecutive gels from our laboratory. We explain the instabilities of the spot pattern on the basis of the melting properties of the individual lambda fragments. A subset of spots is presented that has been stable in all our experiments. Only this set of spots should be used for gel standardization purposes until a new, completely reproducible marker becomes available. Finally, suggestions for an improved marker system are made.

[Ocular localizations of disseminated candidiasis]. / Localisations oculaires des candidoses disséminées

The frequency of disseminated candida infections has considerably increased in the last five years. A presentation of 9 cases of disseminated candida infections localised to the choroid and retina: --review of the literature; --discussion on factors favouring the development of disseminated candida infections, poor general state, antibiotic treatment, impairment of immunological defenses, abdominal or cardio-vascular intervention; --discussion of local and general diagnostic and prognostic features.

[Waiting times and death on the waiting list for coronary artery bypass operation. Experiences in Munich with over 1,000 patients]. / Wartezeiten und Tod auf der Warteliste für eine koronare Bypass-Operation. Erfahrungen in München an über 1000 Patienten.

Short-term and long-term results are the classical parameters for quality assurance in coronary artery bypass graft surgery (CABGS). In contrast, waiting times and the inherent risks of waiting lists are usually neglected. Although the problem of "death on the waiting list" is generally known, related publications are scarce. Therefore, in January 1994, we started a prospective study to document the waiting times and the occurrence of severe complications in our patients waiting for CABGS. Between January 1, 1994 and July 31, 1996, we catheterized 1125 patients with indication for CABGS. 968 patients had social health insurance (SOCL); 157 patients were privately insured (PRIV). The urgency of CABGS was classified as "emergent", "ery urgent" and "less urgent" according to the clinical experience of the responsible cardiologists. All emergency cases could be operated the same day. 69% of the very urgent SOCL patients had to travel beyond the Munich area to be operated, while 84% of the respective PRIV patients were operated in Munich. SOCL patients were therefore separated from their families 4.3 times more frequently then PRIV. Not so urgent SOCL cases were separated from their families 1.8 times more often than PRIV. The mean waiting time for SOCL was 39.5 +/- 39.1 days in 1994, 34.9 +/- 31.5 days in 1995 and 22.7 +/- 16 days in 1996. The corresponding values of PRIV are 19.1 +/- 16.2, 19.8 +/- 14.1 and 17.2 +/- 12.6 days. The risk of dying while waiting for CABGS was 1.3% per month (15/1125). The reduction of waiting times by the factor of two between 1994 and 1996 did not, however, influence the death on the waiting list, because all deaths occurred within 4 weeks after diagnostic catheterization. Our results show that triage practices for patients requiring CABGS are not reliable. To minimize the risk of the "death on the waiting list", CABGS must be offered within a week after diagnostic coronary angiography, even for "elective" cases.

Study of particulate matter in carbenicillin disodium using scanning electron microscopy and microbeam x-ray spectrography.

A scanning electron microscopy membrane filtration study was conducted to determine the particulate contamination of samples of carbenicillin disodium which had been manufactured by bulk filling and by lyophilization. The bulk-filled product contained more contaminating particles than the lyophilized product. In both products, the number of particles increased logarithmically with decreasing particle size in the range measured (exceeding 0.1 micron). X-ray spectrographic analysis of particles larger than 0.5 micron revealed that the major particulate contaminates in both products were composed primarily of elements below atomic number 10. It is concluded that packaging of carbenicillin disodium by lyophilization of a solution results in significantly less submicrometer particulate contamination than packaging by sterile bulk filling of spray-dried powder.