Circles are different: the perception of Glass patterns modulates early event-related potentials

Glass patterns are randomized dot arrays that generate the perception of a global structure. They consist of correlated dot pairs which are generated by geometric transformations. The present study employed behavioral and event-related brain potential (ERP) measures to characterize the underlying neuronal processing when such patterns are perceived. Stimuli were circular, parallel, and randomized Glass patterns presented in two isoluminant colors using a choice reaction paradigm. Sixteen subjects were instructed to differentiate between colors with a button-press response. The N170 component increased in amplitude for circular patterns, and this effect was most pronounced bilaterally over occipito-temporal areas. The results suggest that the global perception of form generated by Glass patterns occurs at a stage of visual processing past area V1.     

In vitro antimicrobial activity of extracts of four Achillea species: the composition of Achillea clavennae L. (Asteraceae) extract

The extracts of aerial parts of Achillea clavennae, Achillea holosericea, Achillea lingulata and Achillea millefolium (hexane:ether:methanol=1:1:1) have been tested for antimicrobial activity in a disk diffusion assay against five bacteria (Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Salmonella enteritidis) and two fungi (Aspergillus niger and Candida albicans). Extracts of all four species possessed a broad spectrum of antimicrobial activity against all tested strains. The composition of the extract of Achillea clavennae, which showed the strongest activity, was investigated and the structures of isolated compounds were elucidated by spectral means (1D and 2D NMR, UV, IR and MS). The extract yielded alkanes, fatty acids, monoterpenes, guaiane sesquiterpenes (rupicolin A and B, 1-deoxy-1alpha-peroxy-rupicolin A and B), and flavonoids (apigenin and centaureidin). This study confirms the ethnopharmacological use of plants from this genus and places Achillea clavennae L. on the same level as the recognized Achillea millefolium.     

Attenuation of haemodynamic, metabolic and energy expenditure responses to isoproterenol in patients with hypertension

OBJECTIVE: Overweight and heightened sympathetic activity are more common in hypertensive than normotensive subjects. beta-adrenoceptor down-regulation has been described in hypertension. We tested the hypothesis that chronic sympathetic overactivity impairs beta-adrenergic-mediated thermogenesis and thereby favours gain of weight in hypertension. PARTICIPANTS: The study included 13 hypertensive subjects aged 35.3 +/- 7.9 years and 25 normotensive subjects of control of similar age. METHODS: To measure beta-adrenergically mediated haemodynamic, metabolic and thermogenic responsiveness, increasing doses of isoproterenol diluted in 2.5 ml saline were injected as intravenous boluses (0.1, 0.25, 0.5, 1.0 and 2.0 microg/m). On a separate day, isoproterenol was infused continuously intravenously in increasing doses (10, 20 and 40 ng/kg per min), each dose for 30 min. RESULTS: The sitting heart rate and body mass were greater in hypertensives (P = 0.000, and P = 0.005, respectively). The heart rate responses to 1 and 2 microg/m isoproterenol bolus (P = 0.01 and P = 0.03, respectively) were reduced in hypertensives. The energy expenditure (P = 0.002) and oxygen consumption (P = 0.0004) increase with 40 ng/kg per min isoproterenol infusion, and glucose and phosphate responses at both 20 (P = 0.01 and P = 0.05) and 40 (P = 0.001 and P = 0.02) ng/kg per min isoproterenol infusion were attenuated in hypertensives. The baseline heart rate negatively correlated with heart rate (P = 0.015) response to isoproterenol bolus and blood pressure (P = 0.02) response to isoproterenol infusion. The urinary noradrenaline negatively correlated with heart rate response to isoproterenol bolus (P = 0.001), and with systolic blood pressure (P = 0.02) and energy expenditure responsiveness to isoproterenol infusion (P = 0.04). Furthermore, plasma noradrenaline negatively correlated with heart rate responsiveness to isoproterenol bolus (P = 0.004). CONCLUSIONS: These results show a generalized decrease of beta-adrenergic responsiveness in stage 1 hypertension and support the concept that sympathetic overactivity, via down-regulation of beta-adrenoceptor-mediated thermogenic responses, may facilitate the development of obesity in hypertension.     

Hantavirus and acute appendicitis—The diagnosis behind the diagnosis?

A 33-year-old man with a history of acute lower abdominal pain was admitted to the emergency room. After laparoscopic appendectomy and pathological confirmed acute appendicitis the patient developed thrombocytopenia and acute renal failure. Serological testing for hantaviruses revealed a positive result for PUUV IgG and IgM. Immunohistochemical work-up detected PUUV antigen in endothelial cells of capillaries and larger vessels. The high percentage of patients with hantavirus infection and severe abdominal pain is remarkable and, up to now, unexplained. To our knowledge this is the first report demonstrating PUUV antigen in the human intestine. Further studies are warranted whether hantaviruses are setting the stage for a secondary bacterial infection or cause an inflammation itself.     

Encapsulating peritoneal sclerosis - an overview

Encapsulating peritoneal sclerosis (EPS) is a rare but life-threatening complication of peritoneal sclerosis (PD). In 2000, the International Society for Peritoneal Dialysis outlined diagnostic guidelines and a clinical definition of EPS. Over the intervening years, new evidence was published and several centers became more experienced managing patients with EPS. Although, further networking was initiated (European EPS Working Group), evidence regarding therapy and diagnosis of EPS is still lacking. Multicenter trials are needed to establish evidence regarding the management of EPS. Risk factors for EPS are identified and patients at risk should be monitored closely. In case of emerging signs of EPS, patients should be referred to an EPS-center before initiation of therapy. Morphology and immunohistochemistry will play a central role in the near future. Nowadays, most pathologists are not sophisticated in the pathology of peritoneal biopsies. Clear histological criteria are warranted. For the outcome of the patient, it is crucial that an EPS experienced surgeon conducts surgery.     

How does neuromodulation work

Although sacral neuromodulation (SNM) is approved and successfully used for different urological and proctologic functional diseases for the long-term treatment, less is known about the working mechanisms underlying SNM. This review highlights SNM clinical application, the current data of LUT neuroanatomy and neurophysiology, SNM techniques and its prospective working mechanisms. Functional imaging techniques have facilitated a more detailed insight into the neural network between the central nervous system (CNS) and the lower urinary tract (LUT). In addition to the well-known factors of the spinal micturition pathway, several pontine (e.g. pontine micturition centre) and suprapontine (e.g. cingulate cortex) regions and their interactions have been identified. An attribution of CNS activity levels to different LUT conditions is possible for the first time. Based on this information, different SNM actions could also have been allocated to different ascending/descending pathways and supraspinal regions, whereas acute SNM especially affects regions of learning activity, chronic SNM might result in CNS plasticity even though clinical effectiveness fades after SNM deactivation. Studies to treat fecal incontinence or to prevent detrusor overactivity in complete spinal cord injured patients support the importance of sympathetic pathways for the action of SNM. Despite increasing knowledge about SNM influence on the CNS, the complexity of its underlying working mechanisms is not understood at all. Further investigations with improved functional imaging techniques will enhance our SNM background.     

How Does Sacral Modulation Work Best? Placement and Programming Techniques to Maximize Efficacy

Since receiving approval from the US Food and Drug Administration in 1997, sacral neuromodulation (SNM) has become the recommended treatment of urinary urge incontinence, urgency–frequency, nonobstructive urinary retention, and fecal incontinence. The manufacturer has introduced different technical modifications while surgeons and researchers have adapted and published various innovations and alterations of the technique. This review summarizes the current knowledge and recommendations of SNM preoperative decision making, the implantation technique, and available programming parameters and algorithms based on MEDLINE research, manufacturer instructions, and the approach of an experienced neurourological team. The primary steps and technical aspects to optimize SNM efficacy were the introduction of the tined-lead electrode and the development of the InterStim II impulse generator (both developed by Medtronic, Inc., Minneapolis, MN). The initiation of the staged implantation technique for sequential evaluation and implantation with the definitive quadripolar electrode completes the treatment algorithm so that an increased responder rate of SNM for all indications can be achieved.