Neurotransmitter receptor heteromers and their integrative role in 'local modules': the striatal spine module

‘Local module’ is a fundamental functional unit of the central nervous system that can be defined as the minimal portion of one or more neurons and/or one or more glial cells that operates as an independent integrative unit. This review focuses on the importance of neurotransmitter receptor heteromers for the operation of local modules. To illustrate this, we use the striatal spine module (SSM), comprised of the dendritic spine of the medium spiny neuron (MSN), its glutamatergic and dopaminergic terminals and astroglial processes. The SSM is found in the striatum, and although aspects such as neurotransmitters and receptors will be specific to the SSM, some general principles should apply to any local module in the brain. The analysis of some of the receptor heteromers in the SSM shows that receptor heteromerization is associated with particular elaborated functions in this local module. Adenosine A_2A receptor–dopamine D₂ receptor–glutamate metabotropic mGlu₅ receptor heteromers are located adjacent to the glutamatergic synapse of the dendritic spine of the enkephalin MSN, and their cross-talk within the receptor heteromers helps to modulate postsynaptic plastic changes at the glutamatergic synapse. A₁ receptor–A_2A receptor heteromers are found in the glutamatergic terminals and the molecular cross-talk between the two receptors in the heteromer helps to modulate glutamate release. Finally, dopamine D₂ receptor–non-α₇ nicotinic acetylcholine receptor heteromers, which are located in dopaminergic terminals, introduce the new concept of autoreceptor heteromer.     

Theory of mind, neurocognition, and functional status in schizotypy

The present study is the first to concurrently examine social cognition, neurocognition, and social functioning in psychometric schizotypes. Screening of 2108 undergraduates with the Schizotypal Personality Questionnaire-Brief (SPQ-B) identified 52 persons high in schizotypy and 40 persons low in schizotypy. All participants were administered a test battery designed to assess two elements of neurocognition, verbal secondary memory (California Verbal Learning Test) and executive functioning (Wisconsin Card Sorting Test), two elements of social cognition, emotion perception (The Awareness of Social Inference Test-Part 1) and theory of mind (The Awareness of Social Inference Test-Parts 2 and 3), and social functioning (Social Adjustment Scale-Self Report). Although the persons with high schizotypy were impaired in social functioning relative to the persons with low schizotypy, they were not impaired in theory of mind, emotion perception, verbal secondary memory, or executive functioning. Theory of mind and verbal secondary memory were correlated in persons with high schizotypy. The present findings suggest that psychometric schizotypes are not impaired in the domains of social cognition and neurocognition examined.     

Detection of Metachronous Neoplasms in Colorectal Cancer Patients: Identification of Risk Factors

Purpose Patients with colorectal cancer have a high risk of developing metachronous neoplasms. Identification of predictive factors associated with such conditions would allow individualized follow-up strategies in these patients. This study was designed to identify individual and familial factors associated with the development of metachronous colorectal neoplasms in patients with colorectal cancer. Methods In the context of a prospective, multicenter, general population-based study—the EPICOLON project—all patients with colorectal cancer attended in ten Spanish hospitals during a one-year period were included. Patients with familial adenomatous polyposis or inflammatory bowel disease were excluded. All patients were monitored by colonoscopy within two years of the diagnoses. Demographic, clinical, pathologic, molecular (microsatellite instability status and immunohistochemistry for MSH2 and MLH1), and familial characteristics (fulfillment of Amsterdam I or II criteria, and revised Bethesda guidelines) were analyzed. Results A total of 353 patients were included in the study. At two years of follow-up, colonoscopy revealed the presence of adenomas in 89 (25 percent) patients and colorectal cancer in 14 (3.9 percent) patients, in 7 cases restricted to anastomosis. Univariate analysis demonstrated that development of metachronous neoplasm (adenoma or colorectal cancer) was associated with personal history of previous colorectal cancer (odds ratio, 5.58; 95 percent confidence interval, 1.01–31.01), and presence of previous or synchronous adenomas (odds ratio, 1.77; 95 percent confidence interval, 1.21–3.17). Although nonstatistical significance was achieved, metachronisms were associated with gender (P < 0.09) and differentiation degree (P < 0.08). Multivariate analysis identified previous or synchronous adenomas (odds ratio, 1.98; 95 percent confidence interval, 1.16–3.38) as independent predictive factor. Neither presence of tumor DNA microsatellite instability nor family history correlated with the presence of metachronous neoplasms. Conclusions Patients with previous or synchronous colorectal adenoma have an increased risk of developing metachronous colorectal neoplasms. Accordingly, this subgroup of patients may benefit from specific surveillance strategies. Supported by grants from the Red Nacional de Investigación en Hepatología y Gastroenterología (Instituto de Salud Carlos III, C03/02) and from Fondo de Investigaciones Sanitarias (FIS PI061384). Xavier Llor is a recipient of a Ramon y Cajal grant form Ministerio de Ciencia y Tecnología of the Spanish government Presented at the meeting of the United European Gastroenterology, Copenhagen, Denmark, October 15 to 19, 2005.     

Pure esophageal atresia with normal outer appearance: case report

Isolated esophageal atresia is characterized by a long segment between the 2 esophageal pouches. This article presents a case of pure esophageal atresia with a 1-cm-long segment at the midportion without discontinuity that resembled the subtype II3 according to the Kluth atlas. Resection of the atretic segment and primary anastomosis were performed successfully.     

Emotional intelligence in schizophrenia

BACKGROUND: Deficits in emotion perception have been extensively documented in schizophrenia and are associated with poor psychosocial functioning. However, little is known about other aspects of emotion processing that are critical for adaptive functioning. The current study assessed schizophrenia patients' performance on a theoretically-based, well-validated, multidimensional measure of emotional intelligence, the Mayer-Salovey-Caruso Emotional Intelligence Test (Mayer, J.D., Salovey, P., Caruso, D.R., 2002. Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT): User's Manual. Multi-Health Systems, Inc., Toronto, Ontario). METHODS: 50 schizophrenia outpatients and 39 non-psychiatric controls completed the MSCEIT, a performance measure comprised of subtests that assess four components (branches) of emotional intelligence: Identifying, Using, Understanding, and Managing Emotions. Among patients, associations between MSCEIT scores and measures of clinical symptoms as well as functional outcome were evaluated. RESULTS: The MSCEIT demonstrated good psychometric properties in both groups. Schizophrenia patients performed significantly worse than controls on the total MSCEIT score, and on three of the four subtests: Identifying, Understanding, and Managing Emotions. Among patients, lower MSCEIT scores significantly correlated with higher negative and disorganized symptoms, as well as worse community functioning. CONCLUSIONS: The MSCEIT is a useful tool for investigating emotion processing in schizophrenia. Individuals with schizophrenia demonstrate deficits across multiple domains of emotion processing. These deficits have significant links with clinical symptoms of schizophrenia and with how patients function in their daily lives. Further research is required to understand the links between emotional intelligence, clinical symptoms, and functional outcome in schizophrenia.     

Seconds from disaster: lessons learned from laparoscopic release of the median arcuate ligament

Median arcuate ligament syndrome (MALS) is a rare entity that manifests as abdominal pain, nausea, vomiting, and diarrhea. The median arcuate ligament is a fibrous band that connects the crura of the diaphragm. In some people, the ligament is positioned in a way that compresses the celiac axis, which in a subset of individuals causes the symptoms associated with MALS. Surgical release of the ligament can relieve these symptoms. After viewing a video that described the laparoscopic median arcuate ligament release technique at the 2006 SAGES meeting and reviewing the online video, we report our experience with two cases and discuss the lessons learned in performing the procedure within a training program. We also discuss the extent to which surgical resident participation contributes to intraoperative complications during a new and complex surgery. Electronic supplementary material  The online version of this article (doi:) contains supplementary material, which is available to authorized users.