Nasal polyposis and its impact on quality of life: comparison between the effects of medical and surgical treatments

BACKGROUND: Nasal polyposis (NP) is not a life-threatening disorder but may have a great impact on the quality of life (QoL). The objective of this study: (i) to investigate the health burden incurred by NP compared with the Spanish general population using the Short Form-36 Health Survey (SF-36) questionnaire; (ii) to compare the QoL outcome after medical or surgical treatment; and (iii) to assess and compare the effect of medical and surgical treatment on nasal symptoms. METHODS: About 109 patients with nasal polyps were included. Fifty-three patients were randomly allocated to receive oral prednisone for 2 weeks and 56 to undergo endoscopic sinus surgery. All patients administered intranasal budesonide for 12 months. Patients were evaluated for nasal symptoms, polyp size, and QoL. RESULTS: In comparison with the Spanish general population, patients with NP had worse scores on all SF-36 domains except for physical functioning. Nonasthmatic patients with NP had better QoL than asthmatic patients with NP on role physical functioning, body pain, and vitality (P <0.05). At 6 and 12 months, a significant improvement on all of SF-36 domains was observed after both medical and surgical treatment reaching the levels of general population (P <0.05). Nasal symptoms and polyp size improved after both medical and surgical treatment at 6 and 12 months (P <0.05). CONCLUSION: These results suggest that NP has considerable impact on a patient's QoL and that both medical and surgical treatment led to similar effects in improving QoL.     

Reforming the coroner and death certification service

The intention of the Home Office is to introduce a new system that combines an independent check on all deaths and a professional oversight of death patterns, with, for the majority of cases, the minimum of bureaucracy. No public consultation is intended, so that reforms are not delayed. However as the proposals are developed in the coming months, the details, practicalities and costs will be discussed “with relevant professionals (not defined) and those with experience of the existing arrangements”. The imperfections of the present system are outlined. It is hoped the medical profession will have an input, since statements such as “ ‘hospital post mortems’, which are for medical research and public health protection purposes” need amendment. There should be a change in perception of the audit value of this procedure to BOTH the family and the treating doctor. Unfortunately it is proposed the new system in total should cost no more than at present. “Professionals” (not defined) will be involved in the financial detail.All deaths, after verification and certification of the medical cause of death (if known) would then be referred to the ‘medical examiner’ based in the coroner's office. He/she would be a qualified doctor employed by the new coroner service and independent of the Health Service. The medical examiner could provide supplementary advice on medical matters required by the coroner. “Retention of tissue should only take place where absolutely necessary and the coroner and his or her other staff should take account of the needs of families and friends carefully throughout the process.” “Coroners could take advice from their medical examiner to ascertain and prescribe the minimum level of invasiveness to establish the cause of death.” This issue is far from resolved, as signified by a recent call from the DoH giving a grant to study the value of MRI versus a full post mortem. No thought is given to systemic diseases, which may present in one organ system or another disease process, other than that causing death. Medical examiners will have to keep abreast of current developments in medicine BUT will be outside the NHS, which could cause problems. Medical examiners will be appointed (with an input from Regional Directors of Public Health) and managed from within the coroner service. They would work closely with the registrar of births and deaths.Deaths from unnatural causes or when the medical cause of death is unknown will result in judicial inquests. The medical examiner will have an input into causes of death and relevant investigations.Details of the proposed structure of the system are given, as well as the investigative and other roles of Coroner's officers.The establishment of medico-legal centres, as “examples of good practice” is advocated. The drawbacks of this system are stressed in this paper. There is at present an on-going review of forensic pathology services and it is hoped thought will be given to the increasing trend for sub-specialisation in medicine.     

Immunocytochemical study of epidermal growth factor receptor, transforming growth factor alpha, and “squamous differentiation” in human endometrial carcinoma

The expression of epidermal growth factor receptor (EGFr) and transforming growth factor alpha (TGF-α) was compared with the presence of “squamous differentiation” (SD) visualized in various histotypes of endometrial carcinoma by using a panel of monoclonal antibodies. The results of the current study demonstrate that EGFr and TGF-α are present in routinely processed endometrial carcinoma. The highest positive EGFr and TGF-α expression was seen in the group of adenocarcinomas with SD. The more intense EGFr and TGF-α immunoreactivity was observed in “squamous” foci both in adenoacanthomas (AA) and in adenosquamous carcinomas (AS). These EGFr- and TGF-α-positive squamous areas prevalently displayed a “stratification-related” cytokeratin (CK) immunoprofile characterized by the expression of CKs 1, 4, 5, 10, 13, 14, and 16. No correlation was found between EGFr- and TGF-α-positive status and depth of myometrial invasion or surgical stage. These results clearly demonstrate that EGFr and TGF-α expression is related remarkably to endometrial carcinoma with “squamous” areas both morphologically and immunophenotypically. This specific association leads us to suggest that EGFr and TGF-α expression in endometrial carcinoma may be prevalently involved in the equilibrium of cell differentiation of the “squamous” foci commonly observed in this group of neoplasias.     

Morphometrical study of the arterial perforators of the deep inferior epigastric perforator flap

Abstract: Although abdominal perforator flaps based on a cutaneous branch of the deep inferior epigastric artery (DIEP flaps) have many advantages, preparing these flaps is technically difficult and requires great skill, especially as the portion of the artery running under the anterior rectus abdominis sheath must be operated upon “blind”. To allow easier preparation and elevation of a DIEP flap pedicle, we propose that the arterial perforator should: 1) be more than 1.0 mm large; 2) run a straight intramuscular course, parallel to the rectus abdominis m. fibers, with no large muscular branches; and 3) have only a short portion running immediately under the anterior rectus abdominis sheath. We examined 329 perforators (more than 0.5 mm in diameter at the anterior sheath) in 66 rectus abdominis mm. from 33 cadavers among them: 1) 52 “large” perforators were over 1.0 mm in diameter; 2) 107 “suitable” perforators ran parallel to the muscle fibers without giving off large muscular branches; and 3) 35 “ideal” perforators combined these characteristics. The ideal perforators were usually located in the mid-abdominal region, 10-30 mm lateral to the umbilicus. The suitable perforators were usually present, often in combination with the ideal perforator(s), in a restricted area 20 mm cranial and 40-50 mm lateral to the umbilicus. We classified the course and ramification pattern of the deep inferior epigastric a. into six patterns, depending on whether the anastomosis was sited in the medial or lateral branch and the level at which the branches originated.     

Genome Sequences and Structures of Two Biologically Distinct Strains of <Emphasis Type="Italic">Grapevine leafroll</Emphasis>-<Emphasis Type="Italic">associated virus</Emphasis> 2 and Sequence Analysis

Grapevine leafroll-associated virus 2 (GLRaV-2), a member of the genus Closterovirus within Closteroviridae, is implicated in several important diseases of grapevines including “leafroll”, “graft-incompatibility”, and “quick decline” worldwide. Several GLRaV-2 isolates have been detected from different grapevine genotypes. However, the genomes of these isolates were not sequenced or only partially sequenced. Consequently, the relationship of these viral isolates at the molecular level has not been determined. Here, we group the various GLRaV-2 isolates into four strains based on their coat protein gene sequences. We show that isolates “PN” (originated from Vitis vinifera cv. “Pinot noir”), “Sem” (from V. vinifera cv. “Semillon”) and “94/970” (from V. vinifera cv. “Muscat of Alexandria”) belong to the same strain, “93/955” (from hybrid “LN-33”) and “H4” (from V. rupestris “St. George”) each represents a distinct strain, while Grapevine rootstock stem lesion-associated virus.     

Phenotypic and genotypic characteristics of aberrant crypt foci in human colorectal mucosa

Aberrant crypt foci (ACF) in colorectal mucosa are proposed to be the earliest morphological lesion in the development of neoplasia, but their characteristics remain controversial. We therefore studied the epithelial phenotype and genotype of ACF from patients with familial adenomatous polyposis (FAP) and of sporadic ACF by evaluating glycoprotein markers associated with neoplasia (lectins Dolichus biflorus agglutinin and peanut agglutinin; monoclonal antibody CA 19-9 against sialyl Lewis-a blood group substance), expression of proliferating cell nuclear antigen, and ras proto-oncogene mutations. The utility of the markers was established by comparing adenomas and hyperplastic polyps. Most FAP ACF resembled adenomas and were found to differ from sporadic ACF in their high frequency of dysplasia, staining with Dolichus biflorus agglutinin, expression of sialyl Lewis-a, proliferation in the epithelium of upper crypts, and low frequency of ras gene mutations (P = . 04 to <. 0000001). By contrast, sporadic ACF and a subset of FAP ACF had phenotypic characteristics resembling hyperplastic polyps but usually had ras mutations, which were inversely related to dysplasia (P = . 00009). Our findings suggest that “aberrant crypt focus” is a generic term analogous to “polyp” and requires further histopathologic, phenotypic, or genotypic classification into dysplastic and heteroplastic (hetero = other, PLASIA = form) types. Dysplastic ACF represent potential precursors to colorectal adenomas and adenocarcinomas, but heteroplastic ACF appear to be associated, rather than precursor, lesions.     

Salivary, nasal wash, and sputum IgA concentrations in atopic and nonatopic individuals

IgA and IgG levels were quantitated in parotid and nasal secretions of atopic and nonatopic children and young adults by single radial diffusion and electroimmunodifsion on the hypothesis that exocrine IgA deficiencies in atopic individuals might facilitate absorption of common “natural” inhalant allergens across respiratory tract mucosal tissues. Mean salivary and nasal wash IgA and nasal wash IgG levels were similar in both groups when expressed as per cent total protein or as IgA/ albumin ratios. Salivary IgA levels varied in individual subjects on repeated weekly, daily, or hourly analysis, but a relationship between IgA and albumin was noted in repeated samples from the same individual. Nasal wash IgA and IgG levels varied markedly among all subjects irrespective of atopic status, whether expressed in absolute values, per cent total protein, or per cent albumin. These findings suggest that a theoretical heightened mucosal absorption of inhalant allergens by atopic individuals cannot be accounted for on the basis of a local “protective” exocrine IgA deficiency per se.     

Recurrence cancer stem cells – Made by cell fusion?

Within the past 10–15 years our knowledge about cancer and how cancer cells might originate has changed dramatically. It is now generally believed that a tumor has its origin in cancer stem cells (CSCs), which originated either from transformed tissue stem cells or transformed progenitor cells that have regained self-renewal activity. CSCs share several characteristics of normal stem cells, such as self-renewal capacity, slow cell cycle activity, differentiation capacity, possessing an enhanced resistance towards cytotoxic agents and radiation, as well as tissue restoration capacity. Due to the increased drug and radiation resistance and slow cell cycle activity concomitant with tumor initiation capacity it is generally assumed that recurrent cancers originate from first line therapy surviving CSCs. But how does the CSC hypothesis explain “oncogenic resistance”, which describes the phenomenon that most recurrent cancers are characterized by both an increased malignancy as well as resistance towards first line cancer therapy. To us, “oncogenic resistance” can not be simply attributed to the resistance properties of normal CSCs. If so, the recurring tumor should be treatable by first line therapy, which is mostly not the case. Thus, we conclude that “oncogenic resistance” demands a new type of tumor initiating cells, the so-called recurrence CSCs (rCSCs). This type of tumor initiating cell originates during first line therapy and is characterized by giving rise to first line therapy resistant and highly malignant progenies. Because several characteristics of “oncogenic resistance”, such as increased drug resistance, increased resistance to apoptosis and an enhanced malignancy have been linked to cell fusion we further conclude that rCSCs might originate from this cellular event. However, which cell types have to fuse with each other to ultimately give rise to rCSCs is not clear. In any case, tumor tissues, particularly those being destructed by first line therapy comprise of a variety of fusogenic cells including tumor cells and CSCs as well as recruited monocytes/macrophages and bone marrow-derived stem cells. The fusogenic properties of these cells concomitant with phenotypic heterogeneity, which is also a property of cell fusion, will then lead to the origin of rCSCs. In accordance with Darwinian evolution only those cells will survive that can resist best to the selection pressure first line therapy.     

Towards a unified theory for immunogenetic systems. IV. A complex-simple probe into the Ag system

The Ag system is a human β-lipoprotein polymorphism of medium complexity discussed in the present article mainly as a model for an analysis of the feedback processes between facts, artifacts and hypotheses. Two Caucasian population materials comprising a total of 530 unrelated individuals are explored at the six-reagent level. Through the new (complex-simple) conceptual framework (language and theory) these 6 × 530 or 3,180 experimental observables or information bits (plus(+) and minus(−) signs) are probed in a most sensitive manner. This probe also permits a perfectly transparent explanation for previously inexplicable-unnoticed pseudo-mysteries with regard to remarkable “clustering” and other relations of observed frequencies for (simple-complex) Ag “genes” and “antigens” within a specified population. The main ambition of this article is to introduce a new model and methodology permitting a more transparent discussion of the complex interrelations between “facts” or “visual sense data” and the (distorting) ability of reason to understand only that which it creates according to its own design. It is concluded that the serologic field (SEF) does indeed have considerable conceptual advantages over other scientific fields with regard to such fundamental epistemological studies concerning the growth of scientific knowledge. The present data illustrate the mutual feedbacks or dualisms between observation and hypotheses where one component has no meaningful existence without the other and where “facts” are not very trustworthy unless produced within a “guiding paradigm”.     

Significance of a “hot patella” in total knee replacement without primary patellar resurfacing

A “hot patella” is a bone scan finding of increased tracer uptake in the patella, greater than the ipsilateral distal femur or the proximal tibia. Increased patellar uptake on the bone scans is a relatively frequent finding; this is often not commented upon. The aim of our study was to define the incidence of a “hot patella” on bone scans following total knee replacements with ongoing symptoms unrelated to sepsis. We wanted to investigate the correlation between the adverse retropatellar symptomatology following total knee replacement with bone scan findings.We undertook a retrospective study of 55 symptomatic total knee replacement patients, who had bone scans. The incidence of a “hot patella” in patients without primary patellar resurfacing was 51% (28/55). Ninety-five percent patients with anterior knee pain and 21% patients with diffuse knee pain had a “hot patella”. Statistical analysis showed a positive association between “hot patella” and anterior knee pain (p value of < 0.001). The patients with “hot patella” who underwent secondary patellar resurfacing had symptomatic relief of symptoms.Our study has shown that the finding of a “hot patella” on a bone scan in patients with anterior knee pain following total knee replacement suggests a problem related to the patellofemoral joint. This study would appear to indicate that a “hot patella” in a patient with clinically defined anterior knee pain is likely to benefit from secondary patellar resurfacing.     

Author index for volume 70

The buoyant density in cesium chloride of the human reoviruslike (HRVL) agent of infantile gastroenteritis was studied utilizing electron microscopy and complement fixation (CF) for the detection of reoviruslike particles in fractions of the density gradient. Three virus positive stool filtrates were studied. “Full” reoviruslike particles had a density of 1.35–1.37 g/cm³, whereas “empty” particles had a density of 1.29 g/cm³. Peak CF activity coincided with the peak fraction of both the “full” and “empty” reoviruslike particles. In addition, by differential centrifugation, CF activity was also associated with the virion and not a “soluble” antigen.     

Topical nasal lysine aspirin in aspirin-sensitive and aspirin-tolerant chronic rhinosinusitis with nasal polyposis

Chronic rhinosinusitis patients with nasal polyps can be aspirin sensitive or aspirin tolerant. The majority belong to the latter group. They tolerate intake of aspirin or other non-steroidal anti-inflammatory drugs, whereas aspirin-sensitive patients have an adverse reaction (asthma, rhinitis and/or urticaria). Diagnosis of aspirin sensitivity is important for the patient, but is rarely undertaken in routine ENT or respiratory medicine practice. Treatment of nasal polyps is by a combination of medical therapy and surgery. Oral and topical steroids form the mainstay of medical therapy, which is aimed at reducing inflammation and symptom improvement. Surgery helps with polyps causing severe nasal obstruction. Despite these therapies, recurrences are common in aspirin sensitive patients. Any adjunctive therapy to prevent or prolong recurrence would be welcome. One such possibility is topical nasal lysine-aspirin. This is an area under current debate and this non-systematic review aims to provide evidence of its use, to date, in aspirin sensitive and aspirin tolerant nasal polyp patients.     

Interaction Between Serum/Glucocorticoid-Regulated Kinase 1 and Interleukin-6 in Chronic Rhinosinusitis

PurposeSerum/glucocorticoid-regulated kinase 1 (SGK1) has recently emerged as a critical regulator of inflammatory diseases. In this study, we examined SGK1 expression and its possible pathogenic roles in chronic rhinosinusitis (CRS).MethodsImmunohistochemistry, western blotting, Bio-Plex assay, enzyme-linked immunosorbent assays, and quantitative real-time polymerase chain reaction were performed to assess protein and gene expression levels. The mRNA expression levels of SGK1 and interleukin-6 (IL-6) were extracted from a CRS database to perform correlation analysis. Stable cell lines with SGK1 overexpression (16HBE) and knockdown (A549) were constructed to investigate the interaction between SGK1 and IL-6 in vitro.ResultsSGK1 exhibited strong cytoplasmic and nuclear staining in the epithelial layers and the lamina propria of nasal polyps (NPs) and in the mucosal tissues of CRS without nasal polyps (CRSsNP). The mRNA and protein expression levels of SGK1 and IL-6 were significantly increased in NPs and CRSsNP tissues, compared to control tissues. SGK1 phosphorylation was significantly greater in NPs than in CRSsNP tissues (P < 0.01). The mRNA levels of SGK1 and IL-6 were significantly correlated (P < 0.001, r = 0.649). Exposure to IL-6 significantly increased SGK1 expression in cultured dispersed NP cells, 16HBE cells, and A549 cells. IL-6 expression was significantly down-regulated in SGK1-overexpressing 16HBE cells (P < 0.01) and significantly up-regulated in SGK1-knockdown A549 cells (P < 0.05). Administration of GSK650394, a SGK1 inhibitor, significantly increased IL-6 self-induced mRNA expression in cultured dispersed NP cells and 16HBE cells.ConclusionsThe interaction between SGK1 and IL-6 may play an anti-inflammatory role in IL-6-induced inflammation in the pathogenesis of CRS.     

Measurement of inflammatory mediators of mast cells and eosinophils in native nasal lavage fluid in nasal polyposis.

BACKGROUND: Nasal polyposis (NP) often coexists with asthma, rhinitis and sinusitis. Polyp histology typically shows chronic, eosinophilic inflammation. The inflammatory cell infiltrate generally includes eosinophils, lymphocytes, plasma cells and mast cells. OBJECTIVE: To gain insight into the natural history of NP, we analysed mediator levels and leukocyte values in nasal fluids and eosinophil cationic protein (ECP), total IgE levels and eosinophils in the blood in several groups of both allergic and non-allergic patients with nasal polyps and in patients with allergic rhinitis (AR). METHODS: Thirty-two patients with nasal polyps entered the study. As a control group, we studied 55 patients with AR, i.e. 20 patients with seasonal AR to grass pollen, 24 with AR sensitive to Parietaria and 11 with AR sensitive to house dust mite (HDM). Eighteen patients with nasal polyps were also allergic patients (8 were sensitive to Parietaria and 10 were sensitive to HDM), whereas 14 were non-allergic patients. Tryptase and histamine values were assayed in nasal fluids, whereas total IgE was determined in serum. ECP values were assayed both in nasal fluids and serum. Eosinophils were quantified both in the blood and nasal fluids. RESULTS: Tryptase levels were significantly higher in the nasal lavages from patients with NP than in those from patients without NP (4.7 vs. 3.5 U/l, p < 0.001) and correlated with symptom scores (r(s) = 0.42, p < 0.0001). The median levels of histamine in nasal fluids from patients with NP were also significantly higher than those observed in patients without NP (50.0 vs. 21.3 ng/ml, p < 0.001), but did not correlate with symptom scores. Finally, the median levels of ECP in nasal fluids from patients with NP were significantly higher than those observed in patients without NP (38.1 vs. 16.1 ng/ml, p < 0.001) and correlated with symptom scores (r(s) = 0.38, p < 0.001). Analysis of variance showed that, among the variables studied, the presence of nasal polyps was the factor responsible for the higher levels of tryptase, histamine and ECP in nasal fluids. With regard to leukocyte counts in nasal fluids, no significant differences were observed between rhinitis patients with NP and those without NP. With regard to serum ECP and serum total IgE, no significant differences were detected between the two groups under study. Blood eosinophil levels in patients with NP were significantly higher than those observed in patients without NP (5.8 vs. 5.6, p = 0.002). Analysis of variance showed that both the presence of nasal polyps and the type of sensitisation were important. Considering the total symptom scores, no significant differences were observed between rhinitis patients with NP and those without NP. CONCLUSIONS: The present findings are consistent with the view that chronic eosinophil mucosal inflammatory disease in NP involves a self-sustaining mechanism, i.e. local release of inflammatory mediators, independent of allergen stimulation of nasal mucosa. Increased release of inflammatory mediators contributes to the development of nasal polyps, determining oedema and an increased recruitment of inflammatory cells. Besides eosinophils, mast cells also play a key role in this process.     

Mucin genes have different expression patterns in healthy and diseased upper airway mucosa

BACKGROUND: Mucus hyper-secretion is a feature of several airways diseases such as chronic rhinosinusitis, asthma, and cystic fibrosis (CF). Since mucins are major components of mucus, the knowledge of their distribution and regulation in nasal tissues is likely to improve mucus hyper-secretion therapy. OBJECTIVE: The aim of this study was to evaluate and compare mucin gene expression at epithelial and glandular levels, and to identify potential mucin expression patterns for specific upper airways pathologies. METHODS: Immunohistochemistry for MUC1, MUC2, and MUC4-MUC8 mucins was performed on healthy nasal mucosa (NM; n=12), bilateral nasal polyps (NP; n=38), NP from CF patients (n=10), and antrochoanal (AC) polyps (n=11). MUC2, MUC4, MUC5AC, and MUC6 mRNA expression were also analysed by in situ hybridization. RESULTS: MUC1, MUC4, and MUC5AC mucins were highly expressed in the epithelium and their expression pattern was similar in all NP types, MUC1 and MUC4 being increased and MUC5AC decreased compared with NM. MUC8 was highly detected at both epithelial and glandular levels with marked variability between groups. MUC5B was mainly detected in glands and the expression in all polyp types was higher than in NM. Moreover, MUC5B expression was higher in NP epithelia from CF patients than in bilateral NP and healthy NM. Although MUC2 expression was low, especially in AC polyps, it was detected in most samples. In NM, MUC6 and MUC7 were scarcely detected and MUC7 expression was restricted to glands. CONCLUSIONS: These results suggest that NP have a different pattern of mucin expression than healthy NM and that CF polyps (increased MUC5B) and AC polyps (decreased MUC2) have a different mucin expression pattern than bilateral NP.     

Cell and cytokine profiles in nasal secretions from patients with nasal polyposis: effects of topical steroids and surgical treatment

BACKGROUND: Nasal polyposis (NP), a chronic inflammatory disease of the paranasal sinus mucosa, is frequently associated with asthma. Previous reports showed that surgical treatment for nasal polyps may influence asthma evolution. We hypothesized that sinus surgery may alter the cytokine network in nasal secretions. METHODS: We evaluated the characteristics (cells and mediators) of nasal lavages in nine patients with untreated NP (group A), 17 patients treated with topical steroids (group B), 21 patients treated by nasal surgery endonasal ethmoidectomy associated with topical steroids (group C), and 12 healthy subjects (controls). RESULTS: Percentages of both eosinophils and neutrophils were higher in NP patients than in controls. Percentages of eosinophils and interleukin-5 (IL-5) level were higher in group A than in group C and controls. There was a positive correlation between IL-5 and eosinophils. In marked contrast, IL-8, IL-10, and IL-1beta levels were significantly higher in group C than in groups A and B and controls; TNF-alpha concentration was significantly lower in group C than in groups A and B and controls; and there was a negative correlation between IL-10 and TNF-alpha. The percentage of eosinophils was higher in asthmatic patients with NP than in nonasthmatic patients. In addition, in group C, asthmatic patients also had a significantly higher level of IL-10 than nonasthmatic patients. CONCLUSIONS: Our study demonstrates that percentages of eosinophils and neutrophils, and IL-5 level were increased in nasal secretions from untreated patients with NP. Topical steroid treatment is associated with a decrease of inflammatory cells and mediators. In marked contrast, nasal surgery is associated with marked changes, in cytokine profile in nasal secretions, that are clearly different from those of controls and topical steroid-treated NP patients.     

Resting frontal EEG alpha-asymmetry predicts the evaluation of affective musical stimuli

Resting frontal electroencephalographic (EEG) alpha-asymmetry was measured in 16 participants to predict affective responses to musical stimuli. Three affective musical stimuli either expressing neutral, positive or negative mood were evaluated by the subjects concerning “expressed mood” and “level of enjoyment”. The results show that individuals with relatively higher alpha power over right frontal electrode sites rated all stimuli more positive than participants with relatively higher alpha power over left frontal electrode sites. On the “expressed mood” scale, the valence of the stimuli did not influence the difference between the ratings of left- and right-active individuals. On the “enjoyment” scale, the largest difference between the ratings of left- and right-active individuals emerged in the negative condition. The results are specific to the alpha frequency band. In line with previous studies, these results suggest that resting frontal alpha-asymmetry reflects a person's predisposition to respond affectively.     

The dissection course – necessary and indispensable for teaching anatomy to medical students

Anatomy is a major basic subject in medicine and related biomedical sciences. A central tool most universities use for teaching anatomy is the “dissection course”, in which medical students learn the basic constructional principles of the human body by dissecting a cadaver. In recent years, the relevance and value of the dissection laboratory have been under discussion at different universities due to high costs and problems of shortness in time in some medical curricula. Indeed, during the last 10 years, several universities in the US and the UK have abandoned dissection and have moved from a cadaver-oriented to a cadaverless anatomy. This development results in a fundamental discussion on the role of the “dissection course” in the medical curriculum, ultimately raising the question as to whether we should continue teaching anatomy by dissection. This article presents nine arguments for the dissection course as a central tool for teaching macroscopic anatomy and is an attestment to the continuation of the use of cadaver material in anatomical laboratories within the auspices of scholastic and university order for the benefit of future physicians with due respect and honour guaranteed for every donor.     

Splenocyte response to T cell-derived cytokines in thymectomized Xenopus

A miniaturized, “hanging-drop” bioassay reveals that splenocytes from earlythymectomized (Tx) Xenopus can respond (by enhanced thymidine incorporation) to thymicdependent “cytokines” generated in PHA- or alloantigen-stimulated cultures. Preliminary evidence, using fluorescence activated cell sorting, indicates that surface IgM⁻ splenocytes, rather than sIgM⁺ cells, from Tx toads are sensitive to the crude, splenocyte-derived, active supernatants. Although these responsive cells display residual, but low, reactivity to PHA, their thymus independence is suggested by flow cytometric observations using the anti-T cell monoclonal antibody XT-1. The development of “T-like” cells in Tx Xenopus is discussed.     

A large-scale cross-sectional and longitudinal study into the ecological validity of neuropsychological test measures in neurologically intact people

It is often assumed that neuropsychological measures are ecologically valid in ‘normal’ people, but this assumption has not yet been thoroughly evaluated.The aim of the present study was to evaluate the cross-sectional and longitudinal ecological validity of individual neuropsychological test scores and their composites in a large sample of neurologically intact people. Three neuropsychological composite measures were established, i.e. a “Memory Quotient”, an “Executive functioning and Speed Quotient”, and a “General Cognitive Quotient”. The ecological validity of the individual neuropsychological measures and their composites was low to moderate. Multivariate models that included both neuropsychological and non-cognitive variables (i.e. demographic variables, depressive symptoms and anxiety) accounted for 4.6–21.4% of the variance in daily life functioning. The General Cognitive Quotient was the neuropsychological measure that was the most consistently related to daily life functioning.