Advance preparation of set-switches in Parkinson's disease

Eighteen patients with Parkinson's disease (PD) and 18 healthy control subjects were presented with a switching task where stimuli elicited either one (no-conflict condition) or two (conflict condition) task-relevant stimulus-response mappings. The response stimulus interval (RSI) between trials was varied to allow investigation of the extent to which participants engaged in advanced preparation of task set. In line with previous findings, set-switching deficits of PD patients were only observed in the conflict condition. Prolonging the RSI led to a reduction of switch costs for control subjects in both the conflict and the no-conflict task, whereas this effect was attenuated for PD patients in the conflict condition. This deficit was explained in terms of a reduced ability to maintain cue-action representations active in working memory in high interference conditions, and was related to the possible role of the frontostriatal circuit in maintaining focussed attention.     

Differential diagnosis of intra- and perilienal tumors by use of a RES-specific MRI contrast agent

PURPOSE: To describe the additional benefit in detection and differential diagnosis of peri- and intrasplenic tumors by use of an superparamagnetic iron oxide contrast agent (SPIO). MATERIALS AND METHODS: We represent 7 patients with known malignant tumors. Aim of the examination was the detection and characterisation of intra- or perisplenic tumors. We performed T2w TSE breath triggered sequences before and 10 min after application of SPIO and T1w Flash 2D GRE sequences before and after SPIO and Gadopentetate dimeglumin application. All images were presented to two radiologists, who were asked to asses the presence and characterisation of tumors by using a five-point confidence scale. RESULTS: In two patient intrasplenic hemangiomas were detected, intrasplenic lymphoma, metastasis was excluded, respectively. In two patients perisplenic tumors were diagnosed as gastrointestinal stroma tumors, confirmed by biopsy. In two patients accessory spleens were identified and lymph node metastasis excluded. In one patient an intrasplenic cyst was diagnosed. SPIO enhanced T2w images and Gadopentetate dimeglumin enhanced T1w sequences were evaluated as superior. CONCLUSION: The examination of the spleen by use of superparamagnetic iron oxides offers additional abilities in depiction and charaterisation of intra- and perisplenic tumors in first experiences. First clinical observations indicate that a combination of SPIO enhanced T2w sequences and Gadopentetate dimeglumin enhanced T1w dynamic sequences might be superior to other sequences in detection and characterisation of splenic tumors.     

Clinical evaluation of the Elecsys CA 15-3 test in breast cancer patients

The aim of the present study was to evaluate the clinical performance of the CA 15-3 assay on Elecsys systems in an international multicenter study (11 centers). A total of 1326 single samples (272 apparently healthy individuals, 34 pregnant women, 308 benign diseases, 273 cancers other than breast, 439 breast cancer) and 538 serial samples of 98 breast cancer patients during follow-up were analyzed. 95% of values in healthy individuals were below 25 kU/L, and 88% in benign breast diseases, respectively. In malignant breast disease at primary diagnosis the value distribution of Elecsys CA 15-3, sensitivity at 95% specificity, as well as the areas under the curve in ROC analysis were clearly correlated to tumor stages: UICC I to IV 88 to 25% of values < 25 kU/L, sensitivity 7 to 78%, areas under the curve 0.53 to 0.94. During follow-up, sensitivity/specificity for detection of recurrences were 90%/71%. In metastatic disease clinical progression/response to therapy were indicated in 91%/78% of patients at a specificity of 92%/78%. The findings indicate that the Elecsys CA 15-3 assay is very suitable in routine work for detection of recurrences as well as for therapy control in metastatic breast cancer.     

The homeobox gene Lbx1 specifies a subpopulation of cardiac neural crest necessary for normal heart development

Cardiac neural crest cells are known to play multiple roles during development of the inflow and outflow tract of the heart and the aortic arch. In addition, cardiac neural crest is required for normal heart tube looping and regulation of myocardial cell proliferation, as well as differentiation and function of the myocardium. We show that the homeobox gene Lbx1 is expressed in a subpopulation of the cardiac neural crest during tubular heart formation. Inactivation of the Lbx1 gene in mice resulted in defects in heart looping, changes in gene expression pattern, and increased cell proliferation ensuing in myocardial hyperplasia. We found that the activity of the Lbx1 promoter, as indicated by a LacZ reporter gene, is upregulated in the hearts of Lbx1(+/-):splotch(1H)/splotch(1H) and Lbx1(-/-) mice, indicating that Pax3 and Lbx1 participate in a negative regulatory feedback that might be necessary for normal differentiation and function of the myocardium during early heart development. Because migration of Lbx1-expressing neural crest cells was not altered in Lbx1(-/-) embryos, we postulate that Lbx1 gene function is critical for specification of a subpopulation of cardiac neural crest subsequent to migration.     

Group cohesion and working alliance: prediction of treatment outcome in cardiac patients receiving cognitive behavioral group psychotherapy

BACKGROUND: Various definitions of both group cohesion and working alliance are used in theories on group psychotherapy, making the study of their relative contribution to the treatment outcome difficult. In this study, two different, nonoverlapping questionnaires were used to explore the relationship between group cohesion, working alliance and treatment outcome in a time-limited, structured cognitive behavioral group psychotherapy aiming at the reduction of coronary risk factors. METHODS: After having undergone percutaneous transluminal coronary angioplasty, 42 patients were treated with the aim to reduce exhaustion, anxiety, hostility and depression. The newly developed Group Cohesion Questionnaire (GCQ) and the Helping Alliance Questionnaire (HAQ-II, measuring the bond between individual patients and the group psychotherapist) were administered after the fifth and tenth treatment session. Exhaustion, quality of life, anxiety, blood pressure and heart rate were measured before and after treatment. To test the relationship between the GCQ, the HAQ-II and outcome variables, Pearson Product-Moment correlations and hierarchical regression was applied. RESULTS: Principal Component Analysis of the GCQ yielded two dimensions, the bond with the group as a whole and the bond with other group members. Hierarchical regression showed that both the bond with other group members and working alliance contributed significantly and independently to the prediction of posttreatment systolic and diastolic blood pressure as well as posttreatment quality of life (confidence). CONCLUSIONS: Conceptually and empirically, group cohesion and the working alliance may be considered to represent different relationships in a psychotherapy group, contributing in different ways to the treatment outcome in cardiac patients receiving cognitive behavioral group psychotherapy.