Spontaneous EEG fluctuations determine the readiness potential: is preconscious brain activation a preparation process to move?

It has been repeatedly shown that specific brain activity related to planning movement develops before the conscious intention to act. This empirical finding strongly challenges the notion of free will. Here, we demonstrate that in the Libet experiment, spontaneous fluctuations of the slow electro-cortical potentials (SCPs) account for a significant fraction of the readiness potential (RP). The individual potential shifts preceding self-initiated movements were classified as showing a negative or positive shift. The negative and positive potential shifts were analyzed in a self-initiated movement condition and in a no-movement condition. Comparing the potential shifts between both conditions, we observed no differences in the early part of the potential. This reveals that the apparently negative RP emerges through an unequal ratio of negative and positive potential shifts. These results suggest that ongoing negative shifts of the SCPs facilitate self-initiated movement but are not related to processes underlying preparation or decision to act.     

Quantification of regurgitation in mitral valve prolapse with automated real time echocardiographic 3D proximal isovelocity surface area: multimodality consistency and role of eccentricity index

The International Journal of Cardiovascular Imaging - Three-dimensional transthoracic echocardiography (3D-TTE) provides a semi-automated proximal isovelocity surface area method (3D-PISA) to...     

Remnant closure after distal pancreatectomy: current state and future perspectives

Remnant closure after distal pancreatectomy remains a surgical challenge and is still associated with a fistula rate of about 30%. Despite numerous technical modifications including the use of stapling devices, artificial patches and glue components, no important progress has been made concerning this topic within the last decade. Although tissue texture, co-morbidities and the type of resection may influence fistula rate, substantial improvement can probably be reached by further technical modifications. In addition to the avoidance of fistula development, the recognition and management of this complication is essential to achieve good postoperative outcome. The present review summarizes the currently available data on technical approaches, incidence and risk factors for failure of remnant closure, fistula-associated complications and management as well as the future perspectives in this field of surgery.     

Distal pouch reconstruction with transverse jejunoplasty after experimental gastrectomy

Purpose  

Various reconstruction methods with or without reservoir formation after total gastrectomy have been established. Transverse intestinoplasty has benefits as a functional peristalsis modification in rectal resections. In this study, we evaluate a distal pouch combined with a transverse jejunoplasty compared to standard Roux-en-Y reconstruction.     

Myokardinfarktnetzwerke

Background

An ST-elevation myocardial infarction (STEMI) is one of the main reasons for emergency physician call-outs. A perfectly structured management algorithm is required for survival of the patient and rapid and complete reperfusion of the infarct-related artery by primary percutaneous coronary intervention (PPCI). Establishing regional myocardial infarction networks is recommended for optimal care.

Key elements

Key elements of such networks are a cooperation agreement of all involved institutions, defined standards for prehospital and intrahospital logistics and treatment and an efficient PPCI center.

Telemetric transmission

Telemetric transmission of a 12-lead electrocardiogram (ECG) to the PPCI center is of particular importance as the communicated, definitive diagnosis of STEMI enables simultaneous activation of the interventional team without false alarms. This allows a direct transfer to the catheter laboratory reducing the door-to-balloon time (DBT) to less than half. Obligatory recording of relevant time intervals leads to a continuous improvement via a transparent feedback to all involved.     

Enhanced urothelial expression of human chorionic gonadotropin beta (hCGβ) in bladder pain syndrome/interstitial cystitis (BPS/IC)

Purpose

Bladder pain syndrome/interstitial cystitis (BPS/IC) is associated with urothelial lesions. Pathomechanisms of urothelial damage and factors for urothelial restoration are unknown. hCG is a factor for cellular differentiation, angiogenesis and immune competence of the endometrium during pregnancy. Clinical observations demonstrate improvement of BPS/IC symptoms during pregnancy or during infertility treatment with hCG. Our research aims were to examine the expression of hCG and luteinizing hormone receptor (LHR) in the urothelium of BPS/IC patients and compare the levels of hCGβ with healthy controls.

Methods

Bladder biopsies of BPS/IC (CLSM: n = 10; qPCR: n = 15); Tumour-free control tissue from cystectomies (n = 12). hCGα, hCGβ and LHR expression were examined by confocal laser scanning microscopy (CLSM), and hCGβ expression was quantified. hCGβ5 and hCGβ7 mRNA splice variants were quantified in real-time polymerase chain reaction.

Results

We found constitutive expression of hCGα, hCGβ and LHR in healthy controls. HCGβ was significantly upregulated in BPS/IC patients in CLSM. PCR analysis revealed higher levels of hCGβ7 than hCGβ5 in controls and BPS/IC patients.

Conclusions

The constitutive expression of hCG and LHR speaks in favour for a functional signalling in urothelial cells without any association with either pregnancy or tumour. We show for the first time that hCGβ is upregulated in BPS/IC urothelium and that hCGβ7 is the dominant splice variant in those cells. Our findings imply a major role of hCG for urothelial integrity and a disturbance of hCG signalling in case of BPS/IC. We conclude that hCG could gain therapeutical relevance in the future.