Sulthiame in adults with refractory epilepsy and learning disability: an open trial

This prospective uncontrolled open study explored the efficacy and long-term tolerability of sulthiame (STM) in 52 patients with refractory epilepsy and learning disability. Thirty-six patients completed a 14-weeks trial period with STM and 22 patients achieved a seizure reduction>50% of which three became seizure-free. Twenty-six patients continued taking STM for now up to 120 weeks, one continued to be seizure-free, whilst five patients stopped STM during this period. These promising observations require further evaluation in a controlled trial.     

Interdisciplinary longitudinal curriculum "Medical psychology,psychotherapy and psychosomatics" (MPPP) at the University of Ulm

We report the clinical part of the longitudinal curriculum MPPP which was developed by the departments of Medical Psychology, Psychotherapy and Psychosomatic Medicine at the University of Ulm. The commitment and creativity of the participating students in their two undergraduate years inspired us to offer them an interest-guided curriculum for their six clinical semesters. Our paper reports the extensive results of two evaluations that we conducted during the clinical part of this new teaching-model. It became evident that we were successful in transferring continuous, intense and patient-centred psychosomatic and psychosocial contents. Yet the transfer of basic and methodological knowledge was not realised to the extent the students would have appreciated. The positive results of our project encouraged us to expand the concept of an interest-guided curriculum onto the whole academic education in psychotherapy and psychosomatic medicine at our university.     

Beyond syntax: language-related positivities reflect the revision of hierarchies

On the basis of an experiment using event-related brain potentials (EPRs), we argue that a characterisation of language-related positivities as necessarily syntax-related is too restrictive. Our data show that, in verb-final German clauses, the processing of a verb which disconfirms the expectations with regard to the hierarchical thematic structure of a sentence (who is doing what to whom) gives rise to an early (200-600 ms) parietal positivity. Thus, positive ERP components elicited during language processing appear to be related to operations (most often revisions) applying to hierarchically structured linguistic information in general, rather than to syntactic structure in particular.     

MEG study of long-term cortical reorganization of sensorimotor areas with respect to using chopsticks

The movements required to use chopsticks are overlearned and routine in Asians. Most non-Asians, on the other hand, typically have difficulty performing this unfamiliar manual activity, and have to focus their attention on the movements required to use chopsticks adequately. Using magnetoencephalography (MEG) we compared the cortical activation of highly trained Asian chopstick users to the activation of Europeans who only occasionally used chopsticks, while they performed the same tasks with chopsticks or a control task of simple tapping of the same fingers. The data were analyzed using the new method of synthetic aperture magnetometry (SAM). In Europeans there was a significantly higher ratio of spectral power in the higher gamma frequency band (60-80 Hz) over the sensorimotor area compared to the Asian subjects. From these results we conclude that the high gamma band activity in the sensorimotor area may reflect focused attention and functional reorganization of the cortical network with respect to sensorimotor experience.     

The effect of the change in air temperature on the number of newborns in Vienna 1984-99

The number of daily births depends on a wide range of sociodemographic, temporal as well as many other mostly unknown factors, resulting in non-random patterns. We tested the hypothesis of the influence of the change in air temperature on the daily number of all newborns in Vienna (n=254 797) in the period 1984-99 (n=5843 days). We found a significant association of sudden changes in temperature with the daily number of births. The observed effect is responsible for up to 0.27% of the explained variation in the regression model.     

Screening of selected basidiomycetes for inhibitory activity on Clostridium histolyticum collagenase and human leukocyte elastase

Collagenase and elastase play a critical role in the degradation of connective tissue. Aqueous and dichloromethane extracts of 15 Basidiomycetes were screened for their ability to inhibit the activity of collagenase and elastase. Collagenase (EC 3.4.24.3) was not inhibited by aqueous extracts, but by dichloromethane extracts in concentrations of 200 microg/mL. For seven extracts an IC(50) less than 200 microg/mL could be observed. Elastase (3.4.21.37) was inhibited by both aqueous and dichloromethane extracts of the Basidiomycetes, with the aqueous extracts active at concentrations of 200 microg/mL. Five extracts inhibited strongly, with an IC(50) 2-20 microg/mL. Except for four, all dichloromethane extracts inhibited the enzyme in concentrations of 2 microg/mL, nine of them very strongly at about 90%.     

A recombinant CD7-specific single-chain immunotoxin is a potent inducer of apoptosis in acute leukemic T cells

A recombinant immunotoxin was constructed from the hybridoma antibody TH-69 directed against human CD7, a surface antigen of leukemic T cells. The antibody was subcloned as a single chain Fv (scFv) fragment and genetically linked to a truncated Pseudomonas exotoxin A fragment containing the catalytic domains II and III but lacking the receptor binding domain I. Domain I was replaced by the scFv, thus conferring restricted specificity for CD7-positive cells. The bacterially expressed and purified toxin retained binding specificity for CD7-positive cells. It promoted apoptosis in two CD7-positive cell lines derived from T-lineage acute lymphoblastic leukemias, CEM and Jurkat, but not in the CD7-negative B-lymphoid lines REH, Nalm-6, and SEM. Maximum killing in excess of 95% was reached after 96 h in CEM and Jurkat cells with a single dose of 100 ng/ml. Cells treated with a similarly constructed scFv-exotoxin A immunotoxin against melanoma-associated chondroitin sulfate proteoglycan, an antigen absent from leukemic T cells, remained unaffected. Lysis of target cells occurred via apoptosis as evidenced by staining with Annexin V and specific cleavage of poly(ADP-ribose) polymerase. Approximately 20% of leukemic cells from a patient with CD7-positive acute T-cell leukemia kept in long-term primary culture for 30 cell generations were killed within 96 h after treatment with the toxin. These findings justify further evaluation of the agent in view of potential therapeutic applications.     

Contents Vol. 60(2002)

Volume Contents

Contents Vol. 60(2002)     

IMCO(++)--a Monte Carlo based IMRT system

The application of intensity modulated radiotherapy (IMRT) to dose escalation in the target volume sets particular demands in terms of accuracy of dose calculation. Dose calculation errors due to approximations are compensated by the optimization algorithm, a procedure that ultimately leads to incorrect fluence modulation. Such inaccuracies affect particularly the dose distribution in areas with secondary electron disequilibrium. In case tissues heterogeneity predominates, conventional dose calculation methods (such as Pencil Beam) can produce relative errors up to more than 10%. The accuracy can be significantly improved by the application of a Monte-Carlo (MC) algorithm. This paper describes a MC-based inverse treatment planning algorithm (IMCO++), based on a non-iterative approach with a feedback-controlling process. The convergence behavior of IMCO++ was investigated and the used MC dose-calculation codes MMms and XVMC were compared by means of a heterogeneous phantom. IMCO++ plans were optimized in various phantoms. All plans showed conformity in terms of dose distribution of the target volume and dose reduction in risk organs (according to the requirements of the target parameter), as well as a very fast convergence of the algorithm (in less than 10 optimization steps).