How do we modulate our emotions? Parametric fMRI reveals cortical midline structures as regions specifically involved in the processing of emotional valences

One of the major problems in affective neuroscience of healthy subjects as well as of patients with emotional dysfunctions is to disentangle emotional core functions and non-emotional processes. Emotional valence is considered an emotional key process. The present study employed a parametric functional magnetic resonance imaging (fMRI) study to address this question. Thirteen healthy volunteers were scanned during emotional stimulus processing (International Affective Picture System). The presented pictures covered the entire range of emotional valences. The fMRI data were consecutively subjected to a preliminary categorical (valence-independent) and a detailed parametric analysis, the latter using individual valence ratings as regressor. The parametric analysis revealed a linear valence-dependent modulation of the BOLD signal in the orbito- and dorsomedial prefrontal cortex (OMPFC, DMPFC), medial parietal cortex (MPC), and insula. In addition, we observed that emotional valence exerts its effects predominantly via modulation of signal decreases. We conclude that the psychological concept of emotional valence may be related to neural processing in cortical midline regions.     

Tuberculosis and atypical mycobacterioses in HIV infection. Results from the Bonn Center 1985 to 1989

485 HIV-positive patients have been treated at our institution in Bonn during 1985 to 1989. Mycobacterial infections occurred in twelve (2.5%) HIV-positive patients. Of 166 AIDS-manifestations according to CDC, eleven (6.6%) were mycobacterial infections. There occurred one case of miliary tuberculosis, six cases of extrapulmonary, one of disseminated tuberculosis and four cases of atypical mycobacteriosis. Mycobacteriosis other than tuberculosis (MOTT) were caused three times by Mycobacterium kansasii and once by Mycobacterium scrofulaceum. Tuberculosis was seen less often in haemophiliacs. Disseminated tuberculosis and atypical mycobacteriosis developed in late stages of HIV-infection with underlying severe immunodeficiency. The lung was the main target organ of tuberculosis. MOTT most often affected the gastrointestinal tract additionally. Noninvasive materials, first of all sputum and gastric acid, were reliably diagnostic but available with delay in particular cases. In those cases histologic studies proved helpful. Application of five-fold regimen (INH, RMP, EMB, PZA and SM) always succeeded in negative cultures in a mean of 15 days in all cases of tuberculosis. Two cases of atypical mycobacteriosis with Mycobacterium kansasii were treated with a five-fold regimen (one case with ciprofloxacin additionally) and culture-negative after six resp. 28 weeks of therapy.     

136. Die stabilisierende Wirkung des autologen corticospongi?sen Spanes in der Behandlung kn?cherner Defekte

ZusammenfaBung In der Behandlung knöcherner Defekte kommt der Defektfüllung mit autologer Spongiosa eine hervorragende Bedeutung zu. Die osteogenetische Potenz autologer Spongiosa ist jedoch in hohem MaBe von mechanischer Ruhe im Transplantatlager abhängig. Mit einer Plattenosteosynthese allein ist häufig mechanische Ruhe wegen fehlender Gegenabstützung für die Platte nicht gewährleistet. Biomechanische Untersuchungen zeigten, daB mit der Verschraubung eines cortico-spongiösen Spanes gegenüber der Platte ein deutlicher Stabilitätszuwachs bei der überbrückung und Behandlung knöcherner Defekte eintritt.     

Immunomodulating properties of the uremic pentapeptide H-Asp-Leu-Trp-Glu-Lys-OH in vitro

Summary A pentapeptide originally isolated by Abiko and coworkers from the ultrafiltrate of a uremic patient was synthesized and studied for its in vitro effects on normal human peripheral blood mononuclear cells. The SRBC-rosette forming capacity of T cells was significantly reduced after preincubation of the cells with the peptide, whereas the viability and the percentage of SRBC-receptor positive cells as determined with a monoclonal antibody remained unchanged. The PHA and ConA induced proliferation of T cells as well as the induction of suppressor cells by ConA were decreased, while the proliferative responses to PWM and specific antigens were enhanced. MLC experiments with separated and reconstituted lymphocyte populations pointed to the T cell as the main target. The data presented demonstrate that at least some of the effects described for so-called middle molecules are reproducible with this peptide at concentrations eventually occurring in patients with chronic renal failure.Abbreviations cpm counts per minute - ConA Concanavalin A - HPLC high performance liquid chromatography - LTT lymphocyte transformation test - MLC mixed lymphocyte culture - PBL peripheral blood lymphocytes - PHA-P,M phythemagglutinin P,M - PPD purified protein derivative - PWM pokeweed mitogen - SRBC sheep reed blood cells - U5P, U5-peptide uremic pentapeptide This work was supported by grants from the Deutsche Forschungsgemeinschaft (Ni 233/1-1) and the Robert-Pfleger-Stiftung     

Progrediente Zytomegalie-Enzephalitis unter erfolgreicher Ganciclovir-Therapie einer Zytomegalie-Retinitis bei einem AIDS-Patienten

Summary We describe a case of an HIV-infected intravenous drug-abuser who died of progressive cytomegalovirus encephalitis despite successful treatment of cytomegalovirus retinitis with ganciclovir. On autopsy, complete remission of retinitis and widespread cytomegalovirus-encephalitis could be demonstrated. Therapeutic failure therefore seems attributable to insufficient CNS-distribution of ganciclovir rather than to ganciclovir-resistant cytomegalovirus strains.

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Abkürzungen CCT Craniales Computertomogramm - MRT Magnet-Resonanz-Tomogramm - CMV Zytomegalie-Virus - KBR Komplement-Bindungs-Reaktion     

Reciprocal modulation and attenuation in the prefrontal cortex: an fMRI study on emotional-cognitive interaction

Everyday and clinical experience demonstrate strong interactions between emotions and cognitions. Nevertheless the neural correlates underlying emotional-cognitive interaction remain unclear. Using event-related fMRI, we investigated BOLD-signal increases and decreases in medial and lateral prefrontal cortical regions during emotional and non-emotional judgment of photographs taken from the International Affective Picture System (IAPS). Emotional and non-emotional judgment conditions were compared to each other as well as with baseline allowing for distinction between relative signal changes (comparison between conditions) and true signal changes (referring to baseline). We have found that: (1) both emotional and non-emotional judgment of IAPS pictures were characterized by signal increases in ventrally and dorsally located lateral prefrontal cortical areas and concurrent signal decreases in ventro- and dorsomedial prefrontal cortex; (2) direct comparison between emotional and non-emotional judgment showed relative signal increases in ventro- and dorsomedial prefrontal cortex, and in contrast, relative signal increases were detected in ventrally and dorsally located lateral prefrontal cortical areas when comparing non-emotional to emotional judgment; and (3) as shown in separate comparisons with baseline, these relative signal changes were due to smaller signal decreases in ventro- and dorsomedial prefrontal cortex and smaller signal increases in ventrally and dorsally located lateral prefrontal cortical areas during emotional judgment. Therefore, the emotional load of a cognitive task lead to both less deactivation of medial prefrontal regions and, at the same time, less activation of lateral prefrontal regions. Analogous patterns of reciprocal modulation and attenuation have previously been described for other cortical regions such as visual and auditory areas. Reciprocal modulation and attenuation in medial and lateral prefrontal cortex might constitute the neurophysiologic basis for emotional-cognitive interaction as observed in both healthy and psychiatric subjects.     

Stage-independence and individual outcome of neuro-cognitive deficits in HIV. A follow-up study of 62 HIV-positive hemophilic patients]

62 of a series of 188 HIV-positive hemophiliacs, who had been neuropsychologically evaluated already in 1988 (T1), were re-examined 1 1/2 years later (T2). The aims of the study were to confirm the cross-sectional results of the 1988 study and to compare cross-sectional and longitudinal aspects of HIV infection and associated neurocognitive deficits. Patients were staged at T1 and T2 according to CDC classification criteria and retested using parallel tests of attention, verbal/nonverbal memory performance and depression. The following results were observed: (i) Data at T2 paralleled the findings from 1988, indicating increased deficits in attention and verbal learning and memory at an advanced stage of the disease. No association with the T4/T8 ratio was found. (ii) Between T1 and T2, 65% of the patients showed no change in stage, 27% changed one stage and only 8% showed a rapid progression through two stages. (iii) Only this latter group showed a significant cognitive deterioration over time. The remaining groups exhibited inconsistent performance changes which did not correlate with depression of changes of the T4/T8 ratio. Conclusively, the longitudinal data support the assumption of stage independent and individual different courses of the neurocognitive manifestations of HIV. A small minority of patients, however, manifested a rapid progression of the disease during the T1-T2 interval.