"Phobic postural vertigo". A further differentiation of psychogenic vertigo conditions seems necessary]

Due to the results of an interdisciplinary study on patients with vertigo as the chief symptom and on the background of psychodynamic theories concerning anxiety disorders the term of phobic postural vertigo (Brandt & Dieterich 1986) is discussed. It becomes obvious that phobic postural vertigo is a generalizing term which encompasses different forms of psychogenic vertigo. The authors plead for a more differentiated diagnosis and subgroup oriented classification of vertigo caused by psychiatric disorders.     

Cloning, expression and isoform classification of a minor oleosin in sesame oil bodies

The oil bodies of plant seeds contain a triacylglycerol matrix surrounded by a monolayer of phospholipids embedded with alkaline proteins termed oleosins. Two distinct oleosins are present in the oil bodies of diverse angiosperms, and classified as high and low Mr isoforms according to their relative molecular masses in each species. In sesame oil bodies, besides the two ubiquitous oleosin isoforms (17 and 15 kDa), an additional minor oleosin (15.5 kDa) was revealed on Tricine SDS-PAGE. A full-length cDNA fragment was cloned, sequenced and deduced to be a putative oleosin of 15,446 Da. The gene was constructed in a fusion or non-fusion vector and then over-expressed with different efficiency in Escherichia coli. All three oleosins purified from sesame oil bodies were subjected to immunoassaying using antibodies raised against the over-expressed oleosin. The results confirmed that this gene encodes the sesame 15.5 kDa oleosin. Sequence comparisons with other known oleosins revealed that sesame 15.5 kDa oleosin does not represent a new oleosin isoform class but may have been derived through gene duplication and truncation of sesame 17 kDa oleosin, and possesses the minimal structure of the high Mr oleosin isoform. A conserved amphipathic alpha-helix is predicted in sesame 15.5 kDa oleosin, which may imply a potential biological function associated with this isoform.     

Food preferences in Prader-Willi syndrome, normal weight and obese controls

OBJECTIVE: The aim of this work was to assess the specific food type (high carbohydrate, high fat, high protein) preference profiles of individuals with Prader-Willi syndrome (PWS), obese controls and normal weight individuals. DESIGN: Subjects tasted a food predominantly high in carbohydrate, a food predominantly high in protein and a food predominantly high in fat over repeated trials and indicated their most preferred, second preferred and least preferred foods. Specific items tested on a given trial were counterbalanced in a block randomized fashion. SUBJECTS: These were 12 individuals with Prader-Willi syndrome, 12 matched obese controls (obese, but otherwise normal) and 14 normal weight subjects. MEASUREMENTS: The basic data were expressed as a proportion of each food type selected as most preferred over the total 27 trials. RESULTS: PWS subjects preferred high carbohydrate foods over high protein foods and high protein foods over high fat foods. These subjects demonstrated a statistically reliable difference in preference for high carbohydrate foods over high fat foods. However, normal weight and obese control subjects demonstrated no difference in food preferences. The only significant between-group comparisons were between PWS subjects and obese controls, with the PWS group showing a significantly greater preference for high carbohydrate foods than obese controls. CONCLUSIONS: The obesity of PWS was shown to have a significant and distinctly different food preference profile from normal weight and obese controls. The differences in food preference between the obese PWS and non-PWS subjects is in accord with the growing recognition of functional subgroups within the obese population, that may have not only differing underlying etiologies, but also distinct behavioral profiles of ingestion.     

The routine determination of the endogenous thrombin potential, first results in different forms of hyper- and hypocoagulability

Temporal changes in respiration could influence navigator-echo (NE)-gated MR coronary angiography (MRCA), but systematic investigation of the effects of such variations and how to limit them has not been performed. We addressed these issues by studying the influence of time in the magnet on diaphragm position and respiratory patterns using NE diaphragm monitoring in volunteers and a phantom model. NE diaphragm monitoring was performed at .5 T in 10 subjects over a total period of 35 minutes. The end-expiratory position was sustained for longer (1.1 vs .4 seconds, P < .001) and with greater position stability (SD 1.9 vs 5.9 mm, P = .01) than the end-inspiratory position. Drift of the end-expiratory position occurred over time, causing a fall in scan efficiency (44-28%, P = .01). Up-drift of the end-expiratory position was most common. Loss of scan efficiency was worse with up-drift because of loss of the end-expiratory pause from the NE window (up-drift 10% mm-1, down-drift 7% mm-1, both P = .03). Scan efficiency also was reduced during sleep (to a nadir of 0%), secondary to loss of the end-expiratory pause, periodic breathing with oscillating end-expiratory position, and periods of apnea. The phantom model used actual diaphragm traces to evaluate the artifact resulting from diaphragm motion during acquisition. Artifact was considerably reduced by NE adaptive motion correction compared with NE gating alone (ghosting ratio 2.0 vs 2.8, P < .01). Artifact also was significantly reduced with up-drift if scan efficiency was maintained above 35% (P = .05). For optimal NE-gated MRCA, the following features are important: the NE window should be placed around the end-expiratory position; subjects should not sleep; scan efficiency should be monitored and the NE window should be repositioned if scan efficiency falls below 35%; and adaptive motion correction should be used.     

Clinical results after en block double lung transplantation with direct bronchial revascularization. The first three and a half years' experience in Denmark

En-bloc double lung transplantation with tracheal anastomosis and direct revascularization of the bronchial arteries to the left internal mammary artery has been carried out in Denmark since June 1992. Forty-seven patients (32 with alfa-1 antitrypsin deficiency, 11 with chronic obstructive pulmonary disease, two with cystic fibrosis and two with primary pulmonary hypertension), 25 men and 22 women, average age 39 years (17-64 years), have received their first double-lung transplant with bronchial artery revascularization. Arteriography of the internal mammary artery and bronchial arteries was performed in 42 (89%) of the patients from 1-150 days after the operation. Successful bronchial artery revascularization was demonstrated arteriographically in 40 patients, in two patients the arteriography failed to show bronchial artery revascularization. Arteriography was not performed in five patients due to early complications and death. Bronchoscopy showed rapid, uncomplicated airway healing in 42 patients. Mucosal necrosis under the tracheal anastomosis was found in three patients, and severe obstructive endobronchial growth of the fungus Aspergillus fumigatus was diagnosed in the last two patients. The one- and two-year survival is 83% (Kaplan-Meier). Eleven patients are dead, five due to pulmonary causes and six due to extra-pulmonary causes. Pulmonary function became normal in nearly all surviving patients between three to six months after the transplantation. In conclusion, en-bloc double-lung transplantation with bronchial artery vascularization has shown good short-term results, and the one- and two-year survival gives hope that a successful bronchial artery revascularization will improve the long-term survival following lung transplantation.     

Psychopathological evaluation of children and adolescents in 4 child and adolescent psychiatry referral groups--a multicenter study

Goal of the multicenter study with the Clinical Assessment Scale of Child and Adolescent Psychopathology (CASCAP) in a sample of N = 5027 patients from the inpatient and outpatient clinics of psychiatry and psychotherapy of childhood and adolescence of the universities of Berlin (Virchow Clinic), Frankfurt, Cologne and Zurich is the comparison of the clinical populations of these institutions with respect to single symptoms, to symptom scales and to the supreme level of aggregation, the clinical diagnoses according to ICD 10. On the level of diagnoses similar distributions can be found in the centers, but there are also significant differences between the centers. This differences can be found again also on the level of symptom scales and single symptoms, though the deviations are comparatively low.     

Clinical characteristics and outcome of hyperglycaemic emergencies in Johannesburg Africans

In this prospective analysis we investigated the clinical characteristics of black South African diabetic patients admitted to hospital with hyperglycaemic emergencies. The study cases were selected from the medical admissions to an urbanized, Johannesburg academic hospital over a period of 12 months. Only patients with severe diabetic ketoacidosis (DKA) or hyperosmolar non-ketotic hyperglycaemia (HNKH) as defined in the text were included. Over the study period, we identified 58 patients with severe DKA (M: 32, F: 26) and 24 with HNKH (M: 14, F:10). Thirty-two of the patients with DKA (55.2%) were classified as having non-insulin dependent (Type 2) diabetes mellitus (NIDDM). Compared to the 26 subjects with insulin-dependent (Type 1) diabetes mellitus (IDDM), the NIDDM patients were older (51.7 vs 27.7 years) and had a significantly higher body mass index (BMI) (29.4 vs 23.5 kg m(-2), p = 0.002), and glucose levels 47.5 vs 34 mmol l(-1) p = 0.004). Mortality from DKA was 6.8 % and from HNKH 16.6%. Infection was the leading precipitating factor for both DKA and HNKH, followed by first presentation and noncompliance. We conclude that the majority of urban African patients admitted to hospital with DKA have NIDDM. Mortality from DKA among the black Africans in Johannesburg is low and comparable to the mortality in western Europe.     

Prediction of complex two-dimensional trajectories by a cerebellar model of smooth pursuit eye movement

A neural network model based on the anatomy and physiology of the cerebellum is presented that can generate both simple and complex predictive pursuit, while also responding in a feedback mode to visual perturbations from an ongoing trajectory. The model allows the prediction of complex movements by adding two features that are not present in other pursuit models: an array of inputs distributed over a range of physiologically justified delays, and a novel, biologically plausible learning rule that generated changes in synaptic strengths in response to retinal slip errors that arrive after long delays. To directly test the model, its output was compared with the behavior of monkeys tracking the same trajectories. There was a close correspondence between model and monkey performance. Complex target trajectories were created by summing two or three sinusoidal components of different frequencies along horizontal and/or vertical axes. Both the model and the monkeys were able to track these complex sum-of-sines trajectories with small phase delays that averaged 8 and 20 ms in magnitude, respectively. Both the model and the monkeys showed a consistent relationship between the high- and low-frequency components of pursuit: high-frequency components were tracked with small phase lags, whereas low-frequency components were tracked with phase leads. The model was also trained to track targets moving along a circular trajectory with infrequent right-angle perturbations that moved the target along a circle meridian. Before the perturbation, the model tracked the target with very small phase differences that averaged 5 ms. After the perturbation, the model overshot the target while continuing along the expected nonperturbed circular trajectory for 80 ms, before it moved toward the new perturbed trajectory. Monkeys showed similar behaviors with an average phase difference of 3 ms during circular pursuit, followed by a perturbation response after 90 ms. In both cases, the delays required to process visual information were much longer than delays associated with nonperturbed circular and sum-of-sines pursuit. This suggests that both the model and the eye make short-term predictions about future events to compensate for visual feedback delays in receiving information about the direction of a target moving along a changing trajectory. In addition, both the eye and the model can adjust to abrupt changes in target direction on the basis of visual feedback, but do so after significant processing delays.     

Absence of a barrier to backwards rotation of the bacterial flagellar motor demonstrated with optical tweezers

A cell of the bacterium Escherichia coli was tethered covalently to a glass coverslip by a single flagellum, and its rotation was stopped by using optical tweezers. The tweezers acted directly on the cell body or indirectly, via a trapped polystyrene bead. The torque generated by the flagellar motor was determined by measuring the displacement of the laser beam on a quadrant photodiode. The coverslip was mounted on a computer-controlled piezo-electric stage that moved the tether point in a circle around the center of the trap so that the speed of rotation of the motor could be varied. The motor generated approximately 4500 pN nm of torque at all angles, regardless of whether it was stalled, allowed to rotate very slowly forwards, or driven very slowly backwards. This argues against models of motor function in which rotation is tightly coupled to proton transit and back-transport of protons is severely limited.     

Ground reaction force patterns of Dutch Warmbloods at the canter

Ground reaction force (GRF) patterns from 20 clinically sound Dutch Warmbloods were recorded at the right fore-leading canter, and a standard horse was composed. These GRF data for the standard can be used for evaluation of jumping horses. The GRF patterns were asymmetric for all 4 limbs. The leading right forelimb decelerated the body. The trailing left forelimb propelled the body and decelerated it slightly. The trailing left hind limb propelled, and the leading right hind limb contributed to deceleration and propulsion. Referred to the maximal vertical load of the leading right forelimb, the load of the trailing left forelimb was 25% more; the load of the right hind limb was slightly less, whereas the load of the left hind limb was about 80% of that value.