Search

Johann Lechner,1 Sabine Schuett,2 Volker von Baehr2 1Clinic for Integrative Dentistry, Munich, 2Department of Immunology and Allergology, Institute for Medical Diagnostics in MVZ GbR, Berlin, Germany Abstract: Of the definitions listed in the International Statistical Classification of Diseases and Related Health Problems, tenth revision (ICD-10), two disease descriptions can be found together: "idiopathic aseptic bone necrosis" and "avascular bone necrosis." The relevant literature on both the conditions abbreviates both as "aseptic ischemic osteonecrosis in the jawbone" (AIOJ). To shed light on the clinical details of this condition, osteolytic jawbone samples of 24 patients with different systemic immunological diseases were examined using four steps: presurgical dental X-ray, postsurgical histology, polymerase chain reaction DNA analysis (PCR DNA) of bacteria, and RANTES/CCL5 (R/C) expression. These four steps showed that neither X-ray nor histology delivered unambiguous results with respect to inflammatory processes; furthermore, the PCR results did not show evidence of any microbial load within the jaw samples. However, there is a striking, coherent overexpression of chemokine R/C in the AIOJ samples. This study proved the aseptic existence of "silent inflammation" within the jawbone. The ICD-10 (AIOJ) definition, which is hard to interpret, can now be substantiated with clinical evidence, while the cytokine expressions described in this report can explain the systemic immunological effects observed within the group of examined patients. Keywords: jawbone, osteonecrosis, RANTES, CCL5, silent inflammation, aseptic inflammation, PCR, ICD-10

In the present study, we examined foveal and parafoveal processing in older compared with younger readers by using gaze-contingent paradigms with 4 conditions. Older and younger readers read sentences in which the text was either a) presented normally, b) the foveal word was masked as soon as it was fixated, c) all of the words to the left of the fixated word were masked, or d) all of the words to the right of the fixated word were masked. Although older and younger readers both found reading when the fixated word was masked quite difficult, the foveal mask increased sentence reading time more than 3-fold (3.4) for the older readers (in comparison with the control condition in which the sentence was presented normally) compared with the younger readers who took 1.3 times longer to read sentences in the foveal mask condition (in comparison with the control condition). The left and right parafoveal masks did not disrupt reading as severely as the foveal mask, though the right mask was more disruptive than the left mask. Also, there was some indication that the younger readers found the right mask condition relatively more disruptive than the left mask condition., (PsycINFO Database Record (c) 2014 APA, all rights reserved.)

Homonymous visual field disorders (HVFD) are frequent and disabling consequences of acquired brain injury, particularly in older age. Their rehabilitation is therefore of great importance. Compensatory oculomotor therapy has been found to be effective in improving the associated functional impairments in reading and visual exploration. But older age is commonly considered to adversely affect practice-dependent functional plasticity and, thus, functional and rehabilitation outcome after acquired brain injury. The effect of age in the compensatory treatment of HVFD, however, has never been investigated hitherto. It remains unknown whether age determines not only patients' functional impairments but also the rehabilitation outcome and the required amount of treatment. We therefore present the first study to determine the effect of age in 38 patients with HVFD receiving compensatory oculomotor treatment for their reading and visual exploration impairments. We investigated whether older patients with HVFD (1) show more pronounced impairments and less spontaneous adaptation, (2) show lesser compensatory treatment-related improvement in reading and visual exploration, and (3) require a higher amount of treatment than younger patients. Our main finding is that older patients achieve the same treatment-induced improvements in reading and visual exploration with the same amount of treatment as younger patients; severity of functional impairment also did not differ between older and younger patients, at least in reading. Age does not seem to be a critical factor determining the functional and rehabilitation outcome in the compensatory treatment of HVFD. Older age per se is not necessarily associated with a decline in practice-dependent functional plasticity and adaptation. To the contrary, the effectiveness of compensatory treatment to reduce the functional impairments to a similar extent in younger and older patients with HVFD adds to the growing evidence for a life-long potential for adaptation to the adverse effects of brain injury., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

It is well acknowledged that genetic variation accounts for the intra-species variability in Staphylococcus aureus isolates. Similarly, deficiency in DNA repair and the resulting increase in genomic mutations determine intra-strain variability in S. aureus small colony variants (SCV). The aim of this study was to investigate whether intra-strain diversity would be associated with an alteration of the host-pathogen interaction. To this end, biofilm formation and immune stimulatory capacity were compared in consecutive SCV isolates originating from a single patient. Despite the relatedness of the isolates, the results revealed significant differences in biofilm formation and immune stimulation determined by Toll-like receptor-2 (TLR2) activity. Variation in the extent of biofilm production could be attributed to differences in the expression of protein A (SpA) and agrA. TLR2 activity only partially correlated with these parameters. Although transiently increased functional activity correlated with clinical remission and was abrogated in MRSA superinfection, we can only speculate that changes in the SCV phenotype reflect alterations in the microbial environment and/or treatment. Taken together, our study provides in vivo evidence for the functional consequences of intra-strain variation in S. aureus., (Copyright © 2013 Elsevier GmbH. All rights reserved.)

Older and younger readers read normal and unspaced text as their eye movements were monitored. A high or low frequency word was embedded in each sentence. Global analyses yielded large effects of spacing with unspaced text leading to much longer reading times for both groups, but the older readers had much more difficulty with unspaced text than younger readers. Local analyses of the target word revealed large main effects due to age, spacing, and frequency. In general, the older readers had more difficulty with the unspaced text than younger readers and some reasons why they did so are suggested.

Disorders of visual perception are frequent and disabling functional consequences of acquired brain injury (20-40%). They also have adverse effects on the assessment, diagnosis and treatment of other functional disorders. Most frequent are visual field disorders followed by disorders of visual acuity and contrast sensitivity, visual adaptation, color and visual space perception as well as of visual recognition. Multiple visual and/or additional cognitive disorders are most common. The differential diagnosis of cerebral visual disorders and an individually tailored and specific approach in the rehabilitation are therefore of great importance. Compensatory treatment methods are to be preferred because of their efficacy, ecological validity as well as a good cost-benefit ratio.

The contralesional line bisection error in unilateral homonymous hemianopia is a frequent but neglected clinical phenomenon. Our knowledge about this bisection error is based on small samples of hemianopic patients. Moreover, horizontal line bisection has never been investigated in other unilateral visual field defects. The present study is the first to examine line bisection in a large, representative sample of patients with unilateral homonymous visual field defects. We investigated horizontal line bisection in 129 patients with left- or right-sided homonymous hemianopia (60.5%), upper and lower quadranopia (24.8%), and paracentral scotoma (14.7%), and determined the magnitude and direction of line bisection error. The contralesional horizontal line bisection error was present not only in patients with hemianopia but also in those with upper or lower quadranopia or paracentral scotoma. Neither the type nor the severity of the visual field defect was found to determine the bisection error. Only the side of the field defect seemed to determine the horizontal direction of the bisection error (left-/rightward). The contralesional bisection error is not a specifically "hemianopic" phenomenon. It is frequently associated with any unilateral homonymous visual field defect, i.e., hemianopia, upper/lower quadranopia, paracentral scotoma. Moreover, our results further support the recent finding that the contralesional bisection error is not a direct consequence of the visual field defect. Yet, they also suggest that, although the visual field defect does not seem to be the primary cause of the contralesional bisection error, it may nevertheless contribute to it., (Copyright © 2010 Elsevier Srl. All rights reserved.)

Mannose-binding lectin (MBL) mediates important functions within the innate immune system, and its deficiency was associated with infectious complications. However, in adults without concomitant immunodeficiency the clinical relevance of MBL deficiency remains controversial. We analyzed the distribution of MBL deficiency and its association with concomitant immunodeficiency in 228 adult Caucasian patients with a history of recurrent and/or severe infections. Two hundred forty-one unrelated Caucasians without recurrent or severe infections served as control subjects. The frequency of severe MBL deficiency (plasma levels

The contralesional line bisection error in hemianopia is a well-known clinical phenomenon. Its origin, however, is still unclear. We therefore investigated the causes of the hemianopic bisection error in 84 patients with unilateral homonymous hemianopia without visuospatial neglect. Our results suggest that the contralesional bisection error is neither a consequence of the visual field defect itself nor a manifestation of strategic adaptation of attention and eye movements into contralesional hemispace. Additional extrastriate brain injury, presumably to occipito-temporal areas including the occipital white matter, seems to be critical for the emergence of the contralesional bisection error that is frequently associated with but separable from homonymous hemianopia.

Hemianopic dyslexia is a frequent and disabling functional impairment following brain injury. This form of dyslexia is an acquired reading disorder whereby patients with homonymous visual field defects have persistent and severe reading difficulties, despite having intact language functions. Hemianopic dyslexia has received little attention from researchers and clinicians, and this article is the first to review the rehabilitation of patients with the condition. In light of advances in our knowledge about the nature and causes of hemianopic dyslexia, I critically examine the available treatment methods for visual field disorders and evaluate their efficiency in alleviating hemianopic dyslexia. On the basis of the reviewed evidence, I suggest that compensatory therapies, which attempt to reorganize eye-movement control, are superior to restorative therapies, which aim at visual field restitution. For the rehabilitation of hemianopic dyslexia, I recommend a treatment protocol that involves the systematic and repetitive practice of specific eye movements for reading. Despite increasing evidence for the effectiveness of this treatment protocol, which has clinically relevant long-term benefits, the underlying mechanism of the therapeutic effect is still unclear. Indeed, more research is required to further improve the efficiency of rehabilitation in patients with hemianopic dyslexia.

Reading and visual exploration impairments in unilateral homonymous hemianopia are well-established clinical phenomena. Spontaneous adaptation of eye-movements to the visual field defect leads to improved reading and visual exploration performance. Yet, it is still unclear whether oculomotor adaptation to visual field loss is task-specific or whether there is a transfer of adaptation-related improvements between reading and visual exploration. We therefore simulated unilateral homonymous hemianopia in healthy participants and explored the specificity with which oculomotor adaptation to this pure visual-sensory dysfunction during uninstructed reading or visual exploration practice leads to improvements in both abilities. Our findings demonstrate that there is no transfer of adaptation-related changes of eye-movements and performance improvements between reading and visual exploration. Efficient oculomotor adaptation to visual field loss is highly specific and task-dependent.

It is still unclear whether the contralateral line bisection error in unilateral homonymous hemianopia is caused by the visual field defect, strategic oculomotor adaptation or by additional extrastriate brain injury. We therefore simulated hemianopia in healthy participants using a gaze-contingent display paradigm and investigated its effects on manual and ocular line bisection performance and eye-movements. Although simulated hemianopia impaired line bisection and induced the adaptive oculomotor eye-movement pattern of hemianopic patients, it did not induce the contralateral bisection error, suggesting that neither the visual field defect nor oculomotor adaptation to it are the primary causes of the hemianopic bisection error.

Hemianopic reading and visual exploration impairments are well-known clinical phenomena. Yet, it is unclear whether they are primarily caused by the hemianopic visual field defect itself or by additional brain injury preventing efficient spontaneous oculomotor adaptation. To establish the extent to which these impairments are visually elicited we simulated unilateral homonymous hemianopia in healthy participants, using a gaze-contingent display paradigm, and investigated its effect on reading and visual exploration. We demonstrate that simulated hemianopia induces the reading and visual exploration impairments of hemianopic patients. Over time, however, all participants showed efficient spontaneous oculomotor adaptation to the visual-sensory loss which improved their reading and visual exploration performance. Our results suggest that the hemianopic visual field defect is a major component of the chronic impairments of reading and visual and exploration found in hemianopic patients although it may not be their sole cause.

We present the first comprehensive review of research into hemianopic dyslexia since Mauthner's original description of 1881. We offer an explanation of the reading impairment in patients with unilateral homonymous visual field disorders and clarify its functional and anatomical bases. The major focus of our review is on visual information processing, visuospatial attention and eye-movement control during reading. An advanced understanding of the basis of hemianopic dyslexia and its rehabilitation also increases our knowledge about normal reading and its underlying neural mechanisms. By drawing together various sources of evidence we illustrate the significance of bottom-up and attentional top-down control of visual information processing and saccadic eye-movements in reading. Reading depends critically on the cortical-subcortical network subserving the integration of visual, attentional and oculomotor processes involved in text processing.

We have used optical imaging of intrinsic signals to visualize the retinotopic organization of mouse visual cortex. The functionally determined position, size, and shape of area 17 corresponded precisely to the location of this area as seen in stained cortical sections. The retinotopic map, which was confirmed with electrophysiological recordings, exhibited very low inter-animal variability, thus allowing averaging of maps across animals. Patches of activity in area 17 were often encircled by regions in which the intrinsic signal dropped below baseline, suggesting the presence of strong surround inhibition. Single-unit recordings revealed that this decrease of the intrinsic signal indeed correlated with a drop of neuronal firing rate below baseline. The averaged maps also greatly facilitated the identification of extrastriate visual activity, pointing to at least four extrastriate visual areas in the mouse. We conclude that optical imaging is ideally suited to visualize retinotopic maps in mice, thus making this a powerful technique for the analysis of map structure in transgenic animals.

We have studied the precise temporal requirements for plasticity of orientation preference maps in kitten visual cortex. Pairing a brief visual stimulus with electrical stimulation in the cortex, we found that the relative timing determines the direction of plasticity: a shift in orientation preference toward the paired orientation occurs if the cortex is activated first visually and then electrically; the cortical response to the paired orientation is diminished if the sequence of visual and electrical activation is reversed. We furthermore show that pinwheel centers are less affected by the pairing than the pinwheel surround. Thus, plasticity is not uniformly distributed across the cortex, and, most importantly, the same spike time-dependent learning rules that have been found in single-cell in vitro studies are also valid on the level of cortical maps.

Endothelin-1 (ET-1) is a potent vasoconstrictive peptide exerting its effects predominantly by paracrine and autocrine mechanisms. ET-1 acts as a mitogen and co-mitogen on vascular smooth muscle cells, and accumulating evidence suggests that ET-1 is involved in the pathogenesis of atherosclerosis. Deposition of low density lipoproteins (LDL) in the vessel wall is known to play a crucial role in the development of atherosclerotic lesions. In the present study, we have investigated the effect of native LDL (nLDL) and oxidatively modified LDL (oxLDL) on ET-1 synthesis and endothelin receptor expression in cultured human coronary artery smooth muscle cells and human monocyte-derived macrophages. Native LDL and oxLDL induced a significant stimulation of ET-1 release and ET-1 mRNA expression in human coronary artery smooth muscle cells and monocyte-derived macrophages. Antibodies against the scavenger receptor CD36 significantly reduced the oxLDL-induced stimulation of ET-1 synthesis. The antioxidants trolox and probucol did not significantly inhibit the LDL-induced rise of ET-1 release. Endothelin B receptor expression was up-regulated in both cell types after incubation with nLDL and oxLDL. In coronary smooth muscle cells, endothelin A receptor expression was slightly increased by LDL, whereas endothelin A receptor was not detectable in monocyte-derived macrophages. Coronary artery smooth muscle cells secreted a more than 150-fold higher amount of immunoreactive ET-1 into the cell culture medium than monocyte-derived macrophages. In summary, the present data, demonstrating a LDL-induced up-regulation of the endothelin system in coronary smooth muscle cells and in monocyte-derived macrophages, provide further support for a pathophysiological role of endothelin in coronary atherosclerosis and suggest that ET-1 might be involved in mediating the atherogenic effects of LDL., (Copyright 2001 Academic Press.)

Low-density lipoproteins (LDL) are known to cause endothelial injury and to promote the development of atherosclerotic lesions. This study demonstrates a significant concentration-dependent stimulatory effect of LDL on hepatocyte growth factor (HGF) synthesis (maximum release: 423 +/- 16% of control) and HGF receptor mRNA expression in cultured human coronary artery endothelial cells (HCAEC). HGF is a potent mitogen for endothelial cells but does not affect smooth muscle cell proliferation. In contrast, endothelin-1 (ET-1) acts as a mitogen on vascular smooth muscle cells and seems to be upregulated in coronary atherosclerosis. In this study, the basal ET-1 synthesis in HCAEC was concentration-dependently reduced by HGF (minimum: 54 +/- 3% of control). This inhibitory effect seems to be mediated via the tyrosine kinase activity of the HGF receptor c-met, since it was antagonized by the tyrosine kinase inhibitor lavendustin A. In addition, HGF also significantly reduced the LDL-stimulated ET-1 release. The LDL-induced upregulation of HGF synthesis in HCAEC and the inhibitory effect of HGF on ET-1 synthesis suggest a protective role of HGF in coronary atherosclerosis.

Objective: To determine differences between infertile wives' and husbands' levels of loneliness and perception of social support and to determine if there is a relationship between loneliness and social support., Design: Comparative descriptive., Setting: University infertility clinic and RESOLVE, an infertility support group., Participants: Convenience sample of 62 couples diagnosed as experiencing either primary or secondary infertility., Outcome Measures: Loneliness was measured using the Revised UCLA Loneliness Scale; social support was measured using the Interpersonal Relationship Inventory with subscales of Social Support, Reciprocity, and Conflict., Results: Wives were significantly more lonely than husbands (t = 2.053, p = 0.04). There was no significant group difference on the social support total score or three subscale scores. Loneliness was inversely related to social support and reciprocity both for wives (r = -0.62, p = 0.001, and r = -0.50, p = 0.002, respectively) and husbands (r = -0.74, p = 0.001, and r = -0.56, p = 0.001, respectively); loneliness correlated with conflict for wives only (r = 0.48, p = 0.007)., Conclusions: Although wives and husbands differed in loneliness, they were similar in perceived social support. Greater social support and reciprocity lessened feelings of loneliness for both groups. Wives who perceived increased conflict in their social relationships were more lonely.