Ho:YLF & Ho:LuLF slab amplifier system delivering 200 mJ, 2 µm single-frequency pulses

A single-frequency single-pass amplifier based on Ho:YLF and Ho:LuLF in a scalable slab architecture delivering up to 210 mJ at 2064 nm is demonstrated. The amplifier was end-pumped by a 1890 nm Tm:YLF slab laser and was seeded with a 69 mJ single-frequency Ho:YLF ring laser operating at 50 Hz.

The Y238X stop codon polymorphism in the human β-glucan receptor dectin-1 and susceptibility to invasive aspergillosis

BACKGROUND

Dectin-1 is the major receptor for fungal β-glucans on myeloid cells. We investigated whether defective Dectin-1 receptor function, because of the early stop codon polymorphism Y238X, enhances susceptibility to invasive aspergillosis (IA) in at-risk patients.

METHODS

Association of Dectin-1 Y238X polymorphism with occurrence and clinical course of IA was evaluated in 71 patients who developed IA post hematopoietic stem cell transplantation (HSCT) and in another 21 non-HSCT patients with IA. The control group consisted of 108 patients who underwent HSCT. Functional studies were performed to investigate consequences of the Y238X Dectin-1 polymorphism.

RESULTS

The Y238X allele frequency was higher in non-HSCT patients with IA (19.0% vs 6.9%-7.7%; P < .05). Heterozygosity for Y238X polymorphism in HSCT recipients showed a trend toward IA susceptibility (odds ratio, 1.79; 95% CI, .77-4.19; P = .17) but did not influence clinical course of IA. Functional assays revealed that although peripheral blood mononuclear cells with defective Dectin-1 function due to Y238X responded less efficiently to Aspergillus, corresponding macrophages showed adequate response to Aspergillus.

CONCLUSIONS

Dectin-1 Y238X heterozygosity has a limited influence on susceptibility to IA and may be important in susceptible non-HSCT patients. This is partly attributable to redundancy inherent in the innate immune system. Larger studies are needed to confirm these findings.

Novel one-stop multidisciplinary follow-up clinic significantly improves cancer risk management in BRCA1/2 carriers

The purpose of this study is to measure the impact of a multidisciplinary one-stop follow-up clinic (MDOSC) on breast and ovarian surveillance, risk reducing surgery and enrolment in clinical trials in BRCA1/2 carriers. All BRCA1/2 carriers in our region were invited and chose which specialists to see in our MDOSC offering best practice using clinical protocols based on national guidelines and published data. Uptake was evaluated over 24 months recording numbers of individuals undergoing breast and ovarian surveillance, risk reducing surgery, newly diagnosed cancers, their method of detection and participation in clinical trials. 172 (60%) of invited BRCA1/2 carriers chose to attend the MDOSC. Breast surveillance was initiated in 88% and screening frequency altered in 14% of women to comply with national guidelines. Risk reducing salpingo-oophorectomy was chosen by 47% of women and an additional 39% were considering it. The rate of failure to remove fallopian tubes fell from 15 to 3% of procedures (P < 0.01) and peritoneal washings and serial sectioning of tubes and ovaries rose from 25% and 14% before, to 67% (P < 0.001) and 63% (P < 0.001) procedures, respectively, after initiation of our MDOSC. 24% of women considered and 18% decided to undergo risk reducing mastectomy during the follow-up period. Participation in clinical trials increased significantly from 51 to 229 enrolments (P < 0.001). Our novel MDOSC designed to devise an individually tailored cancer risk management strategy had a high uptake amongst our BRCA1/2 carriers. Attendance resulted in improved breast and ovarian cancer risk management.

Learner Inclinations to Study Computer Science or Information Systems at Tertiary Level

After the so-called “dot-com crash” of the Internet in the early 2000s, tertiary level student enrolments in IT-related subjects began to experience a significant decline both in international countries and South Africa. The paper replicates research done in the Western Cape, South Africa, by Seymour et al. (2005) [20], in which grade 12 learner inclinations to study Computer Science (CS) and Information Systems (IS) at tertiary level were analysed and underlying factors affecting their interest in the subjects were determined. The study analyses the “misguided” perceptions that learners and students have of these subjects; the implications of the decline in enrolments on students, educational sectors and industry; and determines a set of underlying factors that influence learners in their attitudes toward further degrees in IT, starting from the secondary level of education. The research compares South African Eastern Cape learner perceptions with those from the Western Cape study and establishes three to four years later, that the reasons behind the decline in IT enrolments are still influenced by an underlying demographic and digital divide.

Learner Inclinations to Study Computer Science or Information Systems at Tertiary Level

After the so‐called “dot‐com crash” of the Internet in the early 2000s, tertiary level student enrolments in IT‐related subjects began to experience a significant decline both in international countries and South Africa. The paper replicates research done in the Western Cape, South Africa, by Seymour et al. (2005) [20], in which grade 12 learner inclinations to study Computer Science (CS) and Information Systems (IS) at tertiary level were analysed and underlying factors affecting their interest in the subjects were determined. The study analyses the “misguided” perceptions that learners and students have of these subjects; the implications of the decline in enrolments on students, educational sectors and industry; and determines a set of underlying factors that influence learners in their attitudes toward further degrees in IT, starting from the secondary level of education. The research compares South African Eastern Cape learner perceptions with those from the Western Cape study and establishes three to four years later, that the reasons behind the decline in IT enrolments are still influenced by an underlying demographic and digital divide.

Ho:YLF pumped HBr laser

A Ho:YLF laser pumped HBr molecular laser was developed that produced up to 2.5 mJ of energy in the 4 micron wavelength region. The Ho:YLF laser was fiber pumped using a commercial Tm:fibre laser. The Ho:YLF laser was operated in a single longitudinal mode via injection seeding with a narrow band diode laser which in turn was locked to one of the HBr transitions. The behavior of the HBr laser was described using a rate equation mathematical model and this was solved numerically. Good agreement both qualitatively and quantitatively between the model and experimental results was obtained.

Efficient copackaging and cotransport yields postsynaptic colocalization of neuromodulators associated with synaptic plasticity

Recent data suggest that tissue plasminogen activator (tPA) influences long-term plasticity at hippocampal synapses by converting plasminogen into plasmin, which then generates mature brain-derived neurotrophic factor (mBDNF) from its precursor, proBDNF. Motivated by this hypothesis, we used fluorescent chimeras, expressed in hippocampal neurons, to elucidate (1) mechanisms underlying plasminogen secretion from hippocampal neurons, (2) if tPA, plasminogen, and proBDNF are copackaged and cotransported in hippocampal neurons, especially within dendritic spines, and (3) mechanisms mediating the transport of these neuromodulators to sites of release. We find that plasminogen chimeras traffic through the regulated secretory pathway of hippocampal neurons in dense-core granules (DCGs) and that tPA, plasminogen, and proBDNF chimeras are extensively copackaged in DCGs throughout hippocampal neurons. We also find that 80% of spines that contain DCGs contain chimeras of these neuromodulators in the same DCG. Finally, we demonstrate, for the first time, that neuromodulators undergo cotransport along dendrites in rapidly mobile DCGs, indicating that neuromodulators can be efficiently recruited into active spines. These results support the hypothesis that tPA mediates synaptic activation of BDNF by demonstrating that tPA, plasminogen, and proBDNF colocalize in DCGs in spines, where these neuromodulators can undergo activity-dependent release and then interact and/or mediate changes that influence synaptic efficacy. The results also raise the possibility that frequency-dependent changes in extents of neuromodulator release from DCGs influence the direction of plasticity at hippocampal synapses by altering the relative proportions of two proteins, mBDNF and proBDNF, that exert opposing effects on synaptic efficacy.

Cortisol secretory activity in older people in relation to positive and negative well-being

Secretion of the hormone cortisol, a physiological correlate of affect, has been studied mostly in relation to negative states, especially stress. By contrast, policy initiatives aimed at older populations now routinely emphasise well-being and a 'positive ageing' perspective. In this study, we examined diurnal salivary cortisol profiles from 50 active seniors recruited into a wider community research project (mean age 74 years; 34 F/16 M). Participants' wrist activity was continuously monitored by actimeters in their homes over a 48 h period. During this time two diurnal cycles of cortisol data were collected (8 samples per day); with actimeter data providing a compliance check in regard to timing of self-administered saliva collections. Prior to the trial, participants had completed the GHQ-30 which was scored separately to yield both positive and negative well-being scores which matched closely normative data from over 6000 cases in a large survey. Our data suggest that positive and negative psychological well-being are quite strongly and inversely correlated. However, neither on their own was associated with basal levels of cortisol. Rather, for cortisol secretion in the 45-min period following awakening, but not during the rest of the day, we found a significant interaction between positive and negative well-being (p<0.024). Further analysis of this interaction showed that among participants low on negative well-being, higher positive well-being was significantly associated with lower cortisol; equally, among participants high on positive well-being, lower negative well-being was significantly associated with lower cortisol. Thus, a powerful synergy seemed to be operating in this early morning period such that cortisol secretion was 27% lower in participants with both higher-than-average positive well-being and lower-than-average negative well-being (comprising 34% of the sample). We conclude that cortisol secretion in the first 45 min following awakening is distinct from the rest of the day and most able to discriminate well-being states.

Phase II study of IV vinflunine in patients with chemotherapy naive metastatic malignant melanoma

This phase II study evaluated vinflunine in chemotherapy naive patients with metastatic melanoma. Vinflunine was administered at 350 mg/m(2) every 3 weeks, but after 9 patients this was reduced to 320 mg/m(2) based on interim analyses of all phase II trials. A partial response was observed in 1 of the first 9 patients (11.1%) treated at 350 mg/m(2), which gives a 3.0% [95% confidence interval (CI): 0.08-15.8] response rate in 33 patients. No change was the best response in 13 patients (39.4%) with progressive disease in 16 (48.5%) and 3 were not evaluable for response. The time to response was 1.4 months and duration was 6 months. At 350 mg/m(2) grade 4 neutropaenia occurred in 3 patients (33.3%) and grade 3 in 2 patients (22.2%) while at 320 mg/m(2) grade 4 neutropaenia occurred in 6 patients (25%) and grade 3 in 3 patients (12.5%) with 2 episodes of grade 3 febrile neutropaenia. Two patients (8.3%) had grade 3 anaemia. These results do not show activity at this dose and schedule for vinflunine in patients with chemotherapy naive metastatic melanoma.

Phase II study of RAD001 (everolimus) and depot octreotide (sandostatin LAR) in advanced low grade neuroendocrine carcinoma (LGNET)

4503

Background: Effective systemic therapy for advanced LGNET is lacking. Mutations involving the mTOR pathway including TSC2, NF-1, and vHL are associated with development of LGNET. mTOR also mediate signaling downstream of IGF1 and VEGF. RAD001 is a novel oral mTOR inhibitor. Octreotide has been described to inhibit VEGF and IGF1 production in solid tumors. Methods: Patients (pts) received depot octreotide 30 mg q28 days, and RAD001 5 (pts 1–30) or 10 mg (pts 31–60) po daily. Response was evaluated every 12 weeks (wks). Results: 30 carcinoid (C) and 30 islet cell (I) patients (pts) were enrolled between 2/05–7/06. 38 pts (23 C, 15 I) had prior octreotide. By RECIST criteria, there were 10 PR (17%), 45 SD (75%) (15 pts had > 15% reduction), 5 PD (8%). The response rates within C, and I groups were 13% and 20%. The response rates within the 5 mg and 10 mg groups were 13% and 20% respectively. Of 39 pts with PD prior to study entry, there were 7 (18%) PR, 27 (69%) SD (9 pts had > 15% reduction), 5 (13%) PD. PFS rate at 24 wks was 86%. The median PFS duration is 59 wks. The median PFS duration among the C and I groups were 69 and 39 wks. Among the 39 pts with progression at study entry, the median PFS duration was 38 wks. Of 24 pts with elevated chromogranin A at entry, 19 (56%) had > 50% reduction. Treatment was well tolerated. The most common toxicity was mild aphthous ulceration. CTC G3/4 toxicities included: thrombocytopenia (3), neutropenia (3), hypophosphatemia (5), hyperglycemia (4), hypoglycemia (2), hypokalemia (2), fatigue (6), diarrhea (6), aphthous ulcer (5), rash (3), and 1 each of anemia, hypertriglyceridemia, bilirubin, AST/ALT, pain, nausea, nail, dysgeusia, pneumonitis. Conclusions: RAD001 at 5 or 10 mg daily was well tolerated in combination with octreotide. Promising anti-tumor activity has been observed. The RADIANT (RAD001 In Advanced Neuroendocrine Tumors) trials are underway to evaluate RAD001 in larger patient groups.

No significant financial relationships to disclose.

Providing a community-based cancer risk assessment service for a socially and ethnically diverse population

BACKGROUND

Patients from ethnic minorities are under-represented in referrals to cancer genetics services. In a regional genetics centre that serves two London boroughs, the existing service attracts 3% of its referrals from Black and Minority Ethnic (BME) and other ethnic groups, despite the fact that these groups make up 34% of the population.

OBJECTIVES

To improve access to familial cancer risk assessment in a socially and ethnically diverse population.

SETTING

The London boroughs of Lambeth and Southwark.

DESIGN

Community-based, nurse-led clinics were established for people who were concerned about their familial cancer risk. Patients were asked to triage themselves by answering three questions. Self-referral was encouraged.

MAIN OUTCOME MEASURES

Data were gathered on ethnicity of clients, cancer risk, source of referral and patient and health professional satisfaction with the service.

RESULTS

Of the 415 people who have accessed the service, 46% were from not White British groups and 67% referred themselves to the service, demonstrating the success of this model in reaching 'hard to reach' groups. Thirty-seven percent of patients were assessed as being at population risk and 63% were assessed as being at moderate risk or higher, showing that the clinics were meeting an unmet need in the community.

Neurons expressing serotonin-1B receptor in the basolateral nuclear group of the amygdala in normally behaving and aggressive dogs

The present study aimed to quantify neurons expressing the serotonin-1B receptor and evaluate numerical differences in normally behaving and pathologically aggressive dogs in order to assess whether the serotonin-1B receptor is involved in pathological canine aggression. Because previous studies have reported structural alterations in the basolateral nuclear group (BNG) of the amygdaloid body of aggressive dogs, this structure was selected as region of interest in the present study. Indirect immunohistochemistry was applied to visualise the serotonin-1B-receptor-positive neurons. Immunoreactivity was located predominantly within the neuronal cell bodies and adjacent neuronal processes. In the aggressive dogs the BNGs contained a significantly higher number of serotonin-1B-receptor-positive neurons compared to the normally behaving dogs. This number was strongly correlated with the total number of neurons per BNG, which was also significantly increased in aggressive dogs compared to normal dogs. The percentage of neurons expressing the serotonin-1B receptor did not differ significantly between both groups. No significant asymmetries were observed for the number and percentage of serotonin-1B-receptor-positive neurons. Potential relationships between the present findings and the etiology of aggressive behaviour, the neuroprotective role of the serotonin-1B receptor and receptor dysfunction are discussed.

Neurons expressing serotonin-1B receptor in the basolateral nuclear group of the amygdala in normally behaving and aggressive dogs

The present study aimed to quantify neurons expressing the serotonin-1B receptor and evaluate numerical differences in normally behaving and pathologically aggressive dogs in order to assess whether the serotonin-1B receptor is involved in pathological canine aggression. Because previous studies have reported structural alterations in the basolateral nuclear group (BNG) of the amygdaloid body of aggressive dogs, this structure was selected as region of interest in the present study. Indirect immunohistochemistry was applied to visualise the serotonin-1B-receptor-positive neurons. Immunoreactivity was located predominantly within the neuronal cell bodies and adjacent neuronal processes. In the aggressive dogs the BNGs contained a significantly higher number of serotonin-1B-receptor-positive neurons compared to the normally behaving dogs. This number was strongly correlated with the total number of neurons per BNG, which was also significantly increased in aggressive dogs compared to normal dogs. The percentage of neurons expressing the serotonin-1B receptor did not differ significantly between both groups. No significant asymmetries were observed for the number and percentage of serotonin-1B-receptor-positive neurons. Potential relationships between the present findings and the etiology of aggressive behaviour, the neuroprotective role of the serotonin-1B receptor and receptor dysfunction are discussed.

Increased Number of Neurons Expressing Androgen Receptor in the Basolateral Amygdala of Pathologically Aggressive Dogs

The present study aimed to determine the extent to which the androgen receptor (AR) is directly involved in the hormonal modulation of pathological canine aggressive behaviour in the basolateral nuclear group (BNG) of the amygdaloid body. A stereological quantification of AR-positive neurons was performed in the BNGs of normally behaving and aggressive male dogs. The BNG was selected because it is involved in sexual and behavioural activities that are influenced by androgens. In the aggressive dogs the BNG contained a significantly higher number of AR-positive neurons compared with normally behaving dogs suggesting differences in androgen activity within the BNGs of both the groups. However, additional mechanisms are likely to be involved because the AR-negative fraction of BNG neurons was also increased in the aggressive dogs. It was concluded that most of the AR was unliganded because a cytoplasmic staining pattern of AR positivity was observed in the canine BNG neurons. This indicates that genomic androgen actions, which are mediated through the AR are of minor importance in the testosterone modulation of canine aggression within the BNG. Other non-genomic mechanisms through which androgens may exert their action in the BNG are discussed. The aromatase pathway is suggested to be the main mechanism through which testosterone exerts its action within the BNG.

Phase II study of RAD001 (everolimus) and depot octreotide (Sandostatin LAR) in patients with advanced low grade neuroendocrine carcinoma (LGNET)

4042

Background: Effective systemic therapy for advanced LGNET is lacking. Patients with mutation in TSC2, an endogenous inhibitor of mTOR develop LGNET. mTOR also mediate signaling downstream of IGF1 and VEGF, pathways important in LGNET. RAD001 inhibits the serine-threonine kinase activity of mTOR. Octreotide may have cytostatic activity and has been described to inhibit VEGF and IGF1 production in solid tumors. Methods: Treatment consisted of depot octreotide 30 mg IM q28 days, and RAD001 5 or 10 mg po daily. Response evaluation is performed every 12 weeks. Results: 32 patients (18 carcinoids, 13 islet cell) were enrolled between 2/05 - 1/06. 20 had prior octreotide. 27 patients have completed 12 weeks of therapy at the 5 mg dose level and undergone response evaluation. By RECIST criteria, response rate was 15%. There were 4 PR, 19 SD (including 4 patients having 18–28% reduction), 4 PD. PR occurred in 2 carcinoids, and 2 islet cell. PFS rate at week 24 was 71%. Of 21 patients with radiological progression prior to study entry, 17 have completed 12 weeks of therapy. Among these, there were 3 PR, 10 SD, 4 PD. Of 18 patients with elevated chromogranin A at baseline, 9 (50%) patients had > 50% reduction. Treatment is generally well tolerated. The most common toxicity is mild aphthous ulceration. CTC G3/4 toxicity include: anemia (1), thrombocytopenia (1), leukopenia (1), fatigue (3), aphthous ulcer (2), diarrhea (2), hypoglycemia (2), pain (2), rash (2), hyperglycemia (1), edema (1), nausea (1). Conclusions: RAD001 5 mg po daily is well tolerated in combination with Depot Octreotide. Anti-tumor activity has been observed. An additional cohort will be treated at RAD001 10 mg daily dose. Optional blood draws and tumor biopsies will be performed to help assess biomarkers that may predict benefit.

No significant financial relationships to disclose.

Increased volume and neuronal number of the basolateral nuclear group of the amygdaloid body in aggressive dogs

Involvement of the basolateral nuclear group (BNG) in pathological canine aggression was assessed by stereological determination of the volume of the BNG and quantification of the numerical density and total number of BNG neurons in normally behaving and aggressive dogs. A bilateral BNG enlargement of 40% was observed in the aggressive group. This enlargement appeared to be caused by a significantly increased number of BNG neurons. Other alterations such as an increased vessel density, oedema and scar tissue were not observed in any of the examined BNGs. The potential role of neurotrophins and stress hormones in the increased number of BNG neurons is discussed.

The childhood experience of care and abuse questionnaire (CECA.Q): validation in a community series

BACKGROUND

Childhood neglect and abuse, as measured by retrospective interview, is highly predictive of psychiatric disorder in adult life and has an important role in aetiological models. However, such measures are labour-intensive, costly, and thus restricted to relatively modest sample sizes. A compact self-report assessment of childhood experience is invaluable for research screening purposes and large-scale survey investigation.

METHOD

A self-report questionnaire (CECA.Q) was developed to mirror an existing validated interview measure: the childhood experience of care and abuse (CECA). The questionnaire assessed lack of parental care (neglect and antipathy), parental physical abuse, and sexual abuse from any adult before age 17. A high-risk series of 179 London women were interviewed using the CECA together with the PSE psychiatric assessment, and completed the CECA.Q at later follow-up. Repeat CECA.Qs were returned for 111 women and 99 women additionally completed the parental bonding instrument (PBI; Parker, Tupling, & Brown, 1979).

RESULTS

Satisfactory internal scale consistency was achieved on the CECA.Q for antipathy (alpha = .81) and neglect (alpha = .80) scales. There was satisfactory test-retest for both care and abuse scales. Significant associations were found between CECA.Q scales and the parallel interview scales with cut-offs determined for high sensitivity and specificity. CECA.Q neglect and antipathy scales were also significantly related to PBI parental care. CECA.Q scales were significantly related to lifetime history of depression. Optimal cut-off scores revealed significant odds ratios (average of 2) for individual scales and depression. When indices were compiled to reflect peak severity of each type of adversity across perpetrator, odds-ratios increased (average 3). A dose-response effect was evident with the number of types of neglect/abuse and rate of lifetime depression.

CONCLUSION

The CECA.Q shows satisfactory reliability and validity as a self-report measure for adverse childhood experience. The merits of having parallel questionnaire and interview instruments for both research and clinical work are discussed.

Quantification of neurons expressing androgen receptor and volume estimation of the basolateral nuclear group of the canine amygdaloid body

A protocol was developed for the stereological quantification of neurons expressing androgen receptor (AR) in the basolateral nuclear group (BNG) of the canine amygdaloid body. The Cavalieri method was used to estimate the BNG volume and the physical disector technique was applied for assessing the numerical densities and total numbers of both ordinary and AR-positive BNG neurons. The overall number of BNG neurons and the BNG volume were assessed on Nissl-stained sections, while AR was visualised using indirect immunohistochemistry. The morphological differentiation between neurons, astrocytes, and oligodendrocytes in these immunohistochemical sections was hampered by the cytoplasmic localisation of AR in these cells. Therefore, an additional criterion was developed based on the nuclear diameters of these cells. With the cutoff value of 7.4 microm, a sensitivity of 97.7% and specificity of 97.6% were obtained. A negative correlation was found between the BNG volume and the numerical density of its neurons, implicating that a large BNG will not necessarily have a higher number of neurons. Therefore, the numerical density or BNG volume should always be assessed in addition to the total number of neurons, justifying the use of the physical disector instead of the fractionator technique in the present study. However, higher coefficients of error were obtained for the total number of neurons with the physical disector method because of the indirect measurement of cell numbers. Therefore, the precision of the estimates must be high enough when using the disector method to compensate the precision loss caused by this indirect calculation of the total cell number.

Insulin-like growth factor ligands, receptors, and binding proteins in cancer

This review aims to summarize experimental evidence supporting the role of the insulin-like growth factor (IGF) signalling system in the progression, maintenance, and treatment of cancer. These data implicate the IGF system as an important modifier of cancer cell proliferation, survival, growth, and treatment sensitivity. The role of the IGF system in cancer should be examined in the context of the extra-cellular and intra-cellular signalling networks, in particular: phosphatidylinositol 3-kinase (PI3K), protein kinase B (Akt/PKB), mammalian target of rapamycin (mTOR), and forkhead transcription factors (FOXO). This review highlights evidence derived from molecular structure and functional genetics with respect to how the extra-cellular components of the IGF system function normally, and their subsequent modifications in cancer. The therapeutic relevance of the research evidence described is also addressed, as the challenge is to apply this knowledge to human health.

Volumetric Analysis of the Growth Rate of Incompletely Resected Intracranial Meningiomas

OBJECTIVE

Intracranial meningiomas are mostly considered to be slow growing tumors. However, only a few previous reports provide information on the growth rate of these tumors. The aim of this study was to determine the growth rates of intracranial meningiomas after subtotal resection, analysing their relation to radiological appearance and histological features. Results are compared with our previous analysis of growth rates in incidental meningiomas .

METHODS

The hospital charts, follow up records and imaging studies were reviewed in 36 patients with subtotally resected intracranial meningiomas. The tumor growth rates were determined by calculating the absolute and relative growth rates and the tumor volume doubling times.

RESULTS

In the group of 33 patients with histologically verified grade 1 meningiomas, the mean absolute growth rate was 1.51 cm (3)/year, the median relative growth rate and tumor doubling time was 14.18 %/year and 5.228 years. In young patients annual relative growth rates were significantly higher. The median annual relative growth rate of meningiomas with calcification was significantly lower than in tumors without calcification. Also tumors with hypo- or isointense T (2)-signals on MRI revealed a lower growth rate. There was no significant difference between males and females. Histological studies revealed 22 meningiomas of a meningotheliomatous subtype, 8 fibrous and 3 psammomatous meningiomas. The comparison of growth rates between these subtypes did not show any significant differences. In atypical meningiomas (WHO grade 2), absolute and relative growth rates were significantly higher and tumor doubling times shorter.

CONCLUSION

The majority of intracranial meningiomas are slow growing tumors, although the growth rates may vary widely even among benign grade 1 meningiomas. In meningiomas after subtotal surgical resection, the age of the patients seems to present a predictive factor for tumor growth in analogy to our previous observation in incidental meningiomas. Significantly higher relative growth rates were detected in younger patients. Gender does not seem to play a major role as a predictive factor. Radiological features such as calcification or T (2)-signal intensity may provide additional information to predict the growth potential of meningiomas. Close clinical and radiological observation should be performed in young patients harboring tumors with absence of calcification or high T (2)-signal intensities due to the higher growth potential in this patient group.

The Vulnerable Attachment Style Questionnaire (VASQ): an interview-based measure of attachment styles that predict depressive disorder

BACKGROUND

The Vulnerable Attachment Style Questionnaire (VASQ) was developed to provide a brief self-report tool to assess adult attachment style in relation to depression and validated against an existing investigator-based interview (Attachment Style Interview--ASI). This paper describes the development and scoring of the VASQ and its relationship to poor support and major depression.

METHOD

Items for the VASQ reflected behaviours, emotions and attitudes relating to attachment relationship style, drawn directly from the ASI. The VASQ was validated against the ASI for 262 community-based subjects. Test-retest was determined on 38 subjects.

RESULTS

Factor analysis derived two factors, labelled 'insecurity' and 'proximity-seeking'. The VASQ insecurity dimension had highest mean scores for those with interview-based Angry-dismissive and Fearful styles and was significantly correlated with degree of interview-based insecurity. The proximity-seeking VASQ scores had highest mean for those with Enmeshed interview attachment style and was uncorrelated with ASI insecurity. VASQ scores were highly correlated with a well-known self-report measure of insecure attachment (Relationship Questionnaire) and text-retest reliability of the VASQ was satisfactory. The total VASQ score and the insecurity subscale proved highly related to poor support and to depressive disorder. This was not the case for the proximity-seeking subscale.

CONCLUSION

The VASQ is a brief self-report measure that distinguishes individuals with attachment styles vulnerable for depressive disorder. The use of the measure for screening in research and clinical contexts is discussed.

Assessing the pathological extent of aggressive behaviour in dogs. A review of the literature

In this review the variety of parameters used for evaluating the pathological extent of aggressive behaviour is summarised and the practical usefulness of each parameter is discussed. The selected parameters are: the objective analytic description of the aggressive behaviour, the function of the aggression, the presence of the three phases of a normal aggression sequence, the number of bites per attack, the duration of the attack and the frequency of the aggressive behaviour. Other criteria such as the appropriateness of the aggression in relation to the context, the predictability of the aggression and the severity of the caused injury are biased because of the variation caused by numerous external factors. The relevance of the most suitable parameters will be assessed in a further study in which the distribution of aggression modulating neurotransmitter receptors will be determined.

Skewed balance in basal expression and regulation of activating v inhibitory Fcgamma receptors in macrophages of collagen induced arthritis sensitive mice

BACKGROUND

Recently, it has been found that collagen type II arthritis susceptible mouse strains are hyperreactive to immune complexes (ICs), locally deposited into their knee joints.

OBJECTIVE

To investigate whether this strain specific knee joint hyperreactivity is related to a disturbed regulation of activatory and inhibitory FcgammaR on their macrophages before and after stimulation with ICs.

METHODS

Macrophages from collagen induced arthritis susceptible strains (DBA/1 and B10.RIII) and non-susceptible strains (C57BL/6 and BALB/c) were compared. FcgammaR levels on macrophages were detected at protein level by flow cytometric analysis and at mRNA level by reverse transcriptase-polymerase chain reaction. Macrophages were stimulated with ICs, and production of cytokines and enzymes was measured at different times.

RESULTS

On synovial and peritoneal macrophages of DBA/1 mice a higher basal FcgammaRII and III expression was found, which was skewed towards the activating FcgammaRIII. In B10.RIII macrophages, however, FcgammaRIII levels were much lower. Regulation of FcgammaR mRNA levels in macrophages was tested after stimulation with ICs for one and three days. DBA/1 and B10.RIII macrophages showed a prolonged up regulation of activating FcgammaRI and III, whereas the inhibiting FcgammaRII was significantly down regulated compared with non-susceptible strains. In line with this, DBA/1 and B10.RIII macrophages showed a higher interleukin 1 (IL1) and matrix metalloproteinase (MMP) production after IC exposure, whereas IL6 production was significantly reduced.

CONCLUSIONS

This study indicates that macrophages derived from collagen type II arthritis susceptible mice show a disregulated FcgammaR expression before, and even more clearly, after activation by ICs involved in inflammation and cartilage degradation, resulting in prolonged expression of activatory FcgammaRI and III, down regulation of inhibitory FcgammaRII and increased release of IL1 and MMP.

[Rehabilitation after flexor tendon surgery]

During the last 20 years there have been significant innovations in injury repair and aftercare for patients who sustain zone 2 flexor injuries. Based on improvements in our understanding of the mechanism of repair, new differentiated concepts could be developed. Active extension, passive flexion as introduced by Kleinert is still the standard in flexor tendon surgery. New stronger suture techniques allow immediate active flexion. The purpose of this article is to review the current concepts of flexor tendon and pulley repair as well as reconstruction of these structures and the rehabilitation programs for tenolysis.