[Neurofeedback for the treatment of chronic tinnitus : Review and future perspectives]. / Neurofeedback in der Behandlung des chronischen Tinnitus : Überblick und Ausblick.

Neurofeedback is a noninvasive neuromodulation technique employing real-time display of brain activity in terms of electroencephalography (EEG) signals to teach self-regulation of distinct patterns of brain activity or influence brain activity in a targeted manner. The benefit of this approach for control of symptoms in attention deficit disorders, hyperactivity, depression, and migraine has been proven. Studies in recent years have also repeatedly shown this treatment to improve tinnitus symptoms, although it has not become established as routine therapy. The primary focus of this review is the rational of EEG neurofeedback for tinnitus treatment and the currently available data from published studies. Furthermore, alternative neurofeedback protocols using real-time functional magnetic resonance imaging (fMRI) measurements for tinnitus control are considered. Finally, this article highlights how modern EEG analysis (source localization, connectivity) and the improving understanding of tinnitus pathology can contribute to development of more focused neurofeedback protocols for more sustainable control of tinnitus.

Immunohistochemical distinction between preclinical bovine spongiform encephalopathy and scrapie infection in sheep.

Sheep are susceptible experimentally to bovine spongiform encephalopathy (BSE), the clinical signs being indistinguishable from those of scrapie. Because of the possibility of natural ovine BSE infection, laboratory tests are needed to distinguish between scrapie and BSE infection. The objectives of this study were to determine whether (1) PrPSc accumulates in biopsy samples of the tonsil or third eyelid, or both, of BSE-infected sheep before the appearance of clinical disease, and (2) such samples from BSE- and scrapie-infected sheep differ in respect of PrPSc accumulations. Homozygous ARQ sheep (n = 10) were dosed orally at 4-5 months of age with a brain homogenate from BSE-infected cattle. Third eyelid and tonsillar biopsy samples were taken at < or = 6 monthly intervals post-infection and examined immunohistochemically for PrPSc. Third eyelid protuberances were difficult to identify, resulting in many unsuitable samples; however, third eyelid samples shown to contain lymphoid follicles were invariably negative for PrPSc. In contrast, tonsillar biopsy samples became positive for PrPSc from 11 to 20 months post-infection. Consistent differences in the morphology of PrPSc granules in tingible body macrophages (TBMs) between BSE- and scrapie-infected sheep were detected with anti-peptide antibodies directed towards amino acids 93-106 of the ovine prion protein: thus, PrPSc appeared as single granules in TBMs of tonsillar sections from BSE-infected sheep, whereas clusters of PrPSc granules were observed within TBMs in the tonsils of scrapie-infected sheep. In contrast, antibodies against epitopes situated N- and C-terminally from the 93-106 region of the ovine prion protein revealed no differences between BSE- and scrapie-infected sheep in terms of PrPSc granules in TBMs.

Discrimination between scrapie and bovine spongiform encephalopathy in sheep by molecular size, immunoreactivity, and glycoprofile of prion protein.

A procedure for discrimination between scrapie and bovine spongiform encephalopathy (BSE) in sheep is of importance for establishing whether BSE has entered the sheep population. Since BSE has not yet been found in sheep at the farm level, such discrimination procedures can be developed only with experimental sheep BSE. Two distinctive molecular features of the prion protein (PrP)-molecular size and glycosylation profile-in proteinase K digests of brain stem tissue from sheep were used here; upon Western blotting, these features led to an unequivocal discrimination among natural scrapie, experimental scrapie, and experimental BSE. The higher electrophoretic mobility of PrP in sheep BSE could be best observed after deglycosylation treatment with N-glycosidase F. A simpler method for confirmation of this size difference involved comparison of the ratios for the binding of two monoclonal antibodies: P4 and 66.94b4. Based on epitope mapping studies with P4 and peptides, it appeared that N-terminal amino acid sequence WGQGGSH was intact only in sheep scrapie digests. Another feature typical for PrP in sheep BSE was the large fraction of diglycosylated PrP (70% or more). These data were obtained for a large group of positive sheep, consisting of 7 sheep with experimental BSE infection (genotypes: six ARQ/ARQ and one AHQ/AHQ), 48 sheep naturally infected with scrapie (six different genotypes), and 3 sheep with primary experimental scrapie infection. Routine tests of slaughter material serve well for the initial detection of both BSE and scrapie. With Western blotting as a rapid follow-up test, a 66.94b4/P4 antibody binding ratio above 1.5 is a practical indicator for serious suspicion of BSE infection in sheep.

Evaluation of peripheral lymphoreticular biopsy techniques and their clinical side effects in sheep.

Tissue samples were collected postmortem from 126 sheep at five lymphoreticular sites by different techniques. The three most successful combinations of sites and techniques were: the third eyelids, using a forceps and scissors, which provided a mean (se) of 5.32 (0.70) lymphoid follicles per 5 microm tissue section, a mandibular lymph node, using a Biopty gun, which gave 1.19 (0.26) lymphoid follicles per 5 microm tissue section, and tonsil, using a biopsy forceps, which gave 1.14 (0.27) lymphoid follicles per 5 microm tissue section. These three techniques were repeated once a month for five months on five sheep under general anaesthesia, and their clinical effects were compared with five control sheep which were restrained and anaesthetised in the same way but from which no biopsies were taken. Most lymphoid follicles (3.47 [0.58] per 5 pm tissue section) were obtained by using the third eyelid biopsy technique. There were no clinical side effects associated with the biopsy procedure. There were increases in the plasma concentration of cortisol in all the animals, suggesting that the restraint and anaesthesia were more stressful than the biopsy procedure.

[Cervical lymphadenitis in an immunocompetent patient: Mycobacterium gordonae as the cause?]. / Zervikale Lymphadenitis bei einem immunkompetenten Patienten: Mycobacterium gordonae als Ursache?

HISTORY AND FINDINGS: A 76-year-old man went to an ENT outpatient clinic because of stabbing pain in the left throat and difficult swallowing. He was found to have tonsillitis on the left and cervical lymphadenitis. The symptoms regressed on treatment with amoxycillin and clavulanic acid, but the cervical lymphadenitis persisted. Fine-needle biopsy of the cervical swelling was not diagnostic. Computed tomography of the neck showed an encapsulated liquid space-occupying lesion with infiltration of surrounding soft tissues. TREATMENT AND COURSE: The cervical lymph-node mass was excised and histologically found to contain epithelioid granulomas with a few giant cells and scattered centrally caseous necroses. Tuberculostatic treatment was started; drainage fluid from the wound grew acid-fast bacilli, identified by gene probe as Mycobacterium gordonae. CONCLUSIONS: Mycobacterium gordonae is ubiquitous in the environment and is being identified ever more frequently in microbiological laboratories, usually as contaminant. It rarely causes infections of soft tissues and the lungs or systemically.

[Normal values of left ventricular function. Biplanar angiocardiography with reference to sex-specific differences]. / Normalwerte der linksventrikulären Funktion. Biplane Angiokardiographie, unter Berücksichtigung geschlechtsspezifischer Unterschiede.

Normal values of left ventricular function have been determined in 24 patients by means of biplane angiocardiography. Global parameters were chamber volume, ejection fraction and muscle mass. Regional ventricular function was determined by means of an orthogonal and radial axial system. Radial axis shortening parameters showed smaller standard deviations and smaller coefficient of variations than orthogonal parameters. The smallest coefficient of variation elicited regional area reduction methods. Women showed significantly lower chamber volumes and muscle mass than men. There was no difference between the two sexes in the ejection fraction and wall thickness.