The role of the amygdala in enhanced remembrance of negative episodes and acquired negativity of related neutral cues.

Prior research on the interaction between emotion and episodic memory established that negatively charged events are better remembered compared to neutral events (i.e. enhanced remembrance), as well as that a priori neutral cues that were present in the environment during a negative event can attain aversive meaning by themselves (i.e. acquired negativity). Improved understanding the neural mechanisms that mediate enhanced remembrance of negative episodes and acquired negativity of related neutral cues may carry substantial clinical relevance, particularly in the context of posttraumatic pathophysiology. In order to address this point forty-nine healthy participants completed a novel fMRI task that involve the presentation of neutral pictures before and after a series of short neutral and aversive video-clips from which the neutral pictures were originally extracted, and a subsequent presentation of these pictures as cues for clip recall [termed, Picture-Clip-Picture-Recall (PCPR) task]. Behavioral results indicate that aversive clips were indeed better remembered compared to neutral clips (i.e. enhanced remembrance of negative episode) and that a priori neutral pictures that appeared in aversive clips were rated more negatively after relative to before the exposure to the aversive clips (i.e. acquired negativity of related neutral cues). Whole-brain fMRI analysis revealed that increased amygdala activation in response to pictures when presented as cues for clip recall predicted successful clip remembrance, particularly remembrance of aversive clips. This amygdala activation was also correlated with the magnitude of acquired negativity of the cues following their appearance in aversive clips. Taken together our findings implicate the PCPR as a novel, naturalistic, framework for investigating the neural interface of emotional episodic memory, while highlighting the role of the amygdala in enhanced remembrance of negative episodes and acquired negativity of related neutral cues. Clinical implications are discussed.

The Hadera continent reservoir: a new appendico-umbilical continent stoma mechanism for urinary diversion.

PURPOSE: Creating a reliable continence mechanism for a continent reservoir is a great challenge. We describe an easily formed mechanism for allowing complete continence in such patients. MATERIALS AND METHODS: The native appendix attached to a detubularized right colonic reservoir was used as the catheterizable efferent limb. The continence mechanism was created by crossing 2 nondetached right rectus muscle strips around the appendix. RESULTS: At a mean followup of 32 months (range 4 to 52) in 17 patients complete continence was obtained between 2 to 4-hour self-catheterizations in all positions and even during straining. CONCLUSIONS: This continence mechanism is easy to construct and creates a reliable continent stoma in all patients who are not candidates for orthotopic bladder replacement and who retain the native appendix. In patients who have undergone appendectomy an alternate method is to create a small caliber efferent limb from a tailored terminal ileum and build the continence mechanism around it.

[Severe hypercalcemia due to renal transitional cell carcinoma].

Hypercalcemia is a common metabolic disorder, especially in the elderly. The most common etiologies are hyperparathyroidism or malignancy, most often of the lung, breast, kidney or hematological system. Because hypercalcemia is an uncommon manifestation in urinary tract epithelial tumors, especially those of the renal pelvis, we present a man aged 62 years with hypercalcemia due to renal transitional cell carcinoma.

Objective and subjective comparison of transurethral resection, transurethral incision and balloon dilatation of the prostate. A prospective study.

Each of the treatment alternatives of benign prostatic hyperplasia (BPH) has its own advantages and disadvantages. The needs and the condition of the patient should be considered in choosing the proper treatment. After the treatment, patient satisfaction should also be considered because objective criteria do not always reflect the efficacy of the treatment. The long-term efficacy of the three alternative treatments of BPH (TURP, TUIP, TUBDP) were compared in a total of 60 men with obstructive symptoms. TUIP was found to be the method of treatment we recommended in young patients with a small and symptomatic adenoma, whereas TURP is still the 'gold standard'.

Bio-fragmentable anastomosis ring in urological surgery involving the gastrointestinal tract: early experience and a historical review of mechanical intestinal anastomosis.

We present our experience with use of a bio-fragmentable mechanical device for intestinal anastomosis in 14 patients. No anastomotic leakage occurred in our patients. The technique was easy to learn and shortened the operating time by at least 30 minutes. Our impression is that during time-consuming extensive onco-urological procedures involving the gastrointestinal tract, the use of such a device allows for a shorter operative time to the benefit of the patient and surgeon.

Extracorporeal shock wave lithotripsy of gallstones: early experience in an Israeli population.

Fifty-four patients with symptomatic gallbladder stones were treated by extra-corporeal shock wave lithotripsy (ESWL) and oral bile acids on an outpatient basis. In 49 patients (90%), the stones were successfully fragmented to fragments < 5 mm on follow-up ultrasonography. Patients underwent 1-3 lithotripsy sessions with 7,500-9,750 shock waves per session. The gallbladder clearance rate of fragments was dependent mainly on the number of stones and reached 59% for patients with one or two stones, compared to 34% for patients with more than two stones after 9 months follow-up. The only side effects noted were mild abdominal pain, transient microscopic hematuria and minimal impairment in liver function tests. There were no serious complications such as cholecystitis, bile duct obstruction, or pancreatitis. These results, which are comparable with those of other groups using the same shock wave lithotriptor, indicate that this therapy may become an alternative treatment for selected patients with symptomatic gallbladder stones, especially those who are at high risk for surgical treatment.