Effekte kathodaler transkranieller Gleichstromstimulation (1 mA) auf das Erkennen von Emotionen

Das Erkennen und richtige Einordnen der Emotionen anderer stellt eine wichtige Grundlage des Zusammenlebens der Menschen dar. Bei Gesunden kommt es während der Emotionserkennung zu einer Aktivierung im Bereich des Broca-Zentrums, welches Strukturen des Spiegelneuronensystems (MNS) enthält. Dahingegen liegt bei Personen mit Beeinträchtigung sozialer und emotionaler Fähigkeiten, wie es bei Autismus und Schizophrenie der Fall ist, eine lokale Volumenreduktion und geringere Aktivierung bei Emotionserkennung in diesem Bereich vor. Die transkranielle Gleichstromstimulation (tDCS) stellt ein nichtinvasives Gehirnstimulationsverfahren dar, mit deren Hilfe die kortikale Erregbarkeit verändert werden kann. Ziel dieser Studie war es, neue Erkenntnisse über den Einfluss der tDCS auf die Emotionserkennung bei Gesunden zu erlangen, um nachfolgend möglicherweise neue Behandlungsmöglichkeiten für Patienten mit Einschränkung dieser Fähigkeiten zu eröffnen. In einem doppelt verblindeten Cross-over Design wurde an 24 gesunden rechtshändigen Probanden getestet, welchen Einfluss kathodale tDCS (1 mA, 20 min) des linken Gyrus frontalis inferior (IFC) auf das Erkennen von Emotionen anhand des „Reading the Mind in the Eyes“-Tests (RME) hat. Die kathodale tDCS führte zu keinem signifikanten Effekt auf die Emotionserkennung. Weder die Fehlerzahl noch die Reaktionszeit wurden durch die tDCS signifikant beeinflusst. Eine explorative Untersuchung der erhobenen Daten ergab, dass die Probanden in Abhängigkeit ihres individuellen Händigkeitsquotienten (HQ) unterschiedlich gut beim RME-Test abschnitten. Probanden mit schwächer ausgeprägter Rechtshändigkeit erzielten im RME-Test eine niedrigere Fehlerzahl als Probanden mit stark ausgeprägter Rechtshändigkeit. Die durch tDCS erzielten Effekte scheinen nicht nur von den eingesetzten Stimulationsparametern abhängig zu sein, sondern auch von bestimmten Eigenschaften des jeweiligen Individuums. Zur Ergründung der genauen Zusammenhänge bedarf es weiterer Erforschung dieses nichtinvasiven Gehirnstimulationsverfahrens, sodass dessen Therapiespektrum präzisiert und erweitert werden kann

The obsessive compulsive imagination

Kontemporäre AutorInnen partizipieren am globalen, literarischen Trend der Intertextualität aus diversen Gründen. Die Globalität unserer Kulturen sowie gescheiterte Führerschaften oder andere ontologische und soziale Zivilisationsschäden, welche die Menschheit charakterisieren, rufen Beziehungen und Konfigurationen zwischen Texten und Autoren innerhalb literarischer Genres hervor. Interdependenz herrscht zwischen Literatur und den sozio-kulturellen und politischen Realitäten einer Nation oder eines gegenwärtigen Milieus. Die vorliegende Diplomarbeit beschäftigt sich mit Intertextualität als Stilmittel im gegenwärtigen südafrikanischen Trauma-Roman. Diese Diplomarbeit gibt zunächst Aufschluss über Intertextualität als universales Phänomen, fokussierend auf dessen Formation und Entwicklung. Südafrika als Krisennation, sowie Sigmund Freud´s Konzept des Wiederholungszwangs werden thematisiert. Nach einem Diskurs über Intertextualität im Kontext südafrikanischer Traumaliteratur, werden formale Auswirkungen und die ständige Wiederaufnahme von Krisen als epistemologische Form diskutiert. Das Hauptaugenmerk dieser Diplomarbeit liegt in der Analyse von den folgenden vier Romanen, welche als Beispiele für die vorangegangene Theorie dienen: J.M. Coetzee´s Disgrace, Achmat Dangor´s Bitter Fruit, Ken Barris´s What Kind of Child, und André Brink´s The Rights of Desire. Alle teilen die Thematik „Vergewaltigung“, wobei J.M. Coetzee´s Disgrace als Basis gilt, worauf die anderen drei Autoren mit ihren Werken reagieren

Usefulness of component resolved analysis of cat allergy in routine clinical practice

Background: Cat allergy is of great importance, and its prevalence is increasing worldwide. Cat allergens and house dust mite allergens represent the major indoor allergens;however, they are ubiquitous. Cat sensitization and allergy are known risk factors for rhinitis, bronchial hyperreactivity and asthma. Thus, the diagnosis of sensitization to cats is important for any allergist. Methods: 70 patients with positive skin prick tests for cats were retrospectively compared regarding their skin prick test results, as well as their specific immunoglobulin E antibody profiles with regard to their responses to the native cat extract, rFel d 1, nFel d 2 and rFel d 4. 35 patients were allergic to cats, as determined by positive anamnesis and/or nasal provocation with cat allergens, and 35 patients exhibited clinically non-relevant sensitization, as indicated by negative anamnesis and/or a negative nasal allergen challenge. Results: Native cat extract serology testing detected 100% of patients who were allergic to cats but missed eight patients who showed sensitization in the skin prick test and did not have allergic symptoms. The median values of the skin prick test, as well as those of the specific immunoglobulin E antibodies against the native cat extract, were significantly higher for allergic patients than for patients with clinically non-relevant sensitization. Component based diagnostic testing to rFel d 1 was not as reliable. Sensitization to nFel d 2 and rFel d 4 was seen only in individual patients. Conclusion: Extract based diagnostic methods for identifying cat allergy and sensitization, such as the skin prick test and native cat extract serology, remain crucial in routine clinical practice. In our study, component based diagnostic testing could not replace these methods with regard to the detection of sensitization to cats and differentiation between allergy and sensitization without clinical relevance. However, component resolved allergy diagnostic tools have individual implications, and future studies may facilitate a better understanding of its use and subsequently may improve the clinical management of allergic patients

Clinical Relevance of IgE to Profilin and/or Polcalcin in Pollen-Sensitized Patients

Background: Component-resolved diagnostics is gaining importance in allergy diagnostics. Allergen extracts contain components with different rates of prevalence and clinical relevance, which can be subdivided at molecular level into major and minor allergens. Clinical complaints are usually triggered by major allergens, while the role of sensitization to the panallergens profilin and polcalcin still remains unclear. Methods: Eighty-six patients from southern Bavaria with sensitization to the panallergens profilin (Bet v 2/PhI p 12) and/or polcalcin (Bet v4/Phl p 7) were examined in regard to their sensitization to the 4 main botanic denominations Betulaceae, Oleaceae, Poaceae and Asteraceae by skin prick test and measurement of specific immunoglobulin E antibodies to natural allergen extracts as well as major allergen components rPhl p 1/5, rBet v 1, rOle e 1 and nArt v 1. Sensitization was rated as clinically relevant or irrelevant depending on anamnesis or intranasal allergen challenge. Results: Regarding the 4 botanic denominations, there was no significant difference in the incidence of sensitization to the panallergens profilin, polcalcin or both. The sensitization pattern does not alter when subdividing the cohort into clinically relevant and silent sensitization. We did not find clinically symptomatic sensitization to panallergens without cosensitization to a major allergen. Conclusions: Our results suggest that sole sensitization to panallergens seems to have no clinical relevance in allergic rhinoconjunctivitis. Clinical complaints seem to be triggered manly by major allergens. Thus, component-resolved allergy diagnostics is crucial in the diagnosis and treatment of polysensitized patients. (C) 2016 S. Karger AG, Base

De novo sensitization during subcutaneous allergen specific immunotherapy - an analysis of 51 cases of SCIT and 33 symptomatically treated controls

Since the beneficial implementation of allergen specific subcutaneous immunotherapy (SCIT), there are only a few studies on the risk of SCIT-induced neosensitizations. In 51 patients, we retrospectively analyzed sIgE and sIgG patterns by a multiplex ELISA as well as demographic and clinical features before and after SCIT. 33 allergic patients, who only received symptomatic treatment, served as controls. In 12 of 51 SCIT-treated patients (24%), we found new sIgE against allergen components of the allergen source treated by SCIT;eight of them were adults. Among controls, no adult patient showed neosensitization to components of the primarily affected allergen source. Only two children of the control group were affected by neosensitization, which was limited to major allergen components and rarely accompanied by sIgG. In the SCIT-treated group, neosensitization affected major and minor allergen components, and was accompanied by a strong induction of sIgG against major components. A clear clinical predictor of neosensitization during SCIT was not found. Comparing symptom scores, patients seem to profit more from SCIT, if neosensitization remained absent. Patients undergoing SCIT might carry an enhanced risk of neosensitization towards formerly unrecognized allergen components. According to anamnestic data, these neosensitizations might be of clinical relevance - supporting attempts towards personalized recombinant vaccines

Component resolved analysis of ash pollen allergy in Bavaria

Background: Sensitization to ash pollen is underestimated in various regions. The prevalence in Germany is about 10%. However, allergy to ash pollen is widely overlooked by allergists, since the pollination period of ash and birch in central Europe closely overlap and rhinoconjunctival symptoms during April/May are often assigned to birch pollen. Component resolved analysis of the different ash allergens is not routinely available. Therefore, we would like to question the usefulness of component resolved diagnostic via olive components, as ash and olive are both part of the Oleaceae family.Methods: 113 patients with nasal provocation and skin prick test to ash were retrospectively compared regarding their specific immunoglobulin E antibody profiles with response to native ash extract, rOle e 1, nOle e 7 and rOle e 9.Results: In nasal provocation testing 58% of 113 patients sensitized to ash were allergic, 42% were only sensitized without showing symptoms. Skin prick testing and serology against native ash extract detected most patients sensitized to ash pollen, whereas rOle e 1 was less sensitive. However, the value of measurements of skin prick test, serology to native ash extract and rOle e 1 did not allow a differentiation between an allergy and clinically silent sensitization. Specific antibodies to nOle e 7 and rOle e 9 were only seen in individual patients and were all positive for native ash extract and rOle e 1.Conclusion: Skin prick testing and serology to native extract of ash pollen are the most reliable tools to diagnose a sensitization to ash pollen for patients living in Germany. Component resolved diagnostic to the major allergen rOle e 1 as representative of the Oleaceae family is possible but was less sensitive. Diagnostic of nOle e 7 and rOle e 9 did not show any additional benefit. Regarding differentiation between allergy and clinically silent sensitization to ash pollen, provocation is the leading diagnostic tool. Concluding, in routine clinical practice the standard methodsskin prick test, serology to native ash extract and provocation testingremain crucial in the diagnosis and differentiation of ash sensitization and allergy

Mesenchymal stromal cell and bone marrow concentrate therapies for musculoskeletal indications: a concise review of current literature

The interest on applying mesenchymal stromal cells (MSCs) in orthopedic disorders has risen tremendously in the last years due to scientific successes in preclinical in vitro and animal model studies. In a wide range of diseases and injuries of the musculoskeletal system, MSCs are currently under evaluation, but so far have found access to clinical use only in few cases. The current assignment is to translate the acquired knowledge into clinical practice. Therefore, this review aims at presenting a synopsis of the up-to-date status of the use of MSCs and MSC related cell products in musculoskeletal indications. Clinical studies were included, whereas preclinical and animal study data not have been considered. Most studies published so far investigate the final outcome applying bone marrow derived MSCs. In fewer trials the use of adipose tissue derived MSCs and allogenic MSCs was investigated in different applications. Although the reported results are equivocal in the current literature, the vast majority of the studies shows a benefit of MSC based therapies depending on the cell sources and the indication in clinical use. In summary, the clinical use of MSCs in patients in orthopedic indications has been found to be safe. Standardized protocols and clear definitions of the mechanisms of action and the mode and timing of application as well as further coordinated research efforts will be necessary for finally adding MSC based therapies in standard operating procedures and guidelines for the clinicians treating orthopedic disorders