Neuroimaging investigations have identified the neural correlates of reappraisal in executive areas. These findings have been interpreted as evidence for recruitment of controlled processes, at the expense of automatic processes when responding to emotional stimuli. However, activation of semantic areas has also been reported. The aim of the present work was to address the issue of the importance of semantic areas in emotion regulation by comparing recruitment of executive and semantic neural substrates in studies investigating different reappraisal strategies. With this aim, we reviewed neuroimaging studies on reappraisal and we classified them in two main categories: reappraisal of stimuli (RS) and reappraisal via perspective taking (RPT). We applied a coordinate-based meta-analysis to summarize the results of fMRI studies on different reappraisal strategies. Our results showed that reappraisal, when considered regardless of the specific instruction used in the studies, involved both executive and semantic areas of the brain. When considering different reappraisal strategies separately, in contrast, we found areas associated with executive function to be prominently recruited by RS, even if also semantic areas were activated. Instead, in RPT the most important clusters of brain activity were found in parietal and temporal semantic areas, without significant clusters in executive areas. These results indicate that modulation of activity in semantic areas may constitute an important aspect of emotion regulation in reappraisal, suggesting that semantic processes may be more important to understand the mechanism of emotion regulation than previously thought.

The reticuloendothelial system plays an important role in the prevention of bacterial infection in patients with cirrhosis. Few data are available, however, on its activity in such patients. The aim of this study was to evaluate the maximum removal capacity of hepatic reticuloendothelial system in patients with cirrhosis on the basis of study of the removal kinetics of increasing amounts of 99mTc millimicrospheres and to verify its value as a prognostic factor for death and development of spontaneous bacterial peritonitis. Common clinical and biochemical parameters, Pugh score, maximum removal capacity, aminopyrine metabolic capacity and galactose elimination capacity were measured in 43 patients with cirrhosis (33 with alcoholic cirrhosis, 8 with posthepatitic cirrhosis and 2 with cryptogenic cirrhosis). Hepatic plasma flow and indocyanine green plasma clearance were also measured in 16 of these patients. Reference range of maximum removal capacity was determined in seven normal subjects. Maximal removal capacity below the normal range was found in 24 patients (56%). In the whole series maximum removal capacity averaged 16 +/- 12 micrograms/kg body wt/min (mean +/- S.D.). Maximal removal capacity was significantly correlated with serum albumin, prothrombin index, Pugh score, aminopyrine breath test, galactose elimination capacity and indocyanine green plasma clearance but not with hepatic plasma flow. During follow-up of up to 48 mo, spontaneous bacterial peritonitis developed in six patients, all with impaired maximum uptake capacity, and 11 patients died. Survival was significantly shorter in patients with impaired maximum removal capacity than in those with normal maximum removal capacity (log-rank test: p = 0.024).(ABSTRACT TRUNCATED AT 250 WORDS)

analysis, a prognostic index cut off value of 2-6 had a 94% sensitivity and a 88% specificity. The prognostic index significantly improved prognostic accuracy when compared with a prognostic index calculated from Pugh score and aetiology, but excluding aminopyrine breath test (p=0.05). These data disclose that the aminopyrine breath test offers additional prognostic information to the Pugh score, and it may become a useful tool to better assess the prognosis of patients with cirrhosis.

This prospective study assessed the role of aminopyrine breath test in the prognosis of patients with cirrhosis, and evaluated whether the test provided useful information not included in the Pugh score. During a period of 36 months, 125 patients with biopsy proven liver cirrhosis were included, and followed for up to 48 months (median 17 months). During follow up 43 patients died (20 of liver failure). Survival was univariately related to aminopyrine breath test (p<002), Pugh score (p<0.01), presence of ascites (p<0.01), and sex (p<0.05). Using Cox's regression analysis, Pugh score, aminopyrine breath test, and sex, were independent significant predictors of survival. From the Cox's model a prognostic index was computed. According to a receiver operating characteristic curve analysis, the prognostic index predicting death showed an improvement in area under the curve when compared with a prognostic index calculated excluding aminopyrine breath test, but the improvement did not reach statistical significance (p=0.12). A similar prognostic index was calculated to predict death from liver failure. Cox's regression analysis selected aminopyrine breath test, Pugh score, and aetiology as the best set of predictor covariates. According to a receiver operating characteristic curve analysis, a prognostic index cut off value of 2-6 had a 94% sensitivity and a 88% specificity. The prognostic index significantly improved prognostic accuracy when compared with a prognostic index calculated from Pugh score and aetiology, but excluding aminopyrine breath test (p=0.05). These data disclose that the aminopyrine breath test offers additional prognostic information to the Pugh score, and it may become a useful tool to better assess the prognosis of patients with cirrhosis.

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