The central nervous norepinephrine network links a diminished sense of emotional well-being to an increased body weight.

OBJECTIVES: The neurobiological mechanisms linking obesity to emotional distress remain largely undiscovered. METHODS: In this pilot study, we combined positron emission tomography, using the norepinephrine transporter (NET) tracer [(11)C]-O-methylreboxetine, with functional connectivity magnetic resonance imaging, the Beck depression inventory (BDI), and the impact of weight on quality of life-Lite questionnaire (IWQOL-Lite), to investigate the role of norepinephrine in the severity of depression (BDI), as well as in the loss of emotional well-being with body weight (IWQOL-Lite). RESULTS: In a small group of lean-to-morbidly obese individuals (n=20), we show that an increased body mass index (BMI) is related to a lowered NET availability within the hypothalamus, known as the brain's homeostatic control site. The hypothalamus displayed a strengthened connectivity in relation to the individual hypothalamic NET availability to the anterior insula/frontal operculum, as well as the medial orbitofrontal cortex, assumed to host the primary and secondary gustatory cortex, respectively (n=19). The resting-state activity in these two regions was correlated positively to the BMI and IWQOL-Lite scores, but not to the BDI, suggesting that the higher the resting-state activity in these regions, and hence the higher the BMI, the stronger the negative impact of the body weight on the individual's emotional well-being was. CONCLUSIONS: This pilot study suggests that the loss in emotional well-being with weight is embedded within the central norepinephrine network.

Sex differences in serotonin-hypothalamic connections underpin a diminished sense of emotional well-being with increasing body weight.

BACKGROUND/OBJECTIVES: The neurobiological mechanisms linking obesity to emotional distress related to weight remain largely unknown. PARTICIPANTS/METHODS: Here we combined positron emission tomography, using the serotonin transporter (5-HTT) radiotracer [(11)C]-3-amino-4-(2-dimethylaminomethylphenylsulfanyl)-benzonitrile, with functional connectivity magnetic resonance imaging, the Beck Depression Inventory (BDI-II) and the Impact of Weight on Quality of Life-Lite questionnaire (IWQOL-Lite) to investigate the role of central serotonin in the severity of depression (BDI-II), as well as in the loss of emotional well-being with body weight (IWQOL-Lite). RESULTS: In a group of lean to morbidly obese individuals (n=28), we found sex differences in the 5-HTT availability-related connectivity of the hypothalamus. Males (n=11) presented a strengthened connectivity to the lateral orbitofrontal cortex, whereas in females (n=17) we found strengethened projections to the ventral striatum. Both regions are known as reward regions involved in mediating the emotional response to food. Their resting-state activity correlated positively to the body mass index (BMI) and IWQOL-Lite scores, suggesting that each region in both sexes also underpins a diminished sense of emotional well-being with body weight. Contrarily to males, we found that in females also the BDI-II positively correlated with the BMI and by trend with the activity in ventral striatum, suggesting that in females an increased body weight may convey to other mood dimensions than those weight-related ones included in the IWQOL-Lite. CONCLUSIONS: This study suggests sex differences in serotonin-hypothalamic connections to brain regions of the reward circuitry underpinning a diminished sense of emotional well-being with an increasing body weight.

Atlas vertebra realignment and achievement of arterial pressure goal in hypertensive patients: a pilot study.

Anatomical abnormalities of the cervical spine at the level of the Atlas vertebra are associated with relative ischaemia of the brainstem circulation and increased blood pressure (BP). Manual correction of this mal-alignment has been associated with reduced arterial pressure. This pilot study tests the hypothesis that correcting mal-alignment of the Atlas vertebra reduces and maintains a lower BP. Using a double blind, placebo-controlled design at a single center, 50 drug naïve (n=26) or washed out (n=24) patients with Stage 1 hypertension were randomized to receive a National Upper Cervical Chiropractic (NUCCA) procedure or a sham procedure. Patients received no antihypertensive meds during the 8-week study duration. The primary end point was changed in systolic and diastolic BP comparing baseline and week 8, with a 90% power to detect an 8/5 mm Hg difference at week 8 over the placebo group. The study cohort had a mean age 52.7+/-9.6 years, consisted of 70% males. At week 8, there were differences in systolic BP (-17+/-9 mm Hg, NUCCA versus -3+/-11 mm Hg, placebo; P<0.0001) and diastolic BP (-10+/-11 mm Hg, NUCCA versus -2+/-7 mm Hg; P=0.002). Lateral displacement of Atlas vertebra (1.0, baseline versus 0.04 degrees week 8, NUCCA versus 0.6, baseline versus 0.5 degrees , placebo; P=0.002). Heart rate was not reduced in the NUCCA group (-0.3 beats per minute, NUCCA, versus 0.5 beats per minute, placebo). No adverse effects were recorded. We conclude that restoration of Atlas alignment is associated with marked and sustained reductions in BP similar to the use of two-drug combination therapy.

Temporal neocortical injuries in rats impair attending but not complex visual processing.

The effects of variations of the distance between the relevant stimuli and the animals' response sites were observed upon the performances of a black-white discrimination habit for normal rats or subjects prepared with either bilateral injuries to the visual or temporal neocortex. In addition, the animals were given a strict test of visual form perception. Subjects with injuries to the visual cortex failed the test of visual form perception but performed like normals in discriminating a spatially discontiguous problem. In contrast, subjects with temporal injuries exhibited enormous performance deficits when trained on a spatially discontiguous problem but performed like normals on the test of form perception. The findings parallel the results of studies using primates and suggest that bitemporal injuries result in impairments of attending and not of complex visual processing.

Predicting compliance with follow-up recommendations after colposcopy among indigent urban women.

OBJECTIVE: To determine correlates of compliance with follow-up recommendations after colposcopy. METHODS: Between October 1, 1992, and June 30, 1997, management recommendations were made to 451 consecutive women who attended a resident colposcopy clinic. Compliance was determined after 8-12 months. Correlates of compliance were assessed by univariate and multivariate analyses. RESULTS: Recommendations included repeat cytology in 6 months for 252 women, loop excision for 114, conization for 27, repeat colposcopy for 51, other for three, and not recorded for four. Rates of ever complying were 81% for loop excision, 85% for conization, 62% for repeat colposcopy, and 36% for repeat cytology. In multivariate analysis, the only significant predictors of compliance were history of genital herpes simplex infection (odds ratio [OR] 0.20; 95% confidence interval [CI] 0.05, 0.86, P = .03) and the nature of the recommendation (OR 4.73; CI 2.51, 8.92 for loop excision; OR 8.72; CI 2.57, 29.6 for conization; and OR 2.53; CI 1.30, 4.93 for repeat colposcopy, all against observation, P<.001). CONCLUSION: After colposcopy, women were more likely to comply with earlier, more intensive interventions, although the relative effect of follow-up interval and intervention could not be distinguished.

Effects of successive unilateral ablations of principalis cortex upon performances of delayed alternation and delayed response by monkeys.

Monkeys were trained on delayed alternation (DA), and were then subjected to serial unilateral or simultaneous bilateral ablations of the banks of the sulcus principalis of each frontal lobe. When subjects with unilateral lesions were retrained on DA, their performances were intermediate to those of normal and bilateral animals. This interoperative training failed to protect the serially operated monkeys from losses of DA following their second-stage ablations, for they then performed as poorly as one-stage subjects and subjects prepared with serial ablations that were not given practice on the task between the two operations. Additional postoperative tests of delayed responding (DR) showed that both serially and simultaneously ablated subjects also had severe impairments of performance of DR. This result confirmed, in principle, a finding that monkeys with large unilateral ablations, if reoperated after many months for the removal of the contralateral dorsolateral perfrontal cortex, will thereafter exhibit DR deficits that are both severe and endure for a period of years. It contrasted sharply with a recent observation that DR is retained by monkeys subjected to two-stage symmetrical ablations of the principalis cortex, which suggests that recoveries of frontal-lobe functions are powerfully affected by the orders in which serial extirpations are performed.

The Big Ten Student Suicide Study: a 10-year study of suicides on midwestern university campuses.

The Big Ten Student Suicide Study was undertaken from 1980-1990 to determine the suicide rates on Big Ten University campuses. The study design attempted to address many of the statistical and epidemiological flaws identified in previous studies of campus student suicides. The 10-year study collected demographic and correlational data on 261 suicides of registered students at 12 midwestern campuses. The largest number of suicides for both males and females were in the 20-24-year-old age group (46%), and amongst graduate students (32%). The overall student suicide rate of 7.5/100,000 is one half of the computed national suicide rate (15.0/100,000) for a matched sample by age, gender, and race. Despite the overall lower suicide rate, the analyses revealed that students 25 and over have a significantly higher risk than younger students. Although women have rates roughly half those of men throughout their undergraduate years, graduate women have rates not significantly different from their male counterparts (graduate women 9.1/100,000 and graduate men 11.6/100,000).

Radioligand imaging of α4ß2* nicotinic acetylcholine receptors in Alzheimer's disease and Parkinson's disease.

The α4ß2* nicotinic acetylcholine receptors (α4ß2*-nAChR) are highly abundant in the human brain. As neuromodulators they play an important role in cognitive functions such as memory, learning and attention as well as mood and motor function. Post mortem studies suggest that abnormalities of α4ß2*-nAChRs are closely linked to histopathological hallmarks of Alzheimer's disease (AD), such as amyloid aggregates/oligomers and tangle pathology and of Parkinson's disease (PD) such as Lewy body pathology and the nigrostriatal dopaminergic deficit. In this review we summarize and discuss nicotinic receptor imaging findings of 2-[18F]FA-85380 PET, [11C]nicotine PET and 5-[123I]IA-85380 SPECT studies investigating α4ß2*-nAChR binding in vivo and their relationship to mental dysfunction in the brain of patients with AD and patients out of the spectrum of Lewy body disorders such as PD and Lewy body dementia (DLB). Furthermore, recent developments of novel α4ß2*-nAChR-specific PET radioligands, such as (-)[18F]Flubatine or [18F]AZAN are summarized. We conclude that α4ß2*-nAChR-specific PET might become a biomarker for early diagnostics and drug developments in patients with AD, DLB and PD, even at early or prodromal stages.

[Peripheral facial palsy accompanied by a vesicular rash on the ear and hard palate]. / Periphere Fazialisparese mit Krusten an der Ohrmuschel und Bläschen am Gaumen. Der pädiatrische PRAXIS-Fall.

Ramsay Hunt syndrome (RHS) is defined as a peripheral facial nerve palsy accompanied by an erythematous vesicular rash on the ear (zoster oticus) and hard palate. It is known that varicella zoster virus (VZV) causes RHS. History and neurological examination remain the mainstay of diagnosis. Prednisolone and acyclovir/valacyclovir is helpful in RHS when given within three days of onset. We report on a 14-year-old boy who had RHS accompanied by meningitis. Polymerase chain reaction identified VZV in exudates from the geniculate zone of the ear, the hard palate and in the CSF.

Efeito da contagem de células somáticas sobre o rendimento e a composição físico-química do queijo muçarela / The effect of somatic cell count on yield and physico-chemical composition of Mozzarella cheese

Determinou-se o efeito da contagem de células somáticas do leite sobre o rendimento e a composição físico-química do queijo muçarela. Foram selecionadas vacas com contagem de células somáticas (CCS) <200.000 células/mL; CCS >200.000 a <400.000 células/mL; CCS >400.000 células/mL a <750.000 células/mL e CCS >750.000 células/mL e que não receberam tratamento com antimicrobianos nos dias que antecederam a obtenção do leite utilizado no processamento. Os queijos foram avaliados por meio das análises de pH, acidez, umidade, proteína, gordura, extrato seco total e desengordurado. Os queijos elaborados do leite com alta CCS >750.000 cél./mL apresentaram menor teor de proteína, maior umidade e menor rendimento industrial. Conclui-se que a elevação da CCS cursou com alterações na qualidade do queijo muçarela, o que reflete em sua composição nutricional e microbiológica, pois ocorre um incremento na atividade de água, fator intrínseco indispensável para o crescimento microbiano e consequente redução da vida de prateleira...

The effect of somatic cell count (SCC) on the yield and composition of mozzarella cheese was evaluated. Cows with different levels of SCC in their milk (<200.000 cells/mL; >200.000 to <400.000 cells/mL; >400.000 cells/mL to <750.000 cells/mL and >750.000 cells/mL) were selected. The animals had no antimicrobial treatment prior to or on milk sampling day. The mozzarella cheese quality was evaluated analyzing pH, acidity, moisture and protein content, fat, total solids and nonfat solids. The trial was replicated four times and the experimental design was analyzed through randomized blocks. The mozzarella cheese from milk with high SCC (>750.000 cells/mL) had lower protein content, higher moisture content and lower industrial yield, compared to cheese from milk with lower levels of SCC. High numbers of SCC impaired mozzarella cheese quality, which was reflected in its nutritional and microbiological composition. We observed an increase in water activity, an intrinsic and essential factor for microbial growth...

An approach to identify dairy cows being responsive to recombinant bovine somatotropin.

Forty-eight primiparous and pregnant Holstein cows at 202 (+/-59) days in milk and average daily milk production (DMP) of 22 (+/-5.3) kg at the beginning of the trial were used to study the possibility of identifying animals that are more responsive to recombinant bovine somatotropin (rbST). Animals were housed in free-stall barns, milked three times a day and fed a total mixed ration. Animals were injected with one dose (500 mg each) of rbST every 21 days during a 105-day total period (five doses in all). Daily milk production was recorded to measure average apparent response (AAR) and peak of apparent response (PAR). Average apparent response was defined as the average increase in milk production, expressed as kilogram per cow per day, for days 0-18 after dosing, as compared to the average production calculated for days -1, -2, -3, 19, 20 and 21 after dosing. Peak of apparent response was calculated as the increase in milk production for each day from 0 to 18 days after dosing as compared to the average production for days -1, -2 and -3. There was a positive linear correlation (r = 0.608; p = 0.0001) between AAR for the first 21 days and AAR for the total 105-day period (AATR). A correlation coefficient was calculated between each individual PAR value and AATR. The highest correlation coefficient (r = 0.511; p = 0.0002) was observed for days 8, 9 and 10, and therefore these days were considered the best estimates for calculating AAR when DMP records are not available. Also, high somatic cells count had a negative impact on milk yield response to treatment (p = 0.0162).

Comparison of 49 laparoscopic myomectomies with 49 open myomectomies.

STUDY OBJECTIVES: To compare the results of open myomectomy with those of laparoscopic myomectomy, and to assess complications, surgical results, total hospital cost, and morbidity associated with each procedure. DESIGN: Retrospective chart review. SETTING: Private practice of one surgeon, and Department of Obstetrics and Gynecology, Rush Medical College, Chicago, Illinois. PATIENTS: Ninety-eight women with symptomatic uterine leiomyomata. INTERVENTIONS: Forty-nine consecutive laparoscopic myomectomies were performed between 1993 and 1995, and 49 open myomectomies were performed between 1983 and 1995. MEASUREMENTS AND MAIN RESULTS: Indications for both procedures were similar, including menometrorrhagia, pelvic pain, and enlarging myomata. Mean operating time for open myomectomies was 133 minutes versus 264 minutes for laparoscopies (p <0.0001). Mean blood loss was 340 ml and 110 ml, respectively (p <0. 001). The greatest blood loss was 1000 ml in the open group and 800 ml in the laparoscopic group. Uterine size at surgery was 12 to 14 weeks in 42.9% of the open group and 9 to 11 weeks in 51% of the laparoscopy group. The open group incurred a total of 272 hospital days versus 29 days in the laparoscopic group (maximum 25 and 3 days, respectively; mean 5.6 and 0.6 days, respectively; p <0.001). The frequency of postoperative complications was higher in the open group (17) than in the laparoscopic group (5, p = 0.0068). Of patients in whom postoperative adhesions were evaluated, the overall frequency of adhesions was lower in the laparoscopic group. Three women in the open group required postoperative transfusions, compared with none in the laparoscopic group. Seven pregnancies have thus far occurred in the laparoscopic group. Three women delivered at term by elective cesarean section, at which no evidence of uterine dehiscence was found. Estimated average cost of each procedure, expressed in April 1995 dollars using the Consumer Price Index, were $14,461 for open myomectomies and $13,814 for laparoscopies (p = 0.65). Linear regression with residual analysis was performed on costs for both groups and revealed significantly increasing time trend for open myomectomies. During the years of this study, the open procedures increased in price at a rate of $868/year. The cost of laparoscopic myomectomies showed no time trend. CONCLUSIONS: Compared with open myomectomy, laparoscopic myomectomy had lower morbidity, no identifiable trend of increasing hospital cost, minimal hospital stay, and fewer complications.