Beneath the Surface: Massive Retroperitoneal Liposarcoma Masquerading as Meralgia Paresthetica.

In patients presenting with focal neurologic findings involving the lower extremities, a thorough abdominal examination should be considered an integral part of the full neurologic work up.

Benign Metastasizing Leiomyomas to the Lungs: An Institutional Case Series and a Review of the Recent Literature.

Background: Benign metastasizing leiomyomas (BMLs) represent the extrauterine spread of a benign uterine process. Pulmonary BMLs are the most common example of distant spread of uterine leiomyomas and are usually found incidentally in premenopausal women. The rarity of BMLs accounts for the limited literature that currently exists regarding their underlying pathophysiology, disease course, and management.

Effects of saporin-induced lesions of three arousal populations on daily levels of sleep and wake.

The hypocretin (HCRT) neurons are located only in the perifornical area of the lateral hypothalamus and heavily innervate the cholinergic neurons in the basal forebrain (BF), histamine neurons in the tuberomammillary nucleus (TMN), and the noradrenergic locus ceruleus (LC) neurons, three neuronal populations that have traditionally been implicated in regulating arousal. Based on the innervation, HCRT neurons may regulate arousal by driving these downstream arousal neurons. Here, we directly test this hypothesis by a simultaneous triple lesion of these neurons using three saporin-conjugated neurotoxins.

Adenosine and sleep homeostasis in the Basal forebrain.

It is currently hypothesized that the drive to sleep is determined by the activity of the basal forebrain (BF) cholinergic neurons, which release adenosine (AD), perhaps because of increased metabolic activity associated with the neuronal discharge during waking, and the accumulating AD begins to inhibit these neurons so that sleep-active neurons can become active. This hypothesis grew from the observation that AD induces sleep and AD levels increase with wake in the basal forebrain, but surprisingly it still remains untested. Here we directly test whether the basal forebrain cholinergic neurons are central to the AD regulation of sleep drive by administering 192-IgG-saporin to lesion the BF cholinergic neurons and then measuring AD levels in the BF.

Insomnia following hypocretin2-saporin lesions of the substantia nigra.

The neuropeptide hypocretin, also known as orexin, has been implicated in waking since its deletion leads to the sleep disorder narcolepsy. Hypocretin neurons project to major arousal areas, and in an effort to determine which region is responsible for the changes in sleep-wake architecture we have developed the neurotoxin hypocretin2-saporin, which lesions hypocretin receptor bearing neurons. Here, in rats, we investigate the effects of hypocretin2-saporin lesions of the substantia nigra and ventral tegmental area in the regulation of sleep and wakefulness.

Effects of lesions of the histaminergic tuberomammillary nucleus on spontaneous sleep in rats.

Study Objectives: Extensive evidence suggests that histaminergic neurons promote wakefulness. Histaminergic neurons are found exclusively in the tuberomammillary nucleus (TMN), and electrolytic lesions of the posterior hypothalamus, where the TMN resides, produce intense hypersomnolence. However, electrolytic lesions disrupt fibers of passage, and the effects of fiber-sparing, cell-specific TMN lesions on sleep and wakefulness are unknown.

The diurnal rhythm of hypocretin in young and old F344 rats.

Study Objectives: Hypocretins (HCRT-1 and HCRT-2), also known as orexins, are neuropeptides localized in neurons surrounding the perifornical region of the posterior hypothalamus. These neurons project to major arousal centers in the brain and are implicated in regulating wakefulness. In young rats and monkeys, levels of HCRT-1 are highest at the end of the wake-active period and lowest toward the end of the sleep period.

The molecular genetics of schizophrenia: an emerging consensus.

Schizophrenia is perhaps the most debilitating mental disease and determining the underlying cause has become a challenging area of psychiatric research. It is relatively well established that genes play a role in the aetiology of schizophrenia. In this article, a review of important findings related to schizophrenia as a genetic trait will be provided, including a discussion of family, twin and adoption studies.

Focal origin of atrial tachycardia in dogs with rapid ventricular pacing-induced heart failure.

Unlabelled: Mapping and Ablation of Atrial Tachycardia in Heart Failure.

Introduction: Dogs with rapid ventricular pacing-induced congestive heart failure (CHF) have inducible atrial tachycardia (AT), with a mechanism consistent with delayed afterdepolarization-mediated triggered activity. We assessed the hypothesis that AT has a focal origin.

Extracellular calcium sensing and signalling.

Ca2+ is well established as an intracellular second messenger. However, the molecular identification of a detector for extracellular Ca2+--the extracellular calcium-sensing receptor--has opened up the possibility that Ca2+ might also function as a messenger outside cells. Information about the local extracellular Ca2+ concentration is conveyed to the interior of many cell types through this unique G-protein-coupled receptor.

Characterization of sustained atrial tachycardia in dogs with rapid ventricular pacing-induced heart failure.

Introduction: Atrial arrhythmias often complicate congestive heart failure (CHF). We characterized inducible atrial tachyarrhythmias and electrophysiologic alterations in dogs with CHF and atrial enlargement produced by rapid ventricular pacing.

Methods And Results: Endocardial pacing leads were implanted in the right ventricle, right atrium, and coronary sinus in 18 dogs.

Examination of the in vivo cardiac electrophysiological effects of nesiritide (human brain natriuretic peptide) in conscious dogs.

Background: Human brain natriuretic peptide (hBNP) is a new therapeutic agent, nesiritide, indicated in patients with decompensated congestive heart failure, a group at significant risk of developing cardiac arrhythmias. Whether hBNP has cardiac electrophysiologic effects has not been reported.

Methods And Results: In 9 healthy, chronically instrumented, conscious dogs, hemodynamic and electrophysiologic parameters were assessed at baseline and during recombinant hBNP (nesiritide) infusion at 0.

Linkage of chromosome 13q32 to schizophrenia in a large veterans affairs cooperative study sample.

Several prior reports have suggested that chromosomal region 13q32 may harbor a schizophrenia susceptibility gene. In an attempt to replicate this finding, we assessed linkage between chromosome 13 markers and schizophrenia in 166 families, each with two or more affected members. The families, assembled from multiple centers by the Department of Veterans Affairs Cooperative Studies Program, included 392 sampled affected subjects and 216 affected sib pairs.

Atelectasis and mucus plugging in spinal cord injury: case report and therapeutic approaches.

Introduction: The leading causes of morbidity and mortality in the spinal cord injury (SCI) population are airway mucus plugging and atelectasis.

Objective: To illustrate the risks of pulmonary disease in individuals with SCI, and present effective therapeutic interventions.

Design: Case study of a 60-year-old veteran with T7 ASIA A spinal cord injury, who presented with a complete collapse of the left lung.

Nonverbal social perception and symptomatology in schizophrenia.

This study examined the relationship between nonverbal social perception and symptomatology in schizophrenia. Schizophrenic patients (n=28) and normal controls (n=28) were given the profile of nonverbal sensitivity test (PONS). Patients' symptoms were rated with the brief psychiatric rating scale (BPRS).

Hypocretin-2-saporin lesions of the lateral hypothalamus produce narcoleptic-like sleep behavior in the rat.

Hypocretins (Hcrts) are recently discovered peptides linked to the human sleep disorder narcolepsy. Humans with narcolepsy have decreased numbers of Hcrt neurons and Hcrt-null mice also have narcoleptic symptoms. Hcrt neurons are located only in the lateral hypothalamus (LH) but neither electrolytic nor pharmacological lesions of this or any other brain region have produced narcoleptic-like sleep, suggesting that specific neurons need to be destroyed.

Schizophrenia: family studies and treatment of spectrum disorders.

A substantial part of the contribution of genetic studies to the treatment of schizophrenia involves its emphasis on reliable and valid diagnoses. One consequence of this focus is the recognition that schizophrenic illness is broader than the diagnostic entity of schizophrenia itself, and instead consists of a "spectrum" of related disorders. Because some of the symptoms in these disorders differ from each other, they provide an opportunity to determine which ones reflect a common etiology.

Penile urethral compression-release maneuver as a non-invasive screening test for diagnosing prostatic obstruction.

The purpose of this study was to evaluate the feasibility of using a penile urethral compression and quick release maneuver during urination as a potential non-invasive clinical screening tool in the evaluation of patients with voiding dysfunction and the diagnosis of prostatic obstruction. The penile compression-release maneuver was performed in adult men with symptomatic voiding dysfunction and in asymptomatic normal men by compressing the penile urethra for 2-3 seconds after the initiation of flow and quickly releasing the compression. The penile compression-release index, calculated from the resulting flow rate surge (Q(surge)) and the steady flow rate (Q(surg)-Q(s)/Q(s)), was analyzed with respect to the type of voiding dysfunction.

Effect of galanin and galanin antagonists on peristalsis in esophageal smooth muscle in the opossum.

Galanin, a neuropeptide that is widely distributed in the esophageal nerves, is known to exert a neuromodulatory action in the gut. These studies examined the effect of galanin and galanin antagonists on esophageal peristalsis in anesthetized opossums in vivo. Intraluminal esophageal pressures were recorded at 1, 3, 5, 7, and 9 cm above the lower esophageal sphincter.

Gastric stasis in neuronal nitric oxide synthase-deficient knockout mice.

Background & Aims: Nitric oxide (NO) is a major inhibitory neurotransmitter in the gut. This study aimed to identify the effect of chronic deprivation of NO derived from neuronal (nNOS) or endothelial (eNOS) nitric oxide synthase on gastric emptying.

Methods: nNOS-deficient (knockout) mice were compared with wild-type mice for gastric size, fluoroscopic appearance after gavage of contrast, and histology of the pyloric sphincter.

Schizophrenia: vulnerability versus disease.

One of the most important trends in the treatment of schizophrenia involves its early diagnosis and intervention. The ultimate goal of research is the prevention of the disorder, A major impediment to the development of prevention strategies, however, is that we do not yet know what the liability for schizophrenia is before the onset of psychosis. Consequently, early treatment attempts are focused on the "prodrome," which involves the early symptoms of psychosis.

Oral appliances in the treatment of obstructive sleep apnea and snoring.

Treatment of snoring and obstructive sleep apnea with oral appliances is a promising alternative to continuous positive airway pressure (CPAP) therapy. Although there is wide variability in appliance design, these devices produce enlargement of the upper airway by advancing the mandible, tongue, or both. Oral appliances effectively reduce snoring in a significant proportion of individuals.

Functional anatomy and physiology of the upper esophageal sphincter.

Upper esophageal sphincter (UES) refers to the high-pressure zone located in between the pharynx and the cervical esophagus. The physiological role of this sphincter is to protect against reflux of food into the airways as well as prevent entry of air into the digestive tract. UES is a musculocartilaginous structure with its anterior wall being formed by the full extent of the posterior surface of the cricoid cartilage and arytenoid and interarytenoid muscles in the upper part.

Compensatory sleep response to 12 h wakefulness in young and old rats.

There is a pronounced decline in sleep with age. Diminished output from the circadian oscillator, the suprachiasmatic nucleus, might play a role, because there is a decrease in the amplitude of the day-night sleep rhythm in the elderly. However, sleep is also regulated by homeostatic mechanisms that build sleep drive during wakefulness, and a decline in these mechanisms could also decrease sleep.