Interactions among chronic cold, corticosterone and puberty on energy intake and deposition

We have shown that chronic cold stress strongly interacts with corticosterone (B) to determine subsequent regulation of the hypothalamo-pituitary-adrenal (HPA) axis responses to novel stress. These studies, using the same 2 sets of rats, show that chronic cold also interacts with B and testosterone on signals of energy balance. The two groups of rats differed in weight by 20% and in age by 2 weeks (44-59 days of age). Adrenalectomized rats, replaced with varying doses of B, were exposed to cold or served as controls. Food intake and body weight during the experiments and hormones, metabolites and fat depots were measured on day 5. B, but not cold, affected food intake in the younger rats; by contrast, cold, but not B, affected food intake in the older rats. Testosterone was higher in older control rats and was markedly depressed by cold; younger rats had lower testosterone that was minimally affected by cold. Weight gain decreased in all rats at room temperature with increasing B, whereas they all lost weight in cold independently of B. Cold stimulated and B inhibited interscapular brown adipose tissue DNA content (reflecting sympathetic stimulation of thermogenesis). B stimulated insulin, whereas cold inhibited leptin and insulin; B also increased white adipose tissue weight gain in controls and inhibited its loss in cold. Leptin was unrelated to white adipose tissue depots in older control rats but was strongly related to these stores in younger rats and in all rats in cold. We conclude that: 1. By decreasing signals that act centrally to inhibit food intake (insulin, leptin and testosterone) cold allows B to stimulate food intake; 2. B inhibits weight gain although it causes accrual of fat; 3. Cold, probably through sympathetic stimulation of white adipose tissue, causes fat loss which is modulated by the inhibitory effect of B on sympathetic outflow; and, 4. The slope of the relationship between fat depot size and leptin becomes flatter in cold, possibly because of increased sympathetic outflow to these depots.     

Right-hemispheric language evidence from cortical stimulation

While the left-hemispheric dominance for language in most right-handers is unquestionable, clinical observations suggest that the right, nondominant hemisphere has a considerable capacity for language. Under certain neuroanatomical conditions, the right-hemispheric capacity becomes functional and, thus, measurable. This study focuses on evoked language responses during electrical stimulation of the right hemisphere in three left-dominant patients undergoing temporal lobe resections for medically intractable seizures.     

Effects of intralaminar thalamic stimulation on language functions

Fifteen neurosurgical subjects, who were undergoing thalamic chronic electrode implants as a treatment for dyskinesia and chronic pain, were evaluated on a series of neurolinguistic functions to determine if the stimulation of the centromedianum nucleus of the thalamus affected language and cognitive processing. Analysis of the data revealed that the stimulation of the left centromedianum nucleus had resulted in a notable facilitatory influence on the processing of language functions; this facilitatory effect was measured in terms of the number of errors produced and the patients' response latency time. The facilitatory effect was also noted to have extended to other language functions. The nature of the facilitation from the stimulation of the left centromedianum nucleus, an extension of the brainstem reticular formation, on language functions is discussed.     

Tonotypic cortical representation in man (case report)

Cortical stimulation—evoked perception of tones differing in pitch suggests that the perception of pitch may be discretely organized in the human auditory parakoniocortex. Findings, obtained from a neurosurgical patient undergoing temporal lobectomy, are discussed with reference to anatomical and functional considerations of the auditory parakoniocortex in humans. These tonotypic findings are potentially significant since, as previously reported (see references in Discussion section), auditory sensations have not been analyzed in relation to perceptual categories of pitch. Address correspondence to: Department of Speech Pathology and Audiology, Marquette University, Milwaukee, Wisconsin 53233.     

Creativity in Medical Education: The Value of Having Medical Students Make Stuff

What is the value of having medical students engage in creative production as part of their learning? Creating something new requires medical students to take risks and even to fail--something they tend to be neither accustomed to nor comfortable with doing. “Making stuff” can help students prepare for such failures in a controlled environment that doesn’t threaten their professional identities. Furthermore, doing so can facilitate students becoming resilient and creative problem-solvers who strive to find new ways to address vexing questions. Though creating something new can be fun, this is not the main outcome of interest. Rather, the principle reason we recommend devoting precious curricular time to creative endeavors is because it helps medical students become better doctors.     

Understanding why and how individuals choose to help others: indirect reciprocal considerations and the moderating role of situation severity

In this article, we examine the impact of how helpful an individual is toward third parties on people's willingness to help that individual. Our results show lower willingness to help those that are unhelpful toward others. Further, varying levels of severity of the situation in which help is needed moderates this relationship. Specifically, in less severe situations (i.e., where withholding help does not lead to dire consequences), willingness to help was greater when recipients were seen as being helpful toward others. This effect was also found in moderate severity situations, although to a lesser extent. More severe situations, however, caused people to want to help regardless of how helpful the recipients themselves were. Empathetic feelings toward the recipients mediated these findings.     

Pituitary-adrenal activity in acute and chronically stressed male and female mice lacking the 5-HT-3A receptor

The serotonin (5-HT)-3A receptor has been localized in limbic and brainstem structures that regulate hypothalamic--pituitary--adrenal (HPA) activity. We previously showed that 5-HT-3A receptor knock-out (KO) male mice displayed lower ACTH responses to acute restraint or lipopolysaccharide administration compared to age-matched wild-type (WT) males. In the present study, we found that pituitary-adrenal responses to acute stress were not different in female WT and KO mice. Furthermore, we examined the role of the 5-HT-3A receptor in regulation of chronic stress-induced HPA activity in both male and female WT and KO mice. The results show that ACTH, but not corticosterone, responses to novel restraint are lower in chronically cold stressed females compared to non-stressed control females but no effect of 5-HT-3A receptor deletion was observed. In contrast, male mice showed facilitated responses to novel restraint after chronic cold stress and this facilitation produced sex differences in ACTH responses to novel restraint between male and female chronically stressed KO mice. Together, these results indicate that there are sex differences in HPA responses to novel restraint in chronically stressed mice and these differences are partly related to 5-HT-3A receptor function.     

Hospice Comics: Representations of Patient and Family Experience of Illness and Death in Graphic Novels

Non-fiction graphic novels about illness and death created by patients and their loved ones have much to teach all readers. However, the bond of empathy made possible in the comic form may have special lessons for healthcare providers who read these texts and are open to the insights they provide.