Nutritional level and energetic source are determinants of elevated circulatory lipohydroperoxide concentration.

Dietary energetic impact on oxidative stress is incompletely understood. Therefore, effects of diets on oxidative stress were studied using a crossover block design. In Expt 1, intake of metabolizable energy (ME) was restricted or ad libitum. In Expt 2, isoenergetic and isonitrogenic diets were fed, replacing carbohydrate energy by energy of fatty acids. Circulatory lipohydroperoxides (LOOH), markers of acute oxidative stress, were expressed absolutely and in terms of cholesterol or TAG levels. In Expt 1, plasma (jugularis vein) LOOH was assayed in combination with whole-body oxidative metabolism using gas exchange and heart rate (HR) during feeding periods and at rest. In Expt 2, LOOH was assayed in plasma from portal and a large udder vein and a mesenteric artery. In Expt 1, intake increased VO2, HR and LOOH following overnight fast with higher values (P < 0.05) when feeding ME ad libitum. Intake of ME ad libitum (3 weeks) increased cardiac protein of cytochrome oxidase and endothelial-type nitric oxide synthase (P < 0.05), indicating adaptation of the heart to higher activity. Transient HR responses evoked by an antidiabetic drug (levcromakalim) revealed a linear positive correlation with relative LOOH (r2 0.79), supporting the relationship between oxidative metabolic rate and lipoperoxidation. Evidence for exogenous lipids as LOOH source provided the vessel-specific rise in LOOH through replacing carbohydrate ME by lipid ME (Expt 2). Thus, dietary energy level and energetic source are important for circulatory LOOH with a role of vascular activity in production of oxidant.

Evidence for a tinnitus subgroup responsive to somatosensory based treatment modalities.

Studies have established that the somatosensory system of the upper cervical region and head can be intimately involved in tinnitus. Tinnitus can arise directly from a disorder of the head and upper neck through activation of the somatosensory system. "Somatic testing" (a series of strong muscle contractions of the head and neck) can (1) modulate the tinnitus percept of approximately 80% of people with ongoing tinnitus, and (2) elicit a sound percept in approximately 50% of people with no tinnitus. These somatic phenomena are equally prevalent among people with or without functioning cochlea. Likely neural pathways underlying both the induction and modulation of tinnitus have been revealed in animal studies. Because somatic influences are fundamental to the operation of the auditory system, in general, and to tinnitus, in particular, somatic testing should be incorporated into all evaluations of tinnitus (1) to improve understanding of the role of the somatosensory system in any individual and (2) to identify subgroups of tinnitus patients who may respond to a particular treatment modality (as has already been shown for the tinnitus associated with temporomandibular disorder). Our clinical experience and review of reports of treatment modalities directed toward the somatosensory system supports the hypothesis that these modalities can benefit individuals with symmetric hearing thresholds but asymmetric widely fluctuating tinnitus. Treatment modalities involving the somatosensory system should be re-assessed by targeting this tinnitus subgroup.

Consensus for tinnitus patient assessment and treatment outcome measurement: Tinnitus Research Initiative meeting, Regensburg, July 2006.

There is widespread recognition that consistency between research centres in the ways that patients with tinnitus are assessed and outcomes following interventions are measured would facilitate more effective co-operation and more meaningful evaluations and comparisons of outcomes. At the first Tinnitus Research Initiative meeting held in Regensburg in July 2006 an attempt was made through workshops to gain a consensus both for patient assessments and for outcome measurements. It is hoped that this will contribute towards better cooperation between research centres in finding and evaluating treatments for tinnitus by allowing better comparability between studies.

Isolating the auditory system from acoustic noise during functional magnetic resonance imaging: examination of noise conduction through the ear canal, head, and body.

Approaches were examined for reducing acoustic noise levels heard by subjects during functional magnetic resonance imaging (fMRI), a technique for localizing brain activation in humans. Specifically, it was examined whether a device for isolating the head and ear canal from sound (a "helmet") could add to the isolation provided by conventional hearing protection devices (i.e., earmuffs and earplugs). Both subjective attenuation (the difference in hearing threshold with versus without isolation devices in place) and objective attenuation (difference in ear-canal sound pressure) were measured. In the frequency range of the most intense fMRI noise (1-1.4 kHz), a helmet, earmuffs, and earplugs used together attenuated perceived sound by 55-63 dB, whereas the attenuation provided by the conventional devices alone was substantially less: 30-37 dB for earmuffs, 25-28 dB for earplugs, and 39-41 dB for earmuffs and earplugs used together. The data enabled the clarification of the relative importance of ear canal, head, and body conduction routes to the cochlea under different conditions: At low frequencies (< or =500 Hz), the ear canal was the dominant route of sound conduction to the cochlea for all of the device combinations considered. At higher frequencies (>500 Hz), the ear canal was the dominant route when either earmuffs or earplugs were worn. However, the dominant route of sound conduction was through the head when both earmuffs and earplugs were worn, through both ear canal and body when a helmet and earmuffs were worn, and through the body when a helmet, earmuffs, and earplugs were worn. It is estimated that a helmet, earmuffs, and earplugs together will reduce the most intense fMRI noise levels experienced by a subject to 60-65 dB SPL. Even greater reductions in noise should be achievable by isolating the body from the surrounding noise field.

Frequency-dependent responses exhibited by multiple regions in human auditory cortex.

Recordings in experimental animals have detailed the tonotopic organization of auditory cortex, including the presence of multiple tonotopic maps. In contrast, relatively little is known about tonotopy within human auditory cortex, for which even the number and location of tonotopic maps remains unclear. The present study begins to develop a more complete picture of cortical tonotopic organization in humans using functional magnetic resonance imaging, a technique that enables the non-invasive localization of neural activity in the brain. Subjects were imaged while listening to lower- (below 660 Hz) and higher- (above 2490 Hz) frequency stimuli presented alternately and at moderate intensity. Multiple regions on the superior temporal lobe exhibited responses that depended upon stimulus spectral content. Eight of these 'frequency-dependent response regions' (FDRRs) were identified repeatedly across subjects. Four of the FDRRs exhibited a greater response to higher frequencies, and four exhibited a greater response to lower frequencies. Based upon the location of the eight FDRRs, a correspondence is proposed between FDRRs and anatomically defined cortical areas on the human superior temporal lobe. Our findings suggest that a larger number of tonotopically organized areas exist (i.e., four or more) in the human auditory cortex than was previously recognized.

Acoustic noise during functional magnetic resonance imaging.

Functional magnetic resonance imaging (fMRI) enables sites of brain activation to be localized in human subjects. For studies of the auditory system, acoustic noise generated during fMRI can interfere with assessments of this activation by introducing uncontrolled extraneous sounds. As a first step toward reducing the noise during fMRI, this paper describes the temporal and spectral characteristics of the noise present under typical fMRI study conditions for two imagers with different static magnetic field strengths. Peak noise levels were 123 and 138 dB re 20 microPa in a 1.5-tesla (T) and a 3-T imager, respectively. The noise spectrum (calculated over a 10-ms window coinciding with the highest-amplitude noise) showed a prominent maximum at 1 kHz for the 1.5-T imager (115 dB SPL) and at 1.4 kHz for the 3-T imager (131 dB SPL). The frequency content and timing of the most intense noise components indicated that the noise was primarily attributable to the readout gradients in the imaging pulse sequence. The noise persisted above background levels for 300-500 ms after gradient activity ceased, indicating that resonating structures in the imager or noise reverberating in the imager room were also factors. The gradient noise waveform was highly repeatable. In addition, the coolant pump for the imager's permanent magnet and the room air-handling system were sources of ongoing noise lower in both level and frequency than gradient coil noise. Knowledge of the sources and characteristics of the noise enabled the examination of general approaches to noise control that could be applied to reduce the unwanted noise during fMRI sessions.

Lateralized tinnitus studied with functional magnetic resonance imaging: abnormal inferior colliculus activation.

Tinnitus, the perception of sound in the absence of external stimuli, is a common and often disturbing symptom that is not understood physiologically. This paper presents an approach for using functional magnetic resonance imaging (fMRI) to investigate the physiology of tinnitus and demonstrates that the approach is effective in revealing tinnitus-related abnormalities in brain function. Our approach as applied here included 1) using a masking noise stimulus to change tinnitus loudness and examining the inferior colliculus (IC) for corresponding changes in activity, 2) separately considering subpopulations with particular tinnitus characteristics, in this case tinnitus lateralized to one ear, 3) controlling for intersubject differences in hearing loss by considering only subjects with normal or near-normal audiograms, and 4) tailoring the experimental design to the characteristics of the tinnitus subpopulation under study. For lateralized tinnitus subjects, we hypothesized that sound-evoked activation would be abnormally asymmetric because of the asymmetry of the tinnitus percept. This was tested using two reference groups for comparison: nontinnitus subjects and nonlateralized tinnitus subjects. Binaural noise produced abnormally asymmetric IC activation in every lateralized tinnitus subject (n = 4). In reference subjects (n = 9), activation (i.e., percent change in image signal) in the right versus left IC did not differ significantly. Compared with reference subjects, lateralized tinnitus subjects showed abnormally low percent signal change in the IC contralateral, but not ipsilateral, to the tinnitus percept. Consequently, activation asymmetry (i.e., the ratio of percent signal change in the IC ipsilateral versus contralateral to the tinnitus percept) was significantly greater in lateralized tinnitus subjects as compared with reference subjects. Monaural noise also produced abnormally asymmetric IC activation in lateralized tinnitus subjects. Two possible models are presented to explain why IC activation was abnormally low contralateral to the tinnitus percept in lateralized tinnitus subjects. Both assume that the percept is associated with abnormally high ("tinnitus-related") neural activity in the contralateral IC. Additionally, they assume that either 1) additional activity evoked by sound was limited by saturation or 2) sound stimulation reduced the level of tinnitus-related activity as it reduced the loudness of (i.e., masked) the tinnitus percept. In summary, this work demonstrates that fMRI can provide objective measures of lateralized tinnitus and tinnitus-related activation can be interpreted at a neural level.

The obese client: myths, facts, assessment, and intervention.

The myth that weight (size) is solely under the control of the individual is perpetuated by the $30 billion per year diet industry. Efforts to shape societal attitudes and beliefs about how much people should weigh have been so successful that some professionals have adopted the industry's biases. Because of the widespread concern with weight, social workers need to understand the difference between fact and myth. This article counters many of the weight myths and examines the cultural, social, biological, and psychological factors to be considered when assessing clients who are considered obese. The article also presents a framework for developing an appropriate service plan.

Imaging subcortical auditory activity in humans.

There is a lack of physiological data pertaining to how listening humans process auditory information. Functional magnetic resonance imaging (fMRI) has provided some data for the auditory cortex in awake humans, but there is still a paucity of comparable data for subcortical auditory areas where the early stages of processing take place, as amply demonstrated by single-unit studies in animals. It is unclear why fMRI has been unsuccessful in imaging auditory brain-stem activity, but one problem may be cardiac-related, pulsatile brain-stem motion. To examine this, a method eliminating such motion (using cardiac gating) was applied to map sound-related activity in the auditory cortices and inferior colliculi in the brain stem. Activation in both the colliculi and cortex became more discernible when gating was used. In contrast with the cortex, the improvement in the colliculi resulted from a reduction in signal variability, rather than from an increase in percent signal change. This reduction is consistent with the hypothesis that motion or pulsatile flow is a major factor in brain-stem imaging. The way now seems clear to studying activity throughout the human auditory pathway in listening humans.

Cellular generators of the binaural difference potential in cat.

In humans, lateralization and fusion of binaurally presented clicks are correlated with the latency and amplitude of the binaural difference potential (BDP) (e.g., Furst et al., 1985). The BDP is derived by subtracting the brainstem auditory evoked potential (BAEP) for binaural stimulation from the sum of the BAEPs for left and right monaural stimulation. Our aim in this work was to determine the cellular generators of the BDP and thus identify cells that may be crucial for specific types of binaural sound processing. To this end, we injected kainic acid into the superior olivary complex (SOC) or the cochlear nucleus (CN) in cats and examined the effects of the resulting lesions on the click-evoked BDP. Lesions confined to the anterior anteroventral CN (AVCNa) substantially reduced the BDP, while lesions primarily involving more posterior parts of the CN had little or no effect. BDP reductions occurred for lesions involving either high (> 10 kHz) or lower (< 10 kHz) characteristic frequency (CF) regions of the AVCNa (as well as the posterior CN). Lesions involving the SOC reduced the BDP and, in one case, eliminated the high-pass filtered (270 Hz cutoff) BDP. Combining these results with published information about the physiology and anatomy of auditory brainstem cells, we conclude that: (1) spherical cells in the AVCNa are essential for BDP production, (2) the earliest part of the BDP is generated by medial superior olive (MSO) principal cells which receive spherical cell inputs, (3) a later part is probably generated by the cellular targets of MSO principal cells and, (4) the cells involved in BDP generation have CFs above, as well as below, 10 kHz. Since humans, like cats, have a well-developed MSO, we suggest that the MSO may also be essential for BDP production in humans. Thus, perceptual correlates of the BDP, binaural fusion and click lateralization, apparently involve the MSO.

Generators of the brainstem auditory evoked potential in cat. I. An experimental approach to their identification.

This paper is the first in a series aimed at identifying the cellular generators of the brainstem auditory evoked potential (BAEP) in cats. The approach involves (1) developing experimental procedures for making small selective lesions and determining the corresponding changes in BAEP waveforms, (2) identifying brainstem regions involved in BAEP generation by examining the effects of lesions on the BAEP and (3) identifying specific cell populations involved by combining the lesion results with electrophysiological and anatomical information from other kinds of studies. We created lesions in the lower brainstem by injecting kainic acid which is generally toxic for neuronal cell bodies but not for axons and terminals. This first paper describes the justifications for using kainic acid, explains the associated problems, and develops a methodology that addresses the main difficulties. The issues and aspects of the specific methods are generally applicable to physiological and anatomical studies using any neurotoxin, as well as to the present BAEP study. The methods chosen involved (1) measuring the BAEP at regular intervals until it reached a post-injection steady state and perfusing the animals with fixative shortly after the last BAEP recordings were made, (2) using objective criteria to distinguish injection-related BAEP changes from unrelated ones, (3) making control injections to identify effects not due to kainic acid toxicity, (4) verifying the anatomical and functional integrity of axons in lesioned regions, and (5) examining injected brainstems microscopically for cell loss and cellular abnormalities indicating dysfunction. This combination of methods enabled us to identify BAEP changes which are clearly correlated with lesion locations.

Generators of the brainstem auditory evoked potential in cat. III: Identified cell populations.

This paper examines the relationship between different brainstem cell populations and the brainstem auditory evoked potential (BAEP). First, we present a mathematical model relating the BAEP to underlying cellular activity. Then, we identify specific cellular generators of the click-evoked BAEP in cats by combining model-derived insights with key experimental data. These data include (a) a correspondence between particular brainstem regions and specific extrema in the BAEP waveform, determined from lesion experiments, and (b) values for model parameters derived from published physiological and anatomical information. Ultimately, we conclude (with varying degrees of confidence) that: (1) the earliest extrema in the BAEP are generated by spiral ganglion cells, (2) P2 is mainly generated by cochlear nucleus (CN) globular cells, (3) P3 is partly generated by CN spherical cells and partly by cells receiving inputs from globular cells, (4) P4 is predominantly generated by medial superior olive (MSO) principal cells, which are driven by spherical cells, (5) the generators of P5 are driven by MSO principal cells, and (6) the BAEP, as a whole, is generated mainly by cells with characteristic frequencies above 2 kHz. Thus, the BAEP in cats mainly reflects cellular activity in two parallel pathways, one originating with globular cells and the other with spherical cells. Since the globular cell pathway is poorly represented in humans, we suggest that the human BAEP is largely generated by brainstem cells in the spherical cell pathway. Given our conclusions, it should now be possible to relate activity in specific cell populations to psychophysical performance since the BAEP can be recorded in behaving humans and animals.

Generators of the brainstem auditory evoked potential in cat. II. Correlating lesion sites with waveform changes.

Brainstem regions involved in generating the brainstem auditory evoked potential (BAEP) were identified by examining the effects of lesions on the click-evoked BAEP in cats. An excitotoxin, kainic acid, was injected into various parts of the cochlear nucleus (CN) or into the superior olivary complex (SOC). The locations of the resulting lesions were correlated with the changes produced in the various extrema of the BAEP waveforms. The results indicate that: (1) the earliest BAEP extrema (P1, N1 (recorded between vertex and the earbar ipsilateral to the stimulus) and P1a, P1b, (vertex to contralateral earbar)) are generated by cells with somata peripheral to the CN; (2) P2 is primarily generated by posterior anteroventral CN (AVCNp) and anterior posteroventral CN (PVCNa) cells; (3) SOC, anterior anteroventral CN (AVCNa), AVCNp, and PVCNa cells are involved in generating P3; (4) AVCNa cells are the main CN cells involved in P4, N4, and P5 generation; (5) both ipsilateral and contralateral SOC cells have a role in generating monaurally evoked P4 and P5; and (6) P5 is generated by cells with characteristic frequencies below 10 kHz. From (2) and (4), it is clear that P2 and P4-P5 are generated by cells in distinct, parallel pathways.

[The value of computed tomography in monitoring the preoperative chemotherapy of osteosarcoma]. / Zum Wert der Computertomographie für das Monitoring der präoperativen Chemotherapie des Osteosarkoms.

Computed tomography was performed in 45 patients with osteosarcomas before and after preoperative chemotherapy. Changes of bone alterations, intramedullary tumour spread and the size of soft tissue masses are computer tomographic criteria for tumour response after chemotherapy. The computed tomography decision of responder or non-responder was correct in 37/45 patients. In comparison with conventional x-rays CT was superior. CT is a reliable method for preoperative extension diagnosis and for the decision-marking for limb-saving operations.

Dependence of the MEG on dipole orientation in the rabbit head.

In theory, a radial current dipole in a conducting sphere produces zero magnetic field outside the sphere, while a tangential dipole produces a non-zero field. Because the heads of humans and some animals resemble a conducting sphere, it follows that the magnetic field due to a radial dipole in these heads should be suppressed compared to that due to a tangential dipole. This hypothesis, which is important in the interpretation of the MEG, has never been experimentally tested. We here present a test performed in the rabbit. First, a radial dipole was placed in the rabbit head, and the magnetic field over the head due to this source was measured. Then, a similar but tangential dipole was placed in the head and again the resulting magnetic field was measured. The two magnetic fields were then compared to determine the suppression of the field due to the radial dipole. This suppression was expressed as the ratio R, the magnetic field over the head due to the radial dipole divided by that for the tangential dipole. It was found that R = 0.17 +/- 0.07, or that the magnetic field due to a radial dipole is suppressed by a factor of about 6. Therefore, to first order, the hypothesis is supported for the rabbit head. From a comparison of rabbit and human head geometry, a similar degree of suppression could be expected in the human.