Effects on ingestive behavior in rats of the alpha 1-adrenoceptor agonist cirazoline.

Microinjections of various alpha 1-adrenoceptor agonists including phenylephrine and phenylpropanolamine into the paravenricular hypothalamic nucleus (PVN) suppress food intake in rats, suggesting that this receptor type might act in opposition to previously identified facilatory PVN alpha 2-adrenoceptors in the modulation of feeding. In the present experiments, we examine the effects on food and water intake of intra-PVN as well as systemic injection of cirazoline, a highly potent alpha 1-adrenoceptor agonist. In Experiment 1, intra-PVN microinjection of cirazoline (0, 3, 6, 12 and 24 nmol) suppressed food intake (ED50 = 23.4 nmol) without significant effects on water intake. In Experiment 2, systemic injection of cirazoline (0, 0.05, 0.1, 0.2, 0.4 mg/kg) also markedly suppressed food intake (ED50 = 0.05 mg/kg i.p.), with a less potent action on water intake (ED50 = 0.22 mg/kg i.p.). The results of this study as well as our previous investigations strongly support the notion that alpha 1-adrenoceptors within rat PVN act to reliably suppress food intake.     

Electrosurgery in restorative Dentistry: 2. Clinical applications.

Electrosurgery techniques have been used in dentistry as an aid to soft tissue management for nearly 60 years. However, it was not until the late 1960s that the principles of electrosurgery were understood and improved equipment became available. Part 1 of the two-part series covered the theory behind using this technique. Part 2 will now discusses the clinical applications.     

Overnight and basal metabolic rates in men and women

The FAO/WHO/UNU recommendations for energy requirements assume that the energy cost of sleep is equal to the basal metabolic rate (BMR). We have tested the validity of this assumption by analysing overnight and BMR measurements made by whole-body indirect calorimetry. Data from 80 healthy subjects measured on a total of 246 occasions have been used. In a subgroup of 40 normal lean subjects the mean ratio of overnight metabolic rate (Overnight MR): BMR was 0.95 (range 0.85 - 1.02, s.d. 0.04). The mean ratio of lowest sleeping metabolic rate (Lowest SMR): BMR was 0.88 (range 0.83 - 0.96, s.d. 0.04). Ratios of Overnight MR: BMR were not significantly affected by different levels of exercise on the preceding day. This ratio was significantly higher for subjects who were obese, late pregnant or attached to ECG electrodes. With the exception of the late pregnant subjects these groups had the same Lowest SMR:BMR ratios as the normal lean subjects, indicating that the higher Overnight MR was caused by disturbed sleep. The data suggest that the use of BMR to estimate overnight energy expenditure would introduce an average overestimate of approximately 5 per cent during the actual hours of sleep, but that when applied over 24 h the error becomes negligible.     

Parasymphyseal and associated insufficiency fractures of the pelvis and sacrum

Eleven post-menopausal women presenting with a parasymphyseal insufficiency fracture of the pubis are reported. The plain radiographs showed delayed healing with a mixed lytic and sclerotic area developed at the fracture site simulating a malignant lesion. Aetiological factors included post-menopausal osteoporosis, rheumatoid arthritis and steroid therapy, previous hip replacement and pelvic radiotherapy. Ten patients had concomitant fractures of the pelvis, including nine with sacral fractures. These were all initially missed on presentation because of the subtle radiographic signs of a longitudinal band of sclerosis, usually bilaterally, in the sacral ala. Bone scanning was shown to be the most sensitive technique in detecting the sacral fractures by demonstrating increased uptake in the sacral ala as well as the other fractures of the pelvis. Computed tomography in three cases was helpful in confirming the presence of fractures and excluding the possibility of malignancy.     

Fluoxetine in panic disorder

Twenty-five patients with a primary DSM-III-R diagnosis of panic disorder with or without agoraphobia were treated openly with the serotonin uptake inhibitor fluoxetine for up to 12 months. For most patients, treatment was initiated at 5 mg/day to minimize adverse effects previously reported with initiation at higher doses. Nineteen (76%) experienced moderate to marked improvement in panic attacks. Four (16%) were unable to tolerate fluoxetine due to adverse effects. Initiating treatment of panic disorder with low doses of fluoxetine may increase its acceptability and permit more patients to benefit from fluoxetine.