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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 [11C]-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.

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BackgroundComplex blood flow patterns are a well‐known phenomenon at the carotid bifurcation. However, unlike for the descending aorta, a blood flow reversal has not been detected at the carotid bifurcation, so far.MethodsIn 17 subjects, flow patterns with focus on blood flow reversal were examined at the carotid bifurcation with vector flow imaging.ResultsWe found a blood flow reversal from the external carotid artery (ECA) into the internal carotid artery (ICA) in 13 of 25 (52%) carotid bifurcations. The blood flow reversal ranged 5.3 ± 1.7 mm (range 2.6–8.3 mm) distally to the beginning of the ECA and lasted 105 ± 59 ms (range 32–225 ms). The mean peak systolic velocity within the blood flow reversal was 12.5 ± 4.6 cm/s (range 5–18 cm/s).ConclusionA blood flow reversal from the ECA into the ICA during the systole is a frequent finding at the carotid bifurcation. Considering ischemic stroke, retrograde embolism from plaques in the proximal ECA into the ICA might play a role.

abnormalities. The recording of an amplitude-integrated EEG showed continuous burst suppression pattern ( Fig. 1; time compressed (30 min) amplitude-intergrated EEG segment (blue recording) and real-time EEG recording (bottom) despite administration of phenobarbitone and vitamin B 6). This finding was confirmed by conventional EEG recording (Fig. 2; representative EEG segment (bipolar leads; duration: 10 sec) demonstrating burst suppression pattern). A lumbar puncture was performed and yielded normal results for white cell count, protein, glucose and lactate. The neonate did not have manifest seizures. The family history was unrevealing.

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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.

THERE is no agreement on the significance of the adeiioma as a preeursor of carcinoma of the thy-roid and previous estimates of this relationship have varied considerably. Thus, Cope, Dobyns, Hamlin and Hopkirk (1949) (Doniach, 1960 ; Lindsay, 1960 300 examples of thy-roid adenoma were reviewed for control purposes. Necropsy material was excluded from the study and for the purposes of histological classification it was found convenient to employ a modification of the method described by Meissner and McManus (1952).It is appreciated that the distinction between a colloidal adenoma and a nodular focus of colloidal hypertrophy may be difficult and will depend to some extent on the bias of the individual observer but the diagnostic criteria applied were those enumerated by Lahey, Hare and Warren (1940).It was found necessary to include a small group of atypical adenomas. These tumours showed the atvpical features described by Hazard and Kenyoii (1954) and it is conceded that in reality they may be encapsulated carcinomas ; the absence of vascular invasion was, however taken to be the diaonostic criterion for I zn the exclusion of malignancy as proposed by Graham (1924) and later emphasised by Warren (1931