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Trauma and chronic stress are believed to induce and exacerbate psychopathology by disrupting glutamate synaptic strength. However, in vivo in human methods to estimate synaptic strength are limited. In this study, we established a novel putative biomarker of glutamatergic synaptic strength, termed energy-per-cycle (EPC). Then, we used EPC to investigate the role of prefrontal neurotransmission in trauma psychopathology. Healthy control (n=18) and patients with posttraumatic stress (PTSD; n=16) completed 13C-acetate magnetic resonance spectroscopy scans to estimate prefrontal EPC, which is the ratio of neuronal energetic needs per glutamate neurotransmission cycle (VTCA/VCycle). Patients with PTSD were found to have 28% reduction in prefrontal EPC (t=3.0; df=32, p=0.005). There was no effect of sex on EPC, but age was negatively associated with prefrontal EPC across groups (r=–0.46, n=34, p=0.006). Controlling for age did not affect the study results. The feasibility and utility of EPC were established. Patients with PTSD were found to have reduced prefrontal glutamatergic synaptic strength. These findings suggest that reduced glutamatergic synaptic strength may contribute to the pathophysiology of PTSD and could be targeted by new treatments.HighlightsGlutamatergic synaptic strength is critical for brain function in health and disease.In vivo in human methods to estimate glutamatergic synaptic strength are limited.We here propose a new approach to estimate glutamatergic synaptic strength.The new method employs carbon-13 magnetic resonance spectroscopy (13C MRS).The utility of the new approach was demonstrated in posttraumatic stress disorder (PTSD).

FOR SOME time the value of cervical sympathectomy and cervical sympathetic block in the treatment of retinitis pigmentosa has been disputed. The beneficial results have been inconclusive, and the question has been raised as to whether the benefits derived from such measures are psychologic or organic. For the purpose of evaluating the use of cervical sympathetic block in retinitis pigmentosa, we subjected a group of patients to cervical sympathetic block, first using procaine hydrochloride, and later we repeated the procedure using saline solution instead of procaine. ANATOMIC BASIS OF SYMPATHETIC SURGERY The preganglionic fibers arise from the intermediolateral tract of the gray matter of the spinal cord in the ciliospinal center of Budge. They concentrate in the stellate ganglion (a fusion of the inferior cervical and the first thoracic ganglion) and pass through the middle to the superior cervical ganglion. The majority of fibers travel with the carotid artery, breaking

A CASE of panophthalmitis due to the gas-forming organism Clostridium welchii (Clostridium perfringens) was reported in this country by Berry in 1932. 1 Since then four cases have been added to the American literature 2 and 23 to the foreign. 3 The report by Kluver and O'Brien 2b gives an adequate review of the foreign literature up to 1936 and of the laboratory identification of the Cl. welchii bacillus. REPORT OF CASE A laborer aged 27 was admitted to the Cleveland Clinic Hospital on Nov. 24, 1950. The personal and medical histories were noncontributory. Twenty-eight hours prior to admission the patient had been struck in the left eye by a small fragment from the inside cement framework of a cellar window on which he was chipping with a hammer and chisel. The window was opened only for coal deliveries. He was not conscious of discomfort until three hours later, when

Metastatic carcinoma of the eye involving the retina alone is an extremely rare lesion; only two reports of previous cases have been found in a review of the literature. The first report was that by Arisawa 1 in 1914. However, Smoleroff and Agatston 3 reviewed this case, which was in Sattler's 2 textbook, and concluded that the tumor involved the optic disc as well as the retina. In their article they reported a case of secondary carcinoma limited only to the retina. Our report is of a secondary carcinoma of the macula of the right eye, the primary site of the tumor being the rectosigmoid. Report of Case A 51-year-old white man was first seen by one of us (W. D. R.) on Jan. 30, 1956. because of blurred vision of one month's duration in the right eye. The corrected vision in the right eye was limited to counting fingers

Excerpt Graves' disease may be considered to be a thyroid-pituitary syndrome. The two chief manifestations of the disorder are exophthalmos and hyperplastic goiter with hyperthyroidism. They usuall...

There are many reports in the current literature on the intravenous use of corticotropin and of typhoid; however, there are no articles comparing their clinical use in ophthalmology. This study was undertaken in order to ascertain the clinical value of intravenous corticotropin (ACTH; adrenocorticotropic hormone) in comparison with that of intravenous killed typhoid bacilli in the treatment of optic neuritis: We have compared the results of treatment in two groups of patients, one in which the treatment was with corticotropin and the other in which it was with killed typhoid bacilli. It has been shown by Olson and associates 1 that nonspecific foreign protein, i. e., killed typhoid organisms, among other drugs, produces changes in the adrenal cortex which are characteristic of the general response to stress, and that the benefit derived from this form of therapy could be attributed to the release of endogenous adrenocorticotropic hormone.* The same type

Despite the considerable progress achieved in the last 30 years, vomiting and, especially, nausea, continue to be two of the most distressing side-effects of cancer chemotherapy. In the late 1990s, several professional organisations published recommendations on the optimal antiemetic prophylaxis in patients submitted to chemotherapy and/or radiotherapy. The European Society of Medical Oncology (ESMO) and the Multinational Association of Supportive Care in Cancer (MASCC) published the results of the third Consensus Conference on antiemetics held in Perugia in June 2009 in Annals of Oncology in 2010 [1]. An update of these recommendations, including studies published from 1 January 2009 to 30 June 2015, was discussed in Copenhagen in June 2015 and is presented in this paper. The methodology for the guideline process is described in detail in the 2010 publication [1]. To change a 2010 recommendation or for a new guideline recommendation to be accepted, a consensus of at least 67% of the expert panellists was needed. As a general rule, the panel considered changes of 10% or greater to be sufficient to warrant the changing of a recommendation. Refereed/Peer-reviewed