What Is Picosecond LASER And What Is Its Latest Role In The World Of Medicine?

A brief overview of Picosecond Laser:

Pico- (p) is a prefix used in metric system of measurement to denote the size which is one-trillionth of a meter. This size is a thousand times smaller than nano- which is a billionth of a meter.

PS: If you are interested in learning about the advances in Nanotechnology and its applications in the World of Medicine, please refer to my earlier Nanotechnology post.

Picosecond (ps) LASER (Light Amplification by Stimulated Emission of Radiation) refers to a Laser that emits optical pulses with duration between 1 ps and (usually) some tens of ps.

To learn more about Picosecond Laser please click on the link below:

Encyclopedia of Laser Physics and Technology

Latest role of Picosecond Laser technique in the World of  Medicine has been in the production of  synthetic scaffolds in the field of Regenerative Medicine which is a rapidly growing field which is already rapidly changing the medical world.

Please see my earlier post on 3-D organ printing where you can see Dr. Anthony Atala, a urologist, who is the head of Department of Regenerative Medicine at Wake Forest University in North Carolina, U.S.A. printing out a 3-D kidney using biomimetic synthetic scaffold and cultured human kidney cells using a 3-D organ printer.

The researchers at the Fraunhofer Institute for Laser Technology (ILT; Aachen, Germany) and other Fraunhofer Institutes developed a picosecond laser technique process for producing these biomimetic scaffolds utilizing Picosecond Laser. These scaffolds closely resemble endogenous tissue and assist in the study of 3-D cell growth. They combine organic substances with polymers and produce 3-D structures suitable for building artificial tissue.

For more details, please click on the following link to read the article posted by Lee Mather on 09/02/2011:

BioOpticsWorld: Advances in Lasers, Optics, and imaging for the Life Sciences.

Thank you for updating your medical knowledge at http://www.onlinehealthexpert.blogspot.com

Sincerely,

Harish Malik, M.D.

Women Infected With Human Papilloma Virus (HPV) May Have Increased (2-3 times) Heart Attack, Stroke Risk.

According to a report published in the Journal of the American College of cardiology "Women infected with human papillomavirus or HPV, are two to three times as likely as uninfected women to have had a heart attack or stroke".

Wall Street journal "Health Blog" reported that HPV suppresses the action of retinoblastoma protein, a tumor suppressor protein that has been linked to the development of atherosclerosis (deposition of fibro-fatty plaques) that leads to increased risk of heart attack and strokes.

Further study is needed to see if similar association or a cause and effect relationship can be shown between HPV and cardiovascular and cerebrovascular disease in both sexes. It also reemphasizes the potential roles that other infectious agents in the pathogenesis of atherosclerosis.

This might, in the future, lead to vaccination and anti-microbial therapy becoming a part of prevention and routine management of cardiovascular and cerebrovascular or peripheral arterial disease patients.

Thank you for reading,

Sincerely,

Harish Malik, M.D.

Increased Morbidity And Mortality On Weekends And In July In U.S. Hospitals.

Lots of data is accumulating that shows avoidable deaths, injuries and medication errors occur at teaching hospitals in U.S. in the month of July every year when fresh and inexperienced PGY-1 Resident doctors start their residencies and are eager to use their medical knowledge and skills on their first patients. This is now commonly known as the "July effect"!

David P. Phillips, Ph.D., and Gwendolyn E. C. Barker, B.A. published a study (2010) in the Journal Of General Internal Medicine.

They found “the greater the concentration of teaching hospitals in a region, the greater the July Effect for the intra-institutional medication errors in that region”.

Three key themes reportedly emerged during the study:

1)      Fatal medication errors spiked in July and no other month.

2)      July spike appeared only in counties containing teaching hospitals, and

3)      July mortality from medication errors was 10% above the expected level in these counties.

Another interesting finding shows (so called "Weekend effect") that there is increased mortality in patients who go or are taken to the ER during the weekends when the Attending and the senior faculty is sometimes not available and the burden of care falls on the less experienced Resident doctors and Hospitalists who find it more difficult to reach the patients’ primary care doctors on weekends versus weekdays and have to unravel the medical mysteries from the scratch which is unfair and frustrating for the patients. This leads to the loss of valuable time, in re-diagnosing the patients, which could have been utilized to treat and save their lives. Hospital staffing levels tend to be lower on the weekends than on weekdays. Because of this, weekend ER patients may be less likely to receive invasive procedures and more likely to experience longer in-hospital delays. These invasive procedures have been shown to save more lives when performed early.

Recent studies from Canada, Taiwan, and the United States have reported increased risk of mortality in acute stroke patients arriving to the hospital on the weekend compared to those arriving during the week.

A study published by David J Becker, Ph.D., in the Health Services research in 2007 titled “Do Hospitals Provide Lower Quality Care on Weekends?” concluded:

1)      Patients admitted on the weekend are significantly less likely to receive the primary intensive treatments associated with AMI within the first days of their admission.

2)      Weekend admission with AMI leads to lower subsequent expenditures, but higher 1-year mortality and a higher rate of one major cardiac complication, readmission with CHF.

3)      The effects of weekend admission do vary with patient health status. While weekend admission leads to delays in invasive treatments for all patients, sicker patients (defined by inpatient admission in the prior year) are less likely to experience such delays.

Therefore, weekends and the month of July are not a good time to get hospitalized!

Thank you for reading,

Sincerely,

Harish Malik, M.D.

Vitamin E Supplementation Does Not Protect Men Against Prostate Cancer But Might Increase Risk.

Selenium and Vitamin E Cancer Prevention Trial (SELECT) found that neither selenium nor vitamin E supplements reduced the risk for prostate cancer in men. An updated version in JAMA went on to further state that Vitamin E supplementation can significantly increase the risk for Prostate cancer.

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Learn While You Sleep. Good Sleep Habbits Improves Memory And Potentially Academic Performance.

According to a study done by Michigan State University researchers, and published in Journal of Experimental Psychology: General People may be learning while they are asleep. The team of researchers who studied 250 people is speculating that this is a different form of memory that is formed unconsciously during sleep and contributes to dramatically improving the waking memory and potentially the academic performance for some individuals.

Simply getting a better sleep might lead to improved performance in the classroom!

Further Reading:

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Monkeys Use Their Brains, Not Hands, to 'Move' Virtual Objects

According to a study done Dr. Miguel Nicolelisat and his team at Duke University Medical Center and funded by the U.S. NIH, monkeys were trained to move virtual hands of an "Avtar" and to identify texture of virtual objects.
This study, with further development, will enable quadriplegic patients to be more independent through the use of this demonstration of a brain-machine-brain interface (BMBI) that establishes a direct, bidirectional link between a brain and a virtual body.

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Boys With Autism May Grow Faster as Babies.

According to a study published in Archives of General Psychiatry "Overgrowth" in length, weight and head circumference may signal a problem in male babies. The boy babies with Autism grow faster than their non-autistic counterparts.

 

Prior research had found an association between accelerated head growth and autism. This study adds to that by showing that boys with autism have a tendency toward accelerated growth throughout the rest of the body.

Researchers are next planning on doing a similar study in girls.

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RNA (Ribonucleic acid) more important than DNA (Deoxyribonucleic acid) in encoding and decoding of information and origin of life.

The Central Dogma of Biology where DNA makes RNA which further makes Proteins has been much revered in the past by Biologists. It has plagued many evolutionary and origin of life scientists for almost 40 years as to which among these three came first and created the other two. According to current research and understanding (RNA first world) the RNA has been deemed as the candidate of choice that formed first and was able to work as catalyst (ribozyme) in creating first proteins in accordance with the codon sequences in the RNA. Some scientists have been able to create portions of RNA in the lab by recreating conditions that are thought to be present during the possible origin of life in the so called "primordial soup of life". RNA's were then able to pair up and create DNA through changes in the bases and hydrogen bonding to secure the information for the synthesis of evolving pre-life forms. RNA's are also thought to be the first large molecular life forms, so to say in that they could evolve into DNA Virions) and back to RNA (virions) and help synthesize proteins (prions) to evolve into first membrane (proteins) enveloped viruses and later prokaryotic and eukaryotic life forms. Intelligence as we understand is the ability to encode, decode, retrieve and reproduce information needed to build structures that could reproduce and adapt (learn and survive) making RNA as a stronger candidate thean DNA as the central molecule thought to be the first intelligent living chemical evolving from less complex unintelligent matter.

Further Reading:

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I encourage you to read more, learn more and to ask more questions.

Thank you,

Dr. Harish Malik

Diabetes found to be an independent risk fact for colon and rectal cancers.

According to a study reported in American Journal of Gastroenterology, the researchers from University of California, Berkeley diabetes is an independent risk fact for colon and rectal cancers. A person with diabetes has a 38% higher risk of developing colon cancer compared to other people. Male diabetes patients were found to have a 20% higher risk of developing rectal cancer.

The authors stressed that they took into account variables which might affect the results, such as smoking, obesity and levels of physical activity. They could not point out as to what causes the link between diabetes and colon and rectal cancer.

For more detals, please click on the links below:

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Glycated Hemoglobin (HbA1c) levels fail to diagnose Diabetes and Prediabetes in Arab population

According to the Standards of Medical Care in Diabetes 2011, ADA had recently approved the use of HbA1c levels in diagnosing Diabetes (HbA1c ≥ 6.5%) and Prediabetes (HbA1c levels between 5.7-6.4%). But more and more evidence is accumulating that different cut off values (lower) from the ones suggested by  ADA may be needed in different target populations like this study showed that there were very high false negatives in Arabs with the use of the recommended HbA1c levels. Similarly low sensitivities for diagnosing diabetes and prediabetes with HbA1c have been reported in non-Hispanic whites or blacks, Filipino-Americans, Japanese-Americans, and Native Hawaiians. Thus, it would be unwise to jump and use the HbA1c levels for different target populations and the use of traditional OGTT along with FBS is recommended until we are able to come up with different cut off levels for different target populations.

Caution is advised to medical professionals diagnosing Diabetes and Prediabetes using HbA1c cut off values suggested by ADA across the board for all target populations as this might delay the diagnosis of Diabetes and Prediabetes and thus contribute to increased mortality and morbidity resulting from delayed detection of this disease. Please click on the links below.

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Genes, Not Healthy Living, Get Most to Age 100! FOXO 3A gene varient associated with longevity!

FOXO 3A gene belongs to a forkhead family of so called "superintendent genes" which are critical for the surveillance and maintenance of cellular functions. Having this right variant has been shown in several studies across different species including all races and cultures among humans. Please click on the Link below for more details.

 

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New research suggests that your life choices might not be the crucial factor in determining whether you make it to 95 or beyond; it finds that many extremely old people appear to have been as bad as everyone else at indulging in poor health habits during their younger years.

Olshansky said the findings underscore the importance of genetics to life span. "The only way anyone has any chance at all of living an exceptionally long life is if they won the genetic lottery at birth," he said.

Sources: Jill P. Crandall, M.D., professor, clinical medicine, Albert Einstein College of Medicine, New York City; S. Jay Olshansky, Ph.D., professor, epidemiology, University of Illinois at Chicago; 2011 Journal of the American Geriatrics Society

References:

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Gene Mutation Can Leave People Without Fingerprints (adermatoglyphia)

Study published in the Aug. 4 online edition of the American Journal of Human Genetics,  of a Swiss family with skin-specific version of gene sheds light on rare condition. Fingerprints are fully formed by 24 weeks after fertilization and do not undergo any modification throughout life. Skin-specific version of the gene SMARCAD1 is implicated in the regulation of fingerprint development and also sweat gland development.

 

Source: Cell Press, news release, Aug. 4, 2011

 

References:

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Early Morning Smoking Riskier For Cancer

The online version of journal Cancer Those who have a cigarette as soon as they wake may be more addicted than others.

The findings suggest the desire to have a cigarette immediately after waking up may increase smokers' risk for cancer, the researchers concluded. As a result, these smokers would benefit from smoking cessation programs that specifically target this early morning behavior and the greater risks involved, they added.

Source: Cancer, news release, Aug. 8, 2011

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Maternal Blood Test Can Determine Sex of Fetus at 7 Weeks

Noninvasive Fetal Sex Determination Using Cell-Free Fetal DNA.

The study concluded that "Despite interstudy variability, performance was high using maternal blood. Sensitivity and specificity for detection of Y chromosome sequences was greatest using RTQ-PCR after 20 weeks' gestation. Tests using urine and tests performed before 7 weeks' gestation were unreliable. "

Source: Diana W. Bianchi, M.D., executive director, Mother Infant Research Institute, Tufts Medical Center, Boston; Susannah Baruch, J.D., policy consultant, Generations Ahead; August 10, 2011 Journal of the American Medical Association

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Intelligence largely rooted in GENES!

Journal Molecular Psychiatry reports that there's no one 'smart' gene, but many genes that play a role in high IQs.

References:

Source: Ian Deary, Ph.D., MBChB, professor, differential psychology, University of Edinburgh, Scotland; Peter Visscher, Ph.D., professor, statistical genetics, Queensland Institute of Medical Research, Brisbane, Australia; Aug. 12, 2011, Molecular Psychiatry

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High Protein diet raises risk of Type 2 Diabetes

According to the abstract, presented at Lisbon, Portugal, at European Association for the Study of Diabetes (EASD) 47th Annual Meeting, Swedish researchers found a 37% increased risk for type 2 diabetes associated with high protein intake (hazard ratio [HR], 1.37; 95% confidence interval [CI], 1.17 to 1.61; P for trend < .001]. High intake of processed meat was also associated with an elevated risk for diabetes (HR, 1.17; 95% CI, 1.00 to 1.36; P for trend = .005). Even after controlling for the intake of processed meat, the positive association between protein intake and diabetes remained statistically significant.



High-protein diets have been shown to be effective for short-term weight loss and glycemic control. However, the results of this trial suggest caution when considering this approach for weight loss or better control of diabetes which might be counterproductive in the long run.



The researchers suggested that replacing protein with carbohydrates, especially breads and cereals rich in fiber, might be preferable.



Reference: Medscape medical news, http://www.medscape.com/viewarticle/749500 accessed on Sep. 13, 2011

Hypertension linked to increased Cancer Risk in men and increased mortality in Cancer patients of both sexes.

According to a study released on September 27, 2011 (Stockholm, Sweden), hypertension is associated with an increased risk for cancer death, and that hypertension increases the risk of developing cancer — although the latter effect reached statistical significant only in men, not women.



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What is an Atomic Force Microscope?

Please watch the following video:

Atomic Force Microscopy: An Introduction from Phil Cook on Vimeo.

You can view some really cool never before seen AFM Life Science images at the Atomic Force Microscopy Resource Library.

Thank you for choosing http://www.onlinehealthexpert.blogspot.com/, your number 1 source of links to improving your medical knowledge and understanding.

Harish Malik, MD

Where can I go to find out about nanotechlogy and its application in cancer research?

Latest news about the alliance of nanotechnology and cancer research can be found at the following link.

http://nano.cancer.gov/

How does Cranberry juice help in preventing and treating Urinary Tract Infection (UTI)?

It has been now known since the mid 1990's that the presence of specific compounds called condensed tannins (esp. proanthocyanidins or PAC) in the Vaccinium fruit species like the Cranberries, Blueberries, Red huckleberries, and lingonberries prevents the attachment of the P fimbriae of Uropathogenic Escherichia coli or UPEC to the urothelium or the inner lining of the urinary tract.

With the use of nanotechnology in medicine, it is now possible to visualize the nanoworld with the use of scanning Atomic Force Microscope or AFM. Atomic Force Microscopic image of E. coli can be seen by clicking the hyperlink.

The PAC's in the Cranberry juice changes in the shape of the surface of E. coli and prevents this bacteria from latching to the inner lining of the urinary tract (urothelium). This inturn prevents bacterial proliferation and infection as the bacteria latches on to the urothelium to secure itself and prevent being flushed by typical urine flow. In the presence of cranberry juice (which contains PAC) the force or strength of E. coli's bonding or the latching to the urothelium is decreased to the point that it is easily flushed out by the urinary flow.

What is our Immune System and how does it work?

Immune System in our bodies serves the defense mechanism and can be divided into first, second and third line of defense. It is a complicated body system and shares an analogy to a nation (country), the Border Patrol, the Immigration system, the Army, the Navy, the Air Force, the Marines, the Special Forces, the Secret Service, the CIA, the NSA, the FBI, the Police, the detectives and other security personnel along with all their training academies. The prime purpose of our Immune System is to deter, defend and thwart any attack on any of the body systems including itself. It utilizes both non-specific and specific defense mechanisms and uses very sophisticated organic hardware (Skin - as a barrier along with its shedding mechanism, water resistance, Langerhans cells, many anti-microbial secretions including peroxide; Mucosal barrier - with saliva containing anti-microbial lysozyme, and secretory antibody IgA; Cell-mediated Immune system including all the different types of White Blood Cells; Humoral Immune system including Immunoglobulins  and the Complement system and the Lymphatic System with its organs - lymph nodes, lymph vessels, spleen, thymus, tonsils) along with the  adaptive software (genetic material - DNA).

This brief overview and analogy can easily make us understand how our Immune System works and learns about our body's internal and external environment and keeps it from changing and getting damaged until it works normally.

The battle-grounds inside the body are the sites of injury and the way our immune system responds to it and are referred to as sites of inflammation that result in swelling, redness, heat, pain, sometimes total or partial loss of function. Depending on the nature of injury and the type of forces deployed by the body to fight these battles with foreign agents (antigens and haptens combined with body proteins) the inflammation might be acute (over a short period of time and usually severe), sub-acute (less severe and more insidious than acute), chronic (long standing and not severe) or acute on chronic(severe and on top of a long standing injury).

Injury in our bodies can take various forms and helps us understand the nature and cause of various disease processes and syndromes.

An easy way to remember most of these causes is to remember the mnemonic:

VINDICATE ME, where:

V - Vascular (Heart, Blood vessels, Bone Marrow and the Blood itself)
I - Infections (Bacterial, Viral, Fungal, Protozoans, Parasitic)
N - Neoplasia [new growths: Benign (non-cancerous) and Malignant (cancerous) and Nervous System (Brain disease, Psychiatric and Psycho-social, Spinal cord and Nerves)]
D - Dietary, Drugs (medications and substance abuse) and Developmental
I - Iatrogenic (Illness caused by medical examination or treatment) and Idiopathic (unknown cause) and Immune system
C - Congenital (condition present at birth)
A - Autoimmune (Immune system fails to differentiate between self and non-self and starts attacking our own body)
T - Trauma
E - Endocrine (Hormonal) and Environmental


M - Metabolic (Genetic Inborn errors of metabolism and problems with chemical reactions in the body)
E - Eating Habits and Exercise (lack of) and Education (lack of)

Video Links:


http://www.youtube.com/watch?v=0vdqby8I0Aw&playnext=1&list=PLD8CD72D804D7A1A1

The Lymphatic System

Watch these two videos about the lymphatic sysyem and we will discuss these in class on monday.

Blood and its components

Blood (about 8% of total body weight) is a specialized type of connective tissue which has the liquid portion called the plasma (roughly about 55% of the whole blood) and the solid portion (about 45%) known as formed elements.

The formed elements are mainly the Erythrocytes (Red blood corpuscles or cells or RBCs), Leucocytes or Leukocytes (White blood corpuscles or cells or WBCs) and the Thrombocytes (Platelets). The formed elements of the blood are formed in the red bone marrow in adults mainly found in the ends of long bones like the femur, humerus, and flat bones like the skull bones, sternum, ribs, hip bone etc. In fetus and neonate the blood formation (hemopoiesis) also goes on in the liver and spleen.

The bone marrow which constitutes about 4% of the total body weight in adults is mainly of two types: Red bone marrow (hematopoietic) and the Yellow bone marrow (fat cells and stem cells).

The Plasma, by itself, is straw-yellow in color is aqueous (watery) solution of water (92% of plasma is water) and proteins (roughly close to the rest of the 8% of plasma) and traces of other materials. Plasma contains proteins (Albumin - mainly a carrier protein; Globulins alpha, beta and gamma types- gamma globulins  are Immunoglobulins which are antibodies,  20 types of complement proteins also used for defense), electrolytes (Na⁺, K⁺, Cl^-, HCO₃^-  etc), glucose and traces of other sugars, amino acids, other organic acids, cholesterol, and other lipids, hormones, clotting factors, fibrinogen, urea and other wastes.

The Erythrocytes or the RBCs are mainly involved in the transport and exchange of O₂ (Oxygen) and CO₂ (Carbon dioxide) in the lungs and in the tissues. RBCs appear red and give the human blood its red color due to the presence of a red pigment carrier protein called Hemoglobin. Each hemoglobin molecule can bind to 4 molecules of oxygen. After binding with oxygen it’s called oxyhemoglobin which gives the oxygenated blood its bright red color.

The Leukocytes are divided into two categories bases on the presence of granules (Granulocytes) or the absence of granules (Agranulocytes). The Granulocytes are further divided into three types based on the dye that they pick up on being stained using the Hematoxylin and Eosin stain (H&E). The cells that appear blue after picking up the Hematoxylin stain (blue in color) are called Basophils. The ones that stain Lilac, red or pink shades are called Eosinophils. The ones that stay neutral to the dye and stay clear are called Neutrophils. The Agranulocytes are of two types Lymphocytes and Monocytes.

Visiblebody link for blood cells

Urinary System - Anatomy and Physiology made simple.

Brief Overview: Urinary System is one of the eleven body systems and functions to eliminate waste and helps the body to maintain its internal environment (homeostasis) like the pH (acid-base balance) and electrolyte (Sodium, Potassium, Magnesium, Chloride, Bicarbonate, Phosphorus etc.,) levels, fluid balance along with blood pressure and stimulates the bone marrow to help form new red blood cells. In males it also works along with the reproductive system in forming the passage way for the semen to be ejaculated. The two main hormones that are secreted by the kidneys are the Renin (Renin-Angiotensin-Aldosterone System to maintain blood pressure) and the Erythropoietin (to stimulate Red Blood Cell production). Kidneys also convert part of Calcidiol to Calcitriol which is the active form of Vitamin D which plays a key role in Calcium metabolism and keeping bones healthy.

More details can be found at:

Anatomy of Urinary Sysytem

Some of the facts about the human urinary system can be found at:

Cool facts about the Urinary System

Where can I buy the Cheapest 3M Littman Classic II Blood pressure measurement kit?

3M Littman Classic II S.E. combination Kit

What is nanotechnology and how is it changing the medical field?

Nano- refers to a billionth of a meter. To understand how small is a nanometer click here. It's a size somewhere between atoms and molecules. The matter behaves very differntly at nano scale, like gold which is solid and inert becomes a liquid and is a good catalyst. Imagine this technology giving us the ability to make machines (nanorobots) that when targeted to the right locations on or inside the cell or cellular organelles like the nucleus or the mitochondria will analyse and correct the defects in your genes and the cellular machinery thus helping us remove or repair portions of the cell and help not only find cures for cancers, autoimmune diseases like lupus, diabetes, heart disease, AIDS etc. This will lengthen the human life by decades.

This technology's application can be looked at performing surgery and repair at the cellular and sub-cellular level using molecular machines which can be remote controlled. We plan to use synthetic nanotechnology to generate not only damaged DNA but to replace entire organs with synthetic ones.

As nanotechnology advances, we will see more and more application in the filed of Medicine.

Here are some great vidios to undestand more about this cutting edge technology and it's application in modern medicine:

Is stress always bad for us?

No, stress is not always bad. Infact stress can be good at times called Eustress (good stress). Eustress can lead us to out-perform in certain situations like exams, games etc. Infact the human body's response to stress is designed to save us in extreme conditions and is driven by neural and hormonal responses which put our bodies in a heightened state of alertness and gives us super human strength to overcome the extreme condition faced by us.

The constant stress of our modern day lives, distress (bad stress) is what most people know as stress and can adversly affect our health and lives. Our body's response to stress is designed to last for a very short period of time to overcome the extreme situations that we might be faced. When there is constand stress it causes a burnout of our stress response mechanisms and leads to both mental and physical signs and symptoms in the short term and many chronic medical conditions including heart disease, stroke, cancer, diabetes, rheumatoid arthritis, fibromyalgia, peptic ulcer disease, depression, mood disorders, insomnia etc.

Does wearing a bra increase my chances of developing Breast Cancer?

Wearing a bra does not increse your chances of developing Breast Cancer but it does decrease the chances of early detection of Breast Cancer using the usual Mammogram screening. Its speculated that because of the support provided by using a bra, the breasts stay firmer and denser for longer and the calcifications which are seen in the breasts of a Breast Cancer patient on a mammogram are more difficult to detect. This delays the early detection of Breast Cancer on a mammogram.

Can staying healthy become an obsession?

I am here to talk about how sometimes staying healthy can become an obsession for some people. Our brain is a very powerful organ and controls our every action and is motivated by either reward or punishment or a combination of both. What staying healthy demands is regular exercise along with maintaining a well balanced diet. When our bodies exercise and we start seeing results that we like we start getting a kick out of that because our brain releases endorphins which make us keep coming back for more and more exercise. This changes the circuitry of our neurons (nerve cells) and leads us to keep wanting more of the kick, just like any other addictive substance and makes staying healthy an obsession.