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2,327,900
The role of inflammation in driving left ventricular remodeling in a pre-HFpEF model.
The incidence of HFpEF continues to increase and ∼2/3 of the patient population are post-menopausal women. Unfortunately, most studies focus on the use of male animal models of remodeling. In this study, however, using female rats to set a model of pre-HFpEF, we provide insights to possible mechanisms that contribute to HFpEF development in humans that will lead us to a better understanding of the underlying pathophysiology of HFpEF.
2,327,901
Cell Progeny in the Olfactory Bulb After Targeting Specific Progenitors with Different UbC-StarTrack Approaches.
The large phenotypic variation in the olfactory bulb may be related to heterogeneity in the progenitor cells. Accordingly, the progeny of subventricular zone (SVZ) progenitor cells that are destined for the olfactory bulb is of particular interest, specifically as there are many facets of these progenitors and their molecular profiles remain unknown. Using modified StarTrack genetic tracing strategies, specific SVZ progenitor cells were targeted in E12 mice embryos, and the cell fate of these neural progenitors was determined in the adult olfactory bulb. This study defined the distribution and the phenotypic diversity of olfactory bulb interneurons from specific SVZ-progenitor cells, focusing on their spatial pallial origin, heterogeneity, and genetic profile.
2,327,902
ATRT of lateral ventricle in a child: A Rare Tumor at a Very Rare Location.
Atypical teratoid/rhabdoid tumors (AT/RTs) of infancy are highly malignant central nervous system neoplasms that are most commonly seen during the first 2 years of life with limited therapeutic options. To date, only two cases have been described in the lateral ventricle. A 4-year-old boy presented with a 4-month history of increased intracranial pressure. Cerebral magnetic resonance imaging (MRI) revealed a huge intraventricular tumor, occupying the entire temporal horn and the body of the left lateral ventricle. The boy was operated through a left temporal transventricular approach with gross total removal of the lesion. The histopathological diagnosis was an AT/RT. The infant underwent adjuvant chemotherapy and radiation therapy. The 1-year MRI of control showed a local recurrence of the tumor. Then after, Gamma Knife radiosurgery was performed because of the small volume and the deep location of the lesion. At the 3-month follow-up, the MRI showed a significant growth of the tumor volume, and the child was given additional adjuvant chemotherapy. Unfortunately, he died 9 months later. AT/RT of the lateral ventricle is a very rare tumor in children, associated with a poor prognosis in spite of multimodal treatment. Gamma knife surgery (GKS) was rarely reported as a treatment modality of AT/RT. The aim of this work is to discuss about the rarity of this tumor and the best treatment strategy to improve prognosis.
2,327,903
Cervicomedullary Ependymoma with Hemorrhage: A Case Report and Review of Literature.
Ependymoma is a rare tumor central nervous system that arises from the ependymal lining of the ventricles or the central canal of the spinal cord. They are of neuroectodermal in origin and constitute about 30%-86% of tumors arising in the spinal cord. The occurrence of these tumors in the cervicomedullary region is very rare. Sudden symptomatic neurologic presentations due to hemorrhage in cervicomedullary ependymoma is very rare and so far have never been reported. Mostly presenting as neurologic deficits involving limbs, these tumors pose a technical challenge in their removal. We present a patient who presented with sudden-onset dysesthesia of the upper and lower limbs. On imaging, he was found to have a cystic medullary tumor extending to the cervical region with hemorrhage. We discuss the epidemiology, surgical challenges, and outcome along with review of literature of these rare tumors located in this precarious location.
2,327,904
Evaluation of the Evan's and Bicaudate Index for Rural Population in Central India using Computed Tomography.
Evans index (EI) and Bicaudate index (BCI) are practical markers of ventricular volume and are helpful radiological markers in the diagnosis of normal pressure hydrocephalus. Worldwide, variation exists in normative studies for both these indices. Most of the studies conducted for EI and BCI are based on the Western population data. No study has been performed on the rural population of Central India. The purpose of this study is to develop normative data on EI and BCI that can be extrapolated for future reference.</AbstractText>This was a retrospective study conducted from December 2018 to May 2019 in MGIMS Hospital, Sevagram, Maharashtra, India, which is a rural hospital in Central India. All patients with either a head injury or neurological complaints although with normal computed tomography (CT) brain were included in the study. Patients with diagnosed neurological disorder, clinical features suggesting hydrocephalus, or intracranial pathology on CT brain were excluded from the study. Five hundred and eleven patients were selected for this study, and EI and BCI was calculated for them.</AbstractText>The mean value of EI and BCI in our study was 0.2707 and 0.1121, respectively. Both indices showed a statistically significant difference between males and females. The value of both indices increased with age.</AbstractText>Although our study is in agreement with the cutoff value of EI to diagnose dilated lateral ventricles as 0.3 for age &lt;70 years, cutoff value of EI for the older population should be reconsidered to 0.34.</AbstractText>Copyright: &#xa9; 2020 Asian Journal of Neurosurgery.</CopyrightInformation>
2,327,905
Freehand Insertion of External Ventricular Drainage Catheter: Evaluation of Accuracy in a Single Center.
External ventricular drain (EVD) placement is the gold standard for managing acute hydrocephalus. Freehand EVD, using surface anatomical landmarks, is performed for ventricular cannulation due to its simplicity and efficiency. This study evaluates accuracy and reason(s) for misplacements as few studies have analyzed the accuracy of freehand EVD insertion.</AbstractText>Preoperative and postoperative computed tomography scans of patients who underwent EVD insertion in 2014 were retrospectively reviewed. Diagnosis, Evans ratio, midline shift, position of burr hole, length of the catheter, and procedural complications were tabulated. The procedures were classified as satisfactory (catheter tip in the frontal horn ipsilateral lateral ventricle) and unsatisfactory. Unsatisfactory cases were further analyzed in relation to position of burr hole from midline and length of the catheter.</AbstractText>Seventy-seven EVD placements in seventy patients were evaluated. The mean age of the patients was 57.5 years. About 83.1% were satisfactory placements and 11.7% were unsatisfactory in the contralateral ventricle, corpus callosum, and interhemispheric fissure. Nearly 5.2% were in extraventricular locations. Almost 2.6% EVD placements were complicated by hemorrhage and 1 catheter was reinserted. Suboptimal placements were significantly associated with longer intracranial catheter length. The mean length was 66.54 &#xb1; 10.1 mm in unsatisfactory placements compared to 58.32 &#xb1; 4.85 mm in satisfactory placements. Between the two groups, no significant difference was observed in Evans ratio, midline shift, surgeon's experience, distance of burr hole from midline, and coronal suture.</AbstractText>Freehand EVD insertion is safe and accurate. In small number of cases, unsatisfactory placement is related to longer catheter length.</AbstractText>Copyright: &#xa9; 2020 Asian Journal of Neurosurgery.</CopyrightInformation>
2,327,906
Loss of Asb2 Impairs Cardiomyocyte Differentiation and Leads to Congenital Double Outlet Right Ventricle.
Defining the pathways that control cardiac development facilitates understanding the pathogenesis of congenital heart disease. Herein, we identify enrichment of a Cullin5&#xa0;Ub ligase key subunit, Asb2, in myocardial progenitors and differentiated cardiomyocytes. Using two conditional murine knockouts, Nkx<sup>+/Cre</sup>.Asb2<sup>fl/fl</sup> and AHF-Cre.Asb2<sup>fl/fl</sup>, and tissue clarifying technique, we reveal Asb2 requirement for embryonic survival and complete heart looping. Deletion of Asb2 results in upregulation of its target Filamin A (Flna), and concurrent Flna deletion partially rescues embryonic lethality. Conditional AHF-Cre.Asb2 knockouts harboring one Flna allele have double outlet right ventricle (DORV), which is rescued by biallelic Flna excision. Transcriptomic and immunofluorescence analyses identify Tgf&#x3b2;/Smad as downstream targets of Asb2/Flna. Finally, using CRISPR/Cas9 genome editing, we demonstrate Asb2 requirement for human cardiomyocyte differentiation suggesting a conserved mechanism between mice and humans. Collectively, our study provides deeper mechanistic understanding of the role of the ubiquitin proteasome system in cardiac development and suggests a previously unidentified murine model for DORV.
2,327,907
Neurons in Subcortical Oculomotor Regions Are Vulnerable to Plasma Membrane Damage after Repetitive Diffuse Traumatic Brain Injury in Swine.
Oculomotor deficits, such as insufficiencies in accommodation, convergence, and saccades, are common following traumatic brain injury (TBI). Previous studies in patients with mild TBI attributed these deficits to insufficient activation of subcortical oculomotor nuclei, although the exact mechanism is unknown. A possible cause for neuronal dysfunction in these regions is biomechanically induced plasma membrane permeability. We used our established porcine model of head rotational TBI to investigate whether cell permeability changes occurred in subcortical oculomotor areas following single or repetitive TBI, with repetitive injuries separated by 15&#x2009;min, 3 days, or 7 days. Swine were subjected to sham conditions or head rotational acceleration in the sagittal plane using a HYGE pneumatic actuator. Two hours prior to the final injury, the cell-impermeant dye Lucifer Yellow was injected into the ventricles to diffuse throughout the interstitial space to assess plasmalemmal permeability. Animals were sacrificed 15&#x2009;min after the final injury for immunohistological analysis. Brain regions examined for cell membrane permeability included caudate, substantia nigra pars reticulata, superior colliculus, and cranial nerve oculomotor nuclei. We found that the distribution of permeabilized neurons varied depending on the number and spacing of injuries. Repetitive injuries separated by 15&#x2009;min or 3 days resulted in the most permeability. Many permeabilized cells lost neuron-specific nuclear protein reactivity, although no neuronal loss occurred acutely after injury. Microglia contacted and appeared to begin phagocytosing permeabilized neurons in repetitively injured animals. These pathologies within oculomotor areas may mediate transient dysfunction and/or degeneration that may contribute to oculomotor deficits following diffuse TBI.
2,327,908
Percutaneous Catheter Thrombus Aspiration of Right Renal Infarction Caused by Left Ventricular Thrombi due to Takotsubo Cardiomyopathy.
Takotsubo cardiomyopathy (TC) is a temporal dysfunction of the left ventricle (LV) due to psychological or physiological stress; however, it rarely causes LV thrombus. We report a case of a 49-year-old woman who developed LV thrombi due to TC despite anticoagulation therapy. The thrombi caused acute systemic infarction, with the most severe occlusion being in the right renal artery. The patient underwent percutaneous catheter aspiration thrombectomy of the right renal artery and her renal function recovered shortly after. The results of this case suggest that catheter aspiration thrombectomy is effective in the treatment of thromboembolism in TC.
2,327,909
Novel variants in AP4B1 cause spastic tetraplegia, moderate psychomotor development delay and febrile seizures in a Chinese patient: a case report.
The AP4B1 gene encodes a subunit of adaptor protein complex-4 (AP4), a component of intracellular transportation of proteins which plays important roles in neurons. Bi-allelic mutations in AP4B1 cause autosomal recessive spastic paraplegia-47(SPG47).</AbstractText>Here we present a Chinese patient with spastic tetraplegia, moderate psychomotor development delay and febrile seizures plus. Brain MRIs showed dilated supratentorial ventricle, thin posterior and splenium part of corpus callosum. The patient had little progress through medical treatments and rehabilitating regimens. Whole exome sequencing identified novel compound heterozygous truncating variants c.1207C&#x2009;&gt;&#x2009;T (p.Gln403*) and c.52_53delAC (p.Cys18Glnfs*7) in AP4B1 gene. Causal mutations in AP4B1 have been reported in 29 individuals from 22 families so far, most of which are homozygous mutations.</AbstractText>Our study enriched the genetic and phenotypic spectrum of SPG47. Early discovery, diagnosis and proper treatment on the conditions generally increase chances of improvement on the quality of life for patients.</AbstractText>
2,327,910
ATP- and voltage-dependent electro-metabolic signaling regulates blood flow in heart.
Local control of blood flow in the heart is important yet poorly understood. Here we show that ATP-sensitive K<sup>+</sup> channels (K<sub>ATP</sub>), hugely abundant in cardiac ventricular myocytes, sense the local myocyte metabolic state and communicate a negative feedback signal-correction upstream electrically. This electro-metabolic voltage signal is transmitted instantaneously to cellular elements in the neighboring microvascular network through gap junctions, where it regulates contractile pericytes and smooth muscle cells and thus blood flow. As myocyte ATP is consumed in excess of production, [ATP]<sub>i</sub> decreases to increase the openings of K<sub>ATP</sub> channels, which biases the electrically active myocytes in the hyperpolarization (negative) direction. This change leads to relative hyperpolarization of the electrically connected cells that include capillary endothelial cells, pericytes, and vascular smooth muscle cells. Such hyperpolarization decreases pericyte and vascular smooth muscle [Ca<sup>2+</sup>]<sub>i</sub> levels, thereby relaxing the contractile cells to increase local blood flow and delivery of nutrients to the local cardiac myocytes and to augment ATP production by their mitochondria. Our findings demonstrate the pivotal roles of local cardiac myocyte metabolism and K<sub>ATP</sub> channels and the minor role of inward rectifier K<sup>+</sup> (Kir2.1) channels in regulating blood flow in the heart. These findings establish a conceptually new framework for understanding the hugely reliable and incredibly robust local electro-metabolic microvascular regulation of blood flow in heart.
2,327,911
From the wax cast of brain ventricles (1508-9) by Leonardo da Vinci to air cast ventriculography (1918) by Walter E. Dandy.
The mold of the human cerebral ventricles produced in 1918 by Walter E. Dandy had an experimental precedent, a wax cast of ox ventricles made four hundred years earlier (1508-9) by Leonardo da Vinci (1452-1519). This paper is an homage to the epitome of Renaissance and polymath Leonard da Vinci, as well as to Walter Edward Dandy (1886-1946) who developed the ventriculography (1918) and pneumoencephalography (1919) techniques. Pneumoencephalography was applied broadly up to the late 1970s, when it was replaced by less invasive and more accurate neuroimaging techniques.
2,327,912
High-resolution optoacoustic imaging of tissue responses to vascular-targeted therapies.
The monitoring of vascular-targeted therapies using magnetic resonance imaging, computed tomography or ultrasound is limited by their insufficient spatial resolution. Here, by taking advantage of the intrinsic optical properties of haemoglobin, we show that raster-scanning optoacoustic mesoscopy (RSOM) provides high-resolution images of the tumour vasculature and of the surrounding tissue, and that the detection of a wide range of ultrasound bandwidths enables the distinction of vessels of differing size, providing detailed insights into the vascular responses to vascular-targeted therapy. Using RSOM to examine the responses to vascular-targeted photodynamic therapy in mice with subcutaneous xenografts, we observed a substantial and immediate occlusion of the tumour vessels followed by haemorrhage within the tissue and the eventual collapse of the entire vasculature. Using dual-wavelength RSOM, which distinguishes oxyhaemoglobin from deoxyhaemoglobin, we observed an increase in oxygenation of the entire tumour volume immediately after the application of the therapy, and a second wave of oxygen reperfusion approximately 24&#x2009;h thereafter. We also show that RSOM enables the quantification of differences in neoangiogenesis that predict treatment efficacy.
2,327,913
Zygomatic-Meatal Perpendicular Projection Lines: Bony Landmarks for Early Identification of the Temporal Horn of the Lateral Ventricle.
Localization of the temporal horn of the lateral ventricle (TH) may be required during temporal lobe and ambient cistern surgery. Most available anatomic landmarks for TH localization are based on adjacent cortical landmarks that are inherently variable or subtle. This study aimed to localize the anterior tip of the TH relative to adjacent bony landmarks.</AbstractText>The TH was exposed on 21 sides of 11 cadaveric heads via removal of the middle temporal gyrus. Two lines were defined: (1) a perpendicular line to the zygomatic arch projected from the anterior concavity of the posterior zygomatic root (line A), and (2) a parallel line passing through the anterosuperior corner of the external auditory canal (line B). Sagittal distances from lines A and B to a parallel line passing through the anterior recess of the TH (line H) were measured.</AbstractText>Mean (standard deviation) distances from lines A and B to line H were 13.3 (2.5) mm and 11.9 (2.2) mm, respectively. Line H was at 53% (8%) of the line A-line B interval measured from line A. The best way to search for the TH was to start approximately 15 mm posterior to line A and progress posteriorly such that a more posteriorly located TH tip would not be missed.</AbstractText>The zygomatic-meatal landmark is a reliable tool to localize TH during various approaches. It is independent from the approach trajectory. This landmark may be used as an ancillary tool in conjunction with other cortical landmarks and image guidance.</AbstractText>Copyright &#xa9; 2020 Elsevier Inc. All rights reserved.</CopyrightInformation>
2,327,914
A case of primary central nervous system lymphoma presenting as a shunt complication.
The authors describe an 82-year-old female with a right frontal ventriculoperitoneal (VP) shunt for long-standing normal pressure hydrocephalus (NPH) who presented with worsening incontinence and gait instability. She was found to have right lateral ventricle collapse around the shunt catheter and subsequently underwent shunt revision, which failed to improve her symptoms. Magnetic resonance imaging (MRI) was obtained on postoperative day two, which demonstrated a ventricular lesion. Endoscopic brain biopsy was performed and a diagnosis of primary central nervous system lymphoma (PCNSL) was made. The authors believe this is the first published case of PCNSL presenting as a VP shunt complication in a patient with NPH.
2,327,915
Design of a Fully Integrated Inductive Coupling System: A Discrete Approach Towards Sensing Ventricular Pressure.
In this paper, an alternative strategy for the design of a bidirectional inductive power transfer (IPT) module, intended for the continuous monitoring of cardiac pressure, is presented. This new integrated implantable medical device (IMD) was designed including a precise ventricular pressure sensor, where the available implanting room is restricted to a 1.8 &#xd7; 1.8 cm<sup>2</sup> area. This work considers a robust magnetic coupling between an external reading coil and the implantable module: a three-dimensional inductor and a touch mode capacitive pressure sensor (TMCPS) set. In this approach, the coupling modules were modelled as RCL circuits tuned at a 13.56 MHz frequency. The analytical design was validated by means of Comsol Multiphysics, CoventorWare, and ANSYS HFSS software tools. A power transmission efficiency (PTE) of 94% was achieved through a 3.5 cm-thick biological tissue, based on high magnitudes for the inductance (L) and quality factor (Q) components. A specific absorption rate (SAR) of less than 1.6 W/Kg was attained, which suggests that this IPT system can be implemented in a safe way, according to IEEE C95.1 safety guidelines. The set of inductor and capacitor integrated arrays were designed over a very thin polyimide film, where the 3D coil was 18 mm in diameter and approximately 50% reduced in size, considering any conventional counterpart. Finally, this new approach for the IMD was under development using low-cost thin film manufacturing technologies for flexible electronics. Meanwhile, as an alternative test, this novel system was fabricated using a discrete printed circuit board (PCB) approach, where preliminary electromagnetic characterization demonstrates the viability of this bidirectional IPT design.
2,327,916
[Analysis of misdiagnosis causes of suprasellar arachnoid cysts].
<b>Objective:</b> To investigate the causes of misdiagnosis of suprasellar arachnoid cysts, analyze its characteristics and put forward the diagnostic basis and differential points. <b>Methods:</b> The clinical data fo 97 cases of suprasellar arachnoid cysts diagnosed and treated in the neurosurgery department of Beijing Tiantan Hospital and Hebei General Hospital from March 2015 to March 2019 were analyzed retrospectively. All patients underwent CT and MRI scans with obstructive hydrocephalus. 13 cases were misdiagnosed, including 7 males and 6 females. First visit age 1-31 years old, with an average age of 6.3 years. There were 10 patients younger than 6 years old. The remaining 15-year-old patients, 31-year-old patients and 26-year-old patients each have one case. 11 cases were misdiagnosed as obstructive hydrocephalus, 2 cases as cystic craniopharyngioma. <b>Results:</b> 13 cases were misdiagnosed and mistreated, 11 cases were treated with intraventricular and abdominal shunt, 9 cases were treated with neuroendoscopy and recovered well. One cases of intracranial hematomas underwent craniotomy again, the hematomas were removed again and the bone slise were decompressed. One case had fissured stable after shunt. There were no operative deaths and no complications in this group. After endoscopic reoperation, CT and/or MRI scans showed that the ventricle narrowed in varying degrees, some of them returned to normal size and the flow of cerebrospinal fluid (cerebrospinal fluid) was unobstruct at the end of magnetic resonance cerebrospinal fluid angiography (MRI) fistula after endoscopic reoperation. <b>Conclusions:</b> The incidence of suprasellar arachnoid cysts is low, it is rare in clinic and it is easy to misdiagnose and mistreate. At present, it is recognized that the best treatment methods are partial resection of endoscope cyst wall, cyst ventricle fistula and third ventricle floor fisthla.</Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Qu</LastName><ForeName>Z</ForeName><Initials>Z</Initials><AffiliationInfo><Affiliation>Department of Neurosurgery, 1st Hospital of Shijiazhuang City, Shijiazhuang 050011, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zong</LastName><ForeName>X Y</ForeName><Initials>XY</Initials><AffiliationInfo><Affiliation>Department of Neurosurgery, Beijing Tiantan Hospital, Beijing 100070, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Li</LastName><ForeName>J H</ForeName><Initials>JH</Initials><AffiliationInfo><Affiliation>Department of Neurosurgery, 1st Hospital of Shijiazhuang City, Shijiazhuang 050011, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Qian</LastName><ForeName>T</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Neurosurgery, Hebei Genral Hospital, Shijiazhuang 050051, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ni</LastName><ForeName>H T</ForeName><Initials>HT</Initials><AffiliationInfo><Affiliation>Department of Neurosurgery, Hebei Genral Hospital, Shijiazhuang 050051, China.</Affiliation></AffiliationInfo></Author></AuthorList><Language>chi</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>China</Country><MedlineTA>Zhonghua Yi Xue Za Zhi</MedlineTA><NlmUniqueID>7511141</NlmUniqueID><ISSNLinking>0376-2491</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016080" MajorTopicYN="Y">Arachnoid Cysts</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002648" MajorTopicYN="N">Child</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002675" MajorTopicYN="N">Child, Preschool</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003951" MajorTopicYN="N">Diagnostic Errors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007223" MajorTopicYN="N">Infant</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008279" MajorTopicYN="N">Magnetic Resonance Imaging</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D044583" MajorTopicYN="Y">Neuroendoscopy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010911" MajorTopicYN="Y">Pituitary Neoplasms</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList><OtherAbstract Type="Publisher" Language="chi"><b>&#x76ee;&#x7684;&#xff1a;</b> &#x63a2;&#x8ba8;&#x978d;&#x4e0a;&#x6c60;&#x56ca;&#x80bf;&#x7684;&#x8bef;&#x8bca;&#x539f;&#x56e0;&#xff0c;&#x5206;&#x6790;&#x8bef;&#x8bca;&#x75c5;&#x4f8b;&#x7684;&#x4e34;&#x5e8a;&#x7279;&#x70b9;&#x3001;&#x8bca;&#x65ad;&#x4f9d;&#x636e;&#x548c;&#x9274;&#x522b;&#x8981;&#x70b9;&#x3002; <b>&#x65b9;&#x6cd5;&#xff1a;</b> &#x56de;&#x987e;&#x5206;&#x6790;&#x4e86;2015&#x5e74;3&#x6708;&#x81f3;2019&#x5e74;3&#x6708;&#xff0c;&#x9996;&#x90fd;&#x533b;&#x79d1;&#x5927;&#x5b66;&#x9644;&#x5c5e;&#x5317;&#x4eac;&#x5929;&#x575b;&#x533b;&#x9662;&#x795e;&#x7ecf;&#x5916;&#x79d1;&#x548c;&#x6cb3;&#x5317;&#x7701;&#x4eba;&#x6c11;&#x533b;&#x9662;&#x795e;&#x7ecf;&#x5916;&#x79d1;&#x8bca;&#x6cbb;97&#x4f8b;&#x978d;&#x4e0a;&#x6c60;&#x86db;&#x7f51;&#x819c;&#x56ca;&#x80bf;&#x4e34;&#x5e8a;&#x8d44;&#x6599;&#xff0c;&#x6240;&#x6709;&#x60a3;&#x8005;&#x5747;&#x884c;CT&#x548c;MRI&#x626b;&#x63cf;&#xff0c;&#x5747;&#x4f34;&#x6709;&#x6897;&#x963b;&#x6027;&#x8111;&#x79ef;&#x6c34;&#x3002;97&#x4f8b;&#x4e2d;13&#x4f8b;&#x53d1;&#x751f;&#x8bef;&#x8bca;&#x8bef;&#x6cbb;&#xff0c;&#x5176;&#x4e2d;&#x7537;7&#x4f8b;&#xff0c;&#x5973;6&#x4f8b;&#xff0c;&#x521d;&#x6b21;&#x5c31;&#x8bca;&#x5e74;&#x9f84;1~31&#xff08;6.3&#xff09;&#x5c81;&#xff0c;6&#x5c81;&#x4ee5;&#x4e0b;10&#x4f8b;&#xff0c;15&#x5c81;1&#x4f8b;&#xff0c;31&#x5c81;1&#x4f8b;&#xff0c;26&#x5c81;1&#x4f8b;&#xff0c;&#x8bef;&#x8bca;&#x4e3a;&#x6897;&#x963b;&#x6027;&#x8111;&#x79ef;&#x6c34;11&#x4f8b;&#xff0c;&#x8bef;&#x8bca;&#x4e3a;&#x56ca;&#x6027;&#x9885;&#x54bd;&#x7ba1;&#x7624;2&#x4f8b;&#x3002; <b>&#x7ed3;&#x679c;&#xff1a;</b> 13&#x4f8b;&#x4e2d;11&#x4f8b;&#x884c;&#x8111;&#x5ba4;&#x8179;&#x8154;&#x5206;&#x6d41;&#x672f;&#xff0c;9&#x4f8b;&#x65e0;&#x6548;&#x518d;&#x6b21;&#x884c;&#x795e;&#x7ecf;&#x5185;&#x955c;&#x6cbb;&#x7597;&#xff0c;&#x540c;&#x65f6;&#x53bb;&#x6389;&#x5206;&#x6d41;&#x7ba1;&#xff0c;&#x6062;&#x590d;&#x826f;&#x597d;&#xff0c;1&#x4f8b;&#x5206;&#x6d41;&#x672f;&#x53d1;&#x751f;&#x9885;&#x5185;&#x8840;&#x80bf;&#x518d;&#x6b21;&#x5f00;&#x9885;&#x6e05;&#x9664;&#x8840;&#x80bf;&#x5e76;&#x53bb;&#x9aa8;&#x7247;&#x51cf;&#x538b;&#xff0c;1&#x4f8b;&#x5206;&#x6d41;&#x540e;&#x53d1;&#x751f;&#x88c2;&#x9699;&#x8111;&#x5ba4;&#xff0c;&#x7ed9;&#x4fdd;&#x5b88;&#x89c2;&#x5bdf;&#xff0c;2&#x4f8b;&#x5f00;&#x9885;&#x624b;&#x672f;&#x5207;&#x9664;&#x75c5;&#x4f8b;&#x7a33;&#x5b9a;&#x3002;&#x672c;&#x7ec4;&#x75c5;&#x4f8b;&#x65e0;&#x624b;&#x672f;&#x6b7b;&#x4ea1;&#x8005;&#xff0c;&#x65e0;&#x5e76;&#x53d1;&#x75c7;&#x53d1;&#x751f;&#x3002;&#x5185;&#x955c;&#x518d;&#x6b21;&#x624b;&#x672f;&#x540e;&#x75c5;&#x4f8b;&#xff0c;CT&#x548c;&#xff08;&#x6216;&#xff09;MRI&#x626b;&#x63cf;&#x793a;&#x8111;&#x5ba4;&#x6709;&#x4e0d;&#x540c;&#x7a0b;&#x5ea6;&#x7f29;&#x5c0f;&#xff0c;&#x90e8;&#x5206;&#x6062;&#x590d;&#x6b63;&#x5e38;&#x5927;&#x5c0f;&#xff0c;&#x624b;&#x672f;&#x540e;&#x78c1;&#x5171;&#x632f;&#x8111;&#x810a;&#x6db2;&#x9020;&#x5f71;&#x9020;&#x7618;&#x53e3;&#x5904;&#x8111;&#x810a;&#x6db2;&#x6d41;&#x52a8;&#x901a;&#x7545;&#x3002; <b>&#x7ed3;&#x8bba;&#xff1a;</b> &#x978d;&#x4e0a;&#x6c60;&#x86db;&#x7f51;&#x819c;&#x56ca;&#x80bf;&#x53d1;&#x75c5;&#x7387;&#x4f4e;&#xff0c;&#x4e34;&#x5e8a;&#x4e0a;&#x5c11;&#x89c1;&#xff0c;&#x6613;&#x8bef;&#x8bca;&#x8bef;&#x6cbb;&#x3002;&#x76ee;&#x524d;&#x516c;&#x8ba4;&#x6700;&#x4f73;&#x6cbb;&#x7597;&#x65b9;&#x6cd5;&#x662f;&#x795e;&#x7ecf;&#x5185;&#x955c;&#x56ca;&#x80bf;&#x58c1;&#x90e8;&#x5206;&#x5207;&#x9664;&#x3001;&#x56ca;&#x80bf;&#x8111;&#x5ba4;&#x9020;&#x7618;&#x548c;&#x4e09;&#x8111;&#x5ba4;&#x5e95;&#x9020;&#x7618;&#x672f;&#x3002;.
2,327,917
Subcortical Brain Volume Abnormalities in Individuals With an At-risk Mental State.
Previous structural magnetic resonance imaging studies of psychotic disorders have demonstrated volumetric alterations in subcortical (ie, the basal ganglia, thalamus) and temporolimbic structures, which are involved in high-order cognition and emotional regulation. However, it remains unclear whether individuals at high risk for psychotic disorders with minimal confounding effects of medication exhibit volumetric changes in these regions. This multicenter magnetic resonance imaging study assessed regional volumes of the thalamus, caudate, putamen, nucleus accumbens, globus pallidus, hippocampus, and amygdala, as well as lateral ventricular volume using FreeSurfer software in 107 individuals with an at-risk mental state (ARMS) (of whom 21 [19.6%] later developed psychosis during clinical follow-up [mean = 4.9 years, SD = 2.6 years]) and 104 age- and gender-matched healthy controls recruited at 4 different sites. ARMS individuals as a whole demonstrated significantly larger volumes for the left caudate and bilateral lateral ventricles as well as a smaller volume for the right accumbens compared with controls. In male subjects only, the left globus pallidus was significantly larger in ARMS individuals. The ARMS group was also characterized by left-greater-than-right asymmetries of the lateral ventricle and caudate nucleus. There was no significant difference in the regional volumes between ARMS groups with and without later psychosis onset. The present study suggested that significant volume expansion of the lateral ventricle, caudate, and globus pallidus, as well as volume reduction of the accumbens, in ARMS subjects, which could not be explained only by medication effects, might be related to general vulnerability to psychopathology.
2,327,918
Respiratory pattern and phrenic and hypoglossal nerve activity during normoxia and hypoxia in 6-OHDA-induced bilateral model of Parkinson's disease.
Respiratory disturbances present in Parkinson's disease (PD) are not well understood. Thus, studies in animal models aimed to link brain dopamine (DA) deficits with respiratory impairment are needed. Adult Wistar rats were lesioned with injection of 6-hydroxydopamine (6-OHDA) into the third cerebral ventricle. Two weeks after hypoxic test was performed in whole-body plethysmography chamber, phrenic (PHR) and hypoglossal (HG) nerve activities were recorded in normoxic and hypoxic conditions in anesthetized, vagotomized, paralyzed and mechanically ventilated rats. The effects of activation and blockade of dopaminergic carotid body receptors were investigated during normoxia in anesthetized spontaneously breathing rats. 6-OHDA injection affected resting respiratory pattern in awake animals: an increase in tidal volume and a decrease in respiratory rate had no effect on minute ventilation. Hypoxia magnified the amplitude and minute activity of the PHR and HG nerve of 6-OHDA rats. The ratio of pre-inspiratory to inspiratory HG burst amplitude was reduced in normoxic breathing. Yet, the ratio of pre-inspiratory time to total time of the respiratory cycle was increased during normoxia. 6-OHDA lesion had no impact on DA and domperidone effects on the respiratory pattern, which indicate that peripheral DA receptors are not affected in this model. Analysis of monoamines confirmed substantial striatal depletion of dopamine, serotonin and noradrenaline (NA) and reduction of NA content in the brainstem. In bilateral 6-OHDA model changes in activity of both nerves: HG (linked with increased apnea episodes) and PHR are present. Demonstrated respiratory effects could be related to specific depletion of DA and NA.
2,327,919
The Impact of Diabetic Conditions and AGE/RAGE Signaling on Cardiac Fibroblast Migration.
Diabetic individuals have an increased risk for developing cardiovascular disease due to stiffening of the left ventricle (LV), which is thought to occur, in part, by increased AGE/RAGE signaling inducing fibroblast differentiation. Advanced glycated end-products (AGEs) accumulate within the body over time, and under hyperglycemic conditions, the formation and accumulation of AGEs is accelerated. AGEs exert their effect by binding to their receptor (RAGE) and can induce myofibroblast differentiation, leading to increased cell migration. Previous studies have focused on fibroblast migration during wound healing, in which diabetics have impaired fibroblast migration compared to healthy individuals. However, the impact of diabetic conditions as well as AGE/RAGE signaling has not been extensively studied in cardiac fibroblasts. Therefore, the goal of this study was to determine how the AGE/RAGE signaling pathway impacts cell migration in non-diabetic and diabetic cardiac fibroblasts. Cardiac fibroblasts were isolated from non-diabetic and diabetic mice with and without functional RAGE and used to perform a migration assay. Cardiac fibroblasts were plated on plastic, non-diabetic, or diabetic collagen, and when confluency was reached, a line of migration was generated by scratching the plate and followed by treatment with pharmacological agents that modify AGE/RAGE signaling. Modification of the AGE/RAGE signaling cascade was done with ERK1/2 and PKC-&#x3b6; inhibitors as well as treatment with exogenous AGEs. Diabetic fibroblasts displayed an increase in migration compared to non-diabetic fibroblasts whereas inhibiting the AGE/RAGE signaling pathway resulted in a significant increase in migration. The results indicate that the AGE/RAGE signaling cascade causes a decrease in cardiac fibroblast migration and altering the pathway will produce alterations in cardiac fibroblast migration.
2,327,920
Spontaneous trans-anal extrusion of caudally migrated ventriculo-peritoneal shunt tip in a child: a case report.
Bowel perforation caused by the ventriculo-peritoneal shunt is a rare occurrence with an estimated incidence rate of 0.1% to 1.0% among all cases of VP shunt displacement. This is an unusual report of spontaneous trans-anal extrusion of caudally migrated ventriculo-peritoneal shunt tip in a child. Literature was reviewed to find out therapeutic strategies.</AbstractText>An asymptomatic 8&#x2009;months old boy presented with spontaneous trans-anal extrusion of caudally migrated left-sided Chhabra type of ventriculo-peritoneal (VP) shunt for last 1&#x2009;day, following surgery for hydrocephalus initially done 3&#x2009;months ago. He had no features of peritonitis or encephalitis. Digital X-ray of the whole abdomen in postero-anterior view in erect posture was only evident of the expulsion of radio-opaque distal catheter tip through the anus into the exterior. Noncontrast-enhanced computed tomography scan (NCCT) of brain showed proximal catheter in the lateral ventricle of the brain. Under sedation, the distal part of the VP shunt catheter was resected out, aseptically, over the abdomen and pulled out gently through the anus. The proximal catheter part along with the reservoir was removed through a separate incision in the neck and sent for bacteriological study, which came out later to be negative. Postoperatively, the child was put on a prophylactic antibiotic and 3&#x2009;weeks later another VP shunt was placed in the contralateral side.</AbstractText>Spontaneous trans-anal extrusion of VP shunt tip is a surgical emergency. The whole catheter must be removed aseptically in such a way that both contamination of the cerebral cavity and spillage into the peritoneum can be avoided. Awareness of this unusual complication among surgeons is needed for early recognition, management, and timely intervention to minimize morbidity.</AbstractText>
2,327,921
Syringomyelia in Patient with Concurrent Posttraumatic Hydrocephalus and Tethered Spinal Cord: Implications for Surgical Management.
Posttraumatic syringomyelia is a significant source of disability following spinal cord injury (SCI). Despite this, its etiology and optimal treatment remain controversial. Early identification of and intervention at a presyrinx state may halt progression. Here, we present a unique case illustrating the continuum between presyrinx and syrinx in an adult following severe distraction cervical SCI and traumatic brain injury, resulting in both tethered spinal cord and posttraumatic hydrocephalus and subsequent isolated fourth ventricle. The interplay between these etiologic factors and their therapeutic implications are discussed.</AbstractText>A 48-year-old female developed rapidly progressive cervical spinal cord edema and hydromyelia almost 6 months after severe SCI and traumatic brain injury, with an initial Glasgow Coma Scale score of 3. Imaging demonstrated both ventral tethering of her cord at the site of injury (C5/6), as well as a trapped fourth ventricle following lateral ventricular shunting for posttraumatic hydrocephalus, with diminished flow of cerebrospinal fluid at the craniocervical junction. Additional shunting of the fourth ventricle led to significant clinical improvement and dramatic radiologic regression of her cord abnormality.</AbstractText>Cognizance of the possible presence of multiple etiologic contributors to posttraumatic syringomyelia and an intricate understanding of their interplay are crucial to the optimal management of this complex pathology.</AbstractText>Copyright &#xa9; 2020 Elsevier Inc. All rights reserved.</CopyrightInformation>
2,327,922
Inflammation in acquired hydrocephalus: pathogenic mechanisms and therapeutic targets.
Hydrocephalus is the most common neurosurgical disorder worldwide and is characterized by enlargement of the cerebrospinal fluid (CSF)-filled brain ventricles resulting from failed CSF homeostasis. Since the 1840s, physicians have observed inflammation in the brain and the CSF spaces in both posthaemorrhagic hydrocephalus (PHH) and postinfectious hydrocephalus (PIH). Reparative inflammation is an important protective response that eliminates foreign organisms, damaged cells and physical irritants; however, inappropriately triggered or sustained inflammation can respectively initiate or propagate disease. Recent data have begun to uncover the molecular mechanisms by which inflammation - driven by Toll-like receptor 4-regulated cytokines, immune cells and signalling pathways - contributes to the pathogenesis of hydrocephalus. We propose that therapeutic approaches that target inflammatory mediators in both PHH and PIH could address the multiple drivers of disease, including choroid plexus CSF hypersecretion, ependymal denudation, and damage and scarring of intraventricular and parenchymal (glia-lymphatic) CSF pathways. Here, we review the evidence for a prominent role of inflammation in the pathogenic mechanism of PHH and PIH and highlight promising targets for therapeutic intervention. Focusing research efforts on inflammation could shift our view of hydrocephalus from that of a lifelong neurosurgical disorder to that of a preventable neuroinflammatory condition.
2,327,923
Guidewire Entrapped in the Right Ventricle: A Rare Complication of Hemodialysis Catheter Insertion.
<b>How to cite this article:</b> Verma A, Chitransh V, Jaiswal S, Vishen A, Sheikh WR, Haldar M, <i>et al.</i> Guidewire Entrapped in the Right Ventricle: A Rare Complication of Hemodialysis Catheter Insertion. Indian J Crit Care Med 2020;24(1):80-81.
2,327,924
Intracerebellar Hemorrhage in a Young Adult.
A 28-year-old male was admitted with a history of sudden onset headache, multiple episodes of vomiting, gait disturbance with swaying toward right side, and blurring of vision for 2 days. The patient was conscious, cooperative, and oriented, and his vitals were normal. Bilateral gaze-evoked nystagmus was present. Motor and sensory examinations were within normal limit, and deep tendon reflexes were 2+ in all four limbs. Cerebellar examination reveals positive finger-nose test and dysdiadochokinesia on right side. A computed tomography of head showed acute intraparenchymal hemorrhage in right cerebellar hemisphere with effacement of fourth ventricle and mild hydrocephalus. Computed tomography angiography of cerebral vessels was normal. The coagulation profile (international normalized ratio: 1.02), renal function test, and liver function tests were within normal limit. Urine toxicology screen was positive for tetrahydrocannabinoid. The patient was diagnosed with right cerebellar bleed and cannabis abuse. The patient managed conservatively with intravenous mannitol and was discharged in hemodynamic stable condition.</AbstractText>Pannu AK, Saroch A, Sharma N. Intracerebellar Hemorrhage in a Young Adult. Indian J Crit Care Med 2020;24(1):69-70.</AbstractText>Copyright &#xa9; 2020; Jaypee Brothers Medical Publishers (P) Ltd.</CopyrightInformation>
2,327,925
Comparison Between Transcortical and Interhemispheric Approaches to the Atrium of Lateral Ventricle Using Combined White Matter Fiber Dissections and Magnetic Resonance Tractography.
The objective of this study was to compare transcortical and posterior interhemispheric approaches to the atrium using a combined approach of white matter fiber dissections and magnetic resonance (MR) tractography.</AbstractText>Ten cerebral hemispheres were examined and dissected from the lateral-to-medial surface and from the medial-to-lateral surface, with special attention to the white matter tracts related to the atrium. MR tractography was used to show the relationship of three-dimensional white matter fibers with the atrium of the lateral ventricle and to compare with cadaveric dissection results.</AbstractText>The atrium was related laterally to the superior longitudinal fasciculus II and III, middle longitudinal fasciculus, arcuate fasciculus, vertical occipital fasciculus, and sagittal stratum. Medially, it is related to the superior longitudinal fasciculus I, cingulum, sledge runner, and forceps major.</AbstractText>A combined approach of cadaveric white matter fiber dissections and MR tractography were used to describe the main white matter tracts related to the posterior interhemispheric approach and the transcortical approach, providing an in-depth understanding of the three-dimensional anatomy of white matter fibers and the atrium. In the present study, among approaches examined, the posterior interhemispheric parasplenial transprecuneus approach placed fewer eloquent tracts at risk; however, traversing the sledge runner and the forceps major is unavoidable by this approach.</AbstractText>Copyright &#xa9; 2020 Elsevier Inc. All rights reserved.</CopyrightInformation>
2,327,926
Lymphatic endothelial cells promote T lymphocyte migration into lymph nodes under hyperlipidemic conditions.
Lymphatic vessels serve as conduits through which immune cells traffic. Because lymphatic vessels are also involved in lipid transport, their function is vulnerable to abnormal metabolic conditions such as obesity and hyperlipidemia. Exactly how these conditions impact immune cell trafficking, however, is not well understood. Here, we found higher numbers of LYVE-1-positive lymphatic endothelial cells and CD3-positive T cells in the lymph nodes of mice fed high-cholesterol or high-fat diets compared with those of mice fed a normal chow diet. To confirm the effect of fat content on immune cell trafficking, the lymphatic endothelial SVEC4-10&#xa0;cell line was treated with palmitic acid at a 100&#xa0;&#x3bc;M concentration. After 24&#xa0;h, palmitic acid-treated cells exhibited increased expression of podoplanin and vascular growth-associated molecules (VEGFC, VEGFD, VEGFR3, and NRP2) and enhanced tube formation. Microarray analysis showed an increase in pro-inflammatory cytokine and chemokine transcription after palmitic acid treatment. Finally, transwell migration assay confirmed that T cell line moved toward medium previously cultured with palmitic acid-treated SVEC4-10&#xa0;cells. Together, our results suggest that hyperlipidemia drives lymphatic vessel remodeling and T cell migration toward lymphatic endothelial cells.
2,327,927
Familial intracranial ependymoma mimicking an extra-lesion: A case report and review of the literature.
Familial occurrence of intracranial ependymoma, in the absence of neurofibromatosis type 2 (NF2), is very rare with only a few cases reported in the literature. We report a 62-year-old man, who presented with a posterior fossa ependymoma with the majority of the lesion in the cerebellopontine angle, mimicking an extra-axial tumour. His two brothers also had 4th ventricular ependymomas requiring surgical resection. Such cases add weight to the suggestion of a genetically predisposing mutation in familial cases of intracranial ependymomas. Further genetic testing may help to elucidate the location of the genetic abnormality in patients with non-NF2 familial intracranial ependymomas and promote a better understanding of this rare pathological entity.
2,327,928
Endoscopic approach and stereotactic radiosurgery for a posterior third ventricular Central Neurocytoma - case report and literature review.
Central Neurocytomas (CN) are a rare intracranial tumour, most often arising in the lateral ventricles and presenting with obstructive hydrocephalus. Isolated lesions in the third ventricle are uncommon. We present the fourth reported case of posterior third ventricular CN successfully managed surgically via endoscopy, allowing for concurrent biopsy and therapeutic endoscopic third ventriculostomy (ETV). Stereotactic radiosurgery was administered for the residual lesion. A brief review of CNs and previous similar cases is also provided.</AbstractText>A 58-year-old male presented with progressive decline in cognition and gait. Subsequent Magnetic Resonance Imaging revealed obstructive hydrocephalus secondary to a posterior third ventricular lesion. An endoscopic biopsy and concurrent cerebrospinal fluid diversion by ETV was performed. Pathological analysis was consistent with a CN with positivity to Synaptophysin. MIB-1 proliferation index was 1%. There was good clinical recovery, and the patient underwent adjuvant stereotactic radiosurgery 1.5 months post-surgery.</AbstractText>Due to the rarity of CNs arising from the third ventricle, there are only three previous reports of these approached endoscopically. Such a technique allows for good visualisation of the lesion, and therapeutic ETV to relieve obstructive hydrocephalus. This case supports this approach as a valid, minimally invasive option. Additionally, this is the first case to report the MIB-1 proliferation index, contributing to future outcome evaluation of endoscopic approaches to typical (MIB-1 &lt; = 2%) verses atypical (MIB-1 &gt; 2%) CNs.</AbstractText>Endoscopic biopsy with concurrent ETV and adjuvant stereotactic radiosurgery is a valid treatment option for deep seated isolated small posterior third ventricular CNs.</AbstractText>Copyright &#xa9; 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.</CopyrightInformation>
2,327,929
[Effect of electroacupuncture on silent information regulator 1, fork head transcription factor O1 and proopiomelanocortin in the hypothalamus of rats with obesity induced by high-fat diet].
To investigate the effect of electroacupuncture (EA) on silent information regulator 1 (SIRT1), forkhead transcription factor O1 (FoxO1), and proopiomelanocortin (POMC) in the hypothalamus of rats with high-fat diet-induced obesity (DIO), as well as the mechanism of EA in regulating central appetite peptides to help lose weight.</AbstractText>Male Wistar rats were randomly divided into normal group, model group, EA group, EA&#xff0b;inhibitor group, inhibitor group, and sham-operation group, with 10 rats in each group. High-fat diet was used to establish a rat model of DIO. The rats in the EA group and EA&#xff0b;inhibitor group were given EA at "Fenglong" (ST40), "Zhongwan "(CV12)&#xff0c;"Guanyuan "(CV4), and"Zusanli" (ST36) with continuous wave at a frequency of 2 Hz and an intensity of 1 mA, for 10 minutes each time. The rats in the EA&#xff0b;inhibitor group and inhibitor group were given tube placement in the third ventricle and injection of the specific SIRT1 antagonist EX-527. The rats in the sham-operation group were given tube placement in the third ventricle and injection of artificial cerebrospinal fluid. The above treatment was given 3 times a week for 8 weeks in total. Body weight, food intake, and Lee's index were observed before and after treatment. An automatic biochemical analyzer was used to measure the serum levels of total cholesterol (TC), triglyceride (TG), and free fatty acid (FFA), and Western blot was used to measure the protein expression of SIRT1, FoxO1, acetylated FoxO1(AC-FoxO1), and POMC in the hypothalamus.</AbstractText>Before treatment, the model group, the EA group, the EA&#xff0b;inhibitor group, the inhibitor group, and the sham-operation group had significantly higher body weight and food intake than the normal group (P</i>&lt;0.01), and the model group and the sham-operation group had a significantly higher Lee's index than the normal group (P</i>&lt;0.05). Compared with the model group after treatment, the EA group and the EA&#xff0b;inhibitor group had significant reductions in body weight, food intake, TC, and the protein expression of AC-FoxO1 (P</i>&lt;0.01, P</i>&lt;0.05) and significant increases in the protein expression of SIRT1, FoxO1 and POMC (P</i>&lt;0.01, P</i>&lt;0.05); the EA group had significant reductions in Lee's index and the levels of TG, FFA(P</i>&lt;0.05&#xff0c;P</i>&lt;0.01)&#xff1b;the inhibitor group had significant increases in food intake, the serum levels of TC, TG, FFA(P</i>&lt;0.01) and significant reductions in the protein expression of SIRT1, FoxO1 and POMC (P</i>&lt;0.01&#xff0c;P</i>&lt;0.05). Compared with the EA group, the EA&#xff0b;inhibitor group and the inhibitor group had significant increases in body weight, food intake, Lee's index, the levels of TG, FFA and the protein expression of AC-FoxO1 (P</i>&lt;0.01, P</i>&lt;0.05) and significant reductions in the protein expression of SIRT1, FoxO1 and POMC (P</i>&lt;0.01); the inhibitor group had significant increases in the serum levels of TC (P</i>&lt;0.01). Compared with the EA&#xff0b;inhibitor group, the inhibitor group had significant increases in body weight, food intake, the serum levels of TC, TG, FFA, and the protein expression of AC-FoxO1 (P</i>&lt;0.01), as well as significant reductions in the protein expression of SIRT1, FoxO1 and POMC (P</i>&lt;0.01).</AbstractText>In rats with DIO, EA can effectively up-regulate the expression of SIRT1 in the hypothalamus, exert a deacetylation effect on FoxO1, and promote the expression of the downstream appetite-inhibiting peptide POMC, which may be one of the mechanisms of EA to help lose weight by regulating central appetite peptides in the obesity model.</AbstractText>
2,327,930
Aborting a neurosurgical procedure: analyzing the decision factors, with endoscopic third ventriculostomy as a model.
Aborting a neurosurgical procedure is a situation in which the surgeon modifies the original surgical plan and decides to stop a procedure without achieving the pre-operative goal. While adhering to predefined goals is important, intra-operative judgment, especially in terms of adjusting the risk/benefit ratio in response to real-time data, may change the balance and lead, in selective scenarios, to aborting of a procedure. The literature regarding aborting a surgical procedure is sparse, with no objective guidelines on when, and how, to make such a decision. Defining "when to abort" is difficult and is influenced by many factors, including unexpected intraoperative findings, the surgeon's surgical experience and perspective, and the patient and family perspective. Aborting a procedure is a decision that must be ultimately determined by the surgical findings and the individual treatment alternatives. The aim of this paper is to discuss the condition of aborting a neurosurgical procedure, using the relatively common endoscopic third ventriculostomy (ETV) as a model procedure prototype.
2,327,931
Intrathecal drug delivery in the era of nanomedicine.
Administration of substances directly into the cerebrospinal fluid (CSF) that surrounds the brain and spinal cord is one approach that can circumvent the blood-brain barrier to enable drug delivery to the central nervous system (CNS). However, molecules that have been administered by intrathecal injection, which includes intraventricular, intracisternal, or lumbar locations, encounter new barriers within the subarachnoid space. These barriers include relatively high rates of turnover as CSF clears and potentially inadequate delivery to tissue or cellular targets. Nanomedicine could offer a solution. In contrast to the fate of freely administered drugs, nanomedicine systems can navigate the subarachnoid space to sustain delivery of therapeutic molecules, genes, and imaging agents within the CNS. Some evidence suggests that certain nanomedicine agents can reach the parenchyma following intrathecal administration. Here, we will address the preclinical and clinical use of intrathecal nanomedicine, including nanoparticles, microparticles, dendrimers, micelles, liposomes, polyplexes, and other colloidalal materials that function to alter the distribution of molecules in tissue. Our review forms a foundational understanding of drug delivery to the CSF that can be built upon to better engineer nanomedicine for intrathecal treatment of disease.
2,327,932
What have we learnt 50 years after the first Fontan procedure?<Pagination><StartPage>349</StartPage><EndPage>358</EndPage><MedlinePgn>349-358</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.2459/JCM.0000000000000951</ELocationID><Abstract><AbstractText>The Fontan procedure is often the only definitive palliative surgical option for patients with a variety of complex CHD sharing in common, a single, dominant ventricle. In recent decades, imaging and therapeutic improvement have played a crucial role in those patients in whom many complications can hamper their life. After 50 years from the first procedure, heart transplantation remains the only definitive treatment for those with a failing Fontan circulation.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Gargiulo</LastName><ForeName>Gaetano D</ForeName><Initials>GD</Initials><AffiliationInfo><Affiliation>Pediatric Cardiac Surgery and GUCH Unit, University of Bologna, S.Orsola-Malpighi Hospital Bologna, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bassareo</LastName><ForeName>Pier P</ForeName><Initials>PP</Initials><AffiliationInfo><Affiliation>University College of Dublin, Mater Misericordiae University Hospital and Our Lady's Children's Hospital Crumlin, Dublin, Republic of Ireland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Careddu</LastName><ForeName>Lucio</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Pediatric Cardiac Surgery and GUCH Unit, University of Bologna, S.Orsola-Malpighi Hospital Bologna, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Egidy-Assenza</LastName><ForeName>Gabriele</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Pediatric Cardiac Surgery and GUCH Unit, University of Bologna, S.Orsola-Malpighi Hospital Bologna, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Angeli</LastName><ForeName>Emanuela</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Pediatric Cardiac Surgery and GUCH Unit, University of Bologna, S.Orsola-Malpighi Hospital Bologna, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Calcaterra</LastName><ForeName>Giuseppe</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>University of Palermo, Palermo, Italy.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016456">Historical Article</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Cardiovasc Med (Hagerstown)</MedlineTA><NlmUniqueID>101259752</NlmUniqueID><ISSNLinking>1558-2027</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D004059" MajorTopicYN="N">Diffusion of Innovation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018729" MajorTopicYN="Y">Fontan Procedure</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000266" MajorTopicYN="N">history</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016027" MajorTopicYN="N">Heart Transplantation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006352" MajorTopicYN="N">Heart Ventricles</DescriptorName><QualifierName UI="Q000002" MajorTopicYN="N">abnormalities</QualifierName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006439" MajorTopicYN="N">Hemodynamics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D049673" MajorTopicYN="N">History, 20th Century</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D049674" MajorTopicYN="N">History, 21st Century</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D020127" MajorTopicYN="N">Recovery of Function</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017211" MajorTopicYN="N">Treatment Failure</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000080039" MajorTopicYN="N">Univentricular Heart</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName><QualifierName UI="Q000266" MajorTopicYN="N">history</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016276" MajorTopicYN="N">Ventricular Function</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>3</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>1</Month><Day>20</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>3</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32141975</ArticleId><ArticleId IdType="doi">10.2459/JCM.0000000000000951</ArticleId><ArticleId IdType="pii">01244665-202005000-00002</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>Fontan F, Baudet E. Surgical repair of tricuspid atresia. Thorax 1971; 26:240&#x2013;248.</Citation></Reference><Reference><Citation>O&#x2019;Leary PW. Prevalence, clinical presentation and natural history of patients with single ventricle. Prog Pediatr Cardiol 2002; 16:31&#x2013;38.</Citation></Reference><Reference><Citation>Mercuro G, Bassareo PP, Mariucci E, Deidda M, Zedda AM, Bonvicini M. Sex differences in congenital heart defects and genetically induced arrhythmias. J Cardiovasc Med 2014; 15:855&#x2013;863.</Citation></Reference><Reference><Citation>Gewillig M. The Fontan circulation. Heart 2005; 91:839&#x2013;846.</Citation></Reference><Reference><Citation>d&#x2019;Udekem Y, Iyengar A, Galati J, et al. Redefining expectations of long-term survival after the Fontan procedure: twenty-five years of follow-up from the entire population of Australia and New Zealand. Circulation 2014; 130: (11 Suppl 1): 32&#x2013;39.</Citation></Reference><Reference><Citation>Gewillig M, Goldberg DJ. 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Congenit Heart Dis 2019; 14:140&#x2013;146.</Citation></Reference></ReferenceList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="MEDLINE" Owner="NLM" IndexingMethod="Curated"><PMID Version="1">32141864</PMID><DateCompleted><Year>2020</Year><Month>06</Month><Day>19</Day></DateCompleted><DateRevised><Year>2020</Year><Month>06</Month><Day>19</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">1512-0112</ISSN><JournalIssue CitedMedium="Internet"><Issue>298</Issue><PubDate><Year>2020</Year><Month>Jan</Month></PubDate></JournalIssue><Title>Georgian medical news</Title><ISOAbbreviation>Georgian Med News</ISOAbbreviation></Journal>VENTRICULAR REPOLARIZATION MEASURES IN PROFESSIONAL AND AMATEUR ATHLETES WITH HIGH NORMAL ARTERIAL PRESSURE.
The Fontan procedure is often the only definitive palliative surgical option for patients with a variety of complex CHD sharing in common, a single, dominant ventricle. In recent decades, imaging and therapeutic improvement have played a crucial role in those patients in whom many complications can hamper their life. After 50 years from the first procedure, heart transplantation remains the only definitive treatment for those with a failing Fontan circulation.</Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Gargiulo</LastName><ForeName>Gaetano D</ForeName><Initials>GD</Initials><AffiliationInfo><Affiliation>Pediatric Cardiac Surgery and GUCH Unit, University of Bologna, S.Orsola-Malpighi Hospital Bologna, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bassareo</LastName><ForeName>Pier P</ForeName><Initials>PP</Initials><AffiliationInfo><Affiliation>University College of Dublin, Mater Misericordiae University Hospital and Our Lady's Children's Hospital Crumlin, Dublin, Republic of Ireland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Careddu</LastName><ForeName>Lucio</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Pediatric Cardiac Surgery and GUCH Unit, University of Bologna, S.Orsola-Malpighi Hospital Bologna, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Egidy-Assenza</LastName><ForeName>Gabriele</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Pediatric Cardiac Surgery and GUCH Unit, University of Bologna, S.Orsola-Malpighi Hospital Bologna, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Angeli</LastName><ForeName>Emanuela</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Pediatric Cardiac Surgery and GUCH Unit, University of Bologna, S.Orsola-Malpighi Hospital Bologna, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Calcaterra</LastName><ForeName>Giuseppe</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>University of Palermo, Palermo, Italy.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016456">Historical Article</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Cardiovasc Med (Hagerstown)</MedlineTA><NlmUniqueID>101259752</NlmUniqueID><ISSNLinking>1558-2027</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D004059" MajorTopicYN="N">Diffusion of Innovation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018729" MajorTopicYN="Y">Fontan Procedure</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000266" MajorTopicYN="N">history</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016027" MajorTopicYN="N">Heart Transplantation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006352" MajorTopicYN="N">Heart Ventricles</DescriptorName><QualifierName UI="Q000002" MajorTopicYN="N">abnormalities</QualifierName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006439" MajorTopicYN="N">Hemodynamics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D049673" MajorTopicYN="N">History, 20th Century</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D049674" MajorTopicYN="N">History, 21st Century</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D020127" MajorTopicYN="N">Recovery of Function</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017211" MajorTopicYN="N">Treatment Failure</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000080039" MajorTopicYN="N">Univentricular Heart</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName><QualifierName UI="Q000266" MajorTopicYN="N">history</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016276" MajorTopicYN="N">Ventricular Function</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>3</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>1</Month><Day>20</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>3</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32141975</ArticleId><ArticleId IdType="doi">10.2459/JCM.0000000000000951</ArticleId><ArticleId IdType="pii">01244665-202005000-00002</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>Fontan F, Baudet E. 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BMC Cardiovasc Disord 2013; 13:36.</Citation></Reference><Reference><Citation>Senzaki H, Masutani S, Kobayashi J, et al. Ventricular afterload and ventricular work in Fontan circulation: comparison with normal two-ventricle circulation and single-ventricle circulation with blalock-taussig shunts. Circulation 2002; 105:2885&#x2013;2892.</Citation></Reference><Reference><Citation>van Melle JP, Wolff D, H&#xf6;rer J, et al. Surgical options after Fontan failure. Heart 2016; 102:1127&#x2013;1133.</Citation></Reference><Reference><Citation>Gewillig M, Brown SC. The Fontan circulation after 45 years: update in physiology. Heart 2016; 102:1081&#x2013;1086.</Citation></Reference><Reference><Citation>Bassareo PP, Marras AR, Mercuro G. Twenty-four-hour ambulatory blood pressure monitoring in the follow-up of the univentricular heart after Fontan repair. Blood Press Monit 2012; 17:243&#x2013;247.</Citation></Reference><Reference><Citation>Iyengar AJ. Right ventricular morphology is associated with mortality at all stages of single ventricle palliation. World J Pediatr Congenit Heart Surg 2019; 10:424&#x2013;425.</Citation></Reference><Reference><Citation>Takken T, Tacken MH, Blank AC, Hulzebos EH, Strengers JL, Helders PJ. Exercise limitation in patients with Fontan circulation: a review. J Cardiovasc Med 2007; 8:775&#x2013;781.</Citation></Reference><Reference><Citation>Szabo&#x2019; G, B&#xe4;hrle S. Contractility-afterload mismatch after the Fontan operation. Cardiol Young 2005; 15 (S3):S35&#x2013;S38.</Citation></Reference><Reference><Citation>Gewillig M, Brown SC, van de Bruaene A, Rychick J. Providing a framework of principles for conceptualizing the Fontan circulation. Acta Paediatr 2019; 00:1&#x2013;8.</Citation></Reference><Reference><Citation>Mair DD, Puga FJ, Danielson GK. Late functional status of survivors of the Fontan procedure performed during the 1970s. Circulation 1992; 86: (5 Suppl): 106&#x2013;109.</Citation></Reference><Reference><Citation>Saouti N, Westerhof N, Postmus PE, Vonk-Noordegraaf A. The arterial load in pulmonary hypertension. Eur Respir Rev 2010; 19:197&#x2013;203.</Citation></Reference><Reference><Citation>Presson RG Jr, Baumgartner WA Jr, Peterson AJ, Glenny RW, Wagner WW Jr. Pulmonary capillaries are recruited during pulsatile flow. J Appl Physiol 2002; 92:1183&#x2013;1190.</Citation></Reference><Reference><Citation>Gewillig M, Brown SC, Heying R, et al. Volume load paradox while preparing for the Fontan: not too much for the ventricle, not too little for the lungs. Interact Cardiovasc Thorac Surg 2010; 10:262&#x2013;265.</Citation></Reference><Reference><Citation>Ridderbos FJ, Wolff D, Timmer A, et al. Adverse pulmonary vascular remodeling in the Fontan circulation. J Heart Lung Transplant 2015; 34:404&#x2013;413.</Citation></Reference><Reference><Citation>Henaine R, Vergnat M, Bacha EA, et al. Effects of lack of pulsatility on pulmonary endothelial function in the Fontan circulation. J Thorac Cardiovasc Surg 2013; 146:522&#x2013;529.</Citation></Reference><Reference><Citation>Daniels CJ, Bradley EA, Landzberg MJ, et al. Fontan-associated liver disease: proceedings from the American College of Cardiology stakeholders meeting, October 1 to 2, 2015, Washington DC. J Am Coll Cardiol 2017; 70:3173&#x2013;3194.</Citation></Reference><Reference><Citation>Rathgeber SL, Guttman OR, Lee AF, et al. Fontan-associated liver disease: spectrum of disease in children and adolescents. J Am Heart Ass 2020; 9:e012529.</Citation></Reference><Reference><Citation>Assenza GE, Graham DA, Landzberg MJ, et al. MELD-XI score and cardiac mortality or transplantation in patients after Fontan surgery. Heart 2013; 99:491&#x2013;496.</Citation></Reference><Reference><Citation>Buend&#xed;a-Fuentes F, Melero-Ferrer JL, Plaza-L&#xf3;pez D, et al. Noninvasive liver assessment in adult patients with Fontan circulation using acoustic radiation force impulse elastography and hepatic magnetic resonance imaging. World J Pediatr Congenit Heart Surg 2018; 9:22&#x2013;30.</Citation></Reference><Reference><Citation>Ohuchi H, Negishi J, Hayama Y, Miyazaki A, Shiraishi I, Ichikawa H. Renal resistive index reflects Fontan pathophysiology and predicts mortality. Heart 2017; 103:1631&#x2013;1637.</Citation></Reference><Reference><Citation>Wilson TG, d&#x2019;Udekem Y, Winlaw DS, et al. Creatinine-based estimation of glomerular filtration rate in patients with a Fontan circulation. Congenit Heart Dis 2019; 14:454&#x2013;463.</Citation></Reference><Reference><Citation>Mohanakumar S, Telinius N, Kelly B, et al. Morphology and function of the lymphatic vasculature in patients with a Fontan circulation. Circ Cardiovasc Imaging 2019; 12:e008074.</Citation></Reference><Reference><Citation>Dori Y, Keller MS, Rome JJ, et al. Percutaneous lymphatic embolization of abnormal pulmonary lymphatic flow as treatment of plastic bronchitis in patients with congenital heart disease. Circulation 2016; 133:1160&#x2013;1170.</Citation></Reference><Reference><Citation>Eicken A, Sebening W, Genz T, et al. Site of coronary sinus drainage does not significantly affect coronary flow reserve in patients long term after Fontan operation. Pediatr Cardiol 2006; 27:102&#x2013;109.</Citation></Reference><Reference><Citation>Takahashi K, Cecchin F, Fortescue E, et al. Permanent atrial pacing lead implant route after Fontan operation. Pacing Clin Electrophysiol 2009; 32:779&#x2013;785.</Citation></Reference><Reference><Citation>Leoni L, Ferretto S, Hadas D, Maschietto N, Castaldi B, Milanesi O. Transvenous single-chamber ventricular pacemaker implantation via the left superior vena cava to a collateral of the coronary sinus in a Fontan patient. J Cardiovasc Med 2019; 20:621&#x2013;622.</Citation></Reference><Reference><Citation>Monagle P, Karl TR. Thromboembolic problems after the Fontan operation. Semin Thorac Cardiovasc Surg Annu 2002; 5:36&#x2013;47.</Citation></Reference><Reference><Citation>Driscoll DJ, Offord KP, Feldt RH, Schaff HV, Puga FJ, Danielson GK. Five-to fifteen-year follow-up after Fontan operation. Circulation 1992; 85:469&#x2013;496.</Citation></Reference><Reference><Citation>Zaki NC, Kelleman MS, James Parks W, Slesnick TC, McConnell ME, Oster ME. The utility of cardiac magnetic resonance imaging in post-Fontan surveillance. Congenit Heart Dis 2019; 14:140&#x2013;146.</Citation></Reference></ReferenceList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="MEDLINE" Owner="NLM" IndexingMethod="Curated"><PMID Version="1">32141864</PMID><DateCompleted><Year>2020</Year><Month>06</Month><Day>19</Day></DateCompleted><DateRevised><Year>2020</Year><Month>06</Month><Day>19</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">1512-0112</ISSN><JournalIssue CitedMedium="Internet"><Issue>298</Issue><PubDate><Year>2020</Year><Month>Jan</Month></PubDate></JournalIssue><Title>Georgian medical news</Title><ISOAbbreviation>Georgian Med News</ISOAbbreviation></Journal><ArticleTitle>VENTRICULAR REPOLARIZATION MEASURES IN PROFESSIONAL AND AMATEUR ATHLETES WITH HIGH NORMAL ARTERIAL PRESSURE.</ArticleTitle><Pagination><StartPage>123</StartPage><EndPage>128</EndPage><MedlinePgn>123-128</MedlinePgn></Pagination><Abstract>There is merely little data regarding changes in repolarization among professional athletes with prehypertension, especially in comparison with amateur athletes. It was previously shown that disturbances of repolarization may have an important role in the development of cardiac changes in athletes and be observed in a number of conditions, such as ventricular hypertrophy, channelopathies, and aortic aneurysm. Therefore, in this study, it has been aimed to compare the ventricular repolarization measures in professional and amateur athletes with high normal arterial pressure.Thirty professional and thirty amateur all-around track and field athletes were enrolled in this project. According to the level of sport activities and the presence of HNBP, all athletes were divided into 4 groups. The first group consisted of professional athletes with normal and optimal blood pressure (NOBP) values (&lt;130/80 mmHg, total of 21 persons), the second group was formed by 9 professional athletes with HNBP (&#x2265;130/85 mmHg), the following 3rd (17 persons) and 4th (13 persons) groups were composed by amateur athletes with the level of arterial blood pressure up to 130/85 mmHg and higher respectively. We have indicated that professional athletes with upper normal values of blood pressure have an extension of the TpTe interval compared to other groups of athletes, the average value of this indicator comprised 86 &#xb1; 10.94 ms, which, however, was below the dangerous level of &gt;100 ms. This group of people also showed an increase in the ratio of TpTe/QT values (p=0.001) in the absence of a significant difference in S-Tpc intervals (p=0.605). These changes indicate an increase in transmural dispersion of repolarization with the development of left ventricular remodeling of professional athletes with upper normal values of blood pressure. In order to establish a connection between the revealed features of repolarization and non-functional overreaching/overtraining and altered autonomic cardiovascular activity with sympathetic activation syndrome, other pathogenesis features, their clinical and prognostic value, further examinations are required.
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Three-Dimensionally Printed Microelectromechanical-System Hydrogel Valve for Communicating Hydrocephalus.
Hydrocephalus (HCP) is a chronic neurological brain disorder caused by a malfunction of the cerebrospinal fluid (CSF) drainage mechanism in the brain. The current standard method to treat HCP is a shunt system. Unfortunately, the shunt system suffers from complications including mechanical malfunctions, obstructions, infections, blockage, breakage, overdrainage, and/or underdrainage. Some of these complications may be attributed to the shunts' physically large and lengthy course making them susceptible to external forces, siphoning effects, and risks of infection. Additionally, intracranial catheters artificially traverse the brain and drain the ventricle rather than the subarachnoid space. We report a 3D-printed microelectromechanical system-based implantable valve to improve HCP treatment. This device provides an alternative approach targeting restoration of near-natural CSF dynamics by artificial arachnoid granulations (AGs), natural components for CSF drainage in the brain. The valve, made of hydrogel, aims to regulate the CSF flow between the subarachnoid space and the superior sagittal sinus, in essence, substituting for the obstructed arachnoid granulations. The valve, operating in a fully passive manner, utilizes the hydrogel swelling feature to create nonzero cracking pressure, <i>P</i><sub>T</sub> &#x2248; 47.4 &#xb1; 6.8 mmH<sub>2</sub>O, as well as minimize reverse flow leakage, <i>Q</i><sub>O</sub> &#x2248; 0.7 &#x3bc;L/min on benchtop experiments. The additional measurements performed in realistic experimental setups using a fixed sheep brain also deliver comparable results, <i>P</i><sub>T</sub> &#x2248; 113.0 &#xb1; 9.8 mmH<sub>2</sub>O and <i>Q</i><sub>O</sub> &#x2248; 3.7 &#x3bc;L/min. In automated loop functional tests, the valve maintains functionality for a maximum of 1536 cycles with the <i>P</i><sub>T</sub> variance of 44.5 mmH<sub>2</sub>O &lt; <i>P</i><sub>T</sub> &lt; 61.1 mmH<sub>2</sub>O and negligible average reverse flow leakage rates of &#x223c;0.3 &#x3bc;L/min.
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Macrophage-Derived Exosomal Mir-155&#xa0;Regulating Cardiomyocyte Pyroptosis and Hypertrophy in Uremic&#xa0;Cardiomyopathy.
miR-155 was synthesized and loaded into exosomes in increased infiltration of macrophages in a uremic heart.&#xa0;The released exosomal fusion with the plasma membrane leads to the release of miR-155 into the cytosol&#xa0;and translational repression of forkhead transcription factors of the O class (FoxO3a) in cardiomyocytes. Finally, macrophage-derived miR-155-containing exosomes promoted cardiomyocyte pyroptosis and uremic cardiomyopathy changes (cardiac hypertrophy and fibrosis) by directly targeting FoxO3a in uremic mice.
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Pulsatility Index Reflects Intracranial Pressure Better than Resistive Index in Patients with Clinical Features of Intracranial Hypertension.
<b>Background</b> &#x2003;The intracranial pressure (ICP) is measured through various noninvasive methods to overcome complications of invasive ICP monitoring. In this study, transcranial Doppler was used to measure pulsatility index (PI) and resistive index (RI) that were correlated with opening intraventricular ICP. The opening intraventricular ICP was measured with the placement of intraventricular catheter in lateral ventricle without loss of cerebrospinal fluid. <b>Methods</b> &#x2003;The prospective, observational study was conducted on 40 patients with clinical and radiological features of raised ICP who underwent either endoscopic third ventriculostomy or ventriculoperitoneal shunt surgery. The PI and RI were measured simultaneously with opening ICP measurements under general anesthesia. Both PI and RI were correlated with ICP by using Pearson correlation coefficient. The receiver operating characteristic (ROC) curve was used to get the optimal values of PI ad RI for corresponding ICP values. <b>Results</b> &#x2003;The mean PI was 1.01 &#xb1; 0.41 and mean RI was 0.59 &#xb1; 0.32. The mean opening ICP value was 21.81 &#xb1; 8.68 mm Hg. The correlation between PI and RI with ICP was a statistically significant with correlation coefficient of 0.697 and 0.503, respectively. The ROC curve shown statistically significant association between PI and ICP from 15 to 40 mm Hg, whereas the association between RI and ICP was from 15 to 25 mm Hg, with various sensitivity and specificity. <b>Conclusion</b> &#x2003;The opening intraventricular ICP correlated better with PI than RI in patients with features of raised ICP.
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Bedside Percutaneous Twist Drill Craniostomy of Chronic Subdural Hematoma-A Single-Center Study.
<b>Background</b> &#x2003;Chronic subdural hematoma (CSDH) is predominantly a disease of the elderly. <b>Objectives</b> &#x2003;This article studies the clinical and radiological outcomes in patients with CSDH who had undergone bedside percutaneous twist drill craniostomy (TDC). <b>Patients and Methods</b> &#x2003;A retrospective study was conducted in 80 patients who had undergone percutaneous TDC for CSDH between January 2017 and December 2018. Patients between 18 and 90 years of age were selected. CSDH showing computed tomography (CT) scan findings of homogeneous hypodensity, homogeneous isodensity, mixed density, and CSDH with hyperdense gravity-dependent fluid level were selected. CT evidence of multiple septations, recurrent CSDH, bilateral CSDH, and acute on CSDH were excluded. The presence of midline shift (MLS) was measured as any deviation of the septum pellucidum from the midline. The mass effect was determined by the effacement of the sulci, Sylvian fissure obscuration, or compression of lateral ventricles. Postoperative decrease in the signs and symptoms were considered as the postoperative clinical improvement. Improvement in the postoperative CT scan was determined by the decrease in the thickness of CSDH and absence of MLS with decrease in the mass effect. The presence of the CSDH with mass effect and MLS was considered as the significant residue in the postoperative CT scan. <b>Statistical Analysis</b> &#x2003;Statistical analysis is done using Epi Info software. <b>Results</b> &#x2003;The mean age range was 67.78 years &#xb1; 12.03 standard deviation (SD). There were 49 (61.25%) males and 31 (38.75%) females. Thirty-eight (47.5%) CSDHs were on the right side and 42 (52.5%) on the left side. The locations were in the frontotemporoparietal region in 91.25% patients and in the frontoparietal region in 8.75% patients. The mean duration of symptoms was 4.62 days &#xb1; 5.20 SD. History of trauma was present in 58.75% patients. The mean duration of trauma was 45.78 days &#xb1; 28.32 SD. The most common symptoms were weakness of the limbs (68.75%), altered sensorium or decreased memory (52.5%), and headache (32.5%). The preoperative Glasgow Coma Scale (GCS) score ranged from 4 to 15 (mean 12.86 &#xb1; 2.98 SD). Limb motor weakness was noted in 75% patients. The maximum thickness of the CSDH (in millimeter) in axial CT scan was 8 to 32 (mean 23.22 &#xb1; 4.87 SD). All of the 80 patients had MLS. Postoperative GCS ranged from 3 to 15 (mean 14.1 &#xb1; 2.78 SD). Postoperative power was improved in 95% of affected limbs. Postoperative power was deteriorated (including patients of complications and death) in 5% patients. Clinical improvement was noted in 93.75% patients. Postoperative CT scan improvement was noted in 95% patients. Two patients (2.5%) had significant residue which required reoperation. Two patients (2.5%) developed extradural hematoma which was operated. Five (6.25%) patients developed complications, among which 4 (5%) patients died. The mean duration of stay in the hospital was 6.82 days &#xb1; 4.16 SD. <b>Conclusions</b> &#x2003;CSDH is a disease of elderly population. CSDH is more common in male population. The most common symptom is weakness of the limbs. High clinical and radiological improvement can be achieved with TDC. TDC should be considered as a safe and effective alternative to burr hole craniostomy.
2,327,937
The efficacy of endoscopic third ventriculostomy in children 1 year of age or younger: A systematic review and meta-analysis.
Hydrocephalus is a major cause of morbidity in the pediatric population, with potentially severe consequences if left untreated. Two viable strategies for management of non-communicating hydrocephalus are endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunting. However, there is uncertainty over the safety and efficacy of ETV in younger infants aged 1 year or below. In this systematic review, we aim to elucidate the success rate and procedural risks of ETV in this age group.</AbstractText>A multi-database (PubMed, Embase, Web of Science) literature search between January 1990 and April 2018 was performed in accordance with PRISMA guidelines. Eligible studies were included if they (i) examined non-communicating hydrocephalus; (ii) quantified the success/failure rates of ETV; and (iii) assessed outcomes in children 1 year of age or younger.</AbstractText>A total of 19 articles with 399 patients were eligible for inclusion. Mean age at procedure was 4.2 months (range 34 weeks gestation to 12 months), with 116 females and 143 males. Commonest underlying aetiology was congenital aqueductal stenosis (AS) (60.4%). Remaining causes included post-haemorrhagic, post-infection, Chiari malformations, malignancies and others. Overall and AS mean success rates were 51.6% and 56.5% respectively. Overall complication rate was 10.0%, consisting mainly of CSF leak, infection, and haemorrhage. Younger age was significantly associated with poorer ETV success rate when divided into &lt;6 months and 6-12 months of age (44.4 vs 66.7%; p&#xa0;=&#xa0;0.0007). Underlying pathology had no significant association with ETV outcome when divided into AS and other pathologies (p&#xa0;=&#xa0;0.53).</AbstractText>Age is significantly associated with ETV success rates. Pathology-dependent effects were not found in this age group. Despite a lower ETV success rate at younger ages (44.4 vs 66.7%), it offers a comparable safety profile that is independent of age. ETV remains a viable treatment option for non-communicating hydrocephalus for infants aged 1 year or younger.</AbstractText>Copyright &#xa9; 2020 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.</CopyrightInformation>
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The initial resuscitation of septic shock.
Septic shock is the most severe form of sepsis, characterized by (a) persistent hypotension despite fluid resuscitation and (b) the presence of tissue hypoperfusion. Delays in the diagnosis and initiation of treatment of septic shock is associated with increasing risk for mortality. Early and effective fluid resuscitation and vasopressor administration play a crucial role in maintaining tissue perfusion in septic shock patients. A low diastolic arterial pressure (DAP) correlates with severity of arteriolar vasodilation, compromises left ventricle oxygen supply and can be used for identifying septic shock patients that would potentially benefit from earlier vasopressor therapy. Controversy currently exists as to the balance of fluids and vasopressors to maintain target mean arterial pressure. The aim of this article is to review the rationale for fluid resuscitation and vasopressor therapy and the importance of both mean and diastolic blood pressure during the initial resuscitation of the septic shock. We relate our personal prescription of balancing fluids and vasopressors in the resuscitation of septic shock.
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Calcifying Pseudoneoplasm of Neuraxis (CAPNON) in the Posterior Third Ventricle-Challenge for Neuroendoscopy.
We report the first case of a purely intraventricular calcifying pseudoneoplasm of neuraxis (CAPNON) in the posterior third ventricle.</AbstractText>A 63-year-old male without any previous medical history presented with Hakim triad. Imaging showed a calcified lesion of the posterior third ventricle with hydrocephalus. An endoscopic third ventriculostomy was performed. Endoscopic removal or debulking of the lesion was impossible due to its rock-hard consistency, and thus the procedure was aborted after biopsy.</AbstractText>When encountering such calcified lesions within the ventricular system, especially in proximity to eloquent regions, the decision making process should include the hard consistency and parenchymal adhesions as obstacles to neuroendoscopic removal. Even for biopsy, a higher morbidity rate compared with typical soft tumors should be assumed. Although data on intraventricular CAPNON is limited, biopsy of the lesion and treatment of associated hydrocephalus appear to be the primary neurosurgical goals, followed by imaging surveillance.</AbstractText>Copyright &#xa9; 2020 Elsevier Inc. All rights reserved.</CopyrightInformation>
2,327,940
A comparative study of the turnover of multiciliated cells in the mouse trachea, oviduct, and brain.
In mammals, multiciliated cells (MCCs) line the lumen of the trachea, oviduct, and brain ventricles, where they drive fluid flow across the epithelium. Each MCC population experiences vastly different local environments that may dictate differences in their lifetime and turnover rates. However, with the exception of MCCs in the trachea, the turnover rates of these multiciliated epithelial populations at extended time scales are not well described.</AbstractText>Here, using genetic lineage-labeling techniques we provide a direct comparison of turnover rates of MCCs in these three different tissues.</AbstractText>We find that oviduct turnover is similar to that in the airway (~6 months), while multiciliated ependymal cells turnover more slowly.</AbstractText>&#xa9; 2020 Wiley Periodicals, Inc.</CopyrightInformation>
2,327,941
One- vs Two-Burr-Hole Technique for Combined Endoscopic Third Ventriculostomy and Pineal Region Biopsy: Volumetric Analysis of Brain at Risk.
Pineal region tumors are associated with the ventricular system. Endoscopic third ventriculostomy (ETV) is often performed at the same time as tumor biopsy.</AbstractText>To investigate the volume of brain possibly undergoing injury and forniceal stretching during ETV and tumor biopsy.</AbstractText>We performed a retrospective review of preoperative magnetic resonance imagings (MRIs) and computed tomography (CTs) of patients with pineal region masses and used volumetric image-guided navigation to simulate a 1-burr-hole vs a 2-burr-hole approach through the brain parenchyma. We compared the volumes of parenchyma and fornix at the risk of injury.</AbstractText>The ideal entry point for ETV using 2 burr holes was a mean&#xa0;&#xb1;&#xa0;standard deviation (SD) of 25.8&#xa0;&#xb1;&#xa0;6 mm from the midline and 11.4&#xa0;&#xb1;&#xa0;9 mm behind the coronal suture. The ideal entry point using 2 burr holes for tumor biopsy was 25.7&#xa0;&#xb1;&#xa0;8 mm from the midline and 53.7&#xa0;&#xb1;&#xa0;14 mm anterior to the coronal suture. With 1 burr hole, the mean&#xa0;&#xb1;&#xa0;SD volume of brain parenchyma at risk was 852&#xa0;&#xb1;&#xa0;440 mm3. The volume of brain parenchyma at risk with 2 burr holes was 2159&#xa0;&#xb1;&#xa0;474 mm3 (P&#xa0;&lt;&#xa0;.001; paired t-test). The use of 1 burr hole predisposed the fornix to 14&#xa0;&#xb1;&#xa0;3 mm of possible stretch, which was minimized with the 2-burr-hole approach.</AbstractText>Using 1 burr hole for both the ETV and tumor biopsy is less likely to traumatize the brain parenchyma than using 2 burr holes. However, 1 burr hole predisposes the fornix to stretch injury. We recommend tailoring the entry to each patient according to their anatomy rather than using a 1-size-fits-all approach.</AbstractText>Copyright &#xa9; 2020 by the Congress of Neurological Surgeons.</CopyrightInformation>
2,327,942
Expanding Cyst of the Septum Pellucidum - Endoscopic Observations on the Mechanism of Development and Results of Treatment.
Cysts of the septum pellucidum (CSP) are usually asymptomatic; however, in some cases they can begin expanding and cause neurological deterioration. The mechanism leading to the formation of an expanding cyst of the septum pellucidum (ECSP) is not known. Based on observations made during endoscopic treatment of ECSP we analyzed intraoperative findings in respect to cyst formation mechanism and treatment prognosis. A group of 31 patients was studied. Only cases with bulging cyst walls occupying the frontal horns observed on imaging studies were included. The main symptom was a severe, intermittent headache. In three cases short term memory deficits were diagnosed. In one case papilloedema was observed. All patients underwent endoscopic fenestration of the ECSP. There were no cases of cyst reocclusion during a follow-up period of 1-14 years (mean 6.2 years). In 30 cases headaches resolved completely and in one case its intensity was significantly smaller. There was one case of postoperative hemiparesis. In all but two cases the thin, translucent region in the anterior part of the cyst floor was found. In the region small fissures and in three cases choroid plexus were observed. Endoscopic fenestration is the efficient treatment for ECSP. ECSP is formed on the basis of not completely closed, developmental communication of the cyst with other fluid spaces. The communication is opened by transient elevation of intraventricular pressure, and acts as a valve leading to fluid accumulation among the walls of the previously asymptomatic cavum septum pellucidum.
2,327,943
Dipping and rotating: two maneuvers to achieve maximum magnification during indirect transnasal laryngoscopy.
Since many years, office-based flexible transnasal laryngoscopy is a common routine procedure. The development of new technical equipment such as high-definition cameras and flexible tip-chip endoscopes nowadays allows for much more precise examination than a few years ago. In contrast to rigid laryngoscopy, it is possible to move the tip of the endoscope close to the vocal folds and to other structures of interest. Nevertheless, without professional handling of the equipment, one cannot benefit from the potential of the newest technology.</AbstractText>Two easily performed and very helpful maneuvers in flexible endoscopy are described. The "dipping maneuver" enables a maximum magnification of the mucosal surfaces of the endolarynx as well as the examination of the subglottal region and the trachea by positioning the tip of the endoscope very close to the vocal folds or even in the upper trachea during long transnasal inspiration. During the "rotation laryngoscopy", the tip of the endoscope is positioned in the posterior interarytenoid region by rotating the flexible endoscope by 180&#xb0; and advancing it close to the glottis. This allows a close-up examination of the anterior commissure, the inferior aspect of the vocal folds and the inside of the Morgagni's ventricle. Before performing transnasal flexible endoscopy, we routinely apply topical anesthesia sprayed intranasally.</AbstractText>The described techniques of flexible endoscopy are easily performed and allow a maximum magnification of the mucosal surfaces and otherwise not visible regions of the endolarynx.</AbstractText>
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JC Virus infected choroid plexus epithelial cells produce extracellular vesicles that infect glial cells independently of the virus attachment receptor.
The human polyomavirus, JCPyV, is the causative agent of progressive multifocal leukoencephalopathy (PML) in immunosuppressed and immunomodulated patients. Initial infection with JCPyV is common and the virus establishes a long-term persistent infection in the urogenital system of 50-70% of the human population worldwide. A major gap in the field is that we do not know how the virus traffics from the periphery to the brain to cause disease. Our recent discovery that human choroid plexus epithelial cells are fully susceptible to virus infection together with reports of JCPyV infection of choroid plexus in vivo has led us to hypothesize that the choroid plexus plays a fundamental role in this process. The choroid plexus is known to relay information between the blood and the brain by the release of extracellular vesicles. This is particularly important because human macroglia (oligodendrocytes and astrocytes), the major targets of virus infection in the central nervous system (CNS), do not express the known attachment receptors for the virus and do not bind virus in human tissue sections. In this report we show that JCPyV infected choroid plexus epithelial cells produce extracellular vesicles that contain JCPyV and readily transmit the infection to human glial cells. Transmission of the virus by extracellular vesicles is independent of the known virus attachment receptors and is not neutralized by antisera directed at the virus. We also show that extracellular vesicles containing virus are taken into target glial cells by both clathrin dependent endocytosis and macropinocytosis. Our data support the hypothesis that the choroid plexus plays a fundamental role in the dissemination of virus to brain parenchyma.
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Deregulated hypoxic response in myeloid cells: A model for high-altitude pulmonary oedema (HAPE).
High-altitude pulmonary oedema (HAPE) is a non-cardiogenic pulmonary oedema that can occur during rapid ascent to a high-altitude environment. Classically, HAPE has been described as a condition resulting from a combination of pulmonary vasoconstriction and hypertension. Inflammation has been described as important in HAPE, although as a side effect of pulmonary oedema rather than as a causative factor. In this study, we aim to understand the role of hypoxic response in myeloid cells and its involvement in pathogenesis of HAPE.</AbstractText>We have generated a conditional deletion in mice of the von Hippel-Lindau factor (VHL) in myeloid cells to determine the effect of a deregulated hypoxic response in pulmonary oedema.</AbstractText>The deletion of VHL in pulmonary myeloid cells gave rise to pulmonary oedema, increased pulmonary vascular permeability and reduced performance during exertion. These changes were accompanied by reduced stroke volume in the left ventricle.</AbstractText>In this model, we show that a deregulated myeloid cell hypoxic response can trigger some of the most important symptoms of HAPE, and thus mice with a deletion of VHL in the myeloid lineage can function as a model of HAPE.</AbstractText>&#xa9; 2020 The Authors. Acta Physiologica published by John Wiley &amp; Sons Ltd on behalf of Scandinavian Physiological Society.</CopyrightInformation>
2,327,946
Contralateral Ventriculostomy for Intraoperative Brain Relaxation in Supratentorial Brain Tumors.
CSF drainage from the ventricular system is a popular and effective technique for intraoperative brain relaxation as it reduces ICP, enlarges extra-axial operative corridors, and slackens the brain increasing its tolerance for surgical manipulation. However, sometimes when the ventricular chambers distant from the site of pathology are tapped, there is a risk of neurological worsening due to paradoxical herniation of the brain, exemplified by the phenomenon of upward transtentorial herniation observed in posterior fossa tumors, consequent to a supratentorial ventriculostomy. Expectation of an analogous phenomenon precludes contralateral ventricular drainage in supratentorial brain tumors producing midline shift, subfalcine herniation, and resultant distension of the opposite lateral ventricles.</AbstractText>Demonstrating the safety and efficacy of intraoperative contralateral ventricular drainage in the presence of sub-falcine herniation.</AbstractText>Clinical and imaging information were retrospectively collected for four cases in which this technique was adopted.</AbstractText>The first case was a large clinoidal meningioma with a midline shift and contralateral ventriculomegaly. EVD from the dilated ventricle provided optimum brain conditions for safe resection of the tumor through an orbitopterional approach. The second case required a contralateral EVD to reduce ICP intraoperatively, for a recurrent anaplastic ependymoma with severe mass effect. It reduced the venous hypertension related to raised ICP minimizing the blood loss. Contralateral EVD was utilized to enlarge the working corridor for interhemispheric approach in two cases.</AbstractText>Contralateral ventricular drainage is a safe, effective, and convenient operative step for reducing brain turgor in the presence of sub-falcine herniation produced by large supratentorial tumors.</AbstractText>
2,327,947
A novel nonsense mutation in the L1CAM gene responsible for X-linked congenital hydrocephalus.
Congenital hydrocephalus is a descriptive diagnosis of symptoms, that are present for numerous reasons, including chromosomal disorders, genetic mutations, intrauterine infection and hemorrhage, amongst other factors. Mutation of L1CAM gene is the most frequent cause of congenital hydrocephalus, contributing to approximately 30% of X-linked congenital hydrocephalus.</AbstractText>In the present study, we used whole-exome sequencing and Sanger sequencing to investigate an aborted male fetus present with severe congenital hydrocephalus at 24 weeks of gestation, whose mother had a history of two previous voluntary terminations of pregnancies as a result of hydrocephalus. Magnetic resonance imaging, an autopsy and electron microscopy were performed and the phenotypic changes were described.</AbstractText>Whole-exome sequencing in the fetus, as well as variant segregation analysis, revealed a novel maternally derived hemizygous nonsense mutation (c.2865G&gt;A; p. Y955*) in exon 21 of the L1CAM gene (NM_000425.4). Severe hydrocephalus was observed along with marked dilatation of lateral ventricles. An electron micrograph of the surface of lateral ventricle walls revealed a lack of ependymal cilia.</AbstractText>The present study suggests that L1CAM mutation screening should be considered for a male fetus with isolated hydrocephalus, especially with a family history, which could facilitate prenatal diagnosis in a subsequent pregnancy.</AbstractText>&#xa9; 2020 John Wiley &amp; Sons, Ltd.</CopyrightInformation>
2,327,948
A rare case of post-infarction right ventricular rupture.<Pagination><StartPage>107203</StartPage><MedlinePgn>107203</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.carpath.2020.107203</ELocationID><ELocationID EIdType="pii" ValidYN="Y">S1054-8807(20)30007-7</ELocationID><Abstract><AbstractText>A 62-year-old male patient was pronounced dead on admission to the tertiary care hospital. The victim had right ventricular STEMI three years ago. The autopsy showed pericardial tamponade due to the rupture of an acute myocardial infarction of the right ventricle.</AbstractText><CopyrightInformation>Copyright &#xa9; 2020 Elsevier Inc. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Dandeniya Arachchi</LastName><ForeName>Samadhi</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Forensic Medicine Department, Karapitiya Teaching Hospital, Galle, Sri Lanka. Electronic address: dahsamadhid@gmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ruwanpura</LastName><ForeName>Rohan</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Forensic Medicine Department, Karapitiya Teaching Hospital, Galle, Sri Lanka. Electronic address: rohanruwanpura@gmail.com.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>01</Month><Day>15</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Cardiovasc Pathol</MedlineTA><NlmUniqueID>9212060</NlmUniqueID><ISSNLinking>1054-8807</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D001344" MajorTopicYN="N">Autopsy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002305" MajorTopicYN="N">Cardiac Tamponade</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="Y">etiology</QualifierName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002423" MajorTopicYN="N">Cause of Death</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017809" MajorTopicYN="N">Fatal Outcome</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005355" MajorTopicYN="N">Fibrosis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006342" MajorTopicYN="N">Heart Rupture, Post-Infarction</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="Y">etiology</QualifierName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009206" MajorTopicYN="N">Myocardium</DescriptorName><QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D009336" MajorTopicYN="N">Necrosis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D020556" MajorTopicYN="N">Neutrophil Infiltration</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000072657" MajorTopicYN="N">ST Elevation Myocardial Infarction</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D013997" MajorTopicYN="N">Time Factors</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Acute myocardial infarction</Keyword><Keyword MajorTopicYN="N">Right ventricular rupture</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2019</Year><Month>10</Month><Day>14</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>1</Month><Day>7</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>1</Month><Day>9</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>3</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>7</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>3</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32126495</ArticleId><ArticleId IdType="doi">10.1016/j.carpath.2020.107203</ArticleId><ArticleId IdType="pii">S1054-8807(20)30007-7</ArticleId></ArticleIdList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">32126016</PMID><DateRevised><Year>2020</Year><Month>03</Month><Day>03</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1619-3997</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Mar</Month><Day>03</Day></PubDate></JournalIssue><Title>Journal of perinatal medicine</Title><ISOAbbreviation>J Perinat Med</ISOAbbreviation></Journal>Fetal brain development in small-for-gestational age (SGA) fetuses and normal controls.
A 62-year-old male patient was pronounced dead on admission to the tertiary care hospital. The victim had right ventricular STEMI three years ago. The autopsy showed pericardial tamponade due to the rupture of an acute myocardial infarction of the right ventricle.<CopyrightInformation>Copyright &#xa9; 2020 Elsevier Inc. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Dandeniya Arachchi</LastName><ForeName>Samadhi</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Forensic Medicine Department, Karapitiya Teaching Hospital, Galle, Sri Lanka. Electronic address: dahsamadhid@gmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ruwanpura</LastName><ForeName>Rohan</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Forensic Medicine Department, Karapitiya Teaching Hospital, Galle, Sri Lanka. Electronic address: rohanruwanpura@gmail.com.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>01</Month><Day>15</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Cardiovasc Pathol</MedlineTA><NlmUniqueID>9212060</NlmUniqueID><ISSNLinking>1054-8807</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D001344" MajorTopicYN="N">Autopsy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002305" MajorTopicYN="N">Cardiac Tamponade</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="Y">etiology</QualifierName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002423" MajorTopicYN="N">Cause of Death</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017809" MajorTopicYN="N">Fatal Outcome</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005355" MajorTopicYN="N">Fibrosis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006342" MajorTopicYN="N">Heart Rupture, Post-Infarction</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="Y">etiology</QualifierName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009206" MajorTopicYN="N">Myocardium</DescriptorName><QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D009336" MajorTopicYN="N">Necrosis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D020556" MajorTopicYN="N">Neutrophil Infiltration</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000072657" MajorTopicYN="N">ST Elevation Myocardial Infarction</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D013997" MajorTopicYN="N">Time Factors</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Acute myocardial infarction</Keyword><Keyword MajorTopicYN="N">Right ventricular rupture</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2019</Year><Month>10</Month><Day>14</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>1</Month><Day>7</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>1</Month><Day>9</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>3</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>7</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>3</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32126495</ArticleId><ArticleId IdType="doi">10.1016/j.carpath.2020.107203</ArticleId><ArticleId IdType="pii">S1054-8807(20)30007-7</ArticleId></ArticleIdList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">32126016</PMID><DateRevised><Year>2020</Year><Month>03</Month><Day>03</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1619-3997</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Mar</Month><Day>03</Day></PubDate></JournalIssue><Title>Journal of perinatal medicine</Title><ISOAbbreviation>J Perinat Med</ISOAbbreviation></Journal><ArticleTitle>Fetal brain development in small-for-gestational age (SGA) fetuses and normal controls.</ArticleTitle><ELocationID EIdType="pii" ValidYN="Y">/j/jpme.ahead-of-print/jpm-2019-0401/jpm-2019-0401.xml</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1515/jpm-2019-0401</ELocationID><Abstract>Objective To assess whether fetal brain structures routinely measured during the second and third trimester ultrasound scans, particularly the width of the cavum septi pellucidi (CSP), differ between fetuses small for gestational age (SGA), fetuses very small for gestational age (VSGA) and normal controls. Methods In this retrospective study, we examined standard ultrasound measurements of 116 VSGA, 131 SGA fetuses and 136 normal controls including the head circumference (HC), transversal diameter of the cerebellum (TCD), the sizes of the lateral ventricle (LV) and the cisterna magna (CM) from the second and third trimester ultrasound scans extracted from a clinical database. We measured the CSP in these archived ultrasound scans. The HC/CSP, HC/LV, HC/CM and HC/TCD ratios were calculated as relative values independent of the fetal size. Results The HC/CSP ratio differed notably between the controls and each of the other groups (VSGA P&#x2009;=&#x2009;0.018 and SGA P&#x2009;=&#x2009;0.017). No notable difference in the HC/CSP ratio between the VSGA and SGA groups could be found (P&#x2009;=&#x2009;0.960). The HC/LV, HC/CM and HC/TCD ratios were similar in all the three groups. Conclusion Relative to HC, the CSP is larger in VSGA and SGA fetuses than in normal controls. However, there is no notable difference between VSGA and SGA fetuses, which might be an indicator for abnormal brain development in this group.
2,327,949
Infratentorial choroid plexus tumors in children.
Choroid plexus tumors (CPTs) are rare pediatric intracranial neoplasms, and mostly occur in the lateral ventricle. CPTs located in the infratentorial location are considered to be rare in the pediatric population. We present a series of eight patients treated in the last decade at our institution focusing on clinical presentations and their outcome after excision.</AbstractText>We performed an institutional retrospective review of patients who underwent surgical resection of infratentorial CPTs during the period from 2008 to 2017. Patients' charts were reviewed for demographic data, clinical presentation, surgical treatment, and follow-up.</AbstractText>There were eight patients (6 females and 2 males), with mean age for the cohort at presentation was 9.0&#xa0;years. They represent 75% of 12 CPTs of all locations treated at the same period in our institution. These 8 infratentorial CPTs were in the fourth ventricle in seven, and in the cerebellopontine angle (CPA) in one. Seven patients had choroid plexus papillomas (WHO grade I) and 1 had an atypical choroid plexus papilloma (WHO grade II). Gross total resection was attempted in all patients. However, two of 3 patients with fourth ventricle floor invasion had subtotal resection with a thin layer of tumor left on the floor. The remaining 6 had a gross total resection. Six patients with preoperative hydrocephalus had a perioperative external ventricular drainage but none required permanent shunting after tumor resection. None showed recurrence/tumor progression without adjuvant therapy during the follow-up period of 20&#xa0;months to 11&#xa0;years.</AbstractText>Infratentorial dominance among pediatric CPTs in this series contradicts previous reports. Infratentorial CPTs are amenable to surgical resection. Unresected small residuals due to invasion to the fourth ventricle floor showed no regrowth during 2 to 3&#xa0;years follow-up without adjuvant therapy. However, these patients with incomplete resection need watchful observations.</AbstractText>
2,327,950
Third ventricle choroid plexus papilloma: 2 cases.
The third ventricle is an uncommon location for choroid plexus papillomas. In adults, these tumors most commonly occur in the fourth ventricle. In children, they are more commonly found in the lateral ventricles. When these lesions are discovered in the third ventricle, they are often posteriorly located. Hydrocephalus and macrocephaly are typical sentinel findings. We present 2 cases of this uncommon presentation of third ventricular choroid plexus papilloma.
2,327,951
Long-term, in toto live imaging of cardiomyocyte behaviour during mouse ventricle chamber formation at single-cell resolution.
Mapping of the holistic cell behaviours sculpting the four-chambered mammalian heart has been a goal or previous studies, but so far only success in transparent invertebrates and lower vertebrates with two-chambered hearts has been achieved. Using a live-imaging system comprising a customized vertical light-sheet microscope equipped with a mouse embryo culture module, a heartbeat-gated imaging strategy and a digital image processing framework, we realized volumetric imaging of developing mouse hearts at single-cell resolution and with uninterrupted cell lineages for up to 1.5&#x2009;d. Four-dimensional landscapes of Nppa<sup>+</sup> cardiomyocyte cell behaviours revealed a blueprint for ventricle chamber formation by which biased outward migration of the outermost cardiomyocytes is coupled with cell intercalation and horizontal division. The inner-muscle architecture of trabeculae was developed through dual mechanisms: early fate segregation and transmural cell arrangement involving both oriented cell division and directional migration. Thus, live-imaging reconstruction of uninterrupted cell lineages affords a transformative means for deciphering mammalian organogenesis.
2,327,952
Structural magnetic resonance imaging for the early diagnosis of dementia due to Alzheimer's disease in people with mild cognitive impairment.
Mild cognitive impairment (MCI) due to Alzheimer's disease is the symptomatic predementia phase of Alzheimer's disease dementia, characterised by cognitive and functional impairment not severe enough to fulfil the criteria for dementia. In clinical samples, people with amnestic MCI are at high risk of developing Alzheimer's disease dementia, with annual rates of progression from MCI to Alzheimer's disease estimated at approximately 10% to 15% compared with the base incidence rates of Alzheimer's disease dementia of 1% to 2% per year.</AbstractText>To assess the diagnostic accuracy of structural magnetic resonance imaging (MRI) for the early diagnosis of dementia due to Alzheimer's disease in people with MCI versus the clinical follow-up diagnosis of Alzheimer's disease dementia as a reference standard (delayed verification). To investigate sources of heterogeneity in accuracy, such as the use of qualitative visual assessment or quantitative volumetric measurements, including manual or automatic (MRI) techniques, or the length of follow-up, and age of participants. MRI was evaluated as an add-on test in addition to clinical diagnosis of MCI to improve early diagnosis of dementia due to Alzheimer's disease in people with MCI.</AbstractText>On 29 January 2019 we searched Cochrane Dementia and Cognitive Improvement's Specialised Register and the databases, MEDLINE, Embase, BIOSIS Previews, Science Citation Index, PsycINFO, and LILACS. We also searched the reference lists of all eligible studies identified by the electronic searches.</AbstractText>We considered cohort studies of any size that included prospectively recruited people of any age with a diagnosis of MCI. We included studies that compared the diagnostic test accuracy of baseline structural MRI versus the clinical follow-up diagnosis of Alzheimer's disease dementia (delayed verification). We did not exclude studies on the basis of length of follow-up. We included studies that used either qualitative visual assessment or quantitative volumetric measurements of MRI to detect atrophy in the whole brain or in specific brain regions, such as the hippocampus, medial temporal lobe, lateral ventricles, entorhinal cortex, medial temporal gyrus, lateral temporal lobe, amygdala, and cortical grey matter.</AbstractText>Four teams of two review authors each independently reviewed titles and abstracts of articles identified by the search strategy. Two teams of two review authors each independently assessed the selected full-text articles for eligibility, extracted data and solved disagreements by consensus. Two review authors independently assessed the quality of studies using the QUADAS-2 tool. We used the hierarchical summary receiver operating characteristic (HSROC) model to fit summary ROC curves and to obtain overall measures of relative accuracy in subgroup analyses. We also used these models to obtain pooled estimates of sensitivity and specificity when sufficient data sets were available.</AbstractText>We included 33 studies, published from 1999 to 2019, with 3935 participants of whom 1341 (34%) progressed to Alzheimer's disease dementia and 2594 (66%) did not. Of the participants who did not progress to Alzheimer's disease dementia, 2561 (99%) remained stable MCI and 33 (1%) progressed to other types of dementia. The median proportion of women was 53% and the mean age of participants ranged from 63 to 87 years (median 73 years). The mean length of clinical follow-up ranged from 1 to 7.6 years (median 2 years). Most studies were of poor methodological quality due to risk of bias for participant selection or the index test, or both. Most of the included studies reported data on the volume of the total hippocampus (pooled mean sensitivity 0.73 (95% confidence interval (CI) 0.64 to 0.80); pooled mean specificity 0.71 (95% CI 0.65 to 0.77); 22 studies, 2209 participants). This evidence was of low certainty due to risk of bias and inconsistency. Seven studies reported data on the atrophy of the medial temporal lobe (mean sensitivity 0.64 (95% CI 0.53 to 0.73); mean specificity 0.65 (95% CI 0.51 to 0.76); 1077 participants) and five studies on the volume of the lateral ventricles (mean sensitivity 0.57 (95% CI 0.49 to 0.65); mean specificity 0.64 (95% CI 0.59 to 0.70); 1077 participants). This evidence was of moderate certainty due to risk of bias. Four studies with 529 participants analysed the volume of the total entorhinal cortex and four studies with 424 participants analysed the volume of the whole brain. We did not estimate pooled sensitivity and specificity for the volume of these two regions because available data were sparse and heterogeneous. We could not statistically evaluate the volumes of the lateral temporal lobe, amygdala, medial temporal gyrus, or cortical grey matter assessed in small individual studies. We found no evidence of a difference between studies in the accuracy of the total hippocampal volume with regards to duration of follow-up or age of participants, but the manual MRI technique was superior to automatic techniques in mixed (mostly indirect) comparisons. We did not assess the relative accuracy of the volumes of different brain regions measured by MRI because only indirect comparisons were available, studies were heterogeneous, and the overall accuracy of all regions was moderate.</AbstractText><AbstractText Label="AUTHORS' CONCLUSIONS">The volume of hippocampus or medial temporal lobe, the most studied brain regions, showed low sensitivity and specificity and did not qualify structural MRI as a stand-alone add-on test for an early diagnosis of dementia due to Alzheimer's disease in people with MCI. This is consistent with international guidelines, which recommend imaging to exclude non-degenerative or surgical causes of cognitive impairment and not to diagnose dementia due to Alzheimer's disease. In view of the low quality of most of the included studies, the findings of this review should be interpreted with caution. Future research should not focus on a single biomarker, but rather on combinations of biomarkers to improve an early diagnosis of Alzheimer's disease dementia.</AbstractText>Copyright &#xa9; 2020 The Cochrane Collaboration. Published by John Wiley &amp; Sons, Ltd.</CopyrightInformation>
2,327,953
Predicting Individual Remission After Electroconvulsive Therapy Based on Structural Magnetic Resonance Imaging: A Machine Learning Approach.
To identify important clinical or imaging features predictive of an individual's response to electroconvulsive therapy (ECT) by utilizing a machine learning approach.</AbstractText>Twenty-seven depressed patients who received ECT were recruited. Clinical demographics and pretreatment structural magnetic resonance imaging (MRI) data were used as candidate features to build models to predict remission and post-ECT Hamilton Depression Rating Scale scores. Support vector machine and support vector regression with elastic-net regularization were used to build models using (i) only clinical features, (ii) only MRI features, and (iii) both clinical and MRI features. Consistently selected features across all individuals were identified through leave-one-out cross-validation.</AbstractText>Compared with models that include only clinical variables, the models including MRI data improved the prediction of ECT remission: the prediction accuracy improved from 70% to 93%. Features selected consistently across all individuals included volumes in the gyrus rectus, the right anterior lateral temporal lobe, the cuneus, and the third ventricle, as well as 2 clinical features: psychotic features and family history of mood disorder.</AbstractText>Pretreatment structural MRI data improved the individual predictive accuracy of ECT remission, and only a small subset of features was important for prediction.</AbstractText>
2,327,954
Fetal Ultrasound and Magnetic Resonance Imaging Findings in Suspected Septo-Optic Dysplasia: A Diagnostic Dilemma.
To investigate prenatal imaging findings supporting a diagnosis of suspected septo-optic dysplasia (SOD) by fetal ultrasound (US), magnetic resonance imaging (MRI), or both.</AbstractText>A retrospective review identified 11 patients with SOD: 9 had a clinical diagnosis of SOD postnatally, and 2 were terminated on the basis of suspicious prenatal imaging. Prenatal and neonatal imaging of the cavum septi pellucidi (CSP), frontal horns (FHs), and lateral ventricles was evaluated.</AbstractText>The appearance of the CSP varied on US and MRI. Complete ("fused") FHs or partial absence of the CSP was reported in 6 of 11 patients by fetal US and 7 of 8 patients by fetal MRI. The diagnosis of SOD was prospectively suspected prenatally in 6 of 11 and in an additional 5 of 11 cases retrospectively. Fetal MRI incorrectly initially reported normal morphologic abnormalities for 2 cases with partial absence of the CSP, whereas US accurately identified the morphologic abnormalities in 1 of these cases before MRI. Imaging features were first suggested at anatomic US (4 patients) and follow-up prenatal US (2 patients). Neonatal imaging was concordant in all 9 live births: 5 completely absent CSP, 3 partially absent CSP, and 1 completely present CSP. Clinical manifestations included optic nerve hypoplasia (9 of 9), panhypopituitarism (5 of 9), and neurodevelopmental delays.</AbstractText>Primary imaging features of SOD are "continuous" FHs with complete or partial absence of the CSP. Septo-optic dysplasia can be suspected in utero and can appear isolated but has substantial associated central nervous system anomalies identified on fetal MRI or after birth. Partial absence of the CSP can be a prenatal sign of suspected SOD, although fetal MRI lacked the spatial resolution to identify it accurately in all cases.</AbstractText>&#xa9; 2020 by the American Institute of Ultrasound in Medicine.</CopyrightInformation>
2,327,955
Adherens Junctions: Guardians of Cortical Development.
Apical radial glia comprise the pseudostratified neuroepithelium lining the embryonic lateral ventricles and give rise to the extensive repertoire of pyramidal neuronal subtypes of the neocortex. The establishment of a highly apicobasally polarized radial glial morphology is a mandatory prerequisite for cortical development as it governs neurogenesis, neural migration and the integrity of the ventricular wall. As in all epithelia, cadherin-based adherens junctions (AJs) play an obligate role in the maintenance of radial glial apicobasal polarity and neuroepithelial cohesion. In addition, the assembly of resilient AJs is critical to the integrity of the neuroepithelium which must resist the tensile forces arising from increasing CSF volume and other mechanical stresses associated with the expansion of the ventricles in the embryo and neonate. Junctional instability leads to the collapse of radial glial morphology, disruption of the ventricular surface and cortical lamination defects due to failed neuronal migration. The fidelity of cortical development is therefore dependent on AJ assembly and stability. Mutations in genes known to control radial glial junction formation are causative for a subset of inherited cortical malformations (neuronal heterotopias) as well as perinatal hydrocephalus, reinforcing the concept that radial glial junctions are pivotal determinants of successful corticogenesis. In this review we explore the key animal studies that have revealed important insights into the role of AJs in maintaining apical radial glial morphology and function, and as such, have provided a deeper understanding of the aberrant molecular and cellular processes contributing to debilitating cortical malformations. We highlight the reciprocal interactions between AJs and the epithelial polarity complexes that impose radial glial apicobasal polarity. We also discuss the critical molecular networks promoting AJ assembly in apical radial glia and emphasize the role of the actin cytoskeleton in the stabilization of cadherin adhesion - a crucial factor in buffering the mechanical forces exerted as a consequence of cortical expansion.
2,327,956
Complement Activation and Organ Damage After Trauma-Differential Immune Response Based on Surgical Treatment Strategy.
<b>Background:</b> The complement system is part of the innate immunity, is activated immediately after trauma and is associated with adult respiratory distress syndrome, acute lung injury, multiple organ failure, and with death of multiply injured patients. The aim of the study was to investigate the complement activation in multiply injured pigs as well as its effects on the heart <i>in vivo</i> and <i>in vitro</i>. Moreover, the impact of reamed vs. non-reamed intramedullary nailing was examined with regard to the complement activation after multiple trauma in pigs. <b>Materials and Methods:</b> Male pigs received multiple trauma, followed by femoral nailing with/without prior conventional reaming. Systemic complement hemolytic activity (CH-50 and AH-50) as well as the local cardiac expression of C3a receptor, C5a receptors1/2, and the deposition of the fragments C3b/iC3b/C3c was determined <i>in vivo</i> after trauma. Human cardiomyocytes were exposed to C3a or C5a and analyzed regarding calcium signaling and mitochondrial respiration. <b>Results:</b> Systemic complement activation increased within 6 h after trauma and was mediated via the classical and the alternative pathway. Furthermore, complement activation correlated with invasiveness of fracture treatment. The expression of receptors for complement activation were altered locally <i>in vivo</i> in left ventricles. C3a and C5a acted detrimentally on human cardiomyocytes by affecting their functionality and their mitochondrial respiration <i>in vitro</i>. <b>Conclusion:</b> After multiple trauma, an early activation of the complement system is triggered, affecting the heart <i>in vivo</i> as well as <i>in vitro</i>, leading to complement-induced cardiac dysfunction. The intensity of complement activation after multiple trauma might correlate with the invasiveness of fracture treatment. Reaming of the femoral canal might contribute to an enhanced "second hit" response after trauma. Consequently, the choice of fracture treatment might imply the clinical outcome of the critically injured patients and might be therefore crucial for their survival.
2,327,957
Effects of Aberrant miR-384-5p Expression on Learning and Memory in a Rat Model of Attention Deficit Hyperactivity Disorder.
Attention deficit hyperactivity disorder (ADHD) is a common neuropsychiatric disorder characterized by inattention, hyperactivity, and impulsivity. It may be accompanied by learning difficulties and working memory deficits. Few studies have examined the role of miRNAs in cognitive dysfunction in ADHD. This study investigated the effects of aberrant miR-384-5p expression on learning and memory in a widely used ADHD rat model. Lentiviral vectors were injected into the lateral ventricles of the rats to increase or decrease miR-384-5p level. To determine whether aberrant miR-384-5p expression affects learning and memory, spontaneous activity and cognitive function were assessed with the open field and Morris water maze tests. In the place navigation experiment of the Morris water maze test, time, and total swimming distance to reach the platform decreased compared to the control group when miR-384-5p was overexpressed, whereas down-regulation of miR-384-5p had the opposite effect. There were no obvious changes in brain tissue morphology following miR-384-5p overexpression or inhibition; however, dopamine (DA) receptor D1 (DRD1) level has decreased and increased, respectively, in the prefrontal cortex (PFC). The luciferase activity of the wild-type DRD1 group has decreased in luciferase reporter assay. Cyclic AMP response element-binding protein (CREB) phosphorylation has increased, and DA transporter (DAT) level has decreased in the PFC of spontaneously hypertensive rats (SHR) by miR-384-5p overexpression. On the other hand, miR-384-5p suppression increased DRD1 and decreased DAT and CREB protein levels relative to control rats. These findings suggest that miR-384-5p may play a critical role in learning and memory impairment in ADHD.
2,327,958
Compliant Titin Isoform Content Is Reduced in Left Ventricles of Sedentary Versus Active Rats.
A sedentary lifestyle is associated with increased cardiovascular risk factors and reduced cardiac compliance when compared to a lifestyle that includes exercise training. Exercise training increases cardiac compliance in humans, but the mechanisms underlying this improvement are unknown. A major determinant of cardiac compliance is the compliance of the giant elastic protein titin. Experimentally reducing titin compliance in animal models reduces exercise tolerance, but it is not known whether sedentary versus chronic exercise conditions cause differences in titin isoform content. We hypothesized that sedentary conditions would be associated with a reduction in the content of the longer, more compliant N2BA isoform relative to the stiffer N2B isoform (yielding a reduced N2BA:N2B ratio) compared to age-matched exercising controls. We obtained left ventricles from 16-week old rats housed for 12 weeks in standard (sedentary) or voluntary running wheel (exercised) housing. The N2BA:N2B ratio was decreased in the hearts of sedentary versus active rats (<i>p</i> = 0.041). Gene expression of a <i>titin</i> mRNA splicing factor, RNA Binding Motif 20 protein (RBM20), correlated negatively with N2BA:N2B ratios (<i>p</i> = 0.006, <i>r</i> = -0.449), but was not different between groups, suggesting that RBM20 may be regulated post-transcriptionally. Total phosphorylation of cardiac titin was not different between the active and sedentary groups. This study is the first to demonstrate that sedentary rats exhibit reduced cardiac titin N2BA:N2B isoform ratios, which implies reduced cardiac compliance. These data suggest that a lack of exercise (running wheel) reduces cardiac compliance and that exercise itself increases cardiac compliance.
2,327,959
Fetal ovine skeletal and cardiac muscle transcriptomics are differentially altered by increased maternal cortisol during gestation.
We have previously found that in utero exposure to excess maternal cortisol (1 mg/kg/day) in late gestation increases the incidence of stillbirth during labor and produces fetal bradycardia at birth. In the interventricular septum, mitochondrial DNA (mt-DNA) was decreased, and transcriptomics and metabolomics were consistent with altered mitochondrial metabolism. The present study uses transcriptomics to model effects of increased maternal cortisol on fetal biceps femoris. Transcriptomic modeling revealed that pathways related to mitochondrial metabolism were downregulated, whereas pathways for regulation of reactive oxygen species and activation of the apoptotic cascade were upregulated. Mt-DNA and the protein levels of cytochrome C were significantly decreased in the biceps femoris. RT-PCR validation of the pathways confirmed a significant decrease in SLC2A4 mRNA levels and a significant increase in PDK4, TXNIP, ANGPTL4 mRNA levels, suggesting that insulin sensitivity of the biceps femoris muscle may be reduced in cortisol offspring. We also tested for changes in gene expression in diaphragm by rt-PCR. PDK4, TXNIP, and ANGPTL4 mRNA were also increased in the diaphragm, but SLC2A4, cytochrome C protein, and mt-DNA were unchanged. Comparison of the change in gene expression in biceps femoris to that in cardiac interventricular septum and left ventricle showed few common genes and little overlap in specific metabolic or signaling pathways, despite reduction in mt-DNA in both heart and biceps femoris. Our results suggest that glucocorticoid exposure alters expression of nuclear genes important to mitochondrial activity and oxidative stress in both cardiac and skeletal muscle tissues, but that these effects are tissue-specific.
2,327,960
Thalamic Massa Intermedia in Children with and without Midline Brain Malformations.
The massa intermedia is a normal midline transventricular thalamic connection. Massa intermedia aberrations are common in schizophrenia, Chiari II malformation, X-linked hydrocephalus, Cornelia de Lange syndrome, and diencephalic-mesencephalic junction dysplasia, among others. We have noticed that massa intermedia abnormalities often accompany other midline malformations. The massa intermedia has never been formally evaluated in a group of exclusively pediatric patients, to our knowledge. We sought to compare and contrast the prevalence, size, and location of the massa intermedia in pediatric patients with and without congenital midline brain abnormalities.</AbstractText>Successive 3T brain MR imaging examinations from pediatric patients with and without midline malformations were procured from the imaging data base at a pediatric hospital. Massa intermedia presence, size, morphology, and position were determined using 3D-TIWI with 1-mm isotropic resolution. The brain commissures, septum pellucidum, hypothalamus, hippocampus, vermis, and brain stem were evaluated to determine whether alterations were related to or predictive of massa intermedia abnormalities.</AbstractText>The massa intermedia was more frequently absent, dysmorphic, and/or displaced in patients with additional midline abnormalities than in those without. The massa intermedia was absent in 40% of patients with midline malformations versus 12% of patients with normal findings (P&#x2009;</i>&lt;&#x2009;.001). Massa intermedia absence, surface area, and morphology were predictable by various attributes and alterations of the commissures, hippocampus, hypothalamus, vermis, brain stem, and third ventricle.</AbstractText>Most pediatric patients have a thalamic massa intermedia centered in the anterior/superior third ventricle. Massa intermedia abnormalities are commonly associated with other midline malformations. Normal-variant massa intermedia absence is a diagnosis of exclusion.</AbstractText>&#xa9; 2020 by American Journal of Neuroradiology.</CopyrightInformation>
2,327,961
Development and validation of a synthetic 3D-printed simulator for training in neuroendoscopic ventricular lesion removal.
Neuroendoscopic surgery using an ultrasonic aspirator represents a valid tool with which to perform the safe resection of deep-seated ventricular lesions, but the handling of neuroendoscopic instruments is technically challenging, requiring extensive training to achieve a steep learning curve. Simulation-based methods are increasingly used to improve surgical skills, allowing neurosurgical trainees to practice in a risk-free, reproducible environment. The authors introduce a synthetic, patient-specific simulator that enables trainees to develop skills for endoscopic ventricular tumor removal, and they evaluate the model's validity as a training instrument with regard to realism, mechanical proprieties, procedural content, and handling.</AbstractText>The authors developed a synthetic simulator based on a patient-specific CT data set. The anatomical features were segmented, and several realistic 1:1 skull models with all relevant ventricular structures were fabricated by a 3D printer. Vascular structures and the choroid plexus were included. A tumor model, composed of polyvinyl alcohol, mimicking a soft-consistency lesion, was secured in different spots of the frontal horn and within the third ventricle. Neurosurgical trainees participating in a neuroendoscopic workshop qualitatively assessed, by means of a feedback survey, the properties of the simulator as a training model that teaches neuroendoscopic ultrasonic ventricular tumor surgery; the trainees rated 10 items according to a 5-point Likert scale.</AbstractText>Participants appreciated the model as a valid hands-on training tool for neuroendoscopic ultrasonic aspirator tumor removal, highly rating the procedural content. Furthermore, they mostly agreed on its comparably realistic anatomical and mechanical properties. By the model's first application, the authors were able to recognize possible improvement measures, such as the development of different tumor model textures and the possibility, for the user, of creating a realistic surgical skull approach and neuroendoscopic trajectory.</AbstractText>A low-cost, patient-specific, reusable 3D-printed simulator for the training of neuroendoscopic ultrasonic aspirator tumor removal was successfully developed. The simulator is a useful tool for teaching neuroendoscopic techniques and provides support in the development of the required surgical skills.</AbstractText>
2,327,962
Automated delineation of the clinical target volume using anatomically constrained 3D expansion of the gross tumor volume.
Delineation of the clinical target volume (CTV) is arguably the weakest link in the treatment planning chain. This work aims to support clinicians in this crucial task.</AbstractText>While the CTV itself is ambiguous, it is much easier to identify structures that do not belong to the CTV and serve as barriers to the spread of the disease. We segment the known barrier structures using a convolutional neural network (CNN). The CTV is then obtained by starting from the manually delineated gross tumor volume (GTV) and expanding it while taking into account the barrier structures. Mathematically, we define the CTV as an iso-surface in the 3D map of shortest paths of all voxels from the GTV. The shortest paths are found with the Dijkstra algorithm. While the method is generally applicable, we test it on 206 glioma and glioblastoma cases.</AbstractText>The auto-segmented barrier structures for the brain cases include the ventricles, falx cerebri, tentorium cerebelli, brain sinuses, and the outer surface of the brain. Manual and auto-segmented barrier structures agree with surface Dice Similarity Coefficients (DSC) ranging from 0.91 to 0.97 at 2&#xa0;mm tolerance. Comparison of manual and automatically delineated CTVs shows a median surface DSC of 0.79.</AbstractText>Barrier structures for CTV definition can be auto-delineated with outstanding precision using a CNN. An algorithm for automated calculation of the CTV by 3D expansion of the GTV while respecting anatomical barriers has been developed. It shows good agreement with manual CTV definition for brain tumors.</AbstractText>Copyright &#xa9; 2020 Elsevier B.V. All rights reserved.</CopyrightInformation>
2,327,963
Long-Term Effects of the Replacement of Calcineurin Inhibitors With Everolimus and Mycophenolate in Patients With Calcineurin Inhibitor-Related Nephrotoxicity.
There is little evidence on the long-term effects of calcineurin inhibitor (CNI) withdrawal and substitution with everolimus and mycophenolate mofetil in maintenance therapy of patients who have received heart transplants and have concurrent CNI nephrotoxicity. Aims of this study were to evaluate the progression of renal dysfunction after discontinuation of CNIs and to monitor for major adverse events after therapy change.</AbstractText>Data from 41 patients who underwent heart transplant and have different degrees of renal dysfunction (estimated glomerular filtration rate [eGFR]&#xa0;&lt;60 mL/min/1.73 m2</sup>), without evidence of proteinuria, and in whom CNI therapy was replaced by everolimus, were analyzed. At the time of CNI withdrawal, clinical parameters, echocardiographic data, blood tests of renal function, and monitoring of adverse events were recorded. The median follow-up period was 5 years &#xb1; 28 months.</AbstractText>In 52% of patients, there was a clear improvement in renal function (10.5 mL/min/1.73 m2</sup> of extra eGFR on average). The former were characterized by less advanced age and a short time from the heart transplant. The echocardiographic parameters showed a significant reduction in septum thickness (11.58 &#xb1; 2 mm vs 10.29 &#xb1; 2 mm; P&#xa0;= .0001) and in left ventricle posterior wall thickness (10.74 &#xb1; 1 mm vs 9.74 &#xb1; 1 mm; P&#xa0;= .0004). The incidence of late acute rejection and cardiac allograft vasculopathy was similar in our population compared to literature data.</AbstractText>A therapeutic switch from CNIs to everolimus and mycophenolate mofetil can improve renal function in patients with CNI nephrotoxicity, especially in those with a shorter time period from transplantation, without exposing them to a higher incidence of late acute rejection and cardiac allograft vasculopathy.</AbstractText>Copyright &#xa9; 2020 Elsevier Inc. All rights reserved.</CopyrightInformation>
2,327,964
[The Role of Cardiac MRI in the Diagnosis of Fabry Disease].
Fabry disease is a rare X-linked metabolic disorder that is characterized by the accumulation of glycosphingolipids in various organs, resulting from the deficiency of alpha-galactosidase A. Cardiac involvement is relatively common; myocardial inflammation, left ventricular hypertrophy, and myocardial fibrosis secondary to abnormal lipid deposition in myocytes are often observed. Hence, the diagnosis of cardiac involvement is crucial for evaluating patient prognosis. Cardiac MRI is the standard technique for measuring the function, volume, and mass of the ventricles. It is also useful for myocardial tissue characterizations. The evaluation of native myocardial T1 values can facilitate early diagnosis of cardiac involvement, while measurements of left ventricular myocardial mass can be used to monitor treatment outcomes, in patients with Fabry disease. Consequently, cardiac MRI can provide useful information for diagnosing, monitoring, and treating patients with Fabry disease.<CopyrightInformation>Copyrights &#xa9; 2020 The Korean Society of Radiology.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Hong</LastName><ForeName>Yoo Jin</ForeName><Initials>YJ</Initials><Identifier Source="ORCID">0000-0002-7276-0944</Identifier></Author><Author ValidYN="Y"><LastName>Kim</LastName><ForeName>Young Jin</ForeName><Initials>YJ</Initials><Identifier Source="ORCID">0000-0002-6235-6550</Identifier></Author></AuthorList><Language>kor</Language><PublicationTypeList><PublicationType UI="D004740">English Abstract</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><VernacularTitle>&#xd30c;&#xbe0c;&#xb9ac;&#xbcd1;&#xc5d0;&#xc11c;&#xc758; &#xc2ec;&#xc7a5; &#xc790;&#xae30;&#xacf5;&#xba85;&#xc601;&#xc0c1;&#xc758; &#xc5ed;&#xd560;.</VernacularTitle><ArticleDate DateType="Electronic"><Year>2020</Year><Month>03</Month><Day>31</Day></ArticleDate></Article><MedlineJournalInfo><Country>Korea (South)</Country><MedlineTA>Taehan Yongsang Uihakhoe Chi</MedlineTA><NlmUniqueID>101479271</NlmUniqueID><ISSNLinking>1738-2637</ISSNLinking></MedlineJournalInfo><OtherAbstract Type="Publisher" Language="kor">&#xd30c;&#xbe0c;&#xb9ac;&#xbcd1;(Fabry disease)&#xc740; &#xb9e4;&#xc6b0; &#xb4dc;&#xbb38; X-&#xc5f0;&#xad00; &#xc720;&#xc804; &#xb300;&#xc0ac; &#xc9c8;&#xd658;&#xc73c;&#xb85c; &#xc54c;&#xd30c; &#xac08;&#xb77d;&#xd1a0;&#xc2dc;&#xb2e4;&#xc544;&#xc81c;(alpha galactosidase A)&#xc758; &#xacb0;&#xd54d;&#xc73c;&#xb85c; &#xc778;&#xd558;&#xc5ec; &#xb2e4;&#xc591;&#xd55c; &#xc138;&#xd3ec; &#xbc0f; &#xae30;&#xad00;&#xc5d0; &#xae00;&#xb9ac;&#xcf54;&#xc2a4;&#xd551;&#xace0;&#xc9c0;&#xc9c8;(glycosphingolipid) &#xc758; &#xcd95;&#xc801;&#xc744; &#xcd08;&#xb798;&#xd558;&#xb294; &#xc9c8;&#xd658;&#xc774;&#xb2e4;. &#xc2ec;&#xc7a5; &#xce68;&#xbc94;&#xc774; &#xbe44;&#xad50;&#xc801; &#xd754;&#xd558;&#xba70; &#xbe44;&#xc815;&#xc0c1;&#xc801;&#xc778; &#xc9c0;&#xc9c8;&#xce68;&#xcc29;&#xc73c;&#xb85c; &#xc778;&#xd55c; &#xc2ec;&#xadfc; &#xc5fc;&#xc99d;, &#xc88c;&#xc2ec;&#xc2e4; &#xbe44;&#xb300; &#xbc0f; &#xc2ec;&#xadfc; &#xc12c;&#xc720;&#xc99d;&#xc744; &#xc77c;&#xc73c;&#xd0a8;&#xb2e4;. &#xc2ec;&#xc7a5; &#xce68;&#xbc94;&#xc740; &#xd658;&#xc790; &#xc608;&#xd6c4;&#xb97c; &#xacb0;&#xc815;&#xd558;&#xb294; &#xc911;&#xc694;&#xd55c; &#xc694;&#xc778;&#xc774;&#xbbc0;&#xb85c; &#xc774;&#xb97c; &#xc9c4;&#xb2e8;&#xd558;&#xb294; &#xac83;&#xc740; &#xb9e4;&#xc6b0; &#xc911;&#xc694;&#xd558;&#xb2e4;. &#xc2ec;&#xc7a5; &#xc790;&#xae30;&#xacf5;&#xba85;&#xc601;&#xc0c1;&#xc740; &#xc2ec;&#xc2e4;&#xc758; &#xae30;&#xb2a5;, &#xbd80;&#xd53c; &#xce21;&#xc815;&#xc744; &#xc704;&#xd55c; &#xd45c;&#xc900;&#xae30;&#xbc95;&#xc73c;&#xb85c; &#xc54c;&#xb824;&#xc838; &#xc788;&#xc73c;&#xba70; &#xc2ec;&#xadfc;&#xc758; &#xc870;&#xc9c1; &#xbcc0;&#xd654;&#xb97c; &#xbcfc; &#xc218; &#xc788;&#xb294; &#xc720;&#xc6a9;&#xd55c; &#xae30;&#xbc95;&#xc774;&#xb2e4;. &#xd2b9;&#xd788; &#xcd5c;&#xadfc; &#xb9ce;&#xc774; &#xc4f0;&#xc774;&#xb294; T1 &#xc9c0;&#xb3c4;&#xd654; &#xae30;&#xbc95;&#xc744; &#xd1b5;&#xd55c; &#xc2ec;&#xadfc; &#xc870;&#xc601; &#xc804; T1 &#xc218;&#xce58;&#xb97c; &#xc774;&#xc6a9;&#xd558;&#xc5ec; &#xd30c;&#xbe0c;&#xb9ac;&#xbcd1;&#xc758; &#xc2ec;&#xc7a5; &#xce68;&#xbc94;&#xc744; &#xc870;&#xae30; &#xc9c4;&#xb2e8;&#xd560; &#xc218; &#xc788;&#xc73c;&#xba70; &#xc790;&#xae30;&#xacf5;&#xba85;&#xc601;&#xc0c1;&#xc744; &#xc774;&#xc6a9;&#xd55c; &#xc2ec;&#xadfc; &#xc9c8;&#xb7c9; &#xce21;&#xc815;&#xc73c;&#xb85c; &#xce58;&#xb8cc; &#xbaa8;&#xb2c8;&#xd130;&#xb9c1;&#xc744; &#xd560; &#xc218; &#xc788;&#xb2e4;. &#xc2ec;&#xc7a5; &#xc790;&#xae30;&#xacf5;&#xba85;&#xc601;&#xc0c1;&#xc740; &#xd30c;&#xbe0c;&#xb9ac;&#xbcd1; &#xd658;&#xc790;&#xc5d0;&#xc11c; &#xb2e4;&#xc591;&#xd55c; &#xc5ed;&#xd560;&#xc744; &#xd560; &#xc218; &#xc788;&#xc744; &#xac83;&#xc73c;&#xb85c; &#xc0dd;&#xac01;&#xb418;&#xba70; &#xc774;&#xc5d0; &#xb300;&#xd574; &#xc815;&#xb9ac;&#xd574;&#xbcf4;&#xace0;&#xc790; &#xd55c;&#xb2e4;.
2,327,965
Fetal open spinal dysraphism repair through a mini-hysterotomy: Influence of gestational age at surgery on the perinatal outcomes and postnatal shunt rates.
To analyze the impact of gestational age (GA) at the time of fetal open spinal dysraphism (OSD) repair through a mini-hysterotomy on the perinatal outcomes and the infants' ventriculoperitoneal shunt rates.</AbstractText>Retrospective study of cases of fetal OSD correction performed from 2014 and 2019.</AbstractText>One hundred and ninety women underwent fetal surgery for OSD through a mini-hysterotomy, and 176 (176/190:92.6%) have since delivered. Fetal OSD correction performed earlier in the gestational period, ranging from 19.7 to 26.9&#x2009;weeks, was associated with lower rates of postnatal ventriculoperitoneal shunting (P: .049). Earlier fetal surgeries were associated with shorter surgical times (P: .01), smaller hysterotomy lengths (P &lt;&#x2009;.001), higher frequencies of hindbrain herniation reversal (P: .003), and longer latencies from surgery to delivery (P &lt;&#x2009;.001). Median GA at delivery was 35.3&#x2009;weeks. Multivariate binary logistic regression showed that both fetal lateral ventricle-to-hemisphere ratio (%; P &lt;&#x2009;.001; OR: 1.14 [95% CI: 1.09-1.21]) and GA at the time of fetal surgery (P: .016; OR: 1.37 [95% CI: 1.07-1.77]) were independent predictors of postnatal ventriculoperitoneal shunting.</AbstractText>Fetuses with OSD who were operated on earlier in the gestational interval, which ranged from 19.7 to 26.9&#x2009;weeks, were less prone to receiving postnatal ventriculoperitoneal shunts.</AbstractText>&#xa9; 2020 John Wiley &amp; Sons, Ltd.</CopyrightInformation>
2,327,966
Dynamic Changes in the Neurogenic Potential in the Ventricular-Subventricular Zone of Common Marmoset during Postnatal Brain Development.
Even after birth, neuronal production continues in the ventricular-subventricular zone (V-SVZ) and hippocampus in many mammals. The immature new neurons ("neuroblasts") migrate and then mature at their final destination. In humans, neuroblast production and migration toward the neocortex and the olfactory bulb (OB) occur actively only for a few months after birth and then sharply decline with age. However, the precise spatiotemporal profiles and fates of postnatally born neurons remain unclear due to methodological limitations. We previously found that common marmosets, small nonhuman primates, share many features of V-SVZ organization with humans. Here, using marmosets injected with thymidine analogue(s) during various postnatal periods, we demonstrated spatiotemporal changes in neurogenesis during development. V-SVZ progenitor proliferation and neuroblast migration toward the OB and neocortex sharply decreased by 4&#xa0;months, most strikingly in a V-SVZ subregion from which neuroblasts migrated toward the neocortex. Postnatally born neurons matured within a few months in the OB and hippocampus but remained immature until 6&#xa0;months in the neocortex. While neurogenic activity was sustained for a month after birth, the distribution and/or differentiation diversity was more restricted in 1-month-born cells than in the neonatal-born population. These findings shed light on distinctive features of postnatal neurogenesis in primates.
2,327,967
Role of endoscopic surgical biopsy in diagnoses of intraventricular/periventricular tumors: review of literature including a monocentric case series.
The intra- and periventricular location tumor (IPVT) of a brain remains a hard challenge for the neurosurgeon because of the deep location and eloquent anatomic associations. Due to this high risk of iatrogenic injury, many surgeons elect to perform biopsies of such lesions to establish a diagnosis. On the one hand, stereotaxic needle biopsy (SNB) is a minimally invasive procedure but with a significant risk of complications and a high risk of lack of tissue for molecular analyses for this region [Fukushima in Neurosurgery 2:110-113 (1978)]; on the other hand, the use of endoscopic intraventricular biopsy (EIB) allows for diagnosis with minimal surgical intervention [Iwamoto et al. in Ann Neurol 64(suppl. 6):628-634 (2008)]. IPVTs and related CSF pathway obstructions can be safely and effectively treated with endoscopic techniques. It is not possible to compare EIB with diagnoses made by any other method or with the established treatment. We aim to analyze the accuracy of EIB results by comparing them with results of biopsies performed later, in other methods and thereby evaluating the treatment evolution considering our personal experience. The difficulties and complications encountered are presented and compared with those reported in the literature to obtain the best review possible for this topic. A systematic review of literature was done using MEDLINE, the NIH Library, PubMed, and Google Scholar yielded 1.951 cases for EIB and 1912 for SNB, according to standard systemic review techniques. Review was conducted on 50 studies describing surgical procedures for lesions intra- and para-ventricular. The primary outcome measure was a diagnostic success. We also consider 20 patients with IPVT treated in our department. Clinical characteristics and surgical outcome were evaluated and a systematic review of the literature was performed. Overall, all our biopsies were diagnostic, with a positive histologic sample in 100% of our patients. 8 patients underwent a concurrent endoscopic third ventriculostomy. 4 patients underwent a concurrent ventriculostomy combined with septostomy. For 1 patient was necessary the only septostomy combined with biopsy. Every case has obtained a histological diagnosis. The percentage of complications was very low with only 1 case of post-operative infection and 1 case of hemorrhage. It was impossible to create a specific comparison from literature data of IPVTs between a stereotactic and endoscopic procedure, it presents only the collection of pineal gland tumor [Kelly in Neurosurgery 25(02):185-194 (1989); Quick-Weller in World Neurosurgery 96:124-128 (2016)] or unknown location of the lesion in major review [Marenco-Hillembrand et al. in Front Oncol 8:558 (2018)]. The present study aims to report our experience with the surgical management of IPVTs. The EIB sample yields an accurate histologic diagnosis tumor, with a positive histologic sample in 87, 95% of patients. The choice of the appropriate procedure should consider not only the preference and the experience of the neurosurgeon but also the several other variables as the location. While some periventricular lesions are better approached by endoscopic techniques, others are more suited for stereotactic-guided approaches. The ability to perform an EIB and relieve tumor-associated hydrocephalus by neuroendoscopy is considered to be a benefit of this procedure since this is less invasive than other treatments.
2,327,968
H<sub>2</sub>S-producing enzymes in anoxia-tolerant vertebrates: Effects of cold acclimation, anoxia exposure and reoxygenation on gene and protein expression.
To lend insight into the potential role of the gasotransmitter hydrogen sulfide (H<sub>2</sub>S) in facilitating anoxia survival of anoxia-tolerant vertebrates, we quantified the gene expression of the primary H<sub>2</sub>S-synthesizing enzymes, 3-mercaptopyruvate sulfurtransferase (3MST), cystathionine &#x3b3;-lyase (CSE) and cystathionine &#x3b2;-synthase (CBS), in ventricle and brain of normoxic, anoxic and reoxygenated 21&#xa0;&#xb0;C- and 5&#xa0;&#xb0;C-acclimated freshwater turtles (Trachemys scripta) and 10&#xa0;&#xb0;C-acclimated crucian carp (Carassius carassius). Semi-quantitative Western blotting analysis was also conducted to assess 3MST and CBS protein abundance in ventricle and brain of 5&#xa0;&#xb0;C turtles and 10&#xa0;&#xb0;C crucian carp subjected to normoxia, anoxia and reoxygenation. We hypothesized that if H<sub>2</sub>S was advantageous for anoxia survival, expression levels would remain unchanged or be upregulated with anoxia and/or reoxygenation. Indeed, for both species, gene and protein expression were largely maintained with anoxia exposure (24&#xa0;h, 21&#xa0;&#xb0;C; 5 d, 10&#xa0;&#xb0;C; 14 d, 5&#xa0;&#xb0;C). With reoxygenation, 3MST expression was increased in turtle and crucian carp brain at the protein and gene level, respectively. Additionally, the effect of cold acclimation on gene expression was assessed in several tissues of the turtle. Expression levels were maintained in most tissues, but decreased in others. The maintenance of gene and protein expression of the H<sub>2</sub>S-producing enzymes with anoxia exposure and the up-regulation of 3MST with reoxygenation suggests that H<sub>2</sub>S may facilitate anoxic survival of the two champions of vertebrate anoxia survival. The differential effects of cold acclimation on H<sub>2</sub>S enzyme expression may influence blood flow to different tissues during winter anoxia.
2,327,969
Overlapping Clinical Syndromes in Patients with Glial Fibrillary Acidic Protein IgG.
The aim of this paper is to report 2 cases with overlapping syndromes in autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy.</AbstractText>Antibodies were detected by indirect immunofluorescence assay. Patient data were analyzed retrospectively.</AbstractText>One patient presented with overlapping neuromyelitis optica spectrum disorder (NMOSD) and positive GFAP-IgG and aquaporin-4-IgG. His main symptoms included vision loss, hiccups, fever, headache, and ataxia. High leukocyte count and protein levels were found in cerebrospinal fluid. Brain magnetic resonance imaging (MRI) revealed abnormalities in the hippocampus, midbrain, pons, medulla, and meninges. Characteristic radial enhancing patterns were seen. The other patient was a male with relapsing polychondritis (RP) and positive GFAP-IgG. His main manifestations were meningoencephalitis and dementia. MRI showed extensive abnormalities in the white matter around the ventricles, temporal lobe, and thalamus, with enhancement. Both patients responded well to the treatment with steroids and immunosuppressants.</AbstractText>Although overlapping syndromes are rare, we report positive GFAP-IgG in 2 cases with NMOSD or RP. Both patients had clinical features of GFAP astrocytopathy, but diagnosis of the condition was very challenging because of the overlapping presentation.</AbstractText>&#xa9; 2020 S. Karger AG, Basel.</CopyrightInformation>
2,327,970
Endoscope-Assisted Contralateral Perimedian Supracerebellar Suprapineal Approach to Third Ventricle Surface of the Thalamus: 3-Dimensional Operative Video.
In managing thalamic gliomas, total surgical removal is the most effective way of increasing overall survival. However, the thalamus is a difficult target because of surrounding neurovascular structures. According to the lesion's size/location/growth pattern, relation to neighboring structures, and surgeon's experience, most thalamic lesions can be reached through one of the 4 free surfaces: lateral ventricle, velar, cisternal, and third ventricle surfaces of the thalamus (3VsT).1-3 Approaching the thalamic lesions through the lateral side disrupts the integrity of internal capsule and corona radiata; thus, we never prefer this approach. For the removal of the lesions on the 3VsT, a transcallosal approach can be considered, but with this approach, we cannot reach 3VsT without harming the velar surface. &#x2003;In this 3-dimensional video, we demonstrate an endoscope-assisted contralateral perimedian supracerebellar suprapineal (CPeSS) approach to a glioma on the 3VsT. The patient, a 49-yr-old man, had progressive dizziness for a month. With the patient in a semisitting position, total resection was achieved via the endoscope-assisted CPeSS approach. This approach is entirely transcisternal-transventricular and is a natural route to the 3VsT. Although the route is longer than the ipsilateral approach, it requires no retraction and provides more direct and wider visualization. It allows complete visualization of the lateral border of the lesion. A perimedian approach also avoids the major tentorial bridging veins, which are mostly at the midline. High-definition neuroendoscope was a great adjunct that helped to visualize residual tumors at hidden corners. &#x2003;We suggest this approach for thalamic lesions on the third ventricle surface of the thalamus. &#x2003;The patient consented to the publication of his images and a written consent was obtained.
2,327,971
2D linear measures of ventricular enlargement may be relevant markers of brain atrophy and long-term disability progression in multiple sclerosis.
Aim of this study was to investigate the reliability and validity of 2D linear measures of ventricular enlargement as indirect markers of brain atrophy and possible predictors of clinical disability.</AbstractText>In this retrospective longitudinal analysis of relapsing-remitting MS patients, brain volumes were computed at baseline and after 2&#xa0;years. Frontal horn width (FHW), intercaudate distance (ICD), third ventricle width (TVW), and 4th ventricle width were obtained. Two-dimensional measures associated with brain volume at correlation analyses were entered in linear and logistic regression models testing the relationship with baseline clinical disability and 10-year confirmed disability progression (CDP), respectively. Possible cutoff values for clinically relevant atrophy were estimated via receiver operating characteristic (ROC) analyses and probed as 10-year CDP predictors using hierarchical logistic regression.</AbstractText>Eighty-seven patients were available (61/26&#x2009;=&#x2009;F/M; 34.1&#x2009;&#xb1;&#x2009;8.5&#xa0;years). Moderate negative correlations emerged between ICD and TVW and normalized brain volume (NBV; p&#xa0;&lt;&#x2009;0.001) and percentage brain volume change per year (PBVC/y) and FHW, ICD, and TVW annual changes (p&#xa0;&#x2264;&#xa0;0.005). Baseline disability was moderately associated with NBV, ICD, and TVW (p&#x2009;&lt;&#x2009;0.001), while PBVC/y predicted 10-year CDP (p&#xa0;=&#xa0;0.01). A cutoff percentage ICD change per year (PICDC/y) value of 4.38%, corresponding to -&#x2009;0.91% PBVC/y, correlated with 10-year CDP (p&#xa0;=&#xa0;0.04). These estimated cutoff values provided extra value for predicting 10-year CDP (PBVC/y: p&#xa0;=&#xa0;0.001; PICDC/y: p&#xa0;=&#xa0;0.03).</AbstractText>Two-dimensional measures of ventricular enlargement are reproducible and clinically relevant markers of brain atrophy, with ICD and its increase over time showing the best association with clinical disability. Specifically, a cutoff PICDC/y value of 4.38% could serve as a potential surrogate marker of long-term disability progression.</AbstractText>&#x2022; Assessment of ventricular enlargement as a rapidly accessible indirect marker of brain atrophy may prove useful in cases in which brain volume quantification is not practicable. &#x2022; Two-dimensional linear measures of ventricular enlargement represent reliable, valid, and clinically relevant markers of brain atrophy. &#x2022; A cutoff annualized percentage brain volume change of -&#x2009;0.91% and the corresponding annualized percentage increase of 4.38% for intercaudate distance are able to discriminate patients who will develop long-term disability progression.</AbstractText>
2,327,972
Reverse takotsubo cardiomyopathy- life-threatening symptom of an incidental pheochromocytoma: a case report.
Cardiogenic shock (CS) due to takotsubo cardiomyopathy (TTC) is a life-threatening condition. Therapy is challenging because of the ambivalent effects of catecholamines. Catecholamines are required to stabilize blood pressure but might aggravate TTC. Cardiac assist devices could be a suitable solution for conserving catecholamines and the prevention of TTC perpetuation.</AbstractText>We report the case of a male patient with refractory CS and severe respiratory insufficiency as a result of a reverse TTC, which involved both ventricles. Simultaneous circulatory support with an Impella CP&#xae;</sup> and veno-arterial extracorporeal membrane oxygenation was initiated for cardiopulmonary stabilization and catecholamine weaning. A giant, incidental pheochromocytoma was diagnosed as the cause of TTC. After drug treatment and resection of the tumour, biventricular function completely recovered within 7&#x2009;weeks.</AbstractText>A rare and challenging situation is the coincidence of a nor/epinephrine-secreting tumour, such as a pheochromocytoma, and severe CS complicating TTC. Although percutaneous left ventricular assist devices (pLVAD) are highly complicated and have shown conflicting results in terms of clinical efficacy for CS, its use may prevent the perpetuation of TTC due to reduced catecholamines requirement.</AbstractText>&#xa9; The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology.</CopyrightInformation>
2,327,973
Posterior reversible encephalopathy syndrome induced by intracranial hypotension in a postpartum patient.
<b>Objective:</b> A number of hormonal, physiologic, immunologic, and hemodynamic changes can cause a series of central nervous system-related problems in pregnant and postpartum women. Posterior reversible encephalopathy syndrome (PRES) is commonly seen in these conditions. However, PRES during pregnancy and the postpartum period are not always due to pregnancy.<b>Methods:</b> We describe a patient who presented with headache followed by an epileptic seizure after cesarean section and whose computed tomography (CT) showed bilateral low-density lesions in the frontal lobe. To explore the pathogenesis, we further examined the patient with brain magnetic resonance imaging (MRI) and lumbar puncture.<b>Results:</b> Brain MRI revealed vasogenic edema in the frontal lobe and temporal-occipital regions of both hemispheres. MRI of the brain with contrast showed diffuse enhancement of the supratentorial dura mater and decreased of bilateral lateral ventricles. There was no abnormality in brain magnetic resonance angiography and magnetic resonance venography. Bloody cerebrospinal fluid flowed very slowly during lumbar puncture.<b>Conclusion:</b> These findings suggest that, although rare, intracranial hypotension in postpartum patients may be a cause of PRES.
2,327,974
Invasion of Pheochromocytoma from the Caudal Vena Cava to the Right Ventricular Cavity in a Dog.
Pheochromocytomas are catecholamine-secreting tumors that are composed of neuroectoderm-derived chromaffin cells. An 8-year-old miniature dachshund with abdominal distension was diagnosed with a neuroendocrine tumor with invasion from the caudal vena cava to the right ventricular cavity. The dog died due to hypotensive shock from the vagal reflex, and on autopsy, an extra-adrenal pheochromocytoma (paraganglioma) was diagnosed in the caudal abdomen. At autopsy, the tumor plug of the caudal vena cava was confirmed. To the best of our knowledge, this is the first case report that echo-captured the extension of pheochromocytoma in the right ventricle and shows it in a figure and video file.
2,327,975
Brain structure, IQ, and psychopathology in young offspring of patients with schizophrenia or bipolar disorder.
Studying offspring of schizophrenia (SZo) and bipolar disorder patients (BDo) provides important information on the putative neurodevelopmental trajectories underlying development toward severe mental illnesses. We compared intracranial volume (ICV), as a marker for neurodevelopment, and global and local brain measures between SZo or BDo and control offspring (Co) in relation to IQ and psychopathology.</AbstractText>T1-weighted magnetic resonance imaging (MRI) brain scans were obtained from 146 participants (8-19 years; 40 SZo, 66 BDo, 40 Co). Linear mixed models were applied to compare ICV, global, and local brain measures between groups. To investigate the effect of ICV, IQ (four subtests Wechsler Intelligence Scale for Children/Wechsler Adult Intelligence Scale-III) or presence of psychopathology these variables were each added to the model.</AbstractText>SZo and BDo had significantly lower IQ and more often met criteria for a lifetime psychiatric disorder than Co. ICV was significantly smaller in SZo than in BDo (d = -0.56) and Co (d = -0.59), which was largely independent of IQ (respectively, d = -0.54 and d = -0.35). After ICV correction, the cortex was significantly thinner in SZo than in BDo (d = -0.42) and Co (d = -0.75) and lateral ventricles were larger in BDo than in Co (d = 0.55). Correction for IQ or lifetime psychiatric diagnosis did not change these findings.</AbstractText>Despite sharing a lower IQ and a higher prevalence of psychiatric disorders, brain abnormalities in BDo appear less pronounced (but are not absent) than in SZo. Lower ICV in SZo implies that familial risk for schizophrenia has a stronger association with stunted early brain development than familial risk for bipolar disorder.</AbstractText>
2,327,976
Impact of Targeted Deletion of the Circadian Clock Gene Bmal1 in Excitatory Forebrain Neurons on Adult Neurogenesis and Olfactory Function.
The circadian system is an endogenous timekeeping system that synchronizes physiology and behavior with the 24 h solar day. Mice with total deletion of the core circadian clock gene Bmal1 show circadian arrhythmicity, cognitive deficits, and accelerated age-dependent decline in adult neurogenesis as a consequence of increased oxidative stress. However, it is not yet known if the impaired adult neurogenesis is due to circadian disruption or to loss of the Bmal1 gene function. Therefore, we investigated oxidative stress and adult neurogenesis of the two principle neurogenic niches, the hippocampal subgranular zone and the subventricular zone in mice with a forebrain specific deletion of <i>Bmal1</i> (<i>Bmal1 fKO</i>), which show regular circadian rhythmicity. Moreover, we analyzed the morphology of the olfactory bulb, as well as olfactory function in <i>Bmal1 fKO</i> mice. In <i>Bmal1 fKO</i> mice, oxidative stress was increased in subregions of the hippocampus and the olfactory bulb but not in the neurogenic niches. Consistently, adult neurogenesis was not affected in <i>Bmal1 fKO</i> mice. Although Reelin expression in the olfactory bulb was higher in <i>Bmal1 fKO</i> mice as compared to wildtype mice (<i>Bmal1 WT)</i>, the olfactory function was not affected. Taken together, the targeted deletion of <i>Bmal1</i> in mouse forebrain neurons is associated with a regional increase in oxidative stress and increased Reelin expression in the olfactory bulb but does not affect adult neurogenesis or olfactory function.
2,327,977
Increased miR-34c mediates synaptic deficits by targeting synaptotagmin 1 through ROS-JNK-p53 pathway in Alzheimer's Disease.
Alzheimer's disease (AD) and cancer have inverse relationship in many aspects. Some tumor suppressors, including miR-34c, are decreased in cancer but increased in AD. The upstream regulatory pathways and the downstream mechanisms of miR-34c in AD remain to be investigated. The expression of miR-34c was detected by RT-qPCR in oxidative stressed neurons, hippocampus of SAMP8 mice, or serum of patients with amnestic mild cognitive impairment (aMCI). Dual luciferase assay was performed to confirm the binding sites of miR-34c in its target mRNA. The Morris water maze (MWM) was used to evaluate learning and memory in SAMP8 mice administrated with miR-34c antagomir (AM34c). Golgi staining was used to evaluate the synaptic function and structure. The dramatically increased miR-34c was mediated by ROS-JNK-p53 pathway and negatively regulated synaptotagmin 1 (SYT1) expression by targeting the 3'-untranslated region (3'-UTR) of syt1 in AD. The expression of SYT1 protein was reduced by over expression of miR-34c in the HT-22 cells and vice versa. Administration of AM34c by the third ventricle injection or intranasal delivery markedly increased the brain levels of SYT1 and ameliorated the cognitive function in SAMP8 mice. The serum miR-34c was significantly increased in patients with aMCI and might be a predictive biomarker for diagnosis of aMCI. These results indicated that increased miR-34c mediated synaptic and memory deficits by targeting SYT1 through ROS-JNK-p53 pathway and the miR-34c/SYT1 pathway could be considered as a promising novel therapeutic target for patients with AD.
2,327,978
Increased hippocampal shape asymmetry and volumetric ventricular asymmetry in autism spectrum disorder.
Autism spectrum disorder (ASD) is a prevalent and fast-growing pervasive neurodevelopmental disorder worldwide. Despite the increasing prevalence of ASD and the breadth of research conducted on the disorder, a conclusive etiology has yet to be established and controversy still exists surrounding the anatomical abnormalities in ASD. In particular, structural asymmetries have seldom been investigated in ASD, especially in subcortical regions. Additionally, the majority of studies for identifying structural biomarkers associated with ASD have focused on small sample sizes. Therefore, the present study utilizes a large-scale, multi-site database to investigate asymmetries in the amygdala, hippocampus, and lateral ventricles, given the potential involvement of these regions in ASD. Contrary to prior work, we are not only computing volumetric asymmetries, but also shape asymmetries, using a new measure of asymmetry based on spectral shape descriptors. This measure represents the magnitude of the asymmetry and therefore captures both directional and undirectional asymmetry. The asymmetry analysis is conducted on 437 individuals with ASD and 511 healthy controls using T1-weighted MRI scans from the Autism Brain Imaging Data Exchange (ABIDE) database. Results reveal significant asymmetries in the hippocampus and the ventricles, but not in the amygdala, in individuals with ASD. We observe a significant increase in shape asymmetry in the hippocampus, as well as increased volumetric asymmetry in the lateral ventricles in individuals with ASD. Asymmetries in these regions have not previously been reported, likely due to the different characterization of neuroanatomical asymmetry and smaller sample sizes used in previous studies. Given that these results were demonstrated in a large cohort, such asymmetries may be worthy of consideration in the development of neurodiagnostic classification tools for ASD.
2,327,979
Systemic Consequences of Pulmonary Hypertension and Right-Sided Heart Failure.<Pagination><StartPage>678</StartPage><EndPage>693</EndPage><MedlinePgn>678-693</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1161/CIRCULATIONAHA.116.022362</ELocationID><Abstract><AbstractText>Pulmonary hypertension (PH) is a feature of a variety of diseases and continues to harbor high morbidity and mortality. The main consequence of PH is right-sided heart failure which causes a complex clinical syndrome affecting multiple organ systems including left heart, brain, kidneys, liver, gastrointestinal tract, skeletal muscle, as well as the endocrine, immune, and autonomic systems. Interorgan crosstalk and interdependent mechanisms include hemodynamic consequences such as reduced organ perfusion and congestion as well as maladaptive neurohormonal activation, oxidative stress, hormonal imbalance, and abnormal immune cell signaling. These mechanisms, which may occur in acute, chronic, or acute-on-chronic settings, are common and precipitate adverse functional and structural changes in multiple organs which contribute to increased morbidity and mortality. While the systemic character of PH and right-sided heart failure is often neglected or underestimated, such consequences place additional burden on patients and may represent treatable traits in addition to targeted therapy of PH and underlying causes. Here, we highlight the current state-of-the-art understanding of the systemic consequences of PH and right-sided heart failure on multiple organ systems, focusing on self-perpetuating pathophysiological mechanisms, aspects of increased susceptibility of organ damage, and their reciprocal impact on the course of the disease.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Rosenkranz</LastName><ForeName>Stephan</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Clinic III for Internal Medicine (Cardiology) and Cologne Cardiovascular Research Center (CCRC), Heart Center at the University of Cologne, Germany (S.R.).</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Center for Molecular Medicine Cologne (CMMC), University of Cologne, Germany (S.R.).</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Howard</LastName><ForeName>Luke S</ForeName><Initials>LS</Initials><AffiliationInfo><Affiliation>National Pulmonary Hypertension Service, Imperial College Healthcare NHS Trust, London, United Kingdom (L.S.H.).</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gomberg-Maitland</LastName><ForeName>Mardi</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Medicine, George Washington University, Washington, DC (M.G.M.).</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hoeper</LastName><ForeName>Marius M</ForeName><Initials>MM</Initials><AffiliationInfo><Affiliation>Department of Respiratory Medicine, Hannover Medical School, Germany (M.M.H.).</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>German Center for Lung Research (DZL), Hannover, Germany (M.M.H.).</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>02</Month><Day>24</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Circulation</MedlineTA><NlmUniqueID>0147763</NlmUniqueID><ISSNLinking>0009-7322</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D004703" MajorTopicYN="N">Endocrine System</DescriptorName><QualifierName UI="Q000378" MajorTopicYN="N">metabolism</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006333" MajorTopicYN="N">Heart Failure</DescriptorName><QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006352" MajorTopicYN="N">Heart Ventricles</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006439" MajorTopicYN="N">Hemodynamics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006976" MajorTopicYN="N">Hypertension, Pulmonary</DescriptorName><QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007668" MajorTopicYN="N">Kidney</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="N">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008099" MajorTopicYN="N">Liver</DescriptorName><QualifierName UI="Q000378" MajorTopicYN="N">metabolism</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018482" MajorTopicYN="N">Muscle, Skeletal</DescriptorName><QualifierName UI="Q000378" MajorTopicYN="N">metabolism</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">cognitive function</Keyword><Keyword MajorTopicYN="N">immune system</Keyword><Keyword MajorTopicYN="N">kidney dysfunction</Keyword><Keyword MajorTopicYN="N">liver dysfunction</Keyword><Keyword MajorTopicYN="N">pulmonary hypertension</Keyword><Keyword MajorTopicYN="N">right-sided heart failure</Keyword><Keyword MajorTopicYN="N">sleep</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>2</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>2</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>10</Month><Day>21</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32091921</ArticleId><ArticleId IdType="doi">10.1161/CIRCULATIONAHA.116.022362</ArticleId></ArticleIdList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="MEDLINE" Owner="NLM" IndexingMethod="Curated"><PMID Version="1">32090990</PMID><DateCompleted><Year>2020</Year><Month>09</Month><Day>11</Day></DateCompleted><DateRevised><Year>2020</Year><Month>09</Month><Day>11</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1940-087X</ISSN><JournalIssue CitedMedium="Internet"><Issue>156</Issue><PubDate><Year>2020</Year><Month>Feb</Month><Day>06</Day></PubDate></JournalIssue><Title>Journal of visualized experiments : JoVE</Title><ISOAbbreviation>J Vis Exp</ISOAbbreviation></Journal>Displacement Analysis of Myocardial Mechanical Deformation (DIAMOND) Reveals Segmental Heterogeneity of Cardiac Function in Embryonic Zebrafish.
Pulmonary hypertension (PH) is a feature of a variety of diseases and continues to harbor high morbidity and mortality. The main consequence of PH is right-sided heart failure which causes a complex clinical syndrome affecting multiple organ systems including left heart, brain, kidneys, liver, gastrointestinal tract, skeletal muscle, as well as the endocrine, immune, and autonomic systems. Interorgan crosstalk and interdependent mechanisms include hemodynamic consequences such as reduced organ perfusion and congestion as well as maladaptive neurohormonal activation, oxidative stress, hormonal imbalance, and abnormal immune cell signaling. These mechanisms, which may occur in acute, chronic, or acute-on-chronic settings, are common and precipitate adverse functional and structural changes in multiple organs which contribute to increased morbidity and mortality. While the systemic character of PH and right-sided heart failure is often neglected or underestimated, such consequences place additional burden on patients and may represent treatable traits in addition to targeted therapy of PH and underlying causes. Here, we highlight the current state-of-the-art understanding of the systemic consequences of PH and right-sided heart failure on multiple organ systems, focusing on self-perpetuating pathophysiological mechanisms, aspects of increased susceptibility of organ damage, and their reciprocal impact on the course of the disease.</Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Rosenkranz</LastName><ForeName>Stephan</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Clinic III for Internal Medicine (Cardiology) and Cologne Cardiovascular Research Center (CCRC), Heart Center at the University of Cologne, Germany (S.R.).</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Center for Molecular Medicine Cologne (CMMC), University of Cologne, Germany (S.R.).</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Howard</LastName><ForeName>Luke S</ForeName><Initials>LS</Initials><AffiliationInfo><Affiliation>National Pulmonary Hypertension Service, Imperial College Healthcare NHS Trust, London, United Kingdom (L.S.H.).</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gomberg-Maitland</LastName><ForeName>Mardi</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Medicine, George Washington University, Washington, DC (M.G.M.).</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hoeper</LastName><ForeName>Marius M</ForeName><Initials>MM</Initials><AffiliationInfo><Affiliation>Department of Respiratory Medicine, Hannover Medical School, Germany (M.M.H.).</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>German Center for Lung Research (DZL), Hannover, Germany (M.M.H.).</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>02</Month><Day>24</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Circulation</MedlineTA><NlmUniqueID>0147763</NlmUniqueID><ISSNLinking>0009-7322</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D004703" MajorTopicYN="N">Endocrine System</DescriptorName><QualifierName UI="Q000378" MajorTopicYN="N">metabolism</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006333" MajorTopicYN="N">Heart Failure</DescriptorName><QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006352" MajorTopicYN="N">Heart Ventricles</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006439" MajorTopicYN="N">Hemodynamics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006976" MajorTopicYN="N">Hypertension, Pulmonary</DescriptorName><QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007668" MajorTopicYN="N">Kidney</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="N">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008099" MajorTopicYN="N">Liver</DescriptorName><QualifierName UI="Q000378" MajorTopicYN="N">metabolism</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018482" MajorTopicYN="N">Muscle, Skeletal</DescriptorName><QualifierName UI="Q000378" MajorTopicYN="N">metabolism</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">cognitive function</Keyword><Keyword MajorTopicYN="N">immune system</Keyword><Keyword MajorTopicYN="N">kidney dysfunction</Keyword><Keyword MajorTopicYN="N">liver dysfunction</Keyword><Keyword MajorTopicYN="N">pulmonary hypertension</Keyword><Keyword MajorTopicYN="N">right-sided heart failure</Keyword><Keyword MajorTopicYN="N">sleep</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>2</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>2</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>10</Month><Day>21</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32091921</ArticleId><ArticleId IdType="doi">10.1161/CIRCULATIONAHA.116.022362</ArticleId></ArticleIdList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="MEDLINE" Owner="NLM" IndexingMethod="Curated"><PMID Version="1">32090990</PMID><DateCompleted><Year>2020</Year><Month>09</Month><Day>11</Day></DateCompleted><DateRevised><Year>2020</Year><Month>09</Month><Day>11</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1940-087X</ISSN><JournalIssue CitedMedium="Internet"><Issue>156</Issue><PubDate><Year>2020</Year><Month>Feb</Month><Day>06</Day></PubDate></JournalIssue><Title>Journal of visualized experiments : JoVE</Title><ISOAbbreviation>J Vis Exp</ISOAbbreviation></Journal><ArticleTitle>Displacement Analysis of Myocardial Mechanical Deformation (DIAMOND) Reveals Segmental Heterogeneity of Cardiac Function in Embryonic Zebrafish.</ArticleTitle><ELocationID EIdType="doi" ValidYN="Y">10.3791/60547</ELocationID><Abstract>Zebrafish are increasingly utilized as a model organism for cardiomyopathies and regeneration. Current methods evaluating cardiac function fail to reliably detect segmental mechanics and are not readily feasible in zebrafish. Here we present a semiautomated, open-source method for the quantitative assessment of four-dimensional (4D) segmental cardiac function: displacement analysis of myocardial mechanical deformation (DIAMOND). Transgenic embryonic zebrafish were imaged in vivo using a light-sheet fluorescence microscopy system with 4D cardiac motion synchronization. Acquired 3D digital hearts were reconstructed at end-systole and end-diastole, and the ventricle was manually segmented into binary datasets. Then, the heart was reoriented and isotropically resampled along the true short axis, and the ventricle was evenly divided into eight portions (I-VIII) along the short axis. Due to the different resampling planes and matrices at end-systole and end-diastole, a transformation matrix was applied for image registration to restore the original spatial relationship between the resampled systolic and diastolic image matrices. After image registration, the displacement vector of each segment from end-systole to end-diastole was calculated based on the displacement of mass centroids in three dimensions (3D). DIAMOND shows that basal myocardial segments adjacent to the atrioventricular canal undergo the highest mechanical deformation and are the most susceptible to doxorubicin-induced cardiac injury. Overall, DIAMOND provides novel insights into segmental cardiac mechanics in zebrafish embryos beyond traditional ejection fraction (EF) under both physiological and pathological conditions.
2,327,980
Insights into the passive mechanical behavior of left ventricular myocardium using a robust constitutive model based on full 3D kinematics.
Myocardium possesses a hierarchical structure that results in complex three-dimensional (3D) mechanical behavior, forming a critical component of ventricular function in health and disease. A wide range of constitutive model forms have been proposed for myocardium since the first planar biaxial studies were performed by Demer and Yin (J. Physiol. 339 (1), 1983). While there have been extensive studies since, none have been based on full 3D kinematic data, nor have they utilized optimal experimental design to estimate constitutive parameters, which may limit their predictive capability. Herein we have applied our novel 3D numerical-experimental methodology (Avazmohammadi et al., Biomechanics Model. Mechanobiol. 2018) to explore the applicability of an orthotropic constitutive model for passive ventricular myocardium (Holzapfel and Ogden, Philos. Trans. R. Soc. Lond.: Math. Phys. Eng. Sci. 367, 2009) by integrating 3D optimal loading paths, spatially varying material structure, and inverse modeling techniques. Our findings indicated that the initial model form was not successful in reproducing all optimal loading paths, due to previously unreported coupling behaviors via shearing of myofibers and extracellular collagen fibers in the myocardium. This observation necessitated extension of the constitutive model by adding two additional terms based on the I<sub>8</sub>(C) pseudo-invariant in the fiber-normal and sheet-normal directions. The modified model accurately reproduced all optimal loading paths and exhibited improved predictive capabilities. These unique results suggest that more complete constitutive models are required to fully capture the full 3D biomechanical response of left ventricular myocardium. The present approach is thus crucial for improved understanding and performance in cardiac modeling in healthy, diseased, and treatment scenarios.
2,327,981
A single-center study of treatment outcomes of pediatric basal ganglia germinoma in Taiwan.
A basal ganglia (BG) germinoma is a rare tumor, and the optimal treatment remains unknown. We evaluated the clinical outcomes of treatment of BG germinoma in pediatric patients in Taiwan.</AbstractText>We retrospectively reviewed the medical records of 34 children with BG germinoma who were treated with radiotherapy (RT) at Taipei Veterans General Hospital between 1989 and 2016. The median follow-up time is 8.3&#xa0;years (1.8-25.2&#xa0;years). Survival was analyzed using the Kaplan-Meier estimate. Univariate Cox proportional-hazards models were used to identify the potential risk factors.</AbstractText>Only four patients (11.8%) experienced recurrence and all successfully underwent salvage therapy. One patient (2.97%) died due to suspected radiotherapy (RT)-related sarcoma in the scalp. The 2-, 3-, and 5-year DFS rates were 91.2%, 88.2%, and 79.4%, respectively; the 2-, 3-, and 5-year OS rates were 97.1%, 94.1%, and 82.4%, respectively. Focal RT showed low DFS in the Kaplan-Meier survival curves (P&#x2009;=&#x2009;.028) compared with non-focal RT (whole ventricle, whole brain, or cranial spinal area). In the univariate Cox proportional-hazards model, there was a significant difference in DFS between focal and non-focal RT (P&#x2009;=&#x2009;.03). There is no difference in DFS and OS between BG germinoma patients and non-BG germinoma patients.</AbstractText>We found an excellent DFS and OS in pediatric patients with BG germinoma treated with RT. Whole ventricle irradiation is recommended for good tumor control and low treatment-related toxicity. BG germinoma patients showed similar treatment results as germinoma patients in other common sites.</AbstractText>
2,327,982
A case of bi-ventricular extensive calcification caused by multiple factors.
Extensive myocardial calcification has a low incidence rate, but when the patients do have extensive myocardial cases, the prognosis is usually poor. Several sepsis-related extensive myocardial calcification cases have been reported, but there are cases of biventricular calcifications that are caused by multiple cases besides bacteremia and the treatment for it has a low percentage of success.</AbstractText>A 9 year old girl had an extensive biventricular calcification which is caused by multiple factors including multiple organ failure (heart, lung, liver, and kidney), aseptic cardiomyopathy, systemic inflammatory response syndrome, pulmonary hemorrhage, viral encephalitis. In this case study, the massive myocardial calcification present in the patient was classified as dystrophic. After the patient was transferred to the Intensive care unit, a series of rescue treatments such as anti-inflammatory factor storm were implemented to protect the organs. In the end, the patient was rescued from the rescue treatment procedure. After 18&#x2009;months of follow-up, it was observed that the patient's heart function returned to normal and it was observed that there was no change in myocardial calcification in the patient.</AbstractText>In this case study, it showcased a case of the diffused biventricular calcification that caused by multiple factors. Furthermore, the precise role of calcification on cardiac function was largely unknown and there has to be further follow-up observation on the patient.</AbstractText>
2,327,983
Neuroendoscopic lavage for ventriculitis: Case report and literature review.
Ventriculitis, one of the difficulties in neurosurgical treatment, is a significant cause of death and morbidity in patients with hydrocephalus. Neuroendoscopy is widely used in the treatment of non-communicable hydrocephalus. The advantages of neuroendoscopy may play a decisive role in the treatment of ventriculitis.</AbstractText>We report a 34-year-old male patient with refractory fever and rapid progressive disturbance of consciousness due to ventriculitis caused by intraventricle rupture in a left colliculus abscess. He received intravenous (IV) antibiotics and saline neuroendoscopic lavage (NEL) combined with septostomy and endoscopic third ventriculostomy leading to rapid recovery and remission of symptoms. We also reviewed the use of NEL for ventriculitis in PubMed from 1970 to January 20, 2019.</AbstractText>In our review, 93 cases (including the present report) were treated with NEL; 91 cases of infection subsided, and 7 patients died.</AbstractText>NEL may be an effective method for the treatment of ventriculitis.</AbstractText>Copyright &#xa9; 2020 Elsevier Masson SAS. All rights reserved.</CopyrightInformation>
2,327,984
Ultrasound-Based Phenotyping of Lateral Ventricles to Predict Hydrocephalus Outcome in Premature Neonates.
Prediction of post-hemorrhagic hydrocephalus (PHH) outcome-i.e., whether it requires intervention or not-in premature neonates using cranial ultrasound (CUS) images is challenging. In this paper, we present a novel fully-automatic method to perform phenotyping of the brain lateral ventricles and predict PHH outcome from CUS.</AbstractText>Our method consists of two parts: ventricle quantification followed by prediction of PHH outcome. First, cranial bounding box and brain interhemispheric fissure are detected to determine the anatomical position of ventricles and correct the cranium rotation. Then, lateral ventricles are extracted using a new deep learning-based method by incorporating the convolutional neural network into a probabilistic atlas-based weighted loss function and an image-specific adaption. PHH outcome is predicted using a support vector machine classifier trained using ventricular morphological phenotypes and clinical information.</AbstractText>Experiments demonstrated that our method achieves accurate ventricle segmentation results with an average Dice similarity coefficient of 0.86, as well as very good PHH outcome prediction with accuracy of 0.91.</AbstractText>Automatic CUS-based ventricular phenotyping in premature newborns could objectively and accurately predict the progression to severe PHH.</AbstractText>Early prediction of severe PHH development in premature newborns could potentially advance criteria for diagnosis and offer an opportunity for early interventions to improve outcome.</AbstractText>
2,327,985
Predicted heart mass-based size matching among recipients with moderate pulmonary hypertension: Outcomes and sex effect.
There is a lack of evidence to guide appropriate donor sizing in recipients with moderate pulmonary hypertension (pHTN) awaiting heart transplantation (HTx). It is common practice to oversize donor hearts for such recipients to prevent post-operative right ventricular failure. Therefore, our objective was to determine if oversizing in pre-transplant moderate pHTN provides a survival advantage.</AbstractText>The United Network for Organ Sharing database was analyzed to include HTx recipients from 1994 to 2016. Recipients were considered as having moderate pHTN if the pulmonary vascular resistance (PVR) was 2.5 to 5 Wood units (WU) or transpulmonary gradient (TPG) was 10 to 18 mm&#xa0;Hg. Heart size mismatch was determined using the predicted heart mass equations. A size mismatch of &#x2265;15% in either direction was considered undersized or oversized, respectively. Ninety-day and 1-year survival were analyzed based on size matching via univariate and Cox regression analysis. Propensity matching was performed to specifically evaluate the effect of donor sex among male transplant recipients.</AbstractText>Among 29,441 HTx recipients, 10,666 had moderate pHTN by PVR criteria and 12,624 HTx patients had moderate pHTN according to TPG criteria. Among patients with a PVR of 2.5 to 5 WU, oversizing was not associated with lower mortality compared with matched hearts at 90 days (7.6% vs 7.4%; p&#x202f;=&#x202f;0.75) and 1 year (12.1% vs 11.3%; p&#x202f;=&#x202f;0.26). Conversely, undersizing the donor was associated with a higher 90-day (10.6% vs 7.6% vs 7.4%; p &lt; 0.01) and 1-year (15.3% vs 12.1% vs 11.3%; p &lt; 0.01) mortality than recipients receiving oversized or matched hearts, respectively. On Cox regression analysis, there was no benefit with oversizing at 90&#xa0;days (hazard ratio [HR] 0.88; p&#x202f;=&#x202f;0.23) and 1 year (HR 0.99; p&#x202f;=&#x202f;0.90), whereas undersizing was associated with higher 90-day (HR 1.32; p&#x202f;=&#x202f;0.02) and 1-year mortality (HR 1.23; p&#x202f;=&#x202f;0.03) compared to size-matched controls. Among patients with moderate pHTN based on TPG of 10 to 18 mm&#xa0;Hg, neither undersizing nor oversizing was predictive of mortality at 90&#xa0;days and 1 year according to Cox regression analysis. Propensity matching revealed that female-to-male transplantation had similar 1-year mortality to male-to-male transplantation, and there was no advantage to oversizing female donors for male recipients.</AbstractText>In this registry-based analysis, there was no benefit to oversizing donors for cardiac transplant recipients with moderate pHTN. Elimination of this restriction could increase the donor pool and reduce wait times for such recipients.</AbstractText>Copyright &#xa9; 2020 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.</CopyrightInformation>
2,327,986
Multiple hydatid cysts of the interventricular septum.
Hydatid disease, Echinococcus granulosus, is a parasitic infection which is endemic in some countries. The liver and lungs are the most common sites of infection. Cardiac involvement is extremely rare. The most common localizations of cardiac involvement are the left ventricular free wall, right ventricle, and interventricular septum. Herein, we present a rare case of multiple cardiac hydatid cysts in the interventricular septum.
2,327,987
Increased Presence of Cerebral Microbleeds Correlates With Ventricular Enlargement and Increased White Matter Hyperintensities in Alzheimer's Disease.
<b>Objective</b>: To investigate whether the number of cerebral microbleeds (CMB) could be a useful indicator to predict glymphatic system dysfunction in Alzheimer's disease (AD) patients, by comparing the degree of cerebral spinal fluid (CSF) and interstitial fluid (ISF) stasis. <b>Methods</b>: Forty probable AD patients were included, with those exhibiting two or more CMB were included in the multiple CMB group (mCMB, <i>n</i> = 21, mean = 11.1), and none or one CMB included in the non-multiple CMB group (nmCMB, <i>n</i> = 19, mean = 0.84). CMB was defined in axial gradient recalled echo (GRE) T2*-weighted images. Evans index (EI) was calculated to measure lateral ventricle enlargement, Voxel-based Specific Regional Analysis System for Alzheimer's Disease (VSRAD) software was used to determine the extent of gray and white matter atrophy, and Fazekas scale (FS) was used to determine white matter hyperintensities (WMH). <b>Results</b>: EI was significantly larger in mCMB than in nmCMB, while the gray and white matter volume was not different between groups. Thus, the difference in lateral ventricle enlargement between AD with and without multiple CMB reflects a combination of the degree of brain atrophy and the extent of CSF stasis. FS was higher in mCMB than in the nmCMB, suggesting the failure of ISF elimination was more severe in mCMB cases. <b>Conclusion</b>: The difference in lateral ventricle enlargement and WMH between AD with or without multiple CMB may reflect a difference in the degree of CSF/ISF stagnation.
2,327,988
Successful Treatment of Spontaneous Cerebrospinal Fluid Rhinorrhea With Endoscopic Third Ventriculostomy and Lumboperitoneal Shunt: A Case Report.
Spontaneous cerebrospinal fluid (CSF) rhinorrhea represents an important clinical entity that is being observed with increasing prevalence, ranging from 14 to 55%. Spontaneous CSF rhinorrhea is associated with elevated intracranial pressure (ICP), which is rarely stopped without surgical intervention. Endoscopic endonasal repair is typically warranted for CSF rhinorrhea. However, the recurrence rate of CSF leaks after the endoscopic endonasal repair of skull base defects due to ICP is usually high. We describe a 25-year-old man without a history of head injury, tumor, or obesity. The onset of his symptoms occurred in 1 week in the form of a persistent clear left nostril rhinorrhea. Computed tomography (CT) and magnetic resonance images (MRI) showed signs of CSF in the left sphenoidal sinus, meningocele in the left frontal sinus, empty sella, hydrocephalus, and Chiari I malformation (CIM). Cine-MRI revealed the flow of CSF was obstructed at the aqueduct and the outlet of the fourth ventricle. Endoscopic third ventriculostomy (ETV) was performed for the patient with obstructive hydrocephalus. Post-operative CSF pressure measurement demonstrated elevated ICP. The patient still had case of CSF rhinorrhea, and subsequently underwent lumboperitoneal shunt (LPS) for treatment of ICP. The patient showed a prompt resolution of CSF leak. Ten months later, the patient showed a significant improvement in terms of his herniated tonsil and cessation of CSF rhinorrhea.
2,327,989
Developmental trajectories of subcortical structures in relation to dimensional schizotypy expression along adolescence.<Pagination><StartPage>76</StartPage><EndPage>84</EndPage><MedlinePgn>76-84</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.schres.2020.02.005</ELocationID><ELocationID EIdType="pii" ValidYN="Y">S0920-9964(20)30081-5</ELocationID><Abstract><AbstractText>Morphological abnormalities of subcortical structures have been consistently reported along the schizophrenia clinical spectrum, and they may play an important role in the pathophysiology of psychosis. However, the question arises whether these subcortical features are consequences of medication and illness chronicity, or if they contribute to the vulnerability to develop schizophrenia spectrum disorders. If some of the subcortical abnormalities could be evidenced in community adolescents expressing higher schizotypal traits (psychometric schizotypy), they could potentially shed light on vulnerability markers. To date, very few studies have examined the link between psychometric schizotypy and volumes of subcortical regions, and none of them have used a longitudinal design. This study sets out to investigate developmental trajectories of subcortical volumes in 110 community adolescents (12 to 20&#xa0;years old), for whom MRI-scans were acquired over a period of 5&#xa0;years, reaching a total of 297 scans. Analyses were conducted using Freesurfer, and schizotypal traits were measured with the Schizotypal Personality Questionnaire (SPQ). Using mixed model regression analyses following a region-of-interest approach, we observed differential linear developmental trajectories in four subcortical structures when comparing higher versus lower scorers on the disorganized schizotypy dimension (bilateral hippocampus, left-lateral ventricle and left-pallidum) and the negative schizotypy dimension (bilateral pallidum, and right-thalamus). All results survived a threshold of p&#xa0;&lt;&#xa0;.05 (FDR-corrected) while covarying for the effect of other psychological problems (externalized and internalized psychopathology). These results indicate that expression of higher levels of negative and disorganized schizotypy during adolescence was associated with neural markers linking schizotypy personality features to schizophrenia spectrum disorders.</AbstractText><CopyrightInformation>Copyright &#xa9; 2020 Elsevier B.V. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Derome</LastName><ForeName>M&#xe9;lodie</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland; Developmental Neuroimaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva, Switzerland. Electronic address: Melodie.Derome@unige.ch.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Z&#xf6;ller</LastName><ForeName>Daniela</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Developmental Neuroimaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva, Switzerland; Medical Image Processing Lab, Institute of Bioengineering, EPFL, Lausanne, Switzerland; Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland. Electronic address: Daniela.Zoller@unige.ch.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Modinos</LastName><ForeName>Gemma</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Department of Psychosis Studies, Institute of Psychiatry, Psychology &amp; Neuroscience, King's College London, UK; Department of Neuroimaging, Institute of Psychiatry, Psychology &amp; Neuroscience, King's College London, UK. Electronic address: gemma.modinos@kcl.ac.uk.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schaer</LastName><ForeName>Marie</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Developmental Neuroimaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva, Switzerland. Electronic address: Marie.Schaer@unige.ch.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Eliez</LastName><ForeName>Stephan</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Developmental Neuroimaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva, Switzerland; Department of Genetic Medicine and Development, School of Medicine, University of Geneva, Switzerland. Electronic address: Stephan.Eliez@unige.ch.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Debban&#xe9;</LastName><ForeName>Martin</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland; Developmental Neuroimaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva, Switzerland; Research Department of Clinical, Educational &amp; Health Psychology, University College London, United Kingdom. Electronic address: martin.debbane@unige.ch.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>02</Month><Day>17</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>Schizophr Res</MedlineTA><NlmUniqueID>8804207</NlmUniqueID><ISSNLinking>0920-9964</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002648" MajorTopicYN="N">Child</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011594" MajorTopicYN="N">Psychometrics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011618" MajorTopicYN="Y">Psychotic Disorders</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012559" MajorTopicYN="Y">Schizophrenia</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012569" MajorTopicYN="Y">Schizotypal Personality Disorder</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011795" MajorTopicYN="N">Surveys and Questionnaires</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Adolescence</Keyword><Keyword MajorTopicYN="N">Developmental trajectories</Keyword><Keyword MajorTopicYN="N">Schizophrenia</Keyword><Keyword MajorTopicYN="N">Schizotypy</Keyword><Keyword MajorTopicYN="N">Structural MRI</Keyword></KeywordList><CoiStatement>Declaration of competing interest The authors have declared that there are no conflicts of interest in relation to the subject of this study.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2019</Year><Month>11</Month><Day>26</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>2</Month><Day>9</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>2</Month><Day>9</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>2</Month><Day>23</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>6</Month><Day>22</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>2</Month><Day>22</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32081537</ArticleId><ArticleId IdType="doi">10.1016/j.schres.2020.02.005</ArticleId><ArticleId IdType="pii">S0920-9964(20)30081-5</ArticleId></ArticleIdList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">32081420</PMID><DateRevised><Year>2020</Year><Month>02</Month><Day>21</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1090-2104</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Feb</Month><Day>17</Day></PubDate></JournalIssue><Title>Biochemical and biophysical research communications</Title><ISOAbbreviation>Biochem Biophys Res Commun</ISOAbbreviation></Journal>Mutations of histone demethylase genes encoded by X and Y chromosomes, Kdm5c and Kdm5d, lead to noncompaction cardiomyopathy in mice.
Morphological abnormalities of subcortical structures have been consistently reported along the schizophrenia clinical spectrum, and they may play an important role in the pathophysiology of psychosis. However, the question arises whether these subcortical features are consequences of medication and illness chronicity, or if they contribute to the vulnerability to develop schizophrenia spectrum disorders. If some of the subcortical abnormalities could be evidenced in community adolescents expressing higher schizotypal traits (psychometric schizotypy), they could potentially shed light on vulnerability markers. To date, very few studies have examined the link between psychometric schizotypy and volumes of subcortical regions, and none of them have used a longitudinal design. This study sets out to investigate developmental trajectories of subcortical volumes in 110 community adolescents (12 to 20&#xa0;years old), for whom MRI-scans were acquired over a period of 5&#xa0;years, reaching a total of 297 scans. Analyses were conducted using Freesurfer, and schizotypal traits were measured with the Schizotypal Personality Questionnaire (SPQ). Using mixed model regression analyses following a region-of-interest approach, we observed differential linear developmental trajectories in four subcortical structures when comparing higher versus lower scorers on the disorganized schizotypy dimension (bilateral hippocampus, left-lateral ventricle and left-pallidum) and the negative schizotypy dimension (bilateral pallidum, and right-thalamus). All results survived a threshold of p&#xa0;&lt;&#xa0;.05 (FDR-corrected) while covarying for the effect of other psychological problems (externalized and internalized psychopathology). These results indicate that expression of higher levels of negative and disorganized schizotypy during adolescence was associated with neural markers linking schizotypy personality features to schizophrenia spectrum disorders.<CopyrightInformation>Copyright &#xa9; 2020 Elsevier B.V. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Derome</LastName><ForeName>M&#xe9;lodie</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland; Developmental Neuroimaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva, Switzerland. Electronic address: Melodie.Derome@unige.ch.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Z&#xf6;ller</LastName><ForeName>Daniela</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Developmental Neuroimaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva, Switzerland; Medical Image Processing Lab, Institute of Bioengineering, EPFL, Lausanne, Switzerland; Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland. Electronic address: Daniela.Zoller@unige.ch.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Modinos</LastName><ForeName>Gemma</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Department of Psychosis Studies, Institute of Psychiatry, Psychology &amp; Neuroscience, King's College London, UK; Department of Neuroimaging, Institute of Psychiatry, Psychology &amp; Neuroscience, King's College London, UK. Electronic address: gemma.modinos@kcl.ac.uk.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schaer</LastName><ForeName>Marie</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Developmental Neuroimaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva, Switzerland. Electronic address: Marie.Schaer@unige.ch.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Eliez</LastName><ForeName>Stephan</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Developmental Neuroimaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva, Switzerland; Department of Genetic Medicine and Development, School of Medicine, University of Geneva, Switzerland. Electronic address: Stephan.Eliez@unige.ch.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Debban&#xe9;</LastName><ForeName>Martin</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland; Developmental Neuroimaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva, Switzerland; Research Department of Clinical, Educational &amp; Health Psychology, University College London, United Kingdom. Electronic address: martin.debbane@unige.ch.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>02</Month><Day>17</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>Schizophr Res</MedlineTA><NlmUniqueID>8804207</NlmUniqueID><ISSNLinking>0920-9964</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002648" MajorTopicYN="N">Child</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011594" MajorTopicYN="N">Psychometrics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011618" MajorTopicYN="Y">Psychotic Disorders</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012559" MajorTopicYN="Y">Schizophrenia</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012569" MajorTopicYN="Y">Schizotypal Personality Disorder</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011795" MajorTopicYN="N">Surveys and Questionnaires</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Adolescence</Keyword><Keyword MajorTopicYN="N">Developmental trajectories</Keyword><Keyword MajorTopicYN="N">Schizophrenia</Keyword><Keyword MajorTopicYN="N">Schizotypy</Keyword><Keyword MajorTopicYN="N">Structural MRI</Keyword></KeywordList><CoiStatement>Declaration of competing interest The authors have declared that there are no conflicts of interest in relation to the subject of this study.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2019</Year><Month>11</Month><Day>26</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>2</Month><Day>9</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>2</Month><Day>9</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>2</Month><Day>23</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>6</Month><Day>22</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>2</Month><Day>22</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32081537</ArticleId><ArticleId IdType="doi">10.1016/j.schres.2020.02.005</ArticleId><ArticleId IdType="pii">S0920-9964(20)30081-5</ArticleId></ArticleIdList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">32081420</PMID><DateRevised><Year>2020</Year><Month>02</Month><Day>21</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1090-2104</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Feb</Month><Day>17</Day></PubDate></JournalIssue><Title>Biochemical and biophysical research communications</Title><ISOAbbreviation>Biochem Biophys Res Commun</ISOAbbreviation></Journal><ArticleTitle>Mutations of histone demethylase genes encoded by X and Y chromosomes, Kdm5c and Kdm5d, lead to noncompaction cardiomyopathy in mice.</ArticleTitle><ELocationID EIdType="pii" ValidYN="Y">S0006-291X(20)30311-9</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.bbrc.2020.02.043</ELocationID><Abstract>Mammalian X and Y chromosomes evolved from a pair of autosomes. Although most ancestral genes have been lost from the Y chromosome, a small number of ancestral X-Y gene pairs are still present on the sex chromosomes. The KDM5C and KDM5D genes, which encode H3K4 histone demethylases, are a surviving ancestral gene pair located on the X and Y chromosomes, respectively. Mutations in KDM5C cause X-linked intellectual disability in human males, suggesting functional divergence between KDM5C and KDM5D in the nervous system. In this study, to explore the functional conservation and divergence between these two genes in other organs, we generated female mice lacking Kdm5c (homozygous X<sup>5c-</sup> X<sup>5c-</sup> females) and male mice lacking both Kdm5c and Kdm5d (compound hemizygous X<sup>5c-</sup> Y<sup>5d-</sup> males). Both X<sup>5c-</sup> X<sup>5c-</sup> females and X<sup>5c-</sup> Y<sup>5d-</sup> males showed lower body weights and postnatal lethality. Histological examination of the hearts showed prominent trabecular extension and a thin layer of compacted myocardium in the left and right ventricles, indicating noncompaction cardiomyopathy. However, hemizygous males lacking either Kdm5c or Kdm5d showed no signs of noncompaction cardiomyopathy. These results clearly demonstrate that the function of Kdm5c and Kdm5d in heart development is conserved.
2,327,990
Abundant Self-Amplifying Intermediate Progenitors in the Subventricular Zone of the Chinese Tree Shrew Neocortex.
During evolution, neural progenitor cells in the subventricular zone (SVZ) have fundamental functions, ranging from brain volume expansion to the generation of a six-layered neocortex. In lissencephalic animal models, such as rodents, the majority of neural progenitors in the SVZ are intermediate progenitor cells (IPCs). Most IPCs in rodents undergo neurogenic division, and only a small portion of them divide a very limited number of times to generate a few neurons. Meanwhile, in gyrencephalic animals, such as primates, IPCs are able to self-renew for up to five successive divisions. However, abundant IPCs with successive proliferative capacity have not been directly observed in nonprimate species. In this study, we examined the development of neural progenitors in the Chinese tree shrew (Tupaia belangeri chinensis), a lissencephalic animal with closer affinity than rodents to primates. We identified an expansion of the SVZ and the presence of outer radial glial (oRG) cells in the neocortex. We also found that IPCs have the capacity to self-amplify multiple times and therefore serve as major proliferative progenitors. To our knowledge, our study provides the first direct evidence of abundant IPCs with proliferative potential in a nonprimate species, further supporting the key role of IPCs in brain expansion.
2,327,991
The Lateral Ventricles: A Detailed Review of Anatomy, Development, and Anatomic Variations.
The cerebral ventricles have been studied since the fourth century BC and were originally thought to harbor the soul and higher executive functions. During the infancy of neuroradiology, alterations to the ventricular shape and position on pneumoencephalography and ventriculography were signs of mass effect or volume loss. However, in the current era of high-resolution cross-sectional imaging, variation in ventricular anatomy is more easily detectable and its clinical significance is still being investigated. Interpreting radiologists must be aware of anatomic variations of the ventricular system to prevent mistaking normal variants for pathology. We will review of the anatomy and development of the lateral ventricles and discuss several ventricular variations.
2,327,992
Redefining Hematoma Expansion With the Inclusion of Intraventricular Hemorrhage Growth.
Background and Purpose- Definitions of significant hematoma expansion traditionally focus on changes in intraparenchymal volume. The presence of intraventricular hemorrhage (IVH) is a predictor of poor outcome, but current definitions of hematoma expansion do not include IVH expansion. We evaluated whether including IVH expansion to current definitions of hematoma expansion improves the ability to predict 90-day outcome. Methods- Using data from the PREDICT-ICH study (Predicting Hematoma Growth and Outcome in Intracerebral Hemorrhage Using Contrast Bolus CT), we compared a standard definition of hematoma expansion (&#x2265;6 mL or &#x2265;33%) to revised definitions that includes new IVH development or expansion (&#x2265;6 mL or &#x2265;33% or any IVH; &#x2265;6 mL or &#x2265;33% or IVH expansion &#x2265;1 mL). The primary outcome was poor clinical outcome (modified Rankin Scale score, 4-6) at 90 days. Diagnostic accuracy measures were calculated for each definition, and C statistics for each definition were compared using nonparametric methods. Results- Of the 256 patients eligible for primary analysis, 127 (49.6%) had a modified Rankin Scale score of 4 to 6. Sensitivity and specificity for the standard definition (n=80) were 45.7% (95% CI, 36.8-54.7) and 82.9% (95% CI, 75.3-88.9), respectively. The revised definition, &#x2265;6 mL or &#x2265;33% or any IVH (n=113), possessed a sensitivity of 63.8% (95% CI, 54.8-72.1) and specificity of 75.2% (95% CI, 66.8-82.4). Overall accuracy was significantly improved with the revised definition (<i>P</i>=0.013) and after adjusting for relevant covariates, was associated with a 2.55-fold increased odds (95% CI, 1.31-4.94) of poor outcome at 90 days. A second revised definition, &#x2265;6 mL or &#x2265;33% or IVH expansion &#x2265;1 mL, performed similarly (sensitivity, 56.7% [95% CI, 47.6-65.5]; specificity, 78.3% [95% CI, 40.2-85.1]; aOR, 2.40 [95% CI, 1.23-4.69]). Conclusions- In patients with mild-to-moderate ICH, including IVH expansion to the definition of hematoma expansion improves sensitivity with only minimal decreases to specificity and improves overall prediction of 90-day outcome.
2,327,993
Brain Ventricular System and Cerebrospinal Fluid Development and Function: Light at the End of the Tube: A Primer with Latest Insights.
The brain ventricular system is a series of connected cavities, filled with cerebrospinal fluid (CSF), that forms within the vertebrate central nervous system (CNS). The hollow neural tube is a hallmark of the chordate CNS, and a closed neural tube is essential for normal development. Development and function of the ventricular system is examined, emphasizing three interdigitating components that form a functional system: ventricle walls, CSF fluid properties, and activity of CSF constituent factors. The cellular lining of the ventricle both can produce and is responsive to CSF. Fluid properties and conserved CSF components contribute to normal CNS development. Anomalies of the CSF/ventricular system serve as diagnostics and may cause CNS disorders, further highlighting their importance. This review focuses on the evolution and development of the brain ventricular system, associated function, and connected pathologies. It is geared as an introduction for scholars with little background in the field.
2,327,994
Programmable valve breakage in shunt systems of children with posthemorrhagic hydrocephalus after minor head trauma-a case series.
We report five rare cases of programmable valve breakage (Codman Hakim-Medos valve) in shunt systems of children with posthemorrhagic hydrocephalus. Only four similar studies have been published in the current literature.</AbstractText>Between 2013 and 2018, five children with posthemorrhagic hydrocephalus were admitted to the pediatric department. All patients had a history of slight blows to the head in a minor trauma and follow up MRI scans. After initial clinical examination, cranial computed tomography (CT) and X-ray were conducted.</AbstractText>In all cases, pumping the reservoir resulted in very slow refilling. The cranial CT in one patient showed slit ventricles confirming the suspicion of overdrainage, the other cases a slight enhancement of the hydrocephalus. In lateral X-rays of the skull in comparison to the first X-ray control of the shunt valve, the pressure control chamber could be seen dislocated in the inferior part of the reservoir in all cases. Surgery revealed that the shunt valve was broken. The pressure control chamber had dropped to the bottom of the reservoir. After implantation of a new shunt valve, the symptoms resolved completely in all five children. Overall this complication occurred in 4.3% (5 of 85 implanted Codman Hakim-Medos valve) of all children necessitating ventriculoperitoneal shunt implantation between January 2013 and December 2018.</AbstractText>The well-accepted Codman Hakim-Medos programmable valve is part of a tube-system, which is designed to offer the possibility of a reliable and precise treatment of hydrocephalus. Various mechanical and non-mechanical complications of shunt systems have been reported. Valve breakage is a very rare condition, often missed, and must be kept in mind when trauma and prior MRI scan are reported.</AbstractText>
2,327,995
Magnetic Resonance Imaging Findings in 13 Neurologic Pot-Bellied Pigs.
This study reports the magnetic resonance imaging (MRI) findings in 13 pot-bellied pigs presented to our institution with neurological deficits. Nine pigs had abnormal MRI findings (7 with spinal cord localization and 2 with brain localization), with three of them having histopathological confirmation of the diagnoses. MRI diagnoses included a myopathy suspected to be secondary to <i>Erysipelothrix rhusiopathiae</i>, a round cell neoplasia involving the vertebral canal, myelomalacia, a cervical cyst like extradural lesion, pelvic fracture with secondary cauda equina involvement, two cases of fibrocartilaginous embolism or acute non-compressive nucleus pulposus extrusion, multifocal brain infarcts, and a cystic fourth ventricle dilation resulting in obstructive hydrocephalus and syringomyelia. Four pigs had normal MRI studies, with one of them ultimately diagnosed with idiopathic vestibular disease. This retrospective study illustrates the wide variety of diagnoses achieved with MRI of the head or vertebral column in pigs, several of them having never been described in this species. Some of the conditions identified had a good outcome. This justifies using MRI as an ante-mortem diagnostic tool as it can provide relevant information about the prognosis which can significantly influence treatment recommendations. Our findings suggest that MRI should be considered as a valuable imaging modality, when feasible, in pigs with neurological deficits.
2,327,996
Examining the Progressive Behavior and Neuropathological Outcomes Associated with Chronic Repetitive Mild Traumatic Brain Injury in Rats.
While the physical and behavioral symptomologies associated with a single mild traumatic brain injury (mTBI) are typically transient, repetitive mTBIs (RmTBI) have been associated with persisting neurological deficits. Therefore, this study examined the progressive changes in behavior and the neuropathological outcomes associated with chronic RmTBI through adolescence and adulthood in male and female Sprague Dawley rats. Rats experienced 2 mTBIs/week for 15&#xa0;weeks and were periodically tested for changes in motor behavior, cognitive function, emotional disturbances, and aggression. Brain tissue was examined for neuropathological changes in ventricle size and presentation of Iba1 and GFAP. We did not see progressively worse behavioral impairments with the accumulation of injuries or time, but did find evidence for neurological and functional change (motor disturbance, reduced exploration, reduced aggression, alteration in depressive-like behavior, deficits in short-term working memory). Neuropathological assessment of RmTBI animals identified an increase in ventricle size, prolonged changes in GFAP, and sex differences in Iba1, in the corpus callosum, thalamus, and medial prefrontal cortex. Telomere length reduced exponentially as the injury load increased. Overall, chronic RmTBI did not result in accumulating behavioral impairment, and there is a need to further investigate progressive behavioral changes associated with repeated injuries in adolescence and young adulthood.
2,327,997
The Spatial Distribution of Water Components with Similar T<sub>2</sub> May Provide Insight into Pathways for Large Molecule Transportation in the Brain.
Although there is no lymphatic system in the central nervous system (CNS), there seems to be a mechanism to remove macro molecules from the brain. Cerebrospinal fluid (CSF) and interstitial fluid (ISF) are thought to be parts of this pathway, but the details are not known. In this study, MR signal of the extracellular water was decomposed into components with distinct T2</sub>'s, to obtain some information about distribution of waste material in the brain.</AbstractText>Images were acquired using a Curr, Purcell, Meiboom, Gill (CPMG) imaging sequence. In order to reduce T1</sub> contamination and the signal oscillation, hard pulses were used as refocusing pulses. The signal was then decomposed into many T2</sub> components using non-negative least squares (NNLS) in pixel-by-pixel basis. Finally, a color map was generated by assigning different color for each T2</sub> component, then adding them together.</AbstractText>From the multi-echo images, it was possible to decompose the decaying signal into separate T2</sub> components. By adjusting the color table to create the color map, it is possible to visualize the extracellular water distribution, as well as their T2</sub> values. Several observation points include: (1) CSF inside ventricles has very long T2</sub> (~2 s), and seems to be relatively homogeneous, (2) subarachnoid CSF also have long T2</sub>, but there are short T2</sub> component at the brain surface, at the surface of dura, at the blood vessels in the subarachnoid space, etc., (3) in the brain parenchyma, short T2</sub> components (longer than intracellular component but shorter than CSF) exists along the white matter, in the choroid plexus, etc. These can be considered as distribution of macromolecules (waste materials) in the brain.</AbstractText>From T2</sub> component analysis it is possible to obtain some insight into pathways for the transport of large molecules in the CNS, where no lymphatic system is present.</AbstractText>
2,327,998
Neural stem cell phenotype of tanycyte-like ependymal cells in the circumventricular organs and central canal of adult mouse brain.
Tanycyte is a subtype of ependymal cells which extend long radial processes to brain parenchyma. The present study showed that tanycyte-like ependymal cells in the organum vasculosum of the lamina terminalis, subfornical organ and central canal (CC) expressed neural stem cell (NSC) marker nestin, glial fibrillar acidic protein and sex determining region Y. Proliferation of these tanycyte-like ependymal cells was promoted by continuous intracerebroventricular infusion of fibroblast growth factor-2 and epidermal growth factor. Tanycytes-like ependymal cells in the CC are able to form self-renewing neurospheres and give rise&#xa0;mostly to new astrocytes and oligodendrocytes. Collagenase-induced small medullary hemorrhage increased proliferation of tanycyte-like ependymal cells in the CC. These results demonstrate that these tanycyte-like ependymal cells of the adult mouse brain are NSCs and suggest that they serve as a source for providing new neuronal lineage cells upon brain damage in the medulla oblongata.
2,327,999
Generalizing Deep Learning for Medical Image Segmentation to Unseen Domains via Deep Stacked Transformation.
Recent advances in deep learning for medical image segmentation demonstrate expert-level accuracy. However, application of these models in clinically realistic environments can result in poor generalization and decreased accuracy, mainly due to the domain shift across different hospitals, scanner vendors, imaging protocols, and patient populations etc. Common transfer learning and domain adaptation techniques are proposed to address this bottleneck. However, these solutions require data (and annotations) from the target domain to retrain the model, and is therefore restrictive in practice for widespread model deployment. Ideally, we wish to have a trained (locked) model that can work uniformly well across unseen domains without further training. In this paper, we propose a deep stacked transformation approach for domain generalization. Specifically, a series of n stacked transformations are applied to each image during network training. The underlying assumption is that the "expected" domain shift for a specific medical imaging modality could be simulated by applying extensive data augmentation on a single source domain, and consequently, a deep model trained on the augmented "big" data (BigAug) could generalize well on unseen domains. We exploit four surprisingly effective, but previously understudied, image-based characteristics for data augmentation to overcome the domain generalization problem. We train and evaluate the BigAug model (with n=9 transformations) on three different 3D segmentation tasks (prostate gland, left atrial, left ventricle) covering two medical imaging modalities (MRI and ultrasound) involving eight publicly available challenge datasets. The results show that when training on relatively small dataset (n = 10~32 volumes, depending on the size of the available datasets) from a single source domain: (i) BigAug models degrade an average of 11%(Dice score change) from source to unseen domain, substantially better than conventional augmentation (degrading 39%) and CycleGAN-based domain adaptation method (degrading 25%), (ii) BigAug is better than "shallower" stacked transforms (i.e. those with fewer transforms) on unseen domains and demonstrates modest improvement to conventional augmentation on the source domain, (iii) after training with BigAug on one source domain, performance on an unseen domain is similar to training a model from scratch on that domain when using the same number of training samples. When training on large datasets (n = 465 volumes) with BigAug, (iv) application to unseen domains reaches the performance of state-of-the-art fully supervised models that are trained and tested on their source domains. These findings establish a strong benchmark for the study of domain generalization in medical imaging, and can be generalized to the design of highly robust deep segmentation models for clinical deployment.