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2,328,100
N-acetylcysteine inhibits bacterial lipopeptide-mediated neutrophil transmigration through the choroid plexus in the developing brain.
The etiology of neurological impairments associated with prematurity and other perinatal complications often involves an infectious or pro-inflammatory component. The use of antioxidant molecules have proved useful to protect the neonatal brain from injury. The choroid plexuses-CSF system shapes the central nervous system response to inflammation at the adult stage, but little is known on the neuroimmune interactions that take place at the choroidal blood-CSF barrier during development. We previously described that peripheral administration to neonatal mice of the TLR2 ligand PAM3CSK4 (P3C), a prototypic Gram-positive bacterial lipopeptide, induces the migration of innate immune cells to the CSF. Here we showed in neonatal rats exposed to P3C that the migration of neutrophils into the CSF, which occurred through the choroid plexuses, is abolished following administration of the antioxidant drug N-acetylcysteine. Combining light sheet microscopy imaging of choroid plexus, a differentiated model of the blood-CSF barrier, and multiplex cytokine assays, we showed that the choroidal epithelium responds to the bacterial insult by a specific pattern of cytokine secretion, leading to a selective accumulation of neutrophils in the choroid plexus and to their trafficking into CSF. N-acetylcysteine acted by blocking neutrophil migration across both the endothelium of choroidal stromal vessels and the epithelium forming the blood-CSF barrier, without interfering with neutrophil blood count, neutrophil tropism for choroid plexus, and choroidal chemokine-driven chemotaxis. N-acetylcysteine reduced the injury induced by hypoxia-ischemia in P3C-sensitized neonatal rats. Overall, the data show that a double endothelial and epithelial check point controls the transchoroidal migration of neutrophils into the developing brain. They also point to the efficacy of N-acetylcysteine in reducing the deleterious effects of inflammation-associated perinatal injuries by a previously undescribed mechanism, i.e. the inhibition of innate immune cell migration across the choroid plexuses, without interfering with the systemic inflammatory response to infection.
2,328,101
3D Hermite Transform Optical Flow Estimation inLeft Ventricle CT Sequences.
Heart diseases are the most important causes of death in the world and over the years, thestudy of cardiac movement has been carried out mainly in two dimensions, however, it is important toconsider that the deformations due to the movement of the heart occur in a three-dimensional space.The 3D + t analysis allows to describe most of the motions of the heart, for example, the twistingmotion that takes place on every beat cycle that allows us identifying abnormalities of the heartwalls. Therefore, it is necessary to develop algorithms that help specialists understand the cardiacmovement. In this work, we developed a new approach to determine the cardiac movement inthree dimensions using a differential optical flow approach in which we use the steered Hermitetransform (SHT) which allows us to decompose cardiac volumes taking advantage of it as a model ofthe human vision system (HVS). Our proposal was tested in complete cardiac computed tomography(CT) volumes ( 3D + t), as well as its respective left ventricular segmentation. The robustness tonoise was tested with good results. The evaluation of the results was carried out through errors inforwarding reconstruction, from the volume at time t to time t + 1 using the optical flow obtained(interpolation errors). The parameters were tuned extensively. In the case of the 2D algorithm, theinterpolation errors and normalized interpolation errors are very close and below the values reportedin ground truth flows. In the case of the 3D algorithm, the results were compared with another similarmethod in 3D and the interpolation errors remained below 0.1. These results of interpolation errorsfor complete cardiac volumes and the left ventricle are shown graphically for clarity. Finally, a seriesof graphs are observed where the characteristic of contraction and dilation of the left ventricle isevident through the representation of the 3D optical flow.
2,328,102
Neuroinflammation and Neurogenesis in Alzheimer's Disease and Potential Therapeutic Approaches.
In adult brain, new neurons are generated throughout adulthood in the subventricular zone and the dentate gyrus; this process is commonly known as adult neurogenesis. The regulation or modulation of adult neurogenesis includes various intrinsic pathways (signal transduction pathway and epigenetic or genetic modulation pathways) or extrinsic pathways (metabolic growth factor modulation, vascular, and immune system pathways). Altered neurogenesis has been identified in Alzheimer's disease (AD), in both human AD brains and AD rodent models. The exact mechanism of the dysregulation of adult neurogenesis in AD has not been completely elucidated. However, neuroinflammation has been demonstrated to alter adult neurogenesis. The presence of various inflammatory components, such as immune cells, cytokines, or chemokines, plays a role in regulating the survival, proliferation, and maturation of neural stem cells. Neuroinflammation has also been considered as a hallmark neuropathological feature of AD. In this review, we summarize current, state-of-the art perspectives on adult neurogenesis, neuroinflammation, and the relationship between these two phenomena in AD. Furthermore, we discuss the potential therapeutic approaches, focusing on the anti-inflammatory and proneurogenic interventions that have been reported in this field.
2,328,103
Developmental dynamics of the periventricular parietal crossroads of growing cortical pathways in the fetal brain - In vivo fetal MRI with histological correlation.
The periventricular crossroads have been described as transient structures of the fetal brain where major systems of developing fibers intersect. The triangular parietal crossroad constitutes one major crossroad region. By combining in vivo and post-mortem fetal MRI with histological and immunohistochemical methods, we aimed to characterize these structures. Data from 529 in vivo and 66 post-mortem MRI examinations of fetal brains between gestational weeks (GW) 18-39 were retrospectively reviewed. In each fetus, the area adjacent to the trigone of the lateral ventricles at the exit of the posterior limb of the internal capsule (PLIC) was assessed with respect to signal intensity, size, and shape on T2-weighted images. In addition, by using in vivo diffusion tensor imaging (DTI), the main fiber pathways that intersect in these areas were identified. In order to explain the in vivo features of the parietal crossroads (signal intensity and developmental profile), we analyzed 23 post-mortem fetal human brains, between 16 and ​40 GW of age, processed by histological and immunohistochemical methods. The parietal crossroads were triangular-shaped areas with the base in the continuity of the PLIC, adjacent to the germinal matrix and the trigone of the lateral ventricles, with the tip pointing toward the subplate. These areas appeared hyperintense to the subplate, and corresponded to a convergence zone of the developing external capsule, the PLIC, and the fronto-occipital association fibers. They were best detected between GW 25-26, and, at term, they became isointense to the adjacent structures. The immunohistochemical results showed a distinct cellular, fibrillar, and extracellular matrix arrangement in the parietal crossroads, depending on the stage of development, which influenced the MRI features. The parietal crossroads are transient, but important structures in white matter maturation and their damage may be indicative of a poor prognosis for a fetus with regard to neurological development. In addition, impairment of this region may explain the complex neurodevelopmental deficits in preterm infants with periventricular hypoxic/ischemic or inflammatory lesions.
2,328,104
Lobar holoprosencephaly with craniofacial defects in a Friesian calf: A case report.
Holoprosencephaly is a forebrain deformity that results from varying degrees of separation failure of cerebral hemispheres.&#xa0;The condition is classified based on the degree of non-separation of the hemispheres which, in turn, determines its severity. Holoprosencephaly is usually accompanied by craniofacial defects whose severity tends to reflect the extent of brain deformities. In humans, holoprosencephaly is one of the commonest congenital brain anomalies but in&#xa0;animals, reported cases are scarce. The condition has multifactorial aetiology that involves interactions between several genetic and environmental factors.</AbstractText>A 4-day-old female Friesian calf with a deformed face was reported to the Faculty of veterinary medicine and surgery, Egerton University. The calf and the dam were sired by the same bull. On clinical and radiographic examination, the calf had a short snout that curved dorsally with bilateral cleft lip, right-sided cleft jaw and a largely absent primary palate. Anatomopathological examination revealed brain deformities which included ventral fusion of frontal lobes of cerebral hemispheres, large merged lateral ventricles without septum pellucidum and fornix, hypoplastic corpus callosum, high degree of non-separation between diencephalic structures, poorly developed hippocampal formation and hypoplastic olfactory lobe, optic chiasma, and nerve.</AbstractText>The case was confirmed as lobar holoprosencephaly based on characteristic anatomopathological findings. The aetiology of the defects in the present case could not be determined though they are thought to be either a result of recessive inheritance or exposure to teratogenic steroid alkaloids&#xa0;through materials fed to the dam during early pregnancy.</AbstractText>&#xa9; 2020 The Authors. Veterinary Medicine and Science Published by John Wiley &amp; Sons Ltd.</CopyrightInformation>
2,328,105
Temperature-Controlled Radiofrequency Ablation Using Irrigated Catheters: Maximizing Ventricular Lesion Dimensions While Reducing Steam-Pop Formation.
The goal of this study was to examine the safety and efficacy of radiofrequency ablation (RFA) with irrigated catheters operated in a temperature-controlled mode for ventricular ablation.</AbstractText>Techniques to increase RFA dimensions are associated with higher risk for steam-pops. A novel irrigated catheter with circumferential thermocouples embedded in its ablation surface provides real-time surface temperature data. This study hypothesized that RFA operated in a temperature-controlled mode may allow maximizing lesion dimensions while reducing the occurrence of steam-pops.</AbstractText>RFA with an irrigated catheter incorporating surface thermocouples was examined in 6 swine thigh muscle preparations and 15 beating ventricles at higher (50 W/60 s, Tmax</sub>50o</sup>C) and lower (50 W/60 s, Tmax</sub>45o</sup>C) temperature limits. Biophysical properties, lesion dimensions, and steam-pop occurrence were compared versus RFA with a standard catheter operated in power-control mode at higher (50 W/60 s) and lower (40W/60 s) power, and additionally at high power with half-normal saline (50 W/60 s).</AbstractText>In the thigh muscle preparation, lesion depth and width were similar between all groups (p&#xa0;=&#xa0;0.90 and p&#xa0;=&#xa0;0.17, respectively). Steam-pops were most frequent with power-controlled ablation at 50 W/60&#xa0;s (82%) and least frequent with temperature-controlled ablation at 50 W/60 s, Tmax</sub>45o</sup>C (0%; p&#xa0;&lt;&#xa0;0.001). In the beating ventricle, lesion&#xa0;depth was comparable between all RFA settings (p&#xa0;=&#xa0;0.09). Steam-pops were most frequent using power-controlled ablation at 50 W/60&#xa0;s (37%) and least frequent with temperature-controlled ablation at 50 W/60 s, Tmax</sub>45o</sup>C (7%; p&#xa0;&lt;&#xa0;0.001). Half-normal saline had no incremental effect on lesion dimensions at 50&#xa0;W in either the thigh muscle or the beating heart.</AbstractText>RFA using a novel irrigated catheter with surface thermocouples operated in a temperature-controlled mode can maximize lesion dimensions while reducing the risk for steam-pops.</AbstractText>Copyright &#xa9; 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.</CopyrightInformation>
2,328,106
7T MRI Predicts Amelioration of Neurodegeneration in the Brain after AAV Gene Therapy.
GM1 gangliosidosis (GM1) is a fatal neurodegenerative lysosomal storage disease that occurs most commonly in young children, with no effective treatment available. Long-term follow-up of GM1 cats treated by bilateral thalamic and deep cerebellar nuclei (DCN) injection of adeno-associated virus (AAV)-mediated gene therapy has increased lifespan to 8 years of age, compared with an untreated lifespan of ~8&#xa0;months. Due to risks associated with cerebellar injection in humans, the lateral ventricle was tested as a replacement route to deliver an AAVrh8 vector expressing feline &#x3b2;-galactosidase (&#x3b2;-gal), the defective enzyme in GM1. Treatment via the thalamus and lateral ventricle corrected storage, myelination, astrogliosis, and neuronal morphology in areas where &#x3b2;-gal was effectively delivered. Oligodendrocyte number increased, but only in areas where myelination was corrected. Reduced AAV and &#x3b2;-gal distribution were noted in the cerebellum with subsequent increases in storage, demyelination, astrogliosis, and neuronal degeneration. These postmortem findings were correlated with endpoint MRI and magnetic resonance spectroscopy (MRS). Compared with the moderate dose with which most cats were treated, a higher AAV dose produced superior survival, currently 6.5 years. Thus, MRI and MRS can predict therapeutic efficacy of AAV gene therapy and non-invasively monitor cellular events within the GM1 brain.
2,328,107
A Novel Deep Learning Approach with a 3D Convolutional Ladder Network for Differential Diagnosis of Idiopathic Normal Pressure Hydrocephalus and Alzheimer's Disease.
Idiopathic normal pressure hydrocephalus (iNPH) and Alzheimer's disease (AD) are geriatric diseases and common causes of dementia. Recently, many studies on the segmentation, disease detection, or classification of MRI using deep learning have been conducted. The aim of this study was to differentiate iNPH and AD using a residual extraction approach in the deep learning method.</AbstractText>Twenty-three patients with iNPH, 23 patients with AD and 23 healthy controls were included in this study. All patients and volunteers underwent brain MRI with a 3T unit, and we used only whole-brain three-dimensional (3D) T1</sub>-weighted images. We designed a fully automated, end-to-end 3D deep learning classifier to differentiate iNPH, AD and control. We evaluated the performance of our model using a leave-one-out cross-validation test. We also evaluated the validity of the result by visualizing important areas in the process of differentiating AD and iNPH on the original input image using the Gradient-weighted Class Activation Mapping (Grad-CAM) technique.</AbstractText>Twenty-one out of 23 iNPH cases, 19 out of 23 AD cases and 22 out of 23 controls were correctly diagnosed. The accuracy was 0.90. In the Grad-CAM heat map, brain parenchyma surrounding the lateral ventricle was highlighted in about half of the iNPH cases that were successfully diagnosed. The medial temporal lobe or inferior horn of the lateral ventricle was highlighted in many successfully diagnosed cases of AD. About half of the successful cases showed nonspecific heat maps.</AbstractText>Residual extraction approach in a deep learning method achieved a high accuracy for the differential diagnosis of iNPH, AD, and healthy controls trained with a small number of cases.</AbstractText>
2,328,108
[Protective effects and mechanisms of Xingnaojing Injection on early global brain ischemic-induced deep coma in rats].
To study the protective effect of Xingnaojing Injection on early global brain ischemia-induced deep coma in rats.&#x2029; Methods: The deep coma model was induced by global brain ischemia by using four-vessel occlusion method in male SD rats. According to the body weight, the rats were randomly divided into 8 groups: a model control group, three different dose of Xingnaojing Injection (1.8, 3.6 and 5.4 mL.kg-1) groups, a Xingnaojing Injection (3.6 mL.kg-1) plus PI3K inhibitor group, a naloxone injection (0.04 mL.kg-1) group and a naloxone injection (0.04 mL.kg-1) plus Xingnaojing Injection (3.6 mL.kg-1) group (n=8 per group). In addition, eight animals served as the sham group were performed same operation with the model group excepting no blockage of the blood vessels. After the operation, three different doses of Xingnaojing Injection and/or naloxone injection were given intravenously once a day for three days. Ten &#x3bc;L PI3K inhibitor (LY294002, 10 mmol/L) was injected via anterior cerebral ventricle at once after global brain ischemia. The awakening time after the first drug treatment, the grasping power and the autonomous activity within 10 min after the last drug treatment were recorded. The levels of both dopamine (DA) and glutamate (Glu) in cerebrospinal fluid were detected by ELISA. The pathological changes were observed in brain tissue slices with HE staining and the protein levels of Akt/p-Akt and cAMP-response element binding protein (CREB)/p-CREB in hippocampus were detected by Western blotting.&#x2029; Results: Comparing with the model group, single administration of Xingnaojing Injection could significantly shorten the waking time (P&lt;0.05) and continuous administration of Xingnaojing Injection for 3 d could increase grasping power, distance, frequency and duration of autonomous activities (P&lt;0.05 or P&lt;0.01) in the deep coma rat. Also, Xingnaojing Injection could inhibit these increases in neurotransmitters DA and Glu contents (P&lt;0.05 or P&lt;0.01), and improve pathological changes of hippocampal tissue. Xingnaojing Injection significantly induced protein phosphorylation of both Akt and CREB (P&lt;0.05 or P&lt;0.01); this effect was inhibited by PI3K inhibitor (P&lt;0.05 or P&lt;0.01). Moreover, the protective effects of naloxone on awakening time, grasping power, the autonomous activity and hippocampus damage in global brain ischemia-induced deep coma could be enhanced by joint use of Xingnaojing Injection (P&lt;0.05 or P&lt;0.01).&#x2029; Conclusion: Xingnaojing Injection could significantly improve deep coma induced by global brain ischemia in rat, which is related to inducing PI3K/Akt-dependent protein phosphorylation of CREB, and reducing hippocampal damage. The protective effect of Xingnaojing Injection is synergistically enhanced by naloxone.</Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Xin</LastName><ForeName>Hongya</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Blood, Xiangya Hospital, Central South University, Changsha 410008, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Shi</LastName><ForeName>Zhengang</ForeName><Initials>Z</Initials><AffiliationInfo><Affiliation>Hunan Center of Drug Safety Evaluation and Research of Drugs, Hunan Key Laboratory of Pharmacodynamics and Safety Evaluation of New Drugs, Changsha 410331; Hunan University of Traditional Chinese Medicine, National Key Laboratory Breeding Base of Chinese Medicine Powders and Innovative Drugs/Technology Innovation Center, Changsha 410208, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wu</LastName><ForeName>Lifeng</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Hunan Center of Drug Safety Evaluation and Research of Drugs, Hunan Key Laboratory of Pharmacodynamics and Safety Evaluation of New Drugs, Changsha 410331; Hunan University of Traditional Chinese Medicine, National Key Laboratory Breeding Base of Chinese Medicine Powders and Innovative Drugs/Technology Innovation Center, Changsha 410208, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zhang</LastName><ForeName>Miaohong</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Hunan Center of Drug Safety Evaluation and Research of Drugs, Hunan Key Laboratory of Pharmacodynamics and Safety Evaluation of New Drugs, Changsha 410331, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yuan</LastName><ForeName>Xiangzhong</ForeName><Initials>X</Initials><AffiliationInfo><Affiliation>Hunan Center of Drug Safety Evaluation and Research of Drugs, Hunan Key Laboratory of Pharmacodynamics and Safety Evaluation of New Drugs, Changsha 410331, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wang</LastName><ForeName>Ping</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Hunan Center of Drug Safety Evaluation and Research of Drugs, Hunan Key Laboratory of Pharmacodynamics and Safety Evaluation of New Drugs, Changsha 410331, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Xu</LastName><ForeName>Yongxing</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Hunan Center of Drug Safety Evaluation and Research of Drugs, Hunan Key Laboratory of Pharmacodynamics and Safety Evaluation of New Drugs, Changsha 410331, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zeng</LastName><ForeName>Guirong</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Hunan Center of Drug Safety Evaluation and Research of Drugs, Hunan Key Laboratory of Pharmacodynamics and Safety Evaluation of New Drugs, Changsha 410331, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wang</LastName><ForeName>Haijun</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Cardio-Cerebrovascular Department, A&#xfb03;liated Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.</Affiliation></AffiliationInfo></Author></AuthorList><Language>chi</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>China</Country><MedlineTA>Zhong Nan Da Xue Xue Bao Yi Xue Ban</MedlineTA><NlmUniqueID>101230586</NlmUniqueID><ISSNLinking>1672-7347</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D004365">Drugs, Chinese Herbal</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="C000594497">xingnaojing</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000818" MajorTopicYN="N">Animals</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001921" MajorTopicYN="N">Brain</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002545" MajorTopicYN="Y">Brain Ischemia</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003128" MajorTopicYN="N">Coma</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004365" MajorTopicYN="N">Drugs, Chinese Herbal</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019869" MajorTopicYN="N">Phosphatidylinositol 3-Kinases</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D051381" MajorTopicYN="N">Rats</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017207" MajorTopicYN="N">Rats, Sprague-Dawley</DescriptorName></MeshHeading></MeshHeadingList><OtherAbstract Type="Publisher" Language="chi">&#x76ee;&#x7684;&#xff1a;&#x7814;&#x7a76;&#x9192;&#x8111;&#x9759;&#x6ce8;&#x5c04;&#x6db2;&#x5bf9;&#x5927;&#x9f20;&#x5168;&#x8111;&#x7f3a;&#x8840;&#x6027;&#x6df1;&#x660f;&#x8ff7;&#x7684;&#x65e9;&#x671f;&#x4fdd;&#x62a4;&#x4f5c;&#x7528;&#x53ca;&#x5176;&#x673a;&#x5236;&#x3002;&#x65b9;&#x6cd5;&#xff1a;&#x96c4;&#x6027;SD&#x5927;&#x9f20;&#x91c7;&#x7528;&#x56db;&#x8840;&#x7ba1;&#x963b;&#x585e;&#x6cd5;&#x5efa;&#x7acb;&#x5168;&#x8111;&#x7f3a;&#x8840;&#x6027;&#x6df1;&#x660f;&#x8ff7;&#x6a21;&#x578b;&#x540e;&#x5206;&#x7ec4;&#xff1a;&#x6a21;&#x578b;&#x5bf9;&#x7167;&#x7ec4;&#x3001;&#x9192;&#x8111;&#x9759;&#x4f4e;&#x3001;&#x4e2d;&#x3001;&#x9ad8;&#x5242;&#x91cf;&#x7ec4;(1.8&#xff0c;3.6&#xff0c;5.4 mL/kg)&#x3001;&#x9192;&#x8111;&#x9759;(3.6 mL/kg)+PI3K&#x6291;&#x5236;&#x5242;&#x7ec4;&#x3001;&#x7eb3;&#x6d1b;&#x916e;&#x7ec4;(0.04 mL/kg)&#x3001;&#x9192;&#x8111;&#x9759;(3.6 mL/kg)+&#x7eb3;&#x6d1b;&#x916e;&#x7ec4;(0.04 mL/kg)&#xff0c;&#x6bcf;&#x7ec4;8&#x53ea;&#x3002;&#x53e6;&#x8bbe;8&#x53ea;&#x52a8;&#x7269;&#x4e3a;&#x5047;&#x624b;&#x672f;&#x7ec4;&#x3002;&#x7ed9;&#x836f;&#x7ec4;&#x624b;&#x672f;&#x540e;&#x9759;&#x8109;&#x7ed9;&#x4e88;&#x4e0d;&#x540c;&#x5242;&#x91cf;&#x7684;&#x9192;&#x8111;&#x9759;&#x6ce8;&#x5c04;&#x6db2;&#x548c;/&#x6216;&#x7eb3;&#x6d1b;&#x916e;&#x6ce8;&#x5c04;&#x6db2;&#xff0c;&#x7ed9;&#x836f;&#x4f53;&#x79ef;10.0 mL/kg&#xff0c;&#x8fde;&#x7eed;&#x7ed9;&#x836f;3 d&#xff1b;&#x9192;&#x8111;&#x9759;+PI3K&#x6291;&#x5236;&#x5242;&#x7ec4;&#x4e3a;&#x9020;&#x6a21;&#x540e;&#x7acb;&#x5373;&#x4fa7;&#x8111;&#x5ba4;&#x6ce8;&#x5c04;10.0 &#x3bc;L PI3K&#x6291;&#x5236;&#x5242;LY294002(10 mmol/L)&#xff0c;&#x7136;&#x540e;&#x518d;&#x7ed9;&#x4e88;&#x9192;&#x8111;&#x9759;&#x6ce8;&#x5c04;&#x6db2;(3.6 mL/kg)&#x3002;&#x8bb0;&#x5f55;&#x9996;&#x6b21;&#x7ed9;&#x836f;&#x540e;&#x52a8;&#x7269;&#x82cf;&#x9192;&#x65f6;&#x95f4;&#x3001;&#x672b;&#x6b21;&#x7ed9;&#x836f;&#x540e;&#x6293;&#x529b;&#x548c;10 min&#x5185;&#x81ea;&#x4e3b;&#x6d3b;&#x52a8;&#xff1b;&#x91c7;&#x7528;ELISA&#x6cd5;&#x68c0;&#x6d4b;&#x8111;&#x810a;&#x6db2;&#x591a;&#x5df4;&#x80fa;(dopamine&#xff0c;DA)&#x548c;&#x8c37;&#x6c28;&#x9178;(glutamate&#xff0c;Glu)&#x7684;&#x542b;&#x91cf;&#xff1b;&#x91c7;&#x7528;HE&#x67d3;&#x8272;&#x89c2;&#x5bdf;&#x8111;&#x7ec4;&#x7ec7;&#x75c5;&#x7406;&#x6539;&#x53d8;&#xff1b;&#x91c7;&#x7528;&#x86cb;&#x767d;&#x8d28;&#x514d;&#x75ab;&#x5370;&#x8ff9;&#x6cd5;&#x68c0;&#x6d4b;&#x6d77;&#x9a6c;&#x7ec4;&#x7ec7;&#x86cb;&#x767d;&#x6fc0;&#x9176;B(Akt)&#x86cb;&#x767d;&#x53ca;&#x5176;&#x78f7;&#x9178;&#x5316;&#x86cb;&#x767d;(p-Akt)&#x548c;cAMP&#x5e94;&#x7b54;&#x5143;&#x4ef6;&#x7ed3;&#x5408;&#x86cb;&#x767d;(cAMP-response element binding protein&#xff0c;CREB)&#x53ca;&#x5176;&#x78f7;&#x9178;&#x5316;&#x86cb;&#x767d;(p-CREB)&#x7684;&#x8868;&#x8fbe;&#x3002;&#x7ed3;&#x679c;&#xff1a;&#x4e0e;&#x6a21;&#x578b;&#x5bf9;&#x7167;&#x7ec4;&#x6bd4;&#x8f83;&#xff0c;&#x9192;&#x8111;&#x9759;&#x6ce8;&#x5c04;&#x6db2;&#x5355;&#x6b21;&#x7ed9;&#x836f;&#x80fd;&#x660e;&#x663e;&#x7f29;&#x77ed;&#x5927;&#x9f20;&#x82cf;&#x9192;&#x65f6;&#x95f4;(P&lt;0.05)&#xff0c;&#x8fde;&#x7eed;&#x7ed9;&#x836f;3 d&#x80fd;&#x660e;&#x663e;&#x589e;&#x52a0;&#x5927;&#x9f20;&#x6293;&#x529b;&#x3001;&#x81ea;&#x4e3b;&#x6d3b;&#x52a8;&#x603b;&#x8def;&#x7a0b;&#x3001;&#x6d3b;&#x52a8;&#x6b21;&#x6570;&#x3001;&#x6d3b;&#x52a8;&#x65f6;&#x95f4;(P&lt;0.05&#x6216;P&lt;0.01)&#xff0c;&#x964d;&#x4f4e;DA&#x548c;Glu&#x7684;&#x542b;&#x91cf;(P&lt;0.05&#x6216;P&lt;0.01)&#xff0c;&#x6539;&#x5584;&#x6d77;&#x9a6c;&#x7ec4;&#x7ec7;&#x75c5;&#x7406;&#x6539;&#x53d8;&#x3002;&#x9192;&#x8111;&#x9759;&#x6ce8;&#x5c04;&#x6db2;&#x80fd;&#x663e;&#x8457;&#x8bf1;&#x5bfc;Akt&#x548c;CREB&#x86cb;&#x767d;&#x8d28;&#x7684;&#x78f7;&#x9178;&#x5316;(P&lt;0.05&#x6216;P&lt;0.01)&#x3002;PI3K&#x6291;&#x5236;&#x5242;LY294002&#x80fd;&#x660e;&#x663e;&#x6291;&#x5236;&#x9192;&#x8111;&#x9759;&#x6ce8;&#x5c04;&#x6db2;&#x5bf9;&#x5168;&#x8111;&#x7f3a;&#x8840;&#x6027;&#x6df1;&#x660f;&#x8ff7;&#x5927;&#x9f20;&#x4e0a;&#x8ff0;&#x6539;&#x5584;&#x4f5c;&#x7528;(P&lt;0.05&#x6216;P&lt;0.01)&#x3002;&#x9192;&#x8111;&#x9759;&#x6ce8;&#x5c04;&#x6db2;&#x80fd;&#x663e;&#x8457;&#x589e;&#x52a0;&#x7eb3;&#x6d1b;&#x916e;&#x6ce8;&#x5c04;&#x6db2;&#x5bf9;&#x5927;&#x9f20;&#x5168;&#x8111;&#x7f3a;&#x8840;&#x6027;&#x6df1;&#x660f;&#x8ff7;&#x7684;&#x4e0a;&#x8ff0;&#x6539;&#x5584;&#x4f5c;&#x7528;(P&lt;0.05&#x6216;P&lt;0.01)&#x3002;&#x7ed3;&#x8bba;&#xff1a;&#x9192;&#x8111;&#x9759;&#x6ce8;&#x5c04;&#x6db2;&#x80fd;&#x660e;&#x663e;&#x6539;&#x5584;&#x5927;&#x9f20;&#x5168;&#x8111;&#x7f3a;&#x8840;&#x6027;&#x6df1;&#x660f;&#x8ff7;&#xff0c;&#x5176;&#x673a;&#x5236;&#x4e0e;&#x4e0a;&#x8c03;PI3K/Akt&#x4ecb;&#x5bfc;&#x7684;CREB&#x78f7;&#x9178;&#x5316;&#xff0c;&#x8c03;&#x8282;&#x795e;&#x7ecf;&#x9012;&#x8d28;&#x548c;&#x4fdd;&#x62a4;&#x6d77;&#x9a6c;&#x7ec4;&#x7ec7;&#x6709;&#x5173;&#x3002;&#x9192;&#x8111;&#x9759;&#x6ce8;&#x5c04;&#x6db2;&#x4e0e;&#x7eb3;&#x6d1b;&#x916e;&#x5bf9;&#x5927;&#x9f20;&#x5168;&#x8111;&#x7f3a;&#x8840;&#x6027;&#x6df1;&#x660f;&#x8ff7;&#x6709;&#x534f;&#x540c;&#x589e;&#x6548;&#x4f5c;&#x7528;&#x3002;.
2,328,109
Swift Spontaneous Regression of a Pediatric Traumatic Acute Subdural Hematoma.
We report the case of a 4-year-old girl with acute subdural hematoma who presented to the emergency department after an unwitnessed fall of the balcony. The hematoma was hyperdense along the left convexity of 9 mm thickness with a consequent mass effect with obliteration of the adjacent sulci, left lateral ventricle compression and a midline shift of 7 mm. During her stay in the emergency department while waiting for transfer to the children intensive care unit elsewhere she slightly deteriorated neurologically. Repeat CT scan of the brain 4 h after initial presentation remarkably showed that the subdural hematoma had now largely disappeared, with a decrease in volume and density. Consequently, the mass effect diminished with a near normalization of the midline shift.
2,328,110
Taking pigeons to heart: Birds proficiently diagnose human cardiac disease.
In two experiments, we trained pigeons (Columba livia) to sort visual images (obtained by clinical myocardial perfusion imaging techniques) depicting different degrees of human cardiac disfunction (myocardial hypoperfusion of the left ventricle) into normal and abnormal categories by providing food reward only after correct choice responses. Pigeons proved to be highly proficient at categorizing pseudo-colorized images as well as highly sensitive to the degree of the perfusion deficit depicted in the abnormal images. In later testing, the pigeons completely transferred discriminative responding to novel stimuli, demonstrating that they had fully learned the normal and abnormal categories. Yet, these pigeons failed to transfer discriminative responding to grayscale images containing no color information. We therefore trained a second cohort of pigeons to categorize grayscale image sets from the outset. These birds required substantially more training to achieve similar levels of performance. Yet, they too completely transferred discriminative responding to novel stimuli by relying on both global and local disparities in brightness between the normal and abnormal images. These results confirm that pseudo-colorization can enhance pigeons' categorization of human cardiac images, a result also found with human observers. Overall, our findings further document the potential of the pigeon as a useful aide in studies of medical image perception.
2,328,111
Cranial and ventricular size following shunting or endoscopic third ventriculostomy (ETV) in infants with aqueductal stenosis: further insights from the International Infant Hydrocephalus Study (IIHS).
The craniometrics of head circumference (HC) and ventricular size are part of the clinical assessment of infants with hydrocephalus and are often utilized in conjunction with other clinical and radiological parameters to determine the success of treatment. We aimed to assess the effect of endoscopic third ventriculostomy (ETV) and shunting on craniometric measurements during the follow-up of a cohort of infants with symptomatic triventricular hydrocephalus secondary to aqueductal stenosis.</AbstractText>We performed a post hoc analysis of data from the International Infant Hydrocephalus Study (IIHS)-a prospective, multicenter study of infants (&lt;&#x2009;24&#xa0;months old) with hydrocephalus from aqueductal stenosis who were treated with either an ETV or shunt. During various stages of a 5-year follow-up period, the following craniometrics were measured: HC, HC centile, HC z-score, and frontal-occipital horn ratio (FOR). Data were compared in an analysis of covariance, adjusting for baseline variables including age at surgery and sex.</AbstractText>Of 158 enrolled patients, 115 underwent an ETV, while 43 received a shunt. Both procedures led to improvements in the mean HC centile position and z-score, a trend which continued until the 5-year assessment point. A similar trend was noted for FOR which was measured at 12&#xa0;months and 3&#xa0;years following initial treatment. Although the values were consistently higher for ETV compared with shunt, the differences in HC value, centile, and z-score were not significant. ETV was associated with a significantly higher FOR compared with shunting at 12&#xa0;months (0.52 vs 0.44; p&#x2009;=&#x2009;0.002) and 3&#xa0;years (0.46 vs 0.38; p&#x2009;=&#x2009;0.03) of follow-up.</AbstractText>ETV and shunting led to improvements in HC centile, z-score, and FOR measurements during long-term follow-up of infants with hydrocephalus secondary to aqueductal stenosis. Head size did not significantly differ between the treatment groups during follow-up, however ventricle size was greater in those undergoing ETV when measured at 1 and 3&#xa0;years following treatment.</AbstractText>
2,328,112
Anisotropic conduction in the myocardium due to fibrosis: the effect of texture on wave propagation.
Cardiac fibrosis occurs in many forms of heart disease. It is well established that the spatial pattern of fibrosis, its texture, substantially affects the onset of arrhythmia. However, in most modelling studies fibrosis is represented by multiple randomly distributed short obstacles that mimic only one possible texture, diffuse fibrosis. An important characteristic feature of other fibrosis textures, such as interstitial and patchy textures, is that fibrotic inclusions have substantial length, which is suggested to have a pronounced effect on wave propagation. In this paper, we study the effect of the elongation of inexcitable inclusions (obstacles) on wave propagation in a 2D model of cardiac tissue described by the TP06 model for human ventricular cells. We study in detail how the elongation of obstacles affects various characteristics of the waves. We quantify the anisotropy induced by the textures, its dependency on the obstacle length and the effects of the texture on the shape of the propagating wave. Because such anisotropy is a result of zig-zag propagation we show, for the first time, quantification of the effects of geometry and source-sink relationship, on the zig-zag nature of the pathway of electrical conduction. We also study the effect of fibrosis in the case of pre-existing anisotropy and introduce a procedure for scaling of the fibrosis texture. We show that fibrosis can decrease or increase the preexisting anisotropy depending on its scaled texture.
2,328,113
Transcriptomic profiles reveal differences between the right and left ventricle in normoxia and hypoxia.
Chronic hypoxia from diseases in the lung, such as pulmonary hypertension, pulmonary fibrosis, and chronic obstructive pulmonary disease, can increase pulmonary vascular resistance, resulting in hypertrophy and dysfunction of the right ventricle (RV). In order to obtain insight into RV biology and perhaps uncover potentially novel therapeutic approaches for RV dysfunction, we performed RNA-sequencing (RNA-seq) of RV and LV tissue from rats in normal ambient conditions or subjected to hypoxia (10% O<sub>2</sub> ) for 2&#xa0;weeks. Gene ontology and pathway analysis of the RV and LV revealed multiple transcriptomic differences, in particular increased expression in the RV of genes related to immune function in both normoxia and hypoxia. Immune cell profiling by flow cytometry of cardiac digests revealed that in both conditions, the RV had a larger percentage than the LV of double-positive CD45<sup>+</sup> /CD11b/c<sup>+</sup> cells (which are predominantly macrophages and dendritic cells). Analysis of gene expression changes under hypoxic conditions identified multiple pathways that may contribute to hypoxia-induced changes in the RV, including increased expression of genes related to cell mitosis/proliferation and decreased expression of genes related to metabolic processes. Together, the findings indicate that the RV differs from the LV with respect to content of immune cells and expression of certain genes, thus suggesting the two ventricles differ in aspects of pathophysiology and in potential therapeutic targets for RV dysfunction.
2,328,114
[Using the FOCUS Family Intervention for Family-Centered Care in a Premature Infant With Grade IV Intraventricular Hemorrhage].
Preterm infants face increased rates of mortality and developmental complications, which are a burden on children's parents (and caregivers), who suffer from exhaustion and situational uncertainty. This case focused on an extremely-low-birth-weight (908 gm) premature infant with initial unstable vital signs complicated by a grade 4 intraventricular hemorrhage (IVH) that led to partial brain atrophy and enlarged brain ventricles. A poor neurological outcome was expected due to the high risk of cerebral palsy and impaired cognitive abilities. Long-term healthcare for this critical infant was causing tremendous physical, emotional, and financial strains on the family. The parents suffered from worries over the poor prognosis, resulting in stress, sleep disorders, and relationship difficulties with the healthcare professionals. Considering the poor prognosis of the infant, the parents faced a medical dilemma between choosing aggressive treatment and withdrawal of treatment, which led to stress and sleep disorders. Differences between the parents and health professionals regarding disease severity perception and treatment opinions further strained their mutual relationship. To ameliorate this issue, the author implemented family-centered care (the FOCUS family intervention) to help the patient and his family. This intervention is designed to increase family involvement, foster an optimistic attitude and effective stress coping techniques, and reduce uncertainty and negative emotions. For the patient, we provided symptom-relief management to improve abnormal muscle tone and development delay. Our intervention ameliorated the negative emotions, insomnia symptoms, and imbalanced family relationships and improved the life quality of the caregivers. Furthermore, the intervention enhanced the patient's autoregulatory ability, and both physical and neurological development. This case study is expected to provide experience in critical care for premature infants with a poor prognosis and their family using a FOCUS family intervention as well as to improve the quality of healthcare delivery in intensive clinical settings.</Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Qiu</LastName><ForeName>Xuan-Yu</ForeName><Initials>XY</Initials><AffiliationInfo><Affiliation>BSN, RN, Department of Nursing, National Taiwan University Hospital, Taiwan, ROC.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fann</LastName><ForeName>Guei-Ling</ForeName><Initials>GL</Initials><AffiliationInfo><Affiliation>MSN, RN, Supervisor, Department of Nursing, National Taiwan University Hospital, Taiwan, ROC.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yang</LastName><ForeName>Hsiao-Ling</ForeName><Initials>HL</Initials><AffiliationInfo><Affiliation>PhD, RN, Assistant Professor, School of Nursing, College of Medicine, National Taiwan University, Taiwan, ROC. slyang@ntu.edu.tw.</Affiliation></AffiliationInfo></Author></AuthorList><Language>chi</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>China (Republic : 1949- )</Country><MedlineTA>Hu Li Za Zhi</MedlineTA><NlmUniqueID>0073267</NlmUniqueID></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D002543" MajorTopicYN="N">Cerebral Hemorrhage</DescriptorName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005190" MajorTopicYN="N">Family</DescriptorName><QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D052577" MajorTopicYN="N">Infant, Extremely Low Birth Weight</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007231" MajorTopicYN="N">Infant, Newborn</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007234" MajorTopicYN="N">Infant, Premature</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007235" MajorTopicYN="N">Infant, Premature, Diseases</DescriptorName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011368" MajorTopicYN="Y">Professional-Family Relations</DescriptorName></MeshHeading></MeshHeadingList><OtherAbstract Type="Publisher" Language="chi"><AbstractText Label="TITLE" NlmCategory="BACKGROUND">&#x904b;&#x7528;FOCUS&#x5bb6;&#x5ead;&#x4ecb;&#x5165;&#x63aa;&#x65bd;&#x65bc;&#x56db;&#x5ea6;&#x8166;&#x5ba4;&#x51fa;&#x8840;&#x65e9;&#x7522;&#x5152;&#x53ca;&#x5176;&#x5bb6;&#x5ead;&#x4e4b;&#x7167;&#x8b77;&#x7d93;&#x9a57;.<AbstractText Label="UNLABELLED">&#x65e9;&#x7522;&#x5152;&#x56e0;&#x70ba;&#x5668;&#x5b98;&#x767c;&#x80b2;&#x4e0d;&#x6210;&#x719f;&#xff0c;&#x6709;&#x8f03;&#x9ad8;&#x7684;&#x5408;&#x4f75;&#x75c7;&#x53ca;&#x6b7b;&#x4ea1;&#x7387;&#xff0c;&#x4f7f;&#x5176;&#x7236;&#x6bcd;&#x5728;&#x5145;&#x6eff;&#x91ab;&#x7642;&#x7684;&#x4e0d;&#x78ba;&#x5b9a;&#x6027;&#x8207;&#x7121;&#x529b;&#x611f;&#x4e4b;&#x4e2d;&#xff0c;&#x9032;&#x800c;&#x5c0d;&#x500b;&#x4eba;&#x7684;&#x8eab;&#x5fc3;&#x5065;&#x5eb7;&#x53ca;&#x5168;&#x5bb6;&#x4eba;&#x7684;&#x751f;&#x6d3b;&#x9020;&#x6210;&#x8af8;&#x591a;&#x8ca0;&#x9762;&#x7684;&#x5f71;&#x97ff;&#x3002;&#x672c;&#x6587;&#x500b;&#x6848;&#x70ba;&#x4e00;&#x4f4d;&#x6975;&#x4f4e;&#x51fa;&#x751f;&#x9ad4;&#x91cd;908&#x516c;&#x514b;&#x7684;&#x65e9;&#x7522;&#x5152;&#xff0c;&#x4e00;&#x958b;&#x59cb;&#x751f;&#x547d;&#x5fb5;&#x8c61;&#x4e0d;&#x7a69;&#x5b9a;&#xff0c;&#x800c;&#x5f8c;&#x5408;&#x4f75;&#x56db;&#x5ea6;&#x8166;&#x5ba4;&#x51fa;&#x8840;&#xff0c;&#x9020;&#x6210;&#x8166;&#x840e;&#x7e2e;&#x53ca;&#x8166;&#x5ba4;&#x64f4;&#x5927;&#xff0c;&#x6709;&#x6975;&#x9ad8;&#x7684;&#x6a5f;&#x7387;&#x5c0e;&#x81f4;&#x8166;&#x6027;&#x9ebb;&#x75fa;&#x53ca;&#x8a8d;&#x77e5;&#x969c;&#x7919;&#x3002;&#x500b;&#x6848;&#x4e0d;&#x50c5;&#x672a;&#x4f86;&#x9700;&#x4f9d;&#x8cf4;&#x4ed6;&#x4eba;&#x7167;&#x9867;&#xff0c;&#x4ea6;&#x53ef;&#x80fd;&#x9020;&#x6210;&#x5bb6;&#x4eba;&#x6c89;&#x91cd;&#x7684;&#x8eab;&#x3001;&#x5fc3;&#x53ca;&#x7d93;&#x6fdf;&#x8ca0;&#x64d4;&#x3002;&#x6848;&#x7236;&#x6bcd;&#x5728;&#x9762;&#x5c0d;&#x500b;&#x6848;&#x7684;&#x4e0d;&#x826f;&#x9810;&#x5f8c;&#xff0c;&#x9677;&#x5165;&#x653e;&#x68c4;&#x8207;&#x7a4d;&#x6975;&#x6551;&#x6cbb;&#x7684;&#x73fe;&#x5be6;&#x8207;&#x502b;&#x7406;&#x5169;&#x96e3;&#xff0c;&#x9020;&#x6210;&#x6975;&#x5927;&#x7684;&#x58d3;&#x529b;&#x53ca;&#x7761;&#x7720;&#x554f;&#x984c;&#x3002;&#x5728;&#x91ab;&#x7642;&#x6c7a;&#x7b56;&#x904e;&#x7a0b;&#x4e2d;&#xff0c;&#x6848;&#x7236;&#x6bcd;&#x8207;&#x81e8;&#x5e8a;&#x91ab;&#x8b77;&#x4eba;&#x54e1;&#x5c0d;&#x500b;&#x6848;&#x75c5;&#x6cc1;&#x8207;&#x6cbb;&#x7642;&#x7684;&#x8a8d;&#x77e5;&#x4e0d;&#x540c;&#xff0c;&#x4ea6;&#x5c0e;&#x81f4;&#x91ab;&#x75c5;&#x95dc;&#x4fc2;&#x7dca;&#x5f35;&#x3002;&#x7b46;&#x8005;&#x904b;&#x7528;FOCUS&#x5bb6;&#x5ead;&#x4ecb;&#x5165;&#x63aa;&#x65bd;&#xff08;FOCUS family intervention&#xff09;&#xff0c;&#x63d0;&#x4f9b;&#x4ee5;&#x5bb6;&#x5ead;&#x70ba;&#x4e2d;&#x5fc3;&#x7684;&#x652f;&#x6301;&#x6027;&#x7167;&#x8b77;&#xff0c;&#x5728;&#x5bb6;&#x5ead;&#x65b9;&#x9762;&#xff1a;&#x589e;&#x9032;&#x5bb6;&#x5ead;&#x53c3;&#x8207;&#x3001;&#x6b63;&#x5411;&#x614b;&#x5ea6;&#x3001;&#x6709;&#x6548;&#x7684;&#x58d3;&#x529b;&#x56e0;&#x61c9;&#x65b9;&#x5f0f;&#x3001;&#x964d;&#x4f4e;&#x4e0d;&#x78ba;&#x5b9a;&#x611f;&#x53ca;&#x8ca0;&#x9762;&#x8a55;&#x50f9;&#xff1b;&#x5728;&#x500b;&#x6848;&#x65b9;&#x9762;&#xff1a;&#x7d66;&#x4e88;&#x75c7;&#x72c0;&#x8655;&#x7406;&#xff0c;&#x6e1b;&#x5c11;&#x500b;&#x6848;&#x7570;&#x5e38;&#x7684;&#x808c;&#x8089;&#x5f35;&#x529b;&#x53ca;&#x767c;&#x5c55;&#x9072;&#x7de9;&#xff0c;&#x4f7f;&#x6848;&#x7236;&#x6bcd;&#x5728;&#x9762;&#x5c0d;&#x75be;&#x75c5;&#x7684;&#x904e;&#x7a0b;&#x4e2d;&#x6539;&#x5584;&#x56e0;&#x9762;&#x5c0d;&#x5b69;&#x5b50;&#x75be;&#x75c5;&#x8207;&#x9810;&#x671f;&#x7167;&#x9867;&#x58d3;&#x529b;&#x7684;&#x8ca0;&#x5411;&#x60c5;&#x7dd2;&#x3001;&#x5931;&#x7720;&#x75c7;&#x72c0;&#x3001;&#x5931;&#x8861;&#x7684;&#x5bb6;&#x5ead;&#x95dc;&#x4fc2;&#x53ca;&#x751f;&#x6d3b;&#x54c1;&#x8cea;&#xff0c;&#x4f7f;&#x500b;&#x6848;&#x80fd;&#x589e;&#x9032;&#x81ea;&#x6211;&#x8abf;&#x7bc0;&#x80fd;&#x529b;&#x3001;&#x6e1b;&#x7de9;&#x7570;&#x5e38;&#x7684;&#x795e;&#x7d93;&#x767c;&#x5c55;&#x3002;&#x671f;&#x671b;&#x6b64;&#x7167;&#x8b77;&#x7d93;&#x9a57;&#xff0c;&#x63d0;&#x4f9b;&#x81e8;&#x5e8a;&#x8b77;&#x7406;&#x4eba;&#x54e1;&#x7167;&#x9867;&#x6709;&#x8166;&#x90e8;&#x640d;&#x50b7;&#x65e9;&#x7522;&#x5152;&#x53ca;&#x5176;&#x5bb6;&#x5ead;&#x4e4b;&#x53c3;&#x8003;&#x3002;.
2,328,115
Long-Term Outcomes of Endoscopic Third Ventricle Colloid Cyst Resection: Case Series With a Proposed Grading System.
Endoscopic resection of colloid cysts has gained recent widespread practice. However, reported complication and recurrence rates are variable, possibly, in part, because of a lack of consistency with reporting of the extent of cyst capsule removal.</AbstractText>To present the long-term outcomes of endoscopic resection of third ventricle colloid cysts without complete capsule removal and propose a grading system to allow consistent description of surgical outcomes.</AbstractText>A retrospective review of 74 patients who underwent endoscopic resection of symptomatic third ventricle colloid cysts between 1995 and 2018 was performed. Kaplan-Meier analyses were used to assess recurrence-free survival rates.</AbstractText>Median patient age and cyst diameter were 48.0 (13.0-80.0) yr and 12.0 (5.0-27.0) mm, respectively. Complete emptying of cyst contents with capsule coagulation was achieved in 73 (98.6%) patients. All patients improved or remained stable postoperatively, with a median follow-up duration of 10.3 (0.3-23.7) yr. Radiographic recurrence occurred in 6 (8.1%) patients after their initial surgery, 5 (6.8%) of whom underwent redo endoscopic resection. No major complications or mortality was encountered at primary or recurrence surgery.</AbstractText>Endoscopic resection of third ventricle colloid cysts without emphasizing complete capsule removal is a viable option for successfully treating colloid cysts of the third ventricle. Long-term follow-up demonstrates that it is associated with low risks of complications, morbidity, mortality, and recurrence. The proposed extent of the resection grading scheme will permit comparison between the different surgical approaches and facilitate the establishment of treatment guidelines for colloid cysts.</AbstractText>Copyright &#xa9; 2020 by the Congress of Neurological Surgeons.</CopyrightInformation>
2,328,116
Glymphatic System Impairment in Alzheimer's Disease and Idiopathic Normal Pressure Hydrocephalus.
Approximately 10% of dementia patients have idiopathic normal pressure hydrocephalus (iNPH), an expansion of the cerebrospinal fluid (CSF)-filled brain ventricles. iNPH and Alzheimer's disease (AD) both exhibit sleep disturbances, build-up of brain metabolic wastes and amyloid-&#x3b2; (A&#x3b2;) plaques, perivascular reactive astrogliosis, and mislocalization of astrocyte aquaporin-4 (AQP4). The glia-lymphatic (glymphatic) system facilitates brain fluid clearance and waste removal during sleep via glia-supported perivascular channels. Human studies have implicated impaired glymphatic function in both AD and iNPH. Continued investigation into the role of glymphatic system biology in AD and iNPH models could lead to new strategies to improve brain health by restoring homeostatic brain metabolism and CSF dynamics.
2,328,117
Percutaneous Mechanical Unloading Simultaneously With Reperfusion Induces Increased Myocardial Salvage in Experimental Acute Myocardial Infarction.
Despite advances in reperfusion times, patients presenting with acute myocardial infarction carry an unacceptably high rate of mortality and morbidity. Mechanical unloading of the left ventricle (LV) has been suggested to reduce infarct size after acute myocardial infarction. Although prior studies have investigated LV unloading during ischemia with a delay in reperfusion, little is known about the optimal timing for LV unloading in the setting of acute myocardial infarction.</AbstractText>Studies were conducted in 17 adult Yorkshire swine weighing 67&#xb1;5 kg. A coronary balloon was inflated in the mid left anterior descending for 60 minutes to induce a myocardial infarction. The coronary balloon was then deflated for 120 minutes (reperfusion). The animals were stratified into 3 groups: group 1 (control, reperfusion with no LV unloading, n=5), group 2 (LV unloading during ischemia with delayed reperfusion, n=6), and group 3 (simultaneous LV unloading and reperfusion, n=6). Staining the hearts with Evans blue and 2,3,5-triphenyltetrazolium chloride was used to identify the area at risk and the infarct area respectively. Infarct percent size was defined as the area of infarcted myocardium divided by the area at risk.</AbstractText>Of the 3 groups, group 3 demonstrated significantly smaller infarct percent size compared with controls (54.7&#xb1;20.3% versus 22.2&#xb1;13.4%; P</i>=0.03). Comparison between group 1 and group 2 did not reveal significant difference (54.7&#xb1;20.3% versus 43.3&#xb1;24.6%; P</i>=0.19).</AbstractText>In our large animal experimental model, simultaneous reperfusion and mechanical LV unloading yielded the smallest infarct size compared with no LV unloading or LV unloading with delayed reperfusion. In the context of prior studies showing benefit to unloading before reperfusion, these findings raise questions about how this strategy may be translated to humans.</AbstractText>
2,328,118
Multisite pacing and myocardial scars: a computational study.
Cardiac resynchronization therapy (CRT) is a frequently effective treatment modality for dyssynchronous heart failure, however, 30% of patients do not respond, usually due to suboptimal activation of the left ventricle (LV). Multisite pacing (MSP) may increase the response rate, but its effect in the presence of myocardial scars is not fully understood. We use a computational model to study the outcome of MSP in an LV with scars in two different locations and of two different sizes. The LV was stimulated from anterior, posterior and lateral locations individually and in pairs, while a septal stimulation site represented right ventricular (RV) pacing. Intraventricular pressures were measured, and outcomes evaluated in terms of maximum LV pressure gradient (dP/dt<sub>max</sub>)- change compared to isolated RV pacing. The best result obtained using various LV pacing locations included a combination of sites remote from scars and the septum. The highest dP/dt<sub>max</sub> increase was achieved, regardless of scar size, using MSP with one pacing site located on the LV free wall opposite to the scar and one site opposite to the septum. These in silico modelling results suggest that making placement of pacing electrodes dependent on location of scarring, may alter acute haemodynamics and that such modelling may contribute to future CRT optimization.
2,328,119
Blended phenotype of AP4E1 deficiency and Angelman syndrome caused by paternal isodisomy of chromosome 15.
Atypical phenotype of an imprinting disease can develop with a recessive homozygous variant due to uniparental isodisomy. We present a girl with severe intellectual disability, developmental delay, distinctive facial features, and other neuropsychiatric features. Trio whole exome sequencing revealed a novel homozygous frameshift variant in AP4E1 [NM_007347.5:c.2412dupT:p.(Gly805Trpfs*8)] and uniparental isodisomy of chromosome 15 [iUPD(15)]. Single nucleotide polymorphism mapping analysis of exome data showed that the homozygous AP4E1 variant was derived from her heterozygous carrier father and unmasked by paternal iUPD(15). Brain magnetic resonance imaging confirmed the brain abnormalities characteristic of AP4 deficiency including the dilated ventricles and hypointensity in the globus pallidus in susceptibility-weighted imaging. This is the first case report of a combination of AP4E1 deficiency and Angelman syndrome. Our patient indicates that whole exome sequencing could uncover an atypical phenotype caused by multiple genetic factors including the uniparental isodisomy.
2,328,120
Efficient estimation of load-free left ventricular geometry and passive myocardial properties using principal component analysis.
Models of cardiac mechanics require a well-defined reference geometry from which deformations and hence myocardial strain and stress can be calculated. In the in vivo beating heart, the load-free (LF) geometry generally cannot be measured directly, since, in many cases, there is no stage at which the lumen pressures and contractile state are all zero. Therefore, there is a need for an efficient method to estimate the LF geometry, which is essential for an accurate mechanical simulation of left ventricular (LV) mechanics, and for estimations of passive and contractile constitutive parameters of the heart muscle. In this paper, we present a novel method for estimating both the LF geometry and the passive stiffness of the myocardium. A linear combination of principal components from a population of diastolic displacements is used to construct the LF geometry. For each estimate of the LF geometry and tissue stiffness, LV inflation is simulated, and the model predictions are compared with surface data at multiple stages during passive diastolic filling. The feasibility of this method was demonstrated using synthetically deformation data that were generated using LV models derived from clinical magnetic resonance image data, and the identifiability of the LF geometry and passive stiffness parameters were analysed using Hessian metrics. Applications of this method to clinical data would improve the accuracy of constitutive parameter estimation and allow a better simulation of LV wall strains and stresses.
2,328,121
Fully automated segmentation of left ventricular scar from 3D late gadolinium enhancement magnetic resonance imaging using a cascaded multi-planar U-Net (CMPU-Net).
Three-dimensional (3D) late gadolinium enhancement magnetic resonance (LGE-MR) imaging enables the quantification of myocardial scar at high resolution with unprecedented volumetric visualization. Automated segmentation of myocardial scar is critical for the potential clinical translation of this technique given the number of tomographic images acquired.</AbstractText>In this paper, we describe the development of cascaded multi-planar U-Net (CMPU-Net) to efficiently segment the boundary of the left ventricle (LV) myocardium and scar from 3D LGE-MR images. In this approach, two subnets, each containing three U-Nets, were cascaded to first segment the LV myocardium and then segment the scar within the presegmented LV myocardium. The U-Nets were trained separately using two-dimensional (2D) slices extracted from axial, sagittal, and coronal slices of 3D LGE-MR images. We used 3D LGE-MR images from 34 subjects with chronic ischemic cardiomyopathy. The U-Nets were trained using 8430 slices, extracted in three orthogonal directions from 18 images. In the testing phase, the outputs of U-Nets of each subnet were combined using the majority voting system for final label prediction of each voxel in the image. The developed method was tested for accuracy by comparing its results to manual segmentations of LV myocardium and LV scar from 7250 slices extracted from 16 3D LGE-MR images. Our method was also compared to numerous alternative methods based on machine learning, energy minimization, and intensity-thresholds.</AbstractText>Our algorithm reported a mean dice similarity coefficient (DSC), absolute volume difference (AVD), and Hausdorff distance (HD) of 85.14%&#xa0;&#xb1;&#xa0;3.36%, 43.72&#xa0;&#xb1;&#xa0;27.18&#xa0;cm3</sup> , and 19.21&#xa0;&#xb1;&#xa0;4.74&#xa0;mm for determining the boundaries of LV myocardium from LGE-MR images. Our method also yielded a mean DSC, AVD, and HD of 88.61%&#xa0;&#xb1;&#xa0;2.54%, 9.33&#xa0;&#xb1;&#xa0;7.24&#xa0;cm3</sup> , and 17.04&#xa0;&#xb1;&#xa0;9.93&#xa0;mm for LV scar segmentation on the unobserved test dataset. Our method significantly outperformed the alternative techniques in segmentation accuracy (P&#xa0;&lt;&#xa0;0.05).</AbstractText>The CMPU-Net method provided fully automated segmentation of LV scar from 3D LGE-MR images and outperformed the alternative techniques.</AbstractText>&#xa9; 2020 American Association of Physicists in Medicine.</CopyrightInformation>
2,328,122
Tremor Caused by Dandy-Walker Syndrome Concomitant with Syringomyelia: Case Report and Review of the Literature Review.
Dandy-Walker Syndrome (DWS) is a rare congenital brain malformation characterized by underdevelopment of cerebellar vermis and cystic enlargement of the fourth ventricle and enlargement of the posterior fossa. The cooccurrence of DWS and syringomyelia in adults is very rare.</AbstractText>We report a man aged 19 years who presented with a 2-year history of tremor. Magnetic resonance imaging showed cystic dilation of the fourth ventricle, hypoplasia of the cerebellar vermis, and syringomyelia. Posterior fossa decompression and spinal cord ostomy were performed. Tremor was markedly improved and the fourth ventricular and the syringomyelia were reduced in size postoperatively.</AbstractText>Tremor can be a clinical manifestation in patients of DWS concomitant with syringomyelia in adults. Spinal cord ostomy combined with posterior fossa decompression may be an effective approach for alleviation of symptoms and syringomyelia.</AbstractText>Copyright &#xa9; 2020 Elsevier Inc. All rights reserved.</CopyrightInformation>
2,328,123
Risk Factors for Early Mortality Among Patients with Glioma: A Population-Based Study.
The present study evaluated the early death and factors associated with early mortality in patients with glioma.</AbstractText>The data used for analysis in the present study was extracted from the Surveillance, Epidemiology, and End Results data set.</AbstractText>A total of 58,700 patients with glioma were enrolled in the present study. The proportion of patient death within 1 month and 3 months after the diagnosis was 9.24% and 19.15% for all patients, respectively. The factors significantly associated with death within 1 month after tumor resection on multivariate analysis included age at diagnosis, year of diagnosis, tumor location, histological features, tumor size, and the absence of gross total resection, radiotherapy, and chemotherapy. We also observed similar findings in the evaluation of the factors associated with 3-month mortality.</AbstractText>The early deaths rates, including 1 and 3&#xa0;months after tumor resection in patients with glioma, have decreased slightly during the previous 40 years. The risk factors for early mortality included advanced age, male sex, tumor located in the lateral ventricle, cerebellum, or brainstem, receipt of biopsy only, no chemotherapy or radiotherapy, and specific histopathological types.</AbstractText>Copyright &#xa9; 2020 Elsevier Inc. All rights reserved.</CopyrightInformation>
2,328,124
Neonatal hypoxia-ischemia in rat elicits a region-specific neurotrophic response in SVZ microglia.
Recent findings describe microglia as modulators of neurogenesis in the subventricular zone (SVZ). SVZ microglia in the adult rat are thought to adopt a neurotrophic phenotype after ischemic stroke. Early postnatal microglia are endogenously activated and may therefore exhibit an increased sensitivity to neonatal hypoxia-ischemia (HI). The goal of this study was to investigate the impact of cortico-striatal HI on the microglial phenotype, function, and gene expression in the early postnatal SVZ.</AbstractText>Postnatal day (P)7 rats underwent sham or right-hemispheric HI surgery. Microglia in the SVZ, the uninjured cortex, and corpus callosum were immunohistochemically analyzed at P10, P20, and P40. The transcriptome of microdissected SVZ and cortical microglia was analyzed at P10 and P20, and the effect of P10 SVZ microglia on neurosphere generation in vitro was studied.</AbstractText>The microglial response to HI was region-specific. In the SVZ, a microglial accumulation, prolonged activation and phagocytosis was noted that was not observed in the cortex and corpus callosum. The transcriptome of SVZ microglia and cortical microglia were distinct, and after HI, SVZ microglia concurrently upregulated pro- and anti-inflammatory as well as neurotrophic genes. In vitro, microglia isolated from the SVZ supported neurosphere generation in a concentration-dependent manner.</AbstractText>Microglia are an inherent cellular component of the early postnatal SVZ and undergo developmental changes that are affected on many aspects by neonatal HI injury. Our results demonstrate that early postnatal SVZ microglia are sensitive to HI injury and display a long-lasting region-specific response including neurotrophic features.</AbstractText>
2,328,125
Factors associated with the development and outcome of hydrocephalus after decompressive craniectomy for traumatic brain injury.
Posttraumatic hydrocephalus (PTH) is common in patients undergoing decompressive craniectomy (DC) for traumatic brain injury (TBI), but the incidence, mechanisms, and risk factors have not been fully elucidated. This study aimed to determine the incidence of and the factors associated with PTH. We retrospectively reviewed patients who underwent DC for TBI at our institute between January 2014 and December 2018. We identified and compared the demographic, clinical, and radiological data, and 12-month functional outcome (as assessed by the Glasgow Outcome Scale [GOS]) between patients who developed PTH and those who did not. Logistic regression analyses were performed to identify risk factors for PTH. Additionally, the influence of PTH on unfavorable functional outcome was analyzed. PTH developed in 18 (18.95%) of the 95 patients who survived at 1&#xa0;month after DC. A multivariate analysis indicated that postoperative intraventricular hemorrhage (odds ratio [OR] 4.493, P&#x2009;=&#x2009;0.020), postoperative subdural hygroma (OR 4.074, P&#x2009;=&#x2009;0.021), and postoperative hypothermia treatment (OR 9.705, P&#x2009;=&#x2009;0.010) were significantly associated with PTH. The 12-month functional outcome significantly differed between the patients who developed PTH and those who did not (P&#x2009;=&#x2009;0.049). Patients who developed PTH had significantly poorer 12-month functional outcomes than those who did not (P&#x2009;=&#x2009;0.049). Another multivariate analysis indicated that subdural hemorrhage (OR 6.814, P&#x2009;=&#x2009;0.031) and the presence of at least one dilated pupil before DC (OR 8.202, P&#x2009;=&#x2009;0.000) were significantly associated with unfavorable functional outcomes (GOS grades 1-3). Although the influence of PTH (OR 5.122, P&#x2009;=&#x2009;0.056) was not statistically significant in the multivariate analysis, it had a great impact on unfavorable functional outcomes. PTH considerably affects functional outcomes at 12&#xa0;months after DC for TBI. Furthermore, postoperative imaging findings such as intraventricular hemorrhage and subdural hygroma can predict the development of PTH; therefore, careful observation is required during the follow-up period.
2,328,126
Dysregulation of Notch signaling in cardiac mesenchymal cells of patients with tetralogy of Fallot.<Pagination><StartPage>38</StartPage><EndPage>47</EndPage><MedlinePgn>38-47</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1038/s41390-020-0760-6</ELocationID><Abstract><AbstractText Label="BACKGROUND">Tetralogy of Fallot (TF) is a severe congenital defect of heart development. Fine-tuned sequential activation of Notch signaling genes is responsible for proper heart chamber development. Mutations in Notch genes have been associated with TF. The aim of this study was to analyze the activity of the Notch pathway in cardiac mesenchymal cells derived from ventricular tissue of TF patients.</AbstractText><AbstractText Label="METHODS">Cardiac mesenchymal cells were isolated from 42 TF patients and from 14 patients with ventricular septal defects (VSDs), used as a comparison group. The Notch pathway was analyzed by estimating the expression of Notch-related genes by qPCR. Differentiation and proliferation capacity of the cells was estimated.</AbstractText><AbstractText Label="RESULTS">The TF-derived cells demonstrated a dysregulated pattern of Notch-related gene expression comparing to VSD-derived cells. Correlation of Notch signaling activation level by HEY1/HES1 expression level with proliferation and cardiogenic-like differentiation of cardiac mesenchymal cells was observed but not with clinical parameters nor with the age of the patients.</AbstractText><AbstractText Label="CONCLUSIONS">The data suggest a contribution of dysregulated Notch signaling to the pathogenesis of tetralogy of Fallot and importance of Notch signaling level for the functional state of cardiac mesenchymal cells, which could be critical considering these cells for potential cell therapy approaches.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Kozyrev</LastName><ForeName>Ivan</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>Almazov National Medical Research Centre, St. Petersburg, Russia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dokshin</LastName><ForeName>Pavel</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Almazov National Medical Research Centre, St. Petersburg, Russia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Faculty of Biology, Saint Petersburg State University, St. Petersburg, Russia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kostina</LastName><ForeName>Aleksandra</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Almazov National Medical Research Centre, St. Petersburg, Russia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Institute of Cytology, Russian Academy of Sciences, St. Petersburg, Russia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kiselev</LastName><ForeName>Artem</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Almazov National Medical Research Centre, St. Petersburg, Russia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ignatieva</LastName><ForeName>Elena</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Almazov National Medical Research Centre, St. Petersburg, Russia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Golovkin</LastName><ForeName>Alexey</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Almazov National Medical Research Centre, St. Petersburg, Russia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pervunina</LastName><ForeName>Tatiana</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Almazov National Medical Research Centre, St. Petersburg, Russia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Grekhov</LastName><ForeName>Evgeny</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Almazov National Medical Research Centre, St. Petersburg, Russia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gordeev</LastName><ForeName>Mikhail</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Almazov National Medical Research Centre, St. Petersburg, Russia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kostareva</LastName><ForeName>Anna</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Almazov National Medical Research Centre, St. Petersburg, Russia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Malashicheva</LastName><ForeName>Anna</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Almazov National Medical Research Centre, St. Petersburg, Russia. amalashicheva@gmail.com.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Faculty of Biology, Saint Petersburg State University, St. Petersburg, Russia. amalashicheva@gmail.com.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Institute of Cytology, Russian Academy of Sciences, St. Petersburg, Russia. amalashicheva@gmail.com.</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>01</Month><Day>17</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Pediatr Res</MedlineTA><NlmUniqueID>0100714</NlmUniqueID><ISSNLinking>0031-3998</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D051792">Basic Helix-Loop-Helix Transcription Factors</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D018797">Cell Cycle Proteins</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="C485631">HEY1 protein, human</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D051880">Receptors, Notch</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000072056">Transcription Factor HES-1</NameOfSubstance></Chemical><Chemical><RegistryNumber>149348-15-2</RegistryNumber><NameOfSubstance UI="C078493">HES1 protein, human</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D051792" MajorTopicYN="N">Basic Helix-Loop-Helix Transcription Factors</DescriptorName><QualifierName UI="Q000378" MajorTopicYN="N">metabolism</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018797" MajorTopicYN="N">Cell Cycle Proteins</DescriptorName><QualifierName UI="Q000378" MajorTopicYN="N">metabolism</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002454" MajorTopicYN="N">Cell Differentiation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D049109" MajorTopicYN="N">Cell Proliferation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D020869" MajorTopicYN="N">Gene Expression Profiling</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005786" MajorTopicYN="N">Gene Expression Regulation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006321" MajorTopicYN="N">Heart</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006345" MajorTopicYN="N">Heart Septal Defects, Ventricular</DescriptorName><QualifierName UI="Q000378" MajorTopicYN="Y">metabolism</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006352" MajorTopicYN="N">Heart Ventricles</DescriptorName><QualifierName UI="Q000378" MajorTopicYN="N">metabolism</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000860" MajorTopicYN="N">Hypoxia</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016130" MajorTopicYN="N">Immunophenotyping</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007223" MajorTopicYN="N">Infant</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007231" MajorTopicYN="N">Infant, Newborn</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D059630" MajorTopicYN="N">Mesenchymal Stem Cells</DescriptorName><QualifierName UI="Q000166" MajorTopicYN="Y">cytology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D009154" MajorTopicYN="N">Mutation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009206" MajorTopicYN="N">Myocardium</DescriptorName><QualifierName UI="Q000378" MajorTopicYN="Y">metabolism</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D051880" MajorTopicYN="N">Receptors, Notch</DescriptorName><QualifierName UI="Q000378" MajorTopicYN="Y">metabolism</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015398" MajorTopicYN="N">Signal Transduction</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013771" MajorTopicYN="N">Tetralogy of Fallot</DescriptorName><QualifierName UI="Q000378" MajorTopicYN="Y">metabolism</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000072056" MajorTopicYN="N">Transcription Factor HES-1</DescriptorName><QualifierName UI="Q000378" MajorTopicYN="N">metabolism</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2019</Year><Month>4</Month><Day>10</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2019</Year><Month>11</Month><Day>18</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2019</Year><Month>11</Month><Day>12</Day></PubMedPubDate><PubMedPubDate 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Notch signalling in context. Nat. Rev. Mol. Cell Biol. 17, 722&#x2013;735 (2016).</Citation><ArticleIdList><ArticleId IdType="doi">10.1038/nrm.2016.94</ArticleId></ArticleIdList></Reference><Reference><Citation>Boni, A. et al. Notch1 regulates the fate of cardiac progenitor cells. Proc. Natl Acad. Sci. USA 105, 15529&#x2013;15534 (2008).</Citation><ArticleIdList><ArticleId IdType="doi">10.1073/pnas.0808357105</ArticleId></ArticleIdList></Reference><Reference><Citation>Gude, N. et al. Notch activation enhances lineage commitment and protective signaling in cardiac progenitor cells. Basic Res. Cardiol. 110, 1&#x2013;15. (2015).</Citation><ArticleIdList><ArticleId IdType="doi">10.1007/s00395-015-0488-3</ArticleId></ArticleIdList></Reference><Reference><Citation>Kovall, R. A., Gebelein, B., Sprinzak, D. &amp; Kopan, R. The canonical Notch signaling pathway: structural and biochemical insights into shape, sugar, and force. Dev. Cell 41, 228&#x2013;241 (2017).</Citation><ArticleIdList><ArticleId IdType="doi">10.1016/j.devcel.2017.04.001</ArticleId></ArticleIdList></Reference><Reference><Citation>MacGrogan, D., Munch, J. &amp; de la Pompa, J. L. Notch and interacting signalling pathways in cardiac development, disease, and regeneration. Nat. Rev. Cardiol. 15, 685&#x2013;704 (2018).</Citation><ArticleIdList><ArticleId IdType="doi">10.1038/s41569-018-0100-2</ArticleId></ArticleIdList></Reference><Reference><Citation>Conlon, R. A., Reaume, A. G. &amp; Rossant, J. Notch1 is required for the coordinate segmentation of somites. Development 121, 1533&#x2013;1545 (1995).</Citation><ArticleIdList><ArticleId IdType="pubmed">7789282</ArticleId></ArticleIdList></Reference><Reference><Citation>Koenig, S. N. et al. Notch1 haploinsufficiency causes ascending aortic aneurysms in mice. JCI Insight 2, 91353 (2017).</Citation></Reference><Reference><Citation>Borggrefe, T. et al. The Notch intracellular domain integrates signals from Wnt, Hedgehog, TGFbeta/BMP and hypoxia pathways. Biochim. Biophys. Acta 1863, 303&#x2013;313 (2016).</Citation><ArticleIdList><ArticleId IdType="doi">10.1016/j.bbamcr.2015.11.020</ArticleId></ArticleIdList></Reference><Reference><Citation>Sano, T. et al. Impact of cardiac progenitor cells on heart failure and survival in single ventricle congenital heart disease. Circ. Res. 117, 312311 (2018).</Citation></Reference><Reference><Citation>Urbanek, K. et al. Inhibition of Notch1-dependent cardiomyogenesis leads to a dilated myopathy in the neonatal heart. Circ. Res. 107, 429&#x2013;441 (2010).</Citation><ArticleIdList><ArticleId IdType="doi">10.1161/CIRCRESAHA.110.218487</ArticleId></ArticleIdList></Reference><Reference><Citation>Collesi, C. et al. Reversible Notch1 acetylation tunes proliferative signalling in cardiomyocytes. Cardiovasc. Res. 114, 103&#x2013;122 (2018).</Citation><ArticleIdList><ArticleId IdType="doi">10.1093/cvr/cvx228</ArticleId></ArticleIdList></Reference><Reference><Citation>Geva, T. Indications and timing of pulmonary valve replacement after tetralogy of Fallot repair. Semin. Thorac. Cardiovasc. Surg. Pediatr. Card. Surg. Annu. 11&#x2013;22 (2006).</Citation></Reference><Reference><Citation>Dluzniewska, N. et al. Long-term follow-up in adults after tetralogy of Fallot repair. Cardiovasc. Ultrasound 16, 28 (2018).</Citation><ArticleIdList><ArticleId IdType="doi">10.1186/s12947-018-0146-7</ArticleId></ArticleIdList></Reference><Reference><Citation>Ignatieva, E. et al. Mechanisms of smooth muscle cell differentiation are distinctly altered in thoracic aortic aneurysms associated with bicuspid or tricuspid aortic valves. Front. Physiol. 8, 536 (2017).</Citation></Reference><Reference><Citation>Aquila, G. et al. The Notch pathway: a novel therapeutic target for cardiovascular diseases? Expert Opin. Ther. Targets 23, 695&#x2013;710 (2019).</Citation><ArticleIdList><ArticleId IdType="doi">10.1080/14728222.2019.1641198</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">31952045</PMID><DateRevised><Year>2021</Year><Month>11</Month><Day>09</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1933-0693</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Jan</Month><Day>17</Day></PubDate></JournalIssue><Title>Journal of neurosurgery</Title><ISOAbbreviation>J Neurosurg</ISOAbbreviation></Journal>Cushing's dogged struggle against death: the astonishing case of a patient under cardiac arrest surviving craniopharyngioma surgery.
The decisive role Dr. Harvey Cushing (1869-1939) played in medicine goes far beyond the development of neurosurgery. His scientific devotion and commitment to patient care made him an ethical model of strict professionalism. This paper seeks to analyze the decisions Cushing made with the challenging case of HW, an adolescent boy with a craniopharyngioma (CP) involving the third ventricle. Cushing's earlier failure to successfully remove two similar lesions alerted him to the proximity of HW's tumor and the hypothalamus. Consequently, he decided to use the chiasm-splitting technique for the first time, with the aim of dissecting the CP-hypothalamus boundaries under direct view. Unexpectedly, HW suffered cardiac arrest during the surgery, but Cushing did not give up. He continued with the operation while his assistants performed resuscitation maneuvers. Such determined and courageous action allowed Cushing to succeed in an apparently hopeless case. Cushing's unwavering willingness to save patients' lives, even under extreme circumstances, was a fundamental trait defining his identity as a neurosurgeon. Analyzing the way Cushing dealt with HW's case provides valuable lessons for neurosurgeons today, particularly the importance of assuming proactive attitudes and, in certain cases, making painstaking efforts to overcome daunting situations to save a life.
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Simultaneous Tissue Classification and Lateral Ventricle Segmentation via a 2D U-net Driven by a 3D Fully Convolutional Neural Network.
In this paper, we proposed and validated a novel and fully automatic pipeline for simultaneous tissue classification and lateral ventricle segmentation via a 2D U-net. The 2D U-net was driven by a 3D fully convolutional neural network (FCN). Multiple T1-weighted atlases which had been pre-segmented into six whole-brain regions including the gray matter (GM), white matter (WM), cerebrospinal fluid (CSF), lateral ventricles (LVs), skull, and the background of the entire image were used. In the proposed pipeline, probability maps of the six whole-brain regions of interest (ROIs) were obtained after a pre-segmentation through a trained 3D patch-based FCN. To further capture the global context of the entire image, the to-be-segmented image and the corresponding six probability maps were input to a trained 2D U-net in a 2D slice fashion to obtain the final segmentation map. Experiments were performed on a dataset consisting of 18 T1-weighted images. Compared to the 3D patch-based FCN on segmenting five ROIs (GM, WM, CSF, LVs, skull) and another two classical methods (SPM and FSL) on segmenting GM and WM, the proposed pipeline showed a superior segmentation performance. The proposed segmentation architecture can also be extended to other medical image segmentation tasks.
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Two-Element Fractional-Order Windkessel Model to Assess the Arterial Input Impedance.
Arterial system is completely coupled with the heart, such that the contractile state of the left ventricle and its produced central blood pressure (the pressure in the aorta) are in tune with the arterial mechanical properties. This study investigates the use of fractional-order capacitor and resistor elements to expose, and estimate the main arterial mechanical properties. We propose a simple two-element fractional-order Windkessel model that is able to capture the real aortic impedance dynamic for different cardiac physiological states. To perform a quantitative validation, in-silico ascending aortic blood pressure and flow database of 3,325 virtual subjects was used. The proposed model provides new simplified tool for "hemodynamic problem" solving, offering a pioneer way for a better understanding of vascular mechanical properties dependency on hemodynamic changes such as arterial viscoelasticity.
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Deep CNN with LM learning based myocardial ischemia detection in cardiac magnetic resonance images.
Cardiovascular disease (CVD) is a chronic dysfunction caused by deterioration in cardiac physiology. It results in about 31% of mortality worldwide. Among CVDs, myocardial ischemia (MI) leads to restriction in blood supply to heart tissues. There is a need to develop an effective computer aided detection (CAD) system to reduce the fatality. In this work, an attempt is made to perform mass screening of myocardial ischemic subjects and left ventricle (LV) volume estimation from cardiac magnetic resonance (CMR) images using deep convolutional neural network (CNN) with Levenberg-Marquardt (LM) learning. LV volume measurement is an important predictor of myocardial ischemia. The CMR samples used in this analysis are obtained from Medical Image Computing and Computer Assisted Intervention (MICCAI) 2009 database. The results of the proposed model are compared with deep CNN based on gradient descent (GD) learning algorithm. The results show that deep CNN architecture with LM learning classifies ischemic subjects with high accuracy (86.39%) and sensitivity (90%). The LM learning based method gives an AUC of 0.93. The estimated LV volumes obtained from the trained network gives high correlation with the ground truth. Thus the results support that proposed framework of deep CNN architecture with LM learning can be used as an effective CAD system for diagnosis of cardiovascular disorders.
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Cryopreservation of human pluripotent stem cell-derived cardiomyocytes is not detrimental to their molecular and functional properties.
Human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) have emerged as a powerful platform for in vitro modelling of cardiac diseases, safety pharmacology and drug screening. All these applications require large quantities of well-characterised and standardised batches of hiPSC-CMs. Cryopreservation of hiPSC-CMs without affecting their biochemical or biophysical phenotype is essential for facilitating this, but ideally requires the cells being unchanged by the freeze-thaw procedure. We therefore compared the in vitro functional and molecular characteristics of fresh and cryopreserved hiPSC-CMs generated from multiple independent hiPSC lines. While the frozen hiPSC-CMs exhibited poorer replating than their freshly-derived counterparts, there was no difference in the proportion of cardiomyocytes retrieved from the mixed population when this was factored in, although for several lines a higher percentage of ventricular-like hiPSC-CMs were recovered following cryopreservation. Furthermore, cryopreserved hiPSC-CMs from one line exhibited longer action potential durations. These results provide evidence that cryopreservation does not compromise the in vitro molecular, physiological and mechanical properties of hiPSC-CMs, though can lead to an enrichment in ventricular myocytes. It also validates this procedure for storing hiPSC-CMs, thereby allowing the same batch of hiPSC-CMs to be used for multiple applications and evaluations.
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Explainable Anatomical Shape Analysis Through Deep Hierarchical Generative Models.
Quantification of anatomical shape changes currently relies on scalar global indexes which are largely insensitive to regional or asymmetric modifications. Accurate assessment of pathology-driven anatomical remodeling is a crucial step for the diagnosis and treatment of many conditions. Deep learning approaches have recently achieved wide success in the analysis of medical images, but they lack interpretability in the feature extraction and decision processes. In this work, we propose a new interpretable deep learning model for shape analysis. In particular, we exploit deep generative networks to model a population of anatomical segmentations through a hierarchy of conditional latent variables. At the highest level of this hierarchy, a two-dimensional latent space is simultaneously optimised to discriminate distinct clinical conditions, enabling the direct visualisation of the classification space. Moreover, the anatomical variability encoded by this discriminative latent space can be visualised in the segmentation space thanks to the generative properties of the model, making the classification task transparent. This approach yielded high accuracy in the categorisation of healthy and remodelled left ventricles when tested on unseen segmentations from our own multi-centre dataset as well as in an external validation set, and on hippocampi from healthy controls and patients with Alzheimer's disease when tested on ADNI data. More importantly, it enabled the visualisation in three-dimensions of both global and regional anatomical features which better discriminate between the conditions under exam. The proposed approach scales effectively to large populations, facilitating high-throughput analysis of normal anatomy and pathology in large-scale studies of volumetric imaging.
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A critical appraisal of Monro's erroneous description of the cerebral interventricular foramina: Age-related magnetic resonance imaging spatial morphometry and a proposed new terminology.
Anatomic connections between the cerebral lateral and third ventricles have been mischaracterized since Monro's original erroneous description of his eponymous foramina (FoMs) as being only one T-shaped passage. Accurate knowledge of the in vivo three-dimensional (3D) configuration of FoM has important clinical neuroendoscopic, neurosurgical, and neuroimaging implications. We retrospectively analyzed volumetric high-resolution brain magnetic resonance imaging of 100 normal individuals to characterize the normal spatial anatomy and morphometry for each FoM. We measured the true anatomical 3D angulations of FoMs relative to standard neuroimaging orthogonal planes, and their minimum width, depth, and distance between the medial borders of bilateral FoMs. The right and left FoMs were separate, distinct, and in a V-shaped configuration. Each FoM was a round, oval, or crescent-shaped canal-like passage with well-defined borders formed by the semicircular concavity of the ipsilateral forniceal column. The plane of FoM was angled on average 56.8&#xb0;&#x2009;&#xb1;&#x2009;9.1&#xb0; superiorly from the axial plane, 22.5&#xb0;&#x2009;&#xb1;&#x2009;10.7&#xb0; laterally, and 37.0&#xb0;&#x2009;&#xb1;&#x2009;6.9&#xb0; anteriorly from the midsagittal plane; all these angles changing significantly with increasing age. The mean narrowest diameter of FoM was 2.8&#x2009;&#xb1;&#x2009;1.2&#x2009;mm, and its depth was 2.5&#x2009;&#xb1;&#x2009;0.2&#x2009;mm. Thus, the true size and orientation of FoM differs from that depicted on standard neuroimaging. Notably, in young subjects, FoM has a diameter smaller than its depth, a configuration akin to a short, small canal. We propose that the eponym "Monro" no longer be associated with this structure, and the term "foramen" be abandoned. Instead, FoM should be more appropriately renamed as the "interventricular canaliculus," or IVC, for short.
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Akhirin regulates the proliferation and differentiation of neural stem cells/progenitor cells at neurogenic niches in mouse brain.
Specialized microenvironment, or neurogenic niche, in embryonic and postnatal mouse brain plays critical roles during neurogenesis throughout adulthood. The subventricular zone (SVZ) and the dentate gyrus (DG) of hippocampus in the mouse brain are two major neurogenic niches where neurogenesis is directed by numerous regulatory factors. Now, we report Akhirin (AKH), a stem cell maintenance factor in mouse spinal cord, plays a pivotal regulatory role in the SVZ and in the DG. AKH showed specific distribution during development in embryonic and postnatal neurogenic niches. Loss of AKH led to abnormal development of the ventricular zone and the DG along with reduction of cellular proliferation in both regions. In AKH knockout mice (AKH<sup>-/-</sup> ), quiescent neural stem cells (NSCs) increased, while proliferative NSCs or neural progenitor cells decreased at both neurogenic niches. In vitro NSC culture assay showed increased number of neurospheres and reduced neurogenesis in AKH<sup>-/-</sup> . These results indicate that AKH, at the neurogenic niche, exerts dynamic regulatory role on NSC self-renewal, proliferation and differentiation during SVZ and hippocampal neurogenesis.
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Leucine-rich repeat containing 8A contributes to the expansion of brain ventricles in zebrafish embryos.
The sodium osmotic gradient is necessary for the initiation of brain ventricle inflation, but a previous study predicted that organic and inorganic osmolytes play equivalently important roles in osmotic homeostasis in astrocytes. To test whether organic osmoregulation also plays a role in brain ventricle inflation, the core component for volume-regulated anion and organic osmolyte channel, <i>lrrc8a</i>, was investigated in the zebrafish model. RT-PCR and whole-mount <i>in situ</i> hybridization indicated that both genes were ubiquitously expressed through to 12&#x2005;hpf, and around the ventricular layer of neural tubes and the cardiogenic region at 24&#x2005;hpf. Knocking down either one <i>lrrc8a</i> paralog with morpholino oligos resulted in abnormalities in circulation at 32&#x2005;hpf. Morpholino oligos or CRISPR interference against either paralog led to smaller brain ventricles at 24&#x2005;hpf. Either <i>lrrc8aa</i> or <i>lrrc8ab</i> mRNA rescued the phenotypic penetrance in both <i>lrrc8aa</i> and <i>lrrc8ab</i> morphants. Supplementation of taurine in the E3 medium and overexpression <i>csad</i> mRNA also rescued <i>lrrc8aa</i> and <i>lrrc8ab</i> morphants. Our results indicate that the two zebrafish <i>lrrc8a</i> paralogs are maternal message genes and are ubiquitously expressed in early embryos. The two genes play redundant roles in the expansion of brain ventricles and the circulatory system and taurine contributes to brain ventricle expansion via the volume-regulated anion and organic osmolyte channels.
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Timely-Automatic Procedure for Estimating the Endocardial Limits of the Left Ventricle Assessed Echocardiographically in Clinical Practice.
In this paper, we propose an analytical rapid method to estimate the endocardial borders of the left ventricular walls on echocardiographic images for prospective clinical integration. The procedure was created as a diagnostic support tool for the clinician and it is based on the use of the anisotropic generalized Hough transform. Its application is guided by a Gabor-like filtering for the approximate delimitation of the region of interest without the need for computing further anatomical characteristics. The algorithm is applying directly a deformable template on the predetermined filtered region and therefore it is responsive and straightforward implementable. For accuracy considerations, we have employed a support vector machine classifier to determine the confidence level of the automated marking. The clinical tests were performed at the Cardiology Clinic of the County Emergency Hospital Timisoara and they improved the physicians perception in more than 50% of the cases. The report is concluded with medical discussions.
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Activation of brown adipose tissue in diet-induced thermogenesis is GC-C dependent.
Uroguanylin (UGN) is released from the intestine after a meal. When applied in brain ventricles, UGN increases expression of markers of thermogenesis in brown adipose tissue (BAT). Therefore, we determine the effects of its receptor, guanylate cyclase C (GC-C), on mouse interscapular BAT (iBAT) activity during diet-induced thermogenesis (DIT). The activation of iBAT after a meal is diminished in GC-C KO mice, decreased in female wild type (WT) mice, and abolished in old WT animals. The activation of iBAT after a meal is the highest in male WT animals which leads to an increase in GC-C expression in the hypothalamus, an increase in iBAT volume by aging, and induction of iBAT markers of thermogenesis. In contrast to iBAT activation after a meal, iBAT activation after a cold exposure could still exist in GC-C KO mice and it is significantly higher in female WT mice. The expression of GC-C in the proopiomelanocortin neurons of the arcuate nucleus of the hypothalamus but not in iBAT suggests central regulation of iBAT function. The iBAT activity during DIT has significantly reduced in old mice but an intranasal application of UGN leads to an increase in iBAT activity in a dose-dependent manner which is in strong negative correlation to glucose concentration in blood. This activation was not present in GC-C KO mice. Our results suggest the physiological role of GC-C on the BAT regulation and its importance in the regulation of glucose homeostasis and the development of new therapy for obesity and insulin resistance.
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Postnatal Intracranial Findings Following Fetal Repair of Spinal Dysraphisms.
Our objective is to document the imaging appearance in the intracranial compartment at the time of the infants' first postnatal brain MR imaging after fetal repair for spinal dysraphisms.</AbstractText>Twenty-nine patients were evaluated on fetal and postnatal magnetic resonance imaging for a series of features of Chiari II malformation.</AbstractText>Of the 29 infants, 55% had resolution of tonsillar ectopia, and 62% showed a dorsal outpouching of the near the foramen magnum on postnatal magnetic resonance imaging. The majority had persistence of Chiari II features including: prominent massa intermedia (93%), tectal beaking (93%), towering cerebellum (55%), flattening of the fourth ventricle (90%), hypoplastic tentorium (97%), and tonsillar hypoplasia (59%).</AbstractText>Normally positioned or minimally descended, oftentimes hypoplastic tonsils in the presence of a posterior fossa configuration typical of Chiari II, was the most common presentation. An additional documented feature was an outpouching of the dorsal thecal sac between the opisthion and the posterior arch of C1.</AbstractText>
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p-Chloroamphetamine-Enhanced Neostriatal Dopamine Exocytosis in Rats Neonatally Co-lesioned with 6-OHDA and 5,7-DHT: Relevance to Parkinson's Disease.
Serotoninergic nerves are known to modulate sensitization of dopamine receptors (DA-R) in a rodent model of Parkinson's disease (PD). However, serotoninergic nerves are not known to have a prominent role on DA exocytosis in intact rats. The current study was undertaken to explore the possible influence of serotoninergic nerves on DA exocytosis in Parkinsonian rats. Rat pups were treated at 3&#xa0;days after birth with the neurotoxin 6-hydroxydopamine (6-OHDA; 134&#xa0;&#x3bc;g icv, half into each lateral ventricle; desipramine, 1&#xa0;h pretreatment), in order to produce marked long-lasting destruction of neostriatal dopaminergic innervation, as evidenced by the 90-95% depletion of DA (p&#x2009;&lt;&#x2009;0.001) [HPLC/ED] into adulthood. Controls received vehicle/desipramine in place of 6-OHDA. Other groups received the serotoninergic neurotoxin 5,7-dihydroxytryptamine (5,7-DHT; 25&#xa0;&#x3bc;g base, icv, half in each lateral ventricle; desipramine, 1&#xa0;h; 75&#xa0;mg/kg pargyline HCl, 30&#xa0;min) at 3&#xa0;days post-birth; or both 6-OHDA+5,7-DHT treatments. In adulthood, an in vivo microdialysis study was undertaken to ascertain that p-chloroamphetamine (PCA, 1&#xa0;mM in the microdialysate)-evoked DA release in the neostriatum was reduced approximately 50% in the 6-OHDA group, while PCA-evoked DA release in the 6-OHDA+5,7-DHT group was substantially increased, to a level equivalent to that of the vehicle control. The baseline neostriatal microdialysate level of 3,4-dihydroxyphenylacetic acid (DOPAC) was also higher in the 6-OHDA+5,7-DHT group vs 6-OHDA group; also, during the 2nd hour of PCA infusion. PCA-enhanced DA exocytosis occurred in the absence of changes in hydroxyl radical (HO&#xb7;) in the microdialysate (i.e., assay of 2,3- and 2,5-dihydroxybenzoic acid, 2,3-DHBA; 2,5-DHBA). The overall findings demonstrate that an adulthood serotoninergic nerve lesion enhanced PCA-evoked DA exocytosis in a rodent model of severe PD, while susceptibility to oxidative stress was unchanged. The implication is that serotoninergic nerves may normally suppress the release of DA and/or act as an uptake site and storage sink for accumulated DA in parkinsonian-like neostriatum. Potentially, serotoninergic agonists or antagonists, targeting subtype-selective serotonin receptors, may be viable therapeutic adjuncts in PD.
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TLR4/MyD88/NF-&#x3ba;B-Mediated Inflammation Contributes to Cardiac Dysfunction in Rats of PTSD.
Post-traumatic stress disorder (PTSD) is related with myocardial injury and cardiac dysfunction, while the molecular mechanism has not been clear. This study investigated whether TLR4/MyD88/NF-&#x3ba;B-mediated inflammation involved in myocardial injury of PTSD. Adult male Wistar rats were exposed to single-prolonged stress (SPS), which was used broadly as a animal model of PTSD. Morris Water Maze (MWM) test and forced swimming test (FST) was carried out for behavioral testing. The protein expression of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) in the left ventricular of heart and TLR4/MyD88/NF-&#x3ba;B-mediated inflammation were examined. Our results showed that there were obvious increased in the protein expression of ANP and BNP in heart after exposure to SPS, SPS also significantly enhanced the serum level of IL-1&#x3b2; and TNF-&#x3b1;, and meanwhile, the TLR4/MyD88/NF-&#x3ba;B pathway were activated. These results demonstrated that the TLR4/MyD88/NF-&#x3ba;B pathway were involved in the myocardial injury of PTSD, which might be one of possible molecular mechanism contributed to the pathogenesis of&#xa0;cardiac dysfunction in PTSD.
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Cystic Glioblastoma Rupturing into the Ventricle.
Cystic tumors, such as craniopharyngiomas and Rathke's cleft cysts, as well as arachnoid cysts have been reported to rupture occasionally. Approximately 8-10% of glioblastomas (GBMs) are known to have a significant cystic component; however, to the best of our knowledge, no studies have reported cystic rupturing of GBMs. Here, we describe a unique case of cystic GBM rupturing and penetrating into the cerebral ventricle. A 77-year-old man with a right frontal lobe lesion suspected as GBM with a large cyst was referred to our hospital. At admission, disorientation and left facial weakness were detected. Consciousness disturbance worsened on the 8th day of hospitalization. Computed tomography (CT) revealed prominent shrinkage of the tumor and intratumoral cyst. Signs of meningeal irritation were observed, and chemical meningitis due to cystic tumor rupture and leakage of necrotic components into the ventricle was highly suspected. Surgical resection of the right frontal lobe tumor was performed on the 10th day of hospitalization. During the surgery, clear and colorless cerebrospinal fluid was obtained upon penetration of the tumoral cyst, suggesting traffic of tumor cysts and cerebral ventricle. Adjuvant chemoradiation therapy was initiated postoperatively. Local recurrence was noted at the corpus callosum 7 months postoperatively and was treated with a gamma knife. Further therapy was performed after this recurrence. However, his condition gradually deteriorated 15 months postoperatively, and he was subjected to terminal care. To the best of our knowledge, this is the first report on a cystic GBM rupture.
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Incidental Follow-up Imaging of Previous Ventricular Tuberculosis and Pneumoencephalography in a 57-year-old man.
We present a rare case of follow-up by neuroimaging in a 57-year-old man with a previous pneumoencephalography to evaluate ventricular tuberculosis (TB). Magnetic resonance imaging (MRI) of the whole head was performed at 3T&#xa0;using T1-weighted magnetization-prepared rapid gradient echo (T1-MPRAGE). A full quantitative sensory testing battery on the forearm was also performed, alongside a brief clinical examination. All test results were normal with the exception of the T1-MPRAGE which showed enlarged ventricles and a cyst-like focal changes, mistaken for a sign of old ischaemic infarct. The change, however, is consistent with the insertion of a cannula for the pneumoencephalogram. This is the first follow-up report with neuroimaging presented nearly 40 years after the diagnosis of ventricular TB.
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Nocturnal Hypoxemia Impacts Right Ventricle Diastolic Function in Obstructive Sleep Apnea: A Retrospective Observational Study.
Obstructive sleep apnea (OSA), although a growing healthcare problem and documented risk factor for cardiovascular diseases, is still under-diagnosed in cardiac patients. To investigate the correlation between OSA and echocardiographic parameters of right ventricle diastolic (RVD) dysfunction, in particular trans-tricuspid E-wave deceleration time (EDT), we retrospectively analyzed data of 103 pure (comorbidity-free) OSA patients with comprehensive echocardiographic examination (ETT). Apnea/hypopnea index (AHI), oxygen desaturation index (ODI), mean nighttime oxyhemoglobin saturation (SpO<sub>2</sub>), time elapsed with SpO<sub>2</sub> &lt; 90% (T90) and mean peak desaturation of nocturnal events (Mdes, graded as mild, medium or severe) were compared with echocardiographic parameters. We found RVD dysfunction present in 58.3% of patients. Altered EDT correlated significantly with mean SpO<sub>2</sub>, T90, and Mdes (p &lt; 0.01, all). Nocturnal desaturators had a significantly worse EDT than non-desaturators (p = 0.027) and a higher risk of prolonged EDT (odds ratio, OR = 2.86). EDT differed significantly according to Mdes severity (p = 0.005) with a higher risk of prolonged EDT in medium/severe vs. mild Mdes (OR = 3.44). EDT detected the presence of RVD dysfunction in 58.3% of our pure OSA patients. It correlated poorly with AHI severity but strongly with nocturnal desaturation severity, independently of age. This ETT marker may be useful for deciding appropriate diagnostic and therapeutic strategies.
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Oxytocin receptor antagonist reverses the blunting effect of pair bonding on fear learning in monogamous prairie voles.
Social relationships among spouses, family members, and friends are known to affect physical and mental health. In particular, long-lasting bonds between socio-sexual partners have profound effects on cognitive, social, emotional, and physical well-being. We have previously reported that pair bonding in monogamous prairie voles (Microtus ochrogaster) is prevented by a single prolonged stress (SPS) paradigm, which causes behavioral and endocrine symptoms resembling post-traumatic stress disorder (PTSD) patients in rats (Arai et al., 2016). Since fear memory function is crucial for anxiety-related disorders such as PTSD, we investigated the effects of pair bonding on fear learning in prairie voles. We applied an SPS paradigm to male prairie voles after the cohabitation with a male (cage-mate group) or female (pair-bonded group). The cage-mate group, but not the pair-bonded group, showed enhanced fear response in a contextual fear conditioning test following the SPS treatment. Immunohistochemical analyses revealed that cFos-positive cells in the central amygdala were increased in the pair-bonded group after the contextual fear conditioning test and that oxytocin immunoreactivity in the paraventricular nucleus of the hypothalamus was significantly higher in the pair-bonded group than the cage-mate group. This pair-bonding dependent blunting of fear memory response was confirmed by a passive avoidance test, another fear-based learning test. Interestingly, intracerebroventricular injection of an oxytocin receptor antagonist 30&#xa0;min before the passive avoidance test blocked the blunting effect of pair bonding on fear learning. Thus, pair bonding between socio-sexual partners results in social buffering in the absence of the partner, blunting fear learning, which may be mediated by oxytocin signaling.
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[Retroperitoneal fetus in fetu].
Fetus in Fetu (FIF) is an extremely rare congenital anomaly defined as a mass containing a vertebral axis often associated with other organs or limbs around this axis. We report the case of a female fetus aged 4 months presenting with retroperitoneal mass measuring 7x6x4cm, suggesting teratoma on computerized tomography (CT) scan. The mass was resected. Macroscopic examination showed fetiform mass covered by skin tissue and extending into upper and lower limb buds (A). Sectional views showed that it was centered by several osteocartilaginous fragments arranged in a linear fashion reminding the vertebral axis (B). Histological examination objectified the presence of glial tissue around a cerebral ventricle as well as skin, muscle and bone tissue. The diagnosis of FIF was retained. FIF is mainly reported at the level of the retroperitoneum followed by the sacro-caudal, intra-abdominal, cranial, buccal, mediastinal, pulmonary, renal and scrotal area. Diagnosis is made during the antenatal period in 15% of cases. The etiopathogenesis of FIF includes both the theory of monochorionic diamniotic monozygotic pregnancy in which an aberrant asymmetric twin becomes internalized in the other twin and the theory of a defective embryo implantation in the mesenchyme of its twin instead of the uterine wall. The differential diagnosis includes teratoma, meconium pseudocyst and ectopic pregnancy.
2,328,145
Pleomorphic xanthoastrocytoma inside lateral ventricle: a rare case report and literature review.
Pleomorphic xanthoastrocytoma (PXA) is a relatively rare, low grade astrocytic tumor that usually affects children as well as young adults. The reported cases were predominantly located superficially in the temporal lobe. To our knowledge, so far only two cases of PXA occurring in lateral ventricle were reported in English literature. Herein, we present the third case of PXA intra-lateral ventricle in a 28-year-old Chinese male. Histologically, the tumor was relatively well circumscribed and consisted of spindle-shaped, ovoid, and multinuclear giant cells admixed with scattered eosinophilic granular bodies, inflammatory cells, and xanthomatous cells. Immunohistochemically, the tumor cells were strongly positive for S-100, GFAP, oligo-2 and vimentin, focally positive for synaptophysin and CD34, and negative for cytokeratin, EMA, NeuN and IDH1. Ki-67 proliferation index was approximately 2%. A BRAF V600E mutation was then identified in the tumor. Based on morphologic features, the immunohistochemical staining and BRAF V600E mutation, the tumor was diagnosed as a PXA. Because of the presence of the bizarre multinuclear giant cells and xanthomatous cells and the unusual location, PXA was easily misdiagnosed as a high-grade tumor. It should be noted that PXA was also an important differential diagnosis for intraventricular tumors.
2,328,146
Third ventricle tumor with Bruns sign as the first manifestation: a case report.
This article reported a case of a third ventricle tumor with Bruns syndrome sudden disturbance of consciousness as the first manifestation, to improve the clinician's understanding and awareness of the fatal signs. A 38-year-old healthy man was admitted to our hospital for a sudden onset coma for 2 hours. Head magnetic resonance imaging (MRI) showed midbrain aqueduct occlusion, intraductal abnormal nodule signal, considering space-occupying lesions. On the fourth day of admission, the patient was scheduled to undergo ventriculoscopic resection of the mass, but the patient had a small ventricular foramen, which was difficult to explore the posterior part of the third ventricle, and the possibility of injuring the vein was high. Finally, the third ventriculostomy was performed by ventriculoscope. 6 months later, the tumor grew slowly and the patient had no hydrocephalus.
2,328,147
Extracranial versus intracranial hydro-hemodynamics during aging: a PC-MRI pilot cross-sectional study.
Both aging and changes in blood flow velocity between the extracranial (intraspinal) and intracranial regions of cerebral vessels have an impact on brain hydro-hemodynamics. Arterial and venous cerebral blood flows interact with cerebrospinal fluid (CSF) in the both the cranial and spinal systems. Studies suggest that increased blood and CSF flow pulsatility plays an important role in certain neurological diseases. Here, we investigated the changes in blood-CSF flow pulsatility in the cranial and spinal systems with age as well as the impact of the intracranial compartment on flow patterns.</AbstractText>Phase-contrast magnetic resonance imaging (PC-MRI) was performed in 16 young and 19 elderly healthy volunteers to measure the flows of CSF and blood. CSF stroke volume (SV), blood SV, and arterial and venous pulsatility indexes (PIs) were assessed at intra- and extracranial levels in both samples. Correlations between ventricular and spinal CSF flow, and between blood and CSF flow during aging were also assessed.</AbstractText>There was a significant decrease in arterial cerebral blood flow and intracranial venous cerebral blood flow with aging. We also found a significant increase of intracranial blood SV, spinal CSF SV and arterial/venous pulsatility indexes with aging. In regard to intracranial compartment impact, arterial and venous PIs decreased significantly at intracranial level in elderly volunteers, while young adults exhibited decrease in venous PI only. Intracranial venous PI was paradoxically lower than extracranial venous PI, regardless of age. In both sample groups, spinal CSF SV and aqueductal CSF SV were positively correlated, and so were extracranial blood and spinal CSF SVs.</AbstractText>The study demonstrates that aging changes blood flow but preserves blood and CSF interactions. We also showed that many parameters related to blood and CSF flows differ between young and elderly adults.</AbstractText>
2,328,148
New Insights into the Anterior Complex.
To introduce visualization of the germinal matrix (GM), external angle of the frontal horn, and periventricular white matter while evaluating the anterior complex (AC) during basic ultrasound assessment of the fetal brain.</AbstractText>This is a retrospective observational study of healthy women with singleton pregnancies, with no increased risk of fetal central nervous system anomalies, attending routine ultrasound screening at 20-32 weeks' gestation. Seventeen cases are presented in which an abnormal aspect of the GM or external angle of the frontal horn or periventricular white matter on AC evaluation has allowed a prenatal diagnosis of peri-intraventricular hemorrhage, subependymal cysts, connatal cysts, periventricular venous hemorrhagic infarction, and white matter injury.</AbstractText>An extended AC evaluation could significantly improve the -diagnosis of hemorrhagic/cystic/hypoxic-ischemic lesions during the performance of a basic ultrasound study of the fetal brain.</AbstractText>&#xa9; 2020 S. Karger AG, Basel.</CopyrightInformation>
2,328,149
Characteristics and Outcomes of Patients Presenting With Hypertensive Urgency in the Office Setting: The Campania Salute Network.
Hypertensive urgencies (HypUrg) are defined as severe elevation in blood pressure (BP) without acute target organ damage. In the office setting, treated asymptomatic patients, with severe BP elevation meeting criteria for urgency are often seen. We evaluate incident Cardiovascular (CV) events (n = 311) during follow-up (FU) in patients with HypUrg at first outpatient visit.</AbstractText>HypUrg was defined by systolic BP &#x2265;180 mm Hg and/or diastolic BP &#x2265;110 mm Hg. Patients were &gt;18 years old, with available ultrasound data, without prevalent CV disease, and no more than stage III Chronic Kidney Disease. BP control was defined as the average BP during FU &lt;140/90 mm Hg.</AbstractText>Four hundred and sixty-nine of 6,929 patients presented with HypUrg at first visit. Patients with HypUrg were more likely to be women, obese and diabetic and with higher prevalence of left ventricle (LV) hypertrophy and carotid plaque (all P &lt; &#x2009;0.05). During FU patients with HypUrg had 5-fold higher risk of uncontrolled BP (95% confidence interval (CI) 4.1-6.8, P &lt; 0.0001). In Cox regression presenting with HypUrg was not associated with increased CV risk after adjusting for significant covariates, including age, sex, BP control, LV hypertrophy, and carotid plaque (hazard ratio (HR) 1.42, 95% CI (0.96-2.11), P = 0.08).</AbstractText>Patients with HypUrg have worst CV risk profile, reduced probability of BP control during FU and greater prevalence of target organ damage, but the excess CV event risk appears to be mediated through BP control, non-BP cardio-vascular disease risk factors, and demographic attributes.</AbstractText><AbstractText Label="CLINICALTRIALS.GOV IDENTIFIER">NCT02211365.</AbstractText>&#xa9; American Journal of Hypertension, Ltd 2020. All rights reserved. For Permissions, please email: journals.permissions@oup.com.</CopyrightInformation>
2,328,150
Immunohistochemical and histological evaluations of cyclophosphamide-induced acute cardiotoxicity in wistar rats: The role of turmeric extract (curcuma).
Chemotherapy-induced cardiac derangement is a major concern in health sector. Cyclophosphamide as a chemotherapeutic agent induces acute cardiotoxicity through its toxic metabolite, acrolein. This study evaluated the effect of ethanol extract of turmeric on cyclophosphamide-induced acute cardiotoxicity in Wistar rats. Thirty-five healthy Wistar rats, weighing 200-250g were randomly assigned into 7 groups (Groups A, B, C, D, E, F and G) N=5. Group A was the control, group B was negative control, and group C was administered 200mg/kg of turmeric extract (orally) only. While groups B, D, E, F and G were all administered 100mg/kg cyclophosphamide (i.p) for 10 days. Groups D and E were administered 100mg/kg and 200mg/kg of turmeric extract (orally) respectively for 72 hours before cyclophosphamide administration. Groups F and G were concomitantly administered 100mg/kg cyclophosphamide (i.p) with doses of 100mg/kg and 200mg/kg of turmeric extract (orally) respectively. The rats were sacrificed under ketamine anesthesia (30mg/kg i.m). The left ventricle of the heart was excised. One-way ANOVA was used to analyze data. Results revealed that there was statistically significant (P&lt;0.05) difference in body weight change, CK-MB, and LDH across all experimental groups; which were significantly lower in cyclophosphamide group. Histology and Immunohistochemistry revealed that there were morphological alterations in the myocardium of the left ventricle in group B while turmeric extract ameliorated cyclophosphamide-induced damage in the myocardium in other experimental groups. In conclusion, cyclophosphamide-induced myocardial alterations were significantly ameliorated through administration of ethanol extract of turmeric.
2,328,151
Rapamycin-Preactivated Autophagy Enhances Survival and Differentiation of Mesenchymal Stem Cells After Transplantation into Infarcted Myocardium.
Stem cell transplantation has been limited by poor survival of the engrafted cells in hostile microenvironment of the infarcted myocardium. This study investigated cytoprotective effect of rapamycin-preactivated autophagy on survival of the transplanted mesemchymal stem cells (MSCs). MSCs isolated from rat bone marrow were treated with 50&#xa0;nmol/L rapamycin for 2&#xa0;h, and then the cytoprotective effect of rapamycin was examined. After intramyocardial transplantation in rat ischemia/reperfusion models, the survival and differentiation of the rapamycin-pretreated calls were accessed. After treatment with rapamycin, autophagic activities and lysososme production of the cells were increased significantly. In the condition of short-term or long-term hypoxia and serum deprivation, the apoptotic cells in rapamycin-pretreated cells were less, and secretion of HGF, IGF-1, SCF, SDF-1 and VEGF was increased. After transplantation of rapamycin-pretreated cells, repair of the infarcted myocardium and restoration of cardial function were enhanced dramatically. Expression of HGF, IGF-1, SCF, SDF-1, VEGF, HIF-1&#x3b1; and IL-10 in the myocardium was upregulated, while expression of IL-1&#x3b2; and TNF-&#x3b1; was downregulated. Tracing of GFP and Sry gene showed that the survival of rapamycin-pretreated cells was increased. Cardiomyogenesis and angiogenesis in the infarcted myocardium were strengthened. Some rapamycin-pretreated cells differentiated into cardiomyocytes or endothelial cells. These results demonstrate that moderate preactivation of autophagy with rapamycin enhances the survival and differentiation of the transplanted MSCs. Rapamycin-primed MSCs can promote repair of the infarcted myocardium and improvement of cardiac function effectively.
2,328,152
Cyst fenestration and Ommaya reservoir placement in endoscopic transcortical transventricular approach for recurrent suprasellar cystic craniopharyngioma without ventriculomegaly.
The efficacy of the endoscopic transcortical transventricular approach (ETTA) for craniopharyngioma in the third ventricle with hydrocephalus has been reported focusing on its reduced invasiveness. On the other hand, suprasellar craniopharyngioma without ventriculomegaly is generally surgically managed by craniotomy or the endoscopic endonasal approach (EEA). Here, we report an elderly patient who received cyst fenestration and Ommaya reservoir placement in ETTA for recurrent suprasellar cystic craniopharyngioma without ventriculomegaly. The ETTA as a less invasive procedure is feasible in patients not only with intraventricular craniopharyngioma but also with suprasellar craniopharyngioma without hydrocephalus provided a navigational system is applied and the surgeon has ample experience with transcranial endoscopic procedures.
2,328,153
Dedicated diffusion phantoms for the investigation of free water elimination and mapping: insights into the influence of T<sub>2</sub> relaxation properties.
Conventional diffusion-weighted (DW) MRI suffers from free water contamination due to the finite voxel size. The most common case of free water contamination occurs with cerebrospinal fluid (CSF) in voxels located at the CSF-tissue interface, such as at the ventricles in the human brain. Another case refers to intra-tissue free water as in vasogenic oedema. In order to avoid the bias in diffusion metrics, several multi-compartment methods have been introduced, which explicitly model the presence of a free water compartment. However, fitting multi-compartment models in DW MRI represents a well known ill conditioned problem. Although during the last decade great effort has been devoted to mitigating this estimation problem, the research field remains active. The aim of this work is to introduce the design, characterise the NMR properties and demonstrate the use of two dedicated anisotropic diffusion fibre phantoms, useful for the study of free water elimination (FWE) and mapping models. In particular, we investigate the recently proposed FWE diffusion tensor imaging approach, which takes explicit account of differences in the transverse relaxation times between the free water and tissue compartments.
2,328,154
High-Resolution MRI for Evaluation of Ventriculostomy Tubes: Assessment of Positioning and Proximal Patency.
Imaging evaluation of ventriculostomy tubes, despite the frequency of malfunction, has remained inadequate due to the absence of a systematic way of assessing the catheter itself. In this retrospective review, we assessed the utility of high-resolution 3D MR imaging techniques, including CISS and volumetric interpolated breath-hold examination sequences, in the evaluation of ventriculostomy catheters.</AbstractText>We performed a retrospective review of 23 clinical MR imaging cases of shunted hydrocephalus spanning a 3-year period, all depicting ventriculostomy catheters. The MR imaging examinations included isotropic CISS and volumetric interpolated breath-hold examination sequences performed with and without contrast. These were independently evaluated by 2 neuroradiologists with respect to the catheter course, side hole position, relationship of the side holes to the ventricles, patency, and the presence or absence of intraluminal debris.</AbstractText>The catheter tip was best seen on isotropic CISS sequences reformatted in an oblique plane, and side holes were visualized as CSF signal defects along the catheter wall in 10/23 (43%) cases. The relationship of the catheter side holes to the ventricles was seen in 47% of cases and was best visualized on the coronal CISS sequences. Catheter patency was confirmed in 12/23 (52%) cases, while the other 48% were notable for T2 hypointense filling defects compatible with luminal obstruction. Enhancement of some of these filling defects on imaging is suggestive of choroid plexus ingrowth rather than debris.</AbstractText>High-resolution 3D MR imaging using isotropic CISS sequences allows systematic evaluation of catheter positioning, patency, and potential etiologic differentiation of filling defects when shunt dysfunction is suspected.</AbstractText>&#xa9; 2020 by American Journal of Neuroradiology.</CopyrightInformation>
2,328,155
[Clinical and genetic analysis of an infant with Lowe syndrome caused by exonic duplication of OCRL gene].
To explore the genetic basis of an infant featuring congenital cataract, developmental delay and proteinuria.</AbstractText>Clinical data and peripheral blood samples of the family were collected. Potential variants were screened by using targeted capture and high-throughput sequencing on a NextSeq 500 platform. Suspected variant was verified by quantitative PCR. Pathogenicity of the candidate variant was predicted based on clinical presentation and laboratory tests.</AbstractText>The infant's phenotypes included brain development retardation and proteinuria. Cranial MRI indicated widening of cerebral fissure, bilateral frontal and temporal subarachnoid cavities, and dysplasia of white matter myelination in posterior angular of ventricle. A novel duplication of exons 5 to 16 of the OCRL gene was found in the patient. His mother has carried the same duplication variant.</AbstractText>The duplication variant of the OCRL gene probably underlies the oculo-cerebro-renal syndrome in the infant. Due to the heterogeneity of its clinical manifestation, pertinent genetic detection is essential for acurrate diagnosis of patients who have the related phenotypes.</AbstractText>
2,328,156
Regional Distributions of Iron, Copper and Zinc and Their Relationships With Glia in a Normal Aging Mouse Model.
Microglia and astrocytes can quench metal toxicity to maintain tissue homeostasis, but with age, increasing glial dystrophy alongside metal dyshomeostasis may predispose the aged brain to acquire neurodegenerative diseases. The aim of the present study was to investigate age-related changes in brain metal deposition along with glial distribution in normal C57Bl/6J mice aged 2-, 6-, 19- and 27-months (<i>n</i> = 4/age). Using synchrotron-based X-ray fluorescence elemental mapping, we demonstrated age-related increases in iron, copper, and zinc in the basal ganglia (<i>p</i> &lt; 0.05). Qualitative assessments revealed age-associated increases in iron, particularly in the basal ganglia and zinc in the white matter tracts, while copper showed overt enrichment in the choroid plexus/ventricles. Immunohistochemical staining showed augmented numbers of microglia and astrocytes, as a function of aging, in the basal ganglia (<i>p</i> &lt; 0.05). Moreover, qualitative analysis of the glial immunostaining at the level of the fimbria and ventral commissure, revealed increments in the number of microglia but decrements in astroglia, in older aged mice. Upon morphological evaluation, aged microglia and astroglia displayed enlarged soma and thickened processes, reminiscent of dystrophy. Since glial cells have major roles in metal metabolism, we performed linear regression analysis and found a positive association between iron (<i>R</i> <sup>2</sup> = 0.57, <i>p</i> = 0.0008), copper (<i>R</i> <sup>2</sup> = 0.43, <i>p</i> = 0.0057), and zinc (<i>R</i> <sup>2</sup> = 0.37, <i>p</i> = 0.0132) with microglia in the basal ganglia. Also, higher levels of iron (<i>R</i> <sup>2</sup> = 0.49, <i>p</i> = 0.0025) and zinc (<i>R</i> <sup>2</sup> = 0.27, <i>p</i> = 0.040) were correlated to higher astroglia numbers. Aging was accompanied by a dissociation between metal and glial levels, as we found through the formulation of metal to glia ratios, with regions of basal ganglia being differentially affected. For example, iron to astroglia ratio showed age-related increases in the substantia nigra and globus pallidus, while the ratio was decreased in the striatum. Meanwhile, copper and zinc to astroglia ratios showed a similar regional decline. Our findings suggest that inflammation at the choroid plexus, part of the blood-cerebrospinal-fluid barrier, prompts accumulation of, particularly, copper and iron in the ventricles, implying a compromised barrier system. Moreover, age-related glial dystrophy/senescence appears to disrupt metal homeostasis, likely due to induced oxidative stress, and hence increase the risk of neurodegenerative diseases.
2,328,157
Clozapine protects adult neural stem cells from ketamine-induced cell death in correlation with decreased apoptosis and autophagy.
Adult neurogenesis, the production of newborn neurons from neural stem cells (NSCs) has been suggested to be decreased in patients with schizophrenia. A similar finding was observed in an animal model of schizophrenia, as indicated by decreased bromodeoxyuridine (BrdU) labelling cells in response to a non-competitive N-methyl-d-aspartate (NMDA) receptor antagonist. The antipsychotic drug clozapine was shown to counteract the observed decrease in BrdU-labelled cells in hippocampal dentate gyrus (DG). However, phenotypic determination by immunohistochemistry analysis could not reveal whether BrdU-positive cells were indeed NSCs. Using a previously established cell model for analysing NSC protection in vitro, we investigated a protective effect of clozapine on NSCs. Primary NSCs were isolated from the mouse subventricular zone (SVZ), we show that clozapine had a NSC protective activity alone, as evident by employing an ATP cell viability assay. In contrast, haloperidol did not show any NSC protective properties. Subsequently, cells were exposed to the non-competitive NMDA-receptor antagonist ketamine. Clozapine, but not haloperidol, had a NSC protective/anti-apoptotic activity against ketamine-induced cytotoxicity. The observed NSC protective activity of clozapine was associated with increased expression of the anti-apoptotic marker Bcl-2, decreased expression of the pro-apoptotic cleaved form of caspase-3 and associated with decreased expression of the autophagosome marker 1A/1B-light chain 3 (LC3-II). Collectively, our findings suggest that clozapine may have a protective/anti-apoptotic effect on NSCs, supporting previous in vivo observations, indicating a neurogenesis-promoting activity for clozapine. If the data are further confirmed in vivo, the results may encourage an expanded use of clozapine to restore impaired neurogenesis in schizophrenia.
2,328,158
EphrinB/EphB Signaling Contributes to the Synaptic Plasticity of Chronic Migraine Through NR2B Phosphorylation.
The specific mechanism of migraine chronification remains unclear. We previously demonstrated that synaptic plasticity was associated with migraine chronification. EphB receptors and their ligands, ephrinBs, are considered to be key molecules regulating the synaptic plasticity of the central nervous system. However, whether they can promote the chronification of migraine by regulating synaptic plasticity is unknown. Therefore, we investigated the role of ephrinB/EphB signaling in chronic migraine (CM). Male Sprague-Dawley rats were used to construct a chronic migraine model by dural infusion of an inflammatory soup for 7&#x202f;days. We used qPCR, western blot, and immunofluorescence to detect the mRNA and protein levels of EphB2 and ephrinB2. The paw withdrawal latency and paw withdrawal threshold were measured after lateral ventricle treatment with EphB1-Fc (an inhibitor of EphB receptor). Changes in synaptic plasticity were explored by examining synaptic-associated proteins by western blot, dendritic spines of neurons by Golgi-Cox staining, and synaptic ultrastructure by transmission electron microscopy. We found that the expression of EphB2 and ephrinB2 increased in CM. The administration of EphB1-Fc relieved hyperalgesia and changes in synaptic plasticity induced by CM. In addition, EphB1-Fc inhibited the upregulation of NR2B phosphorylation. These results indicate that ephrinB/EphB signaling may regulate synaptic plasticity in CM via NR2B phosphorylation, which suggests the novel idea that ephrinB/EphB signaling may be a target for the treatment of migraine chronification.
2,328,159
A Rapid Development of a Right Ventricular Aneurysm Postmyocardial Infarction.<Pagination><StartPage>1377</StartPage><EndPage>1379</EndPage><MedlinePgn>1377-1379</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1053/j.jvca.2019.12.006</ELocationID><ELocationID EIdType="pii" ValidYN="Y">S1053-0770(19)31229-7</ELocationID><Abstract><AbstractText>Myocardial infarctions may cause ventricular aneurysms. Ischemia-induced ventricular changes are more common in the left ventricle owing to the larger vascular supply, greater volume of myocardium, and increased intra-ventricular pressure. Ischemia-induced right ventricular free wall abnormalities are rare owing to the lower ventricular pressure. The authors describe the echocardiographic progression of a right ventricular ischemic aneurysm resulting from an ST-elevated myocardial infarction in a 71- year-old man. In this E-Challenge, the authors will review the echocardiographic findings and pathophysiology of ischemic aneurysms.</AbstractText><CopyrightInformation>Copyright &#xa9; 2019 Elsevier Inc. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Ortoleva</LastName><ForeName>Jamel</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Tufts Medical Center, Anesthesiology and Critical Care, Boston, MA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ohlrich</LastName><ForeName>Kelly</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Tufts Medical Center, Cardiac Surgery, Boston, MA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kawabori</LastName><ForeName>Masashi</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Tufts Medical Center, Cardiac Surgery, Boston, MA. Electronic address: kawabori.masashi@gmail.com.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2019</Year><Month>12</Month><Day>09</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Cardiothorac Vasc Anesth</MedlineTA><NlmUniqueID>9110208</NlmUniqueID><ISSNLinking>1053-0770</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>J Cardiothorac Vasc Anesth. 2020 May;34(5):1380-1381</RefSource><PMID Version="1">32241750</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004452" MajorTopicYN="N">Echocardiography</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006322" MajorTopicYN="Y">Heart Aneurysm</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006352" MajorTopicYN="N">Heart Ventricles</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009203" MajorTopicYN="Y">Myocardial Infarction</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D009206" MajorTopicYN="N">Myocardium</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">complication</Keyword><Keyword MajorTopicYN="N">echocardiogram</Keyword><Keyword MajorTopicYN="N">myocardial infarction</Keyword><Keyword MajorTopicYN="N">right ventricle</Keyword><Keyword MajorTopicYN="N">ventricular aneurysm</Keyword></KeywordList><CoiStatement>Conflict of Interest The authors declare no conflicts of interest.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2019</Year><Month>9</Month><Day>18</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2019</Year><Month>11</Month><Day>12</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2019</Year><Month>12</Month><Day>3</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>1</Month><Day>10</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>4</Month><Day>28</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>1</Month><Day>10</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">31917078</ArticleId><ArticleId IdType="doi">10.1053/j.jvca.2019.12.006</ArticleId><ArticleId IdType="pii">S1053-0770(19)31229-7</ArticleId></ArticleIdList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">31917004</PMID><DateRevised><Year>2021</Year><Month>05</Month><Day>27</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">2173-5808</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Jan</Month><Day>06</Day></PubDate></JournalIssue><Title>Neurologia</Title><ISOAbbreviation>Neurologia (Engl Ed)</ISOAbbreviation></Journal>The role of tractography in the localization of the Vim nucleus of the thalamus and the dentato-rubro-thalamic tract for the treatment of tremor.
Myocardial infarctions may cause ventricular aneurysms. Ischemia-induced ventricular changes are more common in the left ventricle owing to the larger vascular supply, greater volume of myocardium, and increased intra-ventricular pressure. Ischemia-induced right ventricular free wall abnormalities are rare owing to the lower ventricular pressure. The authors describe the echocardiographic progression of a right ventricular ischemic aneurysm resulting from an ST-elevated myocardial infarction in a 71- year-old man. In this E-Challenge, the authors will review the echocardiographic findings and pathophysiology of ischemic aneurysms.<CopyrightInformation>Copyright &#xa9; 2019 Elsevier Inc. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Ortoleva</LastName><ForeName>Jamel</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Tufts Medical Center, Anesthesiology and Critical Care, Boston, MA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ohlrich</LastName><ForeName>Kelly</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Tufts Medical Center, Cardiac Surgery, Boston, MA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kawabori</LastName><ForeName>Masashi</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Tufts Medical Center, Cardiac Surgery, Boston, MA. Electronic address: kawabori.masashi@gmail.com.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2019</Year><Month>12</Month><Day>09</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Cardiothorac Vasc Anesth</MedlineTA><NlmUniqueID>9110208</NlmUniqueID><ISSNLinking>1053-0770</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>J Cardiothorac Vasc Anesth. 2020 May;34(5):1380-1381</RefSource><PMID Version="1">32241750</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004452" MajorTopicYN="N">Echocardiography</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006322" MajorTopicYN="Y">Heart Aneurysm</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006352" MajorTopicYN="N">Heart Ventricles</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009203" MajorTopicYN="Y">Myocardial Infarction</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D009206" MajorTopicYN="N">Myocardium</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">complication</Keyword><Keyword MajorTopicYN="N">echocardiogram</Keyword><Keyword MajorTopicYN="N">myocardial infarction</Keyword><Keyword MajorTopicYN="N">right ventricle</Keyword><Keyword MajorTopicYN="N">ventricular aneurysm</Keyword></KeywordList><CoiStatement>Conflict of Interest The authors declare no conflicts of interest.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2019</Year><Month>9</Month><Day>18</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2019</Year><Month>11</Month><Day>12</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2019</Year><Month>12</Month><Day>3</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>1</Month><Day>10</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>4</Month><Day>28</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>1</Month><Day>10</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">31917078</ArticleId><ArticleId IdType="doi">10.1053/j.jvca.2019.12.006</ArticleId><ArticleId IdType="pii">S1053-0770(19)31229-7</ArticleId></ArticleIdList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">31917004</PMID><DateRevised><Year>2021</Year><Month>05</Month><Day>27</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">2173-5808</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Jan</Month><Day>06</Day></PubDate></JournalIssue><Title>Neurologia</Title><ISOAbbreviation>Neurologia (Engl Ed)</ISOAbbreviation></Journal><ArticleTitle>The role of tractography in the localization of the Vim nucleus of the thalamus and the dentato-rubro-thalamic tract for the treatment of tremor.</ArticleTitle><ELocationID EIdType="pii" ValidYN="Y">S0213-4853(19)30131-8</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.nrl.2019.09.006</ELocationID><Abstract><AbstractText Label="INTRODUCTION">The ventralis intermedius (Vim) nucleus of the thalamus is the usual surgical target for tremor. However, locating the structure may be difficult as it is not visible with conventional imaging methods; therefore, surgical procedures typically use indirect calculations correlated with clinical and intraoperative neurophysiological findings. Current ablative surgical procedures such as Gamma-Knife thalamotomy and magnetic resonance-guided focused ultrasound require new alternatives for locating the Vim nucleus. In this review, we compare Vim nucleus location for the treatment of tremor using stereotactic procedures versus direct location by means of tractography.<AbstractText Label="DISCUSSION">The most widely used cytoarchitectonic definition of the Vim nucleus is that established by Schaltenbrand and Wahren. There is a well-defined limit between the motor and the sensory thalamus; Vim neurons respond to passive joint movements and are synchronous with peripheral tremor. The most frequently used stereotactic coordinates for the Vim nucleus are based on indirect calculations referencing the mid-commissural line and third ventricle, which vary between patients. Recent studies suggest that the dentato-rubro-thalamic tract is an optimal target for controlling tremor, citing a clinical improvement; however, this has not yet been corroborated.<AbstractText Label="CONCLUSIONS">Visualisation of the cerebello-rubro-thalamic pathway by tractography may help in locating the Vim nucleus. The technique has several limitations, and the method requires standardisation to obtain more precise results. The utility of direct targeting by tractography over indirect targeting for patients with tremor remains to be demonstrated in the long-term.
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Wenxin Granules Influence the TGF<i>&#x3b2;</i>-P38/JNK MAPK Signaling Pathway and Attenuate the Collagen Deposition in the Left Ventricle of Myocardial Infarction Rats.
A large number of proinflammatory/anti-inflammatory cytokines are produced in the extracellular matrix (ECM) after myocardial infarction (MI), and the inflammatory pathways activated by these inflammatory stimuli are involved in the regulation of lesions with excessive accumulation of ECM. Wenxin granules can play a protective role against MI, but the mechanism of its effect on the inflammatory pathway and ECM collagen expression is still unclear.</AbstractText>To verify the effect of Wenxin granules on the inflammatory pathway and collagen expression after MI.</AbstractText>The proximal left anterior descending coronary artery in rats was ligated to induce acute MI. Then, animals were randomly assigned to the model group, the Carvedilol group, and the Wenxin Granules group. In addition, sham operation rats were used as the control group. 10 rats were allocated in each group. Gavage was given once a day for 4 weeks. The changes of cardiac hemodynamics were detected by the catheter method, morphological changes were observed by HE staining, and myocardial tissue collagen volume was counted by Immunohistochemistry combined with Masson staining, and the expression of inflammatory TGF&#x3b2;</i>-p38/JNK MAPK signal pathway markers was detected by Western blot.</AbstractText>Wenxin granules could significantly improve the hemodynamics, so that the fibrosis scar was relatively dense and uniform, and the residual myocardium was relatively neat, while Collagen type I and III volume and TGF&#x3b2;</i> expression levels were lessened. Although there were no differences in the expression of CTGF, p38, and JNK proteins, their phosphorylation levels showed significant differences.</AbstractText>Wenxin granules can affect the inflammation-related TGF&#x3b2;</i>-p38/JNK MAPK signaling pathway and change the structural properties of myocardium and scar after MI by attenuated collagen deposition in the left ventricular myocardial tissue to improve cardiac function.</AbstractText>Copyright &#xa9; 2019 Ya Huang et al.</CopyrightInformation>
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Functional herniated choroid plexus in brain parenchyma following VP shunt removal.
We report a 4-year-old male who presented with a blocked ventriculoperitoneal (VP) shunt inserted post excision of a WHO Grade 1 cerebellar pilocytic astrocytoma complicated post-operatively by pseudo meningocoele formation. Imaging revealed choroid plexus that had herniated along the shunt tract. Subsequent MRI showed development of cystic changes around the tract. The ectopic choroid plexus was still in continuity with the ventricular ependyma and was producing CSF in the left parietal lobe.
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Accelerated cardiomyocyte senescence contributes to late-onset doxorubicin-induced cardiotoxicity.
Children surviving cancer and chemotherapy are at risk for adverse health events including heart failure that may be delayed by years. Although the early effects of doxorubicin-induced cardiotoxicity may be attributed to a direct effect on the cardiomyocytes, the mechanisms underlying the delayed or late effects (8-20 yr) are unknown. The goal of this project was to develop a model of late-onset doxorubicin-induced cardiotoxicity to better delineate the underlying pathophysiology responsible. The underlying hypothesis was that doxorubicin-induced "late-onset cardiotoxicity" was the result of mitochondrial dysfunction leading to cell failure and death. Wistar rats, 3-4 wk of age, were randomly assigned to vehicle or doxorubicin injection groups (1-45 mg/kg). Cardiovascular function was unaltered at the lower dosages (1-15 kg/mg), but beginning at 6 mo after injection significant cardiac degradation was observed in the 45 mg/kg group. Doxorubicin significantly increased myocardial mitochondrial DNA (mtDNA) damage. In contrast, in isolated c-kit left ventricular (LV) cells, doxorubicin treatment did not increase mtDNA damage. Biomarkers of senescence within the LV were significantly increased, suggesting accelerated aging of the LV. Doxorubicin also significantly increased LV histamine content suggestive of mast cell activation. With the use of flow cytometry, a significant expansion of the c-kit and stage-specific embryonic antigen 1 cell populations within the LV were concomitant with significant decreases in the circulating peripheral blood population of these cells. These results are consistent with the concept that doxorubicin induced significant damage to the cardiomyocyte population and that although the heart attempted to compensate it eventually succumbed to an inability for self-repair.
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Evaluation of changes in magnetic resonance diffusion tensor imaging after treatment of delayed encephalopathy due to carbon monoxide poisoning.
Diffusion tensor imaging of the brain tissue microstructure was performed to predict or diagnose the pathophysiological mechanism underlying delayed encephalopathy after carbon monoxide poisoning and the treatment effect was analyzed. The changes in the diffusion parameters (average diffusion coefficient and fractional anisotropy) in adult patients after hyperbaric oxygen therapy of delayed encephalopathy after carbon monoxide poisoning were not significant differences of the two lateral ventricles or anterior or posterior limb of the internal capsule. In the group exposed to hyperbaric oxygen therapy, the fractional anisotropy values of the white matter in the ventricles of the brain and anterior and posterior limbs of the internal capsule were higher than those recorded before therapy, while the average diffusion coefficient values were significantly lower. These finding provide important monitoring indicators for clinicians.
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MR-Brain Causing Confusion.
This is a T2 weighted image (T2WI). In T2WI compartments filled with fluid appear brighter (as is the case of the CSF in the lateral ventricles). On the contrary, tissues with a high fat content appear as dark. This T2WI demonstrates layering of debris (figure 2- marked red star) in the occipital horn of the lateral ventricles. In this particular patient, the complete MRI report additionally demonstrated that the debris did not show a high T1 signal, demonstrated diffusion restriction, and a high FLAIR sequence. There was also restricting material observed in the fourth ventricle and the sylvian fissures bilaterally. There were no parenchymal changes or pathological contrast enhancements within the brain tissue. Whilst this appearance could represent blood, the appearance of the debrinous material itself was more in keeping with infective/pus material within the ventricles suggestive of ventriculitis.
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MEF2C repressor variant deregulation leads to cell cycle re-entry and development of heart failure.
A pathophysiological link exists between dysregulation of MEF2C transcription factors and heart failure (HF), but the underlying mechanisms remain elusive. Alternative splicing of MEF2C exons &#x3b1;, &#x3b2; and &#x3b3; provides transcript diversity with gene activation or repression functionalities.</AbstractText>Neonatal and adult rat ventricular myocytes were used to overexpress MEF2C splicing variants &#x3b3;+ (repressor) or &#x3b3;-, or the inactive MEF2C&#x3b3;+23/24 (K23T/R24L). Phenotypic alterations in cardiomyocytes were determined by confocal and electron microscopy, flow cytometry and DNA microarray. We used transgenic mice with cardiac-specific overexpression of MEF2C&#x3b3;+ or MEF2C&#x3b3;- to explore the impact of MEF2C&#xa0;variants&#xa0;in cardiac phenotype. Samples of non-infarcted areas of the left ventricle from patients and mouse model of myocardial infarction were used to detect the expression of MEF2C&#x3b3;+ in failing hearts.</AbstractText>We demonstrate a previously unrealized upregulation of the transrepressor MEF2C&#x3b3;+ isoform in human and mouse failing hearts. We show that adenovirus-mediated overexpression of MEF2C&#x3b3;+ downregulates multiple MEF2-target genes, and drives incomplete cell-cycle reentry, partial dedifferentiation and apoptosis in the neonatal and adult rat. None of these changes was observed in cardiomyocytes overexpressing MEF2C&#x3b3;-. Transgenic mice overexpressing MEF2C&#x3b3;+, but not the MEF2C&#x3b3;-, developed dilated cardiomyopathy, correlated to cell-cycle reentry and apoptosis of cardiomyocytes.</AbstractText>Our results provide a mechanistic link between MEF2C&#x3b3;+ and deleterious abnormalities in cardiomyocytes, supporting the notion that splicing dysregulation in MEF2C towards the selection of the MEF2C&#x3b3;+ variant contributes to the pathogenesis of HF by promoting cardiomyocyte dropout.</AbstractText>S&#xe3;o Paulo Research Foundation (FAPESP); Brazilian National Research Council (CNPq).</AbstractText>Copyright &#xa9; 2019 The Authors. Published by Elsevier B.V. All rights reserved.</CopyrightInformation>
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Melanin-concentrating hormone (MCH) in the median raphe nucleus: Fibers, receptors and cellular effects.
Serotonergic neurons of the median raphe nucleus (MnR) and hypothalamic melanin-concentrating hormone (MCH)-containing neurons, have been involved in the control of REM sleep and mood. In the present study, we examined in rats and cats the anatomical relationship between MCH-containing fibers and MnR neurons, as well as the presence of MCHergic receptors in these neurons. In addition, by means of in vivo unit recording in urethane anesthetized rats, we determined the effects of MCH in MnR neuronal firing. Our results showed that MCH-containing fibers were present in the central and paracentral regions of the MnR. MCHergic fibers were in close apposition to serotonergic and non-serotonergic neurons. By means of an indirect approach, we also analyzed the presence of MCHergic receptors within the MnR. Accordingly, we microinjected MCH conjugated with the fluorophore rhodamine (R-MCH) into the lateral ventricle. R-MCH was internalized into serotonergic and non-serotonergic MnR neurons; some of these neurons were GABAergic. Furthermore, we determined that intracerebroventricular administration of MCH induced a significant decrease in the firing rate of 53 % of MnR neurons, while the juxtacellular administration of MCH reduced the frequency of discharge in 67 % of these neurons. Finally, the juxtacellular administration of the MCH-receptor antagonist ATC-0175 produced an increase in the firing rate in 78 % of MnR neurons. Hence, MCH produces a strong regulation of MnR neuronal activity. We hypothesize that MCHergic modulation of the MnR neuronal activity may be involved in the promotion of REM sleep and in the pathophysiology of depressive disorders.
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Determination of the theoretical personalized optimum chest compression point using anteroposterior chest radiography.
There is a traditional assumption that to maximize stroke volume, the point beneath which the left ventricle (LV) is at its maximum diameter (P_max.LV) should be compressed. Thus, we aimed to derive and validate rules to estimate P_max.LV using anteroposterior chest radiography (chest_AP), which is performed for critically ill patients urgently needing determination of their personalized P_max.LV.</AbstractText>A retrospective, cross-sectional study was performed with non-cardiac arrest adults who underwent chest_AP within 1 hour of computed tomography (derivation:validation=3:2). On chest_AP, we defined cardiac diameter (CD), distance from right cardiac border to midline (RB), and cardiac height (CH) from the carina to the uppermost point of left hemi-diaphragm. Setting point zero (0, 0) at the midpoint of the xiphisternal joint and designating leftward and upward directions as positive on x- and y-axes, we located P_max.LV (x_max.LV, y_max.LV). The coefficients of the following mathematically inferred rules were sought: x_max.LV=&#x3b1;0*CD-RB; y_max.LV=&#x3b2;0*CH+&#x3b3;0 (&#x3b1;0: mean of [x_max.LV+RB]/CD; &#x3b2;0, &#x3b3;0: representative coefficient and constant of linear regression model, respectively).</AbstractText>Among 360 cases (52.0&#xb1;18.3 years, 102 females), we derived: x_max.LV=0.643*CD-RB and y_max.LV=55-0.390*CH. This estimated P_max.LV (19&#xb1;11 mm) was as close as the averaged P_max.LV (19&#xb1;11 mm, P=0.13) and closer than the three equidistant points representing the current guidelines (67&#xb1;13, 56&#xb1;10, and 77&#xb1;17 mm; all P&lt;0.001) to the reference identified on computed tomography. Thus, our findings were validated.</AbstractText>Personalized P_max.LV can be estimated using chest_AP. Further studies with actual cardiac arrest victims are needed to verify the safety and effectiveness of the rule.</AbstractText>
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Adult Neurogenesis in the Context of Brain Repair and Functional Relevance.
Urodeles and some fishes possess a remarkable capacity to regenerate their limbs/fins, a property that correlates with their additional ability to regenerate large areas of the brain and/or produce a variety of new neurons during adulthood. In contrast, neurogenesis in adult mammals is apparently restricted to two main regions, the subventricular zone of lateral ventricles and the subgranular zone of the hippocampus. There, astrocyte-like neural stem cells (NSCs) reside and derive into new neurons. Although it is becoming apparent that other brain regions carry out neurogenesis, in many cases, its functional significance is controversial, particularly, because very few putative NSCs capable of deriving into new neurons have been found. Hence, is renewal of certain neurons a requirement for a healthy brain? Are there specific physiological conditions that stimulate neurogenesis in a particular region? Does the complexity of the brain demand reduced neurogenesis? In this study, we review the production of new neurons in the vertebrate adult brain in the context of a possible functional relevance. In addition, we consider the intrinsic properties of potential cellular sources of new neurons, as well as the contribution of the milieu surrounding them to estimate the reparative capacity of the brain upon injury or a neurodegenerative condition. The conclusion of this review should bring into debate the potential and convenience of promoting neuronal regeneration in the adult human brain.
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Unilateral Open-lip Schizencephaly with Tonsillar Herniation in a Preterm Infant.
Schizencephaly is a rare type of neuronal migration disorder characterized by the presence of a cerebral hemispheric cleft that extends from lateral ventricles to the cortical surface of the brain. We report a rare case of prenatally diagnosed unilateral schizencephaly in a late preterm infant who manifested with rapidly progressive hydrocephalus with massive enlargement of posterior cerebrospinal fluid spaces with tonsillar herniation that was successfully treated with placement of a ventriculoperitoneal shunt.
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Inhibitory effect of carvacrol on lipopolysaccharide-induced memory impairment in rats.
Neuroinflammation is an important process underlying a wide variety of neurodegenerative diseases. Carvacrol (CAR) is a phenolic monoterpene commonly used as a food additive due to its antibacterial properties, but it has also been shown to exhibit strong antioxidative, anti-inflammatory, and neuroprotective effects. Here, we sought to investigate the effects of CAR on inflammation in the hippocampus and prefrontal cortex, as well as the molecular mechanisms underlying these effects. In our study, lipopolysaccharide was injected into the lateral ventricle of rats to induce memory impairment and neuroinflammation. Daily administration of CAR (25, 50, and 100 mg/kg) for 21 days improved recognition, discrimination, and memory impairments relative to untreated controls. CAR administration significantly attenuated expression of several inflammatory factors in the brain, including interleukin-1&#x3b2;, tumor necrosis factor-&#x3b1;, and cyclooxygenase-2. In addition, CAR significantly increased expression of brain-derived neurotrophic factor (BDNF) mRNA, and decreased expression of Toll-like receptor 4 (TLR4) mRNA. Taken together, these results show that CAR can improve memory impairment caused by neuroinflammation. This cognitive enhancement is due to the anti-inflammatory effects of CAR medicated by its regulation of BDNF and TLR4. Thus, CAR has significant potential as an inhibitor of memory degeneration in neurodegenerative diseases.
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Brain Metastases Completely Disappear in Non-Small Cell Lung Cancer Using Hydrogen Gas Inhalation: A Case Report.
Lung cancer is the most common type of tumor, prone to contralateral lung, bone and brain metastasis. We report a 44-year-old woman diagnosed with lung cancer with multiple metastases in November 2015. Oral targeted drugs were initiated after the removal of brain metastases, and most lesions remained stable for 28 months. In March 2018, intracranial multiple metastases, as well as hydrocephalus accumulation in the third ventricle and lateral ventricles, and metastases in bone, adrenal gland, liver were noted. Hydrogen-gas monotherapy was started to control the tumor a month later. After 4 months, the size of multiple brain tumors was reduced significantly, and the amount of hydrocephalus in the third ventricle and lateral ventricles reduced significantly. After 1 year, all brain tumors had disappeared, and there were no significant changes in metastases in the liver and lung. These data show that, after standard treatments had failed, hydrogen-gas monotherapy elicited significant effective control of tumors (especially those in the brain), and survival time was lengthened.
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Targeting exosome-associated human antigen R attenuates fibrosis and inflammation in diabetic heart.
RNA-binding proteins like human antigen R (HuR) are key regulators in post-transcriptional control of gene expression in several pathophysiological conditions. Diabetes adversely affects monocyte/macrophage biology and function. It is not known whether diabetic milieu affects cellular/exosome-HuR and its implications on cardiac inflammation and fibrosis. Here, we evaluate in vitro and in vivo effects of diabetic milieu on macrophage cellular/exosome-HuR, alterations in intercellular cross talk with fibroblasts, and its impact on cardiac remodeling. Human failing hearts show higher HuR levels. Diabetic milieu activates HuR expression in cardiac- and cultured bone marrow-derived macrophages (BMM&#xd8;) and stimulates HuR nuclear-to-cytoplasmic translocation and exosome transfer. Exosomes from macrophages exposed to diabetic milieu (high glucose or db/db mice) significantly increase inflammatory and profibrogenic responses in fibroblast (in vitro) and cardiac fibrosis in mice. Intriguingly, Exo-HuR deficiency (HuR knockdown in macrophage) abrogates the above effects. In diabetic mice, macrophage depletion followed by reconstitution with BMM&#xd8;-derived HuR-deficient exosomes inhibits angiotensin II-induced cardiac fibrosis response and preserves left ventricle function as compared to control-exosome administration. To the best of our knowledge, this is the first study to demonstrate that diabetes activates BMM&#xd8; HuR expression and its transfer into exosome. The data suggest that HuR might be targeted to alleviate macrophage dysfunction and pathological fibrosis in diabetes.
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A case of developing obstructive hydrocephalus following aqueductal stenosis caused by developmental venous anomalies.
Developmental venous anomalies (DVAs), previously also known as venous angiomas, are variations of normal trans-medullary veins draining from white and gray matter. DVAs are usually asymptomatic and mostly discovered incidentally on brain imaging. However, some studies have reported symptomatic cases associated with DVAs. In this report, we report an extremely rare case of a 14-month-old boy with obstructive hydrocephalus following aqueductal stenosis caused by developmental venous anomalies. At the age of 14&#xa0;months, his head circumference exceeded +&#x2009;2SD significantly. Brain magnetic resonance imaging (MRI) showed triventriculomegaly and dilated collector vein coursing through the Sylvian aqueduct, causing aqueductal stenosis. Endoscopic third ventriculostomy (ETV) was successfully performed. During the procedure, a dilated collector vein was confirmed obstructing the Sylvian aqueduct. Postoperative cine MRI showed good flow signal through the opening and improvement of hydrocephalus was noted. Obstructive hydrocephalus following aqueductal stenosis caused by DVAs is very rare; nonetheless, it can be considered as a causal differential diagnosis for hydrocephalus. Whether ETV should be chosen, as the technique for diversion of cerebrospinal fluid (CSF) flow, remains controversial. This case report showed that ETV was effective and safe.
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Radial Glial Cell-Derived VCAM1 Regulates Cortical Angiogenesis Through Distinct Enrichments in the Proximal and Distal Radial Processes.
Angiogenesis in the developing cerebral cortex accompanies cortical neurogenesis. However, the precise mechanisms underlying cortical angiogenesis at the embryonic stage remain largely unknown. Here, we show that radial glia-derived vascular cell adhesion molecule 1 (VCAM1) coordinates cortical vascularization through different enrichments in the proximal and distal radial glial processes. We found that VCAM1 was highly enriched around the blood vessels in the inner ventricular zone (VZ), preventing the ingrowth of blood vessels into the mitotic cell layer along the ventricular surface. Disrupting the enrichment of VCAM1 surrounding the blood vessels by a tetraspanin-blocking peptide or conditional deletion of Vcam1 gene in neural progenitor cells increased angiogenesis in the inner VZ. Conversely, VCAM1 expressed in the basal endfeet of radial glial processes promoted angiogenic sprouting from the perineural vascular plexus (PNVP). In utero, overexpression of VCAM1 increased the vessel density in the cortical plate, while knockdown of Vcam1 accomplished the opposite. In vitro, we observed that VCAM1 bidirectionally affected endothelial cell proliferation in a concentration-dependent manner. Taken together, our findings identify that distinct concentrations of VCAM1 around VZ blood vessels and the PNVP differently organize cortical angiogenesis during late embryogenesis.
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Genetic disruption of slc4a10 alters the capacity for cellular metabolism and vectorial ion transport in the choroid plexus epithelium.
Genetic disruption of slc4a10, which encodes the sodium-dependent chloride/bicarbonate exchanger Ncbe, leads to a major decrease in Na+</sup>-dependent HCO3</sub>-</sup> import into choroid plexus epithelial cells in mice and to a marked reduction in brain intraventricular fluid volume. This suggests that Ncbe functionally is a key element in vectorial Na+</sup> transport and thereby for cerebrospinal fluid secretion in the choroid plexus. However, slc4a10 disruption results in severe changes in expression of Na+</sup>,K+</sup>-ATPase complexes and other major transport proteins, indicating that profound cellular changes accompany the genetic manipulation.</AbstractText>A tandem mass tag labeling strategy was chosen for quantitative mass spectrometry. Alterations in the broader patterns of protein expression in the choroid plexus in response to genetic disruption of Ncbe was validated by semi-quantitative immunoblotting, immunohistochemistry and morphometry.</AbstractText>The abundance of 601 proteins were found significantly altered in the choroid plexus from Ncbe ko mice relative to Ncbe wt. In addition to a variety of transport proteins, particularly large changes in the abundance of proteins involved in cellular energy metabolism were detected in the Ncbe ko mice. In general, the abundance of rate limiting glycolytic enzymes and several mitochondrial enzymes were reduced following slc4a10 disruption. Surprisingly, this was accompanied by increased ATP levels in choroid plexus cells, indicating that the reduction in capacity for energy metabolism was adaptive to high ATP rather than causal for a decreased capacity for ion and water transport. Ncbe-deficient cells also had a reduced cell area and decreased K+</sup> content.</AbstractText>Our findings suggest that the lack of effective Na+</sup>-entry into the epithelial cells of the choroid plexus leads to a profound change in the cellular phenotype, shifting from a high-rate secretory function towards a more dormant state; similar to what is observed during ageing or Alzheimer's disease.</AbstractText>
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Prediction of Left Ventricular Mechanics Using Machine Learning.
The goal of this paper was to provide a real-time left ventricular (LV) mechanics simulator using machine learning (ML). Finite element (FE) simulations were conducted for the LV with different material properties to obtain a training set. A hyperelastic fiber-reinforced material model was used to describe the passive behavior of the myocardium during diastole. The active behavior of the heart resulting from myofiber contractions was added to the passive tissue during systole. The active and passive properties govern the LV constitutive equation. These mechanical properties were altered using optimal Latin hypercube design of experiments to obtain training FE models with varied active properties (volume and pressure predictions) and varied passive properties (stress predictions). For prediction of LV pressures, we used eXtreme Gradient Boosting (XGboost) and Cubist, and XGBoost was used for predictions of LV pressures, volumes as well as LV stresses. The LV pressure and volume results obtained from ML were similar to FE computations. The ML results could capture the shape of LV pressure as well as LV pressure-volume loops. The results predicted by Cubist were smoother than those from XGBoost. The mean absolute errors were as follows: XGBoost volume: 1.734 &#xb1; 0.584 ml, XGBoost pressure: 1.544 &#xb1; 0.298 mmHg, Cubist volume: 1.495 &#xb1; 0.260 ml, Cubist pressure: 1.623 &#xb1; 0.191 mmHg, myofiber stress: 0.334 &#xb1; 0.228 kPa, cross myofiber stress: 0.075 &#xb1; 0.024 kPa, and shear stress: 0.050 &#xb1; 0.032 kPa. The simulation results show ML can predict LV mechanics much faster than the FE method. The ML model can be used as a tool to predict LV behavior. Training of our ML model based on a large group of subjects can improve its predictability for real world applications.
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Cavernoma of the Right Lateral Ventricle: A Rare Case Report.
Intraventricular cavernoma (IVC) is a rare pathological entity constituting 2.5%-10.8% of cerebral cavernomas. The lateral ventricles are the most frequent site, followed by the third and fourth ventricles. IVCs usually attain a large size compared to parenchymal cavernomas and cause signs and symptoms mainly due to mass effect. IVCs lack specific clinical manifestations and radiological features. Microsurgical excision of IVCs is a safe and effective treatment option. We present a 71-year-old male patient with right lateral ventricle cavernous angioma. The patient underwent microsurgical resection of the vascular lesion with good neurological outcome.
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Prenatal diagnosis of foetal hydrocephalus and suspected X-linked recessive inheritance of cleft lip in a Chihuahua.
A 3.5-year-old, 2.9 kg, multiparous Chihuahua presented with abdominal distension; pregnancy was diagnosed. On Day 7 before parturition, prenatal sonograms showed anechoic bilateral dilated cerebral lateral ventricles, suggesting fluid-filled regions (ventriculomegaly) in one foetus. A Caesarean section was performed and the male newborn had an abnormally enlarged dome-shaped head and a cleft lip, and died 6 days after birth. According to the family pedigree, the X-linked recessive inheritance of an orofacial cleft from the unaffected mother was suggested. This report clearly demonstrates that canine foetal ventriculomegaly (hydrocephalus) can be diagnosed in utero. For dog breeds predisposed to congenital ventriculomegaly, early detection is important for the prediction of perinatal survival and adequate supportive care can be applied at delivery.
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Ependymal cells in the spinal cord as neuronal progenitors.
Ependymal cells are neural progenitors and form part of the central canal of the spinal cord. Therefore, ependymal cells could serve as a potential source of neural progenitors for regenerative medicine applications. Such applications consist of endogenous activation or exogenous transplantation, alone or in combination with pharmacological treatments, to repair spinal cord injuries. This mini review describes the main phenotypical characteristics of ependymal cells from spinal cord and the opportunities offered for spinal cord injury therapeutic application.
2,328,180
Untangling human neurogenesis to understand and counteract brain disorders.
Neurogenesis in the human postnatal brain occurs in two regions, the subventricular zone of the later ventricle and the dentate gyrus of the hippocampus. While it is well accepted that SVZ and hippocampal neurogenesis are active during juvenile stages in human, their contribution during adulthood and ageing as well as pathological states is recently animating the neural stem cell research field. In this review we will discuss recent evidence about the organization of SVZ and hippocampal neurogenic niches, and will report on how human adult neurogenesis may contribute to disease and appears to respond to neurodegeneration. In light of these novel findings, we will discuss how we can target human adult neurogenesis in order to influence brain disease trajectories.
2,328,181
DeepCQ: Deep multi-task conditional quantification network for estimation of left ventricle parameters.
Automatic cardiac left ventricle (LV) quantification plays an important role in assessing cardiac function. Although many advanced methods have been put forward to quantify related LV parameters, automatic cardiac LV quantification is still a challenge task due to the anatomy construction complexity of heart.</AbstractText>In this work, we propose a novel deep multi-task conditional quantification learning model (DeepCQ) which contains Segmentation module, Quantification encoder, and Dynamic analysis module. Besides, we also use task uncertainty loss function to update the parameters of the network in training.</AbstractText>The proposed framework is validated on the dataset from Left Ventricle Full Quantification Challenge MICCAI 2018 (https://lvquan18.github.io/). The experimental results show that DeepCQ outperforms the other advanced methods.</AbstractText>It illustrates that our method has a great potential in comprehensive cardiac function assessment and could play an auxiliary role in clinicians' diagnosis.</AbstractText>Copyright &#xa9; 2019. Published by Elsevier B.V.</CopyrightInformation>
2,328,182
Is This Truly A "Leave-Me-Alone" Lesion? An Unusual Case of Multiple Ring-shaped Lateral Ventricular Nodules.
Ring-shaped lateral ventricular nodules (RSLVNs) are commonly considered as benign asymptomatic lesions, which are sporadically detected as incidental findings on routine brain magnetic resonance imaging scans. Despite their not irrelevant frequency, the exact biological nature of these lesions remains largely unknown due to the lack of histopathologic studies. Here we present the clinical, neuroradiologic, and histopathologic findings of an unusual case of symptomatic multiple RSLVNs.</AbstractText>A 44-year-old otherwise healthy man presented with a recent history of headache and retching. Neuroradiologic imaging revealed the presence of multiple RSLVNs, the largest of which, located in the cella media of the right lateral ventricle, exerted a mild to moderate mass effect on adjacent brain parenchyma. This latter nodule was successfully removed, with complete resolution of the symptoms. Histopathology revealed glial differentiation, and the specimen was diagnosed as subependymoma.</AbstractText>This report provides novel evidence characterizing RSLVNs as possible variants of subependymoma with a peculiar imaging appearance, also suggesting that, like subependymomas, they may occasionally grow large enough to cause mass effect-related symptoms, thus requiring neurosurgical intervention.</AbstractText>Copyright &#xa9; 2019 Elsevier Inc. All rights reserved.</CopyrightInformation>
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The implications of hippocampal neurogenesis in adolescent rats after status epilepticus: a novel role of notch signaling pathway in regulating epileptogenesis.
Seizure-induced neurogenesis has a widely recognized pro-epileptogenic function. Given the critical role of Notch signaling during the maintenance and neurogenesis of neural stem cells, we hypothesized that Notch may affect epileptogenesis and its progression through its role in neurogenesis in the adolescent rat brain. We used the lithium-pilocarpine-induced epilepsy model in adolescent Sprague-Dawley rats in order to evaluate hippocampal neurogenesis and epileptogenesis following the onset of status epilepticus (SE). We used western blotting analyses and qPCR to measure levels of Notch signaling at different phases after seizures and immunofluorescence to detect the proliferation and differentiation of neural stem cells after seizure. Following the administration of DAPT, a Notch &#x3b3;-secretase inhibitor, into the lateral ventricles, we observed a suppression of abnormal neurogenesis in the acute phase and a reduction of gliosis in the chronic phase after SE. Accordingly, the frequency and duration of spontaneous seizures in chronic phase were decreased. Our results clarify the basic concept regarding the involvement of Notch signaling in the regulation of hippocampal neurogenesis and epileptogenesis, thereby potentially offering a novel and alternative treatment for epilepsy.
2,328,184
Comparison of the beta-hydroxybutyrate, glucose, and lactate concentrations derived from postmortem proton magnetic resonance spectroscopy and biochemical analysis for the diagnosis of fatal metabolic disorders.<Pagination><StartPage>603</StartPage><EndPage>612</EndPage><MedlinePgn>603-612</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1007/s00414-019-02235-6</ELocationID><Abstract><AbstractText Label="PURPOSE" NlmCategory="OBJECTIVE">The detection and quantification of metabolites relevant for the diagnosis of fatal metabolic disorders by proton magnetic resonance spectroscopy (1H-MRS) was recently demonstrated. This prospective study aimed to compare the concentrations of beta-hydroxybutyrate (BHB), glucose (GLC), and lactate (LAC) derived from both biochemical analyses and 1H-MRS for the diagnosis of fatal metabolic disorders.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">In total, 20 cases with suspected fatal metabolic disorders were included in the study. For the agreement based on thresholds, the concentrations of BHB and GLC in the vitreous humor (VH) from the right vitreous and in cerebrospinal fluid (CSF) from the right lateral ventricle were derived from 1H-MRS and biochemical analyses. The predefined thresholds for pathological elevations were 2.5&#xa0;mmol/l for BHB and 10&#xa0;mmol/l for GLC based on the literature. In addition, concentrations of the same metabolites in white matter (WM) tissue from the corona radiata of the right hemisphere were analyzed experimentally using both methods. To enable the biochemical analysis, a dialysate of WM tissue was produced. For all three regions, the LAC concentration was determined by both methods.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">The conclusive agreement based on thresholds was almost perfect between both methods with only one disagreement in a total of 70 comparisons due to the interference of a ferromagnetic dental brace. The differences in the concentrations between both methods showed high standard deviations. Confidence intervals of the bias not including 0 were found in CSF-GLC (-&#x2009;3.1&#xa0;mmol/l), WM-GLC (1.1&#xa0;mmol/l), and WM-LAC (-&#x2009;6.5&#xa0;mmol/l).</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Despite a considerable total error attributable to both methods, MRS derives the same forensic conclusions as conventional biochemical analyses. An adaptation of the protocol to reduce the detected errors and more data are needed for the long-term validation of MRS for the diagnosis of fatal metabolic disorders. The production of WM dialysates cannot be recommended due to high glycolytic loss.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Heimer</LastName><ForeName>Jakob</ForeName><Initials>J</Initials><Identifier Source="ORCID">0000-0003-3499-8801</Identifier><AffiliationInfo><Affiliation>Institute of Forensic Medicine, Department of Forensic Medicine and Imaging, University of Zurich, Winterthurerstrasse 190/52, CH-8057, Zurich, Switzerland. Jakob.Heimer@irm.uzh.ch.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gascho</LastName><ForeName>Dominic</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Institute of Forensic Medicine, Department of Forensic Medicine and Imaging, University of Zurich, Winterthurerstrasse 190/52, CH-8057, Zurich, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Madea</LastName><ForeName>Burkhard</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Institute of Forensic Medicine, Rheinische Friedrich-Wilhelms-University Bonn, Stiftsplatz 12, D-53111, Bonn, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Steuer</LastName><ForeName>Andrea</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Institute of Forensic Medicine, Department of Forensic Pharmacology and Toxicology, University of Zurich, Winterthurerstrasse 190/52, CH-8057, Zurich, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Martinez</LastName><ForeName>Rosa Maria</ForeName><Initials>RM</Initials><AffiliationInfo><Affiliation>Institute of Forensic Medicine, Department of Forensic Medicine and Imaging, University of Zurich, Winterthurerstrasse 190/52, CH-8057, Zurich, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Thali</LastName><ForeName>Michael J</ForeName><Initials>MJ</Initials><AffiliationInfo><Affiliation>Institute of Forensic Medicine, Department of Forensic Medicine and Imaging, University of Zurich, Winterthurerstrasse 190/52, CH-8057, Zurich, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zoelch</LastName><ForeName>Niklaus</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Institute of Forensic Medicine, Department of Forensic Medicine and Imaging, University of Zurich, Winterthurerstrasse 190/52, CH-8057, Zurich, Switzerland.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Hospital of Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Lenggstrasse 31, CH-8032, Zurich, Switzerland.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D003160">Comparative Study</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>01</Month><Day>04</Day></ArticleDate></Article><MedlineJournalInfo><Country>Germany</Country><MedlineTA>Int J Legal Med</MedlineTA><NlmUniqueID>9101456</NlmUniqueID><ISSNLinking>0937-9827</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D015415">Biomarkers</NameOfSubstance></Chemical><Chemical><RegistryNumber>33X04XA5AT</RegistryNumber><NameOfSubstance UI="D019344">Lactic 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MajorTopicYN="Y">analysis</QualifierName><QualifierName UI="Q000134" MajorTopicYN="N">cerebrospinal fluid</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019344" MajorTopicYN="N">Lactic Acid</DescriptorName><QualifierName UI="Q000032" MajorTopicYN="Y">analysis</QualifierName><QualifierName UI="Q000134" MajorTopicYN="N">cerebrospinal fluid</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D020547" MajorTopicYN="N">Lateral Ventricles</DescriptorName><QualifierName UI="Q000737" MajorTopicYN="N">chemistry</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008659" MajorTopicYN="N">Metabolic Diseases</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName><QualifierName UI="Q000401" MajorTopicYN="Y">mortality</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D066244" MajorTopicYN="Y">Proton Magnetic Resonance Spectroscopy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014822" MajorTopicYN="N">Vitreous Body</DescriptorName><QualifierName UI="Q000737" MajorTopicYN="N">chemistry</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D066127" MajorTopicYN="N">White Matter</DescriptorName><QualifierName UI="Q000737" MajorTopicYN="N">chemistry</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Glucose metabolism</Keyword><Keyword MajorTopicYN="N">Ketone bodies</Keyword><Keyword MajorTopicYN="N">Metabolic disorder</Keyword><Keyword MajorTopicYN="N">Method comparison</Keyword><Keyword MajorTopicYN="N">Postmortem biochemistry</Keyword><Keyword MajorTopicYN="N">Proton magnetic resonance spectroscopy</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate 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Clin Chem 40(7):1327&#x2013;1330</Citation><ArticleIdList><ArticleId IdType="pubmed">8013108</ArticleId><ArticleId IdType="doi">10.1093/clinchem/40.7.1327</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">31899871</PMID><DateRevised><Year>2020</Year><Month>01</Month><Day>03</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1933-0693</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Jan</Month><Day>03</Day></PubDate></JournalIssue><Title>Journal of neurosurgery</Title><ISOAbbreviation>J Neurosurg</ISOAbbreviation></Journal>Reversibility of impaired brain structures after transsphenoidal surgery in Cushing's disease: a longitudinal study based on an artificial intelligence-assisted tool.
The detection and quantification of metabolites relevant for the diagnosis of fatal metabolic disorders by proton magnetic resonance spectroscopy (1H-MRS) was recently demonstrated. This prospective study aimed to compare the concentrations of beta-hydroxybutyrate (BHB), glucose (GLC), and lactate (LAC) derived from both biochemical analyses and 1H-MRS for the diagnosis of fatal metabolic disorders.</AbstractText>In total, 20 cases with suspected fatal metabolic disorders were included in the study. For the agreement based on thresholds, the concentrations of BHB and GLC in the vitreous humor (VH) from the right vitreous and in cerebrospinal fluid (CSF) from the right lateral ventricle were derived from 1H-MRS and biochemical analyses. The predefined thresholds for pathological elevations were 2.5&#xa0;mmol/l for BHB and 10&#xa0;mmol/l for GLC based on the literature. In addition, concentrations of the same metabolites in white matter (WM) tissue from the corona radiata of the right hemisphere were analyzed experimentally using both methods. To enable the biochemical analysis, a dialysate of WM tissue was produced. For all three regions, the LAC concentration was determined by both methods.</AbstractText>The conclusive agreement based on thresholds was almost perfect between both methods with only one disagreement in a total of 70 comparisons due to the interference of a ferromagnetic dental brace. The differences in the concentrations between both methods showed high standard deviations. Confidence intervals of the bias not including 0 were found in CSF-GLC (-&#x2009;3.1&#xa0;mmol/l), WM-GLC (1.1&#xa0;mmol/l), and WM-LAC (-&#x2009;6.5&#xa0;mmol/l).</AbstractText>Despite a considerable total error attributable to both methods, MRS derives the same forensic conclusions as conventional biochemical analyses. An adaptation of the protocol to reduce the detected errors and more data are needed for the long-term validation of MRS for the diagnosis of fatal metabolic disorders. The production of WM dialysates cannot be recommended due to high glycolytic loss.</AbstractText>
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Developmental aspects of FXAND in a man with the FMR1 premutation.
Fragile X mental retardation 1 (FMR1) premutation can cause developmental problems including autism spectrum disorder (ASD), social anxiety, depression, and attention deficit hyperactivity disorder (ADHD). These problems fall under an umbrella term of Fragile X-associated Neuropsychiatric Disorders (FXAND) and is separate from Fragile X-associated Tremor/Ataxia syndrome (FXTAS), a neurodegenerative disorder.</AbstractText><AbstractText Label="METHODS/CLINICAL CASE">A 26-year-old Caucasian male with the Fragile X premutation who presented with multiple behavior and emotional problems including depression and anxiety at 10&#xa0;years of age. He was evaluated at 13, 18, and 26&#xa0;years old with age-appropriate cognitive assessments, psychiatric evaluations, and an MRI of the brain.</AbstractText>The Autism Diagnostic Observation Scale (ADOS) was done at 13&#xa0;years old and showed the patient has autism spectrum disorder (ASD). An evaluation at 18&#xa0;years old showed a full-scale IQ of 64. A Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) performed at 26&#xa0;years old confirmed the previous impression of social anxiety disorder, agoraphobia disorder, and selective mutism. His MRI acquired at 26&#xa0;years old showed enlarged ventricles, increased frontal subarachnoid spaces, and hypergyrification.</AbstractText>This is an exemplary case of an FMR1 premutation carrier with significant psychiatric and cognitive issues that demonstrates Fragile X-associated Neuropsychiatric Disorders (FXAND) as separate from the other well-known premutation disorders.</AbstractText>&#xa9; 2019 The Authors. Molecular Genetics &amp; Genomic Medicine published by Wiley Periodicals, Inc.</CopyrightInformation>
2,328,186
Interhemispheric Transcallosal Approach for Resection of Choroidal Arteriovenous Malformation: Operative Video.
Choroidal arteriovenous malformations (AVMs) are rare vascular entities located deep within the brain and in close relationship with vital paraventricular structures.<sup>1</sup><sup>,</sup><sup>2</sup> Recruitment of feeders from the anterior and posterior choroidal arteries is typical in these lesions.<sup>3</sup> We present the case of a 38-year-old woman who presented initially to an outside hospital with an intracranial hemorrhage 17 months prior. Initial computed tomography scan showed a large intraventricular hemorrhage and a right thalamic hemorrhage. She was diagnosed with a cerebral AVM and underwent treatment with placement of an external ventricular drain followed by partial embolization of a feeder with Onyx liquid embolic system (ev3, Irvine, California, USA). The patient had good functional recovery and was referred to our center for management of the residual lesion. Neurologic examination revealed no focal neurologic deficit. Diagnostic cerebral angiogram (DSA) showed persistent filling of the AVM with feeders from anterior and posterior choroidal arteries. Drainage was noted into an arterialized vein that coursed anteriorly and inferiorly prior to joining the internal cerebral vein and ultimately draining into the vein of Galen. After reviewing the management options, decision was made to proceed with microsurgical resection via an interhemispheric transcallosal approach (Video 1). The patient tolerated the procedure well and was discharged home on postoperative day 4 with no evidence of residual AVM on DSA and no neurologic deficit noted at last follow-up.
2,328,187
Deformational changes after convection-enhanced delivery in the pediatric brainstem.
In the brainstem, there are concerns regarding volumetric alterations following convection-enhanced delivery (CED). The relationship between distribution volume and infusion volume is predictably greater than one. Whether this translates into deformational changes and influences clinical management is unknown. As part of a trial using CED for diffuse intrinsic pontine glioma (DIPG), the authors measured treatment-related volumetric alterations in the brainstem and ventricles.</AbstractText>Enrolled patients underwent a single infusion of radioimmunotherapy. Between 2012 and 2019, 23 patients with volumetric pre- and postoperative day 1 (POD1) and day 30 (POD30) MRI scans were analyzed using iPlan&#xae; Flow software for semiautomated volumetric measurements of the ventricles and pontine segment of the brainstem.</AbstractText>Children in the study had a mean age of 7.7 years (range 2-18 years). The mean infusion volume was 3.9 &#xb1; 1.7 ml (range 0.8-8.8 ml). Paired t-tests demonstrated a significant increase in pontine volume immediately following infusion (p &lt; 0.0001), which trended back toward baseline by POD30 (p = 0.046; preoperative 27.6 &#xb1; 8.4 ml, POD1 30.2 &#xb1; 9.0 ml, POD30 29.5 &#xb1; 9.4 ml). Lateral ventricle volume increased (p = 0.02) and remained elevated on POD30 (p = 0.04; preoperative 23.5 &#xb1; 15.4 ml, POD1 26.3 &#xb1; 16.0, POD30 28.6 &#xb1; 21.2). Infusion volume had a weak, positive correlation with pontine and lateral ventricle volume change (r2 = 0.22 and 0.27, respectively). Four of the 23 patients had an increase in preoperative neurological deficits at POD30. No patients required shunt placement within 90 days.</AbstractText>CED infusion into the brainstem correlates with immediate but self-limited deformation changes in the pons. The persistence of increased ventricular volume and no need for CSF diversion post-CED are inconsistent with obstructive hydrocephalus. Defining the degree and time course of these deformational changes can assist in the interpretation of neuroimaging along the DIPG disease continuum when CED is incorporated into the treatment algorithm.</AbstractText>
2,328,188
Endoscopic third ventriculostomy for pediatric tumor-associated hydrocephalus.
Surgical options for managing hydrocephalus secondary to CNS tumors have traditionally included ventriculoperitoneal shunting (VPS) when tumor resection or medical management alone are ineffective. Endoscopic third ventriculostomy (ETV) has emerged as an attractive treatment strategy for tumor-associated hydrocephalus because it offers a lower risk of infection and hardware-related complications; however, relatively little has been written on the topic of ETV specifically for the treatment of tumor-associated hydrocephalus. Here, the authors reviewed the existing literature on the use of ETV in the treatment of tumor-associated hydrocephalus, focusing on the frequency of ETV use and the failure rates in patients with hydrocephalus secondary to CNS tumor.</AbstractText>The authors queried PubMed for the following terms: "endoscopic third ventriculostomy," "tumor," and "pediatric." Papers with only adult populations, case reports, and papers published before the year 2000 were excluded. The authors analyzed the etiology of hydrocephalus and failure rates after ETV, and they compared failure rates of ETV with those of VPS where reported.</AbstractText>Thirty-two studies with data on pediatric patients undergoing ETV for tumor-related hydrocephalus were analyzed. Tumors, particularly in the posterior fossa, were reported as the etiology of hydrocephalus in 38.6% of all ETVs performed (984 of 2547 ETVs, range 29%-55%). The ETV failure rate in tumor-related hydrocephalus ranged from 6% to 38.6%, and in the largest studies analyzed (&gt; 100 patients), the ETV failure rate ranged from 10% to 38.6%. The pooled ETV failure rate was 18.3% (199 failures after 1087 procedures). The mean or median follow-up for ETV failure assessment ranged from 6 months to 8 years in these studies. Only 5 studies directly compared ETV with VPS for tumor-associated hydrocephalus, and they reported mixed results in regard to failure rate and time to failure. Overall failure rates appear similar for ETV and VPS over time, and the risk of infection appears to be lower in those patients undergoing ETV. The literature is mixed regarding the need for routine ETV before resection for posterior fossa tumors with associated hydrocephalus.</AbstractText>Treatment of tumor-related hydrocephalus with ETV is common and is warranted in select pediatric patient populations. Failure rates are overall similar to those of VPS for tumor-associated hydrocephalus.</AbstractText>
2,328,189
A Rare Instance of Chordoid Glioma With Large Calcification Mimicking Craniopharyngioma.
Chordoid glioma (CG) is a world health organization classified grade II tumor whose typical localization is in the anterior part of the third ventricle. It's clinical, neuroimaging, and pathologic features may vary and furthermore mimic other types of benign lesions usually associated with a better outcome, thus representing a potential radiological and diagnostic pitfall. In this article, the authors present a novel case of a 51-year-old male who underwent gross total removal of the tumor of the third ventricle with high calcification. The imaging studies and the intraoperative examination led at first to a hypothesis of craniopharyngioma. In this case, the patient underwent successful operative management and has remained well throughout follow-up.
2,328,190
Diffusion magnetic resonance imaging-derived free water detects neurodegenerative pattern induced by interferon-&#x3b3;.
Imaging biomarkers for immune activation may be valuable for early-stage detection, therapeutic testing, and research on neurodegenerative conditions. In the present study, we determined whether diffusion magnetic resonance imaging-derived free water signal is a sensitive marker for neuroinflammatory effects of interferon-gamma (Ifn-&#x3b3;). Neonatal wild-type mice were injected in the cerebral ventricles with recombinant adeno-associated viruses expressing the inflammatory cytokine Ifn-&#x3b3;. Groups of mice expressing Ifn-&#x3b3; and age-matched controls were imaged at 1, 5 and 8&#xa0;months. Mice deficient in Ifngr1<sup>-/-</sup> and Stat1<sup>-/-</sup> were scanned at 5&#xa0;months as controls for the signaling cascades activated by Ifn-&#x3b3;. The results indicate that Ifn-&#x3b3; affected fractional anisotropy (FA), mean diffusivity (MD), and free water (FW) in white matter structures, midline cortical areas, and medial thalamic areas. In these structures, FA and MD decreased progressively from 1 to 8&#xa0;months of age, while FW increased significantly. The observed reductions in FA and MD and increased FW with elevated brain Ifn-&#x3b3; was not observed in Ifngr1<sup>-/-</sup> or Stat1<sup>-/-</sup> mice. These results suggest that the observed microstructure changes involve the Ifn-gr1 and Stat1 signaling. Interestingly, increases in FW were observed in midbrain of Ifngr1<sup>-/-</sup> mice, which suggests alternative Ifn-&#x3b3; signaling in midbrain. Although initial evidence is offered in relation to the sensitivity of the FW signal to neurodegenerative and/or inflammatory patterns specific to Ifn-&#x3b3;, further research is needed to determine applicability and specificity across animal models of neuroinflammatory and degenerative disorders.
2,328,191
[Adipsic diabetes insipidus patient in postoperative pituitary macroadenoma].
Adipsic diabetes insipidus is a rare condition secondary to injury to osmoreceptors in the anterior hypothalamic area. Only two cases have been published secondary to pituitary tumor surgery.</AbstractText>A 43-year-old man, postoperative of a non-functioning pituitary macroadenoma invading the third ventricle and compressing the hypothalamus. Reoperated for headache and rhinorrhachia, developing diabetes insipidus in the postoperative period was discharged with 20 &#x3bc;g/day nasal desmopressin. He came again due to sensorial disorder and hypernatremia, managing to control with intravenous hydration and desmopressin. It presents with recurrence of hypernatremia every time intravenous hydration is suspended and taken orally. With high sodium levels, there is an absence of thirst. A diagnosis of adipsic diabetes insipidus is made, indicating supervised administration of water orally with favorable evolution.</AbstractText>Adipsic diabetes insipidus is a rare variant of central diabetes insipidus caused by damage to osmoreceptors in the hypothalamus. It manifests with absence of perception of thirst, hypernatremia and polyuria. Its management is complex and requires strict control of the water balance and adherence to treatment.</AbstractText>Copyright: &#xa9; 2020 Revista Medica del Instituto Mexicano del Seguro Social.</CopyrightInformation>
2,328,192
Pathological structural changes in the brain in the course of neurocysticercosis - pathogenesis, serological diagnostics and imaging: a literature review.
Neurocysticercosis is one of the most common parasitic diseases of the brain, it is caused by Taenia solium. Human infection occurs as a result of the ingestion of parasite eggs or undercooked pork. Most infections are recorded in endemic regions, i.e.: South America, Asia, India, Africa, China and Nepal. In cysticercosis, central nervous system involvement accounts for 60-90% of all cases of infection. The location of the changes in the brain is different. Cysts can occur in the ventricles of the brain, in the parenchyma, subarachnoid, within the spinal cord or cerebellum. In recent decades, the prognosis of patients with neurocysticercosis has improved as a result of increased expenditure on health care, education, sanitary and epidemiological supervision and new diagnostic methods. In the first half of the 20th century, infections were almost completely eliminated in Europe. In contrast, the problem is constantly occurring in developing countries. The diagnosis of brain changes is troublesome because it is often impossible to take samples and thus cannot be histopathologically examined. Imaging and serological tests are used to make the diagnosis. The final diagnosis is difficult because changes in the brain may be atypical, and their variability as a result of evolution is an additional factor forcing a deeper diagnosis. In the course of neurocysticercosis histopathological examination, ELISA without modification is not useful. However, imaging tests such as: magnetic resonance imaging (taking into account various protocols), computed tomography, Ag-ELISA are used. Despite the advanced technique, making the diagnosis still causes problems. Therefore, differential diagnosis and confirmation of diagnosis is needed by both imaging and serological tests.
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A curious case of disseminated cysticercosis in an immunocompetent adult.
Cysticercosis is an infection with the larval stage of <i>Taenia Solium</i> which is estimated to affect over 50 million people worldwide. We report a case of disseminated cysticercosis in an immunocompetent 68-year-old male who presented with back pain, presumed to be musculoskeletal in nature initially. Magnetic-resonance-imaging of the lumbar spine revealed intramuscular (paraspinous and psoas muscles) cysts, innumerable small cystic lesions bilaterally throughout the cerebellar and cerebral hemispheres, midbrain, and right ventricle suggestive of cysticercosis. Treatment with albendazole with dexamethasone for 3 months led to resolution of the cysts with complete resolution of symptoms. Despite its importance, current data on prevalence of this infection, disease burden and the incidence of hospitalization remains incomplete. Mandatory reporting of diagnosis would enable complete understanding of epidemiology of the disease. In this case we have emphasized the importance of early diagnosis of a systemic condition that could have caused serious implications if left untreated.
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Non-invasive quantification of cardiac stroke volume in the edible crab <i>Cancer pagurus</i>.<Pagination><StartPage>46</StartPage><MedlinePgn>46</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">46</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1186/s12983-019-0344-7</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Brachyuran crabs can effectively modulate cardiac stroke volume independently of heart rate in response to abiotic drivers. Non-invasive techniques can help to improve the understanding of cardiac performance parameters of these animals. This study demonstrates the in vivo quantification of cardiac performance parameters through magnetic resonance imaging (MRI)&#xa0;on the edible crab <i>Cancer pagurus</i>. Furthermore, the suitability of signal integrals of infra-red photoplethysmographs as a qualitative tool is assessed under severe hypoxia.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Multi-slice self-gated cardiac cinematic (CINE) MRI revealed the structure and motion of the ventricle to quantify heart rates, end-diastolic volume, end-systolic volume, stroke volume and ejection fraction. CINE MRI showed that stroke volumes increased under hypoxia because of a reduction of end-systolic volumes at constant end-diastolic volumes. Plethysmograph recordings allowed for automated heart rate measurements but determination of a qualitative stroke volume proxy strongly depended on the position of the sensor on the animal. Both techniques revealed a doubling in stroke volumes after 6&#x2009;h under severe hypoxia (water <i>P</i>O<sub>2</sub>&#x2009;=&#x2009;15% air saturation).</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">MRI has allowed for detailed descriptions of cardiac performance in intact animals under hypoxia. The temporal resolution of quantitative non-invasive CINE MRI is limited but should encourage further refining. The stroke volume proxy based on plethysmograph recordings is feasible to complement other cardiac measurements over time. The presented methods allow for non-destructive in vivo determinations of multiple cardiac performance parameters, with the possibility to study neuro-hormonal or environmental effects on decapod cardio physiology.</AbstractText><CopyrightInformation>&#xa9; The Author(s). 2019.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Maus</LastName><ForeName>Bastian</ForeName><Initials>B</Initials><Identifier Source="ORCID">0000-0003-1872-9097</Identifier><AffiliationInfo><Affiliation>Alfred-Wegener-Institute, Helmholtz Centre for Polar and Marine Research, Integrative Ecophysiology, Am Handelshafen, 12 27570 Bremerhaven, Germany.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>2Department of Biology and Chemistry, University of Bremen, Bibliothekstra&#xdf;e 1, 28359 Bremen, Germany.</Affiliation><Identifier Source="ISNI">0000 0001 2297 4381</Identifier><Identifier Source="GRID">grid.7704.4</Identifier></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gutsfeld</LastName><ForeName>Sebastian</ForeName><Initials>S</Initials><Identifier Source="ORCID">0000-0001-5250-3695</Identifier><AffiliationInfo><Affiliation>Alfred-Wegener-Institute, Helmholtz Centre for Polar and Marine Research, Integrative Ecophysiology, Am Handelshafen, 12 27570 Bremerhaven, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>P&#xf6;rtner</LastName><ForeName>Hans-Otto</ForeName><Initials>HO</Initials><Identifier Source="ORCID">0000-0001-6535-6575</Identifier><AffiliationInfo><Affiliation>Alfred-Wegener-Institute, Helmholtz Centre for Polar and Marine Research, Integrative Ecophysiology, Am Handelshafen, 12 27570 Bremerhaven, Germany.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>2Department of Biology and Chemistry, University of Bremen, Bibliothekstra&#xdf;e 1, 28359 Bremen, Germany.</Affiliation><Identifier Source="ISNI">0000 0001 2297 4381</Identifier><Identifier Source="GRID">grid.7704.4</Identifier></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bock</LastName><ForeName>Christian</ForeName><Initials>C</Initials><Identifier Source="ORCID">0000-0003-0052-3090</Identifier><AffiliationInfo><Affiliation>Alfred-Wegener-Institute, Helmholtz Centre for Polar and Marine Research, Integrative Ecophysiology, Am Handelshafen, 12 27570 Bremerhaven, Germany.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2019</Year><Month>12</Month><Day>12</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Front Zool</MedlineTA><NlmUniqueID>101231669</NlmUniqueID><ISSNLinking>1742-9994</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Cardiac MRI</Keyword><Keyword MajorTopicYN="N">Crustacea</Keyword><Keyword MajorTopicYN="N">Ejection fraction</Keyword><Keyword MajorTopicYN="N">Heart rate</Keyword><Keyword MajorTopicYN="N">Photoplethysmography</Keyword><Keyword MajorTopicYN="N">Stroke volume</Keyword></KeywordList><CoiStatement>Competing interestsThe authors declare that they have no competing interests.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2019</Year><Month>9</Month><Day>12</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2019</Year><Month>11</Month><Day>29</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>1</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>1</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>1</Month><Day>1</Day><Hour>6</Hour><Minute>1</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">31889965</ArticleId><ArticleId IdType="pmc">PMC6909657</ArticleId><ArticleId IdType="doi">10.1186/s12983-019-0344-7</ArticleId><ArticleId IdType="pii">344</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>Wittmann AC, P&#xf6;rtner H-O. 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Cardiol Clin. 2007;25(1):15&#x2013;33. doi: 10.1016/j.ccl.2007.01.002.</Citation><ArticleIdList><ArticleId IdType="doi">10.1016/j.ccl.2007.01.002</ArticleId><ArticleId IdType="pubmed">17478238</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="MEDLINE" Owner="NLM" IndexingMethod="Curated"><PMID Version="1">31889703</PMID><DateCompleted><Year>2020</Year><Month>01</Month><Day>23</Day></DateCompleted><DateRevised><Year>2020</Year><Month>01</Month><Day>23</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">1512-0112</ISSN><JournalIssue CitedMedium="Internet"><Issue>296</Issue><PubDate><Year>2019</Year><Month>Nov</Month></PubDate></JournalIssue><Title>Georgian medical news</Title><ISOAbbreviation>Georgian Med News</ISOAbbreviation></Journal>[ADAPTIVE CAPABILITIES OF THE CARDIOVASCULAR SYSTEM IN ADOLESCENTS WITH NON-INFLAMMATORY MYOCARDIAL PATHOLOGY, TAKING INTO ACCOUNT MORPHOFUNCTIONAL INDICATORS OF THE HEART].
Brachyuran crabs can effectively modulate cardiac stroke volume independently of heart rate in response to abiotic drivers. Non-invasive techniques can help to improve the understanding of cardiac performance parameters of these animals. This study demonstrates the in vivo quantification of cardiac performance parameters through magnetic resonance imaging (MRI)&#xa0;on the edible crab Cancer pagurus</i>. Furthermore, the suitability of signal integrals of infra-red photoplethysmographs as a qualitative tool is assessed under severe hypoxia.</AbstractText>Multi-slice self-gated cardiac cinematic (CINE) MRI revealed the structure and motion of the ventricle to quantify heart rates, end-diastolic volume, end-systolic volume, stroke volume and ejection fraction. CINE MRI showed that stroke volumes increased under hypoxia because of a reduction of end-systolic volumes at constant end-diastolic volumes. Plethysmograph recordings allowed for automated heart rate measurements but determination of a qualitative stroke volume proxy strongly depended on the position of the sensor on the animal. Both techniques revealed a doubling in stroke volumes after 6&#x2009;h under severe hypoxia (water P</i>O2</sub>&#x2009;=&#x2009;15% air saturation).</AbstractText>MRI has allowed for detailed descriptions of cardiac performance in intact animals under hypoxia. The temporal resolution of quantitative non-invasive CINE MRI is limited but should encourage further refining. The stroke volume proxy based on plethysmograph recordings is feasible to complement other cardiac measurements over time. The presented methods allow for non-destructive in vivo determinations of multiple cardiac performance parameters, with the possibility to study neuro-hormonal or environmental effects on decapod cardio physiology.</AbstractText>&#xa9; The Author(s). 2019.</CopyrightInformation>
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Watch out for the special location of intraventricular silicone oil following an intraocular tamponade - a 10-year follow-up case report based on CT/MRI.
Intraventricular silicone oil is a relatively rare complication resulted from silicone oil tamponade to treat retinal detachment. It is occasionally reported in previous literature. To the best of our knowledge, the long-term longitudinal comparisons of silicone oil both in the brain and in the postoperative eyeball based on CT/MRI were lacking, and intraventricular silicone oil accumulation beside lesions has been reported rarely.</AbstractText>A 63-year-old male patient underwent an intraocular tamponade with silicone oil in June 2009. Eight CT examinations and 2 MRI examinations were acquired between 2011 and 2018.The changes of silicone oil in the brain in CT/MRI as below: Silicone oil initially migration to bilateral lateral ventricular anterior horn was found in November 2011, it was aslo found at right side of suprasellar cisterna, and there was no change in location 6&#x2009;h later; Silicone oil at the anterior horn of right lateral ventricle disappeared but remained at left lateral ventricle and right side of suprasellar cisterna in July 2014, and there was no change in location in a short-term reexamination. It was found at the middle of left lateral ventricle (adjacent to the real cause) in march 2018, but disappeared 3&#x2009;months later, while remained at anterior horn of left lateral ventricular and right side of suprasellar cisterna all the time. There was no change in location in the next 2 follow-up (September and October in 2018). The CT values of silicone oil distributed throughout the brain were dynamically changed with time.</AbstractText>It is important to recognize intraventricular silicone oil in a particular location.More important is to discover "the real murderer", which is the main cause of symptoms in the vicinity of special location. Moreover, the migration of silicone oil between eyeball and brain may not be always in a single direction.</AbstractText>
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Transcriptomic Responses of Bisphenol S Predict Involvement of Immune Function in the Cardiotoxicity of Early Life-Stage Zebrafish (<i>Danio rerio</i>).
Bisphenol S (BPS), an alternative for bisphenol A (BPA) that is present in thermal paper and numerous consumer products, has been linked to estrogenic, cytotoxic, genotoxic, neurotoxic, and immunotoxic responses. However, the mechanisms of BPS toxicity remain poorly understood. Here, following exposure to environmentally relevant concentrations ranging from 0.1 to 100 &#x3bc;g/L BPS, transcriptional changes evaluated by enriched gene ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Ingenuity Pathway Analysis (IPA) predicted cardiac disease and impairment of immune function in zebrafish at the embryo-to-larvae stage. Consistent with impacts predicted by transcriptional changes, significant sublethal impacts were observed ranging from reduced heart rate [8.7 &#xb1; 2.4% reductions at 100 &#x3bc;g/L BPS treatment; <i>P</i> &lt; 0.05] to abnormal cardiac morphology [atrial/ventricle area significantly increased; 36.2 &#xb1; 9.6% at 100 &#x3bc;g/L BPS treatment; <i>P</i> &lt; 0.05]. RNA-sequencing analysis results also indicated changes in nitric oxide synthetase (NOS2) and interleukin 12 (IL12) after BPS treatment, which was confirmed at the protein level. Increased expression of other cytokine genes was observed in larvae, suggesting inflammatory responses may be contributing to cardiac impairment by BPS. BPS caused cardiotoxicity, which temporally corresponded with inflammatory responses as predicted from RNA sequencing and confirmed at the protein and cellular levels of biological organization. Additional study is needed to find causal linkages between these responses.
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Progressively Enlarged Convexity Arachnoid Cysts in Elderly Patients: A Report of 2 Cases.
Generally, enlargement of arachnoid cysts (ACs) has been found mostly in cases occurring during early childhood. Therefore, progressively enlarged ACs found to be symptomatic in elderly patients are extremely rare, and the mechanisms have remained unexplored.</AbstractText>Our first patient was a 72-year-old woman with memory disturbance, who had presented with a large cyst beneath the right temporal convexity 9 years previously. The annual follow-up magnetic resonance imaging (MRI) studies had revealed that the cyst had progressively enlarged. In addition, her memory disturbance had become advanced. Endoscopic cyst fenestration was performed between the cyst and lateral ventricle, resulting in a reduction of her symptoms. Our second patient was a 79-year-old woman with unsteadiness, who had presented with a large cyst under the right parietal convexity 6 years previously. The annual follow-up MRI studies had shown that the cyst had gradually enlarged. She subsequently developed left hemiparesis. Because the pyramidal tract was located between the cyst and ventricle, a cyst-ventricle shunt was placed to allow the cystic fluid into the lateral ventricle, with complete resolution of her symptoms. In both cases, MRI showed obliteration of the subdural spaces around the cysts. Endoscopic observations revealed that the arachnoid membrane was lined under the surrounding brain, leading to the diagnosis of an AC.</AbstractText>The establishment of stable communication between a cyst and the normal cerebrospinal fluid space is important to treat symptomatic ACs characterized by progressive enlargement, even in elderly patients. The 1-way entry of the cerebrospinal fluid into the cyst and the closure of the surrounding subdural space might result in AC enlargement internally.</AbstractText>Copyright &#xa9; 2019 Elsevier Inc. All rights reserved.</CopyrightInformation>
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Pontocerebellar Hypoplasia Maps to Chromosome 7q11.23: An Autopsy Case Report of a Novel Genetic Variant.
Pontocerebellar hypoplasias are a group of autosomal recessive neurodevelopmetal disorders with varied phenotypic presentations and extensive genetic mutational landscape that are currently classified into ten subtypes. This classification is based predominantly on the genetic iterations as the phenotypic presentations are often broad and overlapping. Pontocerebellar hypoplasia type-3 (PCH3) is an autosomal recessive disorder characterized by a small cerebellar vermis, hyperreflexia, and seizures, described in Middle Eastern families in association with a homozygous truncating mutation of the <i>PCLO</i> gene in locus 7q11-21. This is a case of PCH, with previously unreported novel genetic alterations. The patient is a 1-week-old girl, born at term to a 26-year-old G4P0A3 woman in a nonconsanguinous relation. At birth, the baby was depressed and hypertonic with abnormal tonic-clonic movements of extremities. MRI revealed cerebellar and brainstem hypoplasia. Postmortem examination revealed a palmar simian crease. The cerebellum measured 2.5&#x2009;cm from side to side and 1&#x2009;cm from rostral to caudal. The vermis was rudimentary. Sectioning revealed a flattened linear fourth ventricle, scant abortive cerebellar foliae, and a markedly small cerebellum when compared with the cerebrum and with age-matched size. H&amp;E-stained sections of cerebellum revealed scant rudimentary foliae. A rudimentary unilateral embolliform nucleus was identified. The remaining cerebellar nuclei were absent. Chromosomal microarray showed an interstitial duplication of 841&#x2009;kB on chromosome 7q11.23. Locus 7q11.23 contains FGL2 and GSAP genes and is 5&#x2009;MB upstream of the 7q11-21 region, suggesting a possible linkage. This novel genomic finding possibly represents a new familial variant of PCH closely associated with PCH-3 and further strengthens its association with the 7q11 locus.
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Cilia-driven flows in the brain third ventricle.
The brain ventricles are interconnected, elaborate cavities that traverse the brain. They are filled with cerebrospinal fluid (CSF) that is, to a large part, produced by the choroid plexus, a secretory epithelium that reaches into the ventricles. CSF is rich in cytokines, growth factors and extracellular vesicles that glide along the walls of ventricles, powered by bundles of motile cilia that coat the ventricular wall. We review the cellular and biochemical properties of the ventral part of the third ventricle that is surrounded by the hypothalamus. In particular, we consider the recently discovered intricate network of cilia-driven flows that characterize this ventricle and discuss the potential physiological significance of this flow for the directional transport of CSF signals to cellular targets located either within the third ventricle or in the adjacent hypothalamic brain parenchyma. Cilia-driven streams of signalling molecules offer an exciting perspective on how fluid-borne signals are dynamically transmitted in the brain. This article is part of the Theo Murphy meeting issue 'Unity and diversity of cilia in locomotion and transport'.