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Study of the glial cytoarchitecture of the developing olfactory bulb of a shark using immunochemical markers of radial glia.
During development of the olfactory bulb (OB), glial cells play key roles in axonal guiding/targeting, glomerular formation and synaptic plasticity. Studies in mammals have shown that radial glial cells and peripheral olfactory glia (olfactory ensheathing cells, OECs) are involved in the development of the OB. Most studies about the OB glia were carried out in mammals, but data are lacking in most non-mammalian vertebrates. In the present work, we studied the development of the OB glial system in the cartilaginous fish Scyliorhinus canicula (catshark) using antibodies against glial markers, such as glial fibrillary acidic protein (GFAP), brain lipid-binding protein (BLBP), and glutamine synthase (GS). These glial markers were expressed in cells with radial morphology lining the OB ventricle of embryos and this expression continues in ependymal cells (tanycytes) in early juveniles. Astrocyte-like cells were also observed in the granular layer and surrounding glomeruli. Numerous GS-positive cells were present in the primary olfactory pathway of embryos. In the developmental stages analysed, the olfactory nerve layer and the glomerular layer were the regions with higher GFAP, BLBP and GS immuno-reactivity. In addition, numerous BLBP-expressing cells (a marker of mammalian OECs) showing proliferative activity were present in the olfactory nerve layer. Our findings suggest that glial cells of peripheral and central origin coexist in the OB of catshark embryos and early juveniles. These results open the path for future studies about the differential roles of glial cells in the catshark OB during embryonic development and in adulthood.
2,330,501
Identifying gene expression profiles associated with neurogenesis and inflammation in the human subependymal zone from development through aging.
The generation of new neurons within the mammalian forebrain continues throughout life within two main neurogenic niches, the subgranular zone (SGZ) of the hippocampal dentate gyrus, and the subependymal zone (SEZ) lining the lateral ventricles. Though the SEZ is the largest neurogenic niche in the adult human forebrain, our understanding of the mechanisms regulating neurogenesis from development through aging within this region remains limited. This is especially pertinent given that neurogenesis declines dramatically over the postnatal lifespan. Here, we performed transcriptomic profiling on the SEZ from human post-mortem tissue from eight different life-stages ranging from neonates (average age ~ 2 months old) to aged adults (average age ~ 86 years old). We identified transcripts with concomitant profiles across these decades of life and focused on three of the most distinct profiles, namely (1) genes whose expression declined sharply after birth, (2) genes whose expression increased steadily with age, and (3) genes whose expression increased sharply in old age in the SEZ. Critically, these profiles identified neuroinflammation as becoming more prevalent with advancing age within the SEZ and occurring with time courses, one gradual (starting in mid-life) and one sharper (starting in old age).
2,330,502
Cap analysis of gene expression reveals alternative promoter usage in a rat model of hypertension.
The role of alternative promoter usage in tissue-specific gene expression has been well established; however, its role in complex diseases is poorly understood. We performed cap analysis of gene expression (CAGE) sequencing from the left ventricle of a rat model of hypertension, the spontaneously hypertensive rat (SHR), and a normotensive strain, Brown Norway to understand the role of alternative promoter usage in complex disease. We identified 26,560 CAGE-defined transcription start sites in the rat left ventricle, including 1,970 novel cardiac transcription start sites. We identified 28 genes with alternative promoter usage between SHR and Brown Norway, which could lead to protein isoforms differing at the amino terminus between two strains and 475 promoter switching events altering the length of the 5' UTR. We found that the shift in <i>Insr</i> promoter usage was significantly associated with insulin levels and blood pressure within a panel of HXB/BXH recombinant inbred rat strains, suggesting that hyperinsulinemia due to insulin resistance might lead to hypertension in SHR. Our study provides a preliminary evidence of alternative promoter usage in complex diseases.
2,330,503
Acute critical thermal maximum does not predict chronic incremental thermal maximum in Atlantic salmon (Salmo salar).
Atlantic salmon is an important aquaculture species farmed in ocean net-pens and therefore subjected to changing environmental conditions, including rising temperatures. This creates a need for research on the thermal tolerance of this species for the future of sustainable aquaculture. We investigated the thermal tolerance of individually tagged Atlantic salmon post-smolts subjected sequentially to two common high-temperature challenges: critical thermal maximum (CTmax) followed by incremental thermal maximum (ITmax). Our goals were (1) to determine whether CTmax can predict ITmax for individual fish, and (2) to examine connections between various body size (mass, length, condition factor), cardiac (absolute and relative ventricle mass) and blood (hematocrit) metrics and thermal tolerance. We found no relationship between CTmax and ITmax. This is of concern because CTmax, which is a quick and easy test, is often used to predict upper lethal limits in fish despite not using real-world rates of temperature increase and not using death as the experimental endpoint (unlike ITmax). Also, some metrics which correlated in one direction with CTmax had the opposite correlation with ITmax. For instance, smaller fish or fish with smaller ventricles had a higher CTmax but a lower ITmax than larger fish or fish with larger ventricles. Taken together, these results highlight the need to take care when using acute thermal tolerance tests to predict real-world responses to rising temperatures.
2,330,504
Feasibility of awake endoscopic third ventriculostomy in selected patients of obstructive hydrocephalus.
Endoscopic third ventriculostomy (ETV) is usually performed under general anesthesia (GA) with proper head immobilization. However a few patients with hydrocephalus (HCP) may not be suitable for GA. Once the surgeon is familiar with endoscopic ventricular anatomy and gains adequate surgical experience with the procedure, ETV can be attempted under local anesthesia (LA) in selected patients. Here we discuss our experience of treating 32 patients of HCP with ETV under LA.</AbstractText>32 symptomatic HCP patients with in the age range of 13 and 65 years, conscious, alert, cooperative and at high risk for GA owing to deranged liver or renal function, associated co-morbidities, pregnancy were considered for ETV under scalp block. All patients were evaluated for any discomfort during the surgical intervention.</AbstractText>All procedures were completed under LA. Four patients needed additional sedation prior to the scalp block to alleviate their apprehension. Four patients complained of bilateral orbital pain. In three it coincided with irrigation of fluid lower than body temperature. One patient had pain while touching the dorsum sella and needed analgesic supplement. All of them improved and none required additional CSF diversion within the average follow up of 9.5 months.</AbstractText>ETV can be performed under local anesthesia in conscious, alert and cooperative patients in experienced hands. Unnecessary stimulation of the painful structures should be avoided and fluid for irrigation should be at body temperature. This ensures patient comfort and safety of the procedure.</AbstractText>
2,330,505
Cerebellar mutism syndrome in pediatric head trauma with cerebellar injury.
Cerebellar mutism syndrome (CMS) after cerebellar injury in pediatric head trauma is a poorly recognized condition that is not properly diagnosed or treated in our daily practice. We aimed to clinically identify this syndrome after isolated posttraumatic cerebellar injury and to propose pathophysiological explanation.</AbstractText>We retrospectively analyzed 8 consecutive children presenting with isolated cerebellar injury over 16&#xa0;years. Clinical presentation, radiological type and localization of injury, clinical initial CMS symptoms, and long-term neurocognitive outcome were reviewed.</AbstractText>Out of 8 patients presenting with isolated traumatic cerebellar injury, we diagnosed 2 cases with initial clinical symptoms of CMS. Both patients had an injury damaging median structures of the posterior fossa, especially the fourth ventricle and dentate nuclei. Initial symptoms lasted more than 1&#xa0;month for one patient, who still presented concentration difficulties almost 1&#xa0;year after the head injury.</AbstractText>CMS after traumatic cerebellar injury does exist, even if it seems to be a very rare entity. It has to be better detected and studied in order to enrich pathophysiological knowledge about CMS of all etiologies and to bring our concerned patients the suitable follow-up and rehabilitative care that they could benefit from.</AbstractText>&#xa9; 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</CopyrightInformation>
2,330,506
Quantitative analysis of late iodine enhancement using dual-layer spectral detector computed tomography: comparison with magnetic resonance imaging.
To evaluate the segmental myocardial extracellular volume (ECV) fraction and to define a threshold ECV value that can be used to distinguish positive late gadolinium enhancement (LGE) segments from negative myocardial segments using dual-layer spectral detector computed tomography (SDCT), with magnetic resonance imaging (MRI) as a reference.</AbstractText>Fifty-six subjects with cardiac disease or suspected cardiac disease, underwent both late iodine enhancement on CT (CT-LIE) scanning and late gadolinium enhancement on MRI (MRI-LGE) scanning. Each procedure occurred within a week of the other. Global and segmental ECVs of the left ventricle were measured by CT and MRI images. According to the location and pattern of delayed enhancement on MRI image, myocardial segments were classified into 3 groups: ischemic LGE segments (group 1), nonischemic LGE segments (group 2) and negative LGE segments (group 3). The correlation and agreement between CT-ECV and MRI-ECV were compared on a per-segment basis. Receiver operating characteristic (ROC) curve analysis was performed to establish a threshold for LIE detection.</AbstractText>Among the 56 patients, 896 segments were analyzed, and of these, 73 segments were in group 1, 229 segments were in group 2, and 594 segments were in group 3. In segmental analysis, CT-ECV in group 3 (27.0%; 24.9-28.9%) was significantly lower than that in group 1 (33.2%; 30.7-36.3%) and group 2 (34.9%; 32.3-39.8%; all P&lt;0.001). Good correlations were seen between CT-ECV and MRI-ECV for all groups (group 1: r=0.920; group 2: r=0.936; group 3: r=0.799; all P&lt;0.001). Bland-Altman analysis between CT-ECV and MRI-ECV showed a small bias in all 3 groups (group 1: -2.1%, 95% limits of agreement -11.3-7.1%; group 2: -0.6%, 95% limits of agreement -13.1-11.9%; group 3: 1.0%, 95% limits of agreement -12.7-14.7%). CT-ECV could differentiate between LGE-positive and LGE-negative segments with 83.1% sensitivity and 93.3% specificity at a cutoff of 31%.</AbstractText>ECV values derived from CT imaging showed good correlation and agreement with MR imaging findings, and CT-ECV provided high diagnostic accuracy for discriminating between LGE-positive and LGE-negative segments. Thus, cardiac CT imaging might be a suitable noninvasive imaging technique for myocardial ECV quantification.</AbstractText>2022 Quantitative Imaging in Medicine and Surgery. All rights reserved.</CopyrightInformation>
2,330,507
Diagnostic accuracy of qualitative MRI in 550 paediatric brain tumours: evaluating current practice in the computational era.
To investigate the accuracy of qualitative reporting of conventional magnetic resonance imaging (MRI) in the classification of paediatric brain tumours.</AbstractText>Preoperative MRI reports of 608 children prior to resection or biopsy of an intracranial lesion were retrospectively reviewed. A total of 550 children had complete radiological and histopathological notes, thereby reaching our inclusion criteria. Concordance between MRI report and final histopathological diagnosis was assessed using an established lexicon derived from the WHO 2016 classification of CNS tumours. Levels of agreement based on cellular origin, tumour type, and tumour grade were evaluated. Diagnostic accuracy, sensitivity, specificity, confidence intervals, and positive and negative predictive values were calculated.</AbstractText>Diagnostic accuracy differed significantly between tumour types and tumour grades. Sensitivities were highest for ependymomas and sellar, pituitary, pineal, and cranial and/or paraspinal nerve tumours (range 80.65-100%). Sensitivity was slightly lower for astrocytic gliomas, oligodendrogliomas, and choroid plexus, neuronal, mixed neuronal-glial, embryonal, and histiocytic tumours (range 63.33-79.59%). Low sensitivities were noted for meningiomas and mesenchymal non-meningothelial, melanocytic, and germ cell tumours (range 0-56.25%). The most correct tumour type predictions were made in the posterior fossa whilst the most incorrect predictions were made in the lobar regions, pineal/tectal plate area, and the supratentorial ventricles.</AbstractText>This is the largest published series investigating the predictive accuracy of MRI in paediatric brain tumours. We show that diagnostic accuracy varies greatly by tumour type and location. Looking forward, we should develop and leverage computational methods to improve accuracy in the tumour types and anatomical locations where qualitative diagnostic accuracy is lower.</AbstractText>2022 Quantitative Imaging in Medicine and Surgery. All rights reserved.</CopyrightInformation>
2,330,508
Fourth ventricle neurocysticercosis presenting with Bruns' syndrome: A case report.
Neurocysticercosis (NCC) is the most common helminthic infection of the central nervous system. We present a case of the fourth ventricle NCC that presented with Bruns' syndrome (with headaches worsened by head movements, gait ataxia, and vomiting) and the operative technique used for cyst removal.</AbstractText>A 39-year-old woman was admitted to the emergency department with moderate-to-severe headaches that got worse in the afternoon and were triggered by head movements, relieved on prone position, and were associated with gait ataxia and vomiting. A brain magnetic resonance imaging (MRI) showed a fourth ventricle cyst, with an eccentric enhancing nodule compatible with a larvae scolex and associated obstructive hydrocephalus. The patient was positioned prone and underwent a microsurgical resection of the cyst without rupture through a telovelar approach to the fourth ventricle. The postoperative MRI confirmed complete cyst removal and resolution of the hydrocephalus. At 12-month follow-up, the patient remains with no signs of disease recurrence.</AbstractText>In this report, we depict a case of intraventricular NCC successfully treated with a single surgery, allowing intact cyst removal and achieving effective hydrocephalus treatment with no need to resort to cerebrospinal fluid diversion techniques.</AbstractText>Copyright: &#xa9; 2021 Surgical Neurology International.</CopyrightInformation>
2,330,509
Multifocal spinal glioblastoma and leptomeningeal carcinomatosis in an elderly male with hydrocephalus and myelopathy.
Primary spinal glioblastoma multiforme with multifocal leptomeningeal enhancement is rarely diagnosed or documented. We describe a rare case of multifocal spinal isocitrate dehydrogenase (IDH) wild type glioblastoma with leptomeningeal carcinomatosis in an elderly male presenting with a chronic subdural hematoma, progressive myelopathy, and communicating hydrocephalus.</AbstractText>A 77-year-old male with a medical history of an acoustic schwannoma, anterior cranial fossa meningioma, and immune thrombocytopenic purpura presented with right-sided weakness after repeated falls. Magnetic resonance imaging of the brain and spine demonstrated a left-sided subdural hematoma, leptomeningeal enhancement of the brain and skull base, ventricles, and the cranial nerves, and along with florid enhancement of the leptomeninges from the cervicomedullary junction to the cauda equina. Most pertinent was focal thickening of the leptomeninges at T1 and T6 with mass effect on the spinal cord. A T6 laminectomy with excisional biopsy of the lesion was planned and completed. Findings were significant for glioblastoma the World Health Organization Grade IV IDH 1 wild type of the thoracic spinal cord. Subsequently, his mental status declined, and he developed progressive hydrocephalus which required cerebrospinal fluid diversion. Unfortunately, the patient had minimal improvement in his neurological exam and unfortunately died 2 months later.</AbstractText>In a review of the limited literature describing similar cases of primary spinal glioblastoma, the prognosis of this aggressive tumor remains unfavorable, despite aggressive treatment options. The purpose of this report is to increase awareness of this rare condition as a potential differential diagnosis in patients presenting with multifocal invasive spinal lesions.</AbstractText>Copyright: &#xa9; 2021 Surgical Neurology International.</CopyrightInformation>
2,330,510
A bi-foraminal craniometric-guided approach to endoscopic third ventriculostomy and biopsy of a pineal tumour.
Pineal tumors are very rarely encountered, with an incidence of &lt;1% of intracranial lesions in adults. Life-threatening hydrocephalus due to obstruction of the third ventricle can result from the location of these tumours. Endoscopic third ventriculostomy (ETV) and tumor biopsy is a safe and feasible strategy, particularly if the tumor appears benign. This mitigates the high risks of uncontrollable venous bleeding from open and stereotactic biopsies. While typically performed using either ipsilateral single or dual bur holes, the location of the tumor may require modifications to the standard endoscopic techniques.</AbstractText>A 55-year-old male presented with signs of intracranial hypertension and was found to have obstructive hydrocephalus due to a pineal tumour. The tumour displayed a right-sided dominance when the pre-operative imaging was assessed, which would risk forniceal injury if biopsied via a right-sided burr hole. Craniometric measurements revealed a superior trajectory to the tumour via the left foramen of Monro. A biforaminal approach was performed, with a traditional ETV using a right coronal bur hole and biopsy via a left frontal bur hole. This minimized forniceal stretching and allowed a safe biopsy.</AbstractText>The bi-foraminal approach has not been widely described in the literature but can potentially avoid morbidity with biopsy in patients with right-sided pineal tumours. We believe this technique should be considered, particularly in low-resource settings where neuroendoscopy is not commonly done, and where the use of ipsilateral single or dual-bur holes may lead to forniceal injury.</AbstractText>Copyright: &#xa9; 2021 Surgical Neurology International.</CopyrightInformation>
2,330,511
Iron Rims in Patients With Multiple Sclerosis as Neurodegenerative Marker? A 7-Tesla Magnetic Resonance Study.
<b>Introduction:</b> Multiple sclerosis (MS) is a demyelinating and neurodegenerative disease of the central nervous system, characterized by inflammatory-driven demyelination. Symptoms in MS manifest as both physical and neuropsychological deficits. With time, inflammation is accompanied by neurodegeneration, indicated by brain volume loss on an MRI. Here, we combined clinical, imaging, and serum biomarkers in patients with iron rim lesions (IRLs), which lead to severe tissue destruction and thus contribute to the accumulation of clinical disability. <b>Objectives:</b> Subcortical atrophy and ventricular enlargement using an automatic segmentation pipeline for 7 Tesla (T) MRI, serum neurofilament light chain (sNfL) levels, and neuropsychological performance in patients with MS with IRLs and non-IRLs were assessed. <b>Methods:</b> In total 29 patients with MS [15 women, 24 relapsing-remitting multiple sclerosis (RRMS), and five secondary-progressive multiple sclerosis (SPMS)] aged 38 (22-69) years with an Expanded Disability Status Score of 2 (0-8) and a disease duration of 11 (5-40) years underwent neurological and neuropsychological examinations. Volumes of lesions, subcortical structures, and lateral ventricles on 7-T MRI (SWI, FLAIR, and MP2RAGE, 3D Segmentation Software) and sNfL concentrations using the Simoa SR-X Analyzer in IRL and non-IRL patients were assessed. <b>Results:</b> (1) Iron rim lesions patients had a higher FLAIR lesion count (<i>p</i> = 0.047). Patients with higher MP2Rage lesion volume exhibited more IRLs (<i>p</i> &lt;0.014) and showed poorer performance in the information processing speed tested within 1 year using the Symbol Digit Modalities Test (SDMT) (<i>p</i> &lt;0.047). (2) Within 3 years, patients showed atrophy of the thalamus (<i>p</i> = 0.021) and putamen (<i>p</i> = 0.043) and enlargement of the lateral ventricles (<i>p</i> = 0.012). At baseline and after 3 years, thalamic volumes were lower in IRLs than in non-IRL patients (<i>p</i> = 0.045). (3) At baseline, IRL patients had higher sNfL concentrations (<i>p</i> = 0.028). Higher sNfL concentrations were associated with poorer SDMT (<i>p</i> = 0.004), regardless of IRL presence. (4) IRL and non-IRL patients showed no significant difference in the neuropsychological performance within 1 year. <b>Conclusions:</b> Compared with non-IRL patients, IRL patients had higher FLAIR lesion counts, smaller thalamic volumes, and higher sNfL concentrations. Our pilot study combines IRL and sNfL, two biomarkers considered indicative for neurodegenerative processes. Our preliminary data underscore the reported destructive nature of IRLs.
2,330,512
Pediatric heart-lung transplantation: Technique and special considerations.
Heart-lung transplantation has historically been used as a definitive treatment for children with end-stage cardiopulmonary failure, although the number performed has steadily decreased over time. In this review, we discuss current indications, preoperative risk factors, outcomes, and heart-lung transplantation in unique patient subsets, including infants, children with single-ventricle physiology, tetralogy of Fallot/major aortopulmonary collateral arteries, and prior Potts shunt palliation. We also describe the different surgical techniques utilized in pediatric heart-lung transplantation.
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Facilitating drug delivery in the central nervous system by opening the blood-cerebrospinal fluid barrier with a single low energy shockwave pulse.<Pagination><StartPage>3</StartPage><MedlinePgn>3</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">3</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1186/s12987-021-00303-x</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">The blood-cerebrospinal fluid (CSF) barrier (BCSFB) is critically important to the pathophysiology of the central nervous system (CNS). However, this barrier prevents the safe transmission of beneficial drugs from the blood to the CSF and thus the spinal cord and brain, limiting their effectiveness in treating a variety of CNS diseases.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">This study demonstrates a method on SD rats for reversible and site-specific opening of the BCSFB via a noninvasive, low-energy focused shockwave (FSW) pulse (energy flux density 0.03&#xa0;mJ/mm<sup>2</sup>) with SonoVue microbubbles (2&#x2009;&#xd7;&#x2009;10<sup>6</sup> MBs/kg), posing a low risk of injury.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">By opening the BCSFB, the concentrations of certain CNS-impermeable indicators (70&#xa0;kDa Evans blue and 500&#xa0;kDa FITC-dextran) and drugs (penicillin G, doxorubicin, and bevacizumab) could be significantly elevated in the CSF around both the brain and the spinal cord. Moreover, glioblastoma model rats treated by doxorubicin with this FSW-induced BCSFB (FSW-BCSFB) opening technique also survived significantly longer than untreated controls.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">This is the first study to demonstrate and validate a method for noninvasively and selectively opening the BCSFB to enhance drug delivery into CSF circulation. Potential applications may include treatments for neurodegenerative diseases, CNS infections, brain tumors, and leptomeningeal carcinomatosis.</AbstractText><CopyrightInformation>&#xa9; 2022. The Author(s).</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Kung</LastName><ForeName>Yi</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital &amp; National Taiwan University College of Medicine, Taipei City, Taiwan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chen</LastName><ForeName>Kuan-Yu</ForeName><Initials>KY</Initials><AffiliationInfo><Affiliation>Division of Pulmonology, Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei City, Taiwan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Liao</LastName><ForeName>Wei-Hao</ForeName><Initials>WH</Initials><AffiliationInfo><Affiliation>Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital &amp; National Taiwan University College of Medicine, Taipei City, Taiwan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hsu</LastName><ForeName>Yi-Hua</ForeName><Initials>YH</Initials><AffiliationInfo><Affiliation>Department of Surgery, National Taiwan University Hospital, Taipei City, Taiwan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wu</LastName><ForeName>Chueh-Hung</ForeName><Initials>CH</Initials><AffiliationInfo><Affiliation>Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital &amp; National Taiwan University College of Medicine, Taipei City, Taiwan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hsiao</LastName><ForeName>Ming-Yen</ForeName><Initials>MY</Initials><AffiliationInfo><Affiliation>Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital &amp; National Taiwan University College of Medicine, Taipei City, Taiwan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y" EqualContrib="Y"><LastName>Huang</LastName><ForeName>Abel P-H</ForeName><Initials>AP</Initials><AffiliationInfo><Affiliation>Department of Surgery, National Taiwan University Hospital, Taipei City, Taiwan. how.how0622@gmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y" EqualContrib="Y"><LastName>Chen</LastName><ForeName>Wen-Shiang</ForeName><Initials>WS</Initials><Identifier Source="ORCID">0000-0003-1488-5164</Identifier><AffiliationInfo><Affiliation>Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital &amp; National Taiwan University College of Medicine, Taipei City, Taiwan. wenshiang@gmail.com.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Miaoli, Taiwan. wenshiang@gmail.com.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>105-2923-B-002-001-MY3</GrantID><Agency>Ministry of Science and Technology, Taiwan</Agency><Country/></Grant><Grant><GrantID>108-2314-B-002-164</GrantID><Agency>Ministry of Science and Technology, Taiwan</Agency><Country/></Grant><Grant><GrantID>107-M3989</GrantID><Agency>National Taiwan University Hospital</Agency><Country/></Grant><Grant><GrantID>109-M4670</GrantID><Agency>National Taiwan University Hospital</Agency><Country/></Grant><Grant><GrantID>BN-109-PP-03</GrantID><Agency>National Health Research Institutes of the Republic of China (Taiwan)</Agency><Country/></Grant><Grant><GrantID>BN-108-PP-003</GrantID><Agency>National Health Research Institutes of the Republic of China (Taiwan)</Agency><Country/></Grant><Grant><GrantID>grant 109-53</GrantID><Agency>Good Liver Foundation (Taiwan)</Agency><Country/></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D023361">Validation Study</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2022</Year><Month>01</Month><Day>06</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Fluids Barriers CNS</MedlineTA><NlmUniqueID>101553157</NlmUniqueID><ISSNLinking>2045-8118</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000900">Anti-Bacterial Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000970">Antineoplastic Agents</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000818" MajorTopicYN="N">Animals</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000900" MajorTopicYN="N">Anti-Bacterial Agents</DescriptorName><QualifierName UI="Q000493" MajorTopicYN="Y">pharmacokinetics</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000970" MajorTopicYN="N">Antineoplastic Agents</DescriptorName><QualifierName UI="Q000493" MajorTopicYN="Y">pharmacokinetics</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001812" MajorTopicYN="Y">Blood-Brain Barrier</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002555" MajorTopicYN="Y">Cerebrospinal Fluid</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002831" MajorTopicYN="Y">Choroid Plexus</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016503" MajorTopicYN="Y">Drug Delivery Systems</DescriptorName><QualifierName UI="Q000295" MajorTopicYN="N">instrumentation</QualifierName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D051381" MajorTopicYN="N">Rats</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017207" MajorTopicYN="N">Rats, Sprague-Dawley</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013016" MajorTopicYN="N">Sound</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Blood-cerebrospinal fluid barrier</Keyword><Keyword MajorTopicYN="N">Blood&#x2013;brain barrier</Keyword><Keyword MajorTopicYN="N">Central nervous system</Keyword><Keyword MajorTopicYN="N">Glioblastoma multiforme</Keyword><Keyword MajorTopicYN="N">Leptomeningeal carcinomatosis</Keyword><Keyword MajorTopicYN="N">Low-energy extracorporeal focused shockwave pulse</Keyword></KeywordList><CoiStatement>The authors declare no competing interests.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2021</Year><Month>9</Month><Day>8</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2021</Year><Month>12</Month><Day>27</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2022</Year><Month>1</Month><Day>7</Day><Hour>5</Hour><Minute>46</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2022</Year><Month>1</Month><Day>8</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2022</Year><Month>3</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">34991647</ArticleId><ArticleId IdType="pmc">PMC8740485</ArticleId><ArticleId IdType="doi">10.1186/s12987-021-00303-x</ArticleId><ArticleId IdType="pii">10.1186/s12987-021-00303-x</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>Rubio-Perez C, et al. 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The inner CSF&#x2013;brain barrier: developmentally controlled access to the brain via intercellular junctions. Front Neurosci. 2015;9:16.</Citation><ArticleIdList><ArticleId IdType="pmc">PMC4325900</ArticleId><ArticleId IdType="pubmed">25729345</ArticleId></ArticleIdList></Reference><Reference><Citation>Woo KY et al. Local wound care for palliative and malignant wounds, In: Palliative Care. 2nd ed. 2011; p. 223&#x2013;39.</Citation></Reference></ReferenceList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">34991397</PMID><DateRevised><Year>2022</Year><Month>04</Month><Day>29</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1724-6032</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2022</Year><Month>Jan</Month><Day>06</Day></PubDate></JournalIssue><Title>The journal of vascular access</Title><ISOAbbreviation>J Vasc Access</ISOAbbreviation></Journal>Cardiac implications of upper-arm arteriovenous fistulas: A case series.
The blood-cerebrospinal fluid (CSF) barrier (BCSFB) is critically important to the pathophysiology of the central nervous system (CNS). However, this barrier prevents the safe transmission of beneficial drugs from the blood to the CSF and thus the spinal cord and brain, limiting their effectiveness in treating a variety of CNS diseases.</AbstractText>This study demonstrates a method on SD rats for reversible and site-specific opening of the BCSFB via a noninvasive, low-energy focused shockwave (FSW) pulse (energy flux density 0.03&#xa0;mJ/mm2</sup>) with SonoVue microbubbles (2&#x2009;&#xd7;&#x2009;106</sup> MBs/kg), posing a low risk of injury.</AbstractText>By opening the BCSFB, the concentrations of certain CNS-impermeable indicators (70&#xa0;kDa Evans blue and 500&#xa0;kDa FITC-dextran) and drugs (penicillin G, doxorubicin, and bevacizumab) could be significantly elevated in the CSF around both the brain and the spinal cord. Moreover, glioblastoma model rats treated by doxorubicin with this FSW-induced BCSFB (FSW-BCSFB) opening technique also survived significantly longer than untreated controls.</AbstractText>This is the first study to demonstrate and validate a method for noninvasively and selectively opening the BCSFB to enhance drug delivery into CSF circulation. Potential applications may include treatments for neurodegenerative diseases, CNS infections, brain tumors, and leptomeningeal carcinomatosis.</AbstractText>&#xa9; 2022. The Author(s).</CopyrightInformation>
2,330,514
Brain ventricles as windows into brain development and disease.
Dilation of the fluid-filled cerebral ventricles (ventriculomegaly) characterizes hydrocephalus and is frequently seen in autism and schizophrenia. Recent work suggests that the genomic study of congenital hydrocephalus may be unexpectedly fertile ground for revealing insights into neural stem cell regulation, human cerebrocortical development, and pathogenesis of neuropsychiatric disease.
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Effect of dose, dosing intervals, and hypoxic stress on the reversal of pulmonary hypertension by mesenchymal stem cell extracellular vesicles.
Mesenchymal stem cell extracellular vesicles (MSC EVs) reverse pulmonary hypertension, but little information is available regarding what dose is effective and how often it needs to be given. This study examined the effects of dose reduction and use of longer dosing intervals and the effect of hypoxic stress of MSC prior to EV collection.</AbstractText>Adult male rats with pulmonary hypertension induced by Sugen 5416 and three weeks of hypoxia (SuHx-pulmonary hypertension) were injected with MSC EV or phosphate buffered saline the day of removal from hypoxia using one of the following protocols: (1) Once daily for three days at doses of 0.2, 1, 5, 20, and 100&#x2009;&#xb5;g/kg, (2) Once weekly (100&#x2009;&#xb5;g/kg) for five weeks, (3) Once every other week (100&#x2009;&#xb5;g/kg) for 10 weeks, (4) Once daily (20&#x2009;&#xb5;g/kg) for three days using EV obtained from MSC exposed to 48 h of hypoxia (HxEV) or MSC kept in normoxic conditions (NxEV).</AbstractText>MSC EV reversed increases in right ventricular systolic pressure (RVSP), right ventricular to left ventricle&#x2009;+&#x2009;septum weight (RV/LV+S), and muscularization index of pulmonary vessels &#x2264;50&#x2009;&#xb5;m when given at doses of 20 or 100&#x2009;&#x3bc;g/kg. RVSP, RV/LV+S, and muscularization index were significantly higher in SuHx-pulmonary hypertension rats treated once weekly with phosphate buffered saline for five weeks or every other week for 10 weeks than in normoxic controls, but not significantly increased in SuHx-pulmonary hypertension rats given MSC EV. Both NxEV and HxEV significantly reduced RVSP, RV/LV+S, and muscularization index, but no differences were seen between treatment groups.</AbstractText>MSC EV are effective at reversing SuHx-pulmonary hypertension when given at lower doses and longer dosing intervals than previously reported. Hypoxic stress does not enhance the efficacy of MSC EV at reversing pulmonary hypertension. These findings support the feasibility of MSC EV as a long-term treatment for pulmonary hypertension.</AbstractText>&#xa9; The Author(s) 2021.</CopyrightInformation>
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Manganese Dynamics in Mouse Brain After Systemic MnCl<sub>2</sub> Administration for Activation-Induced Manganese-Enhanced MRI.
Activation-induced manganese-enhanced MRI (AIM-MRI) is an attractive tool for non-invasively mapping whole brain activities. Manganese ions (Mn<sup>2+</sup>) enter and accumulate in active neurons via calcium channels. Mn<sup>2+</sup> shortens the longitudinal relaxation time (T1) of H<sup>+</sup>, and the longitudinal relaxation rate R1 (1/T1) is proportional to Mn<sup>2+</sup> concentration. Thus, AIM-MRI can map neural activities throughout the brain by assessing the R1 map. However, AIM-MRI is still not widely used, partially due to insufficient information regarding Mn<sup>2+</sup> dynamics in the brain. To resolve this issue, we conducted a longitudinal study looking at manganese dynamics after systemic administration of MnCl<sub>2</sub> by AIM-MRI with quantitative analysis. In the ventricle, Mn<sup>2+</sup> increased rapidly within 1 h, remained high for 3 h, and returned to near control levels by 24 h after administration. Microdialysis showed that extracellular Mn returned to control levels by 4 h after administration, indicating a high concentration of extracellular Mn<sup>2+</sup> lasts at least about 3 h after administration. In the brain parenchyma, Mn<sup>2+</sup> increased slowly, peaked 24-48 h after administration, and returned to control level by 5 days after a single administration and by 2 weeks after a double administration with a 24-h interval. These time courses suggest that AIM-MRI records neural activity 1-3 h after MnCl<sub>2</sub> administration, an appropriate timing of the MRI scan is in the range of 24-48 h following systemic administration, and at least an interval of 5 days or a couple of weeks for single or double administrations, respectively, is needed for a repeat AIM-MRI experiment.
2,330,517
Widespread choroid plexus contamination in sampling and profiling of brain tissue.
The choroid plexus, a tissue responsible for producing cerebrospinal fluid, is found predominantly in the lateral and fourth ventricles of the brain. This highly vascularized and ciliated tissue is made up of specialized epithelial cells and capillary networks surrounded by connective tissue. Given the complex structure of the choroid plexus, this can potentially result in contamination during routine tissue dissection. Bulk and single-cell RNA sequencing studies, as well as genome-wide in situ hybridization experiments (Allen Brain Atlas), have identified several canonical markers of choroid plexus such as Ttr, Folr1, and Prlr. We used the Ttr gene as a marker to query the Gene Expression Omnibus database for transcriptome studies of brain tissue and identified at least some level of likely choroid contamination in numerous studies that could have potentially confounded data analysis and interpretation. We also analyzed transcriptomic datasets from human samples from Allen Brain Atlas and the Genotype-Tissue Expression (GTEx) database and found abundant choroid contamination, with regions in closer proximity to choroid more likely to be impacted such as hippocampus, cervical spinal cord, substantia nigra, hypothalamus, and amygdala. In addition, analysis of both the Allen Brain Atlas and GTEx datasets for differentially expressed genes between likely "high contamination" and "low contamination" groups revealed a clear enrichment of choroid plexus marker genes and gene ontology pathways characteristic of these ciliated choroid cells. Inclusion of these contaminated samples could result in biological misinterpretation or simply add to the statistical noise and mask true effects. We cannot assert that Ttr or other genes/proteins queried in targeted assays are artifacts from choroid contamination as some of these differentials may be due to true biological effects. However, for studies that have an unequal distribution of choroid contamination among groups, investigators may wish to remove contaminated samples from analyses or incorporate choroid marker gene expression into their statistical modeling. In addition, we suggest that a simple RT-qPCR or western blot for choroid markers would mitigate unintended choroid contamination for any experiment, but particularly for samples intended for more costly omic profiling. This study highlights an unexpected problem for neuroscientists, but it is also quite possible that unintended contamination of adjacent structures occurs during dissections for other tissues but has not been widely recognized.
2,330,518
Diphtheria toxin induced but not CSF1R inhibitor mediated microglia ablation model leads to the loss of CSF/ventricular spaces in vivo that is independent of cytokine upregulation.
Two recently developed novel rodent models have been reported to ablate microglia, either by genetically targeting microglia (via Cx3cr1-creER: iDTR&#x2009;+&#x2009;Dtx) or through pharmacologically targeting the CSF1R receptor with its inhibitor (PLX5622). Both models have been widely used in recent years to define essential functions of microglia and have led to high impact studies that have moved the field forward.</AbstractText>Using either Cx3cr1-iDTR mice in combination with Dtx or via the PLX5622 diet to pharmacologically ablate microglia, we compared the two models via MRI and histology to study the general anatomy of the brain and the CSF/ventricular systems. Additionally, we analyzed the cytokine profile in both microglia ablation models.</AbstractText>We discovered that the genetic ablation (Cx3cr1-iDTR&#x2009;+&#x2009;Dtx), but not the pharmacological microglia ablation (PLX5622), displays a surprisingly rapid pathological condition in the brain represented by loss of CSF/ventricles without brain parenchymal swelling. This phenotype was observed both in MRI and&#xa0;histological analysis. To our surprise, we discovered that the iDTR allele alone leads to the loss of CSF/ventricles phenotype following diphtheria toxin (Dtx) treatment independent of cre expression. To examine the underlying mechanism for the loss of CSF in the Cx3cr1-iDTR ablation and iDTR models, we additionally investigated the cytokine profile in the Cx3cr1-iDTR&#x2009;+&#x2009;Dtx, iDTR&#x2009;+&#x2009;Dtx and the PLX models. We found increases of multiple cytokines in the Cx3cr1-iDTR&#x2009;+&#x2009;Dtx but not in the pharmacological ablation model nor the iDTR&#x2009;+&#x2009;Dtx mouse brains at the time of CSF loss (3&#xa0;days after the first Dtx injection). This result suggests that the upregulation of cytokines is not the cause of the loss of CSF, which is supported by our data indicating that brain parenchyma swelling, or edema are not observed in the Cx3cr1-iDTR&#x2009;+&#x2009;Dtx microglia ablation model. Additionally, pharmacological inhibition of the KC/CXCR2 pathway (the most upregulated cytokine in the Cx3cr1-iDTR&#x2009;+&#x2009;Dtx model) did not resolve the CSF/ventricular loss phenotype in the genetic microglia ablation model. Instead, both the Cx3cr1-iDTR&#x2009;+&#x2009;Dtx ablation and iDTR&#x2009;+&#x2009;Dtx models showed increased activated IBA1&#x2009;+&#x2009;cells in the choroid plexus (CP), suggesting that CP-related pathology might be the contributing factor for the observed CSF/ventricular shrinkage phenotype.</AbstractText>Our data, for the first time, reveal a robust and global CSF/ventricular space shrinkage pathology in the Cx3cr1-iDTR genetic ablation model caused by iDTR allele, but not in the PLX5622 ablation model, and suggest that this pathology is not due to brain edema formation but to CP related pathology. Given the wide utilization of the iDTR allele and the Cx3cr1-iDTR model, it is crucial to fully characterize this pathology to understand the underlying causal mechanisms. Specifically, caution is needed when utilizing this model to interpret subtle neurologic functional changes that are thought to be mediated by microglia but could, instead, be due to CSF/ventricular loss in the genetic ablation model.</AbstractText>&#xa9; 2021. The Author(s).</CopyrightInformation>
2,330,519
Opioid Weaning Protocol Using Morphine Compared With Nonprotocolized Methadone Associated With Decreased Dose and Duration of Opioid After Norwood Procedure.
Opioids are used to manage pain, comfort, maintain devices, and decrease oxygen consumption around Norwood palliation (NP), but in high dose and prolonged exposure, they increase risk of tolerance and iatrogenic withdrawal syndrome (IAWS). Variability in practice for IAWS prevention potentially increases opioid dose and duration. We hypothesize that protocolized weaning with morphine (MOR) versus nonprotocolized methadone (MTD) is associated with reduction in opioid exposure.</AbstractText>A before-versus-after study of outcomes of patients weaned with protocolized MOR versus nonprotocolized MTD including subset analysis for those patients with complications postoperatively. Primary endpoints include daily, wean phase, and total morphine milligram equivalent (MMEq) dose, duration, and, secondarily, length of stay (LOS).</AbstractText>Quaternary-care pediatric cardiac ICU.</AbstractText>Neonates undergoing single-ventricle palliation.</AbstractText>Introduction of IAWS prevention protocol.</AbstractText>Analysis included 54 patients who underwent the NP in 2017-2018 including the subset analysis of 34 who had a complicated postoperative course. The total and wean phase opioid doses for the MTD group were significantly higher than that for the MOR group: 258 versus 22 and 115 versus 6 MMEq/kg; p &lt; 0.001. Duration of opioid exposure was 63 days in the MTD group and 12 days in MOR group (p &lt; 0.001). Subanalysis of the complicated subset also identifies higher total and wean dose for MTD group (293 vs 41 and 116 vs 7 MMEq/kg; p &lt; 0.001) with a longer duration (65 vs 22 days; p = 0.001). Within the subset, LOS was 55% longer in the MTD group than that in the MOR group (150 vs 67 d; p = 0.01) and not different in the uncomplicated group.</AbstractText>After complex NP, a protocolized opioid weaning using MOR versus MTD is associated with 65% shorter opioid duration, 10-fold decreased dose, and shortened LOS.</AbstractText>Copyright &#xa9; 2022 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.</CopyrightInformation>
2,330,520
Cross-modality LGE-CMR Segmentation using Image-to-Image Translation based Data Augmentation.
Accurate segmentation of ventricle and myocardium from the late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) is an important tool for myocardial infarction (MI) analysis. However, the complex enhancement pattern of LGE-CMR and the lack of labeled samples make its automatic segmentation difficult to be implemented. In this paper, we propose an unsupervised LGE-CMR segmentation algorithm by using multiple style transfer networks for data augmentation. It adopts two different style transfer networks to perform style transfer of the easily available annotated balanced-Steady State Free Precession (bSSFP)-CMR images. Then, multiple sets of synthetic LGE-CMR images are generated by the style transfer networks and used as the training data for the improved U-Net. The entire implementation of the algorithm does not require the labeled LGE-CMR. Validation experiments demonstrate the effectiveness and advantages of the proposed algorithm.
2,330,521
Apelin-13 protects against memory impairment and neuronal loss, Induced by Scopolamine in male rats.
The present study aimed to evaluate the effects of Apelin-13 on scopolamine-induced memory impairment in rats.&#xa0;Forty male rats were divided into five groups of eight. The control group received no intervention; the scopolamine group underwent stereotaxic surgery and received 3&#xa0;mg/kg intraperitoneal scopolamine. The treatment groups additionally received 1.25, 2.5 and 5&#xa0;&#xb5;g apelin-13 in right lateral ventricles for 7 days. All rats (except the control group) were tested for the passive avoidance reaction, 24&#xa0;h after the last drug injection. For histological analysis, hippocampal sections were stained with cresyl violet; synaptogenesis biochemical markers were determined by immunoblotting.&#xa0;Apelin-13 alleviated scopolamine-induced passive avoidance memory impairment and neuronal loss in the rats' hippocampus (P&lt;0.001). The reduction observed in mean concentrations of hippocampal synaptic proteins (including neurexin1, neuroligin, and postsynaptic density protein 95) in scopolamine-treated animals was attenuated by apelin-13 treatment.&#xa0;The results demonstrated that apelin-13 can protect against passive avoidance memory deficiency, and neuronal loss, induced by scopolamine in male rats. Further experimental and clinical studies are required to confirm its therapeutic potential in neurodegenerative diseases.
2,330,522
Comparative Analysis of Behavioral Reactions and Morphological Changes in the Rat Brain After Exposure to Ionizing Radiation with Different Physical Characteristics.
The aim of this research was to study behavioral reactions and morphological changes in the brain of adult female Sprague Dawley rats after exposure to 170&#xa0;MeV and 70&#xa0;MeV protons and gamma radiation (60Co) at a dose of 1&#xa0;Gy. The analysis of the behavioral reactions in the T-maze showed that exposure to ionizing radiation with different LETs led to an increase in number of repeated entries into the arms of the maze in the spontaneous alternation test. In the Open Field test a decrease in overall motor activity in the group of irradiated animals (70&#xa0;MeV protons at the Bragg peak) was observed. A decrease in the number of standing positions was seen in all groups of irradiated animals. Morphological analysis showed the development of early amyloidosis, autolysis of the ependymal layer, an increase in the number of neurodegenerative changes in various structures of the brain, and the development of neuronal hypertrophy on the 30th day after irradiation in the cerebellum and hippocampal hilus. Exposure to protons at a dose of 1&#xa0;Gy leads to the development of structural and functional disorders of the central nervous system of animals on the 30th day after irradiation. These data indicate a damage of short-term memory, a decrease in motor activity and exploratory behavior of animals. With an increase in LET, there is an increase in the number of amyloid plaques in the forebrain of rats, autolysis of the ependymal layer of the ventricles, and the development of dystrophic changes. Investigations of behavioral reactions and morphological changes in various parts of the brain of adult rats on the 30th day after influence of ionizing radiation with different physical characteristics at a dose of 1 Gy. Various negative patho-morphological and cognitive-behavioral changes observed.
2,330,523
Surgical management and clinical outcomes of cerebellar liponeurocytomas-a report of seven cases and a pooled analysis of individual patient data.
Cerebellar liponeurocytomas (CLPNs) are very rare, with very few studies on this disease. Their treatment protocol also remains unclear. To better understand the disease, we reviewed the clinical features and outcomes, and proposed a treatment protocol based on previously reported cases as well as cases from our institute. The clinical data were obtained from seven patients with pathologically confirmed CLPNs, who underwent surgical treatment at our institute between November 2011 and June 2021. We also reviewed the relevant literature and 75 patients with CLPNs were identified between September 1993 and June 2021. Risk factors for progression-free survival (PFS) were evaluated in the pooled cohort. Our cohort included four males and three females, with a mean age of 43.9&#x2009;&#xb1;&#x2009;14.5&#xa0;years (range: 29-64&#xa0;years). CLPNs were located in the lateral ventricle in three cases and in the cerebellum in four cases. All seven cases achieved gross total resection (GTR) and radiotherapy was administered to two cases. After a mean follow-up of 44.9&#x2009;&#xb1;&#x2009;44.4&#xa0;months, all patients remained well, with no recurrence or death. Among the 75 patients reported in the literature, 35 were males and 40 were females, with a mean age of 46.2&#x2009;&#xb1;&#x2009;13.6&#xa0;years (range: 6-77&#xa0;years). Biopsy, GTR, and non-GTR were achieved in one (1.3%), 50 (66.7%), and 24 (32%) patients, respectively. Radiotherapy was administered to 16 cases and chemotherapy was administered to only one case. After a mean follow-up of 47.5&#x2009;&#xb1;&#x2009;51.5&#xa0;months, three patients died and tumor recurrence occurred in 17 patients. Multivariate Cox analysis revealed that non-GTR predicted a poor PFS (p&#x2009;=&#x2009;0.020), and postoperative radiotherapy could not prolong PFS (p&#x2009;=&#x2009;0.708). Kaplan-Meier analysis also showed that GTR was significantly associated with longer PFS (p&#x2009;=&#x2009;0.008), and postoperative radiotherapy could not prolong PFS (p&#x2009;=&#x2009;0.707). PFS rates at 1, 5, 10&#xa0;years were 92.7%, 78.0%, 23.8% respectively. CLPNs are very rare brain tumors. Although they have favorable clinical prognosis, the recurrence is relatively high. GTR should be the first choice for treatment and close follow-up is necessary. Postoperative radiotherapy could not improve PFS in this study. A larger cohort is needed to verify our findings.
2,330,524
Tectal Rosette-Forming Glioneuronal Tumor - A Case Report Focusing on a Possible Role for Radiotherapy in Inoperable Tumors.
Rosette-forming glioneuronal tumor (RGNT) is a rare and distinctive glioneuronal tumor. Although surgical excision is considered the standard treatment for these slow growing WHO Grade I tumors, gross-total resection is achieved in less than 50% of RGNTs due to its localisation amidst vital structures. With very few cases with long term follow-up reported, there is limited knowledge of the natural clinical course and the role of radiotherapy in inoperable RGNTs.</AbstractText>A previously well 26-year old male, presented with long standing headache, increasing gait instability and fainting episodes. Imaging revealed a tectal plate mass with hydrocephalous. An endoscopic third ventriculostomy and biopsy was done, revealing RGNT. He received radiotherapy with a curative intent. The patient remained neurologically stable for 4 years. Follow-up imaging done after 4 years showed decrease in tumor size.</AbstractText>The current case highlights a role for radiotherapy in RGNTs occurring in surgically challenging sites.</AbstractText>
2,330,525
Neuroendoscopy in the Surgical Management of Lateral and Third Ventricular Tumors: Looking Beyond Microneurosurgery.
Intraventricular tumors pose a surgical challenge because of the difficulty in reaching their deep location through safe corridors and their adherence or proximity to vital neurovascular structures. Although microneurosurgery is the mainstay of surgical management, neuroendoscopy aided by adjuncts, namely, navigation and ultrasonic aspirators, has made a great contribution to improving surgical results.</AbstractText>This article reviews the experience of a neurosurgical unit with endoscopic procedures for intraventricular tumors. The current indications, benefits, and complications of neuroendoscopy are described.</AbstractText>This is a retrospective, observational study of lateral and third ventricular tumors tackled either purely with an endoscope or with its assistance over 19 years in a single unit at Bombay Hospital Institute of Medical Sciences, Mumbai.</AbstractText>Of a total of 247 operated patients with intraventricular tumors, 85 cases operated using an endoscope were included. The majority of the patients had a tumor in the third ventricle (n = 62), whereas 23 patients had tumor in the lateral ventricle. The most common pathologies were colloid cyst and arachnoid cyst (n = 18). An endoscope was used for microsurgical assisted excision of tumors in 31 cases, biopsy in 24, cyst fenestration in 23, and pure endoscopic excision in seven cases.</AbstractText>Microsurgery remains the gold standard for the removal of giant, vascular intraventricular tumors. However, endoscopic fenestration or excision of cysts and biopsy have become better alternatives in many cases. Endoscope-assisted microsurgery affords safety and helps in achieving a more complete excision.</AbstractText>
2,330,526
Gravity Assisted Retraction Less Occipito Transtentorial and Trans-Splenial Approach for Posterior Third Ventricular Dermoid.
A dermoid is an inclusion cyst. Its presence in the posterior third ventricle is highly infrequent. It usually compresses rather than infiltrates the posterior third ventricle's anatomical structures due to a well-defined capsule. Hence, the surgical anatomy in these tumors is less distorted. The approach to the posterior third ventricular tumors depends upon their relation to the galenic venous complex.</AbstractText>This video abstract presents a case of the posterior third ventricular dermoid operated by gravity-assisted retraction less occipito transtentorial combined with the trans-splenial approach.</AbstractText>A 36-year-old gentleman presented with a headache without any neurological deficits; the magnetic resonance imaging (MRI) revealed a well-defined heterogeneous lesion in the posterior third ventricular region. It was mainly toward the right side, just beneath the splenium, pushing the galenic venous system downward. This made the occipital transtentorial approach favorable as it required the least vessel handling. A right parieto-occipital craniotomy was performed. The patient was placed in a lateral semi-prone position with the head slightly rotated toward the right side with a slight neck extension. This allowed the right occipital lobe to fall away from the Falco-tentorial junction. With sharp dissection, an inter-Rosenthal corridor was made. But as the tumor was higher up in the posterior third ventricle, it was modified to another trans-splenial corridor. Near-total excision was achieved with a thin capsule left attached to the vein of Galen. The capsule was thick, filled with a cheesy white material, and a calcified sebaceous lump within. The postoperative scan showed no residual tumor.</AbstractText>The patient had improvement in the headache. There were no field cuts. The histopathology was suggestive of a dermoid cyst.</AbstractText>Dermoid cysts of the posterior third ventricular region are rare, and judicious surgical decisions result in better outcomes.</AbstractText>
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Association between cumulative blood pressure in early adulthood and right ventricular structure and function in middle age: The CARDIA study.<Pagination><StartPage>83</StartPage><EndPage>90</EndPage><MedlinePgn>83-90</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1002/clc.23763</ELocationID><Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">Cumulative blood pressure (BP) exposure is a known risk factor for cardiovascular disease. This study sought to investigate the association between cumulative BP from early adulthood to middle age and right ventricular (RV) structure and function in middle age.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">We included 2844 participants from the CARDIA study (Coronary Artery Risk Development in Young Adults). Cumulative BP over the 30-years follow-up was defined as the sum of the product of mean BP for each pair of consecutive examinations and the time interval between these two consecutive examinations in years. RV structure and function were assessed by echocardiography. The main analyses utilized logistic and linear regression models.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">In fully adjusted models, higher cumulative systolic BP was independently associated with lower tricuspid annular plane systolic excursion (TAPSE), right ventricular peak systolic velocity (RVS'), right ventricular early diastolic velocity (RVe'), and higher pulmonary arterial systolic pressure. Higher cumulative diastolic BP was independently associated with smaller RV basal diameter, lower TAPSE, RVS', and RVe'. For categorical analyses of RV dysfunction, cumulative systolic BP was not related to systolic dysfunction. Per 1-SD increase in cumulative systolic BP was associated with a higher risk of diastolic dysfunction, while an increase in cumulative diastolic BP was associated with a higher risk of systolic dysfunction and diastolic dysfunction.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Cumulative exposure to increased BP from early adulthood to middle age was associated with incipient RV systolic and diastolic dysfunction in middle age. Exposure to higher diastolic BP levels from early adulthood to middle age was associated with a smaller RV basal diameter in middle age.</AbstractText><CopyrightInformation>&#xa9; 2022 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Liu</LastName><ForeName>Shenrong</ForeName><Initials>S</Initials><Identifier Source="ORCID">0000-0001-6585-9404</Identifier><AffiliationInfo><Affiliation>Department of Cardiac Pediatrics, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Guangzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Liao</LastName><ForeName>Yanfen</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Department of Stomatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zhu</LastName><ForeName>Zongyuan</ForeName><Initials>Z</Initials><AffiliationInfo><Affiliation>Department of Huiqiao Building, Nanfang Hospital, Southern Medical University, Guangzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wang</LastName><ForeName>Shushui</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Cardiac Pediatrics, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Guangzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Li</LastName><ForeName>Yifan</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Department of Cardiac Pediatrics, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Guangzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Liang</LastName><ForeName>Dongpo</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Cardiac Pediatrics, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Guangzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Xie</LastName><ForeName>Yumei</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Department of Cardiac Pediatrics, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Guangzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zhang</LastName><ForeName>Zhiwei</ForeName><Initials>Z</Initials><AffiliationInfo><Affiliation>Department of Cardiac Pediatrics, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Guangzhou, China.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>2020B1111170011</GrantID><Agency>Guangdong Provincial Clinical Research Center for Cardiovascular Disease</Agency><Country/></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2022</Year><Month>01</Month><Day>03</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Clin Cardiol</MedlineTA><NlmUniqueID>7903272</NlmUniqueID><ISSNLinking>0160-9289</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001794" MajorTopicYN="N">Blood Pressure</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004452" MajorTopicYN="N">Echocardiography</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006352" MajorTopicYN="Y">Heart Ventricles</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013599" MajorTopicYN="N">Systole</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018497" MajorTopicYN="Y">Ventricular Dysfunction, Right</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016278" MajorTopicYN="N">Ventricular Function, Right</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">blood pressure</Keyword><Keyword MajorTopicYN="N">right ventricular structure and function</Keyword><Keyword MajorTopicYN="N">young adult</Keyword></KeywordList><CoiStatement>The authors declare that there are no conflict of interests.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="revised"><Year>2021</Year><Month>11</Month><Day>7</Day></PubMedPubDate><PubMedPubDate PubStatus="received"><Year>2021</Year><Month>9</Month><Day>11</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2021</Year><Month>12</Month><Day>13</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2022</Year><Month>1</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2022</Year><Month>2</Month><Day>2</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2022</Year><Month>1</Month><Day>3</Day><Hour>17</Hour><Minute>16</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">34979043</ArticleId><ArticleId IdType="pmc">PMC8799061</ArticleId><ArticleId 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Right ventricular function in cardiovascular disease, part II: pathophysiology, clinical importance, and management of right ventricular failure. Circulation. 2008;117(13):1717&#x2010;1731.</Citation><ArticleIdList><ArticleId IdType="pubmed">18378625</ArticleId></ArticleIdList></Reference><Reference><Citation>Schirone L, Forte M, Palmerio S, et al. A review of the molecular mechanisms underlying the development and progression of cardiac remodeling. Oxid Med Cell Longev. 2017;2017:3920195.</Citation><ArticleIdList><ArticleId IdType="pmc">PMC5511646</ArticleId><ArticleId IdType="pubmed">28751931</ArticleId></ArticleIdList></Reference><Reference><Citation>Brittain EL, Nwabuo C, Xu M, et al. Echocardiographic pulmonary artery systolic pressure in the Coronary Artery Risk Development in Young Adults (CARDIA) study: associations with race and metabolic dysregulation. J Am Heart Assoc. 2017;6(4).</Citation><ArticleIdList><ArticleId IdType="pmc">PMC5533013</ArticleId><ArticleId IdType="pubmed">28360228</ArticleId></ArticleIdList></Reference><Reference><Citation>Gulati A, Ismail TF, Jabbour A, et al. The prevalence and prognostic significance of right ventricular systolic dysfunction in nonischemic dilated cardiomyopathy. Circulation. 2013;128(15):1623&#x2010;1633.</Citation><ArticleIdList><ArticleId IdType="pubmed">23965488</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">34978670</PMID><DateRevised><Year>2022</Year><Month>01</Month><Day>03</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1875-8312</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2022</Year><Month>Jan</Month><Day>03</Day></PubDate></JournalIssue><Title>The international journal of cardiovascular imaging</Title><ISOAbbreviation>Int J Cardiovasc Imaging</ISOAbbreviation></Journal>Comprehensive echocardiographic and speckle tracking strain analysis in rheumatic mitral stenosis patients before and after transvenous mitral commissurotomy.
Percutaneous Transvenous Mitral Commissurotomy (PTMC) is the first line treatment for rheumatic mitral stenosis (MS). We sought to evaluate (1) changes in 2-dimensional (2D) echocardiographic and strain values and (2) differences in these values for patients in atrial fibrillation (AF) and sinus rhythm (SR) pre, immediately and 6&#xa0;months post PTMC. Retrospective study of 136 patients who underwent PTMC between 2011 and 2021. We analyzed their 2D echocardiogram, Global Longitudinal Strain (GLS), Left Atrial Reservoir Strain (LAr-S) and Right Ventricle Free Wall Strain (RVFW-S) pre, immediately and 6&#xa0;months post PTMC. At 6&#xa0;months, mitral valve area increases from 0.94&#x2009;&#xb1;&#x2009;0.23&#xa0;cm<sup>2</sup> to 1.50&#x2009;&#xb1;&#x2009;0.42&#xa0;cm<sup>2</sup>. Ejection fraction (EF) did not change post PTMC (pre; 55.56&#x2009;&#xb1;&#x2009;6.62%, immediate; 56.68&#x2009;&#xb1;&#x2009;7.83%, 6&#xa0;months; 56.28&#x2009;&#xb1;&#x2009;7.00%, p&#x2009;=&#x2009;0.218). Even though EF is preserved, GLS is lower pre-procedure; -&#xa0;11.52&#x2009;&#xb1;&#x2009;3.74% with significant improvement at 6&#xa0;months; -&#xa0;15.16&#x2009;&#xb1;&#x2009;4.28% (p&#x2009;&lt;&#x2009;0.001). Tricuspid annular plane systolic excursion (TAPSE) improved at 6&#xa0;months from 1.95&#x2009;&#xb1;&#x2009;0.43 to 2.11&#x2009;&#xb1;&#x2009;0.49 (p&#x2009;=&#x2009;0.004). RVFW-S increases at 6&#xa0;months from -&#xa0;17.37&#x2009;&#xb1;&#x2009;6.03% to -&#xa0;19.75&#x2009;&#xb1;&#x2009;7.19% (p&#x2009;=&#x2009;0.011). LAr-S improved from 11.23&#x2009;&#xb1;&#x2009;6.83% pre PTMC to 16.80&#x2009;&#xb1;&#x2009;8.82% at 6&#xa0;months (p&#x2009;&lt;&#x2009;0.001) post PTMC. Pre-procedure patients with AF have lower strain values (More LV, RV and LA dysfunction) with statistically significant difference for LAr-S (p&#x2009;&lt;&#x2009;0.001), GLS (p&#x2009;&lt;&#x2009;0.001) and RVFW-S (p&#x2009;&lt;&#x2009;0.001) than patients in SR. Patients with severe rheumatic MS have subclinical left and right ventricle dysfunction despite preserved EF and relatively normal TAPSE with significant improvement seen at 6&#xa0;months post PTMC. AF patients have lower baseline strain values than SR patients.
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A case report of atypical choroid plexus papilloma in the cervicothoracic spinal cord.
Choroid plexus papillomas (CPPs) are uncommon, benign intracranial tumors that can occur in both children and adults. In adults, CPPs are typically identified in the fourth ventricle, whereas in children, they most commonly occur in the lateral ventricle. CPPs that arise from the extraventricular system are extremely rare and difficult to diagnose. We report a case of extraventricular, atypical CPP located in the cervicothoracic spinal cord of a 2-year-old girl.
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Monocytes promote acute neuroinflammation and become pathological microglia in neonatal hypoxic-ischemic brain injury.
<b>Rationale:</b> Monocytes belong to the mononuclear phagocyte system and are immune responders to tissue injury and infection. There were also reports of monocytes transforming to microglia-like cells. Here we explore the roles of monocytes in microglia ontogeny and the pathogenesis of neonatal cerebral hypoxic-ischemic (HI) brain injury in mice. <b>Methods:</b> We used three genetic methods to track the development of monocytes, including CX3CR1<sup>GFP/+</sup>; CCR2<sup>RFP/+</sup> reporter mice, adoptive transfer of GFP<sup>+</sup> monocytes, and fate-mapping with CCR2-CreER mice, in neonatal mouse brains with or without lipopolysaccharide (LPS, 0.3 mg/kg)-sensitized Vannucci HI. We also used genetic (CCR2<sup>RFP/ RFP</sup>, CCR2 knockout) and pharmacological methods (RS102895, a CCR2 antagonist) to test the roles of monocytic influx in LPS/HI brain injury. <b>Results:</b> CCR2<sup>+</sup> monocytes entered the late-embryonic brains via choroid plexus, but rapidly became CX3CR1<sup>+</sup> amoeboid microglial cells (AMCs). The influx of CCR2<sup>+</sup> monocytes declined after birth, but recurred after HI or LPS-sensitized HI (LPS/HI) brain injury, particularly in the hippocampus. The CCR2-CreER-based fate-mapping showed that CCR2<sup>+</sup> monocytes became CD68<sup>+</sup> TNF&#x3b1;<sup>+</sup> macrophages within 4 d after LPS/HI, and maintained as TNF&#x3b1;<sup>+</sup> MHCII<sup>+</sup> macrophages or persisted as Tmem119<sup>+</sup> Sall1<sup>+</sup> P2RY12<sup>+</sup> ramified microglia for at least five months after injury. Genetic deletion of the chemokine receptor CCR2 markedly diminished monocytic influx, the expression of pro- and anti-inflammatory cytokines, and brain damage. Post-LPS/HI application of RS102895 also reduced inflammatory responses and brain damage, leading to better cognitive functions. <b>Conclusion:</b> These results suggest that monocytes promote acute inflammatory responses and may become pathological microglia long after the neonatal LPS/HI insult. Further, blocking the influx of monocytes may be a potential therapy for neonatal brain injury.
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Idiopathic normal pressure hydrocephalus; treatment and outcome in the Region of Southern Denmark.<Pagination><StartPage>107107</StartPage><MedlinePgn>107107</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.clineuro.2021.107107</ELocationID><ELocationID EIdType="pii" ValidYN="Y">S0303-8467(21)00636-3</ELocationID><Abstract><AbstractText Label="OBJECTIVE">Idiopathic normal pressure hydrocephalus (iNPH) is a prevalent and cost-effective disease to treat. However, no gold standard exists to confidently select patients for shunt surgery. The aim of this study was to investigate how patients with suspected iNPH at our center responded to shunt surgery and to compare pre-surgical variables between shunt responders and non-responders.</AbstractText><AbstractText Label="METHODS">Preoperative baseline characteristics, MRI and/or CT scans were retrospectively obtained in 55 shunt-operated iNPH patients. Evan's index, third ventricle diameter, dilation of Sylvian fissures, tight high convexity, focal sulci, callosal angle, Rout value, MMSE score, CSF phosphorylated tau, CSF tau, and a combination of radiologic findings (DESH score) were compared according to whether or not patients expressed satisfactory response to shunt treatment at 1-month follow-up.</AbstractText><AbstractText Label="RESULTS">Multiple logistic regression controlling for age and gender (&#x3b1;&#xa0;=&#xa0;0.05) showed that tight high convexity, dilated Sylvian fissures, focal sulci, CSF tau, CSF phosphorylated tau, and DESH score correlated significantly with subjective shunt response at 1-month follow-up.</AbstractText><AbstractText Label="CONCLUSION">In line with current literature, Shunt responders had lower levels of CSF tau and CSF phosphorylated tau compared to non-responders. While commonly used radiologic markers are of value, they can be aggregated into a score for better selection of shunt candidates.</AbstractText><CopyrightInformation>Copyright &#xa9; 2021 Elsevier B.V. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Johannsson</LastName><ForeName>Bjarni</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>OPEN - Open Patient data Explorative Network, J. B. Winsl&#xf8;ws Vej 9a, Odense, Denmark; Department of Clinical Research, University of Southern Denmark and BRIDGE (Brain Research-Interdisciplinary Guided Excellence), Odense, Denmark; Department of Neurosurgery, Odense University Hospital, J. B. Winsl&#xf8;ws Vej 9a, Odense, Denmark. Electronic address: Bjarni.johannsson@rsyd.dk.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Munthe</LastName><ForeName>Sune</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>OPEN - Open Patient data Explorative Network, J. B. Winsl&#xf8;ws Vej 9a, Odense, Denmark; Department of Clinical Research, University of Southern Denmark and BRIDGE (Brain Research-Interdisciplinary Guided Excellence), Odense, Denmark; Department of Neurosurgery, Odense University Hospital, J. B. Winsl&#xf8;ws Vej 9a, Odense, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Poulsen</LastName><ForeName>Frantz Rom</ForeName><Initials>FR</Initials><AffiliationInfo><Affiliation>OPEN - Open Patient data Explorative Network, J. B. Winsl&#xf8;ws Vej 9a, Odense, Denmark; Department of Clinical Research, University of Southern Denmark and BRIDGE (Brain Research-Interdisciplinary Guided Excellence), Odense, Denmark; Department of Neurosurgery, Odense University Hospital, J. B. Winsl&#xf8;ws Vej 9a, Odense, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pedersen</LastName><ForeName>Christian Bonde</ForeName><Initials>CB</Initials><AffiliationInfo><Affiliation>OPEN - Open Patient data Explorative Network, J. B. Winsl&#xf8;ws Vej 9a, Odense, Denmark; Department of Clinical Research, University of Southern Denmark and BRIDGE (Brain Research-Interdisciplinary Guided Excellence), Odense, Denmark; Department of Neurosurgery, Odense University Hospital, J. B. Winsl&#xf8;ws Vej 9a, Odense, Denmark.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>12</Month><Day>29</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>Clin Neurol Neurosurg</MedlineTA><NlmUniqueID>7502039</NlmUniqueID><ISSNLinking>0303-8467</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D002557" MajorTopicYN="N">Cerebrospinal Fluid Shunts</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003718" MajorTopicYN="N" Type="Geographic">Denmark</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006850" MajorTopicYN="Y">Hydrocephalus, Normal Pressure</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName><QualifierName UI="Q000601" MajorTopicYN="N">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">CSF biomarkers</Keyword><Keyword MajorTopicYN="N">Dementia and related disorders</Keyword><Keyword MajorTopicYN="N">Neurodegenerative disorders</Keyword><Keyword MajorTopicYN="N">Neurogeriatrics</Keyword><Keyword MajorTopicYN="N">Neuroimaging</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2021</Year><Month>6</Month><Day>7</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2021</Year><Month>10</Month><Day>16</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2021</Year><Month>12</Month><Day>25</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2022</Year><Month>1</Month><Day>3</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2022</Year><Month>4</Month><Day>5</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2022</Year><Month>1</Month><Day>2</Day><Hour>20</Hour><Minute>35</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">34974379</ArticleId><ArticleId IdType="doi">10.1016/j.clineuro.2021.107107</ArticleId><ArticleId IdType="pii">S0303-8467(21)00636-3</ArticleId></ArticleIdList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">34974182</PMID><DateRevised><Year>2022</Year><Month>02</Month><Day>06</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1532-8414</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2021</Year><Month>Dec</Month><Day>30</Day></PubDate></JournalIssue><Title>Journal of cardiac failure</Title><ISOAbbreviation>J Card Fail</ISOAbbreviation></Journal>Austin Powers' Steamroller: Lessons Learned to Benefit Patients with Congenital Heart Disease.
A structural crisis is brewing in advanced care for patients with congenital heart disease (CHD)-specifically, single-ventricle patients palliated by the Fontan procedure. The largest study evaluating management practices in pediatric cardiac teams found that 93% of providers believe that after the Fontan procedure, patients "will eventually have signs/symptoms of heart failure (HF) and will need a heart transplant (HT) at some point in their lives."<sup>1</sup> Despite this, the majority either disagreed about (45%) or were undecided about (24%) "whether routine evaluation by a HF/HT cardiologist is needed." This may be, in part, attributable to the lack of an HF/HT subspecialty in the American College of Pediatrics, but these findings highlight a concerning disconnect in the minds of providers caring for patients undergoing the Fontan procedure, for whom the providers' preparation seems incongruous in terms of the anticipated endpoint. This disconnect would likely be even worse had the survey been conducted in adult providers, given that the providers of care for adults with congenital heart disease (ACHD) have limited required HF/HT training, and adult HF/HT cardiologists have little required training in CHD.
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Global Rostral Midbrain Syndrome (GRMS) and Corpus callosum infarction in the context of shunt overdrainage.
We report 3 cases of Global rostral midbrain syndrome (GRMS) and Corpus Callosum (CC) infarction, in the context of hydrocephalus followed by shunt dysfunction and slit ventricles. Prior shunt implantation had been indicated for adult-onset hydrocephalus secondary to aqueductal stenosis of varying causes. All three patients had been stable for months before developing repeated shunt dysfunctions, ultimately progressing to parkinsonism, Parinaud syndrome, akinetic mutism, pyramidal signs, cognitive impairment, CC infarction and slit ventricles, in the context of CSF overdrainage. Parkinsonism-related symptoms responded to dopa in all cases, but Parinaud syndrome and cognitive impairment persisted. Although GRMS has been described in the context of a transtentorial pressure gradient after shunt blockage, in these three cases with similar clinical presentation, reverse transtentorial pressure gradient and slit ventricles due to shunt overdrainage was the likely cause. The authors discuss the role of CC infarction and provide a detailed analysis after gathering previously described data, to unify information under a recognizable clinical entity and better understand the underlying pathophysiology, treatment options and outcome.
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Risk factors for postoperative cerebellar mutism syndrome in pediatric patients: a systematic review and meta-analysis.
A review article assessing all the risk factors reported in the literature for postoperative cerebellar mutism syndrome (pCMS) among children remains absent. The authors sought to perform a systematic review and meta-analysis to evaluate this issue.</AbstractText>PubMed, Embase, and Web of Science were queried to systematically extract potential references. The articles relating to pCMS were required to be written in the English language, involve pediatric patients (&#x2264; 18 years of age), and provide extractable data, which included a comparison group of patients who did not develop pCMS. The quality of the included studies was evaluated using the Newcastle-Ottawa Scale. Data were pooled using RevMan 5.4, and publication bias was assessed by visual inspection for funnel plot asymmetry. The study protocol was registered through PROSPERO (ID: CRD42021256177).</AbstractText>Overall, 28 studies involving 2276 patients were included. Statistically significant risk factors identified from univariate analysis were brainstem invasion (OR 4.28, 95% CI 2.23-8.23; p &lt; 0.0001), fourth ventricle invasion (OR 12.84, 95% CI 4.29-38.44; p &lt; 0.00001), superior cerebellar peduncle invasion (OR 6.77, 95% CI 2.35-19.48; p = 0.0004), diagnosis of medulloblastoma (OR 3.26, 95% CI 1.93-5.52; p &lt; 0.0001), medulloblastoma &gt; 50 mm (OR 8.85, 95% CI 1.30-60.16; p = 0.03), left-handedness (OR 6.57, 95% CI 1.25-34.44; p = 0.03), and a vermis incision (OR 5.44, 95% CI 2.09-14.16; p = 0.0005). On the other hand, a tumor located in the cerebellar hemisphere (OR 0.23, 95% CI 0.06-0.92; p = 0.04), cerebellar hemisphere compression (OR 0.23, 95% CI 0.11-0.45; p &lt; 0.0001), and intraoperative imaging (OR 0.36, 95% CI 0.18-0.72; p = 0.004) reduced the risk of pCMS.</AbstractText>This study provides the largest and most reliable review of risk factors associated with pCMS. Although some risk factors may be dependent on one another, the data may be used by surgeons to better identify patients at risk for pCMS and for intervention planning.</AbstractText>
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Choroid plexus enlargement is associated with neuroinflammation and reduction of blood brain barrier permeability in depression.
Recent studies have shown that choroid plexuses (CP) may be involved in the neuro-immune axes, playing a role in the interaction between the central and peripheral inflammation. Here we aimed to investigate CP volume alterations in depression and their associations with inflammation.</AbstractText>51 depressed participants (HDRS score&#xa0;&gt;&#xa0;13) and 25 age- and sex-matched healthy controls (HCs) from the Wellcome Trust NIMA consortium were re-analysed for the study. All the participants underwent full peripheral cytokine profiling and simultaneous [11C]PK11195 PET/structural MRI imaging for measuring neuroinflammation and CP volume respectively.</AbstractText>We found a significantly greater CP volume in depressed subjects compared to HCs (t(76)</sub> = +2.17) that was positively correlated with [11</sup>C]PK11195 PET binding in the anterior cingulate cortex (r&#xa0;=&#xa0;0.28, p&#xa0;=&#xa0;0.02), prefrontal cortex (r&#xa0;=&#xa0;0.24, p&#xa0;=&#xa0;0.04), and insular cortex (r&#xa0;=&#xa0;0.24, p&#xa0;=&#xa0;0.04), but not with the peripheral inflammatory markers: CRP levels (r&#xa0;=&#xa0;0.07, p&#xa0;=&#xa0;0.53), IL-6 (r&#xa0;=&#xa0;-0.08, p&#xa0;=&#xa0;0.61), and TNF-&#x3b1; (r&#xa0;=&#xa0;-0.06, p&#xa0;=&#xa0;0.70). The CP volume correlated with the [11</sup>C]PK11195 PET binding in CP (r&#xa0;=&#xa0;0.34, p&#xa0;=&#xa0;0.005). Integration of transcriptomic data from the Allen Human Brain Atlas with the brain map depicting the correlations between CP volume and PET imaging found significant gene enrichment for several pathways involved in neuroinflammatory response.</AbstractText>This result supports the hypothesis that changes in brain barriers may cause reduction in solute exchanges between blood and CSF, disturbing the brain homeostasis and ultimately contributing to inflammation in depression. Given that CP anomalies have been recently detected in other brain disorders, these results may not be specific to depression and might extend to other conditions with a peripheral inflammatory component.</AbstractText>Copyright &#xa9; 2021 The Author(s). Published by Elsevier Inc. All rights reserved.</CopyrightInformation>
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Prostaglandin analog effects on cerebrospinal fluid reabsorption via nasal mucosa.<Pagination><StartPage>e0248545</StartPage><MedlinePgn>e0248545</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">e0248545</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1371/journal.pone.0248545</ELocationID><Abstract><AbstractText Label="INTRODUCTION">Cerebrospinal fluid (CSF) outflow has been demonstrated along nasal lymphatics via olfactory nerve projections; flow may be increased by stimulating lymphatic contractility using agents such as noradrenaline and the thromboxane A2 analog U46619. Lymphatics elsewhere in the body show increased contractility upon exposure to the prostaglandin F2alpha analog isoprostane-8-epi-prostaglandin. We investigated the ability of ophthalmic prostaglandin F2alpha analogs to increase CSF outflow when applied to the nasal mucosa by inhalation.</AbstractText><AbstractText Label="METHODS">Latanoprost (0.1, 0.5, or 1mg/ml), bimatoprost (0.3 or 3mg/ml), travoprost (0.04 or 0.4mg/ml), latanoprostene bunod (0.24 or 2.4mg/ml), tafluprost (0.25 or 2.5mg/ml), or control vehicle (10% DMSO) was administered to awake adult C57B/6 mice by nasal inhalation of 2&#x3bc;l droplets. Multiday dosing (daily for 3 days) of latanoprost also was evaluated. A total of 81 animals were studied including controls. General anesthesia was induced by injection, and fluorescent tracer (AlexaFluor647-labelled ovalbumin) was injected under stereotaxic guidance into the right lateral ventricle. Nasal turbinate tissue was harvested and homogenized after 1 hour for tracer detection by ELISA and fluorometric analysis.</AbstractText><AbstractText Label="RESULTS">Inhalation of latanoprost 0.5mg/ml and 1mg/ml led to a 11.5-fold increase in tracer recovery from nasal turbinate tissues compared to controls (3312 pg/ml vs 288 pg/ml, p&lt;0.001 for 0.5mg/ml; 3355 pg/ml vs 288 pg/ml, p&lt;0.001 for 1mg/ml), while latanoprost 0.1 mg/ml enhanced recovery 6-fold (1713 pg/ml vs 288 pg/ml, p&lt;0.01). Tafluprost 0.25mg/ml and bimatoprost 0.3mg/ml showed a modest (1.4x, p&lt;0.05) effect, and the remaining agents showed no significant effect on tracer recovery. After 3 days of daily latanoprost treatment and several hours after the last dose, a persistently increased recovery of tracer was found.</AbstractText><AbstractText Label="CONCLUSIONS">Prostaglandin F2alpha analogs delivered by nasal inhalation resulted in increased nasal recovery of a CSF fluorescent tracer, implying increased CSF outflow via the nasal lymphatics. The greatest effect, partially dose-dependent, was observed using latanoprost. Further studies are needed to determine the efficacy of these agents in reducing ICP in short and long-term applications.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Pedler</LastName><ForeName>Michelle G</ForeName><Initials>MG</Initials><AffiliationInfo><Affiliation>Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, United States of America.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Petrash</LastName><ForeName>J Mark</ForeName><Initials>JM</Initials><Identifier Source="ORCID">0000-0002-6900-4240</Identifier><AffiliationInfo><Affiliation>Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, United States of America.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Subramanian</LastName><ForeName>Prem S</ForeName><Initials>PS</Initials><Identifier Source="ORCID">0000-0001-5824-8322</Identifier><AffiliationInfo><Affiliation>Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, United States of America.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado, United States of America.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado, United States of America.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Division of Ophthalmology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America.</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>2021</Year><Month>12</Month><Day>31</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>PLoS One</MedlineTA><NlmUniqueID>101285081</NlmUniqueID><ISSNLinking>1932-6203</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D005456">Fluorescent Dyes</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D011465">Prostaglandins, Synthetic</NameOfSubstance></Chemical><Chemical><RegistryNumber>6Z5B6HVF6O</RegistryNumber><NameOfSubstance UI="D000077338">Latanoprost</NameOfSubstance></Chemical><Chemical><RegistryNumber>B7IN85G1HY</RegistryNumber><NameOfSubstance UI="D015237">Dinoprost</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D065567" MajorTopicYN="Y">Absorption, Physiological</DescriptorName><QualifierName UI="Q000187" MajorTopicYN="N">drug effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000281" MajorTopicYN="N">Administration, Intranasal</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000818" MajorTopicYN="N">Animals</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002555" MajorTopicYN="N">Cerebrospinal Fluid</DescriptorName><QualifierName UI="Q000378" MajorTopicYN="Y">metabolism</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015237" MajorTopicYN="N">Dinoprost</DescriptorName><QualifierName UI="Q000031" MajorTopicYN="N">analogs &amp; derivatives</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005456" MajorTopicYN="N">Fluorescent Dyes</DescriptorName><QualifierName UI="Q000737" MajorTopicYN="N">chemistry</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005470" MajorTopicYN="N">Fluorometry</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000077338" MajorTopicYN="N">Latanoprost</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008810" MajorTopicYN="N">Mice, Inbred C57BL</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009297" MajorTopicYN="N">Nasal Mucosa</DescriptorName><QualifierName UI="Q000187" MajorTopicYN="N">drug effects</QualifierName><QualifierName UI="Q000378" MajorTopicYN="Y">metabolism</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011465" MajorTopicYN="N">Prostaglandins, Synthetic</DescriptorName><QualifierName UI="Q000494" MajorTopicYN="Y">pharmacology</QualifierName></MeshHeading></MeshHeadingList><CoiStatement>The authors have declared that no competing interests exist.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2021</Year><Month>2</Month><Day>25</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2021</Year><Month>11</Month><Day>8</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>12</Month><Day>31</Day><Hour>17</Hour><Minute>7</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2022</Year><Month>1</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2022</Year><Month>1</Month><Day>12</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">34971554</ArticleId><ArticleId IdType="pmc">PMC8719688</ArticleId><ArticleId IdType="doi">10.1371/journal.pone.0248545</ArticleId><ArticleId IdType="pii">PONE-D-21-06439</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>Bothwell SW, Janigro D, Patabendige A. 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Plos One. 2017;12(1):e0169683. doi: 10.1371/journal.pone.0169683</Citation><ArticleIdList><ArticleId IdType="doi">10.1371/journal.pone.0169683</ArticleId><ArticleId IdType="pmc">PMC5231387</ArticleId><ArticleId IdType="pubmed">28081184</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">34971417</PMID><DateRevised><Year>2021</Year><Month>12</Month><Day>31</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1875-8312</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2021</Year><Month>Dec</Month><Day>31</Day></PubDate></JournalIssue><Title>The international journal of cardiovascular imaging</Title><ISOAbbreviation>Int J Cardiovasc Imaging</ISOAbbreviation></Journal>Left ventricular structure and function in patients with chronic kidney disease assessed by 3D echocardiography: the CPH-CKD ECHO study.
Cardiovascular disease is the leading cause of mortality amongst patients with chronic kidney disease (CKD). This is the first study using 3-dimensional echocardiography (3DE) to investigate associations between adverse changes of the left ventricle, and different stages of CKD. Participants were recruited from the Copenhagen CKD cohort study and the Herlev-Gentofte CKD cohort study. Patients were stratified according to GFR category (G1&#x2009;+&#x2009;2: eGFR&#x2009;&#x2265;&#x2009;60&#xa0;mL/min/1.73&#xa0;m<sup>2</sup>, G3: eGFR&#x2009;=&#x2009;30-59&#xa0;mL/min/1.73&#xa0;m<sup>2</sup>, and G4&#x2009;+&#x2009;5: eGFR&#x2009;&#x2264;&#x2009;29&#xa0;mL/min/1.73&#xa0;m<sup>2</sup>), and according to albuminuria (A1: UACR&#x2009;&lt;&#x2009;30&#xa0;mg/g, A2: 30-300&#xa0;mg/g, A3:&#x2009;&gt;&#x2009;300&#xa0;mg/g). Echocardiograms were analysed for left ventricular (LV) mass index (LVMi), LV ejection fraction (LVEF), and global strain measures. In adjusted analysis, eGFR groups were adjusted for confounders and albuminuria category, while albuminuria groups were adjusted for confounders and GFR category. The study population consisted of 662 outpatients with CKD and 169 controls. Mean age was 57&#x2009;&#xb1;&#x2009;13&#xa0;years, and 61% were males. Mean LVEF and global longitudinal strain (GLS) were increasingly impaired across eGFR groups: LVEF&#x2009;=&#x2009;60.1%, 58.4%, and 57.8% (p&#x2009;=&#x2009;0.013), GLS&#x2009;=&#x2009;&#x2009;-&#x2009;16.1%,&#x2009;-&#x2009;14.8%, and&#x2009;-&#x2009;14.6% (p&#x2009;&lt;&#x2009;0.0001) for G1&#x2009;+&#x2009;2, G3, and G4&#x2009;+&#x2009;5. LVMi and prevalence of LV hypertrophy increased with albuminuria severity: mean LVMi&#x2009;=&#x2009;87.9&#xa0;g/m<sup>2</sup>, 88.1&#xa0;g/m<sup>2</sup>, and 92.1&#xa0;g/m<sup>2</sup> (p&#x2009;=&#x2009;0.007) from A1-3. Adjusted analysis confirmed reduced LVEF in G3 compared with G1&#x2009;+&#x2009;2, and increased LVMi in A3 compared with A1. Increasingly impaired eGFR was associated with adverse changes in LV systolic function, while albuminuria was associated with adverse changes in LV mass assessed by 3DE. Their associations were independent of each other.
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Effective Study: Development and Application of a Question-Driven, Time-Effective Cardiac Magnetic Resonance Scanning Protocol.
Background Long scanning times impede cardiac magnetic resonance (CMR) clinical uptake. A "one-size-fits-all" shortened, focused protocol (eg, only function and late-gadolinium enhancement) reduces scanning time and costs, but provides less information. We developed 2 question-driven CMR and stress-CMR protocols, including tailored advanced tissue characterization, and tested their effectiveness in reducing scanning time while retaining the diagnostic performances of standard protocols. Methods and Results Eighty three consecutive patients with cardiomyopathy or ischemic heart disease underwent the tailored CMR. Each scan consisted of standard cines, late-gadolinium enhancement imaging, native T1-mapping, and extracellular volume. Fat/edema modules, right ventricle cine, and in-line quantitative perfusion mapping were performed as clinically required. Workflow was optimized to avoid gaps. Time target was &lt;30&#xa0;minutes for a CMR and &lt;35&#xa0;minutes for a stress-CMR. CMR was considered impactful when its results drove changes in diagnosis or management. Advanced tissue characterization was considered impactful when it changed the confidence level in the diagnosis. The quality of the images was assessed. A control group of 137 patients was identified among scans performed before February 2020. Compared with standard protocols, the average scan duration dropped by &gt;30% (CMR: from 42&#xb1;8 to 28&#xb1;6&#xa0;minutes; stress-CMR: from 50&#xb1;10 to 34&#xb1;6&#xa0;minutes, both <i>P</i>&lt;0.0001). Independent on the protocol, CMR was impactful in &#x2248;60% cases, and advanced tissue characterization was impactful in &gt;45% of cases. Quality grading was similar between the 2 protocols. Tailored protocols did not require additional staff. Conclusions Tailored CMR and stress-CMR protocols including advanced tissue characterization are accurate and time-effective for cardiomyopathies and ischemic heart disease.
2,330,536
Anatomy of the conduction tissues 100 years on: what have we learned?<Pagination><StartPage>1430</StartPage><EndPage>1437</EndPage><MedlinePgn>1430-1437</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1136/heartjnl-2021-320304</ELocationID><Abstract><AbstractText>Knowledge of the anatomy of the 'conduction tissues' of the heart is a 20th century phenomenon. Although controversies still continue on the topic, most could have been avoided had greater attention been paid to the original descriptions. All cardiomyocytes, of course, have the capacity to conduct the cardiac impulse. The tissues specifically described as 'conducting' first generate the cardiac impulse, and then deliver it in such a fashion that the ventricles contract in orderly fashion. The tissues cannot readily be distinguished by gross inspection. Robust definitions for their recognition had been provided by the end of the first decade of the 20th century. These definitions retain their currency. The sinus node lies as a cigar-shaped structure subepicardially within the terminal groove. There is evidence that it is associated with a paranodal area that may have functional significance. Suggestions of dual nodes, however, are without histological confirmation. The atrioventricular node is located within the triangle of Koch, with significant inferior extensions occupying the atrial vestibules and with septal connections. The conduction axis penetrates the insulating plane of the atrioventricular junctions to continue as the ventricular pathways. Remnants of a ring of cardiomyocytes observed during development are also to be found within the atrial vestibules, particularly a prominent retroaortic remnant, although that their role has still to be determined. Application of the initial criteria for nodes and tracts shows that there are no special 'conducting tissues' in the pulmonary venous sleeves that might underscore the abnormal rhythm of atrial fibrillation.</AbstractText><CopyrightInformation>&#xa9; Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>S&#xe1;nchez-Quintana</LastName><ForeName>Dami&#xe1;n</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Anatomy and Cell Biology, Universidad de Extremadura, Badajoz, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Anderson</LastName><ForeName>Robert H</ForeName><Initials>RH</Initials><Identifier Source="ORCID">0000-0001-5163-9021</Identifier><AffiliationInfo><Affiliation>Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK sejjran@ucl.ac.uk.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tretter</LastName><ForeName>Justin T</ForeName><Initials>JT</Initials><Identifier Source="ORCID">0000-0001-8926-3752</Identifier><AffiliationInfo><Affiliation>Heart Institute, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cabrera</LastName><ForeName>Jos&#xe9; Angel</ForeName><Initials>JA</Initials><AffiliationInfo><Affiliation>Department of Cardiology, Hospital Universitario Quir&#xf3;n-Madrid, European University of Madrid, Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sternick</LastName><ForeName>Eduardo Back</ForeName><Initials>EB</Initials><Identifier Source="ORCID">0000-0003-3249-3711</Identifier><AffiliationInfo><Affiliation>Department of Arrhythmia and Electrophysiology, Biocor Institute, Nova Lima, Brazil.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Farr&#xe9;</LastName><ForeName>Jer&#xf3;nimo</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Madrid Autonomous University, Fundaci&#xf3;n Jim&#xe9;nez D&#xed;az Hospital, Madrid, Spain.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2022</Year><Month>08</Month><Day>25</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Heart</MedlineTA><NlmUniqueID>9602087</NlmUniqueID><ISSNLinking>1355-6037</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D001281" MajorTopicYN="Y">Atrial Fibrillation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001283" MajorTopicYN="N">Atrioventricular Node</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006329" MajorTopicYN="Y">Heart Conduction System</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006339" MajorTopicYN="N">Heart Rate</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012849" MajorTopicYN="N">Sinoatrial Node</DescriptorName><QualifierName UI="Q000033" MajorTopicYN="N">anatomy &amp; histology</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">arrhythmias</Keyword><Keyword MajorTopicYN="N">cardiac</Keyword><Keyword MajorTopicYN="N">electrophysiology</Keyword><Keyword MajorTopicYN="N">supraventricular</Keyword><Keyword MajorTopicYN="N">tachycardia</Keyword></KeywordList><CoiStatement>Competing interests: None declared.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2021</Year><Month>10</Month><Day>29</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2021</Year><Month>11</Month><Day>30</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2022</Year><Month>1</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2022</Year><Month>8</Month><Day>30</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>12</Month><Day>31</Day><Hour>5</Hour><Minute>51</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">34969873</ArticleId><ArticleId IdType="doi">10.1136/heartjnl-2021-320304</ArticleId><ArticleId IdType="pii">heartjnl-2021-320304</ArticleId></ArticleIdList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">34969648</PMID><DateRevised><Year>2021</Year><Month>12</Month><Day>31</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">2531-0437</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2021</Year><Month>Dec</Month><Day>28</Day></PubDate></JournalIssue><Title>Pulmonology</Title><ISOAbbreviation>Pulmonology</ISOAbbreviation></Journal>Severity of precapillary pulmonary hypertension: Predictive factor.
Knowledge of the anatomy of the 'conduction tissues' of the heart is a 20th century phenomenon. Although controversies still continue on the topic, most could have been avoided had greater attention been paid to the original descriptions. All cardiomyocytes, of course, have the capacity to conduct the cardiac impulse. The tissues specifically described as 'conducting' first generate the cardiac impulse, and then deliver it in such a fashion that the ventricles contract in orderly fashion. The tissues cannot readily be distinguished by gross inspection. Robust definitions for their recognition had been provided by the end of the first decade of the 20th century. These definitions retain their currency. The sinus node lies as a cigar-shaped structure subepicardially within the terminal groove. There is evidence that it is associated with a paranodal area that may have functional significance. Suggestions of dual nodes, however, are without histological confirmation. The atrioventricular node is located within the triangle of Koch, with significant inferior extensions occupying the atrial vestibules and with septal connections. The conduction axis penetrates the insulating plane of the atrioventricular junctions to continue as the ventricular pathways. Remnants of a ring of cardiomyocytes observed during development are also to be found within the atrial vestibules, particularly a prominent retroaortic remnant, although that their role has still to be determined. Application of the initial criteria for nodes and tracts shows that there are no special 'conducting tissues' in the pulmonary venous sleeves that might underscore the abnormal rhythm of atrial fibrillation.<CopyrightInformation>&#xa9; Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>S&#xe1;nchez-Quintana</LastName><ForeName>Dami&#xe1;n</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Anatomy and Cell Biology, Universidad de Extremadura, Badajoz, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Anderson</LastName><ForeName>Robert H</ForeName><Initials>RH</Initials><Identifier Source="ORCID">0000-0001-5163-9021</Identifier><AffiliationInfo><Affiliation>Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK sejjran@ucl.ac.uk.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tretter</LastName><ForeName>Justin T</ForeName><Initials>JT</Initials><Identifier Source="ORCID">0000-0001-8926-3752</Identifier><AffiliationInfo><Affiliation>Heart Institute, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cabrera</LastName><ForeName>Jos&#xe9; Angel</ForeName><Initials>JA</Initials><AffiliationInfo><Affiliation>Department of Cardiology, Hospital Universitario Quir&#xf3;n-Madrid, European University of Madrid, Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sternick</LastName><ForeName>Eduardo Back</ForeName><Initials>EB</Initials><Identifier Source="ORCID">0000-0003-3249-3711</Identifier><AffiliationInfo><Affiliation>Department of Arrhythmia and Electrophysiology, Biocor Institute, Nova Lima, Brazil.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Farr&#xe9;</LastName><ForeName>Jer&#xf3;nimo</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Madrid Autonomous University, Fundaci&#xf3;n Jim&#xe9;nez D&#xed;az Hospital, Madrid, Spain.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2022</Year><Month>08</Month><Day>25</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Heart</MedlineTA><NlmUniqueID>9602087</NlmUniqueID><ISSNLinking>1355-6037</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D001281" MajorTopicYN="Y">Atrial Fibrillation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001283" MajorTopicYN="N">Atrioventricular Node</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006329" MajorTopicYN="Y">Heart Conduction System</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006339" MajorTopicYN="N">Heart Rate</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012849" MajorTopicYN="N">Sinoatrial Node</DescriptorName><QualifierName UI="Q000033" MajorTopicYN="N">anatomy &amp; histology</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">arrhythmias</Keyword><Keyword MajorTopicYN="N">cardiac</Keyword><Keyword MajorTopicYN="N">electrophysiology</Keyword><Keyword MajorTopicYN="N">supraventricular</Keyword><Keyword MajorTopicYN="N">tachycardia</Keyword></KeywordList><CoiStatement>Competing interests: None declared.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2021</Year><Month>10</Month><Day>29</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2021</Year><Month>11</Month><Day>30</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2022</Year><Month>1</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2022</Year><Month>8</Month><Day>30</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>12</Month><Day>31</Day><Hour>5</Hour><Minute>51</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">34969873</ArticleId><ArticleId IdType="doi">10.1136/heartjnl-2021-320304</ArticleId><ArticleId IdType="pii">heartjnl-2021-320304</ArticleId></ArticleIdList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">34969648</PMID><DateRevised><Year>2021</Year><Month>12</Month><Day>31</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">2531-0437</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2021</Year><Month>Dec</Month><Day>28</Day></PubDate></JournalIssue><Title>Pulmonology</Title><ISOAbbreviation>Pulmonology</ISOAbbreviation></Journal><ArticleTitle>Severity of precapillary pulmonary hypertension: Predictive factor.</ArticleTitle><ELocationID EIdType="pii" ValidYN="Y">S2531-0437(21)00226-9</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.pulmoe.2021.11.007</ELocationID><Abstract><AbstractText Label="BACKGROUND AND OBJECTIVES" NlmCategory="OBJECTIVE">Patients with pulmonary arterial hypertension (PAH) require risk assessments for prognosis and appropriate therapy. These assessments need to be improved by incorporating clinical and laboratory data such as the analysis of the right ventricle. We aim to establish echocardiographic morphometric data of the right ventricle and its relationship with the left ventricle, to estimate the hemodynamic severity of precapillary pulmonary hypertension (PHprecapillary).<AbstractText Label="METHODS" NlmCategory="METHODS">This cohort, prospective, observational, and cross-sectional study included 41 consecutive patients with PHprecapillary using echocardiographic study and cardiac catheterization.<AbstractText Label="RESULTS" NlmCategory="RESULTS">Patients' mean age was 44.0&#xb1;16.4 years, and 37 were women (90.2%). Idiopathic PAH was diagnosed in 18 patients (43.9%). The World Health Organization/New York Association functional class was III or IV in 31 patients (75.6%). The ratio of the right to left ventricles (RV/LV) echocardiographic diastolic diameters was associated with pulmonary arterial pressures in cardiac catheterization, with the best cutoff per receiver operating characteristic curve being 0.8 for systolic pressure (sensitivity 90.0%, specificity 78.3%, area under the curve [AUC] 0.882) and mean pressure (sensitivity 60.0%, specificity 95.7%, AUC 0.823). Spearman's correlation (R) of RV/LV echocardiographic ratio and the hemodynamic variables was significant for systolic pressure (R&#xa0;=&#xa0;0.7015, p&#xa0;&lt;&#xa0;0.0001), mean pressure (R&#xa0;=&#xa0;0.6332, p&#xa0;&lt;&#xa0;0.0001), transpulmonary pressure gradient (R&#xa0;=&#xa0;0.6524, p&#xa0;&lt;&#xa0;0.0001), pulmonary vascular resistance (R&#xa0;=&#xa0;0.6076, p&#xa0;=&#xa0;0.0021), and pulmonary vascular resistance index (R&#xa0;=&#xa0;0.6229, p&#xa0;=&#xa0;0.0014).<AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">The ratio of RV/LV echocardiographic diastolic diameters contribute to the estimates the hemodynamic severity of precapillary pulmonary hypertension. The best cutoff for this assessment was RV/LV of 0.8.
2,330,537
Modification of gene expression and soluble factor secretion in the lateral ventricle choroid plexus: Analysis of the impacts on the neocortical development.
The choroid plexus (ChP) is the center of soluble factor secretion into the cerebrospinal fluid in the central nervous system. It is known that various signaling factors secreted from the ChP are involved in the regulation of brain development and homeostasis. Intriguingly, the size of the ChP was prominently expanded in the brains of primates, including humans, suggesting that the expansion of the ChP contributed to mammalian brain evolution, leading to the acquisition of higher intelligence and cognitive functions. To address this hypothesis, we established transgenic (Tg) systems using regulatory elements that direct expression of candidate genes in the ChP. Overexpression of sonic hedgehog (Shh) in the developing ChP led to the expansion of the ChP with greater arborization. Shh produced in the ChP caused an increase in neural stem cells (NSCs) in the neocortical region, leading to the expansion of ventricles, ventricular zone and neocortical surface area, and neocortical surface folding. These findings suggest that the activation of Shh signaling via its enhanced secretion from the developing ChP contributed to the evolution of the neocortex. Furthermore, we found that Shh produced in the ChP enhanced NSC proliferation in the postnatal Tg brain, demonstrating that our Tg system can be used to estimate the effects of candidate factors secreted from the ChP on various aspects of brain morphogenesis and functions.
2,330,538
The morphologic analysis of a not well-known anatomical structure's calcifications (Bochdalek's flower basket calcifications).
The aim of the study was to define the morphology of calcifications belonging to a not very well-known anatomical structure (calcification of foramen of Luschka/Bochdalek's flower basket calcification [Boc FBC]).</AbstractText>Two hundred sixty-four computed tomography (CT) scans obtained from healthy patients were included in the study (50.0038 &#xb1; 24.78309 [0-92 years old] [mean age &#xb1; standard deviation; range]). The morphology of the calcifications in the fourth ventricle (CFV) and Boc FBC was evaluated and compared with other common intracranial calcifications in each patient.</AbstractText>Boc FBC was detected in 22.35% (59/264) of the patients. Out of 101 patients aged above 60 years, 59 presented Boc FBC (the rate increased to 55.45%), thus in our sample 94.91% of the detected Boc FBCs (56/59) were seen after 60 years of age. No Boc FBC was found under the age of 50. Statistically, there was a highly significant correlation between Boc FBC and pineal/habenular (p &lt; 0.01) as well as choroid plexus calcifications (p &lt; 0.01). The correlation between CFV and Boc FBC was significant (p &lt; 0.05). It was found that 37.3% of Boc FBCs had a conical form. This form was not accompanied by any vascular calcifications, either basilar or vertebral. Therefore, seeing the conical form was valuable in the differential diagnosis.</AbstractText>In our study, Boc FBCs were seen in advanced age and were not encountered under the age of 50. The conical form was seen in one-third of the cases, but it was a very beneficial finding for distinguishing Boc FBC from other calcifications if any. In the advanced age group, calcifications, especially choroid plexus calcifications and pineal/habenular calcifications, are highly associated with Boc FBC. In the presence of CFV, the probability of encountering Boc FBC is very high.</AbstractText>
2,330,539
RELATIVE TELOMERE LENGTH OF PERIPHERAL BLOOD LYMPHOCYTES AND STRUCTURAL AND FUNCTIONAL STATE OF THE LEFT VENTRICLE MYOCARDIUM IN CLEAN-UP WORKERS OF THE CHORNOBYL ACCIDENT WHO SUFFERED FROM STENOTIC CORONARY ATHEROSCLEROSIS.<Pagination><StartPage>319</StartPage><EndPage>338</EndPage><MedlinePgn>319-338</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.33145/2304-8336-2021-26-319-338</ELocationID><Abstract><AbstractText Label="UNLABELLED">The objective was to analyze the relative telomere length (RTL) of peripheral blood lymphocytes depending onmyocardium structural and functional state in emergency workers (EW) of the Chornobyl accident who suffered fromcoronary arteries stenotic atherosclerosis.</AbstractText><AbstractText Label="MATERIALS AND METHODS" NlmCategory="METHODS">There were examined 60 male EW who operated at the Chornobyl nuclear power plant at1986 and 25 male non-irradiated persons (control group - CG) with coronary heart disease (CHD). Everyone EW andCG patients were almost healthy before the accident. During the period 2016-2021, they underwent a comprehen-sive clinical and laboratory examination, echodopplercardiographic examination and determination of RTL by fluo-rescent hybridization in situ using laser flow cytometry.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">EW almost did not differ from CG according to its clinical characteristics, the presence of risk factors,indices of systolic and diastolic heart functions, as well as RTL. The analysis of variance showed that RTL was influ-enced by the fact of irradiation in combination with obesity (p = 0.020). At normal body weight, RTL average valuein CG was significantly higher than in EW (p = 0.023). According to the results of hierarchical cluster analysis of twovariables as RTL and end-diastolic volume normalized by body surface area (EDV/BSA), EW and CG patients togeth-er were divided into two subgroups. The first subgroup (1st cluster) differed from the second (2nd cluster) by signi-ficantly larger average values of left ventricle (LV) EDV and end-systolic volume (ESV) as well as EDV/BSA andESV/BSA, LV myocardial mass (MM) and MM/BSA, reduced ejection fraction (EF). In patients of the 1st cluster telom-eres were significantly shorter than in the 2nd one (10,3 &#xb1; 1.7 vs. 14.3 &#xb1; 2.0 at p = 0.000). The increase of myocar-dial mass and LV wall thickness caused the development of its hypertrophy. The number of people with hypertrophyLV was significantly higher among patients of the 1st cluster (91.6 vs. 67.2 %, p &lt; 0.001) due to eccentric hypertro-phy LV. Accordingly, concentric hypertrophy LV was more common among patients in the 2nd cluster (24.6 vs. 4.2 %at p &lt; 0.01). Patients of the 1st cluster was characterized by a more severe course of heart failure.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">In patients who suffered from CHD with stenotic atherosclerosis of the coronary arteries and wereexposed to radiation 30-35 years earlier, having normal body weight, there was a reduction in telomere. Hierarchicalcluster analysis proved to be a good tool that allows by the value of RTL and EDV/BSA to separate the group ofpatients with the most severe clinical course of CHD and LV systolic dysfunction among patients with the samepathology.</AbstractText><CopyrightInformation>D. O. Belyi, I. Ilyenko, &#x41e;. Nastina, G. Sydorenko, Z. Gabulavichene, N. Kursina, O. Bazyka, V. Bilaya, O. Kovaliov, D. Bazyka.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Belyi</LastName><ForeName>D O</ForeName><Initials>DO</Initials><AffiliationInfo><Affiliation>State Institution &#xab;National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine&#xbb;, 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ilyenko</LastName><ForeName>I</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>State Institution &#xab;National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine&#xbb;, 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nastina</LastName><ForeName>O</ForeName><Initials>O</Initials><AffiliationInfo><Affiliation>State Institution &#xab;National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine&#xbb;, 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sydorenko</LastName><ForeName>G</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>State Institution &#xab;National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine&#xbb;, 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gabulavichene</LastName><ForeName>Z</ForeName><Initials>Z</Initials><AffiliationInfo><Affiliation>State Institution &#xab;National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine&#xbb;, 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kursina</LastName><ForeName>N</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>State Institution &#xab;National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine&#xbb;, 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bazyka</LastName><ForeName>O</ForeName><Initials>O</Initials><AffiliationInfo><Affiliation>State Institution &#xab;National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine&#xbb;, 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bilaya</LastName><ForeName>V</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>State Institution &#xab;National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine&#xbb;, 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kovaliov</LastName><ForeName>O</ForeName><Initials>O</Initials><AffiliationInfo><Affiliation>State Institution &#xab;National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine&#xbb;, 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bazyka</LastName><ForeName>D</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>State Institution &#xab;National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine&#xbb;, 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><Language>ukr</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><VernacularTitle>VIDNOSNA DOVZhYNA TELOMER LIMFOTsYTIV PERYFERYChNO&#xcf; KROVI TA STRUKTURNO-FUNKTsIONAL'NY&#x12c; STAN MIOKARDA LIVOGO ShLUNOChKA SERTsIa V UChASNYKIV LIKVIDATsI&#xcf; NASLIDKIV ChORNOBYL'S'KO&#xcf; AVARI&#xcf; ZI STENOZUIuChYM ATEROSKLEROZOM KORONARNYKh ARTERI&#x12c;.</VernacularTitle></Article><MedlineJournalInfo><Country>Ukraine</Country><MedlineTA>Probl Radiac Med Radiobiol</MedlineTA><NlmUniqueID>101560511</NlmUniqueID><ISSNLinking>2304-8336</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000016" MajorTopicYN="N">Abnormalities, Radiation-Induced</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000503" MajorTopicYN="Y">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016022" MajorTopicYN="N">Case-Control Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D047852" MajorTopicYN="N">Chernobyl Nuclear Accident</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003324" MajorTopicYN="N">Coronary Artery Disease</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000503" MajorTopicYN="Y">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D060731" MajorTopicYN="N">Emergency Responders</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics &amp; numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006352" MajorTopicYN="N">Heart Ventricles</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="Y">physiopathology</QualifierName><QualifierName UI="Q000528" MajorTopicYN="Y">radiation effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008214" MajorTopicYN="N">Lymphocytes</DescriptorName><QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000069079" MajorTopicYN="N">Radiation Exposure</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011832" MajorTopicYN="N">Radiation Injuries</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018788" MajorTopicYN="N">Radioactive Hazard Release</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="N">statistics &amp; numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D059506" MajorTopicYN="N">Telomere Shortening</DescriptorName><QualifierName UI="Q000528" MajorTopicYN="Y">radiation effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014455" MajorTopicYN="N" Type="Geographic">Ukraine</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading></MeshHeadingList><OtherAbstract Type="Publisher" Language="ukr"><AbstractText>Meta doslidzhennia: provesty analiz vidnosno&#xef; dovzhyny telomer (VDT) limfotsytiv peryferychno&#xef; krovi v uchas-nykiv likvidatsi&#xef; naslidkiv avari&#xef; (ULNA) na Chornobyl's'ki&#x12d; AES (ChAES) zi stenozuiuchym aterosklerozom koro-narnykh arteri&#x12d; zalezhno vid strukturno-funktsional'nogo stanu miokarda.Materialy ta metody. V doslidzhenni obstezheni 60 ULNA na ChAES 1986 roku i 25 neoprominenykh osib (kontrol'-na grupa &#x2013; KG) cholovicho&#xef; stati z IKhS. Vsi ULNA ta patsiienty KG do avari&#xef; buly praktychno zdorovymy. Za period2016&#x2013;2021 rr. vony pro&#x12d;shly kompleksne kliniko-laboratorne obstezhennia, ekhodopplerkardiografichnedoslidzhennia i vyznachennia VDT metodom fluorestsentno&#xef; gibrydyzatsi&#xef; in situ za dopomogoiu lazerno&#xef; protochno&#xef;tsytometri&#xef;.Rezul'taty. Za svoieiu klinichnoiu kharakterystykoiu, naiavnistiu faktoriv ryzyku, pokaznykamy systolichno&#xef; i dias-tolichno&#xef; funktsi&#x12d; sertsia, a takozh za VDT ULNA praktychno ne vidriznialysia vid KG. Provedeny&#x12d; dyspersi&#x12d;ny&#x12d;analiz pokazav, shcho na VDT vplyvav fakt oprominennia v poiednanni z ozhyrinniam (p = 0,020). Pry normal'ni&#x12d; masitila serednie znachennia VDT v KG bulo dostovirno vyshchym, nizh v ULNA (p = 0,023). Za rezul'tatamy iierarkhichnogoklasternogo analizu dvokh zminnykh &#x2013; VDT ta indeksu kintsevo-diastolichnogo ob&#x2019;iemu, ULNA i patsiienty KG buly roz-podileni na dvi pidgrupy. Persha pidgrupa (1-&#x12d; klaster) vidriznialasia vid drugo&#xef; (2-&#x12d; klaster) virogidno bil'shymyserednimy pokaznykamy kintsevo-diastolichnogo ob&#x2019;iemu i kintsevo-systolichnogo ob&#x2019;iemu livogo shlunochka (LSh) ta&#xef;khnikh indeksiv, masy miokarda LSh ta &#x12d;ogo indeksu, znyzhenoiu fraktsiieiu vykydu (FV). U patsiientiv 1-go klasterutelomery buly virogidno korotshi, nizh u 2-go (10,0 &#xb1; 1,7 proty 14,3 &#xb1; 2,0 pry p = 0,000). Zbil'shennia masy miokar-da i tovshchyny stinok LSh obumovliuvalo rozvytok &#x12d;ogo gipertrofi&#xef;. Chyslo osib z gipertrofiieiu LSh bulo dos-tovirno vyshche sered patsiientiv 1-go klasteru (91,6 % proty 67,2 %, p &lt; 0,001) za rakhunok ekstsentrychno&#xef; gipert-rofi&#xef; LSh. Vidpovidno sered patsiientiv 2-go klasteru chastishe zustrichalas' kontsentrychna gipertrofiia LSh (24,6 %proty 4,2 % pry p &lt; 0,01). Dlia patsiientiv 1-go klasteru buv kharakterny&#x12d; bil'sh tiazhky&#x12d; perebig sertsevo&#xef; nedos-tatnosti.Vysnovky. U khvorykh na ishemichnu khvorobu sertsia zi stenozuiuchym aterosklerozom koronarnykh arteri&#x12d;, iaki zazna-ly oprominennia 30&#x2013;35 rokiv tomu, z normal'noiu masoiu tila sposterigalos' skorochennia telomer. Iierarkhichny&#x12d;klasterny&#x12d; analiz pokazav sebe garnym instrumentom, shcho dozvoliaie sered khvorykh z odnakovoiu patologiieiu za po-kaznykamy VDT ta indeksu kintsevo-diastolichnogo ob&#x2019;iemu vidokremyty grupu patsiientiv z na&#x12d;bil'sh tiazhkymklinichnym perebigom ishemichno&#xef; khvoroby sertsia i porushenniam systolichno&#xef; funktsi&#xef; LSh.Kliuchovi slova: uchasnyky likvidatsi&#xef; naslidkiv avari&#xef; na Chornobyl's'ki&#x12d; AES, radiatsi&#x12d;ny&#x12d; vplyv, ishemichna khvo-roba sertsia, stenozuiuchy&#x12d; ateroskleroz koronarnykh arteri&#x12d;, infarkt miokarda, vidnosna dovzhyna telomer,kintsevo-diastolichny&#x12d; ob&#x2019;iem.</AbstractText><CopyrightInformation>D. O. Belyi, I. Ilyenko, &#x41e;. Nastina, G. Sydorenko, Z. Gabulavichene, N. Kursina, O. Bazyka, V. Bilaya, O. Kovaliov, D. Bazyka.</CopyrightInformation></OtherAbstract><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">coronary heart disease</Keyword><Keyword MajorTopicYN="N">emergency workers of the accident at the Chornobyl NPP</Keyword><Keyword MajorTopicYN="N">end-diastolic volume</Keyword><Keyword MajorTopicYN="N">myocardial infarction</Keyword><Keyword MajorTopicYN="N">radiation exposure</Keyword><Keyword MajorTopicYN="N">relative telomere length</Keyword><Keyword MajorTopicYN="N">stenotic atherosclerosis of the coronary arteries</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2021</Year><Month>8</Month><Day>28</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>12</Month><Day>29</Day><Hour>20</Hour><Minute>10</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>12</Month><Day>30</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2022</Year><Month>2</Month><Day>19</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">34965558</ArticleId><ArticleId IdType="doi">10.33145/2304-8336-2021-26-319-338</ArticleId></ArticleIdList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">34965150</PMID><DateRevised><Year>2021</Year><Month>12</Month><Day>29</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1744-4160</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2021</Year><Month>Dec</Month><Day>29</Day></PubDate></JournalIssue><Title>Archives of physiology and biochemistry</Title><ISOAbbreviation>Arch Physiol Biochem</ISOAbbreviation></Journal>Acylated ghrelin protection inhibits apoptosis in the remote myocardium post-myocardial infarction by inhibiting calcineurin and activating ARC.
Meta doslidzhennia: provesty analiz vidnosno&#xef; dovzhyny telomer (VDT) limfotsytiv peryferychno&#xef; krovi v uchas-nykiv likvidatsi&#xef; naslidkiv avari&#xef; (ULNA) na Chornobyl's'ki&#x12d; AES (ChAES) zi stenozuiuchym aterosklerozom koro-narnykh arteri&#x12d; zalezhno vid strukturno-funktsional'nogo stanu miokarda.Materialy ta metody. V doslidzhenni obstezheni 60 ULNA na ChAES 1986 roku i 25 neoprominenykh osib (kontrol'-na grupa &#x2013; KG) cholovicho&#xef; stati z IKhS. Vsi ULNA ta patsiienty KG do avari&#xef; buly praktychno zdorovymy. Za period2016&#x2013;2021 rr. vony pro&#x12d;shly kompleksne kliniko-laboratorne obstezhennia, ekhodopplerkardiografichnedoslidzhennia i vyznachennia VDT metodom fluorestsentno&#xef; gibrydyzatsi&#xef; in situ za dopomogoiu lazerno&#xef; protochno&#xef;tsytometri&#xef;.Rezul'taty. Za svoieiu klinichnoiu kharakterystykoiu, naiavnistiu faktoriv ryzyku, pokaznykamy systolichno&#xef; i dias-tolichno&#xef; funktsi&#x12d; sertsia, a takozh za VDT ULNA praktychno ne vidriznialysia vid KG. Provedeny&#x12d; dyspersi&#x12d;ny&#x12d;analiz pokazav, shcho na VDT vplyvav fakt oprominennia v poiednanni z ozhyrinniam (p = 0,020). Pry normal'ni&#x12d; masitila serednie znachennia VDT v KG bulo dostovirno vyshchym, nizh v ULNA (p = 0,023). Za rezul'tatamy iierarkhichnogoklasternogo analizu dvokh zminnykh &#x2013; VDT ta indeksu kintsevo-diastolichnogo ob&#x2019;iemu, ULNA i patsiienty KG buly roz-podileni na dvi pidgrupy. Persha pidgrupa (1-&#x12d; klaster) vidriznialasia vid drugo&#xef; (2-&#x12d; klaster) virogidno bil'shymyserednimy pokaznykamy kintsevo-diastolichnogo ob&#x2019;iemu i kintsevo-systolichnogo ob&#x2019;iemu livogo shlunochka (LSh) ta&#xef;khnikh indeksiv, masy miokarda LSh ta &#x12d;ogo indeksu, znyzhenoiu fraktsiieiu vykydu (FV). U patsiientiv 1-go klasterutelomery buly virogidno korotshi, nizh u 2-go (10,0 &#xb1; 1,7 proty 14,3 &#xb1; 2,0 pry p = 0,000). Zbil'shennia masy miokar-da i tovshchyny stinok LSh obumovliuvalo rozvytok &#x12d;ogo gipertrofi&#xef;. Chyslo osib z gipertrofiieiu LSh bulo dos-tovirno vyshche sered patsiientiv 1-go klasteru (91,6 % proty 67,2 %, p &lt; 0,001) za rakhunok ekstsentrychno&#xef; gipert-rofi&#xef; LSh. Vidpovidno sered patsiientiv 2-go klasteru chastishe zustrichalas' kontsentrychna gipertrofiia LSh (24,6 %proty 4,2 % pry p &lt; 0,01). Dlia patsiientiv 1-go klasteru buv kharakterny&#x12d; bil'sh tiazhky&#x12d; perebig sertsevo&#xef; nedos-tatnosti.Vysnovky. U khvorykh na ishemichnu khvorobu sertsia zi stenozuiuchym aterosklerozom koronarnykh arteri&#x12d;, iaki zazna-ly oprominennia 30&#x2013;35 rokiv tomu, z normal'noiu masoiu tila sposterigalos' skorochennia telomer. Iierarkhichny&#x12d;klasterny&#x12d; analiz pokazav sebe garnym instrumentom, shcho dozvoliaie sered khvorykh z odnakovoiu patologiieiu za po-kaznykamy VDT ta indeksu kintsevo-diastolichnogo ob&#x2019;iemu vidokremyty grupu patsiientiv z na&#x12d;bil'sh tiazhkymklinichnym perebigom ishemichno&#xef; khvoroby sertsia i porushenniam systolichno&#xef; funktsi&#xef; LSh.Kliuchovi slova: uchasnyky likvidatsi&#xef; naslidkiv avari&#xef; na Chornobyl's'ki&#x12d; AES, radiatsi&#x12d;ny&#x12d; vplyv, ishemichna khvo-roba sertsia, stenozuiuchy&#x12d; ateroskleroz koronarnykh arteri&#x12d;, infarkt miokarda, vidnosna dovzhyna telomer,kintsevo-diastolichny&#x12d; ob&#x2019;iem.<CopyrightInformation>D. O. Belyi, I. Ilyenko, &#x41e;. Nastina, G. Sydorenko, Z. Gabulavichene, N. Kursina, O. Bazyka, V. Bilaya, O. Kovaliov, D. Bazyka.</CopyrightInformation></OtherAbstract><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">coronary heart disease</Keyword><Keyword MajorTopicYN="N">emergency workers of the accident at the Chornobyl NPP</Keyword><Keyword MajorTopicYN="N">end-diastolic volume</Keyword><Keyword MajorTopicYN="N">myocardial infarction</Keyword><Keyword MajorTopicYN="N">radiation exposure</Keyword><Keyword MajorTopicYN="N">relative telomere length</Keyword><Keyword MajorTopicYN="N">stenotic atherosclerosis of the coronary arteries</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2021</Year><Month>8</Month><Day>28</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>12</Month><Day>29</Day><Hour>20</Hour><Minute>10</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>12</Month><Day>30</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2022</Year><Month>2</Month><Day>19</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">34965558</ArticleId><ArticleId IdType="doi">10.33145/2304-8336-2021-26-319-338</ArticleId></ArticleIdList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">34965150</PMID><DateRevised><Year>2021</Year><Month>12</Month><Day>29</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1744-4160</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2021</Year><Month>Dec</Month><Day>29</Day></PubDate></JournalIssue><Title>Archives of physiology and biochemistry</Title><ISOAbbreviation>Arch Physiol Biochem</ISOAbbreviation></Journal><ArticleTitle>Acylated ghrelin protection inhibits apoptosis in the remote myocardium post-myocardial infarction by inhibiting calcineurin and activating ARC.</ArticleTitle><Pagination><StartPage>1</StartPage><EndPage>15</EndPage><MedlinePgn>1-15</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1080/13813455.2021.2017463</ELocationID><Abstract>This study investigated if acylated ghrelin (AG) could inhibit myocardial infarction (MI)-induced apoptosis in the left ventricles (LV) of male rats and tested if this protection involves modulating ARC anti-apoptotic protein. Rats (<i>n</i>&#x2009;=&#x2009;12/group) were assigned as a sham-operated, a sham&#x2009;+&#x2009;AG (100 &#xb5;g/kg, 2x/d, S.C.), MI, and MI&#x2009;+&#x2009;AG. With no antioxidant activity or expression of FAS, AG inhibited caspase-3, 8, and 9 and decreased cytosolic/mitochondrial levels of cytochrome-c, Bax, Bad, and Bad-BCL-2 complex in the LVs of the sham-operated and MI-treated rats. Concomitantly, AG preserved the mitochondria structure, decreased mtPTP, and enhanced state-3 respiration in the LVs of both treated groups. These effects were associated with increased mitochondrial levels of ARC and a reduction in the activity of calcineurin. Overall, AG suppresses MI-induced ventricular apoptosis by inhibition of calcineurin, activation of ARC, and preserving mitochondria integrity.
2,330,540
Agreement Between Automated and Manual MRI Volumetry in Alzheimer's Disease: A Systematic Review and Meta-Analysis.
Automated magnetic resonance imaging (MRI) volumetry is a promising tool to evaluate regional brain volumes in dementia and especially Alzheimer's disease (AD).</AbstractText>To compare automated methods and the gold standard manual segmentation in measuring regional brain volumes on MRI across healthy controls, patients with mild cognitive impairment, and patients with dementia due to AD.</AbstractText>Systematic review and meta-analysis.</AbstractText>MEDLINE, Embase, and PsycINFO were searched through October 2021.</AbstractText>1.0&#x2009;T, 1.5&#xa0;T, or 3.0&#x2009;T.</AbstractText>Two review authors independently identified studies for inclusion and extracted data. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2).</AbstractText>Standardized mean differences (SMD; Hedges' g) were pooled using random-effects meta-analysis with robust variance estimation. Subgroup analyses were undertaken to explore potential sources of heterogeneity. Sensitivity analyses were conducted to examine the impact of the within-study correlation between effect estimates on the meta-analysis results.</AbstractText>Seventeen studies provided sufficient data to evaluate the hippocampus, lateral ventricles, and parahippocampal gyrus. The pooled SMD for the hippocampus, lateral ventricles, and parahippocampal gyrus were 0.22 (95% CI -0.50 to 0.93), 0.12 (95% CI -0.13 to 0.37), and -0.48 (95% CI -1.37 to 0.41), respectively. For the hippocampal data, subgroup analyses suggested that the pooled SMD was invariant across clinical diagnosis and field strength. Subgroup analyses could not be conducted on the lateral ventricles data and the parahippocampal gyrus data due to insufficient data. The results were robust to the selected within-study correlation value.</AbstractText>While automated methods are generally comparable to manual segmentation for measuring hippocampal, lateral ventricle, and parahippocampal gyrus volumes, wide 95% CIs and large heterogeneity suggest that there is substantial uncontrolled variance. Thus, automated methods may be used to measure these regions in patients with AD but should be used with caution.</AbstractText>3 TECHNICAL EFFICACY: Stage 3.</AbstractText>&#xa9; 2021 International Society for Magnetic Resonance in Medicine.</CopyrightInformation>
2,330,541
Cryo-injury procedure-induced cardiac regeneration shows unique gene expression profiles in the newt Pleurodeles waltl.
Cardiac regeneration in the adult mouse is not substantial. Some vertebrates, such as newts and zebrafish, regenerate the heart throughout their lives. To understand how regenerative abilities differ among animal species, comparative research has been conducted in animals like mouse, zebrafish, and newt. For those purposes, cryo-injury is suitable as an experimental model for the pathological condition of human myocardial infarction. In fact, cryo-injury procedures are common in mouse and zebrafish.</AbstractText>In the present study, we induced cryo-damage on the ventricle in Iberian ribbed newts using a liquid nitrogen-chilled probe. We observed that the injured area recovered within 8&#x2009;weeks, with remodeling of scar tissue and proliferation of cardiomyocytes. We investigated the subsequent recovery of cryo-injured and amputated tissues by comparative analysis of the gene expression profiles following these two procedures.</AbstractText>Notably, we established a cryo-injury procedure for the newt and confirmed that regeneration of the cryo-damaged myocardial tissue is achieved by changes in gene expression that are milder than those observed in the amputation model. Our results suggest that the cryo-injury method is suitable for comparing the process of cardiac regeneration in the newt with that in other animal models.</AbstractText>&#xa9; 2021 American Association of Anatomists.</CopyrightInformation>
2,330,542
Immunohistochemical expression of osteopontin and collagens in choroid plexus of human brains.
Evidence showing the functional significance of the choroid plexus is accumulating. Although it is clinically well-known that calcification is frequently seen in the choroid plexus of aged human brains, it is unclear why calcification occurs in the aged choroid plexus and what exert effects on the calcification has. In this study, immunohistochemical localizations of collagens and other molecules related to fibrosis or calcification were investigated on the choroid plexus of autopsied human brains. Densely fibrous or calcified materials were located in the stroma just below the epithelial cells of the choroid plexus of all human brains examined. Immunoreactivity for collagen type I was identified in the stroma just below the epithelial cells, consistent with the densely fibrous or calcified area, whereas that for collagen type III was observed in almost all stroma other than the densely fibrous or calcified areas. Linear or membranous immunoreactivity for collagen type IV was intermittently localized on the epithelium-facing side of the materials, suggesting an injured basement membrane. In addition, clear immunoreactivity for osteopontin was localized on the epithelium-facing side of the fibrous or calcified materials as well as in the cytoplasm of epithelial cells. These findings indicate that collagen type I exists in contact with osteopontin in and around the densely fibrous or calcified materials in the choroid plexus. They suggest that the densely fibrous or calcified materials are deposited in the subepithelial stroma just below an injured basement membrane of epithelial cells via the collagen type I and osteopontin.
2,330,543
[Microscopic excision of a colloyd cyst of the third ventricle assisted by endoscopy. Case report and literature analysis.].
Colloid cysts are histologically benign lesions, probably derived from the endoderm, which represent 0.3-2% of brain tumors. They are usually attached to the roof of the third ventricle in direct relation to the foramen of Monro, which can cause a blockage to the circulation of cerebrospinal fluid, determining hydrocephalus and in some cases sudden death. Other more common symptoms are headache, nausea and vomiting, blurred vision, gait ataxia, and cognitive impairment. Treatment options include microsurgery, endoscopy, stereotaxic casting, or cerebrospinal fluid shunts for the treatment of hydrocephalus. The objective of surgery is the total excision of the lesion. It should be noted that the microsurgical technique allows total excision more frequently, but at the cost of greater manipulation and tissue trauma; on the contrary, endoscopic being minimally invasive, allows better tissue preservation, although the rates of complete tumor excision are usually lower due to the difficulties in dissecting the lesions densely adhered to the roof of the third ventricle.</AbstractText>We present a clinical case of a patient with a third ventricle tumor compatible with a colloid cyst, with progressive hydrocephalus, operated with microsurgical technique and endoscopic assistance.</AbstractText>Total excision of the colloid cyst with improvement of the symptoms. Antegrade memory disorder that resolved completely after 3 months.</AbstractText>The endoscopy-assisted microsurgical technique is safe for the management of this pathology and provides intraoperative benefits.</AbstractText>Universidad Nacional de C&#xf3;rdoba.</CopyrightInformation>
2,330,544
Quantitative assessment of intra- and inter-modality deformable image registration of the heart, left ventricle, and thoracic aorta on longitudinal 4D-CT and MR images.
Magnetic resonance imaging (MRI)-based investigations into radiotherapy (RT)-induced cardiotoxicity require reliable registrations of magnetic resonance (MR) imaging to planning computed tomography (CT) for correlation to regional dose. In this study, the accuracy of intra- and inter-modality deformable image registration (DIR) of longitudinal four-dimensional CT (4D-CT) and MR images were evaluated for heart, left ventricle (LV), and thoracic aorta (TA).</AbstractText>Non-cardiac-gated 4D-CT and T1 volumetric interpolated breath-hold examination (T1-VIBE) MRI datasets from five lung cancer patients were obtained at two breathing phases (inspiration/expiration) and two time points (before treatment and 5 weeks after initiating RT). Heart, LV, and TA were manually contoured. Each organ underwent three intramodal DIRs ((A) CT modality over time, (B) MR modality over time, and (C) MR contrast effect at the same time) and two intermodal DIRs ((D) CT/MR multimodality at same time and (E) CT/MR multimodality over time). Hausdorff distance (HD), mean distance to agreement (MDA), and Dice were evaluated and assessed for compliance with American Association of Physicists in Medicine (AAPM) Task Group (TG)-132 recommendations.</AbstractText>Mean values of HD, MDA, and Dice under all registration scenarios for each region of interest ranged between 8.7 and 16.8&#xa0;mm, 1.0 and 2.6&#xa0;mm, and 0.85 and 0.95, respectively, and were within the TG-132 recommended range (MDA&#xa0;&lt;&#xa0;3&#xa0;mm, Dice&#xa0;&gt;&#xa0;0.8). Intramodal DIR showed slightly better results compared to intermodal DIR. Heart and TA demonstrated higher registration accuracy compared to LV for all scenarios except for HD and Dice values in Group A. Significant differences for each metric and tissue of interest were noted between Groups B and D and between Groups B and E. MDA and Dice significantly differed between LV and heart in all registrations except for MDA in Group E.</AbstractText>DIR of the heart, LV, and TA between non-cardiac-gated longitudinal 4D-CT and MRI across two modalities, breathing phases, and pre/post-contrast is acceptably accurate per AAPM TG-132 guidelines. This study paves the way for future evaluation of RT-induced cardiotoxicity and its related factors using multimodality DIR.</AbstractText>&#xa9; 2021 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, LLC on behalf of The American Association of Physicists in Medicine.</CopyrightInformation>
2,330,545
Age-dependent cerebrospinal fluid-tissue water exchange detected by magnetization transfer indirect spin labeling MRI.
A non-invasive magnetization transfer indirect spin labeling (MISL) MRI method is developed to quantify the water exchange between cerebrospinal fluid (CSF) and other tissues in the brain and to examine the age-dependence of water exchange.</AbstractText>In the pulsed MISL, we implemented a short selective pulse followed by a post-labeling delay before an MRI acquisition with a long echo time; in the continuous MISL, a train of saturation pulses was applied. MISL signal (&#x2206;Z) was obtained by the subtraction of the label MRI at -3.5 ppm from the control MRI at 200 ppm. CSF was extracted from the mouse ventricles for the MISL optimization and validation. Comparison between wild type (WT) and aquaporin-4 knockout (AQP4-/-</sup> ) mice was performed to examine the contributions of CSF water exchange, whereas its age-dependence was investigated by comparing the adult and young WT mice.</AbstractText>The pulsed MISL method observed that the MISL signal reached the maximum at 1.5 s. The continuous MISL method showed the highest MISL signal in the fourth ventricle (&#x2206;Z&#xa0;=&#xa0;13.5%&#xa0;&#xb1;&#xa0;1.4%), whereas the third ventricle and the lateral ventricles had similar MISL &#x2206;Z values (&#x2206;Z&#xa0;=&#xa0;12.0%&#xa0;&#xb1;&#xa0;1.8%). Additionally, significantly lower &#x2206;Z (9.3%-18.7% reduction) was found in all ventricles for the adult mice than those of the young mice (p&#xa0;&lt;&#xa0;0.02). For the AQP4-/-</sup> mice, the &#x2206;Z values were 5.9%-8.3% smaller than those of the age-matched WT mice in the lateral and fourth ventricles, but were not significant.</AbstractText>The MISL method has a great potential to study CSF water exchange with the surrounding tissues in brain.</AbstractText>&#xa9; 2021 International Society for Magnetic Resonance in Medicine.</CopyrightInformation>
2,330,546
Spermidine supplementation influences mitochondrial number and morphology in the heart of aged mice.
Aging is associated with cardiac hypertrophy and progressive decline in heart function. One of the hallmarks of cellular aging is the dysfunction of mitochondria. These organelles occupy around 1/4 to 1/3 of the cardiomyocyte volume. During cardiac aging, the removal of defective or dysfunctional mitochondria by mitophagy as well as the dynamic equilibrium between mitochondrial fusion and fission is distorted. Here, we hypothesized that these changes affect the number of mitochondria and alter their three-dimensional (3D) characteristics in aged mouse hearts. The polyamine spermidine stimulates both mitophagy and mitochondrial biogenesis, and these are associated with improved cardiac function and prolonged lifespan. Therefore, we speculated that oral spermidine administration normalizes the number of mitochondria and their 3D morphology in aged myocardium. Young (4-months old) and old (24-months old) mice, treated or not treated with spermidine, were used in this study (n&#xa0;=&#xa0;10 each). The number of mitochondria in the left ventricles was estimated by design-based stereology using the Euler-Poincar&#xe9; characteristic based on a disector at the transmission electron microscopic level. The 3D morphology of mitochondria was investigated by 3D reconstruction (using manual contour drawing) from electron microscopic z-stacks obtained by focused ion beam scanning electron microscopy. The volume of the left ventricle and cardiomyocytes were significantly increased in aged mice with or without spermidine treatment. Although the number of mitochondria was similar in young and old control mice, it was significantly increased in aged mice treated with spermidine. The interfibrillar mitochondria from old mice exhibited a lower degree of organization and a greater variation in shape and size compared to young animals. The mitochondrial alignment along the myofibrils in the spermidine-treated mice appeared more regular than in control aged mice, however, old mitochondria from animals fed spermidine also showed a greater diversity of shape and size than young mitochondria. In conclusion, mitochondria of the aged mouse left ventricle exhibited changes in number and 3D ultrastructure that is likely the structural correlate of dysfunctional mitochondrial dynamics. Spermidine treatment reduced, at least in part, these morphological changes, indicating a beneficial effect on cardiac mitochondrial alterations associated with aging.
2,330,547
Automated 3D U-net based segmentation of neonatal cerebral ventricles from 3D ultrasound images.
Intraventricular hemorrhaging (IVH) within cerebral lateral ventricles affects 20-30% of very low birth weight infants (&lt;1500&#xa0;g). As the ventricles increase in size, the intracranial pressure increases, leading to post-hemorrhagic ventricle dilatation (PHVD), an abnormal enlargement of the head. The most widely used imaging tool for measuring IVH and PHVD is cranial two-dimensional (2D) ultrasound (US). Estimating volumetric changes over time with 2D US is unreliable due to high user variability when locating the same anatomical location at different scanning sessions. Compared to 2D US, three-dimensional (3D) US is more sensitive to volumetric changes in the ventricles and does not suffer from variability in slice acquisition. However, 3D US images require segmentation of the ventricular surface, which is tedious and time-consuming when done manually.</AbstractText>A fast, automated ventricle segmentation method for 3D US would provide quantitative information in a timely manner when monitoring IVH and PHVD in pre-term neonates. To this end, we developed a fast and fully automated segmentation method to segment neonatal cerebral lateral ventricles from 3D US images using deep learning.</AbstractText>Our method consists of a 3D U-Net ensemble model composed of three U-Net variants, each highlighting various aspects of the segmentation task such as the shape and boundary of the ventricles. The ensemble is made of a U-Net++, attention U-Net, and U-Net with a deep learning-based shape prior combined using a mean voting strategy. We used a dataset consisting of 190 3D US images, which was separated into two subsets, one set of 87 images contained both ventricles, and one set of 103 images contained only one ventricle (caused by limited field-of-view during acquisition). We conducted fivefold cross-validation to evaluate the performance of the models on a larger amount of test data; 165 test images of which 75 have two ventricles (two-ventricle images) and 90 have one ventricle (one-ventricle images). We compared these results to each stand-alone model and to previous works including, 2D multiplane U-Net and 2D SegNet models.</AbstractText>Using fivefold cross-validation, the ensemble method reported a Dice similarity coefficient (DSC) of 0.720 &#xb1; 0.074, absolute volumetric difference (VD) of 3.7 &#xb1; 4.1 cm3</sup> , and a mean absolute surface distance (MAD) of 1.14 &#xb1; 0.41&#xa0;mm on 75 two-ventricle test images. Using 90 test images with a single ventricle, the model after cross-validation reported DSC, VD, and MAD values of 0.806 &#xb1; 0.111, 3.5 &#xb1; 2.9 cm3</sup> , and 1.37 &#xb1; 1.70&#xa0;mm, respectively. Compared to alternatives, the proposed ensemble yielded a higher accuracy in segmentation on both test data sets. Our method required approximately 5 s to segment one image and was substantially faster than the state-of-the-art conventional methods.</AbstractText>Compared to the state-of-the-art non-deep learning methods, our method based on deep learning was more efficient in segmenting neonatal cerebral lateral ventricles from 3D US images with comparable or better DSC, VD, and MAD performance. Our dataset was the largest to date (190 images) for this segmentation problem and the first to segment images that show only one lateral cerebral ventricle.</AbstractText>&#xa9; 2021 American Association of Physicists in Medicine.</CopyrightInformation>
2,330,548
Outlier detection in multimodal MRI identifies rare individual phenotypes among more than 15,000 brains.
Outliers in neuroimaging represent spurious data or the data of unusual phenotypes that deserve special attention such as clinical follow-up. Outliers have usually been detected in a supervised or semi-supervised manner for labeled neuroimaging cohorts. There has been much less work using unsupervised outlier detection on large unlabeled cohorts like the UK Biobank brain imaging dataset. Given its large sample size, rare imaging phenotypes within this unique cohort are of interest, as they are often clinically relevant and could be informative for discovering new processes. Here, we developed a two-level outlier detection and screening methodology to characterize individual outliers from the multimodal MRI dataset of more than 15,000 UK Biobank subjects. In primary screening, using brain ventricles, white matter, cortical thickness, and functional connectivity-based imaging phenotypes, every subject was parameterized with an outlier score per imaging phenotype. Outlier scores of these imaging phenotypes had good-to-excellent test-retest reliability, with the exception of resting-state functional connectivity (RSFC). Due to the low reliability of RSFC outlier scores, RSFC outliers were excluded from further individual-level outlier screening. In secondary screening, the extreme outliers (1,026 subjects) were examined individually, and those arising from data collection/processing errors were eliminated. A representative subgroup of 120 subjects from the remaining non-artifactual outliers were radiologically reviewed, and radiological findings were identified in 97.5% of them. This study establishes an unsupervised framework for investigating rare individual imaging phenotypes within a large neuroimaging cohort.
2,330,549
Cotton rats (Sigmodon hispidus) with a high prevalence of hydrocephalus without clinical symptoms.
Normal-pressure hydrocephalus (NPH) is a condition in which the ventricle is enlarged without elevated cerebrospinal fluid pressure, and it generally develops in later life and progresses slowly. A complete animal model that mimics human idiopathic NPH has not yet been established, and the onset mechanisms and detailed pathomechanisms of NPH are not fully understood. Here, we demonstrate a high spontaneous prevalence (34.6%) of hydrocephalus without clinical symptoms in inbred cotton rats (Sigmodon hispidus). In all 46 hydrocephalic cotton rats, the severity was mild or moderate and not severe. The dilation was limited to the lateral ventricles, and none of the hemorrhage, ventriculitis, meningitis, or tumor formation was found in hydrocephalic cotton rats. These findings indicate that the type of hydrocephalus in cotton rats is similar to that of communicating idiopathic NPH. Histopathological examinations revealed that the inner granular and pyramidal layers (layers IV and V) of the neocortex became thinner in hydrocephalic brains. A small number of pyramidal cells were positive for Fluoro-Jade C (a degenerating neuron marker) and ionized calcium-binding adaptor molecule 1 (Iba1)-immunoreactive microglia were in contact with the degenerating neurons in the hydrocephalic neocortex, suggesting that hydrocephalic cotton rats are more or less impaired projections from the neocortex. This study highlights cotton rats as a candidate for novel models to elucidate the pathomechanism of idiopathic NPH. Additionally, cotton rats have some noticeable systemic pathological phenotypes, such as chronic kidney disease and metabolic disorders. Thus, this model might also be useful for researching the comorbidities of NPH to other diseases.
2,330,550
Expanded Transsphenoidal Trans-Lamina Terminalis Approach to Tumors Extending Into the Third Ventricle: Technique Notes and a Single Institute Experience.
The trans lamina terminalis approach (TLTA) has been described as a way to remove third ventricular tumors. The aim of this paper was to analyze the feasible outcomes of TLTA applied to tumors extending into the third ventricle in our institute.</AbstractText>Suprasellar tumors (n = 149) were treated by the extended endonasal approach from September 2019 to December 2020 in Beijing Tiantan Hospital. Eleven of the tumors were treated by TLTA or TLTA via</i> the trans-chiasm-pituitary corridor (TCPC). The surgical technique notes of TLTA were described and indications and outcomes of the approach were analyzed.</AbstractText>There were 11 patients enrolled in the study, six with papillary craniopharyngiomas, two with adamantinomatous craniopharyngiomas, one with a germinal cell tumor (GCT), one with cavernous malformation and one with chordoid glioma. Four of the patients received a radical resection by TLTA alone, while seven of them received TLTA via</i> the TCPC. Gross total resection was achieved in eight patients (72.7%), and partial resection in three patients (27.3%). Visual function was improved in four of the 11 patients (36.4%), was unchanged in five patients (45.5%), and deteriorated in two patients (18.2%). New-onset hypopituitarism occurred in seven patients (63.3%) and new-onset diabetes insipidus occurred in two patients (18.2%). Electrocyte imbalance were observed in six patients (54.5%) at post-operative week 2. There were no surgery-related deaths or cerebrospinal fluid leaks. Postoperative intracranial infection was observed in one patient (9.1%), and during the follow-up period, tumor recurrence occurred in one patient (9.1%).</AbstractText>The expanded TLTA provides a feasible suprachiasm corridor to remove tumors extending into the third ventricle, especially for craniopharyngiomas. Sound understanding of the major strengths and limitations of this approach, as well as strategies for complication avoidance, is necessary for its safe and effective application.</AbstractText>Copyright &#xa9; 2021 Cao, Wu, Kang, Qiao, Yang, Bai, Zhu, Zhang and Gui.</CopyrightInformation>
2,330,551
MiR-29c-3p May Promote the Progression of Alzheimer's Disease through BACE1.
The aim of this study was to explore the specific role of miR-29c-3p in Alzheimer's disease (AD). Animal models of AD were established by injecting streptozotocin (STZ) into mice through the lateral ventricle, while cell models of AD were induced by 10&#x2009;<i>&#x3bc;</i>M <i>&#x3b2;</i>-amyloid (A<i>&#x3b2;</i>). We detected miR-29c-3p and <i>&#x3b2;</i>-site amyloid precursor protein cleaving enzyme 1 (BACE1) contents and measured AD cell proliferation and apoptosis. A low miR-29c-3p level and a high BACE1 level were detected in the brain tissue of AD animal models and AD cell models. A<i>&#x3b2;</i>-processed cells had markedly lower proliferation activity, higher apoptosis, increased phosphorylation of tau protein was over phosphorylated, but the overexpression of miR-29c-3p or the silencing of BACE1 significantly enhanced the cell proliferation activity and reduced cell apoptosis by regulating the contents of related proteins. Inhibition of miR-29c-3p or overexpression of BACE1 aggravated A<i>&#x3b2;</i>-induced side effects. We used Targetscan7.2 to predict the downstream target genes of miR-29c-3p. Then, we detected that there were target binding sites between miR-29c-3p and BACE1. The rescue experiment identified BACE1 as a functional target for miR-29c-3p. AD leads to decreased miR-29c-3p level and increased BACE1 level. MiR-29c-3p has specific binding sites with the 3'-untranslated region (3'-UTR) of BACE1 and thus negatively regulates the BACE1 level, thereby affecting the progression of AD.
2,330,552
Case Report: No Evidence of Intracranial Fluid Shifts in an Astronaut Following an Aborted Launch.
Spaceflight induces lasting enlargement of the brain's ventricles as well as intracranial fluid shifts. These intracranial fluid shifts have been attributed to prolonged microgravity exposure, however, the potential effects of hypergravity exposure during launch and landing have yet to be elucidated. Here we describe a case report of a Crewmember who experienced an Aborted Launch ("CAL"). CAL's launch and landing experience was dissociated from prolonged microgravity exposure. Using MRI, we show that hypergravity exposure during the aborted launch did not induce lasting ventricular enlargement or intracranial fluid shifts resembling those previously reported with spaceflight. This case study therefore rules out hypergravity during launch and landing as a contributing factor to previously reported long-lasting intracranial fluid changes following spaceflight.
2,330,553
Cerebellar Patterning Defects in Mutant Mice.
The cerebellar cortex is highly compartmentalized and serves as a remarkable model for pattern formation throughout the brain. In brief, the adult cerebellar cortex is subdivided into five anteroposterior units-transverse zones-and subsequently, each zone is divided into &#x223c;20 parasagittal stripes. Zone-and-stripe pattern formation involves the interplay of two parallel developmental pathways-one for inhibitory neurons, the second for excitatory. In the inhibitory pathway, progenitor cells of the 4th ventricle generate the Purkinje cells and inhibitory interneurons. In the excitatory pathway, progenitor cells in the upper rhombic lip give rise to the external granular layer, and subsequently to the granular layer of the adult. Both the excitatory and inhibitory developmental pathways are spatially patterned and the interactions of the two generate the complex topography of the adult. This review briefly describes the cellular and molecular mechanisms that underly zone-and-stripe development with a particular focus on mutations known to interfere with normal cerebellar development and the light they cast on the mechanisms of pattern formation.
2,330,554
Pediatric cardiac and great vessel injuries: Recent experience at two pediatric trauma centers.
Cardiac injuries are rare in pediatric trauma patients and data regarding this type of injury is limited. There is even less data on traumatic great vessel injuries. This study sought to examine and summarize our recent experience at two pediatric trauma centers, which serve a major metropolitan area and large geographic region.</AbstractText>This is a retrospective review of pediatric (&lt;18 years) patients who sustained cardiac or great vessel injuries and were managed at a Level 1 or Level 2 pediatric trauma center between January 1, 2010 and June 30, 2020. Demographic and clinical characteristics were compared using two-sample t-tests, Wilcoxon Rank-Sum tests, Fisher's exact tests and chi-squared tests for continuous, non-normally distributed continuous, and categorical variables, respectively.</AbstractText>A total of 53 patients sustained cardiac and/or great vessel injuries. Of these, 37 (70%) sustained cardiac, 9 (17%) sustained great vessel, and 7 (13%) sustained both types of injuries. The median age was 14.9 years and 74% (n&#xa0;=&#xa0;39) were male. The median injury severity score (ISS) was 36.0 and the injury mechanism was blunt in 31 (58%) patients. The most common cardiac and great vessel injury locations were left ventricle (n&#xa0;=&#xa0;9) and thoracic aorta (n&#xa0;=&#xa0;11), respectively. The overall mortality rate was 53% (n&#xa0;=&#xa0;28). Mortality was highest among those who sustained great vessel injuries (89%).</AbstractText>There is substantial heterogeneity in cardiac and great vessel injuries. Regardless, they are highly morbid and lethal, despite aggressive surgical and catheter-based interventions.</AbstractText>Copyright &#xa9; 2021. Published by Elsevier Inc.</CopyrightInformation>
2,330,555
A novel assay to assess the effects of estrogen on the cardiac calmodulin binding equilibrium.
The Ca2+</sup>-binding protein calmodulin (CaM) modulates numerous target proteins but is produced insufficiently to bind all of them, generating a limiting CaM equilibrium. Menopause increases cardiac morbidity; however, it is unknown if the cardiac CaM equilibrium is affected by estrogen. We devised an assay to assess the effects of ovariectomy and estrogen treatment on the cardiac CaM equilibrium.</AbstractText>Sprague-Dawley rats received sham surgery or ovariectomy, followed by 2-week treatment with vehicle or 17&#x3b2;-estradiol. Ca2+</sup>-saturated left ventricular (LV) lysates were processed through CaM sepharose columns, which retained CaM-binding proteins unoccupied by endogenous CaM. Eluants therefrom were subjected to a competitive binding assay against purified CaM and a CaM biosensor to assess the amounts of unoccupied CaM-binding sites. LV cellular composition was assessed by immunohistochemistry.</AbstractText>LV eluants processed from sham animals reduce biosensor response by ~32%, indicating baseline presence of unoccupied CaM-binding sites and a limiting CaM equilibrium. Ovariectomy exacerbates the limiting CaM equilibrium, reducing biosensor response by ~65%. 17&#x3b2;-estradiol treatment equalizes the difference between sham and ovariectomized animals. These changes reflect whole tissue responses and are not mirrored by changes in total surface areas of cardiomyocytes and fibroblasts. Consistently, Ca2+</sup>-dependent, but not Ca2+</sup>-independent, interaction between CaM and the cardiac inositol trisphosphate receptor (IP3</sub>R) is reduced following ovariectomy and is restored by subsequent 17&#x3b2;-estradiol treatment.</AbstractText>Our assay provides a new parameter to assess tissue CaM equilibrium. The exacerbated limiting CaM equilibrium following estrogen loss may contribute to cardiac morbidity and is prevented by estrogen treatment.</AbstractText>Copyright &#xa9; 2021 Elsevier Inc. All rights reserved.</CopyrightInformation>
2,330,556
Rhomboencephalosynapsis: Review of the Literature.
Rhombencephalosynapsis is a rare congenital anomaly, characterized by partial or total agenesis of the cerebellar vermis with midline fusion of the cerebellar hemispheres, dentate nuclei, and the superior cerebellar peduncles, creating the distinctive keyhole appearance of the fourth ventricle. Rhombencephalosynapsis can be isolated or can occur in association with other congenital anomalies and syndromes such as G&#xf3;mez-L&#xf3;pez-Hern&#xe1;ndez syndrome (GLHS) or VACTERL: vertebral anomalies (V), anal atresia (A), cardiovascular defects (C), esophageal atresia and/or tracheoesophageal fistula (TE), and renal (R) and limb/radial (L) anomalies. Recent advances in prenatal imaging have resulted in an increasing rate of prenatal diagnosis of abnormalities of the posterior fossa including rhombencephalosynapsis. Patients with rhombencephalosynapsis may present with motor developmental delay, ataxia, swallowing difficulties, muscular hypotonia, spastic quadriparesis, abnormal eye movements, and a characteristic "figure-of-eight" head shaking. Cognitive outcome varies from severe intellectual disability to normal intellectual function. Rhombencephalosynapsis with VACTERL is often associated with severe cognitive disabilities, whereas patients with GLHS may have better cognitive function. The most common associated findings with rhombencephalosynapsis include hydrocephalus, mesencephalosynapsis, holoprosencephaly, pontocerebellar hypoplasia, corpus callosum dysgenesis, and absence of septum pellucidum. Patients can be categorized into 4 groups: 1) rhombencephalosynapsis associated with GLHS; 2) rhombencephalosynapsis with VACTERL; 3) rhombencephalosynapsis with atypical holoprosencephaly, and 4) isolated rhomboencephalosynapsis. The etiology of rhombencephalosynapsis is unknown. Here, we discuss several hypotheses about its etiology.
2,330,557
Dandy-Walker syndrome with bilateral choanal atresia: A case report.
Dandy-Walker syndrome is a rare congenital brain malformation characterized by cerebellar vermis agenesis or hypoplasia, cystic dilatation of the fourth ventricle and a large posterior fossa causing upward displacement of tentorium and torcula. In this paper, we present a case of bilateral choanal atresia with Dandy-Walker Syndrome in a female newborn.</AbstractText>We present a case of a female patient who was born at 38th weeks of gestation via emergency cesarean section due to non-reassuring cardiotocography and abnormal antenatal ultrasounds findings. The imaging revealed the presence of Dandy-walker malformation. The patient presented with cyanosis and respiratory distress. Bedside flexible nasoendoscopy revealed bilateral choanal atresia which is confirmed by computed tomography of sinuses. Endoscopic bilateral choanal atresia repair was performed. On postoperative follow up, nasal endoscopy showed bilateral intact flap and patent neochoana.</AbstractText>Dandy-Walker syndrome is a congenital disorder that can be diagnosed prenatally. The syndrome is associated with multiple anomalies. However, there are few published reports of bilateral choanal atresia in Dandy-Walker Syndrome. Bilateral choanal atresia is considered a life-threatening condition in newborns that requires early surgical intervention.</AbstractText>Copyright &#xa9; 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.</CopyrightInformation>
2,330,558
The "Super-Fontan" Phenotype: Characterizing Factors Associated With High Physical Performance.
<b>Background:</b> People with a Fontan circulation usually have moderately impaired exercise performance, although a subset have high physical performance ("Super-Fontan"), which may represent a low-risk phenotype. <b>Methods:</b> People with a "Super-Fontan" phenotype were defined as achieving normal exercise performance [&#x2265;80% predicted peak oxygen uptake (VO<sub>2</sub>) and work rate] during cardiopulmonary exercise testing (CPET) and were identified from the Australian and New Zealand Fontan Registry. A Fontan control group that included people with impaired exercise performance (&lt;80% predicted VO<sub>2</sub> or work rate) was also identified based on a 1:3 allocation ratio. A subset of participants were prospectively recruited and completed a series of physical activity, exercise self-efficacy, and health-related quality of life questionnaires. <b>Results:</b> Sixty CPETs ("Super-Fontan", <i>n</i> = 15; control, <i>n</i> = 45) were included. A subset ("Super-Fontan", <i>n</i> = 10; control, <i>n</i> = 13) completed a series of questionnaires. Average age was 29 &#xb1; 8 years; 48% were males. Exercise capacity reflected by percent predicted VO<sub>2</sub> was 67 &#xb1; 17% in the entire cohort. Compared to the "Super-Fontan" phenotype, age at Fontan completion was higher in controls (4.0 &#xb1; 2.9 vs. 7.2 &#xb1; 5.3 years, <i>p</i> = 0.002). Only one (7%) person in the "Super-Fontan" group had a dominant right ventricle compared to 15 (33%) controls (<i>p</i> = 0.043). None of those in the "Super-Fontan" group were obese, while almost a quarter (22%) of controls were obese based on body mass index (<i>p</i> = 0.046). Lung function abnormalities were less prevalent in the "Super-Fontan" group (20 vs. 70%, <i>p</i> = 0.006). Exercise self-efficacy was greater in the "Super-Fontan" group (34.2 &#xb1; 3.6 vs. 27.9 &#xb1; 7.2, <i>p</i> = 0.02). Self-reported sports participation and physical activity levels during childhood and early adulthood were higher in the "Super-Fontan" group (<i>p</i> &lt; 0.05). The total average time spent participating in structured sports and physical activity was 4.3 &#xb1; 2.6 h/wk in the "Super-Fontan" group compared to 2.0 &#xb1; 3.0 h/wk in controls, <i>p</i> = 0.003. There were no differences in self-reported current total physical activity score or health-related quality of life between groups (<i>p</i> &#x2265; 0.05). <b>Conclusions:</b> The "Super-Fontan" phenotype is associated with a healthy weight, lower age at Fontan completion, better exercise self-efficacy, and higher overall levels of sport and physical activity participation during physical development.
2,330,559
Comparison of Lumbar and Ventricular Cerebrospinal Fluid for Diagnosis and Monitoring of Meningitis.
Severe meningitis, especially basilar meningitis, can lead to hydrocephalus requiring external ventricular drain (EVD) placement. There are differences in cerebrospinal fluid (CSF) obtained from an EVD compared to a lumbar puncture (LP). Hence, it becomes difficult to compare LP and EVD samples for diagnosis and monitoring of meningitis. Recognizing these differences is important to properly treat and discontinue antibiotics. We report a case series of 6 patients with meningitis comparing EVD and LP CSF study analysis. In all 6 patients, CSF from LP was obtained before EVD placement by 1.7 days on average. Although corrected white blood cell (WBC) counts were elevated in CSF obtained from LP and EVD, the counts were significantly higher in LP CSF. Protein concentration in LP CSF was also significantly higher than EVD CSF. Glucose and red blood cells varied in both LP and EVD samples. Even though EVD CSF was obtained later in the clinical course than LP, slower circulation of CSF in lumbar space as compared to ventricles is likely the reason for a more sterile appearance of EVD CSF for the diagnosis of meningitis. It is important to recognize these differences as EVD CSF analysis for diagnosis of meningitis may lead to a missed diagnosis and false perception of significant improvement when monitoring response to treatment. One can consider repeating LP prior to discontinuation of antibiotics to properly determine the extent of improvement given EVD CSF sample appears more sterile in comparison. Larger studies are needed to confirm the above findings.
2,330,560
Acute Effect of Caffeine on the Synthesis of Pro-Inflammatory Cytokines in the Hypothalamus and Choroid Plexus during Endotoxin-Induced Inflammation in a Female Sheep Model.
This study was designed to determine the effect of acute caffeine (CAF) administration, which exerts a broad spectrum of anti-inflammatory activity, on the synthesis of pro-inflammatory cytokines and their receptors in the hypothalamus and choroid plexus (ChP) during acute inflammation caused by the injection of bacterial endotoxin-lipopolysaccharide (LPS). The experiment was performed on 24 female sheep randomly divided into four groups: control; LPS treated (iv.; 400 ng/kg of body mass (bm.)); CAF treated (iv.; 30 mg/kg of bm.); and LPS and CAF treated. The animals were euthanized 3 h after the treatment. It was found that acute administration of CAF suppressed the synthesis of interleukin (IL-1&#x3b2;) and tumor necrosis factor (TNF)&#x3b1;, but did not influence IL-6, in the hypothalamus during LPS-induced inflammation. The injection of CAF reduced the LPS-induced expression of TNF mRNA in the ChP. CAF lowered the gene expression of IL-6 cytokine family signal transducer (<i>IL6ST</i>) and TNF receptor superfamily member 1A (<i>TNFRSF1</i>) in the hypothalamus and IL-1 type II receptor (<i>IL1R2</i>) in the ChP. Our study on the sheep model suggests that CAF may attenuate the inflammatory response at the hypothalamic level and partly influence the inflammatory signal generated by the ChP cells. This suggests the potential of CAF to suppress neuroinflammatory processes induced by peripheral immune/inflammatory challenges.
2,330,561
Potential Applications of Computational Fluid Dynamics for Predicting Hemolysis in Mitral Paravalvular Leaks.
Paravalvular leaks (PVLs) may lead to hemolysis. In vitro shear stress forces above 300 Pa cause erythrocyte destruction. PVL channel dimensions may determine magnitude of shear stress forces that affect erythrocytes; however, this has not been tested. It remains unclear how different properties of PVL channels contribute to presence of hemolysis. A model of a left ventricle was created based on data from computer tomography with Slicer software PVLs of various shapes and sizes were introduced. Blood flow was simulated using ANSYS Fluent software. The following variables were examined: wall shear stress, shear stress in fluid, volume of PVL channel with shear stress exceeding 300 Pa, and duration of exposure of erythrocytes to shear stress values above 300 Pa. In all models, shear stress forces exceeded 300 Pa. Shear stress increased with blood flow rates and cross-sectional areas of any PVL. There was no linear relationship between cross-sectional area of a PVL and volume of a PVL channel with shear stress &gt; 300 Pa. Blood flow through mitral PVLs is associated with shear stress above 300 Pa. Cross-sectional area of a PVL does not correlate with volume of a PVL channel with shear stress &gt; 300 Pa and duration of exposure of erythrocytes to shear stress &gt; 300 Pa.
2,330,562
Development of a 3-Dimensional Model to Study Right Heart Dysfunction in Pulmonary Arterial Hypertension: First Observations.
Pulmonary arterial hypertension (PAH) patients eventually die of right heart failure (RHF). Currently, there is no suitable pre-clinical model to study PAH. Therefore, we aim to develop a right heart dysfunction (RHD) model using the 3-dimensional engineered heart tissue (EHT) approach and cardiomyocytes derived from patient-induced pluripotent stem cells (iPSCs) to unravel the mechanisms that determine the fate of a pressure-overloaded right ventricle. iPSCs from PAH and healthy control subjects were differentiated into cardiomyocytes (iPSC-CMs), incorporated into the EHT, and maintained for 28 days. In comparison with control iPSC-CMs, PAH-derived iPSC-CMs exhibited decreased beating frequency and increased contraction and relaxation times. iPSC-CM alignment within the EHT was observed. PAH-derived EHTs exhibited higher force, and contraction and relaxation times compared with control EHTs. Increased afterload was induced using 2&#xd7; stiffer posts from day 0. Due to high variability, there were no functional differences between normal and stiffer EHTs, and no differences in the hypertrophic gene expression. In conclusion, under baseline spontaneous conditions, PAH-derived iPSC-CMs and EHTs show prolonged contraction compared with controls, as observed clinically in PAH patients. Further optimization of the hypertrophic model and profound characterization may provide a platform for disease modelling and drug screening.
2,330,563
RNA Profiling of Mouse Ependymal Cells after Spinal Cord Injury Identifies the Oncostatin Pathway as a Potential Key Regulator of Spinal Cord Stem Cell Fate.
Ependymal cells reside in the adult spinal cord and display stem cell properties in vitro. They proliferate after spinal cord injury and produce neurons in lower vertebrates but predominantly astrocytes in mammals. The mechanisms underlying this glial-biased differentiation remain ill-defined. We addressed this issue by generating a molecular resource through RNA profiling of ependymal cells before and after injury. We found that these cells activate STAT3 and ERK/MAPK signaling post injury and downregulate cilia-associated genes and FOXJ1, a central transcription factor in ciliogenesis. Conversely, they upregulate 510 genes, seven of them more than 20-fold, namely Crym, Ecm1, Ifi202b, Nupr1, Rbp1, Thbs2 and Osmr-the receptor for oncostatin, a microglia-specific cytokine which too is strongly upregulated after injury. We studied the regulation and role of Osmr using neurospheres derived from the adult spinal cord. We found that oncostatin induced strong Osmr and p-STAT3 expression in these cells which is associated with reduction of proliferation and promotion of astrocytic versus oligodendrocytic differentiation. Microglial cells are apposed to ependymal cells in vivo and co-culture experiments showed that these cells upregulate Osmr in neurosphere cultures. Collectively, these results support the notion that microglial cells and Osmr/Oncostatin pathway may regulate the astrocytic fate of ependymal cells in spinal cord injury.
2,330,564
Spectral Analysis of Tissue Displacement for Cardiac Activation Mapping: Ex Vivo Working Heart and In Vivo Study.<Pagination><StartPage>942</StartPage><EndPage>956</EndPage><MedlinePgn>942-956</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1109/TUFFC.2021.3137989</ELocationID><Abstract><AbstractText>Characterizing myocardial activation is of major interest for understanding the underlying mechanism of cardiac arrhythmias. Electromechanical wave imaging (EWI) is an ultrafast ultrasound-based method used to map the propagation of the local contraction triggered by electrical activation of the heart. This study introduces a novel way to characterize cardiac activation based on the time evolution of the instantaneous frequency content of the cardiac tissue displacement curves. The first validation of this method was performed on an ex vivo dataset of 36 acquisitions acquired from two working heart models in paced rhythms. It was shown that the activation mapping described by spectral analysis of interframe displacement is similar to the standard EWI method based on zero-crossing of interframe strain. An average median error of 3.3 ms was found in the ex vivo dataset between the activation maps obtained with the two methods. The feasibility of mapping cardiac activation by EWI was then investigated on two open-chest pigs during sinus and paced rhythms in a pilot trial of cardiac mapping with an intracardiac probe. Seventy-five acquisitions were performed with reasonable stability and analyzed with the novel algorithm to map cardiac contraction propagation in the left ventricle (LV). Sixty-one qualitatively continuous isochrones were successfully computed based on this method. The region of contraction onset was coherently described while pacing in the imaging plane. These findings highlight the potential of implementing EWI acquisition on intracardiac probes and emphasize the benefit of performing short time-frequency analysis of displacement data to characterize cardiac activation in vivo.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Robert</LastName><ForeName>Jade</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Bessiere</LastName><ForeName>Francis</ForeName><Initials>F</Initials></Author><Author ValidYN="Y"><LastName>Cao</LastName><ForeName>Elodie</ForeName><Initials>E</Initials></Author><Author ValidYN="Y"><LastName>Loyer</LastName><ForeName>Virginie</ForeName><Initials>V</Initials></Author><Author ValidYN="Y"><LastName>Abell</LastName><ForeName>Emma</ForeName><Initials>E</Initials></Author><Author ValidYN="Y"><LastName>Vaillant</LastName><ForeName>Fanny</ForeName><Initials>F</Initials></Author><Author ValidYN="Y"><LastName>Quesson</LastName><ForeName>Bruno</ForeName><Initials>B</Initials></Author><Author ValidYN="Y"><LastName>Catheline</LastName><ForeName>Stefan</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Lafon</LastName><ForeName>Cyril</ForeName><Initials>C</Initials></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>2022</Year><Month>03</Month><Day>02</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>IEEE Trans Ultrason Ferroelectr Freq Control</MedlineTA><NlmUniqueID>9882735</NlmUniqueID><ISSNLinking>0885-3010</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000465" MajorTopicYN="N">Algorithms</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000818" MajorTopicYN="N">Animals</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001145" MajorTopicYN="Y">Arrhythmias, Cardiac</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006352" MajorTopicYN="N">Heart Ventricles</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010496" MajorTopicYN="Y">Pericardium</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013552" MajorTopicYN="N">Swine</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014463" MajorTopicYN="N">Ultrasonography</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>12</Month><Day>24</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2022</Year><Month>3</Month><Day>29</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>12</Month><Day>23</Day><Hour>17</Hour><Minute>18</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">34941506</ArticleId><ArticleId IdType="doi">10.1109/TUFFC.2021.3137989</ArticleId></ArticleIdList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="MEDLINE" Owner="NLM" IndexingMethod="Automated"><PMID Version="1">34941216</PMID><DateCompleted><Year>2021</Year><Month>12</Month><Day>27</Day></DateCompleted><DateRevised><Year>2021</Year><Month>12</Month><Day>27</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0023-1207</ISSN><JournalIssue CitedMedium="Print"><Issue>12</Issue><PubDate><Year>2021</Year></PubDate></JournalIssue><Title>Khirurgiia</Title><ISOAbbreviation>Khirurgiia (Mosk)</ISOAbbreviation></Journal>[Surgical approaches to interventricular septum in hypertrophic cardiomyopathy].
Characterizing myocardial activation is of major interest for understanding the underlying mechanism of cardiac arrhythmias. Electromechanical wave imaging (EWI) is an ultrafast ultrasound-based method used to map the propagation of the local contraction triggered by electrical activation of the heart. This study introduces a novel way to characterize cardiac activation based on the time evolution of the instantaneous frequency content of the cardiac tissue displacement curves. The first validation of this method was performed on an ex vivo dataset of 36 acquisitions acquired from two working heart models in paced rhythms. It was shown that the activation mapping described by spectral analysis of interframe displacement is similar to the standard EWI method based on zero-crossing of interframe strain. An average median error of 3.3 ms was found in the ex vivo dataset between the activation maps obtained with the two methods. The feasibility of mapping cardiac activation by EWI was then investigated on two open-chest pigs during sinus and paced rhythms in a pilot trial of cardiac mapping with an intracardiac probe. Seventy-five acquisitions were performed with reasonable stability and analyzed with the novel algorithm to map cardiac contraction propagation in the left ventricle (LV). Sixty-one qualitatively continuous isochrones were successfully computed based on this method. The region of contraction onset was coherently described while pacing in the imaging plane. These findings highlight the potential of implementing EWI acquisition on intracardiac probes and emphasize the benefit of performing short time-frequency analysis of displacement data to characterize cardiac activation in vivo.</Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Robert</LastName><ForeName>Jade</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Bessiere</LastName><ForeName>Francis</ForeName><Initials>F</Initials></Author><Author ValidYN="Y"><LastName>Cao</LastName><ForeName>Elodie</ForeName><Initials>E</Initials></Author><Author ValidYN="Y"><LastName>Loyer</LastName><ForeName>Virginie</ForeName><Initials>V</Initials></Author><Author ValidYN="Y"><LastName>Abell</LastName><ForeName>Emma</ForeName><Initials>E</Initials></Author><Author ValidYN="Y"><LastName>Vaillant</LastName><ForeName>Fanny</ForeName><Initials>F</Initials></Author><Author ValidYN="Y"><LastName>Quesson</LastName><ForeName>Bruno</ForeName><Initials>B</Initials></Author><Author ValidYN="Y"><LastName>Catheline</LastName><ForeName>Stefan</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Lafon</LastName><ForeName>Cyril</ForeName><Initials>C</Initials></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>2022</Year><Month>03</Month><Day>02</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>IEEE Trans Ultrason Ferroelectr Freq Control</MedlineTA><NlmUniqueID>9882735</NlmUniqueID><ISSNLinking>0885-3010</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000465" MajorTopicYN="N">Algorithms</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000818" MajorTopicYN="N">Animals</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001145" MajorTopicYN="Y">Arrhythmias, Cardiac</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006352" MajorTopicYN="N">Heart Ventricles</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010496" MajorTopicYN="Y">Pericardium</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013552" MajorTopicYN="N">Swine</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014463" MajorTopicYN="N">Ultrasonography</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>12</Month><Day>24</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2022</Year><Month>3</Month><Day>29</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>12</Month><Day>23</Day><Hour>17</Hour><Minute>18</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">34941506</ArticleId><ArticleId IdType="doi">10.1109/TUFFC.2021.3137989</ArticleId></ArticleIdList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="MEDLINE" Owner="NLM" IndexingMethod="Automated"><PMID Version="1">34941216</PMID><DateCompleted><Year>2021</Year><Month>12</Month><Day>27</Day></DateCompleted><DateRevised><Year>2021</Year><Month>12</Month><Day>27</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0023-1207</ISSN><JournalIssue CitedMedium="Print"><Issue>12</Issue><PubDate><Year>2021</Year></PubDate></JournalIssue><Title>Khirurgiia</Title><ISOAbbreviation>Khirurgiia (Mosk)</ISOAbbreviation></Journal><ArticleTitle>[Surgical approaches to interventricular septum in hypertrophic cardiomyopathy].</ArticleTitle><Pagination><StartPage>99</StartPage><EndPage>103</EndPage><MedlinePgn>99-103</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.17116/hirurgia202112199</ELocationID><Abstract>Hypertrophic cardiomyopathy (HCM) is a hereditary myocardial disease characterized by ventricular wall and interventricular septum thickening not associated with heart valve disease or any other external cause. Considering different localization of left ventricular obstruction, surgeons should be aware of various surgical approaches to various segments of interventricular septum. A personalized approach to each patient is essential to achieve favorable postoperative effect with minimal incidence of complications. This review is devoted to various surgical approaches to interventricular septum for different phenotypic variants of HCM.</Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Lysenko</LastName><ForeName>A V</ForeName><Initials>AV</Initials><Identifier Source="ORCID">0000-0002-8394-4116</Identifier><AffiliationInfo><Affiliation>Petrovsky National Research Center of Surgery, Moscow, Russia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Salagaev</LastName><ForeName>G I</ForeName><Initials>GI</Initials><Identifier Source="ORCID">0000-0002-7210-8366</Identifier><AffiliationInfo><Affiliation>Petrovsky National Research Center of Surgery, Moscow, Russia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lednev</LastName><ForeName>P V</ForeName><Initials>PV</Initials><Identifier Source="ORCID">0000-0002-3033-4146</Identifier><AffiliationInfo><Affiliation>Petrovsky National Research Center of Surgery, Moscow, Russia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cherepanova</LastName><ForeName>A E</ForeName><Initials>AE</Initials><Identifier Source="ORCID">0000-0003-1142-3642</Identifier><AffiliationInfo><Affiliation>Sechenov First Moscow State Medical University, Moscow, Russia.</Affiliation></AffiliationInfo></Author></AuthorList><Language>rus</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><VernacularTitle>Varianty dostupa k mezhzheludochkovoi peregorodke serdtsa pri gipertroficheskoi kardiomiopatii.</VernacularTitle></Article><MedlineJournalInfo><Country>Russia (Federation)</Country><MedlineTA>Khirurgiia (Mosk)</MedlineTA><NlmUniqueID>0412765</NlmUniqueID><ISSNLinking>0023-1207</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D002312" MajorTopicYN="Y">Cardiomyopathy, Hypertrophic</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000601" MajorTopicYN="N">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006352" MajorTopicYN="N">Heart Ventricles</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName><QualifierName UI="Q000601" MajorTopicYN="N">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009206" MajorTopicYN="N">Myocardium</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList><OtherAbstract Type="Publisher" Language="rus">&#x413;&#x438;&#x43f;&#x435;&#x440;&#x442;&#x440;&#x43e;&#x444;&#x438;&#x447;&#x435;&#x441;&#x43a;&#x430;&#x44f; 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&#x432;&#x43e;&#x437;&#x43c;&#x43e;&#x436;&#x43d;&#x44b;&#x445; &#x43e;&#x441;&#x43b;&#x43e;&#x436;&#x43d;&#x435;&#x43d;&#x438;&#x439;. &#x41e;&#x431;&#x437;&#x43e;&#x440; &#x43f;&#x43e;&#x441;&#x432;&#x44f;&#x449;&#x435;&#x43d; &#x440;&#x430;&#x437;&#x43b;&#x438;&#x447;&#x43d;&#x44b;&#x43c; &#x445;&#x438;&#x440;&#x443;&#x440;&#x433;&#x438;&#x447;&#x435;&#x441;&#x43a;&#x438;&#x43c; &#x434;&#x43e;&#x441;&#x442;&#x443;&#x43f;&#x430;&#x43c; &#x43a; &#x41c;&#x416;&#x41f; &#x432; &#x441;&#x43e;&#x43e;&#x442;&#x432;&#x435;&#x442;&#x441;&#x442;&#x432;&#x438;&#x438; &#x441; &#x444;&#x435;&#x43d;&#x43e;&#x442;&#x438;&#x43f;&#x438;&#x447;&#x435;&#x441;&#x43a;&#x438;&#x43c; &#x432;&#x430;&#x440;&#x438;&#x430;&#x43d;&#x442;&#x43e;&#x43c; &#x413;&#x41a;&#x41c;&#x41f;.
2,330,565
MRI features of an atypical case of extraventricular neurocytoma: A case report.
Central neurocytoma occurring outside the ventricles is known as extraventricular neurocytoma (EVN). EVN is rare and its magnetic resonance imaging (MRI) findings vary greatly and overlap with the imaging features of other intracerebral primary tumors.</AbstractText>A 21-year-old woman with an intrauterine pregnancy of 18+2&#x200a;weeks complained of dizziness and headache for 3 months.</AbstractText>A 8.6&#x200a;cm&#x200a;&#xd7;&#x200a;5.8&#x200a;cm &#xd7;&#x200a;3.7&#x200a;cm space-occupying lesion was seen in the right frontal lobe on MRI, with mixed long signals on T1-weighted imaging and mixed slightly long signals on T2-weighted imaging, slightly hyperintense on T2-weighted imaging fluid attenuated inversion recovery images, and a large-scope long T1-weighted imaging and long T2-weighted imaging cystic component at the center of the lesion. A thick fence-like enhancement of the solid component at the periphery of the lesion was observed after injecting a contrast medium, while the internal cystic component was not enhanced. The MRI diagnosis was of glioma. The lesion was pathologically confirmed as an atypical central neurocytoma of the right frontal lobe.</AbstractText>Resection of the lesion and postoperative radiotherapy.</AbstractText>The patient was lost to follow-up.</AbstractText>EVN can be considered as a differential diagnosis for lesions occurring in the cerebral hemispheres of young patients with cystic degeneration, thick fence-like enhancement, and peritumoral edema on MRI.</AbstractText>Copyright &#xa9; 2021 the Author(s). Published by Wolters Kluwer Health, Inc.</CopyrightInformation>
2,330,566
The Interventricular Septum Is Biomechanically Distinct from the Ventricular Free Walls.
The interventricular septum contributes to the pumping function of both ventricles. However, unlike the ventricular wall, its mechanical behavior remains largely unknown. To fill the knowledge gap, this study aims to characterize the biaxial and transmural variation of the mechanical properties of the septum and compare it to the free walls of the left and right ventricles (LV/RV). Fresh hearts were obtained from healthy, adult sheep. The septal wall was sliced along the mid-line into two septal sides and compared to the epicardial layers of the LV- and RV-free walls. Biaxial tensile mechanical tests and constitutive modeling were performed to obtain the passive mechanical properties of the LV- and RV-side of the septum and ventricular walls. We found that both sides of the septum were significantly softer than the respective ventricular walls, and that the septum presented significantly less collagen than the ventricular walls. At low strains, we observed the symmetric distribution of the fiber orientations and a similar anisotropic behavior between the LV-side and RV-side of the septum, with a stiffer material property in the longitudinal direction, rather than the circumferential direction. At high strains, both sides showed isotropic behavior. Both septal sides had similar intrinsic elasticity, as evidenced by experimental data and constitutive modeling. These new findings offer important knowledge of the biomechanics of the septum wall, which may deepen the understanding of heart physiology.
2,330,567
Assessments of right ventricular strain using cardiac magnetic resonance imaging following kidney transplantation.
Although kidney transplantation (KT) has been shown to ameliorate adverse left ventricular (LV) remodelling associated with end stage kidney disease, its effects on the right ventricle have not been well studied. Recently, strain imaging has been shown to be a sensitive measure of early subclinical myocardial dysfunction. Using cardiac magnetic resonance imaging (MRI), we examined the effects of KT on right ventricular (RV) strain parameters. In a cohort of 81 patients (39 patients underwent KT and 42 patients remained on dialysis as control group), cardiac MRI studies were obtained at baseline and at 1&#xa0;year follow-up. There were no significant differences in RV strain values between the groups at baseline. After 1&#xa0;year, RV strain values did not significantly change in patients who received KT, and changes in RV strain over 1&#xa0;year were not significantly different between the KT and the dialysis groups. Given the previously demonstrated improvement in LV strain post-KT, the current study suggests that RV and LV remodelling post-KT may have different mechanisms. Further studies elucidating the effects of KT on RV remodelling are needed.
2,330,568
Primary cardiac <i>CIC</i>-rearranged undifferentiated sarcoma in an infant.
Cardiac neoplasms are particularly rare in children, and the majority of these tumors are benign. Approximately 10% of cardiac neoplasms are malignant, including soft tissue sarcomas and lymphomas. Cardiac tumors could also be metastases. Primitive EWSR1-</i>negative round or spindle cell undifferentiated sarcoma harboring CIC</i> gene translocation is a highly aggressive malignancy mainly occurring in soft tissues. However, it has not yet been described in the heart.</AbstractText>We report a sarcoma that arose from the right ventricle in a 1-year-old girl. Histologically, it was composed of closely arranged small round or oval undifferentiated cells with fibrovascular separation, hyaline degeneration, and geographical necrosis. Immunohistochemically, the neoplastic cells exhibited focal membrane positivity for CD99 and diffuse positivity for WT1 and ETV4. Fluorescent in situ</i> hybridization analysis showed EWSR1-</i>negative but CIC</i>-positive split signals. The breakpoint was also confirmed by whole genome sequencing.</AbstractText>Based on morphological, immunohistochemical and molecular findings, this cardiac mass was diagnosed as CIC</i>-rearranged sarcoma.</AbstractText>&#xa9; 2021 Chinese Medical Association. Pediatric Investigation published by John Wiley &amp; Sons Australia, Ltd on behalf of Futang Research Center of Pediatric Development.</CopyrightInformation>
2,330,569
The impact of methylphenidate treatment on the functional and structural properties of the left ventricle: A medium-term prospective study.
Although methylphenidate (MPH) used for treatment of attention deficit hyperactivity disorder (ADHD) are considered safe in healthy children and adolescents in the short and medium term, there is a widespread concern about long-term cardiovascular safety.</AbstractText>Interventional, prospective, longitudinal and comparative study with a crossover design to evaluate the cardiovascular impact of the treatment with MPH in healthy children and adolescents diagnosed with ADHD. A protocol for the cardiovascular evaluation was established at a basal point, after the first and the second year of the beginning with treatment based on the monitoring of blood pressure (BP) and echocardiographic follow-up of the systolic and diastolic functions, and structural cardiac properties.</AbstractText>73 patients completed the study, with an average age of 9&#x202f;&#xb1;&#x202f;2.6 years, 75.3% were male and the majority were thin (64.4%). We found an increase in Systolic and Diastolic BP of 3.7&#x202f;&#xb1;&#x202f;9&#x202f;mmHg (P&#x202f;=&#x202f;0.004) and 2&#x202f;&#xb1;&#x202f;11,5&#x202f;mmHg respectively. There were no severe cardiovascular events. We didn't find any echocardiographic alterations namely on the structural properties or parameters of systolic function. Regarding diastolic function, a significant increase in the isovo-lumic relaxation time (IVRT) (P&#x202f;=&#x202f;0.046) and deceleration time (P&#x202f;=&#x202f;0.016) was observed. However, no significant alterations in the parameters related to distensibility of the LV neither in the early diastolic pressure were found.</AbstractText>Further studies are needed to evaluate the impact of psychostimulants as a modifiable long-term Cardiovascular Risk Factor.</AbstractText>Copyright &#xa9; 2021. Published by Elsevier Espa&#xf1;a, S.L.U.</CopyrightInformation>
2,330,570
Validation of Sonographic Fronto-Occipital Ratio Based on Anatomical Landmarks Compared to MR/CT-Derived Indexes in Children with Chiari II and Ventriculomegaly.
Ultrasound (US)-based indexes such as fronto-occipital ratio (FOR) can be used to obtain an acceptable estimation of ventricular volume. Patients with colpocephaly present a unique challenge due to the shape of their ventricles. In the present study, we aimed to evaluate the validity and reproducibility of the modified US-FOR index in children with Chiari II-related ventriculomegaly.</AbstractText>In this retrospective study, we evaluated Chiari II patients younger than 1 year who underwent head US and MR or CT scans for ventriculomegaly evaluation. MR/CT-based FOR was measured in the axial plane by identifying the widest diameter of frontal horns, occipital horns, and the interparietal diameter (IPD). US-based FOR (US-FOR) was measured using the largest diameter based on the following landmarks: frontal horn and IPD in the coronal plane at the level of the foramen of Monro, IPD just superior to the Sylvian fissures, and occipital horn posterior to the thalami and inferior to the superior margins of the thalami. Intraclass correlation coefficients (ICCs) were used to evaluate inter-rater reliability, and Pearson correlation coefficients and Bland-Altman plots were applied to assess agreement between US and other two modalities.</AbstractText>Sixty-three paired US and MR/CT exams were assessed for agreement between US-FOR and MR/CT-FOR measurements. ICC showed an excellent inter-rater reliability for US-FOR (ICC = 0.99, p &lt; 0.001) and MR/CT-FOR (ICC = 0.99, p &lt; 0.001) measurements. The mean (range) values based on US-FOR showed a slight overestimation in comparison with MR/CT-FOR (0.51 [0.36-0.68] vs. 0.46 [0.34-0.64]). The Pearson correlation coefficient showed high cross-modality agreement for the FOR index (r = 0.83, p &lt; 0.001). The Bland-Altman plot showed excellent concordance between US-FOR and MR/CT-FOR with a bias of 0.05 (95% CI: -0.03 to 0.13).</AbstractText>US-FOR in the coronal plane is a comparable tool for evaluating ventriculomegaly in Chiari II patients when compared with MR/CT-FOR, even in the context of colpocephaly.</AbstractText>&#xa9; 2021 S. Karger AG, Basel.</CopyrightInformation>
2,330,571
Left Ventricular Unloading During Extracorporeal Life Support: Current Practice.
Venoarterial extracorporeal life support (VA-ECLS) is a powerful tool that can provide complete cardiopulmonary support for patients with refractory cardiogenic shock. However, VA-ECLS increases left ventricular (LV) afterload, resulting in greater myocardial oxygen demand, which can impair myocardial recovery and worsen pulmonary edema. These complications can be ameliorated by various LV venting strategies to unload the LV. Evidence suggests that LV venting improves outcomes in VA-ECLS, but there is a paucity of randomized trials to help guide optimal strategy and the timing of venting. In this review, we discuss the available evidence regarding LV venting in VA-ECLS, explain important hemodynamic principles involved, and propose a practical approach to LV venting in VA-ECLS.
2,330,572
The blood-CSF-brain route of neurological disease: The indirect pathway into the brain.
The brain is protected by the endothelial blood-brain barrier (BBB) that limits the access of micro-organisms, tumour cells, immune cells and autoantibodies to the parenchyma. However, the classic model of disease spread across a disrupted BBB does not explain the focal distribution of lesions seen in a variety of neurological diseases and why lesions are frequently adjacent to the cerebrospinal fluid (CSF) spaces. We have critically reviewed the possible role of a blood-CSF-brain route as a disease entry pathway into the brain parenchyma. The initial step of this pathway is the transfer of pathogens or immune components from the blood into the CSF at the choroid plexuses, where the blood-CSF barrier (BCSFB) is located. The flow of CSF results in disease dissemination throughout the CSF spaces. Access to the brain parenchyma from the CSF can then occur across the ependymal layer at the ventricular surface or across the pial-glial barrier of the subarachnoid space and the Virchow-Robin spaces. We have reviewed the anatomy and physiology of the blood-CSF-brain pathway and the brain barriers controlling this process. We then summarised the evidence supporting this brain entry route in a cross-section of neurological diseases including neuromyelitis optica, multiple sclerosis, neurosarcoidosis, neuropsychiatric lupus, cryptococcal infection and both solid and haematological tumours. This summary highlights the conditions that share the blood-CSF-brain pathway as a pathogenetic mechanism. These include the characteristic proximity of lesions to CSF, evidence of disruption of the brain barriers and the identification of significant pathology within the CSF. An improved understanding of pathological transfer through the CSF and across all brain barriers will inform on more effective and targeted treatments of primary and secondary diseases of the central nervous system.
2,330,573
Decellularized Extracellular Matrix Powder Accelerates Metabolic Maturation at Early Stages of Cardiac Differentiation in Human Induced Pluripotent Stem Cell-Derived Cardiomyocytes.
During fetal development, cardiomyocytes switch from glycolysis to oxidative metabolism to sustain the energy requirements of functional cells. State-of-the-art cardiac differentiation protocols yield phenotypically immature cardiomyocytes, and common methods to improve metabolic maturation require multistep protocols to induce maturation only after cardiac specification is completed. Here, we describe a maturation method using ventricle-derived decellularized extracellular matrix (dECM) that promoted early-stage metabolic maturation of cardiomyocytes differentiated from human induced pluripotent stem cells (hiPSCs). Chemically and architecturally preserved particles (45-500 &#x3bc;m) of pig ventricular dECM were added to hiPSCs at the start of differentiation. At the end of our maturation protocol (day 15 of cardiac differentiation), we observed an intimate interaction between cardiomyocytes and dECM particles without impairment of cardiac differentiation efficiency (approx. 70% of cTNT+). Compared with control cells (those cultured without pig dECM), 15-day-old dECM-treated cardiomyocytes demonstrated increased expression of markers related to cardiac metabolic maturation, MAPK1, FOXO1, and FOXO3, and a switch from ITGA6 (the immature integrin isoform) to ITGA3 and ITGA7 (those present in adult cardiomyocytes). Electrical parameters and responsiveness to dobutamine also improved in pig ventricular dECM-treated cells. Extending the culture time to 30 days, we observed a switch from glucose to fatty acid metabolism, indicated by decreased glucose uptake and increased fatty acid consumption in cells cultured with dECM. Together, these data suggest that dECM contains endogenous cues that enable metabolic maturation of hiPSC-CMs at early stages of cardiac differentiation.
2,330,574
Normal Growth, Sexual Dimorphism, and Lateral Asymmetries at Fetal Brain MRI.
Background Tools in image reconstruction, motion correction, and segmentation have enabled the accurate volumetric characterization of fetal brain growth at MRI. Purpose To evaluate the volumetric growth of intracranial structures in healthy fetuses, accounting for gestational age (GA), sex, and laterality with use of a spatiotemporal MRI atlas of fetal brain development. Materials and Methods T2-weighted 3.0-T half-Fourier acquired single-shot turbo spin-echo sequence MRI was performed in healthy fetuses from prospectively recruited pregnant volunteers from March 2013 to May 2019. A previously validated section-to-volume reconstruction algorithm was used to generate intensity-normalized superresolution three-dimensional volumes that were registered to a fetal brain MRI atlas with 28 anatomic regions of interest. Atlas-based segmentation was performed and manually refined. Labels included the bilateral hippocampus, amygdala, caudate nucleus, lentiform nucleus, thalamus, lateral ventricle, cerebellum, cortical plate, hemispheric white matter, internal capsule, ganglionic eminence, ventricular zone, corpus callosum, brainstem, hippocampal commissure, and extra-axial cerebrospinal fluid. For fetuses younger than 31 weeks of GA, the subplate and intermediate zones were delineated. A linear regression analysis was used to determine weekly age-related change adjusted for sex and laterality. Results The final analytic sample consisted of 122 MRI scans in 98 fetuses (mean GA, 29 weeks &#xb1; 5 [range, 20-38 weeks]). All structures had significant volume growth with increasing GA (<i>P</i> &lt; .001). Weekly age-related change for individual structures in the brain parenchyma ranged from 2.0% (95% CI: 0.9, 3.1; <i>P</i> &lt; .001) in the hippocampal commissure to 19.4% (95% CI: 18.7, 20.1; <i>P</i> &lt; .001) in the cerebellum. The largest sex-related differences were 22.1% higher volume in male fetuses for the lateral ventricles (95% CI: 10.9, 34.4; <i>P</i> &lt; .001). There was rightward volumetric asymmetry of 15.6% for the hippocampus (95% CI: 14.2, 17.2; <i>P</i> &lt; .001) and leftward volumetric asymmetry of 8.1% for the lateral ventricles (95% CI: 3.7, 12.2; <i>P</i> &lt; .001). Conclusion With use of a spatiotemporal MRI atlas, volumetric growth of the fetal brain showed complex trajectories dependent on structure, gestational age, sex, and laterality. &#xa9;&#x2009;RSNA, 2021 <i>Online supplemental material is available for this article.</i> See also the editorial by Rollins in this issue.
2,330,575
A three-dimensional atlas of child's cardiac anatomy and the unique morphological alterations associated with obesity.
Statistical shape models (SSMs) of cardiac anatomy provide a new approach for analysis of cardiac anatomy. In adults, specific cardiac morphologies associate with cardiovascular risk factors and early disease stages. However, the relationships between morphology and risk factors in children remain unknown. We propose an SSM of the paediatric left ventricle to describe its morphological variability, examine its relationship with biometric parameters and identify adverse anatomical remodelling associated with obesity.</AbstractText>This cohort includes 2631 children (age 10.2 &#xb1; 0.6 years), mostly Western European (68.3%) with a balanced sex distribution (51.3% girls) from Generation R study. Cardiac magnetic resonance short-axis cine scans were segmented. Three-dimensional left ventricular (LV) meshes are automatically fitted to the segmentations to reconstruct the anatomies. We analyse the relationships between the LV anatomical features and participants' body surface area (BSA), age, and sex, and search for features uniquely related to obesity based on body mass index (BMI). In the SSM, 19 modes described over 90% of the population's LV shape variability. Main modes of variation were related to cardiac size, sphericity, and apical tilting. BSA, age, and sex were mostly correlated with modes describing LV size and sphericity. The modes correlated uniquely with BMI suggested that obese children present with septo-lateral tilting (R2 = 4.0%), compression in the antero-posterior direction (R2 = 3.3%), and decreased eccentricity (R2 = 2.0%).</AbstractText>We describe the variability of the paediatric heart morphology and identify anatomical features related to childhood obesity that could aid in risk stratification. Web service is released to provide access to the new shape parameters.</AbstractText>&#xa9; The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.</CopyrightInformation>
2,330,576
The pressure differential efflux technique - A novel approach for troubleshooting air-locked external ventricular drainage systems: A technical note and review of literature.
External ventricular drainage (EVD) is carried out in many neurosurgical conditions for the diversion of cerebrospinal fluid. These EVD systems can, however, malfunction with potentially lethal consequences. Air bubbles within the EVD can result in air locking of the system with subsequent blockage of drainage, with blood clots and debris being the other causes. There are both non-invasive and invasive methods of rectifying such blockages, with invasive procedures having its associated risks. This is especially so for EVD revisions, with each surgery increasing the risk of ventriculitis. We describe a case of bilateral air locked EVD managed successfully with a novel non-invasive 'pressure differential efflux technique'. This method exploits the pressure gradient established by adjusting each EVD to a different height to evacuate the pneumoventricle. In addition, we present a sequential approach to the management of EVD malfunction, based on the current literature and our institutional protocol.
2,330,577
Endoscopic High Occipital Interhemispheric Transtentorial Approach for Lesions in the Anterosuperior Cerebellum, Upper Fourth Ventricle, and Upper Dorsal Brain Stem.
The occipital transtentorial route is considered the most suitable for surgical treatment of lesions arising from the anterosuperior cerebellum, upper fourth ventricle, and upper dorsal brain stem. Therefore, this study examined the feasibility and effectiveness of the endoscopic high occipital interhemispheric transtentorial approach (EHOTA) for lesions in these areas, in achieving results comparable to the endoscopic occipital interhemispheric transtentorial approach (EOTA). EOTA has recently been reported to be an effective procedure for pineal region tumors, having several advantages that include minimal invasiveness with a small entrance limiting the retraction of the occipital lobe, the elimination of blind spots, and the facilitation of fine manipulation due to the bright, magnified panoramic view.</AbstractText>By using 30 clinical datasets of venous-phase head computed tomography angiogram, measurements on images were performed and differences between EOTA and EHOTA were identified. In addition, the feasibility of EHOTA was verified with 5 cadaver heads.</AbstractText>Although the operative field via EHOTA was considered significantly deeper and less maneuverable than with the procedure via EOTA, beneficial angles for manipulation in the superior cerebellum and the fourth ventricle were obtained in EHOTA, on account of their becoming more obtuse. Using EHOTA, it was possible to reach those regions and effectively manipulate all 10 sides of the 5 cadaveric heads, as well as a case with anterosuperior cerebellar cavernous angioma.</AbstractText>EHOTA, which has the same advantages as EOTA, could prove to be an efficacious procedure for lesions in the anterosuperior cerebellum, upper fourth ventricle, and upper dorsal brain stem.</AbstractText>Copyright &#xa9; 2021 Elsevier Inc. All rights reserved.</CopyrightInformation>
2,330,578
Morphology of septomarginal trabeculae in Hatay mountain gazelle (Gazella gazella).
This study was conducted to reveal the anatomical and histological features of left and right septomarginal trabeculae in the heart of the Hatay mountain gazelle. In the study, two female and two male adult Hatay mountain gazelle hearts were used. For this purpose, the materials detected in 10% formaldehyde solution were stained with Crossman's modified triple staining technique and examined under a light microscope after anatomical examinations and measurements were made. The presence of trabeculae in both ventricles was demonstrated. While the number of septomarginal trabeculae was 1 in each of the samples in the right ventricle, it was determined that it was 2 in each of three hearts and 3 in one heart in the left ventricle. It was observed that the right trabeculae were unbranched and fleshy, while the left trabeculae were filamentous and mostly branched. The lengths and thicknesses of the right trabeculae were measured 12-17&#xa0;mm and 3-4&#xa0;mm and the lengths and thicknesses of the left trabeculae were measured 6-15&#xa0;mm and 0.5-1&#xa0;mm. In the histological examination of both trabeculae, connective tissue, Purkinje fibres and blood vessels were observed, in addition, it was detected that the right trabeculae had myocardial fibres. Few capillaries were found in the left trabecula, while both more capillaries and blood vessels were found in the right trabeculae.
2,330,579
Reinvestigating Tumor-Ventricle Relationship of Craniopharyngiomas With Predominantly Ventricular Involvement: An Endoscopic Endonasal Series Based on Histopathological Assessment.
Craniopharyngiomas (CPs) predominantly involving the third ventricle were commonly termed "intraventricular" lesions. The aim of this study was to clarify the anatomical relationship between the tumor and the third ventricle by both surgical and histological investigation.</AbstractText>A retrospective review of primarily resected CPs by endoscopic endonasal surgery was performed. CPs with predominantly ventricular involvement were selected for study inclusion by preoperative imaging. The surgical procedure of each case was reviewed. The wholly removed tumor specimens were histologically analyzed, in all cases, to investigate the tumor-third ventricle relationship using hematoxylin and eosin, immunochemical, and immunofluorescence staining.</AbstractText>Twenty-six primary CPs predominantly involving the third ventricle were selected from our series of 223 CPs treated by endoscopic endonasal surgery between January 2017 and March 2021. Gross-total resection was achieved in 24 (92.3%) of 26 patients, with achievement of near-total resection in the remaining patients. A circumferential layer of stretched third ventricle floor was identified surrounding the tumor capsule, which could be peeled off easily from the ventricle floor remnants at most areas of the plane of tumor attachment. Some portions of the tumor capsule tightly adhered to the third ventricle floor were removed together with the floor. A breach of various size was observed at the third ventricle floor after tumor removal in most cases, the floor remaining intact in only two cases (7.7%). Histological examination on marked portions of tumor capsule showed that the pia mater was frequently detected at most of the tumor-brain interface, except at the antero-frontal border of tumor contacting with the third ventricle floor. At this point, a layer of gliosis with various thickness was observed between the tumor and the neural tissue of the third ventricle floor.</AbstractText>CPs with predominantly ventricular involvement should be considered as lesions with an extraventricular, epi-pia topography rather than "intraventricular" or "subpial" topography. Accurate understanding of the relationship between the third ventricle and such tumors would predict the circumferential cleavage plane of dissection, and remind neurosurgeons of performing dissection along the safe surgical plane to achieve total tumoral resection with minimizing hypothalamic damage.</AbstractText>Copyright &#xa9; 2021 Fan, Liu, Wang, Feng, Pan, Peng, Peng, Bao, Nie, Qiu and Qi.</CopyrightInformation>
2,330,580
The Antagonism of Corticotropin-Releasing Factor Receptor-1 in Brain Suppress Stress-Induced Propofol Self-Administration in Rats.
Propofol addiction has been detected in humans and rats, which may be facilitated by stress. Corticotropin-releasing factor acts through the corticotropin-releasing factor (CRF) receptor-1 (CRF1R) and CRF2 receptor-2 (CRF2R) and is a crucial candidate target for the interaction between stress and drug abuse, but its role on propofol addiction remains unknown. Tail clip stressful stimulation was performed in rats to test the stress on the establishment of the propofol self-administration behavioral model. Thereafter, the rats were pretreated before the testing session at the bilateral lateral ventricle with one of the doses of antalarmin (CRF1R antagonist, 100-500 ng/site), antisauvagine 30 (CRF2R antagonist, 100-500 ng/site), and RU486 (glucocorticoid receptor antagonist, 100-500 ng/site) or vehicle. The dopamine D1 receptor (D1R) in the nucleus accumbens (NAc) was detected to explore the underlying molecular mechanism. The sucrose self-administration establishment and maintenance, and locomotor activities were also examined to determine the specificity. We found that the establishment of propofol self-administration was promoted in the tail clip treated group (the stress group), which was inhibited by antalarmin at the dose of 100-500 ng/site but was not by antisauvagine 30 or RU486. Accordingly, the expression of D1R in the NAc was attenuated by antalarmin, dose-dependently. Moreover, pretreatments fail to change sucrose self-administration behavior or locomotor activities. This study supports the role of CRF1R in the brain in mediating the central reward processing through D1R in the NAc and provided a possibility that CRF1R antagonist may be a new therapeutic approach for the treatment of propofol addiction.
2,330,581
[Contrast-enhancement Effects of Dual-peak Contrast Medium Injection Method Using Bolus-tracking Technique in Coronary and Aorta CT Angiography].
We compared the contrast-enhancement effects of the coronary arterial phase and the aortic phase in coronary and aorta computed tomography angiography (CA-CTA) using the bolus-tracking technique-based single-peak contrast medium injection (BT-SPI) method and the bolus-tracking technique-based dual-peak contrast medium injection (BT-DPI) method.</AbstractText>CA-CTA images were acquired from 30 patients, using BT-SPI and BT-DPI. Regions of interest were selected in the right ventricle and ascending aorta during the coronary arterial phase, and in the aorta during the aortic phase to obtain mean CT values. The mean CT values were used to compare the contrast-enhancement effects of BT-SPI and BT-DPI.</AbstractText>The mean CT value of the right ventricle during the coronary arterial phase obtained using BT-SPI (320 Hounsfield unit [HU]) and BT-DPI (83 HU) was significantly different (p&lt;0.05). Using BT-SPI and BT-DPI, the mean CT values of the ascending aorta during the coronary arterial phase were 361 HU and 379 HU, respectively, and those of the aorta during the aortic phase were 436 HU and 437 HU, respectively. The difference in the mean CT values for the aorta between BT-SPI and BT-DPI during the coronary arterial and aortic phases was insignificant.</AbstractText>The retention of the contrast medium in the right ventricle during the coronary arterial phase using BT-DPI was lower than that using BT-SPI. BT-DPI showed substantial contrast-enhancement effects in both the coronary arterial and aortic phases.</AbstractText>
2,330,582
Administration of miR-195 Inhibitor Enhances Memory Function Through Improving Synaptic Degradation and Mitochondrial Dysfunction of the Hippocampal Neurons in SAMP8 Mice.
Mitochondrial dysfunction is an early feature of Alzheimer's disease (AD) and miR-195 is involved in mitochondrial disorder through targeting MFN-2 protein in hippocampal neurons of AD.</AbstractText>To clarify if administration of miR-195 inhibitor could enhance the memory deficits through improving hippocampal neuron mitochondrial dysfunction in SAMP8 mice.</AbstractText>The expression of miR-195 was detected by RT-qPCR in primary hippocampal neurons and HT-22 cells treated with A&#x3b2;1-42. Morris water maze (MWM) was used to assess the learning and memory function in SAMP8 mice administrated with antagomir-195. Transmission electron microscopy was employed to determine the morphological changes of synapses and mitochondria of hippocampus in SAMP8 mice. Mitochondrial respiration was measured using a high-resolution oxygraph.</AbstractText>The expression of miR-195 were upregulated in the primary hippocampal neurons and HT-22 cells induced by A&#x3b2;1-42. Inhibition of miR-195 ameliorated the mitochondrial dysfunction in HT-22 cells induced by A&#x3b2;1-42, including mitochondrial morphologic damages, mitochondrial membrane potential, respiration function, and ATP production. Administration of antagomir-195 by the third ventricle injection markedly ameliorated the cognitive function, postsynaptic density thickness, length of synaptic active area, mitochondrial aspect ratio, and area in hippocampus of SAMP8 mice. Finally, antagomir-195 was able to promote an increase in the activity of respiratory chain complex CI and II in SAMP8 mice.</AbstractText>This study demonstrated that miR-195 inhibitor ameliorated the cognitive impairment of AD mice by improving mitochondrial structure damages and dysfunction in the hippocampal neurons, which provide an experimental basis for further exploring the treatment strategy of AD.</AbstractText>
2,330,583
Developmental morphology of the turkey pineal gland in histological images and 3D models.
The histological structure of the avian pineal gland during embryonic life has so far only been studied in chickens. It is known that the pineal organs of hatched chickens and turkeys differ significantly from each other based on their morphology and physiology. The aim of the present study was to investigate the histological structure of the embryonic pineal gland of domestic turkeys. The study was performed on turkey embryos aged 4-28 days. Along with histological analyses, three-dimensional (3D) images of the pineal glands from embryos aged 6-28 days were also obtained. In four-day-old embryos [embryonic day (ED) 4], primary evagination of the pineal gland from the neuroectoderm of the diencephalon was observed. On ED 6, the evagination formed a pineal recess with a thick and folded wall. In the next embryonic stages, the pineal recess was lengthened to the pineal canal, with the lumen opening to the third ventricle. The connection of the pineal lumen with the ventricular lumen was observed in all studied embryos. The first cellular rosettes without the lumen separated from the wall of the pineal recess occurred on ED 6. Several small and round follicles containing their own lumens were visible on ED 8. On ED 10, the pineal parenchyma was composed mainly of small, round follicles. The first oval follicles appeared on ED 12 and branched follicles appeared on ED 16. In some embryos at different stages, follicles formed from secondary evaginations of the diencephalon epithelium were observed. The turkey pineal organ maintained the follicular type of parenchyma without solid cellular aggregates throughout embryonic life. The pineal follicles originated from: 1) rosettes arising from the wall of the pineal canal (from ED 6); 2) an accessory evagination occurring in the neuroectoderm anteriorly and posteriorly to the pineal canal end (from ED 6); 3) direct development in the walls of larger follicles and detaching from them in a manner similar to the budding process (from ED 14); and 4) fusion of smaller follicles into branched ones. The pineal capsule started to develop on ED 6, first as a vascularization and later as a thin mesenchymal outline around the apical part, then at the dorsal and at the end the ventral part of the pineal gland. The pineal stroma was composed of mesenchymal tissue consisting of abundant in cells and blood vessels. The first evagination of the choroid plexus in the diencephalon was observed on ED 8. The attachment of the pineal gland to the dura mater first occurred on ED 16. Finally, the pineal gland of ED 28 embryos consisted of a wide proximal part attached to the dura mater and a narrow distal part that extended into the pineal stalk, which extended to the intercommissural region of the diencephalon. The present study revealed the occurrence of significant morphological differences in the developing embryonic pineal gland of turkeys compared with chickens.
2,330,584
Utilizing phenotypic characteristics of metastatic brain tumors to improve the probability of detecting circulating tumor DNA from cerebrospinal fluid in non-small-cell lung cancer patients: development and validation of a prediction model in a prospective cohort study.
Circulating tumor DNA (ctDNA) in cerebrospinal fluid (CSF) has become a promising surrogate for genomic profiling of central nervous system tumors. However, suboptimal ctDNA detection rates from CSF limit its clinical utility. Thus precise screening of suitable patients is needed to maximize the clinical benefit.</AbstractText>Between February 2017 and December 2020, 66 newly diagnosed non-small-cell lung cancer (NSCLC) patients with brain parenchymal metastases were prospectively enrolled as a training cohort and 30 additional patients were enrolled as an external validation cohort. CSF samples and matched primary tumor tissues were collected before treatment and subjected to next-generation sequencing (NGS). The imageological characteristics of patients' brain tumors were evaluated by radiologists using enhanced magnetic resonance imaging images. The clinical and imageological characteristics were evaluated by complete subsets regression, Akaike information criteria, and Bayesian information criteria methods to establish the prediction model. A nomogram was then built for CSF ctDNA detection prediction.</AbstractText>The somatic mutation detection rate of genes covered by our targeted NGS panel was significantly lower in CSF ctDNA (59.09%) than tumor tissue (91.84%). The Tsize</sub> (diameter of the largest intracranial lesion) and LVDmin</sub> (minimum lesion-ventricle distance for all intracranial lesions) were significantly associated with positive CSF ctDNA detection, and thus, were selected to establish the prediction model, which achieved an area under the ROC curve (AUC) of 0.819 and an accuracy of 0.800. The model's predictive ability was further validated in the independent external cohort (AUC of 0.772, accuracy of 0.767) and by internal cross-validation. The CSF ctDNA detection rate was significantly improved from 58.18% (32/55) to 81.81% (27/33) in patients after model selection (P&#xa0;= 0.022).</AbstractText>This study developed a regression model to predict the probability of detecting CSF ctDNA using the phenotypic characteristics of metastatic brain lesions in NSCLC patients, thus, maximizing the benefits of CSF liquid biopsies.</AbstractText>Copyright &#xa9; 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.</CopyrightInformation>
2,330,585
White matter hyperintensities relate to executive dysfunction, apathy, but not disinhibition in long-term adult survivors of pediatric cerebellar tumor.
White matter hyperintensities (WMHs) have been related to executive dysfunction, apathy and disinhibition in a wide range of neurological populations. However, this relationship has not been examined in survivors of pediatric brain tumor. The goal of this study was to investigate how executive dysfunction, apathy, and disinhibition relate to WMHs in 31 long-term survivors of pediatric cerebellar brain tumor and 58 controls, using informant-report data from the Frontal Systems Behavior Scale. Total WMH volume was quantified using the Lesion Growth Algorithm. Further, periventricular, and subcortical volumes were identified based on proximity to custom ventricle masks generated in FSL. A ratio of WMH volume to whole brain volume was used to obtain normalized WMH volumes. Additionally, a multivariate regression analysis was performed. On average, informant-report scores were within normal limits and only executive dysfunction was significantly higher in survivors compared to controls (t(47.9)&#xa0;=&#xa0;-2.4, p=.023). Informants reported clinically significant levels of apathy in 32.3% of survivors. Informants also reported clinically significant executive dysfunction in 19.4 % of survivors and clinically significant disinhibition in, again, 19.4 % of survivors. Increased volume of WMHs was positively correlated with executive dysfunction (r&#xa0;=&#xa0;0.33, p&#xa0;=&#xa0;0.02) and apathy (r&#xa0;=&#xa0;0.23, p&#xa0;=&#xa0;.04). Similarly, multivariate regression demonstrated correlations with executive dysfunction (p=.05, FDR corrected) and apathy (p=.05, FDR corrected). Exploratory analysis demonstrated an interaction wherein the relationship between total WMHs and executive dysfunction and apathy depends on whether the participant was a survivor. The current findings indicate that increased WMH volumes are associated with higher ratings of apathy and executive dysfunction, and that these results are likely unique to cerebellar brain tumor survivors. WMH burden may serve as a useful marker to identify survivors at risk of executive dysfunction or increased apathy.
2,330,586
Peripapillary retinal nerve fiber layer thinning in patients with progressive supranuclear palsy.
To investigate peripapillary retinal nerve fiber layer (pRNFL) changes in patients with progressive supranuclear palsy (PSP).</AbstractText>We included 21 PSP patients (36 eyes) who underwent peripapillary optical coherence tomography (OCT) scans at 2.5&#x2009;&#xb1;&#x2009;1.3&#xa0;years of disease, without ophthalmologic co-morbidities. We compared pRNFL thicknesses in PSP eyes with age-matched 22 controls (22 eyes) using generalized estimating equation model adjusting for intra-subject inter-eye correlations, age and sex. We also analyzed the correlation between the pRNFL thickness and clinical severity using Spearman's correlation. In twelve PSP patients with 3&#xa0;T brain MRI volumetric scan within 1&#xa0;year of OCT exam, we investigated the correlation between the pRNFL thickness and brain atrophy using Pearson's correlation.</AbstractText>PSP patients had global pRNFL thinning compared to controls (beta&#x2009;=&#x2009;-&#xa0;6.436, p&#x2009;=&#x2009;0.025). Global pRNFL thickness correlated with Hoehn &amp; Yahr stages (r&#x2009;=&#x2009;-&#xa0;0.487, p&#x2009;=&#x2009;0.025), and nasal pRNFL thinning showed a trend of correlation (uncorrected p&#x2009;&lt;&#x2009;0.05). Exploratory correlation analysis between global pRNFL thickness and nonmotor items in the PSP rating scale showed a trend toward association with sleep disturbances (uncorrected p&#x2009;=&#x2009;0.008) and urinary incontinence (uncorrected p&#x2009;=&#x2009;0.031), although not significant after Bonferroni correction (all 28 items). The patients had significant atrophy in the posterior cingulate cortex, third ventricle, pallidum, and midbrain with reduced midbrain-to-pons ratio, but no correlation was found between pRNFL thickness and brain volumes.</AbstractText>The pRNFL seems to be affected in PSP, which is more severe with advanced disease stages. Retinal investigation in a larger longitudinal cohort would help elucidate the pathophysiological role of retinal thinning in PSP.</AbstractText>&#xa9; 2021. The Author(s).</CopyrightInformation>
2,330,587
Spastic paraplegia as the only manifestation in neuropsychiatric lupus: a case report.
Demyelination syndrome is one manifestation of neuropsychiatric lupus erythematosus (NPLE) and is rare in systemic lupus erythematosus (SLE). When SLE presents only neuropsychiatric symptoms without damage to other systems, its diagnosis becomes difficult. Herein, we report a 29-year-old male who suffered from lower limb stiffness with recessive onset and progressive aggravation in one year. He had paraplegia, spastic hypertonia, abnormal gait, and bilateral positive Babinski&#xa0;signs. His symptoms indicated spastic paraplegia. Brain MRI showed multiple small demyelinating lesions in the lateral ventricle, brainstem, and cerebellum. Anti-ds DNA, anti-Sm and anti-RNP antibodies were positive. He was diagnosed with NPLE and had a good treatment response to steroids. To the best of our knowledge, this is the first case of spastic paraplegia as the only manifestation in SLE.
2,330,588
Unusual magnetic resonance imaging of the head in manganese and ephedrone intoxication - a case report.
Manganese intoxication leads to the accumulation of manganese in the brain, mostly in the globus pallidus, which clinically manifests as a L-DOPA - resistant parkinsonian syndrome with specific symptoms, such as spastic-hypokinetic dysarthria and postural instability. A new kind of manganese poisoning associated with drug abuse has been reported in Eastern European countries.</AbstractText>We present an adult patient with neurological abnormalities secondary to manganese intoxication related to the abuse of psychoactive substances. High serum levels of manganese, hyperintense lesions on T1-weighted magnetic resonance imaging (MRI), and parkinsonism in this case confirmed the diagnosis. MRI results showed accumulation of manganese in the basal ganglia which caused an increased signal in this area of the brain on T1 weighted sequence. This is the second case reported with diffuse high signal intensity of the entire white matter due to manganese and ephedron neurointoxication. To the best of our knowledge, this is the first time such extensive pathological changes to cerebellar white matter, located near the fourth ventricle, have been described.</AbstractText>We suggest that chronic exposure to manganese and ephedron damaged the white matter in the cerebral hemispheres and continued to affect the periventricular area of the fourth ventricle, causing continuous changes to the white matter.</AbstractText>&#xa9; 2021 MEDPRESS.</CopyrightInformation>
2,330,589
Lesion covariance networks reveal proposed origins and pathways of diffuse gliomas.
Diffuse gliomas have been hypothesized to originate from neural stem cells in the subventricular zone and develop along previously healthy brain networks. Here, we evaluated these hypotheses by mapping independent sources of glioma localization and determining their relationships with neurogenic niches, genetic markers and large-scale connectivity networks. By applying independent component analysis to lesion data from 242 adult patients with high- and low-grade glioma, we identified three lesion covariance networks, which reflect clusters of frequent glioma localization. Replicability of the lesion covariance networks was assessed in an independent sample of 168 glioma patients. We related the lesion covariance networks to important clinical variables, including tumour grade and patient survival, as well as genomic information such as molecular genetic subtype and bulk transcriptomic profiles. Finally, we systematically cross-correlated the lesion covariance networks with structural and functional connectivity networks derived from neuroimaging data of over 4000 healthy UK BioBank participants to uncover intrinsic brain networks that may that underlie tumour development. The three lesion covariance networks overlapped with the anterior, posterior and inferior horns of the lateral ventricles respectively, extending into the frontal, parietal and temporal cortices. These locations were independently replicated. The first lesion covariance network, which overlapped with the anterior horn, was associated with low-grade, isocitrate dehydrogenase -mutated/1p19q-codeleted tumours, as well as a neural transcriptomic signature and improved overall survival. Each lesion covariance network significantly coincided with multiple structural and functional connectivity networks, with the first bearing an especially strong relationship with brain connectivity, consistent with its neural transcriptomic profile. Finally, we identified subcortical, periventricular structures with functional connectivity patterns to the cortex that significantly matched each lesion covariance network. In conclusion, we demonstrated replicable patterns of glioma localization with clinical relevance and spatial correspondence with large-scale functional and structural connectivity networks. These results are consistent with prior reports of glioma growth along white matter pathways, as well as evidence for the coordination of glioma stem cell proliferation by neuronal activity. Our findings describe how the locations of gliomas relate to their proposed subventricular origins, suggesting a model wherein periventricular brain connectivity guides tumour development.
2,330,590
Sensory Afferent Renal Nerve Activated G&#x3b1;i<sub>2</sub> Subunit Proteins Mediate the Natriuretic, Sympathoinhibitory and Normotensive Responses to Peripheral Sodium Challenges.
We have previously reported that brain G&#x3b1;i<sub>2</sub> subunit proteins are required to maintain sodium homeostasis and are endogenously upregulated in the hypothalamic paraventricular nucleus (PVN) in response to increased dietary salt intake to maintain a salt resistant phenotype in rats. However, the origin of the signal that drives the endogenous activation and up-regulation of PVN G&#x3b1;i<sub>2</sub> subunit protein signal transduction pathways is unknown. By central oligodeoxynucleotide (ODN) administration we show that the pressor responses to central acute administration and central infusion of sodium chloride occur independently of brain G&#x3b1;i<sub>2</sub> protein pathways. In response to an acute volume expansion, we demonstrate, via the use of selective afferent renal denervation (ADNX) and anteroventral third ventricle (AV3V) lesions, that the sensory afferent renal nerves, but not the sodium sensitive AV3V region, are mechanistically involved in G&#x3b1;i<sub>2</sub> protein mediated natriuresis to an acute volume expansion [peak natriuresis (&#x3bc;eq/min) sham AV3V: 43 &#xb1; 4 vs. AV3V 45 &#xb1; 4 vs. AV3V + G&#x3b1;i<sub>2</sub> ODN 25 &#xb1; 4, <i>p</i> &lt; 0.05; sham ADNX: 43 &#xb1; 4 vs. ADNX 23 &#xb1; 6, AV3V + G&#x3b1;i<sub>2</sub> ODN 25 &#xb1; 3, <i>p</i> &lt; 0.05]. Furthermore, in response to chronically elevated dietary sodium intake, endogenous up-regulation of PVN specific G&#x3b1;i<sub>2</sub> proteins does not involve the AV3V region and is mediated by the sensory afferent renal nerves to counter the development of the salt sensitivity of blood pressure (MAP [mmHg] 4% NaCl; Sham ADNX 124 &#xb1; 4 vs. ADNX 145 &#xb1; 4, <i>p</i> &lt; 0.05; Sham AV3V 125 &#xb1; 4 vs. AV3V 121 &#xb1; 5). Additionally, the development of the salt sensitivity of blood pressure following central ODN-mediated G&#x3b1;i<sub>2</sub> protein down-regulation occurs independently of the actions of the brain angiotensin II type 1 receptor. Collectively, our data suggest that in response to alterations in whole body sodium the peripheral sensory afferent renal nerves, but not the central AV3V sodium sensitive region, evoke the up-regulation and activation of PVN G&#x3b1;i<sub>2</sub> protein gated pathways to maintain a salt resistant phenotype. As such, both the sensory afferent renal nerves and PVN G&#x3b1;i<sub>2</sub> protein gated pathways, represent potential targets for the treatment of the salt sensitivity of blood pressure.
2,330,591
Sodium selenate as a disease-modifying treatment for progressive supranuclear palsy: protocol for a phase 2, randomised, double-blind, placebo-controlled trial.
Progressive supranuclear palsy (PSP) is a neurodegenerative disorder for which there are currently no disease-modifying therapies. The neuropathology of PSP is associated with the accumulation of hyperphosphorylated tau in the brain. We have previously shown that protein phosphatase 2 activity in the brain is upregulated by sodium selenate, which enhances dephosphorylation. Therefore, the objective of this study is to evaluate the efficacy and safety of sodium selenate as a disease-modifying therapy for PSP.</AbstractText>This will be a multi-site, phase 2b, double-blind, placebo-controlled trial of sodium selenate. 70 patients will be recruited at six Australian academic hospitals and research institutes. Following the confirmation of eligibility at screening, participants will be randomised (1:1) to receive 52 weeks of active treatment (sodium selenate; 15&#x2009;mg three times a day) or matching placebo. Regular safety and efficacy visits will be completed throughout the study period. The primary study outcome is change in an MRI volume composite (frontal lobe+midbrain-3rd ventricle) over the treatment period. Analysis will be with a general linear model (GLM) with the MRI composite at 52 weeks as the dependent variable, treatment group as an independent variable and baseline MRI composite as a covariate. Secondary outcomes are change in PSP rating scale, clinical global impression of change (clinician) and change in midbrain mean diffusivity. These outcomes will also be analysed with a GLM as above, with the corresponding baseline measure entered as a covariate. Secondary safety and tolerability outcomes are frequency of serious adverse events, frequency of down-titration occurrences and frequency of study discontinuation. Additional, as yet unplanned, exploratory outcomes will include analyses of other imaging, cognitive and biospecimen measures.</AbstractText>The study was approved by the Alfred Health Ethics Committee (594/20). Each participant or their legally authorised representative and their study partner will provide written informed consent at trial commencement. The results of the study will be presented at national and international conferences and published in peer-reviewed journals.</AbstractText>Australian New Zealand Clinical Trials Registry (ACTRN12620001254987).</AbstractText>&#xa9; Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</CopyrightInformation>
2,330,592
PRDM16 Is a Compact Myocardium-Enriched Transcription Factor Required to Maintain Compact Myocardial Cardiomyocyte Identity in Left Ventricle.
Left ventricular noncompaction cardiomyopathy (LVNC) was discovered half a century ago as a cardiomyopathy with excessive trabeculation and a thin ventricular wall. In the decades since, numerous studies have demonstrated that LVNC primarily has an effect on left ventricles (LVs) and is often associated with LV dilation and dysfunction. However, in part because of the lack of suitable mouse models that faithfully mirror the selective LV vulnerability in patients, mechanisms underlying the susceptibility of LVs to dilation and dysfunction in LVNC remain unknown. Genetic studies have revealed that deletions and mutations in PRDM16</i> (PR domain-containing 16) cause LVNC, but previous conditional Prdm16</i> knockout mouse models do not mirror the LVNC phenotype in patients, and the underlying molecular mechanisms by which PRDM16 deficiency causes LVNC are still unclear.</AbstractText>Prdm16</i> cardiomyocyte-specific knockout (Prdm16</i>cKO</i></sup>) mice were generated and analyzed for cardiac phenotypes. RNA sequencing and chromatin immunoprecipitation deep sequencing were performed to identify direct transcriptional targets of PRDM16 in cardiomyocytes. Single-cell RNA sequencing in combination with spatial transcriptomics was used to determine cardiomyocyte identity at the single-cell level.</AbstractText>Cardiomyocyte-specific ablation of Prdm16</i> in mice caused LV-specific dilation and dysfunction, as well as biventricular noncompaction, which fully recapitulated LVNC in patients. PRDM16 functioned mechanistically as a compact myocardium-enriched transcription factor that activated compact myocardial genes while repressing trabecular myocardial genes in LV compact myocardium. Consequently, Prdm16</i>cKO</i></sup> LV compact myocardial cardiomyocytes shifted from their normal transcriptomic identity to a transcriptional signature resembling trabecular myocardial cardiomyocytes or neurons. Chamber-specific transcriptional regulation by PRDM16 was attributable in part to its cooperation with LV-enriched transcription factors Tbx5 and Hand1.</AbstractText>These results demonstrate that disruption of proper specification of compact cardiomyocytes may play a key role in the pathogenesis of LVNC. They also shed light on underlying mechanisms of the LV-restricted transcriptional program governing LV chamber growth and maturation, providing a tangible explanation for the susceptibility of LV in a subset of LVNC cardiomyopathies.</AbstractText>
2,330,593
ATM modulates subventricular zone neural stem cell maintenance and senescence through Notch signaling pathway.
Ataxia telangiectasia mutated (ATM) plays an essential role in DNA damage response and the maintenance of genomic stability. However, the role of ATM in regulating the function of adult neural stem cells (NSCs) remains unclear. Here we report that ATM deficiency led to accumulated DNA damage and decreased DNA damage repair capacity in neural progenitor cells. Moreover, we observed ATM ablation lead to the short-term increase of proliferation of neural progenitor cells, resulting in the depletion of the NSC pool over time, and this loss of NSC quiescence resulted in accelerated cell senescence. We further apply RNA sequencing to unravel that ATM knockout significantly affected Notch signaling pathway, furthermore, notch activation inhibit the abnormal increased proliferation of ATM<sup>-/-</sup> NSCs. Taken together, these findings indicate that ATM can serve as a key regulator for the normal function of adult NSCs by maintaining their stemness and preventing cellular senescence primarily through Notch signaling pathway.
2,330,594
CNS GNPDA2 Does Not Control Appetite, but Regulates Glucose Homeostasis.
<i>GNPDA2</i> has been associated with human obesity and type-2 diabetes by using a GWAS approach. GNPDA2 is an enzyme involved in the hexosamine biosynthesis pathway, which is known to be important for nutrient sensing in various organism. Its counter enzyme, GFAT, has previously been shown to be important to the development of insulin resistance in diabetes. The implication of GNPDA2 and GFAT in metabolism is scarce and the effect of both enzymes over appetite and glucose homeostasis is unknown. <b>Aim:</b> Identify the role of GNPDA2 and GFAT in nutrient sensing circuits of the CNS that are important for the regulation of both appetite and glucose homeostasis. <b>Methods:</b> Using Long Evans rats, we administered either a GNPDA2 or GFAT antagonist or vehicle in <i>i3vt</i>. <b>Key Findings:</b> <i>GNPDA2</i> is highly expressed in hypothalamus and adipose tissue, followed by muscle and liver. <i>GNPDA2</i> is expressed in different hypothalamic nuclei (ARC, DMH, LHA, PVN). <i>GNPDA2</i> is downregulated in hypothalamus under diet-induced obesity (as previously described), but <i>GFAT</i> expression does not change. Moreover, <i>i3vt</i> infusion of GNPDA2 or GFAT inhibitor resulted in increased c-Fos in areas related to appetite and glucose homeostasis control as PVN and DMH and to a lesser extent in the LHA and ARC. Central inhibition of GNPDA2 does not alter either acute food intake or body weight; however, GFAT inhibition diminished appetite and body weight due to visceral illness. In addition, central administration of the GNPDA2 antagonist, prior to an intraperitoneal glucose tolerance test, resulted in glucose intolerance in comparison to vehicle without altering insulin levels. <b>Significance:</b> These results suggest that central GNPDA2 does not control appetite, but regulates glucose homeostasis.
2,330,595
Single-cell delineation of lineage and genetic identity in the mouse brain.
During neurogenesis, mitotic progenitor cells lining the ventricles of the embryonic mouse brain undergo their final rounds of cell division, giving rise to a wide spectrum of postmitotic neurons and glia<sup>1,2</sup>. The link between developmental lineage and cell-type diversity remains an open question. Here we used massively parallel tagging of progenitors to track clonal relationships and transcriptomic signatures during mouse forebrain development. We quantified clonal divergence and convergence across all major cell classes postnatally, and found diverse types of GABAergic neuron that share a common lineage. Divergence of GABAergic clones occurred during embryogenesis upon cell-cycle exit, suggesting that differentiation into subtypes is initiated as a lineage-dependent process at the progenitor cell level.
2,330,596
Metformin attenuates sepsis-induced neuronal injury and cognitive impairment.
Sepsis is considered to be a high-risk factor for cognitive impairment in the brain. The purpose of our study is to explore whether sepsis causes cognitive impairment and try to evaluate the underlying mechanisms and intervention measures.</AbstractText>Here, we used cecum ligation and puncture (CLP) to simulate sepsis. Open field, Novel Objective Recognition, and Morris Water Maze Test were used to detect cognitive function, long-term potentiation was used to assess of synaptic plasticity, and molecular biological technics were used to assess synaptic proteins, ELISA kits were used to detect inflammatory factors. Metformin was injected into the lateral ventricle of SD rats, and we evaluated whether metformin alleviated CLP-mediated cognitive impairment using behavioral, electrophysiological and molecular biological technology experiments.</AbstractText>Here we report hippocampal-dependent cognitive deficits and synaptic dysfunction induced by the CLP, accompanied by a significant increase in inflammatory factors. At the same time, metformin was able to improve cognitive impairment induced by CLP in adult male rats.</AbstractText>These findings highlight a novel pathogenic mechanism of sepsis-related cognitive impairment through activation of inflammatory factors, and these are blocked by metformin to attenuate sepsis-induced neuronal injury and cognitive impairment.</AbstractText>&#xa9; 2021. The Author(s).</CopyrightInformation>
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Correction: Mouse Models of Intracerebral Hemorrhage in Ventricle, Cortex, and Hippocampus by Injections of Autologous Blood or Collagenase.
[This corrects the article DOI: 10.1371/journal.pone.0097423.].
2,330,598
Left Ventricular Noncompaction as a Rare Cause of Syncope.
Left ventricular noncompaction (LVNC) is a relatively rare myocardial disorder which is characterized by trabeculations and deep intertrabecular recesses within the left ventricle. LVNC is often asymptomatic but may present with heart failure, arrhythmias, or systemic thromboembolism. Uncommonly, patients with LVNC can present with syncope. In this article, we report one such presentation of this rare medical condition.
2,330,599
Magnetic resonance imaging of cerebrospinal fluid outflow after low-rate lateral ventricle infusion in mice.
The anatomical routes for the clearance of cerebrospinal fluid (CSF) remain incompletely understood. However, recent evidence has given strong support for routes leading to lymphatic vessels. A current debate centers upon the routes through which CSF can access lymphatics, with evidence emerging for either direct routes to meningeal lymphatics or along cranial nerves to reach lymphatics outside the skull. Here, a method was established to infuse contrast agent into the ventricles using indwelling cannulae during imaging of mice at 2 and 12 months of age by magnetic resonance imaging. As expected, a substantial decline in overall CSF turnover was found with aging. Quantifications demonstrated that the bulk of the contrast agent flowed from the ventricles to the subarachnoid space in the basal cisterns. Comparatively little contrast agent signal was found at the dorsal aspect of the skull. The imaging dynamics from the 2 cohorts revealed that the contrast agent was cleared from the cranium through the cribriform plate to the nasopharyngeal lymphatics. On decalcified sections, we confirmed that fluorescently labeled ovalbumin drained through the cribriform plate and could be found within lymphatics surrounding the nasopharynx. In conclusion, routes leading to nasopharyngeal lymphatics appear to be a major efflux pathway for cranial CSF.