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2,331,400 | Impaired Right Ventricular Calcium Cycling Is an Early Risk Factor in R14del-Phospholamban Arrhythmias. | The inherited mutation (R14del) in the calcium regulatory protein phospholamban (PLN) is linked to malignant ventricular arrhythmia with poor prognosis starting at adolescence. However, the underlying early mechanisms that may serve as prognostic factors remain elusive. This study generated humanized mice in which the endogenous gene was replaced with either human wild type or R14del-PLN and addressed the early molecular and cellular pathogenic mechanisms. R14del-PLN mice exhibited stress-induced impairment of atrioventricular conduction, and prolongation of both ventricular activation and repolarization times in association with ventricular tachyarrhythmia, originating from the right ventricle (RV). Most of these distinct electrocardiographic features were remarkably similar to those in R14del-PLN patients. Studies in isolated cardiomyocytes revealed RV-specific calcium defects, including prolonged action potential duration, depressed calcium kinetics and contractile parameters, and elevated diastolic Ca-levels. Ca-sparks were also higher although SR Ca-load was reduced. Accordingly, stress conditions induced after contractions, and inclusion of the CaMKII inhibitor KN93 reversed this proarrhythmic parameter. Compensatory responses included altered expression of key genes associated with Ca-cycling. These data suggest that R14del-PLN cardiomyopathy originates with RV-specific impairment of Ca-cycling and point to the urgent need to improve risk stratification in asymptomatic carriers to prevent fatal arrhythmias and delay cardiomyopathy onset. |
2,331,401 | Caloric Restriction and Hypothalamic Leptin Gene Therapy Have Differential Effects on Energy Partitioning in Adult Female Rats. | Dieting is a common but often ineffective long-term strategy for preventing weight gain. Similar to humans, adult rats exhibit progressive weight gain. The adipokine leptin regulates appetite and energy expenditure but hyperleptinemia is associated with leptin resistance. Here, we compared the effects of increasing leptin levels in the hypothalamus using gene therapy with conventional caloric restriction on weight gain, food consumption, serum leptin and adiponectin levels, white adipose tissue, marrow adipose tissue, and bone in nine-month-old female Sprague-Dawley rats. Rats (<i>n</i> = 16) were implanted with a cannula in the 3rd ventricle of the hypothalamus and injected with a recombinant adeno-associated virus, encoding the rat gene for leptin (rAAV-<i>Lep</i>), and maintained on standard rat chow for 18 weeks. A second group (<i>n</i> = 15) was calorically-restricted to match the weight of the rAAV-<i>Lep</i> group. Both approaches prevented weight gain, and no differences in bone were detected. However, calorically-restricted rats consumed 15% less food and had lower brown adipose tissue <i>Ucp-1</i> mRNA expression than rAAV-<i>Lep</i> rats. Additionally, calorically-restricted rats had higher abdominal white adipose tissue mass, higher serum leptin and adiponectin levels, and higher marrow adiposity. Caloric restriction and hypothalamic leptin gene therapy, while equally effective in preventing weight gain, differ in their effects on energy intake, energy expenditure, adipokine levels, and body composition. |
2,331,402 | The Right Ventricle in COVID-19. | Infection with the novel severe acute respiratory coronavirus-2 (SARS-CoV2) results in COVID-19, a disease primarily affecting the respiratory system to provoke a spectrum of clinical manifestations, the most severe being acute respiratory distress syndrome (ARDS). A significant proportion of COVID-19 patients also develop various cardiac complications, among which dysfunction of the right ventricle (RV) appears particularly common, especially in severe forms of the disease, and which is associated with a dismal prognosis. Echocardiographic studies indeed reveal right ventricular dysfunction in up to 40% of patients, a proportion even greater when the RV is explored with strain imaging echocardiography. The pathophysiological mechanisms of RV dysfunction in COVID-19 include processes increasing the pulmonary vascular hydraulic load and others reducing RV contractility, which precipitate the acute uncoupling of the RV with the pulmonary circulation. Understanding these mechanisms provides the fundamental basis for the adequate therapeutic management of RV dysfunction, which incorporates protective mechanical ventilation, the prevention and treatment of pulmonary vasoconstriction and thrombotic complications, as well as the appropriate management of RV preload and contractility. This comprehensive review provides a detailed update of the evidence of RV dysfunction in COVID-19, its pathophysiological mechanisms, and its therapy. |
2,331,403 | Inter-Metastatic Heterogeneity of Tumor Marker Expression and Microenvironment Architecture in a Preclinical Cancer Model. | Preclinical drug development studies rarely consider the impact of a candidate drug on established metastatic disease. This may explain why agents that are successful in subcutaneous and even orthotopic preclinical models often fail to demonstrate efficacy in clinical trials. It is reasonable to anticipate that sites of metastasis will be phenotypically unique, as each tumor will have evolved heterogeneously with respect to gene expression as well as the associated phenotypic outcome of that expression. The objective for the studies described here was to gain an understanding of the tumor heterogeneity that exists in established metastatic disease and use this information to define a preclinical model that is more predictive of treatment outcome when testing novel drug candidates clinically.</AbstractText>Female NCr nude mice were inoculated with fluorescent (mKate), Her2/neu-positive human breast cancer cells (JIMT-mKate), either in the mammary fat pad (orthotopic; OT) to replicate a primary tumor, or directly into the left ventricle (intracardiac; IC), where cells eventually localize in multiple sites to create a model of established metastasis. Tumor development was monitored by in vivo fluorescence imaging (IVFI). Subsequently, animals were sacrificed, and tumor tissues were isolated and imaged ex vivo. Tumors within organ tissues were further analyzed via multiplex immunohistochemistry (mIHC) for Her2/neu expression, blood vessels (CD31), as well as a nuclear marker (Hoechst) and fluorescence (mKate) expressed by the tumor cells.</AbstractText>Following IC injection, JIMT-1mKate cells consistently formed tumors in the lung, liver, brain, kidney, ovaries, and adrenal glands. Disseminated tumors were highly variable when assessing vessel density (CD31) and tumor marker expression (mkate, Her2/neu). Interestingly, tumors which developed within an organ did not adopt a vessel microarchitecture that mimicked the organ where growth occurred, nor did the vessel microarchitecture appear comparable to the primary tumor. Rather, metastatic lesions showed considerable variability, suggesting that each secondary tumor is a distinct disease entity from a microenvironmental perspective.</AbstractText>The data indicate that more phenotypic heterogeneity in the tumor microenvironment exists in models of metastatic disease than has been previously appreciated, and this heterogeneity may better reflect the metastatic cancer in patients typically enrolled in early-stage Phase I/II clinical trials. Similar to the suggestion of others in the past, the use of models of established metastasis preclinically should be required as part of the anticancer drug candidate development process, and this may be particularly important for targeted therapeutics and/or nanotherapeutics.</AbstractText> |
2,331,404 | Tenorio syndrome: Description of 14 novel cases and review of the clinical and molecular features. | Tenorio syndrome (TNORS) (OMIM #616260) is a relatively recent disorder with very few cases described so far. Clinical features included macrocephaly, intellectual disability, hypotonia, enlarged ventricles and autoimmune diseases. Molecular underlying mechanism demonstrated missense variants and a large deletion encompassing RNF125, a gene that encodes for an U3 ubiquitin ligase protein. Since the initial description of the disorder in six patients from four families, several new patients were diagnosed, adding more evidence to the clinical spectrum. In this article, we described 14 additional cases with deep phenotyping and make an overall review of all the cases with pathogenic variants in RNF125. Not all patients presented with overgrowth, but instead, most patients showed a common pattern of neurodevelopmental disease, macrocephaly and/or large forehead. Segregation analysis showed that, though the variant was inherited in some patients from an apparently asymptomatic parent, deep phenotyping suggested a mild form of the disease in some of them. The mechanism underlying the development of this disease is not well understood yet and the report of further cases will help to a better understanding and clinical characterization of the syndrome. |
2,331,405 | Cardiocutaneous fistula secondary to left ventricular pseudo-aneurysm rupture. | Cardiocutaneous fistula (CF) is a potentially serious and catastrophic complication. Infection the suture line after left ventricular aneurysm repair, presenting with the CF. We present an unusual case of CF due to staphylococcus infection 6 months after repair of a myocardial rupture secondary to dehiscence repair. |
2,331,406 | Multimodal Simulation of a Novel Device for a Safe and Effective External Ventricular Drain Placement. | External ventricular drain (EVD) placement is mandatory for several pathologies. The misplacement rate of the EVD varies widely in literature, ranging from 12.3 to 60%. The purpose of this simulation study is to provide preliminary data about the possibility of increasing the safety of one of the most common life-saving procedures in neurosurgery by testing a new device for EVD placement.</AbstractText>We used a novel guide for positioning the ventricular catheter (patent RM2014A000376). The trajectory was assessed using 25 anonymized head CT scans. The data sets were used to conduct three-dimensional computer-based and combined navigation and augmented reality-based simulations using plaster models. The data set inclusion criteria were volumetric head CT scan, without midline shift, of patients older than 18. Evans' index was used to quantify the ventricle's size. We excluded patients with slit ventricles, midline shift, skull fractures, or complex skull malformations. The proximal end of the device was tested on the cadaver.</AbstractText>The cadaveric tests proved that a surgeon could use the device without any external help. The multimodal simulation showed Kakarla grade 1 in all cases but one (grade 2) on both sides, after right and left EVD placement. The mean Evans' index was 0.28. The geometric principles that explain the device's efficacy can be summarized by studying the properties of circumference and chord. The contact occurs, for each section considered, at the extreme points of the chord. Its axis, perpendicular to the plane tangent to the spherical surface at the entry point, corresponds to the direction of entry of the catheter guided by the instrument.</AbstractText>According to our multimodal simulation on cadavers, 3D computer-based simulation, 3D plaster modeling, 3D neuronavigation, and augmented reality, the device promises to offer safer and effective EVD placement. Further validation in future clinical studies is recommended.</AbstractText>Copyright © 2021 Umana, Scalia, Yagmurlu, Mineo, Di Bella, Giunta, Spitaleri, Maugeri, Graziano, Fricia, Nicoletti, Tomasi, Raudino, Chaurasia, Bellocchi, Salvati, Iacopino, Cicero, Visocchi and Strigari.</CopyrightInformation> |
2,331,407 | [Penetrating Right Ventricular Injury by Suicide Attempt:Report of a Case]. | Penetrating heart injury is rare in Japan. A 35-year-old man stabbed himself with a fruit knife that was about 10 cm in length on the left precordium in an attempt to commit suicide and was transferred to our hospital. His vital signs were stable, and the knife remained stabbed in the left precordium. Cardiac injury and cardiac tamponade were suspected on computed tomography, and emergency surgery was performed. A large amount of red hematoma was found in the mediastinum and the pericardial space after median sternotomy. The knife had created a fissure of about 15 mm in the free wall of the right ventricle, and the injury was repairable. The knife passed through the sixth costal cartilage and the left internal thoracic artery, and hemostasis was easy. The patient's postoperative course was uneventful, but due to the suicide attempt and adjustment disorder, the patient was transferred to a psychiatric hospital on postoperative day 10. |
2,331,408 | Evaluation of prenatal changes in fetal cardiac morphology and function in maternal diabetes mellitus using a novel fetal speckle-tracking analysis: a prospective cohort study. | Due to metabolic changes in the second trimester and the increasing number of pregnant women with obesity and advanced maternal age, the incidence of gestational diabetes mellitus (GDM) remains high. This study aimed to evaluate the effects of GDM on fetal cardiac morphology and function, and to determine whether these changes increase with increasing estimated fetal weight (EFW).</AbstractText>Fifty-eight women with GDM (GDM group) and 58 women with a healthy pregnancy (control group) were included in this prospective observational cohort study. Each group included subgroups of 31 pregnant women with a gestational age between 24+0</sup> weeks and 27+6</sup> weeks as well as 27 pregnant women with a gestational age between 28+0</sup> weeks and 40+0</sup> weeks. For all fetuses, a cine of 2-3 s in the four-chamber view was obtained, and online speckle-tracking analysis was performed using the GE Automatic Fetal Heart Assessment Tool (fetal HQ; General Electric Healthcare Ultrasound, Zipf, Austria) to measure the global sphericity index (GSI), global longitudinal strain (GLS), fractional area change (FAC), 24-segment sphericity index (SI), and 24-segment end-diastolic diameter of the left ventricle (LV) and right ventricle (RV). Data were analyzed using the independent t-test and Wilcoxon rank-sum test, as applicable.</AbstractText>The GDM group (mean HbA1c value was 5.3 ± 0.57 mmol/L) showed a lower GSI value than the control group (1.21 vs. 1.27, P = 0.000), which indicated a rounder shape of the heart. In addition, fetuses in the GDM group demonstrated significant impairment in cardiac function compared to those in the control group (LV-GLS: -18.26% vs. -22.70%, RV-GLS: -18.52% vs. -22.74%, LV-FAC: 35.30% vs. 42.36%, RV-FAC: 30.89% vs. 36.80%; P = 0.000 for all). Subgroup analyses according to gestational age (24+0</sup>-27+6</sup> weeks and 28+0</sup>-40+0</sup> weeks) showed that the statistical differences were retained between the GDM and control groups in each subgroup.</AbstractText>Fetuses of women with GDM present with signs of biventricular systolic dysfunction according to deformation analysis using fetal HQ. Additionally, the heart had a rounder shape in the GDM group than in the control group. This study showed that fetal HQ can be used to assess fetal cardiac morphology and function easily and quickly, and the effects of GDM on fetal cardiac morphology and function appeared from the second trimester. Thus, whether earlier and stricter clinical intervention was necessary remained to be further studied. Furthermore, future studies will need to supplement the effects of blood glucose levels on GLS, FAC, GSI, and 24-segment SI. Additionally, the long-term follow-up after birth should also be improved to observe the influence of changes in the indicators on the prognosis.</AbstractText> |
2,331,409 | Combined microsurgical-endoscopic paramedian supracerebellar-infratentorial approach for resection of a pineal low-grade glioma. | The authors present the case of a 20-year-old male with a history of headaches and blurred vision found to have a pineal mass and chronic hydrocephalus. The patient initially underwent an endoscopic third ventriculostomy and pineal mass biopsy that revealed a low-grade neuroepithelial neoplasm. A microsurgery-endoscope-assisted paramedian supracerebellar-infratentorial approach was chosen and a gross-total resection was achieved. The patient's postoperative and follow-up course has been unremarkable, with early postoperative imaging demonstrating no residual tumoral mass. The operative video highlights the advantages of endoscopic visualization for deep lesions in the pineal region and posterior third ventricle. The video can be found here: https://stream.cadmore.media/r10.3171/2021.4.FOCVID2119. |
2,331,410 | Retractorless interforniceal approach for microsurgical resection of a papillary tumor of the pineal region: operative video and technical nuances. | In this illustrative video, the authors demonstrate microsurgical resection of a papillary tumor of the pineal region using a retractorless interforniceal approach via the anterior interhemispheric transcallosal route. The tumor presented to the posterior third ventricle occluding the cerebral aqueduct, resulting in obstructive hydrocephalus. The retractorless interforniceal approach is performed in the lateral position with BICOL collagen spacers to keep the corridor open. Gross-total resection was achieved, and the patient was neurologically intact without needing a permanent shunt. The operative nuances and pearls of technique for safe microdissection and gentle handling of the retractorless interforniceal approach are demonstrated. The video can be found here: https://stream.cadmore.media/r10.3171/2021.4.FOCVID2139. |
2,331,411 | Anterior endoscopic transcortical approach to a pineal region cavernous hemangioma. | A 57-year-old female presented with headache and dizziness for 3 months. Preoperative MRI revealed a lesion located at the pineal region and back side of the third ventricle, accompanied by hydrocephalus. The infratentorial supracerebellar approach may cause visuomotor, acousticomotor, and hearing disturbances. With the patient in a supine position, the authors used a frontal linear incision that was 3 cm anterior to the coronal suture and 2 cm away from the midline and an anterior endoscopic transcortical approach, which could achieve endoscopic third ventriculostomy, alleviating and preventing hydrocephalus due to postoperative adhesion and resection of the lesion at the same time. The pathological diagnosis was cavernous hemangioma. The video can be found here: https://stream.cadmore.media/r10.3171/2021.4.FOCVID215. |
2,331,412 | Interhemispheric transcallosal transchoroidal approach to a pineal teratoma in a 15-year-old boy. | In this video, the authors present an interhemispheric transcallosal transchoroidal approach to a pineal mass in a 15-year-old boy. He received emergency endoscopic third ventriculostomy (ETV), then an endoscopic biopsy that revealed an immature teratoma. Surgical removal was selected. The mass was located very high in the posterior third ventricle, hidden behind the splenium of the corpus callosum and the vein of Galen, so an interhemispheric transcallosal approach followed by a complete dissection of the whole choroidal fissure was chosen and allowed complete removal of the tumor. Microsurgical dissection is presented, showing clearly in detail all the neurovascular structures encountered. The video can be found here: https://stream.cadmore.media/r10.3171/2021.4.FOCVID2126. |
2,331,413 | Cardiac Papillary Fibroelastoma in Left Ventricular Trabeculation as a Potential Cause of Cerebral Infarction: A Case Report. | Cardiac papillary fibroelastoma (CPF) is the second or third most common primary cardiac tumor. Although histologically benign, it can cause serious symptoms depending on its location of occurrence, size, and motility. Herein, we report CPF in the left ventricular trabeculation as a potential cause of cerebral infarction.<CopyrightInformation>Copyrights © 2021 The Korean Society of Radiology.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Im</LastName><ForeName>JunYong</ForeName><Initials>J</Initials><Identifier Source="ORCID">0000-0003-3913-9336</Identifier></Author><Author ValidYN="Y"><LastName>Kim</LastName><ForeName>Dong Su</ForeName><Initials>DS</Initials><Identifier Source="ORCID">0000-0001-6318-348X</Identifier></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>04</Month><Day>14</Day></ArticleDate></Article><MedlineJournalInfo><Country>Korea (South)</Country><MedlineTA>Taehan Yongsang Uihakhoe Chi</MedlineTA><NlmUniqueID>101479271</NlmUniqueID><ISSNLinking>1738-2637</ISSNLinking></MedlineJournalInfo><OtherAbstract Type="Publisher" Language="kor">심장섬유탄력종(cardiac papillary fibroelastoma; 이하 CPF)은 두 번째 혹은 세 번째로 흔한 원발성 심장종양이다. 그것은 조직학적으로 양성이지만, 생긴 위치, 크기, 운동성에 따라 심각한 증상을 초래할 수 있다. 우리는 뇌경색을 일으킨 원인으로 생각되는 좌심실 섬유주에 생긴 CPF를 보고하고자 한다.<CopyrightInformation>Copyrights © 2021 The Korean Society of Radiology.</CopyrightInformation></OtherAbstract><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Cardiac Papillary Fibroelastoma</Keyword><Keyword MajorTopicYN="N">Cerebral Infarction</Keyword><Keyword MajorTopicYN="N">Computed Tomography, X-Ray</Keyword><Keyword MajorTopicYN="N">Contrast Echocardiography</Keyword><Keyword MajorTopicYN="N">Echocardiography</Keyword><Keyword MajorTopicYN="N">Left Ventricle</Keyword></KeywordList><CoiStatement>Conflicts of Interest: The authors have no potential conflicts of interest to disclose.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>5</Month><Day>27</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>9</Month><Day>14</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>10</Month><Day>24</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2022</Year><Month>10</Month><Day>14</Day><Hour>2</Hour><Minute>59</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>7</Month><Day>1</Day><Hour>0</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>7</Month><Day>1</Day><Hour>0</Hour><Minute>1</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">36238051</ArticleId><ArticleId IdType="pmc">PMC9514417</ArticleId><ArticleId IdType="doi">10.3348/jksr.2020.0107</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>Gowda RM, Khan IA, Nair CK, Mehta NJ, Vasavada BC, Sacchi TJ. 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Curr Cardiovasc Imaging Rep. 2014;7:9281.</Citation><ArticleIdList><ArticleId IdType="pmc">PMC4090749</ArticleId><ArticleId IdType="pubmed">25018846</ArticleId></ArticleIdList></Reference><Reference><Citation>Hur J, Choi BW. Cardiac CT imaging for ischemic stroke: current and evolving clinical applications. Radiology. 2017;283:14–28.</Citation><ArticleIdList><ArticleId IdType="pubmed">28318443</ArticleId></ArticleIdList></Reference><Reference><Citation>O'Donnell DH, Abbara S, Chaithiraphan V, Yared K, Killeen RP, Cury RC, et al. Cardiac tumors: optimal cardiac MR sequences and spectrum of imaging appearances. AJR Am J Roentgenol. 2009;193:377–387.</Citation><ArticleIdList><ArticleId IdType="pubmed">19620434</ArticleId></ArticleIdList></Reference><Reference><Citation>Hoey ET, Mankad K, Puppala S, Gopalan D, Sivananthan MU. MRI and CT appearances of cardiac tumours in adults. Clin Radiol. 2009;64:1214–1230.</Citation><ArticleIdList><ArticleId IdType="pubmed">19913133</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></PubmedArticle><PubmedBookArticle><BookDocument><PMID Version="1">36173871</PMID><ArticleIdList><ArticleId IdType="bookaccession">NBK584552</ArticleId></ArticleIdList><Book><Publisher><PublisherName>Canadian Agency for Drugs and Technologies in Health</PublisherName><PublisherLocation>Ottawa (ON)</PublisherLocation></Publisher><BookTitle book="rc1367">Transcatheter Aortic Valve Implantation for Patients With Severe Symptomatic Aortic Stenosis</BookTitle><PubDate><Year>2021</Year><Month>07</Month></PubDate><AuthorList Type="authors" CompleteYN="Y"><Author ValidYN="Y"><LastName>Young</LastName><ForeName>Calvin</ForeName><Initials>C</Initials></Author><Author ValidYN="Y"><LastName>Horton</LastName><ForeName>Jennifer</ForeName><Initials>J</Initials></Author></AuthorList><CollectionTitle book="cadthhtechrcollect">CADTH Health Technology Review</CollectionTitle><Medium>Internet</Medium></Book><Language>eng</Language><PublicationType UI="D016454">Review</PublicationType><Abstract>Aortic stenosis is a narrowing of the aortic valve that interferes with the flow of blood from the left ventricle of the heart to the aorta. This progressive valvular disorder affects approximately 2% of the population aged 65 years or older and 5% of those older than 75 years of age. People who are affected by aortic stenosis typically remain asymptomatic for many years and the condition may not measurably impact their health; however, patients who become symptomatic generally have a poor prognosis.<sup>,</sup> Symptoms of aortic stenosis — such as decreased capacity for exercise, heart murmur, chest pain or tightness, heart palpitations, shortness of breath, and feeling faint or dizzy with physical activity — tend to gradually develop as the condition worsens. Serious complications of aortic stenosis include heart failure, stroke, blood clots, endocarditis, and sudden death.<sup>,</sup> Treatment options for severe aortic stenosis include medical therapy (e.g., statin therapy, non-statin lipid-lowering therapy, antihypertensive therapy, and therapies that target or prevent aortic valve calcification) or various surgical procedures, such as aortic valvuloplasty, openheart surgical aortic valve replacement (SAVR), or TAVI (also known as transcatheter aortic replacement). Aortic valvuloplasty may be offered to some patients as a bridge therapy or to provide temporary palliation and symptomatic relief; however, aortic valve replacement using SAVR or TAVI is considered the definitive treatment for severe symptomatic aortic stenosis.<sup>,</sup> TAVI is a minimally invasive procedure, where a prosthetic valve that functionally replaces the damaged aortic valve is implanted through a catheter inserted through the blood vessels. The replacement valve is typically delivered via the femoral artery in the groin, but other access routes such as the subclavian artery, the common carotid artery, the femoral vein, or a route that enters directly into the ascending aorta may be considered as alternatives in some patients.<sup>–</sup> CADTH has previously reviewed evidence regarding the clinical effectiveness of TAVI for the treatment of patients with severe aortic stenosis<sup>–</sup> or with degenerated mitral or tricuspid valve bioprostheses. Additionally, 2 rapid qualitative reviews<sup>,</sup> conducted by CADTH have examined how people with aortic stenosis experience TAVI. While these previous reviews have summarized some of the literature on TAVI, the cost-effectiveness of this procedure is unclear. The objective of this report is to evaluate the cost-effectiveness of TAVI to support decisions involving the use of this therapy for the treatment of patients with severe symptomatic aortic stenosis. |
2,331,414 | Hydrocephalus Revisited: New Insights into Dynamics of Neurofluids on Macro- and Microscales. | New experimental and clinical findings question the historic view of hydrocephalus and its 100-year-old classification. In particular, real-time magnetic resonance imaging (MRI) evaluation of cerebrospinal fluid (CSF) flow and detailed insights into brain water regulation on the molecular scale indicate the existence of at least three main mechanisms that determine the dynamics of neurofluids: (1) inspiration is a major driving force; (2) adequate filling of brain ventricles by balanced CSF upsurge is sensed by cilia; and (3) the perivascular glial network connects the ependymal surface to the pericapillary Virchow-Robin spaces. Hitherto, these aspects have not been considered a common physiologic framework, improving knowledge and therapy for severe disorders of normal-pressure and posthemorrhagic hydrocephalus, spontaneous intracranial hypotension, and spaceflight disease. |
2,331,415 | Endoscopic Third Ventriculostomy With "Rescue" Fourth Ventriculocisternostomy: 2-Dimensional Operative Video. | This case of endoscopic third ventriculostomy (ETV) and flexible endoscopy for lysis of fourth ventricle adhesions for obstructive hydrocephalus illustrates a key anatomical variant (anastomosis of posterior communicating arteries) that increases the difficulty of ETV and should be recognized preoperatively. The video further demonstrates flexible endoscopy for lysis of a fourth ventricular web and excellent third and fourth ventricular anatomy. This patient presented with normal pressure hydrocephalus-like symptoms and magnetic resonance imaging suggestive of a fourth ventricular outflow obstruction. An ETV would be an ideal intervention with a high chance of success1 and avoiding a ventriculoperitoneal shunt or a more invasive suboccipital craniectomy for fourth ventricle exploration; however, variant anatomy and resultant medialization of the bilateral posterior communicating arteries put their location directly beneath the tuber cinereum. After discussing the risks and benefits of the proposed procedure, the patient consented to proceeding with the surgery. Patient is not identifiable either by clinical vignette or through this operative video, which is entirely intraventricular. The care rendered was standard (nonexperimental). The patient did sign consent for filming and production of the educational video submitted.  Here, we present operative video from our ETV, demonstrating an inability to confirm adequate fenestration and subsequent flexible endoscopy for fourth ventriculocisternostomy. |
2,331,416 | Neonatal susceptibility to meningitis results from the immaturity of epithelial barriers and gut microbiota. | Neonates are highly susceptible to bacterial meningitis as compared to children and adults. Group B streptococcus (GBS) is a major cause of neonatal meningitis. Neonatal meningitis can result from GBS intestinal colonization and translocation across the intestinal barrier (IB). Here, we show that the immaturity of the neonatal intestinal microbiota leads to low resistance to GBS intestinal colonization and permissiveness of the gut-vascular barrier. Moreover, the age-dependent but microbiota-independent Wnt activity in intestinal and choroid plexus (CP) epithelia results in a lower degree of cell-cell junctions' polarization, which favors bacterial translocation. This study thus reveals that neonatal susceptibility to GBS meningitis results from the age-dependent immaturity of the intestinal microbiota and developmental pathways associated with neonatal tissue growth, which both concur to GBS gut colonization, systemic dissemination, and neuroinvasion. Whereas the activation of developmental pathways is intrinsic to neonates, interventions aimed at maturing the microbiota may help prevent neonatal meningitis. |
2,331,417 | Accuracy of thin-slice model-based iterative reconstruction designed for brain CT to diagnose acute ischemic stroke in the middle cerebral artery territory: a multicenter study. | Model-based iterative reconstruction (MBIR) yields higher spatial resolution and a lower image noise than conventional reconstruction methods. We hypothesized that thin-slice MBIR designed for brain CT could improve the detectability of acute ischemic stroke in the middle cerebral artery (MCA) territory.</AbstractText>Included were 41 patients with acute ischemic stroke in the MCA territory; they were seen at 4 medical centers. The controls were 39 subjects without acute stroke. Images were reconstructed with hybrid IR and with MBIR designed for brain CT at slice thickness of 2 mm. We measured the image noise in the ventricle and compared the contrast-to-noise ratio (CNR) in the ischemic lesion. We analyzed the ability of reconstructed images to detect ischemic lesions using receiver operating characteristics (ROC) analysis; 8 observers read the routine clinical hybrid IR with 5 mm-thick images, while referring to 2 mm-thick hybrid IR images or MBIR images.</AbstractText>The image noise was significantly lower on MBIR- than hybrid IR images (1.2 vs. 3.4, p < 0.001). The CNR was significantly higher with MBIR than hybrid IR (6.3 vs. 1.6, p < 0.001). The mean area under the ROC curve was also significantly higher on hybrid IR plus MBIR than hybrid IR (0.55 vs. 0.48, p < 0.036). Sensitivity, specificity, and accuracy were 41.2%, 88.8%, and 65.7%, respectively, for hybrid IR; they were 58.8%, 86.1%, and 72.9%, respectively, for hybrid IR plus MBIR.</AbstractText>The additional thin-slice MBIR designed for brain CT may improve the detection of acute MCA stroke.</AbstractText>© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</CopyrightInformation> |
2,331,418 | Case report of a coronary artery-right ventricular fistula following repeat endomyocardial biopsies in a heart transplant patient. | Endomyocardial biopsy (EMB) remains the gold standard for cellular rejection surveillance in heart transplant recipients. Coronary artery fistula formation is a rare late and potentially catastrophic complication of repeated endomyocardial biopsies, without contemporary evidence on incidence or management.</AbstractText>A 47-year-old male was found to have a fistula between his right ventricle and his left anterior descending artery on an angiogram that was performed as a part of regular screening of coronary allograft vasculopathy. Given the low shunt fraction, asymptomatic nature, and lack of guidelines on definitive management, the patient is undergoing conservative management with regular surveillance.</AbstractText>Coronary artery fistulas were once thought to be rare complications of repeated EMB, but the true prevalence is likely to be higher than previously believed. Ideal treatment and monitoring is unknown given the relative rarity of the condition.</AbstractText>© The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.</CopyrightInformation> |
2,331,419 | Successful recovery of central venous catheter fragment from coronary venous sinus and right ventricle: A case report.<Pagination><StartPage>2261</StartPage><EndPage>2265</EndPage><MedlinePgn>2261-2265</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.radcr.2021.03.064</ELocationID><Abstract><AbstractText>Catheter fracture with subsequent embolization is a well known but a potentially serious late complication of central venous catheter placement. Central venous catheters are frequently implanted for the purpose of chemotherapy and parenteral nutrition. Most common vein used for the placement of central venous catheter is subclavian vein. According to case reports, catheter placed in subclavian vein is vulnerable for fracture and is often preceded by the "pinch-off sign", first described by Aikten and Minton. It is due to shearing forces between the clavicle and first rib. Broken catheter frequently embolises to Right atrium, Right Ventricle, Inferior vena cava, Pulmonary arteries and rarely into Coronary sinus. Migration to Coronary sinus is very uncommon and only 5 cases are reported in the literature as of now. We are presenting an unusual case where chemoport catheter severed and lodged partly in coronary venous sinus and partly in right ventricle taking a "U "shape. Fragment was successfully retrieved percutaneously using a snare after straightening it with a pigtail catheter. Though majority of patients deny symptoms however, some do have symptoms or complications. Catheter fragment can lead to arrhythmias, thrombosis, infection and perforation. Thrombosis of coronary sinus is a life threatening complication. Regular follow up with Chest x ray may recognize the fracture and embolization much earlier. In almost all cases the migrated portion can be retrieved safely percutaneously without recourse to surgery.</AbstractText><CopyrightInformation>© 2021 Published by Elsevier Inc. on behalf of University of Washington.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Sudhakar</LastName><ForeName>B G K</ForeName><Initials>BGK</Initials><AffiliationInfo><Affiliation>Consultant Cardiologist, KIMS hospital, Secunderabad, Telangana 500003 India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Teja</LastName><ForeName>B Ravi</ForeName><Initials>BR</Initials><AffiliationInfo><Affiliation>Fellow in cardiology, KIMS hospital, Secunderabad, Telangana, India.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>06</Month><Day>16</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>Radiol Case Rep</MedlineTA><NlmUniqueID>101467888</NlmUniqueID><ISSNLinking>1930-0433</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Chemoport fracture</Keyword><Keyword MajorTopicYN="N">Coronary sinus</Keyword><Keyword MajorTopicYN="N">Embolization</Keyword><Keyword MajorTopicYN="N">Percutaneous technique</Keyword><Keyword MajorTopicYN="N">Pigtail catheter</Keyword><Keyword MajorTopicYN="N">Right ventricle</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2021</Year><Month>1</Month><Day>18</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2021</Year><Month>3</Month><Day>28</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2021</Year><Month>3</Month><Day>28</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>6</Month><Day>30</Day><Hour>6</Hour><Minute>38</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>7</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>7</Month><Day>1</Day><Hour>6</Hour><Minute>1</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">34188739</ArticleId><ArticleId IdType="pmc">PMC8220104</ArticleId><ArticleId IdType="doi">10.1016/j.radcr.2021.03.064</ArticleId><ArticleId IdType="pii">S1930-0433(21)00201-6</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>Klotz HP, Schopke W, Kohler A, Pestalozzi B, Largiader F. Catheter fracture: a rare complication of totally implantable subclavian venous access devices. J Surg Oncol. 1996;62(3):222–225.</Citation><ArticleIdList><ArticleId IdType="pubmed">8667632</ArticleId></ArticleIdList></Reference><Reference><Citation>Shah M, Patni S, Bagarahatta R. Spontaneous chemoport fracture and cardiac migration. Indian J Surg Oncol. 2014;5:325–326.</Citation><ArticleIdList><ArticleId IdType="pmc">PMC4354828</ArticleId><ArticleId IdType="pubmed">25767351</ArticleId></ArticleIdList></Reference><Reference><Citation>Kim J.T., Kim S.M., Lee S.Y., Bae J.W., Hwnag K.K., Kim D.W. Percutaneous retrieval of dislodged totally implantable central venous chemoport in a patient with colon cancer. Korean Circ J. 2012;42:122–124.</Citation><ArticleIdList><ArticleId IdType="pmc">PMC3291723</ArticleId><ArticleId IdType="pubmed">22396701</ArticleId></ArticleIdList></Reference><Reference><Citation>Cheng CC, Tsai TN, Yang CC, Han CL. Percutaneous retrieval of dislodged totally implantable central venous access system in 92 cases: experience in a single hospital. Eur J Radiol. 2009;69:346–350.</Citation><ArticleIdList><ArticleId IdType="pubmed">17976941</ArticleId></ArticleIdList></Reference><Reference><Citation>Pignataro BS, Nishinari K, Wolosker N, Bomfim GA. Fracture and migration into the coronary sinus of a totally implantable catheter introduced via the right internal jugular vein. BMJ case Rep. 2014;1(2014)</Citation><ArticleIdList><ArticleId IdType="pmc">PMC4256600</ArticleId><ArticleId IdType="pubmed">25452299</ArticleId></ArticleIdList></Reference><Reference><Citation>Yeo KK, Davenport J, Raff G, Laird JR. Life-threatening coronary sinus thrombosis following catheter ablation: case report and review of literature. Cardiovasc Revasc Med. 2010;11(4) 262.el-262.e5.</Citation><ArticleIdList><ArticleId IdType="pubmed">20934660</ArticleId></ArticleIdList></Reference><Reference><Citation>Aitken D.R., Minton J.P. The pinch-off sign: a warning of impending problems with permanent subclavian catheters. Am J Surg. 1984;148:633–636.</Citation><ArticleIdList><ArticleId IdType="pubmed">6496853</ArticleId></ArticleIdList></Reference><Reference><Citation>Kwangwon Hyemoon Chung, Ji Yanoon Ha, Seung Kyu Kim. Successful percutaneous transcatheter retrieval of a migrated implantable venous port in a patient who presented with intermittent palpitation. Korean J. Med. 2013;85(2):194.</Citation></Reference><Reference><Citation>Sibylle Mehcat, Edith Eisen huber, Wolf gang Schima. Complications of central venous port system; a pictoral review. Insights into Imaging. 10, Article n0:86[2019]. 1–12.</Citation></Reference><Reference><Citation>Lukito Antonia Anna, Pranata Raymond, Wirawan Marco. Fracture of the port catheter and migration into the coronary sinus: case report and brief review of the literature. Clin Med Insights Case Rep. 2019:12. 12]- failed.</Citation><ArticleIdList><ArticleId IdType="pmc">PMC6393817</ArticleId><ArticleId IdType="pubmed">30833817</ArticleId></ArticleIdList></Reference><Reference><Citation>Pignataro Bruno Sariano, Nishinari K, Wolosker N, Bomfim GAZ. Fracture and migration into the CS of a totally implantable catheter introduced via the right internal jugular vein. BMJ case report. 2014;1 2014.</Citation><ArticleIdList><ArticleId IdType="pmc">PMC4256600</ArticleId><ArticleId IdType="pubmed">25452299</ArticleId></ArticleIdList></Reference><Reference><Citation>Karam AR, Hourani MH, AO Al-Kutoubi. catheter fracture and migration into the coronary sinus- an unusual migration site: case report and review. Clin. Imgin. 2009;33:140–143.</Citation><ArticleIdList><ArticleId IdType="pubmed">19237059</ArticleId></ArticleIdList></Reference><Reference><Citation>Arnould MA, Blanchand O. Catheter migration after fracture is not always in right cavities. Cardiovasc Interv Ther. 2013;28:119–122.</Citation><ArticleIdList><ArticleId IdType="pubmed">23065411</ArticleId></ArticleIdList></Reference><Reference><Citation>Tabatabaie O, Kasumova GG, Esskander MF, Tsng JF. Totally implantable venous access devices: a review of complications and management strategies. Am J Clin Oncol. 2017;40:94–105.</Citation><ArticleIdList><ArticleId IdType="pubmed">28106685</ArticleId></ArticleIdList></Reference><Reference><Citation>Tsai TN, Han CL, Lin WS, Yang S.P., Tsao T.P., Chu K.M. Transcatheter retrieval of dislodged Port-A catheter fragments: experience with 47 cases. Acta cardiol sin. 2006;22:221–228.</Citation></Reference><Reference><Citation>Kusminsky R.E. Complications of central venous catheterization. J Am Coll surg. 2007;204:681–696.</Citation><ArticleIdList><ArticleId IdType="pubmed">17382229</ArticleId></ArticleIdList></Reference><Reference><Citation>Wu C.Y., Fu J., Feng P.H., T.C Kao, Yu S.Y., Li H.J. Catheter fracture of intravenous ports and its management. World J surg. 2011;35:2403–2410.</Citation><ArticleIdList><ArticleId IdType="pubmed">21882033</ArticleId></ArticleIdList></Reference><Reference><Citation>Denny MA, Frank LR. VT secondary to port-cath - fracture and embolization. J Emerg med. 2003;24:29–34.</Citation><ArticleIdList><ArticleId IdType="pubmed">12554037</ArticleId></ArticleIdList></Reference><Reference><Citation>Chuang Ming-Tsung, Ding-Kwo WH, Hsu Jui-Sheng. Concurrent use of pigtail catheter and loop snare catheter for percutaneous retrieval of dislodged central venous port catheter. Kaohsiung J Med Sci. Nov 2011;27(11):514–519.</Citation><ArticleIdList><ArticleId IdType="pubmed">22005161</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">34187687</PMID><DateRevised><Year>2021</Year><Month>10</Month><Day>07</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">2341-1929</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2021</Year><Month>Jun</Month><Day>26</Day></PubDate></JournalIssue><Title>Revista espanola de anestesiologia y reanimacion</Title><ISOAbbreviation>Rev Esp Anestesiol Reanim (Engl Ed)</ISOAbbreviation></Journal>Peripheral VA-ECMO left ventricular dysfunction: A combined biventricular assistance two case-report. | Catheter fracture with subsequent embolization is a well known but a potentially serious late complication of central venous catheter placement. Central venous catheters are frequently implanted for the purpose of chemotherapy and parenteral nutrition. Most common vein used for the placement of central venous catheter is subclavian vein. According to case reports, catheter placed in subclavian vein is vulnerable for fracture and is often preceded by the "pinch-off sign", first described by Aikten and Minton. It is due to shearing forces between the clavicle and first rib. Broken catheter frequently embolises to Right atrium, Right Ventricle, Inferior vena cava, Pulmonary arteries and rarely into Coronary sinus. Migration to Coronary sinus is very uncommon and only 5 cases are reported in the literature as of now. We are presenting an unusual case where chemoport catheter severed and lodged partly in coronary venous sinus and partly in right ventricle taking a "U "shape. Fragment was successfully retrieved percutaneously using a snare after straightening it with a pigtail catheter. Though majority of patients deny symptoms however, some do have symptoms or complications. Catheter fragment can lead to arrhythmias, thrombosis, infection and perforation. Thrombosis of coronary sinus is a life threatening complication. Regular follow up with Chest x ray may recognize the fracture and embolization much earlier. In almost all cases the migrated portion can be retrieved safely percutaneously without recourse to surgery.<CopyrightInformation>© 2021 Published by Elsevier Inc. on behalf of University of Washington.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Sudhakar</LastName><ForeName>B G K</ForeName><Initials>BGK</Initials><AffiliationInfo><Affiliation>Consultant Cardiologist, KIMS hospital, Secunderabad, Telangana 500003 India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Teja</LastName><ForeName>B Ravi</ForeName><Initials>BR</Initials><AffiliationInfo><Affiliation>Fellow in cardiology, KIMS hospital, Secunderabad, Telangana, India.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>06</Month><Day>16</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>Radiol Case Rep</MedlineTA><NlmUniqueID>101467888</NlmUniqueID><ISSNLinking>1930-0433</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Chemoport fracture</Keyword><Keyword MajorTopicYN="N">Coronary sinus</Keyword><Keyword MajorTopicYN="N">Embolization</Keyword><Keyword MajorTopicYN="N">Percutaneous technique</Keyword><Keyword MajorTopicYN="N">Pigtail catheter</Keyword><Keyword MajorTopicYN="N">Right ventricle</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2021</Year><Month>1</Month><Day>18</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2021</Year><Month>3</Month><Day>28</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2021</Year><Month>3</Month><Day>28</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>6</Month><Day>30</Day><Hour>6</Hour><Minute>38</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>7</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>7</Month><Day>1</Day><Hour>6</Hour><Minute>1</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">34188739</ArticleId><ArticleId IdType="pmc">PMC8220104</ArticleId><ArticleId IdType="doi">10.1016/j.radcr.2021.03.064</ArticleId><ArticleId IdType="pii">S1930-0433(21)00201-6</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>Klotz HP, Schopke W, Kohler A, Pestalozzi B, Largiader F. Catheter fracture: a rare complication of totally implantable subclavian venous access devices. J Surg Oncol. 1996;62(3):222–225.</Citation><ArticleIdList><ArticleId IdType="pubmed">8667632</ArticleId></ArticleIdList></Reference><Reference><Citation>Shah M, Patni S, Bagarahatta R. Spontaneous chemoport fracture and cardiac migration. Indian J Surg Oncol. 2014;5:325–326.</Citation><ArticleIdList><ArticleId IdType="pmc">PMC4354828</ArticleId><ArticleId IdType="pubmed">25767351</ArticleId></ArticleIdList></Reference><Reference><Citation>Kim J.T., Kim S.M., Lee S.Y., Bae J.W., Hwnag K.K., Kim D.W. Percutaneous retrieval of dislodged totally implantable central venous chemoport in a patient with colon cancer. Korean Circ J. 2012;42:122–124.</Citation><ArticleIdList><ArticleId IdType="pmc">PMC3291723</ArticleId><ArticleId IdType="pubmed">22396701</ArticleId></ArticleIdList></Reference><Reference><Citation>Cheng CC, Tsai TN, Yang CC, Han CL. Percutaneous retrieval of dislodged totally implantable central venous access system in 92 cases: experience in a single hospital. Eur J Radiol. 2009;69:346–350.</Citation><ArticleIdList><ArticleId IdType="pubmed">17976941</ArticleId></ArticleIdList></Reference><Reference><Citation>Pignataro BS, Nishinari K, Wolosker N, Bomfim GA. Fracture and migration into the coronary sinus of a totally implantable catheter introduced via the right internal jugular vein. BMJ case Rep. 2014;1(2014)</Citation><ArticleIdList><ArticleId IdType="pmc">PMC4256600</ArticleId><ArticleId IdType="pubmed">25452299</ArticleId></ArticleIdList></Reference><Reference><Citation>Yeo KK, Davenport J, Raff G, Laird JR. Life-threatening coronary sinus thrombosis following catheter ablation: case report and review of literature. Cardiovasc Revasc Med. 2010;11(4) 262.el-262.e5.</Citation><ArticleIdList><ArticleId IdType="pubmed">20934660</ArticleId></ArticleIdList></Reference><Reference><Citation>Aitken D.R., Minton J.P. The pinch-off sign: a warning of impending problems with permanent subclavian catheters. Am J Surg. 1984;148:633–636.</Citation><ArticleIdList><ArticleId IdType="pubmed">6496853</ArticleId></ArticleIdList></Reference><Reference><Citation>Kwangwon Hyemoon Chung, Ji Yanoon Ha, Seung Kyu Kim. Successful percutaneous transcatheter retrieval of a migrated implantable venous port in a patient who presented with intermittent palpitation. Korean J. Med. 2013;85(2):194.</Citation></Reference><Reference><Citation>Sibylle Mehcat, Edith Eisen huber, Wolf gang Schima. Complications of central venous port system; a pictoral review. Insights into Imaging. 10, Article n0:86[2019]. 1–12.</Citation></Reference><Reference><Citation>Lukito Antonia Anna, Pranata Raymond, Wirawan Marco. Fracture of the port catheter and migration into the coronary sinus: case report and brief review of the literature. Clin Med Insights Case Rep. 2019:12. 12]- failed.</Citation><ArticleIdList><ArticleId IdType="pmc">PMC6393817</ArticleId><ArticleId IdType="pubmed">30833817</ArticleId></ArticleIdList></Reference><Reference><Citation>Pignataro Bruno Sariano, Nishinari K, Wolosker N, Bomfim GAZ. Fracture and migration into the CS of a totally implantable catheter introduced via the right internal jugular vein. BMJ case report. 2014;1 2014.</Citation><ArticleIdList><ArticleId IdType="pmc">PMC4256600</ArticleId><ArticleId IdType="pubmed">25452299</ArticleId></ArticleIdList></Reference><Reference><Citation>Karam AR, Hourani MH, AO Al-Kutoubi. catheter fracture and migration into the coronary sinus- an unusual migration site: case report and review. Clin. Imgin. 2009;33:140–143.</Citation><ArticleIdList><ArticleId IdType="pubmed">19237059</ArticleId></ArticleIdList></Reference><Reference><Citation>Arnould MA, Blanchand O. Catheter migration after fracture is not always in right cavities. Cardiovasc Interv Ther. 2013;28:119–122.</Citation><ArticleIdList><ArticleId IdType="pubmed">23065411</ArticleId></ArticleIdList></Reference><Reference><Citation>Tabatabaie O, Kasumova GG, Esskander MF, Tsng JF. Totally implantable venous access devices: a review of complications and management strategies. Am J Clin Oncol. 2017;40:94–105.</Citation><ArticleIdList><ArticleId IdType="pubmed">28106685</ArticleId></ArticleIdList></Reference><Reference><Citation>Tsai TN, Han CL, Lin WS, Yang S.P., Tsao T.P., Chu K.M. Transcatheter retrieval of dislodged Port-A catheter fragments: experience with 47 cases. Acta cardiol sin. 2006;22:221–228.</Citation></Reference><Reference><Citation>Kusminsky R.E. Complications of central venous catheterization. J Am Coll surg. 2007;204:681–696.</Citation><ArticleIdList><ArticleId IdType="pubmed">17382229</ArticleId></ArticleIdList></Reference><Reference><Citation>Wu C.Y., Fu J., Feng P.H., T.C Kao, Yu S.Y., Li H.J. Catheter fracture of intravenous ports and its management. World J surg. 2011;35:2403–2410.</Citation><ArticleIdList><ArticleId IdType="pubmed">21882033</ArticleId></ArticleIdList></Reference><Reference><Citation>Denny MA, Frank LR. VT secondary to port-cath - fracture and embolization. J Emerg med. 2003;24:29–34.</Citation><ArticleIdList><ArticleId IdType="pubmed">12554037</ArticleId></ArticleIdList></Reference><Reference><Citation>Chuang Ming-Tsung, Ding-Kwo WH, Hsu Jui-Sheng. Concurrent use of pigtail catheter and loop snare catheter for percutaneous retrieval of dislodged central venous port catheter. Kaohsiung J Med Sci. Nov 2011;27(11):514–519.</Citation><ArticleIdList><ArticleId IdType="pubmed">22005161</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">34187687</PMID><DateRevised><Year>2021</Year><Month>10</Month><Day>07</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">2341-1929</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2021</Year><Month>Jun</Month><Day>26</Day></PubDate></JournalIssue><Title>Revista espanola de anestesiologia y reanimacion</Title><ISOAbbreviation>Rev Esp Anestesiol Reanim (Engl Ed)</ISOAbbreviation></Journal><ArticleTitle>Peripheral VA-ECMO left ventricular dysfunction: A combined biventricular assistance two case-report.</ArticleTitle><ELocationID EIdType="pii" ValidYN="Y">S0034-9356(21)00167-5</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.redar.2021.04.004</ELocationID><Abstract>We report 2patients with cardiogenic shock that developed severe left ventricular dysfunction due to a non-opening aortic valve while on peripheral VA-ECMO (Veno-Arterial Extracorporeal Membrane Oxygenator). Patients were managed combining a LV (Left Ventricle) mechanical assist device, and central VA - ECMO to support the right ventricle, thus providing full circulatory and respiratory assistance. Patients were able to bridge to cardiac transplantation. We therefore recommend such combination in patients with severe LV dysfunction while on p-ECMO (peripheral ECMO) support. |
2,331,420 | A reversible cause of left ventricular dysfunction: Case report and brief review.<Pagination><StartPage>383</StartPage><EndPage>388</EndPage><MedlinePgn>383-388</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.repce.2018.12.012</ELocationID><ELocationID EIdType="pii" ValidYN="Y">S2174-2049(21)00065-9</ELocationID><Abstract><AbstractText>The authors describe a case of a patient admitted to the emergency department with diabetic ketoacidosis. Although there were no symptoms attributable to the cardiovascular system, lab tests revealed elevated troponin I and natriuretic peptides, coupled with repolarization abnormalities on the ECG. The transthoracic echocardiogram (TTE) showed a non-dilated left ventricle with severe left ventricular systolic dysfunction due to diffuse hypokinesia, and a concomitant diagnosis of profile L heart failure was proposed. Etiologic investigation was negative, and when a new TTE was performed seven days after the first, left ventricular function was normal. Although rarely considered, metabolic and electrolyte disorders, especially diabetic ketoacidosis, can be a cause of left ventricular systolic dysfunction, and should be considered in the differential diagnosis. This is another way diabetes can have an impact on the cardiovascular system.</AbstractText><CopyrightInformation>Published by Elsevier España, S.L.U.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Roque</LastName><ForeName>David</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Serviço de Cardiologia, Hospital Professor Doutor Fernando da Fonseca, EPE, Amadora, Portugal. Electronic address: roque_866@hotmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Faria</LastName><ForeName>Daniel</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Serviço de Cardiologia, Hospital Professor Doutor Fernando da Fonseca, EPE, Amadora, Portugal.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ferreira</LastName><ForeName>João</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Serviço de Cardiologia, Hospital Professor Doutor Fernando da Fonseca, EPE, Amadora, Portugal.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ferreira</LastName><ForeName>Hilaryano</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Serviço de Cardiologia, Hospital Professor Doutor Fernando da Fonseca, EPE, Amadora, Portugal.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Beringuilho</LastName><ForeName>Marco</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Serviço de Cardiologia, Hospital Professor Doutor Fernando da Fonseca, EPE, Amadora, Portugal.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Magno</LastName><ForeName>Pedro</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Serviço de Cardiologia, Hospital Professor Doutor Fernando da Fonseca, EPE, Amadora, Portugal.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Morais</LastName><ForeName>Carlos</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Serviço de Cardiologia, Hospital Professor Doutor Fernando da Fonseca, EPE, Amadora, Portugal.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>06</Month><Day>12</Day></ArticleDate></Article><MedlineJournalInfo><Country>Spain</Country><MedlineTA>Rev Port Cardiol (Engl Ed)</MedlineTA><NlmUniqueID>101770878</NlmUniqueID><ISSNLinking>2174-2049</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D004452" MajorTopicYN="N">Echocardiography</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006333" MajorTopicYN="Y">Heart Failure</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006352" MajorTopicYN="N">Heart Ventricles</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018487" MajorTopicYN="Y">Ventricular Dysfunction, Left</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016277" MajorTopicYN="N">Ventricular Function, Left</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Acidemia</Keyword><Keyword MajorTopicYN="N">Acidosis</Keyword><Keyword MajorTopicYN="N">Cetoacidose diabética</Keyword><Keyword MajorTopicYN="N">Diabetic ketoacidosis</Keyword><Keyword MajorTopicYN="N">Disfunção ventricular esquerda</Keyword><Keyword MajorTopicYN="N">Left ventricular dysfunction</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2018</Year><Month>5</Month><Day>19</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2018</Year><Month>12</Month><Day>27</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>6</Month><Day>30</Day><Hour>5</Hour><Minute>45</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>7</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>9</Month><Day>18</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">34187641</ArticleId><ArticleId IdType="doi">10.1016/j.repce.2018.12.012</ArticleId><ArticleId IdType="pii">S2174-2049(21)00065-9</ArticleId></ArticleIdList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">34187266</PMID><DateRevised><Year>2022</Year><Month>04</Month><Day>24</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1360-046X</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2021</Year><Month>Jun</Month><Day>30</Day></PubDate></JournalIssue><Title>British journal of neurosurgery</Title><ISOAbbreviation>Br J Neurosurg</ISOAbbreviation></Journal>Neuromate<sup>®</sup> robot-assisted ventricular catheter insertion. | The authors describe a case of a patient admitted to the emergency department with diabetic ketoacidosis. Although there were no symptoms attributable to the cardiovascular system, lab tests revealed elevated troponin I and natriuretic peptides, coupled with repolarization abnormalities on the ECG. The transthoracic echocardiogram (TTE) showed a non-dilated left ventricle with severe left ventricular systolic dysfunction due to diffuse hypokinesia, and a concomitant diagnosis of profile L heart failure was proposed. Etiologic investigation was negative, and when a new TTE was performed seven days after the first, left ventricular function was normal. Although rarely considered, metabolic and electrolyte disorders, especially diabetic ketoacidosis, can be a cause of left ventricular systolic dysfunction, and should be considered in the differential diagnosis. This is another way diabetes can have an impact on the cardiovascular system.<CopyrightInformation>Published by Elsevier España, S.L.U.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Roque</LastName><ForeName>David</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Serviço de Cardiologia, Hospital Professor Doutor Fernando da Fonseca, EPE, Amadora, Portugal. Electronic address: roque_866@hotmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Faria</LastName><ForeName>Daniel</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Serviço de Cardiologia, Hospital Professor Doutor Fernando da Fonseca, EPE, Amadora, Portugal.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ferreira</LastName><ForeName>João</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Serviço de Cardiologia, Hospital Professor Doutor Fernando da Fonseca, EPE, Amadora, Portugal.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ferreira</LastName><ForeName>Hilaryano</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Serviço de Cardiologia, Hospital Professor Doutor Fernando da Fonseca, EPE, Amadora, Portugal.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Beringuilho</LastName><ForeName>Marco</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Serviço de Cardiologia, Hospital Professor Doutor Fernando da Fonseca, EPE, Amadora, Portugal.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Magno</LastName><ForeName>Pedro</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Serviço de Cardiologia, Hospital Professor Doutor Fernando da Fonseca, EPE, Amadora, Portugal.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Morais</LastName><ForeName>Carlos</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Serviço de Cardiologia, Hospital Professor Doutor Fernando da Fonseca, EPE, Amadora, Portugal.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>06</Month><Day>12</Day></ArticleDate></Article><MedlineJournalInfo><Country>Spain</Country><MedlineTA>Rev Port Cardiol (Engl Ed)</MedlineTA><NlmUniqueID>101770878</NlmUniqueID><ISSNLinking>2174-2049</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D004452" MajorTopicYN="N">Echocardiography</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006333" MajorTopicYN="Y">Heart Failure</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006352" MajorTopicYN="N">Heart Ventricles</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018487" MajorTopicYN="Y">Ventricular Dysfunction, Left</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016277" MajorTopicYN="N">Ventricular Function, Left</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Acidemia</Keyword><Keyword MajorTopicYN="N">Acidosis</Keyword><Keyword MajorTopicYN="N">Cetoacidose diabética</Keyword><Keyword MajorTopicYN="N">Diabetic ketoacidosis</Keyword><Keyword MajorTopicYN="N">Disfunção ventricular esquerda</Keyword><Keyword MajorTopicYN="N">Left ventricular dysfunction</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2018</Year><Month>5</Month><Day>19</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2018</Year><Month>12</Month><Day>27</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>6</Month><Day>30</Day><Hour>5</Hour><Minute>45</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>7</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>9</Month><Day>18</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">34187641</ArticleId><ArticleId IdType="doi">10.1016/j.repce.2018.12.012</ArticleId><ArticleId IdType="pii">S2174-2049(21)00065-9</ArticleId></ArticleIdList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">34187266</PMID><DateRevised><Year>2022</Year><Month>04</Month><Day>24</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1360-046X</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2021</Year><Month>Jun</Month><Day>30</Day></PubDate></JournalIssue><Title>British journal of neurosurgery</Title><ISOAbbreviation>Br J Neurosurg</ISOAbbreviation></Journal><ArticleTitle>Neuromate<sup>®</sup> robot-assisted ventricular catheter insertion.</ArticleTitle><Pagination><StartPage>1</StartPage><EndPage>4</EndPage><MedlinePgn>1-4</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1080/02688697.2021.1941762</ELocationID><Abstract><AbstractText Label="BACKGROUND AND IMPORTANCE" NlmCategory="BACKGROUND">Insertion of ventricular catheters into small ventricles may require image guidance. Several options exist, including ultrasound guidance, frameless, and frame-based stereotactic approaches. There is no literature on management options when conventional image guidance fails to cannulate the ventricle. The accuracy of the robotic arm is well established in functional and epilepsy surgery. We report the first case using the Neuromate<sup>®</sup> robot for the placement of a shunt ventricular catheter into the lateral ventricle after a failed attempt with a more commonly used frameless electromagnetic navigation system.<AbstractText Label="CLINICAL PRESENTATION" NlmCategory="METHODS">A 30-year-old man had twice previously undergone foramen magnum decompression for a Chiari 1 malformation. He subsequently developed a significant cervical syrinx with clinical deterioration and a decision was made to place a ventriculoperitoneal shunt. As the ventricles were small, frameless electromagnetic navigation was used but the ventricle could not be cannulated. The Neuromate<sup>®</sup> robot was subsequently used to place the ventricular catheter successfully.<AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Neuromate<sup>®</sup> robot-assisted ventricular catheter placement may be considered when difficulty is experienced with more commonly used image guidance techniques. |
2,331,421 | Multiphysics Computational Modelling of the Cardiac Ventricles. | Development of cardiac multiphysics models has progressed significantly over the decades and simulations combining multiple physics interactions have become increasingly common. In this review, we summarise the progress in this field focusing on various approaches of integrating ventricular structures. electrophysiological properties, myocardial mechanics, as well as incorporating blood hemodynamics and the circulatory system. Common coupling approaches are discussed and compared, including the advantages and shortcomings of each. Currently used strategies for patient-specific implementations are highlighted and potential future improvements considered. |
2,331,422 | MRI Natural History of the Leukodystrophy Vanishing White Matter. | Background In vanishing white matter (VWM), a form of leukodystrophy, earlier onset is associated with faster clinical progression. MRI typically shows rarefaction and cystic destruction of the cerebral white matter. Information on the evolution of VWM according to age at onset is lacking. Purpose To determine whether nature and progression of cerebral white matter abnormalities in VWM differ according to age at onset. Materials and Methods Patients with genetically confirmed VWM were stratified into six groups according to age at onset: younger than 1 year, 1 year to younger than 2 years, 2 years to younger than 4 years, 4 years to younger than 8 years, 8 years to younger than 18 years, and 18 years or older. With institutional review board approval, all available MRI scans obtained between 1985 and 2019 were retrospectively analyzed with three methods: <i>(a)</i> ratio of the width of the lateral ventricles over the skull (ventricle-to-skull ratio [VSR]) was measured to estimate brain atrophy; <i>(b)</i> cerebral white matter was visually scored as percentage normal, hyperintense, rarefied, or cystic on fluid-attenuated inversion recovery (FLAIR) images and converted into a white matter decay score; and <i>(c)</i> the intracranial volume was segmented into normal-appearing white and gray matter, abnormal but structurally present (FLAIR-hyperintense) and rarefied or cystic (FLAIR-hypointense) white matter, and ventricular and extracerebral cerebrospinal fluid (CSF). Multilevel regression analyses with patient as a clustering variable were performed to account for the nested data structure. Results A total of 461 examinations in 270 patients (median age, 7 years [interquartile range, 3-18 years]; 144 female patients) were evaluated; 112 patients had undergone serial imaging. Patients with later onset had higher VSR [F(5) = 8.42; <i>P</i> < .001] and CSF volume [F(5) = 21.7; <i>P</i> < .001] and lower white matter decay score [F(5) = 4.68; <i>P</i> < .001] and rarefied or cystic white matter volume [F(5) = 13.3; <i>P</i> < .001]. Rate of progression of white matter decay scores [b = -1.6, t(109) = -3.9; <i>P</i> < .001] and VSRs [b = -0.05, t (109) = -3.7; <i>P</i> < .001] were lower with later onset. Conclusion A radiologic spectrum based on age at onset exists in vanishing white matter. The earlier the onset, the faster and more cystic the white matter decay, whereas with later onset, white matter atrophy and gliosis predominate. © RSNA, 2021. |
2,331,423 | Treatment Outcome of Hydrocephalus Associated with Vestibular Schwannoma. | Managing hydrocephalus in patients with vestibular schwannoma (VS) is controversial. We evaluated the clinical factors associated with hydrocephalus.</AbstractText>Between 2000 and 2019, 562 patients with VS were treated at our institute. We applied endoscopic third ventriculostomy (ETV), external ventricular drainage (EVD), and ventriculoperitoneal (VP) shunts to patients with hydrocephalus. The relationships of patient, tumor, and surgical variables with the hydrocephalus outcome were assessed.</AbstractText>Preoperative hydrocephalus (Evans ratio ≥0.3) was present in 128 patients. Six patients who received a preresectional VP shunt were excluded after analyzing the hydrocephalus outcome. Seven of the remaining 122 patients had severe hydrocephalus (Evans ratio ≥0.4). Primary tumor resection, VP shunting, ETV, and EVD were performed in 60, 6, 57, and 5 patients, respectively. The hydrocephalus treatment failure rate was highest in the EVD group. Persistent hydrocephalus was present in five (8%) and seven (12%) patients in the primary resection and ETV groups, respectively. Multivariate analysis revealed that severe hydrocephalus, the cystic tumor, and the extent of resection (subtotal resection or partial resection) were associated with hydrocephalus treatment failure.</AbstractText>Larger ventricles and a higher cystic portion are predictive of persistent hydrocephalus. We recommend attempting near-total tumor resection in patients with VS.</AbstractText>Copyright © 2021 Korean Neurological Association.</CopyrightInformation> |
2,331,424 | Localization of fibroblast growth factor 23 protein in the rat hypothalamus. | Fibroblast growth factor 23 (FGF23) is an endocrine growth factor and known to play a pivotal role in phosphate homeostasis. Interestingly, several studies point towards a function of FGF23 in the hypothalamus. FGF23 classically activates the FGF receptor 1 in the presence of the co-receptor αKlotho, of both gene expression in the brain was previously established. However, studies on gene and protein expression of FGF23 in the brain are scarce and have been inconsistent. Therefore, our aim was to localise FGF23 gene and protein expression in the rat brain with focus on the hypothalamus. Also, we investigated the protein expression of αKlotho. Adult rat brains were used to localise and visualise FGF23 and αKlotho protein in the hypothalamus by immunofluorescence labelling. Furthermore, western blots were used for assessing hypothalamic FGF23 protein expression. FGF23 gene expression was investigated by qPCR in punches of the arcuate nucleus, lateral hypothalamus, paraventricular nucleus, choroid plexus, ventrolateral thalamic nucleus and the ventromedial hypothalamus. Immunoreactivity for FGF23 and αKlotho protein was found in the hypothalamus, third ventricle lining and the choroid plexus. Western blot analysis of the hypothalamus confirmed the presence of FGF23. Gene expression of FGF23 was not detected, suggesting that the observed FGF23 protein is not brain-derived. Several FGF receptors are known to be present in the brain. Therefore, we conclude that the machinery for FGF23 signal transduction is present in several brain areas, indeed suggesting a role for FGF23 in the brain. |
2,331,425 | Inversion-recovery MR elastography of the human brain for improved stiffness quantification near fluid-solid boundaries. | In vivo MR elastography (MRE) holds promise as a neuroimaging marker. In cerebral MRE, shear waves are introduced into the brain, which also stimulate vibrations in adjacent CSF, resulting in blurring and biased stiffness values near brain surfaces. We here propose inversion-recovery MRE (IR-MRE) to suppress CSF signal and improve stiffness quantification in brain surface areas.</AbstractText>Inversion-recovery MRE was demonstrated in agar-based phantoms with solid-fluid interfaces and 11 healthy volunteers using 31.25-Hz harmonic vibrations. It was performed by standard single-shot, spin-echo EPI MRE following 2800-ms IR preparation. Wave fields were acquired in 10 axial slices and analyzed for shear wave speed (SWS) as a surrogate marker of tissue stiffness by wavenumber-based multicomponent inversion.</AbstractText>Phantom SWS values near fluid interfaces were 7.5 ± 3.0% higher in IR-MRE than MRE (P = .01). In the brain, IR-MRE SNR was 17% lower than in MRE, without influencing parenchymal SWS (MRE: 1.38 ± 0.02 m/s; IR-MRE: 1.39 ± 0.03 m/s; P = .18). The IR-MRE tissue-CSF interfaces appeared sharper, showing 10% higher SWS near brain surfaces (MRE: 1.01 ± 0.03 m/s; IR-MRE: 1.11 ± 0.01 m/s; P < .001) and 39% smaller ventricle sizes than MRE (P < .001).</AbstractText>Our results show that brain MRE is affected by fluid oscillations that can be suppressed by IR-MRE, which improves the depiction of anatomy in stiffness maps and the quantification of stiffness values in brain surface areas. Moreover, we measured similar stiffness values in brain parenchyma with and without fluid suppression, which indicates that shear wavelengths in solid and fluid compartments are identical, consistent with the theory of biphasic poroelastic media.</AbstractText>© 2021 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.</CopyrightInformation> |
2,331,426 | Extra-axial tentorial medulloblastoma: a rare presentation of a common posterior fossa tumour. | Medulloblastoma is a common paediatric posterior fossa tumour typically presenting as midline intra-axial mass involving the cerebellar vermis and/or roof of fourth ventricle with typical radiological features. These can be extra-axial in extremely rare instances with less than 50 cases reported so far in literature. We present a case of 18-year-old boy presenting with ataxia and headache. MRI showed dural mass (involving the left tentorium cerebellum) with typical imaging features of extra-axial lesion. The patient underwent near total excision of the tumour. Histopathology along with immunohistochemistry revealed the mass to be medulloblastoma. We present this case to highlight rarity of this location for medulloblastoma and the importance of considering this in the differential diagnosis of atypical posterior fossa extra-axial lesions. This can help in performing other relevant preoperative workup similar on the lines of medulloblastoma and planning of relevant management. |
2,331,427 | Breaking the barrier: In vitro models to study choroid plexus development. | The choroid plexus is central to normal brain function by secreting cerebrospinal fluid and dynamically regulating its composition throughout development and homoeostasis. Much of our current understanding of this region of the brain comes from studies in animal models. These fundamental studies have shed light on choroid plexus mechanisms of secretion, barrier function and homoeostatic regulation. However, how these specific mechanisms are regulated in the human choroid plexus is much less understood, due to ethical and technical limitations. A number of recent breakthroughs have enabled a new range of techniques and tools for functional characterisation of choroid plexus development and physiology. With the advance of new technologies such as in vivo imaging, single-cell transcriptomics and in vitro three-dimensional cultures we are now able to address a number of outstanding questions in choroid plexus biology. Here, we discuss some of these recent breakthroughs and we focus in particular on how in vitro models can be a powerful tool to study human cerebrospinal fluid secretion and barrier function. |
2,331,428 | Cardiac mechanical efficiency is preserved in primary cardiac hypertrophy despite impaired mechanical function.<ELocationID EIdType="pii" ValidYN="Y">e202012841</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1085/jgp.202012841</ELocationID><Abstract><AbstractText>Increased heart size is a major risk factor for heart failure and premature mortality. Although abnormal heart growth subsequent to hypertension often accompanies disturbances in mechano-energetics and cardiac efficiency, it remains uncertain whether hypertrophy is their primary driver. In this study, we aimed to investigate the direct association between cardiac hypertrophy and cardiac mechano-energetics using isolated left-ventricular trabeculae from a rat model of primary cardiac hypertrophy and its control. We evaluated energy expenditure (heat output) and mechanical performance (force length work production) simultaneously at a range of preloads and afterloads in a microcalorimeter, we determined energy expenditure related to cross-bridge cycling and Ca2+ cycling (activation heat), and we quantified energy efficiency. Rats with cardiac hypertrophy exhibited increased cardiomyocyte length and width. Their trabeculae showed mechanical impairment, evidenced by lower force production, extent and kinetics of shortening, and work output. Lower force was associated with lower energy expenditure related to Ca2+ cycling and to cross-bridge cycling. However, despite these changes, both mechanical and cross-bridge energy efficiency were unchanged. Our results show that cardiac hypertrophy is associated with impaired contractile performance and with preservation of energy efficiency. These findings provide direction for future investigations targeting metabolic and Ca2+ disturbances underlying cardiac mechanical and energetic impairment in primary cardiac hypertrophy.</AbstractText><CopyrightInformation>© 2021 Han et al.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Han</LastName><ForeName>June-Chiew</ForeName><Initials>JC</Initials><Identifier Source="ORCID">0000-0002-6396-7628</Identifier><AffiliationInfo><Affiliation>Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tran</LastName><ForeName>Kenneth</ForeName><Initials>K</Initials><Identifier Source="ORCID">0000-0002-8651-3557</Identifier><AffiliationInfo><Affiliation>Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Crossman</LastName><ForeName>David J</ForeName><Initials>DJ</Initials><AffiliationInfo><Affiliation>Department of Physiology, University of Auckland, Auckland, New Zealand.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Curl</LastName><ForeName>Claire L</ForeName><Initials>CL</Initials><Identifier Source="ORCID">0000-0002-8092-9236</Identifier><AffiliationInfo><Affiliation>Department of Physiology, University of Melbourne, Melbourne, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Koutsifeli</LastName><ForeName>Parisa</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Physiology, University of Auckland, Auckland, New Zealand.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Neale</LastName><ForeName>Joshua P H</ForeName><Initials>JPH</Initials><AffiliationInfo><Affiliation>Department of Physiology, University of Auckland, Auckland, New Zealand.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Li</LastName><ForeName>Xun</ForeName><Initials>X</Initials><AffiliationInfo><Affiliation>Department of Physiology, University of Auckland, Auckland, New Zealand.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Harrap</LastName><ForeName>Stephen B</ForeName><Initials>SB</Initials><AffiliationInfo><Affiliation>Department of Physiology, University of Melbourne, Melbourne, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Taberner</LastName><ForeName>Andrew J</ForeName><Initials>AJ</Initials><Identifier Source="ORCID">0000-0002-0452-0308</Identifier><AffiliationInfo><Affiliation>Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Engineering Science, University of Auckland, Auckland, New Zealand.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Delbridge</LastName><ForeName>Lea M D</ForeName><Initials>LMD</Initials><AffiliationInfo><Affiliation>Department of Physiology, University of Melbourne, Melbourne, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Loiselle</LastName><ForeName>Denis S</ForeName><Initials>DS</Initials><Identifier Source="ORCID">0000-0002-6928-4019</Identifier><AffiliationInfo><Affiliation>Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Physiology, University of Auckland, Auckland, New Zealand.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mellor</LastName><ForeName>Kimberley M</ForeName><Initials>KM</Initials><Identifier Source="ORCID">0000-0002-8443-9365</Identifier><AffiliationInfo><Affiliation>Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Physiology, University of Auckland, Auckland, New Zealand.</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>06</Month><Day>28</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Gen Physiol</MedlineTA><NlmUniqueID>2985110R</NlmUniqueID><ISSNLinking>0022-1295</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000818" MajorTopicYN="N">Animals</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006332" MajorTopicYN="N">Cardiomegaly</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006333" MajorTopicYN="Y">Heart Failure</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006352" MajorTopicYN="N">Heart 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Heart Fail. 4:700–706. 10.1161/CIRCHEARTFAILURE.111.962381</Citation><ArticleIdList><ArticleId IdType="doi">10.1161/CIRCHEARTFAILURE.111.962381</ArticleId><ArticleId IdType="pubmed">21900188</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="MEDLINE" Owner="NLM" IndexingMethod="Automated"><PMID Version="1">34180902</PMID><DateCompleted><Year>2021</Year><Month>10</Month><Day>15</Day></DateCompleted><DateRevised><Year>2021</Year><Month>10</Month><Day>15</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1940-087X</ISSN><JournalIssue CitedMedium="Internet"><Issue>172</Issue><PubDate><Year>2021</Year><Month>Jun</Month><Day>10</Day></PubDate></JournalIssue><Title>Journal of visualized experiments : JoVE</Title><ISOAbbreviation>J Vis Exp</ISOAbbreviation></Journal>A New Model of Heart Failure Post-Myocardial Infarction in the Rat.<ELocationID EIdType="doi" ValidYN="Y">10.3791/62540</ELocationID><Abstract><AbstractText>Ligation of the left anterior descending (LAD) coronary artery has been widely used to establish the rat model of heart failure (HF) post myocardial infarction (MI). However, the disadvantages of this model include high mortality rate after ligation and larger variations both in the infarct size and the degree of impaired cardiac function. In addition, a ventilator or exteriorization of the heart is indispensable for the previous models, which complicates the procedure during the ligation. In this study, we developed a reliable and reproducible model without the ventilator or exteriorization of the heart by ligating the LAD coronary artery. Four weeks after the procedure, we found that the serum concentrations of CK-MB, NT-proBNP, and Renin, which were used to assist diagnoses of MI and HF, were significantly higher in the MI group compared to the sham group. In contrast, the value of left ventricle ejection fraction (LVEF) in the MI group was obviously less than in the sham group. Furthermore, the infarct size and cardiac fibrosis area were individually confirmed and quantitatively analyzed by TTC staining and Masson's trichrome staining. Smaller variations were found in either infarct size or fibrosis area in the MI group, which helped to develop a reliable and reproducible model of HF post-MI. This new model of HF post-MI in the rat is vital for studying the potential mechanisms of MI and HF. This new method can be used to develop the new drug for treatment of MI and HF in rats by using pharmacological strategies.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Li</LastName><ForeName>Honglei</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine; Department of Intensive Care Unit, Jinan Municipal Hospital of Traditional Chinese Medicine.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Huang</LastName><ForeName>Jiansheng</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Medicine, Vanderbilt University Medical Center.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Liu</LastName><ForeName>Caihong</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zhang</LastName><ForeName>Zhentao</ForeName><Initials>Z</Initials><AffiliationInfo><Affiliation>Department of Medicine, Vanderbilt University Medical Center.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Song</LastName><ForeName>Kuiquan</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Intensive Care Unit, Jinan Municipal Hospital of Traditional Chinese Medicine.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ma</LastName><ForeName>Ke</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dennewitz</LastName><ForeName>Connor W</ForeName><Initials>CW</Initials><AffiliationInfo><Affiliation>Department of Medicine, Vanderbilt University Medical Center.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wang</LastName><ForeName>Shijun</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine; Shandong Co-Innovation Center of Classic TCM Formula, Shandong Provincial Education Department; pathology@163.com.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType><PublicationType UI="D059040">Video-Audio Media</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>06</Month><Day>10</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Vis Exp</MedlineTA><NlmUniqueID>101313252</NlmUniqueID><ISSNLinking>1940-087X</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000818" MajorTopicYN="N">Animals</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003331" MajorTopicYN="N">Coronary Vessels</DescriptorName><QualifierName UI="Q000601" MajorTopicYN="N">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004195" MajorTopicYN="N">Disease Models, Animal</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006321" MajorTopicYN="N">Heart</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006333" MajorTopicYN="Y">Heart Failure</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D009203" MajorTopicYN="Y">Myocardial Infarction</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009206" MajorTopicYN="N">Myocardium</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D051381" MajorTopicYN="N">Rats</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016277" MajorTopicYN="N">Ventricular Function, Left</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>6</Month><Day>28</Day><Hour>12</Hour><Minute>20</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>6</Month><Day>29</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>10</Month><Day>16</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">34180902</ArticleId><ArticleId IdType="doi">10.3791/62540</ArticleId></ArticleIdList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="MEDLINE" Owner="NLM" IndexingMethod="Automated"><PMID Version="1">34180879</PMID><DateCompleted><Year>2021</Year><Month>10</Month><Day>15</Day></DateCompleted><DateRevised><Year>2021</Year><Month>10</Month><Day>15</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1940-087X</ISSN><JournalIssue CitedMedium="Internet"><Issue>172</Issue><PubDate><Year>2021</Year><Month>Jun</Month><Day>12</Day></PubDate></JournalIssue><Title>Journal of visualized experiments : JoVE</Title><ISOAbbreviation>J Vis Exp</ISOAbbreviation></Journal>Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock. | Increased heart size is a major risk factor for heart failure and premature mortality. Although abnormal heart growth subsequent to hypertension often accompanies disturbances in mechano-energetics and cardiac efficiency, it remains uncertain whether hypertrophy is their primary driver. In this study, we aimed to investigate the direct association between cardiac hypertrophy and cardiac mechano-energetics using isolated left-ventricular trabeculae from a rat model of primary cardiac hypertrophy and its control. We evaluated energy expenditure (heat output) and mechanical performance (force length work production) simultaneously at a range of preloads and afterloads in a microcalorimeter, we determined energy expenditure related to cross-bridge cycling and Ca2+ cycling (activation heat), and we quantified energy efficiency. Rats with cardiac hypertrophy exhibited increased cardiomyocyte length and width. Their trabeculae showed mechanical impairment, evidenced by lower force production, extent and kinetics of shortening, and work output. Lower force was associated with lower energy expenditure related to Ca2+ cycling and to cross-bridge cycling. However, despite these changes, both mechanical and cross-bridge energy efficiency were unchanged. Our results show that cardiac hypertrophy is associated with impaired contractile performance and with preservation of energy efficiency. These findings provide direction for future investigations targeting metabolic and Ca2+ disturbances underlying cardiac mechanical and energetic impairment in primary cardiac hypertrophy.<CopyrightInformation>© 2021 Han et al.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Han</LastName><ForeName>June-Chiew</ForeName><Initials>JC</Initials><Identifier Source="ORCID">0000-0002-6396-7628</Identifier><AffiliationInfo><Affiliation>Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tran</LastName><ForeName>Kenneth</ForeName><Initials>K</Initials><Identifier Source="ORCID">0000-0002-8651-3557</Identifier><AffiliationInfo><Affiliation>Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Crossman</LastName><ForeName>David J</ForeName><Initials>DJ</Initials><AffiliationInfo><Affiliation>Department of Physiology, University of Auckland, Auckland, New Zealand.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Curl</LastName><ForeName>Claire L</ForeName><Initials>CL</Initials><Identifier Source="ORCID">0000-0002-8092-9236</Identifier><AffiliationInfo><Affiliation>Department of Physiology, University of Melbourne, Melbourne, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Koutsifeli</LastName><ForeName>Parisa</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Physiology, University of Auckland, Auckland, New Zealand.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Neale</LastName><ForeName>Joshua P H</ForeName><Initials>JPH</Initials><AffiliationInfo><Affiliation>Department of Physiology, University of Auckland, Auckland, New Zealand.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Li</LastName><ForeName>Xun</ForeName><Initials>X</Initials><AffiliationInfo><Affiliation>Department of Physiology, University of Auckland, Auckland, New Zealand.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Harrap</LastName><ForeName>Stephen B</ForeName><Initials>SB</Initials><AffiliationInfo><Affiliation>Department of Physiology, University of Melbourne, Melbourne, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Taberner</LastName><ForeName>Andrew J</ForeName><Initials>AJ</Initials><Identifier Source="ORCID">0000-0002-0452-0308</Identifier><AffiliationInfo><Affiliation>Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Engineering Science, University of Auckland, Auckland, New Zealand.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Delbridge</LastName><ForeName>Lea M D</ForeName><Initials>LMD</Initials><AffiliationInfo><Affiliation>Department of Physiology, University of Melbourne, Melbourne, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Loiselle</LastName><ForeName>Denis S</ForeName><Initials>DS</Initials><Identifier Source="ORCID">0000-0002-6928-4019</Identifier><AffiliationInfo><Affiliation>Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Physiology, University of Auckland, Auckland, New Zealand.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mellor</LastName><ForeName>Kimberley M</ForeName><Initials>KM</Initials><Identifier Source="ORCID">0000-0002-8443-9365</Identifier><AffiliationInfo><Affiliation>Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Physiology, University of Auckland, Auckland, New Zealand.</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>06</Month><Day>28</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Gen Physiol</MedlineTA><NlmUniqueID>2985110R</NlmUniqueID><ISSNLinking>0022-1295</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000818" MajorTopicYN="N">Animals</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006332" MajorTopicYN="N">Cardiomegaly</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006333" MajorTopicYN="Y">Heart Failure</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006352" MajorTopicYN="N">Heart 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Heart Fail. 4:700–706. 10.1161/CIRCHEARTFAILURE.111.962381</Citation><ArticleIdList><ArticleId IdType="doi">10.1161/CIRCHEARTFAILURE.111.962381</ArticleId><ArticleId IdType="pubmed">21900188</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="MEDLINE" Owner="NLM" IndexingMethod="Automated"><PMID Version="1">34180902</PMID><DateCompleted><Year>2021</Year><Month>10</Month><Day>15</Day></DateCompleted><DateRevised><Year>2021</Year><Month>10</Month><Day>15</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1940-087X</ISSN><JournalIssue CitedMedium="Internet"><Issue>172</Issue><PubDate><Year>2021</Year><Month>Jun</Month><Day>10</Day></PubDate></JournalIssue><Title>Journal of visualized experiments : JoVE</Title><ISOAbbreviation>J Vis Exp</ISOAbbreviation></Journal><ArticleTitle>A New Model of Heart Failure Post-Myocardial Infarction in the Rat.</ArticleTitle><ELocationID EIdType="doi" ValidYN="Y">10.3791/62540</ELocationID><Abstract>Ligation of the left anterior descending (LAD) coronary artery has been widely used to establish the rat model of heart failure (HF) post myocardial infarction (MI). However, the disadvantages of this model include high mortality rate after ligation and larger variations both in the infarct size and the degree of impaired cardiac function. In addition, a ventilator or exteriorization of the heart is indispensable for the previous models, which complicates the procedure during the ligation. In this study, we developed a reliable and reproducible model without the ventilator or exteriorization of the heart by ligating the LAD coronary artery. Four weeks after the procedure, we found that the serum concentrations of CK-MB, NT-proBNP, and Renin, which were used to assist diagnoses of MI and HF, were significantly higher in the MI group compared to the sham group. In contrast, the value of left ventricle ejection fraction (LVEF) in the MI group was obviously less than in the sham group. Furthermore, the infarct size and cardiac fibrosis area were individually confirmed and quantitatively analyzed by TTC staining and Masson's trichrome staining. Smaller variations were found in either infarct size or fibrosis area in the MI group, which helped to develop a reliable and reproducible model of HF post-MI. This new model of HF post-MI in the rat is vital for studying the potential mechanisms of MI and HF. This new method can be used to develop the new drug for treatment of MI and HF in rats by using pharmacological strategies.</Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Li</LastName><ForeName>Honglei</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine; Department of Intensive Care Unit, Jinan Municipal Hospital of Traditional Chinese Medicine.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Huang</LastName><ForeName>Jiansheng</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Medicine, Vanderbilt University Medical Center.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Liu</LastName><ForeName>Caihong</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zhang</LastName><ForeName>Zhentao</ForeName><Initials>Z</Initials><AffiliationInfo><Affiliation>Department of Medicine, Vanderbilt University Medical Center.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Song</LastName><ForeName>Kuiquan</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Intensive Care Unit, Jinan Municipal Hospital of Traditional Chinese Medicine.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ma</LastName><ForeName>Ke</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dennewitz</LastName><ForeName>Connor W</ForeName><Initials>CW</Initials><AffiliationInfo><Affiliation>Department of Medicine, Vanderbilt University Medical Center.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wang</LastName><ForeName>Shijun</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine; Shandong Co-Innovation Center of Classic TCM Formula, Shandong Provincial Education Department; pathology@163.com.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType><PublicationType UI="D059040">Video-Audio Media</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>06</Month><Day>10</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Vis Exp</MedlineTA><NlmUniqueID>101313252</NlmUniqueID><ISSNLinking>1940-087X</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000818" MajorTopicYN="N">Animals</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003331" MajorTopicYN="N">Coronary Vessels</DescriptorName><QualifierName UI="Q000601" MajorTopicYN="N">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004195" MajorTopicYN="N">Disease Models, Animal</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006321" MajorTopicYN="N">Heart</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006333" MajorTopicYN="Y">Heart Failure</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D009203" MajorTopicYN="Y">Myocardial Infarction</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009206" MajorTopicYN="N">Myocardium</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D051381" MajorTopicYN="N">Rats</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016277" MajorTopicYN="N">Ventricular Function, Left</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>6</Month><Day>28</Day><Hour>12</Hour><Minute>20</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>6</Month><Day>29</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>10</Month><Day>16</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">34180902</ArticleId><ArticleId IdType="doi">10.3791/62540</ArticleId></ArticleIdList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="MEDLINE" Owner="NLM" IndexingMethod="Automated"><PMID Version="1">34180879</PMID><DateCompleted><Year>2021</Year><Month>10</Month><Day>15</Day></DateCompleted><DateRevised><Year>2021</Year><Month>10</Month><Day>15</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1940-087X</ISSN><JournalIssue CitedMedium="Internet"><Issue>172</Issue><PubDate><Year>2021</Year><Month>Jun</Month><Day>12</Day></PubDate></JournalIssue><Title>Journal of visualized experiments : JoVE</Title><ISOAbbreviation>J Vis Exp</ISOAbbreviation></Journal><ArticleTitle>Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock.</ArticleTitle><ELocationID EIdType="doi" ValidYN="Y">10.3791/62110</ELocationID><Abstract>Cardiogenic shock is defined as persistent hypotension, accompanied by evidence of end organ hypo-perfusion. Percutaneous ventricular assist devices (PVADs) are used for the treatment of cardiogenic shock in an effort to improve hemodynamics. Impella is currently the most common PVAD and actively pumps blood from the left ventricle into the aorta. PVADs unload the left ventricle, increase cardiac output and improve coronary perfusion. PVADs are typically placed in the cardiac catheterization laboratory under fluoroscopic guidance via the femoral artery when feasible. In cases of severe peripheral arterial disease, PVADs can be implanted through an alternative access. In this article, we summarize the mechanism of action of PVAD and the data supporting their use in the treatment of cardiogenic shock. |
2,331,429 | <i>In silico</i> investigation of pro-arrhythmic effects of azithromycin on the human ventricle. | The macrolide antibiotic azithromycin (AZM) is widely used for respiratory infections and has been suggested to be a possible treatment for the Coronavirus Disease of 2019 (COVID-19). However, AZM-associated QT interval prolongation and arrhythmias have been reported. Integrated mechanistic information on AZM actions on human ventricular excitation and conduction is lacking. Therefore, this study was undertaken to investigate the actions of AZM on ventricular cell and tissue electrical activity. The O'Hara- Virag-Varro-Rudy dynamic (ORd) model of human ventricular cells was modified to incorporate experimental data on the concentration-dependent actions of AZM on multiple ion channels, including I<sub>Na</sub>, I<sub>CaL</sub>, I<sub>Kr</sub>, I<sub>Ks</sub>, I<sub>K1</sub> and I<sub>NaL</sub> in both acute and chronic exposure conditions. In the single cell model, AZM prolonged the action potential duration (APD) in a concentration-dependent manner, which was predominantly attributable to I<sub>Kr</sub> reduction in the acute condition and potentiated I<sub>NaL</sub> in the chronic condition. High concentrations of AZM also increased action potential (AP) triangulation (determined as an increased difference between APD<sub>30</sub> and APD<sub>90</sub>) which is a marker of arrhythmia risk. In the chronic condition, the potentiated I<sub>NaL</sub> caused a modest intracellular Na <sup>+</sup> concentration accumulation at fast pacing rates. At the 1D tissue level, the AZM-prolonged APD at the cellular level was reflected by an increased QT interval in the simulated pseudo-ECG, consistent with clinical observations. Additionally, AZM reduced the conduction velocity (CV) of APs in the acute condition due to a reduced I<sub>Na</sub>, and it augmented the transmural APD dispersion of the ventricular tissue, which is also pro-arrhythmic. Such actions were markedly augmented when the effects of chronic exposure of AZM were also considered, or with additional I<sub>Kr</sub> block, as may occur with concurrent use of other medications. This study provides insights into the ionic mechanisms by which high concentrations of AZM may modulate ventricular electrophysiology and susceptibility to arrhythmia. |
2,331,430 | Sex-Specific Association of Left Ventricular Hypertrophy With Rheumatoid Arthritis. | <b>Objectives:</b> Clinical expression of rheumatoid arthritis (RA) varies by gender, but whether cardiovascular disease (CVD) is gender related in RA is unknown. Left ventricular (LV) hypertrophy (LVH) is a hallmark of CVD in RA patients. We investigated whether the association of LVH with RA is gender driven. <b>Methods:</b> Consecutive outpatients with established RA underwent echocardiography with measurement of LVH at baseline and one follow-up. All participants had no prior history of CVD or diabetes mellitus. We assessed CVD risk factors associated with LVH at follow-up, including sex, age, arterial blood pressure, and body mass index (BMI). We also evaluated inflammatory markers, autoimmunity, disease activity, and the use of RA medications as predictors of LVH. <b>Results:</b> We recruited 145 RA patients (121 females, 83%) and reassessed them after a median (interquartile range) of 36 months (24-50). At baseline, women were more dyslipidemic but otherwise had fewer CVD risk factors than men, including less prevalent smoking habit and hypertension, and smaller waist circumference. At follow-up, we detected LVH in 42/145 (44%) RA patients. LV mass significantly increased only in women. In multiple Cox regression analysis, women with RA had the strongest association with LVH, independently from the presence of CVD risk factors (OR, 6.56; 95% CI, 1.34-30.96) or RA-specific characteristics (OR, 5.14; 95% CI, 1.24-21.34). BMI was also significantly and independently associated with LVH. <b>Conclusion:</b> Among established RA patients, women carry the highest predisposition for LVH. |
2,331,431 | Automatic Segmentation and Cardiac Mechanics Analysis of Evolving Zebrafish Using Deep Learning. | <b>Background:</b> In the study of early cardiac development, it is essential to acquire accurate volume changes of the heart chambers. Although advanced imaging techniques, such as light-sheet fluorescent microscopy (LSFM), provide an accurate procedure for analyzing the heart structure, rapid, and robust segmentation is required to reduce laborious time and accurately quantify developmental cardiac mechanics. <b>Methods:</b> The traditional biomedical analysis involving segmentation of the intracardiac volume occurs manually, presenting bottlenecks due to enormous data volume at high axial resolution. Our advanced deep-learning techniques provide a robust method to segment the volume within a few minutes. Our U-net-based segmentation adopted manually segmented intracardiac volume changes as training data and automatically produced the other LSFM zebrafish cardiac motion images. <b>Results:</b> Three cardiac cycles from 2 to 5 days postfertilization (dpf) were successfully segmented by our U-net-based network providing volume changes over time. In addition to understanding each of the two chambers' cardiac function, the ventricle and atrium were separated by 3D erode morphology methods. Therefore, cardiac mechanical properties were measured rapidly and demonstrated incremental volume changes of both chambers separately. Interestingly, stroke volume (SV) remains similar in the atrium while that of the ventricle increases SV gradually. <b>Conclusion:</b> Our U-net-based segmentation provides a delicate method to segment the intricate inner volume of the zebrafish heart during development, thus providing an accurate, robust, and efficient algorithm to accelerate cardiac research by bypassing the labor-intensive task as well as improving the consistency in the results. |
2,331,432 | Solitary Metastasis of Colon Adenocarcinoma Mimicking Colloid Cyst of the Third Ventricle. | Metastatic lesions to the choroid plexus, although far less common than colloid cysts, can present very similarly both symptomatically and radiographically. Choroid plexus metastases are most common in the lateral ventricles, however, when they occur in the third and fourth ventricles they may cause obstructive hydrocephalus typical of a colloid cyst lesion. Renal cell carcinoma is the most common primary cancer, but many rare primaries have been reported. When patients are presenting with symptoms typical of colloid cysts it is important to consider past oncological history and if past medical history is significant for cancer using MR spectroscopy may be valuable in distinguishing between cystic and metastatic lesions. |
2,331,433 | Imaging Findings of Lipomatous Hypertrophy of the Interventricular Septum: A Case Report. | Primary cardiac tumors are rare. We report a case of lipomatous hypertrophy of the interventricular septum in a healthy, asymptomatic, 16 year old female, diagnosed initially by echocardiogram. Non contrast Computed tomography (CT) and Cardiac magnetic resonance imaging (CMR) were also performed to confirm the diagnosis of this rarely reported condition. Lipomatous hypertrophy of the interventricular septum is a rare form of benign cardiac tumor characterized by the proliferation of adipose tissue (fat) in the interventricular septum. This clinical entity has to be differentiated from cardiac lipoma which is a benign, encapsulated tumor. CMR helps is differentiating between the 2 conditions. As the lesion was neither causing compression of the ventricle nor obstruction to blood flow, she was managed conservatively and advised follow up. |
2,331,434 | Ventricle shape analysis using modified WKS for atrophy detection. | Brain ventricle is one of the biomarkers for detecting neurological disorders. Studying the shape of the ventricles will aid in the diagnosis process of atrophy and other CSF-related neurological disorders, as ventricles are filled with CSF. This paper introduces a spectral analysis algorithm based on wave kernel signature. This shape signature was used for studying the shape of segmented ventricles from the brain images. Based on the shape signature, the study groups were classified as normal subjects and atrophy subjects. The proposed algorithm is simple, effective, automated, and less time consuming. The proposed method performed better than the other methods heat kernel signature, scale invariant heat kernel signature, wave kernel signature, and spectral graph wavelet signature, which were used for validation purpose, by producing 94-95% classification accuracy by classifying normal and atrophy subjects correctly for CT, MR, and OASIS datasets. |
2,331,435 | Efficacy and safety of flexible versus rigid endoscopic third ventriculostomy in pediatric and adult populations: a systematic review and meta-analysis. | Endoscopic third ventriculostomy (ETV) is a well-established surgical procedure for hydrocephalus treatment, but there is sparse evidence on the optimal choice between flexible and rigid approaches. A meta-analysis was conducted to compare efficacy and safety profiles of both techniques in pediatrics and adults. A comprehensive search was conducted on PubMED, EMBASE, and Cochrane until 11/10/2019. Efficacy was evaluated comparing incidence of ETV failure, while safety was defined by the incidence of perioperative complications, intraoperative bleedings, and deaths. Random-effects models were used to pool the incidence. Out of 1365 studies, 46 case series were meta-analyzed, yielding 821 patients who underwent flexible ETV and 2918 who underwent rigid ETV, with an age range of [5 days-87 years]. Although flexible ETV had a higher incidence of failure in adults (flexible: 54%, 95%CI: 22-82% vs rigid: 20%, 95%CI: 22-82%) possibly due to confounding due to etiology in adults treated with flexible, a smaller difference was seen in pediatrics (flexible: 36%, pediatric: 32%). Safety profiles were acceptable for both techniques, with a certain degree of variability for complications (flexible 2%, rigid 18%) and death (flexible 1%, rigid 3%) in pediatrics as well as complications (rigid 9%, flexible 13%), death (flexible 4%, rigid 6%) and intra-operative bleeding events (rigid 6%, flexible 8%) in adults. No clear superiority in efficacy could be depicted between flexible and rigid ETV for hydrocephalus treatment. Safety profiles varied by age but were acceptable for both techniques. Well-designed comparative studies are needed to assess the optimal endoscopic treatment option for hydrocephalus. |
2,331,436 | Endoscopic Placement of Fourth Ventricular Catheter Using Seldinger Technique: Description of Technique and Case Series. | Neonatal intraventricular hemorrhage remains a significant source of morbidity in premature and low-weight patients. Approximately 15% of patients who require cerebrospinal fluid shunting develop trapped fourth ventricle (TFV). Surgical treatment presents challenges with short- and long-term complications.</AbstractText>To describe a technique that applies the Seldinger technique with image-guided endoscopy for direct visualization of catheter placement.</AbstractText>A guidewire is passed down the endoscope while it is positioned in the fourth ventricle. The endoscope is removed while the guidewire is held in place. The catheter is slid down the guidewire. The guidewire is removed and placement is confirmed with image guidance.</AbstractText>Three patients, all less than 14 mo old, with history of prematurity and intraventricular hemorrhage with ventriculoperitoneal shunts, presented with loculated hydrocephalus with TFV. They each underwent image-guided endoscopic fenestration of the fourth ventricle with placement of a fourth ventricular catheter performed by our described technique. All 3 patients recovered well and were discharged on postoperative day 1. Follow-up imaging showed decompression of the fourth ventricle and good placement of the fourth ventricular catheter. None have had complications from catheter placement, and one revision of a fourth ventricular catheter was needed, which was completed with the same described technique.</AbstractText>This technique is well suited for cases in which a fourth ventricular catheter or a difficult trajectory catheter is needed during endoscopic fenestration or when distorted anatomy is present that would make a straight trajectory with a pen endoscope more difficult or higher risk.</AbstractText>© Congress of Neurological Surgeons 2021.</CopyrightInformation> |
2,331,437 | Fourth ventricle roof angle as a measure of fourth ventricle bowing and a radiographic predictor of brainstem dysfunction in Chiari malformation type I. | Chiari malformation type I (CM-I) is a congenital and developmental abnormality that results in tonsillar descent 5 mm below the foramen magnum. However, this cutoff value has poor specificity as a predictor of clinical severity. Therefore, the authors sought to identify a novel radiographic marker predictive of clinical severity to assist in the management of patients with CM-I.</AbstractText>The authors retrospectively reviewed 102 symptomatic CM-I (sCM-I) patients and compared them to 60 age-matched normal healthy controls and 30 asymptomatic CM-I (aCM-I) patients. The authors used the fourth ventricle roof angle (FVRA) to identify fourth ventricle "bowing," a configuration change suggestive of fourth ventricle outlet obstruction, and compared these results across all three cohorts. A receiver operating characteristic (ROC) curve was used to identify a predictive cutoff for brainstem dysfunction. Binary logistic regression was used to determine whether bowing of the fourth ventricle was more predictive of brainstem dysfunction than tonsillar descent, clival canal angle, or obex position in aCM-I and sCM-I patients.</AbstractText>The FVRA had excellent interrater reliability (intraclass correlation 0.930, 95% CI 0.905-0.949, Spearman r2 = 0.766, p < 0.0001). The FVRA was significantly greater in the sCM-I group than the aCM-I and healthy control groups (59.3° vs 41.8° vs 45.2°, p < 0.0001). No difference was observed between aCM-I patients and healthy controls (p = 0.347). ROC analysis indicated that an FVRA of 65° had a specificity of 93% and a sensitivity of 50%, with a positive predictive value of 76% for brainstem dysfunction. FVRA > 65° was more predictive of brainstem dysfunction (OR 5.058, 95% CI 1.845-13.865, p = 0.002) than tonsillar herniation > 10 mm (OR 2.564, 95% CI 1.050-6.258, p = 0.039), although increasing age was also associated with brainstem dysfunction (OR 1.045, 95% CI 1.011-1.080, p = 0.009). A clival canal angle < 140° (p = 0.793) and obex below the foramen magnum (p = 0.563) had no association with brainstem dysfunction.</AbstractText>The authors identified a novel radiographic measure, the FVRA, that can be used to assess fourth ventricular bowing in CM-I and is more predictive of brainstem dysfunction than tonsillar herniation. The FVRA is easy to measure, has excellent interrater variability, and can be a reliable universal radiographic measure. The FVRA will be useful in further describing CM-I radiographically and clinically by identifying patients more likely to be symptomatic as a result of brainstem dysfunction.</AbstractText> |
2,331,438 | Left Ventricular Decompression by Transaortic Catheter Venting in Extracorporeal Membrane Oxygenation. | Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been widely applied to patients with cardiogenic shock. Left ventricle (LV) decompression is important when LV distension develops with pulmonary edema. The purpose of this study was to present the results of transaortic catheter venting (TACV) performed during VA-ECMO. We retrospectively reviewed the medical records of 18 patients who underwent both VA-ECMO and TACV between January 2017 and December 2019. Venoarterial extracorporeal membrane oxygenation was applied uneventfully. Lactate level and norepinephrine requirement for patients of weaning success were lower than those of patients of weaning failure after the application of TACV (p = 0.032 and p = 0.015, respectively). The successful weaning rate of ECMO was 77.8% (15/18) and survival rate was 50% (9/18). Transaortic catheter venting may be an easy, safe, and effective technique for LV decompression in patients with VA-ECMO for cardiogenic shock. Also, this technique may be helpful as an alternative or bridge method. |
2,331,439 | Early and late brain resonance findings of two siblings with Hunter syndrome. | Mucopolysaccharidosis type II (MPS II) is a lysosomal disease caused by deficiency of the enzyme iduronate-2-sulfatase (IDS), linked to the X chromosome, producing a wide spectrum of clinical manifestations.</AbstractText>We present the case of two siblings with MPS II of different paternal origin with the same genetic mutation; the age at the time of diagnosis was 5 years of age (case 1) and 8 months of age (case 2). These brethren present different findings in brain magnetic resonance imaging (MRI) with each other, case 1 presented classic findings for age, case 2 presented multiple early findings, such as dilated perivascular spaces up to 9.5 mm, magna megacisterna, among others; without neurological manifestations.</AbstractText>This patient's brain compromise was presented before the year of age and prior to hepatosplenomegaly, thus, MRI becomes an early diagnostic tool for MPS II.</AbstractText> |
2,331,440 | Tuberculoma in the Fourth Ventricle: An Unusual Location. | To present a young immunocompetent patient with a fourth ventricle tuberculoma without pulmonary tuberculosis. A previously healthy young male patient presented with a history of headache, nausea, and blurred vision. Neuroimaging revealed a mass present in the fourth ventricle. The lesion was successfully resected. Histological and microbiological findings suggested the presence of a tuberculoma. Tuberculomas can be found in the posterior fossa in adults. This infectious pathology should not be forsaken when considering the differential diagnosis for infratentorial masses. |
2,331,441 | Bilateral Lambdoid and Sagittal Craniosynostosis with Hydrocephalus: ETV, Bifrontal Craniotomy, Anterior Cranial Vault Remodeling, and Posterior Cranial Vault Expansion. | Bilateral lambdoid and sagittal craniosynostosis (BLSS), also known as Mercedes Benz pattern craniosynostosis, is a rare form of craniosynostosis. The whole cranial vault remodeling gives the best result.</AbstractText>To describe the role of endoscopic third ventriculostomy (ETV) and whole cranial vault remodeling for treatment of BLSS.</AbstractText>Surgical technique/procedure: A single-sitting three-step surgery was performed for a 7-month-old child who had BLSS and hydrocephalus. First ETV and anterior cranial vault remodeling were done in the supine position. The posterior cranial vault expansion was done in the prone position.</AbstractText>The ventricle volume reduced at follow-up and the frontal bossing also reduced. The whole cranial vault remodeling gives the best result for BLSS.</AbstractText> |
2,331,442 | SHAPE-REGULARIZED UNSUPERVISED LEFT VENTRICULAR MOTION NETWORK WITH SEGMENTATION CAPABILITY IN 3D+TIME ECHOCARDIOGRAPHY. | Accurate motion estimation and segmentation of the left ventricle from medical images are important tasks for quantitative evaluation of cardiovascular health. Echocardiography offers a cost-efficient and non-invasive modality for examining the heart, but provides additional challenges for automated analyses due to the low signal-to-noise ratio inherent in ultrasound imaging. In this work, we propose a shape regularized convolutional neural network for estimating dense displacement fields between sequential 3D B-mode echocardiography images with the capability of also predicting left ventricular segmentation masks. Manually traced segmentations are used as a guide to assist in the unsupervised estimation of displacement between a source and a target image while also serving as labels to train the network to additionally predict segmentations. To enforce realistic cardiac motion patterns, a flow incompressibility term is also incorporated to penalize divergence. Our proposed network is evaluated on an <i>in vivo</i> canine 3D+t B-mode echocardiographic dataset. It is shown that the shape regularizer improves the motion estimation performance of the network and our overall model performs favorably against competing methods. |
2,331,443 | A case of chronic dysaesthesia in the torso and upper limbs: lessons from a cervical spinal cord subependymoma. | Subependymomas are slow growing WHO grade 1 tumours, typically attached to the ventricular wall of the fourth or lateral ventricles. Spinal subependymomas are rarer still and experience of their biological characteristics remains limited.</AbstractText>A 29-year-old lady presented with chronic attacks of itchy dysaesthesia involving the left hand, neck and trunk, and associated with ipsilateral leg spasms. Recent symptomatic change involved occasional limping and left sided facial numbness but no pain. MRI showed an intradural mass surrounding most of the cervical spinal cord, which appeared scalloped extrinsically, rather than diffusely expanded, by a seemingly extramedullary lesion. At operation, the cord appeared expanded, with no clear margin or distinction between tumour and cord tissue; and the tumour was found to be intramedullary with an exophytic component, rather than extramedullary. Moderate reduction of the left abductor pollicis brevis evoked potential led to a pause in surgery. There was transient hand weakness postoperatively with full recovery, and no radiological change in the tumour morphology for a further 6 years.</AbstractText>An intramedullary tumour such as a spinal cord subependymoma can be mistaken radiologically for an extramedullary tumour, such as an epidermoid. If a subependymoma is suspected, given its indolent course and long-term survival, caution in the extent of surgical resection is advisable in order to avoid surgical morbidity.</AbstractText> |
2,331,444 | Associations of Binge Drinking With Vascular Brain Injury and Atrophy in Older American Indians: The Strong Heart Study. | <b>Objectives:</b> American Indians (AIs) generally consume less alcohol than the US general population; however, the prevalence of alcohol use disorder is higher. This is the first large cohort study to examine binge drinking as a risk factor for vascular brain injury (VBI). <b>Methods:</b> We used linear and Poisson regression to examine the association of self-reported binge drinking with VBI, measured via magnetic resonance imaging (MRI), in 817 older AIs who participated in the Strong Heart and Cerebrovascular Disease and Its Consequences in American Indians studies. <b>Results:</b> Any binge drinking at multiple time-points was associated with increased sulcal (β = 0.360, 95% CI [0.079, 0.641]) and ventricle dilatation (β = 0.512, 95% CI [0.174, 0.850]) compared to no binge drinking. <b>Discussion:</b> These observed associations are consistent with previous findings. Identifying how binge drinking may contribute to VBI in older AIs may suggest modifiable health behaviors for neurological risk reduction and disease prevention. |
2,331,445 | How I do it: parietal trans-sulcal para-fascicular approach to lateral thalamic/internal capsule cavernous malformation. | The surgical management of deep brain lesions is challenging, with significant morbidity. Advances in surgical technology have presented the opportunity to tackle these lesions.</AbstractText>We performed a complete resection of a thalamic/internal capsule CM using a tubular retractor system via a parietal trans-sulcal para-fascicular (PTPF) approach without collateral injury to the nearby white matter tracts.</AbstractText>PTPF approach to lateral thalamic/internal capsule lesions can be safely performed without injury to eloquent white matter fibres. The paucity of major vessels along this trajectory and the preservation of lateral ventricle integrity make this approach a feasible alternative to traditional approaches.</AbstractText>© 2021. The Author(s).</CopyrightInformation> |
2,331,446 | Assessment of Myocardial Dysfunction by Three-Dimensional Echocardiography Combined With Myocardial Contrast Echocardiography in Type 2 Diabetes Mellitus. | <b>Background:</b> We aimed to explore the value of combining real-time three-dimensional echocardiography (RT-3DE) and myocardial contrast echocardiography (MCE) in the left ventricle (LV) evaluating myocardial dysfunction in type 2 diabetes mellitus (T2DM) patients. <b>Patients and Methods:</b> A total of 58 T2DM patients and 32 healthy individuals were selected for this study. T2DM patients were further divided into T2DM without microvascular complications (<i>n</i> = 29) and T2DM with microvascular complications (<i>n</i> = 29) subgroups. All participants underwent RT-3DE and MCE. The standard deviation (SD) and the maximum time difference (Dif) of the time to the minimum systolic volume (Tmsv) of the left ventricle were measured by RT-3DE. MCE was performed to obtain the perfusion measurement of each segment of the ventricular wall, including acoustic intensity (A), flow velocity (β), and A·β. <b>Results:</b> There were significant differences in all Tmsv indices except for Tmsv6-Dif among the three groups (all <i>P</i> < 0.05). After heart rate correction, all Tmsv indices of the T2DM with microvascular complications group were prolonged compared with the control group (all <i>P</i> < 0.05). The parameters of A, β, and A·β for overall segments showed a gradually decreasing trend in three groups, while the differences between the three groups were statistically significant (all <i>P</i> < 0.01). For segmental evaluation of MCE, the value of A, β, and A·β in all segments showed a decreasing trend and significantly differed among the three groups (all <i>P</i> < 0.05). <b>Conclusions:</b> The RT-3DE and MCE can detect subclinical myocardial dysfunction and impaired myocardial microvascular perfusion. Left ventricular dyssynchrony occurred in T2DM patients with or without microvascular complications and was related to left ventricular dysfunction. Myocardial perfusion was reduced in T2DM patients, presenting as diffuse damage, which was aggravated by microvascular complications in other organs. |
2,331,447 | 1p36 Deletion Syndrome and Left Ventricular Non-compaction Cardiomyopathy-Two Cases Report. | 1p36 deletion is the most common terminal deletion syndrome in humans. Herein, we report two cases, a 5-month-old female and a 14.5-year-old female, both with 1p36 deletion and left ventricular non-compaction cardiomyopathy. They presented with severely depressed left ventricle function and underwent heart transplantation with excellent outcomes. Given the incidence of heart defects and cardiomyopathy in 1p36 deletion syndrome, it should be recommended that children with this genetic condition have screening for cardiac disease. These cases add to the current literature by demonstrating the potential therapeutic options for non-compaction in 1p36 deletion syndrome and showed the favorable outcomes. |
2,331,448 | Design of a Proteolytically Stable Sodium-Calcium Exchanger 1 Activator Peptide for <i>In Vivo</i> Studies. | The cardiac sodium-calcium exchanger (NCX1) is important for normal Na<sup>+</sup>- and Ca<sup>2+</sup>-homeostasis and cardiomyocyte relaxation and contraction. It has been suggested that NCX1 activity is reduced by phosphorylated phospholemman (pSer68-PLM); however its direct interaction with PLM is debated. Disruption of the potentially inhibitory pSer68-PLM-NCX1 interaction might be a therapeutic strategy to increase NCX1 activity in cardiac disease. In the present study, we aimed to analyze the binding affinities and kinetics of the PLM-NCX1 and pSer68-PLM-NCX1 interactions by surface plasmon resonance (SPR) and to develop a proteolytically stable NCX1 activator peptide for future <i>in vivo</i> studies. The cytoplasmic parts of PLM (PLM<sub>cyt</sub>) and pSer68-PLM (pSer68-PLM<sub>cyt</sub>) were found to bind strongly to the intracellular loop of NCX1 (NCX1<sub>cyt</sub>) with similar <i>K</i> <sub><i>D</i></sub> values of 4.1 ± 1.0 nM and 4.3 ± 1.9 nM, but the PLM<sub>cyt</sub>-NCX1<sub>cyt</sub> interaction showed higher on/off rates. To develop a proteolytically stable NCX1 activator, we took advantage of a previously designed, high-affinity PLM binding peptide (OPT) that was derived from the PLM binding region in NCX1 and that reverses the inhibitory PLM (S68D)-NCX1 interaction in HEK293. We performed N- and C-terminal truncations of OPT and identified PYKEIEQLIELANYQV as the minimum sequence required for pSer68-PLM binding. To increase peptide stability in human serum, we replaced the proline with an N-methyl-proline (NOPT) after identification of N-terminus as substitution tolerant by two-dimensional peptide array analysis. Mass spectrometry analysis revealed that the half-life of NOPT was increased 17-fold from that of OPT. NOPT pulled down endogenous PLM from rat left ventricle lysate and exhibited direct pSer68-PLM binding in an ELISA-based assay and bound to pSer68-PLM<sub>cyt</sub> with a <i>K</i> <sub><i>D</i></sub> of 129 nM. Excess NOPT also reduced the PLM<sub>cyt</sub>-NCX1<sub>cyt</sub> interaction in an ELISA-based competition assay, but in line with that NCX1 and PLM form oligomers, NOPT was not able to outcompete the physical interaction between endogenous full length proteins. Importantly, cell-permeable NOPT-TAT increased NCX1 activity in cardiomyocytes isolated from both SHAM-operated and aorta banded heart failure (HF) mice, indicating that NOPT disrupted the inhibitory pSer68-PLM-NCX1 interaction. In conclusion, we have developed a proteolytically stable NCX1-derived PLM binding peptide that upregulates NCX1 activity in SHAM and HF cardiomyocytes. |
2,331,449 | The Ependymal Region Prevents Glioblastoma From Penetrating Into the Ventricle via a Nonmechanical Force. | Intraventricular penetration is rare in glioblastoma (GBM). Whether the ependymal region including the ependyma and subventricular zone (SVZ) can prevent GBM invasion remains unclear.</AbstractText>Magnetic resonance imaging (MRI) and haematoxylin-eosin (HE) staining were performed to evaluate the size and anatomical locations of GBM. Binary logistic regression analysis was used to assess the correlation between tumor-ependyma contact, ventricle penetration and clinical characteristics. Cell migration and invasion were assessed via Transwell assays and an orthotopic transplantation model.</AbstractText>Among 357 patients with GBM, the majority (66%) showed ependymal region contact, and 34 patients (10%) showed ventricle penetration of GBM. GBM cells were spread along the ependyma in the orthotopic transplantation model. The longest tumor diameter was an independent risk factor for GBM-ependymal region contact, as demonstrated by univariate (OR = 1.706, p</i> < 0.0001) and multivariate logistic regression analyses (OR = 1.767, p</i> < 0.0001), but was not associated with ventricle penetration. Cerebrospinal fluid (CSF) could significantly induce tumor cell migration (p</i> < 0.0001), and GBM could grow in CSF. Compared with those from the cortex, cells from the ependymal region attenuated the invasion of C6 whether cocultured with C6 or mixed with Matrigel (p</i> = 0.0054 and p</i> = 0.0488). Immunofluorescence analysis shows a thin gap with GFAP expression delimiting the tumor and ependymal region.</AbstractText>The ependymal region might restrict GBM cells from entering the ventricle via a non-mechanical force. Further studies in this area may reveal mechanisms that occur in GBM patients and may enable the design of new therapeutic strategies.</AbstractText>Copyright © 2021 Li, Song, Wang, Lin, Yi, Yang, Ni, Wang, Zhu, Zhang, Wang, Liu, Huang and Liu.</CopyrightInformation> |
2,331,450 | Spatiotemporal dynamics of γH2AX in the mouse brain after acute irradiation at different postnatal days with special reference to the dentate gyrus of the hippocampus. | Gamma H2A histone family member X (γH2AX) is a molecular marker of aging and disease. However, radiosensitivity of the different brain cells, including neurons, glial cells, cells in cerebrovascular system, epithelial cells in pia mater, ependymal cells lining the ventricles of the brain in immature animals at different postnatal days remains unknown. Whether radiation-induced γH2AX foci in immature brain persist in adult animals still needs to be investigated. Hence, using a mouse model, we showed an extensive postnatal age-dependent induction of γH2AX foci in different brain regions at 1 day after whole body gamma irradiation with 5Gy at postnatal day 3 (P3), P10 and P21. P3 mouse brain epithelial cells in pia mater, glial cells in white matter and cells in cerebrovascular system were more radiosensitive at one day after radiation exposure than those from P10 and P21 mice. Persistent DNA damage foci (PDDF) were consistently demonstrated in the brain at 120 days and 15 months after irradiation at P3, P10 and P21, and these mice had shortened lifespan compared to the age-matched control. Our results suggest that early life irradiation-induced PDDF at later stages of animal life may be related to the brain aging and shortened life expectancy of irradiated animals. |
2,331,451 | Cardiac fibroma with cardiac arrest: a rare clinical presentation of Gorlin syndrome in an 8-month-old infant. | Paediatric cardiac tumours are rare, often benign and carry associations with genetic conditions. Cardiac fibromas are mainly composed of fibroblast and connective tissue . They can lead to symptoms due to obstruction of blood flow or arrythmias. In this case, we report an 8-month-old girl child who presented to paediatric cardiology office for cardiac evaluation given a family history of Gorlin syndrome, also known as nevoid basal cell carcinoma syndrome, found to have a large 4×4×6 cm fibroma in the apical lateral free wall of the left ventricle and later presented to the emergency department with cardiac arrest. |
2,331,452 | Spindle Cell Squamous Cell Carcinoma of the Larynx with Malignant Osteoid Differentiation: A Case Report and Review of Literature. | Spindle cell squamous cell carcinoma of the larynx is a rare, aggressive variant of squamous cell carcinoma. It comprises 0.6-1.5% of all laryngeal cancers. Heterologous mesenchymal differentiation as bone, cartilage, and muscle is uncommon, especially malignant osteoid differentiation, as a handful of cases reported in the literature. We present the case of a 66-year-old male active smoker who presented with dysphonia and acute stridor. On examination, a 2.0 cm pedunculated, broad-base, glottic mass involving the left true vocal cord and ventricle was noted, with extension to the anterior commissure causing a narrowing of the airway. The patient underwent localized left vocal cordectomy. The histopathologic and immunohistochemical findings were consistent with spindle cell carcinoma with malignant osteoid differentiation. The patient is alive, status-post adjuvant five cycles of cisplatin therapy, with no recurrence at 18 months of follow-up. We discuss a literature review of this rare entity with either malignant osteoid or osteocartilaginous differentiation. |
2,331,453 | Evaluation of the sphericity index of the fetal heart during middle and late pregnancy using fetalHQ. | To explore the feasibility of the fetal heart quantitative technique (fetalHQ) for evaluating the sphericity index (SI) of the fetal heart during middle and late pregnancy.</AbstractText>Ninety-six normal fetuses in middle and late gestation who underwent systemic ultrasound examination in the Department of Ultrasound of the Maternal and Child Health Care Hospital of Hunan Province in November 2020 were enrolled, and dynamic images of the four-chamber view of the fetal heart were collected. The correlation between the global sphericity index (GSI), ventricular 24-segment SI, and gestational age (GA) was analyzed, and the differences between the left and right ventricular 24-segment SI were compared.</AbstractText>The success rate of fetalHQ analysis was 93.75%. There was no significant linear correlation between GSI and ventricular 24-segment SI and GA (all p</i>s > .05). The differences in SI between segments 1 and 9 and 15 and 24 in the left and right ventricles were statistically significant (all p</i>s < .05), while the differences in SI between segments 10 and 14 were not statistically significant (all p</i>s > .05). In segments 1-9, the SI of the right ventricle was smaller than that of the left ventricle, indicating that the right ventricle was significantly more spherical than the left ventricle. In segments 15-24, the opposite was true.</AbstractText>FetalHQ is a simple and reliable method for evaluating the GSI and 24-segment SI of the left and right ventricles. It can provide some theoretical basis for the clinical quantitative evaluation of fetal heart geometry and lay a foundation for the quantitative evaluation of fetal heart function in cases of structural and functional abnormalities.</AbstractText> |
2,331,454 | Effects of platelet rich plasma on experimentally induced diabetic heart injury. | Diabetic heart is one of the common complications of diabetes mellitus. Platelet-rich plasma (PRP) is an autologous product rich in growth factors that can enhance tissue regeneration. This work was conducted to study the PRP ability to improve diabetes-inducing cardiac changes. Also, it sheds more light on the possible mechanisms through which PRP induces its effects. Rats were divided into; control, PRP, diabetic, and PRP-diabetic groups. Cardiac specimens were obtained and processed for biochemical, histological, and immunohistochemical study. The diabetic group exhibited a significant increase in cardiac oxidative stress, inflammation, and cardiac injury markers if compared with the control group. Additionally, the cardiac tissue showed variable morphological changes in the form of focal distortion and loss of cardiac myocytes. Distorted mitochondria and heterochromatic nuclei were observed in the cardiac muscle fibers. The mean number of charcoal-stained macrophages, and mean area fraction for collagen fibers, mean number of PCNA-immune positive cardiac muscle were significantly decrease in PRP- diabetic group. Collectively, the results showed that PRP treatment ameliorated most of all these previous changes. CONCLUSION: PRP ameliorated the diabetic cardiac injury via inhibition of oxidative stress and inflammation. It was confirmed by biochemical, histological, and immunohistochemical study. It could be concluded that PRP could be used as a potential therapy for diabetic heart. |
2,331,455 | Morphological Analysis of the Hindbrain Glucose Sensor-Hypothalamic Neural Pathway Activated by Hindbrain Glucoprivation. | Lowered glucose availability, sensed by the hindbrain, has been suggested to enhance gluconeogenesis and food intake as well as suppress reproductive function. In fact, our previous histological and in vitro studies suggest that hindbrain ependymal cells function as a glucose sensor. The present study aimed to clarify the hindbrain glucose sensor-hypothalamic neural pathway activated in response to hindbrain glucoprivation to mediate counterregulatory physiological responses. Administration of 2-deoxy-D-glucose (2DG), an inhibitor of glucose utilization, into the fourth ventricle (4V) of male rats for 0.5 hour induced messenger RNA (mRNA) expression of c-fos, a marker for cellular activation, in ependymal cells in the 4V, but not in the lateral ventricle, the third ventricle or the central canal without a significant change in blood glucose and testosterone levels. Administration of 2DG into the 4V for 1 hour significantly increased blood glucose levels, food intake, and decreased blood testosterone levels. Simultaneously, the expression of c-Fos protein was detected in the 4V ependymal cells; dopamine β-hydroxylase-immunoreactive cells in the C1, C2, and A6 regions; neuropeptide Y (NPY) mRNA-positive cells in the C2; corticotropin-releasing hormone (CRH) mRNA-positive cells in the hypothalamic paraventricular nucleus (PVN); and NPY mRNA-positive cells in the arcuate nucleus (ARC). Taken together, these results suggest that lowered glucose availability, sensed by 4V ependymal cells, activates hindbrain catecholaminergic and/or NPY neurons followed by CRH neurons in the PVN and NPY neurons in the ARC, thereby leading to counterregulatory responses, such as an enhancement of gluconeogenesis, increased food intake, and suppression of sex steroid secretion. |
2,331,456 | The Heart of Pediatric Patients with COVID-19: New Insights from a Systematic Echocardiographic Study in a Tertiary Hospital in Brazil. | COVID-19 pandemic represents a huge burden to the health system in the world. Although pediatric COVID-19 patients have been relatively spared compared with adults, recent reports showed an increasing number of critically ill patients with multisystemic inflammatory syndrome in children (MIS-c), with marked cardiovascular impairment. Nevertheless, little is known about the relationship between cardiac abnormalities and inflammatory and coagulation biomarkers.</AbstractText>to investigate echocardiographic abnormalities in pediatric patients with COVID-19 admitted to tertiary hospital.</AbstractText>this was a retrospective longitudinal study, based on the review of medical records and echocardiograms of patients (0-19 years) admitted to a tertiary hospital between March 30 and June 30, 2020. For statistical analysis, the significance level was set at 5% (p < 0.05).</AbstractText>Forty-eight patients were enrolled, 73% with preexisting diseases, 20 (41.7%) with MIS-c. Median age was 7.5 (0-18.6) years; 27 (56.2%) were male. Median duration of hospitalization was 15.4 (2-92) days and seven (14.6%) patients died. A total of 70 echocardiograms were performed; 66.7% patients were scanned only once and 33.3% multiple times. Twenty-three (48%) patients showed echocardiographic abnormalities: eight (16.6%) left ventricle (LV) systolic dysfunction, six (12.5%) right ventricle (RV) systolic dysfunction and 12 (25%) coronary dilatation (Z-score>+2.5). Echocardiographic abnormalities were significantly associated with MIS-c, admission to the pediatric intensive care unit, multiple organ dysfunction, ventilatory/vasoactive support, and death (p<0.05). Significantly higher d-dimer (ng/mL) levels were detected in patients with LV dysfunction [16733(4157-115668) vs. 2406.5(190-95040)], RV dysfunction [25769(3422-115668) vs. 2803.5(190-95040)] and coronary artery dilation [9652.5(921-115668) vs. 2724(190- 95040)] (p<0.05).</AbstractText>Echocardiographic abnormalities in COVID-19 pediatric patients were frequent and associated with worse clinical outcomes. Exacerbation of the inflammation and coagulation pathways may play an important role in cardiovascular injury in those patients.</AbstractText> |
2,331,457 | Malignant intraventricular meningioma: literature review and case report. | Malignant intraventricular meningiomas (IVMs) are very rare with only a few reported cases. A midline search up to December 2020 selected 40 articles for a total of 65 patients. The inclusion criteria were series and case reports in English language, as well as papers written in other languages, but with abstracts written in English. Malignant IVMs at the first diagnosis (group A, 50 patients) and those with anaplastic transformation from previous WHO grades I and II tumors (group B, 15 patients) were separately analyzed. The unique personal case among 1285 meningiomas (0.078%) is also added. Malignant IVMs mainly occur in women (61%) with a median age of 45 years and are mainly located in the lateral ventricle (93%) and trigonal region (74%), with no cases in the fourth ventricle. Irregular borders (80%), heterogeneous enhancement (83%), and perilesional edema (76%) are the most frequent radiological findings. The histology was mainly pure anaplastic (85%), whereas papillary (7%), rhabdoid (5%), and mixed forms (3%) are very rare. The CSF spread was found in 60% of the cases. The prognosis is very dismal, with an overall median survival of 17.5 months after surgery for the anaplastic forms. Malignant IVMs at initial diagnosis (group A) show better overall survival (25 months) than those occurring from anaplastic transformation of lower grade tumors (group B) (10.1 months). |
2,331,458 | Analgesic effect of central relaxin receptor activation on persistent inflammatory pain in mice: behavioral and neurochemical data. | The relaxin peptide signaling system is involved in diverse physiological processes, but its possible roles in the brain, including nociception, are largely unexplored.</AbstractText>In light of abundant expression of relaxin receptor (RXFP1) mRNA/protein in brain regions involved in pain processing, we investigated the effects of central RXFP1 activation on nociceptive behavior in a mouse model of inflammatory pain and examined the neurochemical phenotype and connectivity of relaxin and RXFP1 mRNA-positive neurons.</AbstractText>Mice were injected with Complete Freund Adjuvant (CFA) into a hind paw. After 4 days, the RXFP1 agonist peptides, H2-relaxin or B7-33, ± the RXFP1 antagonist, B-R13/17K-H2, were injected into the lateral cerebral ventricle, and mechanical and thermal sensitivity were assessed at 30 to 120 minutes. Relaxin and RXFP1 mRNA in excitatory and inhibitory neurons were examined using multiplex, fluorescent in situ hybridization. Relaxin-containing neurons were detected using immunohistochemistry and their projections assessed using fluorogold retrograde tract-tracing.</AbstractText>Both H2-relaxin and B7-33 produced a strong, but transient, reduction in mechanical and thermal sensitivity of the CFA-injected hind paw alone, at 30 minutes postinjection. Notably, coinjection of B-R13/17K-H2 blocked mechanical, but not thermal, analgesia. In the claustrum, cingulate cortex, and subiculum, RXFP1 mRNA was expressed in excitatory neurons. Relaxin immunoreactivity was detected in neurons in forebrain and midbrain areas involved in pain processing and sending projections to the RXFP1-rich, claustrum and cingulate cortex. No changes were detected in CFA mice.</AbstractText>Our study identified a previously unexplored peptidergic system that can control pain processing in the brain and produce analgesia.</AbstractText>Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The International Association for the Study of Pain.</CopyrightInformation> |
2,331,459 | miRNAs generated from Meg3-Mirg locus are downregulated during aging. | Aging determines a multilevel functional decline and increases the risk for cardiovascular pathologies. MicroRNAs are recognized as fine tuners of all cellular functions, being involved in various cardiac diseases. The heart is one of the most affected organs in aged individuals, however little is known about the extent and robustness to which miRNA profiles are modulated in cardiac cells during aging. This paper provides a comprehensive characterization of the aging-associated miRNA profile in the murine cardiac fibroblasts, which are increasingly recognized for their active involvement in the cardiac physiology and pathology. Next-generation sequencing of cardiac fibroblasts isolated from young and old mice revealed that an important fraction of the miRNAs generated by the Meg3-Mirg locus was downregulated during aging. To address the specificity of this repression, four miRNAs selected as representative for this locus were further assessed in other cells and organs isolated from aged mice. The results suggested that the repression of miRNAs generated by the Meg3-Mirg locus was a general feature of aging in multiple organs. Bioinformatic analysis of the predicted target genes identified Integrin Beta-2 as an aged-upregulated gene, which was thereafter confirmed in multiple mouse organs. In conclusion, our study provides new data concerning the mechanisms of natural aging and highlights the robustness of the miRNA modulation during this process. |
2,331,460 | Hidden danger of COVID-19 outbreak: evaluation of subclinical myocardial dysfunction in patients with mild symptoms. | The COVID-19 infection, which is caused by the novel coronavirus SARS-CoV-2, has rapidly emerged as a global public health issue. Cardiac complications secondary to this infection are common and associated with mortality. This study aimed to evaluate whether subclinical myocardial dysfunction exists in non-hospitalized mildly symptomatic COVID-19 patients using left ventricular global longitudinal strain (LVGLS). In this cross-sectional, single-center study, data were collected from non-hospitalized mildly symptomatic COVID-19 patients between January 01 and February 01, 2021. Fifty (26 male, 24 female) COVID-19 patients and 50 age- and sex-matched healthy volunteers were included in the study. Apical four-, three-, and two-chamber images were analyzed longitudinally by conventional methods and speckle tracking echocardiography (STE) for left ventricle functions. The mean age of the COVID-19 patients was 39.5 ± 8.96, and 52% of them were male. The most prevalent presenting symptoms were fever [in 34 (68%)], asthenia [in 30 (60%)], loss of appetite [in 21 (42%)], myalgia [in 20 (40%)], and cough [in 13 (26%)]. Plasma levels of C-reactive protein (CRP) were significantly higher in the COVID-19 patients than in the controls (10.84 ± 12.44 vs. 4.50 ± 2.81, p < 0.001). There was no significant difference between the groups in terms of standard echocardiography and Doppler parameters (p > 0.05). Left ventricular longitudinal strain and strain velocity parameters were significantly decreased in COVID-19 patients compared to healthy individuals. LV-GLS values (- 21.72 ± 3.85% vs. - 23.11 ± 4.16%; p = 0.003) were significantly lower in COVID-19 patients compared with the healthy controls. Mildly symptomatic COVID-19 patients also have subclinical myocardial dysfunction similar to hospitalized patients. STE has the potential for detecting subclinical LV systolic dysfunction, and can provide useful information regarding cardiac status in mildly symptomatic COVID-19 population. |
2,331,461 | Dysregulation of brain and choroid plexus cell types in severe COVID-19. | Although SARS-CoV-2 primarily targets the respiratory system, patients with and survivors of COVID-19 can suffer neurological symptoms<sup>1-3</sup>. However, an unbiased understanding of the cellular and molecular processes that are affected in the brains of patients with COVID-19 is missing. Here we profile 65,309 single-nucleus transcriptomes from 30 frontal cortex and choroid plexus samples across 14 control individuals (including 1 patient with terminal influenza) and 8 patients with COVID-19. Although our systematic analysis yields no molecular traces of SARS-CoV-2 in the brain, we observe broad cellular perturbations indicating that barrier cells of the choroid plexus sense and relay peripheral inflammation into the brain and show that peripheral T cells infiltrate the parenchyma. We discover microglia and astrocyte subpopulations associated with COVID-19 that share features with pathological cell states that have previously been reported in human neurodegenerative disease<sup>4-6</sup>. Synaptic signalling of upper-layer excitatory neurons-which are evolutionarily expanded in humans<sup>7</sup> and linked to cognitive function<sup>8</sup>-is preferentially affected in COVID-19. Across cell types, perturbations associated with COVID-19 overlap with those found in chronic brain disorders and reside in genetic variants associated with cognition, schizophrenia and depression. Our findings and public dataset provide a molecular framework to understand current observations of COVID-19-related neurological disease, and any such disease that may emerge at a later date. |
2,331,462 | Glucose fluctuation accelerates cardiac injury of diabetic mice via sodium-dependent glucose cotransporter 1 (SGLT1). | Recent studies have shown that blood glucose fluctuation is associated with complications of diabetes mellitus (DM). SGLT1 (sodium-dependent glucose cotransporter 1), is highly expressed in pathological conditions of heart, and is expressed in cardiomyocytes induced by high glucose. Herein, we constructed a diabetic mouse model with glucose fluctuation to investigate whether SGLT1 is involved in glucose fluctuation-induced cardiac injury. Echocardiography, histology examination, and TUNEL staining were performed to evaluate cardiac dysfunction and damage. To assess glucose fluctuation-induced oxidative stress, reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), and glutathione (GSH) levels were measured. To assess mitochondrial dysfunction, mitochondrial membrane potential (MMP), ATP content, mitochondrial respiratory chain complex activity, and expression of mitochondrial fusion and fission proteins were determined. The results indicated that diabetic mice with glucose fluctuation showed elevation of cardiac SGLT1 expression, left ventricular dysfunction, oxidative stress and mitochondrial dysfunction. Knockdown of SGLT1 could abrogate the effects of glucose fluctuation on cardiac injury. Thus, our study highlighted that SGLT1 plays an important role in glucose fluctuation induced cardiac injury through oxidative stress and mitochondrial dysfunction. |
2,331,463 | Hemorrhagic transformation and stroke recurrence in children with cardiac disease receiving antithrombotic therapy for secondary stroke prevention. | Antithrombotic therapy is currently recommended for stroke prevention in pediatric cardioembolic stroke where the recurrence risk is high; however, safety concerns remain. The primary objective of this study was to evaluate clinical and radiographic predictors of hemorrhagic transformation and stroke recurrence in children with cardiac disease to ascertain the safety and failure rates for secondary stroke prevention.</AbstractText>This was a single-center, retrospective analysis of a prospectively enrolled cohort of children with radiologically confirmed cardioembolic stroke from January 2003 to December 2017 treated with institutional guidelines.</AbstractText>Eighty-two children met inclusion criteria (male 44 [54%]; neonates 23 [28%]; median age 0.43 years [0.08-4.23]). Hemorrhagic transformation occurred in 20 (24%) with the majority (75% of 20) being petechial and asymptomatic. One death (1%) was reported from hemorrhagic transformation. Four children (5%) had major extracranial hemorrhage. Most (95%) received antithrombic therapy, with anticoagulation being favored (82%). Greater stroke volume was associated with hemorrhagic transformation using the pediatric Alberta Stroke Program Early CT Score (6.1 ± 3.3 vs. 3.5 ± 2.3; p = .006). Stroke recurred in 11 (13%) children at a median 32 days (5.5-93) from the index event and the majority (90%) were on treatment at the time of recurrence. Children with univentricular physiology were less likely to have hemorrhagic transformation (RR 0.31; 95% CI 0.09-0.96, p = .04); however, they had higher rates of recurrent stroke before final palliative repair.</AbstractText>In spite of the 24% hemorrhagic transformation rate, antithrombotic therapy has a positive risk-balance in certain cardioembolic stroke subgroups, particularly in those with single-ventricle physiology, when accounting for stroke volume.</AbstractText>© 2021 International Society on Thrombosis and Haemostasis.</CopyrightInformation> |
2,331,464 | FACS Enrichment of Total Interstitial Cells and Fibroblasts from Adult Mouse Ventricles. | Besides cardiomyocytes, the heart contains numerous interstitial cell types, including cardiac fibroblasts, endothelial cells, immune (myeloid and lymphoid) cells, and mural cells (pericytes and vascular smooth muscle cells), which play key roles in heart repair, regeneration, and disease. We recently published a comprehensive map of cardiac stromal cell heterogeneity and flux in healthy and infarcted hearts using single-cell RNA sequencing (scRNA-seq) ( Farbehi <i>et al.</i>, 2019 ). Here, we describe the FACS (Fluorescent Activated Cell Sorting)-based method used in that study for isolation of two cardiac cell fractions from adult mouse ventricles: the total interstitial cell population (TIP; non-cardiomyocytes) and enriched (<i>Pdgfra</i>-GFP<sup>+</sup>) cardiac fibroblasts. |
2,331,465 | Magnetic resonance imaging of a third ventricular chordoid glioma. | Chordoid gliomas are uncommon neoplasms located within the anterior portion of the third ventricle. In this article, we aimed to describe the clinical presentation, magnetic resonance imaging characteristics, histological findings, and surgical treatment applied to a case of chordoid glioma. Chordoid gliomas are typically observed as solid masses within the anterior segment of the third ventricle, characterized by homogenous and vivid enhancement. Despite being classified as a low-grade neoplasm, the outcome of choroid glioma is often uncertain. |
2,331,466 | Influence of Fibrosis Amount and Patterns on Ventricular Arrhythmogenesis and Pumping Efficacy: Computational Study. | Myocardial fibrosis is an integral component of most forms of heart failure. Clinical and computational studies have reported that spatial fibrosis pattern and fibrosis amount play a significant role in ventricular arrhythmogenicity. This study investigated the effect of the spatial distribution of fibrosis and fibrosis amount on the electrophysiology and mechanical performance of the human ventricles. Seventy-five fibrosis distributions comprising diffuse, patchy, and compact fibrosis types that contain 10-50% fibrosis amount were generated. The spatial fibrosis distribution was quantified using the fibrosis entropy (FE) metric. Electrical simulations under reentry conditions induced using the S1-S2 protocol were conducted to investigate the fibrosis arrhythmogenicity. We also performed mechanical simulations to examine the influence of the fibrosis amount and the spatial distribution of fibrosis on the pumping efficacy of the LV. We observed that the mean FE of the compact type is the largest among the three types. The electrical simulation results revealed that the ventricular arrhythmogenicity of diffuse fibrosis depends on the fibrosis amount and marginally on the spatial distribution of fibrosis. Meanwhile, the ventricular arrhythmogenicity of the compact and patchy fibrosis pattern is more reliant on the spatial distribution of fibrosis than on the fibrosis amount. The average number of phase singularities (PSs) in the compact fibrosis pattern was the highest among the three patterns of fibrosis. The diffuse type of fibrosis has the lowest average number of PSs than that in the patchy and compact fibrosis. The reduction in the stroke volume (SV) showed high influence from the electrical instabilities induced by the fibrosis amount and pattern. The compact fibrosis exhibited the lowest SV among the three patterns except in the 40% fibrosis amount. In conclusion, the fibrosis pattern is as crucial as the fibrosis amount for sustaining and aggravating ventricular arrhythmogenesis. |
2,331,467 | Left Ventricular Pressure Ratio Predicts In-Hospital Outcomes in Hospitalized Heart Failure With Reduced Ejection Fraction.<Pagination><StartPage>E507</StartPage><EndPage>E515</EndPage><MedlinePgn>E507-E515</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">JIC20210616-1</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Given the risk of hemodynamic compromise in heart failure with reduced ejection fraction (HFrEF) patients undergoing left heart catheterization (LHC), there is a need for a simple parameter that can predict clinical outcomes. We hypothesize that left ventricular pressure ratio (LVPR), calculated as left ventricle systolic/left ventricle end-diastolic pressure, is a strong predictor of hemodynamic collapse in these patients.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Retrospective analysis of consecutive hospitalized HFrEF patients undergoing combined LHC and right heart catheterization (RHC) at a single institution from 2015-2017 was performed. LVPR was compared with standard RHC hemodynamic variables. The primary outcome was in-hospital escalation of therapy, defined as ≥40 mm Hg drop in systolic blood pressure (SBP), SBP ≤90 mm Hg for ≥15 minutes, start or escalation of vasoactive medications, cardiopulmonary resuscitation, or in-hospital death. Receiver-operating characteristic (ROC) analysis and Kaplan-Meier survival analysis were performed for prediction of the primary outcome.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">A total of 176 patients were included in this study. ROC analysis determined an optimal cut-off value of ≤3.96, which correlated with an area under the curve (AUC) of 0.65 (sensitivity, 45.9%; specificity, 83.2%; correctly classified, 64.9%). AUC was similar to other variables obtained using RHC. In-hospital survival free of escalation of therapy was lower in the low LVPR group vs the high LVPR group (0% vs 33%, respectively; P<.01).</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">LVPR is an easily measured index obtained during LHC that can risk stratify hospitalized patients with HFrEF at the time of LHC.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Almousa</LastName><ForeName>Sameh W</ForeName><Initials>SW</Initials></Author><Author ValidYN="Y"><LastName>Belkin</LastName><ForeName>Mark N</ForeName><Initials>MN</Initials></Author><Author ValidYN="Y"><LastName>Allan</LastName><ForeName>Tess</ForeName><Initials>T</Initials></Author><Author ValidYN="Y"><LastName>Stephens</LastName><ForeName>Allison</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Kern</LastName><ForeName>Joseph</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Cisneros</LastName><ForeName>Miryea</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Friant</LastName><ForeName>Janet</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Arevalo</LastName><ForeName>Cynthia</ForeName><Initials>C</Initials></Author><Author ValidYN="Y"><LastName>Nathan</LastName><ForeName>Sandeep</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Shah</LastName><ForeName>Atman P</ForeName><Initials>AP</Initials></Author><Author ValidYN="Y"><LastName>Paul</LastName><ForeName>Jonathan</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Kalathiya</LastName><ForeName>Rohan</ForeName><Initials>R</Initials></Author><Author ValidYN="Y"><LastName>Grinstein</LastName><ForeName>Jonathan</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Blair</LastName><ForeName>John E A</ForeName><Initials>JEA</Initials><AffiliationInfo><Affiliation>Section of Cardiology, Department of Medicine, The University of Chicago Medicine, 5841 South Maryland, M-547, MC 5076, Chicago, IL 60637 USA. jblair2@medicine.bsd.uchicago.edu.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>T32 HL007381</GrantID><Acronym>HL</Acronym><Agency>NHLBI NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>06</Month><Day>16</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Invasive Cardiol</MedlineTA><NlmUniqueID>8917477</NlmUniqueID><ISSNLinking>1042-3931</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D006333" MajorTopicYN="Y">Heart Failure</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D017052" MajorTopicYN="N">Hospital Mortality</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006761" MajorTopicYN="N">Hospitals</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013318" MajorTopicYN="N">Stroke Volume</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016277" MajorTopicYN="N">Ventricular Function, Left</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017725" MajorTopicYN="N">Ventricular Pressure</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">cardiac catheterization</Keyword><Keyword MajorTopicYN="N">heart failure</Keyword><Keyword MajorTopicYN="N">invasive hemodynamics</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>6</Month><Day>22</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>10</Month><Day>16</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>6</Month><Day>21</Day><Hour>5</Hour><Minute>39</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">34148868</ArticleId><ArticleId IdType="mid">NIHMS1796386</ArticleId><ArticleId IdType="pmc">PMC9125341</ArticleId><ArticleId IdType="pii">JIC20210616-1</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>Briguori C, Sarais C, Pagnotta P, et al. 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J Am Coll Cardiol. 2017;69:278–287.</Citation><ArticleIdList><ArticleId IdType="pubmed">27810347</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">34148688</PMID><DateRevised><Year>2021</Year><Month>10</Month><Day>07</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">2341-1929</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2021</Year><Month>Jun</Month><Day>17</Day></PubDate></JournalIssue><Title>Revista espanola de anestesiologia y reanimacion</Title><ISOAbbreviation>Rev Esp Anestesiol Reanim (Engl Ed)</ISOAbbreviation></Journal>Intraventricular hemorrhage as complication after spinal surgery. Case report. | Remote intracranial hemorrhage (ICH) is a rare but dreaded complication after spinal surgery. The physiopathology of this phenomenon is closely related to a loss of cerebrospinal fluid (CSF) after an incidental durotomy during spine surgery. The most common remote ICH location is cerebellar, but few articles report intraventricular hemorrhage. Its clinic is associated with cerebral hypotension due to decreased CSF, mainly headache, dysarthria, hemiparesis, an impaired level of awareness and seizures. The diagnosis of remote ICH after a non-cranial surgery can be a challenge to anesthesiologists, this pathology should be suspected face an immediate neurological deterioration after anesthetic awakening. Non-specific symptoms make it difficult to identify the origin of intracranial hemorrhagic from other differential diagnoses. We present a patient with an impaired level of awareness and seizures who suffered a hemorrhage in the right ventricle with cerebral and cerebellar edema in the immediate postoperative period after spinal surgery. |
2,331,468 | Customising the surgical management for intraventricular meningiomas - 'one size doesn't fit all'. | Intraventricular meningiomas are uncommon and gross total resection is the recommended treatment. However, total resection may not always be possible, especially in locations in which the lesions are adherent to veins and neural structures. We share our experience with intraventricular meningiomas, focusing on the management strategies and outcomes.</AbstractText>We describe the data of 7 patients with intraventricular meningiomas operated at our institute over the last 9 years. Three patients had a third ventricular tumor of which two had lesions straddling across the foramen of Monro. The remaining 4 patients had trigonal mass. The clinico-radiological features, management strategies and outcomes have been elaborated with a mean follow-up of 57 months.</AbstractText>The common clinical presentations were raised intracranial pressure symptoms, visual field defects and memory deficits. One patient had multiple meningiomas. Total excision was achieved in all except in 2 patients in whom the lesion straddled across the foramen of Monro with dense adhesions to veins and neural structures. Staged resection was required in one patient with a large trigonal mass. All patients had a low-grade lesion. The tumor recurred in one patient (post-pregnancy) after partial resection. All the patients improved neurologically, and none had added deficits.</AbstractText>Gross total resection of intraventricular meningiomas although desirable may not be possible in certain cases in which the risks outweigh the benefits. These tumors often are of low histological grade and the treatment strategies should be individualized. Regular follow-up is warranted as these tumors may recur despite a low histological grade.</AbstractText> |
2,331,469 | Implantation of Carmustine wafers after resection of malignant glioma with and without opening of the ventricular system. | Implantation of biodegradable Carmustine wafers in patients with malignant glioma is not generally recommended when the ventricular system is opened during tumor resection. Thrombin/fibrinogenn-covered collagen fleeces showed promising results in sufficiently closing ventricular defects. The aim of this study was to evaluate the postoperative morbidity in patients with implanted Carmustine wafers either with opened or intact ventricular system.</AbstractText>A consecutive series of patients who underwent resection of malignant glioma with implantation of Carmustine wafers was analyzed. In case of opening of the ventricular system, the defect in the ventricle wall was sealed using a collagen sponge coated with fibrinogen and thrombin prior to the implantation of the wafers. Postoperative adverse events (AE) and Karnofsky performance status scale (KPS) at follow up were compared between both groups.</AbstractText>Fifty-four patients were included. The ventricular system was opened in 33 patients and remained intact in 21 patients. Both groups were comparable in terms of age, rate of primary and recurrent glioma, preoperative KPS, rate of gross total resection and number of implanted wafers. Postoperative AEs occurred in 9/33 patients (27.3%) with opened and in 5/21 patients (23.8%) with intact ventricular system (p = 0.13). At follow-up assessments, KPS was not significantly different between both groups (p = 0.18). Opened ventricular system was not associated with a higher incidence of postoperative AEs (p = 0.98).</AbstractText>Appropriate closure of opened ventricular system during resection of malignant glioma allows for a safe implantation of Carmustine wafers and is not associated with a higher incidence of postoperative AEs.</AbstractText>© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.</CopyrightInformation> |
2,331,470 | Ependymoma Presenting as a -Rim-Enhancing Lesion in the Brainstem. | The posterior fossa is the most common intracranial location for pediatric ependymoma. While ependymoma usually arises from the ventricular lining of the fourth ventricle as a solid mass, it rarely originates from the brainstem. Grade II ependymomas also infrequently appear as a cavitary ring-enhancing lesion.</AbstractText>We describe a case of a 6-year-old boy with an ependymoma arising within the medulla with imaging features of a thick-walled rim-enhancing cavitary lesion. A stereotactic biopsy was obtained which confirmed a grade II ependymoma. The patient received focal proton beam radiation therapy and is doing well with no concerns for disease progression at 28 months after diagnosis.</AbstractText>Posterior fossa ependymomas typically arise from ependymal cells within the fourth ventricle or foramina of Luschka. They rarely invade or arise within the brainstem parenchyma. Our case had atypical imaging findings in addition to the atypical tumor location. The lesion was described as a thick-walled rim-enhancing focal cystic necrotic lesion centered within the medulla with surrounding nonenhancing expansile infiltrative changes. Ring-enhancing lesions can be seen in patients with anaplastic ependymoma, but is not commonly reported in grade II ependymomas. In summary, this report highlights a unique case of a posterior fossa ependymoma in a pediatric patient arising in an atypical brainstem location as well as having unique imaging features.</AbstractText>© 2021 S. Karger AG, Basel.</CopyrightInformation> |
2,331,471 | Quadrigeminal Cistern Epidermoid Cyst: Neuroendoscopy and Endoscope-Assisted Supracerebellar Infratentorial Approach. | The pineal region is a complex anatomical location with multiple surrounding important neurovascular structures.<sup>1</sup><sup>,</sup><sup>2</sup> Several approaches to this region have been described, including posterior interhemispheric, transchoroidal, infratentorial supracerebellar, supracerebellar and infracerebellar trans-sinus, and their modifications. Neuroendoscopy and endoscope-assisted surgery have been widely applied to aid resection of pineal region lesions.<sup>3-5</sup> A 40-year-old man presented with tonic-clonic seizures and bilateral papillary edema on fundus examination. Computed tomography showed a midline lesion at the level of the quadrigeminal cistern with mass effect on the aqueduct of Sylvius and posterior wall of the third ventricle, triggering obstructive triventricular hydrocephalus. As a first intervention, a third ventriculostomy was attempted unsuccessfully owing to unfavorable third ventricle floor anatomy. This approach was used to obtain a biopsy specimen, which showed an epidermoid cyst. Ventriculoscopy showed a communication of the pineal recess and quadrigeminal cistern owing to tumor invasion. An external ventricular drain was placed to control the hydrocephalus until complete resection was performed (Video 1). Several days later, tumor resection was carried out via the median supracerebellar infratentorial approach with the patient in semisitting position. After near-total resection under microscope, the third ventricle and both lateral recesses were explored with the endoscope. A small tumor remnant (visible only with endoscope) was identified and removed. This step was essential to achieve complete resection, confirmed by magnetic resonance imaging. The patient was discharged 6 days later without complications. During follow-up, the patient remains asymptomatic. The combination of microneurosurgery, neuroendoscopy, and endoscope-assisted surgery improves management of pineal region lesions and facilitates complete resection. |
2,331,472 | Brain ventricular volume changes in schizophrenia. A narrative review. | Brain ventricles are among the most studied structures in psychotic illness. In our mini-review we present available evidence on brain ventricle changes during the course of schizophrenia, from high-risk subjects and the first episode of schizophrenia to patients with chronic schizophrenia. We present current findings on the relationship between ventricle changes and level of psychopathology. The potential pathophysiological background of ventricle changes is also discussed. Understanding the dynamics of brain ventricle changes could resolve long-standing questions on the proportion of neurodegenerative and neurodevelopmental processes in the pathophysiology of schizophrenia. |
2,331,473 | Automatic left ventricular cavity segmentation via deep spatial sequential network in 4D computed tomography. | Automated segmentation of left ventricular cavity (LVC) in temporal cardiac image sequences (consisting of multiple time-points) is a fundamental requirement for quantitative analysis of cardiac structural and functional changes. Deep learning methods for segmentation are the state-of-the-art in performance; however, these methods are generally formulated to work on a single time-point, and thus disregard the complementary information available from the temporal image sequences that can aid in segmentation accuracy and consistency across the time-points. In particular, single time-point segmentation methods perform poorly in segmenting the end-systole (ES) phase image in the cardiac sequence, where the left ventricle deforms to the smallest irregular shape, and the boundary between the blood chamber and the myocardium becomes inconspicuous and ambiguous. To overcome these limitations in automatically segmenting temporal LVCs, we present a spatial sequential network (SS-Net) to learn the deformation and motion characteristics of the LVCs in an unsupervised manner; these characteristics are then integrated with sequential context information derived from bi-directional learning (BL) where both chronological and reverse-chronological directions of the image sequence are used. Our experimental results on a cardiac computed tomography (CT) dataset demonstrate that our spatial-sequential network with bi-directional learning (SS-BL-Net) outperforms existing methods for spatiotemporal LVC segmentation. |
2,331,474 | Identification to cardiac conduction cells in humans and pigs according to their zonal distribution, using histological, immunohistochemical and morphometric study. | Histologically, the cardiac conduction network is formed of electrically isolated subendocardial fibers that comprise specialized cells with fewer myofibrils and mitochondria than cardiomyocytes. Our aim is to uncover regional variations of cardiac conduction fibers through histological and morphometric study in a porcine and human model. We analyzed five male adult human hearts and five male pig hearts. The left ventricles were dissected and sectioned in the axial plane into three parts: basal, middle third and apex regions. Cardiac conduction fibers study was carried out using hematoxylin-eosin and Masson's trichrome staining, and cardiac conduction cells and their junctions were identified using desmin, and a PAS method. Cardiac conduction fibers were difficult to pinpoint in humans, mostly showing a darker color or equal to cardiomyocytes. Cardiac conduction fibers in humans were in the subendocardium and in pigs in the myocardium and subendocardium. Cardiac conduction fibers were located mainly in the septal region in both humans and pigs. In our morphometric analysis, we were able to determine that cardiac conduction cells in humans (18.52 +/- 5.41 μm) and pigs (21.32 +/- 6.45 μm) were large, compared to cardiomyocytes. Conduction fiber-myocardial junctions were present in 10% in humans and 24.2% in pigs. The performance of immunohistochemical methods made it possible to improve the identification of cardiac conduction cells in the species studied. Study of cardiac conduction fibers and cells and their myocardial junctions is vital to gain insight into their normal distribution in the species analyzed, and thus advance the use of pigs in experimental models of the cardiac conduction system in humans. |
2,331,475 | Massa intermedia of the thalamus: an anatomical study using magnetic resonance imaging. | Few studies have explored the morphology of massa intermedia (MI). The aim of the present study was to characterize it using magnetic resonance imaging (MRI).</AbstractText>A total of 205 patients were enrolled in this study. Following initial examinations with conventional MRI sequences, thin-slice coronal and sagittal T2-weighted imaging was performed. For MI localization, the third ventricle was arbitrarily divided into nine areas on the midsagittal image.</AbstractText>MI was identified in 93% of the total patients-89% in male and 91% in female patients. Among them, 68% showed a single, styloid-shaped MI with variable thickness and cross sectional configuration, followed by broad and double MIs that were found in 18% and 10% patients, respectively. In the anteroposterior dimension, 99% of the MIs were identified in the middle third area, followed by the posterior third area. In the supero-inferior dimension, 95% of the MIs were identified in the middle third area, followed by the upper third area. With a significant difference, a broad MI was more frequently found in women than in men.</AbstractText>MIs are commonly located in the middle third of the third ventricle as a single commissure with high morphological variability. Compared to men, women may have a well-developed, broader MI.</AbstractText>© 2021. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.</CopyrightInformation> |
2,331,476 | Deep learning prediction of mild cognitive impairment conversion to Alzheimer's disease at 3 years after diagnosis using longitudinal and whole-brain 3D MRI. | While there is no cure for Alzheimer's disease (AD), early diagnosis and accurate prognosis of AD may enable or encourage lifestyle changes, neurocognitive enrichment, and interventions to slow the rate of cognitive decline. The goal of our study was to develop and evaluate a novel deep learning algorithm to predict mild cognitive impairment (MCI) to AD conversion at three years after diagnosis using longitudinal and whole-brain 3D MRI.</AbstractText>This retrospective study consisted of 320 normal cognition (NC), 554 MCI, and 237 AD patients. Longitudinal data include T1-weighted 3D MRI obtained at initial presentation with diagnosis of MCI and at 12-month follow up. Whole-brain 3D MRI volumes were used without a priori segmentation of regional structural volumes or cortical thicknesses. MRIs of the AD and NC cohort were used to train a deep learning classification model to obtain weights to be applied via transfer learning for prediction of MCI patient conversion to AD at three years post-diagnosis. Two (zero-shot and fine tuning) transfer learning methods were evaluated. Three different convolutional neural network (CNN) architectures (sequential, residual bottleneck, and wide residual) were compared. Data were split into 75% and 25% for training and testing, respectively, with 4-fold cross validation. Prediction accuracy was evaluated using balanced accuracy. Heatmaps were generated.</AbstractText>The sequential convolutional approach yielded slightly better performance than the residual-based architecture, the zero-shot transfer learning approach yielded better performance than fine tuning, and CNN using longitudinal data performed better than CNN using a single timepoint MRI in predicting MCI conversion to AD. The best CNN model for predicting MCI conversion to AD at three years after diagnosis yielded a balanced accuracy of 0.793. Heatmaps of the prediction model showed regions most relevant to the network including the lateral ventricles, periventricular white matter and cortical gray matter.</AbstractText>This is the first convolutional neural network model using longitudinal and whole-brain 3D MRIs without extracting regional brain volumes or cortical thicknesses to predict future MCI to AD conversion at 3 years after diagnosis. This approach could lead to early prediction of patients who are likely to progress to AD and thus may lead to better management of the disease.</AbstractText>©2021 Ocasio and Duong.</CopyrightInformation> |
2,331,477 | Asymptomatic traumatic rupture of an intracranial dermoid cyst: A case report. | Previous studies reported that most of the intracranial dermoid cyst ruptures were spontaneous, and only a few were traumatic, with asymptomatic much rarer than the symptomatic ruptures. Hence, how to deal with the asymptomatic traumatic rupture of intracranial dermoid cyst remains a challenge in the clinic.</AbstractText>A 59-year-old man was accidentally diagnosed with intracranial dermoid cyst through a cranial computed tomography (CT) scan due to a car accident. A mixed-density lesion with fat and a calcified margin was observed in the midline of the posterior fossa, accompanied with lipid droplet drifts in brain sulci, fissures, cisterns, and ventricles. After 1 wk of conservative observation, no change was observed on the updated cranial CT scan. After 2 wk of conservative observation, magnetic resonance imaging examination confirmed that the lesion was a traumatic rupture of a posterior fossa dermoid cyst with lipid droplet drifts. As the patient exhibited no adverse symptoms throughout the 2 wk, a 6-mo follow-up visit was arranged for him instead of aggressive treatment. Nonetheless, the patient did not show any abnormal neurological symptoms in the 6 mo of follow-up visits.</AbstractText>Asymptomatic traumatic rupture of intracranial dermoid cyst could be just followed or treated conservatively rather than treated aggressively.</AbstractText>©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.</CopyrightInformation> |
2,331,478 | Sex Differences in Cardiac Adaptation to Distinct Modalities of Exercise: A Cardiac Magnetic Resonance Study.<Pagination><StartPage>2543</StartPage><EndPage>2552</EndPage><MedlinePgn>2543-2552</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1249/MSS.0000000000002729</ELocationID><Abstract><AbstractText Label="PURPOSE">No previous study has described sex differences in chronic cardiac adaptation in response to distinct modalities of exercise training in humans.</AbstractText><AbstractText Label="METHODS">Cardiac magnetic resonance imaging (1.5 T) was used to assess left ventricular (LV) outcomes in 78 untrained subjects (46F, 26 M; 26.1 ± 5.4 yr). Subjects underwent 3 months of closely supervised and monitored resistance (RES) and endurance (END) training, separated by a 3-month washout period.</AbstractText><AbstractText Label="RESULTS">LV mass (LVM) increased in response to END in both sexes (females △3.98 ± 7.98 g, P = 0.002; males △5.99 ± 10.67 g, P = 0.005), whereas LV end-diastolic volume (EDV) increased in males (△7.48 ± 11.91 mL, P = 0.002) but not females (△1.54 ± 10.49 mL, P = 0.373). In response to RES, LVM and EDV did not increase in either sex. The proportion of subjects exhibiting a positive response to training (i.e., a change >0) for LVM and EDV did not differ between sexes for either training modality.</AbstractText><AbstractText Label="CONCLUSION">Eccentric hypertrophy in response to END training was more apparent in males than females, whereas there were no notable cardiac changes between sexes for RES training. The proportion of low versus high responders to training was not sex specific for LVM or EDV in response to either commonly prescribed exercise training modality.</AbstractText><CopyrightInformation>Copyright © 2021 by the American College of Sports Medicine.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Marsh</LastName><ForeName>Channa E</ForeName><Initials>CE</Initials><AffiliationInfo><Affiliation>School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Western Australia, AUSTRALIA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Thomas</LastName><ForeName>Hannah J</ForeName><Initials>HJ</Initials><AffiliationInfo><Affiliation>School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Western Australia, AUSTRALIA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Naylor</LastName><ForeName>Louise H</ForeName><Initials>LH</Initials><AffiliationInfo><Affiliation>School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Western Australia, AUSTRALIA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dembo</LastName><ForeName>Lawrence G</ForeName><Initials>LG</Initials></Author><Author ValidYN="Y"><LastName>Green</LastName><ForeName>Daniel J</ForeName><Initials>DJ</Initials><AffiliationInfo><Affiliation>School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Western Australia, AUSTRALIA.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016449">Randomized Controlled Trial</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Med Sci Sports Exerc</MedlineTA><NlmUniqueID>8005433</NlmUniqueID><ISSNLinking>0195-9131</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018592" MajorTopicYN="N">Cross-Over Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003430" MajorTopicYN="N">Cross-Sectional Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000076663" MajorTopicYN="N">Endurance Training</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015444" MajorTopicYN="N">Exercise</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006352" MajorTopicYN="N">Heart Ventricles</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017379" MajorTopicYN="N">Hypertrophy, Left Ventricular</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="Y">etiology</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008279" MajorTopicYN="N">Magnetic Resonance Imaging</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055070" MajorTopicYN="N">Resistance Training</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012737" MajorTopicYN="N">Sex Factors</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>6</Month><Day>18</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2022</Year><Month>2</Month><Day>15</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>6</Month><Day>17</Day><Hour>17</Hour><Minute>22</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">34138817</ArticleId><ArticleId IdType="doi">10.1249/MSS.0000000000002729</ArticleId><ArticleId IdType="pii">00005768-202112000-00010</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>Diaz-Canestro C, Pentz B, Sehgal A, et al. 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Eur Radiol . 2000;10(3):438–42.</Citation></Reference></ReferenceList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">34138749</PMID><DateRevised><Year>2022</Year><Month>04</Month><Day>24</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Print">2498-602X</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2021</Year><Month>Jun</Month><Day>16</Day></PubDate></JournalIssue><Title>Physiology international</Title><ISOAbbreviation>Physiol Int</ISOAbbreviation></Journal>Level of kisspeptin-10 in patients with multiple sclerosis and the association between third ventricle diameter size and vitamin D level. | No previous study has described sex differences in chronic cardiac adaptation in response to distinct modalities of exercise training in humans.</AbstractText>Cardiac magnetic resonance imaging (1.5 T) was used to assess left ventricular (LV) outcomes in 78 untrained subjects (46F, 26 M; 26.1 ± 5.4 yr). Subjects underwent 3 months of closely supervised and monitored resistance (RES) and endurance (END) training, separated by a 3-month washout period.</AbstractText>LV mass (LVM) increased in response to END in both sexes (females △3.98 ± 7.98 g, P = 0.002; males △5.99 ± 10.67 g, P = 0.005), whereas LV end-diastolic volume (EDV) increased in males (△7.48 ± 11.91 mL, P = 0.002) but not females (△1.54 ± 10.49 mL, P = 0.373). In response to RES, LVM and EDV did not increase in either sex. The proportion of subjects exhibiting a positive response to training (i.e., a change >0) for LVM and EDV did not differ between sexes for either training modality.</AbstractText>Eccentric hypertrophy in response to END training was more apparent in males than females, whereas there were no notable cardiac changes between sexes for RES training. The proportion of low versus high responders to training was not sex specific for LVM or EDV in response to either commonly prescribed exercise training modality.</AbstractText>Copyright © 2021 by the American College of Sports Medicine.</CopyrightInformation> |
2,331,479 | Early Myocardial Dysfunction and Benefits of Cardiac Treatment in Young X-Linked Duchenne Muscular Dystrophy Mice. | Duchenne muscular dystrophy (DMD) is associated with a progressive alteration in cardiac function.</AbstractText>The aim of this study was to detect early cardiac dysfunction using the high sensitive two-dimensional speckle-tracking echocardiography (2D strain) in mdx mouse model and to investigate the potential preventive effects of the S107 ryanodine receptor (RyR2) stabilizer on early onset of DMD-related cardiomyopathy.</AbstractText>Conventional echocardiography and global and segmental left ventricle (LV) 2D strains were assessed in male mdx mice and control C57/BL10 mice from 2 to 12 months of age. Up to 12 months of age, mdx mice showed preserved myocardial function as assessed by conventional echocardiography. However, global longitudinal, radial, and circumferential LV 2D strains significantly declined in mdx mice compared to controls from the 9 months of age. Segmental 2D strain analysis found a predominant alteration in posterior, inferior, and lateral LV segments, with a more marked impairment with aging. Then, mdx mice were treated with S107 in the drinking water at a dose of 250 mg/L using two different protocols: earlier therapy from 2 to 6 months of age and later therapy from 6 to 9 months of age. The treatment with S107 was efficient only when administered earlier in very young animals (from 2 to 6 months of age) and prevented the segmental alterations seen in non-treated mdx mice.</AbstractText>This is the first animal study to evaluate the therapeutic effect of a drug targeting early onset of DMD-related cardiomyopathy, using 2D strain echocardiography. Speckle-tracking analyses revealed early alterations of LV posterior segments that could be prevented by 4 months of RyR2 stabilization.</AbstractText>© 2021. Springer Science+Business Media, LLC, part of Springer Nature.</CopyrightInformation> |
2,331,480 | Induction of autophagy has protective roles in imatinib-induced cardiotoxicity. | Cardiotoxicity is one of the severe adverse effects of chemotherapeutic agents. Imatinib was previously reported to induce cardiotoxicity. Autophagy is an intracellular bulk protein and organelle degradation process, but its roles in cardiac diseases are unclear. We examined whether imatinib induces cardiomyocyte autophagy, and the role of autophagy in imatinib-induced cardiotoxicity using <i>in vitro</i> and <i>in vivo</i> experiments. In <i>in vitro</i> experiments, neonatal rat cardiomyocytes were treated with imatinib (1, 5, or 10 μM; 6 h). Myocyte autophagy was assessed by microtubule-associated protein light chain (LC) 3-II, beclin 1, mature cathepsin D, and acridine orange-stained mature autolysosome expression. Imatinib increased their expression, suggesting that it induced autophagy. Consequently, imatinib altered the production of mitochondria-derived reactive oxygen species (ROS) and loss of mitochondrial membrane potential, which were assessed by the fluorescent indicator MitoSOX and JC-1, respectively, leading to cardiomyocyte apoptosis. 3-methyl-adenine (3MA), an autophagic inhibitor, exacerbated imatinib-induced apoptosis by 30 %. In <i>in vivo</i> experiments, C57BL/6 mice were treated with imatinib (50 and 200 mg/kg/day) for 5 weeks in the presence or absence of 3MA. Echocardiographic measurement revealed that imatinib (200 mg) caused dilatation of the left ventricle (LV) and reduced LV fractional shortening. Apoptosis and LC3-II expression in cardiac tissue were increased by imatinib. Co-treatment with 3MA and imatinib further impaired imatinib-induced cardiac apoptosis and LV dysfunction. This study suggests that imatinib induces cardiomyocyte apoptosis, leading to cardiac dysfunction. Imatinib increases cardiomyocyte autophagy as a consequence of apoptosis and autophagy has a pro-survival role in imatinib-induced cardiac impairment. |
2,331,481 | Physiological Effects of Intermittent Passive Exposure to Hypobaric Hypoxia and Cold in Rats. | The benefits of intermittent hypobaric hypoxia (IHH) exposure for health and its potential use as a training tool are well-documented. However, since hypobaric hypoxia and cold are environmental factors always strongly associated in the biosphere, additive or synergistic adaptations could have evolved in animals' genomes. For that reason, the aim of the present study was to investigate body composition and hematological and muscle morphofunctional responses to simultaneous intermittent exposure to hypoxia and cold. Adult male rats were randomly divided into four groups: (1) control, maintained in normoxia at 25°C (CTRL); (2) IHH exposed 4 h/day at 4,500 m (HYPO); (3) intermittent cold exposed 4 h/day at 4°C (COLD); and (4) simultaneously cold and hypoxia exposed (COHY). At the end of 9 and 21 days of exposure, blood was withdrawn and gastrocnemius (GAS) and tibialis anterior muscles, perigonadal and brown adipose tissue, diaphragm, and heart were excised. GAS transversal sections were stained for myofibrillar ATPase and succinate dehydrogenase for fiber typing and for endothelial ATPase to assess capillarization. Hypoxia-inducible factor 1α (HIF-1α), vascular endothelial growth factor (VEGF), and glucose transporter 1 (GLUT1) from GAS samples were semi-quantified by Western blotting. COLD and HYPO underwent physiological adjustments such as higher brown adipose tissue weight and increase in blood-related oxygen transport parameters, while avoiding some negative effects of chronic exposure to cold and hypoxia, such as body weight and muscle mass loss. COHY presented an additive erythropoietic response and was prevented from right ventricle hypertrophy. Intermittent cold exposure induced muscle angiogenesis, and IHH seems to indicate better muscle oxygenation through fiber area reduction. |
2,331,482 | Radiomics side experiments and DAFIT approach in identifying pulmonary hypertension using Cardiac MRI derived radiomics based machine learning models. | Side experiments are performed on radiomics models to improve their reproducibility. We measure the impact of myocardial masks, radiomic side experiments and data augmentation for information transfer (DAFIT) approach to differentiate patients with and without pulmonary hypertension (PH) using cardiac MRI (CMRI) derived radiomics. Feature extraction was performed from the left ventricle (LV) and right ventricle (RV) myocardial masks using CMRI in 82 patients (42 PH and 40 controls). Various side study experiments were evaluated: Original data without and with intraclass correlation (ICC) feature-filtering and DAFIT approach (without and with ICC feature-filtering). Multiple machine learning and feature selection strategies were evaluated. Primary analysis included all PH patients with subgroup analysis including PH patients with preserved LVEF (≥ 50%). For both primary and subgroup analysis, DAFIT approach without feature-filtering was the highest performer (AUC 0.957-0.958). ICC approaches showed poor performance compared to DAFIT approach. The performance of combined LV and RV masks was superior to individual masks alone. There was variation in top performing models across all approaches (AUC 0.862-0.958). DAFIT approach with features from combined LV and RV masks provide superior performance with poor performance of feature filtering approaches. Model performance varies based upon the feature selection and model combination. |
2,331,483 | [DJ-1 alleviates oxidative stress injury by activating the Nrf2 pathway in rats with cerebral ischemia-reperfusion injury]. | To investigate the antioxidant effect of DJ-1 (Park7) in rats with cerebral ischemia/reperfusion (IR) injury and its potential mechanism.</AbstractText>A total of 108 SD rats were randomly divided into sham-operated group, middle cerebral artery occlusion (MCAO) group, Scramble group, DJ-1 siRNA group, negative control (NC) group and DJ-1 overexpression group. Except for those in the sham group, all the rats were subjected to MCAO to establish models of cerebral IR injury. In DJ-1 siRNA and DJ-1 overexpression group, a DJ-1 siRNA and an adeno-associated virus vector carrying DJ-1 gene was injected into the lateral ventricle of the rats, respectively. In each group, neurological scores and brain water content were determined after the operation, and pathological changes of the brain tissue and neuronal injury in the cortical infarction area were assessed using HE and Nissl staining. Oxidative stress in the brain tissues was analyzed by detecting superoxide dismutase (SOD) and malondialdehyde (MDA). The expression levels of DJ-1, Nrf2, Ho-1 and NQO1 in the brain tissue were detected with Western blotting, and the expression and nucleation of Nrf2 was determined by immunofluorescence staining.</AbstractText>Compared with those in MCAO group, the neurological scores (P</i> < 0.001) and brain water content (P</i> < 0.001) were significantly increased in DJ-1 siRNA group. Intracerebral injection of DJ-1 siRNA following MCAO obviously aggravated neuron injury in cerebral ischemia region, further reduced SOD activity and increased MDA content (P</i> < 0.001), and significantly lowered the expression levels of Nrf2 and its downstream proteins HO-1 and NQO1 (P</i> < 0.001). Intracerebral injection of the adenoviral vector for DJ-1 (P</i>=0.003) overexpression significantly upregulated the levels of Nrf2 (P</i>=0.006) and its downstream proteins HO-1 (P</i>=0.004) and NQO1 (P</i>=0.014).</AbstractText>As an important neuroprotective factor, DJ-1 alleviates oxidative stress induced by cerebral IR injury in rats by activating the Nrf2 pathway.</AbstractText> |
2,331,484 | Chordoid glioma in the thalamus of a child: Rare location and atypical imaging findings. | Chordoid glioma is a rare intracranial tumour, which usually occurs in middle-aged female patients, mainly in the third ventricle, hypothalamus and suprasellar region. It can reportedly occur in the temporal-parietal lobe, occipital horn of the lateral ventricle and left thalamus. Here, we report a case of chordoid glioma in the thalamic region of a female child, which is different from the previously reported chordoid glioma in the left thalamus. Given its atypical location and imaging findings, it is often misdiagnosed as low-grade glioma before operation. Through the study of this case, we recognized the atypical imaging manifestations of chordoid glioma in a rare location. |
2,331,485 | Freshly Thawed Cryobanked Human Neural Stem Cells Engraft within Endogenous Neurogenic Niches and Restore Cognitive Function after Chronic Traumatic Brain Injury. | Human neural stem cells (hNSCs) have potential as a cell therapy after traumatic brain injury (TBI). While various studies have demonstrated the efficacy of NSCs from ongoing culture, there is a significant gap in our understanding of freshly thawed cells from cryobanked stocks-a more clinically relevant source. To address these shortfalls, the therapeutic potential of our previously validated Shef-6.0 human embryonic stem cell (hESC)-derived hNSC line was tested after long-term cryostorage and thawing before transplant. Immunodeficient athymic nude rats received a moderate unilateral controlled cortical impact (CCI) injury. At four weeks post-injury, 6<b> ×</b> 10<sup>5</sup> freshly thawed hNSCs were transplanted into six injection sites (two ipsi- and four contra-lateral) with 53.4% of cells surviving three months post-transplant. Interestingly, most hNSCs were engrafted in the meninges and the lining of lateral ventricles, associated with high CXCR4 expression and a chemotactic response to SDF1alpha (CXCL12). While some expressed markers of neuron, astrocyte, and oligodendrocyte lineages, the majority remained progenitors, identified through doublecortin expression (78.1%). Importantly, transplantation resulted in improved spatial learning and memory in Morris water maze navigation and reduced risk taking in an elevated plus maze. Investigating potential mechanisms of action, we identified an increase in ipsilateral host hippocampus cornu ammonis (CA) neuron survival, contralateral dentate gyrus (DG) volume, and DG neural progenitor morphology as well as a reduction in neuroinflammation. Together, these findings validate the potential of hNSCs to improve function after TBI and demonstrate that long-term biobanking of cells and thawing aliquots before use may be suitable for clinical deployment. |
2,331,486 | Basement Membrane Extracellular Matrix Proteins in Pulmonary Vascular and Right Ventricular Remodeling in Pulmonary Hypertension. | The extracellular matrix (ECM), a highly organized network of structural and nonstructural proteins, plays a pivotal role in cellular and tissue homeostasis. Changes in the ECM are critical for normal tissue repair, whereas dysregulation contributes to aberrant tissue remodeling. Pulmonary arterial hypertension is a severe disorder of the pulmonary vasculature characterized by pathologic remodeling of the pulmonary vasculature and right ventricle, increased production and deposition of structural and nonstructural proteins, and altered expression of ECM growth factors and proteases. Furthermore, ECM remodeling plays a significant role in disease progression, as several dynamic changes in its composition, quantity, and organization are documented in both humans and animal models of disease. These ECM changes impact vascular cell biology and affect proliferation of resident cells. Furthermore, ECM components determine the tissue architecture of the pulmonary and myocardial vasculature as well as the myocardium itself and provide mechanical stability crucial for tissue homeostasis. However, little is known about the basement membrane (BM), a specialized, self-assembled conglomerate of ECM proteins, during remodeling. In the vasculature, the BM is in close physical association with the vascular endothelium and smooth muscle cells. While in the myocardium, each cardiomyocyte is enclosed by a BM that serves as the interface between cardiomyocytes and the surrounding interstitial matrix. In this review, we provide a brief overview on the current state of knowledge of the BM and its ECM composition and their impact on pulmonary vascular remodeling and right ventricle dysfunction and failure in pulmonary arterial hypertension. |
2,331,487 | Neurosurgical anatomy of the floor of the third ventricle and related vascular structures. | Anatomical knowledge of the floor of the third ventricle (FTV) is essential in avoiding surgical complications during endoscopic third ventriculostomy. The purpose of this study was to characterize the morphometry of FTV and related arteries, particularly the basilar artery (BA), as well as the factors that influence it.</AbstractText>Twenty-six formalin-fixed adult brains and two hundred adult brain MRIs were studied focusing on FTV and related arteries. Dimensions of interest were measured using image analysis software. Morphometric data obtained were statistically analysed.</AbstractText>Distances between FTV, intermammillary sulcus (IMS), infundibulum, BA bifurcation, and posterior communicating arteries (PCoAs) were described on the cadavers and the MRIs. Distance between right and left PCoAs was greater at their anterior extremity (p < 0.001). Right PCoA was longer (p = 0.016). BA was lateralized in 58.4% of cases and its calibre was larger in males (p < 0.001). The distance from BA apex to FTV was inversely correlated with BA diameter (p < 0.001) and age (p = 0.004). Distance from IMS to infundibulum and the distance between both PCoAs were greater in MRI series when compared to cadaver series (p < 0.001).</AbstractText>A quantitative description of the morphometry of the region of the FTV and related vessels was obtained, helping neurosurgeons in planning their surgical approach. The distance from BA apex to FTV was shorter in individuals with larger BA calibre and in older subjects. MRI studies were qualitatively superior to cadaveric studies in evaluating the anatomy of this region.</AbstractText>© 2021. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.</CopyrightInformation> |
2,331,488 | The impact of real-time fMRI denoising on online evaluation of brain activity and functional connectivity. | <i>Objective</i>. Comprehensive denoising is imperative in functional magnetic resonance imaging (fMRI) analysis to reliably evaluate neural activity from the blood oxygenation level dependent signal. In real-time fMRI, however, only a minimal denoising process has been applied and the impact of insufficient denoising on online brain activity estimation has not been assessed comprehensively. This study evaluated the noise reduction performance of online fMRI processes in a real-time estimation of regional brain activity and functional connectivity.<i>Approach.</i>We performed a series of real-time processing simulations of online fMRI processing, including slice-timing correction, motion correction, spatial smoothing, signal scaling, and noise regression with high-pass filtering, motion parameters, motion derivatives, global signal, white matter/ventricle average signals, and physiological noise models with image-based retrospective correction of physiological motion effects (RETROICOR) and respiration volume per time (RVT).<i>Main results.</i>All the processing was completed in less than 400 ms for whole-brain voxels. Most processing had a benefit for noise reduction except for RVT that did not work due to the limitation of the online peak detection. The global signal regression, white matter/ventricle signal regression, and RETROICOR had a distinctive noise reduction effect, depending on the target signal, and could not substitute for each other. Global signal regression could eliminate the noise-associated bias in the mean dynamic functional connectivity across time.<i>Significance.</i>The results indicate that extensive real-time denoising is possible and highly recommended for real-time fMRI applications. |
2,331,489 | Multi-institutional analysis of treatment modalities in basal ganglia and thalamic germinoma. | Central nervous system (CNS) germinomas are treatment-sensitive tumors with excellent survival outcomes. Current treatment strategies combine chemotherapy with radiotherapy (RT) in order to reduce the field and dose of RT. Germinomas originating in the basal ganglia/thalamus (BGTGs) have proven challenging to treat given their rarity and poorly defined imaging characteristics. Craniospinal (CSI), whole brain (WBI), whole ventricle (WVI), and focal RT have all been utilized; however, the best treatment strategy remains unclear.</AbstractText>Retrospective multi-institutional analysis has been conducted across 18 institutions in four countries.</AbstractText>For 43 cases of nonmetastatic BGTGs, the 5- and 10-year event-free survivals (EFS) were 85.8% and 81.0%, respectively, while the 5- and 10-year overall survivals (OS) were 100% and 95.5%, respectively (one patient fatality from unrelated cause). Median RT doses were as follows: CSI: 2250 cGy/cGy(RBE) (1980-2400); WBI: 2340 cGy/cGy(RBE) (1800-3000); WVI: 2340 cGy/cGy(RBE) (1800-2550); focal: 3600 cGy (3060-5400). Thirty-eight patients (90.5%) received chemotherapy. There was no statistically significant difference in the EFS based on initial field extent (p = .84). Nevertheless, no relapses were reported in patients who received CSI or WBI. Chemotherapy alone had significantly inferior EFS compared to combined therapy (p = .0092), but patients were salvageable with RT.</AbstractText>Patients with BGTGs have excellent outcomes and RT proved to be an integral component of the treatment plan. This group of patients should be included in future prospective clinical trials and the best RT field should be investigated further.</AbstractText>© 2021 Wiley Periodicals LLC.</CopyrightInformation> |
2,331,490 | Cardiac Abnormalities in COVID-19 Patients: Should a Cardiac Echocardiogram be Routine? | Current scientific evidence shows that SARS-CoV-2 infection is associated with an increased risk of thromboembolic events. In patients with ischaemic heart disease and heart failure, thrombi of the left ventricle can increase patient mortality, mainly due to the risk of systemic embolization. Given the hypercoagulable state associated with COVID-19, such events may be more likely. We describe a patient hospitalized for congestive heart failure and SARS-CoV-2 infection who was diagnosed with a thrombus in the left ventricle. After the thrombus was identified on echocardiography and treated with anticoagulation, it completely resolved and cardiac function improved.</AbstractText>SARS-CoV-2 infection has been frequently associated with thromboembolic phenomena and intracardiac thrombi.Echocardiographic evaluation in patients with SARS-CoV-2 infection is important, especially in cases with known or new-onset cardiac pathology which predisposes to thromboembolic phenomena.The timely diagnosis and treatment of intracardiac thrombi can prevent complications and improve patient prognosis.</AbstractText>© EFIM 2021.</CopyrightInformation> |
2,331,491 | Current Understanding of the Right Ventricle Structure and Function in Pulmonary Arterial Hypertension. | Pulmonary arterial hypertension (PAH) is a disease resulting in increased right ventricular (RV) afterload and RV remodeling. PAH results in altered RV structure and function at different scales from organ-level hemodynamics to tissue-level biomechanical properties, fiber-level architecture, and cardiomyocyte-level contractility. Biomechanical analysis of RV pathophysiology has drawn significant attention over the past years and recent work has found a close link between RV biomechanics and physiological function. Building upon previously developed techniques, biomechanical studies have employed multi-scale analysis frameworks to investigate the underlying mechanisms of RV remodeling in PAH and effects of potential therapeutic interventions on these mechanisms. In this review, we discuss the current understanding of RV structure and function in PAH, highlighting the findings from recent studies on the biomechanics of RV remodeling at organ, tissue, fiber, and cellular levels. Recent progress in understanding the underlying mechanisms of RV remodeling in PAH, and effects of potential therapeutics, will be highlighted from a biomechanical perspective. The clinical relevance of RV biomechanics in PAH will be discussed, followed by addressing the current knowledge gaps and providing suggested directions for future research. |
2,331,492 | Cerebrospinal Fluid Leaks From the Lateral Ventricle: A Case Series. | Describe the diagnosis and management of lateral skull base (LSB) cerebrospinal fluid (CSF) leaks originating from the lateral ventricle.</AbstractText>Retrospective case review.</AbstractText>Tertiary referral academic center.</AbstractText>Patients with CSF leaks with direct communication to the lateral ventricle on preoperative imaging.</AbstractText>Surgical repair via the middle cranial fossa (MCF) approach.</AbstractText>CSF leak patient characteristics (age, sex, body mass index [BMI]) and postoperative course (complications and CSF leak resolution) were collected.</AbstractText>Three patients had CSF leaks from the lateral ventricle and all patients demonstrated encephalomalacia of the temporal lobe on preoperative imaging. Encephalomalacia resulted from trauma in one case (age 5) and neurodegeneration in two cases (age 77 and 84). BMI ranged from 16.3 to 26.6 mg/kg2 and follow-up ranged from 4 to 21 months. Two patients presented with preoperative meningitis and all patients had resolution of CSF leaks after MCF repair. With the exception of the higher rate of meningitis, patient presentations did not differ from other spontaneous CSF leaks through middle fossa defects. There were no minor or major postoperative complications.</AbstractText>CSF leaks from the lateral ventricle represent a rare subset of LSB CSF leaks and can occur in non-obese patients secondary to temporal lobe encephalomalacia. The MCF approach allows for repair of the dura and skull base in this cohort of patients with high-flow CSF leaks and loss of brain parenchyma.</AbstractText>Copyright © 2021, Otology & Neurotology, Inc.</CopyrightInformation> |
2,331,493 | Segmented Linear Mixed Model Analysis Reveals Association of the APOEɛ4 Allele with Faster Rate of Alzheimer's Disease Dementia Progression. | APOEɛ4 allele carriers present with an increased risk for late-onset Alzheimer's disease (AD), show cognitive symptoms at an earlier age, and are more likely to transition from mild cognitive impairment (MCI) to dementia but despite this, it remains unclear whether or not the ɛ4 allele controls the rate of disease progression.</AbstractText>To determine the effects of the ɛ4 allele on rates of cognitive decline and brain atrophy during MCI and dementia stages of AD.</AbstractText>A segmented linear mixed model was chosen for longitudinal modeling of cognitive and brain volumetric data of 73 ɛ3/ɛ3, 99 ɛ3/ɛ4, and 39 ɛ4/ɛ4 Alzheimer's Disease Neuroimaging Initiative participants who transitioned during the study from MCI to AD dementia.</AbstractText>ɛ4 carriers showed faster decline on MMSE, ADAS-11, CDR-SB, and MoCA scales, with the last two measures showing significant ɛ4 allele-dose effects after dementia transition but not during MCI. The ɛ4 effect was more prevalent in younger participants and in females. ɛ4 carriers also demonstrated faster rates of atrophy of the whole brain, the hippocampus, the entorhinal cortex, the middle temporal gyrus, and expansion of the ventricles after transitioning to dementia but not during MCI.</AbstractText>Possession of the ɛ4 allele is associated with a faster progression of dementia due to AD. Our observations support the notion that APOE genotype not only controls AD risk but also differentially regulates mechanisms of neurodegeneration underlying disease advancement. Furthermore, our findings carry significance for AD clinical trial design.</AbstractText> |
2,331,494 | Choroid plexus epithelial cells as a model to study nongenomic steroid signaling and its effect on ion channel function. | The choroid plexus (CP) is an epithelial tissue primarily responsible for the secretion of the cerebrospinal fluid (CSF). Choroid plexuses are found in each of the four brain ventricles: two laterals, third and fourth. They ensure continuous production of CSF to provide nutrients, remove waste products and provide a mechanical buffer to protect the brain. Tight junctions in the CP epithelium form a barrier between the blood plasma and the CSF, which allow channels and transporters in the CP to establish a highly regulated concentration gradient of ions between the two fluids, thereby controlling the composition of CSF. CP plays an important part in healthy brain homeostasis, as its failure to maintain adequate CSF perfusion is implicated in Alzheimer's disease and traumatic brain injury. And yet, the physiology of CP and the mechanism of its age-related functional decline is one of the most understudied areas of neurobiology. Here, we describe a protocol to isolate and identify individual choroid plexus epithelial cells (CPEC) from murine brain for whole-cell patch-clamp recordings and ion channel identification. Using the recording from the inwardly rectifying potassium channel K<sub>ir</sub>7.1 and TRPM3 that are abundant in CP, we demonstrate a technique to study the regulators of ion channels in the choroid plexus. |
2,331,495 | Regional adiposity, cardiorespiratory fitness, and left ventricular strain: an analysis from the Dallas Heart Study. | Low cardiorespiratory fitness (CRF), high body mass index, and excess visceral adiposity are each associated with impairment in left ventricular (LV) peak circumferential strain (Ecc</sub>), an intermediate phenotype that precedes the development of clinical heart failure (HF). However, the association of regional fat distribution and CRF with Ecc</sub> independent of each other and other potential confounders is not known.</AbstractText>Participants from the Dallas Heart Study Phase 2 who underwent dual energy X-ray absorptiometry assessment of regional fat distribution, CRF assessment by submaximal treadmill test, and Ecc</sub> quantification by tissue-tagged cardiovascular magnetic resonance were included in the analysis. The cross-sectional associations of measures of regional adiposity, namely visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and lower-body fat (LBF) with Ecc</sub> after adjustment for CRF and other potential confounders (independent variables) were assessed using multivariable linear regression analysis.</AbstractText>The study included 1089 participants (55% female, 39% black). In the unadjusted analysis, higher VAT was associated with greater impairment in Ecc</sub>. After adjustment for baseline risk factors, CRF, parameters of LV structure and function, and other fat depots such as SAT and LBF, higher VAT remained associated with greater impairment in Ecc</sub> (β: 0.19, P = 0.002). SAT and LBF were not significantly associated with Ecc</sub>, however, CRF remained associated with Ecc</sub> in the fully adjusted model including all fat depots (β: - 0.15, P < 0.001).</AbstractText>VAT and CRF are each independently associated with impairment in Ecc</sub>, suggesting that higher VAT burden and low CRF mediate pathological cardiac remodeling through distinct mechanisms.</AbstractText> |
2,331,496 | Clinical features, diagnosis, and survival analysis of dogs with glioma. | Gliomas in dogs remain poorly understood.</AbstractText>To characterize the clinicopathologic findings, diagnostic imaging features and survival of a large sample of dogs with glioma using the Comparative Brain Tumor Consortium diagnostic classification.</AbstractText>Ninety-one dogs with histopathological diagnosis of glioma.</AbstractText>Multicentric retrospective case series. Signalment, clinicopathologic findings, diagnostic imaging characteristics, treatment, and outcome were used. Tumors were reclassified according to the new canine glioma diagnostic scheme.</AbstractText>No associations were found between clinicopathologic findings or survival and tumor type or grade. However, definitive treatments provided significantly (P = .03) improved median survival time (84 days; 95% confidence interval [CI], 45-190) compared to palliative treatment (26 days; 95% CI, 11-54). On magnetic resonance imaging (MRI), oligodendrogliomas were associated with smooth margins and T1-weighted hypointensity compared to astrocytomas (odds ratio [OR], 42.5; 95% CI, 2.42-744.97; P = .04; OR, 45.5; 95% CI, 5.78-333.33; P < .001, respectively) and undefined gliomas (OR, 84; 95% CI, 3.43-999.99; P = .02; OR, 32.3; 95% CI, 2.51-500.00; P = .008, respectively) and were more commonly in contact with the ventricles than astrocytomas (OR, 7.47; 95% CI, 1.03-53.95; P = .049). Tumor spread to neighboring brain structures was associated with high-grade glioma (OR, 6.02; 95% CI, 1.06-34.48; P = .04).</AbstractText>Dogs with gliomas have poor outcomes, but risk factors identified in survival analysis inform prognosis and the newly identified MRI characteristics could refine diagnosis of tumor type and grade.</AbstractText>© 2021 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.</CopyrightInformation> |
2,331,497 | Distribution and morphology of ventricular bands in the hearts of ringed seals. | In contrast to studies on domestic animals, few reports describe ventricular bands in wildlife, and none in aquatic mammals. Ventricular bands in the endangered Saimaa ringed seal (Pusa hispida saimensis) and the Baltic ringed seal (Pusa hispida botnica) were examined as part of an ongoing research on the comparative anatomy of ringed seal subspecies. The dissections illustrated that a varying number of thin or thick ventricular bands from the papillary muscles to the ventricular walls were visible in the ventricles of all ringed seal specimens examined. The histological appearance of the ventricular bands was characterized by a fibromuscular pattern. |
2,331,498 | Left ventricle motion estimation for cine MR images using sparse representation with shape constraint. | To propose a left ventricle (LV) motion estimation method based on sparse representation, in order to handle the spatial-varying intensity distortions caused by tissue deformation.</AbstractText>For each myocardial landmark, an adaptive dictionary was generated by learning transformations from a training dataset. Then the landmark was tracked using sparse representation. Next, a point distribution model was applied to the overall tracking results. Finally, the dense displacement field of the LV myocardium was estimated based on the correspondence between each landmark. Using the dense displacement field estimated, the circumferential strain was calculated to assess the myocardial function. The performance of the proposed method was quantified by the average perpendicular distance (APD), the Dice metric, and the mean symmetric contour distance (SCD).</AbstractText>Comparing to the state-of-the-art techniques, the smallest value of APD and SCD, and the highest value of Dice can be obtained using the proposed method, for three public cardiac datasets. Moreover, the mean value of strain difference between the proposed method and the commercial software Medis Suite MR was -0.01, while the intraclass correlation coefficient between these two methods was 0.91.</AbstractText>The proposed method could estimate the dense displacement field of the LV accurately, which outperforms other state-of-the-art techniques. The circumferential strain derived from the proposed method was in excellent agreement with that derived from the Medis Suite MR software, while segmental strain abnormalities were detected for most of the subjects with heart diseases, which indicates the potential of the proposed method for clinical usage.</AbstractText>Copyright © 2021 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.</CopyrightInformation> |
2,331,499 | Combining stem cells in myocardial infarction: The road to superior repair? | Myocardial infarction irreversibly destroys millions of cardiomyocytes in the ventricle, making it the leading cause of heart failure worldwide. Over the past two decades, many progenitor and stem cell types were proposed as the ideal candidate to regenerate the heart after injury. The potential of stem cell therapy has been investigated thoroughly in animal and human studies, aiming at cardiac repair by true tissue replacement, by immune modulation, or by the secretion of paracrine factors that stimulate endogenous repair processes. Despite some successful results in animal models, the outcome from clinical trials remains overall disappointing, largely due to the limited stem cell survival and retention after transplantation. Extensive interest was developed regarding the combinational use of stem cells and various priming strategies to improve the efficacy of regenerative cell therapy. In this review, we provide a critical discussion of the different stem cell types investigated in preclinical and clinical studies in the field of cardiac repair. Moreover, we give an update on the potential of stem cell combinations as well as preconditioning and explore the future promises of these novel regenerative strategies. |
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