Unnamed: 0 int64 0 2.34M | titles stringlengths 5 21.5M | abst stringlengths 1 21.5M |
|---|---|---|
2,331,600 | Evans index among adult Ghanaians on normal head computerized tomography scan. | Normal-Pressure Hydrocephalus (NPH) is a neurological condition which is made up of a clinical triad of gait disturbance, dementia and urinary incontinence and can be reversed by ventricular shunting. Currently, some guidelines suggest the use of Evans' index (EI) for diagnosis of hydrocephalus radiologically. Most of the studies are based on the Western population data. None of these studies have been performed in the Ghanaian population setting yet. The aim of this study was to quantitatively establish normal borderline value for Evans Index in the Ghanaian adult population with respect to age and sex.</AbstractText>This study was retrospectively conducted on normal enhanced head CT scan images of 266 males and 241 females. EI was calculated as the linear ratio of Maximum Anterior Horn Width (MAHW) of the frontal horns of the lateral ventricles at the level of foramina of Monroe and the Maximum Intracranial Diameter (MICD) of the inner skull. Student T-test, ANOVA and Pearson's correlation were used to analyze the data. A test for a relationship was performed with a scatter plot and a linear regression was performed based on age, sex and different EI of ventricular size.</AbstractText>The mean and median value of EI was 0.24 ± 0.02. There was no statistically significant difference in the EI values between males and females, (p-value = 0.61). A steady increase in EI with age was observed. There was a strong correlation coefficient r = 0.89 of EI and age, which suggested a strong linear relationship between EI and Age. The overall linear relationship model was EI = 0.1879 + 0.0011∗Age.</AbstractText>The mean EI of 0.24 ± 0.02 in our study agrees with adapted international guidelines cut-off value for normal adult patients of (<0.30) and can be a useful tool in determining ventricular enlargement particularly in resource limited settings.</AbstractText>© 2021 The Author(s).</CopyrightInformation> |
2,331,601 | Intraventricular dysembryoplastic neuroepithelial tumor in the temporal horn with Broad involvement of the ependyma. | Though typical dysembryoplastic neuroepithelial tumors (DNETs) are located in the cerebral cortex, an atypical DNET could occur in the temporal horn of the lateral ventricle and broadly involve the ependyma. Awareness of this atypical form of DNET is of value for the wright diagnosis and management of atypical DNETs. |
2,331,602 | Toward a phenomenology of congenital illness: a case of single-ventricle heart disease. | Phenomenology has contributed to healthcare by providing resources for understanding the lived experience of the patient and their situation. But within a burgeoning literature on the characteristic features of illness, there has not yet been an account appropriate to describe congenital illnesses: conditions which are present from birth and cause suffering or medical threat to their bearers. Congenital illness sits uncomfortably with standard accounts in phenomenology of illness, in which concepts such as loss, doubt, alienation and unhomelikeness presuppose prior health. These accounts reflect, in different ways, Maurice Merleau-Ponty's assumption that the ways of living of the ill contain allusions to fundamental, healthy functions. The originality of congenital illness complicates this assumption and demands its own original phenomenology. In this paper, I sketch my personal experience living with a single-ventricle heart condition. While some of this story may reflect my own idiosyncratic experience, I hope that much of it will resonate with the congenital illness experience. I argue that the phenomenological literature on illness, grounded in the notion of loss, does not describe the congenital illness experience. I show how a number of other patient-centred theories of health and illness which have been influential on phenomenology can and cannot elucidate congenital illness. In particular, I consider Georges Canguilhem's account of the normal and the pathological; debates in disability; and the notion of illness as biographical disruption. I show that congenital illness results in the preadmission of its patients to a paradoxical logic of medical palliation, one product of which is existential maturity. |
2,331,603 | Choroid plexus carcinoma with leptomeningeal spread in an adult: a case report and  review of the literature. | Choroid plexus carcinoma is an intraventricular neoplasm originating from the choroid plexus epithelium and is of rare occurrence in adults. However, owing to the low prevalence of choroid plexus carcinoma, there is very limited information about the disease entity and treatment. Here we report a rare case of choroid plexus carcinoma in an adult patient.</AbstractText>A 46-year-old South Korean (East Asian) male presented with low back pain, headache, and diplopia. Magnetic resonance imaging demonstrated enhancing mass lesion in the left trigone, cerebellar with leptomeningeal spread. Surgery was performed via left parietal craniotomy, and the lesion was histologically confirmed to be choroid plexus carcinoma. The patient received adjuvant craniospinal irradiation for remnant mass and leptomeningeal spread. Magnetic resonance imaging performed immediately after completion of the treatment revealed a partial decrease in the size of the tumor. However, the patient expired died as a result of acute respiratory distress syndrome before follow-up of long-term outcome.</AbstractText>Choroid plexus carcinoma with leptomeningeal spread in adults is very important for rapid diagnosis and treatment. In the case of the presence of leptomeningeal spread, craniospinal irradiation can be considered as a treatment method, but may have serious complications. Hence, the technique should be applied with care.</AbstractText> |
2,331,604 | Brain Barriers and brain fluids research in 2020 and the fluids and barriers of the CNS thematic series on advances in in vitro modeling of the blood-brain barrier and neurovascular unit. | This editorial discusses advances in brain barrier and brain fluid research in 2020. Topics include: the cerebral endothelium and the neurovascular unit; the choroid plexus; the meninges; cerebrospinal fluid and the glymphatic system; disease states impacting the brain barriers and brain fluids; drug delivery to the brain. This editorial also highlights the recently completed Fluids Barriers CNS thematic series entitled, 'Advances in in vitro modeling of the blood-brain barrier and neurovascular unit'. Such in vitro modeling is progressing rapidly. |
2,331,605 | Multi-channel bioimpedance spectroscopy based on orthogonal baseband shifting. | <i>Objective</i>. Multi-channel bioimpedance spectroscopy (BIS) systems typically sample each channel's impedance sequentially using multiplexers and a single analog-to-digital converter. These systems may lose their real-time capability with an increasing number of channels, especially for low excitation frequencies. We propose a new method, called orthogonal baseband shifting (OBS), for high-speed parallel BIS data acquisition at multiple excitation frequencies with low hardware and computational effort.<i>Approach</i>. Similar to orthogonal frequency-division multiplexing, used for digital data transmission, OBS systems use channel-specific orthogonal carrier frequencies to modulate the voltage response of the tissue. Given a suitable choice of carrier frequencies, the modulated signals of all channels sum up without loss of information and cross-talk. The fast Fourier transform (FFT) of the summed signal reveals a spectrum of non-overlapping, interleaved BIS data from which the corresponding BIS data of each channel can be calculated.<i>Main results</i>. In simulations, the system design requires a minimum signal-to-noise ratio of 30 dB to achieve amplitude errors below 1% and phase errors below 0.8°. The hardware realization, called 'AixBIS', has been evaluated for impedance measurements between 0.1 and 10 Ω with multi-frequency excitations between 45 and 180 kHz. The impedance values acquired had an averaged precision of 3.67 mΩ, which is only 0.65‰ in relation to the measured impedance. The phase had a mean precision of 0.46°. Moreover,<i>in vitro</i>measurements achieved 140 full spectrum acquisitions per second. The impedance change measured in a silicone heart phantom showed a high correlation of 0.83 with the ventricles volume change (flow).<i>Significance</i>. The proposed method enables very fast impedance acquisition of all channels. A complete measurement is performed in the time of a single FFT acquisition, which is equal to the resolution bandwidth of the FFT. In addition, portable and low-power multi-channel BIS devices profit from highly reduced hardware effort. The outstanding performance of OBS measurements with the AixBIS system have the potential for<i>in vivo</i>BIS measurements in real-time. |
2,331,606 | Nonoperative management of enlarging syringomyelia in clinically stable patients after decompression of Chiari malformation type I.<Pagination><StartPage>28</StartPage><EndPage>33</EndPage><MedlinePgn>28-33</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.3171/2020.12.PEDS20621</ELocationID><Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">The authors aimed to describe the natural history and optimal management of persistent syringomyelia after suboccipital craniectomy for Chiari malformation type I (CM-I).</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">A cohort of all patients who presented to a tertiary pediatric hospital with newly diagnosed CM-I between 2009 and 2017 was identified. Patients with persistent or worsened syringomyelia were identified on the basis of a retrospective review of medical records and imaging studies. The management of these patients and their clinical courses were then described.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">A total of 153 children with CM-I and syringomyelia were evaluated between 2009 and 2017. Of these, 115 (68.8%) patients underwent surgical intervention: 40 patients underwent posterior fossa decompression (PFD) alone, 43 underwent PFD with duraplasty, and 32 underwent PFD with duraplasty and fourth ventricle stent placement. Eleven (7.19%) patients had increased syringomyelia on subsequent postoperative imaging. Three of these patients underwent revision surgery because of worsening scoliosis or pain, 2 of whom were lost to follow-up, and 4 were managed nonoperatively with close surveillance and serial MRI evaluations. The syringes decreased in size in 3 patients and resolved completely in 1 patient.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Persistent or worsened syringomyelia after CM-I decompression is uncommon. In the absence of symptoms, nonoperative management with close observation is safe for patients with persistent syrinx.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Szuflita</LastName><ForeName>Nicholas S</ForeName><Initials>NS</Initials><AffiliationInfo><Affiliation>1Division of Neurosurgery, Walter Reed National Military Medical Center, Bethesda, Maryland; and.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Phan</LastName><ForeName>Tiffany N</ForeName><Initials>TN</Initials><AffiliationInfo><Affiliation>2Division of Neurosurgery, Children's National Health System, Washington, DC.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Boulter</LastName><ForeName>Jason H</ForeName><Initials>JH</Initials><AffiliationInfo><Affiliation>1Division of Neurosurgery, Walter Reed National Military Medical Center, Bethesda, Maryland; and.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Keating</LastName><ForeName>Robert F</ForeName><Initials>RF</Initials><AffiliationInfo><Affiliation>2Division of Neurosurgery, Children's National Health System, Washington, DC.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Myseros</LastName><ForeName>John S</ForeName><Initials>JS</Initials><AffiliationInfo><Affiliation>2Division of Neurosurgery, Children's National Health System, Washington, DC.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>05</Month><Day>21</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Neurosurg Pediatr</MedlineTA><NlmUniqueID>101463759</NlmUniqueID><ISSNLinking>1933-0707</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Chiari I malformation</Keyword><Keyword MajorTopicYN="N">suboccipital decompression</Keyword><Keyword MajorTopicYN="N">syringomyelia</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>7</Month><Day>16</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>12</Month><Day>7</Day></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>5</Month><Day>22</Day><Hour>6</Hour><Minute>1</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>5</Month><Day>22</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>5</Month><Day>21</Day><Hour>20</Hour><Minute>32</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">34020421</ArticleId><ArticleId IdType="doi">10.3171/2020.12.PEDS20621</ArticleId><ArticleId IdType="pii">2020.12.PEDS20621</ArticleId></ArticleIdList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">34020413</PMID><DateRevised><Year>2021</Year><Month>05</Month><Day>28</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1933-0715</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2021</Year><Month>May</Month><Day>21</Day></PubDate></JournalIssue><Title>Journal of neurosurgery. Pediatrics</Title><ISOAbbreviation>J Neurosurg Pediatr</ISOAbbreviation></Journal>Hydrocephalus surveillance following shunt placement or endoscopic third ventriculostomy: a survey of surgeons in the Hydrocephalus Clinical Research Networks. | The authors aimed to describe the natural history and optimal management of persistent syringomyelia after suboccipital craniectomy for Chiari malformation type I (CM-I).</AbstractText>A cohort of all patients who presented to a tertiary pediatric hospital with newly diagnosed CM-I between 2009 and 2017 was identified. Patients with persistent or worsened syringomyelia were identified on the basis of a retrospective review of medical records and imaging studies. The management of these patients and their clinical courses were then described.</AbstractText>A total of 153 children with CM-I and syringomyelia were evaluated between 2009 and 2017. Of these, 115 (68.8%) patients underwent surgical intervention: 40 patients underwent posterior fossa decompression (PFD) alone, 43 underwent PFD with duraplasty, and 32 underwent PFD with duraplasty and fourth ventricle stent placement. Eleven (7.19%) patients had increased syringomyelia on subsequent postoperative imaging. Three of these patients underwent revision surgery because of worsening scoliosis or pain, 2 of whom were lost to follow-up, and 4 were managed nonoperatively with close surveillance and serial MRI evaluations. The syringes decreased in size in 3 patients and resolved completely in 1 patient.</AbstractText>Persistent or worsened syringomyelia after CM-I decompression is uncommon. In the absence of symptoms, nonoperative management with close observation is safe for patients with persistent syrinx.</AbstractText> |
2,331,607 | Biophysics-based statistical learning: Application to heart and brain interactions. | Initiatives such as the UK Biobank provide joint cardiac and brain imaging information for thousands of individuals, representing a unique opportunity to study the relationship between heart and brain. Most of research on large multimodal databases has been focusing on studying the associations among the available measurements by means of univariate and multivariate association models. However, these approaches do not provide insights about the underlying mechanisms and are often hampered by the lack of prior knowledge on the physiological relationships between measurements. For instance, important indices of the cardiovascular function, such as cardiac contractility, cannot be measured in-vivo. While these non-observable parameters can be estimated by means of biophysical models, their personalisation is generally an ill-posed problem, often lacking critical data and only applied to small datasets. Therefore, to jointly study brain and heart, we propose an approach in which the parameter personalisation of a lumped cardiovascular model is constrained by the statistical relationships observed between model parameters and brain-volumetric indices extracted from imaging, i.e. ventricles or white matter hyperintensities volumes, and clinical information such as age or body surface area. We explored the plausibility of the learnt relationships by inferring the model parameters conditioned on the absence of part of the target clinical features, applying this framework in a cohort of more than 3 000 subjects and in a pathological subgroup of 59 subjects diagnosed with atrial fibrillation. Our results demonstrate the impact of such external features in the cardiovascular model personalisation by learning more informative parameter-space constraints. Moreover, physiologically plausible mechanisms are captured through these personalised models as well as significant differences associated to specific clinical conditions. |
2,331,608 | The role of imaging in the evaluation of hoarseness: A review. | Hoarseness is a common symptom indicating an abnormal change in the quality of voice and has a lifetime prevalence of around 30%. There are multiple causes of hoarseness, ranging from acute laryngitis, chronic laryngitis, laryngopharyngeal reflux, functional dysphonia due to vocal overuse or abuse, vocal cord paralysis (VCP), to various pathologies and masses in the larynx. A detailed history and thorough physical examination, and in many cases, laryngoscopy by a clinician are the initial steps in its management. Laryngoscopy should be considered if hoarseness persists for more than 2 weeks without a known benign cause. An Ear Nose and Throat surgeon performs direct visualization by laryngoscopy to rule out VCP or a lesion in the larynx, and it should be performed before ordering any imaging. CT with contrast is the imaging of choice to evaluate the laryngeal tumors and find the etiology of VCP. Typical findings of VCP are ipsilateral dilatation of the pyriform sinus and laryngeal ventricle, thickening and medialization of the ipsilateral aryepiglottic fold, medialization of the arytenoid cartilage and posterior aspect of the true vocal cord (TVC) atrophy of the TVC, and loss of the subglottic arch. The lesions causing the VCP may extend from the medulla, jugular foramen, carotid space, and upper mediastinum. CT neck must cover the aorticopulmonary window when evaluating the left VCP to cover the left recurrent laryngeal nerve's origin. |
2,331,609 | Icarrin prevents cardiomyocyte apoptosis in spontaneously hypertensive rats by inhibiting endoplasmic reticulum stress pathways. | This study aimed to explore whether icarrin (ICA) can protect cardiomyocytes from hypertension-induced damage by inhibiting endoplasmic reticulum stress (ERS).</AbstractText>Spontaneously hypertensive rats (SHRs) were orally administered water or ICA at 10, 20 and 40 mg/kg once daily for 12 weeks, and Wistar-Kyoto (WKY) rats were used as control. Changes in the growth and blood pressure of rats were assessed. Cardiac function was determined by ultrasound and the left ventricle mass was calculated. Myocardial tissue structure was assessed by haematoxylin and eosin staining, cardiomyocyte apoptosis was observed by TUNEL staining and the expression of ERS-related proteins was determined by western blotting.</AbstractText>In the SHR group, blood pressure was significantly high, left ventricular function decreased and left ventricular mass index increased. Additionally, left ventricular cardiomyocyte hypertrophy, disordered myofilament arrangement and increased cardiomyocyte apoptosis were observed by histological staining. ERS-induced proteins associated with apoptosis, including GRP78, PERK, ATF-6, ATF-4, CHOP, DR5, Caspase 12, c-JUN and ASK-1 were found to be highly expressed. ICA treatment reduced blood pressure and regulated the expression of proteins induced by ERS. Cardiomyocyte apoptosis decreased and left ventricular function improved.</AbstractText>ICA can inhibit ERS-induced apoptosis of cardiomyocytes and protect ventricular function in SHR.</AbstractText>© The Author(s) 2021. Published by Oxford University Press on behalf of the Royal Pharmaceutical Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</CopyrightInformation> |
2,331,610 | Multiparametric Rest and Dobutamine Stress Magnetic Resonance in Assessment of Myocardial Viability. | MR feature-tracking (FT) is a novel technique that quantitatively calculates myocardial strain and can assess myocardial viability.</AbstractText>To evaluate the feasibility of FT at rest and with low-dose dobutamine (LDD), visual assessment of contractility with LDD and left ventricle (LV) end-diastolic wall thickness (EDWT) in the assessment of viability in ischemic cardiomyopathy (ICM) patients compared to delayed gadolinium enhancement (DGE).</AbstractText>Prospective.</AbstractText>Thirty ICM patients and 30 healthy volunteers.</AbstractText><AbstractText Label="FIELD STRENGTH/SEQUENCES">A 1.5 T with balanced steady-state free precession (bSSFP) cine and phase-sensitive inversion prepared segmented gradient echo sequences.</AbstractText>LDD (5 μg/kg/min and 10 μg/kg/min) was administered in the patient group. LV was divided into 16 segments and MR-FT was derived from bSSFP cine images using dedicated software. Viable segments were defined as those with a dobutamine-induced increase in resting MR-FT values >20%, a dobutamine-induced increase in systolic wall thickening ≥2 mm by visual assessment, ≤50% fibrosis on DGE, and resting EDWT ≥5.5 mm.</AbstractText>One-way analysis of variance (ANOVA), two-sampled t-test, paired samples t-test, and receiver operating characteristic (ROC) curve analysis. A P value < 0.05 was considered statistically significant.</AbstractText>Resting peak global circumferential (Ecc) and radial (Err) strains were significantly impaired in patients compared to controls (-11.7 ± 7.9 vs. -20.1 ± 5.7 and 19.7 ± 13.9 vs. 32.7 ± 15.4, respectively). Segments with no DGE (n = 354) and ≤ 50% (n = 38) DGE showed significant improvement of both Ecc and Err with LDD while segments with >50% DGE (n = 88) showed no improvement. In comparison to viable and nonviable segments identified by reference-standard DGE, the sensitivity, specificity, and diagnostic accuracy of the four methods were: 74%, 92%, and 89%, respectively, for Ecc; 70%, 89%, and 86%, respectively, for Err; 67%, 88%, and 84% for visual assessment; and 39%, 90%, and 80% for EDWT.</AbstractText>Quantitative assessment of MR-FT, along with EDWT and qualitative visual assessment of myocardial contractility with LDD, are feasible alternative methods for the assessment of myocardial viability with moderate sensitivity and high specificity.</AbstractText>1 TECHNICAL EFFICACY: Stage: 2.</AbstractText>© 2021 International Society for Magnetic Resonance in Medicine.</CopyrightInformation> |
2,331,611 | The rosette-forming glioneuronal tumor mimicked cerebral cysticercosis: a case report. | Rosette-forming glioneuronal tumor (RGNT) is a rare variety of slow growing mixed glioneuronal tumor involving primarily fourth ventricular region. This is a comprehensive analysis of a 22-year-old woman with RGNT composed of mainly cystic components. In addition, the case showed multiple lesions located in brain parenchyma which mimicked cerebral cysticercosis. Here, we analyzed this case and listed some characteristics of RGNTs in reported literature which occurring in atypical locations for further understanding it.</AbstractText>A 22-year-old woman presented with a history of transient dizziness, nausea, and vomiting. Magnetic resonance imaging (MRI) showed multiple cystic lesions in brain parenchyma and then the patient was diagnosed with cerebral cysticercosis possibility. Empirical anti-infective therapy in addition to a follow-up post 2 weeks of MRI examination showed the lesions unchanged. Finally, a biopsy of the right cerebellar hemisphere lesions verified RGNT.</AbstractText>RGNT is an uncommon tumor classified as grade I glioma by World Health Organization (WHO) with slightly longer course. The imaging findings of RGNT are not specific especially in atypical areas. RGNT is rare, but we should also consider the possibility in diagnosis and differential diagnosis.</AbstractText>© 2021. The Author(s).</CopyrightInformation> |
2,331,612 | Correlation between the levels of NLRP3, Hcy, IL-1β, IL-18 and the prognosis in patients with hemorrhagic stroke. | To explore the connection of nucleotide-binding oligomerization domain-like receptors 3 (NLRP3), homocysteine (Hcy), interleukin-1β (IL-1β), interleukin-18 (IL-18) in peripheral blood and prognosis in patients with hemorrhagic stroke.</AbstractText>A total of 84 patients with hemorrhagic stroke treated in our hospital were selected and divided into the good prognosis group (48 cases) and the poor prognosis group (36 cases) according to the Glasgow Prognostic Scale (GOS) at month 6 after discharge. 40 people who were matched for age, sex and risk factors for cerebral hemorrhage, but did not have cerebral hemorrhage, were selected as a control group. We detected the levels of NLRP3, Hcy, IL-1β and IL-18 in peripheral blood, and analyzed their correlation with GOS score. Then we performed Logistic regression analysis to investigate the risk factors for poor prognosis.</AbstractText>The expressions of NLRP3 mRNA, Hcy, IL-1β and IL-18 in peripheral blood in the poor prognosis group were higher than those in the good prognosis group (P<0.05). The expression levels of NLRP3 mRNA, Hcy, IL-1β and IL-18 were negatively correlated with GOS scores (P<0.05). Regression analysis showed that the expression of NLRP3 mRNA, serum Hcy, bleeding volume and ventricular system penetration were independent risk factors for poor prognosis.</AbstractText>In patients with poor prognosis of hemorrhagic stroke, the mRNA levels of NLRP3 and serum Hcy, IL-1β and IL-18 levels in peripheral blood elevated. High NLRP3 mRNA levels, Hcy levels, bleeding volume and ventricle system penetration are independent risk factors for poor prognosis.</AbstractText>AJTR Copyright © 2021.</CopyrightInformation> |
2,331,613 | Integrated Clinical and Magnetic Resonance Imaging Assessments Late After Fontan Operation. | Several clinical and cardiac magnetic resonance (CMR)-derived parameters have been shown to be associated with death or heart transplant late after the Fontan operation.</AbstractText>The objective of this study was to identify the relative importance and interactions of clinical and CMR-based parameters for risk stratification after the Fontan operation.</AbstractText>Fontan patients were retrospectively reviewed. Clinical and CMR parameters were analyzed using univariable Cox regression. The primary endpoint was time to death or (listing for) heart transplant. To identify the patients at highest risk for the endpoint, classification and regression tree survival analysis was performed, including all significant variables from Cox regression.</AbstractText>The cohort consisted of 416 patients (62% male) with a median age of 16 years (25th, 75th percentiles: 11, 23 years). Over a median follow-up of 5.4 years (25th, 75th percentiles: 2.4, 10.0 years) after CMR, 57 patients (14%) reached the endpoint (46 deaths, 7 heart transplants, 4 heart transplant listings). Lower total indexed end-diastolic volume (EDVi</sub>) was the strongest predictor of transplant-free survival. Among patients with dilated ventricles (EDVi</sub> ≥156 ml/BSA1.3</sup>), worse global circumferential strain (GCS) was the next most important predictor (73% vs. 44%). In patients with smaller ventricles (EDVi</sub> <156 ml/BSA1.3</sup>), New York Heart Association functional class ≥II was the next most important predictor (30% vs. 4%).</AbstractText>In this cohort of patients late after Fontan operation, increased ventricular dilation was the strongest independent predictor of death or transplant (listing). Patients with both ventricular dilation and worse GCS were at highest risk. These data highlight the value of integrating CMR and clinical parameters for risk stratification in this population.</AbstractText>Copyright © 2021 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.</CopyrightInformation> |
2,331,614 | In utero fetal left ventricular rupture and pseudoaneurysm formation: a case report. | Cardiac ventricular aneurysms affect 1 in 200,000 live births. To the best of our knowledge, no reported cases of a left ventricular pseudoaneurym and in utero rupture exist to guide optimal management.</AbstractText>We present a case of fetal left ventricular rupture with a large pericardial effusion, cardiac tamponade and subsequent pseudoaneurysm formation with concerns for a poor prognosis. Interventional drainage of the pericardial effusion led to resolution of tamponade and significant improvement in fetal condition. A multidisciplinary team was utilised to plan birth to minimise risk of pseudoaneurysmal rupture and a catastrophic bleed at birth.</AbstractText>For similar cases we recommend consideration of birth by caesarean section, delayed cord clamping and a prostaglandin E1 infusion, to reduce the systemic pressures on the left ventricle during transition from fetal to neonatal circulations, until definitive surgical repair. In this case, this resulted in a successful outcome.</AbstractText> |
2,331,615 | Extracellular Vesicle TGF-β1 Is Linked to Cardiopulmonary Dysfunction in Human Immunodeficiency Virus. | Extracellular vesicles (EVs) have emerged as important mediators in cell-cell communication; however, their relevance in pulmonary hypertension (PH) secondary to human immunodeficiency virus (HIV) infection is yet to be explored. Considering that circulating monocytes are the source of the increased number of perivascular macrophages surrounding the remodeled vessels in PH, this study aimed to identify the role of circulating small EVs and EVs released by HIV-infected human monocyte-derived macrophages in the development of PH. We report significantly higher numbers of plasma-derived EVs carrying higher levels of TGF-β1 (transforming growth factor-β1) in HIV-positive individuals with PH compared with individuals without PH. Importantly, levels of these TGF-β1-loaded, plasma-derived EVs correlated with pulmonary arterial systolic pressures and CD4 counts but did not correlate with the Dl <sub>CO</sub> or viral load. Correspondingly, enhanced TGF-β1-dependent pulmonary endothelial injury and smooth muscle hyperplasia were observed. HIV-1 infection of monocyte-derived macrophages in the presence of cocaine resulted in an increased number of TGF-β1-high EVs, and intravenous injection of these EVs in rats led to increased right ventricle systolic pressure accompanied by myocardial injury and increased levels of serum ET-1 (endothelin-1), TNF-α, and cardiac troponin-I. Conversely, pretreatment of rats with TGF-β receptor 1 inhibitor prevented these EV-mediated changes. Findings define the ability of macrophage-derived small EVs to cause pulmonary vascular modeling and PH via modulation of TGF-β signaling and suggest clinical implications of circulating TGF-β-high EVs as a potential biomarker of HIV-associated PH. |
2,331,616 | Association of Structural Changes in the Brain and Retina After Long-Duration Spaceflight. | Long-duration spaceflight induces structural changes in the brain and eye. Identification of an association between cerebral and ocular changes could help determine if there are common or independent causes and inform targeted prevention strategies or treatments.</AbstractText>To determine if there is an association between quantitative changes in intracranial compartment volumes and peripapillary total retinal thickness after spaceflight.</AbstractText><AbstractText Label="DESIGN, SETTING, AND PARTICIPANTS" NlmCategory="METHODS">This cohort study included healthy International Space Station crew members before and immediately after long-duration spaceflight. Data on race were not collected. Analysis was conducted from September to November 2020.</AbstractText>Long-duration spaceflight (mean [SD], 191 [55] days).</AbstractText>Optical coherence tomography-derived peripapillary total retinal thickness as a quantitative assessment and early sign of optic disc edema and magnetic resonance imaging-derived measures of lateral ventricle volume, white matter volume, and whole brain plus cerebrospinal fluid volume.</AbstractText>In 19 healthy crew members included in this study (5 women [26.3%], 14 men [73.7%]; mean [SD] age, 45.2 [6.4] years), analyses revealed a positive, although not definitive, association between spaceflight-induced changes in total retinal thickness and lateral ventricle volume (4.7-μm increase in postflight total retinal thickness [95% CI, -1.5 to 10.8 μm; P = .13] per 1-mL postflight increase in lateral ventricle volume). Adjustments for mission duration improved the strength of association (5.1 μm; 95% CI, -0.4 to 10.5 μm; P = .07). No associations were detected between spaceflight-induced changes in total retinal thickness and white matter volume (0.02 μm; 95% CI, -0.5 to 0.5 μm; P = .94) or brain tissue plus cerebrospinal fluid volume, an estimate of intracranial volume (0.02 μm; 95% CI, -0.6 to 0.6 μm; P = .95).</AbstractText>These results help characterize spaceflight-associated neuro-ocular syndrome and the physiologic associations of headward fluid shifts with outcomes during spaceflight on the central nervous system. The possibly weak association between increased total retinal thickness and lateral ventricle volume suggest that while weightlessness-induced fluid redistribution during spaceflight may be a common stressor to the brain and retina, the development of optic disc edema appears to be uncoupled with changes occurring in the intracranial compartment.</AbstractText> |
2,331,617 | Is there myocardial involvement in children with long-term follow-up for Kawasaki disease? A study based on two-dimensional speckle tracking echocardiography. | This study aimed to determine the possibility of subclinical myocardial dysfunction detected by strain echocardiography in the late period of children with Kawasaki disease.</AbstractText>The study enrolled 30 patients with Kawasaki disease with a follow-up period of at least 12 months and 30 healthy age- and gender-matched children. During the follow-up period, standard echocardiography, pulsed and tissue Doppler, and strain echocardiography were recorded for both groups.</AbstractText>The mean age at the time of the diagnosis was 2.6±2.3 years (2 months-11 years). The mean follow-up period after the diagnosis was 3.55±2.20 years. Conventional echocardiography, M mode, pulsed and tissue Doppler values, and myocard performance index did not reveal significant differences. Left ventricle strain and strain rate parameters obtained by apical four-, three-, and two-chamber views did not show statistical differences between patients and controls. There was a positive correlation between the duration of follow-up and global four- and three-chamber longitudinal strain and global longitudinal strain values (r=0.465, p=0.010; r=0.414, p=0.023; r=0.492, p=0.006, respectively), whereas global radial strain showed negative correlation (r=-0.517, p=0.003).</AbstractText>The analysis of systolic strain and strain rate did not detect a subclinical myocardial dysfunction in the long-term follow-up of Kawasaki disease. However, strain values showed variability with the follow-up periods, which indicates that Kawasaki disease might cause left ventricular dysfunction in the later phases. Therefore, a follow-up of children with a diagnosis of Kawasaki disease is of capital importance.</AbstractText>Copyright © 2021 Turkish Pediatric Association.</CopyrightInformation> |
2,331,618 | Cerebrospinal Fluid Drop Metastases of Canine Glioma: Magnetic Resonance Imaging Classification. | Dissemination of glioma in humans can occur as leptomeningeal nodules, diffuse leptomeningeal lesions, or ependymal lesions. Cerebrospinal fluid (CSF) drop metastasis of glioma is not well-recognized in dogs. Ten dogs with at least two anatomically distinct and histologically confirmed foci of glioma were included in this study. The 10 dogs underwent 28 magnetic resonance imaging (MRI) examinations, with distant CSF drop metastasis revealed in 13 MRIs. The CSF drop metastases appeared as leptomeningeal nodules in four dogs, diffuse leptomeningeal lesions in six dogs, and ependymal lesions in seven dogs; six dogs had a combination of lesion types. Primary tumors were generally T2-heterogeneous and contrast-enhancing. Many metastases were T2-homogeneous and non-enhancing. Diffuse leptomeningeal lesions were seen as widespread extra-axial contrast-enhancement, again very dissimilar to the intra-axial primary mass. Primary masses were rostrotentorial, whereas metastases generally occurred in the direction of CSF flow, in ventricles, CSF cisterns, and the central canal or leptomeninges of the cervical or thoracolumbar spinal cord. Seven of the dogs had received therapy limited to the primary mass, such as surgery or stereotactic radiation, then developed metastasis in the following months. CSF drop metastasis of glioma may take a very different appearance on MRI to the primary mass, including periventricular lesions that are more homogeneous and less contrast-enhancing, rostral horn signal changes, or leptomeningeal enhancement ventral to the brainstem or encircling the spinal cord. |
2,331,619 | Lateral ventricular medulloepithelioma in children: a case report. | Medulloepithelioma is an extremely rare highly malignant and rapidly growing tumor that occurs in the central nervous system. There are few reports of medulloepithelioma located in the ventricle. Medulloepithelioma is common in young children and adolescence. Herein, we described an unusual case of vomiting in a 4-year-old male patient with medulloepithelioma, presenting with enlarging head circumference. Because of computed tomography (CT) scan of the head showed signs of brain tumors and hydrocephalus, and enhanced magnetic resonance imaging (MRI) sequence showed increased heterogeneity and honeycomb-like changes on the mass after the administration of a contrast agent, the patient was first diagnosed as choroid plexus papilloma. After undergoing a surgical craniotomy, the patient was diagnosed as medulloepithelioma through pathological examination. We hope that this work will provide more understanding and knowledge of intracranial medulloepithelioma. For medulloepithelioma that occurs in the central nervous system, radiological examination is not sufficient to make a definite diagnosis of the tumor. Pathological examination can confirm the diagnosis of medulloepithelioma and distinguish it from other central system tumors. Surgical resection is a safe and effective method that can prolong the life of patients. However, the prognosis of medulloepithelioma is still poor, and further research is needed to improve the diagnosis and treatment of this rare disease. |
2,331,620 | Developmental Toxicity of the Neural Tube Induced by Titanium Dioxide Nanoparticles in Mouse Embryos. | This study investigated the potential effects of Titanium dioxide nanoparticles (Tio2NPs) followed by maternal gavage on fetal development and neural tube formation during pregnancy in mice.</AbstractText>Thirty pregnant mice were randomly divided into five main study groups including the untreated control and 4 experimental groups (n=6 per group). The control group was treated with normal saline and the experimental groups were orally treated with doses of 30, 150, 300, and 500 mg/kg</i> Body Weight (BW) of Tio2NPs during pregnancy. On gestational day 16 and 19 (n=3 per group), pregnant mice were euthanized and then examined for neural tube defects and compared with control. Serial transverse sections were prepared in both cranial region and in lumbar region of spinal cord.</AbstractText>Treatment with Tio2NPs resulted in low fetal weight and short length, dilation of lateral ventricle, thinning of cerebral cortex and spinal cord, spina bifida occulta and an increase in the number of apoptotic neurons in exposed embryos at doses of 300 and 500 mg/kg</i> (p<0.05).</AbstractText>It seems that exposure to nanoparticles of Tio2 during pregnancy induces growth retardation and for the first time, teratogenicity of this nanomaterial in neural tube development and induction of defects such as spinal bifida, reduction in cortical thickness and dilatation of lateral ventricles were verified which can be related to incidence of apoptosis in central nervous system.</AbstractText>Copyright© 2021 Avicenna Research Institute.</CopyrightInformation> |
2,331,621 | Benefits of Endoscopic Sheath in Intraventricular Neuroendoscopy: Technical Note. |  The usefulness of the endoscopic sheath is underreported in the literature.</AbstractText> To explain the use of an endoscopic sheath and to highlight its benefits.</AbstractText> In addition to protecting the surrounding brain parenchyma when inserting the endoscope, the endoscopic sheath is a very useful tool to retract neurovascular structures, achieve hemostasis, and create adequate working space within narrow ventricles. The sheath can be moved within the ventricular system, and the endoscope can be moved independently within the sheath. These movements represent all the advantages of the endoscopic sheath.</AbstractText> We used an endoscopic sheath in ∼ 300 intraventricular neuroendoscopic procedures and consider the sheath an essential part of a ventriculoscopic system. Proper use of the sheath can help avoid or manage endoscopic complications.</AbstractText>Thieme. All rights reserved.</CopyrightInformation> |
2,331,622 | The stress responsive gene ankrd1a is dynamically regulated during skeletal muscle development and upregulated following cardiac injury in border zone cardiomyocytes in adult zebrafish. | Ankyrin repeat domain 1 (ANKRD1) is a functionally pleiotropic protein found in the nuclei and sarcomeres of cardiac and skeletal muscles, with a proposed role in linking myofibrilar stress and transcriptional regulation. Rapid upregulation of its expression in response to both physiological and pathological stress supports the involvement of ANKRD1 in muscle tissue adaptation and remodeling. However, the exact role of ANKRD1 remains poorly understood. To begin to investigate its function at higher resolution, we have generated and characterized a TgBAC(ankrd1a:EGFP) zebrafish line. This reporter line displays transgene expression in slow skeletal muscle fibers during development and exercise responsiveness in adult cardiac muscle. To better understand the role of Ankrd1a in pathological conditions in adult zebrafish, we assessed ankrd1a expression after cardiac ventricle cryoinjury and observed localized upregulation in cardiomyocytes in the border zone. We show that this expression in injured hearts is recapitulated by the TgBAC(ankrd1a:EGFP) reporter. Our results identify novel expression domains of ankrd1a and suggest an important role for Ankrd1a in the early stress response and regeneration of cardiac tissue. This new reporter line will help decipher the role of Ankrd1a in striated muscle stress response, including after cardiac injury. |
2,331,623 | Stereo-EEG Evaluation and Surgical Treatment in Patients With Drug-Resistant Focal Epilepsy Associated With Nodular Heterotopia. | Nodular heterotopia (NH) is a common cause of drug-resistant epilepsy. Only limited studies detail the treatment of NH with laser interstitial thermal therapy and none analyze the relation between epileptogenicity and NH location.</AbstractText>We retrospectively studied nine patients with drug-resistant epilepsy and NH who underwent stereoelectroencephalography and subsequent epilepsy surgery. Nodular heterotopia in the frontal lobes or along the bodies of the lateral ventricles was classified as anterior NH. Nodular heterotopia in the trigones, temporal or occipital horns, or temporal lobes was classified as posterior NH. Nodular heterotopia in both anterior and posterior locations was classified as diffuse NH. Interictal and ictal stereoelectroencephalography were analyzed, and patients were followed postoperatively to assess outcomes.</AbstractText>Of the six patients who underwent nine laser interstitial thermal therapy procedures either in isolation or in combination with other surgical therapies, four patients were Engel Ia, one was Engel IIb, and one was Engel IIIa, with an average follow-up of 22.8 months. All patients with posterior NH had interictal epileptiform abnormalities and seizures originating from the posterior NH. None of the patients with anterior NH had epileptiform activity recorded from their NH.</AbstractText>Laser interstitial thermal therapy alone or in combination with other surgical therapies is an effective treatment in those with drug-resistant epilepsy because of NH, even in those with extensive NH and broad seizure onset. We observed a trend suggesting that posterior NH are more likely to be epileptogenic compared with anterior NH and recommend that in patients with anterior NH, alternative epilepsy etiologies and stereoelectroencephalography implantation strategies be considered.</AbstractText>Copyright © 2021 by the American Clinical Neurophysiology Society.</CopyrightInformation> |
2,331,624 | Pre-operative embolization for staged treatment of infantile choroid plexus papilloma. | Choroid plexus papillomas (CPPs) are benign but rare neuroepithelial neoplasms of the choroid plexus that represent the non-malignant form of a spectrum of tumors of the choroid plexus. The vast majority of CPPs present in children under 5 years of age. Some CPPs are diagnosed prenatally, but many of them reach a large size before diagnosis. CPPs typically present with signs and symptoms of hydrocephalus. Treatment of these tumors has traditionally been with surgical resection. Large CPPs in young children present a challenge due to risk of high blood loss during resection. Here, the authors describe the case of a 3-month-old presenting with hydrocephalus and a large CPP of the third ventricle that was managed with a staged strategy of embolization followed by a delayed resection, allowing the tumor to involute prior to surgery. |
2,331,625 | Prognostic value of right ventricular dilatation in patients with COVID-19: a multicentre study. | Although cardiac involvement has prognostic significance in coronavirus disease 2019 (COVID-19) and is associated with severe forms, few studies have explored the prognostic role of transthoracic echocardiography (TTE). We investigated the link between TTE parameters and prognosis in COVID-19.</AbstractText>Consecutive patients with COVID-19 admitted to 24 French hospitals were retrospectively included. Comprehensive data, including clinical and biological parameters, were recorded at admission. Focused TTE was performed during hospitalization, according to clinical indication. Patients were followed for a primary composite outcome of death or transfer to intensive care unit (ICU) during hospitalization. Among 2878 patients, 445 (15%) underwent TTE. Most of these had cardiovascular risk factors, a history of cardiovascular disease, and were on cardiovascular treatments. Dilatation and dysfunction were observed in, respectively, 12% (48/412) and 23% (102/442) of patients for the left ventricle, and in 12% (47/407) and 16% (65/402) for the right ventricle (RV). Primary composite outcome occurred in 44% (n = 196) of patients [9% (n = 42) for death without ICU transfer and 35% (n = 154) for admission to ICU]. RV dilatation was the only TTE parameter associated with the primary outcome. After adjustment, male sex [hazard ratio (HR) 1.56, 95% confidence interval (CI) 1.09 - 2.25; P = 0.02], higher body mass index (HR 1.10, 95% CI 1.02 - 1.18; P = 0.01), anticoagulation (HR 0.53, 95% CI 0.33 - 0.86; P = 0.01), and RV dilatation (HR 1.66, 95% CI 1.05 - 2.64; P = 0.03) remained independently associated with the primary outcome.</AbstractText>Echocardiographic evaluation of RV dilatation could be useful for assessing risk of severe COVID-19 developing in hospitalized patients.</AbstractText>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.</CopyrightInformation> |
2,331,626 | Open-source 3D printable frameless stereotaxic system for young and adult pigs. | Here we present an open-source solution, comprising several 3D-printable mechanical pieces and software tools, for frameless stereotaxic targeting in young and adult pigs of varying weights.</AbstractText>Localization was achieved using an IR camera and CT imaging. The positions of the tools were followed, after registration of the pig stereotaxic space, with a CT scan and open-source brain atlas. The system was used to target the lateral ventricle and the subthalamic nucleus (STN) in one piglet and two adult Yucatan miniature pigs, which were either normal weight or obese.</AbstractText>Positive targeting was confirmed in the first trial for all subjects, either by radiopaque CT enhancement of the ventricle or actual recording of the STN electrophysiological signature. We conclude that open-source freely available models, easily built with low-end 3D printers, and their associated software can be effectively used for brain surgery in pigs, at a minimal cost, irrespective of the weight of the animal.</AbstractText>Copyright © 2021 Elsevier B.V. All rights reserved.</CopyrightInformation> |
2,331,627 | Early second-trimester three-dimensional transvaginal neurosonography of fetal midbrain and hindbrain: normative data and technical aspects. | To provide a detailed description of the sonographic appearance and development of various fetal structures of the midbrain and hindbrain (MBHB) during the early second trimester, and to evaluate the impact of the frequency of the transvaginal sonography (TVS) transducer on the early recognition of these structures.</AbstractText>This was a retrospective analysis of three-dimensional volumetric datasets of the MBHB from apparently normal fetuses at 14-19 gestational weeks, acquired by TVS in the midsagittal view through the posterior fontanelle. Using a multiplanar approach, we measured the tectal thickness and length, aqueductal thickness, tegmental thickness and width and height of the Blake's pouch (BP) neck. In addition, we assessed the existence of early vermian fissures, the linear shape of the brainstem and the components of the fastigium. The correlation between gestational age according to last menstrual period and sonographic measurements of MBHB structures was evaluated using Pearson's correlation (r). A subanalysis was performed to assess the performance of a 5-9-MHz vs a 6-12-MHz TVS transducer in visualizing the MBHB structures in the early second trimester.</AbstractText>Sixty brain volumes were included in the study, obtained at a mean gestational age of 16.2 weeks (range, 14.1-19.0 weeks), with a transverse cerebellar diameter range of 13.0-19.8 mm. We found a strong correlation between gestational age and all MBHB measurements, with the exception of the tectal, tegmental and aqueductal thicknesses, for which the correlation was moderate. There was good-to-excellent intraobserver and moderate-to-good interobserver correlation for most MBHB measurements. We observed that the BP neck was patent in all fetuses between 14 and 18 weeks with decreasing diameter, and that the aqueductal thickness was significantly smaller at ≥ 18 weeks compared with at < 16 weeks. The early vermian fissures and the linear shape of the brainstem were present in all fetuses from 14 weeks. We found that, in the early second trimester, the horizontal arm of the presumed 'fastigium' evolves from the fourth ventricular choroid plexus and not the posterior vermis, indicating that this is not the fastigium. Standard- and high-resolution TVS transducers performed similarly in the assessment of MBHB anatomy.</AbstractText>Detailed early second-trimester assessment of the MBHB is feasible by transvaginal neurosonography and provides reference data which may help in the early detection of brain pathology involving the MBHB. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.</AbstractText>© 2021 International Society of Ultrasound in Obstetrics and Gynecology.</CopyrightInformation> |
2,331,628 | Acute effect of thymoquinone on action potential and ionic currents of rat cardiac myocytes. | This study aims to investigate the acute effects of thymoquinone (TQ) which has been suggested to be a cardioprotective agent, on ventricular myocytes.</AbstractText>Freshly isolated rat ventricular myocytes were exposed to TQ and using standard whole-cell patch-clamp technique action potential (AP), sodium current (INa), L-type calcium current (ICaL) and transient outward potassium current (Ito) were measured.</AbstractText>TQ prolonged the duration of AP and decreased the peak value compared to that of control myocytes. Consistently, it inhibited INa in a concentration-dependent manner and shifted the channel kinetics to more hyperpolarized voltages. Besides, TQ not only inhibited Ito and ICaL but also significantly attenuated the isoproterenol-induced increase in ICaL.</AbstractText>The effect of TQ on cardiomyocytes has been demonstrated for the first time. TQ changes AP morphology along with ionic currents and alleviates β-adrenergic response in adult ventricular myocytes. These results indicate that TQ may be considered as a therapeutic agent in cases such as diabetic cardiomyopathy and cardiac hypertrophy, wherein the β-adrenergic system is over-activated (Tab. 2, Fig. 6, Ref. 30).</AbstractText> |
2,331,629 | Kidins220 deficiency causes ventriculomegaly via SNX27-retromer-dependent AQP4 degradation. | Several psychiatric, neurologic and neurodegenerative disorders present increased brain ventricles volume, being hydrocephalus the disease with the major manifestation of ventriculomegaly caused by the accumulation of high amounts of cerebrospinal fluid (CSF). The molecules and pathomechanisms underlying cerebral ventricular enlargement are widely unknown. Kinase D interacting substrate of 220 kDa (KIDINS220) gene has been recently associated with schizophrenia and with a novel syndrome characterized by spastic paraplegia, intellectual disability, nystagmus and obesity (SINO syndrome), diseases frequently occurring with ventriculomegaly. Here we show that Kidins220, a transmembrane protein effector of various key neuronal signalling pathways, is a critical regulator of CSF homeostasis. We observe that both KIDINS220 and the water channel aquaporin-4 (AQP4) are markedly downregulated at the ventricular ependymal lining of idiopathic normal pressure hydrocephalus (iNPH) patients. We also find that Kidins220 deficient mice develop ventriculomegaly accompanied by water dyshomeostasis and loss of AQP4 in the brain ventricular ependymal layer and astrocytes. Kidins220 is a known cargo of the SNX27-retromer, a complex that redirects endocytosed plasma membrane proteins (cargos) back to the cell surface, thus avoiding their targeting to lysosomes for degradation. Mechanistically, we show that AQP4 is a novel cargo of the SNX27-retromer and that Kidins220 deficiency promotes a striking and unexpected downregulation of the SNX27-retromer that results in AQP4 lysosomal degradation. Accordingly, SNX27 silencing decreases AQP4 levels in wild-type astrocytes whereas SNX27 overexpression restores AQP4 content in Kidins220 deficient astrocytes. Together our data suggest that the KIDINS220-SNX27-retromer-AQP4 pathway is involved in human ventriculomegaly and open novel therapeutic perspectives. |
2,331,630 | Causal relationship of CA3 back-projection to the dentate gyrus and its role in CA1 fast ripple generation. | Pathophysiological evidence from temporal lobe epilepsy models highlights the hippocampus as the most affected structure due to its high degree of neuroplasticity and control of the dynamics of limbic structures, which are necessary to encode information, conferring to it an intrinsic epileptogenicity. A loss in this control results in observable oscillatory perturbations called fast ripples, in epileptic rats those events are found in CA1, CA3, and the dentate gyrus (DG), which are the principal regions of the trisynaptic circuit of the hippocampus. The present work used Granger causality to address which relationships among these three regions of the trisynaptic circuit are needed to cause fast ripples in CA1 in an in vivo model. For these purposes, male Wistar rats (210-300 g) were injected with a single dose of pilocarpine hydrochloride (2.4 mg/2 µl) into the right lateral ventricle and video-monitored 24 h/day to detect spontaneous and recurrent seizures. Once detected, rats were implanted with microelectrodes in these regions (fixed-recording tungsten wire electrodes, 60-μm outer diameter) ipsilateral to the pilocarpine injection. A total of 336 fast ripples were recorded and probabilistically characterized, from those fast ripples we made a subset of all the fast ripple events associated with sharp-waves in CA1 region (n = 40) to analyze them with Granger Causality.</AbstractText>Our results support existing evidence in vitro in which fast ripple events in CA1 are initiated by CA3 multiunit activity and describe a general synchronization in the theta band across the three regions analyzed DG, CA3, and CA1, just before the fast ripple event in CA1 have begun.</AbstractText>This in vivo study highlights the causal participation of the CA3 back-projection to the DG, a connection commonly overlooked in the trisynaptic circuit, as a facilitator of a closed-loop among these regions that prolongs the excitatory activity of CA3. We speculate that the loss of inhibitory drive of DG and the mechanisms of ripple-related memory consolidation in which also the CA3 back-projection to DG has a fundamental role might be underlying processes of the fast ripples generation in CA1.</AbstractText> |
2,331,631 | Comparison of IQOS (heated tobacco) and cigarette smoking on cardiac functions by two-dimensional speckle tracking echocardiography. | IQOS is a novel tobacco product claimed to be safer than conventional cigarette smoking due to the heat-not-burn system. This study aimed to evaluate the acute effects of IQOS smoking on myocardial systolic and diastolic functions and also compare the acute impacts of IQOS with cigarette smoking.</AbstractText>In this prospective study, twenty-seven healthy participants who were using IQOS were included. Transthoracic echocardiography was performed three times for each participant; before smoking any tobacco product (group1), after IQOS smoking (group 2), after cigarette smoking (group3). In addition to conventional echocardiographic measurements, left ventricle (LV) and right ventricle (RV) strain analyses were performed by speckle tracking echocardiography.</AbstractText>In comparison with non-smoking status, LV global longitudinal strain (GLS) decreased after IQOS and cigarette smoking (-18.9 ± 2.4% in baseline vs. -17.9 ± 2.4% in IQOS vs. -17.9 ± 2.8% in cigarette smoking; p = 0.003, p = 0.001; respectively). LV global circumferential strain (GCS) reduced after IQOS and cigarette smoking (-19.8 ± 4.4% in baseline vs. -18.3 ± 3.9% in IQOS vs. -17.5 ± 3.9% in cigarette smoking; p = 0.005, p < 0.001; respectively). RV GLS was significantly lower in groups smoking IQOS and cigarette (-23.2 ± 4.6% in baseline vs. -21.4 ± 4.1% in IQOS vs. -19.4 ± 4.1% in cigarette smoking; p < 0.001, p = 0.001; respectively).</AbstractText>IQOS (heat-not-burn) tobacco smoking impairs myocardial systolic and diastolic functions in the acute phase like conventional cigarette smoking. The use of IQOS is rising among young adults in recent years, so further studies should be designed to evaluate the chronic effects of IQOS on myocardial function.</AbstractText>Copyright © 2021 Elsevier Inc. All rights reserved.</CopyrightInformation> |
2,331,632 | Neurons and Astrocytes in Ventrolateral Periaqueductal Gray Contribute to Restraint Water Immersion Stress-Induced Gastric Mucosal Damage via the ERK1/2 Signaling Pathway. | The restraint water immersion stress (RWIS) model includes both psychological and physical stimulation, which may lead to gastrointestinal disorders and cause gastric mucosal damage. The ventrolateral periaqueductal gray (VLPAG) contributes to gastrointestinal function, but whether it is involved in RWIS-induced gastric mucosal damage has not yet been reported.</AbstractText>The expression of glial fibrillary acidic protein, neuronal c-Fos, and phosphorylated extracellular signal regulated kinase 1/2 in the VLPAG after RWIS was assessed using western blotting and immunocytochemical staining methods. Lateral ventricle injection of astrocytic toxin L-a-aminoadipate and treatment with extracellular signal-regulated kinase (ERK)1/2 signaling pathway inhibitor PD98059 were further used to study protein expression and distribution in the VLPAG after RWIS.</AbstractText>The expression of c-Fos, glial fibrillary acidic protein, and phosphorylated extracellular signal regulated kinase 1/2 in the VLPAG significantly increased following RWIS and peaked at 1 hour after RWIS. Lateral ventricle injection of the astrocytic toxin L-a-aminoadipate significantly alleviated gastric mucosal injury and decreased the activation of neurons and astrocytes. Treatment with the ERK1/2 signaling pathway inhibitor PD98059 obviously suppressed gastric mucosal damage as well as the RWIS-induced activation of neurons and astrocytes in the VLPAG.</AbstractText>These results suggested that activation of VLPAG neurons and astrocytes induced by RWIS through the ERK1/2 signaling pathway may play a critical role in RWIS-induced gastric mucosa damage.</AbstractText>© The Author(s) 2021. Published by Oxford University Press on behalf of CINP.</CopyrightInformation> |
2,331,633 | Lower-body dynamic exercise reduces wave reflection in healthy young adults. | What is the central question of this study? There is a paradoxical reduction in augmentation index during lower-body dynamic (LBD) exercise in the face of an increase in central pressure. To determine causality, the amplitudes of forward and backward pressure waves were assessed separately using wave separation analysis. What is the main finding and its importance? Reflection magnitude decreased during LBD exercise in healthy young adults and was attributable to an increased forward pressure wave amplitude and decreased backward pressure wave amplitude. This vasoactive response might limit the adverse effects of wave reflection during LBD exercise, optimizing ventricular-arterial interactions.</AbstractText>Acute lower-body dynamic (LBD) exercise decreases surrogate measures of wave reflection, such as the augmentation index. However, the augmentation index is influenced by the combined effects of wave reflection timing, magnitude and other confounding factors external to wave reflection, which make it difficult to discern the origin of changes in surrogate measures. The relative contributions of forward (Pf) and backward (Pb) pressure wave amplitudes to central pressure can be determined by wave separation analysis. Reflection magnitude (RM = Pb/Pf) and the timing of apparent wave reflection return can also be determined. We tested the hypothesis that acute LBD exercise decreases RM and reflected wave transit time (RWTT). Applanation tonometry was used to record radial artery pressure waveforms in 25 adults (24 ± 4 years of age) at baseline and during light-, moderate- and vigorous-intensity exercise. Wave separation analysis was conducted offline using a personalized physiological flow wave to determine Pf, Pb, RM and RWTT. The RM decreased during all intensities of exercise compared with baseline (all P < 0.001; baseline, 43 ± 5%; light, 33 ± 6%; moderate, 23 ± 7%; vigorous, 17 ± 5%). The reduction in RM was attributable to the combined effect of increased Pf and decreased Pb during exercise. The RWTT decreased during all intensities of exercise compared with baseline (all P < 0.04; baseline, 156 ± 17 ms; light, 144 ± 15 ms; moderate, 129 ± 16 ms; vigorous, 121 ± 17 ms). Lastly, in a stepwise multilinear regression, Pf, but not Pb and RWTT, contributed to increased central pulse pressure during LBD exercise. These data show that wave reflection decreased and that central pulse pressure is most influenced by Pf during LBD exercise.</AbstractText>© 2021 The Authors. Experimental Physiology © 2021 The Physiological Society.</CopyrightInformation> |
2,331,634 | Mutations in HID1 Cause Syndromic Infantile Encephalopathy and Hypopituitarism. | Precursors of peptide hormones undergo posttranslational modifications within the trans-Golgi network (TGN). Dysfunction of proteins involved at different steps of this process cause several complex syndromes affecting the central nervous system (CNS). We aimed to clarify the genetic cause in a group of patients characterized by hypopituitarism in combination with brain atrophy, thin corpus callosum, severe developmental delay, visual impairment, and epilepsy.</AbstractText>Whole exome sequencing was performed in seven individuals of six unrelated families with these features. Postmortem histopathological and HID1 expression analysis of brain tissue and pituitary gland were conducted in one patient. Functional consequences of the homozygous HID1 variant p.R433W were investigated by Seahorse XF Assay in fibroblasts of two patients.</AbstractText>Bi-allelic variants in the gene HID1 domain-containing protein 1 (HID1) were identified in all patients. Postmortem examination confirmed cerebral atrophy with enlarged lateral ventricles. Markedly reduced expression of pituitary hormones was found in pituitary gland tissue. Colocalization of HID1 protein with the TGN was not altered in fibroblasts of patients compared to controls, while the extracellular acidification rate upon stimulation with potassium chloride was significantly reduced in patient fibroblasts compared to controls.</AbstractText>Our findings indicate that mutations in HID1 cause an early infantile encephalopathy with hypopituitarism as the leading presentation, and expand the list of syndromic CNS diseases caused by interference of TGN function. ANN NEUROL 2021;90:149-164.</AbstractText>© 2021 The Authors. Annals of Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.</CopyrightInformation> |
2,331,635 | Ependymal ciliary motion and their role in congenital hydrocephalus. | Since a case of hydrocephalus in humans considered to be caused by ciliary dysfunction was first reported by Greenstone et al. in 1984, numerous papers on the correlation between ciliary function and hydrocephalus have been published.</AbstractText>We reviewed the published literature on primary ciliary dyskinesia in humans causing hydrocephalus, focusing on articles specifically examining the relation between ciliary function and hydrocephalus and its treatment. In addition, the authors' experience is briefly discussed.</AbstractText>Full texts of 16 articles reporting cases of human hydrocephalus (including ventriculomegaly) due to defects in ependymal ciliary function or primary ciliary dyskinesia observed in clinical practice were extracted. In recent years, studies on animal models, especially employing knockout mice, have revealed genetic mutations that cause hydrocephalus via ciliary dysfunction. However, a few reports on the onset of hydrocephalus in human patients with primary ciliary dyskinesia have confirmed that the incidence of this condition was extremely low compared to that in animal models.</AbstractText>In humans, it is rare for hydrocephalus to develop solely because of abnormalities in the cilia, and it is highly likely that other factors are also involved along with ciliary dysfunction.</AbstractText>© 2021. The Author(s).</CopyrightInformation> |
2,331,636 | [Myocardial infarction in a patient with a single ventricle of the heart]. | A clinical case of myocardial infarction in a patient with single ventricle heart defect is described. |
2,331,637 | Endoscopic Assistance in the Deep and Narrow Spaces of the Brain-Microscopic Tumor Surgery Supported by the New Micro-Inspection Tool QEVO® (Technical Note). | <b>Introduction:</b> To evaluate the feasibility and efficacy of the innovative micro-inspection tool QEVO® (Carl Zeiss Meditec, Oberkochen, Germany) as an endoscopic adjunct to microscopes for better visualization of the surgical field in complex deep-seated intracranial tumors in infants and adults. <b>Materials and Methods:</b> We retrospectively assessed the surgical videos of 25 consecutive patients with 26 complex intracranial lesions (time frame 2018-2020). Lesions were classified according to their anatomical area: 1 = sellar region (<i>n</i> = 6), 2 = intra-ventricular (except IV.ventricle, <i>n</i> = 9), 3 = IV.ventricle and rhomboid fossa (<i>n</i> = 4), and 4 = cerebellopontine angle (CPA) and foramen magnum (<i>n</i> = 7). Indications to use the QEVO® tool were divided into five "QEVO® categories": A = target localization, B = tailoring of the approach, C = looking beyond the lesion, D = resection control, and E = inspection of remote areas. <b>Results:</b> Overall, the most frequent indications for using the QEVO® tool were categories D (<i>n</i> = 19), C (<i>n</i> = 17), and E (<i>n</i> = 16). QEVO® categories B (<i>n</i> = 8) and A (<i>n</i> = 5) were mainly applied to intra-ventricular procedures (anatomical area 2). <b>Discussion:</b> The new micro-inspection tool QEVO® is a powerful endoscopic device to support the comprehensive visualization of complex intracranial lesions and thus instantly increases intraoperative morphological understanding. However, its use is restricted to the specific properties of the respective anatomical area. |
2,331,638 | Case Report: An Adult Patient With Deficiency of Adenosine Deaminase 2 Resembled Unilateral Frosted Branch Angiitis. | <b>Purpose:</b> Deficiency of adenosine deaminase 2 (DADA2) is a rare autosomal recessive systemic autoinflammatory disorder. We describe a rare case of an adult patient with DADA2 who presented with unilateral frosted branch angiitis (FBA) combined with branch retinal vein occlusion and panuveitis. <b>Method:</b> This paper is a clinical case report. <b>Results:</b> A 31-year-old male patient complained of blurred vision in his right eye for 2 days. His fundus examination showed FBA combined with branch retinal vein occlusion and panuveitis. He had a medical history of intermittent and recurrent fever, skin rash and aphthous ulcer for 5 years, and lacunar infarction for 1 month. Laboratory examinations showed hypogammaglobulinemia and mild prolonged activated partial thromboplastin time (APTT). Brain magnetic resonance imaging (MRI) revealed old lacunar infarction in the right basal ganglia and the lateral ventricle and fresh lacunar infarction in the right pons, respectively. The perivascular sheathing of FBA and macular edema were resolved after steroid administration and treatment of intravitreal anti-VEGF injection. During the period of follow-up, the patient subsequently suffered from recurrence of strokes, abnormality of coagulation function, sudden hearing loss of the left ear, and diplopia. His gene sequencing results demonstrated several deletion mutations in <i>ADA2</i>, and the diagnosis of DADA2 was eventually confirmed. <b>Conclusions:</b> FBA represents a very rare ocular feature of DADA2 and may in some cases be the presenting manifestation. Therefore, ophthalmologists need to be aware of this rare autoinflammatory disease. |
2,331,639 | Case Report: Aicardi-Goutières Syndrome Caused by Novel TREX1 Variants. | TREX1 (three prime repair exonuclease 1) gene encodes DNA 3' end repair exonuclease that plays an important role in DNA repair. Mutations in TREX1 gene have been identified as the cause of a rare autoimmune neurological disease, Aicardi-Goutières syndrome (AGS). Here, we report an AGS case of a 6-month-old Chinese girl with novel TREX1 variants. The patient had mild rashes on the face and legs, increased muscle tensions in the limbs, and positive cervical correction reflex. Cranial magnetic resonance imaging showed that there were patches of slightly longer T1 and T2 signals in the bilateral cerebral hemisphere and brainstem white matter, mainly in the frontotemporal lobe, together with decreased white matter volume, enlarged ventricles, and widened sulcus fissure. Total exon sequencing showed that the TREX1 gene of the child had mutations of c.137_138insC and c.292_293insA, which had not been reported before. In addition, elevated type I interferons were detected by using enzyme-linked immunosorbent assay in the patient's serum. Together, our study demonstrated that novel TREX1 variants (c.137_138insC and c.292_293insA) cause AGS for the first time. |
2,331,640 | Enlarging Ventriculus Terminalis in a Patient With Polyarteritis Nodosa. | Ventriculus terminalis (VT) is a cystic embryological remnant within the conus medullaris that normally regresses after birth. In rare cases, it may persist into adulthood and give rise to neurologic symptoms. The pathogenesis remains unclear but is thought to be related to failed embryonic regression with other proposed possible etiologies including vascular disturbances. We present an intriguing case of a slow-growing VT in a woman with progressive neurologic symptoms who experiences symptomatic relief following thoracic laminectomy and fenestration. Our case is the first to present a unique association with polyarteritis nodosa and only the third to report a case of documented enlargement of the VT over time successfully treated with surgical fenestration. |
2,331,641 | Isolated cerebral Rosai-Dorfman disease presenting as a sole mass protruding into the fourth ventricle: A case report. | Rosai-Dorfman disease is a non-Langherans cell histiocytosis typically revealed by a lymphadenopathy. Central nervous system involvement is rare, exceptionally isolated, and usually consists of dural masses mimicking meningioma. Very few reports have described non-dural-based lesions, especially with an intra-ventricular development. We report hereby the case of a Rosai-Dorfman disease in a 30-year-old man presenting as an isolated mass arising from the right cerebellar peduncle and protruding into the fourth ventricle. We provide the results of the MRI examination with a special focus on advanced MRI features. As the diagnosis relies on pathological examination, we also detail the results of the analysis that followed the surgical resection of the mass including the immunohistochemical profile. This report highlights the necessity to consider Rosai-Dorfman disease as a potential diagnosis in case of an infra-tentorial mass and/or intra-ventricular mass. |
2,331,642 | Nosological Differences in the Nature of Punctate White Matter Lesions in Preterm Infants. | <b>Background:</b> The pathogenesis of punctuate white matter lesions (PWMLs), a mild form of white matter damage observed in preterm infants, is still a matter of debate. Susceptibility-weighted imaging (SWI) allows to differentiate PWMLs based on the presence (SWI+) or absence (SWI-) of hemosiderin, but little is known about the significance of this distinction. This retrospective study aimed to compare neuroradiological and clinical characteristics of SWI+ and SWI- PWMLs. <b>Materials and Methods:</b> MR images of all VLBW infants scanned consecutively at term-equivalent age between April 2012 and May 2018 were retrospectively reviewed, and infants with PWMLs defined as small areas of high T1 and/or low T2 signal in the periventricular white matter were selected and included in the study. Each lesion was analyzed separately and characterized by localization, organization pattern, and distance from the lateral ventricle. Clinical data were retrieved from the department database. <b>Results:</b> A total of 517 PWMLs were registered in 81 patients, with 93 lesions (18%) visible on SWI (SWI+), revealing the presence of hemosiderin deposits. On univariate analysis, compared to SWI- PWML, SWI+ lesions were closer to the ventricle wall, more frequently organized in linear pattern and associated with lower birth weight, lower gestational age, lower admission temperature, need for intubation, bronchopulmonary dysplasia, retinopathy of prematurity, and presence of GMH-IVH. On multivariate analysis, closer distance to the ventricle wall on axial scan and lower birth weight were associated with visibility of PMWLs on SWI (<i>p</i> = 0.003 and <i>p</i> = 0.0001, respectively). <b>Conclusions:</b> Our results suggest a nosological difference between SWI+ and SWI- PWMLs. Other prospective studies are warranted to corroborate these observations. |
2,331,643 | Cardiac Resynchronization Therapy Remote Monitoring - COVID-19 Pandemic Experiences and Future Perspectives. | Cardiac resynchronization therapy (CRT) is a well-established form of the treatment for heart failure (HF) in patients with left ventricle contraction dyssynchrony. Apart from typical in-office management, remote monitoring enables constant surveillance on both the patient's and the device's condition. This way, in case of any problems, clinical decisions could be made earlier leading to better outcome of CRT patients. COVID-19 pandemic with following lockdowns in many countries resulted in getting more attention on remote monitoring systems. The aim of this paper was to gather and summarize worldwide experiences from CRT remote monitoring during COVID-19 pandemic and point out future possibilities for HF patients treated with CRT. Already published experiences from remote monitoring of CRT devices during COVID-19 restrictions confirmed previous advantages of telemedical approach, however, more publications in this area would be helpful. |
2,331,644 | Intraventricular haemorrhage and posthaemorrhagic ventricular dilatation: moving beyond CSF diversion. | Advances in medical care have led to more premature babies surviving the neonatal period. In these babies, germinal matrix haemorrhage (GMH), intraventricular haemorrhage (IVH) and posthaemorrhagic ventricular dilatation (PHVD) are the most important determinants of long-term cognitive and developmental outcomes. In this review, we discuss current neurosurgical management of IVH and PHVD, including the importance of early diagnosis of PHVD, thresholds for intervention, options for early management through the use of temporising measures and subsequent definitive CSF diversion. We also discuss treatment options for the evolving paradigm to manage intraventricular blood and its breakdown products. We review the evidence for techniques such as drainage, irrigation, fibrinolytic therapy (DRIFT) and neuroendoscopic lavage in the context of optimising cognitive, neurodevelopmental and quality of life outcomes in these premature infants. |
2,331,645 | Renal denervation prevents myocardial structural remodeling and arrhythmogenicity in a chronic kidney disease rabbit model. | The electrophysiological (EP) effects and safety of renal artery denervation (RDN) in chronic kidney disease (CKD) are unclear.</AbstractText>The purpose of this study was to investigate the arrhythmogenicity of RDN in a rabbit model of CKD.</AbstractText>Eighteen New Zealand white rabbits were randomized to control (n = 6), CKD (n = 6), and CKD-RDN (n = 6) groups. A 5/6 nephrectomy was selected for the CKD model. RDN was applied in the CKD-RDN group. All rabbits underwent cardiac EP studies for evaluation. Immunohistochemistry, myocardial fibrosis, and renal catecholamine levels were evaluated.</AbstractText>The CKD group (34.8% ± 9.2%) had a significantly higher ventricular arrhythmia (VA) inducibility than the control (8.6% ± 3.8%; P <.01) and CKD-RDN (19.5% ± 6.3%; P = .01) groups. In the CKD-RDN group, ventricular fibrosis was significantly decreased compared to the CKD group (7.4% ± 2.0 % vs 10.4% ± 3.7%; P = .02). Sympathetic innervation in the CKD group was significantly increased compared to the control and CKD-RDN groups [left ventricle: 4.1 ± 1.8 vs 0.8 ± 0.5 (102</sup> μm2</sup>/mm2</sup>), P <.01; 4.1 ± 1.8 vs 0.9± 0.6 (102</sup> μm2</sup>/mm2</sup>), P <.01; right ventricle: 3.6 ± 1.0 vs 1.0 ± 0.4 (102</sup> μm2</sup>/mm2</sup>), P <.01; 3.6 ± 1.0 vs 1.0 ± 0.5 (102</sup> μm2</sup>/mm2</sup>), P <.01].</AbstractText>Neuromodulation by RDN demonstrated protective effects with less structural and electrical remodeling, leading to attenuated VAs. In a rabbit model of CKD, RDN plays a therapeutic role by lowering the risk of VA caused by autonomic dysfunction.</AbstractText>Copyright © 2021 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.</CopyrightInformation> |
2,331,646 | Large lateral intraventricular tumors - Outcome of radical surgery. | This is a retrospective analysis of 145 cases of lateral intraventricular tumors that were larger than 4 cm in their maximum dimension. The aim of surgery was radical tumor resection. During the period January 2000 to December 2019, 145 cases of lateral intraventricular tumors were treated by surgery by an interhemispheric approach. There were 101 males and 44 females. The ages of the patients ranged from 2 months to 77 years (average 29 years). Histological examination of tumors identified 73 central neurocytomas, 20 choroid plexus papillomas, 23 subependymal giant cell astrocytomas (SEGA), 5 ependymomas, 21 gliomas, 2 primitive neuroectodermal tumors (PNET/embryonal tumors) and 1 atypical teratoid rhabdoid tumor (ATRT). Nineteen patients had mild to severe hemiparesis in the immediate post-operative period. Eight patients died in the postoperative period. At a follow up of 1 year 137 patients were leading active and symptom free lives. Twenty seven patients received adjuvant radiation treatment. At a follow-up of more than 3 years, 8 additional patients died of their disease. Tumor recurrence or re-growth was observed in 13 patients and 2 patients needed reoperation. Surgery on large lateral intraventricular tumors can be associated with significant postoperative morbidity and mortality. Majority of tumors in this location are relatively 'low-grade' malignant tumors and when successfully treated, the long term outcome can be gratifying. |
2,331,647 | The splenial angle: a novel radiological index for idiopathic normal pressure hydrocephalus. | To evaluate the utility of the splenial angle (SA), an axial angular index of lateral ventriculomegaly measured on diffusion tensor MRI color fractional anisotropy maps, in differentiating NPH from Alzheimer's disease (AD), Parkinson's disease (PD), and healthy controls (HC), and post-shunt changes in NPH, compared to Evans' index and callosal angle.</AbstractText>Evans' index, callosal angle, and SA were measured on brain MRI of 76 subjects comprising equal numbers of age- and sex-matched subjects from each cohort of NPH, AD, PD, and HC by two raters. Receiver operating characteristics (ROC) and multivariable analysis were used to assess the screening performance of each measure in differentiating and predicting NPH from non-NPH groups respectively. Temporal changes in the measures on 1-year follow-up MRI in 11 NPH patients (with or without ventriculoperitoneal shunting) were also assessed.</AbstractText>Inter-rater and intra-rater reliability were excellent for all measurements (intraclass correlation coefficients > 0.9). Pairwise comparison showed that SA was statistically different between NPH and AD/PD/HC subjects (p < 0.0001). SA performed the best in predicting NPH, with an area under the ROC curve of > 0.98, and was the only measure left in the final model of the multivariable analysis. Significant (p < 0.01) change in SA was seen at follow-up MRI of NPH patients who were shunted compared to those who were not.</AbstractText>The SA is readily measured on axial DTI color FA maps compared to the callosal angle and shows superior performance differentiating NPH from neurodegenerative disorders and sensitivity to ventricular changes in NPH after surgical intervention.</AbstractText>• The splenial angle is a novel simple angular radiological index proposed for idiopathic normal pressure hydrocephalus, measured in the ubiquitous axial plane on DTI color fractional anisotropy maps. • The splenial angle quantitates the compression and stretching of the posterior callosal commissural fibers alongside the distended lateral ventricles in idiopathic normal pressure hydrocephalus (NPH) using tools readily accessible in clinical practice and shows excellent test-retest reliability. • Splenial angle outperforms Evans' index and callosal angle in predicting NPH from healthy, Parkinson's disease, and Alzheimer's disease subjects on ROC analysis with an area under the curve of > 0.98 and is sensitive to morphological ventricular changes in NPH patients after ventricular shunting.</AbstractText>© 2021. The Author(s).</CopyrightInformation> |
2,331,648 | Endoscopic third ventriculostomy and choroid plexus cauterization (ETV/CPC) for hydrocephalus of infancy: a technical review. | In the twenty-first century, choroid plexus cauterization (CPC) in combination with endoscopic third ventriculostomy (ETV) has emerged as an effective treatment for some infants with hydrocephalus, leading to the favourable condition of 'shunt independence'. Herein we provide a narrative technical review considering the indications, procedural aspects, morbidity and its avoidance, postoperative care and follow-up. The CP has been the target of hydrocephalus treatment for more than a century. Early eminent neurosurgeons including Dandy, Putnam and Scarff performed CPC achieving generally poor results, and so the procedure fell out of favour. In recent years, the addition of CPC to ETV was one of the reasons greater ETV success rates were observed in Africa, compared to developed nations, and its popularity worldwide has since increased. Initial results indicate that when ETV/CPC is performed successfully, shunt independence is more likely than when ETV is undertaken alone. CPC is commonly performed using a flexible endoscope via septostomy and aims to maximally cauterize the CP. Success is more likely in infants aged >1 month, those with hydrocephalus secondary to myelomeningocele and aqueductal obstruction and those with >90% cauterized CP. Failure is more likely in those with post-haemorrhagic hydrocephalus of prematurity (PHHP), particularly those <1 month of corrected age and those with prepontine scarring. High-quality evidence comparing the efficacy of ETV/CPC with shunting is emerging, with data from ongoing and future trials offering additional promise to enhance our understanding of the true utility of ETV/CPC. |
2,331,649 | Intracardiac Echocardiography to Guide Catheter Ablation of Idiopathic Ventricular Arrythmias. | Catheter ablation is the most effective treatment option for idiopathic ventricular arrhythmias. Intracardiac echocardiography (ICE) has been increasingly used during ablation procedures, allowing real-time visualization of cardiac anatomy, and improving our understanding of the relationships between different cardiac structures. In this article we review the adjuvant role of ICE to guide mapping and ablation of ventricular arrhythmias in the structurally normal heart. |
2,331,650 | Spatiotemporal control of cell cycle acceleration during axolotl spinal cord regeneration. | Axolotls are uniquely able to resolve spinal cord injuries, but little is known about the mechanisms underlying spinal cord regeneration. We previously found that tail amputation leads to reactivation of a developmental-like program in spinal cord ependymal cells (Rodrigo Albors et al., 2015), characterized by a high-proliferation zone emerging 4 days post-amputation (Rost et al., 2016). What underlies this spatiotemporal pattern of cell proliferation, however, remained unknown. Here, we use modeling, tightly linked to experimental data, to demonstrate that this regenerative response is consistent with a signal that recruits ependymal cells during ~85 hours after amputation within ~830 μm of the injury. We adapted Fluorescent Ubiquitination-based Cell Cycle Indicator (FUCCI) technology to axolotls (AxFUCCI) to visualize cell cycles in vivo. AxFUCCI axolotls confirmed the predicted appearance time and size of the injury-induced recruitment zone and revealed cell cycle synchrony between ependymal cells. Our modeling and imaging move us closer to understanding <i>bona fide</i> spinal cord regeneration. |
2,331,651 | Adult neurogenic process in the subventricular zone-olfactory bulb system is regulated by Tau protein under prolonged stress. | The area of the subventricular zone (SVZ) in the adult brain exhibits the highest number of proliferative cells, which, together with the olfactory bulb (OB), maintains constant brain plasticity through the generation, migration and integration of newly born neurons. Despite Tau and its malfunction is increasingly related to deficits of adult hippocampal neurogenesis and brain plasticity under pathological conditions [e.g. in Alzheimer's disease (AD)], it remains unknown whether Tau plays a role in the neurogenic process of the SVZ and OB system under conditions of chronic stress, a well-known sculptor of brain and risk factor for AD.</AbstractText>Different types of newly born cells in SVZ and OB were analysed in animals that lack Tau gene (Tau-KO) and their wild-type littermates (WT) under control or chronic stress conditions.</AbstractText>We demonstrate that chronic stress reduced the number of proliferating cells and neuroblasts in the SVZ leading to decreased number of newborn neurons in the OB of adult WT, but not Tau-KO, mice. Interestingly, while stress-evoked changes were not detected in OB granular cell layer, Tau-KO exhibited increased number of mature neurons in this layer indicating altered neuronal migration due to Tau loss.</AbstractText>Our findings suggest the critical involvement of Tau in the neurogenesis suppression of SVZ and OB neurogenic niche under stressful conditions highlighting the role of Tau protein as an essential regulator of stress-driven plasticity deficits.</AbstractText>© 2021 The Authors. Cell Proliferation published by John Wiley & Sons Ltd.</CopyrightInformation> |
2,331,652 | Cerebrospinal fluid and intraoperative squash cytology of childhood ependymoma. | Ependymomas are glial neoplasms of central nervous system originated from the ependymal lining of the brain ventricles and spinal cord central canal, and rarely exfoliated into cerebrospinal fluid (CSF). In this case we report the cytomorphological and immunocytomorphological features of ependymoma in CSF and intraoperative squash preparations, confirmed by histology. Case report. The patient  was a nineteen months old female presented at the University hospital of Heraklion, Crete, in a hemicoma, and was intubated. Computed tomography, scanning and magnetic resonance imaging (MRI), were performed and a mass in the posterior fossa was found. A sample of cerebrospinal fluid (CSF) was sent for cytologic evaluation. A diagnosis of ependymoma was rendered, followed by tumor resection, during which intraoperative squash smears for cytologic interpretation were obtained. Cytological consultation disclosed a grade II ependymoma (WHO grade II), with focally anaplastic features (WHO grade III). |
2,331,653 | Impact of Viral PCR Positive Nasal Swabs (Non Covid-19) on Outcomes Following Cardiac Surgery. | Viral bronchiolitis is a relative contraindication to elective pediatric cardiac surgery. Nasopharyngeal swab utilizing polymerase chain reaction (PCR) screening for viruses known to cause bronchiolitis are commonly available. The objective of this study was to evaluate clinical outcomes in patients with nasopharyngeal viral PCR positive findings at the time of cardiac surgery. Retrospective review from January 2013 to May 2019 for patients with virus detected by PCR on nasopharyngeal swabs at the time of cardiac surgery. Single ventricle and two ventricle patients were compared to control group of age and procedure matched patients viral negative at the time of surgery. Outcome measures included OR extubation, reintubation, hospital length of stay, and mortality. For two ventricle patients (n = 81; control group = 165), there was no statistical difference in any outcome variable (OR extubation 74% vs 72%; p = 0.9; reintubation 9% vs 11% vs; p = 0.7; hospital length of stay 5 days (1-46) vs 4 days (2-131); p = 0.4; mortality 2 vs 1; p = 0.3). For single ventricle patients, there was no statistical difference in any outcome variable (OR extubation 81% vs 76%; p = 0.6; reintubation 14% vs 21% vs; p = 0.5; hospital length of stay 9.5 days (3-116) vs 15 days (2-241); p = 0.1; mortality 0 vs 3; (p = 0.6)). PCR is a sensitive test that fails to predict which patients will proceed to have a clinically significant infection. Viral bronchiolitis remains a relative risk factor for cardiac surgery; presence of detectable virus via nasopharyngeal swab with limited clinical symptoms may not be a contraindication to cardiac surgery. |
2,331,654 | Incidental Discovery of a Presacral Extradural Myxopapillary Ependymoma. | Ependymoma is a malignant central nervous system tumor arising from the lining of the ventricles or central canal of the spinal cord. Extradural spinal ependymomas arise from heterotopic ependymal cells or the coccygeal medullary vestige and are extremely infrequent. We present a rare case of presacral extradural ependymoma. Extradural ependymomas typically demonstrate an extraneural spread and, thus, surveillance of the entire central nervous system is not typically recommended. A radiograph of the chest, liver profile, and attention to palpable lymphadenopathy (especially inguinal) on physical examination are vital for surveillance. Obtaining an R0 resection is the most important prognostic factor in survival and local recurrence. |
2,331,655 | Methamphetamine Enhances HIV-Induced Aberrant Proliferation of Neural Progenitor Cells via the FOXO3-Mediated Mechanism. | Maintaining an intact pool of neural progenitor cells (NPCs) is crucial for generating new and functionally active neurons. Methamphetamine (METH) can exacerbate the HIV-induced deficit of adult neurogenesis; however, potential mechanisms of this influence are still poorly understood. In the present study, we present evidence that chronic exposure to METH combined with brain infection by EcoHIV results in enhanced proliferation of NPCs in the subventricular zone (SVZ) in mice. This effect was long-lasting as it was preserved ex vivo in NPCs isolated from the exposed mice over several passages in the absence of additional treatments. Increased proliferation in response to METH plus HIV was associated with dysregulation of cyclin B1 and cyclin D. Transcriptomic studies indicated that 27 out of the top 30 differentially expressed genes in response to METH plus EcoHIV were targets of the forkhead box O transcriptional factor (FOXO) and primarily FOXO3. Additional ex vivo studies and in vitro experiments using human NPCs exposed to METH and infected with HIV revealed upregulation of the CXCL12-CXCR4 axis, leading to activation of downstream pAkt and pErk, the pathways that can phosphorylate FOXO3 and force its exports from the nuclei into the cytoplasm. Indeed, nuclear expulsion of FOXO3 was demonstrated both in mice exposed to METH and infected with EcoHIV and in cell cultures of human NPCs. These results provide novel information that exposure to METH combined with HIV infection can induce aberrant proliferation of SVZ-derived NPCs and identifies CXCL12-CXCR4-Akt-1-mediated phosphorylation of FOXO3 as the mechanism responsible for this effect. |
2,331,656 | Parametric-based feature selection via spherical harmonic coefficients for the left ventricle myocardial infarction screening. | Computer-aided diagnosis (CAD) of heart diseases using machine learning techniques has recently received much attention. In this study, we present a novel parametric-based feature selection method using the three-dimensional spherical harmonic (SHs) shape descriptors of the left ventricle (LV) for intelligent myocardial infarction (MI) classification. The main hypothesis is that the SH coefficients of the parameterized endocardial shapes in MI patients are recognizable and distinguishable from healthy subjects. The SH parameterization, expansion, and registration of the LV endocardial shapes were performed, then parametric-based features were extracted. The proposed method performance was investigated by varying considered phases (i.e., the end-systole (ES) or the end-diastole (ED) frames), the spatial alignment procedures based on three modes (i.e., the center of the apical (CoA), the center of mass (CoM), and the center of the basal (CoB)), and considered orders of SH coefficients. After applying principal component analysis (PCA) on the feature vectors, support vector machine (SVM), K-nearest neighbors (K-NN), and random forest (RF) were trained and tested using the leave-one-out cross-validation (LOOCV). The proposed method validation was performed via a dataset containing healthy and MI subjects selected from the automated cardiac diagnosis challenge (ACDC) database. The promising results show the effectiveness of the proposed classification model. SVM reached the best performance with accuracy, sensitivity, specificity, and F-score of 97.50%, 95.00%, 100.00%, and 97.56%, respectively, using the introduced optimum feature set. This study demonstrates the robustness of combining the SH coefficients and machine learning techniques. We also quantify and notably highlight the contribution of different parameters in the classification and finally introduce an optimal feature set with maximum discriminant strength for the MI classification task. Moreover, the obtained results confirm that the proposed method performs more accurately than conventional point-based methods and also the current start-of-the-art, i.e., clinical measures. We showed our method's generalizability using employing it in dilated cardiomyopathy (DCM) detection and achieving promising results too. Parametric-based feature selection via spherical harmonics coefficients for the left ventricle myocardial infarction screening. |
2,331,657 | Severe hydrocephalus in a raccoon dog (Nyctereutes procyonoides). | Hydrocephalus is one of the most common central nervous system malformations in domestic dogs, yet they are poorly documented and studied in wild carnivoran mammals. A pup of raccoon dog (Nyctereutes procyonoides) was rescued and brought to Wildlife Center. The pup showed generalized ataxia, a domed skull, and an open bregmatic fontanelle. Ultrasound and MRI showed severe enlargement of the lateral ventricle with the loss of septum pellucidum resulting in a single large ventricle and cervical syringohydromyelia. Although treatment was attempted, the animal was euthanized due to poor prognosis. At necropsy, macroscopic findings were identical to the diagnostic imaging, where marked enlargement of the calvarium, and attenuated gyri and sulci were observed. Finally, hydrocephalus was confirmed. Here, we describe a case of hydrocephalus in a raccoon dog (Nyctereutes procyonoides). |
2,331,658 | Contrast Enhancement of the Normal Infundibular Recess Using Heavily T2-weighted 3D FLAIR. | The purpose of the present study was to evaluate contrast enhancement of the infundibular recess in the normal state using heavily T2-weighted 3D fluid-attenuated inversion recovery (FLAIR) (HT2-FLAIR).</AbstractText>Twenty-six patients were retrospectively recruited. We subjectively assessed overall contrast enhancement of the infundibular recess between postcontrast, 4-hour (4-h) delayed postcontrast, and precontrast HT2-FLAIR images. We also objectively conducted chronological and spatial comparisons by measuring the signal intensity (SI) ratio (SIR). Chronological comparisons were performed by comparing SI of the infundibular recess/SI of the midbrain (SIRIR-MB</sub>). Spatial comparisons were conducted by comparing SI on postcontrast HT2-FLAIR/SI on precontrast HT2-FLAIR (SIRPost-Pre</sub>) of the infundibular recess with that of other cerebrospinal fluid (CSF) spaces, including the superior part of the third ventricle, lateral ventricles, fourth ventricle, and interpeduncular cistern.</AbstractText>In the subjective analysis, all cases showed contrast enhancement of the infundibular recess on both postcontrast and 4-h delayed postcontrast HT2-FLAIR, and showed weaker contrast enhancement of the infundibular recess on 4-h delayed postcontrast HT2-FLAIR than on postcontrast HT2-FLAIR. In the objective analysis, SIRIR-MB</sub> was the highest on postcontrast images, followed by 4-h delayed postcontrast images. SIRPost-Pre</sub> was significantly higher in the infundibular recess than in the other CSF spaces.</AbstractText>The present results demonstrated that the infundibular recess was enhanced on HT2-FLAIR after an intravenous gadolinium injection. The infundibular recess may be a potential source of the leakage of intravenously administered gadolinium into the CSF.</AbstractText> |
2,331,659 | Identification of the Facial Colliculus in Two-dimensional and Three-dimensional Images. | The facial colliculus (FC), an important landmark for planning a surgical approach to brainstem cavernous malformation (BCM), is a microstructure; therefore, it may be difficult to identify on magnetic resonance imaging (MRI). Three-dimensional (3D) images may improve the FC-identification certainty; hence, this study attempted to validate the FC-identification certainty between two-dimensional (2D) and 3D images of patients with a normal brainstem and those with BCM. In this retrospective study, we included 10 patients with a normal brainstem and 10 patients who underwent surgery for BCM. The region of the FC in 2D and 3D images was independently identified by three neurosurgeons, three times in each case, using the method for continuously distributed test results (0-100). The intra- and inter-rater reliability of the identification certainty were confirmed using the intraclass correlation coefficient (ICC). The FC-identification certainty for 2D and 3D images was compared using the Wilcoxon signed-rank test. The ICC (1,3) and ICC (3,3) in both groups ranged from 0.88 to 0.99; therefore, the intra- and inter-rater reliability were good. In both groups, the FC-identification certainty was significantly higher for 3D images than for 2D images (normal brainstem group; 82.4 vs. 61.5, P = .0020, BCM group; 40.2 vs. 24.6, P = .0059 for the unaffected side, 29.3 vs. 17.3, P = .0020 for the affected side). In the normal brainstem and BCM groups, 3D images had better FC-identification certainty. 3D images are effective for the identification of the FC. |
2,331,660 | Systemic vascular air embolus following CT-guided transthoracic needle biopsy: a potentially fatal complication. | Following an uncomplicated CT-guided transthoracic biopsy, a patient becomes unconscious and subsequently dies despite immediate cardiac resuscitation. The patient felt well during the procedure but started complaining about dizziness and chest pain when he sat up. When he again was put in a supine position, cardiac arrest was noted. A CT scan performed when the symptoms initiated was afterwards rigorously reviewed by the team and revealed air located in the left ventricle, aorta and right coronary artery.We present a rare but potentially lethal complication following CT-guided transthoracic needle biopsy-systemic vascular air embolus. Knowledge and evidence about the complication are sparse because of low incidence and varying presentation. However, immediate initiation of treatment can save a life, and awareness of the complication is therefore crucial. |
2,331,661 | Right Ventricular Dysfunction in Patients With COVID-19: A Systematic Review and Meta-analysis. | This systematic review and meta-analysis aimed to describe the features of right ventricular impairment and pulmonary hypertension in coronavirus disease (COVID-19) and assess their effect on mortality.</AbstractText>The authors carried out a systematic review and meta-analysis of observational studies.</AbstractText>The authors performed a search through PubMed, the International Clinical Trials Registry Platform, and the Cochrane Library for studies reporting right ventricular dysfunction in patients with COVID-19 and outcomes.</AbstractText>The search yielded nine studies in which the appropriate data were available.</AbstractText>Pooled odds ratios were calculated according to the random-effects model.</AbstractText>Overall, 1,450 patients were analyzed, and half of them were invasively ventilated. Primary outcome was mortality at the longest follow-up available. Mortality was 48.5% versus 24.7% in patients with or without right ventricular impairment (n = 7; OR = 3.10; 95% confidence interval [CI] 1.72-5.58; p = 0.0002), 56.3% versus 30.6% in patients with or without right ventricular dilatation (n = 6; OR = 2.43; 95% CI 1.41-4.18; p = 0.001), and 52.9% versus 14.8% in patients with or without pulmonary hypertension (n = 3; OR = 5.75; 95% CI 2.67-12.38; p < 0.001).</AbstractText>Mortality in patients with COVID-19 requiring respiratory support and with a diagnosis of right ventricular dysfunction, dilatation, or pulmonary hypertension is high. Future studies should highlight the mechanisms of right ventricular derangement in COVID-19, and early detection of right ventricular impairment using ultrasound might be important to individualize therapies and improve outcomes.</AbstractText>Copyright © 2021 Elsevier Inc. All rights reserved.</CopyrightInformation> |
2,331,662 | SARS-CoV-2 targets glial cells in human cortical organoids. | Coronavirus disease 2019 (COVID-19) patients have manifested a variety of neurological complications, and there is still much to reveal regarding the neurotropism of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Human stem cell-derived brain organoids offer a valuable in vitro approach to study the cellular effects of SARS-CoV-2 on the brain. Here we used human embryonic stem cell-derived cortical organoids to investigate whether SARS-CoV-2 could infect brain tissue in vitro and found that cortical organoids could be infected at low viral titers and within 6 h. Importantly, we show that glial cells and cells of the choroid plexus were preferentially targeted in our model, but not neurons. Interestingly, we also found expression of angiotensin-converting enzyme 2 in SARS-CoV-2 infected cells; however, viral replication and cell death involving DNA fragmentation does not occur. We believe that our model is a tractable platform to study the cellular effects of SARS-CoV-2 infection in brain tissue. |
2,331,663 | The Outcomes of Endoscopic Third Ventriculostomy in the Treatment of Hydrocephalus: 317 Pediatric and Adult Cases. | To evaluate the role of endoscopic third ventriculostomy (ETV) as a primary or secondary treatment for hydrocephalus and factors affecting ETV success.</AbstractText>Pediatric and adult patients with symptomatic hydrocephalus treated with ETV during 11 years (2008?2019) in our clinic were retrospectively evaluated. Patients were divided into primary ETV group, in which ETV was the first method of hydrocephalus treatment, and secondary ETV group, in which cerebrospinal fluid (CSF) drainage procedures were initially attempted. Statistical data analyses were performed to compare the outcomes of primary and secondary ETV groups.</AbstractText>In total, 317 patients treated with ETV [140 (44%) patients aged 3?18 years and 177 (55%) aged 19?80 years] were followed-up for a mean duration of 60 months. Primary and secondary ETV groups comprised 207 and 110 patients, respectively. Further, 170 (82%) patients in the primary ETV group and fifty-nine patients (53%) in the secondary ETV group benefited from ETV. Primary ETV was associated with the highest probability of success (OR: 11.87). Increasing age (OR: 0.97) and male sex (OR: 4.719) increase the probability of achieving success. The overall prediction accuracy of the model was 72.2%. Kaplan?Meier survival analysis showed no significant difference between categorical groups in terms of time to failure (1.3 and 5 years), sex, ETV type, and categorized age (below 18 and above) (p > 0.05). Complications occurred during or after ETV in 14 patients.</AbstractText>Unlike most studies, our study includes both adult and pediatric groups. According to the findings obtained in our study, the recovery rate was higher in the primary ETV group (82%) than in the secondary ETV group (53%). According to the model we created, our prediction rate of recovery was 72%. Primary ETV, male sex, and advanced age are important predictors of success in ETV.</AbstractText> |
2,331,664 | Scale-adaptive deep network for deformable image registration. | Multiresolution hierarchical strategy is typically used in conventional optimization-based image registration to capture varying magnitudes of deformations while avoiding undesirable local minima. A rough concept of the scale is captured in deep networks by the reception field of kernels, and it has been realized to be both desirable and challenging to capture convolutions of different scales simultaneously in registration networks. In this study, we propose a registration network that is conscious of and self-adaptive to deformation of various scales to improve registration performance.</AbstractText>Dilated inception modules (DIMs) are proposed to incorporate receptive fields of different sizes in a computationally efficient way. Scale adaptive modules (SAMs) are proposed to guide and adjust shallow features using convolutional kernels with spatially adaptive dilation rate learned from deep features. DIMs and SAMs are integrated into a registration network which takes a U-net structure. The network is trained in an unsupervised setting and completes registration with a single evaluation run.</AbstractText>Experiment with two-dimensional (2D) cardiac MRIs showed that the adaptive dilation rate in SAM corresponded well to the deformation scale. Evaluated with left ventricle segmentation, our method achieved a Dice coefficient of (0.93 ± 0.02), significantly better than SimpleElastix and networks without DIM or SAM. The average surface distance was less than 2 mm, comparable to SimpleElastix without statistical significance. Experiment with synthetic data demonstrated the effectiveness of DIMs and SAMs, which led to a significant reduction in target registration error (TRE) based on dense deformation field. The three-dimensional (3D) version of the network achieved a 2.52 mm mean TRE on anatomical landmarks in DIR-Lab thoracic 4DCTs, lower than SimpleElastix and networks without DIM or SAM with statistical significance. The average registration times were 0.002 s for 2D images with size 256 × 256 and 0.42 s for 3D images with size 256 × 256 × 96.</AbstractText>The introduction and integration of DIMs and SAMs addressed the heterogeneous scale problem in an efficient and self-adaptive way. The proposed method provides an alternative to the inefficient multiresolution registration setups.</AbstractText>© 2021 American Association of Physicists in Medicine.</CopyrightInformation> |
2,331,665 | High resolution structural and functional MRI of the hippocampus in young adults with Down syndrome. | Down syndrome is the phenotypic consequence of trisomy 21, with clinical presentation including both neurodevelopmental and neurodegenerative components. Although the intellectual disability typically displayed by individuals with Down syndrome is generally global, it also involves disproportionate deficits in hippocampally-mediated cognitive processes. Hippocampal dysfunction may also relate to Alzheimer's disease-type pathology, which can appear in as early as the first decade of life and becomes universal by age 40. Using 7-tesla MRI of the brain, we present an assessment of the structure and function of the hippocampus in 34 individuals with Down syndrome (mean age 24.5 years ± 6.5) and 27 age- and sex-matched typically developing healthy controls. In addition to increased whole-brain mean cortical thickness and lateral ventricle volumes (<i>P </i><<i> </i>1.0 × 10<sup>-4</sup>), individuals with Down syndrome showed selective volume reductions in bilateral hippocampal subfields cornu Ammonis field 1, dentate gyrus, and tail (<i>P </i><<i> </i>0.005). In the group with Down syndrome, bilateral hippocampi showed widespread reductions in the strength of functional connectivity, predominately to frontal regions (<i>P </i><<i> </i>0.02). Age was not related to hippocampal volumes or functional connectivity measures in either group, but both groups showed similar relationships of age to whole-brain volume measures (<i>P </i><<i> </i>0.05). Finally, we performed an exploratory analysis of a subgroup of individuals with Down syndrome with both imaging and neuropsychological assessments. This analysis indicated that measures of spatial memory were related to mean cortical thickness, total grey matter volume and right hemisphere hippocampal subfield volumes (<i>P</i> < 0.02). This work provides a first demonstration of the usefulness of high-field MRI to detect subtle differences in structure and function of the hippocampus in individuals with Down syndrome, and suggests the potential for development of MRI-derived measures as surrogate markers of drug efficacy in pharmacological studies designed to investigate enhancement of cognitive function. |
2,331,666 | Human urine-derived stem cell-derived exosomal miR-21-5p promotes neurogenesis to attenuate Rett syndrome via the EPha4/TEK axis. | Rett syndrome (RTT) is a rare neurodevelopmental disorder that results in multiple disabilities. Exosomal microRNA (miRs) from urine-derived stem cells (USCs) have been shown to induce neurogenesis and aid in functional recovery from brain ischemia. In the present study, we sought to determine whether that exosomal miR-21-5p from USCs could promote early neural formation in a model of RTT. USCs were isolated and evaluated by flow cytometry. Exosomes were analyzed by transmission electron microscopy, tunable resistive pulse sensing (TRPS), and western blotting. PKH26 fluorescent dyes were used to observe intake of exosomes in vivo and in vitro. An RTT mouse model was treated with exosomes for behavioral studies. Dual-luciferase report gene assays were conducted to evaluate the relationship between miR-21-5p and Eph receptor A4 (EphA4). In vitro, treatment with exosomes from human urine-derived stem cells (USC-Exos) increased the percentage of neuron-specific class III beta-tubulin (Tuj1)<sup>+</sup> nerve cells as well as the transcription levels of β-III tubulin and doublecortin (DCX). A higher level of miR-21-5p was observed in USC-Exos, which promoted differentiation in NSCs by targeting the EPha4/TEK axis. In vivo, exosomal miR-21-5p improved the behavior, motor coordination, and cognitive ability of mice, facilitated the differentiation of NSCs in the subventricular zone of the lateral ventricle and promoted a marked rise in the number of DCX<sup>+</sup> cells. Our data provide evidence that exosomal miR-21-5p from human USCs facilitate early nerve formation by regulating the EPha4/TEK axis. |
2,331,667 | Perspectives on Endoscopic Transseptal Interforniceal Approach for Retroforaminal Colloid Cysts. | Although the interforniceal approach with the preservation of the fornix is useful during the endoscopic approach for retroforaminal colloid cysts, it carries a significant risk of memory and cognitive difficulties. Because most reports have reported the endoscopic approach to colloid cysts through the foramen with little emphasis on retroforaminal cysts, the aim of this study was to investigate colloid cysts as a special entity with regard to their different characteristics and surgical approaches and outcomes.</AbstractText>In this retrospective study, 12 patients with third ventricular colloid cysts with retroforaminal extensions were included. All patients underwent endoscopic transseptal interforniceal approach with tumor resection. The surgical technique was briefly described, and preoperative and postoperative data were evaluated.</AbstractText>Among the 12 patients included in this study, most of our patients were males. Average diameter of the colloid cyst was relatively large (average 22 mm). Gross total resection was achieved in 10 cases (83.3%). The stable images showed no local recurrence in the long-term follow-up period except in 1 case at the 28-month follow-up period.</AbstractText>Retroforaminal colloid cyst represents a unique entity that requires special attention to its mode of growth. The endoscopic approach for retroforaminal colloid cysts is nearly the same as that for foraminal cysts. It has a lower incidence rate of postoperative memory changes, lower chances of total resection, and lower incidence rate of hard contents. Moreover, sufficient knowledge on morbid anatomy is important to avoid fornix injury.</AbstractText>Copyright © 2021 Elsevier Inc. All rights reserved.</CopyrightInformation> |
2,331,668 | Leptomeningeal and intraventricular myelomatosis manifesting an aggressive form of communicating hydrocephalus. | Leptomeningeal myelomatosis (LMM) is a fatal complication that occurs in < 1% of patients with multiple myeloma. Many patients with LMM present with neurologic symptoms referable to cranial neuropathies, while the manifestation of communicating hydrocephalus has been underrecognized. A Japanese man with Bence Jones protein-κ multiple myeloma developed fever and headache at age 54 years. He then became somnolent and went into a coma. Neuroimaging analyses identified rapidly progressive communicating hydrocephalus due to meningitis. He died 83 days after the onset of headache without any response to treatment at age 55 years. No symptoms or signs associated with cranial nerves were found during the course of illness. Postmortem examination revealed hydrocephalus and diffuse infiltration of myeloma cells into the subarachnoid space of the cerebrum, cerebellum, and brainstem. In addition, the interstitial tissue of the choroid plexuses was filled with myeloma cells. These myeloma cells were positive for CD156 and light chain κ. The Ki-67 labeling index in myeloma cells of the central nervous system (CNS) was 30-40%. Histopathological examination further revealed many myeloma cells on the surface of the lateral, third and fourth ventricles and at the area postrema of the medulla oblongata. Patients with LMM can develop an aggressive form of communicating hydrocephalus. Given that cerebrospinal fluid, produced by epithelial cells in the choroid plexuses of the ventricles, passes into the subarachnoid space through the third and fourth ventricles, myeloma cells may invade the CNS through the choroid plexuses. |
2,331,669 | Complications in AVM Surgery. | In AVM surgery perioperative complications can arise and can have serious perioperative consequences. Surgically related complications in AVM treatment, in many cases, can be avoided by paying attention to details:1. Careful selection of the patient: - addressing a patient with eloquent AVM to Gamma Knife treatment - preoperative treatment with selective embolization of the accessible deep feeders - preoperative gamma knife or embolize those patient with an over-expressed venous pattern2. Meticulous coagulation of deep medullary feeders: - Using dirty coagulation - Using dry non-stick coagulation - Using micro clips - Using laser - Reaching the choroidal vessel in the ventricle when possible - Avoiding occlusive coagulation with hemostatic agents3. Check and avoiding any residual of the AVM4. Keep the patient under pressure control during postoperative periodFulfilling these steps contributes to reduce complications in this difficult surgery, leading to a safer treatment that compares favorably with natural history of brain arteriovenous malformations. |
2,331,670 | LRIG1 is a gatekeeper to exit from quiescence in adult neural stem cells. | Adult neural stem cells (NSCs) must tightly regulate quiescence and proliferation. Single-cell analysis has suggested a continuum of cell states as NSCs exit quiescence. Here we capture and characterize in vitro primed quiescent NSCs and identify LRIG1 as an important regulator. We show that BMP-4 signaling induces a dormant non-cycling quiescent state (d-qNSCs), whereas combined BMP-4/FGF-2 signaling induces a distinct primed quiescent state poised for cell cycle re-entry. Primed quiescent NSCs (p-qNSCs) are defined by high levels of LRIG1 and CD9, as well as an interferon response signature, and can efficiently engraft into the adult subventricular zone (SVZ) niche. Genetic disruption of Lrig1 in vivo within the SVZ NSCs leads an enhanced proliferation. Mechanistically, LRIG1 primes quiescent NSCs for cell cycle re-entry and EGFR responsiveness by enabling EGFR protein levels to increase but limiting signaling activation. LRIG1 is therefore an important functional regulator of NSC exit from quiescence. |
2,331,671 | Left ventricular twist predicts mortality in severe aortic stenosis.<Pagination><StartPage>225</StartPage><EndPage>232</EndPage><MedlinePgn>225-232</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1136/heartjnl-2020-318800</ELocationID><Abstract><AbstractText Label="OBJECTIVE">Left ventricular (LV) twist is a major component of ventricular mechanics reflecting the helical orientation of cardiac fibres and compensating for afterload mismatch. However, it is not known whether it determines outcome after transcatheter aortic valve implantation (TAVI). This study sought to investigate TAVI-induced short-term changes of LV twist and to define its role in outcome prediction.</AbstractText><AbstractText Label="METHODS">A total of 146 patients (median age 81.78 years, 50.7% male) undergoing TAVI for severe aortic stenosis were included. LV rotation and twist were determined by speckle tracking echocardiography within 3 months before and 2 weeks after TAVI. All-cause mortality at 2 years was defined as primary end point.</AbstractText><AbstractText Label="RESULTS">Patients who survived exhibited a higher apical peak systolic rotation (APSR) (p<0.001), twist (p=0.003) and torsion (p=0.019) pre-TAVI compared with those who died (n=22). Within 2 weeks after TAVI, APSR, twist and torsion decreased in patients who survived (all p<0.001), while no change occurred in those who died. Cox regression analysis showed an association of pre-TAVI APSR (HR 0.92, p=0.010), twist (HR 0.93, p=0.018) and torsion (HR 0.68, p=0.040) with all-cause mortality and an even stronger association of the respective changes after TAVI (∆APSR: HR 1.15, p<0.001; ∆twist: HR 1.14, p<0.001; ∆torsion: HR 2.53, p<0.001). All the parameters determined outcome independently of global longitudinal strain (GLS) and LV ejection fraction (LVEF).</AbstractText><AbstractText Label="CONCLUSION">APSR, twist and torsion pre-TAVI as well as their change within 2 weeks after TAVI predict 2-year all-cause mortality after TAVI, adding incremental prognostic value to LVEF and GLS.</AbstractText><CopyrightInformation>© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y" EqualContrib="Y"><LastName>Erhart</LastName><ForeName>Ladina</ForeName><Initials>L</Initials><Identifier Source="ORCID">0000-0003-0909-9118</Identifier><AffiliationInfo><Affiliation>Department of Cardiology, University Heart Center Zurich, Zurich, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y" EqualContrib="Y"><LastName>Donati</LastName><ForeName>Thierry</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Cardiology, University Heart Center Zurich, Zurich, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Anwer</LastName><ForeName>Shehab</ForeName><Initials>S</Initials><Identifier Source="ORCID">0000-0003-4357-8913</Identifier><AffiliationInfo><Affiliation>Department of Cardiology, University Heart Center Zurich, Zurich, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schindler</LastName><ForeName>Matthias</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Cardiology, University Heart Center Zurich, Zurich, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gremminger</LastName><ForeName>Miriam</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Cardiology, University Heart Center Zurich, Zurich, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Renzulli</LastName><ForeName>Melanie</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Radiology, University Hospital Zurich, Zurich, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kuzo</LastName><ForeName>Nazar</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Department of Cardiology, University Heart Center Zurich, Zurich, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Walther</LastName><ForeName>Anna L</ForeName><Initials>AL</Initials><AffiliationInfo><Affiliation>Department of Cardiology, University Heart Center Zurich, Zurich, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zürcher</LastName><ForeName>Dominik</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Cardiology, University Heart Center Zurich, Zurich, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hosseini</LastName><ForeName>Sara</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Cardiology, University Heart Center Zurich, Zurich, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Eberhard</LastName><ForeName>Matthias</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Radiology, University Hospital Zurich, Zurich, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Stähli</LastName><ForeName>Barbara E</ForeName><Initials>BE</Initials><AffiliationInfo><Affiliation>Department of Cardiology, University Heart Center Zurich, Zurich, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tanner</LastName><ForeName>Felix C</ForeName><Initials>FC</Initials><AffiliationInfo><Affiliation>Department of Cardiology, University Heart Center Zurich, Zurich, Switzerland felix.tanner@usz.ch.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>05</Month><Day>10</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Heart</MedlineTA><NlmUniqueID>9602087</NlmUniqueID><ISSNLinking>1355-6037</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001024" MajorTopicYN="Y">Aortic Valve Stenosis</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName><QualifierName UI="Q000601" MajorTopicYN="N">surgery</QualifierName></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="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013318" MajorTopicYN="N">Stroke Volume</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D065467" MajorTopicYN="Y">Transcatheter Aortic Valve Replacement</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018487" MajorTopicYN="Y">Ventricular Dysfunction, Left</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016277" MajorTopicYN="N">Ventricular Function, Left</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">aortic stenosis</Keyword><Keyword MajorTopicYN="N">transcatheter aortic valve replacement</Keyword></KeywordList><CoiStatement>Competing interests: None declared.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>12</Month><Day>9</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2021</Year><Month>3</Month><Day>27</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2021</Year><Month>3</Month><Day>30</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>5</Month><Day>12</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2022</Year><Month>4</Month><Day>30</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>5</Month><Day>11</Day><Hour>5</Hour><Minute>57</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33972358</ArticleId><ArticleId IdType="doi">10.1136/heartjnl-2020-318800</ArticleId><ArticleId IdType="pii">heartjnl-2020-318800</ArticleId></ArticleIdList></PubmedData></PubmedArticle><PubmedBookArticle><BookDocument><PMID Version="1">35853109</PMID><ArticleIdList><ArticleId IdType="bookaccession">NBK573750</ArticleId><ArticleId IdType="doi">10.1007/978-3-030-63453-7_11</ArticleId></ArticleIdList><Book><Publisher><PublisherName>Springer</PublisherName><PublisherLocation>Cham (CH)</PublisherLocation></Publisher><BookTitle book="spr9783030634537">Trends in Cerebrovascular Surgery and Interventions</BookTitle><PubDate><Year>2021</Year></PubDate><AuthorList Type="editors" CompleteYN="Y"><Author ValidYN="Y"><LastName>Esposito</LastName><ForeName>Giuseppe</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland</Affiliation><Identifier Source="GRID">grid.412004.3</Identifier><Identifier Source="ISNI">0000 0004 0478 9977</Identifier></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Regli</LastName><ForeName>Luca</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland</Affiliation><Identifier Source="GRID">grid.412004.3</Identifier><Identifier Source="ISNI">0000 0004 0478 9977</Identifier></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cenzato</LastName><ForeName>Marco</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Neurosurgery, Ospedale Niguarda Ca’ Granda, Milan, Italy</Affiliation><Identifier Source="GRID">grid.416200.1</Identifier></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kaku</LastName><ForeName>Yasuhiko</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Department of Neurosurgery, Asahi University Hospital, Gifu, Japan</Affiliation><Identifier Source="GRID">grid.411456.3</Identifier><Identifier Source="ISNI">0000 0000 9220 8466</Identifier></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tanaka</LastName><ForeName>Michihiro</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Neuroendovascular Surgery, Kameda Medical Center, Chiba, Japan</Affiliation><Identifier Source="GRID">grid.414927.d</Identifier><Identifier Source="ISNI">0000 0004 0378 2140</Identifier></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tsukahara</LastName><ForeName>Tetsuya</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Neurosurgery, Kyoto Medical Center, Kyoto, Japan</Affiliation><Identifier Source="GRID">grid.410835.b</Identifier></AffiliationInfo></Author></AuthorList><Isbn>9783030634520</Isbn><Isbn>9783030634537</Isbn><ELocationID EIdType="doi">10.1007/978-3-030-63453-7</ELocationID><Medium>Internet</Medium></Book><ArticleTitle book="spr9783030634537" part="ch11">Complications in AVM Surgery | In AVM surgery perioperative complications can arise and can have serious perioperative consequences. Surgically related complications in AVM treatment, in many cases, can be avoided by paying attention to details: 1. Careful selection of the patient: - addressing a patient with eloquent AVM to Gamma Knife treatment - preoperative treatment with selective embolization of the accessible deep feeders - preoperative gamma knife or embolize those patient with an over-expressed venous pattern 2. Meticulous coagulation of deep medullary feeders: - Using dirty coagulation - Using dry non-stick coagulation - Using micro clips - Using laser - Reaching the choroidal vessel in the ventricle when possible - Avoiding occlusive coagulation with hemostatic agents 3. Check and avoiding any residual of the AVM 4. Keep the patient under pressure control during postoperative period Fulfilling these steps contributes to reduce complications in this difficult surgery, leading to a safer treatment that compares favorably with natural history of brain arteriovenous malformations. |
2,331,672 | Nitric Oxide-cGMP Pathway Modulation in an Experimental Model of Hypoxic Pulmonary Hypertension. | Manipulation of nitric oxide (NO) may enable control of progression and treatment of pulmonary hypertension (PH). Several approaches may modulate the NO-cGMP pathway in vivo. Here, we investigate the effectiveness of 3 modulatory sites: (i) the amount of l-arginine; (ii) the size of plasma NO stores that stimulate soluble guanylate cyclase; (iii) the conversion of cGMP into inactive 5'-GMP, with respect to hypoxia, to test the effectiveness of the treatments with respect to hypoxia-induced PH. Male rats (n = 80; 10/group) maintained in normoxic (21% O<sub>2</sub>) or hypoxic chambers (10% O<sub>2</sub>) for 14 days were subdivided in 4 sub-groups: placebo, l-arginine (20 mg/ml), the NO donor molsidomine (15 mg/kg in drinking water), and phoshodiesterase-5 inhibitor sildenafil (1.4 mg/kg in 0.3 ml saline, i.p.). Hypoxia depressed homeostasis and increased erythropoiesis, heart and right ventricle hypertrophy, myocardial fibrosis and apoptosis inducing pulmonary remodeling. Stimulating anyone of the 3 mechanisms that enhance the NO-cGMP pathway helped rescuing the functional and morphological changes in the cardiopulmonary system leading to improvement, sometimes normalization, of the pressures. None of the treatments affected the observed parameters in normoxia. Thus, the 3 modulatory sites are essentially similar in enhancing the NO-cGMP pathway, thereby attenuating the hypoxia-related effects that lead to pulmonary hypertension. |
2,331,673 | TREM2 variants as a possible cause of frontotemporal dementia with distinct neuroimaging features. | Nasu-Hakola disease (NHD) is a rare, autosomal recessive disorder characterized by skeletal and neurological symptoms. Behavioral symptoms with cognitive impairment may mimic the behavioral variant of frontotemporal dementia (bvFTD) and other early-onset dementias. Our patients were analyzed and the literature was reviewed to delineate neurological and neuroimaging findings suggestive of NHD.</AbstractText>Fourteen patients carrying a pathogenic mutation in the TREM2 gene were found in our database. Demographic, clinical, laboratory and radiological data were retrieved and analyzed.</AbstractText>The presenting clinical picture was behavioral changes with cognitive decline resembling bvFTD in all patients. The mean age was 37.1 ± 4.97 years and the mean duration of the disease was 8.9 ± 3.51 years. Only two patients had typical bone cysts. Seven patients had bilateral calcification of the basal ganglia in computed tomography of the brain. Magnetic resonance imaging of the brain revealed severe atrophy of the corpus callosum, enlargement of the ventricles, atrophy of the caudate nuclei and periventricular white matter changes in all patients. Symmetrical global atrophy of the brain mainly affecting frontoparietal and lateral temporal regions were observed in all cases, and 13 patients had atrophy of the hippocampus. Cerebrospinal fluid examination of 10 patients showed elevated protein levels in six and the presence of oligoclonal bands in four patients.</AbstractText>A combination of white matter changes, enlarged ventricles, atrophy of the caudate nuclei and thinning of the corpus callosum in magnetic resonance imaging strongly suggests NHD in patients with FTD syndrome. Molecular genetic analysis should be performed in suspected cases, and families should receive genetic counseling.</AbstractText>© 2021 European Academy of Neurology.</CopyrightInformation> |
2,331,674 | Insights into therapeutic targets and biomarkers using integrated multi-'omics' approaches for dilated and ischemic cardiomyopathies. | At present, heart failure (HF) treatment only targets the symptoms based on the left ventricle dysfunction severity; however, the lack of systemic 'omics' studies and available biological data to uncover the heterogeneous underlying mechanisms signifies the need to shift the analytical paradigm towards network-centric and data mining approaches. This study, for the first time, aimed to investigate how bulk and single cell RNA-sequencing as well as the proteomics analysis of the human heart tissue can be integrated to uncover HF-specific networks and potential therapeutic targets or biomarkers. We also aimed to address the issue of dealing with a limited number of samples and to show how appropriate statistical models, enrichment with other datasets as well as machine learning-guided analysis can aid in such cases. Furthermore, we elucidated specific gene expression profiles using transcriptomic and mined data from public databases. This was achieved using the two-step machine learning algorithm to predict the likelihood of the therapeutic target or biomarker tractability based on a novel scoring system, which has also been introduced in this study. The described methodology could be very useful for the target or biomarker selection and evaluation during the pre-clinical therapeutics development stage as well as disease progression monitoring. In addition, the present study sheds new light into the complex aetiology of HF, differentiating between subtle changes in dilated cardiomyopathies (DCs) and ischemic cardiomyopathies (ICs) on the single cell, proteome and whole transcriptome level, demonstrating that HF might be dependent on the involvement of not only the cardiomyocytes but also on other cell populations. Identified tissue remodelling and inflammatory processes can be beneficial when selecting targeted pharmacological management for DCs or ICs, respectively. |
2,331,675 | The Protective Effect of Aspirin against Myocardial Hypertrophy in Rats. | The protective effect of aspirin against myocardial hypertrophy (MH) was studied. Model rats of pressure overload MH were prepared by abdominal aortic coarctation. Rats were randomly divided into the sham group (<i>n</i> = 9), MH model group (<i>n</i> = 9), and MH+aspirin group (<i>n</i> = 9), which was, respectively, divided into the 4-week group and 8-week group according to the time of intragastric administration. Arterial blood pressure and left ventricular mass index (LVMI) were measured. Changes in myocardial tissue structure were observed by HE staining, Masson staining, and reticular fiber staining. Cardiomyocyte apoptosis was detected by TUNEL assay. The levels of TNF-<i>α</i>, IL-10, TXA2, and PGI2 in myocardium and plasma were detected by ELISA. The arterial blood pressure in the MH model group was significantly higher than that in the 4- and 8-week sham groups, but that in the MH+aspirin group was significantly lower than that in the MH model group. At 4 and 8 weeks, the LVWI in the MH model group was significantly higher than that in the sham group, but it was significantly reduced after aspirin treatment. The myocardial cell hypertrophy was obvious, collagen fibers were proliferated, and reticular fibers were reduced in the 4- and 8-week MH model groups. Compared with the MH model groups, myocardial cells in the MH+aspirin groups were significantly reduced, the collagen fiber content was significantly reduced, and the reticular fiber content was increased. The apoptotic cardiomyocytes in the 4- and 8-week MH model groups were obviously increased. The apoptosis of myocardial cells in the MH+aspirin groups was obviously decreased. The TNF-<i>α</i> levels in the myocardial tissue of the 4- and 8-week MH model groups were significantly increased, while those of the MH+aspirin groups were significantly decreased. There was no significant change in the IL-10 level or PGI2 level at 4 weeks. At 8 weeks, the PGI2 level was significantly decreased in the MH model group while significantly increased in the MH+aspirin group. The TXA2 levels were significantly increased in the 4- and 8-week MH model groups and those in the 4- and 8-week MH+aspirin groups were significantly lower. Aspirin has an anti-inflammatory effect, can effectively reduce the expression of inflammatory factors, inhibit myocardial apoptosis, and has a certain protective effect against MH. |
2,331,676 | Successful percutaneous treatment with the Konar MF™-VSD Occluder in an infant with Abernethy syndrome-case report. | Cyanosis persisting after surgical repair of complex congenital heart disease (CHD) may be related to the underlying disease. However, extracardiac causes should be also considered. We report on a patient with heterotaxy syndrome and double outlet right ventricle, in whom postoperative cyanosis was associated with an Abernethy malformation type II causing a hepatopulmonary syndrome. Despite this complex anatomy, interventional closure of the portosystemic shunt was done with a Konar MF™-VSD Occluder. The patient recovered rapidly with relief of cyanosis within one month. This case highlights the importance of a careful diagnostic assessment in patients with complex CHD, who presents cyanoses after surgical repair. In addition, it shows the feasibility and safety of a percutaneous approach with complete closure of the vascular malformation in a patient with a complex anatomy. |
2,331,677 | Exosomes derived from human amniotic fluid mesenchymal stem cells alleviate cardiac fibrosis via enhancing angiogenesis <i>in vivo</i> and <i>in vitro</i>. | Cardiac fibrosis is a pathological process characterized by excess extracellular matrix (ECM) deposition and plays a critical role in nearly all types of heart disease. The mechanism of cardiac fibrosis is still unclear and no effective medication treatment of cardiac fibrosis. Research showed that mesenchymal stem cell (MSC) derived exosomes may play a critical role in cardiac fibrosis. The effect of human amniotic fluid MSC (hAFMSC)-derived exosomes (hAFMSCExos) on cardiac fibrosis has remained unclear.</AbstractText>The hAFMSCExos were extracted using a sequential centrifugation approach. The effects of hAFMSCExos on angiogenesis were analyzed both in human umbilical vein endothelial cells (HUVECs) after oxygen and glucose deprivation (OGD) in vitro</i>, and in isoproterenol (ISO) induced-cardiac fibrosis in vivo</i>.</AbstractText>The hAFMSCExos remarkably up-regulate the motility and migration of HUVECs after OGD compared with phosphate-buffered saline (PBS). Meanwhile, total tube length, total branching points and total loops were significantly raised in HUVECs after OGD treated with hAFMSCExos. The hAFMSCExos alleviated the cardiac fibrosis degree tested by hematoxylin-eosin (H&E) and Masson staining. The protein levels of Collagen I and α-smooth muscle actin (α-SMA) were lower in exosomes group rats than PBS group. Immunofluorescence suggested that hAFMSCExos can promote the expression of CD31 in the rats. Meanwhile, the number of regenerated microvessels was significantly enhanced in rats administrated with exosomes by quantitative analysis of microvessel density. Furthermore, the micro-CT scanning evidenced that hAFMSCExos promote angiogenesis after cardiac fibrosis. The levels of hypoxia-inducible factor 1 α (HIF-1α) and vascular endothelial growth factor (VEGF) expression in the left ventricle accepted HUVECs were higher than PBS treatment at 7 days post-treatment by Western blot analysis.</AbstractText>The hAFMSCExos have proangiogenic effects on endothelial cells and enhanced angiogenesis in cardiac fibrosis. The hAFMSCExos may be a promising potential treatment strategy for cardiac fibrosis.</AbstractText>2021 Cardiovascular Diagnosis and Therapy. All rights reserved.</CopyrightInformation> |
2,331,678 | ID4 Is Required for Normal Ependymal Cell Development. | Ependymal cells are radial glia-derived multiciliated cells lining the lateral ventricles of the brain and spinal cord. Correct development and coordinated cilia beating is essential for proper cerebrospinal fluid (CSF) flow and neurogenesis modulation. Dysfunctions of ependymal cells were associated with transcription factor deregulation. Here we provide evidence that the transcriptional regulator ID4 is involved in ependymal cell development and maturation. We observed that <i>Id4</i>-deficient mice display altered ventricular cell cytoarchitecture, decreased ependymal cell number and enlarged ventricles. In addition, absence of ID4 during embryonic development resulted in decreased ependymal cell number and delayed maturation. Our findings open the way for a potential role of ID4 in ependymal cell development and motor cilia function. |
2,331,679 | Failing Fontan. | Dr. O.P. Yadava, CEO & Chief Cardiac Surgeon, National Heart Institute, New Delhi, India, and Editor-in-Chief, <i>Indian Journal of Thoracic and Cardiovascular Surgery</i>, in conversation with Prof. Richard Jonas, Paediatric Cardiac Surgeon from Washington DC, USA, on Failing Fontan. |
2,331,680 | Cruveilhier's Unrecognized Case (c1831) of Dyke-Davidoff-Masson Syndrome. | In his serially published atlas of pathology, Anatomie Pathologique du Corps Humain (1829-1842), French anatomist and pathologist Jean Cruveilhier (1791-1874) provided an early clinical-pathologic description of Dyke-Davidoff-Masson syndrome. Cruveilhier's case was initially published around 1830, more than a century before the clinical and radiologic report of Dyke and colleagues in 1933 based on a series of patients studied with pneumoencephalography. Although Dyke and colleagues were apparently unaware of Cruveilhier's prior description, Cruveilhier's case manifested all of the key osseous and neuropathological features of Dyke-Davidoff-Masson syndrome as later elaborated by Dyke and colleagues: (1) cerebral hemiatrophy with ex vacuo dilation of the lateral ventricle, (2) ipsilateral thickening of the diploe of the skull, and (3) ipsilateral hyper-pneumatization of the frontal sinuses. In addition, Cruveilhier noted crossed cerebral-cerebellar atrophy in his case and correctly inferred a "crossed effect" between the involved cerebral hemisphere and the contralateral cerebellum. Cruveilhier's pathological case from 1830 clearly anticipated both the cases reported more than a century later by Dyke and colleagues based on pneumoencephalography and the more recent case reports recognized with computed tomography or magnetic resonance imaging. |
2,331,681 | Long-Term Outcomes of Patients with Hydrocephalus Secondary to Tectal Plate Glioma versus Idiopathic Aqueductal Stenosis: Results from a Single Center. | Tectal plate gliomas (TPG) constitute a distinct entity of benign tumors of the brain stem which show an indolent clinical course. Adequate treatment of secondary hydrocephalus is undoubtedly a major factor in the outcome. However, little is known about to what degree the tumor itself determines the long-term outcome of these patients.</AbstractText>We retrospectively analyzed and compared the clinical and radiological data of 16 pediatric TPG patients with data of 12 pediatric idiopathic aqueductal stenosis (IAS) patients treated in our center from 1988 to 2018. For both groups, we assessed the long-term outcome in terms of hydrocephalus management, and for the TPG group, we assessed tumor growth during follow-up. In a separate prospective part of the study, we performed a neuropsychological evaluation in a subgroup of patients using a standardized testing battery, covering intelligence, learning, memory, executive functions, and an inventory on depression.</AbstractText>In the TPG group, the mean clinical and radiological follow-up was 84 and 70 months, respectively. On average, the maximum diameter of the tumor increased by 11% (p = 0.031) and the estimated tumor volume with 35% (p = 0.026) on radiological follow-up. The fronto-occipital horn ratio (FOHR) decreased by 23% on average after treatment. In the IAS group, the mean clinical and radiological follow-up was 117 and 85 months, respectively. In this group, the FOHR decreased by 21% on average. Neurocognitive testing revealed significant higher scores in the TPG group on global intelligence (TPG = 109, IAS = 85.5, U = 3, p < 0.01, z = -2.71), performance (TPG= 100, IAS = 85, U = 7, p = 0.03, z = -2.2), and verbal intelligence (TPG = 122, IAS = 91.5, U = 2, p < 0.00, z = -2.87) as well as working memory (TPG = 109.5, IAS = 77, U = 0.5, p = 0.01, z = -2.46).</AbstractText>Our results suggest that the long-term outcome in TPG patients is acceptable and that cognition is substantially better preserved than in patients with IAS. This puts the idea of a significant contribution of the tumoral mass to disease outcome on the long term in question. Adequate and prompt management of hydrocephalus is the most important factor in long-term cognitive outcome.</AbstractText>© 2021 S. Karger AG, Basel.</CopyrightInformation> |
2,331,682 | Catheter-based interventions versus medical and surgical approaches in acute pulmonary embolism.<Pagination><StartPage>1382</StartPage><EndPage>1390</EndPage><MedlinePgn>1382-1390</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.jvsv.2021.02.015</ELocationID><ELocationID EIdType="pii" ValidYN="Y">S2213-333X(21)00101-3</ELocationID><Abstract><AbstractText Label="OBJECTIVE">Catheter-based intervention (CBI) has become an increasingly popular option for treating pulmonary embolism (PE); however, the real benefits are unknown. The purpose of the present study was to compare the outcomes of patients treated with CBI with the outcomes of those treated with medical or surgical approaches.</AbstractText><AbstractText Label="METHODS">We performed a retrospective analysis of patients admitted from October 2015 to December 2017 with a diagnosis of acute PE. We compared patients aged ≥18 years with a diagnosis of acute PE treated with CBI against a control group identified by propensity score matching. The control group was divided into those who had undergone surgical pulmonary embolectomy (SPE) as the surgical group and those who had not undergone SPE as the medical group. The primary outcome was mortality (in-hospital and overall mortality). The secondary outcomes were major bleeding, length of hospital stay, thrombus resolution, right ventricle improvement in systolic function and dilatation, and recurrent PE.</AbstractText><AbstractText Label="RESULTS">Of the 108 patients, 30 were in the CBI group and 78 were in the control group (62 in the medical group and 16 in the surgical group). The patient characteristics on admission were similar, except for the body mass index, which was greater in the CBI group (P = .03). No difference was found in clinical severity, clot burden, right ventricle function, or biomarkers. Recurrent PE was less frequent in the CBI group than in the medical group (0% vs 6.4%). Otherwise, no significant differences were found in the outcomes between the CBI and medical groups. When CBI was compared with the surgical group, SPE was associated with improved mortality (0% vs 16.6%) but a longer median length of hospital stay (median, 7 days; interquartile range, 3-12 days; vs median, 8 days; interquartile range, 6.5-17 days).</AbstractText><AbstractText Label="CONCLUSIONS">The use of CBI reduced the number of recurrent PE events compared with the medically treated patients; however, the mortality was higher than that in the surgical group.</AbstractText><CopyrightInformation>Copyright © 2021 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Cires-Drouet</LastName><ForeName>Rafael S</ForeName><Initials>RS</Initials><AffiliationInfo><Affiliation>Department of Surgery, University of Maryland School of Medicine, Baltimore, Md; Department of Medicine, University of Maryland School of Medicine, Baltimore, Md. Electronic address: rcires@som.umaryland.edu.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nagarsheth</LastName><ForeName>Khanjan</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Surgery, University of Maryland School of Medicine, Baltimore, Md.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kaczorowski</LastName><ForeName>David J</ForeName><Initials>DJ</Initials><AffiliationInfo><Affiliation>Department of Surgery, University of Maryland School of Medicine, Baltimore, Md.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Toursavadkohi</LastName><ForeName>Shahab</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Surgery, University of Maryland School of Medicine, Baltimore, Md; Vascular Service, Baltimore Veterans Affairs Medical Center, Baltimore, Md.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Deatrick</LastName><ForeName>Kristopher</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Surgery, University of Maryland School of Medicine, Baltimore, Md.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Madathil</LastName><ForeName>Ronson J</ForeName><Initials>RJ</Initials><AffiliationInfo><Affiliation>Department of Surgery, University of Maryland School of Medicine, Baltimore, Md.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jones</LastName><ForeName>Kevin M</ForeName><Initials>KM</Initials><AffiliationInfo><Affiliation>Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Md.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Liskov</LastName><ForeName>Steven</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Medicine, University of Maryland School of Medicine, Baltimore, Md.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fitch</LastName><ForeName>Jeffrey</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Medicine, University of Maryland School of Medicine, Baltimore, Md.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sayad</LastName><ForeName>Michelle</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Medicine, University of Maryland School of Medicine, Baltimore, Md.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pasrija</LastName><ForeName>Chetan</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Surgery, University of Maryland School of Medicine, Baltimore, Md.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mayorga-Carlin</LastName><ForeName>Minerva</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Surgery, University of Maryland School of Medicine, Baltimore, Md.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Herr</LastName><ForeName>Daniel</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Surgery, University of Maryland School of Medicine, Baltimore, Md.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sorkin</LastName><ForeName>John D</ForeName><Initials>JD</Initials><AffiliationInfo><Affiliation>Department of Medicine, University of Maryland School of Medicine, Baltimore, Md; Baltimore Veterans Affairs Geriatrics Research, Education, and Clinical Center, Baltimore Veterans Affairs Medical Center, Baltimore, Md.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Griffith</LastName><ForeName>Bartley</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Department of Surgery, University of Maryland School of Medicine, Baltimore, Md.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lal</LastName><ForeName>Brajesh K</ForeName><Initials>BK</Initials><AffiliationInfo><Affiliation>Department of Surgery, University of Maryland School of Medicine, Baltimore, Md; Vascular Service, Baltimore Veterans Affairs Medical Center, Baltimore, Md.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gammie</LastName><ForeName>James S</ForeName><Initials>JS</Initials><AffiliationInfo><Affiliation>Department of Surgery, University of Maryland School of Medicine, Baltimore, Md.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>U01 NS080168</GrantID><Acronym>NS</Acronym><Agency>NINDS NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>P30 AG028747</GrantID><Acronym>AG</Acronym><Agency>NIA NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>I01 CX001621</GrantID><Acronym>CX</Acronym><Agency>CSRD VA</Agency><Country>United States</Country></Grant><Grant><GrantID>P30 DK072488</GrantID><Acronym>DK</Acronym><Agency>NIDDK NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>I01 RX000995</GrantID><Acronym>RX</Acronym><Agency>RRD VA</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D003160">Comparative Study</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>05</Month><Day>07</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Vasc Surg Venous Lymphat Disord</MedlineTA><NlmUniqueID>101607771</NlmUniqueID></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000208" MajorTopicYN="N">Acute Disease</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002404" MajorTopicYN="Y">Catheterization</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011655" MajorTopicYN="N">Pulmonary Embolism</DescriptorName><QualifierName UI="Q000601" MajorTopicYN="N">surgery</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014656" MajorTopicYN="Y">Vascular Surgical Procedures</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Anticoagulation</Keyword><Keyword MajorTopicYN="N">Catheter-based therapies</Keyword><Keyword MajorTopicYN="N">Pulmonary embolism</Keyword><Keyword MajorTopicYN="N">Surgical pulmonary embolectomy</Keyword></KeywordList><CoiStatement>Author conflict of interest: none.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>11</Month><Day>17</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2021</Year><Month>2</Month><Day>21</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>5</Month><Day>10</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2022</Year><Month>3</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>5</Month><Day>9</Day><Hour>20</Hour><Minute>38</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33965609</ArticleId><ArticleId IdType="mid">NIHMS1781832</ArticleId><ArticleId IdType="pmc">PMC9048149</ArticleId><ArticleId IdType="doi">10.1016/j.jvsv.2021.02.015</ArticleId><ArticleId IdType="pii">S2213-333X(21)00101-3</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>Beckman MG, Hooper WC, Critchley SE, Ortel TL. Venous thromboembolism: a public health concern. Am J Prev Med 2010;38(Suppl): S495–501.</Citation><ArticleIdList><ArticleId IdType="pubmed">20331949</ArticleId></ArticleIdList></Reference><Reference><Citation>Riedel M. Acute pulmonary embolism 1: pathophysiology, clinical presentation, and diagnosis. Heart 2001;85:229–40.</Citation><ArticleIdList><ArticleId IdType="pmc">PMC1729607</ArticleId><ArticleId IdType="pubmed">11156681</ArticleId></ArticleIdList></Reference><Reference><Citation>Kucher N, Rossi E, De Rosa M, Goldhaber SZ. Massive pulmonary embolism. Circulation 2006;113:577–82.</Citation><ArticleIdList><ArticleId IdType="pubmed">16432055</ArticleId></ArticleIdList></Reference><Reference><Citation>Kearon C, Akl EA, Ornelas J, Blaivas A, Jiménez D, Bounameaux H, et al. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report. Chest 2016;149:315–52.</Citation><ArticleIdList><ArticleId IdType="pubmed">26867832</ArticleId></ArticleIdList></Reference><Reference><Citation>Chatterjee S, Chakraborty A, Weinberg I, Kadakia M, Wilensky R, Sardar P, et al. Thrombolysis for pulmonary embolism and risk of all-cause mortality, major bleeding, and intracranial hemorrhage: a meta-analysis. JAMA 2014;311:2414–21.</Citation><ArticleIdList><ArticleId IdType="pubmed">24938564</ArticleId></ArticleIdList></Reference><Reference><Citation>Kucher N, Boekstegers P, Müller OJ, Kupatt C, Beyer-Westendorf J, Heitzer T, et al. Randomized, controlled trial of ultrasound-assisted catheter-directed thrombolysis for acute intermediate-risk pulmonary embolism. Circulation 2014;129:479–86.</Citation><ArticleIdList><ArticleId IdType="pubmed">24226805</ArticleId></ArticleIdList></Reference><Reference><Citation>Piazza G, Hohlfelder B, Jaff MR, Ouriel K, Engelhardt T, Sterling K, et al. A prospective, single-arm, multicenter trial of ultrasound-facilitated, catheter-directed, low-dose fibrinolysis for acute massive and submassive pulmonary embolism: the SEATTLE II study. JACC Cardiovasc Interv 2015;8:1382–92.</Citation><ArticleIdList><ArticleId IdType="pubmed">26315743</ArticleId></ArticleIdList></Reference><Reference><Citation>Tapson VF, Sterling K, Jones N, Elder M, Tripathy U, Brower J, et al. A randomized trial of the optimum duration of acoustic pulse thrombolysis procedure in acute intermediate-risk pulmonary embolism: the OPTALYSE PE trial. JACC Cardiovasc Interv 2018;11: 1401–10.</Citation><ArticleIdList><ArticleId IdType="pubmed">30025734</ArticleId></ArticleIdList></Reference><Reference><Citation>Jaff MR, McMurtry MS, Archer SL, Cushman M, Goldenberg N, Goldhaber SZ, et al. Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart Association. Circulation 2011;123:1788–830.</Citation><ArticleIdList><ArticleId IdType="pubmed">21422387</ArticleId></ArticleIdList></Reference><Reference><Citation>Jimenez D, Aujesky D, Moores L, Gomez V, Lobo JL, Uresandi F, et al. Simplification of the pulmonary embolism severity index for prognostication in patients with acute symptomatic pulmonary embolism. Arch Intern Med 2010;170:1383–9.</Citation><ArticleIdList><ArticleId IdType="pubmed">20696966</ArticleId></ArticleIdList></Reference><Reference><Citation>Kaatz S, Ahmad D, Spyropoulos AC, Schulman S. Definition of clinically relevant non-major bleeding in studies of anticoagulants in atrial fibrillation and venous thromboembolic disease in non-surgical patients: communication from the SSC of the ISTH. J Thromb Haemost 2015;13:2119–26.</Citation><ArticleIdList><ArticleId IdType="pubmed">26764429</ArticleId></ArticleIdList></Reference><Reference><Citation>Wible BC, Buckley JR, Cho KH, Bunte MC, Saucier NA, Borsa JJ. Safety and efficacy of acute pulmonary embolism treated via large-bore aspiration mechanical thrombectomy using the Inari FlowTriever device. J Vasc Interv Radiol 2019;30:1370–5.</Citation><ArticleIdList><ArticleId IdType="pubmed">31375449</ArticleId></ArticleIdList></Reference><Reference><Citation>Avgerinos ED, Abou Ali A, Toma C, Wu B, Saadeddin Z, McDaniel B, et al. Catheter-directed thrombolysis versus suction thrombectomy in the management of acute pulmonary embolism. J Vasc Surg Venous Lymphat Disorders 2019;7:623–8.</Citation><ArticleIdList><ArticleId IdType="pubmed">30902560</ArticleId></ArticleIdList></Reference><Reference><Citation>Pasrija C, Kronfli A, Rouse M, Raithel M, Bittle G, Pousatis S, et al. Outcomes after surgical pulmonary embolectomy for acute submassive and massive pulmonary embolism: a single-center experience. J Thorac Cardiovasc Surg 2018;155:1095–106.e2.</Citation><ArticleIdList><ArticleId IdType="pubmed">29452460</ArticleId></ArticleIdList></Reference><Reference><Citation>Neely RC, Byrne JG, Gosev I, Cohn L, Javed Q, Rawn JD, et al. Surgical embolectomy for acute massive and submassive pulmonary embolism in a series of 115 patients. Ann Thorac Surg 2015;100: 1245–51.</Citation><ArticleIdList><ArticleId IdType="pubmed">26165484</ArticleId></ArticleIdList></Reference><Reference><Citation>Kuo WT, Banerjee A, Kim PS, DeMarco FJ, Levy JR, Facchini FR, et al. Pulmonary embolism response to fragmentation, embolectomy, and catheter thrombolysis (PERFECT): initial results from a prospective multicenter registry. Chest 2015;148:667–73.</Citation><ArticleIdList><ArticleId IdType="pubmed">25856269</ArticleId></ArticleIdList></Reference><Reference><Citation>Kasper W, Konstantinides S, Geibel A, Olschewski M, Heinrick F, Grosser KD, et al. Management strategies and determinants of outcome in acute major pulmonary embolism: results of a multicenter registry. J Am Coll Cardiol 1997;30:1165–71.</Citation><ArticleIdList><ArticleId IdType="pubmed">9350909</ArticleId></ArticleIdList></Reference><Reference><Citation>Pasrija C, Kronfli A, George P, Raithel M, Boulos F, Herr D, et al. Utilization of veno-arterial extracorporeal membrane oxygenation for massive pulmonary embolism. Ann Thorac Surg 2018;105:498–504.</Citation><ArticleIdList><ArticleId IdType="pubmed">29174781</ArticleId></ArticleIdList></Reference><Reference><Citation>Pesavento R, Filippi L, Palla A, Visona A, Bova C, Marzolo M, et al. Impact of residual pulmonary obstruction on the long-term outcome of patients with pulmonary embolism. Eur Respir J 2017;49:1601980.</Citation><ArticleIdList><ArticleId IdType="pubmed">28546279</ArticleId></ArticleIdList></Reference><Reference><Citation>Nijkeuter M, Hovens MMC, Davidson BL, Huisman MV. Resolution of thromboemboli in patients with acute pulmonary embolism: a systematic review. Chest 2006;129:192–7.</Citation><ArticleIdList><ArticleId IdType="pubmed">16424432</ArticleId></ArticleIdList></Reference><Reference><Citation>Heresi GA, Bair N, Dweik RA, Auger W, Sockrider M. Chronic thromboembolic pulmonary hypertension. Am J Respir Crit Care Med 2018;197:P5–6.</Citation><ArticleIdList><ArticleId IdType="pubmed">29446688</ArticleId></ArticleIdList></Reference><Reference><Citation>Simonneau G, Torbicki A, Dorfmüller P, Kim N. The pathophysiology of chronic thromboembolic pulmonary hypertension. Eur Respir Rev 2017;26:160112.</Citation><ArticleIdList><ArticleId IdType="pubmed">28356405</ArticleId></ArticleIdList></Reference><Reference><Citation>Piazza G, Goldhaber SZ. Chronic thromboembolic pulmonary hypertension. N Engl J Med 2011;364:351–60.</Citation><ArticleIdList><ArticleId IdType="pubmed">21268727</ArticleId></ArticleIdList></Reference><Reference><Citation>Prandoni P. Residual clot in patients with deep vein thrombosis and pulmonary embolism: prognostic implications. J Hematol Thromb 2015;1:1–3.</Citation></Reference><Reference><Citation>Prandoni P, Lensing AWA, Prins MH, Pesavento R, Piccioli A, Sartori M, et al. The impact of residual thrombosis on the long-term outcome of patients with deep venous thrombosis treated with conventional anticoagulation. Semin Thromb Hemost 2015;41:133–40.</Citation><ArticleIdList><ArticleId IdType="pubmed">25682083</ArticleId></ArticleIdList></Reference><Reference><Citation>Meyer G, Vicaut E, Danays T, Agnelli G, Becattini C, Beyer-Westendorf J, et al. Fibrinolysis for patients with intermediate-risk pulmonary embolism. N Engl J Med 2014;370:1402–11.</Citation><ArticleIdList><ArticleId IdType="pubmed">24716681</ArticleId></ArticleIdList></Reference><Reference><Citation>Giri J, Sista AK, Weinberg I, Kearon C, Kumbhani DJ, Desai N, et al. Interventional therapies for acute pulmonary embolism: current status and principles for the development of novel evidence: a scientific statement from the American Heart Association. Circulation 2019;140:e774–801.</Citation><ArticleIdList><ArticleId IdType="pubmed">31585051</ArticleId></ArticleIdList></Reference><Reference><Citation>Kahn SR, Akaberi A, Granton JT, Anderson DR, Wells PS, Rodger MA, et al. Quality of life, dyspnea, and functional exercise capacity following a first episode of pulmonary embolism: results of the ELOPE cohort study. Am J Med 2017;130. 990.e9–990.e21.</Citation><ArticleIdList><ArticleId IdType="pubmed">28400247</ArticleId></ArticleIdList></Reference><Reference><Citation>Kahn SR, Hirsch AM, Akaberi A, Hernandez P, Anserson DR, Wells PS, et al. Functional and exercise limitations after a first episode of pulmonary embolism: results of the ELOPE prospective cohort study. Chest 2017;151:1058–68.</Citation><ArticleIdList><ArticleId IdType="pubmed">27932051</ArticleId></ArticleIdList></Reference><Reference><Citation>Kucher N, Rossi E, De Rosa M, Goldhaber SZ. Prognostic role of echocardiography among patients with acute pulmonary embolism and a systolic arterial pressure of 90 mm Hg or higher. Arch Intern Med 2005;165:1777–81.</Citation><ArticleIdList><ArticleId IdType="pubmed">16087827</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></PubmedArticle><PubmedArticle><MedlineCitation Status="MEDLINE" Owner="NLM" IndexingMethod="Curated"><PMID Version="1">33964825</PMID><DateCompleted><Year>2021</Year><Month>05</Month><Day>11</Day></DateCompleted><DateRevised><Year>2022</Year><Month>05</Month><Day>31</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">1512-0112</ISSN><JournalIssue CitedMedium="Internet"><Issue>312</Issue><PubDate><Year>2021</Year><Month>Mar</Month></PubDate></JournalIssue><Title>Georgian medical news</Title><ISOAbbreviation>Georgian Med News</ISOAbbreviation></Journal>[REMODELING OF THE LEFT VENTRICLE, SUBCLINICAL MANIFESTATIONS OF ATHEROSCLEROSIS IN PATIENTS WITH HYPERTONIC DISEASE WITH RHEUMATOID ARTHRITIS BY THE INFLUENCE OF DIFFERENT TREATMENT SCHEMES]. | Objective - to determine the features of the daily profile of blood pressure (BP), blood lipid spectrum, features of left ventricular remodeling in patients with hypertension in combination with RA and to evaluate the effectiveness of using medium doses of rosuvastatin to correct dyslipidemia in this group of patients. 70 patients aged 40-65 years were examined (average - M±m - 54.88±0.96 years). Hypertensive disease in combination with rheumatoid arthritis was found in 50 patients, which made up the main group. The patients were divided into 2 subgroups: the first group included 25 patients with essential hypertension in combination with rheumatoid arthritis, who took valsartan at a dose of 80 mg at home, indapamide 1.5 mg, rosuvastatin 20 mg. The second subgroup included 25 patients who took valsartan at a dose of 80 mg / day, amlodipine at a dose of 5 mg, rosuvastatin at a dose of 20 mg. The control group (comparison) consisted of 20 patients with arterial hypertension without RA, matched by sex and age with the main groups. (3 people, 17 women, average age 55.65±1.19 years). 1. Valsartan therapy and its combination with indapamide in hypertensive patients in combination with rheumatoid arthritis led to regression of LVH in all patients, normalization of LV geometry in 33% of patients, improvement of LV diastolic function in 88.2%. 2. The addition of indapamide to therapy led to a further decrease in the average values of blood pressure at night, increased the number of patients who achieved normalization of blood pressure from 50 to 75%, while therapy with amlodipine with indapamide did not change the severity of the circadian rhythm of blood pressure and the degree of nighttime decrease in SBP and in general the group remained inadequate. 3. Changes in the diurnal blood pressure profile, found in the majority of patients with arterial hypertension in combination with rheumatoid arthritis, were characterized by increased mean daily, mean systolic blood pressure levels, increased daytime variability, and a lower degree of nocturnal decrease in comparison with patients without RA. 4. The use of 20 mg rosuvastatin as part of complex therapy in patients with hypertension in combination with RA contributed to the achievement of target levels of lipid spectrum in the blood in most patients.ent of target levels of lipid spectrum in the blood in most patients. |
2,331,683 | Chromatin remodelling complexes in cerebral cortex development and neurodevelopmental disorders. | The diverse number of neurons in the cerebral cortex are generated during development by neural stem cells lining the ventricle, and they continue maturing postnatally. Dynamic chromatin regulation in these neural stem cells is a fundamental determinant of the emerging property of the functional neural network, and the chromatin remodellers are critical determinants of this process. Chromatin remodellers participate in several steps of this process from proliferation, differentiation, migration leading to complex network formation which forms the basis of higher-order functions of cognition and behaviour. Here we review the role of these ATP-dependent chromatin remodellers in cortical development in health and disease and highlight several key mouse mutants of the subunits of the complexes which have revealed how the remodelling mechanisms control the cortical stem cell chromatin landscape for expression of stage-specific transcripts. Consistent with their role in cortical development, several putative risk variants in the subunits of the remodelling complexes have been identified as the underlying causes of several neurodevelopmental disorders. A basic understanding of the detailed molecular mechanism of their action is key to understating how mutations in the same networks lead to disease pathologies and perhaps pave the way for therapeutic development for these complex multifactorial disorders. |
2,331,684 | Non-cell-autonomous OTX2 transcription factor regulates anxiety-related behavior in the mouse. | The OTX2 homeoprotein transcription factor is expressed in the dopaminergic neurons of the ventral tegmental area, which projects to limbic structures controlling complex behaviors. OTX2 is also produced in choroid plexus epithelium, from which it is secreted into cerebrospinal fluid and transferred to limbic structure parvalbumin interneurons. Previously, adult male mice subjected to early-life stress were found susceptible to anxiety-like behaviors, with accompanying OTX2 expression changes in ventral tegmental area or choroid plexus. Here, we investigated the consequences of reduced OTX2 levels in Otx2 heterozygote mice, as well as in Otx2<sup>+/AA</sup> and scFvOtx2<sup>tg/0</sup> mouse models for decreasing OTX2 transfer from choroid plexus to parvalbumin interneurons. Both male and female adult mice show anxiolysis-like phenotypes in all three models. In Otx2 heterozygote mice, we observed no changes in dopaminergic neuron numbers and morphology in ventral tegmental area, nor in their metabolic output and projections to target structures. However, we found reduced expression of parvalbumin in medial prefrontal cortex, which could be rescued in part by adult overexpression of Otx2 specifically in choroid plexus, resulting in increased anxiety-like behavior. Taken together, OTX2 synthesis by the choroid plexus followed by its secretion into the cerebrospinal fluid is an important regulator of anxiety-related phenotypes in the mouse. |
2,331,685 | Longitudinal MRI brain volume changes over one year in children with mucopolysaccharidosis types IIIA and IIIB. | To quantify changes in segmented brain volumes over 12 months in children with mucopolysaccharidosis types IIIA and IIIB (MPS IIIA and IIIB).</AbstractText>In order to establish suitable outcome measures for clinical trials, twenty-five children greater than 2 years of age were enrolled in a prospective natural history study of MPS IIIA and IIIB at Nationwide Children's Hospital. Data from sedated non-contrast brain 3 T MRIs and neuropsychological measures were reviewed from the baseline visit and at 12-month follow-up. No intervention beyond standard clinical care was provided. Age- and sex-matched controls were gathered from the National Institute of Mental Health Data Archive. Automated brain volume segmentation with longitudinal processing was performed using FreeSurfer.</AbstractText>Of the 25 subjects enrolled with MPS III, 17 children (4 females, 13 males) completed at least one MRI with interpretable volumetric data. The ages ranged from 2.8 to 13.7 years old (average 7.2 years old) at enrollment, including 8 with MPS IIIA and 9 with MPS IIIB. At baseline, individuals with MPS III demonstrated reduced cerebral white matter and corpus callosum volumes, but greater volumes of the lateral ventricles, cerebellar cortex, and cerebellar white matter compared to controls. Among the 13 individuals with MPS III with two interpretable MRIs, there were annualized losses or plateaus in supratentorial brain tissue volumes (cerebral cortex -42.10 ± 18.52 cm3</sup>/year [mean ± SD], cerebral white matter -4.37 ± 11.82 cm3</sup>/year, subcortical gray matter -6.54 ± 3.63 cm3</sup>/year, corpus callosum -0.18 ± 0.62 cm3</sup>/yr) and in cerebellar cortex (-0.49 ± 12.57 cm3</sup>/year), with a compensatory increase in lateral ventricular volume (7.17 ± 6.79 cm3</sup>/year). Reductions in the cerebral cortex and subcortical gray matter were more striking in individuals younger than 8 years of age. Greater cerebral cortex volume was associated with higher fine and gross motor functioning on the Mullen Scales of Early Learning, while greater subcortical gray matter volume was associated with higher nonverbal functioning on the Leiter International Performance Scale. Larger cerebellar cortex was associated with higher receptive language performance on the Mullen, but greater cerebellar white matter correlated with worse adaptive functioning on the Vineland Adaptive Behavioral Scales and visual problem-solving on the Mullen.</AbstractText>Loss or plateauing of supratentorial brain tissue volumes may serve as longitudinal biomarkers of MPS III age-related disease progression compared to age-related growth in typically developing controls. Abnormally increased cerebellar white matter in MPS III, and its association with worse performance on neuropsychological measures, suggest the possibility of pathophysiological mechanisms distinct from neurodegeneration-associated atrophy that warrant further investigation.</AbstractText>Copyright © 2021. Published by Elsevier Inc.</CopyrightInformation> |
2,331,686 | Premedication with pioglitazone prevents doxorubicin-induced left ventricular dysfunction in mice. | Doxorubicin (DOX) is widely used as an effective chemotherapeutic agent for cancers; however, DOX induces cardiac toxicity, called DOX-induced cardiomyopathy. Although DOX-induced cardiomyopathy is known to be associated with a high cumulative dose of DOX, the mechanisms of its long-term effects have not been completely elucidated. Pioglitazone (Pio) is presently contraindicated in patients with symptomatic heart failure owing to the side effects. The concept of drug repositioning led us to hypothesize the potential effects of Pio as a premedication before DOX treatment, and to analyze this hypothesis in mice.</AbstractText>First, for the hyperacute (day 1) and acute (day 7) DOX-induced dysfunction models, mice were fed a standard diet with or without 0.02% (wt/wt) Pio for 5 days before DOX treatment (15 mg/kg body weight [BW] via intraperitoneal [i.p.] administration). The following 3 treatment groups were analyzed: standard diet + vehicle (Vehicle), standard diet + DOX (DOX), and Pio + DOX. Next, for the chronic model (day 35), the mice were administrated DOX once a week for 5 weeks (5 mg/kg BW/week, i.p.).</AbstractText>In the acute phase after DOX treatment, the percent fractional shortening of the left ventricle (LV) was significantly decreased in DOX mice. This cardiac malfunction was improved in Pio + DOX mice. In the chronic phase, we observed that LV function was preserved in Pio + DOX mice.</AbstractText>Our findings may provide a new pathophysiological explanation by which Pio plays a role in the treatment of DOX-induced cardiomyopathy, but the molecular links between Pio and DOX-induced LV dysfunction remain largely elusive.</AbstractText> |
2,331,687 | Endothelial dysfunction in obstructive sleep apnea patients. | Obstructive sleep apnea syndrome (OSAS) is an independent risk factor for cardiovascular diseases. The aim of the study was to assess the influence of OSAS on endothelial dysfunction and thrombosis biomarkers and to evaluate the effect of treatment with continuous positive airway pressure (CPAP) on biomarker levels.</AbstractText>NT-proBNP, sICAM-1, endothelin-1, von Willebrand factor, D-dimers, and thrombin-antithrombin complex (TAT) were measured in 50 patients diagnosed with moderate-to-severe OSAS. All patients underwent transthoracic echocardiography, and 38 months after the inclusion, 16 CPAP users and 22 non-CPAP users were reassessed.</AbstractText>Sleep-related indices of apnea-hypopnea index (AHI) and mean SpO2</sub> were associated with higher sICAM-1 levels (AHI < 30: 7.3 ± 4.7 vs. AHI ≥ 30: 19.5 ± 19.4 mg/ml, p = 0.04; SpO2</sub> ≥ 90%: 11.9 ± 9.3 vs. SpO2</sub> < 90%: 23.6 ± 25.8, p = 0.04). sICAM-1 levels were significantly higher in obese patients, particularly with BMI ≥ 40. Plasma levels of TAT were significantly correlated with the increased right ventricular size (right ventricular diameter ≤ 37 mm: 0.86 ± 0.70 vs. > 37 mm: 1.96 ± 1.20 ng/ml, p = 0.04). Endothelin-1 levels were higher in patients with decreased right ventricular function (right ventricle TDI-derived S' ≥ 12 cm/s: 11.5 ± 10.9 vs. < 12 cm/s: 26.0 ± 13.2 pg/ml, p = 0.04). An increase in NT-proBNP was related to impaired parameters of the right ventricular contractile function. There were no correlations between long-term CPAP therapy and the levels of biomarkers.</AbstractText>Severe OSAS influences endothelial damage as manifested by an increase in sICAM-1 levels. Changes in right ventricular structure and function, observed mainly in patients with higher TAT and endothelin-1 levels, are also manifested by an increase in NT-proBNP levels. Long-term CPAP treatment does not seem to influence biomarkers in patients with moderate-to-severe OSAS, which may help to explain the lack of influence of CPAP on cardiovascular risk reduction.</AbstractText>© 2021. The Author(s).</CopyrightInformation> |
2,331,688 | Tension pneumoventricle: Reversible cause for aphasia. | Pneumocephalus is air in the cranium commonly seen in postcraniotomy and in head injury patients. When this air causes an increase in intracranial pressure leading to neurological deterioration, it is called tension pneumocephalus. Similarly, intraventricular air causing compression on vital centers and increasing intracranial pressure is called tension pneumoventricle, and this causes expressive aphasia, which is rarely described in the literature. This study reported a case of a traumatic cerebrospinal fluid (CSF) leak leading to tension pneumoventricle and aphasia. Case: A young male patient sustained severe head injury and had extradural hematoma (EDH) and multiple skull and skull base fractures. EDH was drained, and he recovered and was discharged with a Glasgow coma scale score of 15. He presented to neurosurgical outpatient with CSF leak, aphasia, and loss of bowel and bladder control for a duration of three days. Computed tomography brain scan showed tension pneumoventricles, and he was started on conservative management. His general condition deteriorated, and the next day, his pupils became unequal, and Glasgow coma scale (GCS) dropped to 8/15. He was immediately taken to theater, and the air was aspirated from the ventricles, and an external ventricular drain was inserted. The patient woke up in the immediate postoperative period and started talking normally by day four. Conclusion: Tension pneumoventricles should be considered a cause of aphasia. Immediate intervention and reduction of intracranial pressure are crucial to reverse neurological abnormality and improve patient's outcome. |
2,331,689 | Comprehensive genetic analysis confers high diagnostic yield in 16 Japanese patients with corpus callosum anomalies. | Corpus callosum anomalies (CCA) is a common congenital brain anomaly with various etiologies. Although one of the most important etiologies is genetic factors, the genetic background of CCA is heterogenous and diverse types of variants are likely to be causative. In this study, we analyzed 16 Japanese patients with corpus callosum anomalies to delineate clinical features and the genetic background of CCAs. We observed the common phenotypes accompanied by CCAs: intellectual disability (100%), motor developmental delay (93.8%), seizures (60%), and facial dysmorphisms (50%). Brain magnetic resonance imaging showed colpocephaly (enlarged posterior horn of the lateral ventricles, 84.6%) and enlarged supracerebellar cistern (41.7%). Whole exome sequencing revealed genetic alterations in 9 of the 16 patients (56.3%), including 8 de novo alterations (2 copy number variants and variants in ARID1B, CDK8, HIVEP2, and TCF4) and a recessive variant of TBCK. De novo ARID1B variants were identified in three unrelated individuals, suggesting that ARID1B variants are major genetic causes of CCAs. A de novo TCF4 variant and somatic mosaic deletion at 18q21.31-qter encompassing TCF4 suggest an association of TCF4 abnormalities with CCAs. This study, which analyzes CCA patients usung whole exome sequencing, demonstrates that comprehensive genetic analysis would be useful for investigating various causal variants of CCAs. |
2,331,690 | A 3D personalized cardiac myocyte aggregate orientation model using MRI data-driven low-rank basis functions. | Cardiac myocyte aggregate orientation has a strong impact on cardiac electrophysiology and mechanics. Studying the link between structural characteristics, strain, and stresses over the cardiac cycle and cardiac function requires a full volumetric representation of the microstructure. In this work, we exploit the structural similarity across hearts to extract a low-rank representation of predominant myocyte orientation in the left ventricle from high-resolution magnetic resonance ex-vivo cardiac diffusion tensor imaging (cDTI) in porcine hearts. We compared two reduction methods, Proper Generalized Decomposition combined with Singular Value Decomposition and Proper Orthogonal Decomposition. We demonstrate the existence of a general set of basis functions of aggregated myocyte orientation which defines a data-driven, personalizable, parametric model featuring higher flexibility than existing atlas and rule-based approaches. A more detailed representation of microstructure matching the available patient data can improve the accuracy of personalized computational models. Additionally, we approximate the myocyte orientation of one ex-vivo human heart and demonstrate the feasibility of transferring the basis functions to humans. |
2,331,691 | Echocardiographic Indicators Associated with Adverse Clinical Course and Cardiac Sequelae in Multisystem Inflammatory Syndrome in Children with Coronavirus Disease 2019. | Multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 causes significant cardiovascular involvement, which can be a determinant of clinical course and outcome. The aim of this study was to investigate whether echocardiographic measures of ventricular function were independently associated with adverse clinical course and cardiac sequelae in patients with MIS-C.</AbstractText>In a longitudinal observational study of 54 patients with MIS-C (mean age, 6.8 ± 4.4 years; 46% male; 56% African American), measures of ventricular function and morphometry at initial presentation, predischarge, and at a median of 3- and 10-week follow-up were retrospectively analyzed and were compared with those in 108 age- and gender-matched normal control subjects. The magnitude of strain is expressed as an absolute value. Risk stratification for adverse clinical course and outcomes were analyzed among the tertiles of clinical and echocardiographic data using analysis of variance and univariate and multivariate regression.</AbstractText>Median left ventricular apical four-chamber peak longitudinal strain (LVA4LS) and left ventricular global longitudinal strain (LVGLS) at initial presentation were significantly decreased in patients with MIS-C compared with the normal cohort (16.2% and 15.1% vs 22.3% and 22.0%, respectively, P < .01). Patients in the lowest LVA4LS tertile (<13%) had significantly higher C-reactive protein and high-sensitivity troponin, need for intensive care, and need for mechanical life support as well as longer hospital length of stay compared with those in the highest tertile (>18.5%; P < .01). Initial LVA4LS and LVGLS were normal in 13 of 54 and 10 of 39 patients, respectively. There was no mortality. In multivariate regression, only LVA4LS was associated with both the need for intensive care and length of stay. At median 10-week follow-up to date, seven of 36 patients (19%) and six of 25 patients (24%) had abnormal LVA4LS and LVGLS, respectively. Initial LVA4LS < 16.2% indicated abnormal LVA4LS at follow-up with 100% sensitivity.</AbstractText>Impaired LVGLS and LVA4LS at initial presentation independently indicate a higher risk for adverse acute clinical course and persistent subclinical left ventricular dysfunction at 10-week follow-up, suggesting that they could be applied to identify higher risk children with MIS-C.</AbstractText>Published by Elsevier Inc.</CopyrightInformation> |
2,331,692 | Neuroanatomical organization of methionine-enkephalinergic system in the brain of the Mozambique tilapia Oreochromis mossambicus. | Enkephalins are a class of opioid peptides implicated in several physiological and neuroendocrine responses in vertebrates. In this study, using immunocytochemical or immunofluorescence technique, we examined the neuroanatomical distribution of methionine enkephalin (M-ENK) immunoreactivity in the central nervous system (CNS) of the cichlid fish Oreochromis mossambicus. In the telencephalon, no M-ENK-like-immunoreactive (M-ENK-L-ir) perikarya, but sparsely distributed fibres were detected in the glomerular layer and the granule cell layer of the olfactory bulb. Although intensely labeled M-ENK-L-ir cells and fibres were found in the pallium, no M-ENK immunoreactivity was observed in the subpallium. The preoptic area showed a few M-ENK-L-ir somata and dense innervations of fibres. In the hypothalamic area, M-ENK-L-ir cells and fibres were located in magnocellular and parvocellular subdivisions of the nucleus preopticus, and medial and lateral subdivisions of the nucleus lateralis tuberis. Surrounding the recessus lateralis of the third ventricle, several intensely stained and packed M-ENK-L-ir cells and fibres were seen in dorsal, lateral and ventral subdivisions of the nucleus recessus lateralis. In the diencephalon, M-ENK immunoreactivity was restricted to the habenula, the thalamus, the pretectal area and the nucleus posterior tuberis. Dense aggregations of M-ENK-L-ir fibres were seen in the mesencephalic subdivisions, the optic tectum and the torus semicircularis, whereas a few fusiform M-ENK-L-ir cells and fibres were scattered in the midbrain tegmentum. In the rhombencephalon, different populations of ovoid or spindle shaped M-ENK-L-ir cells were observed in the secondary gustatory nucleus, the sensory trigeminal nerve nucleus, the nucleus reticularis medialis and the vagal motor nucleus, whereas bands of fibres were seen in the rostral spinal cord. Collectively, the widespread distribution of M-ENK immunoreactivity in the CNS suggests a role for this opioid peptide in regulation of neuroendocrine control of reproduction and modulation of sensorimotor functions in fish. |
2,331,693 | Endogenous µ-opioid receptor activity in the lateral and capsular subdivisions of the right central nucleus of the amygdala prevents chronic postoperative pain. | Tissue injury induces a long-lasting latent sensitization (LS) of spinal nociceptive signaling that is kept in remission by an opposing µ-opioid receptor (MOR) constitutive activity. To test the hypothesis that supraspinal sites become engaged, we induced hindpaw inflammation, waited 3 weeks for mechanical hypersensitivity to resolve, and then injected the opioid receptor inhibitors naltrexone, CTOP or β-funaltrexamine subcutaneously, and/or into the cerebral ventricles. Intracerebroventricular injection of each inhibitor reinstated hypersensitivity and produced somatic signs of withdrawal, indicative of LS and endogenous opioid dependence, respectively. In naïve or sham controls, systemic naloxone (3 mg/kg) produced conditioned place aversion, and systemic naltrexone (3 mg/kg) increased Fos expression in the central nucleus of the amygdala (CeA). In LS animals tested 3 weeks after plantar incision, systemic naltrexone reinstated mechanical hypersensitivity and produced an even greater increase in Fos than in sham controls, particularly in the capsular subdivision of the right CeA. One third of Fos+ profiles co-expressed protein kinase C delta (PKCδ), and 35% of PKCδ neurons co-expressed tdTomato+ in Oprm1<sup>Cre</sup> ::tdTomato transgenic mice. CeA microinjection of naltrexone (1 µg) reinstated mechanical hypersensitivity only in male mice and did not produce signs of somatic withdrawal. Intra-CeA injection of the MOR-selective inhibitor CTAP (300 ng) reinstated hypersensitivity in both male and female mice. We conclude that MORs in the capsular subdivision of the right CeA prevent the transition from acute to chronic postoperative pain. |
2,331,694 | Residual alterations of cardiac and endothelial function in patients who recovered from Takotsubo cardiomyopathy. | Takotsubo cardiomyopathy (TCM) is characterized by transient left ventricle dysfunction.</AbstractText>A residual cardiac and endothelial dysfunction is present in patients who recovered from TCM.</AbstractText>In this single-center prospective study, patients with prior TCM were included and followed for 6.4 ± 1.6 years. All underwent comprehensive cardiac function assessment, including tissue Doppler imaging (TDI) and 2-dimensional strain (2DS) echocardiography at their first visit. The number of circulating endothelial progenitor cells and levels of proangiogenic vascular endothelial growth factor (VEGF) and its receptor (VEGF-R) were measured. All measurements were compared with healthy controls.</AbstractText>Forty-two women (age 58. ±8.6 years, LVEF 58.1 ± 6.1%) comprised the TCM group. Patients post-TCM had significantly lower early velocities E' (6 (5.0-8.0) vs. 9 (7.0-11.0) cm/s, p = .001) by TDI and higher E/E' ratio (p = .002), lower LV global average longitudinal strain (LGS) (-18.9 ± 3.5% vs. -21.7 ± 2.3%, p = .002) and RV LGS (-20.1 ± 3.9% vs. -23.4 ± 2.8%, p = .003) were evident. There was a trend toward a higher VEGF-R (p = .09) along with decreased VEGF/VEGF-R ratio representing inadequate VEGF production. In-hospital mortality was not reported and only two non-cardiac deaths occurred at long-term follow-up.</AbstractText>Altered TDI and 2DS indices suggest residual biventricular myocardial injury in post-TCM patients with the apparent LV function recovery. Inappropriate production of VEGF and VEGF-R were observed, suggesting a possible underlying endothelial dysfunction in these patients.</AbstractText>© 2021 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.</CopyrightInformation> |
2,331,695 | Ultrahigh density atrio-ventricular dual-chamber mapping as a next generation tool for ablation of accessory pathways. | Detailed three-dimensional (3D) mapping has been useful for effective radiofrequency catheter ablation. The Rhythmia system can create atrio-ventricular dual-chamber mapping, which reveals the atrial and ventricular potentials all at once in the same map. The aim of this study was to investigate the utility of mapping the atrium and ventricle simultaneously with a high-density 3D mapping system for the ablation of accessory pathways (AP).</AbstractText>From July 2015 to August 2020, 111 patients underwent ablation of APs. Dual-chamber maps were created in 50 patients (median age 15 [10-54], 32 male [64.0%]), while 61 patients underwent radiofrequency (RF) ablation with conventional single-chamber 3D maps. The background characteristics and procedural details were compared between the dual-chamber mapping group and the conventional single-chamber mapping group.</AbstractText>The number of RF applications (median [IQR]; 1.0 [1.0-3.0] vs. 3.0 [1.0-6.0], p = .0023), RF time (median [IQR], s; 9.2 [2.0-95.7] vs. 95.6 [4.1-248.7], p = .0107), and RF energy (median [IQR], J; 248.4 [58.7-3328.2] vs. 2867.6 [134.2-7728.4], p = .0115) were significantly lower in the dual-chamber group. The fluoroscopy time (median [IQR], min; 19.9 [14.2-26.1] vs. 26.5 [17.7-43.4], p = .0025) and fluoroscopy dose (median [IQR], mGy; 52.5 [31.3-146.0] vs. 119.0 [43.7-213.5], p = .0249) were also significantly lower in the dual-chamber than single-chamber mapping group.</AbstractText>The dual-chamber mapping was useful for ablating accessory pathways and reducing the number of RF applications, total RF energy, and radiation exposure as compared with traditional mapping techniques.</AbstractText>© 2021 Wiley Periodicals LLC.</CopyrightInformation> |
2,331,696 | PSMB4 inhibits cardiomyocyte apoptosis via activating NF-κB signaling pathway during myocardial ischemia/reperfusion injury. | Myocardial ischemia/reperfusion (I/R) injury induces cardiomyocyte apoptosis to deteriorate heart function. Thus, how to inhibit cardiomyocyte apoptosis is the focus of recent researches. Proteasome family member PSMB4 (proteasome subunit beta type-4) promotes cell survival. The relationship between PSMB4 and cardiomyocyte apoptosis during myocardial I/R is unknown. In this study, PSMB4 expression increased in rat myocardial I/R model, positively correlated with cleaved caspase-3 expression, negatively correlated with Bcl-2 expression. In vitro, neonatal ventricle cardiomyocyte hypoxia/reoxygenation (H/R) model was constructed to mimic myocardial I/R. PSMB4 silence promoted cardiomyocyte apoptosis and IκBα expression, inhibited the activation of NF-κB. On the contrary, PSMB4 overexpession inhibited cardiomyocyte apoptosis and IκBα expression, promoted the activation of NF-κB. Additionally, PSMB4-IκBα interaction was identified, suggesting that PSMB4 might participate in the proteasome dependent degradation of IκBα. The data indicates that PSMB4 inhibits cardiomyocyte apoptosis via activating NF-κB signaling pathway during myocardial I/R, which can supply novel molecular target for the treatment of ischemic heart disease. |
2,331,697 | Native contrast visualization and tissue characterization of myocardial radiofrequency ablation and acetic acid chemoablation lesions at 0.55 T. | Low-field (0.55 T) high-performance cardiovascular magnetic resonance (CMR) is an attractive platform for CMR-guided intervention as device heating is reduced around 7.5-fold compared to 1.5 T. This work determines the feasibility of visualizing cardiac radiofrequency (RF) ablation lesions at low field CMR and explores a novel alternative method for targeted tissue destruction: acetic acid chemoablation.</AbstractText>N = 10 swine underwent X-ray fluoroscopy-guided RF ablation (6-7 lesions) and acetic acid chemoablation (2-3 lesions) of the left ventricle. Animals were imaged at 0.55 T with native contrast 3D-navigator gated T1-weighted T1w) CMR for lesion visualization, gated single-shot imaging to determine potential for real-time visualization of lesion formation, and T1 mapping to measure change in T1 in response to ablation. Seven animals were euthanized on ablation day and hearts imaged ex vivo. The remaining animals were imaged again in vivo at 21 days post ablation to observe lesion evolution.</AbstractText>Chemoablation lesions could be visualized and displayed much higher contrast than necrotic RF ablation lesions with T1w imaging. On the day of ablation, in vivo myocardial T1 dropped by 19 ± 7% in RF ablation lesion cores, and by 40 ± 7% in chemoablation lesion cores (p < 4e-5). In high resolution ex vivo imaging, with reduced partial volume effects, lesion core T1 dropped by 18 ± 3% and 42 ± 6% for RF and chemoablation, respectively. Mean, median, and peak lesion signal-to-noise ratio (SNR) were all at least 75% higher with chemoablation. Lesion core to myocardium contrast-to-noise (CNR) was 3.8 × higher for chemoablation. Correlation between in vivo and ex vivo CMR and histology indicated that the periphery of RF ablation lesions do not exhibit changes in T1 while the entire extent of chemoablation exhibits T1 changes. Correlation of T1w enhancing lesion volumes indicated in vivo estimates of lesion volume are accurate for chemoablation but underestimate extent of necrosis for RF ablation.</AbstractText>The visualization of coagulation necrosis from cardiac ablation is feasible using low-field high-performance CMR. Chemoablation produced a more pronounced change in lesion T1 than RF ablation, increasing SNR and CNR and thereby making it easier to visualize in both 3D navigator-gated and real-time CMR and more suitable for low-field imaging.</AbstractText> |
2,331,698 | Brain MRS correlates with mitochondrial dysfunction biomarkers in MELAS-associated mtDNA mutations. | The purpose of this study was to investigate correlations between brain proton magnetic resonance spectroscopy (1</sup> H-MRS) findings with serum biomarkers and heteroplasmy of mitochondrial DNA (mtDNA) mutations. This study enrolled patients carrying mtDNA mutations associated with Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke-like episodes (MELAS), and MELAS-Spectrum Syndrome (MSS).</AbstractText>Consecutive patients carrying mtDNA mutations associated with MELAS and MSS were recruited and their serum concentrations of lactate, alanine, and heteroplasmic mtDNA mutant load were evaluated. The brain protocol included single-voxel 1</sup> H-MRS (1.5T) in the medial parieto-occipital cortex (MPOC), left cerebellar hemisphere, parieto-occipital white matter (POWM), and lateral ventricles. Relative metabolite concentrations of N-acetyl-aspartate (NAA), choline (Cho), and myo-inositol (mI) were estimated relative to creatine (Cr), using LCModel 6.3.</AbstractText>Six patients with MELAS (age 28 ± 13 years, 3 [50%] female) and 17 with MSS (age 45 ± 11 years, 7 [41%] female) and 39 sex- and age-matched healthy controls (HC) were enrolled. These patients demonstrated a lower NAA/Cr ratio in MPOC compared to HC (p = 0.006), which inversely correlated with serum lactate (p = 0.021, rho = -0.68) and muscle mtDNA heteroplasmy (p < 0.001, rho = -0.80). Similarly, in the cerebellum patients had lower NAA/Cr (p < 0.001), Cho/Cr (p = 0.002), and NAA/mI (p = 0.001) ratios, which negatively correlated with mtDNA blood heteroplasmy (p = 0.001, rho = -0.81) and with alanine (p = 0.050, rho = -0.67). Ventricular lactate was present in 78.3% (18/23) of patients, correlating with serum lactate (p = 0.024, rho = 0.58).</AbstractText>Correlations were found between the peripheral and biochemical markers of mitochondrial dysfunction and brain in vivo markers of neurodegeneration, supporting the use of both biomarkers as signatures of MELAS and MSS disease, to evaluate the efficacy of potential treatments.</AbstractText>© 2021 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.</CopyrightInformation> |
2,331,699 | Intracranial Cerebrospinal Fluid Volume Evaluation in Healthy People and Hydrocephalus Patients using SPACE Sequence. | Cerebrospinal Fluid (CSF) is produced mainly by the choroid plexus but with a substantial influence by the ependymal lining of the ventricles in the brain. Hydrocephalus occurs as a result of discrepancy in the production as well as circulation of CSF as a result of congenital and acquired conditions. Nevertheless, studies on the differences between CSF dynamics according to age and gender are still insufficient. Thus, this study evaluated the volume of intracranial CSF in healthy people and hydrocephalus patients taking into account the differences between CSF dynamics according to age and gender using Sampling Perfection with Application optimised Contrast using different flip-angle Evolution (SPACE) sequence.</AbstractText>120 healthy volunteers and 60 patients with hydrocephalus were included in this study. SPACE sequence was used to evaluate intracranial CSF with a 3.0T magnetic resonance machine. The total volume of intracranial CSF and the amount of CSF in the ventricle were obtained using a software, and the volume ratio of CSF in the subarachnoid space, the ventricle and the subarachnoid space were calculated.</AbstractText>The mean volume of intracranial CSF, ventricular CSF, and subarachnoid CSF of male volunteers were (206.9±47.7) cm3, (33.0±10.7) cm3, (173.9±37.9) cm3 respectively. The average volume of intracranial CSF, ventricular CSF, and subarachnoid CSF of female volunteers were (199.7±44.9) cm3, (30.8±9.4) cm3, and (168.9±37.0) cm3, respectively. Thus, no significant statistically (P>0.05) difference between males and females was found. (3) The mean values of intracranial CSF, ventricle CSF and subarachnoid CSF, ventricle and subarachnoid CSF volume ratio in patients with hydrocephalus were significantly greater than health volunteers. Thus, the difference between the two groups was statistically significant (P<0.05).</AbstractText>SPACE sequence can quantitatively determine the content of CSF. The change of CSF volume has nothing to do with gender but with age. It is feasible to use SPACE sequence to evaluate the spatial distribution and volume of intracranial CSF.</AbstractText>Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.</CopyrightInformation> |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.