Agricultural practices influence flow regimes of headwater streams in western Iowa.

Agricultural tillage influences runoff and infiltration, but consequent effects on watershed hydrology are poorly documented. This study evaluated 25 yr (1971-1995) hydrologic records from four first-order watersheds in Iowa's loess hills. Two watersheds were under conventional tillage and two were under conservation (ridge) tillage, one of which was terraced. All four watersheds grew corn (Zea mays L.) every year. Flow-frequency statistics and autoregressive modeling were used to determine how conservation treatments influenced stream hydrology. The autoregressive modeling characterized variations in discharge, baseflow, and runoff at multi-year, annual, and shorter time scales. The ridge-tilled watershed (nonterraced) had 47% less runoff and 36% more baseflow than the conventional watershed of similar landform and slope. Recovery of baseflow after drought was quicker in the conservation watersheds, as evidenced by 365-d moving average plots, and 67% greater baseflow during the driest 2 yr. The two conventional watersheds were similar, except the steeper watershed discharged more runoff and baseflow during short (<30 d), wet periods. Significant multi-year and annual cycles occurred in all variables. Under ridge-till, seasonal (annual-cycle) variations in baseflow had greater amplitude, showing the seasonality of subsurface contaminant movement could increase under conservation practices. However, deviations from the modeled cycles of baseflow were also more persistent under conservation practices, indicating baseflow was more stable. Indeed, flow-frequency curves showed wet-weather discharge decreased and dry-weather discharge increased under conservation practices. Although mean discharge increased in the conservation watersheds, variance and skewness of daily values were smaller. Ridge tillage with or without terraces increased stream discharge but reduced its variability.

Cognitive and neuroimaging findings in physically abused preschoolers.

AIMS: To characterise the cognitive, motor, and language skills of toddlers and preschoolers who had been physically abused and to obtain concurrent MRIs of the brain. METHODS: A between groups design was used to compare a sample of 19 children, aged 14-77 months, who had been hospitalised for physical abuse with no evidence of neurological injury to a comparison group of 19 children matched for age and socioeconomic status. Children underwent cognitive, language, and motor testing within three months of their discharge from the hospital. Caregivers of the injured children were interviewed and were asked to complete questionnaires to characterise the child's developmental level and behaviour just prior to the hospitalisation. RESULTS: Children who had been physically abused scored significantly lower than the comparison group on measures of cognitive functioning, motor skills, and language skills. The groups did not differ in child behaviour ratings completed by the caregivers. MRI of the brain was performed for 15 children in the physical abuse group; two were found to have significant cerebral atrophy. CONCLUSIONS: Children who have been physically abused are at high risk for delays in cognitive, motor, and language development. Standard of care for these children should include developmental testing as well as neuroimaging of the brain to detect occult brain injury.

Assessment of the human cellular immune response to T27K, a coccidioidal antigen preparation, by flow cytometry of whole blood.

Whole blood flow cytometry was performed among donors with various clinical forms of coccidioidomycosis using T27K, a coccidioidal antigen preparation protective in mice but not previously studied in humans. The median percent of CD3+ lymphocytes (CD3+) producing intracellular interferon-gamma (IFN-gamma) among healthy immune donors was 0.43%, significantly above that for non-immune donors (0.01%) and greater than that for subjects with other forms of coccidioidomycosis, including chronic pulmonary (0.11%), disseminated (0.09%) and concomitant human immunodeficiency virus (HIV) infection (0.07%) (P < or =0.002 for all). No increase in intracellular interleukin (IL)-10 production or apoptosis was noted in samples incubated with T27K. Among 14 HIV-infected patients with concomitant coccidioidomycosis, seven of eight patients whose peripheral blood CD4 concentration was > 200 cells microl(-1) had > 0.06% of CD3+ produce intracellular IFN-gamma, compared to none of six whose peripheral blood CD4+ lymphocyte concentration was < or =200 cells microl(-1) (P = 0.005). These data indicate that there is a specific human cellular immune response to T27K as a coccidioidal antigen and that this response can be categorized based on the clinical status of the coccidioidally infected patient.

Projectile cylinder accidents resulting from the presence of ferromagnetic nitrous oxide or oxygen tanks in the MR suite.

OBJECTIVE: The purpose of this study is to alert MR users to the potentially lethal consequences of projectile cylinder accidents in the MR environment. CONCLUSION: Projectile cylinder tank accidents still occur and may be increasing, despite adherence to screening policies before MR imaging and safety education of hospital personnel. Four of the last five accidents at our institutions occurred within the past 3 years.

Spectrum of congenital anomalies of the inferior vena cava: cross-sectional imaging findings.

Congenital anomalies of the inferior vena cava (IVC) and its tributaries have become more commonly recognized in asymptomatic patients. The embryogenesis of the IVC is a complex process involving the formation of several anastomoses between three paired embryonic veins. The result is numerous variations in the basic venous plan of the abdomen and pelvis. A left IVC typically ends at the left renal vein, which crosses anterior to the aorta to form a normal right-sided prerenal IVC. In double IVC, the left IVC typically ends at the left renal vein, which crosses anterior to the aorta to join the right IVC. In azygos continuation of the IVC, the prerenal IVC passes posterior to the diaphragmatic crura to enter the thorax as the azygos vein. In circumaortic left renal vein, one left renal vein crosses anterior to the aorta and another crosses posterior to the aorta. In retroaortic left renal vein, the left renal vein passes posterior to the aorta. In circumcaval ureter, the proximal ureter courses posterior to the IVC. Other anomalies include absence of the infrarenal IVC or the entire IVC. These anomalies can have significant clinical implications. Awareness of these anomalies is necessary to avoid diagnostic pitfalls.

Advances in the imaging of common duct stones using magnetic resonance cholangiography, endoscopic ultrasonography, and laparoscopic ultrasonography.

Advances in magnetic resonance cholangiography (MRC) have resulted in consistently high sensitivity and specificity for the detection of common duct stones by MRC. There are multiple advantages to using MRC over endoscopic retrograde cholangiography (ERC) in the diagnosis of common duct stones, thereby reserving the use of ERC mainly as a therapeutic tool. Endoscopic ultrasonography has emerged as a modality capable of common duct stone detection and, when available, will compete with MRC and ERC for the diagnosis of common duct stones. However, its ability to image intrahepatic or proximal common duct stones would seem to be limited. Laparoscopic ultrasonography helps shorten operative time and costs less compared with intraoperative cholangiography. As more surgeons gather experience with laparoscopic ultrasonography and it becomes widely available, it has the promise to substitute for intraoperative cholangiography.

Transgenic overexpression of beta(2)-adrenergic receptors in airway smooth muscle alters myocyte function and ablates bronchial hyperreactivity.

beta(2)-Adrenergic receptors (beta(2)AR) act to relax airway smooth muscle and can serve to counteract hyperresponsiveness, although the effect may not be ablative even in the presence of exogenous agonist. Within this signaling cascade that ultimately transduces smooth muscle relaxation, a significant "spare receptor" pool has been hypothesized to be present in the airway. In order to modify the relationship between beta(2)AR and downstream effectors, transgenic mice (TG) were created overexpressing beta(2)AR approximately 75-fold in airway smooth muscle using a mouse smooth muscle alpha-actin promoter. While >90% of these receptors were expressed on the smooth muscle cell surface, the percentage of receptors able to form the agonist-promoted high affinity complex was less than that found with nontransgenic (NTG) cells (R(H) = 18 versus 36%). Nevertheless, beta(2)AR signaling was found to be enhanced. Intact airway smooth muscle cells from TG had basal cAMP levels that were greater than NTG cells. A marked increase in agonist-stimulated cAMP levels was found in the TG ( approximately 200% stimulation over basal) compared with NTG ( approximately 50% over basal) cells. Adenylyl cyclase studies gave similar results and also showed a 10-fold lower EC(50) for TG cells. Tracheal rings from TG mice that were precontracted with acetylcholine had an enhanced responsiveness (relaxation) to beta-agonist, with a 60-fold decrease in the ED(50), indicating that the enhanced signaling imposed by overexpression results in an increase in the coordinated function of the intact airway cells. In vivo studies showed a significantly blunted airway resistance response to the inhaled bronchoconstrictor methacholine in the TG mice. Indeed, with beta-agonist pretreatment, the TG mice displayed no response whatsoever to methacholine. These results are consistent with beta(2)AR being the limiting factor in the transduction system. Increases in the initial component of this transduction system (the beta(2)AR) are sufficient to markedly alter signaling and airway smooth muscle function to the extent that bronchial hyperresponsiveness is ablated, consistent with an anti-asthma phenotype.

Normal anatomy of the fetus at MR imaging.

Owing to recent advances in magnetic resonance (MR) imaging, the role of obstetric MR imaging has increased in cases in which the results of ultrasonography are equivocal. Fast MR imaging sequences, such as T2-weighted fast spin-echo (SE), half-Fourier single-shot fast SE, 0.5-signal-acquired single-shot fast SE, and echo-planar imaging, have virtually eliminated the need for fetal premedication, with a concomitant improvement in image resolution and diminished blurring. Artifacts related to maternal respiratory motion and fetal motion no longer limit the anatomic detail that can be demonstrated with MR imaging. With such advances in obstetric MR imaging, knowledge of normal fetal anatomy at MR imaging is essential to detect disease in utero. MR imaging can demonstrate fetal anatomy in detail, especially the brain, thorax, abdomen, pelvis, and vasculature. Major developmental structures of the fetus, particularly the cranial nervous system, naso- and oropharynx, lungs, and major abdominal viscera, can be adequately evaluated with targeted fast MR imaging as early as the beginning of the second trimester. However, MR imaging of the heart remains limited. Fetal MR imaging during the first trimester remains controversial secondary to biosafety issues and is limited due to diminutive fetal size.

Magnetic resonance angiography of primary varicella vasculitis: report of two cases.

Two patients with onset of hemiparesis 3 weeks following primary varicella infection demonstrated contralateral temporal lobe and basal ganglia infarctions on magnetic resonance imaging. In both cases, magnetic resonance angiography (MRA) was performed and demonstrated flow abnormalities ipsilateral to the infarcts. Digital subtraction angiography was performed in one case; however, the findings were significantly less conspicuous than those of the MRA. MRA proved to be sensitive to the diagnosis of varicella-induced vasculitis in two consecutive cases and provided a noninvasive means of following the progression of the disease process in response to therapy.

Neuroanatomic and neuropsychological outcome in school-age children with achondroplasia.

We previously reported on cognitive and respiratory factors in a series of infants with achondroplasia (ACH). We now present the results of neuropsychological evaluation and magnetic resonance imaging in 16 school-age children with ACH, 7 of whom had been included as infants in our previous report. We examined the neuroanatomic and cognitive status of this sample, as well as the predictive stability of the prior infant assessment. Seventeen normally developing children of average stature and 21 preterm children with arrested (compensated, unshunted) hydrocephalus constituted the comparison groups. Brain volumes of children with ACH were significantly larger than those of the comparison groups. In addition, children with ACH exhibited kinking of the medulla and neuroanatomic abnormalities consistent with arrested hydrocephalus, including enlarged ventricles and hypoplasia of the corpus callosum. Cognitive abilities at school age were average, although mild deficits were seen on visual-spatial tasks, similar to those obtained by the hydrocephalic comparison group. Only gross motor coordination deficits distinguished the ACH group from the hydrocephalic controls. Infant assessment overestimated later school-age IQ scores in those infants with ACH who scored above average. These findings point to generally preserved cognitive skills in selected children with ACH at early school age, although children with ACH should be evaluated individually as they are at risk for cognitive, academic, and motor deficits.

Polymorphisms of the 5' leader cistron of the human beta2-adrenergic receptor regulate receptor expression.

Cellular expression of the beta2-adrenergic receptor (beta2AR) is controlled in part by a 19-amino acid peptide that regulates mRNA translation. This peptide is encoded by a short open reading frame, termed the 5' leader cistron (5'LC), which is 102 bp upstream of the beta2AR coding block. In 176 normal subjects we found a single nucleotide polymorphism resulting in either Arg (previously denoted wild-type) or Cys at position 19 of this peptide. Allele frequencies were 0.37 for Arg and 0.63 for Cys. To determine if these variants altered beta2AR expression, COS-7 cells were transfected with polymorphic constructs consisting of 1,989 bp encompassing the 5'LC and the beta2AR coding block exactly as found in the human gene. beta2AR density, as determined by [125I]CYP radioligand binding, was 72% higher in cells transfected with the 5'LC-Cys19 construct as compared with those transfected with the 5'LC-Arg19 construct and 110% higher when a cotransfection technique with a luciferase construct was used to control for transfection efficiency. Levels of the two mRNA transcripts were not different, confirming in vitro studies that the upstream peptide regulates receptor expression at the translational level. In human airway smooth muscle cells that natively express beta2AR, receptor expression was approximately twofold higher in those bearing the Cys versus the Arg polymorphism, confirming the phenotype in a relevant cell type. Linkage disequilibrium was observed between the 5'LC-Cys polymorphism and the beta2AR coding block polymorphisms Arg16 and Gln27 (P < 0.0001), although several different haplotypes were identified. Thus, beta2AR expression in the human population is controlled by a common polymorphism of this 5'LC, and may be responsible for interindividual variation in betaAR responsiveness.

Memory functions in children with early hydrocephalus.

Children with arrested, shunted, and no hydrocephalus were compared on verbal and nonverbal memory tasks assessing multiple components of memory. A gradient of severity was hypothesized, with the shunted hydrocephalus group expected to exhibit the most significant memory impairments and the arrested group expected to perform more poorly than children with no hydrocephalus. Etiologies of prematurity, spina bifida, and aqueductal stenosis were represented by 157 participants. Results supported the hypothesis; the shunted hydrocephalus group performed poorer on all memory measures. Differences for the arrested group were less frequently statistically significant relative to children with no hydrocephalus. Irrespective of etiology, the shunted hydrocephalus group exhibited a pattern of performance suggestive of encoding and retrieval deficits on both verbal and nonverbal tasks, showing a pervasive disturbance of memory processes.

Magnetic resonance imaging of renal masses.

Renal cancer is diagnosed in 27,000 Americans and accounts for 12,000 deaths per year. Fortunately, improvements in imaging technology have resulted in earlier detection and longer survival. Although computed tomography (CT) and ultrasound (US) have accounted for much of this success, magnetic resonance (MR) imaging can offer several improvements in renal cancer imaging. MR imaging has demonstrated increased detection of tumor thrombus in the renal vein and IVC with better delineation of the superior extent of the tumor thrombus in the IVC, especially in the region of the right atrium. This information potentially impacts the surgical approach in cases where CT or US is equivocal. Visualization of tumor extension to the liver, spleen, and psoas muscle is also improved with MR imaging, increasing staging accuracy in selected cases. In addition, because of the relatively low nephrotoxicity and allergic potential of gadolinium chelates, contrast-enhanced MR imaging remains the study of choice for patients who cannot tolerate iodinated contrast agents. Although the current role of MR in renal cancer imaging is complementary to that of CT and US, its future role has not yet been completely defined. Recent developments in rapid MR imaging techniques have suggested the possibility of improved detection and characterization of renal masses relative to CT. In addition, as MR spectroscopic imaging of the kidney evolves, the possibility of future identification and characterization of renal masses on a biochemical basis may provide completely new insight into our understanding of renal cancer.

Effects of intraventricular hemorrhage and hydrocephalus on the long-term neurobehavioral development of preterm very-low-birthweight infants.

Measures of intelligence, neuropsychological functions, academic skills, and behavioral adjustment were obtained at school-age from children born preterm with no hydrocephalus (N=29), arrested hydrocephalus (N=19), and shunted hydrocephalus (N=17), and a term comparison group (N=23). Most children also received concurrent neurological examinations and MRI brain scans. Results revealed significantly poorer neurobehavioral development in all four domains in preterm children with shunted hydrocephalus. Despite abnormal MRI findings in virtually all children with arrested hydrocephalus, significant differences between preterm children with arrested hydrocephalus and those with no hydrocephalus were largely in areas involving attentional and academic skills. Preterm children with no hydrocephalus tended to show poorer motor development relative to term children. Neurological abnormalities were restricted to children with spasticity in the arrested (N=2) and shunted (N=10) groups. These results highlight the importance of separating cases according to residual neurological and neuroimaging abnormalities in accounting for variations in the neurobehavioral development of preterm, low-birth-weight infants.

Capillary hemangioma of the neck: prenatal MR findings.

Prenatal MR findings of a case of extracranial capillary hemangioma simulating an encephalocele at sonography are reported. MR imaging had an adjunctive diagnostic role in excluding the possibility of an encephalocele. The capillary hemangioma had diffuse T2 hypointensity prenatally, which is atypical of postnatal imaging findings.

Massive edema of the ovary: high resolution MR findings using a phased-array pelvic coil.

We report a rare premenarchal case of massive ovarian edema in which high resolution MRI findings more accurately reflected characteristic pathologic changes of this condition compared with CT and ultrasound. A potential role of MR in preoperative diagnosis of massive ovarian edema is suggested.

Antepartum bilateral ovarian vein thrombosis: magnetic resonance imaging diagnosis.

Antepartum cases of ovarian vein thrombosis are extremely rare and often misdiagnosed. A 22-year-old nullipara at 29 weeks' gestation presented with right lower quadrant pain and fever. Sonography revealed a tubular, hypoechoic mass. At laparotomy, a noninflamed appendix was found and a 2 x 4 cm retroperitoneal mass was palpated near the right ureter. Postoperative magnetic resonance imaging (MRI) revealed bilateral thrombosis of the ovarian veins with caval extension. Therapeutic anticoagulation was achieved, but the patient underwent cesarean delivery 4 days later due to active labor and malpresentation. Postoperative MRI showed no extension of the thrombi, and her postpartum course was otherwise unremarkable. MRI is a valuable, noninvasive tool in the diagnosis of venous thrombi in pregnancy.

Regional brain tissue composition in children with hydrocephalus. Relationships with cognitive development.

OBJECTIVE: To determine whether children with shunted hydrocephalus show variations in regional brain tissue composition that relate to cognitive functions. DESIGN: Nonequivalent control group. PATIENTS AND METHODS: Magnetic resonance imaging (MRI) and cognitive skills assessments were obtained on 28 children, 6 to 9 years of age, with shunted hydrocephalus and 13 normal control subjects comparable in age, gender, ethnicity, and socioeconomic status. Three consecutive MRI slices below the vertex were segmented using a fuzzy clustering algorithm to separate pixels into gray matter, white matter, and cerebrospinal fluid (CSF) in quadrants representing left and right anterior and posterior brain regions. The cognitive skills assessments included the Wechsler Intelligence Scale for Children-Revised verbal and performance IQ scores, neuropsychological composites of language and visuospatial skills, a measure of visuomotor dexterity, and 2 measures of problem-solving abilities. The MRI data were analyzed in a group x tissue x hemisphere x region analysis of variance. Spearman rho correlations were computed within the hydrocephalus group between the MRI and cognitive measures. RESULTS: Children with hydrocephalus showed reductions in overall gray matter percentages and corresponding increased CSF percentages that were more pronounced in posterior than anterior regions of both hemispheres. White matter percentages were reduced in children with hydrocephalus only in the left posterior quadrant. Correlations of posterior, but not anterior, CSF and gray matter percentages were significant with verbal and performance IQ scores and language, visuospatial, and visuomotor dexterity skills, but not with problem-solving abilities. Children with hydrocephalus who had proportionately greater posterior than anterior CSF percentages had significantly poorer visuomotor dexterity and visuospatial skills than did hydrocephalic children with proportionate CSF percentages. CONCLUSION: Regional variations in brain tissue composition in children with shunted hydrocephalus correlate with a variety of cognitive and visuomotor functions.

Morphometric evaluation of the hydrocephalic brain: relationships with cognitive development.

The effects of early hydrocephalus and related brain anomalies on cognitive skills are not well understood. In this study, magnetic resonance scans were obtained from 99 children aged from 6 to 13 years with either shunted hydrocephalus (n = 42) or arrested (unshunted) hydrocephalus (n = 19), from patient controls with no hydrocephalus (n = 23), and from normal, nonpatient controls (n = 15). Lateral ventricle volumes and area measurements of the internal capsules and centra semiovale in both hemispheres were obtained from these scans, along with area measurements of the corpus callosum. Results revealed reductions in the size of the corpus callosum in the shunted hydrocephalus group. In addition, lateral ventricle volumes were larger and internal capsule areas were smaller in both hemispheres in children with shunted and arrested hydrocephalus. The centra semiovale measurements did not differentiate the groups. Correlating these measurements with concurrent assessments of verbal and nonverbal cognitive skills, motor abilities, and executive functions revealed robust relationships only between the area of the corpus callosum and nonverbal cognitive skills and motor abilities. These results support the theory of a prominent role for the corpus callosum defects characteristic of many children with shunted hydrocephalus in the spatial cognition deficits commonly observed in these children.