RESUMO
The integrative properties of cortical pyramidal dendrites are essential to the neural basis of cognitive function, but the impact of amyloid beta protein (abeta) on these properties in early Alzheimer's is poorly understood. In animal models, electrophysiological studies of proximal dendrites have shown that abeta induces hyperexcitability by blocking A-type K+ currents (I(A)), disrupting signal integration. The present study uses a computational approach to analyze the hyperexcitability induced in distal dendrites beyond the experimental recording sites. The results show that back-propagating action potentials in the dendrites induce hyperexcitability and excessive calcium concentrations not only in the main apical trunk of pyramidal cell dendrites, but also in their oblique dendrites. Evidence is provided that these thin branches are particularly sensitive to local reductions in I(A). The results suggest the hypothesis that the oblique branches may be most vulnerable to disruptions of I(A) by early exposure to abeta, and point the way to further experimental analysis of these actions as factors in the neural basis of the early decline of cognitive function in Alzheimer's.
RESUMO
PURPOSE: To retrospectively determine if renal cell carcinoma can be differentiated from high-attenuation renal cysts at unenhanced computed tomography (CT) based on Hounsfield unit measurements and heterogeneity. MATERIALS AND METHODS: The Human Investigation Committee at our institution approved this study with waiver of informed consent. This study was compliant with the HIPAA. Fifty-four pathologically proved renal cell carcinomas in 54 patients (36 men and 18 women; average age, 53 years; range, 23-90 years) and 56 high-attenuation renal cysts in 51 patients (30 men and 21 women; average age, 63 years; range, 28-86 years) were retrospectively evaluated at unenhanced CT. Two independent readers reviewed randomized unenhanced CT images and obtained Hounsfield unit readings of each mass. A subjective determination of lesion heterogeneity was also performed by using a four-point scale (1: homogeneous, 2: mildly heterogeneous, 3: moderately heterogeneous, 4: markedly heterogeneous). Statistical analysis was performed by using Bland-Altman regression tree, classification and regression tree, and Shapiro-Wilk normality test. RESULTS: The average attenuation of cysts for reader 1 was 53.4 HU (range, 23-113 HU) and for reader 2 was 53.8 HU (range, 21-108 HU). The average attenuation of neoplasms for reader 1 was 34.7 HU (range, 21-60 HU) and for reader 2 was 38.4 HU (range, 22-60 HU). For cyst heterogeneity, a score of 1 was given in 55 of 56 (98%) cysts for reader 1 and in 53 of 56 (95%) cysts for reader 2. For neoplasm heterogeneity, a score of 1 was given in 35 of 54 (65%) neoplasms for reader 1 and in 36 of 54 (67%) for reader 2. Given the distribution of cyst and tumor attenuation values and lesion heterogeneity, a homogeneous mass measuring 70 HU or greater at unenhanced CT has a greater than 99.9% chance of representing a high-attenuation renal cyst. CONCLUSION: The findings from this study may help differentiate high-attenuation renal cysts from renal cell carcinomas at unenhanced CT and may suggest the next appropriate imaging study for definitive characterization.
