A Volumetric and Functional Connectivity MRI Study of Brain Arginine-Vasopressin Pathways in Autistic Children.

Dysfunction of brain-derived arginine-vasopressin (AVP) systems may be involved in the etiology of autism spectrum disorder (ASD). Certain regions such as the hypothalamus, amygdala, and hippocampus are known to contain either AVP neurons or terminals and may play an important role in regulating complex social behaviors. The present study was designed to investigate the concomitant changes in autistic behaviors, circulating AVP levels, and the structure and functional connectivity (FC) of specific brain regions in autistic children compared with typically developing children (TDC) aged from 3 to 5 years. The results showed: (1) children with ASD had a significantly increased volume in the left amygdala and left hippocampus, and a significantly decreased volume in the bilateral hypothalamus compared to TDC, and these were positively correlated with plasma AVP level. (2) Autistic children had a negative FC between the left amygdala and the bilateral supramarginal gyri compared to TDC. The degree of the negative FC between amygdala and supramarginal gyrus was associated with a higher score on the clinical autism behavior checklist. (3) The degree of negative FC between left amygdala and left supramarginal gyrus was associated with a lowering of the circulating AVP concentration in boys with ASD. (4) Autistic children showed a higher FC between left hippocampus and right subcortical area compared to TDC. (5) The circulating AVP was negatively correlated with the visual and listening response score of the childhood autism rating scale. These results strongly suggest that changes in structure and FC in brain regions containing AVP may be involved in the etiology of autism.

Prognostic value of coronary artery calcium score in patients with stable angina pectoris after percutaneous coronary intervention.

OBJECTIVES: To evaluate the prognostic value of the coronary artery calcium (CAC) score in patients with stable angina pectoris (SAP) who underwent percutaneous coronary intervention (PCI). METHODS: A total of 334 consecutive patients with SAP who underwent first PCI following multi-slice computer tomography (MSCT) were enrolled from our institution between January 2007 and June 2012. The CAC score was calculated according to the standard Agatston calcium scoring algorithm. Complex PCI was defined as use of high pressure balloon, kissing balloon and/or rotablator. Procedure-related complications included dissection, occlusion, perforation, no/slow flow and emergency coronary artery bypass grafting. Main adverse cardiac events (MACE) were defined as a combined end point of death, non-fatal myocardial infarction, target lesion revascularization and rehospitalization for cardiac ischemic events. RESULTS: Patients with a CAC score > 300 (n = 145) had significantly higher PCI complexity (13.1% vs. 5.8%, P = 0.017) and rate of procedure-related complications (17.2% vs. 7.4%, P = 0.005) than patients with a CAC score ≤ 300 (n = 189). After a median follow-up of 22.5 months (4-72 months), patients with a CAC score ≤ 300 differ greatly than those patients with CAC score > 300 in cumulative non-events survival rates (88.9 vs. 79.0%, Log rank 4.577, P = 0.032). After adjusted for other factors, the risk of MACE was significantly higher [hazard ratio (HR): 4.3, 95% confidence interval (95% CI): 2.4-8.2, P = 0.038] in patients with a CAC score > 300 compared to patients with a lower CAC score. CONCLUSIONS: The CAC score is an independent predictor for MACE in SAP patients who underwent PCI and indicates complexity of PCI and procedure-related complications.

Differences in cerebral response to esophageal acid stimuli and psychological anticipation in GERD subtypes--an fMRI study.

BACKGROUND: To evaluate whether there are differences in the cerebral response to intraesophageal acid and psychological anticipation stimuli among subtypes of gastroesophageal reflux disease (GERD). METHODS: Thirty nine patients with GERD and 11 healthy controls were enrolled in this study after gastroscopy and 24 hr pH monitoring. GERD subjects were divided into four subgroups: RE (reflux esophagitis), NERD+ (non-erosive reflux disease with excessive acid reflux), NERD-SI+ (normal acid exposure and positive symptom index) and NERD-SI+ (normal acid exposure and negative symptom index, but responded to proton pump inhibitor trial). Cerebral responses to intraesophageal acid and psychological anticipation were evaluated with fMRI. RESULTS: During intraesophageal acid stimulation, the prefrontal cortex (PFC) region was significantly activated in all subgroups of GERD; the insular cortex (IC) region was also activated in RE, NERD+ and NERD-SI- groups; the anterior cingulated cortex (ACC) region was activated only in RE and NERD-SI- groups. The RE subgroup had the shortest peak time in the PFC region after acid was infused, and presented the greatest change in fMRI signals in the PFC and ACC region (P=0.008 and P=0.001, respectively). During psychological anticipation, the PFC was significantly activated in both the control and GERD groups. Activation of the IC region was found in the RE, NERD-SI+ and NERD-SI- subgroups. The ACC was activated only in the NERD-SI+ and NERD-SI- subgroups. In the PFC region, the NERD-SI- subgroup had the shortest onset time (P=0.008) and peak time (P<0.001). Compared with actual acid infusion, ACC in RE and IC in NERD+ were deactivated while additional areas including the IC and ACC were activated in the NERD-SI+ group; and in NERD-SI- group, onset-time and peak time in the PFC and IC areas were obviously shorter in induced anticipation than in actual acid infusion. CONCLUSIONS: The four subgroups of GERD patients and controls showed distinctly different activation patterns and we therefore conclude GERD patients have different patterns of visceral perception and psychological anticipation. Psychological factors play a more important role in NERD-SI+ and NERD-SI- groups than in RE and NERD+ groups.

Mixed epithelial and stromal tumor of the kidney: an analysis of multidetector computed tomography manifestations and clinicopathologic findings.

OBJECTIVES: To explore the features of mixed epithelial and stromal tumor of kidney (MESTK) on the images of multidetector computed tomography with clinical manifestations and pathological findings as a reference. METHODS: On the basis of a blind retrospective review, we analyzed the images of 6 cases of MESTK on multidetector computed tomography and compared them with pathological results postoperatively. Two reviewers were asked to classify the tumors according to the Bosniak classification. We also combined them with clinical data, pathological findings, and reviewed literatures. RESULTS: All tumors were single, unilateral, and well circumscribed with a clear delineation from renal parenchyma. Five were round or oval, whereas 1 was irregularly shaped. One tumor processed to renal pelvis, 1 protruded from the cortex, and 4 large masses processed to both the cortex and the pelvis. In 6 cases, all MESTKs consisted of an irregular mixture of solid and cystic areas. The cysts were multilocular with smooth walls and low-density cystic liquid. No mural nodules were observed. Five tumors were diagnosed as Bosniak III, and 1 as Bosniak IV. Solid parts presented a mild-to-moderate enhancement and delayed enhancement without any enhancement of the cystic ones. CONCLUSIONS: Radiologists should consider the possibility of MESTK when they find that the tumor is a single solid or a cystic solid mass, especially in a female patient, and that the solid components present a mild-to-moderate enhancement during the corticomedullary phase and delayed enhancement, but the definite diagnosis depends on pathology.

[Investigation in vivo of effect of ultrasound-mediated microbubble destruction on entrance of feridex into the aortal wall].

OBJECTIVE: To explore feasibility for entrance of the contrast agent Sonovue and Feridex into the aortal wall. METHODS: 17 male Japanese giant ears rabbits (common grade), including 11 atherosclerosis (AS) animal models fed with food containing high-content lipid and normal animals fed with common food as control. Respectively, 10 animals in the AS group and 6 animals in the normal group were selected in a random way to undergo ultrasound-mediated microbubble destruction (UMMD) and no ultrasound-mediated microbubble destruction (-UMMD) half and half. One animal was administrated with double doses of Feridex. After general anesthesia, MR plain scan and intravenous injection of Feridex 100 micromol Fe/kg, immediately ultrasound focused on the front wall of the aortic arch, which underwent UMMD at the pressure of 3.5 Mpa with MI1.2 while 10 ml solution (Sonovue + normal saline)was injected intravenously at the speed of 0.5 ml/min FOR 20 min. 3T magnetic resonance (MR) was performed with a moderately T2* weighted gradient sequence. Enhanced scan were performed for 1 h, 24 h, 48 h, 72 h and after killing the animal. then the specimen were delivered to conduct optical and electronic microscope examination. Variance test for the re-measured data was adopted to verify the data obtained in every group. RESULTS: The effect of UMMD group on SPIO particles entrance into the aortal wall is of marked significance (P = 0.0004) statistically. The effect of UMMD on distribution in the vessel wall is of statistical significance (P = 0.01), more particles in the dventitia. Gas or microbubbles were found to enter into the intima, media of the aorta, and verified by Oil Red O staining. After staining the findings of iron particle in the cell and out of the cell are different. CONCLUSIONS: UMMD may facilitate entrance of those SPIO particles with a bigger diameter and microbubbles into the aortal wall. This discovery may provide a new solution for penetration of complex macromolecule probes and gene-carried drug through the tunica intima of the aorta.

Dynamic changes in brain activations and functional connectivity during affectively different tactile stimuli.

In the present study, we compared brain activations produced by pleasant, neutral and unpleasant touch, to the anterior lateral surface of lower leg of human subjects. It was found that several brain regions, including the contralateral primary somatosensory area (SI), bilateral secondary somatosensory area (SII), as well as contralateral middle and posterior insula cortex were commonly activated under the three touch conditions. In addition, pleasant and unpleasant touch conditions shared a few brain regions including the contralateral posterior parietal cortex (PPC) and bilateral premotor cortex (PMC). Unpleasant touch specifically activated a set of pain-related brain regions such as contralateral supplementary motor area (SMA) and dorsal parts of bilateral anterior cingulated cortex, etc. Brain regions specifically activated by pleasant touch comprised bilateral lateral orbitofrontal cortex (OFC), posterior cingulate cortex (PCC), medial prefrontal cortex (mPFC), intraparietal cortex and left dorsal lateral prefrontal cortex (DLPFC). Using a novel functional connectivity model based on graph theory, we showed that a series of brain regions related to affectively different touch had significant functional connectivity during the resting state. Furthermore, it was found that such a network can be modulated between affectively different touch conditions.

[Application of functional magnetic resonance imaging (fMRI) in the study of visceral hypersensitivity of the gut].

Functional magnetic resonance imaging (fMRI) has been widely applied in many fields, such as neurology, psychology, etc. Recently it has also been used to study the visceral hypersensitivity of the gut. This review gives an overview of the basic principle of fMRI and its application in the visceral sensitivity of esophagus and rectum.