Takatsune Kawaguchi

Usefulness of 3D-PRESTO imaging in evaluating putaminal abnormality in parkinsonian variant of multiple system atrophy.

IntroductionPrinciples of echo shifting with a train of observations (PRESTO) sequence has long echo time which emphasizes the effect of T2* relaxation time and contribute to its high sensitivity to the susceptibility change. The aim of our study was to evaluate the ability of 3D-PRESTO sequence in detecting putaminal hypointensity in patients with parkinsonian variant of multiple system atrophy (MSA-P) and in discriminating between MSA-P and Parkinsons disease (PD).MethodsThe signal intensity of the putamen and localization of abnormality were evaluated on 3D-PRESTO, T2*-weighted (T2*W), and T2-weighted (T2W) sequences in ten patients with MSA-P, 14 with PD, and ten controls. The putaminal signal intensity was assessed in all sequences and graded relative to the palladium. Atrophy of the putamen and posterolateral hyperintensity rim on T2W sequence were also evaluated in MSA-P patients.ResultsPutaminal hypointensity was more often seen in MSA-P than PD and controls on 3D-PRESTO sequence (p = 0.002) as well as on T2*W sequence (p = 0.003). 3D-PRESTO sequence could reveal lower intensity better than T2*W sequence in four of ten MSA-P cases. Hemi- or bilateral putaminal hypointensity, atrophy, and posterolateral hyperintensity rim were recognized in 90%, 70%, and 70% of ten MSA-P cases, respectively. Three cases revealed hypointensity on 3D-PRESTO sequence without posterolateral hyperintensity rim. Putaminal signal changes occurred in the posterolateral part with a striking lateral to medial gradient in all nine cases with putaminal hypointensity (nine out of nine, 100%).Conclusions3D-PRESTO sequence appears to be useful for depicting putaminal hypointensity in MSA-P patients and in differentiating MSA-P from PD.

Dexamethasone induces different wheel running activity than corticosterone through vasopressin release from the suprachiasmatic nucleus

During the analysis of wheel running activity, we found that corticosterone (1 mg/100 g BW) injection decreased wheel activity, while dexamethasone (0.1 mg/100 g) increased the activity. To clarify the functional differences between corticosterone and dexamethasone, we measured Arg-vasopressin (AVP) release from the suprachiasmatic nucleus (SCN) slice culture in vitro and AVP coding mRNA in the SCN in vivo. The corticosterone (0.2 and 2 microg/ml, final concentration in medium) decreased the AVP release, while it increased by dexamethasone (0.2 and 2 microg/ml). An AVP mRNA in the SCN was decreased by both corticosterone (1 mg/100 g) and dexamethasone (0.1 mg/100 g). The differences in wheel activity by corticosterone and dexamethasone are discussed from the changes of AVP in the SCN.

Insular Volume Reduction in Patients with Social Anxiety Disorder.

Despite the fact that social anxiety disorder (SAD) is highly prevalent, there have been only a few structural imaging studies. Moreover, most of them reported about a volume reduction in amygdale, which plays a key role in the neural function of SAD. Insula is another region of interest. Its hyperactivity in regard to processing negative emotional information or interoceptive awareness has been detected in patients with SAD. Referring to these studies, we hypothesized that insular volumes might reduce in patients with SAD and made a comparison of insular volumes between 13 patients with SAD and 18 healthy controls with matched age and gender using voxel-based morphometry. As a result, we found a significant volume reduction in insula in the SAD group. Our results suggest that the patients with SAD might have an insular volume reduction apart from amygdala. Since insula plays a critical role in the pathology of SAD, more attention should be paid not only to functional study but also morphometrical study of insula.

Internal carotid artery blister-like aneurysm caused by Aspergillus - case report.

Summary Background Blister-like aneurysm of the supraclinoid internal carotid artery (ICA) is a well-documented cause of subarachnoid hemorrhage. Generally, this type of aneurysm is associated with various conditions such as hypertension, arteriosclerosis, and ICA dissection. Although Aspergillus is the most common organism causing intracranial fungal aneurysmal formation, there is no report of a blister-like aneurysm caused by Aspergillus infection. Case Report An 83-year-old man received corticosteroid pulse therapy followed by oral steroid therapy for an inflammatory pseudotumor of the clivus. Two months later, the patient was transported to an emergency department due to the diffuse subarachnoid hemorrhage, classified as Fisher group 4. Subsequent 3D computed tomography angiogram revealed a blister-like aneurysm at the superior wall of the left ICA. Six days later, the patient died of subarachnoid hemorrhage caused by the left ICA aneurysm rerupture. Autopsy revealed proliferation of Aspergillus hyphae in the wall of the aneurysm. Notably, that change was present more densely in the inner membrane than in the outer one. Thus, it was considered that Aspergillus hyphae caused infectious aneurysm formation in the left ICA via hematogenous seeding rather than direct invasion. Conclusions The blister-like aneurysm is a rare but important cause of subarachnoid hemorrhage. This case report documents another cause of blister-like aneurysms, that is an infectious aneurysm associated with Aspergillus infection.

A predictive diagnostic model using multiparametric MRI for differentiating uterine carcinosarcoma from carcinoma of the uterine corpus

PurposeTo construct a diagnostic model for differentiating carcinosarcoma from carcinoma of the uterus.Materials and methodsTwenty-six patients with carcinosarcomas and 26 with uterine corpus carcinomas constituted a derivation cohort. The following nine MRI features of the tumors were evaluated: inhomogeneity, predominant signal intensity, presence of hyper- and hypointense areas, conspicuity of tumor margin, cervical canal extension on T2WI, presence of hyperintense areas on T1WI, contrast defect area volume percentage, and degree of enhancement. Two predictive models—with and without contrast—were constructed using multivariate logistic regression analysis. Fifteen other patients with carcinosarcomas and 30 patients with carcinomas constituted a validation cohort. The sensitivity and specificity of each model for the validation cohort were calculated.ResultsInhomogeneity, predominant signal intensity on T2WI, and presence of hyperintense areas on T1WI were significant predictors in the unenhanced-MRI-based model. Presence of hyperintensity on T1WI, contrast defect area volume percentage, and degree of enhancement were significant predictors in the enhanced-MRI-based model. The sensitivity/specificity of unenhanced MRI were 87/73 and 87/70% according to reviewer 1 and 2, respectively. The sensitivity/specificity of the enhanced-MRI-based model were 87/70% according to both reviewers.ConclusionsOur diagnostic models can differentiate carcinosarcoma from carcinoma of the uterus with high sensitivity and moderate specificity.

Utility of the fluid-attenuated inversion recovery sequence in detecting a hyperintense putaminal rim in multiple system atrophy-parkinsonism: a preliminary study.

Objective: To investigate the utility of fluid-attenuated inversion recovery (FLAIR) imaging for diagnosing multiple system atrophy-parkinsonism (MSA-P). Methods: We retrospectively evaluated 49 subjects (19 with MSA-P including 11 with early-stage disease, 15 with Parkinson’s disease and 15 matched controls) in order to compare the diagnostic value of FLAIR imaging to detect a hyperintense putaminal rim (HPR) with that of T2-weighted (T2W) imaging. Results: Compared with T2W imaging, FLAIR imaging detected HPR more conspicuously in the 19 MSA-P patients (p = 0.01); this trend was also observed in 11 early-stage MSA-P patients (p = 0.01). Furthermore, FLAIR imaging tended to increase sensitivity of detecting HPR compared with T2W imaging (all patients: 89 vs. 58%, p = 0.07; early-stage patients: 100 vs. 55%, p = 0.06). Conclusions: FLAIR imaging might be more useful for detecting HPR in MSA-P patients, even though they are at an early stage.

Thermoregulatory responses in rat pups during the nursing period: effects of separation from the dam on Per2, Bmal1, LDH and Arg-vasopressin mRNAs in the suprachiasmatic nucleus

Abstract Thermoregulatory responses of rat pups with or separated from the dam were examined in relation to clock-controlled genes in the suprachiasmatic nucleus (SCN). During the nursing period, the decreased incidence of maternal contact with the pups was correlated inversely with the rising body temperature of the dam under the dark period. We determined the levels of Per2, Bmal1 and AVP mRNAs using RT-PCR in the SCN of pups after separation from the dam, which induces hypothermia. The Per2 changes were coordinated with the body temperature decrease after separation from the dam. In adult rats, the body temperature drop induced by pentobarbital administration was larger during the light than in the darkness. The alpha- and γ-enolase, LDHa and LDHb mRNA, which are coupled with the metabolic state, were measured simultaneously with the clock related gene mRNAs, following hypothermia in pups on postnatal day 6. After dam separation, the Per2 and Bmal1 levels in pups increased after 1 h during the dark period, while AVP decreased after 9 h during the light period. The results indicate that the nursing dam influences Per2, Bmal1 and AVP mRNA transcriptions in the pup SCN through hypothermia (non-photic stimulation) induced by separation from the dam.