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Imaging Study (imaging + study)
Kinds of Imaging Study Selected AbstractsIMAGING STUDY: Prefrontal cortex morphometry in abstinent adolescent marijuana users: subtle gender effectsADDICTION BIOLOGY, Issue 4 2009Krista Lisdahl Medina ABSTRACT Adult human studies suggest frontal dysfunction associated with chronic marijuana (MJ) use, but due to continued neuromaturation, adult studies may not generalize to adolescents. This study characterized prefrontal cortex (PFC) morphometry in chronic MJ-using adolescents following 1 month of monitored abstinence. Data were collected from MJ users (n = 16) and controls (n = 16) aged 16,18. Extensive exclusionary criteria included co-morbid psychiatric and neurologic disorders. Substance use and anatomical measures were collected after 28 days of monitored abstinence. PFC volumes were ascertained from manual tracing by reliable raters on high-resolution magnetic resonance images. After controlling for lifetime alcohol use, gender and intracranial volume, MJ users did not differ from controls in PFC volume. However, marginal group-by-gender interactions were observed (P < 0.09): female MJ users demonstrated comparatively larger PFC volumes while male MJ users had smaller volumes compared with same-gender controls. Further, group status and total PFC volume interacted in predicting executive functioning (P < 0.05). Among MJ users, smaller PFC total volume was associated with better executive functioning while the opposite pattern was seen among the controls. These preliminary results indicate that gender may moderate the relationship between MJ use and PFC morphometry. Given the relationship between larger PFC total volumes and poorer executive functioning among MJ users, female MJ users may be at increased risk for neurocognitive consequences. Future research will measure PFC gray and white matter separately and follow boys and girls over adolescence to examine the influence of MJ use on neurodevelopment. [source] IMAGING STUDY: Exposure to smoking cues during an emotion recognition task can modulate limbic fMRI activation in cigarette smokersADDICTION BIOLOGY, Issue 4 2009Eric Artiges ABSTRACT Smoking cues (SCs) refer to smoking-associated environmental stimuli that may trigger craving and withdrawal symptoms, and predispose to relapse in smokers. Although previous brain imaging studies have explored neural responses to SCs, no study has characterized the effects of SCs on cerebral activity in smokers engaged in an attention-demanding cognitive task that is unrelated to smoking. Thirteen tobacco smokers and a demographically matched group of 13 healthy non-smokers participated in a fast event-related functional magnetic resonance imaging (fMRI) study that involved a visual task integrating SCs and neutral cues (NCs) during emotion recognition trials requiring a high level of attention. No significant SC-induced alterations were detected in smokers' behavioural performance. fMRI results show that non-smokers exhibited no difference between SC and NC trials; in contrast, smokers showed SC-induced widespread deactivations in a limbic, paralimbic and striatal network classically involved in addiction, and activation in the right dorsolateral prefrontal cortex. In addition, a correlation between deactivation of the right insula and the severity of smoking dependence (Fagerström test) was detected in smokers. These results suggest that the neural reactivity of smokers to SCs can be modified in the context of a cognitive challenge. This could reflect smokers' ability to inhibit cue-induced craving and may help in smoking cessation. [source] CLINICAL AND IMAGING STUDY: Glucocorticoid negative feedback in methadone-maintained former heroin addicts with ongoing cocaine dependence: dose,response to dexamethasone suppressionADDICTION BIOLOGY, Issue 1 2006Bruno Aouizerate ABSTRACT Combined cocaine and illicit opiate use is common. This study aimed to test the hypothesis that cocaine dependence in former heroin-addicted patients maintained on methadone treatment is associated with enhanced glucocorticoid negative feedback. Multiple dose dexamethasone suppression tests, using a conventional 2.0 mg dose, and two lower doses, 0.5 mg and 0.125 mg, were performed in 10 methadone-maintained former heroin addicts with ongoing cocaine dependence (C-MM), 10 stabilized methadone-maintained former heroin addicts with no ongoing drug or alcohol use (MM), and 22 normal volunteers (NV). At 9 hours, there was no difference in plasma adrenocorticotropin hormone (ACTH) and/or cortisol levels among groups on the baseline day, as well as after the two lower doses of dexamethasone. At 17 hours, C-MM and MM had significantly lower plasma ACTH and/or cortisol levels than NV. However, C-MM did not significantly differ from MM in their hormonal levels. When the hormonal responses to dexamethasone are expressed as magnitude of lowering from baseline, there was no significant difference at any dose among groups. Therefore, C-MM exhibited a normal glucocorticoid negative feedback in the morning. Using the standard interpretation of dexamethasone suppression testing based on the examination of the actual hormonal levels rather than the difference from baseline condition, C-MM appear to have glucocorticoid effects similar to MM, yet were both greater than NV in the late afternoon. Thus, further studies are needed to know whether altered glucocorticoid negative feedback is related to chronic cocaine exposure, or is the result of former heroin addiction and/or its long-term treatment with methadone. [source] A Short-echo-time Proton Magnetic Resonance Spectroscopic Imaging Study of Temporal Lobe EpilepsyEPILEPSIA, Issue 9 2002Robert J. Simister Summary: ,Purpose: We used short-echo-time proton magnetic resonance spectroscopy imaging (MRSI) to study metabolite concentration variation through the temporal lobe in patients with temporal lobe epilepsy (TLE) with and without abnormal MRI. Methods: MRSI was performed at TE = 30 ms to study 10 control subjects, 10 patients with TLE and unilateral hippocampal sclerosis, and 10 patients with TLE and unremarkable MRI (MRI negative). We measured the concentrations of N -acetyl aspartate +N -acetyl aspartyl-glutamate (NAAt), creatine (Cr), choline (Cho), glutamate + glutamine (Glx), and myoinositol, in the anterior, middle, and posterior medial temporal lobe (MTL), and in the posterior lateral temporal lobe. Segmented volumetric T1 -weighted MRIs gave the tissue composition of each MRSI voxel. Normal ranges were defined as the control mean ± 3 SD. Results: In the hippocampal sclerosis group, seven of 10 had abnormally low NAAt in the ipsilateral anterior MTL. In the MRI-negative group, four of 10 had low NAAt in the middle MTL voxel ipsilateral to seizure onset. Metabolite ratios were less sensitive to abnormality than was the NAAt concentration. Group analysis showed low NAAt, Cr, and Cho in the anterior MTL in hippocampal sclerosis. Glx was elevated in the anterior voxel contralateral to seizure onset in the MRI-negative group. Metabolite concentrations were influenced by voxel position and tissue composition. Conclusions: (a) Low NAAt, Cr, and Cho were features of the anterior sclerotic hippocampus, whereas low NAAt was observed in the MRI-negative group in the middle MTL region. The posterior temporal lobe regions were not associated with significant metabolite abnormality; (b) The two patient groups demonstrated different metabolite profiles across the temporal lobe, with elevated Glx a feature of the MRI-negative group; and (c) Voxel tissue composition and position influenced obtained metabolite concentrations. [source] Cortical Sensorimotor Control in Vocalization: A Functional Magnetic Resonance Imaging Study,THE LARYNGOSCOPE, Issue 11 2008Arno Olthoff MD Abstract Background: Verbal communication is a human feature and volitional vocalization is its basis. However, little is known regarding the cortical areas involved in human vocalization. Methods: Therefore, functional magnetic resonance imaging at 3 Tesla was performed in 16 healthy adults to evaluate brain activations related to voice production. The main experiments included tasks involving motor control of laryngeal muscles with and without intonation. In addition, reference mappings of the sensorimotor hand area and the auditory cortices were performed. Results: Related to vocalization, in addition to activation of the most lateral aspect of the primary sensorimotor cortex close to the Sylvian fissure (M1c), we found activations medially (M1a) and laterally (M1b) of the well-known sensorimotor hand area. Moreover, the supplementary motor area and the anterior cingulate cortex were activated. Conclusions: Although M1a could be ascribed to motor control of breathing, M1b has been associated with laryngeal motor control. Consequently, even though M1c represents a laryngeal sensorimotor area, its exclusiveness as suggested previously could not be confirmed. Activations in the supplementary motor area and anterior cingulate cortex were ascribed to "vocal-motor planning." The present data provide the basis for further functional magnetic resonance imaging studies in patients with neurological laryngeal disorders. [source] Vascular Leiomyoma of the Head and NeckTHE LARYNGOSCOPE, Issue 4 2004Cheng-Ping Wang MD Abstract Objectives/Hypothesis Vascular leiomyoma, a benign tumor composed of smooth muscle cell and vascular endothelium, is rare in the head and neck region. The authors report their experience with 21 patients. Study Design Retrospective review. Methods From 1988 to 2001, the clinical records of 21 patients with vascular leiomyoma of the head and neck were reviewed. The pathological material of each tumor was reviewed again for confirmation of the diagnosis and histological classification proposed by Morimoto. Results Twelve male and 9 female patients were studied. The mean age was 48 years. The locations and numbers of cases of the tumors were as follows: auricle, five; nasal cavity, three; external nose, 3; neck, 3; lip, 3; inner canthus, 2; forehead, 1; and hard palate, 1. All tumors were painless, and most were less than 2 cm in diameter. Three vascular leiomyomas of the neck were larger than 2 cm. Two of the three tumors originating in the nasal cavity presented with nasal obstruction or epistaxis. Regarding histological subtype, 14 of 21 (67%) tumors were solid type; 6 (28%) were cavernous type, and only one (5%) was venous type. Only one tumor (5%) recurred after excision. Conclusion Vascular leiomyoma usually presents as a small, painless mass. Auricle, nose, lip, and neck are the most common sites of occurrence. Unusually large vascular leiomyomas are developed in the deep space of the neck. Imaging study or cytological examination is not helpful for diagnosis. Histological classification is not necessary. Simple excision yields excellent results. [source] Structural and functional neuroimaging in Klinefelter (47,XXY) syndrome: A review of the literature and preliminary results from a functional magnetic resonance imaging study of languageDEVELOPMENTAL DISABILITIES RESEARCH REVIEW, Issue 4 2009Kyle Steinman Abstract Klinefelter (47,XXY) syndrome (KS), the most common form of sex-chromosomal aneuploidy, is characterized by physical, endocrinologic, and reproductive abnormalities. Individuals with KS also exhibit a cognitive/behavioral phenotype characterized by language and language-based learning disabilities and executive and attentional dysfunction in the setting of normal general intelligence. The underlying neurobiologic mechanisms are just now beginning to be elucidated through structural and functional neuroimaging. Here, we review the literature of structural and functional neural findings in KS identified by neuroimaging and present preliminary results from a functional magnetic resonance imaging study examining brain activity during a verb generation task in KS. © 2009 Wiley-Liss, Inc. Dev Disabil Res Rev 2009;15:295,308. [source] Prospective Study of Accuracy and Outcome of Emergency Ultrasound for Abdominal Aortic Aneurysm over Two YearsACADEMIC EMERGENCY MEDICINE, Issue 8 2003Vivek S. Tayal MD Abstract Determination of the presence of an abdominal aortic aneurysm (AAA) is essential in the management of the symptomatic emergency department (ED) patient. Objectives: To identify whether emergency ultrasound of the abdominal aorta (EUS-AA) by emergency physicians could accurately determine the presence of AAA and guide ED disposition. Methods: This was a prospective, observational study at an urban ED with more than 100,000 annual patient visits with consecutive patients enrolled over a two-year period. All patients suspected to have AAA underwent standard ED evaluation consisting of EUS-AA, followed by a confirmatory imaging study or laparotomy. AAA was defined as any measured diameter greater than 3 cm. Demographic data, results of confirmatory testing, and patient outcome were collected by retrospective review. Results: A total of 125 patients had EUS-AA performed over a two-year period. The patient population had the following characteristics: average age 66 years, male 54%, hypertension 56%, coronary artery disease 39%, diabetes 22%, and peripheral vascular disease 14%. Confirmatory tests included radiology ultrasound, 28/125 (22%); abdominal computed tomography, 95/125 (76%); abdominal magnetic resonance imaging, 1/125 (1%); and laparotomy, 1/125 (1%). AAA was diagnosed in 29/125 (23%); of those, 27/29 patients had AAA on confirmatory testing. EUS-AA had 100% sensitivity (95% CI = 89.5 to 100), 98% specificity (95% CI = 92.8 to 99.8), 93% positive predictive value (27/29), and 100% negative predictive value (96/96). Admission rate for the study group overall was 70%. Immediate operative management was considered in 17 of 27 (63%) patients with AAA; ten patients were taken to the operating room. Conclusions: EUS-AA in a symptomatic population for AAA is sensitive and specific. These data suggest that the presence of AAA on EUS-AA should guide urgent consultation. Emergency physicians were able to exclude AAA regardless of disposition from the ED. [source] Motor foundations of higher cognition: similarities and differences in processing regular and violated perceptual sequences of different specificityEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 12 2009Andreja Bubic Abstract Processing perceptual sequences relies on the motor system, which is able to simulate the dynamics of the environment by developing internal representations of external events and using them to predict the incoming stimuli. Although it has previously been demonstrated that such models may incorporate predictions based on exact stimulus properties and single stimulus dimensions, it is not known whether they can also support abstract predictions pertaining to the level of stimulus categories. This issue was investigated within the present event-related functional magnetic resonance imaging study, which compared the processing of perceptual sequences of different specificity, namely those in which the sequential structure was based on the order of presentation of individual stimuli (token), and those in which such structure was defined by stimulus categories (type). The results obtained indicate a comparable engagement of the basic premotor,parietal network in processing both specific and categorical perceptual sequences. However, type sequences additionally elicited activations within the lateral prefrontal, occipital and posterior temporal regions that supported categorization in this task context. Introducing sequential deviants into token sequences activated parietotemporal and ventrolateral frontal cortices, whereas a less pronounced overall response, dominated by lateral prefrontal activation, was elicited by violations introduced into type sequences. Overall, the findings obtained suggest that, although forward models in perception may be able to incorporate expectations of lower specificity when compared to the motor domain, such processing is crucially dependent on additional contributions from lateral prefrontal as well as inferior occipital and temporal cortices that support categorization occurring in such a dynamic context. [source] Primary and secondary neural networks of auditory prepulse inhibition: a functional magnetic resonance imaging study of sensorimotor gating of the human acoustic startle responseEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 8 2007Linda E. Campbell Abstract Feedforward inhibition deficits have been consistently demonstrated in a range of neuropsychiatric conditions using prepulse inhibition (PPI) of the acoustic startle eye-blink reflex when assessing sensorimotor gating. While PPI can be recorded in acutely decerebrated rats, behavioural, pharmacological and psychophysiological studies suggest the involvement of a complex neural network extending from brainstem nuclei to higher order cortical areas. The current functional magnetic resonance imaging study investigated the neural network underlying PPI and its association with electromyographically (EMG) recorded PPI of the acoustic startle eye-blink reflex in 16 healthy volunteers. A sparse imaging design was employed to model signal changes in blood oxygenation level-dependent (BOLD) responses to acoustic startle probes that were preceded by a prepulse at 120 ms or 480 ms stimulus onset asynchrony or without prepulse. Sensorimotor gating was EMG confirmed for the 120-ms prepulse condition, while startle responses in the 480-ms prepulse condition did not differ from startle alone. Multiple regression analysis of BOLD contrasts identified activation in pons, thalamus, caudate nuclei, left angular gyrus and bilaterally in anterior cingulate, associated with EMG-recorded sensorimotor gating. Planned contrasts confirmed increased pons activation for startle alone vs 120-ms prepulse condition, while increased anterior superior frontal gyrus activation was confirmed for the reverse contrast. Our findings are consistent with a primary pontine circuitry of sensorimotor gating that interconnects with inferior parietal, superior temporal, frontal and prefrontal cortices via thalamus and striatum. PPI processes in the prefrontal, frontal and superior temporal cortex were functionally distinct from sensorimotor gating. [source] Functional segregation of plural regions representing cardinal contours in cat primary visual cortexEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 7 2004Gang Wang Abstract Our previous data based on an imaging study suggested that, in cat area 17, the representations of cardinal orientations overlap less than the representation of their nearby angles. The purpose of this study was to further investigate the underlying single-cell properties. Optical imaging was performed first to map the cortical regions corresponding to the four principal contours, the two cardinals and the two obliques. The cortical region activated by a principal orientation but not by the +10° or ,10° neighbouring angles, namely the area with optically relative independent orientation selectivity (RIOS), was mapped together with the regions that overlapped with the +10° and/or ,10° neighbouring angles (non-RIOS). Electrode penetrations were targeted to the RIOS and non-RIOS regions in each of the four orientations. A comparison between the RIOS and the non-RIOS regions documented a significantly higher percentage of cells with the orientation preference of the cardinal orientations in the cardinal RIOS region than that seen in the other regions. Additionally, the difference in the tuning width of cells between the RIOS and non-RIOS in the cardinal region was significantly larger than the difference between the RIOS and non-RIOS in the oblique region. The cells in the cardinal RIOS region were tuned more sharply and the cells in cardinal non-RIOS region more broadly than the oblique RIOS and/or the non-RIOS region, which showed no significant difference. These data strongly suggest the existence of functional segregation in the region corresponding to the cardinal contours. [source] Differential amygdala responses to winning and losing: a functional magnetic resonance imaging study in humansEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 5 2000Tiziana Zalla Abstract The amygdala has been shown to respond to many distinct types of affective stimuli, including reward and punishment feedback in animals. In humans, winning and losing situations can be considered as reward and punishment experiences, respectively. In this study, we used functional magnetic resonance imaging (fMRI) to measure regional brain activity when human subjects were given feedback on their performance during a simple response time task in a fictitious competitive tournament. Lexical stimuli were used to convey positive ,win' or negative ,lose' feedback. The frequency of positive and negative trials was parametrically varied by the experimenters independently from the subjects' actual performance and unbeknownst to them. The results showed that the parametric increase of winning was associated with left amygdala activation whereas the parametric increase of losing was associated with right amygdala activation. These findings provide functional evidence that the human amygdala differentially responds to changes in magnitude of positive or negative reinforcement conveyed by lexical stimuli. [source] Intellectual abilities and white matter microstructure in development: A diffusion tensor imaging studyHUMAN BRAIN MAPPING, Issue 10 2010Christian K. Tamnes Abstract Higher-order cognitive functions are supported by distributed networks of multiple interconnected cortical and subcortical regions. Efficient cognitive processing depends on fast communication between these regions, so the integrity of the connections between them is of great importance. It is known that white matter (WM) development is a slow process, continuing into adulthood. While the significance of cortical maturation for intellectual development is described, less is known about the relationships between cognitive functions and maturation of WM connectivity. In this cross-sectional study, we investigated the associations between intellectual abilities and development of diffusion tensor imaging (DTI) derived measures of WM microstructure in 168 right-handed participants aged 8,30 years. Independently of age and sex, both verbal and performance abilities were positively related to fractional anisotropy (FA) and negatively related to mean diffusivity (MD) and radial diffusivity (RD), predominantly in the left hemisphere. Further, verbal, but not performance abilities, were associated with developmental differences in DTI indices in widespread regions in both hemispheres. Regional analyses showed relations with both FA and RD bilaterally in the anterior thalamic radiation and the cortico-spinal tract and in the right superior longitudinal fasciculus. In these regions, our results suggest that participants with high verbal abilities may show accelerated WM development in late childhood and a subsequent earlier developmental plateau, in contrast to a steadier and prolonged development in participants with average verbal abilities. Longitudinal data are needed to validate these interpretations. The results provide insight into the neurobiological underpinnings of intellectual development. Hum Brain Mapp, 2010. © 2010 Wiley-Liss, Inc. [source] Frontolimbic responses to emotional face memory: The neural correlates of first impressionsHUMAN BRAIN MAPPING, Issue 11 2009Theodore D. Satterthwaite Abstract First impressions, especially of emotional faces, may critically impact later evaluation of social interactions. Activity in limbic regions, including the amygdala and ventral striatum, has previously been shown to correlate with identification of emotional content in faces; however, little work has been done describing how these signals may influence emotional face memory. We report an event-related functional magnetic resonance imaging study in 21 healthy adults where subjects attempted to recognize a neutral face that was previously viewed with a threatening (angry or fearful) or nonthreatening (happy or sad) affect. In a hypothesis-driven region of interest analysis, we found that neutral faces previously presented with a threatening affect recruited the left amygdala. In contrast, faces previously presented with a nonthreatening affect activated the left ventral striatum. A whole-brain analysis revealed increased response in the right orbitofrontal cortex to faces previously seen with threatening affect. These effects of prior emotion were independent of task performance, with differences being seen in the amygdala and ventral striatum even if only incorrect trials were considered. The results indicate that a network of frontolimbic regions may provide emotional bias signals during facial recognition. Hum Brain Mapp, 2009. © 2009 Wiley-Liss, Inc. [source] Heritability of regional and global brain structure at the onset of puberty: A magnetic resonance imaging study in 9-year-old twin pairsHUMAN BRAIN MAPPING, Issue 7 2009Jiska S. Peper Abstract Puberty represents the phase of sexual maturity, signaling the change from childhood into adulthood. During childhood and adolescence, prominent changes take place in the brain. Recently, variation in frontal, temporal, and parietal areas was found to be under varying genetic control between 5 and 19 years of age. However, at the onset of puberty, the extent to which variation in brain structures is influenced by genetic factors (heritability) is not known. Moreover, whether a direct link between human pubertal development and brain structure exists has not been studied. Here, we studied the heritability of brain structures at 9 years of age in 107 monozygotic and dizygotic twin pairs (N = 210 individuals) using volumetric MRI and voxel-based morphometry. Children showing the first signs of secondary sexual characteristics (N = 47 individuals) were compared with children without these signs, based on Tanner-stages. High heritabilities of intracranial, total brain, cerebellum, and gray and white matter volumes (up to 91%) were found. Regionally, the posterior fronto-occipital, corpus callosum, and superior longitudinal fascicles (up to 93%), and the amygdala, superior frontal and middle temporal cortices (up to 83%) were significantly heritable. The onset of secondary sexual characteristics of puberty was associated with decreased frontal and parietal gray matter densities. Thus, in 9-year-old children, global brain volumes, white matter density in fronto-occipital and superior longitudinal fascicles, and gray matter density of (pre-)frontal and temporal areas are highly heritable. Pubertal development may be directly involved in the decreases in gray matter areas that accompany the transition of our brains from childhood into adulthood. Hum Brain Mapp, 2009. © 2009 Wiley-Liss, Inc. [source] Different activation dynamics in multiple neural systems during simulated drivingHUMAN BRAIN MAPPING, Issue 3 2002Vince D. Calhoun Abstract Driving is a complex behavior that recruits multiple cognitive elements. We report on an imaging study of simulated driving that reveals multiple neural systems, each of which have different activation dynamics. The neural correlates of driving behavior are identified with fMRI and their modulation with speed is investigated. We decompose the activation into interpretable pieces using a novel, generally applicable approach, based upon independent component analysis. Some regions turn on or off, others exhibit a gradual decay, and yet others turn on transiently when starting or stopping driving. Signal in the anterior cingulate cortex, an area often associated with error monitoring and inhibition, decreases exponentially with a rate proportional to driving speed, whereas decreases in frontoparietal regions, implicated in vigilance, correlate with speed. Increases in cerebellar and occipital areas, presumably related to complex visuomotor integration, are activated during driving but not associated with driving speed. Hum. Brain Mapping 16:158,167, 2002. © 2002 Wiley-Liss, Inc. [source] Comparison of neuronal and hemodynamic measures of the brain response to visual stimulation: An optical imaging studyHUMAN BRAIN MAPPING, Issue 1 2001Gabriele Gratton Abstract The noninvasive mapping of hemodynamic brain activity has led to significant advances in neuroimaging. This approach is based in part on the assumption that hemodynamic changes are proportional to (and therefore constitute a linear measure of) neuronal activity. We report a study investigating the quantitative relationship between neuronal and hemodynamic measures. This study exploited the fact that optical imaging methods can simultaneously provide noninvasive measures of neuronal and hemodynamic activity from the same region of the brain. We manipulated visual stimulation frequency and measured responses from the medial occipital area of 8 young adults. The results were consistent with a model postulating a linear relationship between the neuronal activity integrated over time and the amplitude of the hemodynamic response. The hemodynamic response colocalized with the neuronal response. These data support the use of quantitative neuroimaging methods to infer the intensity and localization of neuronal activity in occipital areas. Hum. Brain Mapping 13:13,25, 2001. © 2001 Wiley-Liss, Inc. [source] The relative position of ilioinguinal and iliohypogastric nerves in different age groups of pediatric patientsACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 5 2010J.-Y. HONG Background: Ilioinguinal nerve (IIN) and iliohypogastric nerve (IHN) blocks provide good perioperative pain relief for children undergoing inguinal procedures such as inguinal hernia repair, orchiopexy, and hydrocelectomy. The aim of this ultrasound imaging study is to compare the relative anatomical positions of IIN and IHN in different age groups of pediatrics. Methods: Two-hundred children (aged 1,82 months, ASA I or II) undergoing day-case surgery were consecutively included in this study. Following the induction of general anesthesia, an ultrasonographic exam was performed using a high-frequency linear probe that was placed on an imaginary line connecting the anterior superior iliac spine (ASIS) to the umbilicus. Results: There were significant differences in ASIS,IIN (distance from ASIS to IIN), ASIS,IHN (distance from the ASIS to the IHN), and IIN,IHN (distance between IIN and IHN) between the age groups: <12 months (n=84), 12,36 months (n=80), and >37 months (n=36). However, IIN,Peritoneum (distances from IIN to peritoneum), skin,IIN, and skin,IHN (depth of IIN and IHN relative to skin) were similar in three groups. ASIS,IIN and ASIS,IHN showed significantly positive correlations with age. Conclusions: Age should be considered when placing a needle in landmark techniques for pediatric II/IH nerve blocks. However, needle depth should be confirmed by the fascial click due to the lack of predictable physiologic factors. [source] Assessment of Pulmonary Vein Anatomic Variability by Magnetic Resonance Imaging:JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 4 2004Implications for Catheter Ablation Techniques for Atrial Fibrillation Introduction: Pulmonary vein (PV) isolation for atrial fibrillation (AF) currently is performed using either an ostial or an extra-ostial approach. The objective of this study was to analyze by three-dimensional (3D) magnetic resonance angiography (MRA) the anatomy of the PVs in order to detect structural variability that would impact the choice of ablation approach. Methods and Results: Three-dimensional MRA was performed in 105 patients undergoing PV isolation. The ostial diameter, branching pattern, and PV angulation were analyzed. Fifty-nine (56%) patients had the typical pattern of 4 PVs with 4 separate ostia, 30 (29%) patients had an additional PV, and 18 (17%) patients had a left common PV trunk. In two patients, there were three right-sided veins and a common left-sided trunk, giving rise to four ostia: three on the right and one on the left. Two different populations of right middle PVs were noted: one where the additional vein projected anteriorly to drain the right middle lobe and one posterior to drain the superior portion of the right lower lobe. The average intrapatient variability in PV diameter was 7.9 ± 4.2 mm. The PV ostium was <10 mm in 26 (25%) patients and >25 mm in 15 (14%) patients. The first branch originated 6.7 ± 2.3 mm from the ostium. The left superior, right superior, right inferior, and left inferior PVs were found to enter the left atrium at the following angles: 32 ± 13°, 131 ± 11°, 206 ± 16°, and 329 ± 14°, respectively. Forty-nine patients (47%) had at least one funnel shaped PV. Conclusion: This largest PV imaging study to date demonstrates that MRA is a valuable tool that allows detection of marked intrapatient and interpatient anatomic variability of the PVs. These findings suggest that, at least in some patients, circumferential extra-ostial left atrial encirclement of the PVs may be preferable to ostial PV isolation. These findings also may have significant implications on the future development of coil- and balloon-based catheter ablation designs for AF ablation. (J Cardiovasc Electrophysiol, Vol. 15, pp. 387-393, April 2004) [source] A method for the direct electrical stimulation of the auditory system in deaf subjects: A functional magnetic resonance imaging studyJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 1 2002Adnan Z. Alwatban BSc Abstract Purpose To develop a safe functional magnetic resonance imaging (fMRI) procedure for auditory assessment of deaf subjects. Materials and Methods A gold-plated tungsten electrode has been developed which has zero magnetic susceptibility. Used with carbon leads and a carbon reference pad, it enables safe, distortion-free fMRI studies of deaf subjects following direct electrical stimulation of the acoustic nerve. Minor pickup of the radio frequency (RF) pulses by the electrode assembly is difficult to eliminate, and a SPARSE acquisition sequence is used to avoid any effects of unintentional auditory nerve stimulation. Results The procedure is demonstrated in a deaf volunteer. Activation is observed in the contralateral but not the ipsilateral primary auditory cortex. This is in sharp contrast to studies of auditory processing in hearing subjects, but consistent with the small number of previous positron emission tomography (PET) and MR studies on adult deaf subjects. Conclusion The fMRI procedure is able to demonstrate whether the auditory pathway is fully intact, and may provide a useful method for preoperative assessment of candidates for cochlear implantation. J. Magn. Reson. Imaging 2002;16:6,12. © 2002 Wiley-Liss, Inc. [source] Spinal Cord Pilomyxoid Astrocytoma: An Unusual TumorJOURNAL OF NEUROIMAGING, Issue 4 2007Mishal Mendiratta-Lala MD ABSTRACT We present the imaging findings of a case of spinal pilomyxoid astrocytoma in a 29-year-old woman with history of neck and back pain and weakness of bilateral upper extremities. A contrast-enhanced magnetic resonance (MR) imaging study revealed an extensive intradural extramedullary lesion occupying most of the thecal sac extending from mid cervical up to the lumbosacral region with extensive contrast enhancement. Spinal pilomyxoid astrocytoma is rare with only three reported cases in pediatric population in the literature. This report illustrates the MR findings of an unusual case of intradural extramedullary spinal pilomyxoid tumor in an adult patient. [source] In vivo bioluminescence imaging study to monitor ectopic bone formation by luciferase gene marked mesenchymal stem cellsJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 7 2008Cristina Olivo Abstract Mesenchymal stem cells (MSCs) represent a powerful tool for applications in regenerative medicine. In this study, we used in vivo bioluminescence imaging to noninvasively investigate the fate and the contribution to bone formation of adult MSCs in tissue engineered constructs. Goat MSCs expressing GFP-luciferase were seeded on ceramic scaffolds and implanted subcutaneously in immune-deficient mice. The constructs were monitored weekly with bioluminescence imaging and were retrieved after 7 weeks to quantify bone formation by histomorphometry. With increasing amounts of seeded MSCs (from 0 to 1,×,106 MSC/scaffold), a cell-dose related increase in bioluminescence was observed at all time points, correlating with increased bone formation at 7 weeks. To investigate the relevance of MSC proliferation to bone deposition, cell-seeded scaffolds were irradiated. The irradiated cells were functional with respect to oxygen consumption but no increase in bioluminescence was observed in vivo, and only minimal bone was produced. Proliferating MSCs are likely required for initiation of bone formation in tissue engineered constructs in vivo. Bioluminescence is a useful tool to monitor cellular responses and predict bone formation in vivo. © 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 26:901,909, 2008 [source] The Learning Curve of Resident Physicians Using Emergency Ultrasonography for Obstructive UropathyACADEMIC EMERGENCY MEDICINE, Issue 9 2010Timothy B. Jang MD Abstract Background:, Given the time, expense, and radiation exposure associated with computed tomography (CT), ultrasonography (US) is considered an alternative imaging study that could expedite patient care in patients with suspected obstructive uropathy. However, there is a paucity of literature regarding bedside US for obstructive uropathy in the emergency department (ED), and it is unknown how much experience is required for competency in such exams. Objectives:, The objective was to assess the learning curve for the detection of obstructive uropathy of resident physicians training in ED bedside US (EUS) during a dedicated EUS elective. Methods:, This was a prospective cohort study of residents participating in an EUS elective. Patients presenting with acute abdominal or flank pain suggestive of an obstructive uropathy were enrolled and underwent EUS prior to noncontrast CT. Physicians who had previously performed at least 10 EUS exams for obstructive uropathy recorded results on a standardized data sheet, which was subsequently compared to the results of noncontrast CT read by board-certified radiologists blinded to the results of the EUS. In addition to an unadjusted chi-square test for trend, a multivariable logistic regression analysis, adjusting for stone size and operator, was performed. Finally, generalized estimating equations were used to describe test characteristics while accounting for potential clustering between exams by operator. Results:, Twenty-three resident physicians participated and enrolled a convenience sample of 393 patients. A total of 157 patients (40%) were diagnosed with an obstructing ureterolith, and three (1%) were diagnosed with nonobstructing ureterolithiasis. An unadjusted chi-square test for trend demonstrated a statistically significant increase in both sensitivity (,2 = 11.4, p = 0.02) and specificity (,2 = 6.4, p = 0.04) for each level of increase in number of exams. On multivariable regression analysis, when adjusting for size of stone and operator, for every five additional exams after the first 10 EUS exams, the odds ratio for a true positive for obstruction increased by 1.7 (95% confidence interval [CI] = 1.2 to 2.5, p = 0.003). After accounting for clustering of exams by operator, overall EUS sensitivity and specificity for obstructive uropathy were 82% (95% CI = 77% to 87%) and 88% (95% CI = 85% to 92%). Stratifying by number of exams, the sensitivity was 72% (95% CI = 62% to 80%) for the 11th through 20th exams, 90% (95% CI = 83% to 96%) for the 21st through 30th exams, and 95% (95% CI = 91% to 99%) for the 31st through 43rd exams. Likewise, specificity was 82% (95% CI = 75% to 89%) for the 11th through 20th exams, 90% (95% CI = 85% to 95%) for the 21st through 30th exams, and 92% (95% CI = 86% to 98%) for the 31st through 50th exams. Conclusions:, Physicians training in EUS may be able to accurately assess for obstructive uropathy after 30 exams. ACADEMIC EMERGENCY MEDICINE 2010; 17:1024,1027 © 2010 by the Society for Academic Emergency Medicine [source] In vivo near-IR imaging of approximal dental decay at 1,310,nmLASERS IN SURGERY AND MEDICINE, Issue 4 2010Michal Staninec DDS Abstract Objective The high transparency of dental enamel in the near-IR (NIR) light at 1,310-nm can be exploited for imaging dental caries without the use of ionizing radiation (X-rays). We present the results of the first in vivo imaging study in which NIR images were acquired of approximal contact surfaces. Methods NIR imaging hand-pieces were developed and attached to a compact InGaAs focal plane array and subsequently used to acquire in vivo NIR images of 33 caries lesions on 18 test subjects. The carious lesions were discernible on bitewing radiographs, but were not visible upon clinical examination. Results NIR images were acquired in vivo from three directions and the majority of lesions examined were too small to require restoration, based on accepted bitewing radiograph criteria. All but one of the 33 lesions examined were successfully imaged from at least one direction. Conclusion This first in vivo study of imaging at the 1,310-nm wavelength region shows that NIR imaging has great potential as a screening tool for the detection of approximal lesions without the use of ionizing radiation. Lasers Surg. Med. 42:292,298, 2010. © 2010 Wiley-Liss, Inc. [source] Cerebral plasticity in crossed C7 grafts of the brachial plexus: An fMRI studyMICROSURGERY, Issue 4 2006Jean-Yves Beaulieu M.D. In order to rescue elbow flexion after complete accidental avulsion of one brachial plexus, seven patients underwent a neurotization of the biceps with fibers from the contralateral C7 root. The C7 fibers used for the graft belonged to the pyramidal pathway, which descends from the cerebral hemisphere ipsilateral to the damaged plexus, and which controls extension and abduction of the contralateral arm. After several months of reeducation, a functional magentic resonance imaging study was performed with a 1.5 tesla clinical magnetic resonance scan system, in order to investigate the central neural networks involved in the recovery of elbow flexion. Functional brain images were acquired under four conditions: flexion of each of the two elbows, and imagined flexion of each elbow. Results show that flexion of the neurotized arm is associated with a bilateral network activity. The contralateral cortex originally involved in control of the rescued arm still participates in the elaboration and control of the task through the bilateral premotor and primary motor cortex. The location of the ipsilateral clusters in the primary motor, premotor, supplementary motor area, and posterior parietal areas is similar among patients. The location of contralateral activations within the same areas differs across patients. © 2006 Wiley-Liss, Inc. Microsurgery, 2006. [source] Senile chorea treated by deep brain stimulation,A clinical, neurophysiological and functional imaging study,MOVEMENT DISORDERS, Issue 5 2004John Yianni MRCS Abstract We report on a patient with senile chorea, treated with deep brain stimulation of the left globus pallidus internus and subsequently the left ventralis oralis posterior nucleus of the thalamus. Deep brain field potential recordings and functional imaging using single photon emission tomography enabled us to suggest pathophysiological mechanisms for the symptoms. © 2004 Movement Disorder Society [source] Patterns of muscle involvement in inclusion body myositis: Clinical and magnetic resonance imaging studyMUSCLE AND NERVE, Issue 11 2001Beverley A. Phillips PhD Abstract The differential patterns of muscle involvement in the upper and lower limbs in sporadic inclusion body myositis (sIBM) were examined in 18 patients using both quantitative and manual muscle testing as well as magnetic resonance imaging (MRI) in 9 patients. Weakness of the quadriceps femoris and the forearm flexors was present in most patients, but there was considerable variability in the patterns and severity of muscle involvement. MRI disclosed preferential patterns of muscle involvement within functional groups such as the quadriceps femoris, in which there was severe involvement of the vasti with relative sparing of the rectus femoris, and the triceps surae, in which selective involvement of the medial gastrocnemius was common. Involvement of flexor digitorum profundus on MRI was found in only one third of patients. The results emphasize the variability in the clinical phenotype and differential susceptibility of muscles to the disease process in sIBM. © 2001 John Wiley & Sons, Inc. Muscle Nerve 24: 1526,1534, 2001 [source] Ventricular cerebrospinal fluid lactate is increased in chronic fatigue syndrome compared with generalized anxiety disorder: an in vivo 3.0 T 1H MRS imaging study,NMR IN BIOMEDICINE, Issue 3 2009Sanjay J. Mathew Abstract Chronic fatigue syndrome (CFS) is a controversial diagnosis because of the lack of biomarkers for the illness and its symptom overlap with neuropsychiatric, infectious, and rheumatological disorders. We compared lateral ventricular volumes derived from tissue-segmented T1 -weighted volumetric MRI data and cerebrospinal fluid (CSF) lactate concentrations measured by proton MRS imaging (1H MRSI) in 16 subjects with CFS (modified US Centers for Disease Control and Prevention criteria) with those in 14 patients with generalized anxiety disorder (GAD) and in 15 healthy volunteers, matched group-wise for age, sex, body mass index, handedness, and IQ. Mean lateral ventricular lactate concentrations measured by 1H MRSI in CFS were increased by 297% compared with those in GAD (P,<,0.001) and by 348% compared with those in healthy volunteers (P,<,0.001), even after controlling for ventricular volume, which did not differ significantly between the groups. Regression analysis revealed that diagnosis accounted for 43% of the variance in ventricular lactate. CFS is associated with significantly raised concentrations of ventricular lactate, potentially consistent with recent evidence of decreased cortical blood flow, secondary mitochondrial dysfunction, and/or oxidative stress abnormalities in the disorder. Copyright © 2008 John Wiley & Sons, Ltd. [source] Therapeutic efficacy of 5-fluorouracil-loaded microspheres on rat glioma: a magnetic resonance imaging studyNMR IN BIOMEDICINE, Issue 6 2001L. Lemaire Abstract The aim of this work was to assess the therapeutic efficacy of an intratumoral bolus injection of 5-fluorouracil (FU) compared to that of drug loaded in biodegradable microspheres, for the treatment of brain tumour. Experiments were carried out using a fast-growing C6-glioma rat model. The therapeutic protocols were performed 12 days after the injection of glioma cells. At this stage, the tumours were installed and the mean volume was 13,±,2,µl as measured by proton magnetic resonance (MR) imaging. This technique was used for the follow-up of the tumour volume with respect to time and therapy. In terms of rat survival, both therapies induced a significant 50% increase in animal life span (p,<,0.05) compared to animals receiving no drug or unloaded microspheres. Whilst no cure was observed, analysis of the MR images showed that the local and sustained delivery of FU slowed the tumour development in the vicinity of the microspheres by a factor of 3, compared with the bolus intratumoral injection. Copyright © 2001 John Wiley & Sons, Ltd. [source] Fungus ball of the paranasal sinuses: Experience in 160 patients treated with endoscopic surgeryTHE LARYNGOSCOPE, Issue 11 2009Piero Nicolai MD Abstract Objectives/Hypothesis: Herein we present our experience in the management of fungus ball (FB) of the paranasal sinuses. Preoperative imaging strategy and findings, surgical technique, and pathologic and microbiologic results are discussed. Study Design: Retrospective chart review of patients with FB of the paranasal sinuses who underwent endoscopic surgery at the Department of Otorhinolaryngology of the University of Brescia, Italy. Methods: From January 1990 to December 2006, 160 patients with sinonasal fungus ball were treated with a purely endoscopic approach. All patients underwent preoperative computed tomography (CT) and/or magnetic resonance (MR) imaging; an endo-oral dental x-ray or orthopantomography and odontological evaluation were also performed in patients with maxillary sinus localization. All removed material was sent for pathologic and microbiologic evaluation. All patients were prospectively followed with endoscopic control every 2 months during the first postoperative year and subsequently every 6 months. Results: The patient cohort included 118 females and 42 males, with an age from 19 to 85 years (mean, 52.7 years). FB was located in the maxillary sinus in 135 (84.4%) patients; in two cases both sinuses were affected. Sphenoid and ethmoid involvement was observed in 23 (14.4%) and 1 (0.6%) patients, respectively. Simultaneous ethmoid and sphenoid involvement was found in one (0.6%) case. In all patients complete removal of fungal debris was obtained through wide sinusotomy. No recurrence was observed. Conclusions: Endoscopic surgery is a safe and effective treatment for paranasal sinuses FB. A proper imaging study by MR and/or CT can address diagnosis, which is based upon detection of fungal hyphae at histology. Laryngoscope, 2009 [source] | |||||||||||||||||||||||||||||||