Two-Stage Processing of Aesthetic Information in the Human Brain Revealed by Neural Adaptation Paradigm

Some researchers in aesthetics assume visual features related to aesthetic perception (e.g. golden ratio and symmetry) commonly embedded in masterpieces. If this is true, an intriguing hypothesis is that the human brain has neural circuitry specialized for the processing of visual beauty. We presently tested this hypothesis by combining a neuroimaging technique with the repetition suppression (RS) paradigm. Subjects (non-experts in art) viewed two images of sculptures sequentially presented. Some sculptures obeyed the golden ratio (canonical images), while the golden proportion were impaired in other sculptures (deformed images). We found that the occipito-temporal cortex in the right hemisphere showed the RS when a canonical sculpture (e.g. Venus de Milo) was repeatedly presented, but not when its deformed version was repeated. Furthermore, the right parietal cortex showed the RS to the canonical proportion even when two sculptures had different identities (e.g. Venus de Milo as the first stimulus and David di Michelangelo as the second), indicating that this region encodes the golden ratio as an abstract rule shared by different sculptures. Those results suggest two separate stages of neural processing for aesthetic information (one in the occipito-temporal and another in the parietal regions) that are hierarchically arranged in the human brain.     

The iliac wing sign: an indicator of the presence of bone and/or soft-tissue injury of the pelvis and hips

Purpose

To prospectively evaluate the feasibility of using the “iliac wing sign (IWS)” as an indicator of bone and/or soft-tissue injury of the pelvis and hips on magnetic resonance (MR) imaging. IWS means edema of the iliacus muscle attachment entering the iliac wing that is visualized as a linear high signal intensity on fat-suppressed T2-weighted MR images.

Methods

Consecutive 106 patients who complained of hip pain were enrolled in this study. We evaluated the correlation between IWS and bone and/or soft-tissue injury of the pelvis and hips using Fisher's exact test. Further, performance parameters of sensitivity, specificity, accuracy, the positive predictive value (PPV), and negative predictive value (NPV) of IWS were calculated.

Results

Thirty-eight of the 106 (36%) patients had bone and/or soft-tissue injury. Twenty-seven of these 38 (71%) patients with injury showed a positive IWS, while only 11 of 68 (16%) patients without injury showed a positive IWS (p < .0001). IWS, thus, yielded a sensitivity of 71%, specificity of 84%, accuracy of 79%, positive predictive value (PPV) of 71%, and negative predictive value (NPV) of 84%.

Conclusion

In cases with a positive IWS, the careful interpretation of MR images is needed because injury presence is highly likely, as suggested by the relatively high sensitivity and PPV. IWS absence may mean a low probability of injury because of the high specificity and NPV.     

Contrast-induced nephropathy in patients with renal insufficiency undergoing contrast-enhanced MDCT

Objectives

To evaluate the safety of contrast-enhanced MDCT in patients with renal impairment.

Methods

We conducted a retrospective review of 938 patients with stable renal insufficiency (eGFR between 15 and 60?ml/min) who underwent contrast-enhanced MDCT. SCr levels were measured at baseline and 48–72?h after contrast medium administration. The incidence of contrast-induced nephropathy (CIN) in the total study population was assessed. As a control group, 1,164 separate patients with renal insufficiency who did not receive contrast medium for CT were also reviewed.

Results

The overall incidence of CIN in the patient population with renal insufficiency was 6.1?%; the incidence was 4.4?%, 10.5?% and 10.0?% for patients whose eGFR was 45–60, 30–45 and ≤30?ml/min, respectively (P?P?=?0.82)

Conclusions

The risk of CIN from contrast-enhanced MDCT in patients with renal insufficiency appeared to be low, and there was no significant difference in the incidence of CIN in comparison with patients who did not receive CM.

Key Points

? The contrast medium used for multidetector CT can induce nephropathy. ? Contrast-induced nephropathy (CIN) developed in 6.1?% of patients with renal insufficiency. ? However, nephropathy developed in 5.8?% of similar patients not receiving contrast medium. ? Thus, the risk of CIN associated with MDCT appears to be low. ? Special care should still be taken in patients with renal insufficiency.     

Neutralization of tumor necrosis factor abrogates hepatic failure induced by alpha-galactosylceramide without attenuating its antitumor effect in aged mice

BACKGROUND/AIMS: The functions of mouse liver NK1.1+ T (NKT) cells stimulated with alpha-galactosylceramide (alpha-GalCer) are enhanced age dependently, and the antitumor and anti-metastatic effect in the liver is dependent on IFN-gamma. However, hepatic injury is independent of IFN-gamma and Fas/Fas-ligand dependent. The aim of this study is to investigate how tumor necrosis factor is involved in the alpha-GalCer-mediated immune phenomena. METHODS: C57BL/6 mice were intraperitoneally treated with anti-TNF antibody 1 h before alpha-GalCer injection, and Fas-ligand expression of NKT cells, the serum ALT levels and histopathological findings of the liver, kidney and lung and mortality after alpha-GalCer injection were evaluated. IFN-gamma production and antitumor immunity in the liver after the intravenous injection of EL-4 cells were also assessed. RESULTS: Serum TNF levels after alpha-GalCer injection increased age dependently in mice. Anti-TNF Ab reduced Fas-ligand (Fas-L) expression of NKT cells while it completely inhibited organ injuries induced by alpha-GalCer and thereby reduced the mortality of old mice, whereas it did not affect the IFN-gamma production from NKT cells, the antitumor immunity in the liver nor the mouse survival after EL-4 injection. CONCLUSIONS: NKT cells activated by alpha-galactosylceramide participated in either antitumor immunity or hepatic injury using IFN-gamma and TNF/Fas-L, respectively.     

Percutaneous removal of a fully expanded SMART stent from the pulmonary artery using various adjunctive techniques

A 36-year-old man with an implanted arteriovenous shunt for hemodialysis was referred for shunt malfunction. Venography of the right upper extremity showed occlusion of the subclavian vein, and a SMART stent was deployed. The fully expanded stent immediately migrated centrally into the left pulmonary artery. As initial efforts to pass a snare over the stent failed, we intentionally passed a microguidewire through stent interstices, snared the end of the microguidewire to create a loop, and pulled the stent/microguidewire/snare combination back into the right ventricle where it separated from the loop because of stent mesh destruction. As the stent remained in the right ventricle, we advanced a 0.035-in. guidewire into the stent lumen, passed an angioplasty balloon over the guidewire, inflated the balloon in the stent, and performed pull-back into the right distal external iliac artery. The stent was then surgically removed via a right inguinal incision without eliciting any complications. Although retrieval of the stent malpositioned in the pulmonary artery was difficult, we retrieved it safely by applying various adjunctive techniques.     

Emergent thoracic endovascular aortic repair in a patient with hemoptysis due to bronchial fistula: a case for airway management

Bronchial fistula due to bronchial compression is a rare complication following both open surgical and endovascular repair of thoracic aortic aneurysms. We report on the airway management for a case of emergent thoracic endovascular aortic repair (TEVAR) in a patient with left bronchial obstruction due to hemoptysis. A 68-year-old man had undergone total arch replacement 8 years before, and was preoperatively diagnosed with aortobronchial fistula in the left lung. To prevent obstruction of the right lung by rebleeding in the left bronchus, we planned to exchange the single lumen endotracheal tube placed following hemoptysis to a double lumen tube prior to the operation. With assisted spontaneous breathing, bronchoscopy performed before replacing of the endotracheal tube showed obstruction of the left bronchus with many clots. With bronchoscopic assistance, clots were removed from the left bronchus and oxygenation improved significantly. We found a blue nylon suture penetrating the bronchial wall, most likely from a previous operation. However, bronchoscopy did not disclose aortobronchial fistula. Following TEVAR, the patient was diagnosed with bronchopleural fistula induced by bronchial compression due to blood vessel prosthesis and surrounding felt strips. Cooperation from surgeons and careful airway management were required to prevent life-threatening oxygenation insufficiency.