Optimization of opacity function for computed tomography volume rendered images of the prostate using magnetic resonance reference volumes

Objective To enhance the opacity function for computed tomography (CT)-based prostate volume rendered (VR) images using reference magnetic resonance (MR) images. Materials and Methods After simulating on phantoms, ten patients with CT and MR datasets were identified/ registered. Optimal VR images were produced, and intra-modality and cross-modality errors [mean distance in voxel units (VU) from VR partial surface to target] were computed. On the CT VR images, a global transformation was computed to relate the opacity functions obtained using CT reference volumes with those obtained using MR reference volumes. Results The prostate was better visualized on MR than CT, as the intra-modality errors obtained using MR (2.78 ± 1.02 VU) were lower than on CT (3.68 ± 2.15 VU). Despite similar qualitative results as the intra-modality CT images, the cross-modality errors obtained using the individual patient data (2.77 ± 0.99 VU) and using the global transformation (2.89 ± 0.99 VU) were each closer (P = 0.010 and P = 0.011, respectively) to the intra-modality MR errors than were the intra-modality CT errors. Conclusion By optimizing the opacity function using MR reference images, CT VR images of the prostate could closely represent the prostate defined on MR; furthermore, this process can be approximated by a simple transformation. Overall, the errors were reduced to a level (<3 VU) justifying further exploration in CT-based radiotherapy treatment planning. Grant Support: This work was supported by an American Society of Therapeutic Radiology and Oncology (ASTRO) Junior Faculty Research Grant/Award, and was an oral presentation at the annual meeting of ASTRO in Philadelphia, PA in November 2006.     

Thyroid-stimulating autoantibodies in Graves disease preferentially recognize the free A subunit,not the thyrotropin holoreceptor

Graves disease is directly caused by thyroid-stimulating autoantibodies (TSAb's) that activate the thyrotropin receptor (TSHR). We observed upon flow cytometry using intact cells that a mouse mAb (3BD10) recognized the TSHR ectodomain with a glycosidylphosphatidylinositol (ECD-GPI) anchor approximately tenfold better than the same ectodomain on the wild-type TSHR, despite the far higher level of expression of the latter. The 3BD10 epitope contains the N-terminal cysteine cluster critical for TSAb action. Consequently, we hypothesized and confirmed that TSAb (but not thyrotropin-blocking autoantibodies [TBAb's]) also poorly recognize the wild-type TSHR relative to the ECD-GPI. Despite poor recognition by TSAb of the holoreceptor, soluble TSHR A subunits (known to be shed from surface TSHR) fully neutralized autoantibody-binding activity. These data indicate that the epitope(s) for TSAb's, but not for TBAb's, are partially sterically hindered on the holoreceptor by the plasma membrane, the serpentine region of the TSHR, or by TSHR dimerization. However, the TSAb epitope on the soluble A subunit is freely accessible. This observation, as well as other evidence, supports the concept that A subunit shedding either initiates or amplifies the autoimmune response to the TSHR, thereby causing Graves disease in genetically susceptible individuals.     

A common haplotype at the CD36 locus is associated with high free fatty acid levels and increased cardiovascular risk in Caucasians

CD36 is a class B scavenger receptor recognizing a variety of ligands including long-chain fatty acids and modified LDL. We investigated whether genetic variability at this locus is a determinant of free fatty acid (FFA) plasma levels and risk of coronary artery disease (CAD) in Caucasians. Typing of 21 polymorphic markers, evenly spanning the CD36 gene, revealed two linkage disequilibrium (LD) blocks that could be tagged by five polymorphisms (-33137A>G, -31118G>A, 25444G>A, 27645del>ins and 30294G>C). In 585 non-diabetic individuals of Caucasian origin, the 30294G>C polymorphism was significantly associated with FFA levels (P = 0.02)--an effect that was especially visible among men (P = 0.009). A similar association was observed in this gender at -33137 (P = 0.008) and -31118 (P = 0.028). When the five tag polymorphisms were considered together, men carrying the AGGIG haplotype had 31% higher FFA (P = 0.0002) and 20% higher triglycerides (P = 0.025) than non-carriers. The same haplotype was associated with increased risk of CAD in 197 type 2 diabetic individuals from the US (OR = 2.3, 95% CI 1.2-4.2). A similar tendency was observed in a group of 321 type 2 diabetic individuals from Italy (OR = 1.4, 0.9-2.3), resulting in an overall relative risk of 1.6 (1.1-2.3, P = 0.015) in the two populations considered together. By targeted resequencing, we identified a common variant in the CD36 promoter that is in strong LD with the AGGIG haplotype and could be partly responsible for these findings. In conclusion, this comprehensive study of CD36 variability indicates that the common polymorphisms at this locus modulate lipid metabolism and cardiovascular risk in Caucasians.     

Rare copy number variants in neuropsychiatric disorders: Specific phenotype or not?

From a number of genome-wide association studies it was shown that de novo and/or rare copy number variants (CNVs) are found at an increased frequency in neuropsychiatric diseases. In this study we examined the prevalence of CNVs in six genomic regions (1q21.1, 2p16.3, 3q29, 15q11.2, 15q13.3, and 16p11.2) previously implicated in neuropsychiatric diseases. Hereto, a cohort of four neuropsychiatric disorders (schizophrenia, bipolar disorder, major depressive disorder, and intellectual disability) and control individuals from three different populations was used in combination with Multilpex Amplicon Quantifiaction (MAQ) assays, capable of high resolution (kb range) and custom-tailored CNV detection. Our results confirm the etiological candidacy of the six selected CNV regions for neuropsychiatric diseases. It is possible that CNVs in these regions can result in disturbed brain development and in this way lead to an increased susceptibility for different neuropsychiatric disorders, dependent on additional genetic and environmental factors. Our results also suggest that the neurodevelopmental component is larger in the etiology of schizophrenia and intellectual disability than in mood disorders. Finally, our data suggest that deletions are in general more pathogenic than duplications. Given the high frequency of the examined CNVs (1-2%) in patients of different neuropsychiatric disorders, screening of large cohorts with an affordable and feasible method like the MAQ assays used in this study is likely to result in important progress in unraveling the genetic factors leading to an increased susceptibility for several psychiatric disorders. ? 2012 Wiley Periodicals, Inc.     

Behavioural and ERP indices of response inhibition during a Stop-signal task in children with two subtypes of Attention-Deficit Hyperactivity Disorder.

Previous research has shown that children with Attention-Deficit Hyperactivity Disorder of the Combined Type (AD/HDcom) have problems with response inhibition, with poorer task performance and atypical inhibition-related ERPs relative to control subjects, while little is known about response inhibition in children with Attention-deficit Hyperactivity Disorder of the Predominantly Inattentive Type (AD/HDin). In this study children with AD/HDin (N=12), AD/HDcom (N=13) and age-matched controls (N=13) aged between 8 and 14 years completed a Stop-signal task, with visual Go and auditory Stop-signal stimuli, while EEG was recorded. The results indicated that the groups did not differ on any inhibitory task performance measure, but the AD/HD groups showed more errors of omission to Go stimuli than controls. ERPs to the visual Go stimuli differed between children with AD/HDin and controls (increased central N1 and N2, decreased central P2 and increased parietal P3), while the AD/HDcom group showed only minor scalp distribution differences for N2 and P3. The AD/HDin group showed amplitude differences from controls to Stop signals (larger central N1 and parietal P3; reduced midline N2) and did not show a Successful vs. Failed inhibition effect for P3. The AD/HDcom group showed reduced parietal P3 to Stop signals, with the Trial Type effect present for N2 but not P3. These data suggest that the apparent atypical inhibitory processing at N2 and P3 may stem, at least in part, from atypical early sensory/alerting processing of all stimuli in children with AD/HDin.     

The effects of difficulty and gain versus loss on vocal physiology and acoustics

To examine the basis of emotional changes to the voice, physiological and electroglottal measures were combined with acoustic speech analysis of 30 men performing a computer task in which they lost or gained points under two levels of difficulty. Predictions of the main effects of difficulty and reward on the voice were not borne out by the data. Instead, vocal changes depended largely on interactions between gain versus loss and difficulty. The rate at which the vocal folds open and close (fundamental frequency; fo) was higher for loss than for gain when difficulty was high, but not when difficulty was low. Electroglottal measures revealed that fo changes corresponded to shorter glottal open times for the loss conditions. Longer closed and shorter open phases were consistent with raised laryngeal tension in difficult loss conditions. Similarly, skin conductance indicated higher sympathetic arousal in loss than gain conditions, particularly when difficulty was high. The results provide evidence of the physiological basis of affective vocal responses, confirming the utility of measuring physiology and voice in the study of emotion.     

Errorless learning and the cognitive rehabilitation of memory-impaired schizophrenic patients

BACKGROUND: In recent years, evidence has accumulated that a significant proportion of schizophrenic patients have severe memory impairment, which cannot be attributed to the effects of medication, chronicity or institutionalization. Our group has demonstrated that memory impairment is associated with poor psychosocial outcome and treatment resistance. Work on the classical amnesic syndrome has suggested that memory training is facilitated by adopting an 'errorless learning' approach, where subjects do not experience failure during learning. This is based on the theory that the preserved implicit memory of amnesic patients results in implicitly remembered incorrect responses interfering with target items, in the absence of a functioning explicit memory system to allow differentiation. METHOD: We compared three groups of subjects, memory-impaired schizophrenic patients, memory unimpaired schizophrenic patients and healthy controls. RESULTS: An errorless learning approach conferred a significant advantage on the memory-impaired schizophrenic group, bringing their performance up to the level of both control groups. In contrast, adopting a traditional trial and error, or errorful approach resulted in markedly impaired performance in the memory-impaired schizophrenic group only. CONCLUSIONS: We conclude that errorless learning approaches may be worthy of further evaluation in the cognitive rehabilitation of memory-impaired schizophrenic patients.     

T cell receptor usage in patients with non-progressing HIV infection

It is still unclear why some patients with HIV progress more slowly than others to developing full blown AIDS. In this study using flow cytometry we have investigated the TCRBV repertoire of peripheral blood T lymphocytes in 17 long-term non-progressing HIV patients (LTNP) to determine if there is a biased usage of T cell receptor V gene products. Patients were identified from hospital records and entered into the study. Three colour flow cytometry was used to determine the expression of the TCRBV3S5, BV5S1, BV5S2, BV5S3, BV6S1, BV7S1, BV9, BV11, BV12, BV13, BV14, BV16, BV17, BV18, BV20, BV21S3, BV22, and BV23 by CD8 and CD4 positive cells isolated from the peripheral blood of patients and controls. Increases in the absolute numbers of CD8+ T cells expressing TCRBV2 and 8 were observed in the HIV-LTNP population (P < 0.05 in both cases). No differences were seen in numbers of CD8+ T cells expressing other TCRBV or in any TCRBV within the CD4+ T cell popu-lation. At follow up (1-2 years later), those patients in which CD4 levels were below 500 x 106/l were those initially found to have lower levels of TCRBV8 +ve CD8 cells. A significant increase in the absolute numbers of T cells coexpressing the gamma delta (gammadelta) T cell receptor and CD8 were also seen in the HIV-LTNP patients compared with controls (P = 0.002). The increase in CD8+ T cells in the HIV-LTNP patients may be interpreted as either an antigen specific, or group of antigen specific responses to viral antigen, or less likely a viral superantigen. A low level of TCRBV8, CD8+ T cells might be predictive of a more rapid disease progression and might indicate a protective role for this population in HIV infected patients. The increase in gammadeltaT cells bearing the CD8 coreceptor suggests a role for this cell type in the response to HIV infection.