Intrauterine growth retardation: evaluation by magnetic resonance. Work in progress

Eleven high risk fetuses between 32 and 37 menstrual weeks gestational age were examined by magnetic resonance (MR) imaging. Serial obstetrical sonograms, birth weights, and serial postnatal examinations were obtained in all subjects. Sagittal MR spin echo images obtained using TR = 0.5 sec and TE = 28 msec were useful for assessing subcutaneous fat. Prospective estimates of fetal fat stores correlated with neonatal outcome better than sonographic measurements of fetal growth parameters or actual birth weight. MR appears to be a safe and useful technique that offers information complementary to obstetrical sonography when IUGR is suspected.     

Functional impairment in social anxiety disorder

The present study examined functional impairment among treatment seekers with social anxiety disorder (SAD). We investigated the effects of diagnostic subtypes of SAD and comorbidity with mood and anxiety disorders on impairment. In addition, we used cluster analysis procedures to empirically identify subgroups of individuals with distinct patterns of impairment. Participants were 216 treatment-seeking individuals with SAD. Clinical interviews were undertaken to determine diagnoses of anxiety disorders and major depressive disorder, and a battery of self-report measures was administered to index symptoms of social anxiety, depression and extent of impairment. Results indicated that individuals with the generalized subtype of SAD had greater impairment in all three life domains compared to individuals with the nongeneralized subtype. Comorbidity with mood disorders was associated with greater impairment than SAD alone, but comorbidity with anxiety disorders was not. Four distinct impairment profiles emerged from the cluster analysis: primary work/studies impairment, primary social life impairment, both work/studies and social impairment, and impairment in all domains. Findings from this study suggest that SAD is associated with substantial impairment across multiple domains, and that individuals with SAD present diverse impairment profiles. These profiles may inform subtyping of the disorder as well as therapeutic interventions.     

Comparison of a non‐stationary voxelation‐corrected cluster‐size test with TFCE for group‐Level MRI inference

Two powerful methods for statistical inference on MRI brain images have been proposed recently, a non‐stationary voxelation‐corrected cluster‐size test (CST) based on random field theory and threshold‐free cluster enhancement (TFCE) based on calculating the level of local support for a cluster, then using permutation testing for inference. Unlike other statistical approaches, these two methods do not rest on the assumptions of a uniform and high degree of spatial smoothness of the statistic image. Thus, they are strongly recommended for group‐level fMRI analysis compared to other statistical methods. In this work, the non‐stationary voxelation‐corrected CST and TFCE methods for group‐level analysis were evaluated for both stationary and non‐stationary images under varying smoothness levels, degrees of freedom and signal to noise ratios. Our results suggest that, both methods provide adequate control for the number of voxel‐wise statistical tests being performed during inference on fMRI data and they are both superior to current CSTs implemented in popular MRI data analysis software packages. However, TFCE is more sensitive and stable for group‐level analysis of VBM data. Thus, the voxelation‐corrected CST approach may confer some advantages by being computationally less demanding for fMRI data analysis than TFCE with permutation testing and by also being applicable for single‐subject fMRI analyses, while the TFCE approach is advantageous for VBM data. Hum Brain Mapp 38:1269–1280, 2017. © 2016 Wiley Periodicals, Inc.     

Comparison of stage IV and IV-S neuroblastoma in the first year of life

Clinical staging and factors related to survival were evaluated in 44 stage IV-S and 44 stage IV patients with neuroblastoma, ages 0 to 12 months, seen at Children's Cancer Study Group (CCSG) institutions from 1972 to 1979. In 73 patients with complete surgical staging, the life-table projected survival at 3 years was 91% for stage IV-S and 44% for stage IV. The only deaths in stage IV-S disease occurred in three patients less than 2 months old at diagnosis. In stage IV-S, 3 to 12 months old at diagnosis, the disease-free survival was 97%. Chemotherapy or radiation therapy did not appear to improve the survival rate in stage IV-S. These studies further document a significant clinical and biologic difference between patients with stage IV and stage IV-S neuroblastoma and suggest that they require different therapeutic management.     

Distance running improves fitness in asthmatic children without pulmonary complications or changes in exercise-induced bronchospasm

The effect of a distance running program was studied in 15 children with severe chronic asthma. Following a 6-week control period, the subjects ran four days a week for 6 weeks. The distance was increased gradually to 3.2 km. Clinical status and need for treatment did not change. Episodes of exercise-induced bronchospasm were readily reversed. Fitness improved as measured by the distance run in 12 minutes (P less than .005). Resting pulmonary function did not change. Exercise-induced bronchospasm following a bicycle ergometer stress test under comparable conditions did not change. Ventilatory muscle strength, measured as the maximal inspiratory pressure, and endurance, measured as the sustainable inspiratory pressure, were at a high level initially and did not change. It is concluded that distance running is safe and can increase the fitness of asthmatic children who are receiving adequate therapy.     

Protocol biopsies in the management of renal allograft recipients

The safety of the renal allograft biopsy and the standardization of allograft histopathology interpretation have renewed interest in the protocol biopsy. Recent studies in the areas of 'marginal' donors, surveillance of acute rejection, molecular biology and chronic rejection are discussed.