Automated brain MRI metrics in the EPIRMEX cohort of preterm newborns: Correlation with the neurodevelopmental outcome at 2 years

PurposeThe purpose of this study was to identify in the EPIRMEX cohort the correlations between MRI brain metrics, including diffuse excessive high signal intensities (DEHSI) obtained with an automated quantitative method and neurodevelopmental outcomes at 2 years.Materials and methodsA total of 390 very preterm infants (gestational age at birth ≤ 32 weeks) who underwent brain MRI at term equivalent age at 1.5T (n = 338) or 3T (n = 52) were prospectively included. Using a validated algorithm, automated metrics of the main brain surfaces (cortical and deep gray matter, white matter, cerebrospinal fluid) and DEHSI with three thresholds were obtained. Linear adjust regressions were performed to assess the correlation between brain metrics with the ages and stages questionnaire (ASQ) score at 2 years.ResultsBasal ganglia and thalami, cortex and white matter surfaces positively and significantly correlated with the global ASQ score. For all ASQ sub-domains, basal ganglia and thalami surfaces significantly correlated with the scores. DEHSI was present in 289 premature newborns (74%) without any correlation with the ASQ score. Metrics of DEHSI were greater at 3T than at 1.5T.ConclusionBrain MRI metrics obtained in our multicentric cohort correlate with the neurodevelopmental outcome at 2 years of age. The quantitative detection of DEHSI is not predictive of adverse outcomes. Our automated algorithm might easily provide useful predictive information in daily practice.     

MRI as complementary tool added to ultrasound in the diagnosis of fetal renal abnormalities – any added value?

Purpose

To assess the potential role of magnetic resonance imaging (MRI) as a complementary diagnostic tool to ultrasonography (US) in the diagnosis of fetal renal anomalies in pregnant women with oligohydramnios in the absence of amniotic membrane rupture.

Methods

Ninety pregnant women, with oligohydramnios were prospectively evaluated using both US and MRI. Prenatal findings were correlated with the babies’ outcome.

Results

MRI studies of diagnostic quality were obtained in all fetuses. The US and MRI findings were concordant in 79 (87.8%) of the fetuses. MRI modified and changed the diagnosis in 11 fetuses (12.2%), these were five fetuses in which US diagnosis was inconclusive, five cases in which the diagnosis changed from bilateral renal agenesis to unilateral agenesis with the other kidney multicystic dysplastic kidney (MCDK), and in the remaining fetuses the modification was from bilateral renal agenesis to unilateral agenesis with the other kidney structurally normal.Concordant findings for the prenatal US and MRI scans were seen in 100% of the autosomal recessive polycystic kidney disease (APCKD), 96% of MCDK, and 92.9% of bilateral normal kidneys.

Conclusion

MRI is of value in cases of oligohydramnios in limited circumstance when US findings were inconclusive.     

Can diffusion tensor imaging predict motor power affection after moderate traumatic brain injury?

Objective

To determine whether commissural and projection fibers fractional anisotropy (FA) abnormalities can help in the prediction of long-term outcome of motor power affection after moderately severe traumatic brain injury (TBI).

Methods

MRI protocol included diffusion tensor imaging (DTI) and was performed for 32 patients with moderate TBI and 32 matched control subjects. Regions of interests were applied in the FA maps in the corpus callosum, internal capsules posterior limb, and cerebral peduncles. Results were compared in patients with motor power affection and patients without motor power affection to the control group.

Results

All patients had FA values lower than the control group with significance differences in the corpus callosum. Patient group with weakness had FA values lower than the control groups with significance differences in the posterior limb of the left internal capsules (p = 0.001) and left cerebral peduncles (p < 0.001). Significant differences were found when comparing the posterior limb of the left internal capsule (p = 0.002) and left cerebral peduncle (p = 0.022) to the right side in the weakness group.

Conclusion

FA values measured in the acute stage provided information about associated and projectional fibers disruptions, which have a prognostic value about motor power affection.     

A case of pericoronary pseudotumor due to localized Castleman's disease

BackgroundA 59-year-old male had a latent epicardial mass discovered at cardiovascular imaging during the assessment of an aortic murmur.ResultsThe resected mass surrounded the left anterior descending coronary artery. It was a well-limited pericoronary cellular lesion. It was made of a mixture of polytypic plasma cells, lymphocytes with lymphoid follicles, hyaline vascular hyperplasia, and focal eosinophils. No immunoglobulin and TCR-γ gene rearrangements were detected. In this immunocompetent patient, HHV-8 was negative.ConclusionThe pattern was consistent with a pericoronary localized Castleman's disease of composite histologic subtype.     

Increased levels of transforming growth factor-betal and -beta2 in the aqueous humor of patients with neovascular glaucoma.

BACKGROUND AND OBJECTIVE: To measure the concentrations of transforming growth factor-betal and beta2 (TGF-beta1 and TGF-beta2) in the aqueous humor of patients with neovascular glaucoma (NVG). PATIENTS AND METHODS: Patients were divided into four groups: NVG secondary to central retinal vein occlusion (group 1), NVG secondary to proliferative diabetic retinopathy (group 2), central retinal vein occlusion without rubeosis (group 3), and senile cataract (group 4). The total TGF-beta 1 and TGF-beta2 concentrations in the aqueous humor of the four groups were measured by enzyme linked immunosorbent assay. RESULTS: The mean concentrations of total TGF-betal were 600.7 +/-436.7 microg/mL in group 1, 802.0 +/-359.5 pg/mL in group 2, and undetectable in groups 3 and group 4 (P < .05). The mean concentrations of total TGF-beta2 were 6,307.9+/- 2,206.2 microg/mL in group 1, 5,908.0+/-2,033.2 microg/mL in group 2, 899.7+/- 425.6 microg/mL in group 3, and 385.7 +/-89.9 microg/mL in group 4. The total TGF-betal and TGF-beta2 concentrations in groups 1 and 2 were significantly higher than those in groups 3 and 4, whereas the total TGF-beta2 concentration in group 3 was significantly higher than that in group 4 (P < .05). There was no significant difference in the TGF-betal or TGF-beta2 concentrations between groups 1 and 2 (P> .05). CONCLUSIONS: The abnormally high concentrations of TGF-betal and TGF-beta2 in the aqueous humor of patients with NVG may explain some aspects of the pathogenesis of NVG and the high failure rate of filtering operations in NVG.     

Testing the fertility of the spermatozoa

The sperm count, an absolutely necessary examination, seems no longer sufficient to establish a prognosis of fertility. Fertilization in vitro, for a diagnostic purpose, would be the ideal examination, but because of the ethical and technical problems it raises, other tests have been developed. The test of spermatozoid survival at 24 hours in Menezzo's B2 medium and interspecific fertilization in vitro (hamster-test) are carried out on isolated spermatozoids according the FIV protocol. The survival test provides two parameters: the presence of mobility and the rate of retention of the mobility after 24 hours. With the hamster-test it is possible to study the penetration and decondensation of the spermatozoids in the ovocytes. The results obtained with the survival test show that the absence of gradual mobility and a retention rate below 25 p. cent after 24 hours, significantly affect the cleavage of ovocytes during FIV. These two parameters affect, in a similar fashion, the percentage of fertilized ovocytes in the hamster-test. The latter seems less specific than the survival test to establish a prognosis before FIV. However, it is interesting as it allows the study of the different stages of fertilization of spermatozoid samples, from the same ejaculation, under varied experimental conditions. These tests require a standardization and present a definite advantage during exploration prior to FIV, AIC.     

In Vivo Reversal of Multidrug Resistance by Two New Dihydropyridine Derivatives, S16317 and S16324

Two new dihydropyridine derivatives with low calcium channel affinity, S16317 and S16324, were found to fully overcome multidrug resistance in vitro. These two compounds increased doxorubicin cytotoxicity on the human COLO 320DM cell line and completely reversed the vincristine resistance of murine P388/VCR cells. In vivo, S16324 administered p.o. (200 mg/kg on days 1 to 4) or i.p. (50mg/kg on days 1, 5, 9) in combination with vincristine (i.p.) restored the antitumor activity of vincristine in P388/VCR-bearing mice. S16317 showed a reversing activity when administered p.o., i.v. (days 1 to 4) or i.p. (days 1, 5, 9) at the same dose (25 mg/kg), suggesting a remarkable bioavailability. Moreover, these two compounds potentiated the antitumor activity of vincristine in the sensitive P388 leukemia, increasing the number of long-term survivors. These results suggest that combination chemotherapy using S16317 or S16324 would be effective not only in circumventing multidrug resistance but also in preventing the emergency of a population of resistant tumor cells in sensitive tumors.