Serial brain MRI and ultrasound findings: relation to gestational age, bilirubin level, neonatal neurologic status and neurodevelopmental outcome in infants at risk of kernicterus

Aims

To describe cranial ultrasound (cUS) and magnetic resonance imaging (MRI) findings in neonates at risk of kernicterus, in relation to gestational age (GA), total serum bilirubin (TSB), age at imaging and neurodevelopmental outcome.

Patients and methods

Neonates with peak TSB > 400 μmol/L and/or signs of bilirubin encephalopathy. Review of neonatal data, cUS, preterm, term and later MRI scans and neurodevelopmental outcome.

Results

11 infants were studied, two < 31, four 34-36 and five 37-40 weeks GA. TSB levels: 235-583 μmol/L (preterms); 423-720 μmol/L (terms). Neonatal neurological examination was abnormal in 8/10. cUS showed increased basal ganglia (BG) in 4/9 infants and white matter (WM) echogenicity, lenticulostriate vasculopathy (LSV) and caudothalamic hyperechogencity/cysts (GLCs) in 5/9 infants. MRI showed abnormal signal intensity (SI) in the globus pallidum (GP) in 1/2 preterm, 8/9 term and 9/11 later scans. Abnormal WM SI occurred in 2 preterm, 7 term and 10/11 later scans. Seven infants developed athetoid/dystonic cerebral palsy (CP) and 6 hearing loss (HL). Adverse outcome was associated with abnormal BG on cUS (3/4 CP, 4/4 HL), with high SI in GP (7/9 CP, 6/9 HL) on late T2-weighted MRI (all GA) and on T1/T2-weighted term MRI, mainly in term-born infants. WM abnormalities, GLCs and LSV did not correlate with outcome.

Conclusions

Severe CP occurred with relatively low TSB levels in preterms but only at high levels in full-terms; HL was difficult to predict. Early scans did not reliably predict motor deficits whilst all children with CP had abnormal central grey matter on later scans. Abnormal WM was seen early suggesting primary involvement rather than change secondary to grey matter damage. Why characteristic central grey matter MRI features of kernicterus are not seen early remains unexplained.     

Spatial frequency tuning of upright and inverted face identification

Previous research suggests that observers use information near the eyes and eyebrows to identify both upright and inverted faces [Sekuler, A. B., Gaspar, C. M., Gold, J. M., & Bennett, P. J. (2004). Inversion leads to quantitative, not qualitative, changes in face processing. Current Biology, 14(5), 391–396]. Here we ask whether more significant differences between upright and inverted face processing exist in the spatial frequency domain. Thresholds were measured in a 1-of-10 identification task with upright and inverted faces presented in no noise, white Gaussian noise, and in low-pass and high-pass filtered noises with various cutoff frequencies. In Experiment 1, all faces were presented in fronto-parallel view; in Experiment 2, viewpoint varied across trials. Thresholds were higher for inverted faces, but the magnitude of the inversion effect did not vary across conditions or experiments. Moreover, the shapes of the noise-masking functions obtained with low-pass and high-pass noise were the same for upright and inverted faces, did not vary between experiments, and revealed that identification was based on information carried by a 1.5 octave wide band of spatial frequencies centered on approximately 7 cycles per face width. Finally, individual differences in the magnitude of the inversion effect were not related to individual differences in the frequency selectivity of face identification. The results indicate that the face inversion effect for identification judgments is not due to subjects using different bands of spatial frequencies to identify upright and inverted faces.     

急性髓系白血病16号染色体倒位的研究进展

 inv(16)是急性髓系白血病（AML）M4Eo的特征性的异常核型,是预后较好的一个标志。inv(16)的结果是16q22上的CBFb基因和 16p13上的MYH11基因重排,产生CBFb-MYH11融合基因,可能在白血病的发病机制中起重要作用。本文就inv(16) AML的临床、血液学特点及分子生物学特征等方面的研究进展作一综述。     

Unicircular structure of the Brassica hirta mitochondrial genome

Summary Restriction mapping studies reveal that the mitochondrial genome of white mustard (Brassica hirta) exists in the form of a single circular 208 kb chromosome. The B. hirta genome has only one copy of the two sequences which, in several related Brassica species, are duplicated and undergo intramolecular recombination. This first report of a plant mitochondrial DNA that does not exist in a multipartite structure indicates that high frequency intramolecular recombination is not an obligatory feature of plant mitochondrial genomes. Heterologous filter hybridizatios reveal that the mitochondrial genomes of B. hirta and B. campestris have diverged radically in sequence arrangement, as the result of approximately 10 large inversions. At the same time, however, the two genomes are similar in size, sequence content, and primary sequence.     

Pseudomass of the left upper quadrant from inversion of the left hemidiaphragm: CT diagnosis

Two cases of inversion of the left hemidiaphragm due to a large pleural effusion and presenting with dysphagia were diagnosed by computed tomographic (CT) scanning. The relationship of the dysphagia to the diaphragmatic inversion, a differential of the causes of this entity, and the role of CT in its diagnosis are discussed.     

产后急性子宫内翻3例临床分析

目的:总结产后急性子宫内翻的诊治及预防知识。方法:对我院历年收治的3例子宫内翻患者的临床资料进行回顾性分析。结果:3例均有多次生育史,产后检查胎盘均大部分附着于宫底,第三产程的非适当处理为直接原因。结论:提供新法接生,提高助产技术,正确处理第三产程是预防子宫内翻的关键,而提高对子宫内翻的认识,早期发现,及时正确处理,是治疗子宫内翻的关键。     

鼠疫菌研究进展

目的阐述鼠疫菌研究动向。方法通过查阅相关资料、联系鼠疫防治实际工作,从鼠疫菌的基因结构、自然疫源性、菌苗和今后工作的重点4个方面进行了论述。结果大量的插入序列和基因的水平转移是鼠疫菌进化的关键。结论鼠疫菌基因的表达和致病性受环境因素调节,特别是毒力岛。     

平衡式稳态自由进动序列在非对比剂腹部血管成像方面的应用

近年来,众多学者采用平衡式稳态自由进动序列(b SSFP)进行非对比剂腹部血管成像。本文主要介绍b SSFP序列的特点及其应用于非对比剂腹部血管成像的技术原理,探讨利用该序列进行腹部血管成像的临床应用要点。     

Effects of repetition learning on upright, inverted and contrast-reversed face processing using ERPs

The effects of short-term learning on memory for inverted, contrast-reversed and upright faces were investigated using event-related potentials (ERPs) in a target/nontarget discrimination task following a learning phase of the target. Subjects were equally accurate for all three face types although responding more slowly to inverted and negative faces compared to upright faces. Face type affected both early ERP components P1 and N170, and long-latency components at frontal and parietal sites, reflecting the difficulty of processing inverted faces. Different effects of face type were found for P1 and N170 latencies and amplitudes, suggesting face processing could start around 100-120 ms and is sensitive to facial configuration. Repetition effects were also found on both early and long-latency components. Reduced N170 latency and amplitude for repeated targets are likely due to perceptual priming. Repetition effects on the N250 were delayed for inverted and negative faces, suggesting delayed access to stored facial representations for these formats. Increased frontopolar positivity at 250-300 ms and parietal positivity from 300 to 500 ms reflected familiarity 'old-new' repetition effects that were of similar magnitude for all three face types, indexing the accurate recognition of all faces. Thus, while structural encoding was disrupted by inversion and contrast-reversal, the learning phase was sufficient to abolish the effects of these configural manipulations behaviourally; all three face types were equally well recognised and this was reflected as equally large parietal old-new effects.     

Lumbar disc disease: the effect of inversion on clinical symptoms and a comparison of the rate of surgery after inversion therapy with the rate of surgery in neurosurgery controls

[Purpose] We have previously shown inversion therapy to be effective in a small prospective randomised controlled trial of patients with lumbar disc protrusions. Our purpose now was to measure symptoms and to compare the surgery rate following inversion for 85 participants with the surgery rate in 3 control groups. [Participants and Methods] Each of the 85 inverted participants acted as their own control for the “symptomatic” part of the study. In the “Need for surgery” part of the study, one control group was made up of similar patients with leg pain and sciatica who were referred to the same clinic in the same year. Two additional control groups were examined: the original control group from the pilot trial and the lumbar disc surgery waiting list patients. [Results] Inversion therapy relieved symptoms: there were improvements in the Visual Analogue Score, Roland Morris and Oswestry Disease indices and Health Utility Score compared with their pre-treatment status. Also, the 2 year surgery rate in the inversion participants in the registry (21%) was significantly lower than in the matched control group (39% at two years and 43% at four years). It was also lower than the surgery rate in the other 2 control groups. [Conclusion] Inversion therapy relieved symptoms and avoided surgery.