Purα regulates the induction of Znf179 transcription during neuronal differentiation.

Development of the mammalian central nervous system is an important process, which is accomplished through precise regulations of many different genes. Zinc finger protein 179 (Znf179) is one of the essential genes that plays a critical role in neuronal differentiation. In our previous study, Znf179 knockout mice displayed brain malformation and impaired brain functions. We have also previously shown that Znf179 involves in cell cycle regulation, but the regulatory mechanism of Znf179 expression is not yet fully characterized. Herein, we identified that Purα is an essential factor for the promotor activity of Znf179. We also showed concurrent expression of Znf179 and Purα during neuronal differentiation. We also found that overexpression of Purα increased Znf179 expression in neuronal differentiated P19 cells. Through its direct binding to Znf179, as shown using DAPA, Purα upregulates Znf179 expression, suggesting that Purα is important for the regulation of Znf179 expression during neuronal differentiation. Our data indicated that Purα is involved in the transcriptional regulation of Znf179 gene during neuronal differentiation, and is indispensable during the brain development.

Image Quality of 256-Slice Computed Tomography for Coronary Angiography.

PURPOSE: To assess the image quality of 256-slice computed tomographic angiography (CTA) and to identify possible impact factors associated with image quality. METHODS: From November 2009 to January 2010, 506 patients underwent 256-slice CTA at our institute. A total of 451 patients were enrolled in our study, after 55 patients were excluded because of prior bypass surgery and stenting. CTA image quality was graded by two observers using a 4-point scale: excellent (score 1), good (score 2), moderate (score 3), poor and non-diagnostic (score 4). The coronary arteries were divided into 15 segments. Image quality was correlated to the subjects' age, gender, body mass index, heart rate, and calcium scores. RESULTS: We evaluated 6650 coronary segments from CTA images of our enrolled 451 patients. The mean image quality score of all coronary segments was 1.14. Most coronary segments (99.7%) were assessable, and only 21 segments (0.3%) were non-diagnostic. A total of 5824 coronary segments were classified as having excellent image quality. Forty-two patients (9.3%) required control of heart rate with beta-blockers before CTA could be performed. Male patients had better image quality than female patients. Heart rate and severity of calcification were impact factors associated with image quality. CONCLUSIONS: Examination with 256-slice CTA provides good image quality and can effectively evaluate most coronary segments. KEY WORDS: Coronary angiography; Heart rate; Image quality; Multi-slice computed tomography.

Diagnostic Performance of 64- versus 256-Slice Computed Tomography Coronary Angiography Compared with Conventional Coronary Angiography in Patients with Suspected Coronary Artery Disease.

PUPOSE: The newer 256-slice computed tomography coronary angiography (CTCA) has the capability of improving diagnostic performance in the detection of obstructive coronary artery disease (CAD) compared to 64-slice CTCA. The aim of this study was to compare the diagnostic performance of 64- versus 256-slice CTCA in two similar populations. METHODS: Our study included 120 consecutive patients who were referred for CTCA and subsequently underwent conventional coronary angiography (CCA). Sixty patients were studied by 64-slice CTCA, with the other 60 by 256-slice CTCA. We compared the technical characteristics and diagnostic performance of 64- and 256-slice CTCA for the detection of ≥ 50% stenosis of the coronary arteries on CCA. RESULTS: The 256-slice CTCA had a shorter scanning time (4.4 ± 0.6 sec vs. 5.0 ± 0.7 sec, p < 0.001) compared to 64-slice CTCA. The diagnostic accuracy rates of 256-slice CTCA based on patient analysis (97% vs. 83%, p < 0.05), vessel analysis (95% vs. 85%, p < 0.05), and segment analysis (94% vs. 88%, p < 0.05) were significantly superior to those of 64-slice CTCA. The diagnostic accuracy rates of 64- and 256-slice CTCA were affected by the presence of stent (65% vs. 75%, respectively, p > 0.05) and severe calcifications (75% vs. 82%, respectively, p > 0.05). CONCLUSIONS: In two similar populations, 256-slice CTCA displayed superior diagnostic performance than 64-slice CTCA. However, the performance of 256-slide CTCA is affected in those segments that are severely calcified and/or stented. KEY WORDS: Computed tomography coronary angiography (CTCA); Conventional coronary angiography; Diagnostic performance; 64-slice helical CTCA; 256-slice helical CTCA.

The diagnostic accuracy of 256-row computed tomographic angiography compared with invasive coronary angiography in patients with suspected coronary artery disease.

AIMS: To assess the diagnostic accuracy of 256-row computed tomographic angiography (CTA) in patients with suspected coronary artery disease (CAD). Non-invasive imaging of the coronary artery by CTA has increasingly been used in recent years. The accuracy of 256-row CTA has not yet been studied. We sought to assess the accuracy of 256-row CTA compared with invasive coronary angiography (ICA) in the diagnosis and assessment of CAD. METHODS AND RESULTS: We prospectively evaluated 104 consecutive individuals who accepted CTA and then underwent ICA. The presence of stenosis > or =50% was considered obstructive. The diagnostic accuracy of CTA for detecting obstructive stenosis was compared with that of ICA. The area under the receiver-operating-characteristic curve (AUC) was used to evaluate the diagnostic accuracy of CTA relative to ICA. A total of 86 patients had obstructive CAD. The patient-based analysis of CTA for detecting stenosis > or =50% according to ICA revealed an AUC of 0.744 [95% confidence interval (CI), 0.572-0.916], with a sensitivity of 98.8%, a specificity of 50%, a positive predictive value (PPV) of 92.4%, and a negative predictive value (NPV) of 87.5%. The segment-based analysis revealed an AUC of 0.915 (95% CI, 0.847-0.982), with a sensitivity of 93.5%, a specificity of 95%, a PPV of 77.6%, and an NPV of 98.7%. The vessel-based analysis revealed an AUC of 0.887 (95% CI, 0.808-0.966), with a sensitivity of 94.3%, a specificity of 87.3%, a PPV of 82.7%, and an NPV of 95.9%. CONCLUSION: 256-Row CTA is a highly sensitive test of CAD and has a high predictive value. 256-Row CTA may be a potential alternative to detect coronary artery stenosis and rule out CAD in suspected patients.

Synchronous Thyrolipoma and Papillary Thyroid Carcinoma: A Rare but Significant Event.

The presence of adipocytes within thyroid glands is a rare finding seen in thyrolipoma, diffuse lipomatosis, or thyroid teratoma. Although some cases present with multinodular goiter or autoimmune thyroiditis, the exact cause has not yet been elucidated. Among reported cases, thyrolipomas mainly occur in females and usually present as a solitary lesion. However, a few reported cases had coexisting papillary thyroid carcinomas. Herein, we present a 51-year-old female with synchronous thyrolipoma (2.0 × 1.5 × 1.3 cm) and papillary thyroid carcinoma (0.7 × 0.6 × 0.6 cm) within the same thyroid lobe. She had diabetes mellitus and hypertension and complained of anterior neck enlargement and discomfort for three months. Thyroid sonography showed multiple hypoechoic nodules, one of which was heterogeneous and ill-defined. Fine needle aspirate cytology for the ill-defined nodule was suspicious for papillary thyroid carcinoma. She subsequently received radical thyroidectomy and neck lymph node dissection. Histopathologically, one thyrolipoma and one papillary thyroid carcinoma were identified in the right lobe of the thyroid gland without metastases of lymph nodes, while other nodules were multinodular goiter. Notably, thyrolipoma may not be simply an incidental finding but might coexist with thyroid carcinomas. A brief review of the pertinent literature of prior reports is also provided.

Potential therapeutic effect of curcumin, a natural mTOR inhibitor, in tuberous sclerosis complex.

BACKGROUND: Curcumin is a polyphenol natural product of the plant Curcuma longa. Recent studies suggest that curcumin inhibit mTOR activity in vitro, which prompts us to investigate curcumin function as a new class of mTOR inhibitor suitable for tuberous sclerosis complex (TSC) treatment. PURPOSE: We aim to investigate the efficacy of curcumin in the treatment of TSC related manifestations in animal model. STUDY DESIGN: Solid lipid curcumin particle (SLCP), a novel curcumin formulation, was used to treat TSC related manifestations in Tsc2 knockout mice. METHODS: The novel object recognition test was used to analyze the recognition memory function. The long-term potentiation was studied using electrophysiological analysis. Western blotting was used to assess the protein expression and activation status. RESULTS: Recognition memory deficit began as early as 4 weeks of age in both male and female Tsc2+/- mice. Oral administration with SLCP activates AMPK activity and inhibits mTOR activity in the brain tissue of Tsc2+/- mice, and can rescue the electrophysiological abnormality and object recognition memory loss in the mice. CONCLUSIONS: Our results suggest that SLCP could be an effective treatment for TSC patients.

Important Roles of Ring Finger Protein 112 in Embryonic Vascular Development and Brain Functions.

Rnf112 is a member of the RING finger protein family. The expression of Rnf112 is abundant in the brain and is regulated during brain development. Our previous study has revealed that Rnf112 can promote neuronal differentiation by inhibiting the progression of the cell cycle in cell models. In this study, we further revealed the important functions of Rnf112 in embryo development and in adult brain. Our data showed that most of the Rnf112 -/- embryos exhibited blood vascular defects and died in utero. Upon further investigation, we found that the survival rate of homozygous Rnf112 knockout mice in 129/sv and C57BL/6 mixed genetic background was increased. The survived newborns of Rnf112 -/- mice manifested growth retardation as indicated by smaller size and a reduced weight. Although the overall organization of the brain did not appear to be severely affected in Rnf112 -/- mice, using in vivo 3D MRI imaging, we found that when compared to wild-type littermates, brains of Rnf112 -/- mice were smaller. In addition, Rnf112 -/- mice displayed impairment of brain functions including motor balance, and spatial learning and memory. Our results provide important aspects for the study of Rnf112 gene functions.

Disseminated cryptococcosis with pulmonary and marrow involvement mimicking radiological features of malignancy.

The most commonly involved sites of cryptococcosis are the lungs and the central nervous system. Cryptococcal osteomyelitis is a rare complication of disseminated cryptococcosis, and the vertebraes are the most common site of this infection. The most common underlying disease is sarcoidosis, followed by tuberculosis and previous steroid therapy. Conservative treatment alone or treatment with a combination of the medical and surgical curettage is successful in most cases. We report a case of cryptococcal osteomyelitis in a 63-year-old immunocompetent male who presented with lower back pain over the sacral region for several years. Radiologic studies showed a pulmonary mass and a radiolytic lesion involving the left ischial bone, which mimicked pulmonary malignancy with bone metastasis. Biopsy of the lung mass and the bone lesion revealed abundant cryptococcal organisms, and cryptococcal osteomyelitis was diagnosed.

Unilateral agenesis of the parotid gland with contralateral compensation hypermetabolism of FDG.

A 75-year-old man with prostate adenocarcinoma had a baseline FDG PET/CT that demonstrated increased left parotid and absent right parotid activity. The CT revealed fat in the right parotid space and enlargement of the left parotid gland. There was no history of dry mouth. Agenesis of one or more of the salivary glands is extremely rare with only few reported cases. Awareness of anatomic variations is helpful for reviewing PET without CT or pertechnetate, sestimibi, and gallium examinations where salivary gland activity may typically be interpreted without coregistered CT.

Utility of source images of three-dimensional time-of-flight magnetic resonance angiography in the diagnosis of indirect carotid-cavernous sinus fistulas.

BACKGROUND: We sought to assess the relative contribution of magnetic resonance imaging (MRI), maximum intensity projection (MIP), and source images of three-dimensional (3D) time-of-flight (TOF) magnetic resonance angiography (MRA) to the diagnosis of indirect (dural) carotid-cavernous sinus fistulas (CCFs). METHODS: MRI and 3D TOF MRA were obtained in eight consecutive patients with indirect CCFs confirmed by conventional catheter angiography. Two radiologists masked to the angiographic results reviewed images retrospectively to evaluate the efficacy of MRI and 3D TOF MRA source and MIP images in the diagnosis of CCF. RESULTS: MRI disclosed CCF in five of eight cases; MIP images of TOF MRA disclosed CCF in four cases; source images of TOF MRA disclosed all eight CCF cases. CONCLUSIONS: The MRA source images are indispensable for a confirmatory diagnosis of indirect (dural) CCF. Underdiagnosis may occur by relying on MRI or 3D TOF MIP images alone.