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1.
Nature ; 628(8006): 154-161, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38480892

RESUMO

Several genetic risk factors for Alzheimer's disease implicate genes involved in lipid metabolism and many of these lipid genes are highly expressed in glial cells1. However, the relationship between lipid metabolism in glia and Alzheimer's disease pathology remains poorly understood. Through single-nucleus RNA sequencing of brain tissue in Alzheimer's disease, we have identified a microglial state defined by the expression of the lipid droplet-associated enzyme ACSL1 with ACSL1-positive microglia being most abundant in patients with Alzheimer's disease having the APOE4/4 genotype. In human induced pluripotent stem cell-derived microglia, fibrillar Aß induces ACSL1 expression, triglyceride synthesis and lipid droplet accumulation in an APOE-dependent manner. Additionally, conditioned media from lipid droplet-containing microglia lead to Tau phosphorylation and neurotoxicity in an APOE-dependent manner. Our findings suggest a link between genetic risk factors for Alzheimer's disease with microglial lipid droplet accumulation and neurotoxic microglia-derived factors, potentially providing therapeutic strategies for Alzheimer's disease.


Assuntos
Doença de Alzheimer , Apolipoproteína E4 , Gotículas Lipídicas , Microglia , Animais , Feminino , Humanos , Masculino , Camundongos , Doença de Alzheimer/genética , Doença de Alzheimer/metabolismo , Doença de Alzheimer/patologia , Peptídeos beta-Amiloides/metabolismo , Apolipoproteína E4/genética , Apolipoproteína E4/metabolismo , Células-Tronco Pluripotentes Induzidas/citologia , Gotículas Lipídicas/metabolismo , Gotículas Lipídicas/patologia , Microglia/citologia , Microglia/metabolismo , Microglia/patologia , Triglicerídeos , Proteínas tau , Meios de Cultivo Condicionados , Fosforilação , Predisposição Genética para Doença
2.
Radiology ; 310(2): e230628, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38411515

RESUMO

HISTORY: A 15-year-old boy presented with a 3-week history of inner left thigh pain provoked by activity and experienced occasionally at rest. He denied nighttime pain, fever, or chills. Laboratory investigation revealed the following normal values: hemoglobin level of 15.6 g/dL (normal range, 13-16 g/dL), platelet count of 240 × 103/µL (normal range, 140-440 × 103/µL), and total leukocyte count of 7100 cells/µL (normal range, 4500-11 000 cells/µL). The percentage of neutrophils was considered low at 44% (normal range, 54%-62%), and the percentage of eosinophils was slightly high at 3.7% (normal range, 0%-3%). An anteroposterior radiograph of the left hip is shown (Fig 1). Physical therapy was initiated, with no improvement after 2 weeks of therapy. The patient was referred to an orthopedist for further evaluation. On physical examination, the patient endorsed marked left hip pain with hip flexion to 90°, limited internal and external rotation (5° and 15°, respectively), and antalgic gait favoring the left leg. Hip MRI (Fig 2) and further serologic analysis were requested for further evaluation. Although the serologic testing was performed at an outside laboratory, the physician reported positive immunoglobulin-G Lyme titers, normal C-reactive protein level, and normal erythrocyte sedimentation rate. Pelvic CT was requested (Fig 3). The patient was prescribed a course of doxycycline (100 mg twice daily for 28 days), with reported resolution of symptoms 2 weeks after initiation of treatment. Three weeks later, he presented to our department with recurrent left hip pain, which was similar in severity compared with initial presentation. A second MRI of the left hip was performed 4 months after initial presentation (Fig 4).


Assuntos
Artralgia , Dor , Masculino , Humanos , Adolescente , Cognição , Doxiciclina , Febre
3.
J Cardiothorac Vasc Anesth ; 38(4): 992-1005, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38365467

RESUMO

OBJECTIVES: Cardiac surgery on cardiopulmonary bypass (CPB) during the neonatal period can cause perioperative organ injuries. The primary aim of this study was to determine the incidence and risk factors associated with postoperative mechanical ventilation duration and acute lung injury after the arterial switch operation (ASO). The secondary aim was to examine the utility of the Brixia score for characterizing postoperative acute lung injury (ALI). DESIGN: A retrospective study. SETTING: A single-center university hospital. PARTICIPANTS: A total of 93 neonates with transposition of great arteries with intact ventricular septum (dTGA IVS) underwent ASO. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: From January 2015 to December 2022, 93 neonates with dTGA IVS were included in the study. The cohort had a median age of 4.0 (3.0-5.0) days and a mean weight of 3.3 ± 0.5 kg. About 63% of patients had ≥48 hours of postoperative mechanical ventilation after ASO. Risk factors included prematurity, post-CPB transfusion of salvaged red cells, platelets and cryoprecipitate, and postoperative fluid balance by univariate analysis. The larger transfused platelet volume was associated with the risk of ALI by multivariate analysis. The median baseline Brixia scores were 11.0 (9.0-12.0) and increased significantly in the postoperative day 1 in patients who developed moderate ALI 24 hours after admission to the intensive care unit (15.0 [13.0-16.0] v 12.0 [10.0-14.0], p = 0.046). CONCLUSIONS: Arterial switch operation results in a high incidence of ≥48-hour postoperative mechanical ventilation. Blood component transfusion is a potentially modifiable risk factor. The Brixia scores also may be used to characterize postoperative acute lung injury.


Assuntos
Lesão Pulmonar Aguda , Transposição das Grandes Artérias , Transposição dos Grandes Vasos , Recém-Nascido , Humanos , Transposição das Grandes Artérias/efeitos adversos , Estudos Retrospectivos , Respiração Artificial/efeitos adversos , Transposição dos Grandes Vasos/cirurgia , Resultado do Tratamento
4.
bioRxiv ; 2024 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-38370821

RESUMO

Although genome-wide association studies (GWAS) have identified loci associated with alcohol consumption and alcohol use disorder (AUD), they do not identify which variants are functional. To approach this, we evaluated the impact of variants in 3' untranslated regions (3'-UTRs) of genes in loci associated with substance use and neurological disorders using a massively parallel reporter assay (MPRA) in neuroblastoma and microglia cells. Functionally impactful variants explained a higher proportion of heritability of alcohol traits than non-functional variants. We identified genes whose 3'UTR activities are associated with AUD and alcohol consumption by combining variant effects from MPRA with GWAS results. We examined their effects by evaluating gene expression after CRISPR inhibition of neuronal cells and stratifying brain tissue samples by MPRA-derived 3'-UTR activity. A pathway analysis of differentially expressed genes identified inflammation response pathways. These analyses suggest that variation in response to inflammation contributes to the propensity to increase alcohol consumption.

5.
Pediatr Radiol ; 53(13): 2662-2671, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37833504

RESUMO

BACKGROUND: Hip displacement in children with cerebral palsy (CP) is monitored by measuring migration percentage on anteroposterior pelvis radiographs. However, proper positioning for radiography in children with spasticity is difficult. The reliability and accuracy of migration percentage as a function of patient positioning is unknown. OBJECTIVE: To determine the effects of patient positioning on migration percentage measurements in children with CP. MATERIALS AND METHODS: We identified children with CP (≤18-year-old) with pelvis CT and anteroposterior pelvis radiograph obtained <6 months apart (10/2018-11/2021). Digitally reconstructed radiographs were generated from each pelvis CT, to simulate nine different patient positions: neutral; 10° and 20° lordosis and kyphosis; and 10° and 20° right rotation and left rotation. Two radiologists measured migration percentages from the simulated and real pelvis radiographs. We used Spearman's rho to assess inter-rater reliability, and Wilcoxon signed rank test to determine statistical significance. RESULTS: We studied sixty-three children (male=41; median age=8 years; range=4-18 years). The two radiologists' migration percentage measurements were highly correlated with each other across all simulated and real radiographs (Spearman's rho=0.86-0.99, P<0.01). For both readers and hips, migration percentages measured from real radiographs were significantly different from those measured from neutral simulated radiographs (P<0.01), with median absolute difference=5-6 percentage points (PP) and interquartile range (IQR)=9-12 PP. When comparing migration percentage measurements from neutral simulated radiographs to those in kyphosis/lordosis and right/left rotations, median absolute differences were 2-4 PP (IQR=3-8 PP) and 4-15 PP (IQR=6-17 PP), respectively. CONCLUSION: Inter-rater reliability of measured migration percentages is high, but accuracy decreases with patient positional changes.


Assuntos
Paralisia Cerebral , Luxação do Quadril , Cifose , Lordose , Humanos , Criança , Masculino , Adolescente , Lordose/diagnóstico por imagem , Paralisia Cerebral/diagnóstico por imagem , Reprodutibilidade dos Testes , Luxação do Quadril/diagnóstico por imagem , Radiografia , Cifose/diagnóstico por imagem , Pelve/diagnóstico por imagem , Posicionamento do Paciente
6.
Immunity ; 56(9): 2121-2136.e6, 2023 09 12.
Artigo em Inglês | MEDLINE | ID: mdl-37659412

RESUMO

Genetic association studies have demonstrated the critical involvement of the microglial immune response in Alzheimer's disease (AD) pathogenesis. Phospholipase C-gamma-2 (PLCG2) is selectively expressed by microglia and functions in many immune receptor signaling pathways. In AD, PLCG2 is induced uniquely in plaque-associated microglia. A genetic variant of PLCG2, PLCG2P522R, is a mild hypermorph that attenuates AD risk. Here, we identified a loss-of-function PLCG2 variant, PLCG2M28L, that confers an increased AD risk. PLCG2P522R attenuated disease in an amyloidogenic murine AD model, whereas PLCG2M28L exacerbated the plaque burden associated with altered phagocytosis and Aß clearance. The variants bidirectionally modulated disease pathology by inducing distinct transcriptional programs that identified microglial subpopulations associated with protective or detrimental phenotypes. These findings identify PLCG2M28L as a potential AD risk variant and demonstrate that PLCG2 variants can differentially orchestrate microglial responses in AD pathogenesis that can be therapeutically targeted.


Assuntos
Doença de Alzheimer , Animais , Camundongos , Doença de Alzheimer/genética , Estudos de Associação Genética , Microglia , Fagocitose/genética , Fenótipo , Placa Amiloide , Fosfolipase C gama/metabolismo
7.
Patterns (N Y) ; 4(9): 100802, 2023 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-37720336

RESUMO

Artificial intelligence (AI) models for automatic generation of narrative radiology reports from images have the potential to enhance efficiency and reduce the workload of radiologists. However, evaluating the correctness of these reports requires metrics that can capture clinically pertinent differences. In this study, we investigate the alignment between automated metrics and radiologists' scoring of errors in report generation. We address the limitations of existing metrics by proposing new metrics, RadGraph F1 and RadCliQ, which demonstrate stronger correlation with radiologists' evaluations. In addition, we analyze the failure modes of the metrics to understand their limitations and provide guidance for metric selection and interpretation. This study establishes RadGraph F1 and RadCliQ as meaningful metrics for guiding future research in radiology report generation.

8.
Nat Methods ; 20(11): 1748-1758, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37770712

RESUMO

The inhomogeneous refractive indices of biological tissues blur and distort single-molecule emission patterns generating image artifacts and decreasing the achievable resolution of single-molecule localization microscopy (SMLM). Conventional sensorless adaptive optics methods rely on iterative mirror changes and image-quality metrics. However, these metrics result in inconsistent metric responses and thus fundamentally limit their efficacy for aberration correction in tissues. To bypass iterative trial-then-evaluate processes, we developed deep learning-driven adaptive optics for SMLM to allow direct inference of wavefront distortion and near real-time compensation. Our trained deep neural network monitors the individual emission patterns from single-molecule experiments, infers their shared wavefront distortion, feeds the estimates through a dynamic filter and drives a deformable mirror to compensate sample-induced aberrations. We demonstrated that our method simultaneously estimates and compensates 28 wavefront deformation shapes and improves the resolution and fidelity of three-dimensional SMLM through >130-µm-thick brain tissue specimens.


Assuntos
Aprendizado Profundo , Microscopia , Óptica e Fotônica , Encéfalo
9.
Pediatr Radiol ; 53(12): 2411-2423, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37740782

RESUMO

BACKGROUND: Quantifying femoral version is crucial in diagnosing femoral version abnormalities and for accurate pre-surgical planning. There are numerous methods for measuring femoral version, however, reliability studies for most of these methods excluded children with hip deformities. OBJECTIVE: To propose a method of measuring femoral version based on a virtual 3D femur model, and systematically compare its reliability to the widely used Murphy's 2D axial slice technique. MATERIALS AND METHODS: We searched our imaging database to identify hip/femur CTs performed on children (<18 years old) with a clinical indication of femoral version measurement (September 2021-August 2022). Exclusion criteria were prior hip surgery, and inadequate image quality or field-of-view. Two blinded radiologists independently measured femoral version using the virtual 3D femur model and Murphy's 2D axial slice method. To assess intrareader variability, we randomly selected 20% of the study sample for re-measurements by the two radiologists >2 weeks later. We analyzed the reliability and correlation of these techniques via intraclass correlation coefficient (ICC), Bland-Altman analysis, and deformity subgroup analysis. RESULTS: Our study sample consisted of 142 femurs from 71 patients (10.6±4.4 years, male=31). Intra- and inter-reader correlations for both techniques were excellent (ICC≥0.91). However, Bland-Altman analysis revealed that the standard deviation (SD) of the absolute difference between the two radiologists for the Murphy method (mean 13.7°) was larger than that of the 3D femur model technique (mean 4.8°), indicating higher reader variability. In femurs with hip flexion deformity, the SD of the absolute difference for the Murphy technique was 17°, compared to 6.5° for the 3D femur model technique. In femurs with apparent coxa valga deformity, the SD of the absolute difference for the Murphy technique was 10.4°, compared to 5.2° for the 3D femur model technique. CONCLUSION: The 3D femur model technique is more reliable than the Murphy's 2D axial slice technique in measuring femoral version, especially in children with hip flexion and apparent coxa valga deformities.


Assuntos
Coxa Valga , Criança , Humanos , Masculino , Adolescente , Reprodutibilidade dos Testes , Tomografia Computadorizada por Raios X/métodos , Fêmur/diagnóstico por imagem , Extremidade Inferior , Imageamento Tridimensional/métodos
10.
bioRxiv ; 2023 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-37546938

RESUMO

Several genetic risk factors for Alzheimer's Disease (AD) implicate genes involved in lipid metabolism and many of these lipid genes are highly expressed in glial cells. However, the relationship between lipid metabolism in glia and AD pathology remains poorly understood. Through single-nucleus RNA-sequencing of AD brain tissue, we have identified a microglial state defined by the expression of the lipid droplet (LD) associated enzyme ACSL1 with ACSL1-positive microglia most abundant in AD patients with the APOE4/4 genotype. In human iPSC-derived microglia (iMG) fibrillar Aß (fAß) induces ACSL1 expression, triglyceride synthesis, and LD accumulation in an APOE-dependent manner. Additionally, conditioned media from LD-containing microglia leads to Tau phosphorylation and neurotoxicity in an APOE-dependent manner. Our findings suggest a link between genetic risk factors for AD with microglial LD accumulation and neurotoxic microglial-derived factors, potentially providing novel therapeutic strategies for AD.

11.
Pediatr Radiol ; 53(10): 2054-2059, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37423916

RESUMO

BACKGROUND: Only verbal pregnancy screening is recommended for post-menarcheal females undergoing pelvic radiographs. In contrast, usually, a urine/serum pregnancy test for pelvic computed tomographic (CT) exams is required out of concern for higher radiation exposure. OBJECTIVE: To estimate patient-specific fetus absorbed dose to a potentially pregnant minor from an optimized dose CT of the pelvis for femoral version and surgical planning and provide evidence that such examinations of the pelvis can be performed with only verbal pregnancy screening. METHODS AND METHODS: A retrospective study was performed on 102 female patients between 12-18 years of age (15.4 ± 2.1 years) who underwent optimized dose CT of the pelvis for orthopedic evaluation of femoral version and surgical planning. Optimized CT exams were performed with weight-adjusted kVp and tube current modulation. Patient-specific dose from the optimized dose CT was calculated using the National Cancer Institute Dosimetry System for CT (NCICT) database by matching each patient to a phantom from the NCI non-reference phantom library based on patient sex, weight, and height. The calculated absorbed uterus dose was used as a surrogate for the fetus dose. Furthermore, patient-specific organ doses were used to estimate the effective dose. The strengths of the linear relationships between the dose metrics and patient characteristics were assessed using Pearson correlation coefficients through linear regression. RESULTS: The mean patient-specific effective dose for an optimized dose CT of the pelvis was 0.54 ± 0.20 mSv (range: 0.15-1.22 mSv). The mean estimated absorbed uterine dose was 1.57 ± 0.67 mGy (range: 0.42-4.81 mGy). Both effective dose and estimated uterine dose correlated poorly with patient physical characteristics (R = -0.26; 95% CI: [-0.43, -0.007] for age, R = 0.03; 95% CI: [-0.17, 0.22] for weight) but correlated strongly (R = 0.79, 95% CI: [0.7, 0.85]) with CTDIvol. CONCLUSION: The estimated fetus dose in case of pregnancy was significantly lower than 20 mGy for urine/serum pregnancy screening, suggesting that the pregnancy screening protocols in minors undergoing optimized dose CT require reassessment and may be safely performed by verbal attestation only.


Assuntos
Menores de Idade , Tomografia Computadorizada por Raios X , Gravidez , Humanos , Feminino , Adolescente , Doses de Radiação , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos , Feto/diagnóstico por imagem , Imagens de Fantasmas , Pelve/diagnóstico por imagem
12.
Genome Med ; 15(1): 11, 2023 02 20.
Artigo em Inglês | MEDLINE | ID: mdl-36805764

RESUMO

BACKGROUND: TREM2 is a transmembrane receptor expressed by myeloid cells and acts to regulate their immune response. TREM2 governs the response of microglia to amyloid and tau pathologies in the Alzheimer's disease (AD) brain. TREM2 is also present in a soluble form (sTREM2), and its CSF levels fluctuate as a function of AD progression. Analysis of stroke and AD mouse models revealed that sTREM2 proteins bind to neurons, which suggests sTREM2 may act in a non-cell autonomous manner to influence neuronal function. sTREM2 arises from the proteolytic cleavage of the membrane-associated receptor. However, alternatively spliced TREM2 species lacking a transmembrane domain have been postulated to contribute to the pool of sTREM2. Thus, both the source of sTREM2 species and its actions in the brain remain unclear. METHODS: The expression of TREM2 isoforms in the AD brain was assessed through the analysis of the Accelerating Medicines Partnership for Alzheimer's Disease Consortium transcriptomics data, as well as qPCR analysis using post-mortem samples of AD patients and of the AD mouse model 5xFAD. TREM2 cleavage and secretion were studied in vitro using HEK-293T and HMC3 cell lines. Synaptic plasticity, as evaluated by induction of LTP in hippocampal brain slices, was employed as a measure of sTREM2 actions. RESULTS: Three distinct TREM2 transcripts, namely ENST00000373113 (TREM2230), which encodes the full-length transmembrane receptor, and the alternatively spliced isoforms ENST00000373122 (TREM2222) and ENST00000338469 (TREM2219), are moderately increased in specific brain regions of patients with AD. We provide experimental evidence that TREM2 alternatively spliced isoforms are translated and secreted as sTREM2. Furthermore, our functional analysis reveals that all sTREM2 species inhibit LTP induction, and this effect is abolished by the GABAA receptor antagonist picrotoxin. CONCLUSIONS: TREM2 transcripts can give rise to a heterogeneous pool of sTREM2 which acts to inhibit LTP. These results provide novel insight into the generation, regulation, and function of sTREM2 which fits into the complex biology of TREM2 and its role in human health and disease. Given that sTREM2 levels are linked to AD pathogenesis and progression, our finding that sTREM2 species interfere with LTP furthers our understanding about the role of TREM2 in AD.


Assuntos
Doença de Alzheimer , Potenciação de Longa Duração , Animais , Camundongos , Humanos , Doença de Alzheimer/genética , Isoformas de Proteínas/genética , Encéfalo , Linhagem Celular , Modelos Animais de Doenças , Glicoproteínas de Membrana/genética , Receptores Imunológicos/genética
13.
Pediatr Radiol ; 53(6): 1117-1124, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36637464

RESUMO

BACKGROUND: Fracture dating from skeletal surveys is crucial in the diagnosis and investigation of infant abuse. However, this task is challenging because of the subjective nature of the radiologic interpretation and the lack of ground truth. Researchers have used birth-related clavicle fractures as a surrogate to study the radiographic pattern of healing; however, they did not elucidate the accuracy performance of the radiologists in dating fractures. OBJECTIVE: To determine the accuracy of radiologists in dating birth-related clavicle fractures and compare their performance to that achieved by computer algorithm. MATERIALS AND METHODS: We used a previously assembled birth-related clavicle fracture database consisting of 416 anteroposterior clavicle radiographs as the study cohort. The average and standard deviation of the fracture age within this database were 24 days and 18 days, respectively. Three blinded radiologists independently estimated the ages of the clavicle fractures depicted in the radiographs within the database. We compared these estimation results to those made by a recently published deep-learning (DL) model conducted with the identical infant cohort. We calculated standard error metrics to compare the accuracy performances of the radiologists and the computer model. RESULTS: The intra- and inter-reader agreements of the fracture age estimates by the radiologists were moderate to good. The radiologists estimated the fracture ages with a mean absolute error (MAE) of 6.1-7.1 days, and standard deviation of the absolute error of 6.3-8.3 days. The accuracy performances of the three radiologists were not significantly different from one another. In comparison, the DL model estimated the age of clavicle fractures with an MAE of 4.2 days, significantly lower than all of the radiologists (P < 0.001). CONCLUSION: Three experienced pediatric radiologists dated clavicular fractures with moderate-good intra- and inter-reader agreements. The correlations between the radiologists' estimates and the ground truth were moderate to good. The fracture ages assigned by the DL model showed superior correlation with the ground truth compared to radiologists' dating estimates.


Assuntos
Clavícula , Fraturas Ósseas , Lactente , Criança , Humanos , Recém-Nascido , Clavícula/diagnóstico por imagem , Inteligência Artificial , Fraturas Ósseas/diagnóstico por imagem , Consolidação da Fratura , Radiologistas , Estudos Retrospectivos
14.
Pediatr Blood Cancer ; 70(1): e30057, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36266951

RESUMO

OBJECTIVE: Currently, there is no consensus protocol on the initial staging evaluation for Langerhans cell histiocytosis (LCH). Our institutional protocol consists of a skeletal survey and a whole-body positron emission tomography with 2-deoxy-2-[fluorine-18] fluoro-D-glucose integrated with computed tomography (FDG PET/CT) study. The utility of the PET/CT lies in its sensitivity in detecting osseous and extra-osseous lesions, and in determining the baseline metabolic activity of LCH lesions to assess treatment response. However, the added utility of the skeletal survey in staging LCH is unclear. Therefore, this study retrospectively assessed the added diagnostic value of skeletal surveys in patients with baseline PET/CTs for initial staging of LCH. METHODS: We retrospectively searched the medical records of all patients less than or equal to 18 years old at a large children's hospital (May 2013 to September 2021). The inclusion criteria were (a) biopsy-proven diagnosis of LCH and (b) initial staging PET/CT and skeletal survey performed less than or equal to 1 month apart. A blinded pediatric radiologist reviewed the skeletal surveys and another reviewed the PET/CTs in identifying LCH osseous lesions. RESULTS: Our study cohort consisted of 49 children with 86 LCH osseous lesions. In non-extremity locations, PET/CT identified 70/70 (100%) osseous lesions, while skeletal surveys detected 43/70 (61.4%) osseous lesions. In the extremities, PET/CT identified 13/16 (81.3%) osseous lesions, while skeletal surveys detected 15/16 (93.8%) osseous lesions. CONCLUSION: Skeletal surveys increased the detection rate of osseous lesions in the extremities, but added no diagnostic value to the detection of osseous lesions in non-extremity locations. Therefore, we propose to abbreviate the skeletal survey to include only extremity radiographs.


Assuntos
Fluordesoxiglucose F18 , Histiocitose de Células de Langerhans , Criança , Humanos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Estudos Retrospectivos , Tomografia por Emissão de Pósitrons , Histiocitose de Células de Langerhans/terapia , Compostos Radiofarmacêuticos , Estadiamento de Neoplasias
15.
Invest Radiol ; 58(3): 190-198, 2023 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-36070536

RESUMO

OBJECTIVES: Hip displacement is the second most common orthopedic problem affecting children with cerebral palsy (CP). Routine radiographic hip surveillance typically involves an anteroposterior (AP) pelvis radiograph. Unfortunately, this imaging protocol is limited by its projectional technique and the positioning challenges in children with CP. Alternatively, hip low-dose computed tomography (LDCT) has been advocated as a more accurate strategy for imaging surveillance as it provides biofidelic details of the hip that is independent of patient positioning. However, the tradeoff is the (presumed) higher radiation dose to the patient. The goal of this study is to estimate patient-specific radiation doses of hip LDCTs and AP pelvis radiographs in CP patients, and perform an intrapatient dose comparison. MATERIALS AND METHODS: A search of our imaging database was performed to identify children with CP who underwent hip LDCT and AP pelvis radiograph within 6 months of each other. The LDCTs were performed using weight-adjusted kVp and tube current modulation, whereas the radiographs were obtained with age-/size-adjusted kVp/mAs. The patient-specific organ and effective doses for LDCT were estimated by matching the patients to a nonreference pediatric phantom library from the National Cancer Institute Dosimetry System for Computed Tomography database with Monte Carlo-based dosimetry. The patient-specific organ and effective doses for radiograph were estimated using the National Cancer Institute Dosimetry System for Radiography and Fluoroscopy with Monte Carlo-based dose calculation. Dose conversion k-factors of dose area product for radiography and dose length product for LDCT were adapted, and the estimation results were compared with patient-specific dosimetry. RESULTS: Our study cohort consisted of 70 paired imaging studies from 67 children (age, 9.1 ± 3.3 years). The patient-specific and dose length product-based effective doses for LDCT were 0.42 ± 0.21 mSv and 0.59 ± 0.28 mSv, respectively. The patient-specific and dose area product-based effective doses for radiography were 0.14 ± 0.09 mSv and 0.08 ± 0.06 mSv, respectively. CONCLUSIONS: The radiation dose for a hip LDCT is ~4 times higher than pelvis radiograph, but it is still very low and poses minimal risk to the patient.


Assuntos
Paralisia Cerebral , Humanos , Criança , Pré-Escolar , Doses de Radiação , Paralisia Cerebral/diagnóstico por imagem , Radiografia , Radiometria/métodos , Tomografia Computadorizada por Raios X/métodos , Imagens de Fantasmas , Método de Monte Carlo
16.
J Med Chem ; 66(1): 460-472, 2023 01 12.
Artigo em Inglês | MEDLINE | ID: mdl-36562986

RESUMO

A series of small-molecule YEATS4 binders have been discovered as part of an ongoing research effort to generate high-quality probe molecules for emerging and/or challenging epigenetic targets. Analogues such as 4d and 4e demonstrate excellent potency and selectivity for YEATS4 binding versus YEATS1,2,3 and exhibit good physical properties and in vitro safety profiles. A new X-ray crystal structure confirms direct binding of this chemical series to YEATS4 at the lysine acetylation recognition site of the YEATS domain. Multiple analogues engage YEATS4 with nanomolar potency in a whole-cell nanoluciferase bioluminescent resonance energy transfer assay. Rodent pharmacokinetic studies demonstrate the competency of several analogues as in vivo-capable binders.


Assuntos
Regulação da Expressão Gênica , Processamento de Proteína Pós-Traducional , Domínios Proteicos , Acetilação , Epigênese Genética
17.
NMR Biomed ; 36(5): e4887, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36454009

RESUMO

High-resolution magnetic resonance imaging (MRI) affords unique image contrasts to nondestructively probe the tissue microstructure; validation of MRI findings with conventional histology is essential to better understand the MRI contrasts. However, the dramatic difference in the spatial resolution and image contrast of these two techniques impedes accurate comparison between MRI metrics and traditional histology. To better validate various MRI metrics, we acquired whole mouse brain multigradient recalled-echo and multishell diffusion MRI datasets at 25-µm isotropic resolution. The recently developed Allen Mouse Brain Common Coordinate Framework (CCFv3) provides opportunities to integrate multimodal and multiscale datasets of the whole mouse brain in a common three-dimensional (3D) space. The T2*, quantitative susceptibility mapping, diffusion tensor imaging, and neurite orientation dispersion and density imaging parameters were compared with both serial two-photon tomography images and 3D Nissl staining images in the CCFv3 at the same spatial resolution. The correlation between MRI and Nissl staining strongly depends on different metrics and different regions of the brain. Integrating different imaging modalities to the same space may substantially improve our understanding of the complexity of the brain at different scales.


Assuntos
Imagem de Tensor de Difusão , Imageamento por Ressonância Magnética , Animais , Camundongos , Imagem de Tensor de Difusão/métodos , Imagem de Difusão por Ressonância Magnética/métodos , Encéfalo/diagnóstico por imagem , Neuritos/patologia
18.
Alzheimers Dement ; 19(6): 2528-2537, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36524682

RESUMO

INTRODUCTION: Inositol polyphosphate-5-phosphatase (INPP5D) is a microglia-enriched lipid phosphatase in the central nervous system. A non-coding variant (rs35349669) in INPP5D increases the risk for Alzheimer's disease (AD), and elevated INPP5D expression is associated with increased plaque deposition. INPP5D negatively regulates signaling via several microglial cell surface receptors, including triggering receptor expressed on myeloid cells 2 (TREM2); however, the impact of INPP5D inhibition on AD pathology remains unclear. METHODS: We used the 5xFAD mouse model of amyloidosis to assess how Inpp5d haplodeficiency regulates amyloid pathogenesis. RESULTS: Inpp5d haplodeficiency perturbs the microglial intracellular signaling pathways regulating the immune response, including phagocytosis and clearing of amyloid beta (Aß). It is important to note that Inpp5d haploinsufficiency leads to the preservation of cognitive function. Spatial transcriptomic analysis revealed that pathways altered by Inpp5d haploinsufficiency are related to synaptic regulation and immune cell activation. CONCLUSION: These data demonstrate that Inpp5d haplodeficiency enhances microglial functions by increasing plaque clearance and preserves cognitive abilities in 5xFAD mice. Inhibition of INPP5D is a potential therapeutic strategy for AD.


Assuntos
Doença de Alzheimer , Camundongos , Animais , Doença de Alzheimer/patologia , Peptídeos beta-Amiloides/metabolismo , Amiloide/metabolismo , Microglia/metabolismo , Placa Amiloide/patologia , Monoéster Fosfórico Hidrolases/genética , Monoéster Fosfórico Hidrolases/metabolismo , Modelos Animais de Doenças , Camundongos Transgênicos
20.
Front Neurosci ; 16: 964654, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36061588

RESUMO

Purpose: To evaluate the age-dependent microstructure changes in 5xFAD mice using high-resolution diffusion tensor imaging (DTI). Methods: The 5xFAD mice at 4, 7.5, and 12 months and the wild-type controls at 4 months were scanned at 9.4T using a 3D echo-planar imaging (EPI) pulse sequence with the isotropic spatial resolution of 100 µm. The b-value was 3000 s/mm2 for all the diffusion MRI scans. The samples were also acquired with a gradient echo pulse sequence at 50 µm isotropic resolution. The microstructure changes were quantified with DTI metrics, including fractional anisotropy (FA) and mean diffusivity (MD). The conventional histology was performed to validate with MRI findings. Results: The FA values (p = 0.028) showed significant differences in the cortex between wild-type (WT) and 5xFAD mice at 4 months, while hippocampus, anterior commissure, corpus callosum, and fornix showed no significant differences for either FA and MD. FA values of 5xFAD mice gradually decreased in cortex (0.140 ± 0.007 at 4 months, 0.132 ± 0.008 at 7.5 months, 0.126 ± 0.013 at 12 months) and fornix (0.140 ± 0.007 at 4 months, 0.132 ± 0.008 at 7.5 months, 0.126 ± 0.013 at 12 months) with aging. Both FA (p = 0.029) and MD (p = 0.037) demonstrated significant differences in corpus callosum between 4 and 12 months age old. FA and MD were not significantly different in the hippocampus or anterior commissure. The age-dependent microstructure alterations were better captured by FA when compared to MD. Conclusion: FA showed higher sensitivity to monitor amyloid deposition in 5xFAD mice. DTI may be utilized as a sensitive biomarker to monitor beta-amyloid progression for preclinical studies.

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