Nonbacterial Thrombotic Endocarditis Related to Adenocarcinoma of the Uterine Cervix

We report a 66-year-old female patient who presented with acute onset of visual loss with relative afferent pupillary defect, hemineglect, hemihypesthesia, and apraxia. Magnetic resonance imaging of the brain demonstrated different stages of ischemic stroke in different vascular territories, suggesting cardiogenic embolism. Past history was significant for advanced-stage adenocarcinoma of the uterine cervix under chemoradiation treatment. On echocardiogram, vegetation at the aortic valve was observed. With the absence of evidence of infectious endocarditis, diagnosis of nonbacterial thrombotic endocarditis was made, and the patient was treated by long-term anticoagulant. This case is unique in terms of the adenocarcinoma cell type of cervical cancer, which is uncommon and has been rarely reported to be related to nonbacterial thrombotic endocarditis.

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Increased neural reactivity to emotional pictures in men with high hair testosterone concentrations

Social Cognitive and Affective Neuroscience ◽

10.1093/scan/nsz067 ◽

2019 ◽

Vol 14 (9) ◽

pp. 1009-1016

Author(s):

Sanja Klein ◽

Onno Kruse ◽

Isabell Tapia León ◽

Tobias Stalder ◽

Rudolf Stark ◽

...

Keyword(s):

Emotional Reactivity ◽

Neural Activation ◽

Functional Magnetic Resonance ◽

Resonance Imaging ◽

Testosterone Levels ◽

Passive Viewing ◽

Emotional Pictures ◽

Neural Reactivity ◽

The Brain

Abstract Testosterone has been linked to alterations in the activity of emotion neurocircuitry including amygdala, orbitofrontal cortex (OFC) and insula and diminished functional amygdala/prefrontal coupling. Such associations have only ever been studied using acute measures of testosterone, thus little is known about respective relationships with long-term testosterone secretion. Here, we examine associations between hair testosterone concentration (HTC), an index of long-term cumulative testosterone levels and neural reactivity during an emotional passive viewing task using functional magnetic resonance imaging (fMRI). Forty-six men viewed negative, positive and neutral pictures in the MRI. HTCs were assessed from 2 cm hair segments. The emotional paradigm elicited neural activation in the amygdala, insula and OFC. HTCs were associated with increased reactivity to negative pictures in the insula and increased reactivity to positive pictures in the OFC. We show an association of long-term testosterone levels with increased emotional reactivity in the brain. These results suggest a heightened emotional vigilance in individuals with high trait testosterone levels.

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MECHANISMS IN ENDOCRINOLOGY: Cushing's syndrome causes irreversible effects on the human brain: a systematic review of structural and functional magnetic resonance imaging studies

Acta Endocrinologica ◽

10.1530/eje-14-1101 ◽

2015 ◽

Vol 173 (1) ◽

pp. R1-R14 ◽

Cited By ~ 87

Author(s):

Cornelie D Andela ◽

Femke M van Haalen ◽

Oskar Ragnarsson ◽

Eleni Papakokkinou ◽

Gudmundur Johannsson ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Systematic Review ◽

Magnetic Resonance ◽

Cushing’S Syndrome ◽

Cushing's Syndrome ◽

Resonance Imaging ◽

Biochemical Cure ◽

The Brain ◽

Active Disease

BackgroundCushing's syndrome (CS) is characterized by excessive exposure to cortisol, and is associated with both metabolic and behavioral abnormalities. Symptoms improve substantially after biochemical cure, but may persist during long-term remission. The causes for persistent morbidity are probably multi-factorial, including a profound effect of cortisol excess on the brain, a major target area for glucocorticoids.ObjectiveTo review publications evaluating brain characteristics in patients with CS using magnetic resonance imaging (MRI).MethodsSystematic review of literature published in PubMed, Embase, Web of Knowledge, and Cochrane databases.ResultsNineteen studies using MRI in patients with CS were selected, including studies in patients with active disease, patients in long-term remission, and longitudinal studies, covering a total of 339 unique patients. Patients with active disease showed smaller hippocampal volumes, enlarged ventricles, and cerebral atrophy as well as alterations in neurochemical concentrations and functional activity. After abrogation of cortisol excess, the reversibility of structural and neurochemical alterations was incomplete after long-term remission. MRI findings were related to clinical characteristics (i.e., cortisol levels, duration of exposure to hypercortisolism, current age, age at diagnosis, and triglyceride levels) and behavioral outcome (i.e., cognitive and emotional functioning, mood, and quality of life).ConclusionPatients with active CS demonstrate brain abnormalities, which only partly recover after biochemical cure, because these still occur even after long-term remission. CS might be considered as a human model of nature that provides a keyhole perspective of the neurotoxic effects of exogenous glucocorticoids on the brain.

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Cerebral and Brain Stem Changes After ECT Revealed by Nuclear Magnetic Resonance Imaging

The British Journal of Psychiatry ◽

10.1192/bjp.151.1.69 ◽

1987 ◽

Vol 151 (1) ◽

pp. 69-71 ◽

Cited By ~ 29

Author(s):

A. J. Mander ◽

A. Whitfield ◽

D. M. Kean ◽

M. A. Smith ◽

R. H. B. Douglas ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Nuclear Magnetic Resonance ◽

Relaxation Time ◽

Major Depression ◽

Magnetic Resonance ◽

Magnetic Resonance Images ◽

Resonance Imaging ◽

The Brain ◽

Nuclear Magnetic

Nuclear magnetic resonance images of the brain were obtained in fourteen patients with major depression during a course of ECT. The T1, relaxation time rose immediately after the fit reaching a maximum 4–6 h later. The T1, values then returned to their original level; no long-term increase occurred over the course of treatment. These results are consistent with an extensive but temporary breakdown of the blood-brain barrier during ECT.

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Long-term Implication of Metronidazole Induced Reversible Cerebellar Toxicity and Peripheral Neuropathy- A Case Report

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/48155.15200 ◽

2021 ◽

Author(s):

Parmendra Sirohi ◽

Hardeva Ram Nehara ◽

Avadusidda Arakeri ◽

Atma Ram Chhimpa ◽

IH Sunil

Keyword(s):

Resonance Imaging ◽

Central Nervous System Toxicity ◽

Mri Scan ◽

Fluid Attenuated Inversion Recovery ◽

Magnetic Resonance Imaging Mri ◽

Permanent Neurological Deficit ◽

The Brain ◽

System Toxicity ◽

Cerebellar Symptoms

Metronidazole Induced Encephalopathy (MIE) is rare and serious central nervous system toxicity. A 40-year-old male, on long-term self treatment with metronidazole (cumulative dose: 102 gm) presented with dysarthria, nystagmus, unsteadiness, and numbness in both legs. A Magnetic Resonance Imaging (MRI) scan of the brain revealed a symmetric hyperintensity in both the dentate nuclei of cerebellum on both T2 weighted and Fluid-Attenuated Inversion-Recovery (FLAIR) imaging. Discontinuation of metronidazole resulted in resolution of the imaging findings and clinical improvement occurred within one month. Metronidazole-induced neurotoxicity should be considered in patient who present with cerebellar symptoms and characteristic lesion on MRI in close temporal relation with metronidazole intake and drug should be discontinued to prevent permanent neurological deficit.

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Hand–Arm-Vibration Syndrome (HAVS): Is There a Central Nervous Component? an fMRI Study

Journal of Hand Surgery (European Volume) ◽

10.1054/jhsb.2002.0813 ◽

2002 ◽

Vol 27 (6) ◽

pp. 514-519 ◽

Cited By ~ 7

Author(s):

G. LUNDBORG ◽

B. ROSÉN ◽

L. KNUTSSON ◽

S. HOLTÅS ◽

F. STÅHLBERG ◽

...

Keyword(s):

Tactile Stimulation ◽

Motor Dysfunction ◽

Functional Magnetic Resonance ◽

Resonance Imaging ◽

Vibration Syndrome ◽

Ipsilateral Hemisphere ◽

Neuromuscular Dysfunction ◽

Fmri Study ◽

The Brain

Hand-held vibrating tools may result in neuromuscular dysfunction and vasospastic problems of the hand. Sensory and motor dysfunction can be explained by injury to peripheral structures, but could also be due to changes in cortical somatotopic mapping of the hand in the brain. The purpose of the present study was to use functional magnetic resonance imaging (fMRI) to assess the somatotopic cortical representation of the hands of workers subjected to occupational vibration. The study included six men with severe vibration exposures who were suffering from hand–arm-vibration syndrome (HAVS) and six controls. The analysis focused on the pattern and degree of activation of contra- and ipsilateral hemispheres of the brain with tactile stimulation and motor activation of the hand. These stimulations resulted in well-defined activation of the contralateral, and to a lesser extent the ipsilateral hemisphere. Statistical analysis of this limited patient material did not indicate any significant somatotopic cortical changes following long-term exposure to vibrating hand-held tools, although there was a tendency to a shift of activation towards the more cranial parts of the cortex in the patient group.

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Acute Rhino-orbital-cerebral Mucormycosis in a Patient with COVID – 19

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v38i1.1301 ◽

2021 ◽

Vol 38 (1) ◽

Author(s):

Warda Ali Naqvi ◽

Muhammad Javid Bhutta ◽

Ejaz Ahmed Khan ◽

Aftab Akhtar ◽

Sania Raza

Keyword(s):

Maxillary Sinusitis ◽

Orbital Cellulitis ◽

Resonance Imaging ◽

Rt Pcr ◽

Fungal Hyphae ◽

Magnetic Resonance Imaging Mri ◽

The Brain ◽

Nasal Biopsy ◽

Increased Susceptibility

COVID-19 patients are known to have immunosuppression due to decreased lymphocytes and increased susceptibility to co-infections (Bacterial and fungal). We present a case of 61-year-old patient who had diabetes, hypertension and ischemic heart disease with COVID-19 infection admitted after RT-PCR positive result. He developed rhino-orbital Mucormycosis during treatment. He received Remdesivir with parenteral Methylprednisolone and Meropenem. While admitted in the ward, he developed signs of orbital cellulitis. Magnetic resonance imaging (MRI) of the brain, orbits, and paranasal sinuses revealed right frontal, ethmoidal, and maxillary sinusitis with the extension of the sinisuidal disease to the orbit. A nasal biopsy revealed broad aseptate filamentous fungal hyphae suggestive of Mucormycosis. Long-term use of steroids/monoclonal antibodies/broad-spectrum antibiotics may contribute to the predisposition to fungal disease. Early diagnosis and prompt management are warranted to avoid morbidity. Key Words: Mucormycosis, COVID – 19, Orbital Cellulitis.

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Mapping of Brain Functions and Spatial Luminance Distributions as Innovative Tools for Assessing Discomfort Glare in the Built Environment

Enquiry A Journal for Architectural Research ◽

10.17831/enq:arcc.v4i1.59 ◽

2007 ◽

Vol 4 (1) ◽

Author(s):

Peter Raynham ◽

Werner Osterhaus ◽

Michael Davies

Keyword(s):

Built Environment ◽

Proof Of Concept ◽

Functional Magnetic Resonance ◽

Resonance Imaging ◽

Brain Functions ◽

Discomfort Glare ◽

Innovative Tool ◽

New Research ◽

The Brain

A series of "proof-of-concept" projects are set out aimed at bringing together built environment researchers attempting to understand what constitutes ‘comfortable’ space and neuroscientists investigating the functional characteristics of the human brain. The long-term goal is to address the question of whether there are regions of the brain that are specifically engaged when people experience spaces they consider to be comfortable, pleasing or even beautiful. Glare is an area of research that has been recognised as a problem in both interior and exterior lighting. Recent advances in technology make it an ideal candidate for the proposed “proof-of-concept” study. The mapping of brain functions through functional magnetic resonance imaging, the mapping of luminance distributionsin a visual scene, and the study of distraction and its influence on discomfort glare can be combined to form the basis of an innovative tool box for new research.

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Peripherally derived macrophages can engraft the brain independent of irradiation and maintain an identity distinct from microglia

Journal of Experimental Medicine ◽

10.1084/jem.20180247 ◽

2018 ◽

Vol 215 (6) ◽

pp. 1627-1647 ◽

Cited By ~ 114

Author(s):

James C. Cronk ◽

Anthony J. Filiano ◽

Antoine Louveau ◽

Ioana Marin ◽

Rachel Marsh ◽

...

Keyword(s):

Central Nervous System ◽

Bone Marrow ◽

Nervous System ◽

Bone Marrow Transplantation ◽

Brain Function ◽

Cell Type ◽

Cns Inflammation ◽

Conditioning Regimens ◽

The Brain

Peripherally derived macrophages infiltrate the brain after bone marrow transplantation and during central nervous system (CNS) inflammation. It was initially suggested that these engrafting cells were newly derived microglia and that irradiation was essential for engraftment to occur. However, it remains unclear whether brain-engrafting macrophages (beMφs) acquire a unique phenotype in the brain, whether long-term engraftment may occur without irradiation, and whether brain function is affected by the engrafted cells. In this study, we demonstrate that chronic, partial microglia depletion is sufficient for beMφs to populate the niche and that the presence of beMφs does not alter behavior. Furthermore, beMφs maintain a unique functional and transcriptional identity as compared with microglia. Overall, this study establishes beMφs as a unique CNS cell type and demonstrates that therapeutic engraftment of beMφs may be possible with irradiation-free conditioning regimens.

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Gastric leptin: a putative role in the short-term regulation of food intake

British Journal Of Nutrition ◽

10.1079/bjn2003945 ◽

2003 ◽

Vol 90 (4) ◽

pp. 735-741 ◽

Cited By ~ 53

Author(s):

Catalina Picó ◽

Paula Oliver ◽

Juana Sánchez ◽

Andreu Palou

Keyword(s):

Food Intake ◽

Cell Type ◽

Digestive Physiology ◽

Short Term ◽

Fat Depots ◽

Short And Long Term ◽

Endocrine Cell Type ◽

The Brain

The discovery of the production of leptin by the stomach, in addition to its production by adipose tissue, has initiated new investigation into the possible role of this protein in the digestive physiology, in particular in the short-term control of energy balance. Leptin has been identified in the lower half of the stomach glands both in the pepsinogen granules of chief cells and in the granules of a specific endocrine cell type, suggesting that leptin action is exerted by both exocrine and endocrine pathways. Gastric leptin is sensitive to the nutritional state, being rapidly mobilized in response to food intake following fasting, or after the administration of satiety factors; this suggests a role for this protein in the short-term regulation of feeding, acting in collaboration with satiety peptides such as cholecystokinin. Leptin, produced by gastric cells and by adipocytes, could act on both acute and chronic regulation of feeding behaviour respectively, giving information to the brain on the availability of external (food) and internal (fat depots) energy resources, thus participating in short- and long-term satiation.

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Acute Onset Asymmetric Sensorimotor Paraparesis: Not Always Spinal!

Journal of Stroke Medicine ◽

10.1177/2516608520927198 ◽

2020 ◽

Vol 3 (1) ◽

pp. 40-42

Author(s):

Dhananjay Gupta ◽

Pradeep R ◽

Anish Mehta ◽

Mahendra Javali ◽

Purshottam T. Acharya ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Cerebral Infarction ◽

Symptomatic Improvement ◽

Acute Onset ◽

Lower Limbs ◽

Sensory Loss ◽

Cerebral Stroke ◽

Resonance Imaging ◽

The Brain

Objective: To report an atypical case of acute onset sensorimotor paraparesis secondary to bilateral cerebral stroke. Background: Acute onset paraparesis or paraplegia is usually secondary to a spinal cord disease. Central or cerebral causes of paraparesis are rare and include parasagittal and bilateral precentral lesions. Design/Methods: Case report and literature review. Results: A 65-year-old man presented with acute onset weakness of both lower limbs, associated with pins and needle sensation. On examination, he was found to have paraparesis (grade 2/5, both legs) and an asymmetric sensory loss in both legs and thighs. Spinal magnetic resonance imaging ruled out any compressive or noncompressive etiology. Magnetic resonance imaging of the brain showed an acute infarction in the bilateral cerebral hemisphere in both the pre- and postcentral gyrus. An angiogram of the brain revealed an aplastic right ACA-A1 with left ACA-A1 feeding bilateral A2. There was distal left ACA-A1 stenosis seen, the probable cause of bilateral stroke in this patient. The patient was treated conservatively and showed symptomatic improvement during the course of stay at the hospital. Conclusion: This case of acute paraparesis secondary to bilateral cerebral infarction demonstrates the need to always look for a cerebral cause. In patients with cerebral infarction, who present early to a hospital, it may provide a window for thrombolytic or endovascular therapy.

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