265 resultados para carcinome cortico-surrénalien
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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A utilização de técnicas ultrassonográficas na área de Medicina Veterinária está cada vez mais presente e a capacitação nesta área tornou-se indispensável para o clínico, auxiliando-o na obtenção de informações rápidas e valiosas das afecções patológicas que podem acometer os animais. O exame ultrassonográfico renal revelou-se de grande importância neste âmbito, com o objetivo de avaliar e mensurar os parâmetros morfométricos renais normais de fêmeas caprinas (Capra hircus). Por meio de técnicas ultrassonográficas procedeu-se o estudo de 30 fêmeas da raça Saanen, divididas em três grupos: fêmeas com idade inferior a 6 meses (3,0±1,0 meses), de 6-18 meses (9,0±4,3 meses) e com idade superior a 18 meses (46,3±17,4 meses). Realizaram-se imagens dos rins, em secções longitudinais, medidas de comprimento e largura e, em secções transversais, medidas de altura (ou espessura). Com estes valores calcularam-se volumes renais, corticais e medulares, além da relação cortico-medular. Com relação ao comprimento renal os grupos com idade inferior a 6 meses, de 6-18 meses e com idade superior a 18 meses obtiveram média e desvio padrão de 4,20±0,36cm, 5,56±0,40cm e 6,77±0,64cm, respectivamente. Tratando-se do volume renal, estes grupos apresentaram média e desvio padrão de 17,02±3,99cm³, 19,99±5,86cm³; e, 41,23±13,05cm³. Comparou-se a equivalência métrica das médias entre os dois rins de forma que os parâmetros volumétricos e lineares renais com diferença entre si são comprimento renal, volume renal e volume cortical para o grupo de fêmeas com idade de 6-18 meses, e comprimento renal e comprimento medular para o grupo com idade superior a 18 meses. Entre diferentes grupos observou-se que somente o comprimento medular esquerdo apresentou média equivalente em todos os grupos, ou seja, entre o grupo com idade inferior a 6 meses e o grupo com idade de 6-18 meses e, entre este último e o grupo com idade superior a 18 meses. Os resultados mostraram correlações diretas e positivas entre peso corporal e idade com os parâmetros lineares e volumétricos, a relação cortico-medular esquerda foi a única que apresentou correlação significativa com o peso (r= -0,365; P = 0,047). Para aqueles parâmetros que apresentaram correlação significativa foi realizada análise de regressão, obtendo-se a linha de melhor ajuste das variáveis.
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Anxiety is an important component of the psychopathology of the obsessive-compulsive disorder (OCD). So far, most interventions that have proven to be effective for treating OCD are similar to those developed for other anxiety disorders. However, neurobiological studies of OCD came to conclusions that are not always compatible with those previously associated with other anxiety disorders. OBJECTIVES: The aim of this study is to review the degree of overlap between OCD and other anxiety disorders phenomenology and pathophysiology to support the rationale that guides research in this field. RESULTS: Clues about the neurocircuits involved in the manifestation of anxiety disorders have been obtained through the study of animal anxiety models, and structural and functional neuroimaging in humans. These investigations suggest that in OCD, in addition to dysfunction in cortico-striatal pathways, the functioning of an alternative neurocircuitry, which involves amygdalo-cortical interactions and participates in fear conditioning and extinction processes, may be impaired. CONCLUSION: It is likely that anxiety is a relevant dimension of OCD that impacts on other features of this disorder. Therefore, future studies may benefit from the investigation of the expression of fear and anxiety by OCD patients according to their type of obsessions and compulsions, age of OCD onset, comorbidities, and patterns of treatment response.
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Nel presente lavoro di tesi ho sviluppato un metodo di analisi di dati di DW-MRI (Diffusion-Weighted Magnetic Resonance Imaging)cerebrale, tramite un algoritmo di trattografia, per la ricostruzione del tratto corticospinale, in un campione di 25 volontari sani. Il diffusion tensor imaging (DTI) sfrutta la capacità del tensore di diffusione D di misurare il processo di diffusione dell’acqua, per stimare quantitativamente l’anisotropia dei tessuti. In particolare, nella sostanza bianca cerebrale la diffusione delle molecole di acqua è direzionata preferenzialmente lungo le fibre, mentre è ostacolata perpendicolarmente ad esse. La trattografia utilizza le informazioni ottenute tramite il DW imaging per fornire una misura della connettività strutturale fra diverse regioni del cervello. Nel lavoro si è concentrata l’attenzione sul fascio corticospinale, che è coinvolto nella motricità volontaria, trasmettendo gli impulsi dalla corteccia motoria ai motoneuroni del midollo spinale. Il lavoro si è articolato in 3 fasi. Nella prima ho sviluppato il pre-processing di immagini DW acquisite con un gradiente di diffusione sia 25 che a 64 direzioni in ognuno dei 25 volontari sani. Si è messo a punto un metodo originale ed innovativo, basato su “Regions of Interest” (ROIs), ottenute attraverso la segmentazione automatizzata della sostanza grigia e ROIs definite manualmente su un template comune a tutti i soggetti in esame. Per ricostruire il fascio si è usato un algoritmo di trattografia probabilistica che stima la direzione più probabile delle fibre e, con un numero elevato di direzioni del gradiente, riesce ad individuare, se presente, più di una direzione dominante (seconda fibra). Nella seconda parte del lavoro, ciascun fascio è stato suddiviso in 100 segmenti (percentili). Sono stati stimati anisotropia frazionaria (FA), diffusività media, probabilità di connettività, volume del fascio e della seconda fibra con un’analisi quantitativa “along-tract”, per ottenere un confronto accurato dei rispettivi percentili dei fasci nei diversi soggetti. Nella terza parte dello studio è stato fatto il confronto dei dati ottenuti a 25 e 64 direzioni del gradiente ed il confronto del fascio fra entrambi i lati. Dall’analisi statistica dei dati inter-subject e intra-subject è emersa un’elevata variabilità tra soggetti, dimostrando l’importanza di parametrizzare il tratto. I risultati ottenuti confermano che il metodo di analisi trattografica del fascio cortico-spinale messo a punto è risultato affidabile e riproducibile. Inoltre, è risultato che un’acquisizione con 25 direzioni di DTI, meglio tollerata dal paziente per la minore durata dello scan, assicura risultati attendibili. La principale applicazione clinica riguarda patologie neurodegenerative con sintomi motori sia acquisite, quali sindromi parkinsoniane sia su base genetica o la valutazione di masse endocraniche, per la definizione del grado di contiguità del fascio. Infine, sono state poste le basi per la standardizzazione dell’analisi quantitativa di altri fasci di interesse in ambito clinico o di studi di ricerca fisiopatogenetica.
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I dati riportati in letteratura relativi alla struttura degli organi linfoidi dei Cetacei sono scarsi, talvolta discordanti e riferiti solo ad alcune specie. Per questo motivo è stato condotto il presente studio che ha utilizzato il tursiope (Tursiops truncatus) come specie di riferimento. In particolare, in tre soggetti di tursiope è stata analizzata, mediante l’ausilio di specifici software di analisi dell’immagine, la struttura dei seguenti organi linfoidi: timo, milza e linfonodi. Il timo, analogamente a quanto si osserva negli altri Mammiferi, si presenta come organo lobulato. In ciascun lobulo è possibile individuare due zone: la corticale e la midollare. A differenza di quanto si osserva nell’Uomo, è interessante sottolineare come nella midollare di ciascun lobulo non sia mai stata osservata la componente fibrillare. E’ possibile ipotizzare che tale differenza sia dovuta ad eventi connessi con l’organogenesi del timo. Nel tursiope il rapporto cortico/midollare non mostra differenze rispetto a quanto si osserva in altri Mammiferi. La milza del tursiope mostra caratteristiche strutturali simili a quelle osservate in altri Mammiferi. Nel tursiope, rispetto ad altri Mammiferi (Equidi, Ruminanti, Suidi e Carnivori), la quantità di polpa bianca, sul totale della polpa splenica, appare decisamente inferiore (5% vs 30%). Dal momento che le dimensioni della milza non sono particolarmente evidenti, anche la polpa rossa, se rapportata alle dimensioni dell’animale, non si presenta abbondante come in altre specie. Tale dato indica come la milza del tursiope, analogamente a quanto si osserva nell’Uomo e nei Roditori, non svolge alcuna funzione di deposito del sangue. I linfonodi di tursiope sono, tra gli organi linfoidi esaminati, quelli che mostrano le maggiori differenze strutturali rispetto a quelli di numerosi altri Mammiferi (eccezion fatta per il maiale). I noduli linfatici ed il tessuto internodulare sono, infatti, posti sia nella parte superficiale che in quella profonda del linfonodo. Tale aspetto non consente di identificare la zona paracorticale e di definire una precisa delimitazione topografica tra corticale e midollare. Il rapporto tra noduli linfatici e tessuto internodulare indica come nel linfonodo di tursiope sia più diffuso il tessuto internodulare che, a differenza del nodulo linfatico (area B-competente), contiene anche territori T-competenti.
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Generalised epileptic seizures are frequently accompanied by sudden, reversible transitions from low amplitude, irregular background activity to high amplitude, regular spike-wave discharges (SWD) in the EEG. The underlying mechanisms responsible for SWD generation and for the apparently spontaneous transitions to SWD and back again are still not fully understood. Specifically, the role of spatial cortico-cortical interactions in ictogenesis is not well studied. We present a macroscopic, neural mass model of a cortical column which includes two distinct time scales of inhibition. This model can produce both an oscillatory background and a pathological SWD rhythm. We demonstrate that coupling two of these cortical columns can lead to a bistability between out-of-phase, low amplitude background dynamics and in-phase, high amplitude SWD activity. Stimuli can cause state-dependent transitions from background into SWD. In an extended local area of cortex, spatial heterogeneities in a model parameter can lead to spontaneous reversible transitions from a desynchronised background to synchronous SWD due to intermittency. The deterministic model is therefore capable of producing absence seizure-like events without any time dependent adjustment of model parameters. The emergence of such mechanisms due to spatial coupling demonstrates the importance of spatial interactions in modelling ictal dynamics, and in the study of ictogenesis.
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Schizophrenia has been postulated to involve impaired neuronal cooperation in large-scale neural networks, including cortico-cortical circuitry. Alterations in gamma band oscillations have attracted a great deal of interest as they appear to represent a pathophysiological process of cortical dysfunction in schizophrenia. Gamma band oscillations reflect local cortical activities, and the synchronization of these activities among spatially distributed cortical areas has been suggested to play a central role in the formation of networks. To assess global coordination across spatially distributed brain regions, Omega complexity (OC) in multichannel EEG was proposed. Using OC, we investigated global coordination of resting-state EEG activities in both gamma (30–50 Hz) and below-gamma (1.5–30 Hz) bands in drug-naïve patients with schizophrenia and investigated the effects of neuroleptic treatment. We found that gamma band OC was significantly higher in drug-naïve patients with schizophrenia compared to control subjects and that a right frontal electrode (F3) contributed significantly to the higher OC. After neuroleptic treatment, reductions in the contribution of frontal electrodes to global OC in both bands correlated with the improvement of schizophrenia symptomatology. The present study suggests that frontal brain processes in schizophrenia were less coordinated with activity in the remaining brain. In addition, beneficial effects of neuroleptic treatment were accompanied by improvement of brain coordination predominantly due to changes in frontal regions. Our study provides new evidence of improper intrinsic brain integration in schizophrenia by investigating the resting-state gamma band activity.
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Objectives: Recent anatomical-functional studies have transformed our understanding of cerebral motor control away from a hierarchical structure and toward parallel and interconnected specialized circuits. Subcortical electrical stimulation during awake surgery provides a unique opportunity to identify white matter tracts involved in motor control. For the first time, this study reports the findings on motor modulatory responses evoked by subcortical stimulation and investigates the cortico-subcortical connectivity of cerebral motor control. Experimental design: Twenty-one selected patients were operated while awake for frontal, insular, and parietal diffuse low-grade gliomas. Subcortical electrostimulation mapping was used to search for interference with voluntary movements. The corresponding stimulation sites were localized on brain schemas using the anterior and posterior commissures method. Principal observations: Subcortical negative motor responses were evoked in 20/21 patients, whereas acceleration of voluntary movements and positive motor responses were observed in three and five patients, respectively. The majority of the stimulation sites were detected rostral of the corticospinal tract near the vertical anterior-commissural line, and additional sites were seen in the frontal and parietal white matter. Conclusions: The diverse interferences with motor function resulting in inhibition and acceleration imply a modulatory influence of the detected fiber network. The subcortical stimulation sites were distributed veil-like, anterior to the primary motor fibers, suggesting descending pathways originating from premotor areas known for negative motor response characteristics. Further stimulation sites in the parietal white matter as well as in the anterior arm of the internal capsule indicate a large-scale fronto-parietal motor control network. Hum Brain Mapp, 2012. © 2012 Wiley Periodicals, Inc.
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Pavlovian fear conditioning, a simple form of associative learning, is thought to involve the induction of associative, NMDA receptor-dependent long-term potentiation (LTP) in the lateral amygdala. Using a combined genetic and electrophysiological approach, we show here that lack of a specific GABA(B) receptor subtype, GABA(B(1a,2)), unmasks a nonassociative, NMDA receptor-independent form of presynaptic LTP at cortico-amygdala afferents. Moreover, the level of presynaptic GABA(B(1a,2)) receptor activation, and hence the balance between associative and nonassociative forms of LTP, can be dynamically modulated by local inhibitory activity. At the behavioral level, genetic loss of GABA(B(1a)) results in a generalization of conditioned fear to nonconditioned stimuli. Our findings indicate that presynaptic inhibition through GABA(B(1a,2)) receptors serves as an activity-dependent constraint on the induction of homosynaptic plasticity, which may be important to prevent the generalization of conditioned fear.
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Repetitive transcranial magnetic stimulation (rTMS) is a means to study the function and connectivity of brain areas. The present study addressed the question of hemispheric asymmetry of frontal regions and aimed to further understand the acute effects of high- and low-frequency rTMS on regional cerebral blood flow (rCBF). Sixteen healthy right-handed men were imaged using H(2)(15)O positron emission tomography (PET) immediately after stimulation. High (10 Hz)- and low (1 Hz)-frequency suprathreshold short-duration rTMS was applied over either the left or right dorsolateral prefrontal cortex (DLPFC). Slow and fast rTMS applied over the left DLPFC significantly increased CBF in the stimulated area. Compared to baseline, slow rTMS induced a significant increase in CBF contralateral to the stimulation site, in the right caudate body and in the anterior cingulum. Furthermore, slow rTMS decreased CBF in the orbitofrontal cortex (OFC, ipsilateral to stimulation side). Fast rTMS applied over the right DLPFC was associated with increased activity at the stimulation site, in the bilateral orbitofrontal cortex and in the left medial thalamus compared to 1-Hz rTMS. These results show that rCBF changes induced by prefrontal rTMS differ upon hemisphere stimulated and vary with stimulation frequency. These differential neurophysiological effects of short-train rTMS with respect to side and frequency suggest hemisphere-dependent functional circuits of frontal cortico-subcortical areas.
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Blood oxygenation level-dependent (BOLD) MRI was shown to allow non-invasive observation of renal oxygenation in humans. However, clinical applications of this type of functional MRI of the kidney are still limited, most likely because of difficulties in obtaining reproducible and reliable information. The aim of this study was to evaluate the reproducibility and robustness of a BOLD method applied to the kidneys and to identify systematic physiological changes potentially influencing the renal oxygenation of healthy volunteers. To measure the BOLD effect, a modified multi-echo data image combination (MEDIC) sequence was used to acquire 12 T2*-weighted images within a single breath-hold. Three identical measurements were performed on three axial and three coronal slices of right and left kidneys in 18 volunteers. The mean R2* (1/T2*) values determined in medulla and cortex showed no significant differences over three repetitions and low intra-subject coefficients of variation (CV) (3 and 4% in medulla and cortex, respectively). The average R2* values were higher in the medulla (16.15 +/- 0.11) than in the cortex (11.69 +/- 0.18) (P < 0.001). Only a minor influence of slice orientation was observed. Mean R2* values were slightly higher (3%) in the left than in the right kidney (P < 0.001). Differences between volunteers were identified (P < 0.001). Part of these differences was attributable to age-dependent R2* values, since these values increased with age when medulla (P < 0.001, r = 0.67) or cortex (P < 0.020, r = 0.42) were considered. Thus, BOLD measurements in the kidney are highly reproducible and robust. The results allow one to identify the known cortico-medullary gradient of oxygenation evidenced by the gradient of R2* values and suggest that medulla is more hypoxic in older than younger individuals. BOLD-MRI is therefore a useful tool to study sequentially and non-invasively regional oxygenation of human kidneys.
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The genesis of Tourette syndrome is still unknown, but a core role for the pathways of cortico-striatal-thalamic-cortical circuitry (CSTC) is supposed. Volume-rendering magnetic resonance imaging data-sets were analysed in 14 boys with Tourette syndrome and 15 age-matched controls using optimised voxel-based morphometry. Locally increased grey-matter volumes (corrected P < 0.001) were found bilaterally in the ventral putamen. Regional decreases in grey matter were observed in the left hippocampal gyrus. This unbiased analysis confirmed an association between striatal abnormalities and Tourette syndrome, and the hippocampal volume alterations indicate an involvement of temporolimbic pathways of the CSTC in the syndrome.
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Based on an integrative brain model which focuses on memory-driven and EEG state-dependent information processing for the organisation of behaviour, we used the developmental changes of the awake EEG to further investigate the hypothesis that neurodevelopmental abnormalities (deviations in organisation and reorganisation of cortico-cortical connectivity during development) are involved in the pathogenesis of schizophrenia. First-episode, neuroleptic-naive schizophrenics and their matched controls and three age groups of normal adolescents were studied (total: 70 subjects). 19-channel EEG delta-theta, alpha and beta spectral band centroid frequencies during resting (baseline) and after verbal stimuli were used as measure of the level of attained complexity and momentary excitability of the neuronal network (working memory). Schizophrenics compared with all control groups showed lower delta-theta activity centroids and higher alpha and beta activity centroids. Reactivity centroids (centroid after stimulus minus centroid during resting) were used as measure of update of working memory. Schizophrenics showed partial similarities in delta-theta and beta reactivity centroids with the 11-year olds and in alpha reactivity centroids with the 13-year olds. Within the framework of our model, the results suggest multifactorially elicited imbalances in the level of excitability of neuronal networks in schizophrenia, resulting in network activation at dissociated complexity levels, partially regressed and partially prematurely developed. It is hypothesised that activation of age- and/or state-inadequate representations for coping with realities becomes manifest as productive schizophrenic symptoms. Thus, the results support some aspects of the neurodevelopmental hypothesis.
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Phase locking or synchronization of brain areas is a key concept of information processing in the brain. Synchronous oscillations have been observed and investigated extensively in EEG during the past decades. EEG oscillations occur over a wide frequency range. In EEG, a prominent type of oscillations is alpha-band activity, present typically when a subject is awake, but at rest with closed eyes. The spectral power of alpha rhythms has recently been investigated in simultaneous EEG/fMRI recordings, establishing a wide-range cortico-thalamic network. However, spectral power and synchronization are different measures and little is known about the correlations between BOLD effects and EEG synchronization. Interestingly, the fMRI BOLD signal also displays synchronous oscillations across different brain regions. These oscillations delineate so-called resting state networks (RSNs) that resemble the correlation patterns of simultaneous EEG/fMRI recordings. However, the nature of these BOLD oscillations and their relations to EEG activity is still poorly understood. One hypothesis is that the subunits constituting a specific RSN may be coordinated by different EEG rhythms. In this study we report on evidence for this hypothesis. The BOLD correlates of global EEG synchronization (GFS) in the alpha frequency band are located in brain areas involved in specific RSNs, e.g. the 'default mode network'. Furthermore, our results confirm the hypothesis that specific RSNs are organized by long-range synchronization at least in the alpha frequency band. Finally, we could localize specific areas where the GFS BOLD correlates and the associated RSN overlap. Thus, we claim that not only the spectral dynamics of EEG are important, but also their spatio-temporal organization.
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Little is known about hemispheric lateralization of subcortical structures. Here, we show a higher expression of the subunit NR2A of the NMDA receptor mRNA in the striatum and of vGluT1 mRNA in the cingulate cortex, in the left hemisphere compared to the right one. This suggests a lateralization of the glutamatergic cortico-subcortical system, at the level of postsynaptic receptors as well as at the level of corticostriatal projections. Such lateralization could play a role in asymmetric diseases like Parkinson's disease.