Perifornical Urocortin-3 mediates the link between stress-induced anxiety and energy homeostasis

In response to physiological or psychological challenges, the brain activates behavioral and neuroendocrine systems linked to both metabolic and emotional outputs designed to adapt to the demand. However, dysregulation of integration of these physiological responses to challenge can have severe psychological and physiological consequences, and inappropriate regulation, disproportional intensity, or chronic or irreversible activation of the stress response is linked to the etiology and pathophysiology of mood and metabolic disorders. Using a transgenic mouse model and lentiviral approach, we demonstrate the involvement of the hypothalamic neuropeptide Urocortin-3, a specific ligand for the type-2 corticotropin-releasing factor receptor, in modulating septal and hypothalamic nuclei responsible for anxiety-like behaviors and metabolic functions, respectively. These results position Urocortin-3 as a neuromodulator linking stress-induced anxiety and energy homeostasis and pave the way toward better understanding of the mechanisms that mediate the reciprocal relationships between stress, mood and metabolic disorders.     

Clinical utility of doppler ultrasonography in evaluation of early therapeutic efficacy after transcatheter arterial embolization in patients with hepatocellular carcinoma

This study was undertaken to determine the value of Doppler ultrasonography in the early evaluation of therapeutic efficacy of hepatocellular carcinoma after transcatheter arterial embolization (TAE). Fifty-two nodules in which tumor vascularity had been detected by Doppler ultrasonography before TAE were examined in 41 patients. Doppler signals were evaluated 1 week after TAE, and the results were compared with tumor vascularity as determined by dynamic magnetic resonance imaging (dynamic MRI), which was used as the gold standard. The sonographic signal disappeared in 41 (79%) of the 52 nodules and remained in 11 (21%). All nodules in which intratumor vascularity had been detected showed positive stain to dynamic MRI. Four of 41 nodules in which the sonographic signal disappeard showed positive stain on dynamic MRI. The Sensitivity of Doppler ultrasonography was 73%; specificity, 100%; and accuracy, 92%. Flow signal in deeply (≥5 cm) located small (<3 cm) nodules tended to be more difficult to detect. We conclude that Doppler ultrasonography warrants use after TAE in the early evaluation as a specific and noninvasive imaging technique.     

The efferent blood flow of early hepatocellular carcinoma and borderline lesions: Demonstration by color Doppler imaging

We performed waveform analysis of the efferent signal detected within early hepatocellular carcinomas and borderline lesions, in which portal flow was demonstrated. Continuity of this flow with the surrounding vessels was also analyzed. Nine nodules in 7 patients with early hepatocellular carcinomas and borderline lesions were included in this study. Tumor diameter ranged from 1.2 to 3.5 cm; average, 2.1 cm. Waveform of the efferent flow signal from within these nodules was continuous in 5 nodules and biphasic venous in 4 nodules. Outside the nodules, the waveform of the efferent flow signal was that of a biphasic venous wave. All efferent signals were confirmed to continue in the hepatic vein. These findings thus suggest that the draining vessel in early hepatocellular carcinomas and their borderline lesions is the hepatic vein.     

A 1HMRS study of the anterior cingulate gyrus in euthymic bipolar patients

INTRODUCTION: The anterior cingulate region has been implicated in the pathophysiology of mood disorders. Studies have reported anatomical and functional abnormalities in this region in bipolar disorder patients. Few neurochemical studies have evaluated this region, especially on medicated bipolar patients. Lithium has been reported to increase NAA levels but not by all studies. We used proton magnetic spectroscopy ((1)HMRS) to measure the levels of N-acetyl-L-aspartate (NAA) and choline (Cho) relative to creatine (Cr) in the anterior cingulate of euthymic medicated bipolar subjects. METHODS: (1)HMRS was performed using a GE Signa 1.5 Tesla scanner in 13 euthymic bipolar patients who were taking lithium for at least four weeks before the scan and in 15 normal controls. The (1)HMRS signal was collected from an 8 cm(3) voxel placed in the anterior cingulate. Data analysis was performed with the automated PROBE/SV quantification tool. RESULTS: NAA/Cr and Cho/Cr ratios were not significantly different between patients and controls (NAA/Cr: 1.60 +/- 0.34 in patients, 1.68 +/- 0.34 in controls; Cho/Cr: 1.13 +/- 0.13 in patients, 1.11 +/- 0.20 in controls). CONCLUSIONS: We did not find a significant difference in the NAA/Cr and Cho/Cr ratio between bipolar patients and healthy controls. Chronic administration of psychotropic drugs could have had an effect on NAA/Cr levels of bipolar patients.     

Epicardial flow in the right ventricular wall on echocardiography: A sign of chronic total occlusion of left anterior descending artery

Transthoracic coronary Doppler echocardiography (TCDE) can be useful for the detection of chronic total occlusion (CTO) of the proximal left anterior descending coronary artery (LAD) noninvasively, by detecting retrograde flow through the distal LAD or its septal branch. This intriguing case report details the detection of abnormal blood flow in the right ventricular free wall by TCDE. This detection of abnormal flow may be useful to predict CTO of the LAD, even in the absence of retrograde flow in the LAD and its septal branch.     

Sign of wall motion abnormality observed in wall thickness change, excursion, and stroke volume obtained by M-mode: The parameter revealing wall motion abnormality in stress echocardiography (2)

To improve the evaluation of regional wall motion abnormalities (WMA) during stress echocardiography, the parameters of the wall thickness change, excursion and stroke volume, with time-dependent changes in two regional portions of the interventricular septum and the posterior wall evaluated with M-mode ultrasonography are proposed. Response to the dipyridamole stress test was studied in two normal subjects and eight subjects with coronary disease. Regional wall motion and stroke volume were measured, and the results were compared with results obtained with coronary angiography, 2-D echography, and radioisotope scintigraphy. In normal subjects, these parameters showed only monotonous change with the passage of time. In patients with coronary artery disease, however, discrepancy in wall thickness and excursion between the interventricular septum and the posterior wall appeared within 1 to 3 minutes after the start of the test. Thus, despite the limitation of the examined area imposed by use of M-mode, the motion of the interventricular septum and the posterior wall described the details of WMA and an ischemic state.