Diagnostic specificity of focal white matter abnormalities in bipolar and unipolar mood disorder.
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
J Hesselink
Publications and source records attributed to J Hesselink.
Magnetic resonance imaging and mood disorders. Localization of white matter and other subcortical abnormalities.
BACKGROUND: Recent reports in the literature document an association between focal white matter abnormalities in bipolar as well as unipolar mood disorder. The importance of this finding and other associated anatomic differences is uncertain. METHODS: We examined the volume of abnormal white matter and other brain volumes using quantitative magnetic resonance imaging analysis. We explored the relationship of these variables with diagnosis, cognitive function, and clinical variables in 36 patients with bipolar disorder, 30 patients with unipolar disorder, and 26 control subjects who were free from significant medical and neurologic illness. RESULTS: Younger patients with bipolar disorder (but not similarly aged patients with unipolar disorder or controls) have an increased volume of abnormal white matter. Data also indicate that the total volume of abnormal white matter may be associated with increased cognitive impairment, increased rate of psychiatric illness in the family, and onset after adolescence. CONCLUSION: Patients with bipolar disorder demonstrate a pattern of subcortical brain morphologic abnormalities and cognitive impairment.
Adult↗
Gender differences in schizophrenia.
In an assessment of gender differences in schizophrenia, 85 outpatients (53 men and 32 women) with schizophrenia were evaluated for illness history, symptom severity, IQ, neurocognitive status, cerebral volume loss, and cortical asymmetry. Social functioning was assessed using marital status, independent living skills, and employment status. Significant gender differences were found, as women were on lower doses of neuroleptic medications and more frequently met criteria for paranoid and disorganized subtypes of schizophrenia than men. Women also were better educated and more often married, living independently, and employed. No gender differences were found in present age, symptom severity, neurocognitive functioning, or clinical magnetic resonance imaging scan readings. Our findings suggest that women may experience less of the adverse interpersonal psychosocial consequences of schizophrenia than men, even when symptom and neurocognitive status is equivalent between groups. However, more extensive investigations are warranted to better understand the role of pathophysiological or social mechanisms in gender differences.
Activities of Daily Living↗
Clinical and histopathologic study of varicella zoster virus retinitis in patients with the acquired immunodeficiency syndrome.
Varicella zoster virus retinitis in patients with the acquired immunodeficiency syndrome is known to be a devastating disease. We studied a series of six consecutive patients that sheds new light on the clinical manifestations and treatment options of this disorder. All patients had episodes of cutaneous zoster, long-term exposure to oral acyclovir, and CD4+ T lymphocyte counts less than 50 cells/mm3. Two of the six patients had simultaneous radiographically demonstrable and histologically proven varicella zoster virus encephalitis; this is an important association. Histologic examination of autopsy specimens disclosed that the retinal infection by varicella zoster virus involves the retinal pigment epithelium more heavily than the inner retina, which is consistent with the characteristic clinical impression of an outer retinal necrosis.
AIDS-Related Opportunistic Infections↗
New views from the reading room.
Explore the source record for details and available documents.
California↗
Cine magnetic resonance imaging for evaluation of anatomy and flow relations in infants and children with coarctation of the aorta.
Sixteen cine magnetic resonance imaging (MRI) studies were performed in 14 patients aged 1 week to 17 years (mean age, 46 months), who had coarctation of the aorta confirmed at angiography or surgery. Conventional echocardiographic-gated MRI was first performed in axial and rotated sagittal views and was used to identify the slice locations for cine MRI. Cine MRI was performed by gradient-recalled acquisition in steady state with a 30 degree flip angle, 12-msec echo time, 22-msec pulse repetition time, and a 128 x 256 acquisition matrix. Coarctation anatomy was extremely well defined in all but one patient who had vascular clips at the coarctation repair site. The smallest descending aortic flow diameter on cine MRI showed excellent agreement with angiography (r = 0.90). Lucent jets of high-velocity flow through the site of coarctation were imaged in eight patients, and jet length correlated well with the angiographic severity of coarctation (r = -0.81). Two patients were restudied after surgery, and they exhibited excellent repair and normal flow patterns. Cine MRI provides high-resolution imaging of coarctation anatomy with a dynamic spatial and temporal visualization of flow and with excellent detail of vascular anatomy and flow both proximal and distal to the coarctation.
Adolescent↗
Magnetic resonance imaging of the lumbar spinous processes and adjacent soft tissues: normal and pathologic appearances.
The spinous processes and intervening soft tissues of the lumbar region may be involved by degenerative, inflammatory, neoplastic, and traumatic processes resulting in low back pain. While conventional radiography and computed tomography have proven useful in the demonstration of abnormalities affecting the spinous processes, they are of limited utility in the evaluation of the intervening soft tissues, which are the predominant site of initial pathologic involvement. To explore the potential role of magnetic resonance imaging (MRI) in the assessment of the spinous processes and adjacent ligaments, a retrospective review of 55 consecutive examinations of the lumbar spine was performed. The normal and pathologic appearances of the region on both T1 and T2 weighted images were characterized, and the optimal imaging variables for demonstration of the spinous processes and adjacent soft tissues were determined with subsequent prospective application to new cases. Correlative examination of cadaveric sections and dried specimens was also performed to facilitate understanding of anatomical relationships visualized by MRI. Based upon the results of this investigation, MRI is the procedure of choice in the evaluation of disease processes affecting the spinous processes and intervening ligaments, primarily owing to the ability to image directly in the sagittal plane and its superior soft tissue contrast discrimination capability.
Adolescent↗