Encephalitis that primarily involves limbic system structures such as the hippocampus and parahippocampal gyrus has been described in early papers, most commonly characterized by a subacute progressive impairment of short-term memory, psychiatric features and seizures. While these findings might be caused by viral infections or systemic autoimmune disorders, many patients with limbic encephalitis have an immune-mediated etiology (paraneoplastic or not) characterized with serum or CSF antineuronal antibodies. This case reports about non-paraneoplastic autoantibody-negative limbic encephalitis in which there are no detection of antigens and no evidence of tumors.
Antibodies ; Encephalitis ; Hippocampus ; Humans ; Limbic Encephalitis* ; Limbic System ; Memory* ; Memory, Short-Term ; Parahippocampal Gyrus ; Seizures

PURPOSE: A new compressed sensing technique by iterative truncation of small transformed coefficients (ITSC) is proposed for fast cardiac CINE MRI. MATERIALS AND METHODS: The proposed reconstruction is composed of two processes: truncation of the small transformed coefficients in the r-f domain, and restoration of the measured data in the k-t domain. The two processes are sequentially applied iteratively until the reconstructed images converge, with the assumption that the cardiac CINE images are inherently sparse in the r-f domain. A novel sampling strategy to reduce the normalized mean square error of the reconstructed images is proposed. RESULTS: The technique shows the least normalized mean square error among the four methods under comparison (zero filling, view sharing, k-t FOCUSS, and ITSC). Application of ITSC for multi-slice cardiac CINE imaging was tested with the number of slices of 2 to 8 in a single breath-hold, to demonstrate the clinical usefulness of the technique. CONCLUSIONS: Reconstructed images with the compression factors of 3-4 appear very close to the images without compression. Furthermore the proposed algorithm is computationally efficient and is stable without using matrix inversion during the reconstruction.
Magnetic Resonance Imaging, Cine*

PURPOSE: We proposed a multi-physiological signals based real-time intelligent triggering system(MITS) for Cardiac MRI. Induced noise of the system was analyzed. MATERIALS AND METHODS: MITS makes cardiac MR imaging sequence synchronize to the cardiac motion using ECG, respiratory signal and second order derivative of SPO2 signal. Abnormal peaks due to arrhythmia or subject's motion are rejected using the average R-R intervals and R-peak values. Induced eddy currents by gradients switching in cardiac MR imaging are analyzed. The induced eddy currents were removed by hardware and software filters. RESULTS: Cardiac MR images that synchronized to the cardiac and respiratory motion are acquired using MITS successfully without artifacts caused by induced eddy currents of gradient switching or subject's motion or arrhythmia. We showed that the second order derivative of the SPO2 signal can be used as a complement to the ECG signals. CONCLUSION: The proposed system performs cardiac and respiratory gating with multi-physiological signals in real time. During the cardiac gating, induced noise caused by eddy currents is removed. False triggers due to subject's motion or arrhythmia are rejected. The cardiac MR imaging with free breathing is obtained using MITS.
Arrhythmias, Cardiac ; Artifacts ; Complement System Proteins ; Electrocardiography ; Magnetic Resonance Imaging* ; Noise ; Respiration

The human microbiome is known to play an essential role in influencing host health. Extracellular vesicles (EVs) have also been reported to act on a variety of signaling pathways, distally transport cellular components such as proteins, lipids, and nucleic acid, and have immunomodulatory effects. Here we shall review the current understanding of the intersectionality of the human microbiome and EVs in the emerging field of microbiota-derived EVs and their pharmacological potential. Microbes secrete several classes of EVs: outer membrane vesicles (OMVs), membrane vesicles (MVs), and apoptotic bodies. EV biogenesis is unique to each cell and regulated by sophisticated signaling pathways. EVs are primarily composed of lipids, proteins, nucleic acids, and recent evidence suggests they may also carry metabolites. These components interact with host cells and control various cellular processes by transferring their constituents. The pharmacological potential of microbiomederived EVs as vaccine candidates, biomarkers, and a smart drug delivery system is a promising area of future research. Therefore, it is necessary to elucidate in detail the mechanisms of microbiome-derived EV action in host health in a multi-disciplinary manner.
Biomarkers ; Drug Delivery Systems ; Extracellular Vesicles ; Membranes ; Microbiota ; Nucleic Acids

The role of infectious agents in the etiology of inflammatory diseases once believed to be non-infectious is increasingly being recognized. Many bacterial components in the indoor dust can evoke inflammatory lung diseases. Bacteria secrete nanometer-sized vesicles into the extracellular milieu, so-called extracellular vesicles (EV). which are pathophysiologically related to inflammatory diseases. Microbiota compositions in the indoor dust revealed the presence of both Gram-negative and Gram-positive bacteria. Escherichia coli is a model organism of Gram-negative Enterobacteriaceae. The repeated inhalation of E. coli-derived EVs caused neutrophilic inflammation and emphysema in a dose-dependent manner. The emphysema induced by E. coli-derived EVs was partially eliminated by the absence of Interferon-gamma or interleukin-17, suggesting that Th1 and/or Th17 cell responses are important in the emphysema development. Meanwhile, the repeated inhalation of Staphylococcus aureus-derived EVs did not induce emphysema, although they induced neutrophilic inflammation in the lung. In terms of microbial EV compositions in the indoor dust, genera Pseudomonas, Acinetobacter, Enterobacter, and Staphylococcus were dominant. As for the clinical significance of sensitization to EVs in the indoor dust, EV sensitization was closely associated with asthma, chronic obstructive pulmonary disorder (COPD), and lung cancer. These data indicate that biological ultrafine particles in the indoor dust, which are mainly composed of microbial EVs, are important in the pathogenesis of chronic lung diseases associated with neutrophilic inflammation. Taken together, microbial EVs in the indoor dust are an important diagnostic and therapeutic target for the control of chronic lung diseases, such as asthma, COPD, and lung cancer.
Acinetobacter ; Asthma ; Bacteria ; Dust ; Emphysema ; Enterobacter ; Enterobacteriaceae ; Escherichia coli ; Extracellular Vesicles ; Gram-Positive Bacteria ; Inflammation ; Inhalation ; Interferon-gamma ; Interleukin-17 ; Lung Diseases ; Lung Neoplasms ; Lung ; Microbiota ; Neutrophils ; Particulate Matter ; Pseudomonas ; Pulmonary Disease, Chronic Obstructive ; Staphylococcus ; Th17 Cells

Synovial chondromatosis is an uncommon disease of cartilage transformation of synovial membrane with formation of loose bodies within the joint space. The knee and elbow are the most commonly involved sites and involvement of temporomandibular joint is very rare. Symtoms include swelling, pain, stiffness of the jaw, and inability to close the jaw. A case involving the temporomandibular joint (TMJ) is presented. A 28-year-old women had experienced pain of the left TMJ area and limitation of mouth opening. Radiographs of the left TMJ revealed calcified mass surrounding over the mandibular condyle and under the glenoid fossa. Treatment consisted of removal of calcified mass, reshaping of affected condyle and reconstruction with a auricular cartilage. After surgery, the patient's range of motion improved although deviation to the affected side. Until present after surgery there have been no recurrence of symtoms. We think that findings of this patitent agree with those of synovial synchondrmatosis in many aspects.
Adult ; Cartilage ; Chondromatosis, Synovial* ; Ear Cartilage ; Elbow ; Female ; Humans ; Jaw ; Joints ; Knee ; Mandibular Condyle ; Mouth ; Range of Motion, Articular ; Recurrence ; Synovial Membrane ; Temporomandibular Joint*

Dementia pugilistica (DP) or chronic traumatic encephalopathy (CTE) is a neurodegenerative disease or dementia that may affect amateur or professional boxers as well as athletes in other sports who suffer concussions. The condition is thought to affect around 15% to 20% of professional boxers and caused by repeated concussive or subconcussive blows. CTE was in the past referred to as dementia pugilistica, which reflected the prevailing notion that this condition was restricted to boxers. Recent research, however, has demonstrated neuropathological evidence of CTE in retired American football players, a professional wrestler, a professional hockey player and a soccer player, as well as in nonathletes. It is probable that many individuals are susceptible to CTE, including those who experience falls, motor vehicle accidents, assaults, epileptic seizures, or military combat, and that repeated mild closed head trauma of diverse origin is capable of instigating the neurodegenerative cascade leading to CTE. We report a 62-year old man suspicious of dementia pugilistica with clinical features of frontotemporal dementia and parkinsonism.
Athletes ; Brain Injury, Chronic ; Dementia ; Epilepsy ; Football ; Frontotemporal Dementia ; Head Injuries, Closed ; Hockey ; Humans ; Military Personnel ; Motor Vehicles ; Neurodegenerative Diseases ; Parkinsonian Disorders ; Soccer ; Sports

PURPOSE: Bronchial hyperresponsiveness(BHR) in asthma is thought to be a consequence of underlying airway inflammation. But the mechanism responsible for persistent BHR in adolescents with long-term asthma remission is poorly understood. The aim of this study was to examine whether BHR in adolescents with asthma remission is associated with peripheral blood eosinophilia and/or increased serum levels of eosinophil cationic protein(ECP). METHODS: We studied 35 adolescents with long-term asthma remission(neither symptoms nor medication during the previous two years) who have persistent BHR(remission group) and 35 adolescents with symptomatic asthma(symptomatic group) who were matched for methacholine provocative concentration producing a 20% fall in FEV1(PC20) with subjects in the remission group. The peripheral blood eosinophil counts and serum ECP concentrations were compared between these two groups. Correlations between PC20 and peripheral blood eosinophil counts or serum ECP concentrations were assessed in these two groups. RESULTS: Peripheral blood eosinophil counts and serum ECP concentrations were significantly lower in the remission group than in the symptomatic group(273+/-108 vs. 365+/-178/microliter; 16.3+/-9.4 vs. 26.5+/-15.1 microgram/L, both, P<0.05). PC20 was correlated with peripheral blood eosinophil counts and serum ECP concentrations in the symptomatic group(r=-0.385, P=0.022; r=-0.439, P=0.008), but not in the remission group(r=-0.292, P=0.089; r=-0.243, P=0.159). CONCLUSION: BHR in adolescents with long-term asthma remission is not associated with peripheral blood eosinophilia or an increase in serum ECP concentration, which suggests that BHR in this clinical setting may not be attributed to airway eosinophilic inflammation. Further studies including direct assessment of airway inflammation are needed to confirm this conclusion.
Adolescent* ; Asthma* ; Eosinophil Cationic Protein ; Eosinophilia ; Eosinophils* ; Humans ; Inflammation ; Methacholine Chloride

PURPOSE: We investigate biases in the assessments of left ventricular function (LVF), by compressed sensing (CS)-cine magnetic resonance imaging (MRI). MATERIALS AND METHODS: Cardiovascular cine images with short axis view, were obtained for 8 volunteers without CS. LVFs were assessed with subsampled data, with compression factors (CF) of 2, 3, 4, and 8. A semi-automatic segmentation program was used, for the assessment. The assessments by 3 CS methods (ITSC, FOCUSS, and view sharing (VS)), were compared to those without CS. Bland-Altman analysis and paired t-test were used, for comparison. In addition, real-time CS-cine imaging was also performed, with CF of 2, 3, 4, and 8 for the same volunteers. Assessments of LVF were similarly made, for CS data. A fixed compensation technique is suggested, to reduce the bias. RESULTS: The assessment of LVF by CS-cine, includes bias and random noise. Bias appeared much larger than random noise. Median of end-diastolic volume (EDV) with CS-cine (ITSC or FOCUSS) appeared −1.4% to −7.1% smaller, compared to that of standard cine, depending on CF from (2 to 8). End-systolic volume (ESV) appeared +1.6% to +14.3% larger, stroke volume (SV), −2.4% to −16.4% smaller, and ejection fraction (EF), −1.1% to −9.2% smaller, with P < 0.05. Bias was reduced from −5.6% to −1.8% for EF, by compensation applied to real-time CS-cine (CF = 8). CONCLUSION: Loss of temporal resolution by adopting missing data from nearby cardiac frames, causes an underestimation for EDV, and an overestimation for ESV, resulting in underestimations for SV and EF. The bias is not random. Thus it should be removed or reduced for better diagnosis. A fixed compensation is suggested, to reduce bias in the assessment of LVF.
Bias (Epidemiology) ; Compensation and Redress ; Diagnosis ; Magnetic Resonance Imaging ; Magnetic Resonance Imaging, Cine ; Noise ; Stroke Volume ; Ventricular Function, Left ; Volunteers

Purpose: Diabetes mellitus (DM) is implicated in the pathogenesis of iron dysregulation and Alzheimer’s disease. We aimed to evaluate whether the presence of DM and status of cognitive impairment affect cortical iron accumulation in older adults, as quantified by the susceptibility measurements using the deep neural network QSMnet+. Materials and Methods: In this retrospective analysis of a prospective cohort, 50 patients with normal cognition with or without subjective memory impairment (controls), 49 with early mild cognitive impairment (MCI), and 43 with late MCI were evaluated. We employed QSMnet+ to compute a quantitative susceptibility map and FreeSurfer 6.0 to obtain anatomical labels. The effects of MCI and DM on cortical susceptibility and volume were evaluated using a two-way analysis of covariance. Results: Whole-cortex susceptibility differed according to MCI (p < 0.001) but not according to DM (p = 0.554), with higher values in the early and late MCI groups than in the control group. MCI and the DM status showed a significant interaction in the whole cortex (p = 0.023). Among the patients with early MCI, those with DM exhibited higher cortical susceptibility than those without DM, whereas those with late MCI showed no such difference. Cortical susceptibility did not correlate with the cortical volume in patients with DM and inversely correlated with the cortical volume in patients without DM. Only disease status (p = 0.008) and DM (p = 0.023) were independent predictors of whole-cortex susceptibility, after correcting for covariates. Conclusion Our findings demonstrated that cognitive impairment and DM are linked to alterations in cortical susceptibility in older adults. This observation suggests that cortical iron accumulation results from the combined effects of DM and neurodegenerative processes related to the cognitive status.