This article reports the case of a 51-year-old woman in whom brain MRI to follow up multiple sclerosis incidentally discovered an intramural haematoma in the extracranial internal carotid artery. MR angiography of the supra-aortic trunks and CT angiography of the aorta showed arterial dilations, aneurysms, dissections, and intramural hematomas in the internal carotid arteries, vertebral arteries, and arteries in the splanchnic territory. These findings raised suspicion of segmental arterial mediolysis. After 6 months of treatment with antiplatelet drugs, the arterial involvement resolved.Segmental arterial mediolysis is an uncommon disease; low clinical suspicion and radiologists’ lack of knowledge about this entity mean that it can go undetected or be confused with other vasculitides. This report describes the most relevant pathophysiological findings and correlates them with the imaging findings.Se presenta el caso de una paciente de 51 años con esclerosis múltiple en la que de forma incidental se observó un haematoma intramural en la arteria carótida interna extracraneal en una resonancia magnética (RM) cerebral de control por su enfermedad de base. Adicionalmente se realizó una angio-RM de troncos supraaórticos y una angiografía por tomografía computarizada de aorta, donde se observó la presencia de dilataciones arteriales, aneurismas, disecciones y hematomas intramurales de las arterias carótidas internas, arterias vertebrales y arterias del territorio esplácnico. Estos hallazgos condujeron a la sospecha de mediolisis arterial segmentaria. Seis meses después, tras tratamiento antiagregante, la afectación arterial se autorresolvió. La mediolisis arterial segmentaria es una patología infrecuente, lo que unido a la baja sospecha clínica y al desconocimiento de esta entidad por parte de los radiólogos hace que pueda pasar desapercibida o ser confundida con otras vasculitis. En esta comunicación, se describen los hallazgos fisiopatológicos más relevantes y su correlación con las pruebas de imagen.
The effects of supplementation of growth medium with high concentrations of methionine (5 mm) and/or vitamin B12 (10 nm) on the activities of five enzymes of the methionine regulon were measured in wild-type Escherichia coli K12, a metJ prototrophic and three metJ methionine auxotrophic derivatives. Growth on vitamin B12 causes lowering of the activities of the non-B12 methyltransferase while growth on methionine causes elevation of its activity in all four metJ mutants. The previous observation that this enzyme is not repressed by vitamin B12 addition in metH mutants together with our observation that vitamin B12 causes repression in mutants (metF) unable to synthesize the donor for homocysteine methylation supports the model of Kung et al. (10) that the holo-B12-methyltransferase functions as a repressor of synthesis of the non-B12-methyltransferase. Growth on methionine causes lowering of cystathionase activity, and growth on vitamin B12 results in elevation of cystathionase activity in a metJ prototroph and one metJ auxotroph. The metJmetA strain (RG326) has a higher than normal level of cystathionase while the metJmetF strain (RG191) has lower than normal cystathionase activity. These results indicate the existence of a metJ independent system that modulates the activity of cystathionase possibly in response to changes in concentration of unidentified metabolite(s).
The participants in the NIMH-MATRICS Consensus Development Conference on Negative Symptoms recommended that an instrument be developed that measured blunted affect, alogia, asociality, anhedonia, and avolition. The Brief Negative Symptom Scale (BNSS) is a 13-item instrument designed for clinical trials and other studies that measures these 5 domains. The interrater, test-retest, and internal consistency of the instrument were strong, with respective intraclass correlation coefficients of 0.93 for the BNSS total score and values of 0.89-0.95 for individual subscales. Comparisons with positive symptoms and other negative symptom instruments supported the discriminant and concurrent validity of the instrument.
The aim of this study was to evaluate the impact of psychoeducation in serum levels of BDNF, NGF and GDNF in young adults presenting bipolar disorder (BD). This is a randomized clinical trial including 39 young adults (18–29 years) diagnosed with BD through the Structured Clinical Interview for DSM-IV (SCID-CV). Participants were randomized in two treatment groups: usual treatment (medication) and combined intervention (medication plus psychoeducation). Depressive symptoms were assessed using the Hamilton Depression Rating Scale (HDRS) and severity of manic and hypomanic symptoms was evaluated through the Young Mania Rating Scale (YMRS). The serum levels of trophic factors were measured with an ELISA kit. In both intervention groups, there was an improvement in depressive symptoms significantly between baseline and post-intervention. In the combined intervention, GDNF serum levels increased significantly from baseline to post-intervention. However, there were no differences in BDNF and NGF serum levels. In the usual treatment group, no changes were observed in serum levels of GDNF, BDNF, and NGF the post-intervention in individuals. Our data suggests that only combined intervention was effective in improving depressive symptoms and increasing GDNF levels in a sample of young adults with bipolar disorder.
Previous studies exploring mental time travel paradigms with functional neuroimaging techniques have uncovered both common and distinct neural correlates of re-experiencing past events or pre-experiencing future events. A gap in the mental time travel literature exists, as paradigms have not explored the affective component of re-experiencing past episodic events; this study explored this sparsely researched area. The present study employed standardized low resolution electromagnetic tomography (sLORETA) to identify electrophysiological correlates of re-experience affect-laden and non-affective past events, as well as pre-experiencing a future anticipated event. Our results confirm previous research and are also novel in that we illustrate common and distinct electrophysiological correlates of re-experiencing affective episodic events. Furthermore, research from this experiment yields results outlining a pattern of activation in the frontal and temporal regions is correlated with the time frame of past or future events subjects imagined.