The hemispheres of the human brain are functionally and structurally asymmetric. The study of structural asymmetries provides important clues to the neuroanatomical basis of lateralized brain functions. Previous studies have demonstrated age-related changes in morphology and diffusion properties of brain tissue. In this study, we simultaneously explored gray and white matter asymmetry using voxel-based morphometry (VBM) and diffusion tensor imaging (DTI) in 109 young healthy individuals (58 females and 51 males). To eliminate the potential confounding effects of aging and handedness, we restricted the study to right-handed subjects aged 21-29 years. VBM and voxel-based analysis of fractional anisotropy (FA) maps derived from DTI revealed a number of gray matter volume asymmetries (including the right frontal and left occipital petalias and leftward asymmetry of the planum temporale) and white matter FA asymmetries (including leftward asymmetry of the arcuate fasciculus, cingulum, and corticospinal tract). There was no significant effect of sex on gray and white matter asymmetry. Leftward volume asymmetry of the planum temporale and leftward FA asymmetry of the arcuate fasciculus were simultaneously demonstrated. Post hoc analysis showed that the gray matter volume of the planum temporale and FA of the arcuate fasciculus were positively related (Pearson correlation coefficient, 0.43; P < 0.0001). The results of our study demonstrate gray and white matter asymmetry in right-handed healthy young adults and suggest that leftward volume asymmetry of the planum temporale and leftward FA asymmetry of the arcuate fasciculus may be related.
In this study, hepatocyte-specific Gd-EOB-DTPA was shown to be safe and to improve the detection and characterization of focal hepatic lesions compared with unenhanced MR imaging. When compared with spiral CT, Gd-EOB-DTPA enhanced MRI seems to be beneficial especially for the detection for smaller lesions or hepatocellular carcinoma underlying cirrhotic liver.
Nonalcoholic steatohepatitis (NASH) is a hepatic phenotype of the metabolic syndrome, and increases the risk of cirrhosis and hepatocellular carcinoma (HCC). Although increasing evidence points to the therapeutic implications of certain types of anti-diabetic agents in NASH, it remains to be elucidated whether their effects on NASH are independent of their effects on diabetes. Genetically obese melanocortin 4 receptor-deficient (MC4R-KO) mice fed Western diet are a murine model that sequentially develops hepatic steatosis, NASH, and HCC in the presence of obesity and insulin resistance. In this study, we investigated the effect of the dipeptidyl peptidase-4 (DPP-4) inhibitor anagliptin on NASH and HCC development in MC4R-KO mice. Anagliptin treatment effectively prevented inflammation, fibrosis, and carcinogenesis in the liver of MC4R-KO mice. Interestingly, anagliptin only marginally affected body weight, systemic glucose and lipid metabolism, and hepatic steatosis. Histological data and gene expression analysis suggest that anagliptin treatment targets macrophage activation in the liver during the progression from simple steatosis to NASH. As a molecular mechanism underlying anagliptin action, we showed that glucagon-like peptide-1 suppressed proinflammatory and profibrotic phenotypes of macrophages in vitro. This study highlights the glucose metabolism-independent effects of anagliptin on NASH and HCC development.
Aims
We aimed to examine the benefits of catheter ablation in patients with non-paroxysmal atrial fibrillation (AF) accompanied by heart failure (HF) with preserved ejection fraction (HFpEF), in comparison with the benefits in patients with AF accompanied by HF with reduced ejection fraction (HFrEF) or patients with no HF.
Methods and results
From 1173 consecutive patients undergoing catheter ablation, 502 with non-paroxysmal AF were divided into three groups: no history of HF [plasma B-type natriuretic peptide (BNP) <100 pg/mL and no HF hospitalization; n = 125], HFpEF [left ventricular (LV) EF ≥50%; n = 293], and HF with midrange EF (HFmrEF) + HFrEF (LVEF <50%; n = 84) groups. The endpoints were AF recurrence at 1 year, changes in symptomatic and image-based functional status, and changes in BNP levels from baseline to 1 year. In the HFpEF group, AF recurred in 48 patients (16.4%) and 278 patients (94.8%) had sinus rhythm at 1 year; these values were comparable with those in the other groups. Significant improvement was observed in the left atrial diameter, LVEF, and New York Heart Association functional class in the HFpEF and HFmrEF + HFrEF groups. The BNP level significantly decreased irrespective of the index rate control status, and freedom from AF recurrence was an independent predictor of HF remission, defined as BNP <100 pg/mL at 1 year, in the HFpEF group.
Conclusion
Catheter ablation is highly feasible for restoring sinus rhythm in non-paroxysmal AF with coexisting HFpEF, thereby improving cardiac function and BNP levels. Catheter ablation for AF may be an optional management strategy.
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