Imaging Findings of Cerebral Amyloid Angiopathy, A\u3b2-Related Angiitis (ABRA), and Cerebral Amyloid Angiopathy-Related Inflammation

Vascular inflammation is present in a subset of patients with cerebral amyloid angiopathy (CAA) and has a major influence in determining the disease manifestations. Radiological characterization of this subset is particularly important to achieve early recognition and treatment. We conducted this study to investigate the role of imaging in differentiating CAA with and without inflammation. We reviewed neuroimaging findings for 54 patients seen at Mayo Clinic over 25 years with pathological evidence of CAA and with available neuroimaging at the time of diagnosis. Clinical data were also recorded. Patients were grouped into CAA alone (no vascular inflammation), A\u3b2-related angiitis or ABRA (angiodestructive inflammation), and CAA-related inflammation or CAA-RI (perivascular inflammation). Imaging findings at presentation were compared among patient subgroups. Radiological features supporting a diagnosis of ABRA or CAA-RI were identified. Radiologic findings at diagnosis were available in 27 patients with CAA without inflammation, 22 with ABRA, and 5 with CAA-RI. On MRI, leptomeningeal disease alone or with infiltrative white matter was significantly more frequent at presentation in patients with ABRA or CAA-RI compared with those with CAA (29.6% vs. 3.7%, P=0.02; and 40.7% vs. 3.7%, P=0.002, respectively), whereas lobar hemorrhage was more frequent in patients with CAA (62.3% vs. 7.4%, P=0.0001). Overall, leptomeningeal involvement at presentation was present in 70.4% of patients with ABRA or CAA-RI and in only 7.4% of patients with CAA (P=0.0001). The sensitivity and specificity of leptomeningeal enhancement to identify patients with ABRA or CAA-RI were 70.4% and 92.6%, respectively, whereas the positive likelihood ratio (LR) was 9.5. The sensitivity and specificity of intracerebral hemorrhage to identify patients with CAA were 62.9% and 92.6%, respectively, whereas the positive LR was 8.5. Microbleeds were found in 70.4% of patients with inflammatory CAA at presentation. In conclusion, leptomeningeal enhancement and lobar hemorrhage at presentation may enable differentiation between CAA with and without inflammation. The identification at initial MRI of diffuse cortical-subcortical microbleeds in elderly patients presenting with infiltrative white matter process or prominent leptomeningeal enhancement is highly suggestive of vascular inflammatory CAA

An Update of the Mayo Clinic Cohort of Patients with Adult Primary Central Nervous System Vasculitis

Primary central nervous system vasculitis (PCNSV) is an uncommon condition in which lesions are limited to vessels of the brain and spinal cord. Because the clinical manifestations are not specific, the diagnosis is often difficult, and permanent disability and death are frequent outcomes. This study is based on a cohort of 163 consecutive patients with PCNSV who were examined at the Mayo Clinic over a 29-year period from 1983 to 2011. The aim of the study was to define the characteristics of these patients, which represents the largest series in adults reported to date. A total of 105 patients were diagnosed by angiographic findings and 58 by biopsy results. The patients diagnosed by biopsy more frequently had at presentation cognitive dysfunction, greater cerebrospinal fluid total protein concentrations, less frequent cerebral infarcts, and more frequent leptomeningeal gadolinium-enhanced lesions on magnetic resonance imaging (MRI), along with less mortality and disability at last follow-up. The patients diagnosed by angiograms more frequently had at presentation hemiparesis or a persistent neurologic deficit or stroke, more frequent infarcts on MRI and an increased mortality. These differences were mainly related to the different size of the vessels involved in the 2 groups. Although most patients responded to therapy with glucocorticoids alone or in conjunction with cyclophosphamide and tended to improve during the follow-up period, an overall increased mortality rate was observed. Relapses occurred in one-quarter of the patients and were less frequent in patients treated with prednisone and cyclophosphamide compared with those treated with prednisone alone. The mortality rate and degree of disability at last follow-up were greater in those with increasing age, cerebral infarctions on MRI, angiographic large vessel involvement, and diagnosis made by angiography alone, but were lower in those with gadolinium-enhanced lesions on MRI and in those with cerebral amyloid angiopathy. The annual incidence rate of PCNSV was estimated at 2.4 cases per 1,000,000 person-years. PCNSV appears to consist of several subsets defined by the size of the vessels involved, the clinical characteristics at presentation, MRI findings, and histopathological patterns on biopsy. Early recognition and treatment may reduce poor outcomes

Hyperparathyroidism, platelet intracellular free calcium and hypertension in chronic renal failure

Hyperparathyroidism, platelet intracellular free calcium and hypertension in chronic renal failure. To investigate possible relationships between hyperparathyroidism, alterations in intracellular free calcium concentration ([Ca2+]i and hypertension in chronic renal failure, serum concentrations of intact parathyroid hormone (PTH) were measured by two-site immunometric assay, and platelet ([Ca2+]i) was assessed using the fluorescent indicator fura-2. Thirty-six patients with chronic renal failure were studied, 10 with normal serum PTH concentrations (mean 8.0 ± 0.6 pmol/liter), 17 with elevated serum PTH (35.0 ± 7.2 pmol/liter) and 9 patients with elevated PTH (36.2 ±5.9 pmol/liter) who were receiving nifedipine. Platelet [Ca2+]i was increased in patients with elevated PTH, compared with those in whom PTH was normal (138 ± 16 vs. 83 ± 7 nmol/liter, P < 0.01). A linear relation was observed between serum PTH and platelet [Ca2+]i in these patients (r = 0.818, P < 0.001). In contrast, platelet [Ca2+]i was not elevated (84 ± 9 nmol/liter) in the patients with elevated PTH who were receiving nifedipine. A linear relation was also present between both serum PTH (r = 0.616, P < 0.001) and platelet [Ca2+]i (r = 0.576, P < 0.005) and mean blood pressure. Nine patients with hyperparathyroidism were restudied after treatment with the vitamin D analogue alfacalcidol. This resulted in significant decreases in serum PTH (P < 0.01), platelet [Ca2+]i (P < 0.02), and mean blood pressure (P < 0.05). These studies indicate that [Ca2+]i may be increased early in renal failure, and that this increase occurs in association with both hyperparathyroidism and hypertension. Furthermore, treatment of hyperparathyroidism with alfacalcidol may result in reductions in both [Ca2+]i and blood pressure. The lack of elevation in [Ca2+]i in nifedipine-treated patients with hyperparathyroidism suggests that, in uremia, increases in cytosolic calcium induced by PTH or other factors may be mediated in part by dihydropyridine-sensitive mechanisms

Unidentified EGRET Sources and the Extragalactic Gamma-Ray Background

The large majority of EGRET point sources remain to this day without an identified low-energy counterpart. Whatever the nature of the EGRET unidentified sources, faint unresolved objects of the same class must have a contribution to the diffuse gamma-ray background: if most unidentified objects are extragalactic, faint unresolved sources of the same class contribute to the background, as a distinct extragalactic population; on the other hand, if most unidentified sources are Galactic, their counterparts in external galaxies will contribute to the unresolved emission from these systems. Understanding this component of the gamma-ray background, along with other guaranteed contributions from known sources, is essential in any attempt to use gamma-ray observations to constrain exotic high-energy physics. Here, we follow an empirical approach to estimate whether a potential contribution of unidentified sources to the extragalactic gamma-ray background is likely to be important, and we find that it is. Additionally, we comment on how the anticipated GLAST measurement of the diffuse gamma-ray background will change, depending on the nature of the majority of these sources.Comment: 6 pages, 3 figures, to appear in proceedings of "The Multi-Messenger Approach to High Energy Gamma-Ray Sources", Barcelona, 4-7 July 2006; comments welcom

GTI-space : the space of generalized topological indices

A new extension of the generalized topological indices (GTI) approach is carried out torepresent 'simple' and 'composite' topological indices (TIs) in an unified way. Thisapproach defines a GTI-space from which both simple and composite TIs represent particular subspaces. Accordingly, simple TIs such as Wiener, Balaban, Zagreb, Harary and Randićconnectivity indices are expressed by means of the same GTI representation introduced for composite TIs such as hyper-Wiener, molecular topological index (MTI), Gutman index andreverse MTI. Using GTI-space approach we easily identify mathematical relations between some composite and simple indices, such as the relationship between hyper-Wiener and Wiener index and the relation between MTI and first Zagreb index. The relation of the GTI space with the sub-structural cluster expansion of property/activity is also analysed and some routes for the applications of this approach to QSPR/QSAR are also given

Transiting Exoplanets with JWST

The era of exoplanet characterization is upon us. For a subset of exoplanets -- the transiting planets -- physical properties can be measured, including mass, radius, and atmosphere characteristics. Indeed, measuring the atmospheres of a further subset of transiting planets, the hot Jupiters, is now routine with the Spitzer Space Telescope. The James Webb Space Telescope (JWST) will continue Spitzer's legacy with its large mirror size and precise thermal stability. JWST is poised for the significant achievement of identifying habitable planets around bright M through G stars--rocky planets lacking extensive gas envelopes, with water vapor and signs of chemical disequilibrium in their atmospheres. Favorable transiting planet systems, are, however, anticipated to be rare and their atmosphere observations will require tens to hundreds of hours of JWST time per planet. We review what is known about the physical characteristics of transiting planets, summarize lessons learned from Spitzer high-contrast exoplanet measurements, and give several examples of potential JWST observations.Comment: 22 pages, 11 figures. In press in "Astrophysics in the Next Decade: JWST and Concurrent Facilities, Astrophysics & Space Science Library, Thronson, H. A., Tielens, A., Stiavelli, M., eds., Springer: Dordrecht (2008)." The original publication will be available at http://www.springerlink.co

Nucleon Axial Form Factor from Lattice QCD

Results for the isovector axial form factors of the proton from a lattice QCD calculation are presented for both point-split and local currents. They are obtained on a quenched $16^{3} \times 24$ lattice at $\beta= 6.0$ with Wilson fermions for a range of quark masses from strange to charm. We determine the finite lattice renormalization for both the local and point-split currents of heavy quarks. Results extrapolated to the chiral limit show that the $q^2$ dependence of the axial form factor agrees reasonably well with experiment. The axial coupling constant $g_A$ calculated for the local and the point-split currents is about 6\% and 12\% smaller than the experimental value respectively.Comment: 8 pages, 5 figures (included in part 2), UK/93-0

Tetracritical behavior in strongly interacting theories

We suggest a tetracritical fixed point to naturally occur in strongly interacting theories. As a fundamental example we analyze the temperature--quark chemical potential phase diagram of QCD with fermions in the adjoint representation of the gauge group (i.e. adjoint QCD). Here we show that such a non trivial multicritical point exists and is due to the interplay between the spontaneous breaking of a global U(1) symmetry and the center group symmetry associated to confinement. Our results demonstrate that taking confinement into account is essential for understanding the critical behavior as well as the full structure of the phase diagram of adjoint QCD. This is in contrast to ordinary QCD where the center group symmetry associated to confinement is explicitly broken when the quarks are part of the theory.Comment: RevTex, 5 figures. Final version to appear in PR

Earthworms increase plant production: a meta- analysis

To meet the challenge of feeding a growing world population with minimal environmental impact, we need comprehensive and quantitative knowledge of ecological factors affecting crop production. Earthworms are among the most important soil dwelling invertebrates. Their activity affects both biotic and abiotic soil properties, in turn affecting plant growth. Yet, studies on the effect of earthworm presence on crop yields have not been quantitatively synthesized. Here we show, using meta-analysis, that on average earthworm presence in agroecosystems leads to a 25% increase in crop yield and a 23% increase in aboveground biomass. The magnitude of these effects depends on presence of crop residue, earthworm density and type and rate of fertilization. The positive effects of earthworms become larger when more residue is returned to the soil, but disappear when soil nitrogen availability is high. This suggests that earthworms stimulate plant growth predominantly through releasing nitrogen locked away in residue and soil organic matter. Our results therefore imply that earthworms are of crucial importance to decrease the yield gap of farmers who can't -or won't- use nitrogen fertilizer