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Biomedical subjects

Todd Harshbarger

Publications and source records attributed to Todd Harshbarger.

2 recordsLinked to original sources

Functional activation using apparent diffusion coefficient-dependent contrast allows better spatial localization to the neuronal activity: evidence using diffusion tensor imaging and fiber tracking.

Recent studies suggested that functional activation using apparent diffusion coefficient (ADC) contrast can be used to detect synchronized functional MRI (fMRI) signal changes during brain activation. Such changes may reflect better spatial localization to the smaller vessels, which are closely coupled to the true neuronal activation. Since it is generally believed that there are neural pathways among neuronally relevant areas, methods that would allow clear delineation of such pathways could help validate the neuronal relevance of the activated functional areas. The development of diffusion tensor imaging (DTI) has shown promise in detailed nerve fiber tracking. In this report, DTI was adopted to track the fiber connections among the discrete areas determined using the ADC contrast, in an effort to confirm the neuronal origin of these activated areas. As a comparison, activated areas using blood oxygenation level-dependent (BOLD) contrast were also obtained. Our results showed that the areas determined by the ADC contrast consistently allowed better fiber tracking within, while the BOLD-activated areas were more spatially diffused due to the smearing effect of brain vasculature, rendering the task of fiber tracking more difficult. This observation provides converging evidence that the activated areas using ADC contrast are more closely coupled to the neuronal activity than those using BOLD contrast.

Brain↗

Suprasellar adrenocorticotropic hormone-secreting ectopic pituitary adenoma: case report and literature Review.

OBJECTIVE AND IMPORTANCE: Functional ectopic pituitary adenomas are rare and can be misdiagnosed as extensions of pituitary adenomas when they are located in the vicinity of the normal gland. In this report, we present a case of an ectopic adrenocorticotropic hormone-secreting suprasellar pituitary adenoma that caused Cushing's disease. A literature review of previously reported ectopic pituitary adenomas is included to illustrate the diverse clinical manifestations of this disease entity. CLINICAL PRESENTATION: An 11-year-old boy was noted to have hirsutism, a buffalo hump, and unexplained weight gain consistent with Cushing's syndrome. Laboratory investigations revealed that the boy had elevated adrenocorticotropic hormone and serum cortisol levels unsuppressed by dexamethasone. Magnetic resonance imaging scans were suggestive of a pituitary adenoma with suprasellar extension. INTERVENTION: The initial transsphenoidal approach failed to achieve complete surgical resection. A repeat operation in which the pterional approach was used revealed a suprasellar pituitary adenoma without association with intrasellar contents. The patient's cushingoid symptoms improved significantly 3 months after surgery. CONCLUSION: Ectopic pituitary adenomas should be considered in the differential diagnosis for all patients with Cushing's syndrome. Furthermore, surgical approaches should be chosen carefully once the diagnosis of ectopic pituitary adenoma is made.

ACTH Syndrome, Ectopic↗