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The lowdown on the monster summer music festival Outside Lands, top souvenir picks and where to catch a live show. Strolling down the main promenade of Bridgeway, we shopped at a number of quaint stores, and headed toward one of my favorite Sausalito galleries, Bubble Street Gallery, which describes itself as an emporium celebrating realms of the imagination.
Lucky for us, the artist and co-owner Daniel Merriam was on hand to chat and share the stories behind some of his colorful and joyous works. Afterwards, we stopped at the waterfront Barrel House Tavern for adult beverages and New American fare, which included options for the plant-based eater in me.
I was no better way to end the day than taking in the stunning city and bay views! Where magazine and the logo are registered trademarks of Morris Visitor Publications.
Where makes every effort to ensure the accuracy of the information it publishes, but cannot be held responsible for any consequences arising from errors or omissions. Reproduction in whole or in part strictly prohibited. Dramatic fog patterns turn conventional daily and seasonal weather patterns upside down, nourishing towering ancient coast redwoods found nowhere else which scientists are now learning support entire ecosystems high up in their branches.
Welcome to a majestic place! Look for us when you visit any of the following cities, or plan ahead for your next trip by visiting us online at wheretraveler. Louis, Tampa, Tucson, Washington, D. Going to free Sunday summer concerts at Stern Grove. Claiming a spot early is the way to go, but I also enjoy splurging for a picnic table because it puts you front and center to the entertainment and also helps fund the admission-free concerts and education programs for everyone.
Where do you send guests looking for live music? Mondays through Thursdays I make reservations for my guests to the subterranean hideaway Local Edition. They have a live jazz band beginning at 8 pm. Located in the historic Hearst Building, it pays homage to the newspaper business with decor that features vintage typewriters and old San Francisco news clippings.
The Bay Lights is the light art installation designed by Leo Villarreal to commemorate the 75th anniversary of the opening of the Bay Bridge. What activity do you recommend for young children? They have incredible interactive exhibits that are appealing to children from 6 months old to 10 years old. This is a place that excites children and assists in burning all of their energy. American Craft Show The largest juried craft show on the West Coast is back with top contemporary fine jewelry, ceramics, textiles, furniture and home decor artists from around the country.
Learn how to integrate high-end, unique designs into everyday life with programs titled Make Room: Fort Mason Center, 2 Marina Blvd. The annual festival attracts 35, filmgoers each year with over screenings and events throughout the Bay Area. An artist feels he must choose between his art and his lover in this performance of the Pulitzer Prize-winning musical at SF Playhouse.
Pistahan Parade and Festival Now in its 25th year, this annual festival is known as the largest celebration of Filipino art, dance, music and cuisine in the country. Saturday brings the parade, and the ensuing festival at Yerba Buena Gardens features live entertainment, ice-cream-eating contests, cultural exhibits, delectable Filipino cuisine and hands-on workshops for kids and adults. Eat Drink SF Taste samples from top restaurants; sip wine, beer and cocktails poured by acclaimed sommeliers, cicerones and mixologists; and hone your skills at cooking demos and classes taught by renowned tastemakers.
Come to eat and drink, take in dance and musical performances and browse the art and local merchandise. This dazzling production of the fifth-longest running musical introduces new staging and reinvented scenery inspired by the paintings of Victor Hugo.
Early evenings and weekend afternoons feature no-cover early shows, and door fees for late-night concerts are given to the performers, which range from soulful jazz singers Lavay Smith and Allegra Bandy to blues band HowellDevine. With a cozy fireplace and strong drinks, the Riptide is a seaside destination for relaxed Ca lifornia country shows and open mic nights.
The newest live music venue downtown located in what was formerly the Ruby Skye nightclub is constantly adding new acts to its daily calendar, showcasing nationally recognized bands and DJ sets. Now in its 11th year, the festival attracts over , fans and has become one of the most popular and successful festivals in the country.
Consider renting a bike. Buses are packed, taxis are scarce, rideshares are overpriced and parking is nonexistent. Alternatively, purchase a pass for the official shuttle that runs from Bill Graham Civic Auditorium to the festival entrance, starting at 11 am and ending at Past years have been notoriously chilly, windy and sometimes wet, so be sure to bring layers.
And don't forget to claim a locker early to stash those layers once the sun comes out. It weighs 2 ounces and carries 40 pounds. These San Francisco-themed, upcycled silent no-ticking! Find them at an Arts Commissionlicensed stall at the foot of Market Street by the Embarcadero and at TreasureFest, where over craft and vintage vendors gather every last weekend of the month. Modern eatery with seasonal menu and breathtaking views of San Francisco.
Sustainable seafood, local and organic with spectacular Golden Gate Bridge views. The majority of the shops lining the streets of this neighborhood are independent and familyowned. It stocks everything from new hardcover and paperback releases to political and art-centric magazines. Children will discover soft stuffed animals, wooden nesting dolls, animal-shaped nursery lamps and whimsical party supplies at Tantrum.
At Foggy Notion, California-inspired eclectic homegoods, including handmade jewelry and organic skincare products, are the focus. William the BeeKeeper sells locally produced honey, handmade soaps and charming ceramics. Turkish-style mezze plates meant for sharing. Start with the creamy hummus before moving on to moussaka—lamb or vegetarian—or lamb kebabs, and save room for perfectly semisweet homemade baklava for dessert. For hearty Burmese cuisine, Burma Superstar is a neighborhood destination with a waitlist almost as legendary as its tealeaf salad.
For take-home treats, head to Schubert's Bakery. A local institution since , its known for its marzipanwrapped Swedish Princess Cake. Drink For 35 years, Toy Boat Dessert Cafe has specialized in treats and delights, including a mechanical horse for kids.
Adults can head to Scarlet Lounge for cool cocktails, lovely decor and a welcoming vibe. Located in a winery built in , V Marketplace is a two-story, brick shopping center housing galleries, boutiques and shops where local merchants sell candles, toys, wine, gelato, coffee, home goods and chocolate. It mixes freshly ground grape seeds in a scrub and incorporates wine corks to stimulate reflex points during the massage. Napa Valley Bike Tours offers independent bike rentals and guided tours complete with picnic lunches.
Tours; wood-fired pizza oven at Redd Wood; dining room at chef Richard Reddington's 13 year-old restaurant Redd. This sophisticated little town bordered by the Napa River and the Mayacamas mountains in the middle of Napa Valley has become a sort of culinary mecca. Outrigger Resorts Signature Experiences immerse you in an array of locally-inspired programs and amenities that help connect you to the cultures of Outrigger Resorts throughout the world.
Find out at Outrigger. Snap a great moment in San Francisco, and tag it on Instagram with wheresanfrancisco for a chance to appear in an upcoming issue. And you've probably heard horror stories about how rental prices keep skyrocketing here or read headlines about how home prices are some of the highest in the nation. We've compiled the ultimate guide to exploring some of San Francisco's best sights, entertainment and culture without opening your wallet.
Aim to stop at 77 and 49 Geary St. The rotating exhibitions often feature big names. But the real crowd pleaser is the view from the rooftop—the romance is off the charts. If you can only take one walk, head to Lands End Trail for postcard views of the Pacific coast and Golden Gate Bridge framed by windswept cypresses. The urban skyline juts out above them, making for a scene that attracts busloads of amateur photographers. The free restorative yoga class on Tuesday evenings draws hundreds of locals.
Download the free visitor guide online. But this visitor center at ground level offers history exhibits, a video and a degree camera feed from the top. Soak up the festive atmosphere at no charge. Catch free cooking demos during the Saturday farmers' market, where you can also eat your fill of fresh produce samples. The winding route was first designed in Take the Muni line from the city. San Francisco is a mosaic of distinct neighborhoods that are villages in and of themselves.
Here are sights worth seeking out in four of these diverse areas. Shoppers can walk in to browse and try on the feminine and quirky styles so many fun prints! The new Pacific Heights boutique also carries the ModCloth wedding line, accessories gifts, home goods and even vintage items. Founded in , Detroitbased Shinola was conceived with the belief that products should be well made and built to last.
As makers of modern watches, bicycles, journals and leather goods, Shinola stands for skill at scale, the preservation of craft and the beauty of industry.
A bike messenger founded this bag company in a garage in the Mission District in , and the factory is still located in the same neighborhood. The flagship Hayes Valley boutique carries messengers, laptop bags, backpacks, luggage, totes and accessories in limited-edition designs. Customers can choose their own color combinations and play with specialty fabrics.
All designs are guaranteed to last a lifetime. This casual clothing company sells luxuriously soft sweatshirts, tees and scarves that are sustainably made right here in San Francisco.
The custom fabric is a blend of two yarns, pima cotton and MicroModal, which is a biobased material that comes from recycled beechwood. This Haight-Ashbury institution has one of the largest selections of CDs, DVDs, videos, vinyl records and vintage rock posters anywhere.
It features books on everything from the traditions of colonial India to the kitchens of s America and hosts numerous events with high-profile chefs and authors. Writer Dave Eggers opened this pirate supply store that serves as a front for a tutoring center. You can buy eye patches, message bottles and spy glasses. The center also hosts interesting events and creative activities for the whole family. Featuring new, antiquarian and collectible books by and for culinary gurus, this bookstore is a wonderland for readers interested in food.
A fabulous display of imagination and design, this shop is an homage to the natural creativity of children./p>
Pacific Heights spice blend,. Founded by a husband and wife team in , this eco-fashion brand is now sold in stores worldwide. Based in the Dogpatch neighborhood, the company opened its first freestanding boutique in Hayes Valley in and is gearing up for a rapid expansion that will set a new standard for socially responsible clothing. The pieces combine timeless design with premium materials to tell unique stories of heritage, craftsmanship and travel. Bring your fashion appetite with you to this chic, personable Hayes Valley boutique that stocks a premium selection from independent designers.
Find well-edited pieces from casual chic to classic formal in the airy, minimalist space. This stylish and charming Jackson Square boutique stocks a one-of-a kind collection of clothing, jewelry and home decor all vintage, handmade or imported from Europe. No ordinary corner market, this is a hip European fashion oasis featuring cool clothing with a rock-star twist. Jeans and more jeans and a worldclass selection of tees hang on simple rolling racks lining both sides of the huge space.
Designer shoes and jewelry round out the merchandise mix. The knitwear line grew into a full collection and led her to open her first retail store on Claude Lane just off Union Square.
Active elegance meets California chic at this local clothing company that evolved from a hand-loomed. The limited-edition collections and exclusive collaborations tend to veer toward simplicity with an emphasis on oxford shirts, classic stripes and denim. Channel your inner Natalie Wood at Ver Unica, an absolute must for vintage lovers. Save every day at five Premium Outlet locations throughout the Bay Area: Gilroy, Livermore, Napa, Petaluma and Vacaville. The indoor and open-air centers are home to impressive collections of designer and name-brand outlet stores.
Located in the San Francisco International Airport, DFS offers a selection of fashion products and accessories, including watches and jewelry, spirits, food, fragrances and a variety of other gifts. Admire the award-winning gardens and picturesque sculptures by California artists, too.
Art Botticelli, Raphael and the Victorians The Pre-Raphaelite Brotherhood found inspiration in late medieval and early Renaissance art rather than the high Renaissance style popular in the Victorian era. This hip arts space on an alley just two blocks south of Market Street doubles as a bar and club and features work in all media by emerging and alternative artistic talent.
This shop has a fine collection of original Art Nouveau antique items, which include signed Tiffany lamps and glass, Handel lamps, Pairpoint lamps and other lamps and chandeliers of the period. It carries art glass of the period, including Galle, Daum Nancy and Loetz and other makers. Also find over stained and beveled glass windows, American Brilliant Cut glass, bronzes, sculptures and furniture.
This premier San Francisco gallery features paintings, drawings and original prints by European masters. This gallery space is home to a collection of original paintings by noteworthy American and European contemporary artists.
In addition to mounting exhibitions, the gallery works closely with new and experienced collectors, locating works of art, managing commissions and assisting clients to find the perfect pieces. Artists with developmental disabilities create art for sale and exhibition here. The gallery offers remarkable art at surprisingly affordable prices and hosts exhibitions on a variety of engaging themes.
Celebrating more than 20 years in its location, this family-owned gallery exhibits original paintings, prints and sculptures. It features more than 20 international and local artists, including Boulanger and Olbinski,.
Cheryl Haines, the owner of this gallery at 49 Geary, has a sharp eye for new talent and relationships with major museums that allow for siginificant exhibitions. The space showcases diverse contemporary works, including minimalist, abstract, conceptual and multimedia. Bay Area artists and tastes are well represented. Founded in , Martin Lawrence Galleries specializes in original paintings, sculptures and limited-edition graphics. Warhol and Keith Haring along with the best emerging artists.
Check specific galleries for hours, as each maintains its own. The only gallery of its kind in San Francisco, Montague Gallery features an expansive roster of respected and sought-after names in the contemporary fine art glass world, including Lino.
The gallery also features jewelry and painting. The gallery features original photographs, paintings, drawings and limited-edition prints of The Beatles, Rolling Stones, Jimi Hendrix and more. Open M-Sa 10 am-6 pm. This gallery and studio showcases every artistic aspect of books, from the antique to the experimental. Ponder exhibitions on censorship and literary forms from various cultures or take a peek at. Located in a stunning Daniel Libeskind-designed building, the CJM engages audiences of all ages and backgrounds through dynamic exhibitions and programs that explore contemporary perspectives on Jewish culture, history, art and ideas.
Free first Tu of the month. Home to more than 18, exquisite art objects spanning 6, years of history and culture throughout Asia, this museum is one of the largest in the Western Hemisphere devoted exclusively to Asian art. Founded in , the impressively varied museum is currently housed in an architectural masterpiece designed by the Swiss firm Herzog and de Meuron. It showcases collections from the Americas, Pacific Islands and Africa and features a tower observation deck.
The collection includes works by European masters and major holdings of Rodin sculptures. MCD develops and presents engaging exhibitions and educational programs that explore and define the role of craft and design in the changing global culture, encouraging its audience to see the world differently.
After a three-year hiatus, SFMOMA has unveiled a Snohetta-led expansion that makes it the largest modern art space in the nation, easily housing entire floors of abstract American art and minimalist and pop art. The Pritzker Center for Photography dedicates about 15, square feet to photography, more than any other U.
The open-ceiling seventh floor houses nothing but contemporary art. This contemporary art center highlights multicultural issues through the artworks displayed in its two main gallery spaces, high-tech gallery and video screening room.
This recently renovated cultural institution reminds visitors that Africa is the birthplace of humankind and celebrates the global contributions of people of African decent. Located in the heart of downtown Sausalito, this contemporary gallery encompasses the working studio of artist and owner Sue Averell.
Visitors can see her works-in-progress, purchase completed 2D and 3D pieces, or commission custom pieces for a home or business. From the bizarre to the romantic, Bubble Street Gallery offers an eclectic mix of fine arts and crafts. The OMCA brings together collections of art, history and natural science under one roof to tell the extraordinary stories of California and its people.
Stay to hang out by the fire pits, play games or take a guided brewery tour. One of the best bars in the city for a perfectly crafted, creative cocktail, this dim, hidden spot in an alley off the North Beach strip also serves well-priced carnival-themed bar bites. Offering a long list of both classic cocktails and original concoctions, this Haight Ashbury restaurant and bar is a great place to try something new, like the Blood and Sand. Homemade brews and local food are the specialty, making it a true San Francisco experience.
A must-visit for any beer aficionado, Barrel Head offers 30 rotating micro-beers on. The brewhouse also offers a weekend brunch menu, featuring salads, Hog Island oysters, steak and eggs, and bottomless mimosas. Located in Hayes Valley, this traditional beer garden offers a variety of German beers on tap and serves up locally sourced food like sausages and salaten—all to be enjoyed alfresco.
This Tenderloin speakeasy offers strong Prohibition-era cocktails in a s private club atmosphere. Imbibe Champagne or bourbon-heavy libations at the library or book a booth in the main bar in the back. Check the website for reservations and read the rules before you go. Pull up a red velvet bar stool and watch as expert mixologists shake and. Located in the Mission District, this expansive rooftop bar offers sweeping views of the city skyline.
Drinks range from pisco-based cocktails to esoteric Brazilian beer. Dig into tasty nibbles like empanadas, ceviche and meat skewers or visit the downstairs dining room for a more serious, meat-focused menu.
Sip boutique bourbons, hardto-find whiskeys and more at this bar specializing in artisanal distillers. Created by the people behind Bourbon and Branch, this is the place to find a well-crafted drink, and with engraving services at hand, maybe even a thoughtful gift. The menu features small plates and appetizers— including Dungeness crab with spicy giardiniera—as well as an extensive selection of wine, beer and cocktails.
This Mission Dolores bar— part pub, part sports bar, part lounge and part certified green business—offers a taste of the Old West. Tuesday nights are a hit with bar trivia, and weekends bring a makeyour-own Bloody Mary bar. The newest hotspot in the NoPa neighborhood, Horsefeather is already a standout with its late-night food menu serving until 2 am and stellar lineup of cocktails made with fresh ingredients, housemade syrups and hand-cut ice.
But the drinks are strong and the experience is unique. And the drinks are equally on point: Located on the ground floor of a Victorian building, this beer bar features 40 taps from some of the best breweries in the world, two cask handles, exclusive house beers and a full kitchen serving up tasty bar bites that pair perfectly with beer.
The cellar is home to the Tivoli Sour Room, where lambics and sour beers are on tap. This cozy Mission gastropub specializes in craft beer, serving 24 draughts and over bottles of Belgian and Californian brews. The kitchen is open every night until 1 am for upscale pub food. On your first visit, try the Dizzy cocktail East India sherry, terroir gin, cynar and the catfish po boy cabbage slaw, tartar sauce, side of hand-cut Cajun fries.
This waterfront sports bar features more than 35 HDTVs, sports channels, 85 arcade games and 15 beers on tap. The menu offers bar bites and American fare. Step into this bustling saloon and the sweet, musky odor of bourbon slaps you across the face. And for good reason. Groups of four should throw in their cards and order the Pisco Punch Bowl, a guaranteed party maker. Taste the past, present and future of rum here, from traditional drinks of the Caribbean islands to classic libations of Prohibition-Era Havana to exotic cocktails from legendary tiki bars.
Modeled after both a pirate ship and a tiki hut and featuring a waterfall, this bar offers a whole new approach to rum, showcasing more than varieties from. The drink menu includes more than 70 cocktails made from premium spirits and liqueurs, house-made ingredients and fresh citrus juiced inhouse daily. This pub offers more than 45 beers on tap and hundreds more bottled. Local bar stars The Bon Vivants opened this hot spot in the Mission District, focusing on hand-crafted, inventive drinks and late-night nibbles.
The converted warehouse space features a dimly lit, downstairs bar with retro decor, and a small, loft-like restaurant upstairs serving multicultural elevated bar food.
These days, it can be packed on the weekends with a healthy mixture of locals and tourists. The extensive drink offerings are by no means limited to gin, and the food menu features pub fare and several Indian dishes. The airy, multi-level SoMa space delivers reasonably priced, homebrewed beer in unique flavors alongside dependable standards like cheeseburgers and house-made chili.
The watermelon wheat beer, served alongside a slice of watermelon, is a customer favorite. The oldest brewery-restaurant in the city and the only organic brewery serves house-made ales that complement Spanish-inspired cuisine, with dishes served primarily in tapas-sized portions.
Located in the historic War Memorial Opera House since , this is the second largest opera company in North America, bringing exciting performances to the stage each season. Boogie to live music seven nights a week. Located within the Hotel Nikko San Francisco, this elegant, intimate, seat nightclub is operated in partnership with multi-platinum-selling entertainer Michael Feinstein and presents a wide range of local, regional and national entertainers. It continues to inspire through performances and involvement in human rights, empowerment and inclusiveness, establishing it as an icon among LGBT organizations.
This is the first stand-alone performance venue of its kind in the country built specifically for jazz.
The 35,squarefoot glass structure seating to people, located in bustling Hayes Valley a block from Davies Symphony Hall, boasts the acoustic qualities of a great concert hall and the. Offering classical and contemporary theater productions, the A. Persons under 21 not admitted to evening performances. NCTC is renowned for its diverse range of innovative, high-quality productions and shows for young audiences, as well as its foundational anti-bullying work with youth and educators through YouthAware.
It delivers a range of theatrical experiences: Located in the heart of the SoMa neighborhood, this destination is both a working winery and a place to relax and enjoy a drink or two. The tasting room features expansive windows looking into the working winery, allowing you to enjoy a flight of wine while watching the crafting process.
Wine, food and fun are the driving force behind this wine bar in the SoMa district. The no-nonsense tasting room brings local wines and varietal information to both new and experienced tasters. After tasting, delve into delicious food offered by food trucks.
Buy a bottle of wine, and when it runs dry bring it back to one of the sustainable bottling events to get a refill at a reduced cost. Attached to the store of the same name, this wine bar offers visitors the opportunity to sample a rotating selection of wines. Grab some cheese from Cowgirl Creamery, a loaf of bread from Acme Bakery, a seat at the bar and let the knowledgeable guide you.
Located in the luxurious cellar space of the Four Seasons Hotel, this chic urban tasting room offers a wine country experience right in the middle of the city, uncorking an array of wines direct from acclaimed California wineries.
It features social sipping lounges, rare and specialty beers on tap and light bites for delicious pairings. Like a fine Zinfandel, this sophisticated Jackson Square wine bar offers a complex and satisfying bouquet of flavors for the discerning palate.
The staff is knowledgeable, the atmosphere unpretentious and the menu thorough. As much a dining as a gaming destination, the complex packs in about a dozen eateries.
W, Rohnert Park, This iconic restaurant represents classic steakhouse dining, but chef Michael Buhagiar adds a California sensibility. The Kobe ribeye, cut from select Japanese cattle reared for optimal marbling, has a rich and delicate texture. A red cabernet butter melts on its seared surface, typifying a subtle flair for the unexpected. The wine list is carefully curated to pair with the extensive menu, and the dim, thoughtfully decorated dining room has a romantic feel.
Brunch Su , D nightly , closed M. California cuisine in a neighborhood setting, acclaimed Frances serves delights that will be sure to satisfy. Chinese This bustling spot has a colorful lounge and cheerful, modest decor in the dining room downstairs. The Hong Kong-style menu includes tank-fresh seafood. The giant salad buffet is included. The menu is a modern take on traditional dishes with seasonal ingredients.
L SaSu , D nightly. Brunch Sa-Su , D nightly until 1 am. Mustorder items include innovative snacks like sardine chips and porcini doughnuts and creative cocktails. Hayes Valley, this Greek sandwich shop is inspired by the casual neighborhood souvlaki joints found throughout Greece. The sandwiches are made with spit-roasted all-natural meats on warm pita bread with spiced yogurt sauces and fresh herb salads.
This San Francisco institution has been in business for more than 35 years and is most famous for its cooked-to-order roast chicken for two allow an hour , a true stand-out on the Mediterranean-inspired menu of roasted and grilled goodness. Watch the vintage street cars roll down Market Street through the floor-toceiling windows while you wait.
Brunch Su , L, D daily , closed M. B, L, and D daily. Get the Dungeness crab. American Known for its warm hospitality and all-day breakfast, the key word at this diner is homemade, from meltin-your-mouth blueberry pancakes to gravy-smothered biscuits. The outside patio is a great spot to enjoy a break from city life.
B, L daily , D SaSu. B, L, D daily. The ample selections include the top-selling pearl milk tea series, Yakult, macchiato and the slush series. Menu highights include fish and chips, sizzling iron skillet mussels and whole roasted Dungeness crab. Free parking with validation. Seafood This freshly renovated restaurant, oyster bar and lounge has been feeding fishermen since Come for incredible harbor views and a friendly atmosphere. Latin American The traditional Peruvian dishes at this attractive, modern space on the waterfront showcase fresh seafood with influences from China and Japan.
Signature offerings include ceviches, causas, empanadas and anticuchos, as well classic and updated main courses.
Pair them with a pisco sour cocktail. One of the most profitable dining establishments in the city, it won the James Beard Outstanding Restaurant Award in Italian This casual cousin to the acclaimed two Michelin star Quince restaurant next door opened under the same chef-owners.
The rustic Italian eatery serves a seasonally changing menu that features spit-roasted meats and game birds, wood-oven pizzas,. L MSa , D nightly. A multi-course tasting menu is available, and dining a la carte is also an option in the salon. The Progress is a James Beard Award winner. This creative and innovative Michelin star restaurant does dim sum,.
L W-F , D nightly. Giving center stage to the food, the seat dining room has an earthy, minimalist appearance with teak tables, fig trees and glass orbs that provide soft lighting. Diners can select from one of two multi-course tasting menus. The succinct, frequently updated menu features simple, fresh preparations of locally sourced meats and seasonal produce.
Dishes may include chilled tomato soup; seared squid with avocado, celery and pine nut mousse; and slow baked halibut with fried mussels, tomatoes and nasturtium. Brunch Su , D nightly. The bakery is famous for the Rebel Within, a savory breakfast muffin with asiago cheese, green onion and breakfast sausage baked into the mix and a full soft-cooked farm egg in the center. It has received rave reviews since its opening in and still packs the house and outdoor patio each night.
The vast, bohemian-chic space suits the always excellent California-Mediterranean cuisine. A heated, covered patio screens a rotation of classic, foreign and independent films projected onto one of three walls, and speakers on each table allow you to adjust the volume. Meandering through the changing exhibits in the adjacent gallery is the perfect way to wait. Sustainability is a huge focus here, and the recently renovated space features a wall-sized mural with playful instructions on how to eat sushi correctly.
Past menus featured dishes like halibut with asparagus, Perigord truffle and fingerling potatoes; and lamb with mustards, farro and garum. L F-Su , D nightly. Start off with antipasti like fried olives, then dig into saucy pastas like rigatoni alla carbonara and charcoal-grilled dishes featuring lamb, quail and spareribs. The wine and cocktail offerings are excellent, too. Beretta and Starbelly has created a new kind of steakhouse, one that marries the flavors of Argentina with the culinary sensibility of California.
This stylish and moody Mission spot offers Latin-inspired small plates, but the real draw here is the assortment of grilled meats.
Breakfast quiches, gourmet sandwiches, classic pastries and an addictive bread pudding keep folks lining up. The menu changes daily and features seasonal produce as well as locally sourced, sustainably-raised and caught meats and seafood.
L M-Sa , closed Su. The sleek design and friendly service make for a festive evening. Pick a glass of sparkling Cava or Rioja from the all-Spanish wine list and stay for the chocolate and churros dessert. D nightly , closed M. American Adored by locals, this neighborhood spot with a homey feel has been a destination since its opening. The food is comfortable and creative, and vegetarians will find at least two meatless main courses on every menu in addition to multiple appetizer options.
The menu changes along with the seasons, and the sangria and margaritas are popular. B FSu , D nightly. It has has more than 20 varieties of pastas to choose from, most of them made in-house. Brunch Sa-Su , L, D daily. The award-winning wine list boasts over bottles to pair with house specialties such as chicken al mattone with Italian herbs, filet of lamb alla Bruno and cioppino alla pescatora.
The four dining rooms cater to a variety of occasions, from a power lunch to a first date. Some tables have a direct view of the church steps where Joe DiMaggio and Marilyn Monroe were married. The spacious brasserie boasts a market-driven menu of shareable plates, boldly flavored seafood and meat dishes and unique-cumclassic cocktails.
Small plates are divided by raw, fried and smoked offerings. The seafood restaurant serves up oysters and clams on the half shell, Boston-style clam chowder, baccala, crab cioppino, Louis salads, seafood pastas and more.
L, D M-Sa , close Su. The diverse array of styles, from the famous pizza Margherita to the savory Cal Italia, require seven different ovens. Food and sea lion spotting is a possibility and Sutro Baths. The camera obscura on the deck is on the National Register of Historic Places. The owners designed the space themselves, and a recent renovation has made the intimate space formerly notorious for long lines that much more accessible.
The grilled cheese sandwich served with housemade levain bread is the menu standout, but the regular lineup of pastries, soups and cold and openface sandwiches is always worth the trip. The artfully presented desserts are playful riffs on childhood classics, like peanut butter and jelly doughnuts. Neighborhood foodies rave about the Sunday brunch. It offers inspired, progressive.
American cuisine in a historic, cleanly designed space. The a la carte menu allows for individualized customization, and the tasting menu varies between courses, reflecting seasonality and evolution.
The menu features fresh, simple fare emphasizing a nose-to-tail cooking philosophy. Local ingredient sourcing extends to the wine list. Dishes include grass-fed beef burgers and steaks, apple-fed pork with cheddar grits and several selections of house-made charcuterie and salumi. While known for its craft cocktail menu with an emphasis on brown spirits and seasonal bar bites, it also features a limited dinner menu with seasonal dishes.
Park Tavern just moved into sleek new digs in the SoMa district. The market-driven menu is known for upscale comfort foods like the famous burger, crispy brussel sprout chips and deviled eggs. L MF , D nightly. The menu includes a selection of items that are farmed, foraged and crafted, as well as small plates to share and large plates to savor yourself. Breakfast, lunch and weekend brunch, too. Further follow up is required to determine whether patients with MRI-only MS are at risk of physical disability and cognitive impairment in the long term.
Multiple sclerosis MS and neuromyelitis optica NMO are recognized to be clinically distinct entities which management differs. Western studies have shown that certain radiological features may be helpful in discriminating them from one other. However, such data is scarce in the Chinese population.
All patients who have been diagnosed with MS or NMO in a single regional hospital from to were recruited. They were retrospectively analyzed based on their most updated diagnosis as of March , according to the McDonald criteria and the Wingerchuk criteria.
All of the brain and spine magnetic resonance images ever performed for each subject were reviewed and compared. A total of 92 patients were recruited. The mean disease duration was 9. Spinal cord lesions in MS patients were more likely to be multiple short segmented OR These brain lesions were more prevalent at the area postrema OR Our review suggests that radiological features that discriminate NMO from MS in the western population are also applicable in Chinese patients.
This technique can be utilized for characterizing the presence of central veins within white matter WM lesions, a potentially highly predictive marker of MS diagnosis [Quinn MP et al.
However, there are problems inherent to 7T imaging, such as a strong image bias caused by field inhomogeneity, which must be addressed in order to allow clinicians to read the images reliably. Image acquisition included the following sequences: A total of white matter lesions were identified in the cerebrum of the four MS patients mean Of those lesions, The lesions without visible veins were very small median size 12mm 3 and primarily located in the upper cerebrum.
Here, almost all of the white matter MS lesions appeared venocentric. Further study will include a larger cohort of MS patients. Changes in resting state functional connectivity rsFC in the default-mode network DMN represent a potential biomarker for clinical disability in multiple sclerosis MS.
Cortical areas part of the DMN are also frequently affected by subpial demyelination. However, given that cortical atrophy may result from pathology in both gray and white matter WM , the link between subpial pathology and rsFC in MS remains elusive. These include compensatory mechanisms and the contribution of WM injury.
Some of the available treatments for multiple sclerosis MS have demonstrated to improve the curve of brain atrophy compared to placebo. These results may sometimes be difficult to interpret due to the pseudoatrophy effect.
A brain MRI was performed at baseline not more than 3 months prior and 12 months after therapy onset in all patients. Statistical Parametric Mapping 8 software was used for volumetric analysis.
Descriptive statistics and lineal regression models were performed. Nineteen patients were excluded due to missegmentation and two patients were excluded due to outlier values in gadolinium counts, leading to a final cohort of 84 patients. Demographic and clinical characteristics at therapy onset are as follows: Baseline inflammation has to be taken into account when interpreting early brain volume changes on therapy. Quantitative T1-mapping measures longitudinal relaxation times T1 and can be used to study differences within normal appearing brain tissue.
Many studies have documented increased T1 associated with multiple sclerosis MS disease progression in normal appearing white and gray matter. T1-maps hence provide valuable information for studying the progression and treatment of MS. However, T1-maps are often more time-consuming and difficult to obtain than standard clinical images and are thus not included in standard clinical protocols.
A method for estimating T1-maps from commonly available MR modalities would greatly, and retroactively, increase the availability of T1-maps available for research.
Our estimated maps should accurately reconstruct observed group-level differences in T1 between MS patients and controls and between MS subtypes. Two datasets were used to evaluate the performance of our T1-map estimation model.
Model training and cross-validation was performed on Dataset 1, and model validation was performed on Dataset 2.
Each modality excluding T1-map was intensity normalized using z-score normalization Shinohara et al. This procedure extracts quantitative information from the unitless clinical modalities. The group difference in median T1 was We have proposed and validated a method for estimating quantitative T1-maps using commonly available scans. Following further validation, this method can be used to greatly increase the availability of T1-maps for research of MS and other neurodegenerative diseases.
Ultra high-field MR spectroscopic imaging has the potential to provide mechanistic insights in multiple sclerosis MS. These results were computed based on ratios to Creatine Cr. Wilcoxon rank sum tests were used to compare regions and spearman correlation tests were used to compare metabolites.
We found the expected decrease in NAA and increase in mI - but also show that these metabolites are inversely correlated in MS. This observation suggests that oxidative stress may be better understood in functioning axons. We reported this preliminary data in relative concentration to tCr; further analyses will study absolute concentrations. The patients in this study are being followed longitudinally for changes in metabolite levels and lesion evolution.
Magnetic Resonance Imaging MRI is an important tool in establishing MS diagnosis, as well as monitoring the course of disease and response to therapy. However, little is known about its impact on therapeutic decision- making in clinically stable patients who are receiving disease modifying therapy DMT. Types, indications, and results of MRI, and whether change of DMT occurred as a result of the scan were documented and analyzed in the study.
The mean age and disease duration of the patients included were The majority were female A total of 1, scans were obtained: Changes were observed on 84 9. But only 19 of the 84 changed scans It is evident from the results obtained in this patient cohort that one should question the practice of obtaining routine MRI scanning in clinically statle patients who have been receiving DMT.
The use of routine MRI has, at least in part, been supported by radiologic evidences of ongoing disease activity in patients who appeared to be clinically stable. Iron increase in the basal ganglia BG of MS patients measured by T2 hypointensity has been associated with physical and cognitive disability and correlates with EDSS and brain atrophy.
The objective was to examine the association between BG iron and performance on measures of inhibitory control. Given the functional significance of BG to engage in task-relevant information, while ignoring task-irrelevant information, we hypothesized a negative association between iron deposition and measures of inhibitory control.
Globus pallidus, putamen and caudate were manually traced. All patients underwent comprehensive neuropsychological testing involving assessment of working memory, episodic memory, selective attention, and inhibitory control. Specifically, we examined associations between iron and interference scores on the Stroop and Flanker tasks. The Stroop task involves presenting list of colored words, and requires responding to the color of the word, while ignoring the identity of the word congruent, incongruent and neutral conditions.
The Flanker task presents five arrows, and participants are asked to respond to the direction of the central arrow, while ignoring the flanking arrows congruent, incongruent conditions.
The dependent variables are reaction time RT and accuracy Acc interference scores measuring greater conflict in the incongruent, relative to the congruent condition for both tasks. Our novel QSM processing retained anatomic detail with only minimal streaking and blurring artifact. Small vessels and regional variability were seen in BG. Higher iron deposition in globus pallidus and caudate was associated with RT interference score on the Flanker, but not the Stroop task. We have preliminary support for an association between BG iron and performance measures of inhibitory control.
Future directions of the ongoing study include a more parsimonious examination of iron deposition with nuanced measures of inhibitory control. Brain atrophy in multiple sclerosis MS occurs at a faster rate than the normal population. Disease modifying therapies DMTs have demonstrated the ability to alter the clinical and radiographic course of MS.
However, access to objective volumetric imaging has been limited to research labs until the advent of NeuroQuant—a fully automated volumetry platform for conventional MRI. Retrospective chart review was performed on patients at our MS center. Potential predictor variables of brain volume screened: Cross-sectional analysis using multilinear regression was applied on candidate predictors to total brain volume.
Cumulative first- and second-line DMT exposure: Adjusted predictors of brain volume [beta coefficient p-value ]: NeuroQuant vMRI metrics are easy to obtain in routine clinical practice and correlate brain atrophy with physical disability. Independent predictors of brain volume include ICV and progressive disease status which suggests that NeuroQuant may help identify relevant neurodegenerative tissue changes of the brain in routine clinical practice.
Exposure-time on DMT is not an independent predictor of brain volume and may suggest a beneficial effect of DMT in mitigating the rate of whole brain atrophy in MS.
Previous studies have shown an association between depression and hippocampal atrophy in patients with multiple sclerosis MS. Aim of this study was to investigate the interaction between depressive symptoms and hippocampal resting state RS functional connectivity FC in MS. The main clinical and demographic characteristics did not differ between D and nD MS patients. Compared to HC, MS patients had significant atrophy of the whole brain and bilateral hippocampi, without significant differences between D and nD MS patients.
Depressive symptoms in MS are related to RS FC alterations within limbic-neocortical networks independently from the presence of hippocampal atrophy. Functional imaging studies have shown an abnormal recruitment of the network connecting the basal ganglia to the frontal lobes in MS patients with fatigue.
Using a motor task during functional MRI fMRI , we wished to provide some additional insights into the pathophysiology of fatigue in MS by investigating its functional correlates according to the presence of cognitive or motor fatigue and the influence of disease duration on these findings.
Adaptation of motor network recruitment during prolonged effort were also assessed. Full factorial and multiple regression analyses were performed with SPM8. A time modulation analysis was also performed. Compared to HC and nF patients, F-MS patients had reduced activations of the left middle temporal gyrus, left supplementary motor area SMA , bilateral superior frontal gyrus, left postcentral gyrus, left putamen and bilateral caudate nucleus.
They also showed selective increased activation of the right middle frontal gyrus BA This latter finding was mainly driven from F MS patients with disease duration longer than 5 years.
In HC, the time modulation analysis showed a reduced activity of the SMA and right precentral gyrus and increased activity of the basal ganglia over time. Such a behaviour was significantly impaired in F MS patients. Distributed abnormalities of activation as well impaired timing of communication between different areas of the motor network occur in MS patients with fatigue. The involvement of specific GM regions, only partially related to disease duration, may contribute to explain differences between cognitive and motor fatigue in these patients.
The relationship between these MRI measures and underlying pathology, however, remains obscure. The objective of this study was to determine the neuropathological correlates of DTI and MTI measures in a mouse model of inflammatory cerebral demyelination.
The seamless combination of in vivo MRI and post-mortem 3D qIHC data is a valuable strategy for interrogating the relationship between quantitative neuroimaging and gold-standard quantitative neuropathology measures.
This unique approach is expected to provide improved interpretation of MRI data and guide the rational use of imaging biomarkers in MS clinical development. The presence and location of white matter lesions on magnetic resonance imaging MRI are important criteria for diagnosis, follow-up and prognosis of multiple sclerosis. Quantitative values such as lesion volumetry are expected to have high impact in clinical practice. However, manual lesion quantification is time-consuming, costly, and suffers from observer variability.
We propose an accurate, automatic method for lesion quantification based on MRI, which is independent of the scanner and acquisition protocol and does not require a validated patient population. Lesion segmentation is performed based on prior knowledge that lesions appear hyperintense on FLAIR images. Expert lesion identification and manual segmentation was performed based on the FLAIR images by a highly trained neuroradiological team. The total volume of the lesions in the brain is computed for both the automated method and the expert lesion segmentation.
We report the mean, standard deviation and range of the total lesion volume over all patients, as well as the overlap between both segmentations. The consistency between the two methods is assessed by the intraclass correlation coefficient ICC. The automatic method provides lesion volumes that are in agreement with those obtained by manual tracing.
The total lesion volume obtained from the automatic segmentation is The overlap between the automated and manual lesion segmentation is The ICC equals We propose a fully automatic method that is generally applicable and allows consistent and reliable volumetry of lesions in the whole brain or in different brain regions.
Complementary information is thus provided to the MS clinicians, supporting early diagnosis. Moreover, segmentation of new lesions and volume changes of old lesions over time is also possible.
Multiple sclerosis MS lesions typically develop in the periventricular, juxtacortical, and infratentorial white matter of the brain. To combine the contrast of PD and T2w sequences for improvement of infratentorial image quality and better assessment of infratentorial WML. Whole brain, 2D dual-echo T2-weighted fast spin echo scans were acquired slice thickness, 3mm; acquisition time, 1 minute 57 sec; repetition time, msec; echo time 1, 23 msec; echo time 2, msec.
Each of two trained raters evaluated the 3 sequences separately. Qualitative assessment was performed for supratentorial and infratentorial image quality and lesion conspicuity using a grading system. MRI data from 16 patients 8 women; mean age, 42 years were analyzed. As the infratentorial brain is one of the cardinal compartments for diagnosis of MS, use of this post-processing technique, which requires no additional acquisition time, could improve our ability to diagnose and monitor the disease and is feasible in the clinical setting.
Functional MRI studies have demonstrated consistent reorganization of brain networks in patients with multiple sclerosis MS , with complex relationships with disability. We aimed to assess in this longitudinal resting-state functional MRI rs-fMRI study the potential relationships between disability progression and alteration of brain functional topology using graph theoretical approach. In the first step of the study, we assessed the stability over time of graph metrics derived from rs-fMRI data performed on 6 healthy subjects at baseline and at year 2.
The three main functional connectivity metrics characterizing the brain network topology namely the long-range connectivity nodal efficiency, Enod , the short-range connectivity local efficiency, Eloc and the density of connections degree, k were assessed.
Connectivity metrics in healthy controls remained stable over time. They underwent rs-fMRI at baseline and at two years. During the follow-up period, Enod and k of patients decreased to reach normal values at year 2.
At the regional level, long-range functional connectivity and density of connections reflected by Enod and k respectively were increased mainly in hubs at baseline, whereas high short-range connectivity reflected by Eloc was equally distributed throughout the brain. This longitudinal rs-fMRI study evidenced that brain functional reorganization characterized by widespread higher functional connectivity, involving mainly the hubs, dramatically decreased with disease progression.
The disruption of reorganization in brain functional topology was significantly associated with disability progression suggesting that compensatory mechanisms progressively failed with the course of MS. Cortical gray matter lesions CL constitute a relevant aspect of multiple sclerosis MS pathology. Studies based on double inversion recovery DIR images have demonstrated an association between CL load and both cognitive and physical disability in MS patients.
PSIR and DIR images were jointly used to classify lesions as purely intracortical, mixed gray-white matter leukocortical , and juxtacortical. Moreover, we confirm the higher accuracy and sensitivity of PSIR in classifying the types of lesions. The presence of at least one intracortical lesion in all CIS patient further points out the relevance of cortical pathology in MS.
Altered functional connectivity appears to be a robust feature in multiple sclerosis MS. Compensatory mechanisms, whereby functional connectivity between brain regions is enhanced to compensate for disrupted connectivity elsewhere may represent an independent therapeutic target to minimize overall disability. To determine if there are robust alterations in fMRI connectivity patterns in patients with relapsing multiple sclerosis RMS compared to age and gender matched healthy controls.
Resting state fMRI scans were acquired with resolution 80x80 mm, 36 slices, volumes and TR ms 8 min. Cortical parcellation was performed in Freesurfer and 38 ROIs, including cognitive regions, were chosen for connectivity analysis.
In addition, simple correlation results were calculated to compare to the BN approach. These results suggest a fundamental remapping of connectivity involving inferior prefrontal regions: The results emphasize the importance of distinguishing direct vs indirect co-activation connectivity in MS, which is possible with the BN approach but not with correlation analysis.
Our observations suggest that the increased overall co-activation in MS is a result of de-differentiation of normally focal connectivity patterns between discrete regions. The co-activation changes in RMS likely represent compensatory, broadly-enhanced connectivity of still intact pathways. We have previously reported increased permeability of the blood-brain barrier BBB in normal appearing white matter NAWM in patients with multiple sclerosis Cramer et al.
Measurements were compared with 17 HCs matched for age and gender. In normal appearing grey matter and thalamic tissue, no such difference was found. However, ON patients who did not convert to MS also had significantly higher permeability when compared to HCs, indicating that BBB permeability is also a marker of non-specific CNS inflammation, although it must be kept in mind that the observation period was only two years. It is not well established whether gradient-echo GE or spin-echo SE is the sequence of choice to detect enhancing multiple sclerosis MS lesions with 3.
The aim of this study was to compare the ability of these two sequences to detect active MS lesions. GE images were acquired 15 minutes after injection of a double dose 0. In half of the patients, SE images were acquired just before, and in the other half just after, acquisition of the GE images.
To define the gold standard, an experienced neuroradiologist identified and marked contrast-enhanced MS lesions in these sequences using Jim 5. Each of the two sets of contrast-enhanced T1W scans was then evaluated in a random order by three experienced neuroradiologists. The results were compared with the gold standard reference to obtain the number of true-positive TP , false-negative FN , and false-positive FP evaluations. Quantitative assessment of lesion conspicuity and the effect of spatial location were based on image contrast and the contrast-to-noise ratio, and division of the intracranial region into four quadrants in each slice.
We found MS lesions periventricular, subcortical, juxtacortical, and 63 infratentorial. Most lesions showed a nodular pattern of contrast uptake nodular, ; ring, 13; open-ring, 34; heterogeneous, We found a better sensitivity to detect lesions with GE images 0.
SE images showed a higher image contrast TP, 0. Finally, for both sequences, most misclassifications occurred in the right posterior quadrant. Selection of the best sequence requires the use of image indices that incorporate surrounding complexity of lesions rather than only the image contrast ratio. Homologous regions, symmetric areas of the right and left hemisphere, have high inter-hemispheric resting state functional connectivity RSFC in somatomotor and visual cortices in healthy controls HC.
In multiple sclerosis MS , studies have largely examined inter-hemispheric connectivity of a single seed in the motor area to its homologous point. Establishing whole-brain homologous connectivity provides unique information of functional homotopy between hemispheres and can potentially be a useful tool for detecting inter-hemispheric impairment in MS.
A novel surface-based registration technique aligning cortical folding patterns across both hemispheres was performed on the anatomical images. Data were Fisher Z-transformed to facilitate group comparison. Network HIFC was extracted using a commonly used 7-network parcellation scheme.
Whole brain HIFC is decreased in MS, particularly in areas represented by the default mode, dorsal attention, frontoparietal control, and visual networks, suggesting widespread inter-hemispheric dysfunction. Alterations of HIFC may have implications for cognitive and motor dysfunction in MS and may be sites for targeted interventions to improve connectivity.
Multiple Sclerosis MS is an auto-immune like disease characterized by the infiltration of T-cells into the central nervous system CNS resulting in demyelination of white matter. The most common motor side effects due to MS are reductions in muscle strength, balance perturbations, and difficulties in ambulation.
Regions of interest where identified on corresponding CT images to quantify skeletal muscle GU and statistical parametric mapping SPM was used to quantify GU within regions of the brain. GU is reported in mean standard uptake values.
Global brain GU was lower in patients with MS compared to healthy controls 2. Increased GU in the skeletal muscles of the legs could lead to an increased cost of walking in patients with MS which may play a role in the reduced GU in certain brain regions responsible for continuous integration of sensory and motor drive during walking. Additionally, alterations in corticospinal tract activation could contribute to the increased difficulty in ambulation seen in many patients with MS.
Larger future studies are needed to expand the generalizability of these findings. Quantification of brain atrophy in relapsing-remitting MS RRMS could be a marker of clinical state, disease progression and treatment response but no one study compared effect of first-line and second-line disease-modifying drugs DMD on cerebral volume. The aim of this study is to compare effect of first-line and second-line DMD on brain atrophy progression up to 48 months of follow-up through a meta-analytic approach.
For each study, number of patients, percentage of brain volume change PBVC to baseline, technique of atrophy measurement and DMD were collected. Glatiramer acetate, interferon, teriflunomide, dimethyl fumarate and laquinimod were classified as first-line DMD and natalizumab, fingolimod, daclizumab and alemtuzumab classified as second-line ones. We identified studies between January 1, and August 31, For period A, there was a statistical difference for annual slope of atrophy between second-line DMD and placebo 0.
For period B, annual slope of atrophy was reduced for second-line DMD compared to placebo 0. This meta-analytic approach suggests that second-line DMD reduced brain atrophy slope in RRMS whatever the period considered and methods of atrophy measurement. These results suggests that long term atrophy measurement may be a major surrogate marker for DMD effect and offers new insights about mechanisms underlying atrophy process. The assessment of multiple sclerosis MS is largely based on clinical scores and only a few quantitative measures derived from magnetic resonance imaging MRI , such as lesion count and total lesion load.
We exploit a large set of quantitative features about individual lesions to perform 5-way classification into one of the five subcategories of MS relapsing-remitting, primary progressive, secondary progressive, progressive relapsing and clinically isolated syndrome by using support vector machines SVMs.
In addition to producing an accurate objective classifier, we sought to determine which types of features are most important for successful classification. In addition to basic clinical measures EDSS, PASAT, disease duration and demographic variables age, gender , our classifier uses a wide range of lesion-specific measures. Lesion geometry is measured with Minkowski functionals, i. Lesion-specific values are aggregated into whole-brain or white-matter track-specific summaries incl.
Lesion segmentation was done for all image types and subjects using a strict semiautomatic protocol with two independent raters and review by a third. However, even better accuracy was found with the addition of geometric and intensity measures SVM weights showed that the significance of various features largely depends on the subtypes involved during classification: For most classifiers, T2w features are more important than their T1w counterparts.
Additionally, EPC showed higher weights than lesion count; median lesion volume, area and mean breadth were more useful than the respective means; finally, better prediction accuracy was obtained by decomposing scores by ROI tracks than using whole brain summaries.
We found that prediction of MS subtypes can be made more accurate by using different aspects of lesion geometry and intra-lesion intensity measures. Multiple sclerosis MS is a demyelinating disease affecting both the brain and spinal cord. Advances in imaging techniques have improved the ability to detect spinal cord lesions, facilitating the diagnosis of MS and the identification of important disability correlates.
As the cervical spinal cord is more frequently involved, little is known about its relationship to the presence of lesions within the thoracic spine.
To determine if the presence of cervical spine lesions predicts the presence of thoracic spinal cord lesions in patients with MS. All MS patients, with MRI studies of the brain, cervical, and thoracic spine obtained during a single scanning session were consecutively acquired during a 1-year period from a single MS clinic. The presence of cervical spine demyelinating lesions was analyzed as a predictor of thoracic spinal cord involvement. Clinical, demographic and imaging covariates were used in a multivariate regression model to refine predictors of thoracic spine involvement.
A total of patients were consecutively evaluated over a 1-year period. The presence of at least 1 demyelinating lesion within the cervical and thoracic spinal cord was identified in The multivariate logistic regression model demonstrated a substantial increase in the odds of thoracic spine involvement with each increasing number of cervical spine lesions: Our findings suggest that the presence of thoracic spinal cord lesions is predicated on the presence and degree of cervical spine involvement in patients with MS, a risk that appears to be independent of brain findings or clinical features.
Magnetic resonance spectroscopic imaging MRSI in patients with multiple sclerosis MS offers the possibility to detect metabolic alterations in combination with morphological changes. In our study, we aimed to differentiate RRMS patients with mild and fulminant disease progression by identifying reliable metabolic markers of disease severity. Clinical classification was based on the current treatment level of the MS patients. Fourteen patients were receiving no medical therapy NT , 17 immunomodulatory baseline therapy BT and 13 escalation therapy ET.
The latter were treated with Natalizumab, recently reported not to change metabolite concentrations pre- to post-treatment in MRSI.
The volume of interest was localized above the corpus callosum in all subjects. One-way ANOVA tests were used to compare the concentrations in 4 central white-matter voxels between the four groups.
Ins concentrations were increased in all patient groups, increasing continuously from the HC to ET group. NAA exhibited no significant differences between groups. All RRMS patients showed elevations in a marker for neuro inflammation, namely myo-inositol. However, our study demonstrated that metabolites of neuronal excitotoxicity Glx were specifically upregulated in the patient group with a more aggressive disease course, indicating surrogate factors for progression.
Interestingly, as other groups have reported, we found no reduction in NAA in our groups. Thus, if one does not question NAA as a parameter for neuronal integrity, it must be concluded that neuronal excitotoxicity precedes neuronal loss, indicated by the higher Glx but stable NAA values in all our patient groups.
For a long time MS has been regarded as a demyelinating autoimmune disorder of the central nervous system related to T lymphocytes autoreactive for myelin. However, there is also an axonal degeneration that is present from the early stages of the disease and seems to correlate better with the progressive neurological disability. The relation between inflammation and neurodegeneration is currently intensively debated and, at later stages of MS, brain atrophy often occurs in the absence of new inflammatory lesions.
However, in the earlier stages of the disease where inflammation is more pronounced, there is little data addressing the contribution of disease activity to GM atrophy. Forty-two RRMS patients and 30 controls were followed up for 24 months.
Clinical features evaluated were: MRI metrics included accumulation of cortical and WM lesions, and gadolinium-enhancing lesions during follow-up. GM atrophy rates cortical and subcortical were calculated. Group comparisons and correlations were performed with age as covariate.
Multivariate analyses were performed to assess the contribution of clinical and MRI metrics to GM atrophy rates.
In the patients group, atrophy rates were significantly higher than controls for cortical 2. On multivariate analyses no clinical or MRI factor remained in the model as predictor of GM atrophy rate. GM atrophy is significantly higher in RRMS patients when compared to healthy subjects but atrophy rate is not influenced by clinical factors, disease activity or accumulation of demyelinating lesions.
Mechanisms other than inflammatory lesions may contribute to GM degeneration. Recent pathological studies suggest that geometrical distributions e. MRI sequences sensitive to susceptibility may therefore have the potential to serve as markers of disease activity in MS patients.
This has been demonstrated in numerical simulations and MRI phantoms experiments. Here we investigate whether the same patterns are present in in vivo MS patient imaging data.
To demonstrate geometrical patterns created by MS lesions on phase and QSM and to explore whether shell-appearing lesions on phase may correspond to either solid or shell lesions on QSM.
For each MS patient, a neuroradiologist identified the largest lesions on the T2w images. Given previous work validating that QSM accurately depicts solid and shell patterns of magnetic susceptibility, here we show that phase imaging may depict in vivo MS lesions with solid susceptibility distributions as shell-like. QSM also detects more lesions than phase imaging.
In light of the potential importance of susceptibility geometry in characterizing clinically relevant characteristics of MS lesions, QSM should be included in future MRI studies of susceptibility in MS.
In addition, WM tissue outside focal lesions, referred to as diffusely abnormal and normal appearing WM, is increasingly recognized as being affected by the disease. Meandering through the changing exhibits in the adjacent gallery is the perfect way to wait. Brunch Sa-Su , D nightly. Breakfast quiches, gourmet sandwiches, classic pastries and an addictive bread pudding keep folks lining up. Steaks This swanky, sprawling steakhouse with a striking Art Deco interior is located just across the street from Grace Cathedral in the storied Nob Hill neighborhood.
Menu standouts include dry-aged steaks and buttery Dungeness crab. It has has more than 20 varieties of pastas to choose from, most of them made in-house.
Join us for dinner nightly and weekdays for lunch. The award-winning wine list boasts over bottles to pair with house specialties such as chicken al mattone with Italian herbs, filet of lamb alla Bruno and cioppino alla pescatora. The four dining rooms cater to a variety of occasions, from a power lunch to a first date.
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This restaurant goes through more than 5, pounds of the pungent ingredient each month. Specialties include 40 clove garlic chicken, pork chops, roasted Dungeness crab and even garlic ice cream.
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Chef-owner Ranjan Dey creates daily specials with his six gourmet spice blends. Try the Madras Madness or Oh! L M-Sa , D nightly. With unparalleled ocean views it is famous worldwide, attracting visitors from around the globe and is a favorite destination of the locals.
It is a favorite with locals and national celebrities most recently Olympia Dukakis, Renee Zellweger and Drew Brees , who enjoy the great steaks, fresh seafood with excellent service at honest prices in. Walking distance from downtown hotels and theatres. Private banquet rooms are available.
Every table boasts a view: Open daily 11am - 10pm. Still serving bountiful meals - all-day breakfasts, as well as lunch and dinner, and of course, its famous Irish Coffee. Chef Ranjan has been serving guests from around the world at the same location for over 25 years, creating classic and unique dishes from all over India - using fresh, local ingredients.
Join us for an experience you cannot find anywhere else! We offer ales, lagers, sours, cask-conditioned, and barrel-aged beers, paired with exceptional Spanish tapas, paella, artisan cheeses and charcuterie. ThirstyBear takes a contemporary approach to traditional Spanish cuisine.
We use organic ingredients and the freshest seasonal produce, seafood, and meats sourced from local farms. Our full bar offers artisanal cocktails, and premium California and Spanish wines. Sotto Mare serves the freshest fish and shellfish in town. Oysters, Boston style clam chowder, crab cioppino, Louis salads, seafood pastas, seafood risotto and a selection of fresh fish daily.
Private parties are available in our restaurant and banquet room. We also sell our fresh fish retail. The Wine Park has a 3,square-foot outdoor swimming pool with a cafe. Adults can partake in wine-tastings more than 40 wines are produced onsite. Attractions also include two restaurants, a movie gallery, a performing-arts pavilion and a park area with game tables and bocce courts. A sleek stretch of renovated warehouses once part of an apple processing plant in downtown Sebastopol is home to some of the best local food producers, winemakers, brewers and artisans.
This unique space is the first business community in the country to connect customers not only with products and the people who make them, but also with the production itself. Visit this gourmet mall for the freshest local ingredients for an afternoon picnic before wine tasting. Or stick around and order from the selection of independent eateries offering elevated takes on pizza, burgers and tacos plus oysters and rotisserie chicken and then grab a seat on the patio overlooking the Napa River.
Shed also has the only fermentation bar in the area, where local wines, beers, kombuchas, natural sodas and hard ciders are all available on tap. With over wineries between Napa and Sonoma, deciding where to go can be overwhelming.
Bin offers unique excursions hosted by a certified sommelier to wineries offering the perfect combination of amazing wines, warm hospitality and beautiful scenery.
Passengers sip select Napa Valley wines and indulge in gourmet cuisine as they ride past vineyards on these three-hour lunch and dinner tours aboard restored Pullman coaches. This more than year-old winery is the longest continually operating winery in Napa Valley and is the production site for the flagship Cabernet Sauvignon. Beaulieu was founded on a four-acre ranch by a French winemaker who envisioned a company producing fine wine unparalleled.
Beringer is known for its Cabernet Sauvignons and bold, oaky Chardonnays. The large facility includes a gift shop that offers tableware, stemware and kitchen and home accessories. A variety of tours and seminars are available. Daily 10 am—5 pm. Named for its first drink— Chardonnay combined with brandy—Charbay now produces much more than just wine and brandy.
Discover the artisan world of distilling many spirits like whiskey, vodka and rum from a family in the distillery business for 13 generations. Tastings open to the public. Our brand new tasting room is a truly unique and inviting space where visitors can gather for an unparalleled Napa Valley experience.
Taste exclusive, small-lot, single-vineyard wines from our premier Napa Valley estates, sample delectable food and wine pairings, and discover the art of winemaking like never before through behind-the-scenes barrel tastings in our wine cave. Today, we welcome visitors to be part of our extended family. To schedule a private tour, call 1. Since its opening in , Charles Krug winery has produced award-winning Cabernets and renowned Sauvignon Blanc.
Tasting room open daily. Featuring a unique fusion of outstanding wine-growing, environmental consciousness and international philanthropy, this is a California winery through and through. Organic and biodynamic farming techniques are used to produce a small portfolio of estate-grown wines.
Stop by the tasting room in the Westin St. Francis hotel in Union Square, open five days a week W-Su. This winery transforms the very finest Carneros and Napa Valley grapes into world-class wines sought out by the most discriminating wine lovers. Grgich, whose belongings were appropriated by the Smithsonian, gained international recognition in when judges at the Paris Tasting named his Chateau Montelena Chardonnay the best white wine in the world.
In , he partnered with Austin Hills of the Hills Bros. Tastings and tours open to the public. This winery plants twice as many vines per acre in comparison to traditional practices, resulting in smaller vines.
It boasts five estate vineyards planted with acres of classic Bordeaux varietals: Cabernet Sauvignon, Merlot and Sauvignon Blanc. The monumental new LEED-certified visitor center features wine tasting, food and wine education, tours, gardens and an impressive contemporary art collection. A winding road near Mt.
Veeder leads to this winery and art gallery. Founded in , Chateau St. Jean is inspired by the formal estate gardens in the south of France. Stroll the gardens or relax on the beautiful patio and take in the perfect vista as you sip their acclaimed reserve and single-vineyard wines.
Discover Napa in a whole new fashion. Its first vintage Cabernet was one of only six California cabs selected for the now-legendary Paris tasting.
Tastings open to the public; tours by appointment. The wines are made from acres of certified organically grown grapes. Children can float small wooden boats in a courtyard reflecting pool free of charge. Reservations recommended for tastings and tours.
Formerly owned by the Michael Mondavi Family, this acre property in the coveted Carneros region was purchased by American businessman Kieu Hoang in Located among the rolling hills of Carneros with breathtaking views of the San Pablo Bay, this second-generation, family-owned and operated winery specializes in Chardonnay and Pinot Noir.
Liana Estates also offers brunch and yoga overlooking the San Pablo Bay, gourmet picnics in the vineyards, culinary experiences and more. Celebrating 30 years in the Napa Valley, this winery is a garden oasis along Highway 29 in the famed Rutherford appellation. Known for its legendary Cabernet Sauvignon, it produces many award-winning varietals,.
Guests can make an appointment for a private wine tasting 50 feet up in the French Provincial tasting room tower. The winery joins a fabulous olive mill and features a stunning tasting room with dramatic views that complement the world-class Cabernet Sauvignons and Sauvignon Blancs. Tastings and tours by appointment. Established in by the Schlatter family as a sister property to the Bordeauxfocused Merryvale Vineyards, Starmont Winery, with its distinctive terroir, thoughtful farming and hands-on winemaking, results in serious yet approachable wines.
Tastings and self-guided tours open to the public; guided tours at 11 am. Founded in the s when white wine was a rarity in Napa Valley, this small, family-run winery high on the northeast slope of Spring Mountain continues to produce elegant and balanced. Tours and tastings by appointment. The Trinchero family has been making wine in Napa Valley since , and is best known for their Cabernet Sauvignon. Visit the Vineyard Tasting Room to learn about the rich history of California winemaking, book a class at the Winemakers Studio to blend your own bottle or make an appointment for a private group tasting in the historic wine caves.
The stylish and friendly staff knows their stuff, and the wine, made with yeasts, is solid. The winery maintains its leadership role in California winegrowing under ownership and management by the Fourth and Fifth Generations of the Wente family. Blending traditional and innovative winemaking practices, the winery draws from approximately 3, acres of sustainably farmed Estate vineyards to create an outstanding portfolio of fine wines.
Located on an idyllic estate in Rutherford, the winery is home to lush gardens, distinctive architecture, and a tasting room offering world-class hospitality and culinary experiences. The winery is open daily for tastings from 10 am-6 pm. Helena Highway, Rutherford, Get tasting room tips, restaurant recommendations and spa suggestions, plus an overview of the local arts and.
Thursdays bring the After Dark series for ages 18 and up. The popular tactile dome, in which visitors crawl through a series of chambers and mazes in total darkness, is open special evening hours most weekends, and on June 23, the entire museum is free after 5pm. The dynamic minute cellhouse audio tour, offered in 11 languages, features the voices of former Alcatraz prison guards and inmates who recount escape attempts, prison riots and solitary confinement.
The night tours include a narrated boat ride around the island. Tours sell out quickly, so be sure to make reservations in advance. You can touch leopard sharks, rays and sea stars. Daily events include animal feedings and naturalist presentations.
You can also take tours of the ballpark that allow fans to explore areas normally closed to the public. Local artists commissioned by the Works Progress Administration a New Deal agency employing millions of unskilled workers to carry out public works projects painted the murals inside in Admission to the ground-floor gift shop.
Open daily 10 am Guided mural tours 11 am Sa. The botanical wonderland in Golden Gate Park is the oldest wood and glass conservatory in North America. The striking white exterior is as eye-catching as the inside, which houses nearly 2, plant species in five galleries. A nationally protected former U. Army airfield, this strikingly scenic waterfront recreation area is now a favorite among active locals and visitors. A wide stroller and wheelchair-friendly trail between Marina Green and Fort Point is perfect for an easy walk, jog or bike ride.
Offering unparalleled views of the Golden Gate Bridge in one direction and the city in the other, the shoreline is home to sandy beaches, picnic tables, tidal marsh overlooks and a nationally renowned windsurfing site, as well as cafes, bookstores and an environmental education center. Kids play on the monster playground, dogs romp together and adults in couples and groups lounge on the grass with picnics. Rallies and organized community events are not uncommon sights. ORG for special promotions, hours and updated daily events.
Several bay charter boats depart from the piers. Old port piers and warehouses have been transformed into the workspaces, theaters, galleries, museums and event pavilions of the nonprofit Fort Mason Center. Paved, accessible trails and steep steps connect the lush lawn of Fort Mason park—boasting a view of the Golden Gate Bridge and attracting picnickers and runners—with the Fort Mason Center buildings below.
This powerful fort guarded the Golden Gate Bridge entrance for almost half a century until its original cannons were removed. Visitors can explore its brick casemates, grand arches and spiral stairs and even participate in a cannon drill. The renovated former chocolate factory site is now home to boutiques, restaurants and the original Ghirardelli Ice Cream and Chocolate Shop.
Take a slow stroll among bonsai trees and koi fish in the oldest public Japanese garden in the United States. Originally built as the Japanese Village for the California Midwinter International Exposition, the Japanese Tea Garden boasts traditional monuments, bowed bridges, native Japanese plants and trees, serene ponds and some of the best photo opps in the city.
Conclude your visit with a cup of tea or snack at the teahouse. It contains Japanese supermarkets and shops selling books, anime and gifts as well as restaurants, sushi bars, galleries and night spots. Post and Buchanan streets, Golden Gate Bridge framed by windswept cypresses. The crown jewel is the jaw-droppingly scenic and dog-friendly and partially wheelchair accessible Coastal Trail, with postcard views of the Pacific coast and.
The quarter-mile downhill stretch is lined with gorgeous gardens and barriers to ensure that drivers maintain a speed of five miles per hour. Those who simply walk to the top of the hill are reward-.
This small pedestrian lane southeast of Russian Hill is a quintessential hidden garden. It begins with a fairy-tale wooden trellis, continues with a quiet cobbled lane lined with Edwardian cottages and trees and ends with wooden stairs leading to Taylor Street with magnificent bay views.
Two blocks eastwest between Leavenworth and Taylor streets, paralleling Union and Green streets. At the Taylor Street end, a set of steps descend from the lane to Taylor Street. Sights between Fort Mason and the Presidio, surrounded by the historic mansions of the Marina neighborhood. The adjacent marina is home to the St.
The first memorial of its kind in the United States, the Grove stands as a constant reminder of how this disease devastated the San Francisco community and why the struggle against AIDS must continue today. Often windy and foggy, the notorious currents attract serious surfers who brave the frigid waters. This little stretch of homes is often also called Postcard Row.
Originally designed for the Panama Pacific International Exposition, this domed rotunda is all that remains from eight identical structures built to show the world that San Francisco had risen from the ashes after the devastating earthquake. Featuring a lagoon with swans, today this is a popular spot to stroll and take photos.
A patchwork of eucalyptus groves, freshwater creeks, wildflower-splashed sand dunes and coastal prairie covers the Presidio, a historic. Come see vibrant flora from around the globe! Exploring the 1,acre playground starts with 24 miles of trails and eight scenic overlooks with postcard-worthy views of the Golden Gate Bridge and San Francisco Bay.
Three installations by nature artist Andy Goldsworthy grace the park, inspired by acres of pine, cypress and eucalyptus trees planted there in the late s. Accessed via Washington Blvd. The building is also home to Arguello, a new Mexican restaurant from acclaimed chef Traci Des Jardins.
Inside are original pendants and wall sconces as well as a bar made from the reclaimed wood of a demolished Presidio building.
Adjacent to the restaurant is the latest sculpture from nature artist Andy Goldsworthy, which incorporates local eucalyptus trees. This internationally recognized urban oasis and self-described outdoor classroom includes 55 acres of gardens displaying more than 8, different kinds of plants, plus a library, bookstore, family activities and guided walks.
The visitors center in the nearby Argonaut Hotel Jefferson St. Join the free pirate party called Chantey Sing at 8 pm on the first Saturday of each month. The sea lions that hang out at the docks by Pier 39 have become a world-famous tourist attraction, getting millions of visitors each year.
Now sightseers have the chance to not only see and hear and smell the giant mammals, which started appearing at the pier out of the blue about 25 years ago, but also learn about the creatures at the Sea Lion Center, operated by the nearby conservation-focused Aquarium by the Bay.
Located above the dock and staffed by naturalists who give free presentations, this educational hub features a classroom and an interactive. Sights exhibit space with a sea lion skeleton, a great white shark replica and informative films. Embarcadero at Beach St.
One of the gems of Golden Gate Park, this serene, manmade lake has provided an escape from city living since Rent a rowboat, pedal boat or electric boat and gently cruise under the many bridges and visit the waterfall. This is a scenic and relaxing retreat for couples and families alike. It is the only intact private home of the period that is open regularly as a museum, complete with authentic furniture and artifacts.
This spectacular mural is a culmination of a multi-cultural, multi-generation collaboration of seven women artists. The iconic pyramid is now a source of great city pride and includes , square feet of office space. After your game, grab a bite at the upstairs restaurant serving California comfort food with organic and locally sourced igredients. The large complex next to Moscone Center has much to offer in the way of theater, restaurants, public art and formal gardens.
Facilities include an ice rink, a lane bowling alley and a historic carousel. The Yerba Buena Center for the Arts offers visual, performing and film arts, plus educational programs. The area also hosts the annual Yerba Buena Gardens Festival, offering free outdoor multicultural performances throughout the summer.
A vast array of wildlife awaits at this facility near the far edge of Ocean Beach. Sights made San Francisco a part of literary history, this museum showcases artifacts from authors such as Jack Kerouac and Lawrence Ferlinghetti. Located across the street from City Lights Books. Open 10 am-7 pm daily. Located in the historic Washington-Mason cable car depot and powerhouse in Nob Hill, the small museum houses a collection of historic cable cars, photographs and mechanical displays.
The academy is an international center for scientific education and research and the only museum in the world to house an aquarium, planetarium and natural history museum under one living roof. Relocated to a spectacular waterfront location on Pier 15 as of , this educational center offers an array of interactive scientific exhibits and hands-on displays that stimulate the senses and minds of the young and old alike. Located in the heart of the Castro, it features long-term and changing multimedia exhibitions.
Not only does it afford some of the best views of the city and the bay, but the park includes large trampoline decks with trampoline walls dodgeball, anyone? Visitors can take a tour of the stadium and visit the 49ers Museum. One of the longest-established professional baseball teams, the , and MLB World Series champions attract 3 million fans annually. Westward Expansion from the mid s through early s. Windswept ridges, protected valleys and beaches offer opportunities for hiking, biking and picnics.
Start at Marin Headlands Visitor Center and see an exhibit showcasing the history of the indigenous Miwok people.
If you brought a canine friend, check out the dog-friendly Rodeo Beach for beautiful ocean views and a perfect picnic spot. Perched on a nearby cliff, the still-active, year-old Point Bonita Lighthouse is accessible via a hiking trail. This nonprofit organization in the majestic Marin Headlands rescues and nurses back to health more than dis-. Oracle Arena, Coliseum Way, Oakland, One of the largest hospitals of its kind to combine rehabilitation with a research lab, the center welcomes visitors, who can observe the animal care and work quarters.
Exhibits and tours explore the interdependence between marine wildlife and humans. Activities include a leisurely wheelchair accessible hike alongside a salmon-filled creek. A Muir Woods shuttle runs on weekends and holidays during peak season, with pickups in Sausalito and Shoreline Highway. Open daily 8 am-sunset. The Winchester Rifle heiress spent 38 years directing the construction of her room Victorian home, a mansion full of inexplicable oddities.
Target Cartwheel, a whole new spin on coupons. Find & share the best deals in all your favorite categories: grocery, baby, apparel, health & beauty & more. A whole new spin on saving on the products you love. Target Cartwheel, a whole new spin on coupons. Find & share the best deals in all your favorite categories: grocery, baby, apparel. San Francisco National Cemetary is a well-known burial site that tells the story of generations of locals. Natural World Museum is a fun filled day for everybody and you are sure to discover some interesting things about our planet. Explore Yountville. Located in the heart of the Napa Valley, Yountville is home to some of the finest hotels, restaurants and wineries in Northern California. Picnic Fun at Provenance Vineyards. SEPTEMBER EVENTS. Explore. September Events in Yountville and the Napa Valley. HOTEL YOUNTVILLE. Explore. A Getaway at Hotel Yountville.