Vergleich der nach Essen-Möller berechneten Vaterschaftswahrscheinlichkeit einschließlich „Zuordnung“ mit anthropologischen Resultaten bei Einmannfällen

Zusammenfassung Nach der Formel von Essen-Möller berechnete Vaterschaftswahrscheinlichkeiten von 909 Vätern und 909 Nichtvätern, ausgedrückt als lg Y/X, verteilen sich in einer aus 2 Normalverteilungen zusammengesetzten Kurve. Der überlagernde Anteil von 5% der Fälle wird auf eine Beimengung echter bzw. falscher Terzetten mit einem populationsfremden Mann zurückgeführt. Der Mittelwert von Nichtvätern liegt bei einem höheren lg Y/X-Wert als der von Vätern. Die Zuordnungswahrscheinlichkeiten von Vätern, ausgedrückt als lg(1–Z)/Z, sind ebenfalls normal verteilt, während Nichtväter und — in geringerem Maß — serologisch nichtausgeschlossene Männer aus Ein- und Mehrmannsachen (n=910) eine nach niederen Z-Werten hin schiefe Verteilung zeigten. Serostatistische und anthropologische Urteile gehen, wie an 331 Einmannfällen gezeigt werden konnte, weitgehend parallel. In 7 Fällen kam es zum Widerspruch zwischen der serostatistischen Vaterschaftswahrscheinlichkeit (W90%) und dem anthropologischen Ergebnis (Vaterschaft sehr unwahrscheinlich bis praktisch ausgeschlossen). Bei 5 von diesen handelte es sich jedoch im eigentlichen Sinn um Mehrmannfälle.Unter Anwendung der Grundsätze des Feststellungsparagraphen des neuen Unehelichengesetzes der BRD wären 254 von 331 bei Einmannfällen beteiligte Männer aufgrund des serostatistischen Resultats (W80%) und weitere 61 aufgrund des anthropologischen als Erzeuger zu verurteilen. In 16 Fällen müßte die Klage abgewiesen werden, weil aufgrund des anthropologischen Befundes an der Vaterschaft des beteiligten Mannes ernsthaft zu zweifeln ist.

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Evaluation of probability of paternity as determined by the essen-möller formula in a given mother-child constellation

Summary Using the formula of Essen-Möller, the probability of paternity was evaluated in 909 fathers and in 909 non-fathers. The lg Y/X of these groups yield two identical curves of gaussian distribution. 5% of the total number of cases is believed to result from an admixure of true or false trios with a man outside of the normal population. Non-fathers show a higher mean value of lg Y/X than fathers. The classification possibility of fathers, expressed as lg(1–Z)/Z shows a normal distribution curve; non-fathers, however, and to a smaller extent also serologically non-excluded individuals involved in single or multiple-men cases (n=910), show an oblique curve. Evaluation of the serological and anthropological data in 331 single-man cases indicates a significant correlation. In 7 cases there was a discrepancy between the serological evaluation of paternity (W90%) and the anthropological results (paternity very unlikely or practically excluded). Five of these were multiple-men cases, however. According to the new illegitimacy law of the German Federal Republic, 254 men out of 331 single-man paternity cases should be found guilty on the grounds of serostatistical data (W80%) and an additional 61 should be found guilty of paternity on the basis of anthropological findings. 16 cases should be dismissed on the basis of serious doubt cast by the anthropological data.

     

Comparison of FP-CIT SPECT with F-DOPA PET in patients with de novo and advanced Parkinson’s disease

Purpose Diagnosis of Parkinsons disease (PD) can be difficult. F-DOPA PET is able to quantify striatal dopa decarboxylase activity and storage capacity of F-dopamine, but is expensive and not generally available. FP-CIT binds to the dopamine transporter, and FP-CIT SPECT is cheaper and more widely available, but has a lower resolution. The aim of this study was to compare these two methods in the same patients with different stages of PD to assess their power in demonstrating deficits of the striatal dopaminergic system.Methods Thirteen patients with de novo PD and 17 patients with advanced PD underwent FP-CIT SPECT and static F-DOPA PET. After data transfer to standard stereotactic space, a template with regions of interest was used to sample values of the caudate, putamen and an occipital reference region. The outcome value was striato-occipital ratios. Patients were clinically examined in the off state (UPDRS-III and H&Y stage).Results Good correlations were found between striatal F-DOPA uptake and striatal FP-CIT uptake (r=0.78) and between putaminal F-DOPA uptake and putaminal FP-CIT uptake (r=0.84, both p<0.0001). Both striatal uptake of FP-CIT and that of F-DOPA correlated moderately with H&Y stage (=–0.52 for both techniques), UPDRS-III (=–0.38 for F-DOPA; =–0.45 for FP-CIT) and disease duration (=–0.59 for F-DOPA; =–0.49 for FP-CIT, all p<0.05).Conclusion FP-CIT values correlate well with F-DOPA values. Both methods correlate moderately with motor scores and are equally able to distinguish patients with advanced PD from patients with de novo PD.     

Ossification and pseudoepiphysis formation in the “nonepiphyseal” end of bones of the hands and feet

Metacarpals, metatarsals, and phalanges were studied to assess the developmental morphology of secondary ossification in the nonepiphyseal ends of these bones as well as the formation of the pseudoepiphysis as an epiphyseal ossification variant. Both direct ossification extension from the metaphysis into the epiphysis and pseudoepiphysis formation preceded, and continued to be more mature than, formation and expansion of the classic epiphyseal (secondary) ossification center at the opposite end of each specific bone. Direct metaphyseal to epiphyseal ossification usually started centrally and expanded hemispherically, replacing both physeal and epiphyseal cartilage simultaneously. In contrast, when remnants of physis were retained, while juxtaposed epiphyseal cartilage was replaced, a pseudoepiphysis formed. There were three basic patterns of pseudoepiphysis formation. First, a central osseous bridge extended from the metaphysis across the physis into the epiphysis and subsequently expanded to create a mushroom-like osseous structure. In the second pattern a peripheral osseous bridge formed, creating either an osseous ring or an eccentric bridge between the metaphysis and the epiphysis. In the third pattern, multiple bridging occurred. In each situation the associated remnant physis lacked typical cell columns and was incapable of significantly contributing to the postnatal longitudinal growth of the involved bone. Pseudoepiphyses were well formed by 4–5 years and coalesced with the rest of the bone months of years before skeletal maturation was attained at the opposite epiphyseal end, which ossified in the typical pattern (i.e., formation of a secondary center de novo completely within the cartilaginous epiphysis). This process may also affect the development and appearance of ossification within the longitudinal epiphyseal bracket (delta phalanx).     

“Menigeal sign”: a characteristic finding of meningiomas on contrast-enhanced MR images

Summary In meningiomas, a flat, contrast-enhancing, probably dural structure adjacent to the tumor can occasionally be observed on Gadolinium-DTPA enhanced MR images. This so called meningeal sign was evaluated with respect to the differential diagnosis of meningiomas in MR imaging. The study included 29 patients with intracranial meningiomas and 24 patients with non-meningeal brain tumors. In all meningiomas, MR studies included T2-weighted as well as unenhanced and Gadolinium-DTPA-enhanced T1-weighted images. In all nonmeningeal tumors, Gd-DTPA-enhanced MR images were available. All images were evaluated with respect to the presence of the meningeal sign. In meningiomas, a meningeal sign was seen in 15/29 cases on Gadolinium-DTPA-enhanced images. No abnormalities corresponding to the areas of contrast enhancement were found on unenhanced T2- and T1-weighted MR images. In nonmeningeal tumors only 2/24 cases showed a meningeal sign. In conclusion, with a sensitivity of 52% and a specificity of 92%, the demonstration of the meningeal sign improved the differential diagnosis of intracranial meningiomas in contrast-enhanced MR imaging.     

γ-Glutamyltransferase test as a new tool for identification of seminal stains

Summary A simple qualitative method for identification of seminal stains based on a high activity of -glutamyltransferase (-GTP) in human semen is described. It employs the release of -naphthylamine from N--glutamyl--naphthylamide by the -GTP action; -naphthylamine couples with Fast Garnet GBC salt to produce a strong brownish-red color. The data on its simplicity, specificity, and stability show that the present method is suitable for medicolegal examination of seminal stains as a preliminary test.     

Die Abhängigkeit des Faktors β von der Konzentrationshöhe

Zusammenfassung Die Begriffe des Konzentrationsabfalles \ und des Reduktionsfaktors sowie die Variationsbreiten dieser Größen werden diskutiert.Die mittlere Abbaugeschwindigkeit während langer Zeitspannen lag bei Blutalkoholkonzentrationen oberhalb 1,5 mindestens bei 0,16, wenn der errechnete Höchstwert (r = 0,7) annähernd erreicht wurde.Die statistische Auswertung von den 4118 Einzelentnahmen und den Entnahmen in zeitlichem Abstand bei 922 Personen zeigt die am häufigsten beobachtete Blutalkoholkonzentration bei 1,8und ein mittleres \₆₀ von 0,184.Der Faktor nimmt mit steigender Blutalkoholkonzentration zu. Die Unterschiede zwischen den Bereichen 0,41—1,2 und oberhalb 2,0 sind statistisch gesichert, die mittleren \₆₀-Werte von 0,17 bzw. 0,203 damit signifikant.Auszugsweise vorgetragen auf dem Kongreß für Gerichtliche und Soziale Medizim 1954 in Kiel.     

Transferrin receptor upregulation: in vitro labeling of rat mesenchymal stem cells with superparamagnetic iron oxide

PURPOSE: To prospectively evaluate the influence of superparamagnetic iron oxide (SPIO) or ultrasmall SPIO (USPIO) particles on the surface epitope pattern of adult mesenchymal stem cells (MSCs) by regulating the expression of transferrin receptor and to prospectively evaluate the influence of transfection agents (TAs) on the uptake of SPIO or USPIO particles in MSCs. MATERIALS AND METHODS: The study was approved by the institutional animal care committee of the University of Tübingen. MSCs were isolated from the bone marrow of four rats. To obtain highly homogeneous MSC populations, MSCs from one rat were single-cell cloned. One MSC clone was characterized and selected for the labeling experiments. The MSCs, which were characterized with flow cytometry and in vitro differentiation, were labeled with 200 microg/mL SPIO or USPIO or with 60 microg/mL SPIO or USPIO in combination with TAs. Aggregations of labeled cells were accommodated inside a defined volume in an agar gel matrix. Magnetic resonance (MR) imaging was performed to measure SPIO- or USPIO-induced signal voids. Quantification of cellular total iron load (TIL) (intracellular iron plus iron coating the cellular surface), determination of cellular viability, and electron microscopy were also performed. RESULTS: Labeling of MSCs with SPIO or USPIO was feasible without affecting cell viability (91.1%-94.7%) or differentiation potential. For MR imaging, SPIO plus a TA was most effective, depicting 5000 cells with an average TIL of 76.5 pg per cell. SPIO or USPIO particles in combination with TAs coated the cellular surface but were not incorporated into cells. In nontransfected cells, SPIO or USPIO was taken up. MSCs labeled with SPIO or USPIO but without a TA showed enhanced expression of transferrin receptor, in contrary to both MSCs labeled with SPIO or USPIO and a TA and control cells. CONCLUSION: SPIO or USPIO labeling without TAs has an influence on gene expression of MSCs upregulating transferrin receptor. Furthermore, SPIO labeling with a TA will coat the cellular surface.     

Physical and biological characterization of superparamagnetic iron oxide- and ultrasmall superparamagnetic iron oxide-labeled cells: a comparison

RATIONALE: Superparamagnetic iron-oxide particles are used frequently for cellular magnetic resonance imaging and in vivo cell tracking. The purpose of this study was to compare the labeling characteristics and efficiency as well as toxicity of superparamagnetic iron oxide (SPIO) and ultrasmall superparamagnetic iron oxide (USPIO) for 3 cell lines. METHODS: Using human fibroblasts, immortalized rat progenitor cells and HEP-G2-hepatoma cells, dose- and time-dependence of SPIO and USPIO uptake were evaluated. The amount of intracellular (U)SPIO was monitored over 2 weeks after incubation by T2-magnetic resonance relaxometry, ICP-mass-spectrometry, and histology. Transmission-electronmicroscopy was used to specify the intracellular localization of the endocytosed iron particles. Cell death-rate and proliferation-index were assessed as indicators of cell-toxicity. RESULT: For all cell lines, SPIO showed better uptake than USPIO, which was highest in HEP-G2 cells (110 +/- 2 pg Fe/cell). Cellular iron concentrations in progenitor cells and fibroblasts were 13 +/- 1pg Fe/cell and 7.2 +/- 0.3pg Fe/cell, respectively. For all cell lines T2-relaxation times in cell pellets were below detection threshold (<3 milliseconds) after 5 hours of incubation with SPIO (3.0 micromol Fe/mL growth medium) and continued to be near the detection for the next 6 days. For both particle types and all cell lines cellular iron oxide contents decreased after recultivation and surprisingly were found lower than in unlabeled control cells after 15 days. Viability and proliferation of (U)SPIO-labeled and unlabeled cells were not significantly different. CONCLUSIONS: The hematopoetic progenitor, mesenchymal fibroblast and epithelial HEP-G2 cell lines accumulated SPIO more efficiently than USPIO indicating SPIO to be better suited for cell labeling. However, the results indicate that there may be an induction of forced cellular iron elimination after incubation with (U)SPIO.     

Patterns of radioiodine uptake by the lactating breast

Breast uptake of radioiodine, if not suspected, may be misinterpreted as thyroid cancer metastasis to the lung. To characterize the patterns of radioiodine breast uptake, we retrospectively studied 20 radioiodine scans that were performed within 1 week of cessation of breast feeding. Four patterns of uptake were identified: full, focal, crescent and irregular. The uptake was asymmetric in 60% (left>right in 45%, right>left in 15%), symmetric in 25% and unilateral in 15% of cases. A characteristic full bilateral uptake was present in 40% of cases. In three cases with the irregular pattern, caused in part by external contamination with radioactive milk, the uptake closely mimicked lung metastases. Delayed images, obtained in one case, showed an apparent radioiodine shift from the breast to the thyroid, suggesting that the presence of breast uptake can modulate radioiodine uptake by thyroid tissue. In a case of unilateral breast uptake, a history of mastitis was obtained, which to our knowledge has not been previously reported. Breast uptake of radioiodine may take several scintigraphic patterns that are not always characteristic of the lactating breast and may affect the apparent extent of thyroid remnant/metastasis.     

Headache after lumbar iohexol myelography: the influence of a history of headaches and early ambulation

Whether a history of headache or early versus late ambulation (no bed rest or bed rest for 24 h) influence the occurrence of headache after lumbar iohexol myelography was studied by blinded interviews in 158 consecutive patients referred for elective lumbar myelography (LM) because of suspected lumbar disc prolapse or spinal stenosis. Headache after LM occurred more often in patients with a history of headache (57%) than in patients without such a history (29%),P<0.001. Patients with normal myelographic findings complained of headache after LM more often (55%) than patients with abnormal normal myelographams (31%),P<0.008. No difference in the incidence of headache after LM was demonstrated in early versus late ambulation.Died 27 July 1991     

Facet formation sign in sarcoidosis: a new sign in endoscopic ultrasonography

Endoscopic ultrasound was performed in 56 patients with histologically or clinically proven mediastinal or lung diseases. These 56 patients comprised 12 with sarcoidosis, 8 with lymphoma, 20 with lung cancer, 10 with oesophageal cancer, and 6 with other diseases. A 7.5 MHz electronic linear-arrayed ultrasonic endoscope was used. In 38 of the 56 patients lymph nodes were detected by endoscopic ultrasound. Eleven patients with sarcoidosis showed lymph nodes in a facet formation (like stones in an old stone wall), while lymph nodes in the other 27 patients were round in shape and did not form facets. The facet formation sign, evaluated by endoscopic ultrasound, may be a characteristic finding in sarcoidosis. Correspondence to: M. Mori     

Neuropsychological correlates of brain atrophy in Huntington's disease: a magnetic resonance imaging study

Summary Magnetic resonance imaging and a comprehensive cognitive evaluation were carried out in a series of 29 patients with mild to moderate Huntington's disease (HD). A factor analysis of the neuropsychological test scores provided three factors: a memory/speed-of-processing factor, a frontal factor, and a response inhibition factor. The memory/speed factor correlated significantly with measures of caudate atrophy, frontal atrophy, and atrophy of the left (but not the right) sylvian cistern. There were no significant correlations between the frontal or response inhibition factors and measures of cortical or subcortical brain atrophy. Our findings confirm that subcortical atrophy is significantly correlated with specific cognitive deficits in HD, and demonstrate that cortical atrophy also has important association with the cognitive deficits of patients with HD.     

Unusual MR manifestations of neurocysticercosis

Summary MR and CT features of neurocysticercosis are variable and depend fundametally on the stage in evolution of the infection, location, number and size of the worm. The authors retrospectively evaluated MR images obtained on a 2.0T superconducting unit in 22 neurocysticercosis patients and observed various MR features including some new findings. A variety of MR findings are presented with special reference to six case reports. The features include: (1) a large simple cyst containing both internal septations and a scolex; (2) suprasellar racemose cysts mimicking other cysts, (3) a fourth ventricular cyst readily depicted by aid of CSF flow-void in the sagittal plane; (4) degenerating cysts showing white target appearance; (5) granulomatous lesions having a black target appearance; and (6) a meningitic form showing Gd-DTPA enhancement of basal cisterns and of a subacute infarct.     

Vertragszahnärzte/Honorarverteilungsmassstab/individuelle Budgets

Abstrakt 1. Das Landesschiedsamt ist zum Erlass eines (Ersatz-)HVM befugt, wenn der angegriffene HVM die Gesamtvergütung nicht gleichmässig auf das gesamte Jahr verteilt.2. x85 Abs. 4 S. 3 SGB V fordert im Ausgangspunkt eine Vergütung (zahn-)ärztlicher Leistungen mit einheitlichem Punktwert (leistungsproportionale Vergütung).3. Solange nicht die Gefahr übermässiger Ausdehnung der vertrags(zahn)ärztlichen Tätigkeit i.S. des x85 Abs. 4 S. 5 SGB V (a.F.; heute: x85 Abs. 4 S. 6 SGB V) zu besorgen ist, ist die Vorgabe von Budgets, bei deren Überschreitung keine oder nur eine wirtschaftlich unbedeutende Restvergütung gewährt wird, nur dann mit dem Grundsatz der leistungsproportionalen Vergütung zu vereinbaren, wenn eine angemessene Korrelation zwischen dem abzudeckenden Versorgungsbedarf und der Budgetgrösse besteht.4. Ein HVM, der bei der Vergütung von Leistungen oberhalb einer zulässigen Leistungsobergrenze (Restleistungen) nicht sachgerecht die unterschiedlichen Auswirkungen auf die verschiedenen Arztuntergruppen berücksichtigt, ist wegen Verstosses gegen Art. 3 Abs. 1 GG rechtswidrig. (Nr. 1, 2, 4: Leitsätze des Bearbeiters; Nr. 2: amtlicher Leitsatz).     

Auftreffgeschwindigkeiten manueller Stichversuche

Zusammenfassung Es wurde eine Versuchsanordnung mitgeteilt, die geeignet ist, die Auftreffgeschwindigkeiten manueller Stichversuche zu messen. Von 96 erwachsenen Probanden (je 48 Männer und Frauen) wurden mit der rechten und mit der linken Hand je 5 Einzelstiche ausgeführt. Die festgestellten Geschwindigkeiten wurden statistisch ausgewertet. Dabei ergaben sich signifikante Unterschiede zwischen den Werten von Männern und Frauen sowie den Werten der Arbeitshand und der Nicht-Arbeitshand. Die männlichen Probanden erzielten ca. 45% größere Auftreffgeschwindigkeiten als die weiblichen Probanden.

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Summary An experimental test is reported, which is suitable for measuring the impact velocities in manual stabbing tests. 96 adult test persons (48 men and 48 women) carried out 5 single stabbing thrusts, with the right and left hand respectively. The measured velocities were statistically analysed. Here significant differences between the values for men and women in general, as well as the values of the work hand and the non-work hand were discovered. The male test persons achieved about 45% greater impact velocities than did the female test persons.

Für die hilfreiche Unterstützung, die Meßwerte dieser Arbeit zügig zusammenzutragen, gilt unser persönlicher Dank dem Ärztlichen Direktor der Klinischen Anstalten der RWTH Aachen, Herrn Professor Dr. med. Klages (Abteilung Psychiatrie), Herrn Oberverwaltungs-direktor Lämmersdorff sowie Herrn Professor Dr. med. Effert (Helmholtz-Institut), Herrn Professor Dr. med. Gahlen (Abteilung Dermatologie) sowie Herrn Professor Dr. med. Repkes (Abteilung Medizinische Dokumentation) und seinem Mitarbeiter, Herrn Roebruck. Weiterhin bedanken wir uns bei allen Probanden für ihren persönlichen Einsatz.     

The immunohistochemical localization of alpha1-antichymotrypsin and fibronectin and its meaning for the determination of the vitality of human skin wounds

Summary A total of 39 vital human skin wounds (20 cases with short survival times ranging from a few seconds to approximately 30 min and 19 cases with wound ages between 50 min and 13 days) were investigated. Alpha,-antichymotrypsin (A₁-ACT) was visualized by immunohistochemistry. Additionally, fibronectin was localized in 13 of these wounds (8 cases with short and 5 cases with longer survival times). Furthermore, 13 postmortem lesions (stab wounds) were removed from corpses approximately 4h after infliction and analyzed for A₁-ACT and fibronectin. The vital reaction previously described for A₁-ACT in form of a band-shaped staining pattern at the wound edges was observed in both vital wounds and in most postmortem lesions. A similar reaction was also obtained for fibronectin in wounds inflicted after death, but could be unambiguously distinguished from vital fibronectin staining by morphological criteria. Therefore, it seems questionable that the vitality of skin wounds can be determined by the immunohistochemical detection of A₁-ACT and probably other proteinase inhibitors. The meaning of the localization of fibronectin for the determination of the vitality of human skin wounds with a survival time of at least a few minutes could be confirmed.This study was supported by a grant from the Deutsche Forschungsgemeinschaft (grant No. Ei 209/3-1) and by a grant from the Friedrich-Baur-Stiftung, University of Munich, Germany     

β-Methyl-15-p-iodophenylpentadecanoic acid metabolism and kinetics in the isolated rat heart

The use of 15-p-iodophenyl--methyl-pentadecanoic acid (Me-IPPA) as an indicator of long chain fatty acid (LCFA) utilization in nuclear medicine studies was evaluated in the isolated, perfused, working rat heart. Time courses of radioctivity (residue curves) were obtained following bolus injections of both Me-IPPA and its straight chain counterpart 15-p-iodophenyl-pentadecanoic acid (IPPA). IPPA kinetics clearly indicated flow independent impairment of fatty acid oxidation caused by the carnitine palmitoyltransferase I inhibitor 2[5(4-chlorophenyl)pentyl]oxirane-2-carboxylate (POCA). In contrast, Me-IPPA kinetics were insenstive to changes in fatty acid oxidation rate and net utilization of long chain fatty acid. Analysis of radiolabeled species in coronary effluent and heart homogenates showed the methylated fatty acid to be readily incorporated into complex lipids but a poor substrate for oxidation. POCA did not significatly alter metabolism of the tracer, suggesting that the tracer is poorly metabolized beyond Me-IPPA-CoA in the oxidative pathway.     

Evaluation of 111In labelled white blood cells by in vitro functional tests and electron microscopy

We have studied the influence of granulocyte labelling with commercially available ¹¹¹In-oxine, tropolone (trop) or home made ¹¹¹In-Mercapto pyridine (Merc) prepared by the method of Thakur (1985) on the cell structure by electron microscopy and on the cell function by enzymatic tests, random migration, chemotaxis, phagocytosis and bactericidal activity. The granulocytes were labelled with 400 Ci ¹¹¹In-oxine in saline or ¹¹¹In-trop or Merc in plasma. The effect of the chelating agents with and without addition of the tracer was studied (n=4) with varying concentrations: 5–10 g/ml oxine, 10–160 g/ml trop and 1–4 g/ml Merc. Chemotaxis and random migration were not affected by ¹¹¹In-trop and clearly supressed by ¹¹¹In-oxine and Merc; the other tests were normal. The cell structure was disturbed by Merc. The labelling efficiency was excellent with oxine (90%), acceptable with trop (30%–80%) and poor with Merc (10%–25%). Without ¹¹¹In, chemotaxis and random migration were normal up to a concentration of 80 g/ml trop, 8.5 g/ml oxine and 1 g/ml Merc. With addition of ¹¹¹In, chemotaxis and random migration were unaffected up to 80 gmg/ml by trop and markedly supressed by Merc and oxine. It is concluded that labelling with ¹¹¹In-trop assures intact cells.     

Comparison of iodine-123 labelled 2β-carbomethoxy-3β-(4-iodophenyl)tropane and 2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl)nortropane for imaging of the dopamine transporter in the living human brain

Several cocaine congeners are of potential for imaging the dopamine transporter (DAT). Previous studies have shown that iodine-123 labelled 2-carbomethoxy-3-(4-iodophenyl)tropane ([¹²³I]-CIT) is a promising radiotracer for imaging the serotonin (5-HT) and dopamine (DA) transporters in the living human brain with single-photon emission tomography (SPET). [¹²³I]-CIT was found to be not very practical for 1-day DAT imaging protocols since peak DAT uptake occurs later than 8 h. Here we report a pilot comparison of [¹²³I]-CIT and 2-carbomethoxy-3-(4-iodophenyl)-N-(3-fluoropropyl)nortropane ([¹²³I]-CIT FP), using SPET imaging in four healthy male subjects. Peak uptake of [¹²³I]-CIT-FP into the basal ganglia occurred earlier (3–4 h after injection of tracer) than that of [¹²³I]-CIT (>8 h). However, the specific DAT binding of [¹²³I]-CIT-FP in the basal ganglia was somewhat less (0.813±0.047) than that of [¹²³I]-CIT (0.922±0.004). Imaging quality is excellent with both tracers and they are potentially of value for brain imaging in various neuropsychiatric disorders.     

Resolution of spinal epidural vascular pseudotumor following balloon occlusion of a postoperative vertebral arteriovenous fistula

Summary We describe a case of a vascular mass arising secondary to a postoperative vertebral arteriovenous fistula mimicking recurrent cervical neurofibroma on CT in a patient with neurofibromatosis. Angiography was required for diagnosis. The recurrent tumor resolved following balloon embolization of the fistula.