Die besonderen konstruktionsmerkmale des japanischen „Tan-to“-(Messers) als Kriterien für dessen Gefährlichkeit

Zusammenfassung Es wird auf die besondere Klingenform japanischer Blankwaffen und auf die Neuentwicklung eines Verwandlungs-Tan-to verwiesen. Bei letzterem läßt sich die Klinge in der Handgriffmitte um 90° drehen und arretieren, eine ideale Fixierung dieses Messers durch Faustschluß am Quergriff. Durch diese Bedingungen ist eine hohe Verletzungsgefährdung mit tödlichem Ausgang gegeben. Diese seit kurzer Zeit im Handel erhältlichen Messer sollten nach § 37 Waff G umgehend als verbotene Gegenstände definiert werden.     

“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.     

Symptomatic vertebral hemangiomas: a report of four cases

Neural compression complicating vertebral hemangioma is associated with: (1) compression fracture, (2) hematoma, (3) epidural extension of tumor, and/or (4) bony expansion or ballooning. Four cases of symptomatic vertebral hemangioma are presented. Discussion includes imaging modalities, preoperative embolization, and surgical approach.     

Enhancement of [123I]β-CIT binding in the striatum with clomipramine: Is there a serotonin-dopamine interaction?

Many reports support the concept of serotonergic-dopaminergic interaction in the brain. However, at present, there are few methods to study this relationship in vivo. The purpose of this study was to investigate the effect of serotonin (5-HT) uptake inhibitor, clomipramine, on a dopamine (DA) transporter ligand, [¹²³I]-CIT (RTI-55), in rat brain. Dose-dependent changes in [¹²³I]-CIT specific binding induced by clomipramine were studied in the striatum (rich in DA transporter) and the hypothalamus (rich in 5-HT transporter). The changes in the time-activity curves of [¹²³I]-CIT specific binding after clomipramine injection were also examined in these two regions. Using the cerebellum as the reference region,k ₃ andk ₄ values with and without clomipramine administration were estimated by a two-compartment kinetic analysis. Clomipramine inhibited [¹²³I]-CIT specific binding in the hypothalamus, but enhanced its specific binding in the striatum in a dose-dependent manner. Kinetic analysis showed thatk ₃ in the striatum was increased by 55%. In conclusion, enhancement of [¹²³I]-CIT binding in the striatum after clomipramine administration indicated the possibility of 5-HT-DA interaction.     

Hyperextension strain or “whiplash” injuries to the cervical spine

Purpose To define whiplash radiologically. Material and methods. A full cervical spine radiographic series (including flexion and extension views) was reviewed in 40 patients with clinically proven whiplash injuries and compared to the radiographs in 105 normal controls. The level and degree of kinking or kyphosis, subluxation, and the difference in the amount of fanning between spinous processes on flexion and extension films were measured in each patient.Results Localized kinking greater than 10° and over 12 mm of fanning, often occurring at the level below the kinking or kyphosis, occurred mainly in the group of whiplash patients (sensitivity 81%, specificity 76%, accuracy 80%).Conclusions Localized kinking greater than 10° and fanning greater than 12 mm are useful measurements by which to separate patients with true whiplash injuries from those with minor ligamentous tears. Flexion and extension views are essential to help define whiplash and other ligamentous injuries of the cervical spine.     

Virtopsy

Zusammenfassung Computed-tomography-Verfahren sind während der letzen 10 Jahre weiterentwickelt worden und haben verschiedene Anwendungen im rechtsmedizinischen Fachgebiet gefunden. Die neueste Entwicklung besteht in der multislice computed tomography, kombiniert mit photogrammetry-based surface optical scanning und Image-rendering-Techniken. Diese Kombination kann für die 3-dimensionale Darstellung von Verletzungsmustern zum Vergleich mit infrage kommenden Tatwaffen sowie zum Screening nach pathologischen Befunden in lebenden oder verstorbenen Personen eingesetzt werden. Es handelt sich um ein minimal-invasives Verfahren, mit dem forensisch relevante Bilder erfasst werden können, die auch im Gerichtssaal vorgeführt werden können. Die rasche Weiterentwicklung der Imaging-Technnik könnte in der Zukunft eine Alternative zur konventionellen Obduktionen darstellen.     

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.     

In vitro and in vivo characterisation of nor-β-CIT: a potential radioligand for visualisation of the serotonin transporter in the brain

Radiolabelled 2-Cabomethoxy-3-(4-iodophenyl)tropane (-CIT) has been used in clinical studies for the imaging of dopamine and serotonin transporters with single-photon emission tomography (SPET). 2-Carbomethoxy-3-(4-iodophenyl)nortropane (nor--CIT) is a des-methyl analogue of -CIT, which in vitro has tenfold higher affinity (IC₅₀=0.36 nM) to the serotonin transporter than -CIT (IC₅₀=4.2 nM). Nor--CIT may thus be a useful radioligand for imaging of the serotonin transporter. In the present study iodine-125 and carbon-11 labelled nor--CIT were prepared for in vitro autoradiographic studies on post-mortem human brain cryosections and for in vivo positron emission tomography (PET) studies in Cynomolgus monkeys. Whole hemisphere autoradiography with [¹²⁵I]nor--CIT demonstrated high binding in the striatum, the thalamus and cortical regions of the human brain. Addition of a high concentration (1 M) of citalopram inhibited binding in the thalamus and the neocortex, but not in the striatum. In PET studies with [¹¹C]nor--CIT there was rapid uptake of radioactivity in the monkey brain (6% of injected dose at 15 min) and high accumulation of radioactivity in the striatum, thalamus and neocortex. Thalamus to cerebellum and cortex to cerebellum ratios were 2.5 and 1.8 at 60 min, respectively. The ratios obtained with [¹¹C]nor--CIT were 20%–40% higher than those previously obtained with [¹¹C]-CIT. Radioactivity in the thalamus and the neocortex but not in the striatum was displaceable with citalopram (5 mg/kg). In conclusion, nor--CIT binds to the serotonin transporter in the primate brain in vitro and in vivo and has potential for PET and SPET imaging of the serotonin transporter in human brain.     

Über die Zuverlässigkeit von AB0-Befunden in gelagerten Blutproben

Zusammenfassung Bericht über das Auftreten von erworbenem A bzw. B in gelagerten Blutproben. Diese bakteriell bedingte Veränderung spielt vor allem dann eine Rolle, wenn infolge von fortgeschrittener Hämolyse eine indirekte Untersuchung mit der Absorptions-Elutions-Methode erfolgt. Bei Identitätsuntersuchungen (Alkoholblutproben) ist diese Störungsquelle zu beachten. Bei getrockneten Blutspuren haben wir Abweichungen dieser Art bisher nicht festgestellt, bei Genitalsekretspuren ist dagegen damit zu rechnen.     

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.     

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).     

Orbital “blow-in” fracture: MRI

A case of traumatic orbital encephalocele following a blow-in fracture is presented. Computed tomography (CT) and magnetic resonance imaging (MRI) findings are shown. Although CT was useful for identifying the orbital roof fracture, bone fragments and soft tissue abnormalities, MRI was more sensitive to brain herniation and an intraorbital haematoma.     

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.     

PET imaging of brain with the β-amyloid probe, [11C]6-OH-BTA-1, in a transgenic mouse model of Alzheimer’s disease

Purpose The purpose of this study was to evaluate the capacity of [¹¹C]6-OH-BTA-1 and positron emission tomography (PET) to quantify -amyloid (A) plaques in the Tg2576 mouse model of Alzheimers disease (AD).Methods PET imaging was performed with the NIH ATLAS small animal scanner in six elderly transgenic mice (Tg2576; age 22.0±1.8 months; 23.6±2.6 g) overexpressing a mutated form of human -amyloid precursor protein (APP) known to result in the production of A plaques, and in six elderly wild-type litter mates (age 21.8±1.6 months; 29.5±4.7 g). Dynamic PET scans were performed for 30 min in each mouse under 1% isoflurane inhalation anesthesia after a bolus injection of 13–46 MBq of [¹¹C]6-OH-BTA-1. PET data were reconstructed with 3D OSEM. On the coronal PET image, irregular regions of interest (ROIs) were placed on frontal cortex (FR), parietal cortex (PA), striatum (ST), thalamus (TH), pons (PO), and cerebellum (CE), guided by a mouse stereotaxic atlas. Time–activity curves (TACs) (expressed as percent injected dose per gram normalized to body weight: % ID-kg/g) were obtained for FR, PA, ST, TH, PO, and CE. ROI-to-CE radioactivity ratios were also calculated. Following PET scans, sections of mouse brain prepared from anesthetized and fixative-perfused mice were stained with thioflavin-S.Results TACs for [¹¹C]6-OH-BTA-1 in all ROIs peaked early (at 30–55 s), with radioactivity washing out quickly thereafter in both transgenic and wild-type mice. Peak uptake in all regions was significantly lower in transgenic mice than in wild-type mice. During the later part of the washout phase (12–30 min), the mean FR/CE and PA/CE ratios were higher in transgenic than in wild-type mice (1.06±0.04 vs 0.98±0.07, p=0.04; 1.06±0.09 vs 0.93±0.08 p=0.02) while ST/CE, TH/CE, and PO/CE ratios were not. Ex vivo staining revealed widespread A plaques in cortex, but not in cerebellum of transgenic mice or in any brain regions of wild-type mice.Conclusion Marked reductions in brain uptake of this radioligand in transgenic mice may be due to reduced cerebral blood flow relative to that in wild-type mice. Specific [¹¹C]6-OH-BTA-1 binding to A plaques, if any, is probably very low, as reflected in the small FR/CE and PA/CE ratio differences. FR/CE and PA/CE ratios are considerably higher in AD patients while A plaque densities in 22-month-old transgenic mice may be expected to show essentially the same density as is observed in the AD brain. This implies that the absence of tracer retention in 22-month-old transgenic mice may be due to the smaller number of A plaque binding sites and/or to lower affinity of the binding sites for [¹¹C]6-OH-BTA-1 as compared with AD patients. [¹¹C]6-OH-BTA-1 shows excellent brain uptake in mice.This work was presented at the 51st Annual Meeting of the Society of Nuclear Medicine in Philadelphia, PA, June 19–23, 2004.     

Preparation of crystalline bovine liver β-glucuronidase

Summary A method is described for the preparation of pure -glucuronidase from bovine liver. The procedure includes ammonium sulfate, acetone and ethanol fractionation and a simple two-step ion exchange chromatography. The yield is acceptable and the method requires only standard laboratory equipment. The pure enzyme is easily crystallized from ammonium sulfate. Some practical applications of the pure -glucuronidase are discussed.     

Physiologische und morphologische Untersuchungen zu Mechanismus und Verlauf der Totenstarre

Zusammenfassung Die Spannungsentwicklung bei der Ausbildung der Totenstarre beträgt 80 bis 90 p pro Gramm Muskelgewicht. Wird die Muskulatur einer menschlichen Leiche mit durchschnittlich 30 kp angenommen, so kann daraus eine Gesamtspannung von mehreren Tonnen resultieren.Die Rigorentwicklung in Tyrodelösung verläuft zweigipflig. Der erste Spannungsanstieg von ca. 10% der Gesamtfläche ist offenbar auf den Calciumeinstrom aus dem Membranbereich zurückzuführen, während der zweite Kontrakturanstieg wahrscheinlich durch den Einstrom von Calciumionen aus den Vesikeln des endoplasmatischen Reticulums infolge Energiemangels der Calciumpumpe hervorgerufen wird. Durch Membranpotentialsmessungen, Ionenbestimmungen, Mechanogrammregistrierungen und elektronenmikroskopische Untersuchungen im Zusammenhang mit bisher noch nicht veröffentlichten Untersuchungsergebnissen wurde versucht, eine Calcium-Ankopplungs-Theorie der Totenstarre zu erörtern, die zwar der energetischen Grundkonzeption der ATP-Theorie entspricht, mit der aber im Gegensatz dazu der detalliertere Mechanismus des Rigorprozesses näher beschrieben werden könnte.Der Verlauf des Rigor mortis wurde in drei Phasen eingeteilt: 1. experimentell reversible postmortale Muskelkontraktur, 2. irreversible postmortale Muskelstarre und 3. Lösung der Totenstarre infolge Entkopplung der Myofilamente, Fibrillenrupturen und Strukturauflösung.

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Summary The shortening of isolated rat muscle in development of rigor mortis was 80–90 p/g muscle. If the muscle weight of men is about 30 kp, a total shortening of several 1000 kp post mortem can result.In Tyrode-solution the shortening of muscles shows two maxima during rigor mortis, which causal mechanism is discussed. The first maximum was 10% of the second and based probably on the Ca-influx out of the membrane. In the following hours the reserve of energy diminishes, and Ca-ions out of the vesicle of the endoplasmic reticulum diffuses into the intra-cellular fluid and the second interaction of myofilaments occurs. Other methods of investigation consisted of the measurements of membrane potentials and ions, electronmicroscopy and some unpublished experiments. The results suggest that a Ca-theory of rigor mortis, based on the ATP-theory, in our opinion seems to be a good hypothesis for further studies with the possibility to describe the mechanism of rigor mortis more distinctly.The development of rigor mortis can be divided in three phases: 1. experimentally reversible contracture of muscle, 2. non reversible postmortem rigor and 3. loosening of rigor through dissociation of the myofilaments, rupture of the fibrills and lysis of structure.

Herrn Prof. Dr. B. Mueller zum 75. Geburtstag gewidmet.     

Thyroid abnormality secondary to tortous carotid artery

A 59-year-old man was referred to the nuclear medicine service for a thyroid scan, as his neck was thick and the thyroid was not palpable. In the past the patient had undergone head and neck irradiation for acne. A¹²³I-thyroid scan was interpreted as a cold nodule in the lower pole of the right lobe, but thyroid ultrasound showed no thyroid abnormality. Repeat ultrasound examination eventually showed a tortuous carotid artery behind the lower pole of the right lobe of the thyroid that corresponded to the cold defect.     

Characterization of IMPY as a potential imaging agent for β-amyloid plaques in double transgenic PSAPP mice

Deposition of -amyloid (A) plaques in the brain is likely linked to the pathogenesis of Alzheimers disease (AD). Developing specific A aggregate-binding ligands as in vivo imaging agents may be useful for diagnosis and monitoring the progression of AD. We have prepared a thioflavin derivative, 6-iodo-2-(4-dimethylamino-)phenyl-imidazo[1,2-a]pyridine, IMPY, which is readily radiolabeled with ¹²⁵I/¹²³I for binding or single-photon emission computerized tomography (SPECT) imaging studies. Characterization of [¹²⁵I]IMPY binding to plaque-like structures was evaluated in double transgenic PSAPP mice. [¹²⁵I]IMPY labeled A plaques in transgenic mouse brain sections, and the labeling was consistent with fluorescent staining and A-specific antibody labeling. Significant amounts of A plaques present in the cortical, hippocampal, and entorhinal regions of the transgenic mouse brain were clearly detected with [¹²⁵I]IMPY via ex vivo autoradiography. In contrast, [¹²⁵I]IMPY showed little labeling in the age-matched control mouse brain. Tissue homogenate binding further corroborated the A plaque-specific distribution in various brain regions of transgenic mouse, and correlated well with the known density of A deposition. Using a tissue dissection technique, [¹²⁵I]IMPY showed a moderate increase in the cortical region of transgenic mice as compared to the age-matched controls. In vitro blocking of [¹²⁵I]IMPY by carrier observed via autoradiography in mouse brain sections was not replicated by an in vivo blocking experiment in living TT mouse brain. The failure was most likely due to a significant carrier effect, which slows down the tracer in vivo metabolism, leading to an increased brain uptake. Taken together, these data indicate that [¹²³I]IMPY is a potentially useful SPECT imaging agent for in vivo labeling of A plaques in the living brain.     

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.     

Retro-odontoid “ghost” pseudotumours in atlanto-axial instability caused by rheumatoid arthritis

Among 27 cases of marked atlanto-axial instability investigated in the last 10 years we found three with reducible dislocation, in which a cystic ghost pseudotumours appeared behind the odontoid, maintaining cord compression even in the reduced position, thus influencing the strategy of operative treatment.