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.     

Location of the “zero zone” and its role in the pathogenesis of cervical spondylosis

Summary Significant correlation between the location of the zero zone and spondylosis was found in the cervical spine. The possible role of the zero zone in the development of spondylosis is suggested and the deleterious effect of counteracting forces as compared with a unidirectional traction is stressed.

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Die Stelle der Nullzone und ihre Rolle in der Pathogenese der zervikalen Spondylose

Zusammenfassung Die Ergebnisse der dynamischen Studien scheinen darauf hinzuweisen, daß ein Zusammenhang zwischen den häufigsten Stellen der Nullzone und der Spondylose besteht. Es scheint, daß das Bindegewebssystem der Halswirbelsäule auf die Überlastung durch entgegengesetzte Zugkomponenten sehr empfindlich ist und durch diese stärker beschädigt wird als durch eine Traktion, die nur in einer Richtung ausgeübt wird.

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Localisation de la zone zero et son rôle dans la pathogenie de la spondylose cervicale

Résumé Il semble y avoir une corrélation entre la zone zéro et le développement d'une spondylose cervicale et que la détérioration discale se fasse spécialement au niveau des mouvements intervertébraux bidirectionnels opposés.

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From the annual congress of the European Society of Neuroradiology (Geilo, September 1975)     

Serial MRI of olivary hypertrophy: Long-term follow-up of a patient with the “top of the basilar” syndrome

We describe a patient with the top of the basilar syndrome, in whom MRI documented the appearance and regression of olivary hypertrophy.     

Morphological detection of X- and Y-chromosomes in smears and paraffin-embedded tissues using a non-isotopic in situ hybridization technique (NISH)

Pharyngeal smears and paraffin-embedded tissue specimens (skeletal muscle, kidney) obtained from 10 male and 10 female individuals were evaluated using non-isotopic in situ hybridization (NISH) with commercial X- and Y-specific biotinylated probes which recognize the pericentromeric regions DXZ1 and DYZ1/DYZ3 of the X- and Y-chromosome, respectively. The results provide evidence that the morphological sex determination of a single cell can be performed by critical application of this staining method leading to one nuclear signal in male cells using the Y-specific probe whereas female cells are negative. In situ hybridization of female tissues with an X-specific probe results regularly in 2 signals whereas male cells show only one spot in the nucleus.     

Analysis of “Ecstasy” by capillary electrophoresis

Capillary electrophoresis (CE) and it's applications in forensic toxicology are demonstrated by the investigation of amphetamine derivatives in Ecstasy tablets. The method is based on capillary zone electrophoresis (CZE) with a phosphate running buffer (pH 2.2). The drugs were dissolved in 0.01 N hydrochloric acid, diluted with distilled water and phenylephrine was added to the samples as an internal standard. A separation of the charged substances is obtained by the different velocities in the electric field. The qualitative determination can be made by the migration times or more accurately by the relative migration times. Other possibilities for identification are the UV-spectra using a diode array detector or the on-column standard addition procedure. By this procedure the sample solution is initially injected followed by the standard solution. Both are concentrated in the column before separation begins. CE shows clear advantages in comparison to high-performance liquid (HPLC) or gas chromatography (GC). The quantitative analysis was carried out using the internal standard phenylephrine.The values obtained for 56 Ecstasy tablets and powder containing amphetamine or its derivatives were compared in this study after analysis with CE and HPLC. The results were in very good agreement. Because of it's speed, the high resolving power and the possibility of identification with the on-column standard addition, CE is a powerful alternative to HPLC or GC for the investigation of Ecstasy tablets.     

Zum „Utilitäts“-Prinzip im Rahmen der gerichtlichen Feststellung von Blutsverwandtschaft mittels Serostatistik

Zusammenfassung Die realistische A-priori-Wahrscheinlichkeit bei serologischer Abstammungsbegutachtung — welche stets ein Akten-a-priori bedeutet — stellt eine Teilinformation im gesamten, dem Richter zur Verfügung stehenden Beweiskonvolut dar und nimmt keine eigentliche Sonderstellung ein. — Eine neutrale A-priori-Wahrscheinlichkeit kann es der Sache nach nicht geben. Entweder ist eine solche mit Nichtwissen gleichzusetzen, dann entfällt sie als Information, oder sie steht mit dem Utilitäts-Prinzip in Zusammenhang und stellt damit keine Wahrscheinlichkeit dar. — Das Utilitäts-Prinzip ist rechtspolitisch definiert; es kann zahlenmäßig nicht ausgedrückt werden. — Das Utilitäts-Prinzip wird nur wirksam, wenn der Richter (unter Benutzung aller ihm zur verfügung stehenden Beweise) eine Entscheidung fällt. Es bestimmt dabei die Gewichtung der im Prozeß zur Debatte stehenden Rechtsgüter der Beteiligten. — Der Gutachter hat eine neutrale Utilitäts-Komponente anzuwenden, d.h. er gibt in Zweihypothesenfällen (welche die Regel sind) der Null- wie der Gegenhypothese dasselbe Bedeutungsgewicht. Null- und Gegenhypothese können dabei aus mehreren Einzelhypothesen zusammengefaßt sein; deren Häufigkeiten werden gemittelt. — Die Mitführung eines Akten-a-priori bei der Berechnung eines W-Werts sollte in aller Regel unterbleiben. — Eine Irrtumserwartung soll einen möglichst realistischen Charakter haben; sie sollte daher unter Mitwirkung eines Akten-a-priori zustandekommen.     

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.     

Sodium bicarbonate-augmented stress thallium myocardial scintigraphy

It is well known that sodium bicarbonate in pharmacological doses induces transient alkalosis, causing intracellular transport of serum potassium. The aims of this study were (a) to investigate whether, in humans, myocardial thallium-201 uptake can be augmented by pretreatment with a single bolus of sodium bicarbonate at a pharmacological dose, (b) to verify general safety aspects of the intervention and (c) to evaluate the clinical implications of augmentation of ²⁰¹Tl uptake, if any. Routine exercise myocardial scintigraphy was performed twice in eight adult volunteers (five normal and three abnormal), once without intervention and the second time (within a week) following intravenous administration of sodium bicarbonate (88 mEq in 50 ml) as a slow bolus 1 h prior to the injection of ²⁰¹Tl. Conventional myocardial thallium study was compared with sodium bicarbonate interventional myocardial scintigraphy with respect to myocardial uptake (counts per minute per mCi injected dose), washout patterns in normal and abnormal myocardial segments, and overall clinical interpretation based on planar and single-photon emission tomographic (SPET) images. All patients remained asymptomatic after the intervention. A mean increase of 53% in myocardial uptake of thallium was noted in post-exercise acquisitions after the intervention, confirming uptake of the tracer via the potassium-hydrogen pump and its augmentation by transient alkalosis. The washout pattern remained unchanged. The visual quality of planar and SPET images improved significantly after the intervention. Out of the five abnormal myocardial segments identified in three cases, four showed significant filling-in after the intervention, causing the diagnosis to be upgraded from partial scar to ischaemia, or from ischaemia to normal. The overall scan impression changed in two out of three such cases. Sodium bicarbonate augmentation may have significant implications for stress-thallium scintigraphy and may be a new parameter for defining myocardial viability.     

Magnetic resonance imaging and histopathology of cerebral gliomas

Summary The correlation of magnetic resonance imaging (MRI) with histopathological findings was analysed in 26 patients with untreated cerebral gliomas. In low-grade gliomas, T2-weighted images demonstrated relatively homogeneous high-intensity lesions involving both the grey and the white matter. In high-grade gliomas, especially grade IV, T2-weighted images demonstrated prominent heterogeneity in signal intensity, which consisted of a hyperintense core, less hyperintense or normal intensity rim and surrounding finger-like areas of high intensity. Marked and irregular contrast enhancement was evident in all but one case of these high-grade gliomas in which gadolinium-DTPA was used. Histological examination revealed tumour cells extending as far as the borders of the high-intensity areas shown on T2-weighted images in both high-and low-grade gliomas, but in 5 of 8 low-grade and 4 of 18 high-grade gliomas, isolated tumour cells extended beyond the hyperintense areas shown on T2-weighted images.     

Acute injuries of the axis vertebra

A retrospective analysis of 165 patients admitted to Hermann Hospital with acute injuries of the axis vertebra revealed 68 (41%) dens fractures, 62 (38%) cases of traumatic spondylolisthesis (hangman's fracture), 21 (13%) extension teardrop fractures, 10 (6%) hyperextension dislocations, and 2 (1.0%) fractures each of the laminae and spinous processes. Of the 68 dens fractures, none (0%) were of the Anderson and D'Alonzo Type I; 21 (31%) were Type II (high); and 47 (69%) were Type III (low). The 62 traumatic spondylolistheses included 13 (21%) Effendi type I, 35 (56%) type II and 3 (5%) type III. This review disclosed an additional 11 (18%) patients with an atypical variety of traumatic spondylolisthesis, not previously reported, in which one or both fractures involved the posterior cortex of the axis body. Of the axis injuries 31 (18%) were limited to the axis body alone. Of these, 21 (61%) were hyperextension teardrop fractures and 10 (32%) were hyperextension dislocations. Axis injuries were associated with acute injuries of other cervical vertebrae in 14 (8%) of the patients.This work was supported, in part, by a grant from the John S. Dunn Foundation     

Didactic review of 175 radionuclide-guided excisions of osteoid osteomas

The complete removal of a lesion which resembles, or is covered by adjacent tissue may be difficult. Therefore, the capacity of certain lesions to specifically concentrate a radiopharmaceutical has been used to orient progress during surgery. Usually, the measurements of radioactivity in the operative field are carried out by means of small, handy radiation-detecting probes which can be sterilized. Intra-operative nuclear medicine or radionuclide-guided surgery has steadily gained in importance. However, this technique is not being taught. Our study, based on radionuclide-guided surgery of 175 orthopaedic patients suspected of having osteoid osteoma, is well suited to teach the particularities of intra-operative radiation detection, as well as the collaboration between the nuclear physician and the surgeon in the operating theatre.Part of this work was carried out when M.W. and A. S.-A. were at the Saint-Antoine (Paris) and Henri Mondor (Créteil) hospitals respectively.     

Population genetic and family data for the human minisatellite locus D16S309 (MS205) in Germans

The distribution of restriction fragments at the DNA minisatellite locus D16S309 was estimated by investigating blood samples from 2617 unrelated West German Caucasians and 1269 offspring. Furthermore segregation of fragments was studied in a large family and in trios. Altogether 2296 meioses were studied, revealing 7 paternal and 3 maternal mutations. Inspection of phenotypes did not reveal any remarkable deviation from Hardy-Weinberg equilibrium.     

Problems with the “dural tail” sign

Prominent enhancement of the dura mater, the dural tail adjacent to a peripherally located mass on gadolinium-enhanced MRI has been described as being characteristic of meningiomas. We present a cerebral glioma showing the classical dural tail.     

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.     

“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.     

Anflutung und Verteilung von Alkohol bei oraler Resorption

Zusammenfassung Die geringere Alkohol-Konzentrationstoleranz während der Anflutungsphase kann auf eine stärkere Alkoholanflutung im Gehirn zurückgeführt werden. Die Ursache liegt in der gegenüber dem peripheren Venenblut überhöhten Alkoholkonzentration im arteriellen Blut und einem schnellen Konzentrationsausgleich zwischen arteriellem Blut und Hirngewebe. Die arterio-venöse Alkohol-Konzentrationsdifferenz nach Gabe von 0,8 g Alkohol (33 W/W% Lösung, 15 min Trinkzeit) wurde bei 5 Patienten einer Intensivstation bestimmt. Sie betrug maximal 0,27±0,20. Als maximale Alkoholkonzentration wurden im arteriellen Blut 0,94, im venösen 0,81 erreicht. Die Eliminationsrate ( 60) war mit 0,30±0,05 sehr hoch. Vergleichsweise wurde die Eliminationsrate ( 60-Wert) bei 5 Patienten während einer Halothan-Narkose bestimmt. Sie betrug 0,15±0,02 und lag damit im Normbereich. Auch Tierversuche an Ratten ergaben keine sicher verminderte Alkohol-Eliminationsrate unter Halothan. Eine mögliche geringe Verminderung des Äthanolabbaus durch kompetitive Hemmung der ADH-Aktivität durch das Halothan-Abbauprodukt Trifluoräthanol erscheint bei der Rückrechnung durch Anwendung eines 60-Wertes von 0,10 hinreichend berücksichtigt.Vortrag: 50. Jahrestagung der Deutschen Gesellschaft für Rechtsmedizin, Köln, 3.–7. 10. 1971.     

PET and MR imaging in a neuro-behçet syndrome

Positron emission tomography (PET) and magnetic resonance imaging (MRI) studies were performed on a case of neuro-Behçet's syndrome. In accordance with the clinical signs, FDG PET (using¹⁸F-labeled 2-F-2-desoxyglucose) revealed disseminated storage defects in the cerebrum and cerebellum. Focal regions of enhanced signal intensity were demonstrated in the parietal white matter of the cerebrum in T2-weighted images and in the brain stem by MRI.This article was presented at the 1st EEC workshop on accuracy determination in PET, January 19–20th. 1989 Pisa, Italy (COMAC-BME Concerted Project Characterization and Standardization of PET Instrumentation)     

PET tomography in studies of distributions of 7.6-min potassium 38 in the dog heart

Potassium 38 emits a 2.68-MeV (max) positron, followed promptly by a 2.17-MeV -ray in 99.8% of its disintegrations. A positron is emitted also, followed by a 3.94-MeV -ray, in 0.2% of the decays. The pairs of 511-keV PET^±-quanta, which are emitted at 180±0.3° to each other, are in true coincidence with the prompt -rays emitted by the daughter nucleus, within the resolving time of PET instrumentation. Studies made with phantoms by means of a commercial version of the MGH PET camera demonstrated that quantitatively satisfactory images are derived, despite the presence of the prompt -rays. Two-dimensional (2-D) focal-plane images reveal high uptake of³⁸K promptly in the myocardium of dogs, under barbiturate sedation. Third-dimensional (3-D) transverse section PET tomographic images, through four 1.0-cm-thick heart slices orthogonal to the plane of the 2-D images and with 1.4-cm sequential spacing, show³⁸K uptake to be concentrated especially highly in the left ventricle, as expected. Peak levels of activity were observed over the myocardium at 12 s after intravenous bolus injection of ionic³⁸K. Dynamic mode 2-D images were taken at intervals as short as 0.5 s and extending to 1 h.     

Zur Entstehung fluoreszierender Verbindungen in formalinfixierten Organen

Zusammenfassung In formalinfixierten Organen bilden sich fluoreszierende Verbindungen. Wir konnten nachweisen, daß es sich bei diesen Verbindungen um 3,4 Dihydroisochinoline bzw. 3,4 Dihydro--carboline handelt, die durch eine Reaktion des Formaldehyds mit biogenen Aminen des Typs -Phenyläthylamin bzw. -(3 Indolyl)äthylamin entstehen.

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On formation of fluorescent compounds in formaldehyde treated tissues

Summary In formaldehyde treated tissues, fluorescent compounds are formed. We could demonstrate, that these compounds result from a reaction of biogenic amines such as -phenylethylamines or -(3 indolyl) ethylamines with formaldehyde to yield the fluorescent 3,4 dihydroisoquinolines or 3,4 dihydro--carbolines.

Auszugsweise vorgetragen auf der 54. Jahrestagung der Deutschen Gesellschaft für Rechtsmedizin in Frankfurt, September 1975     

Problematische Rhesusausschlüsse

Zusammenfassung In einer Vaterschaftssache wurde nach Aufdeckung einer scheinbar unmöglichen Mutter-Kind-Verbindung im Rh-System eine komplette Familienuntersuchung durchgeführt. Aufgrund der Rh-Befunde der Familienmitglieder konnte eine sogenannte Rh-Chromosomendeletion der drei Genorte für C, D und E nachgewiesen werden. Ohne Kenntnis dieses besonderen Sachverhaltes wären sechs von insgesamt zehn Familienmitgliedern aus dem Familien verband zu Unrecht auszuschließen gewesen. In diesem Zusammenhang werden verschiedene Probleme mit besonderer Berücksichtigung des gerichtlichen Beweiswertes von Rh-Ausschlüssen diskutiert.

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Problematic paternity exclusion in the Rh-system

Summary A legal paternity case is presented with an apparent mother-child exclusion in the Rh blood group system. Testing the whole family the existence of a so-called chromosome deletion concerning the C, D, and E gen loci could be proven. Without recognition of this peculiarity six members out of ten would habe been falsely excluded. In this connection several problems with special reference to the proof are stressed.