Brain perfusion spect in juvenile neuro-Beh?et's disease.

Regional cerebral blood flow was evaluated by (99m)Tc-hexamethylpropyleneamine oxime SPECT in 7 patients (age range, 7--18 y; mean age, 9.1 y) affected with Beh?et's disease and signs or symptoms of central nervous system involvement at different times of their clinical history. METHODS: Three patients suffered from seizures, 3 patients were affected with severe persistent headache that was refractory to common analgesic and nonsteroidal antiinflammatory drugs, and 1 patient had recurrent episodes of acute intracranial hypertension. Electroencephalography was performed on all patients, MRI on 5 patients, and CT on 1 patient. Brain SPECT was performed using a high-resolution, brain-dedicated camera. After conventional visual analysis by 2 expert readers, 2 transaxial sections were drawn parallel to the bicommissural line: the first across the thalami and the second across the temporal lobe at the level of the mesiotemporal structures. Cortical regions of interest were drawn automatically on the cortical ribbon on the 2 sections, whereas other regions of interest were drawn by hand around the basal ganglia, the thalami, and the mesiotemporal structures. Asymmetry analysis was then applied, and hypoperfusion was considered when the asymmetry value was >10%. RESULTS: Hypoperfusion was observed in all patients by visual and asymmetry analyses; this finding was localized mainly in the basal ganglia, the thalami, and the temporal cortex, including its mesial portion. Temporal hypoperfusion was found primarily in patients with seizures, and hypoperfusion of deep gray nuclei was found mainly in the other patients. Electroencephalography disclosed brain functional impairment in 5 of 6 patients, where- as MRI showed multiple bilateral white matter lesions in 1 patient suffering from persistent headache. CONCLUSION: As in adults, perfusion SPECT seems to be very sensitive in disclosing brain abnormalities in children and adolescents with Beh?et's disease and signs or symptoms of central nervous system involvement, even with negative findings on brain MRI.     

Ultraviolet Difference Spectral Studies in the γ-radiolysis of DNA and Model Compounds. II. Oxygen and Temperature Dependence in Adenine Radiation Chemistry

Summary

Ultraviolet difference spectra between γ-irradiated and unirradiated aqueous solutions of oxygenated adenine reveal spectral maxima at 224, 286 and 360 nm, and suggest the existence of multiple radiation products. The presence of long-wavelength absorbing products implies the extension of the conjugation of the adenine ring. The product absorbing at 360 nm appears only in the presence of oxygen, with its yield dependent on both oxygen concentration and temperature. The absorbance peak at 360 nm in the UV difference spectra appears to demonstrate simple first-order decay kinetics, with a half-life of 50 min at 3°C. At temperatures below 23°C relative yields of the radiation products are approximately constant, suggesting a common mechanism. Higher temperatures apparently induce a mechanistic alteration. Since the temperature during and subsequent to irradiation, as well as the oxygen concentration of the solution, affects the absolute yields and distribution of the radiation products, great care must be exercised in controlling these variables.     

F. Wiethold (Frankfurt a. M.): Überblick über die Entwicklung der gerichtlichen und sozialen Medizin in Frankfurt a. M.

Ohne Zusammenfassung     

Unusual, tumor-like calcinosis in scleroderma. Thibièrge-Weissenbach syndrome

In patients with progressive scleroderma, interstitial calcifications are present to a varying extent. They are mostly located in the soft tissues of the fingers, resembling points, commas or dashes. They may also appear as "calcinosis universalis" and reach a considerable size. Thus they mimic proliferative tumors. Scintigraphy, proving the existence of further calcifications can be helpful. We report the case of a female patient who presented with such a "pseudotumor" of unusual size, site and extent in the lumbar region.     

Conventional MR in rotator cuff pathology. Is it sufficient?

Background

Magnetic resonance (MR) provides detailed information for the depiction of shoulder lesions. It allows a unique anatomical and tissue characterization providing a detailed evaluation of the rotator cuff (RC) and the surrounding bones.

Childhood Guillain-Barré syndrome. MR imaging in diagnosis and follow-up

PURPOSE: To evaluate the value of serially obtained spinal MR images in the diagnosis and clinical follow-up of childhood Guillain-Barré syndrome (GBS), and the time period for resolution of contrast enhancement during the course of illness. MATERIAL AND METHODS: Contrast-enhanced spinal MR images of 11 pediatric patients with GBS were reviewed prospectively. In the first group of 6 patients, follow-up MR was performed three times after the 1st, 3rd and 6th months after onset of the disease. In the second group (the other 5 patients) who had not accepted serial MR examinations, control MR was repeated once after 1 year. Patients were graded clinically into five categories according to their initial clinical signs and symptoms and three grades (mild, moderate and severe) according to level of contrast enhancement on T1-weighted images to correlate the severity of enhancement with clinical findings and recovery. RESULTS: Ten of the 11 patients revealed contrast enhancement in varying degrees in the spinal nerve roots surrounding the conus medullaris and extending the length of the cauda equina. One patient showed no contrast enhancement. Anterior nerve roots enhanced more intensely than the posterior roots in 3 patients. Follow-up MR images in all patients revealed diminishing or resolving contrast enhancement in the nerve roots as the clinical symptoms improved. CONCLUSION: We suggest contrast-enhanced spinal MR imaging as a supplementary diagnostic modality in diagnosing GBS, especially when the clinical and electrophysiological findings are equivocal. Follow-up images may play a role in predicting the clinical course of the disease.