Destructive changes of the spine in magnetic resonance imaging

Summary Twenty-nine patients were examined by magnetic resonance imaging for various lesions of the spine. The results of these scans were compared with those of plain radiographs, computertomographs, and radionuclide bone scans. The findings were substantiated by intraoperative or histological findings in 18 cases. The MRI scans proved to be very sensitive in the detection of a wide spectrum of morphological changes of the bone marrow of vertebral bodies. Characteristic changes of the signal patterns for inflammatory and tumorous lesions were not observed. The differentiation of these lesions will presently continue to have to be based on morphological criteria.No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this study. No funds were received in support of this study     

Mechanical energy absorption in human hand-arm exposed to sinusoidal vibration

Summary A possible basis for risk assessment of human exposure to vibration when using hand-held tools may be to determine the amount of mechanical energy that is absorbed by the hand-arm system. The aim of this investigation was to study the absorption of mechanical energy in the human hand-arm system during exposure to sinusoidal vibration within the frequency range of 20 to 1500 Hz. A handle, specially designed for this type of experiments, was used during the measurements. The influence of various experimental conditions, such as three different hand-arm postures, grip force (25–75 N) and vibration levels (27–53 mm/s_rms), were studied on eight subjects. The outcome clearly shows that the energy absorption properties of the human hand-arm system are more or less dependent on all of the experimental conditions studied, but mainly to the frequency of the vibration stimuli. Furthermore, the results indicate a non-linear relationship between the energy absorbed and all other variables studies.     

MAO-A inhibition in brain after dosing with esuprone, moclobemide and placebo in healthy volunteers: in vivo studies with positron emission tomography

Objective: The aim of the study was to investigate whether or not esuprone binds substantially to MAO-A in the human brain. Methods: In a randomised double-blind placebo-controlled study 16 male healthy volunteers were examined␣with positron emission tomography (PET) with [¹¹C]harmine. Eight of the volunteers were given daily doses of 800 mg esuprone, four were given bi-daily doses of 300 mg moclobemide, and four volunteers were given placebo tablets. PET was performed before initiation of a 7-day treatment period. On day 7, one investigation was made immediately before administration of the drug, representing 23 h after the previous day's treatment for esuprone and 11 h after the last tablets of moclobemide. Further investigations were made 4 h and 8 h after the morning dose on day 7. Results: PET showed a high degree of binding of [¹¹C]harmine, a high-affinity ligand for MAO-A, before the start of treatment, and a marked and similar reduction after treatment with esuprone and moclobemide. A slight tendency for normalisation of enzyme binding was observed at the last time point. In the placebo group no change was observed. Plasma kinetics of esuprone showed a rapid elimination with a half-life of about 4 h. Conclusion: The study demonstrates that esuprone was comparable to moclobemide in its effect on MAO-A inhibition in the brain at the doses given. This is an illustration of the potential of PET to monitor drug effects directly on target biochemical systems in the brain in human volunteers, and the possibility of using these data, rather than pharmacokinetic data, for the determination of dosing intervals. Received: 21 August 1996 / Accepted in revised form: 22 November 1996     

MRI of the fingers in patients with systemic scleroderma. Early results of contrast-enhanced examinations on a dedicated MRI system

Purpose. To estimate disease activity in patients with systemic sclerosis using contrast-enhanced MRI of the skin. Material and Methods. In a pre-study, sequences of a low-field (0.2 T) scanner (Artoscan, Esaote, Genova, Italy) were optimized for detection of intravenous contrast (0.1 mmol/l Gd-DTPA) in six patients with the autoimmune disease systemic scleroderma. Based on the results of the pre-study, 17 patients with scleroderma (7 sclerotic/10 active inflammatory disease) were scanned using gradient-spoiled 3D GRE sequences (FA 90 °, TR 100 ms, TE 18 ms), which had been established as most sensitive for intravenous contrast. Contrast enhancement of the skin was determined quantitatively by contrast-to-noise ratios (CNR), comparing post- to pre-contrast and dynamic scans (for 6 min, 1 acquisition/min). Patients in the chronic state with sclerodactylia and active inflammation of the hands were considered separately and compared to a control group (n = 10) matched according to age. Results. CNR increase after intravenous contrast was significantly higher in patients with active disease (86 ± 16 % increase) than sclerosing disease (29 ± 3 %, p < 0.05) and the control group (4 ± 2 %, p < 0.05). The dynamic examination showed a significantly slower decrease after the peak rise in the first minute in patients with active disease (CNR 15.4 ± 0.7 to 14.2 ± 1.4) than in those with chronic disease (14.1 ± 0.5 to 11.3 ± 0.9, p < 0.05). Discussion. Capillary leakage is the most likely explanation for the increased enhancement in patients with active scleroderma. Using sequences optimized for contrast detection, disease activity in the course of scleroderma and response to therapy can be determined by MRI in the future.      

Ausmaß von Resektion und Lymphadenektomie beim Magenkarzinom – eine anhaltende Kontroverse

Die aktuelle Diskussion zur Behandlung des Magenkarzinoms betrifft vorwiegend das ad?quate Ausma? der Lymphadenektomie, also die extra- luminale Resektion. Die bestehende Kontroverse ist auf verschiedene Multicenterstudien zu Morbidit?t und Mortalit?t bei D1- bzw. D2- Lymphadenektomie zurückzuführen. Ziel dieser übersicht war es, die bisher vorliegenden Daten zum luminalen und extraluminalen Resektionsausma? beim Magenkarzinom zu bilanzieren und die m?glichen Schlu?folgerungen für den Stand im Jahre 1998 zu ziehen.     

Differences in the temporal dynamics of the visual ON and OFF pathways

The temporal structure of spike trains recorded from optic fibers and single units of the lateral geniculate nucleus (LGN) and primary visual cortex of the cat was studied with a novel method of inter-spike interval analysis. ON type relay cells of the LGN exhibited a multimodal interval distribution preferring a distinct interval (fundamental interval) and its multiples during the sustained light response, whereas most OFF cells showed a broad, unimodal distribution. The general pattern of the interval distribution was relatively independent of stimulus size and contrast and the degree of light adaptation. Simultaneously recorded S-potentials originating from the retinal input generally produced only a single peak at the fundamental interval length. Therefore, the multimodal interval distribution of LGN cells seems to be a result of intra-geniculate inhibition. Cortical cells also showed a weak tendency to fire with spike intervals similar to LGN cells. Therefore, the regular firing pattern observed at peripheral stages of the visual pathway can persist at higher levels and might promote the occurrence of oscillatory activity.     

A path-analytical approach to differentiate between direct and indirect drug effects on negative symptoms in schizophrenic patients

The hypothesis that differences in drug effects of risperidone and haloperidol on negative symptoms in schizophrenia are secondary to effects on positive, extrapyramidal, and depressive symptoms was investigated by means of an analysis of the data from the USA-Canada risperidone double-blind randomized clinical trial of 523 chronic schizophrenic patients. Regression analyses in the total sample and within treatment groups confirmed a strong relationship between changes in negative symptoms and the other variables studied (R²=0.50–0.51,p<0.001). Only depressive symptoms did not contribute significantly to these results (p>0.10). Path analysis showed that the greater mean change (p<0.05) of negative symptoms with risperidone compared to haloperidol could not be fully explained by correlations with favourable effects on positive and extrapyramidal symptoms. The relationship between shift in extrapyramidal symptoms and shift in negative symptoms failed to reach statistical significance; however, there was a clear tendency in the expected direction in both treatment groups.