Ankle: surface coil MR imaging at 1.5 T

High-field surface coil magnetic resonance (MR) images were obtained of 12 ankles: two from healthy volunteers, seven from patients, and three from fresh cadavers. The cadaver ankles were sectioned in the coronal, sagittal, and axial planes for direct comparison with the MR images. Plain film confirmation of pathologic conditions was obtained in all patients, and five underwent arthroscopy or surgery, or both. MR imaging provided excellent delineation of ligaments and cartilaginous structures in all cases.     

When Academicians Collaborate With Community Agencies in Effectiveness Research

The conflicts and challenges that confront academic researchers who seek to collaborate with community agencies have many sources. First among these is academe, itself, which is not geared to accommodate faculty who are community collaborators; academic institutions are likely to undervalue the contribution such collaborators make to science and society. The community agencies that collaborate with academic scientists are dynamic, complex, and changing organizations that require much time and commitment from the academic researcher for which there is remuneration in terms of salary or released time from academic responsibilities only if the investigator is able to secure funding. The grant writing and funding process, per se, is also poorly attuned to the conditions under which the academic researcher works with an agency. In contrast, however, collaboration with community agencies typically means that the academician and the agency work hand in hand to assess problems and evaluate solutions, learning from one another over time. Productive collaboration requires long-term commitment by the academic researcher despite all the conditions that make this difficult.     

Prenatal findings in patients with prolonged QT interval in the neonatal period.

OBJECTIVE: To describe prenatal abnormalities of cardiac rhythm in patients with prolonged QT interval in the neonatal period. DESIGN: A retrospective analysis of the results of fetal echocardiography and the outcome in patients with prolonged QT interval in the neonatal period who had been referred for prenatal evaluation. SETTING: Two university hospitals. PATIENTS: Nine patients with prolonged QT interval in the neonatal period who had been referred for prenatal evaluation. Fetal echocardiograms were obtained from 24 to 40 weeks of gestation. Indications were fetal bradycardia (five patients), a family history of long QT syndrome (two patients), and complex arrhythmias (two patients). RESULTS: Seven fetuses had persistent sinus bradycardia without ventricular arrhythmias (heart rates 70-120 beats/ min). Five patients were treated with propranolol, after the diagnosis had been established by postnatal electrocardiogram (ECG). One of these patients died suddenly at the age of 3 weeks, after the treatment had been stopped because of profound bradycardia. One of the remaining two patients who did not receive propranolol had a syncope at the age of 6 weeks. Two fetuses presented with frequent runs of ventricular tachycardia and intermittent bradycardia caused by intermittent, functional second degree atrioventricular block. Both patients died on the first day of life despite treatment with propranolol and transvenous temporary pacing. CONCLUSIONS: Sinus bradycardia in an otherwise normal fetus may be a symptom of long QT syndrome. Postnatal ECGs and a family examination are strongly recommended in these children. In fetuses with frequent runs of ventricular tachycardia and intermittent second degree atrioventricular block long QT syndrome should be suspected prenatally. These high risk patients should be delivered in centres with a paediatric cardiology unit.     

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Mitteilungen des BV Geriatrie

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Frontotemporal dementia in metachromatic leukodystrophy

The case of a 39-year old woman with metachromatic leukodystrophy (MLD) is presented. In the clinical examination she revealed symptoms of a frontotemporal dementia without any signs of polyneuropathy. If frontotemporal dementia is diagnosed MLD should be excluded.