Randomised double blind controlled trial of cyclosporin in multiple sclerosis.

In a 2 year double blind controlled trial of cyclosporin against placebo in multiple sclerosis conducted at two centres there was a beneficial effect of the therapy upon the progression of the disease, relapse rate and relapse severity at one of the centres where the patients received a mean dose of 7.2 mg/kg/day. This beneficial effect was not seen in the other centre where a lower dose (mean 5 mg/kg/day) was given. Reduction in clinical progression was accompanied by decreased IgG synthesis in the central nervous system. Side effects included hypertension, renal insufficiency and anaemia and were of such severity to preclude the use of cyclosporin in a high enough dose to alter the course of the disease.     

Radiculomeningeal vascular malformations of the spine: MR imaging

Three patients (two men, one woman; 63-81 years old) with radiculomeningeal vascular malformations of the spine were examined using high-resolution surface coil magnetic resonance (MR) imaging at 1.5 T. The findings included previously described high-velocity signal loss within the vessels of the malformation as well as previously unreported signal-intensity changes within the cord (long T1/long T2) distal to the malformation. The MR images correlate well with previous reports of location and pathophysiology of these dural lesions.     

Three-dimensional (volume) gradient-echo imaging of the carotid bifurcation: preliminary clinical experience

This study was designed to test the accuracy of magnetic resonance (MR) imaging with a FLASH (fast low-angle shot) 40 degrees volume pulse sequence by comparing it with intraarterial digital subtraction angiography (DSA) in patients with suspected carotid artery stenoses. Fifteen patients referred for evaluation of anterior circulation in cerebrovascular disease composed the pilot group. Twelve patients underwent correlative intraarterial DSA examinations. The FLASH volume sequence, with an echo time of 7.7 seconds, produced high-signal-intensity vascular images for 28 of 30 bifurcations. Of the 24 carotid bifurcations studied with DSA, 22 were depicted with MR angiography. Among the depicted bifurcations, 21 showed good correlation with the DSA images. These included four of four normal bifurcations, three of three with mild stenosis, four of four with moderate stenosis, eight of nine with severe stenosis, and two of two with occlusions. With respect to ulceration, three of four MR angiographic studies showed good correlation with DSA images. This preliminary experience indicates that the method is reproducible and capable of delineating carotid lesions in patients and that it can be performed in conjunction with conventional spin-echo imaging of the brain with only a small increase in patient examination time.     

Aluminum toxicity in patients undergoing dialysis: radiographic findings and prediction of bone biopsy results

Aluminum toxicity in patients undergoing dialysis currently requires bone biopsy for definitive diagnosis. The authors retrospectively reviewed clinical, histologic, and radiographic findings in 63 patients undergoing dialysis. In 30 patients, biopsy specimens were negative for aluminum toxicity, and in 33 patients, specimens were positive. In 21 of the 30 patients who had a negative biopsy specimen, absence of aluminum toxicity could be predicted by a high immunoreactive parathyroid hormone level (greater than 2,000 microliter Eq/ml [2,210 pM]) and fewer than three fractures, by the presence of osteosclerosis on radiographs, or if serum aluminum levels were less than 30 ng/ml. None of the patients who had a positive biopsy specimen met these criteria. In 18 of 33 patients who had a positive biopsy specimen, aluminum toxicity could be predicted by a low immunoreactive parathyroid hormone level (less than 500 microliter Eq/ml [553 pM]) and more than three fractures, or if serum aluminum levels were greater than 300 ng/ml. None of the patients who had a negative biopsy specimen met these criteria. Thus, based on the criteria identified, the aluminum status of 62% of these patients would have been correctly diagnosed.     

Rotator cuff tears: diagnostic performance of MR imaging

To determine the diagnostic performance of magnetic resonance (MR) imaging in the evaluation of suspected rotator cuff tears, eight asymptomatic volunteers and 32 patients with rotator cuff tendonopathy who underwent surgery were examined with MR imaging. Twenty-four of these patients also underwent contrast arthrography. The ability of MR imaging to depict the size of cuff tears and the quality of torn tendon edges was also evaluated. The MR imaging and arthrographic studies were reviewed without knowledge of surgical results or of the other studies. A scoring system was developed and a score assigned to each patient's MR study. The sensitivity of MR imaging for all tears (partial and full thickness) was 0.91, and the specificity was 0.88; whereas the sensitivity and specificity of arthrography were each 0.71. The scoring system improved the sensitivity to 1.0 and the specificity to 0.92. Linear regression analysis showed excellent correlation between preoperative assessment of the size of rotator cuff tears and measurement at surgery (r = .95).     

麻黄中麻黄生物碱的气相色谱测定法

本文应用毛细管气相色谱法,配备氮磷检测器对麻黄中六种生物碱:麻黄碱、伪麻黄碱、去甲麻黄碱、去甲伪麻黄碱、甲基麻黄碱和甲基伪麻黄碱进行分离、测定。对生药样品预处理方法作了较大改进,采用直接碱化醚提法。简化操作步骤。用内标法,线性方程定最测定了国产十二种麻黄,结果与高效液相色谱法基本一致。