Intracranial circulation: pulse-sequence considerations in three- dimensional (volume) MR angiography

The technique and feasibility of magnetic resonance (MR) angiography of intracranial vessels were studied in 35 healthy volunteers. Variations in image orientation, repetition time (TR), and flip angle were evaluated to determine their effects on flow-related enhancement. Gradient modifications--including echo time (TE), motion compensation, bandwidth, and field of view--were also studied in an effort to reduce motion-induced phase shifts. Results indicated that a FISP (fast imaging with steady precession) sequence with a TR of 50 msec, TE of 15 msec, velocity compensation in the read and section-select directions, acceleration compensation in the read direction, anisotropic volume, and a 1.25-mm partition thickness produced three-dimensional angiographic MR images that were accurate and reproducible in the depiction of the major intracranial vessels. Difficulties with field of view, persistent signal void secondary to higher-order motion, and spatial resolution remain major problems requiring additional study.     

Use of the modified relative dose response (MRDR) assay in rats and its application to humans for the measurement of vitamin A status

After an appropriate dose of 3,4-didehydroretinol (vitamin A2, DR) is given orally in corn oil to retinol (R)-depleted rats, the ratio of plasma DR/R values at 3.5 h is inversely related to the liver concentration of vitamin A (Tanumihardjo & Olson, 1988). In the present study, a similar procedure, termed the modified relative dose response (MRDR) assay, was employed with rats containing a much broader range of liver reserves; ie, less than 2 to 107 nmol of vitamin A per g wet weight of liver (less than 1 to 30 micrograms/g). The DR/R ratio for 15 of 16 rats with liver reserves less than 17 nmol/g (less than 5 micrograms/g) was greater than 0.15, whereas the ratio was less than 0.15 for 7 of 8 rats with liver reserves greater than 17 nmol/g. This distribution provides sensitivity, specificity and positive predictive values of 94, 88 and 94 per cent, respectively. The DR/R ratios reached a maximal plateau in two other groups of rats between 3.5 and 8 h. At all times up to 24 h, mean DR/R ratios for vitamin A-depleted rats (45 +/- 6 nmoles of vitamin A/g liver) were approximately twice those for vitamin A-sufficient rats (230 +/- 40 nmoles of vitamin A/g liver). In three well-nourished adults, presumably with liver reserves of greater than 300 nmol/g wet weight liver (greater than 80 micrograms retinol equivalents/g), and in two young (1- and 3-years old) well-nourished children, maximal DR/R ratios were less than 0.023. In these cases, peak DR/R ratios were observed, with one possible exception, between 8 and 12 h.(ABSTRACT TRUNCATED AT 250 WORDS)     

FM sonography in diffuse liver disease: prospective assessment and blinded analysis

FM sonography - a signal-processing technique that uses frequency and phase information as well as amplitude data - shows promise in evaluation of patients with diffuse liver disease. In a prospective blinded review of 37 patients with biopsy-proved liver disease and 42 healthy volunteers, FM sonography was clearly superior to traditional amplitude-based (AM) sonography in distinguishing healthy from diseased subjects. Statistically significant differences were seen in accuracy (FM, 98.7%; AM, 84.8%), sensitivity (FM, 97.3%; AM, 70.3%), and negative predictive value (FM, 97.7%; AM, 78.8%). Our data also suggest that current FM sonographic techniques cannot differentiate among histologic findings associated with different hepatic parenchymal abnormalities. It is unclear, therefore, whether FM imaging can reduce the numbers of patients who require biopsy for diagnosis or the frequency of biopsy procedures in patients with known disease.     

Epidemiology of migraine headache in Santiago, Chile: a prevalence study

Objective . To describe the importance of migraine in Santiago, Chile, by analyzing its prevalence, clinical features and impact by age, gender and socioeconomic status. Methods . In 1993, a representative sample of 1,540 adults of the province of Santiago were interviewed using a standard questionnaire. A total of 1,385 (89.9%) subjects responded to the survey. Initially, a designated member of each household responded to the questionnaire. Subsequently, each household member with headaches was asked to respond to questions about severity, frequency, location, duration, associated symptoms and impact in work and social activities of their most frequent headaches. Migraine diagnoses were determined in accordance with the International Headache Society (IHS) criteria of 1988. Results. Recurrent headaches in the past year were found in 516 (36.82%) respondents, 145 (28.1%) males and 371 (71.9%) females. Total prevalence of migraine was found to be 7.3% (95%, CI 5.9–8.6); 11.9% (95% CI 9.6–14.2) in females and 2.0% (95% CI 0.9–3.0) in males. Overall, migraine constituted 19.6% (101/516) of all headaches reported in this sample. The prevalence did not vary significantly by age groups or socioeconomic status (SES). Migraine with aura had an overall prevalence of 3.5% (CI 0.8–7.1), and was significantly more frequent in females. In 60–70% of cases the attacks lasted 2–6 h and the frequency was 3.3 and 3.4 per month in females and males respectively. Both males and females reported significantly high percentages of attacks during work. Conclusions . Migraine prevalence in a sample of adults of Santiago is similar to that reported in previous studies using IHS criteria. Women of all socioeconomic levels are at an increased risk.