The aim of this study was to evaluate typical magnetic resonance imaging (MRI) findings in early rheumatic diseases manifesting at the soft tissues of the hand using a retrospective analysis. A total of 186 MRI examinations of patients with clinical suspicion of a rheumatic disease were evaluated in a consensus reading by two experienced radiologists. All imaging patterns were assessed with respect to their type and localization. Under blinded and non-blinded conditions diagnoses were correlated with final clinical diagnosis. The most frequent diagnoses were rheumatoid arthritis (RA, 45.7%) and psoriatic arthritis (PsA, 15.6%). The mean correlation between clinical and MRI diagnosis (r) was 0.75 in blinded and 0.853 in non-blinded reading (p <0.001). The following extra-articular imaging patterns were found: synovitis (59.1%), tendovaginitis (91.4%), dactylitis (14.5%), and bone marrow edema (18.3%). Only dactylitis was specific for a particular rheumatic disease (PsA; r=0.934; ...
Aim: The purpose of this prospective study was to evaluate the value of immunoscintigraphy (ISG) with anti-225.28S in clinically suspected ocular melanoma. Methods: For this purpose standardized ISG was performed in 36 patients using both planar acquisition and emission computed tomography (ECT). Ocular melanoma was present in 31 patients. In 21 patients therapy was enucleation of the eye. These specimens were evaluated by histology and immunohistochemistry in 11 of 21 patients. Results: Regarding the clinical diagnosis, ISG was positive only in 15 of 31 patients with ocular melanoma, regarding histology in 11 of 21 and regarding immunohistochemistry in 5 of 6 patients with a positive immunoreaction. 5 patients showed no immunoreactivity, their ISG was negative. Conclusion: Thus a good correlation between ISG and immunohistochemistry was observed. However ISG using the cutaneous melanoma antibody 225.28S cannot be recommended for the diagnostic work-up of an ocular melanoma considering ...
Vulnerability to abused drugs is influenced by multiple genes unique to each drug as well as to risk genes for polydrug abuse. If several inbred mouse strains respond to different drugs similarly,...Full Text Available
BackgroundThe substance abuse prevention goal of the theatre production "TUNNELS" was to provide community education on substance abuse to an audience in Durham, NC and surrounding...Full Text Available
The paper describes advances in statistical methods for prevention research with a particular focus on substance abuse prevention. Standard analysis methods are extended to the typical research...Full Text Available
Serum specimens obtained from a nationwide sample of parenteral drug abusers (PDAs) during the period 1971-72 had previously been screened for human immunodeficiency virus (HIV) antibodies. Some specimens...Full Text Available
Clinical features and treatment outcome were compared in depressed outpatients with and without a history of emotional and physical abuse (EPA), including childhood maltreatment. Patients were...Full Text Available
Improving patient compliance with physicians’ treatment or prescription recommendations is an important goal in medical practice. We examine the relationship between treatment progress...Full Text Available
Dopamine (DA) D3 and D2 receptor mechanisms are implicated in cocaine's abuse-related behavioral effects, but the relative contribution of the two receptor subtypes is only partially characterized....Full Text Available
ObjectiveThe aims of the study were to: determine the attitudes of parents, pediatric residents, and medical students from a Turkish population toward childhood disciplinary methods; ascertain the association of participants' abusive childhood history with their attitudes toward discipline; and assess their attitudes about disciplinary actions, which should be reported as abuse.MethodA cross-sectional survey was conducted in Ankara University School of Medicine, Department of Social Pediatrics. Sixty-five parents, 39 pediatric residents, and 106 medical students completed a questionnaire (Survey of Standards of Discipline). This questionnaire was designed to measure sociodemographic characteristics, attitudes toward childhood disciplinary practices, and abusive childhood experiences. There...
The clinical feasibility of using interventional examination techniques was tested with an equipment combining fluoroscopy and MR imaging. This hybrid system showed to be of advantage in a great number of interventional examinations. The 1.5 Tesla magnet proved to be superior to open MR scanning systems in terms of image quality and scanning times. (orig.) [Deutsch] Es wurde die klinische Durchfuehrbarkeit interventioneller Techniken an einem kombinierten Durchleuchtungs- und MR-Arbeitsplatz untersucht. Dieses Hybridsystem erwies sich bei einer Vielzahl interventioneller Eingriffe als vorteilhaft. Der 1,5 Tesla-Magnet ist offenen MR-Systemen hinsichtlich Bildqualitaet und Messzeit ueberlegen. (orig.)
ObjectivesUse of prescription opioids for chronic pain is increasing, as is abuse of these medications, though the nature of the link between these trends is unclear....Full Text Available
During 1975 we studied 100 patients--77 men and 23 women--who had a history of alcohol abuse and disturbed liver function test results. On presentation the women were less likely to be suspected of...Full Text Available
The juxtacapsular BNST (jcBNST) is activated in response to basolateral amygdala (BLA) inputs through the stria terminalis and projects back to the anterior BLA and to the central nucleus of...Full Text Available
The nicotinic acetylcholine receptor (AChR) controls signal transmission between cells in the nervous system. Abused drugs such as cocaine inhibit this receptor. Transient kinetic investigations indicate...Full Text Available
Cocaine is a worldwide used drug and its abuse is associated with physical, psychiatric and social problems. The mechanism by which cocaine causes neurological damage is very complex and involves several...Full Text Available
The tendency for some individuals to partake in high-risk behaviors (eg, substance abuse, gambling, risky sexual activities) is a matter of great public health concern, yet the characteristics and neural...Full Text Available
Muscarinic cholinergic receptors modulate dopaminergic function in brain pathways thought to mediate cocaine's abuse-related effects. Here, we sought to confirm and ...Full Text Available
Background Previous reports in adults have suggested that the effects experienced after cannabis use can be described in terms of positive and negative subtypes that are heritable and are associated with abuse and dependence. This study extends existing research by inclusion of adolescents and young adults in an offspring of twins design which makes it possible to take into account genetic and environmental risks for substance use disorder. Methods Data were collected from 725 twin members of the Vietnam Era Twin Registry, 839 of their 12-32 year old biological offspring and 427 mothers. Offspring who had ever used cannabis (n=464) were asked the degree to which they typically experienced 13 subjective effects shortly after using cannabis. Latent class analysis (LCA) was used to derive sub...
To address lithium-ion cell safety issues in demanding power applications, electrical and thermal abuse tests were performed on 18650 sized cells. Video and electrically monitored abuse tests in air included short circuit, forced overcharge, forced reversal, and controlled overheating (thermal) modes. Controlled overheating tests to 200 C were performed in a sealed chamber under a helium atmosphere and the gases released from the cell during thermal runaway were analyzed at regular intervals using gas chromatography and mass spectrometry. In addition to alkane and alkene solvent breakdown fragments, significant H{sub 2} was detected and evidence that HF was evolved was also found.
It is concluded that the Department paid out over $16 million in the past two years for FTS service charges on telephone calls bearing no relationship to official Departmental business. When one adds in the costs of compensation paid to Departmental and contractor employees for the worktime spent making unauthorized FTS calls, the total costs to the Department due to FTS abuse exceeded $28 million for the fiscal years 1983 and 1984. These cost figures, moreover, fail to account for the effect of an annual loss of an estimated 40,000 man-days on the Department's productivity. It is recommended that the Assistant Secretary review the system to identify possible restrictions on usage of the lines by employees and to consider additional recording and accounting procedures to track FTS usage, especially when the lines are used for calls to telephones outside the FTS network.
A qualitative method, involving supported liquid?liquid extraction (SLE) and ultra high pressure liquid chromatography coupled to tandem mass spectrometry (UHPLC-MS?MS), was developed for the rapid tentative identification of various drugs of abuse in urine. In this study, 28 drugs and metabolites were covered by the screening procedure. Before analysis, urine samples were extracted by SLE and good extraction recoveries were obtained for most investigated compounds. The UHPLC strategy was then selected for the rapid separation of amphetamines, cocaine, opiates and related compounds in urine. Using columns packed with sub-2??m particles, analysis time was reduced down to 2?min, while maintaining acceptable performance. Finally, the detection was by tandem MS operating in the single reaction...
There is increasing evidence that adolescence, like early life, is a sensitive period in which ongoing brain development can be influenced by environmental factors. This review describes our use of social instability as a model of mild adolescent social stress, its effects on social interactions and on hypothalamic?pituitary?adrenal function over the course of the procedure and in response to new stressors. The effects of social instability are sex-specific, with qualitative differences between the sexes on HPA function over the course of the stressor procedure, and with greater effects in males on behaviour observed during the social instability and greater effects in females on behavioural responses to drugs of abuse into adulthood, long after the stress exposure. The results from invest...
35 patients with ankle sprain were examined by MRI and stress radiographs. 13 were operated afterwards, 22 patients underwent a functional conservative therapy and were examined by MRI and stress radiographs and second time after three months. MRI reports were correct in 12 of 13 operated cases. After conservative therapy we did not find any disrupted ankle ligament. MRI showed intact ligaments thickened by scar. (orig./MG) [Deutsch] 35 Patienten mit klinischem Verdacht auf Aussenbandruptur wurden mit der MRT untersucht. 13 Patienten wurden operiert, 22 konzervativ therapiert. Letztere wurden nach drei Monaten erneut mit MRT und gehaltenen Aufnahmen untersucht. Die MRT-Befunde stimmten in 12 von 13 Faellen mit den operativ erhobenen Befunden ueberein. Nach dreimonatiger konzervativer Therapie waren alle 22 Sprunggelenke stabil. Die rupturierten Baender stellten sich verdickt und durchgaengig dar. (orig./MG)
... Space weather is the biggest driver of ozone depletion and much else we are only beginning to understand. Solar Cycle 24 may turn out to be weak in terms of sun spot count but the amount of energy delivered by CME/SPE will probably not be. Remember that the Carrington Event in 1859 happened during a cycle with a lowish sun spot count. Recommend (1) Report abuse ...
Abstract Clonidine Extended Release Augmentation of Psychostimulants in ADHD ADHD a Risk Factor for Substance Abuse; Cognitive Deficits Not a Predictor Commentary on Kollins et al.; Clonidine XR Augmentation for ADHD Pharmacologic Treatment of Childhood Insomnias Effects of Guanfacine Extended Release on Alertness in ADHD Long Term ADHD Drug Treatment Bipolar Disorder Rates Similar Across Selected Countries Group CBT Alone or Group CBT Plus SSRIs in Childhood Anxiety Resolution of Quetiapine-Induced Oral Dyskinesia From the FDA
... Wanting to help a charity is commendable but the main focus of generosity should be the people in front of you, not your choice of spiritual overlord - especially so if the group is being funded with money from taxpayers. Recommend? (44) Report abuse | Link ...
Simultaneous bilateral femoral neck fractures are extremely rare and associated with various conditions. Up to now Most cases had correlations with major trauma, repetitive minor trauma, seizure, parathyroid...Full Text Available
Parathyroid hormone (PTH) is used clinically in osteoporotic patients to increase bone mass by enhancing bone formation. PTH therapy is not uniformly effective at all skeletal sites and “lifestyle”...Full Text Available
Gonadotropin–releasing hormone (GnRH) neurons are the central regulators of reproduction. GABAergic transmission plays a critical role in pubertal activation of pulsatile GnRH secretion....Full Text Available
During their life, intervertebral discs undergo degenerative changes which need not necessarily become lesions. Conventional X-rays do not provide information on the condition of the intervertebral discs, so MRT or CT are recommended as primary techniques as they are non-invasive. Invasive methods like myelography and especially discography should not be used unless a case is highly problematic. In infants with pains in the back, MRT should be carried out as early as possible as there is nearly always an organic cause. (orig.) [German] Die Bandscheibe ist im Laufe des Lebens degenerativen Veraenderungen unterworfen, die klinisch zu Beschwerden fuehren koennen, aber nicht fuehren muessen. Konventionlle Roentgenaufnahmen lassen zwar die Hoehenminderung des Bandscheibenfachs und begleitende knoecherne Veraenderungen erkennen, nicht aber den Zustand der Bandscheibe selbst. Die Beurteilung der Bandscheibe und des Knochens gelingt mit der CT, die parallel zum ...
The early diagnosis of such disorders is of major importance because, in most cases, severe consequences can only be averted by early treatment. The value of magnetic resonance imaging (MRI) in many orthopaedic and traumatological conditions is generally accepted. The value of MRI in this particular field is illustrated by typical case reports on common clinical problems [Deutsch] Der Fruehdiagnose von Erkrankungen des Kindes- und Jugendalters kommt grosse Bedeutung zu, da oftmals nur durch eine daraus resultierende Fruehbehandlung schwerwiegende Folgen vermieden werden koennen. Die Kernspintomographie (Magnetresonanztomographie=MRT) ist in zahlreichen orthopaedischen-traumatologischen Fragestellungen bereits etabliert. An ausgewaehlten Fallbeispielen haeufiger klinischer Problemstellungen soll in der vorliegenden Arbeit der Stellenwert der MRT dargestellt werden. (orig.)
Summary A prospective and randomized trial design is of utmost interest when it comes to evaluating new developments in the management of cardiovascular medicine. By defining the primary end point and a profound related statistic new therapeutic options can be tested with an adequate number of patients. The course of the trial is supervised by a Clinical Events Committee and a Data and Safety Monitoring Board. Registries are promising tools for describing how the results of clinical trials are translated into daily practice. Their drawbacks include lack of control of the clinical endpoints and their uniform definition and lack of a control group. There are numerous examples from cardiology of the limited usefulness of data obtained from registry studies with their often unexpected results ...
College students are more at-risk for developing a gambling problem than the general adult U.S. population. Information behavior and information seeking theories, as well as empirical evidence, indicate that one resource that may provide guidance for students dealing with this issue is the college counseling center website (CCW). This study addressed the presence and nature of problem gambling messages on CCWs. As a random sample, 203 CCWs were selected to assess how frequently they provided any information about problem gambling, as well as the specific types of communications CCWs offered on this topic. Results showed that CCWs rarely included any messages about problem gambling. Specifically, only 15% of all CCWs contained information about problem gambling. Furthermore, messages about problem gambling were presented significantly less frequently than messages involving alcohol abuse, substance abuse, depression, anxiety/stress, and ...
Preliminary psychometric properties of a new instrument, Angie/Andy Cartoon Trauma Scales (ACTS), are presented. Angie/Andy features a cartoon-based methodology, measuring trauma-related sequelae of prolonged, repeated abuse. A sample of 208 children comprised intrafamilial trauma, extrafamilial trauma, combined trauma, and nontrauma groups. Angie/Andy demonstrated high internal consistency, with coefficient alphas from 0.70 to 0.95. The three trauma groups scored significantly higher than the nontrauma group on all scales (p's < 0.0001). Generally, the most severely traumatized group scored significantly higher than the less severely traumatized groups. The number of types of violence exposures correlated with Angie/Andy scores from 0.55 to 0.74. The frequency and severity of trauma exposure correlated with Angie/Andy scores from 0.44 to 0.56. The Angie/Andy parent version correlated with a standardized parent scale from 0.71 to 0.81. Parent/child agreement was ...
The chemist and pharmacologist Fritz Hauschild developed the sympathomimetic agent Pervitin (metamphetamin) in the 1930s. Not only because of the abuse of the stimulant during the Second World War ("pilot's chocolate") it is one of the most controversial substances in drug history. Nearly forgotten are Hauschild's contributions to build up the drug system in the GDR. Although he was a convinced communist, the skilful pharmacologist gave very early warning of the imminent lack of innovation in the GDR pharmaceutical industry. A letter which he addressed to the Minister of Health, Max Sefrin (born 1913), did not lack explicitness. PMID:15997840
The abuse of volatile solvents may be due to their ability to produce an intoxication similar to that produced by classical central nervous system depressants such as the barbiturates and ethanol. To evaluate this hypothesis, mice were trained to discriminate pentobarbital from saline injections in a two-lever operant task. Stimulus generalization was examined following 20-min inhalation exposures to toluene (300-5400 ppm). In 8 of 10 subjects, pentobarbital-lever responding occurred following toluene exposure indicating an overlap in the discriminative stimulus properties of toluene and pentobarbital.
In rare cases, large adrenal masses with a suspicion of malignancy exhibit tumor extension into the adrenal vein and inferior vena cava. When planning surgery, the relationship of the extension to the inferior vena cava is of decisive improtance. We describe in two cases on the detection of a tumor thrombus in the inferior vena cava arising from a malignant adrenal mass by means of MR angiography (TOF, coronary 2D GRE images [FLASH], 3 slices acquired during 15 second apnea). The angiograms correlated well with the results of DSA venacavography and with the intraoperative findings. Thus, MRA has been demonstrated to be suitable for the certain proof of a venous tumor thrombus not only in cases of renal cell carcinomas but also in cases of malignant adrenal masses. The method should be applied whenever there is evidence of a venous involvement in the adrenal MR images. (orig.) [Deutsch] Grosse malignomverdaechtige Nebennierentumoren zeigen in seltenen Faellen eine Tumorausdehnung in die ...
Infrainguinal peripheral occlusive disease is increasingly being treated by endovascular techniques. Bare metal stainless steel, self-expanding nitinol stents, drug-eluting and covered stents (stent grafts) are becoming increasingly more important adjuncts to percutaneous translumninal angioplasty in the treatment of peripheral artery disease. In this article the available evidence supporting the use of stents in the femoropopliteal and tibial arteries will be described as well as their limitations. Future stent developments will also be discussed. (orig.) [German] Die endovaskulaere Therapie spielt bei der Therapie der peripheren arteriellen Verschlusskrankheit (PAVK) eine wichtige Rolle. Unbeschichtete ballonexpandierbare Stahlstents, selbstexpandierende Nitinolstents sowie medikamentenbeschichtete und ''covered stents'' (Stentgrafts) haben eine zunehmende Bedeutung als Zusatztherapie zusammen mit der primaeren Ballonangioplastie gewonnen. In ...
This richly illustrated toolbook and atlas contains information on all aspects of nmr diagnostic imaging of benign or malignant neoplasms of female and male mammary glands. It offers pinpointed guidance and insight for vocational training and continuing training of radiology assistants, students and medical radiologists. (orig./AJ) [German] Die MRT als hochaufloesendes und schaedigungsfreies Diagnostikum gewinnt gerade in der emotional stark besetzten Mammadiagnostik zunehmend an Bedeutung. Dennoch beherrschen nur wenige Zentren im deutschsprachigen Raum diese Technik, die - eine hohe Reproduzierbarkeit bei fehlender Belastung fuer die Patientin bietet, - invasive Karzinome bereits ab einer Groesse von 5 mm mit hoher Zuverlaessigkeit ausschliessen kann und - gerade bei widerspruechlichen Befunden zwischen klinischer Untersuchung, Roentgenmammographie und perkutaner Biopsie eine wesentliche Entscheidungshilfe bieten kann. Aus einem der fuehrenden Zentren in der ...
Put in place to protect the rights of the child, the Convention on the Rights of the Child is a set of non-negotiable standards. A core principle underpinning the Convention is the child's right to participate fully in social arenas and to access sources of social support without excessive interference. Juxtaposing this is the right of the child to be shielded from harm, abuse and exploitation. Over the past several decades the Internet has emerged as a fast and easily accessible medium for people to connect and communicate. While the Internet provides children with a source of support through chat rooms, online communities and social networking sites, just as equally it can expose vulnerable children to predatory and deviant individuals exacerbating the potential for harm. Upholding the Convention in cyberspace is a challenge. The Internet is not owned or regulated by any governing body and accountability is difficult to enforce. This article discusses some of the ...
In the by now extended debate about the end of the Cold War and its causes, very little attention has been paid to the role played by historical memory in helping shape the way policy-makers approached the collapse of the post-war order. As this article shows, many, if not most policy elites at the time, confronted the passing of the old world with a great degree of caution and trepidation; and one of the key reasons they did so, it is argued here, is because of their reading of the past. This reading, I go on to suggest, made many of them especially cautious and fearful when faced with great change. In the end of course these changes proved irresistible, and for liberals at least seemed to augur in more peaceful and prosperous times. However, as we shall see here, this unguarded optimism ...
Major depressive disorder and alcohol dependence are common and serious mental illnesses. There is a great interest in discovering useful treatments for both mood symptoms and alcohol abuse in those patients with depressive disorders and comorbid alcohol dependence. The primary purpose of this study was to evaluate the effectiveness and tolerability of mirtazapine for the treatment of patients with alcohol dependence comorbid with a depressive disorder in an open label, naturalistic multicentre treatment setting. The 17-item Hamilton Depression Rating Scale (HDRS), the Hamilton Anxiety Rating Scale (HARS) and the Clinical Global Impression-Severity (CGI-S) scale were measured at baseline and at weeks 4 and 8 for the assessment of treatment effectiveness. Alcohol craving was measured using ...
Research shows that comment spamming (comments which are unsolicited, unrelated, abusive, hateful, commercial advertisements etc) in online discussion forums has become a common phenomenon in Web 2.0 applications and there is a strong need to counter or combat comment spamming. We present a method to automatically detect comment spammer in YouTube (largest and a popular video sharing website) forums. The proposed technique is based on mining comment activity log of a user and extracting patterns (such as time interval between subsequent comments, presence of exactly same comment across multiple unrelated videos) indicating spam behavior. We perform empirical analysis on data crawled from YouTube and demonstrate that the proposed method is effective for the task of comment spammer detection.
Aim To determine the fate and clinical implication of large (?2cm), non-hypervascular nodules depicted on magnetic resonance imaging (MRI) in the cirrhotic liver. Materials and methods In 21 patients with cirrhosis (14 hepatitis B, two ethanol abuse, four cryptogenic, one Wilson's disease), 25 large (?2cm in the longest dimension) non-hypervascular nodules were identified on dynamic MRI. The implications for diagnosis of the initial size, contour, and signal characteristics on MRI in addition to patients' age and cause of cirrhosis were assessed in our analysis. Results Twelve (75%) out of 16 lesions were malignant or potentially-malignant from 14 hepatitis B patients, while seven (78%) of the nine lesions from other patients were benign (p=0.016). The mean age of the patients who ha...
Abstract Introduction.- Cannabis (marijuana) is the most widely used illicit drug globally. Given the prevalence of nonprescription illicit drug abuse, there is a growing interest in the study of its potential effects on male sexual health. In this review, we discuss the effects of cannabis on male sexual health. Objective.- In this review, we discuss the effects of cannabis on male sexual health. Methods and Main Outcome Measure.- Critical review of scientific literature examining the impact of cannabis use on male sexual health. Results.- Studies examining the effects of cannabis use on male sexual function have been limited in both quality and quantity. Most results of these studies are conflicting and contradictory. While some did outline the beneficial effects of cannabis in enhancing...
The replacement of lithium metal from the negative electrode of lithium batteries by a material allowing the reversible insertion of lithium ions is an undeniable commercial success. Carbon electrodes, generally called Li{sub x}C{sub 6}, are the most common type and allow to increase the service life of the battery, its charging fastness and its safety. The safety of such batteries is well known in normal conditions of use, but it has to be known also in any abusive condition of use, whatever is the charging state. The mastery of the phenomena that can occur requires a good knowledge of the kinetics of the exothermal chemical reactions involved. (J.S.) 8 refs.
Lung cancer staging according to the TNM system is based on morphological assessment of the primary cancer, lymph nodes and metastases. All aspects of this important oncological classification are measurable with MRI. Pulmonary nodules can be detected at the clinically relevant size of 4-5 mm in diameter. The extent of mediastinal, hilar and supraclavicular lymph node affection can be assessed at the same time. The predominant metastatic spread to the adrenal glands and spine can be detected in coronal orientation during dedicated MRI of the lungs. Search focused whole body MRI completes the staging. Various additional MR imaging techniques provide further functional and clinically relevant information during a single examination. In the oncological context the most important techniques are imaging of perfusion and tumor motion. Functional MRI of the lungs complements the pure staging and improves surgical approaches and radiotherapy planning. (orig.) [German] Das Staging des ...
The comprehensive survey explains the indications and the specific value of the modern tomographic modalities with respect to the various diagnostic issues. Numerous reproductions of CT, MRI, US scans illustrate the aspects discussed. (orig./CB) [German] Bildgebende Verfahren kommen bei der Abklaerung von Erkrankungen des weiblichen Urogenitaltrakts ergaenzend zu der klinischen Untersuchung zur Anwendung. Kongenitale Uterusanomalien werden primaer mit der HSG oder der Laparoskopie diagnostiziert. Zusaetzlich koennen der transvaginale US und in unklaren Faellen die MRT eingesetzt werden. Die Diagnose entzuendlicher Erkrankungen des weiblichen Genitaltrakts erfolgt in der Regel klinisch. Schnittbildverfahren werden bei therapieresistenten, komplizierten Faellen angewendet. Initial werden benigne Neoplasien des Uterus mit dem transvaginalen US abgeklaert. Eine Verdickung des Endometriums ist dabei ein unspezifischer Befund und kann auf eine Hyperplasie, Polypen oder ...
Early recognition of recurrence and work-up of clinically indeterminate lesions may be impaired after reconstruction with silicone implants due to superimposition of the implant or to scarring. This study was undertaken to evaluate the use of contrast-enhanced MRI in patients with silicone implant after breast cancer. Contrast-enhanded MRI was offered to 169 patients. Comparative two- to three-view mammography was also performed in 169 patients, as well as comparative sonography in 144 patients. Conventional imaging and clinical examination detected only 8/13 recurrences, whereas 12/13 were detected by MRI. One recurrence had been visible as a strongly enhancing 2-mm dot in a previous examination (2 years before), but was not called. It was therefore counted as false negative. In addition, multicentricity was detected by MRI alone in two of three cases. MRI correctly diagnosed scar tissue in all cases with indeterminate findings. However, due to false-positive calls caused by enhancing ...
Material related to routine as well as sensitive aspects of parent/day care center relationships is presented in this training module, one of a series providing staff development information for programs operated for dependents of military personnel. The module offers a brief discussion of ways caregivers can help parents feel at ease about leaving their children in child care and presents a set of multiple-choice skill-building exercises for effectively working with parents. Exercises focus on various topics, including how parents can be approached when their child may have a health problem, when child abuse or neglect is suspected, and when parental cooperation is needed to stop a child's undesirable or disruptive behavior. Exercises are also devoted to the questions of whether or not caregivers should act as advisors to parents or tell parents about their child's behavior at the center. Concluding exercises indicate how caregivers can handle parent requests for ...
Pulmonary clearance of an aerosol of "9"9Tc"m DTPA was measured in 21 non-smoking AIDS and pneumocystosis patients. The results were compared with those of pulmonary scintiscanning with gallium. All the patients exhibited increased clearance, evidence of a considerable alteration in alveolar permeability. This increase was also observed in patients with normal chest X-rays and normal blood gases. The average clearance in these patients was 6 #+-# 2% min"-"1 as compared with a normal 1.1 #+-# 0.3% min"-"1. Conversely, only four out of eight patients with normal chest X-rays had abnormal gallium scans. Clearance returned to normal after recovery. Measurement of DTPA clearance appears to be a very sensitive indicator for the detection and follow-up of pneumocystosis. However, it is not very specific since it can be increased by tobacco poisoning, drug abuse and the presence of lymphocytic alveolitis. An examination with normal findings can therefore exclude the ...
Anxiety is a common symptom during ethanol withdrawal contributing to its continuous abuse and alcoholism. Ethanol withdrawal in rats produces an interoceptive discriminative stimulus (IDS) similar to that produced by the anxiogenic drug pentylenetetrazol (PTZ). This stimulus peaks at 12 hours after last dose of ethanol and thereafter the IDS is detected for several days (protracted withdrawal) by sensitization to a probe drug. previously, the authors have shown that during the protracted withdrawal, the IDS is enhanced by GABA receptor antagonists suggesting alteration of brain GABA systems. This report provides further evidence that chronic ethanol alters GABAergic systems. Rats were trained to discriminate PTZ (20 mg/kg, ip) from saline. Diazepam, pentobarbital and phenobarbital blocked the PTZ-IDS dose dependently. Ethanol, 4.5% w/v, was then given in a nutritionally complete diet for a week. On termination of the ethanol diet, rats exhibited signs and symptoms ...
A personal account of Richard Berendzen's life as president of The American University (AU) in Washington, D.C. during the 1983-1984 academic year is presented in diary form. The account describes his interactions with faculty, students, administrators, and people outside the university to further the goals of the institution. In the year prior to the diary entries, enrollments at AU had dropped unexpectedly while tuition had not been raised to make up for the shortfall. There were empty beds of former students who faced economic pressures. A union protested AU's consequent firing of its custodians and its contracting with an independent custodial firm, which employed primarily blacks as custodians. The issue of racism surfaced when students and faculty supported demonstrators. Since AU has no wholly assured flow of applicants or donors, Berendzen recognized that to improve, or even to maintain, the relative position of AU, he had to become not only its pedagogical leader but also a ...
Summary Background Systematic screening for liver fibrosis in heavy-drinking patients is a challenge. Aims To assess Fibroscan for non-invasive diagnosis of asymptomatic liver fibrosis in alcohol abuse patients, to determine diagnostic liver stiffness cut-off values and to compare performance of Fibroscan with seven non-invasive laboratory tests. Methods One hundred and three alcoholic patients were studied. Liver fibrosis was staged by METAVIR system. Fibroscan, Fibrotest, Fibrometer, Hepascore, APRI, PGA, PGAA and hyaluronic acid tests were performed. Liver stiffness cut-offs were determined using receiver-operating characteristic (ROC) curves. Results Liver stiffness was correlated with fibrosis (r = 0.72, P < 0.014), with median at 5.7, 6.3, 8.4, 15 and 47.3 kPa for F0 (n = 8), F1 (n =...
The identification of genes influencing sensitivity to stimulants and opioids is important for determining their mechanism of action and may provide fundamental insights into the genetics of drug abuse. We used a panel of C57BL/6J (B6; recipient)x A/J (donor) chromosome substitution strains (CSSs) to identify quantitative trait loci (QTL) for both open field activity and sensitivity to the locomotor stimulant response to methamphetamine (MA). Mice were injected with saline (days 1 and 2) and MA (day 3; 2 mg/kg i.p.). We analyzed the total distance traveled in the open field for 30 min following each injection. CSS-8, -11 and -16 showed reduced MA-induced locomotor activity relative to B6, whereas CSS-10 and -12 showed increased MA-induced locomotor activity. Further analysis focused on CSS...
In a prospective study 102 patients with malignant tumors of the tongue, oropharynx, hypopharynx, and larynx were staged by means of MRI. Special attention was directed at those tumour extensions that could influence the treatment strategy. The MR findings were correlated with the results of palpation, endoscopy, ultrasound, computerised tomography and histopathological findings. MRI showed a good delineation of pT{sub 2} to pT{sub 4} tumours. However, visualisation of small tumours in the soft palate, the tonsils, the pyriform sinuses and vocal cords was difficult. In conclusion our results suggest that in addition to endoscopy MRI is a valuable tool for the examination of tumours of tongue, oropharynx, hypopharynx and larynx. (orig.) [Deutsch] In einer prospektiven Studie wurden 102 Patienten mit malignen Tumoren der Mundhoehle, des Oro- und Hypopharynx sowie des Larynx mit der Mgnetresonanztomographie (MRT) untersucht, wobei besonders Wert auf die Bestimmung derjenigen ...
Clinical information is indispensable for swift and cost-effective clarification of diseases of the larynx. While quality clarification of neurological changes in the area of the posterior cranial fossa and in the course of the vagus nerve as a cause of glottis malfunction is possible with MRI, localized disease of the larynx can more effectively be assessed with low-artifact CT. In the particularly difficult assessment of the post-operative larynx, a recurrence can be diagnosed only after a baseline study has been carried out after the end of therapy. With knowledge of the pretherapeutic findings, the findings immediately post-therapy, and the operation technique used, the optimal CT examination, which can be carried out quickly, will be able to provide more information about recurrence. (orig.) [Deutsch] Zur schnellen und kostenguenstigen Abklaerung von Erkrankungen des Larynx ist die klinische Information unabdingbar: Wenn neurologische Veraenderungen im Bereich ...
Already, MR Imaging is superior in diagnostic imaging of joints in many cases; however, there have been recent developments, which are the subjects of this paper. With gradient-echo sequences acquired in 3D technique, it is possible to produce high-resolution images of joints in acceptable scantime, because gradient-echo sequences are less time-consuming than convential SE sequences. With the acquisition of two echoes, phase difference between water and fat protons have to be considered. 3D Imaging is capable of displaying complex pathology in a superior way, which should be useful in preoperative planning. Tissue contrast is altered by fat saturation or magnetization transfer in order to achieve better conspicuity of lesions. Although diagnostic value of some of these options is not yet clear and further clinical studies are needed, they are a promising possibility for improving MR Imaging of the joints. (orig.) [Deutsch] In der Gelenkdiagnostik gibt es einige neuere Entwicklungen in ...
Pulmonary infections and tumors are a major cause of death in patients with AIDS. The combination of clinical, radiological, laboratory, and pathohistological data helps to narrow the spectrum of differential diagnoses or even allows a specific diagnosis in many patients. Nevertheless, an accurate diagnosis should be obtained as soon as possible during the clinical course of the illness to initiate treatment in time. Computed tomography (CT) has proven to provide promising results in the diagnosis of AIDS-related throacic diseases. The aim of this paper was to demonstrate the diagnostic capacities of CT in the context of particular AIDS-related thoracic pathologies. Additional information on the spectrum of pathological agents and on differential diagnostic signs is summarized. (orig.) [Deutsch] Pulmonale Infektionen und Tumore sind eine wesentliche Todesursache bei Patienten, die am erworbenen Immunmangelsyndrom AIDS leiden. In den meisten Faellen gelingt es, durch Zusammenschau ...
Clinical studies have proved the effectiveness of local ablading methods in pations with non-resectable liver metastases of a colorectal carcinoma. RF ablation and LITT are a potentially curative therapy option and an alternative to systemic chemotherapy; the latter is carried out primarily for reducing tumour size with the goal of secondary resectability. The number of R0-sesectable metastases can be enhanced by a combined therapy of surgery and local ablading methods, e.g. by preoperative, intraoperative or postoperative ablasion of further non-resectable tumours during surgery. Systemic chemotherapy combined with surgery as an adjuvant method is not recommended unless in cases of non-abladable tumour recidivation. Currently, systemic chemotherapy is used as a neo-adjuvant therapy for tumour size reduction with the goal of secondary resectability or, in case of inoperability, local ablation. (orig.) [German] Abladierende Verfahren. Klinische Studien belegen die ...
Aim: Changes within the brain detected by MRI after chronic manganese poisoning raised the question whether morphological changes of the basal ganglia, particularly of the globus pallidus, could be detected after chronic occupational exposure to manganese dioxide. Results: No cases of parkinsonism were detected in clinical examinations or by other means. The mean manganese concentration in blood was 12 {mu}g/l (range: 3.9-23.3 {mu}g/l). In comparison to the upper reference value of 10 {mu}g/l, 42 workers (56%) had a higher body burden. A significant positive correlation between manganese levels in blood and the PI (indicated by T{sub 1}-shortening) was observed as well as between the CBI and workplace-specific exposure. Brain atrophy was not detected in any of the observed cases. Conclusions: Long-term exposure to manganese dioxide dust correlates with the Pallidum-Index in MRI scans. Although the MRI findings have no current clinical relevance for individuals, further studies are ...
Purpose: The determination of tumor volume in ocular tumors is very important for the planning and success of radiation therapy. This study uses an animal model to evaluate the accuracy of MR-based volumetry of ocular tumors. Materials and methods: In a total of 25 porcine eyes obtained from the slaughterhouse, ocular tumors were produced by injecting a mixture of hand creme and Gd-DTPA under ophthalmoscopic guidance. The injected volume varied between 0.05 ml and 2.7 ml. The eyes were examined with a 1.5 Tesla scanner and a 4 cm circular surface coil especially developed for ocular MRI. After data transfer to a separate workstation, volumetric analysis was carried out by three independent radiologists using semiautomated software. The determined volume was compared with the injected volume. Results: Of the 25 prepared porcine eyes, 23 were suitable for volumetric analysis. The injection of the mixture of hand creme and GD-DTPA produced two different types of tumors. ...
Aim: Treatment of carcinoma of the uterine cervix by remote afterloading brachytherapy has been accompanied with new isotopes having dose rates different from the classical low-dose rate (LDR) radium source. The dose rate conversion factor from LDR to high-dose rate (HDR) found to be around 0.54 in most studies. As regards medium-dose rate (MDR) brachytherapie, the published data are very few and the experience is still short. In this study the experience of Osaka University Hospital with micro-HDR-Selectron and Selectron-MDR, as a preliminary report of the clinical trial, is presented. Results: The 3-year survival and loco-regional control rates for both modalities were nearly equivalent (62% and 67% for HDR and 68% and 74% for MDR)(totally 45 patients). The cumulative rectal and bladder complication rates were the same in both groups (29% at 3 years), with only 1 patient (MDR-group) developed grade 3 rectal and bladder complication. In this study, point A dose rate correction factor ...
Nuclear medicine and magnetic resonance imaging (MRI) are widely used in cardiac diagnostics. Both techniques have been carefully evaluated and are equivalent for the assessment of regional and global wall motion as well as the evaluation of ejection fraction and cardiac volumes, though MRI is herein currently seen as gold standard. For evaluation of myocardial perfusion, extensive data exist for nuclear imaging, that, next to high diagnostic accuracy for evaluation of coronary artery disease, show incremental prognostic information and allow for independent risk stratification. Because of rapid technical advance, myocardial perfusion imaging has also become feasible with cardiac MRI. Results of recent studies are promising, but the data are few compared to perfusion scintigraphy. For viability assessment in patients with ischemic cardiomyopathy, positron emission tomography (PET) with FDG is currently seen as gold standard. However, single photon emission computed tomography (SPECT) ...
Magnetic resonance imaging (MRI) as a diagnostic imaging tool relies on the generation of magnetic fields, whereas the computerized tomography (CT) uses X-radiation. The fundamental principle of MRI is the magnetic resonance of paramagnetic atomic nuclei. These nuclei, as e.g. protons (= hydrogen nuclei), are aligned in required orientation by application of a strong magnetic field. Upon simultaneous application of an electromagnetic high-frequency field perpendicular to the axis of the basic magnetic field, and in response to periodical changing of the electromagnetic field at a given frequency, the originally aligned paramagnetic nuclei are forced into a movement similar to that of a ``whipping top``. When the resonance frequency is shut off, the nuclei return to their former, aligned positions, inducing a weak signal in a coil. The series of signals generated by multiple repetition of this process of excitation of nuclei and their return to aligned rest is used as input to a ...
Purpose: To report on the nephron-sparing, percutaneous ablation of a large renal cell carcinoma by combined superselective embolization and percutaneous radiofrequency ablation. Materials and Methods: A 5 cm renal cell carcinoma of a 43-year-old drug abusing male with serologically proven HIV, hepatitis B and C infection, who refused surgery, was superselectively embolized using microspheres (size: 500 - 700 {mu}m) and a platinum coil under local anesthesia. Percutaneous radiofrequency ablation using a 7F LeVeen probe (size of expanded probe tip: 40 mm) and a 200 Watt generator was performed one day after transcatheter embolization under general anesthesia. Results: The combined treatment resulted in complete destruction of the tumor without relevant damage of the surrounding healthy renal tissue. The patient was discharged 24 hours after RF ablation. No complications like urinary leaks or fistulas were observed and follow up CT one day and 4 weeks after the ...
Purpose: Measurement of the oscillating CSF flow in the spinal canal (SC) of healthy volunteers and in patients with post-traumatic syringomyelia (PTS) using an optimized MRI protocol as well as to determine whether stenosis induced velocity changes are detectable using MRI. Methods: In 68 healthy volunteers quantitative studies of CSF flow in the cervical, thoracic, and lumbar regions were performed. First, an optimized sequence was developed and tested in 19 volunteers using four different flow-encoding velocities (4, 8, 12, 16 cm/s). Secondly, the optimized sequence was employed in 49 volunteers to measure the different CSF patterns in the cervical, thoracic, and lumbar spinal canals (CSC, TSC, LSC). Part three of the study, in which patients with PTS are being examined is still underway. We measured the maximum velocity (cm/s), the pixel area (mm{sup 2}), and the stroke volume (ml/s). Using a flow model the velocities prior to and after compression with 5 different power levels ...