[Subacute lower back pain and acute kidney failure in a 47-year old man]. / Subakute lumbale Rückenschmerzen und akute Niereninsuffizienz bei einem 47-jährigen Mann.

A 47-year-old man presented with subacute, low back pain and increased creatinine levels. A CT scan showed an extrinsic, bilateral compression of the ureters by a retroperitoneal mass with pronounced uptake of 18F-fluorodeoxyglucose in positron emission tomography. Histological findings were consistent with the diagnosis of retroperitoneal fibrosis. Urological decompression was performed. The initiated corticosteroids led to a rapid clinical improvement and regression of the retroperitoneal mass. A relapse occurred after tapering of corticosteroids with a prompt response to increase of the dosage.

Mars: Detection of Atmospheric Water Vapor during the Southern Hemisphere Spring and Summer Season.

Water vapor was found to reappear in the atmosphere of Mars during its southern hemisphere spring and summer season, with a maximum vertical column abundance of 45 to 50 microns of precipitable water averaged over the entire planet. Although the spring-summer seasons for each hemisphere are generally symmetrical with respect to the appearance of water vapor, the data suggest that water vapor may appear later in the season and in slightly larger amounts during the southern hemisphere spring-summer.

Mercury: observations of the 3.4-millimeter radio emission.

Observations of the 3.4-millimeter radio emission from Mercury during 1965 and 1966 yielded the following relationship between average brightness temperature T(B) of the disk and the planetocentric phase angle i: T(B) = 277 (+/- 12) + 97 (+/- 17) cos [i + 29 deg (+/- 10 deg)] degrees K The errors are statistical standard; the phase shift corresponds to a phase lag-that is, the maximum and minimum of insolation lag the maximum and minimum of planetary radiation.

Experimental MR imaging-guided interstitial cryotherapy of the brain.

BACKGROUND AND PURPOSE: Hyperthermal ablation techniques such as laser or RF ablation require dedicated heat-sensitive MR imaging sequences for monitoring MR imaging--guided interventions. Because cryotherapy does not have these limitations, the purpose of this study was to evaluate the feasibility of MR imaging--guided percutaneous cryotherapy of the brain. METHODS: An experimental cryoprobe with an outer diameter of 2.7 mm was inserted into the right frontal lobe of 11 healthy pigs under MR imaging control. Freezing procedures were monitored by using an interventional 1.5-T magnet and a gradient-echo sequence with radial k-space trajectories, a fast T2-weighted single-shot spin-echo sequence, and a T1-weighted single-shot gradient-echo sequence. In three animals, the procedure was also monitored by using dynamic CT. A freeze-thaw cycle with a duration of 3 minutes was repeated three times per animal. Follow-up MR images were obtained 3, 7, and 14 days after cryotherapy by using conventional MR sequences. Six animals were killed 7 days after intervention, and five animals were killed 14 days after intervention. The brains were sectioned, and the histologic findings of the lesions were compared with the MR imaging appearance. RESULTS: No artifacts due to the probe were observed on the MR images or CT scans. The ice formation (mean diameter, 12.5 mm) was very well delineated as a signal-free sphere. MR monitoring of the freezing procedure yielded a significantly higher ice:tissue contrast than did CT. The size of the ice ball as imaged by MR imaging and CT during the intervention correlated well with the MR imaging appearance of the lesions at the 14-day follow-up examination and with the histologic findings. Histologically, coagulation necrosis and gliosis were found, surrounded by a transition zone of edema and a disrupted blood-brain barrier, corresponding to a contrast-enhancing rim around the lesions on follow-up MR images. CONCLUSION: MR imaging-guided cryotherapy of the brain is possible and allows a precise prediction of the resulting necrosis. MR imaging of the freezing process does not require heat-sensitive sequences and is superior to CT for monitoring of cryoablation.

[Experimental MRI-controlled cryotherapy of the brain with almost real-time imaging by radial k-space scanning]. / Experimentelle MR-gesteuerte Kryotherapie des Gehirns mit nahezu Echtzeitdarstellung durch radiale k-Raum-Abtastung.

PURPOSE: To test radial k-space scanning by MR fluoroscopy to guide and control MR-guided interstitial cryotherapy of the healthy pig brain. METHODS: After MR tomographic planning of the approach, an MR-compatible experimental cryotherapy probe of 2.7 mm diameter was introduced through a 5 mm burr hole into the right frontal brain of five healthy pigs. The freeze-thaw cycles were imaged using a T1-weighted gradient echo sequence with radial k-Space scanning in coronal, sagittal, and axial directions. RESULTS: The high temporal resolution of the chosen sequence permits a continuous representation of the freezing process with good image quality and high contrast between ice and unfrozen brain parenchyma. Because of the interactive conception of the sequence the layer plane could be chosen as desired during the measurement. Ice formation was sharply demarcated, spherically configurated, and was free of signals. Its maximum diameter was 13 mm. CONCLUSIONS: With use of the novel, interactively controllable gradient echo sequence with radial k-space scanning, guidance of the intervention under fluoroscopic conditions with the advantages of MRT is possible. MR-guided cryotherapy allows a minimally-invasive, precisely dosable focal tissue ablation.

[Aortitis due to Salmonella]. / Infektiöse Aortitis mit Salmonellen-Bakteriämie.

HISTORY AND CLINICAL FINDINGS: A 72-year-old man received treatment with amoxicillin/clavulanic acid because of fever and abdominal pain as an outpatient setting. Salmonella enteritidis infection was confirmed by a positive blood culture. The febrile patient showed abdominal tenderness on palpation. INVESTIGATIONS: CT and PET scans revealed an aneurysmatic soft tissue inflammation which was interpreted as infectious aortitis in the context of salmonella bacteraemia. TREATMENT AND COURSE: After several weeks of antibiotic treatment with ceftriaxone, an elective reconstruction using xenopericard with replacement of the mesenterial vessels was performed. After a postoperative course of antibiotics the patient recovered completely. CONCLUSION: In patients with positive blood cultures for Salmonella in combination with fever, back or abdominal pain a workup for infectious aortitis and a rapid treatment is recommended.

[Anti-RNA polymerase III antibodies in scleroderma renal crisis]. / Anti-RNA-Polymerase-III-Antikörper bei renaler Krise der systemischen Sklerose.

HISTORY AND CLINICAL FINDINGS: A 67-year old patient underwent a kidney biopsy because of newly diagnosed hypertension, haemolytic anemia with fragmentocytes and acute kidney failure requiring dialysis therapy. The biopsy showed thrombotic microangiopathy. Since last winter Raynaud's phenomenon and changes of hands and lips were recognised. INVESTIGATIONS: Initial immunological tests revealed anti-nuclear antibodies (ANA) but neither anti-centromere nor anti-Scl70 antibodies. The positive analysis of anti-RNA polymerase III antibodies confirmed the clinical suspicion of scleroderma renal crisis in the setting of first diagnosis of systemic sclerosis. TREATMENT AND COURSE: After diagnosis therapy with lisinopril, candesartan and amlodipin was established. Four months after discharge dialysis dependency persisted. CONCLUSION: Scleroderma renal crisis is an important differential diagnosis in the setting of acute kidney failure. Medical history, clinical examination and immunological test confirm the diagnosis. The mainstay of therapy is aggressive blood pressure control with ACE-inhibitors (or angiotensin receptor blocking agents).

High Dispersion Spectroscopic Observation of Venus. IV: The Weak Carbon Dioxide Band at 7883 A.

The average rotational temperature of the Cytherean atmosphere above the cloud tops was found to be T(rot) = 244 +/- 10 K based on twelve plates of the 7883-A CO(2) band. If the temperatures found from the 7820-A band on the same plate are averaged with the temperatures found from the 7883-A band, we obtaina temperature of T(rot) = 245 +/- 6 K. The observations of Venus were made between April and December of 1967. Laboratory measurements of the 7883-A band are lacking, but we infer that the band is half as strong as the 7820-A band.