Tactile Stimulation in Adult Rats Modulates Dopaminergic Molecular Parameters in the Nucleus accumbens Preventing Amphetamine Relapse.

Amphetamine (AMPH) is a psychostimulant drug frequently related to addiction, which is characterized by functional and molecular changes in the brain reward system, favoring relapse development, and pharmacotherapies have shown low effectiveness. Considering the beneficial influences of tactile stimulation (TS) in different diseases that affect the central nervous system (CNS), here we evaluated if TS applied in adult rats could prevent or minimize the AMPH-relapse behavior also accessing molecular neuroadaptations in the nucleus accumbens (NAc). Following AMPH conditioning in the conditioned place preference (CPP) paradigm, male rats were submitted to TS (15-min session, 3 times a day, for 8 days) during the drug abstinence period, which were re-exposed to the drug in the CPP paradigm for additional 3 days for relapse observation and molecular assessment. Our findings showed that besides AMPH relapse, TS prevented the dopamine transporter (DAT), dopamine 1 receptor (D1R), tyrosine hydroxylase (TH), mu opioid receptor (MOR) increase, and AMPH-induced delta FosB (ΔFosB). Based on these outcomes, we propose TS as a useful tool to treat psychostimulant addiction, which is subsequent to clinical studies; it could be included in detoxification programs together with pharmacotherapies and psychological treatments already conventionally established.

Binge and Subchronic Exposure to Ketamine Promote Memory Impairments and Damages in the Hippocampus and Peripheral Tissues in Rats: Gallic Acid Protective Effects.

Ketamine (KET) is a dissociative anesthetic for restrict medical use with high potential for abuse and neurotoxicity which does not prevent its recreational use. Gallic acid (GA) is a natural free radical "scavenger." We evaluated the GA protective role regarding binge or subchronic (SbChro) KET-induced toxicity in adolescent rats. In the binge protocol, animals were treated with GA (one dose of 13.5 mg/kg, p.o. every 2 h, totaling 3 doses) 12 h after KET exposure (one dose of 10 mg/kg, i.p., every 3 h, totaling 5 doses). In the SbChro, animals were treated with GA (one dose of 13.5 mg/kg/day, p.o., for 3 days) 48 h following KET exposure (one dose of 10 mg/kg/day, i.p) for 10 days. Our findings show that binge-KET impaired memory, increased pro-BDNF and TrkB levels in the hippocampus, and increased lipid peroxidation (LP) in the kidney and hippocampus, while SbChro-KET impaired memory, increased pro-BDNF, and decreased both BDNF and TrkB levels in the hippocampus, and increased LP in the kidney, liver, and hippocampus. GA treatment reversed the subchronically KET-induced harmful influences better. Interestingly, only memory impairment observed in the SbChro-KET protocol was reversed by GA. Memory impairments showed a positive correlation with hippocampal BDNF levels and negative with LP levels in the same brain area. This last hippocampal damage (LP) showed a negative correlation with BDNF levels in the hippocampus, indicating an interesting and close causal connection. Our outcomes show that the deleterious effects of SbChro-KET exposure can be attenuated or abolished with GA administration, a natural antioxidant that could be considered in KET abuse treatment.

Benefits and risks of oxygen therapy during acute medical illness: Just a matter of dose!

Oxygen therapy is used to reverse hypoxemia since more than a century. Current usage is broader and includes routine oxygen administration despite normoxemia which may result in prolonged periods of hyperoxemia. While systematic oxygen therapy was expected to be of benefit in some ischemic diseases such as stroke or acute myocardial infarction, recent randomised controlled trials (RCTs) have challenged this hypothesis by showing the absence of clinical improvement. Although oxygen is known to be toxic at high inspired oxygen fractions, a recent meta-analysis of RCTs revealed the life-threatening effect of hyperoxemia, with a dose-dependent relationship. Several recommendations have therefore been updated: (i) to monitor peripheral oxygen saturation (SpO2) as a surrogate for arterial oxygen saturation (SaO2); (ii) to initiate oxygen only when the lower SpO2 threshold is crossed; (iii) to titrate the delivered oxygen fraction to maintain SpO2 within a target range; and (iv) to stop supplying oxygen when the upper limit of SpO2 is surpassed, in order to prevent hyperoxemia. The lower and upper limits of SpO2 depend on the presence of risk factors for oxygen-induced hypercapnia (Chronic obstructive pulmonary disease, asthma, and obesity-associated hypoventilation). For patients at risk, oxygen therapy should be started when SpO2 is≤88% and stopped when it is>92%. For patients without risk factors, oxygen therapy should be started when SpO2 is≤92% and stopped when it is >96%. High-flow oxygen should only be used in a few diseases such as carbon monoxide poisoning, cluster headaches, sickle cell crisis and pneumothorax.

Influence of physical activity on addiction parameters of rats exposed to amphetamine which were previously supplemented with hydrogenated vegetable fat.

Amphetamine (AMPH) and its derivatives are addictive drugs used to promote and enhance alertness, motivation, willingness, courage and wellbeing. However, their chronic use is related to memory loss, emotional instability, insomnia, psychosis and paranoia. In the last decades, modern society has included processed foods, rich in trans fatty acids (TFA), in their diet, what has been related to several health problems including increased AMPH preference and self-administration. In this scenario, physical activity appears to be useful to attenuate rewarding symptoms related to addictive drugs mainly by affecting brain neuroplasticity and neurotransmission. The current study has been developed to assess the influence of physical activity on addiction parameters of rats exposed to AMPH which were previously supplemented with hydrogenated vegetable fat (HVF), rich in TFA. After six weeks of HVF or soybean oil (SO, control group) supplementation, adult rats were conditioned with d,l-AMPH or vehicle for 14 days. Then, half of each experimental group was submitted to physical activity in treadmill running sessions (60min/day, 5 days/week) for 5 weeks. Animals were re-conditioned with AMPH or vehicle for 3 more days, to observe drug relapse. Locomotor activity and anxiety-like symptoms were observed 24h after the last AMPH reconditioning, and fatty acids composition was quantified in the ventral tegmental area, striatum and prefrontal cortex. All animals showed AMPH preference, but only SO sedentary showed drug relapse. No differences were observed in locomotor activity among groups, while HVF-supplemented group showed decreased exploration per se, and physical activity prevented this. Moreover, AMPH-HVF group showed increased anxiety-like symptoms, which were prevented by physical activity. These results indicate that HVF supplementation modifies AMPH addiction, whereas regular physical activity could be protective against both AMPH and TFA damages.

Neonatal abstinence syndrome in European and North American neonates: differences in clinical characteristics derived from a prospective randomized trial.

BACKGROUND: Due to the steady increase of substance-dependent pregnant women the neonatal abstinence syndrome has become an increasingly important issue in neonatology. The present study investigates site-specific differences of detailed symptoms and treatment of neonatal abstinence syndrome within the context of an international multicenter clinical trial. METHODS: Site specific neonatal data analyses from a prospective randomized, double-blind, double-dummy clinical trial (MOTHER study) was performed. A standardized NAS rating and treatment protocol was applied, while non-pharmacological care of NAS symptoms differed across the sites. RESULTS: Urban US neonates exhibited most neurological symptoms (p<0.001) while in Europe autonomous, respiratory and gastrointestinal symptoms were found significantly more often compared to urban and/or rural US (p<0.05). Methadone produced significantly greater scores than buprenorphine in neurological, behavioural and respiratory symptoms regardless of the sites (ps<0.05). NAS treatment rates in all site clusters were similar for methadone-exposed neonates, while in Europe significantly more buprenorphine-exposed neonates were treated (p=0.001) than in US site clusters. Urban US neonates had significantly higher NAS scores (p<0.01) compared to rural US and European neonates, and needed significantly higher morphine doses (p<0.05) with longer treatment duration. Birth weight, length and head circumference did not differ significantly among the site clusters, but APGAR scores were significantly higher in European (p<0.01) neonates. CONCLUSION: In addition to intrauterine medication exposure other aspects such as different addiction severity of the mothers, different treatment modalities including rooming-in as well as the frequency of NAS ratings may be influencing the course of NAS.

The INE-Beamline for actinide science at ANKA.

Since its inauguration in 2005, the INE-Beamline for actinide research at the synchrotron source ANKA (KIT North Campus) provides dedicated instrumentation for x-ray spectroscopic characterization of actinide samples and other radioactive materials. R&D work at the beamline focuses on various aspects of nuclear waste disposal within INE's mission to provide the scientific basis for assessing long-term safety of a final nuclear waste repository. The INE-Beamline is accessible for the actinide and radiochemistry community through the ANKA proposal system and the European Union Integrated Infrastructure Initiative ACTINET-I3. Experiments with activities up to 1 × 10(+6) times the European exemption limit are feasible within a safe but flexible containment concept. Measurements with monochromatic radiation are performed at photon energies varying between ~2.1 keV (P K-edge) and ~25 keV (Pd K-edge), including the lanthanide L-edges and the actinide M- and L3-edges up to Cf. The close proximity of the INE-Beamline to INE controlled area labs offers infrastructure unique in Europe for the spectroscopic and microscopic characterization of actinide samples. The modular beamline design enables sufficient flexibility to adapt sample environments and detection systems to many scientific questions. The well-established bulk techniques x-ray absorption fine structure (XAFS) spectroscopy in transmission and fluorescence mode have been augmented by advanced methods using a microfocused beam, including (confocal) XAFS/x-ray fluorescence detection and a combination of (micro-)XAFS and (micro-)x-ray diffraction. Additional instrumentation for high energy-resolution x-ray emission spectroscopy has been successfully developed and tested.

Radiological emergency room management with emphasis on multidetector-row CT.

Trauma is the fifth leading cause of death after disease of the cardiovascular system, malignomas and disease of the respiratory and digestive system. The management of severely injured patients, including radiological imaging, is a matter of ongoing development. In particular, as for the imaging modalities, multidetector-row CT represents a substantial refinement in the diagnostic work-up of multitrauma patients. Sufficient therapy within the first hour after trauma increases the patient's chances for survival significantly. Thus, therapeutic procedures and diagnostic evaluation have to be concomitant events, performed by a multidisciplinary team, namely trauma surgeon, anesthesiologist and, last but not least, radiologist. The increased performance of multidetector-row CT leads to increased spatial resolution, which is a prerequisite for sophisticated two- and three-dimensional postprocessing. The increased volume coverage speed allows for comprehensive whole-body CT at still high levels of spatial resolution, resulting in significant spare of time which influences patient's survival. Using this technique conventional imaging such as plane film or angiography may be omitted.

Shortening of the patellar tendon length does not influence the patellofemoral alignment in a cadaveric model.

INTRODUCTION: Anterior cruciate ligament (ACL) reconstruction with the use of autograft tissue represents the standard treatment. The use of a bone-patellar tendon-bone transplant for symptomatic ACL deficiency achieves good long-term results. The purpose of the study was to investigate in a cadaveric model whether reproducible patellar tendon shortening changes the patellofemoral alignment. MATERIALS AND METHODS: Using five cadaveric knees, an MRI investigation was performed with the patellar tendon left unchanged, shortened 5 mm and shortened 10 mm, respectively, in both 20 and 45 degrees of knee flexion. The lateral patellofemoral and the congruence angles were measured and compared using a one-way analysis of variance for repeated measurements. RESULTS: Shortening the patella tendon by approximately 20% did not significantly influence the patellofemoral alignment. CONCLUSION: Although anterior cruciate ligament-reconstruction using the patellar tendon has become a standard procedure, postoperative problems such as anterior knee pain, and patellofemoral osteoarthritis occur quite often. In this cadaver study we did not find a significant difference for the patellofemoral alignment, irrespective of the patellar tendon length.

Geochemical evaluation of different groundwater-host rock systems for radioactive waste disposal.

The geochemical suitability of a deep bedrock repository for radioactive waste disposal is determined by the composition of geomatrix and groundwater. Both influence radionuclide solubility, chemical buffer capacity and radionuclide retention. They also determine the chemical compatibility of waste forms, containers and backfill materials. Evaluation of different groundwater-host rock systems is performed by modeling the geochemical environments and the resulting radionuclide concentrations. In order to demonstrate the evaluation method, model calculations are applied to data sets available for various geological formations such as granite, clay and rocksalt. The saturation state of the groundwater-geomatrix system is found to be fundamental for the evaluation process. Hence, calculations are performed to determine if groundwater is in equilibrium with mineral phases of the geological formation. In addition, corrosion of waste forms in different groundwater is examined by means of reaction path modeling. The corrosion reactions change the solution compositions and pH, resulting in significant changes of radionuclide solubilities. The results demonstrate that geochemical modeling of saturation state and compatibility of the host formation environment with the radioactive waste proves to be a feasible tool for evaluation of various sites considered as deep underground repositories.

Galactography: method of choice in pathologic nipple discharge?

Our objective was to assess the role of galactography in the diagnostic work-up of patients with pathological nipple discharge together with exfoliative cytology, and investigation of secretion colour. All galactographies performed in this center between 1993 and 1998 were evaluated retrospectively. In 134 cases, outcomes, defined as either a postoperative histology or a negative follow-up over 2 years after galactography, were available. In 96 of these cases, exfoliative cytology was performed, and in 65 cases the colour of the secretion was determined. Galactograms, cytological findings and colour of the secretions were compared with the outcomes. At galactography, the radiographic findings had the following individual sensitivities/specificities in detecting carcinomas: filling defect 55.6%/62.1%; ductectasia 22.2%/94%; and filling stop 5.6%/77.6%. Normal galactograms (n=33, 25%) had a sensitivity of 78% and a specificity of 93% in predicting absence of disease. Technically inadequate investigations occurred in 16 (12%) cases. Cytology showed 69.2%/66.8% for papillomatous borderline or malignant cells; 53.8%/75.3% for borderline or malignant cells; and 7.7%/100% for one case of malignant cells. For the assessment of pathological secretions, galactography is a sensitive but unspecific method for the detection of papillomas or carcinomas. Filling defects, ductectasia and ductal distortion carry the highest levels of suspicion for carcinoma. A normal galactogram is a specific yet moderately sensitive indicator of absence of localized disease. Exfoliative cytology shows low sensitivity but better specificity for carcinomas when borderline or malignant cells are found. In the present series, the colour of the secretions does not add significant information about underlying pathology.

[Intravenous administration of iodinated, non-ionic, low or isoosmolar contrast media: safety aspects]. / Intravenöse Anwendung von jodiertem, nichtionischem, nieder- bis isoosmolarem Kontrastmittel: Sicherheitsaspekte.

It is the purpose of this review to provide information about the safe use of intravenously administered, iodinated, non-ionic, low or isoosmolar contrast media for radiological examinations, how to avoid adverse events, and how to react professionally in case of an anaphylactic reaction. Methods of prophylaxis and therapy for anaphylactic and chemotoxic effects of contrast media administration as well as absolute and relative contraindications are discussed. Medico-legal considerations of contrast agent administration, informed consent of patients, and methods of risk management for undesired contrast media reactions are considered in this article. Establishment of adminstration standards for contrast media is of tremendous importance to standardize radiological procedures. This basic radiological documentation is part of the institutional and individual legal safety management.

Scaphoid fractures: evaluation with high-spatial-resolution US initial results.

PURPOSE: To evaluate the diagnostic accuracy of high-spatial-resolution ultrasonography (US) in the diagnosis of scaphoid fractures. MATERIALS AND METHODS: In 72 hours after acute wrist trauma, 15 consecutive patients were examined for possible scaphoid fractures clinically and with conventional radiographs, including scaphoid views. Thereafter, high-spatial-resolution US was performed by two experienced radiologists blinded to the results of the previously performed investigations. High-spatial-resolution US of the scaphoid bones was performed from the palmar, lateral, and dorsal directions in the longitudinal and transverse planes. US findings indicative of a scaphoid fracture were cortical discontinuity and/or periosteal elevation. Finally, magnetic resonance (MR) images (short inversion time inversion-recovery, T1- and T2*-weighted) (ie, the standard) of the affected wrist were obtained and evaluated for a possible scaphoid fracture by two radiologists in consensus. RESULTS: Nine of 15 patients had scaphoid fractures. Seven (78%) of nine patients had positive findings at high-spatial-resolution US and five (56%) had such findings at conventional radiography (ie, four occult scaphoid fractures), with an accuracy of 87% and 73%, respectively. Two (50%) of four radiographically occult scaphoid fractures were depicted with high-spatial-resolution US. Sonographic findings of scaphoid fractures were either cortical discontinuity (n = 4), periosteal elevation (n = 2), or a combination of these two findings (n = 1). CONCLUSION: High-spatial-resolution US is a reliable diagnostic tool for the evaluation of occult scaphoid fractures and should be considered an adequate alternative diagnostic tool prior to computed tomography or MR imaging.

[Trauma of the bones of the hand and wrist]. / Knöchernes Hand- und Handgelenktrauma.

Fractures of the distal radius are common counting for 17 percent of all fractures. With conventional radiography they can be classified readily. Magnetic resonance imaging (MRI) is a suitable technique for the detection of occult forms of fractures and of associated soft tissue injuries. In the wrist, fractures are 10 times less common than in the distal radius, with the scaphoid bone to be involved most commonly. Indications for computed tomography (CT) are complex fractures, occult fractures, or dislocations. MRI should be performed to evaluate the soft tissues, to detect occult fractures, or to analyse osteochondral lesions. Indications for arthrography are injuries of the ligaments or of the joint capsule. Fractures and dislocations of the metacarpal, and the phalangeal bones are the most common fractures of the skeletal system. Conventional radiography is the primary imaging technique, followed by sonography and MRI to detect injuries of the ligaments and tendons.

[Necrotizing enterocolitis (NEC) in the newborn]. / Nekrotisierende Enterokolitis (NEC) beim Neugeborenen.

Necrotizing enterocolitis (NEC) is a disease of the premature neonate that requires early therapy, sometimes even surgery and therefore early diagnosis. In general, plain radiography of the abdomen and sonography are valuable imaging techniques for diagnosis of NEC. COURSE OF NEC: The disease starts with distension of small bowel loops. Furthermore the children develop pneumatosis in the bowel wall, which is a nonspecific pattern. If the NEC persists, the air passes into the portal vein system, causing a pneumoportogram. Finally, the disease can lead to perforation. In doubtful cases, the plain radiogram must be repeated within a period of 6 h. With sonography distension of the bowel, thickening of and pneumatosis in the bowel wall, the pneumoportogram and free intraperitoneal fluid can be easily depicted. The most common complications of NEC are intestinal stenosis and strictures that can lead to ileus. DIFFERENTIAL DIAGNOSIS: Focal perforation of ileum, volvulus and Hirschsprung's disease are some of the differential diagnoses.

Tracheal agenesis: evaluation by helical computed tomography.

We present a newborn infant with type II tracheal agenesis. Helical CT was performed and confirmed the diagnosis. Retrospective coronal and sagittal multiplanar reconstructions clearly demonstrated the complex anatomy of the malformation. The absence of a significant portion of healthy trachea did not present any possibility for surgical correction.

Radiologic measurement of the scapholunate joint: implications of biologic variation in scapholunate joint morphology.

To determine the optimal location for measurement of the scapholunate (SL) joint intercortical width, normal biologic variation in SL joint morphology was evaluated in 40 normal, skeletally mature wrists (16 volunteers, 24 cadavers) using thin-section 1.5T magnetic resonance imaging performed in the axial and coronal planes. The integrity of the SL ligaments was confirmed by magnetic resonance imaging and verified with anatomic dissection of the cadaver wrists. Patterns of SL articular morphology were qualitatively determined using similarity grouping. Scapholunate interval measurements were made at 3 locations each on the mid-SL joint image from both the axial and coronal planes: the articular margins (dorsal-palmar and proximal-distal) and midjoint. Three patterns of midjoint space cortical conformation were observed: parallel congruent (78%), inverted Y (15%), and point-like (8%). The most consistent and narrowest distance between the scaphoid and lunate was found at midjoint: coronal 1.45 mm (44% coefficient of variation) and axial 1.00 mm (22% coefficient of variation). This study demonstrated that measurement of the apparent SL joint interval in an inappropriate site, as with extended or flexed clenched fist views, may provide inaccurate SL joint interval distance assessments. Regardless of SL joint configuration, the midportion of the SL joint shows only moderate biologic variation and the least absolute measurement variance in width and should be the most precise part of the joint to measure. On magnetic resonance imaging, the normal SL joint interval measures less than 2 mm.

Open meniscal repair: clinical and magnetic resonance imaging findings after twelve years.

The purpose of this study was to document the longterm clinical, radiographic, and magnetic resonance imaging results after open meniscal repair. Twenty-two patients, with 23 open meniscal repairs, were evaluated after a mean follow-up of 12.9 years using patient history, physical examination, KT-1000 arthrometer testing, the "Orthopaedische Arbeitsgemeinschaft Knie" knee evaluation scheme, Tegner activity score, weightbearing radiographs, and magnetic resonance imaging. Two of the 22 patients had retears and both occurred in unstable knees. Radiographs revealed no degenerative changes in 17 of the 23 compartments. Grade III and IV signal alterations were present on magnetic resonance imaging scans in more than 50% of the repaired menisci. We concluded that the longterm survival rate of repaired menisci was 91%, and that magnetic resonance imaging is unsuitable for diagnosis of the healing process of a repaired meniscus.

Patellar alignment evaluated by MRI.

We analyzed the congruence of the articular cartilage surfaces and the corresponding subchondral bone in the patellar joint. 20 volunteers underwent MRI investigations of the right patellar joint in 20 degree and 45 degree flexion in the axial plane. The sulcus, congruence, and lateral patellofemoral angles, measured on MRI slices centered through the midtransverse patella, were recorded. In 20 degree and 45 degree knee flexion, the bony sulcus and lateral patellofemoral angles were significantly different from the respective cartilagineous angle. We conclude that 1) measurement of the bony sulcus and lateral patellofemoral angles does not allow conclusions about the articular cartilage surface and its thickness, 2) the bony congruence angle corresponds well to the articular cartilage surface as an indicator of patellar centralization.

MR imaging in children with nonperforated acute appendicitis: value of unenhanced MR imaging in sonographically selected cases.

OBJECTIVE: The aim of this study was to describe the MR appearance of acute appendicitis and to determine the value of MR imaging for diagnosis of acute appendicitis. SUBJECTS AND METHODS: Forty-five children (28 girls, 17 boys), 7-16 years old (mean age, 13 years old), with clinically diagnosed acute appendicitis underwent independently graded compression sonography by two radiologists. MR imaging was performed when sonography revealed acute appendicitis (observer 1, 16 [36%] patients; observer 2, 18 [40%] patients), was inconclusive (observer 1, two [4%] patients; observer 2, one [2%] patient), and was interpreted as normal (observer 1, two [4%] patients; observer 2, one [2%] patient) (n = 20). Axial T1-weighted turbo spin-echo sequences, T2-weighted turbo spin-echo sequences in the axial and coronal planes, and fat-suppressed short inversion time inversion recovery turbo spin-echo sequences in the axial plane (4-mm slice thickness) were obtained and evaluated independently by two radiologists. The ability to see acute appendicitis with MR imaging was evaluated, the appearance and morphologic changes were described, and the most accurate sequence was determined. All children in whom MR imaging was performed underwent surgery. RESULTS: MR imaging revealed acute appendicitis in all cases (100%) by both observers. On T2-weighted ultra turbo spin-echo images, acute appendicitis appeared with a markedly hyperintense center, a slightly hyperintense thickened wall, and markedly hyperintense periappendiceal tissue. Unenhanced axial T2-weighted spin-echo imaging was the most sensitive sequence. CONCLUSION: In this study group, MR imaging was a valuable technique for depiction of acute appendicitis.

[Prevalence of abdominal aortic aneurysms: a sonographic screening study]. / Prävalenz des abdominellen Aortenaneurysmas: Eine sonographische Screeningstudie.

PURPOSE: To determine the prevalence of abdominal aortic aneurysms (AAA) in males above 60 years of age. METHODS: 1043 males of 60 years of age or older underwent sonographic examinations of the abdominal aorta. All of the candidates had volunteered for the examination, and special care was taken to avoid preselection of the candidates. Wherever possible, information was obtained on the following risk factors: cholesterol level, nicotine, diabetes, insulin and other medication, hypertonia and cardiac risk. RESULTS: An AAA was diagnosed in 2.59% of the cases, while ectasia of the abdominal aorta was detected in 11.89%. The mean diameter of the aneurysms was 39.1 mm. Significant correlations between the various risk factors and abnormalities of the abdominal aorta could be established in patients suffering from angina pectoris (p = 0.004) and from congestive heart failure (p = 0.014). CONCLUSIONS: AAA in males above 60 occurs in 2,590 out of 100,000 cases. The most noteworthy risk factors in the development of AAA are cardiovascular disorders.