Delayed matching to sample task 48: assessment of malingering with simulating design.

The results of neuropsychological tests may be distorted by patients who exaggerate cognitive deficits. Eighty-three patients with cognitive deficit [Amnestic Mild Cognitive Impairment (aMCI), n = 53; Alzheimer's disease (AD) dementia, n = 30], 44 healthy older adults (HA), and 30 simulators of AD (s-AD) underwent comprehensive neuropsychological assessment. Receiver Operating Characteristic (ROC) analysis revealed high specificity but low sensitivity of the Delayed Matching to Sample Task (DMS48) in differentiating s-AD from AD dementia (87 and 53%, respectively) and from aMCI (96 and 57%). The sensitivity was considerably increased by using the DMS48/Rey Auditory Verbal Learning Test (RAVLT) ratio (specificity and sensitivity 93% and 93% for AD dementia and 96% and 80% for aMCI). The DMS48 differentiates s-AD from both aMCI and AD dementia with high specificity but low sensitivity. Its predictive value greatly increased when evaluated together with the RAVLT.

[Correlation among clinical and morphological findings in a diffuse axonal injury]. / Korelace klinických a morfologických nálezu u difuzního axonálního poranení.

In a man of 56 years--a victim of traffic accident, contusions in both temporal lobes of the brain and a small subdural and subarachnoid haemorrhage were diagnosed by CT and MR examination. According to the findings of petechial haemorrhages in the corpus callosum a diffuse axonal injury was clinically diagnosed. After 2 months the patient died. Excisions of corpus callosum and the brain-stem were examined by histological staining including Palmgren@s method and by immunohistochemical detection of neuron-specific enolase (NSE) in damaged axons. Clinical findings were compared with morphological findings, i.e. autopsy, histological and immunohistochemical examination. The possibilities of clinical diagnostics of diffuse axonal injury are discussed.

Unusual complication of total thyroidectomy: arteriovenous fistula.

We describe the case of a 29-year-old woman from the Chernobyl area, who moved to the Czech Republic 10 years after the Chernobyl nuclear disaster. She was evaluated for a large goiter. Fine-needle aspiration cytology indicated a diagnosis of a typical degenerated Hurthle cell adenoma. She underwent total thyroidectomy but a continual loud murmur was found 1 month after surgery. An arteriovenous (AV) fistula between the right thyrocervical trunk and the right jugular vein was proven angiographically. This fistula was successfully closed by artificial embolization performed by detachable Gianturco-Anderson-Wallace (GAW) coil. This is the first description of using such a procedure in order to close an AV fistula after thyroidectomy.

[Prunella vulgaris L.--a rediscovered medicinal plant]. / Cernohlávek obecný (Prunella vulgaris L.)--znovu objevená lécivá rostlina.

In the past, the self-heal (Prunella vulgaris L.) was primarily used as a remedy alleviating pains in the throat, fevers and accelerating wound healing. A high content of rosmarinic acid, immunomodulation effects of the polysaccharide prunelline and antiviral activity of some constituents make the plant interesting from the viewpoint of therapeutical applications. The paper summarizes the contemporary phytochemical knowledge about the self-heal and the results of pharmacological studies of the extracts and pure substances from this plant.

[Digital subtraction angiography in intracranial vascular malformations]. / Digitální subtrakcní angiografie u nitrolebních cévních malformací.

From a total number of 350 DSA examinations in the cervicocranial region intracranial vascular malformations were detected in 14 patients, i.e. in 4%. In six instances an aneurysm was involved, six times arteriovenous and twice a venous malformation. Using digital subtraction angiography, it is usually possible to diagnose by the intravenous or intraaortal route major findings, however, in the majority the finding serves only for orientation. For a more detailed diagnosis, in particular of small findings and findings before operation, a selective examination is more suitable.

[Anomalous branching of the inferior thyroid artery from the left vertebral artery]. / Anomální odstup arteria thyreoidea inferior z levé vertebrální tepny.

In a 53 years old woman hospitalized for a suddenly developed picture of vascular insufficiency in the verterobrobasillary vascular bed the authors detected an anomalous division of the left vertebral artery from aortic arch. Moreover, at the level of thyroid gland there was the division of inferior thyroid artery from the vertebral artery. We express the opinion that the finding did not participate in the clinical symptomatology.

Digital subtraction angiography in cerebrovascular diseases. Correlation of DSA with clinical findings. / Digitální subtrakcní angiografie u cévních onemocnení mozku. Korelace DSA a klinického nálezu.

Digital subtraction angiography (DSA) was performed in 100 patients with cerebrovascular diseases. The results of angiographic examination were compared with clinical findings on admission to and on discharge from hospital. The statistical evaluation was made on computers. Processing of anamnestic data revealed in the patients a large number of risk factors and other diseases, on average 3.68 per man and 3.96 per woman. 71% of the patients were examined on account of a relapse of some cerebrovascular disease. No relationship was found between the degree of the neurological deficit and clinical units on the angiographic finding. Clinically assumed arterial stenosis or occlusion was confirmed by DSA in 44.4%. On the other hand, in 57.9% of 38 affected subjects a stenotizing or obliterating process of the extracranial portion of the internal carotid was diagnosed in the absence of previous clinical suspicion. Of 76 patients with arteriosclerotic change in 56.6% the extracranial portion of the internal carotid was affected, incl. its bifurcation. Of 38 patients with stenosis or occlusion in 36.8% the affection was bilateral. Nine patients were indicated for operation, in another four endarterectomy of the internal carotid was done previously. DSA is a very useful examination method in patients with arteriosclerotic changes of the cerebral and cerebellar arteries. The risk for patients is, as compared with classical angiography, reduced while the obtained information on anatomical changes of the arterial wall is sufficient.