[Altered hip muscle activation in patients with chronic non-specific low back pain]. / Veränderte Beckenmuskelaktivierung bei Patienten mit chronischem nichtspezifischem Rückenschmerz.

BACKGROUND: The aim of this study was to examine postural control in patients with chronic non-specific low back pain (CNRS). Furthermore the influence of visual information (eyes open versus eyes closed) was analyzed. MATERIAL AND METHODS: A total of 8 patients with CNRS and 12 healthy control subjects were examined. Surface electromyography (SEMG) recordings were made from 5 trunk and 5 lower limb muscles as well as one hip muscle during application of distal lateral perturbation. RESULTS: Healthy controls (mean ± standard deviation: 96.42±64.77 µV) showed a significantly higher maximum amplitude of the gluteus medius muscle in comparison to patients with CNRS (56.29±39.63 µV). Furthermore activation of several lower limb muscles was found to be dependent on visual information. CONCLUSION: Patients showed an altered reflex response of the gluteus medius muscle which could be associated with reduced hip stability.

Impact of positron emission tomography on strategy in liver resection for primary and secondary liver tumors.

PURPOSE: Outcome of patients with metastatic disease mainly depends on accurate preoperative tumor staging. 18[F]fluorodeoxyglucose positron emission tomography (18F-PET) has been proven to be a valuable diagnostic tool in a number of different tumors but its direct influence on liver surgery has not been thoroughly investigated. MATERIALS AND METHODS: Between July 1999 and March 2000, 50 consecutive patients with 174 suspected liver lesions were admitted to the University Hospital Jena. All 50 patients underwent abdominal ultrasound, CT-scan, and 18-FDG positron emission tomography scanning. In 23 patients the diagnostic work-up was completed by MRI scan. RESULTS: Altogether there were a total of 174 histologically proven intrahepatic lesions, nine of which were benign. The sensitivity, specificity, and positive predictive value of PET for all hepatic lesions was 82%, 25%, and 96% compared with 63%, 50%, and 96% for abdominal ultrasound, 71%, 50%, and 97% for CT-scan, and 83%, 57%, and 97% for MRI-scan. In 23 of 50 patients 24 extrahepatic lesions were identified. In these patients the sensitivity and specificity of PET-compared to abdominal ultrasound, CT-scan, and MRI-scan for all extrahepatic lesions-was 63% and 60%, 29% and 25%, 47% and 50% and 40% and 50%, respectively. The findings on PET scan had a direct impact on operative management in nine patients (18%). CONCLUSIONS: Our series demonstrates good sensitivity and specificity for the detection of primary and secondary liver lesions which is superior to ultrasound and CT scan but not to MRI scan. The main value of PET scan consists in the detection of extrahepatic tumor (64%). Due to better detection of extrahepatic tumor, FDG-PET is a very useful addition to the currently used anatomically-based images in all cases of advanced tumor spread with high risk of extrahepatic tumor.