Quantitation of reperfused myocardial infarction by Gd-DOTA-enhanced magnetic resonance imaging. An experimental study.

Because there is evidence that myocardial infarct size is modified by coronary artery reperfusion, an ex vivo experimental model of myocardial infarction was developed to determine the influence of the timing of gadolinium-tetraazacyclododecane tetraacetic acid (Gd-DOTA)-enhanced magnetic resonance imaging (MRI) on the accuracy of infarct size quantitation. Eighteen dogs underwent a 2-hour coronary occlusion followed by 1 (n = 6), 6 (n = 6), or 48 (n = 6) hours of reperfusion. Gd-DOTA was injected 10 minutes before the dogs were killed. T1 (SE 250/26) and T2 (SE 1500/78) weighted images were performed on excised hearts. Gd-DOTA concentration was measured in myocardium by atomic emission spectrometry, and correlated with myocardial blood flow evaluated by radioactive microspheres. All dogs presented with myocardial infarction (mean size 20.4% +/- 3.1% of the left ventricle), and a corresponding area of increased signal intensity on T1-weighted MR images. In none of the three groups did the area of high signal intensity correlate with the ischemic area. By contrast, after 6 and 48 hours of reperfusion, the high signal intensity area (17.9% +/- 2.4%) closely matched the area of nonreversible jeopardized tissue (16.4% +/- 2.5%), as determined on tetrazolium-stained heart slices. Although a noreflow phenomenon was observed in the jeopardized tissue, Gd-DOTA concentration was higher in the subendocardial central ischemic zone than in normally perfused myocardium. Gd-DOTA imaging enhancement seems to be the consequence of a delayed clearance of the agent from the injured tissue. Gd-DOTA-enhanced MRI accurately quantitates the size of reperfused myocardial infarction on the ex vivo heart for more than 6 hours after the beginning of reperfusion. It remains to be determined whether the in vitro results obtained here can be applied to assess the myocardial infarct size in vivo.

Critical quantum chaos and the one-dimensional harper model

We obtain numerically a scale-invariant distribution of the bandwidths S for the critical Harper model, which is closely described by a semi-Poisson P(S) = 4Sexp(-2S) curve. After a suitable unfolding of spectra, derived from different boundary conditions, a semi-Poisson level spacing distribution and a sub-Poisson linear number variance are deduced from the bandwidth distribution. The obtained results support possible universality of the critical spectral statistics and suggest its connection to spectral multifractality.

Bromazepam in generalized anxiety. Randomized, multi-practice comparisons with both chlorprothixene and placebo.

Bromazepam was compared with placebo and with chlorprothixene in a randomized, double-blind group-comparative multicenter trial in general practice. Two hundred and forty-five patients with generalized anxiety disorder (DSM-III 1980) were treated for 2 weeks with two daily doses of bromazepam, 3 mg or chlorprothixene, 15 mg or placebo. Median reductions in Hamilton Anxiety rating were 12 (bromazepam), 10.3 (chlorprothixene) and 7.3 (placebo). The study revealed significant superiority of bromazepam over placebo (median differences 3.3, 95% confidence limits: 0.3 and 6.1) but not over chlorprothixene (median difference 1.4, 95% confidence limits -0.8 and +3.5). Significantly higher rates of tiredness, sedation and hypersomnia were found on bromazepam and chlorprothixene compared to placebo. Tolerance was rated as "at least good" in 85.6% on bromazepam, in 86% on chlorprothixene and in 87.8% on placebo. Neither previous psychopharmacological treatment nor presence of psychosocial stress were of perceptible influence. Bromazepam and chlorprothixene are both superior to placebo in generalized anxiety states treated in general practice, but spontaneous improvements/placebo effects are substantial.

A 'cyanoacrylate case' for developing fingerprints in cars.

A portable case has been developed by which cyanoacrylate (super glue) fuming can be used inside a vehicle suspected of being involved in serious crime. The car itself serves as a fumigation chamber and the cyanoacrylate vapours are fed into the car via a hose. Connected to the hose and suspended inside the car is a vapour diffuser. The cyanoacrylate originates from a portable case where there is a sealed heater and also a command panel with hygrometer and thermometer for a technician to control the process. There is also space inside the case for other necessary equipment.

[Should athletic injuries be treated with non-steroidal anti-rheumatic agents (NSAID)? Tenoxicam, piroxicam and placebo in the treatment of acute stress-induced injuries]. / Skal sportsskader behandles med ikke-steroide antireumatika (NSAID)? Tenoxicam, piroxicam og placebo ved behandling af akutte belastningsinducerede skader.

A total of 212 patients with acute sports injuries were allotted at random to treatment with 20 mg tenoxicam daily, 20 piroxicam daily or a placebo for ten days. The injuries could be subdivided into six groups: Tendinitis, periostitis, sprains, tendovaginitis, epicondylitis and muscular ruptures. Treatment was well tolerated and analysis of the total material showed a slight but significantly better effect in the group treated with the active drugs. More detailed analysis revealed that this increased effect was produced by a definitely better therapeutic result in the group of patients with tendinitis treated with non-steroid anti-inflammatory drugs (NSAID) while, in the other types of injury, no definite effect could be observed. On the basis of these observations, the authors conclude that acute tendinitis may be treated with NSAID (tenoxicam) while the question is not yet solved where other acute stress-induced injuries are concerned.

Critical quantum chaos and the one-dimensional harper model.

We obtain numerically a scale-invariant distribution of the bandwidths S for the critical Harper model, which is closely described by a semi-Poisson P(S)=4Sexp(-2S) curve. After a suitable unfolding of spectra, derived from different boundary conditions, a semi-Poisson level spacing distribution and a sub-Poisson linear number variance are deduced from the bandwidth distribution. The obtained results support possible universality of the critical spectral statistics and suggest its connection to spectral multifractality.

[Risk factors of non-proliferating retinopathy in insulin-dependent diabetes]. / Facteurs de risque de la rétinopathie non proliférante dans le diabète insulinodépendant.

Risk factors for non proliferative retinopathy were investigated by comparing two groups of insulin dependent diabetic patients: group NR of 25 patients without retinopathy and group R of 25 patients studied at the time of discovery of non proliferative retinopathy. The two groups were matched for age, sex and diabete duration. They were significantly different for insulin treatment regimens, blood glucose control and blood pressure. Lipid parameters and renal function were similar in the two groups.

A long-term randomised trial on tenoxicam and piroxicam in osteoarthritis of the hip or knee: a 24-month interim report focusing on the 12-24 month interval.

The long-acting antiphlogistics tenoxicam (Ro 12-0068, Tilcotil) and piroxicam in single daily oral doses of 20 mg are compared in a double-blind, group-comparative, randomised trial planned to last for five years. Results of 12 months' treatment of 108 patients with osteoarthritis of the hip or knee have been reported. This interim analysis focuses mainly on the 12 to 24 month interval. The clinical improvements obtained within the first 12 months persisted during the second year in the 55 patients remaining on treatment. After 24 months, 53 patients had been withdrawn prematurely, three-quarters because of inefficacy or intolerance. Only six patients were withdrawn between 12 and 24 months, three for lack of efficacy, two for side-effects and one for reasons unrelated to therapy. There was no difference between the treatment groups with regard to incidence, time or reason for withdrawal, and only small, insignificant differences in efficacy and tolerability. This trial shows that long-term treatment of osteoarthritis with tenoxicam and with piroxicam is beneficial. Once efficacy and tolerability have been established, maintenance of therapy is feasible.

Treatment of lichen planus with acitretin. A double-blind, placebo-controlled study in 65 patients.

Sixty-five patients with lichen planus were included in a multicenter trial of acitretin. At the end of an 8-week placebo-controlled, double-blind phase, a significantly higher number of patients treated with 30 mg/day acitretin (64%) showed remission or marked improvement compared with placebo (13%). Furthermore, during the subsequent 8-week open phase, 83% of previously placebo-treated patients responded favorably to acitretin therapy. Typical retinoid adverse reactions were present in all patients on active drug. Laboratory studies did not show any clinically significant changes. This study shows that acitretin is an effective and acceptable therapy for severe cases of lichen planus.