[Experimental studies of the value of SPIO for MRI of bone marrow before and after whole body irradiation]. / Experimentelle Untersuchungen zur Wertigkeit von SPIO für die MRT des Knochenmarkes vor und nach Ganzkörperbestrahlung.

PURPOSE: Evaluation of the value of superparamagnetic iron oxides (SPIO; Endorem) for MRI-derived quantifications of the permeability of the blood-bone marrow barrier and the phagocytic activity of reticuloendothelial system (RES) bone marrow cells before and after TBI. METHODS: 12 New Zealand white rabbits underwent MRI of the lumbar spine and os sacrum using T1-weighted spinecho (SE) and T2-weighted Turbo-SE (TSE) sequences before and after injection of SPIO (Endorem). Four animals each were examined without irradiation, after 4 Gy total body irradiation (TBI), and after 12 Gy TBI. Changes in bone marrow signal intensities (SI) after contrast agent injection were quantified as delta SI(%) = SIpost-SIpre)/SIpre) x 100% and these data were correlated with bone marrow histopathology. RESULTS: Histopathology of the bone marrow revealed a radiation-induced decline of all hematopoetic cell lines. SPIO were phagocytosed by bone marrow RES cells and caused a significant bone marrow signal decline on postcontrast T2-weighted images (p < 0.05). delta SI(%) data for T2-weighted images were significantly higher for the irradiated bone marrow as compared to non-irradiated controls (p < 0.05). Dynamic T1-weighted images directly after contrast medium injection were not able to characterize the permeability of the blood-bone marrow barrier. CONCLUSION: Hematopoetic bone marrow can be labelled with SPIO. Irradiation does not impair the phagocytic activity of bone marrow RES cells. However, the bone marrow enhancement with SPIO is smaller as compared to previous results obtained by our group with USPIO.

Rigid removable dressing in a case of poor wound healing.

The rigid removable dressing technique for below-knee amputees has many advantages over other conventional systems. There is some reluctance to use this system in the presence of an open lesion. We present a patient with severe wound dehiscence who had success with this system. The advantages of the rigid removable dressing are protection of the stump and better shrinkage, combined with the ability to remove the dressing and look at the wound. This makes the technique ideal for a stump with poor wound healing.

Cardiomyopathy and Cerebrovascular Accident Associated With Anabolic-Androgenic Steroid Use.

In brief: This case report describes a 32-year-old bodybuilder who sustained an ischemic cerebrovascular accident and showed signs of cardiomyopathy. No cause was found for either condition, but he had been using steroids for 16 years. Questions remain about the association between the two conditions and steroid use, and the full effects of long-term, high-dose steroid use have yet to be elucidated. As steroid use becomes more popular among athletes, the medical community must be alert to the possible adverse effects of these substances.

Detachable cast pylon technique for rigid dressings on below-knee amputee patients.

The attachment of a pylon and prosthetic foot to a postoperative rigid dressing can be beneficial in the management of a below-the-knee amputation. Recently, a rigid, removable dressing has been used to allow easy inspection of the stump during healing. The removal of the pylon and prosthetic foot at night, preventing unsupervised ambulation, is accomplished by a disconnecting mechanism, which is permanently attached to the end of the rigid removable dressing. This disconnecting mechanism adds to the bulk and weight of the rigid dressing, increasing the shear force on the stump. We are introducing the detachable cast pylon technique, in which a fabricated sleeve attached to the pylon is easily and completely attached and detached from a rigid dressing. It is lightweight, less bulky, easily fabricated, and inexpensive. It offers a quick disconnect system for either the Otto-Bock attachment plate or uniquely with PVC tubing. In addition, this technique affords consistency in shaping the stump, as the same rigid dressing can be used for both rest and training. Its intent is for in-hospital use or when ambulation is restricted to supervised situations.

The value of propoxyphene hydrochloride (Darvon) for the treatment of hyperhidrosis in the spinal cord injured patient: an anecdotal experience and case reports.

Hyperhidrosis is a condition affecting the spinal cord injured (SCI) patient that often does not respond well to medical management. While the aetiology of hyperhidrosis in SCI patients is not completely understood, the standard form of treatment is aimed at interrupting the sympathetic cholinergic eccrine sweat glands. It has been our experience in treating this condition that many patients will have a significant decrease in hyperhidrosis using propoxyphene hydrochloride (Darvon) 65 mg once or twice per day. Two of these patients are presented. While the mechanism of action is purely speculative, there is evidence to support the concept that opioids may act as a weak ganglionic blocking agent. We have found that a trial of this medication for SCI patients suffering from hyperhidrosis may produce very gratifying results. Further investigation into the treatment of this condition with propoxyphene hydrochloride is indicated.