Brain serotonin2 receptors in major depression: a positron emission tomography study.

BACKGROUND: Postmortem and brain imaging studies that measured brain serotinin(2) (5-HT(2)) receptors in major depression reported an increase, decrease, and no change compared with controls. In this study, we assessed brain 5-HT(2) receptors in 20 depressed patients (mean +/- SD age, 40.1 +/- 9.5 years; range, 22-60 years) and 20 healthy controls similar in age (37.2 +/- 12.6 years; range, 19-59 years) using positron emission tomography and setoperone labeled with fluorine 18 ([(18)F]setoperone). METHODS: Patients with DSM-IV major depression and healthy controls underwent scanning with [(18)F]setoperone. All study subjects were drug free for at least 2 weeks. The 5-HT(2) binding images were created using region-to-cerebellum ratios. The differences in 5-HT(2) receptor binding potential between the two groups were determined with statistical parametric mapping software and region of interest analysis. RESULTS: There was a significant negative correlation between 5-HT(2) receptor binding potential and age in both patients and controls, and the magnitude of this correlation was similar in both groups. Both statistical parametric mapping and region of interest analyses showed that, compared with healthy controls, depressed patients had significantly lower 5-HT(2) receptor binding potential in frontal, temporal, parietal, and occipital cortical regions. Statistical parametric mapping analysis showed that the mean decrease in 5-HT(2) receptor binding potential for the entire cluster in these regions was 22%, and it ranged from 22% to 27% for local maxima within the clusters of significant voxels. CONCLUSION: This study suggests that brain 5-HT(2) receptors are decreased in patients with major depression.

Laparoscopic jejunostomy.

A laparoscopic jejunostomy was performed in a patient for long-term feeding purposes. The more important details of the surgical technique are described, as well as a description of a new laparoscopic needle holder, for the suturing in the peritoneal cavity.

Quadriplegia: urological complications.

Unlike the general public, quadriplegics are prone to various urological complications as a direct/indirect result of spinal cord lesions. These complications include neurogenic bladder, urinary tract infections, renal and bladder calculi, obstructive uropathy, renal failure, and bladder neoplasms. A significant portion of upper urinary tract disease, including pyelonephritis, hypernephrosis, and calculi are usually secondary to neurogenic bladder related to detrusor sphincter dysfunction. These complications will be discussed in some detail in the following report.

Initial experiences with a formalised teaching programme in diagnostic radiology during the clinical undergraduate course.

The initial experiences of a four-week clinical undergraduate attachment in diagnostic radiology are described. The course is divided into (1) a series of prepared lecture programmes which cover aspects of diagnostic radiology in a systematic manner, (2) experience in hospital X-ray departments, observing special investigations and routine reporting, attending clinicoradiological conferences and receiving informal and formal tuition from radiologists, and (3) visits to specialised radiological and other imaging departments, namely ultrasound, nuclear medicine, neuroradiology and paediatrics. The aims of the courses are: (i) to provide a means of teaching clinical subjects and pathology in a dimension which crosses the tightly compartmentalised undergraduate curriculum; (ii) to instil basic principles of radiological interpretation, (iii) to teach undergraduates how to use the facilities of diagnostic imaging departments effectively and efficiently when they have qualified; (iv) to increase interest in the specialty, and insight into student opinion. There are difficulties involved in this large teaching commitment, for instance, understaffing, and the development of the course has been geared to counteracting these problems.

A system of organisation of an X-ray film library.

The physical arrangement of radiographs and a method for their retrieval is discussed. The aim is to facilitate access to examples of various conditions from several possible approaches by a method of specific classification of each item and a comprehensive card index. A system to maintain consistency and to achieve relevance for the potential user is described.