["Arteriosclerotic" aneurysm of the abdominal aorta]. / "Arteriosklerotisches" Aneurysma der Aorta abdominalis.

We present a patient with an aortic aneurysm and the epidemiology, etiology, screening, symptoms and therapeutic options of abdominal aortic aneurysms are discussed. A widening of the abdominal aorta >3 cm is termed aortic aneurysm. As patients with aortic aneurysm are mostly oligosymptomatic until rupture occurs and an estimated 30,000 patients annually die from ruptured aortic aneurysm in the US a screening of the population at greatest risk (smokers, familial predisposition) is recommended. Screening is best done by ultrasound. Noninvasive therapy is limited to antiplatelet therapy and optimal adjustment of risk factors. For definitive treatment endovascular aortic repair (EVAR) is considered an established alternative to open surgery with lower 30 days mortality but higher reintervention rate.

[Check-up, what else?]. / Check-up, was sonst?

Evidence-based check-up does not only include medical history and physical examination but consultation with regard to recommended vaccinations, screening for cancer and cardiovascular risk factors. Patients with PAD are at high risk for cardiovascular events but frequently claudication is not mentioned during anamnesis, thus specific attention to exercise-dependent leg discomfort is necessary. Recognition of PAD related symptoms is important because it may implicate secondary cardiovascular prevention and specific therapeutic options including walking exercise and endovascular revascularisation exist.

["Good Morning, Doctor, I'm Flying to Australia Next Week!"]. / "Herr Doktor, ich fliege nächste Woche nach Australien!"

Travel-related venous thromboembolism (VTE) is probably less frequent than previously suspected and becomes relevant when a flight lasts eight hours or more. Usually, general measures such as avoiding constrictive clothing or dehydration and doing gymnastics and walking around in the cabin are sufficient for preventing VTE. Compression stockings can be recommended when risk factors for VTE are present. Low molecular weight heparins in prophylactic dosage should be considered after previous VTE.

Head movement in normal subjects during simulated PET brain imaging with and without head restraint.

UNLABELLED: Head movement during brain imaging is recognized as a source of image degradation in PET and most other forms of medical brain imaging. However, little quantitative information is available on the kind and amount of head movement that actually occurs during these studies. We sought to obtain this information by measuring head movement in normal volunteers. METHODS: Head position data were acquired for 40 min in each of 13 supine subjects with and without head restraint. These data were then used to drive a mathematically simulated head through exactly the same set of movements. The positions of point sources embedded in this head were computed at each location and these data summarized as movement at FWHM in each of the three coordinate directions. RESULTS: Head movement increased with the length of the sampling interval for studies of either type (with or without head restraint), but the amount and rate of increase with restraint was much smaller. In contrast, head movement during consecutive, short sampling intervals was small and did not increase with time. Spatial gradients in head movement were detected within each study type, and significant spatial differences in head movement were found between study types. CONCLUSIONS: Head movements in normal, supine subjects, though small, can cause the effective resolution of a brain imaging study to appear to vary in space and time. These effects can be reduced significantly with head restraint and may also be reduced by dividing the acquisition of a single image into a sequence of short images (instead of a single long image), aligning these images spatially and summing the result.

The paramedian diencephalic syndrome: a dynamic phenomenon.

The paramedian diencephalic syndrome is characterized by a clinical triad: hypersomnolent apathy, amnesic syndrome, and impaired vertical gaze. We studied 4 cases with computed tomography evidence of bilateral diencephalic infarctions. Each case began abruptly with hypersomnolent apathy followed by fluctuations from appropriate affect, full orientation, and alertness to labile mood, confabulation, and apathy. Speech varied from hypophonia to normal; handwriting varied from legible script to gross scrawl. Psychological testing revealed poor learning and recall, with low performance scores. In 3 patients the predominant abnormality was in downward gaze.

Can embolic stroke be diagnosed on the basis of neurologic clinical criteria?

Diagnosis of embolic stroke is based on identification of a source of embolus (SOE) and on neurologic symptoms acknowledged as "clinical criteria." To test the validity of these criteria, we analyzed the symptoms at onset in 193 patients hospitalized after acute cerebral infarction. Patients were grouped according to identification of a cardiac SOE (106 patients), an arterial SOE (38 patients), or no SOE (49 patients). Cross-tabulations demonstrated that only rapidity and loss of consciousness at onset were associated with the presence of a cardiac SOE to a significant degree. Although these symptoms were highly specific for cardiac SOE, they were not sensitive. A distinct clinical neurologic profile from the symptoms and mode of onset was not identified.

An evaluation of root resections. A ten-year study.

A study was undertaken to evaluate the long term results of root resections. Records of 100 patients who had undergone root resections 10 years prior to the study were reviewed. Although the immediate postoperative results were gratifying, they were not always lasting. Eighty-four per cent of the failures occurred after 5 years. Most failures were in the mandibular arch and derived from reasons other than inflammatory periodontal disease. Suggestions are made as to how to improve the prognosis of resected teeth.

Histological assessment of autogenous bone graft. A case report and critical evaluation.

A histological study of the site of a clinically successful bone graft revealed the presence of a downgrowing junctional epithelium between the root surface and the altered graft bone. No new cementum could be seen associated with the osseous autograft, nor was a functional periodontal ligament in evidence adjacent to the grafted bone. It is suggested that the presence of newly formed bone on surgical reentry following bone grafting in periodontal lesions does not necessarily imply that regeneration of the periodontium has occurred.