Retrospective Analysis of the Association of a Small Vestibular Aqueduct with Cochleovestibular Symptoms in a Large, Single-Center Cohort Undergoing CT.

BACKGROUND AND PURPOSE: Temporal bones in some patients with Ménière disease have demonstrated small vestibular aqueducts; however, the prevalence and clinical importance of small vestibular aqueducts remain unclear in patients without Ménière disease. This study correlates the presence of a small vestibular aqueduct with cochleovestibular symptoms. MATERIALS AND METHODS: Consecutive temporal bone CTs in adults from January to December 2020 were reviewed. The midpoint vestibular aqueduct size in the 45°-oblique Pöschl view was measured by 2 reviewers independently in 684 patients (1346 ears). Retrospective chart review for the clinical diagnosis of Ménière disease, the presence of cochleovestibular symptoms, and indications for CT was performed. RESULTS: Fifty-two of 684 patients (7.6% of patients, 62/1346 ears) had small vestibular aqueducts. Twelve patients (15/1346 ears) had Ménière disease. Five of 12 patients with Ménière disease (5 ears) had a small vestibular aqueduct. There was a significant correlation between a small vestibular aqueduct and Ménière disease (P < .001). There was no statistical difference between the small vestibular aqueduct cohort and the cohort with normal vestibular aqueducts (0.3-0.7 mm) regarding tinnitus (P = .06), hearing loss (P = .88), vertigo (P = .26), dizziness (P = .83), and aural fullness (P = .61). CONCLUSIONS: While patients with Ménière disease were proportionately more likely to have a small vestibular aqueduct than patients without Ménière disease, the small vestibular aqueduct was more frequently seen in patients without Ménière disease and had no correlation with hearing loss, vertigo, dizziness, or aural fullness. We suggest that the finding of a small vestibular aqueduct on CT could be reported by radiologists as a possible finding in Ménière disease, but it remains of uncertain, and potentially unlikely, clinical importance in the absence of symptoms of Ménière disease.

Recruitment of fat cell precursors during high fat diet in C57BL/6J mice is fat depot specific.

OBJECTIVE: The study aims to explore long-term dietary effects on increases in body mass and fat depot enlargement through the recruitment of early in life labeled progenitor cells to the adipolineage. METHODS: Neonate male C57BL/6J (B6) mice were injected intraperitoneally with BrdU. From 4 until 30 weeks of age they were fed either low fat diet (LFD) or high fat diet (HFD). BrdU-labeled cells were analyzed by flow cytometric and immunohistochemical assays after 10 days and 4, 8, 16, and 30 weeks. RESULTS: Mice fed HFD were heavier than mice fed LFD with the most dramatic disparity recorded between week 16 and 30. BrdU-bearing cells showed the decrease in the percentage content of labeled cells in inguinal (iWAT), epididymal (eWAT) and bone marrow (BM) tissues, regardless diets. However, iWAT collected from animals on HFD showed significant increase in labeled-cells at week 16th, which coincides with robust increase in inguinal but not epididymal fat weight between 16 and 30 weeks age. CONCLUSIONS: Cells labeled with BrdU during neonate life of B6 mice persist in fat tissues for long period of time and are recruited to the adipocyte lineage in a favorable (obesogenic) environment in iWAT but not in eWAT.

Orientation sensitive properties of visually driven neurons in extrastriate area 21a of cat cortex.

Orientation sensitive properties of extrastriate area 21a neurons were investigated. Special attention was paid to the qualitative characteristics of neuron responses to the different orientations of visual stimulus motion across neuron classical receptive fields (CRF). The results of experiments have shown that a group of neurons (31%) in area 21a with specialized responses to moving visual stimuli changed their direction selective (DS) characteristics depending on the orientation of the stimulus movement. Some neurons reveal an abrupt drop of the direction sensitivity index (DI) to certain orientation (58%), and some show significant increase of DI at one of applied orientations of stimulus motion (22%). Detailed investigation of response patterns of non-directional neurons to different orientations of stimulus motion have revealed clear-cut qualitative differences, such as different regularities in the distribution of inter-peak inhibitory intervals in the response pattern in dependence of the orientation of stimulus motion. The investigation of neuron CRF stationary functional organization did not reveal correlations between RF's spatial functional organization, and that of qualitative modulations of neuron response patterns. A suggestion was put forward, that visual information central processing of orientation discrimination is a complex integrative process that includes quantitative as well as qualitative transformations of neuron activity.

Spatial summation processes in the receptive fields of visually driven neurons of the cat's cortical area 21a.

The spatial summation in receptive fields (RF) of single neurons in cat's extrastriate area 21a was investigated as a basic neurophysiological substrate for central integration processing of visual information. The results showed that the majority of investigated neurons changed their response patterns with gradual increase of applied stimulus size. In approximately 82% of cases the suppression of neuron discharges was observed when the length of the moving strip exceeded that of the RF. In some neurons the increased size of the moving stimulus leads to the changes in the RF substructure. Receptive fields of neurons recorded at the same microelectrode penetration depth showed a great variety of RF superpositions distributed in a spatially asymmetric manner. As a result, every single RF consists of multiple sub-regions within the RF, differing from each other by the number of superimposed RF-s (density factor). We suggest that such complex spatial organization of the RF provides the neurophysiological basis for central integration processing of the visual information.

The spatial substructure of visual receptive fields in the cat's superior colliculus.

Although the direction selective properties of the superficial layer cells of the cat's superior colliculus have been extensively studied, the mechanisms underlying this property remain controversial. With the aim to understand the mechanism(s) underlying directional selectivity of collicular neurons we examined the substructure of their visual receptive fields. 1. The strength of cell responses and the direction selectivity indices varied in relation to the location of the tested region within the receptive field and the amplitude of stimulus movement. 2. Decrease of the amplitude of motion resulted in a decrease of direction selectivity index both in the group of direction-selective cells and in the group of cells classified as direction nonselective but with a directional bias. 3. The decrease of direction selectivity for small amplitude movement resulted mainly from increase in the magnitude of response in the nonpreferred direction of movement. 4. These results suggest that the receptive fields of most collicular cells are composed of subregions with different response profiles and indicate that inhibitory mechanisms dictate direction selectivity of collicular cells.

[Inhibition of 18F-FDG uptake in glioblastoma cells by FDG and glucose]. / Hemmung der 18F-FDG-Aufnahme in Glioblastoma-Zellen durch FDG und Glucose.

It was the aim of the study to compare the inhibition of 18F-2-Fluor-D-deoxy-glucose uptake (18F-FDG) in tumor cells by various concentrations of FDG carrier or D-glucose in an experimental model using tissue culture and positron emission tomography (PET). Glioblastoma cells in culture were incubated with 18F-FDG with and without added carrier or in presence of glucose concentrations in the range from 0-5 mmol/L. Cellular uptake of 18F-FDG was measured after 20 min. of incubation in PBS-buffer containing different sugar concentrations. The uptake was determined with a PET camera. The similarity of the kinetics of the FDG and glucose uptake are backing the hypothesis that both substrates use the same carrier system. The more intense inhibition of the 18F-uptake by FDG can be explained by the different intracellular metabolism of both substrates. The results explain the clinical experience that there is an optimal 18F-FDG uptake in the patient's tumor when the blood glucose level is as low as possible and the specific activity of 18F-FDG is very high.

[Toxicity and radiation dosage of 2-(18F)-2-desoxy-D-glucose in positron emission tomography]. / Toxizität und Strahlendosis von 2-[18F]-2-Desoxy-D-Glukose in der Positronenemissionstomographie.

2-[18F]-FDG, a non-physiological glucose analogue, is the most important positron-emission- tomography (PET) radiopharmaceutical. As an example we refer to the production of 2-[18F]-FDG at the research center in Karlsruhe. 2-[18F]-FDG is synthesized in a "no carrier added" process. It is delivered at a maximal filling volume of 10 ml from a 14.5 ml batch with a batch-to-batch yield fluctuation from 5075 to 50,750 MBq and a specific activity from 1 to 10 GBq/mumol. The residual remaining synthesis reagents like solvents or catalysts have no toxicological relevance. The applicated dose per patient is in a range from 185 to 370 MBq and 1000 times lower than the correlating concentrations of stable FDG which can be regarded harmless in animals. 2-[18F]-FDG does not interfere with normal glucose metabolism. It is taken up by cells and phosphorylated to 2-[18F]-FDG-6-phosphate. The following dephosphorylation step is slow and the labeled compound is retained over several hours within the cells. Non-metabolized 2-[18F]-FDG is excreted rapidly in the urine to an extent of about 16% after 60 min, and 50% after 135 min, respectively. Fluorine-18F decays by emission of 511 KeV gamma photons. The whole body effective dose is reported to be 21 to 27 microSv/MBq. In case of an intravenous injection of 370 MBq this leads to a total dose of 7.8 to 10 mSv. The critical organ is the bladder wall (radiation dose 120 to 170 microSv/MBq or 80 to 100 mrem/mCi). The risk of a radiation induced late malignoma at 10 mSv can be estimated to be 1:2000. The genetical risk as a consequence of FDG-PET diagnostics would be 1:100,000 to 2:100,000 for dominant, and 5 times higher for recessive mutations.

Summation effects in receptive fields of the cat's pretectal neurons to stationary and moving visual stimuli.

1. Numerous investigations have shown that the cat's pretectal region (PR) is involved in performance of various visual habits, visually guided behaviour and learning processes. Thus, visually driven PR neurons must have abilities to integrate incoming sensory information. 2. Responses of 102 PR neurons to moving and stationary visual stimuli were investigated in cats. Special attention was paid to the comparative characteristics of summation processes in the same neuron elicited by stationary and moving visual stimuli. 3. The results indicate that only a small proportion (20%) of pretectal neurons revealed similar courses of summation for stationary and moving stimuli. The great majority of neurons (about 80%) showed differentiated courses of summation, depending on the type of visual stimuli used. 4. These data indicate that there are probably discrete mechanisms in the PR which contribute to integration of sensory information in the visually sensitive cells according to the different types of visual stimuli used.

Fluorodeoxyglucose whole-body positron emission tomography in colorectal cancer patients studied in routine daily practice.

PURPOSE: To evaluate the routine clinical value of attenuation-corrected whole-body fluorodeoxyglucose positron emission tomography in colorectal cancer, a total of 59 patients who were referred for evaluation of suspected or proven colorectal cancers were studied. METHODS: Positron emission tomography scans were recorded using a Siemens ECAT Exact 921/47. RESULTS: Median follow-up after the positron emission tomography study was 11 (mean, 12.3; range, 1-21) months. According to computed tomography, coloscopy, and ultrasound, we recorded eight apparently false-positive results. During later follow-up, however, three of those cases, which were negative with computed tomography, magnetic resonance imaging, sonography, or laparoscopy, turned out to be true-positive instead. In 3 patients, a primary colorectal cancer was suspected; in 26 patients, a recurrence of colorectal cancer was suspected. Eight patients were studied for follow-up after the history of colorectal cancer with no suspicion of recurrence. In 12 patients, the rise of serum tumor marker concentrations was the reason for the positron emission tomography study; 12 patients with known metastatic disease were also included ("restaging"). With regard to the entire patient population, we found an overall sensitivity of 100 percent, a specificity of 67 percent, and positive and negative predictive values of 92 and 100 percent, respectively. Being merely confirmative with respect to tumor recurrence or distant metastases in the majority of patients, positron emission tomography revealed a primary tumor in one patient and confirmed metastatic foci in several patients that had not been delineated by other imaging modalities. CONCLUSION: A whole-body positron emission tomography scan provides optimum conditions to locate metastatic lesions that might not be seen otherwise. There is a trend showing that positron emission tomography diagnostics as a consequence of early increased tumor markers is a highly sensitive combination, because computed tomography and magnetic resonance imaging were not as sensitive in early recurrences. Positron emission tomography, as performed in daily clinical practice, proved to be a powerful diagnostic tool in our subset of colorectal cancer patients.

[PET scan in general practice for diagnosis of breast carcinoma]. / PET in der Praxis bei der Diagnostik des Mammakarzinoms.

The value of whole body positron emission tomography using 18F-fluoro-deoxy-glucose (18FDG) in primary work-up and follow-up was evaluated retrospectively in 104 patients with primary or metastatic breast cancer. Compared to other imaging methods, FDG-PET sensitivity was superior to sonography, CT or MRT. Another advantage is the possibility of whole body imaging and the earlier detection of lymph node metastasis due to the recognition of functional metabolic changes compared to structural changes found with conventional imaging methods.

Standardized uptake values of fluorine-18 fluorodeoxyglucose: the value of different normalization procedures.

While the evident advantages of absolute metabolic rate determinations cannot be equalled by static image analysis of fluorine-18 fluorodeoxyglucose positron emission tomographic (FDG PET) studies, various algorithms for the normalization of static FDG uptake values have been proposed. This study was performed to compare different normalization procedures in terms of dependency on individual patient characteristics. Standardized FDG uptake values (SUVs) were calculated for liver and lung tissue in 126 patients studied with whole-body FDG PET. Uptake values were normalized for total body weight, lean body mass and body surface area. Ranges, means, medians, standard deviations and variation coefficients of these SUV parameters were calculated and their interdependency with total body weight, lean body mass, body surface area, patient height and blood sugar levels was calculated by means of regression analysis. Standardized FDG uptake values normalized for body surface area were clearly superior to SUV parameters normalized for total body weight or lean body mass. Variation and correlation coefficients of body surface area-normalized uptake values were minimal when compared with SUV parameters derived from the other normalization procedures. Normalization for total body weight resulted in uptake values still dependent on body weight and blood sugar levels, while normalization for lean body mass did not eliminate the positive correlation with lean body mass and patient height. It is concluded that normalization of FDG uptake values for body surface area is less dependent on the individual patient characteristics than are FDG uptake values normalized for other parameters, and therefore appears to be preferable for FDG PET studies in oncology.

Fluorine-18 fluorodeoxyglucose positron emission tomography in the follow-up of differentiated thyroid cancer.

Whole-body fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) imaging was performed during the follow-up of 33 patients suffering from differentiated thyroid cancer. Among them there were 26 patients with papillary and seven with follicular tumours. Primary tumour stage (pT) was pT1 in six cases, pT2 in eight cases, pT3 in three cases and pT4 in 14 cases. FDG PET was normal in 18 patients. In three patients a slightly increased metabolism was observed in the thyroid bed, assumed to be related to remnant tissue. In one case local recurrence, in ten cases lymph node metastases (one false-positive, caused by sarcoidosis) and in three cases distant metastases were found with FDG PET. In comparison with whole-body scintigraphy using iodine-131 (WBS) there were a lot of discrepancies in imaging results. Whereas three patients had distant metastases (proven with 131I) and a negative FDG PET, in four cases 131I-negative lymph node metastases were detectable with PET. Even in the patients with concordant "staging", differences between 131I and FDG were observed as to the exact lesion localization. Therefore, a coexistence of 131I-positive/FDG-negative, 131I-negative/FDG-positive and 131I-positive/FDG-positive malignant tissue can be assumed in these patients. A higher correlation of FDG PET was observed with hexakis (2-methoxyisobutylisonitrile) technetium-99m (I) (MIBI) scintigraphy (performed in 20 cases) than with WBS. In highly differentiated tumours 131I scintigraphy had a high sensitivity, whereas in poorly differentiated carcinomas FDG PET was superior. The clinical use of FDG PET can be recommended in all cases of suspected or proven recurrence and/or metastases of differentiated thyroid cancer and is particularly useful in cases with elevated serum thyroglobulin levels and negative WBS.

Spatial organization of receptive fields of cat's. Hippocampal visually driven neurones.

According to the spatial configurations of receptive fields two broad groups of neurones in dorsal hippocampal region (HR) were distinguished. The receptive field borders of 22 cells have regular (R) smooth contours (squares or rectangles), usually with a horizontally oriented longitudinal axis. The second group was composed of neurones (20 cells) with irregular (IR) configurations of receptive fields. Some neurones (16 cells) of this group had relatively simple spatial configurations of receptive fields and 4 neurones had receptive fields with more intricate spatial configurations which formed complex geometrical shapes in the visual field. The exploration of the distribution of response properties a to stationary flashing spot over the RF surface revealed that the majority of cells with regular receptive fields have heterogeneous stationary structure with ON, ON-OFF and OFF subregions sequentially located in the receptive field, and these neurones, as a rule, were direction-sensitive. The neurones with irregular receptive fields, on the other hand, had a rather homogeneous structure of RFs when tested by a stationary flashing spot and only four neurones of 20 investigated were directionally sensitive.

Responses of cat's dorsal hippocampal neurones to moving visual stimuli.

Response properties of visually driven neurones in the cat's hippocampal region were investigated. Out of 688 single cells observed 181 (26%) were visually driven. Ocular dominance was determined for 147 of those cells, 90 of which were driven only by the contralateral eye, 20 were driven exclusively by ipsilateral eye and 37 neurones could be activated by both eyes. Receptive field boundaries were outlined for 157; 152 of those neurones were movement-sensitive, and 125 neurones were sensitive to stationary stimuli. A small group of neurones (13%) showed more pronounced reactions to the vertical direction of motion. Some neurones (22%) revealed sensitivity to the shape and size of the applied visual stimuli. These results confirmed earlier data indicating that visually driven neurones in hippocampal region possess complex properties. They are probably involved in a higher level of visual information processing.

Spatial summation processes in visually driven neurones of cat's pretectal region.

The spatial summation processes of single neurones of cat's pretectal region were investigated with moving and stationary visual stimuli. The results indicate that the majority of the investigated neurones changed their responses essentially at the gradual increase of size of the applied stimuli (i.e. showed negative or positive summation). Particularly, direction non-sensitive neurones showed symmetrical changes of spatial summation curves in response to two opposite directions of movement. By contrast, in some direction sensitive neurones different characteristics of responses for the two opposite directions of movement were observed. Thus the number of discharges in the responses to the preferred direction could increase or decrease at the gradual increase of the moving stimulus size, while the responses to the null direction could remain stable or vice versa. The same was observed for the "ON" and "OFF" responses in the ON-OFF neurones. Thus, it appears that the pattern of responses of a given neurone to different directions of movement and to the "on" and "off" periods of stationary stimulation are shaped by independent mechanisms.

[The retinotopic organization of the posterior suprasylvian area of the cerebral cortex in the cat]. / Retinotopicheskaia organizatsiia zadnei suprasil'vievoi oblasti kory mozga koshki.

Posterior suprasylvian area (PSA) is one of the extrastriate visual structures of the cat cortex. Representation of the visual field in the PSA has been investigated by the mapping method. Results of experiments revealed that receptive fields (RF) of the PSA neurons were located mostly in the upper contralateral quadrant of the visual field. About 10% of RF were located in the upper ipsilateral quadrant of the visual field. In the upper PSA (21a, 21b) area centralis is mainly represented including the space of the radius of 20-30 degrees of the visual field. In the lower PSA (20a, 20b) more peripheral part of the visual field was represented. The experiments did not confirm essential differences in the retinotopic organization between areas 20a and 20b, 21a and 21b. Proceeding from the presented experiments the suggestion is put forward that PSA consists of two main areas (21 and 20) without dividing into subareas.

[Structure of receptive fields of visually sensitive neurons of the cat hippocampus]. / Stroenie retseptivnykh polei zritel'nochuvstvitel'nykh neironov gippokampa koshki.

Structure of receptive fields of visually sensitive neurons in areas CA1 and CA3 of the dorsal hippocampus was investigated in alert cats with the brain-stem pretrigeminal section. The receptive field (RF) structure of 76 hippocampal neurons was analyzed by methods of scanning the RF by moving stimuli and mapping all their surface by a stationary flashing spot. According to presented data the neurons were classified into three groups: neurons with homogeneous structure of the RF (54%), with nonhomogeneous (28%) and neurons more sensitive to stimulus motion (18%) than to a stationary flashing light. Experiments have shown that responses of hippocampal neurons are highly specific ones. Thus, 9% of neurons with the nonhomogeneous RF structure have shown specific responses to variation of the contrast and contours of moving stimuli. The presented results show that hippocampal visually driven neurons have well developed mechanism for processing visual sensory information and apparently this quality ensures participation of the limbic system in visually controlled behavior of the animal.