Flat detector angio-CT following intra-arterial therapy of acute ischemic stroke: identification of hemorrhage and distinction from contrast accumulation due to blood-brain barrier disruption.

BACKGROUND AND PURPOSE: Flat panel detector CT in the angiography suite may be valuable for the detection of intracranial hematomas; however, abnormal contrast enhancement frequently mimics hemorrhage. We aimed to assess the accuracy of flat panel detector CT in detecting/excluding intracranial bleeding after endovascular stroke therapy and whether it was able to reliably differentiate hemorrhage from early blood-brain barrier disruption. MATERIALS AND METHODS: Seventy-three patients were included for retrospective evaluation following endovascular stroke therapy: 32 after stent-assisted thrombectomy, 14 after intra-arterial thrombolysis, and 27 after a combination of both. Flat panel CT images were assessed for image quality and the presence and type of intracranial hemorrhage and BBB disruption by 2 readers separately and in consensus. Follow-up by multisection head CT, serving as the reference standard, was evaluated by a single reader. RESULTS: Conventional head CT revealed intracranial hematomas in 12 patients (8 subarachnoid hemorrhages, 7 cases of intracerebral bleeding, 3 SAHs plus intracerebral bleeding). Image quality of flat panel detector CT was considered sufficient in all cases supratentorially and in 92% in the posterior fossa. Regarding detection or exclusion of intracranial hemorrhage, flat panel detector CT reached a sensitivity, specificity, positive and negative predictive values, and accuracy of 58%, 85%, 44%, 91%, and 81%, respectively. Maximum attenuation measurements were not valuable for the differentiation of hemorrhage and BBB disruption. CONCLUSIONS: Flat panel CT after endovascular stroke treatment was able to exclude the rare event of an intracranial hemorrhage with a high negative predictive value. Future studies should evaluate the predictive value of BBB disruptions in flat panel detector CT for the development of relevant hematomas.

Pulsed Photon-Stimulated Luminescence (PPSL) as a tool in retrospective dosimetry.

The analysis of luminescence of minerals extracted from pottery and bricks is a well-known tool in retrospective dosimetry. In the past, the detection limit of this method has been reported to lie in general in the order of magnitude of about 10 mGy. For most applications in accidental dosimetry, this is more than sufficient. Still there are some applications, such as the determination of the natural dose if the samples are comparatively young and the doses involved are small (e.g. in epidemiological studies), where the possibility of determining much smaller doses is desirable. As the detection limit is often defined by the measurement background, in this study the application of the 'SURRC Pulsed Photostimulated Luminescence (PPSL) Irradiated Food Screening System (SURRC PPSL Irradiated Food Screening System)', where the measurement background is suppressed in a very innovative way, was tested for dosimetric purposes. Therefore, the luminescence parameters were determined for a set of nine samples of modern bricks. It was found that depending on individual samples, it was possible to determine values as small as a few 100 microGy. Herewith a new application for the 'SURRC PPSL Irradiated Food Screening System' presented itself and further applications in dose reconstruction became available. As to the dosimetric properties of the sample material, it was found that although all the samples were from different brickmakers and places throughout Germany, surprisingly the luminescence parameters were similar, so that it was possible to define a generalised measurement sequence. An interpretation is given.

[Effect of whole body vibration on the neuromuscular performance of females 65 years and older. One-year results of the controlled randomized ELVIS study]. / Effekte von Ganzkörpervibrationen auf die neuromuskuläre Leistungsfähigkeit von Frauen über dem 65. Lebensjahr. Einjahresergebnisse der kontrollierten randomisierten ELVIS-Studie.

Sarcopenia is linked to an increased risk of morbidity and mortality in the aging. Whole body vibration (WBV) exercises are currently discussed as a "gentle" alternative to conventional exercises to improve muscle mass. The present study scrutinized whether a multipurpose (exercise) training program using WBV can improve muscle mass and neuromuscular capacity, while lowering fall risk. A total of 151 postmenopausal women were randomized into three groups: exercise group (TG), exercise group with vibration (VTG), and fitness control group (CG). The TG group participated in an exercise program including leg strengthening training twice a week over 12 months, while the VTG carried out an identical program with the leg exercises performed under WBV. Despite a positive trend regarding lean body mass in the two exercise groups, there was no difference between groups. Both exercise groups showed a significant increase (vs. KG) in trunk strength. An improvement in both exercise groups was also measured with respect to leg strength, but only the VTG showed significant differences compared to the CG. In addition, a significant lower risk of falls compared with the CG was evident only in VTG.