[Levodopa in the treatment of Parkinson's disease: myths and realties].

In recent years we have witnessed a growing tendency to opt for the use of dopamine agonists (DA) as treatment for Parkinson's disease (PD), with the aim of delaying as far as possible the development of fluctuations and dyskinesias. Yet, levodopa continues to be the most effective antiparkinson drug and is probably the one that improves the greatest number of symptoms of the disease. This article reports on the results of a comprehensive review of the literature dealing with the benefits and risks of levodopa treatment in patients with PD which was conducted by a group of expert neurologists and members of the Spanish Neurology Society's Movement Disorder Group.

[Evolution of severe pain associated to spontaneous spinal epidural hematoma].

Introduction: Spontaneous spinal epidural hematoma is an infrequent disease, whose clinical presentation is very characteristic, with severe pain in region corresponding to the metameres affected, which orients its diagnosis and early treatment.

Clinical Cases: Three clinical cases that occurred during 2003 and 2004 are presented. All three were middle- aged men, with spondyloarthrosis signs, posterolateral cervical location of hematoma, which debuted with severe cervical and cervicobrachial pain.

[Vascular hemichorea: clinical-radiological correlation].

Introduction: Hemichorea is uncommon in acute cerebrovascular accidents. Its appearance is in relation to the contralateral involvement of the basal ganglia, particularly the striate ganglion. With current neuroimaging techniques it is possible to identify the lesions responsible for these abnormal movements.

[Reference values for the central motor conduction time and silent period obtained by the transcranial magnetic stimulation].

Introduction: Normal values of reference to transcranial magnetic stimulation for the motor central conduction time (CCT) and silent period (SP) is recorded in 30 healthy control subjects over abductor pollicis brevis.

Material And Methods: We get for the CCT four measurements: two with low intensity of stimulus, 5% plus the motor threshold, with and without facilitation (CCT1 and CCT1 fac.); and two with high intensities of stimulus, elevating the magnetic stimulation intensity to 1.

PET perfusion and vasodilator function after angioplasty for acute myocardial infarction.

Unlabelled: The aims of this study were to validate invasive coronary Doppler flows against noninvasive PET assessments of myocardial perfusion and to examine the timing and degree of regional coronary vasodilator reserve recovery in patients who are successfully reperfused with primary angioplasty (PTCA) for acute myocardial infarction.

Methods: PTCA was performed in 21 consecutive patients with acute myocardial infarction; the final diameter stenosis was 25% +/- 7%. After restoration of TIMI Grade 3 flow, all patients underwent quantitative coronary angiography and distal Doppler coronary blood flow studies (basal and after adenosine-induced hyperemia) in the infarct and noninfarct vessels.

Clinical outcome of patients evaluated with emergency centre myocardial perfusion SPET for unexplained chest pain.

The clinical outcome of 68 patients with unexplained chest pain triaged with emergency centre (EC) SPET myocardial perfusion imaging (MPI) was assessed at 9 month follow-up. Based on clinical presentation and EC-MPI, 63% (43/68) of patients were discharged from the EC; 84% (36/43) of these patients reported no further symptoms at follow-up. There were no adverse clinical events in patients with totally normal EC-MPI.

Cost-effectiveness of myocardial perfusion imaging with SPECT in the emergency department evaluation of patients with unexplained chest pain.

Purpose: To determine the cost-effectiveness of promptly performing myocardial perfusion (MP) imaging with single photon emission computed tomography (SPECT) in patients presenting to the emergency department with unexplained chest pain.

Materials And Methods: Fifty patients with unexplained chest pain underwent MP imaging with SPECT and technetium-99m sestamibi. The cardiologists' management plans before and after receipt of imaging findings were compared.

Modified PIOPED criteria used in clinical practice.

Unlabelled: To assess the use of modified PIOPED scintigraphic criteria for lung scan (V/Q) interpretation to detect pulmonary embolism (PE), we prospectively applied these criteria in suspected PE patients referred for V/Q from 9/1/92 to 2/7/94. PIOPED criteria were modified by placing a moderate segmental perfusion mismatch in the intermediate instead of low probability of PE category and using the "stripe sign."

Methods: Patients were studied by six-view V/Q imaging using 74 MBq (2 mCi) 99mTc-MAA followed by 148-370 MBq (4-10 mCi) 99mTc-DTPA aerosol, contrast pulmonary selective angiography and Doppler sonography with leg compression as needed.

Quantitative myocardial SPECT for infarct sizing: feasibility of a multicenter trial evaluated using a cardiac phantom.

Unlabelled: This study determined the feasibility of performing a multicenter trial using quantitative SPECT myocardial perfusion imaging in patients with acute myocardial infarction. The feasibility was assessed by a cardiac phantom.

Methods: Twenty-two gamma camera systems in 19 laboratories were evaluated.

Krukenberg tumor and lung metastases from colon carcinoma diagnosed with F-18 FDG PET.

The authors report a case of a patient with postsurgical colorectal carcinoma and metastatic disease to the ovaries (Krukenberg tumor), the lung, and the liver first revealed by F-18 FDG PET imaging. The value of PET in a patient with an unexplained rising CEA is cited.

Indium-111 OncoScint CR/OV and F-18 FDG in colorectal and ovarian carcinoma recurrences. Early observations.

Indium-111 satumomab pendetide (In-111 OncoScint) planar and SPECT imaging and F-18 FDG positron emission tomography (PET) have been found individually to be helpful in the detection of recurrent colorectal and ovarian cancer, but have not been compared. Twelve patients who were examined for recurrent colorectal or ovarian carcinoma underwent both In-111 OncoScint imaging and F-18 FDG PET imaging. All had normal or equivocal results of CT or MR studies.

Watershed ischemia demonstrated with acetazolamide enhanced Tc-99m HMPAO SPECT.

A 75-year-old man who had a small right parietal infarction 8 months earlier underwent baseline and acetazolamide enhanced Tc-99m hexamethylpropylene amineoxime brain SPECT imaging. The acetazolamide study demonstrated a bilaterally symmetric perfusion deficit posteriorly near the midline. The baseline study was essentially normal.

Ventilation-perfusion scintigraphy in the PIOPED study. Part II. Evaluation of the scintigraphic criteria and interpretations.

This article presents an evaluation of the criteria used for categorical interpretation of the ventilation-perfusion (V/Q) scans performed in the PIOPED study. In addition, the correlation of percent probability estimates with the actual frequency of pulmonary embolism (PE) is presented. Cases which met the PIOPED criteria for various diagnostic categories were selected by computerized search of the detailed scan descriptions that had been done as part of the study.

Ventilation-perfusion scintigraphy in the PIOPED study. Part I. Data collection and tabulation.

The Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) study of more than 700 patients is the largest existing study of the accuracy of lung scintigraphy in the diagnosis of acute pulmonary embolism. Perfusion scans were obtained in all patients and ventilation scans in almost all, using standardized techniques. Chest radiographs were obtained in all patients within 12 hr of the lung scan.

Effects of alterations in systolic pressure on radionuclide measurements of left ventricular filling dynamics.

To determine the effects of steady-state left ventricular systolic pressure alterations on radionuclide measures of left ventricular filling dynamics, we studied 15 normal patients and 17 patients with nonischemic heart disease. Micromanometer left ventricular pressures and computer assisted forward gated radionuclide angiograms were acquired simultaneously. Right atrial pacing maintained heart rates constant during the baseline condition and methoxamine and nitroprusside infusions.

Ratio of hepatic arterial-to-portal venous blood flow--validation of radionuclide techniques in an animal model.

The ratio of hepatic arterial-to-portal venous blood flow can be determined from the analysis of a first-pass bolus through the liver by a number of techniques. This study examines the validity of four radiotracer techniques in an animal model. Thirty-four flow studies (3 mCi 99mTc-DTPA/study) were performed in seven anesthetized pigs.