We studied 52 asymptomatic subjects using magnetic resonance imaging, and we compared age-matched groups (51-70 years old) with and without white matter lesions with respect to carotid ultrasonography, cerebral blood flow (xenon-133 injection), and cerebrovascular risk factors. In the group with white matter signal abnormalities, we noted a higher frequency of extracranial carotid artery disease, a lower mean gray matter blood flow (Fl), and a significant reduction (p<0.05) in blood flow of the slow-flowing (F2) compartment. Hypertension, diabetes mellitus, and cardiac diseases (p<0.002) were found more often in this group. Our results indicate that a higher incidence of changes known to be associated with an increased risk for stroke exists in the presence of white matter lesions in normal elderly individuals. 12 as well as in normal aging. 34 The frequency of these hyperintense white matter foci on T2-weighted images increases with advancing age 2 and with the number of cerebrovascular risk factors.5 A correlation between the presence of white matter lesions (WMLs) and cerebrovascular disease has therefore been suggested, '-35 implying that magnetic resonance signal abnormalities in asymptomatic subjects may provide evidence of "silent" cerebrovascular disease. 6To test further the significance of WMLs, we investigated their association with factors known to increase the risk for stroke 7 -10 in a population of symptom-free individuals. To our knowledge, ours is the first study to evaluate normal subjects with respect to cerebrovascular changes using magnetic resonance imaging (MRI), the xenon-133 injection method of cerebral blood flow (CBF) measurement, and carotid ultrasonography simultaneously. Subjects and MethodsThe 52 subjects (mean age 58, range 31-78 years) we used are a sample of volunteers participating in a prospective field study on the incidence of cerebrovascular risk factors in the population of Graz, Austria, and the surrounding region. Subjects were eligible for the study if they had no evidence of cerebrovascular disease on history or neurologic examination and after exclusion of other neurologic or psychiatric disorders. Subjects were free of symptoms of systemic diseases and had not come to medical attention for cerebrovascular risk factors. MRI and extracranial Doppler ultrasonography were performed in all subjects, and CBF was measured in 32 subjects; these tests were carried out within 1 day. Evidence of hypertension (blood pressure of >160 mm Hg systolic), diabetes mellitus (fasting blood sugar concentration of >160 mg/dl), and cardiac diseases (coronary heart disease, cardiomyopathy, arrhythmias, etc.) was based on appropriate findings on two independent visits.All subjects were studied with a superconducting magnet at a field strength of 1.5 T (Gyroscan S15, Philips, Eindhoven, The Netherlands) and the spin-

The incidence, average number, and localization of lesions of the white matter detected by the T2-weighted nuclear magnetic resonance images among volunteers without cerebrovascular symptoms have been correlated with the number of risk factors for stroke. Accepted risk factors were arterial hypertension, diabetes mellitus, smoking, hypercholesterolemia, and cardiac disease. The 42 subjects examined were divided into Group A (0-1 risk factor, mean age 59.36 ± 5.73 years), Group B (2 risk factors, mean age 61.54±8.33 years), and Group C (53 risk factors, mean age 62.57±9.83 years). Multiple risk factors among the age-matched groups was accompanied by a highly significant increase (p<0.001, Group A versus Group B; p < 0.01, Group A versus Group C) of the incidence of white matter lesions. The average number of white matter lesions was increased (p < 0.001) when Group A was compared with Groups B and C. Ninety-two percent of the white matter lesions were localized in watershed zones. Only 11 of the 155 abnormalities of the white matter detected by nuclear magnetic resonance imaging could be detected by computed tomography. White matter lesions in T2-weighted images appear to be an early stage of cerebrovascular disease. {Stroke 1988;19:263-265) N uclear magnetic resonance imaging (NMRI) demonstrates lesions of the white matter on T2-weighted images among 30% of individuals aged s 60 years.1 There are positive correlations with advancing age but also with the occurrence of risk factors for stroke and cerebrovascular symptoms as described in retrospective studies.23 So far, there has been no prospective study comparing age-matched groups showing a relation between white matter lesions in subjects free of cerebrovascular symptoms and the number of coexisting factors for stroke. Subjects and MethodsA prospective study of 42 volunteers was undertaken to establish the incidence of cerebrovascular risk factors in the Styrian population that lives in Graz, Austria, and the surrounding region. This cohort was divided into three groups according to the number of risk factors for stroke. Group A (22 persons, mean age 59.36 ± 5.73 years) exhibited zero to one risk factor for stroke, Group B (13 persons, mean age 61.54 ± 8.33 years) had two risk factors for stroke, and Group C (7 persons, mean age 62.57 ± 9.83 years) had three or more risk factors. The age distribution was in

Night sleep recordings were performed in 10 patients with sleep disturbances in falling asleep as well as in maintaining sleep using a mobile 4-channel EEG registration system. Three consecutive nights, which were spent under different conditions, were evaluated automatically. The first night without treatment was used as a baseline night to objectify the disturbed sleep, the second night was measured following an infusion of a physiological saline solution and prior to the third recording 5 g l-tryptophane were applied to the patients. Besides a significant decrease of delayed latency times until the appearance of the light sleep stages, an influence was seen on the quantitative sleep parameters such as sleep period time and total sleep time. In parallel, an improvement of the subjective feeling measured by a self-rating scale resulted after l-tryptophane. On the other hand, no definite influence on the other sleep parameters such as an increase of slow wave sleep was observed, so that the use of this treatment might be recommended in disturbances in falling asleep particularly.

Disturbances of the flow properties of the blood may occur in more than 40% of patients with CVD. Abnormal rheologic conditions can be measured as increased blood viscosity and may be caused by corpuscular as well as by plasmatic factors.

We conclude that in patients with MRSA pneumonia an approach using a 7-day course of intravenous linezolid plus rifampicin, intratracheal vancomycin, nasal mupirocin, cutaneous and oropharyngeal chlorhexidin plus povidone-iodine cures pneumonia and is effective for MRSA eradication.