Using dynamic [18F]fluorodeoxyglucose (FDG) positron emission tomography with a high-resolution, seven-slice positron camera, the kinetic constants of the original three-compartment model of Sokoloff and co-workers (1977) were determined in 43 distinct topographic brain regions of seven healthy male volunteers aged 28-38 years. Regional averages of the cerebral metabolic rate for glucose ( CMRglu ) were calculated both from individually fitted rate constants ( CMRglukinetic ) and from activity maps recorded 30-40 min after FDG injection, employing a four-parameter operational equation with standard rate constants from the literature ( CMRgluautoradiographic ). Metabolic rates and kinetic constants varied significantly among regions and subjects, but not between hemispheres. k1 ranged between 0.0485 +/- 0.00778 min-1 in the oval center and 0.0990 +/- 0.01347 min-1 in the primary visual cortex. k2 ranged from 0.1198 +/- 0.01533 min-1 in the temporal white matter to 0.1472 +/- 0.01817 min-1 in the cerebellar dentate nucleus. k3 was lowest (0.0386 +/- 0.01482 min-1) in temporal white matter and highest (0.0823 +/- 0.02552 min-1) in the caudate nucleus. Maximum likelihood cluster analysis revealed four homogeneous groups of brain regions according to their respective kinetic constants: (1) white matter and mixed brainstem structures; (2) cerebellar gray matter and hippocampal formations; (3) basal ganglia and frontolateral and primary visual cortex; and (4) other cerebral cortex and thalamus. Across the entire brain, k1 and k2 were positively correlated (r = 0.79); k1 and k3 showed some correlation (r = 0.59); but no significant linear association was found between k2 and k3. A strong correlation with CMRglu could be demonstrated for k1 (r = 0.88) and k3 (r = 0.90), but k2 was loosely correlated (r = 0.56). CMRglu kinetic ranged from 17.0 +/- 2.45 mumol/100 g/min in the occipital white matter to 41.1 +/- 5.62 mumol/100 g/min in the frontolateral cortex. In most regions the mean values of CMRglu kinetic did not differ significantly from CMRglu autoradiographic. With few exceptions, however, within-region variance was significantly less for CMRglu kinetic than for CMRglu autoradiographic, suggesting greater individual reliability of results obtained by the kinetic approach.

Severe potassium deficiency is an uncommon cause of rhabdomyolysis. We recently treated a 45-year-old patient with myalgia, serious generalized weakness, increased serum creatine kinase and myoglobin level as well as excessive hypokalemia. Histological examination of deltoid muscle biopsy showed rhabdomyolysis. After complete recovery of muscle damage by potassium substitution Bartter's syndrome proved to be the cause of initial and persistent hypokalemia.

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