Simultaneous ventricular sympathetic reinnervation assessed by MIBG and sinus node sympathetic reinnervation assessed by heart rate variability in supine as in upright position were detected only in two patients (17%). The results of our study show that eventual sinus node sympathetic reinnervation and left ventricular sympathetic reinnervation do not occur simultaneously.

The present study evaluated the effect of high-altitude acclimatisation on the cold-induced vasodilatation (CIVD) response. A group of highly trained mountaineers (N = 9; Alpinists) were tested before and after a 3 week high-altitude Himalayan expedition (altitude ranging from 3,985 to 6,828 m). A control group (N = 7) with no mountaineering experience was tested at the same time points. During each test, subjects first immersed their hand to the styloid process in 37 degrees C water for 5 min and then in 10 degrees C water for 30 min. Upon completion of the hand immersion, the same procedure was repeated for the foot. Skin temperature of the pads of all immersed digits was measured throughout the immersion and for 10 min following the immersion. In the Alpinists, a significant increase in amplitude of CIVD and absolute maximum finger skin temperature during immersion was observed in the hand post-expedition. For the foot, peak time of CIVD was significantly shorter in the Alpinist group, and there were significant increases in minimum and maximum toe skin temperature during CIVD, mean toe skin temperature during immersion, absolute minimum and maximum toe skin temperature during immersion, and absolute amplitude during immersion. The results demonstrate a significant enhancement of the CIVD response as a consequence of a brief high altitude acclimatisation, and that these changes were especially prominent in the toes.

Depression is one of the most common psychiatric illnesses. Its influence on brain perfusion has been demonstrated, but conflicting data exist on follow-up after drug treatment. The aim of our study was to evaluate the effects of antidepressant drugs on regional cerebral blood flow (rCBF) in patients with depression after 3 weeks and 6 months of drug therapy. Clinical criteria for depression without psychosis were met according to psychiatric evaluation. Severity of depression was evaluated with the Hamilton Depression Rating Scale (HAMD) before every scintigraphic study. rCBF was assessed using technetium-99m bicisate (Neurolite) brain single-photon emission tomography in nine patients with severe depression before the beginning of antidepressant drug therapy and 3 weeks and six months after initiation of therapy. Only patients with no change in antidepressant medication during the study were included. No antipsychotic drugs were used. Cerebellum was used as the reference region. rCBF was evaluated for eight regions in each study in three consecutive transversal slices. Follow-up studies were compared with the baseline study. The mean HAMD score was 25.5 points initially, 16 at the second examination and 8.8 after 6 months. Global CBF was decreased compared with the reference region in drug-free patients. Perfusion of left frontal and temporal regions was significantly lower (P < 0.005) in comparison with the contralateral side. After therapy, a moderate decrease in perfusion was seen in the right frontal region (P < 0.05). Perfusion decreased further after 6 months in the right frontal (P < 0.005) and temporal regions (P < 0.01). The highly significant asymmetry in perfusion between the left and right frontal and temporal lobes almost disappeared during treatment. Our findings implicate dysfunction of the frontal and temporal cortex in clinically depressed patients before specific drug treatment. Clinical improvement and decreases in HAMD score after 3 weeks and after 6 months reflect the treatment effect on mood-related rCBF changes.

Reproducibility of DRF estimation was excellent in adults in both intraobserver and interobserver analysis. In pediatric patients, intraobserver DRF reproducibility was very good, whereas variation in interobserver analysis was rather high with a potential influence on patient management, but occurred mainly in a subgroup of patients with impaired drainage and ipsilaterally reduced DRF. Drainage assessment was highly reproducible in both patient groups; factors confounding drainage interpretation in discordant patient cases remained unidentified.

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