The aim of our study is to describe the appearance of normal vertebral arteries by color-coded Doppler sonography to provide basic information for further clinical studies. Subjects and MethodsWe studied 42 persons (19 women and 23 men, mean age 62.3 years) without history or physical signs of cerebrovascular disease related to the vertebrobasilar system. We used a color-coded Doppler sonography unit equipped with a 7.5-MHz linear array transducer (Acuson 128, Mountain View, Calif.). The system analyzed returning echoes for ampli- Received October 30, 1989; accepted April 13, 1990. rude, phase shift, and frequency shift. Amplitude data were displayed as a gray-scale or tissue (Bmode) image. Moving structures (such as blood cells) caused phase and frequency shifts. Color (red or blue) depended on the direction of blood flow with respect to the transducer and could be selected by the operator. Color shade reflected the frequency shift and depended on the velocity of the blood and the angle of the sound beam in relation to the long axis of the vessel. The system also allowed application of pulsed Doppler ultrasound with the possibility of angle-corrected velocity measurements. The sample volume was 1.5 mm.Sensitivity of the system for detecting motion was set for each subject to slightly above the level of color noise. In addition to the color display, Doppler waveforms were obtained from all parts of the vertebral artery. We measured maximum and minimum blood flow velocities as well as resistive indices calculated as 1 -(end-diastolic blood velocity/peak systolic blood velocity). All examinations were recorded on videotape and reviewed by two observers who did not perform the examination.Each person was examined in the supine position, with the shoulders kept down and with the head turned slightly to the opposite side. At the beginning of the examination, the probe was positioned on the lateral cervical region along the long axis of the carotid artery. To identify the middle portion of the vertebral artery, the scanhead was simultaneously shifted laterally and angled until the transverse processes of the cervical vertebrae and the intertransverse portion of the vertebral artery were readily seen. The course of the vessel was then followed down to the subclavian artery and up to the base of by guest on May 11, 2018 http://stroke.ahajournals.org/ Downloaded from

CT is superior to chest radiography for detection of functionally relevant pulmonary disease and is an important adjunct in early assessment of SLE.

Bronchial wall thickness on thin-section CT scans should be evaluated with window centers between -250 and -700 HU and with window widths greater than 1,000 HU. Other than window settings, notably window widths less than 1,000 HU, can lead to substantial artificial thickening of bronchial walls.

No abstract

To assess the effect of chronically elevated plasma growth hormone (GH) levels on bone metabolism and bone mineral density (BMD), 16 patients (10 females and 6 males) with a mean age of 49.1 +/- 13.2 years (range 33-68) with active acromegaly were studied and compared to a control group of 16 sex- and age-matched subjects. BMD of the lumbar spine and two different sites of the proximal femur were measured by dual-energy x-ray absorptiometry (Norland XR-26). In the acromegalic patients the mean plasma GH concentration was 30.1 +/- 11.1 micrograms/liter, and the mean plasma somatomedin C (SMC) concentration was 6.5 +/- 1.5 U/liter. Mean serum osteocalcin (OC) levels (14.3 +/- 1.1 versus 7.2 +/- 0.4 ng/ml, p < 0.001) as well as the urinary hydroxyproline excretion (OHP; 8.8 +/- 1.4 versus 2.7 +/- 0.3 mg, p < 0.0001) were significantly higher in the acromegalic patients than in the control subjects. In the acromegalic patients BMD was significantly elevated in the two examined regions of the proximal femur, that is, the femoral neck (1.06 +/- 0.05 versus 0.86 +/- 0.03 g/cm2, p < 0.05) and Ward's triangle (0.92 +/- 0.06 versus 0.76 +/- 0.03 g/cm2, p < 0.02), whereas the BMD of the lumbar spine was not significantly different from that of control subjects. Among the patients with acromegaly a significant positive correlation between serum OC concentrations, on the one hand, and urinary OHP excretion (r = 0.7, p < 0.004) as well as BMD in the proximal femur (r = 0.64, p < 0.007), on the other hand, could be observed.(ABSTRACT TRUNCATED AT 250 WORDS)