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Continuous ratings of breathlessness during exercise by children and young adults with asthma and healthy controls.

Although it is recommended and common practise for adults with respiratory disease to rate symptoms (e.g., dyspnea and/or leg discomfort) during exercise testing, there are no reports on whether children can rate their perception of breathlessness during exercise. Our aims were to evaluate the ability of children and young adults with asthma to continuously rate breathlessness on the 0-10 category-ratio (CR-10) scale with a computerized system during cycle ergometry, and to compare their results with those of healthy subjects. At an initial visit, subjects were familiarized with equipment and exercise protocol, and practised rating breathlessness while cycling. At a follow-up visit (2-4 days later), subjects performed incremental exercise and rated breathlessness using a computer system, mouse, and monitor. Changing the position of the mouse caused movement of a vertical bar located adjacent to the CR-10 scale to indicate the severity of breathlessness. Baseline characteristics of the 14 subjects with asthma (age, 15 +/- 3 years) and 33 healthy subjects (age, 16 +/- 2 years) were similar. The two groups had comparable levels of fitness as measured by peak oxygen consumption (VO(2)). Correlations between exercise physiologic variables (power production, VO(2), and minute ventilation) and breathlessness ratings were >0.90. Subjects reported progressively more ratings of breathlessness with increasing exercise intensities. There were no differences between groups for slopes, x-intercepts, and absolute thresholds relating physiologic variables and breathlessness. In conclusion, children and young adults with asthma as well as healthy individuals of comparable age successfully used the computerized system to rate breathlessness continuously during cycle ergometry. Both groups reported more ratings of breathlessness with this technique as exercise progressed.

Adolescent↗

Implantation techniques and experience with percutaneous intramuscular electrodes in the lower extremities.

Innervated paralyzed muscles have been implanted with temporary percutaneous intramuscular electrodes in order to allow selective stimulation of as many muscles as necessary to achieve a cosmetically acceptable and energy-efficient gait in paraplegic subjects. Fine wire electrodes were implanted under sterile conditions at the motor points (MP) of hip extensors, flexors, abductors and adductors; knee extensors; and ankle plantar- and dorsi-flexors. Electrodes were routed to the MP's from one of four skin sites on the legs where the wires emerged. Employed were both a direct approach from the skin site to the MP and an indirect approach which involved one or more subcutaneous passages of the electrode wire from the MP to the skin site. Muscles were stimulated approximately 12 hours per week in daily electrical exercise and gait training. Electrodes were removed when they exhibited one of two types of failure: breakage, as determined by high impedance, or loss of adequate function as a result of electrode movement. Of 1025 electrodes implanted in 6 subjects over a period of 38 months, 35 percent failed within the first 4 months; more than 75 percent of those early failures resulted from electrode movement. Complete withdrawal of those electrodes was usually possible. The probability of electrode failure decreased exponentially during the first 4 months and reached less than 4 percent per month for electrodes implanted for longer than 6 months. These procedures have allowed multiple revisions toward a more functional neuro-orthotic system.

Electric Stimulation Therapy↗

[Physical therapy of frozen shoulder: literature review].

OBJECTIVE: To determine the efficacy of physical treatments in adhesive capsulitis of the shoulder by a systematic review of literature, attempting to perform a meta-analysis from randomised clinical trials. METHOD: A systematic literature search was conducted to retrieve all randomised controlled trials of physical therapy such as physiotherapy and manipulation, but also arthrographic distension, mobilisation under general anaesthesia or nerve block, arthroscopic distension or arthrolysis, and intra-articular corticoid injections. The main outcome for meta-analysis was the restoration of range of movement between the sixth week and the third month. RESULTS: Only 16 articles could be selected, and only three about capsular distension were included in a meta-analysis because of the heterogeneity of the criteria assessing the functional results and of the poor methodological value of most of the articles. DISCUSSION: Some open studies stressed the value of daily manipulations and physiotherapy, intra-articular corticosteroid injections, but their quality was poor or limited. Nothing was written about antalgic drugs to facilitate joint mobilisation, and the use of a thoraco-brachial abduction device between exercises was only quoted. The most refractory cases might need more aggressive interventions: arthrographic distension with local anaesthesia and steroid injection; mobilisation under general or local anaesthesia, specially interscalene brachial plexus block; arthroscopic release. But there was no randomised controlled study comparing these three techniques and it seemed impossible to come to any conclusion about the superiority of one of them. The meta-analysis showed yet that capsular distension with intra-articular corticoid injections was better than corticoid injections alone. CONCLUSION: This demonstrated the need of a consensus about the criteria of assessment, the time of evaluation, before assessing by randomised clinical trials of good quality their therapeutic value.

Adrenal Cortex Hormones↗

Little orphan Anastasia, Part Two: developmental growth, love, and therapeutic change.

This is the second paper on a project that was undertaken to explore the opportunities and difficulties that might be encountered in writing about an ongoing child analytic case. For many reasons having to do with confidentiality and with the risks of reaching premature conclusions amid the normal confusions of the analytic process psychoanalysts generally write only after a case has been completed. Our project has sought to explore whether, as was the case with early psychoanalytic writings, the exercise of recording and synthesizing material gleaned from fresh open-ended psychoanalytic process might be accompanied by a more supple, informed, and nuanced clinical understanding. The first paper deals with two main questions. First, how could an infant survive and grow in the grim circumstances of a Siberian orphanage? Secondly, how do we understand the ways in which analytic technique interacted with Anastasia's extreme defensive activity to unstick her disorder of relatedness? Anastasia was born sickly. She was placed at two months in an orphanage where she developed a stool withholding disorder along with an attachment disorder. She was partially socialized in the home of the American parents who adopted her at nine months of age. However great gaps persisted between her intelligence and the use of her imagination and the torment and rage accompanying her infrequent bowel movements. Anastasia entered child analysis at age five and a half. The first paper described Anastasia's recovery from encopresis early in her child analysis and her subsequent struggle to overcome the psychological sequelae if her anti-dyadic state of relatedness. This paper will ponder some of the viscissitudes of transference and development that accompanied Anastasia's emerging capacity for love as she continued to overcome her alienation from her body and from significant others in her outside world. It will re-examine ways of thinking about object relationships and new objects to further understand Anastasia's recovery process.

Child↗

Contractures in orthopaedic and neurological conditions: a review of causes and treatment.

PURPOSE: To examine the techniques used for the treatment of contracture in the context of current scientific knowledge of muscle. METHOD: Synthesis of data available from MEDLINE, RECAL, EMBASE, the Cochrane Library and relevant texts. RESULTS: The development of contractures through immobilisation, muscle weakness and spasticity is described. The effects of passive stretching, continuous passive movement, serial plastering, splinting, electrical stimulation, botulinum injections and surgical tenotomies in the treatment of contractures in persons with neurological and orthopaedic conditions are identified. The strengths and weaknesses of these modalities are discussed. CONCLUSION: Predisposing factors persist after treatment of contractures thus for treatment to be effective long-term management programmes need to be developed. New treatment techniques, used in series or combined, offer the prospect of improved management of contracture. Scientific and clinical research is needed to investigate the effect of contracture treatment.

Activities of Daily Living↗

Longitudinal analysis of cartilage atrophy in the knees of patients with spinal cord injury.

OBJECTIVE: A previous cross-sectional study indicated that the morphology of patellar and tibial cartilage is subject to change after spinal cord injury (SCI). The aim of this study was to perform a longitudinal analysis of cartilage atrophy in all knee compartments, including the femoral condyles, in SCI patients over 12 months. METHODS: The right knees of 9 patients with complete, traumatic SCI were examined shortly after the injury (mean +/- SD 9 +/- 4 weeks) and at 6 and 12 months postinjury. Three-dimensional morphology of the patellar, tibial, and femoral cartilage (mean and maximum thickness, volume, and surface area) was determined from coronal and transversal magnetic resonance images (fat-suppressed gradient-echo sequences) using validated postprocessing techniques. RESULTS: The mean thickness of knee joint cartilage decreased significantly during the first 6 months after injury (range 5-7%; P < 0.05). The mean change at 12 months was 9% in the patella, 11% in the medial tibia, 11% in the medial femoral condyle, 13% in the lateral tibia, and 10% in the lateral femoral condyle (P < 0.05 for all compartments). CONCLUSION: This is the first report of a longitudinal analysis of cartilage atrophy in patients with SCI. These data show that human cartilage atrophies in the absence of normal joint loading and movement after SCI, with a rate of change that is higher than that observed in osteoarthritis (OA). A potential clinical implication is that cartilage thinning after SCI may affect the stress distribution in the joint and render it vulnerable to OA. Future studies should focus on whether specific exercise protocols and rehabilitation programs can prevent cartilage thinning.

Adolescent↗

[The musician's hand: aspects of music physiology and performing arts medicine].

Musicians are particularly demanding hand patients. Increased expectancy towards the hand surgeon as well as principle aversion to any kind of operative treatment of the musician's hand impede the relationship between hand surgeon and patient. Knowledge and experience of the specific demands towards the musician's hand--including the background of basics in physiology of music making and instrumental techniques--facilitate history taking, examinations, diagnosing as well as the selection of therapy. Besides tendinitis and tendovaginitis, pathologies of the musician's hand are not more frequent compared to the entire population. Still several pathologies reach a significantly pronounced importance through the specific professional requirements. This is true especially for peripheral nerve compression syndromes, arthritis, ganglia, contractures, joint laxity and focal dystonias. The treatment of these disorders and hand trauma require, besides an utmost of hand surgical care, creativity and the implementation of the professional musical surroundings in therapy and rehabilitation, including also the musical instruments. The indication for surgery might be restrained in certain cases, although there are, without doubt, situations, when a professional musician should be operated on at an early stage. This should enhance a rapid return to play the musical instrument and to exercise delicate and demanding skilled movement patterns of his hand.

Adult↗

Cerebrovascular accidents.

CVA comprises a large number of clinical entities, depending on the site of infarction in the brain. Accurate evaluation of deficits in the patient's sensory and/or motor systems and the patient's intellectual status are paramount in establishing realistic rehabilitation goals. With respect to the motor system, two types of voluntary movement may occur. These include synergistic or pattern movement and selective movement. Spasticity in the affected lower extremity may result in a variety of lower-extremity deformities and contractures. Those most commonly encountered include hip flexion and adduction contracture, inadequate knee flexion and knee flexion contracture, and ankle equinus, varus, and equinovarus. Correct evaluation of deformities may be aided by the use of poly-EMG analysis and evaluation after nerve block or motor point blocks. In hemiplegic gait dysfunction, the basic requirements for functional ambulation include (1) ability to maintain standing balance; (2) voluntary hip flexion; (3) leg stability; and (4) ability to follow instructions and adequate motivation. Often a hemiplegic patient can be trained to ambulate if an adequate extensor synergy pattern develops, since mass extension can provide stability of the leg for weight bearing. Medical rehabilitative management of the CVA patient includes early mobilization, restorative exercises (including neuromuscular facilitation techniques), measures to prevent or correct contractures, the use of AFOs, and occasionally functional electrical stimulation. Orthopedic management of deformities in CVA is indicated where conservative measures fail. Surgical procedures seek to alter the forces causing shortening of the muscles and tendons. Hence, the most commonly performed surgical procedures include (1) tendon lengthening or release; (2) soft-tissue release; and (3) tendon transfer. Surgery for hip contractures is not common; however, occasional release of hip flexors is indicated when hip flexion contracture impedes ambulation or prone lying. Inadequate knee flexion, caused by dysphasic quadriceps contraction, can be corrected by release of the vastus medialis and rectus femoris muscles. Distal hamstring tendon release with or without knee joint capsule release is the surgical procedure of choice for severe knee flexion contractures. Surgical correction of an equinus deformity is by TAL, with or without neurectomy of tibial nerve branches to the gastrocsoleus muscles. Severe ankle varus may require a SPLATT procedure. Surgery for equinovarus includes the combined surgery for both equinus and varus (that is, TAL and SPLATT procedures). Toe curling is corrected by toe flexor releases.(ABSTRACT TRUNCATED AT 400 WORDS)

Cerebrovascular Disorders↗

The effectiveness of neuromuscular facial retraining combined with electromyography in facial paralysis rehabilitation.

OBJECTIVE: The study goal was to present the effectiveness of neuromuscular facial retraining techniques used in combination with electromyography for improving facial function even in cases of longstanding paralysis. STUDY DESIGN AND SETTING: We conducted a retrospective case review in a tertiary neurotology clinic. PATIENTS: Twenty-four patients with facial paralysis received neuromuscular facial retraining between April 1999 and April 2001. The patient sample included 6 males and 18 females, with an average age of 44 years. A control group consisted of 6 patients (4 females and 2 males). RESULTS: All patient groups made significant improvements in function with improved symmetry in dual-channel electromyographic readings and increased facial movement percentages. Some of the percentages of posttreatment facial function were as follows: acoustic neuromas, 93%; Bell's palsy/Ramsay Hunt syndrome, 80%; and facial nerve anastomosis, 71%. Synkinesis was reduced by at least 2 levels in patients who initially demonstrated synkinesis. CONCLUSIONS: Neuromuscular facial retraining exercises and electromyography are effective for improving facial movements. SIGNIFICANCE: Facial retraining is an excellent example of the plasticity of the central nervous system to reorganize, even in cases of longstanding paralysis.

Adolescent↗

Neuromuscular adaptation to actual and simulated weightlessness.

The chronic "unloading" of the neuromuscular system during spaceflight has detrimental functional and morphological effects. Changes in the metabolic and mechanical properties of the musculature can be attributed largely to the loss of muscle protein and the alteration in the relative proportion of the proteins in skeletal muscle, particularly in the muscles that have an antigravity function under normal loading conditions. These adaptations could result in decrements in the performance of routine or specialized motor tasks, both of which may be critical for survival in an altered gravitational field, i.e., during spaceflight and during return to 1 G. For example, the loss in extensor muscle mass requires a higher percentage of recruitment of the motor pools for any specific motor task. Thus, a faster rate of fatigue will occur in the activated muscles. These consequences emphasize the importance of developing techniques for minimizing muscle loss during spaceflight, at least in preparation for the return to 1 G after spaceflight. New insights into the complexity and the interactive elements that contribute to the neuromuscular adaptations to space have been gained from studies of the role of exercise and/or growth factors as countermeasures of atrophy. The present chapter illustrates the inevitable interactive effects of neural and muscular systems in adapting to space. It also describes the considerable progress that has been made toward the goal of minimizing the functional impact of the stimuli that induce the neuromuscular adaptations to space.

Adaptation, Physiological↗

Lifestyle modifications to prevent and control hypertension. 4. Recommendations on physical exercise training. Canadian Hypertension Society, Canadian Coalition for High Blood Pressure Prevention and Control, Laboratory Centre for Disease Control at Health Canada, Heart and Stroke Foundation of Canada.

OBJECTIVE: To provide updated, evidence-based recommendations for health care professionals concerning the effects of regular physical activity on the prevention and control of hypertension in otherwise healthy adults. OPTIONS: People may engage in no, sporadic or regular physical activity that may be of low, moderate or vigorous intensity. For sedentary people with hypertension, the options are to undertake or maintain regular physical activity and to avoid or moderate medication use; to use another lifestyle modification technique; to commence or continue antihypertensive medication; or to take no action and remain at increased risk of cardiovascular disease. OUTCOMES: The health outcomes considered were changes in blood pressure and in morbidity and mortality rates. Because of insufficient evidence, no economic outcomes were considered. EVIDENCE: A MEDLINE search was conducted for the period 1966-1997 with the terms exercise, exertion, physical activity, hypertension and blood pressure. Both reports of trials and review articles were obtained. Other relevant evidence was obtained from the reference lists of these articles, from the personal files of the authors and through contacts with experts. The articles were reviewed, classified according to study design and graded according to level of evidence. VALUES: A high value was placed on avoidance of cardiovascular morbidity and premature death caused by untreated hypertension. BENEFITS, HARMS AND COSTS: Physical activity of moderate intensity involving rhythmic movements with the lower limbs for 50-60 minutes, 3 or 4 times per week, reduces blood pressure and appears to be more effective than vigorous exercise. Harm is uncommon and is generally restricted to the musculoskeletal injuries that may occur with any repetitive activity. Injury occurs more often with jogging than with walking, cycling or swimming. The costs include the costs of appropriate shoes, garments and equipment, but these were not specifically measured. RECOMMENDATIONS: (1) People with mild hypertension should engage in 50-60 minutes of moderate rhythmic exercise of the lower limbs, such as brisk walking or cycling, 3 or 4 times per week to reduce blood pressure, (2) Exercise should be prescribed as an adjunctive therapy for people who require pharmacologic therapy for hypertension, especially those who are not receiving beta-blockers. (3) People who do not have hypertension should participate in regular exercise as it will decrease blood pressure and reduce the risk of coronary artery disease, although there is no direct evidence that it will prevent hypertension. VALIDATION: These recommendations agree with those of the World Hypertension League, the American College of Sports Medicine, the report of the US Surgeon General on physical activity and health, and the US National Institutes of Health Consensus Development Panel on Physical Activity and Cardiovascular Health. These guidelines have not been clinically tested. SPONSORS: The Canadian Hypertension Society, the Canadian Coalition for High Blood Pressure Prevention and Control, the Laboratory Centre for Disease Control at Health Canada, and the Heart and Stroke Foundation of Canada.

Adrenergic beta-Antagonists↗

Active mobilisation after flexor tendon repair: comparison of results following injuries in zone 2 and other zones.

PURPOSE: To prospectively study the role of active mobilisation after flexor tendon repair. METHODS: The standard modified Kessler's technique was used to repair 46 digits in 32 patients with flexor tendon injuries. Early active mobilisation of the repaired digit was commenced on the third postoperative day. Range of movement was monitored and recovery from injury in zone 2 was compared with injury in other zones. RESULTS: There were 24 and 22 injuries in zone 2 and other zones respectively. The total active motion score of the American Society for Surgery of the Hand was measured. Patients with zone-2 injuries achieved similar results to those with other-zone injuries apart from a 3-week delay in recovery. The final results were good to excellent in 71% and 77% of zone-2 and other-zone cases respectively (p < 0.05). There were 2 ruptures in zone-2 and one rupture in zone-3 repairs (6.5%). CONCLUSION: Preliminary results of this study showed that active mobilisation following flexor tendon repair provides comparable clinical results and is as safe as conventional mobilisation programmes although recovery in patients with zone-2 injury was delayed.

Adolescent↗

Prognostic value of radionuclide ventriculography after myocardial infarction.

We have studied 50 consecutive patients who had sustained their first myocardial infarction. Using the noninvasive technique of radionuclide ventriculography, ventricular performance, as assessed by left ventricular ejection fraction (EF), was measured at rest just before discharge from hospital when patients were well and free from cardiac failure and then at one and four months after infarction, at rest and during submaximal supine exercise. Left ventricular ejection fraction was below normal in 42 patients (normal range 0.43-0.71). Mean EF for those patients recovering from inferior infarction was 0.43 +/- 0.09 (mean +/- 1 S.D.), whereas for those who had sustained anterior infarction mean EF was significantly lower, 0.33 +/- 0.13 (p less than 0.01). EF was significantly reduced (p less than 0.01) in those patients whose early progress was complicated either by serious arrhythmia or left ventricular failure. There was only poor correlation between EF and radiographically determined heart size but global left ventricular performance correlated well with the presence of abnormalities of regional wall movement. Over the first four months low EF failed to improve in seven patients with areas of dyskinesis (EF less tha 0.30) and despite diuretic therapy five suffered further episodes of cardiac failure. Excluding those with dyskinesis there were 18 patients who were unable to increase EF on exercise on month after infarction. Of these four already had symptoms of angina but a further 10 patients developed angina in the subsequent three months. Poor left ventricular performance is common after anterior myocardial infarction, complicated in the acute phase by serious arrhythmia or left ventricular failure. Patients with persistently low EF had an increased risk of further episodes of cardiac failure, whereas a fall in EF on exercise was associated with subsequent angina.

Adult↗

Lactate transport in rat sarcolemmal vesicles and intact skeletal muscle, and after muscle contraction.

To determine whether it was possible to measure lactate transport rates into intact skeletal muscles, the transport of lactate (zero-trans) was determined in soleus muscle strips incubated in vitro and compared with lactate transport in sarcolemmal vesicles. In addition, the effects of muscle contractility on lactate transport were investigated in electrically-stimulated soleus muscle strips. In both the intact muscle and the sarcolemmal preparations the rates of transport were saturable, stereospecific, and inhibitable by monocarboxylates (pyruvate, alpha-cyano-4-hydroxycinnamate) and a protein modifier (N-ethylmaleimide; P < 0.05). The anion exchange inhibitor SITS had no effect on lactate uptake (P > 0.05). In both preparations lactate transport followed an inwardly directed proton gradient. Relative comparisons (%) between the preparations indicated a similar slope of increasing transport rates with increasing lactate concentrations and similar responses to a changing pH environment. These characterizations of L-lactate transport into isolated sarcolemmal vesicles and muscle strips revealed that both preparations yielded similar conclusions regarding the transmembrane movement of L-lactate. By using this more physiological muscle preparation, contractile activity, induced by electrical stimulation, did not increase lactate uptake in skeletal muscle in the post-exercise period whereas under similar conditions a marked increase in 2-deoxy-D-glucose uptake occurred (+ 47%; P < 0.05). These data suggest that the transport of glucose and lactate in contracting muscle is regulated differently. These studies also show that the incubated muscle strip preparation may be useful for studying lactate transport in an intact cell system during physiological experiments.

Animals↗

Physical activity and energy expenditure in lean and obese adult human subjects.

We compared the physical activity of 11 lean and 11 obese men and women over a 7-day period. There were no significant differences in either the amount of movement recorded with an accelerometer (9.5 (SD 3.9) vs 9.9 (SD 2.6) kcounts.day-1), or in the energy expenditure due to physical activity reflected by the difference between the average daily metabolic rate measured by the doubly labelled water technique and the sleeping metabolic rate measured in a respiration chamber and adjusted for fat-free mass: 112 (SD 33) vs 118 (SD 22) kJ.kg-1.day-1. The obese showed a non-significant loss of body mass of 0.5 (SD 1.1) kg, probably due to reduced intake during the 7-day intake recording period.

Adult↗

[Fresh sections of the flexor tendons of the fingers and thumb. New therapeutic trends. Apropos of a clinical series of 77 tendon lesions].

In flexor tendon surgery, the main concern of hand surgeons in the last two decades has been to find an effective and reproducible means to avoid post-operative adhesions. For most authors, these adhesions were responsible for the bad results. Since 1960, a constant progress has been achieved with the progress in operative procedures and the better understanding of tendon healing process. Post-operative rehabilitation, especially Kleinert's and Duran's active and passive methods, have radically transformed the prognosis of fresh tendon lesions. In spite of all this progress, zone II tendon injuries are still a difficult problem. In this clinical study, we wanted to introduce two new orientations in order to improve the overall results, the use of human fibrin sealant instead of the epitendinous running suture and an improvement of Duran's technique, developed by the Bichat rehabilitation team since 1987. Seventy-seven tendon lesions treated according to our technique (55 fingers and 22 thumbs) between 1987 and 1991, were reviewed. All the lesions studied were in zone II and T II. The mean follow-up is 14.4 months. The evaluation is based on the International Federation of Hand Surgery score for fingers, and the Tubiana score for thumbs. 74% of fingers and 86% of thumbs were scored as good and excellent.

Adult↗

Signal decomposition method of evaluating head movement to measure induced forelimb lameness in horses trotting on a treadmill.

In horses at a trot, the head moves up and down twice in one stride. In horses with unilateral forelimb lameness this movement is asymmetric. Computer-assisted kinematic analysis of vertical head movement can be used to quantify objectively lameness in horses in clinical trials. However, in mild lameness, absolute measurements of vertical head height may not be sensitive enough to detect small differences in lameness, and extraneous head movement by the horse due to curiosity, excitement or nervousness interferes with the accurate measurement of vertical head movement asymmetry. We describe a simple, signal-decompensation method of evaluating vertical head movement using a model of induced mild foot lameness in 9 horses. The technique assumes that the vertical head movement pattern can be broken down into 3 components; the vertical head movement caused by forelimb lameness (A1), the amplitude of the natural biphasic vertical head movement (A2) and extraneous head movement. Extraneous head movement is mathematically removed from the vertical head movement pattern. A1 and A2 are then calculated. After induction of lameness, mean A1 increased by 1.63 cm (range 0.10-3.33 cm, P = 0:005). Mean A2 did not significantly change after lameness induction. Error in reproduction of the original head movement pattern was 0.3-0.5%. We calculated that a hypothetical clinical trial would require 12 subjects for testing to be 80% certain that this difference would be successfully detected using this method of lameness evaluation.

Animals↗

Motion artifacts in quantitative magnetic resonance imaging.

Several investigators have emphasized the potential value of quantitative relaxation times in the assessment of diseases. In performing such measurements using the spin-echo technique, we have encountered several anomalous results, whereby the intensity of the organ parenchyma on second-echo images is greater than on first echo images. This is most likely a result of respiratory motion, and it occurs only rarely. Several volunteers were studied before and after exercise to see if respiratory motion could reproduce the anomalous intensity reverse; a reversal of intensities in renal parenchyma was observed in two of five individuals. We conclude that respiratory motion artifacts will seriously limit quantitative magnetic resonance imaging of the upper abdomen if respiratory gating during imaging is not used.

Humans↗