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Es sollte in dieser Schrift untersucht werden, inwieweit bei Änderungen im Bereich der Planung, Durchführung und Auswertung von klinischen Arzneimittelprüfungen die Bewertung mit wissenschaftlichen oder politischen Begründungen erfolgt und inwieweit wissenschaftliche Regeln für politische Zwecke genutzt werden.
Serendipities in der Medizin
(2016)
Zufälle begleiten unser Leben. Auch bei wichtigen Entdeckungen und Entwicklungen in der Medizin spielt der „Zufall“ (engl. „serendipity“) eine Rolle. Hierzu gehören u. a. die Mendelschen Gesetze, die Ermittlung der menschlichen Chromosomenzahl, die Entdeckung der DNS durch Watson und Crick, der PAP-Test oder die Entdeckung der Röntgenstrahlung und der Radioaktivität. Aber auch und gerade in der Pharmakologie gibt es viele Beispiele für Serendipitäten. Einige gehen eng mit Zufällen bei der Entdeckung der Bakteriologie einher.
Im Jahr 1504 verlor der deutsche Ritter Gottfried („Götz“) von Berlichingen seine
rechte Hand. Schon während seiner Genesung dachte er daran, die Hand zu ersetzen,
und beauftragte bald darauf die erste Handprothese, die sogenannte „Eiserne Hand“.
Jahre später wurde die aufwändigere zweite „Eiserne Hand“ gebaut. Wir haben die erste
Prothese auf der Basis früherer Literaturdaten von
Quasigroch (1982) mit Hilfe von 3-D
Computer-Aided Design (CAD) rekonstruiert. Dazu mussten einige Abmessungen angepasst
und ein paar Annahmen für das CAD-Modell gemacht werden. Die historische passive
Prothese des Götz von Berlichingen ist für die moderne Neuroprothetik interessant, da sie
eine Alternative zu komplexen invasiven Brain-Machine-Interface-Konzepten darstellen
könnte, wo diese Konzepte nicht notwendig, möglich oder vom Patienten gewünscht sind.
Auf Grundlage der Computer-Aided-Design (CAD)-rekonstruierten ersten „Eisernen Hand“ des Götz von Berlichingen wird ein umgebautes, controllergesteuertes sensomotorisches Fingersystem auf seine Funktionalität beim Greifen von unterschiedlichen Gegenständen beschrieben und geprüft. Die elektronischen Finger, die den „Pinzettengriff“ nachahmen und automatisch bei dem zuvor eingestellten Anpressdruck abschalten, bewiesen eine bemerkenswerte Alltagstauglichkeit. Das vorgestellte Grundkonzept könnte eine Alternative bei der Entwicklung einfacher und kostengünstiger, aber dennoch gut einsatzfähiger bionischer Hände sein und zeigt einmal mehr, wie historische Ideen in die Gegenwart transferiert werden können.
Concussions in sports and during recreational activities are a major source of traumatic brain injury in our society. This is mainly relevant in adolescence and young adulthood, where the annual rate of diagnosed concussions is increasing from year to year. Contact sports (e.g., ice hockey, American football, or boxing) are especially exposed to repeated concussions. While most of the athletes recover fully from the trauma, some experience a variety of symptoms including headache, fatigue, dizziness, anxiety, abnormal balance and postural instability, impaired memory, or other cognitive deficits. Moreover, there is growing evidence regarding clinical and neuropathological consequences of repetitive concussions, which are also linked to an increased risk for depression and Alzheimer’s disease or the development of chronic traumatic encephalopathy. With little contribution of conventional structural imaging (computed tomography (CT) or magnetic resonance imaging (MRI)) to the evaluation of concussion, nuclear imaging techniques (i.e., positron emission tomography (PET) and single-photon emission computed tomography (SPECT)) are in a favorable position to provide reliable tools for a better understanding of the pathophysiology and the clinical evaluation of athletes suffering a concussion.
There is increasing evidence of central hyperexcitability in chronic whiplash-associated disorders (cWAD). However, little is known about how an apparently simple cervical spine injury can induce changes in cerebral processes. The present study was designed (1) to validate previous results showing alterations of regional cerebral blood flow (rCBF) in cWAD, (2) to test if central hyperexcitability reflects changes in rCBF upon non-painful stimulation of the neck, and (3) to verify our hypothesis that the missing link in understanding the underlying pathophysiology could be the close interaction between the neck and midbrain structures. For this purpose, alterations of rCBF were explored in a case-control study using H215O positron emission tomography, where each group was exposed to four different conditions, including rest and different levels of non-painful electrical stimulation of the neck. rCBF was found to be elevated in patients with cWAD in the posterior cingulate and precuneus, and decreased in the superior temporal, parahippocampal, and inferior frontal gyri, the thalamus and the insular cortex when compared with rCBF in healthy controls. No differences in rCBF were observed between different levels of electrical stimulation. The alterations in regions directly involved with pain perception and interoceptive processing indicate that cWAD symptoms might be the consequence of a mismatch during the integration of information in brain regions involved in pain processing.
Dementia is a clinical diagnosis reflecting many possible underlying pathologies, for example, vascular dementia and neurodegenerative disorders such as frontotemporal dementia, Lewy body-type disorder or Alzheimer’s disease (AD). The breakthrough of 99mtechnetium-labelled perfusion tracers in the 1990s resulted in many SPECT studies of flow changes in AD. In the first decade of 2000, the role of perfusion SPECT was shifted from diagnosis towards differential diagnosis, parallel to the growing attention for diagnosing early stages of dementia. Previously a diagnosis based largely on a process of exclusion, new guidelines have emerged increasingly employing positive criteria to establish the diagnosis, including neuroimaging biomarkers. Nowadays, FDG PET has largely limited the role of perfusion SPECT, although it is still considered a valuable and cost-effective alternative when PET is not available.
Das 20. Jahrhundert ist geprägt von Aufsehen erregenden medizintechnischen Durchbrüchen: Von der ersten erfolgreichen Herztransplantation über die Entdeckung des Penicillins, vom Kampf gegen Infektionskrankheiten bis hin zu ersten Röntgenaufnahmen und Computer-Scans. Die Technologie und die medizinische Forschung haben in der Welt zu umwälzenden Fortschritten geführt. Krankheiten können gelindert oder sogar geheilt werden. Die Entwicklung von künstlichen Hüftgelenken, Cochlea-Implantaten sowie Herzschrittmachern sind in unserer Zeit zu alltäglichen Errungenschaften geworden. Auch die Behandlung neurologischer Bewegungsstörungen ist in den Fokus des technisch-medizinischen Fortschritts gelangt: „Hirnschrittmachersysteme“ – symptomfrei auf Knopfdruck. Ein Eingriff in das Gehirn, um gezielt elektrische Impulse abzugeben, um die Symptome beispielsweise von pharmakoresistenter Parkinsonpatienten effektiv zu behandeln. Dieses Therapieverfahren stellt für viele Patienten die letzte Möglichkeit dar, ein mehr oder weniger beschwerdefreies Leben führen zu können. Gleichzeitig ist dieses Verfahren ethisch heftig umstritten, zumal der Eingriff in das Gehirn gleichbedeutend mit einem Eingriff in den ‚Sitz des Selbst‘, der Persönlichkeit eines Patienten, verbunden ist.
Chronic insomnia is defined by difficulties in falling asleep, maintaining sleep, and early morning awakening, and is coupled with daytime consequences such as fatigue, attention deficits, and mood instability. These symptoms persist over a period of at least 3 months (Diagnostic and Statistical Manual 5 criteria). Chronic insomnia can be a symptom of many medical, neurological, and mental disorders. As a disorder, it incurs substantial health-care and occupational costs, and poses substantial risks for the development of cardiovascular and mental disorders, including cognitive deficits. Family and twin studies confirm that chronic insomnia can have a genetic component (heritability coefficients between 42% and 57%), whereas the investigation of autonomous and central nervous system parameters has identified hyperarousal as a final common pathway of the pathophysiology, implicating an imbalance of sleep–wake regulation consisting of either overactivity of the arousal systems, hypoactivity of the sleep-inducing systems, or both. Insomnia treatments include benzodiazepines, benzodiazepine-receptor agonists, and cognitive behavioural therapy. Treatments currently under investigation include transcranial magnetic or electrical brain stimulation, and novel methods to deliver psychological interventions.
Routine nuclear cardiology examinations indicate heart rate, cardiac rhythm, the height of cardiac pulse and respiration rhythm. It would be of interest to study whether these data, especially if the same tests are repeated, can indicate patients’ well being in the future and perhaps patients’ life span, other factors being equal. Related old theories and suggestions are mentioned. Furthermore, some drugs like I-f channel antagonists and stress tests testing cardiac reserves could support such a study.
In this study, we tested the function of a replica of the over 500-year-old original of the
famous Franconian Imperial Knight Götz von Berlichingen’s first “iron hand”, which we
reconstructed by computer-aided design (CAD) and recently printed using a multi-material
3D printer. In different everyday tasks, the artificial hand prosthesis proved to be remarkably
helpful. Thus, the hand could hold a wine glass, some grapes, or a smartphone. With a
suitable pencil, even writing was possible without any problem. Although for all these
functions the healthy other hand was necessary to assist at the beginning, the artificial hand
is an astonishing mechanical aid with many possibilities. Therefore, in certain cases, the
non-invasive approach of a passive mechanical hand replacement, which is an individual,
quick and cheap solution due to modern 3D printing, may always be worth considering
also for today’s requirements.
Wir haben die erste „Eiserne Hand“ des Götz von Berlichingen mit 3D-Computer-Aided Design rekonstruiert und über einen Multimaterial-3D-Drucker ausgedruckt. Dabei ließ sich feststellen, dass die 500 Jahre alte Technik keinesfalls veraltet ist: Das Innenleben der „Eisernen Hand“ ist ausgefeilter als bisher angenommen. Sie könnte sogar spannende Impulse für die Entwicklung neuer künstlicher Handprothesen liefern.
All you need is sleep
(2016)
In 21st century, the century when the humanity hopes to embark on interplanetary travel, we are yet to fully reach an understanding of our very own idiosyncratic terra incognita – the human sleep. Sleep is a highly conserved evolutionary process that constitutes approximately one third of our life, and the lack or inadequate sleep may lead to impairment across multiple cognitive domains (Tononi and Cirelli, 2014; Lim and Dinges, 2010). Sleep deprivation also leads to aberrant brain functioning, immunological and metabolic collapse, and if it is sufficiently prolonged it will ultimately lead to death (Tononi and Cirelli, 2014).
The famous violin virtuoso Nicolò Paganini (born on 27 October 1782 in Genoa, died on 27 May 1840 in Nice) left us with many puzzles. An interesting aspect is his hair: In the 19th century, hair given away as a token of friendship or romantic love became very popular, and Paganini also seems to have made use of this fad. In 2009, a lock of hair, purportedly that of Paganini, kept in a locked presentation box together with a bilingual autograph inscription saying: "Alla Signora Chatterton avec les compliments de Nicolò Paganini" was bought at an auction. From this hair lock a sample was taken and was investigated morphologically by using digital light microscopy (digital microscope VHX-100, Keyence) in reflected and transmitted light with and without polarization at different magnifications up to 1:5,000. The sample was then compared with a hair sample from the possession of the Paganini family, which had been microscopically examined in 2012 by the co-author of this paper yielding numerous figures with measurement results that had been stored and could be retrieved for direct comparison. The hair sample consisted of ten strands of hair or hair fragments and was investigated with great effort for the following parameters: exogenous hair damage, especially feeding traces caused by parasites, modeling and angulation of hairs, hair thickness, medulla and pigmentation, curling and mercury load on the trace material. After evaluation of all findings not only a non-exclusion of identity can be determined, but due to the broad match of also rare findings there is no reasonable doubt about their identity. In addition, the findings suggest that the studied hair samples are in fact from Paganini's head. The present case of Nicolò Paganini's hair lock is also an excellent starting point for reflections on the probative value of trace hair investigations. This point is also critically discussed in the paper. Finally, this study shows that said lock of hair had probably really been dedicated and given to Eliza Davenport Latham (born on 25 November 1806, died on 9 January 1877), the future wife of the, at that time, best-known and most famous English harpist John Balsir Chatterton (born on 25 November 1804, died on 9 April 1871). Paganini must have met her on his concert tour 1831/32, where he had travelled to Paris, London, the rest of England, Scotland and Ireland.
Cardiac resynchronisation therapy (CRT) is a promising treatment option in patients with chronic heart failure. In this article the roles of semi-invasive esophageal left-heart electrocardiography and functional cardiac nuclear imaging in the field of CRT are highlighted, as the combination of both could be a favourable diagnostic approach in special cardiac situations. Also original esophageal left heart electrogram data of exemplary CRT patients is presented.
Hybrid SPECT/US
(2014)
eLetter zum Artikel "Hybrid EEG/EOG-based brain/neural hand exoskeleton restores fully independent daily living activities after quadriplegia" von Surjo R. Soekadar et al., veröffentlicht in Science Robotics, Vol. 1, No. 1 (DOI: 10.1126/scirobotics.aag3296)
Nicht-invasives, nicht-ionisierendes funktionelles Neuroimaging mit räumlich und zeitlich hochauflösender Elektroenzephalographie oder Echtzeit-Naheinfrarotspektroskopie in Kombination mit modernen Robotorsystemen ist ein entscheidender Entwicklungsschritt auf dem Gebiet der Neuroprothetik und Brain-Machine-Interfaces. In der Medizintechnik an der Hochschule Offenburg wird hierzu geforscht.
Im Archiv für Kriminologie wurden bislang drei Arbeiten zur 3-D-CAD-Rekonstruktion der ersten "Eisernen Hand" des berühmten Reichsritters Gottfried ("Götz") von Berlichingen (1480-1562) vorgestellt. Mittlerweile sind einige neue Gesichtspunkte herausgearbeitet worden, die hier kurz als Ergänzung mitgeteilt werden sollen.
"Ad fontes!"
Francesco Petrarca (1301–1374)
In the beginning, there was an idea: the reconstruction of the first "Iron Hand" of the Franconian imperial knight Götz von Berlichingen (1480–1562). We found that with this historical prosthesis, simple actions for daily use, such as holding a wine glass, a mobile phone, a bicycle handlebar grip, a horse’s reins, or some grapes, are possible without effort. Controlling this passive artificial hand, however, is based on the help of a healthy second hand.
Geleitwort
(2012)
Knight Götz von Berlichingen (1480–1562) lost his right hand distal to the wrist due to a cannon ball splinter injury in 1504 in the Landshut War of Succession at the age of 24. Early on, Götz commissioned a gunsmith to build the first “Iron Hand,” in which the artificial thumb and two finger blocks could be moved in their basic joints by a spring mechanism and released by a push button. Some years later, probably around 1530, a second “Iron Hand” was built, in which the fingers could be moved passively in all joints. In this review, the 3D computer-aided design (CAD) reconstructions and 3D multi-material polymer replica printings of the first “Iron hand“, which were developed in the last few years at Offenburg University, are presented. Even by today’s standards, the first “Iron Hand”—as could be shown in the replicas—demonstrates sophisticated mechanics and well thought-out functionality and still offers inspiration and food for discussion when it comes to the question of an artificial prosthetic replacement for a hand. It is also outlined how some of the ideas of this mechanical passive prosthesis can be translated into a modern motorized active prosthetic hand by using simple, commercially available electronic components.
Kommentar zu "Intracortical microstimulation of human somatosensory cortex" von Sharlene N. Flesher et al., veröffentlicht in Science Translational Medicine, Vol. 8, No. 361, Seite 361ra141 (DOI: 10.1126/scitranslmed.aaf8083)
In der vorliegenden Arbeit werden fotografische Aufnahmen zweier verschiedener Abgüsse von Paganinis rechter Hand vorgestellt und näher beschrieben. Es handelt sich um einen mutmaßlich originalen Bronzeabguss, der vermutlich kurz nach Paganinis Tod auf dessen Totenbett abgenommen wurde, und eine in heutiger Zeit angefertigte Kopie aus Fiberplastik mit goldfarbenem Anstrich. Die Hand ist im proximalen Handgelenk stark abgewinkelt, was dafür spricht, dass die Hand des Toten auf einem Kissen gelegen haben könnte, um den Abguss vorzunehmen. Überdies zeigt sich eine verkrampfte Stellung der Finger und Hand, am ehesten infolge Totenstarre. Man findet zudem arthrotische Veränderungen sowie hervortretende Sehnen und atrophierte Muskulatur. Beim Bronzeabguss sind die beschriebenen Auffälligkeiten deutlicher zu erkennen. Ein 3D-Scan des Bronzeabgusses der rechten Hand Paganinis mit einem Strukturlichtscanner würde die Möglichkeit eröffnen, Messdaten der Hand zu erhalten.
eLetter zum Artikel "Plague Through History" von Nils Chr. Stenseth, veröffentlicht in Science, Vol. 321, Issue 5890, Seite 773-774 (doi.org/10.1126/science.1161496)
(1) Background: Little is known about the baroque composer Domenico Scarlatti (1685-1757), whose life was centred behind closed doors at the royal court in Spain. There are no reports about his illnesses. From his compositions, mainly for harpsichord, an outstanding virtuosity can be read. (2) Case Presentation: In this case report, the only known oil painting of Domenico Scarlatti is presented, on which he is about 50 years old. In it one recognizes conspicuous hands with hints of watch glass nails and drumstick fingers. (3) Discussion: Whether Scarlatti had chronic hypoxia of peripheral body regions as a sign of, e.g., bronchial cancer or a severe heart disease, is not known. (4) Conclusions: The above-mentioned signs recorded in the oil painting, even if they were not interpretable at that time, are clearly represented and recorded for us and are open to diagnostic discussion from today's point of view.
In this entry, the 3D CAD reconstructions and 3D multi-material polymer replica printings of knight Götz von Berlichingen´s first „Iron Hand,“ which were developed in the last few years at Offenburg University, are presented. Even by today's standards, the first “Iron Hand”–as could be shown in the replicas–demonstrates sophisticated mechanics and well thought-out functionality and still offers inspiration and food for discussion when it comes to the question of an artificial prosthetic replacement for a hand.
In der vorliegenden Arbeit wurde die von Wilhelm His Sr. angefertigte und im Jahr 1895 publizierte Fotografie des mutmaßlichen Skeletts von Johann Sebastian Bach auf ihre Abbildungsqualität untersucht. Dies erfolgte durch direkte Messungen an einem digitalen Scan der Fotografie. Dabei wurde der von His der Fotografie beigelegte Lineal-Maßstab in mehrere 10-cm-Stücke unterteilt und die Länge dieser Abschnitte im Digitalisat mit dem Messinstrument von Adobe Acrobat ausgemessen. Darüber hinaus wurden die Längen der Femora ermittelt und mit den Maßen verglichen, die 1895 an den tatsächlichen (realen) Knochen ermittelt wurden. In dem Digitalisat entsprachen 190 cm im Lineal 244,48 mm. Der Mittelwert der 19 bestimmten 10-cm-Abschnitte betrug 100,49 mm (Median 100,49 mm, Standardabweichung 0,49 mm). Die historische Femurlänge links betrug 443,5 mm, rechts 451,0 mm. Die im Digitalisat ermittelte Femurlänge betrug links 443,8 mm, rechts 451,1 mm. Zusätzlich wurden die projizierten Centrum-Collum-Diaphysen-Winkel bestimmt. Die Daten lassen den Schluss zu, dass die Oben/unten-Verzerrung sowie die Rechts/links-Verzerrung nicht nennenswert sind und das von His angefertigte Foto mit einer hohen Genauigkeit der Abbildungsqualität und des Linsenapparats der Kamera angefertigt wurde, die es ermöglicht, bestimmte Skelettanteile aussagekräftig zu beurteilen und auszumessen.
In this editorial, a topic for general discussion in the field of neuroprosthetics of the upper limb is addressed: which way—invasive or non-invasive—is the right one for the future in the development of neuroprosthetic concepts. At present, two groups of research priorities (namely the invasive versus the non-invasive approach) seem to be emerging, without taking a closer look at the wishes but also the concerns of the patients. This piece is intended to stimulate the discussion on this.
Die “Selbstbetrachtungen” des Marc Aurel – medizinisch-ethische Betrachtungen des Menschseins
(2013)
Who is Who? Joseph Fourier
(2015)
This paper presents new measurements of a bronze cast from the right hand of the famous Italian violin virtuoso Nicolò Paganini (1782-1840). These are compared to anthropometric standard values. In addition, detailed dorsal and palmar views of the cast are shown. With a middle finger length of 75 mm, the palm width is 60 mm and the hand length 152 mm, which is significantly below the 5% percentile of today's standard values. Also the finger length index (0.55), the ratio of finger length to palm length (0.98) and the ratio of finger length to palm width (1.25) are significantly above normal limits. Hence, Paganini had abnormal hand measurements with a very small palm and relatively "long" fingers. This remarkable constellation, among others, could have been advantageous for his amazing skills as a violinist.
Fünf Jahre vor seinem Tod, im Jahr 1932, wurde der berühmte französische Komponist Maurice Ravel (1875–1937), der an einer frontotemporalen Demenz (M. Pick) mit primär progressiver Aphasie litt, bei einem Unfall verletzt, als er in einem Pariser Taxi saß. In diesem Fallbericht wird der Unfallmechanismus unter bestimmten Annahmen dargestellt und diskutiert. Ausgehend von diesen Überlegungen ist ein Unfall bei geringer Kollisionsgeschwindigkeit wahrscheinlich. Trotz eines Unfalls mit nur geringer Geschwindigkeit ist nicht von der Hand zu weisen, dass dieser Unfall zumindest zu einer deutlichen Verschlimmerung der Krankheitssymptome geführt haben könnte, da Ravel seit diesem Taxiunfall bis zu seinem Tod keine weiteren Kompositionen mehr vollendet hat.
In dieser Arbeit wird ein historischer Fallbericht des bis heute weit über seine Landesgrenzen bekannten italienischen Kriminalanthropologen Cesare Lombroso (1835–1909) vorgestellt. In diesem Fallbericht wird der berüchtigte und psychisch auffällige Dieb Pietro Bersone mit Hilfe eines sog. Hydrosphygmographen überführt, einem zur damaligen Zeit neuartigen technischen Gerät, das den Puls nicht-invasiv aufzeichnen konnte. Lombroso ist vermutlich einer der ersten, wenn nicht sogar der erste, der durch den Einsatz eines solchen Geräts die Idee zum „Lügendetektor“ vorweggenommen hat. Die vorgestellte Textstelle aus Lombrosos Buch „Neue Fortschritte in den Verbrecherstudien“ ist daher ein besonderes Fundstück auch für die Geschichte der Polygraphie.
eLetter zum Artikel "The Hannes hand prosthesis replicates the key biological properties of the human hand" von Matteo Laffranchi et al., veröffentlicht in Science Robotics, Vol. 5, Issue 46, eabb0467 (doi.org/10.1126/scirobotics.abb0467)
eLetter: "The ancient Capua leg from 300 BC and the 1941 air raid on the Royal College of Surgeons"
(2021)
eLetter zum Artikel "The College of Surgeons, London", veröffentlicht in Science, Vol. 93, Issue 2425, Seite 587 (DOI: 10.1126/science.93.2425.587).
Am Buffet des Lebens
(2017)
eLetter zum Artikel "Condiciones neuropsi-quiátricas y probable causa de muerte de Maurice Ravel" von Gómez-Carvajal AM, Botero-Meneses JS, Palacios-Espinosa X und Palacios-Sánchez L., veröffentlicht in Iatreia 35(3), Seite 341-8 (DOI: https://doi.org/10.17533/udea.iatreia.154).
Whiplash injury
(2012)
eLetter zum Artikel "How hair can reveal a history" von Hanae Armitage & Nala Rogers, veröffentlicht in Science, Vol. 351, Issue 6278, Seite 1134 (doi.org/10.1126/science.351.6278.1134)
Musik und Neurophysiologie
(2017)
Online comment on: "Printing ferromagnetic domains for untethered fast-transforming soft materials"
(2018)
Streustrahlung in der Ultraschall-Computertomographie zur Verifizierung der Echtheit von Perlen
(2017)
This paper describes a new analysis method developed to distinguish real from fake
pearls using non-ionizing, non-destructive ultrasound computed tomography (USCT): In the USCT Shepp-Logan-filtered time-of-flight image, a fake pearl shows irregular, asymmetric
scattering of ultrasound, whereas the pattern in a natural pearl is regular and symmetric.
We strongly assume that pattern recognition of the scattering of ultrasound cannot only
play an important role in verifying pearls, but also in testing other materials and tissues in
(bio-)medical engineering. Furthermore, and most importantly, this new approach could
be helpful for a variety of clinical diagnoses using high-resolution 3D-USCT, such as the
detection of X-ray-negative micro-calcifications in early breast cancer. Moreover looking
at scattering patterns in dedicated positron emission tomography systems may promote
new developments in nuclear medicine diagnostics.
This book, now in its second, completely revised and updated edition, offers a critical approach to the challenging interpretation of the latest research data obtained using functional neuroimaging in whiplash injury. Such a comprehensive guide to recent and current international research in the field is more necessary than ever, given that the confusion regarding the condition and the medicolegal discussions surrounding it have increased further despite the publication of much literature on the subject. In recent decades especially the functional imaging methods – such as single-photon emission tomography, positron emission tomography, functional MRI, and hybrid techniques – have demonstrated a variety of significant brain alterations. Functional Neuroimaging in Whiplash Injury - New Approaches covers all aspects, including the imaging tools themselves, the various methods of image analysis, different atlas systems, and diagnostic and clinical aspects. The book will help physicians, patients and their relatives and friends, and others to understand this condition as a disease.
This book, now in its third, completely revised and updated edition, offers a critical approach to the challenging interpretation of the latest research data obtained using functional neuroimaging in whiplash injury. Such a comprehensive guide to recent and current international research in the field is more necessary than ever, given that the confusion regarding the condition and the medicolegal discussions surrounding it have increased further despite the publication of much literature on the subject. In recent decades especially the functional imaging methods – such as single-photon emission tomography, positron emission tomography, functional MRI, and hybrid techniques – have demonstrated a variety of significant brain alterations. Functional Neuroimaging in Whiplash Injury - New Approaches covers all aspects, including the imaging tools themselves and the various methods of image analysis. Details on biomechanics, including the finite element method and facts on historical whiplash experiments and crash tests have now been added to this new edition. The book will continue to help physicians, patients and their relatives and friends, and others to understand this condition as a disease.