European Stars and Stripes (Newspaper) - October 15, 1991, Darmstadt, Hesse                                A amps Lynda Davidson at left. In a photo of an Fri picture the Arrow identifies a tumor on the spine. In an a Ray of the same patient at right the widening of the vertebrae Only subtly reveals the tumor. The not so Friendly medical Marvel by Peggy Davidson staff writer sgt. Karl Nelson was surprisingly relaxed considering he was sliding into an ominous looking Tunnel that vibrates bumps and All but howls in the night. No Nelson was t being tortured. He was being examined Lor a knee injury in the Lan Stuhl army regional medical Center s magnetic resonance imaging system. The Fri As it is colled was relaying computer pictures of Nelsons knee to waiting technicians. Unlike a regular a Ray machine the in agog system does t use radiation to take pictures of the human body. Instead radio Waves scatter protons in the human cells and then As a Magnet realigns the protons takes pictures to show lesions tutors and other medical problems said it col or Keith Mcmurdo or a radiologist at Lan Stuhl. The $2 million machine is especially useful in diagnosing disorders in soil tissues and has helped doctors diagnose neurological spinal and joint problems. Groundbreaking for the building housing the Fri system began in october 1990. The 10-ton Magnet was installed in March Lan Stuhl near Kaiserslautern Germany is the first military Hospital in Europe with an Fri said col. Thomas Verdon. The medical Center commander. The army and air Force have 10 others elsewhere the Magnet has been known to pull pens and Small calculators from doctors pockets dram watch battens a amps Lyndo Davidson staff sgt. Harry Acosta prepares patient Francis Reed of Augsburg Germany for an Fri session. Erase cassette tapes and Clear magnetic strips on credit cards. Quot i wiped out my credit cards the first week Quot said sgt Paul Martin an a Ray technician and assistant noncommissioned officer in charge of the the Fri. 1 m getting into the habit of taking my watch off though the Fri is used primarily for spinal and neurological diagnoses Mcmurdo expects that will change rapidly As radiologists become More familiar with the system and learn to use it for other medical problems a regular a rays produce very Subtle findings Quot Mcmurdo said and radiologists May not see Early stages of some tutors. With the Fri the contrast Between some tutors and healthy tissue is much greater he said. Quot lesions Are much easier to detect in general he said. Quot its a big improvement for  Mcmurdo said the system is Safe for children but has not been approved yet for pregnant women. There Are no known biological risks Quot he said. An Fri exam is not a simple procedure. Typically a patient is in the machine for 40 to 45 minutes and sometimes As Long As an hour said staff sgt. Harry Acosta the non commissioned officer in charge of the system. In that time 80 to 100 images will be created he said. It can be a daunting procedure for Many patients because they must stay absolutely still while the images Are being created. This can be especially hard for patients undergoing cranial exams Many of whom find it difficult to remain motionless while the machine vibrates and chunks inches from their face. Mcmurdo said the problem can be aggravated in people with a tendency toward Claustrophobia. Having a magnetic image made is Quot like being in a Tunnel he said. A very Small Tunnel at that. A in civilian hospitals music often is piped into the enclosure to help soothe the patient but that option is not a amps Lynda Davidson sgt. Paul Martin at the Fri computer controls. Available in military hospitals. Quot music systems Are too expensive Quot said Martin. However earplugs Are available. Nelson the Fri patient with the knee injury was Able to stay so relaxed because he went into the machine feet first. The Soldier who is assigned to the 45th Ord co in Nurnberg Germany also said that the technicians explained the entire procedure allaying any fears he might have had. Nelson was delighted with the Fri scan. The Only other method for determining the extent of his knee injury was an arthr Ogram a painful procedure in which a fiber optic filament is inserted into the joint. It takes longer to recover from a Needle Quot Nelson said. Martin said that since May. When the system went into use about one in 10 patients have been unable to contend with the noise and discomfort of the Fri requiring the exams to be aborted. That failure rate is comparable to those in civilian hospitals. Quot a lot of people Don t know they have Claustrophobia until they get in Quot Martin said. There Are several methods used at Lan Stuhl to ease the stress of the test. Patients can have a spouse in the room with them can Wear special glasses that allow them to see out of the Tunnel or receive medication to Calm them. Despite the drawbacks the Fri is a valuable tool an major acquisition for the Hospital officials said Quot this bongs us up to the Peak of technology Quot said Verdon i can t think of anything else we need for a High powered medical  chiropractors join the medical mainstream by Elisabeth Rosenthal the new York times frustrated by a l ack of Good treatments Tor Back pain doctors Are turning to a therapy they have Long dismissed As chiropractic quackery spinal manipulation. The american association of orthopaedic surgeons this year for the first Lime included a symposium on Back manipulation at its meeting and. In a show of hands almost a third of the 1,000-member audience bashfully admitted that they had referred patients for the technique Quot no question manipulation is More accepted said or. Scott Haldeman a neurologist who is also a chiropractor. Quot ten years ago if you practice manipulation you were a quack you could t get published and were never invited to meetings. Now i can t keep up with the  this year s edition of the major textbook on backs. The adult spine includes manipulation therapy in its first chapter. But perhaps the most convincing sign that the therapy is moving Center stage is that researchers at Rand corp. Who have studied the medical Utility of coronary bypass surgery and hysterectomies have recently turned their attention to spinal manipulation. And to their Surprise Early studies indicate that the technique holds up Well. In a recent report a panel of medical experts assembled by Rand to review the medical literature concluded that manipulation was appropriate for patients with certain types of Low Back pain. The Best candidates were patients whose pain had now alter years of trying _ to discredit it. People in this country Are saying maybe there s something there or. Paul g. Shekelle internist  lasted less than three weeks who had no signs of spinal nerve damage and whose spines appeared to be Normal in a rays. In studies patients in this group had significant Relief after manipulation and were Able to return to work sooner than similar patients treated with conventional methods. Quot i was surprised at How much agreement there was on when manipulation was appropriate and surprised at the interest on the part of the Ortho pudists Quot said or Paul g Shekelle an internist who is leading the Rand project at one time he said he would never have sent a patient to a chiropractor but he now does so on occasion. Or. John Frymoyer director of the Mcclure Tuscul skeletal research Center at the University of Vermont says that a growing number of Doci uss Pra Clicc manipulation themselves or More commonly refer patients to other professionals who Are skilled in the technique from chiropractors to physical therapists or. Nortin Hadler a professor of Rheuma ology at the University of North Carolina medical school at Chapel Hill describing himself As Quot a cantankerous doctor who would have never dealt with manipulation in the past Quot said. Quot it s not mainstream but it has become acceptable to talk about because some of us establishment figures have become  today most hands on Back therapy is done by chiropractors who believe that Back pain and a number. Of other maladies can be treated by manipulation the physical movement of joints past their Normal Range of motion in their View manipulation relieves aching backs because it restores Normal mobility to vertebral joints that Aie abnormally stiff ult ung the Dunckon of a Diament Muscles and nerves while few doctors accept the whole of elite Metie doctrine and remain sceptical of Elmo Iachio explanations a growing number of physicians have turned to chiropractors for their hands on skills chiropractors who used to be Ostia ired. Aie now invited into major hospitals Quot Haldeman said or Louis Sportelli past president of the american chiropractic association said that two decades ago he could not get doctors to accept his phone Calls today he said new surgeons in town invite him to lunch and lie often Quot co manages Quot patients with neurosurgeons or Litho pudists. Quot until a few years ago they were still buying into the Ama Effort to eliminate chiropractors Quot he said Quot now. There s no stigma attached to referring people to  until recently the american medical association held that it was unethical for a doctor to associate with a chiropractor. As acceptance of manipulation has spread physical therapists osteopaths and even conventional doctors Are offering a service once shunned. Traditional osteopathic doctors Learned manipulation but that waned in recent decades As they took on mainstream medical jobs when or. Stanley pans a physical therapist joined the Boston ump easily acuity two decades ago the University forbade him to practice teach or Wale about the manipulation technique lie had Lent nod in his native new zealand. He now lectures at major hospitals acres the country and at his private Institute of graduate physical therapy in St Augustine Flatie trams 2,000 physical therapists to manipulate backs cacti yeat spinal manipulation to treat Back Pam dates to Hippo Siatos and was widely practice by american doctors until the last Century when in the name of science it fell out of favor a overseas some medical doctors continued the practice. Quot now after years of trying to discredit it people in this country arc saying maybe there s something there. Shekelle said the current spate of interest started 10 years ago when reports began to appear in conventional medical journals showing that manipulation held some Promise four years ago Hadler and or. Peter Curtis conducted a tightly controlled study designed to prove it did t work Quot said Hadler the researchers found that Tor patients with less Ilian two weeks of pain manipulation did not make a difference Bui Lor people whose pain had persisted Tor two to four weeks a single manipulation produced significant Relief and allowed patients to return to activity sooner. Their findings were reported in the journal spine other studies have since confirmed and expanded the results. Quot for acute Back pain the general Drift from All these trials is that there a a Short term Benefit for people who get manipulation that lasts three to six weeks said Shekelle although some of the studies have design problems he added "tin.1 control group never do Betler Quot Quot there Are a lot More Good studies on this than on other things doctors accept and do All the Lime said or Robert Brook a loader of the Rand group the stars and stripes Page 15page 14 b the stars and stripes tuesday october 15, 199i