Use of shielding to prevent folding in MR imaging

Aluminum foil was used as a shielding device during magnetic resonance imaging. During imaging of the abdomen or thorax, foil placed over the arms of the subject prevented folding over the limbs in the phase-encoding direction of the images.     

Radioprotective action of carbimazole in radioiodine therapy for thyrotoxicosis — influence of the drug on iodine kinetics

Pretreatment with carbimazole of patients given radioiodine (¹³¹I) therapy for thyrotoxicosis reduces the incidence of early hypothyroidism. The possibility that this radioprotective effect might be a consequence of drug induced alteration in thyroidal iodide turnover, leading to a reduction in thyroid irradiation, was investigated in a prospective study of 24 thyrotoxic patients. Subjects were randomly assigned to receive ¹³¹I alone or to be treated with carbimazole for a minimum of three months before ¹³¹I. Thyroxine supplements were given in the latter group to prevent iatrogenic hypothyroidism. The effective half-life of therapeutic ¹³¹I in the thyroid was measured using a gamma camera/computer system after oral administration of the dose, allowing the biological half life of the anion and estimated radiation dose to the thyroid to be derived. Effective half life of ¹³¹I, biological half life of ¹³¹I and estimated radiation dose to the thyroid were similar in the two groups of subjects. It is concluded that the radioprotective action of carbimazole is not a consequence of altered thyroidal iodide kinetics.     

Intraluminal stents in atherosclerotic iliac artery stenosis: preliminary report of a multicenter study

Fifteen patients with symptomatic iliac artery stenosis were treated with intraluminal placement of balloon-expandable stents. Before treatment, 14 patients had intermittent claudication, and one had a limb at risk for amputation. One patient had diabetes mellitus, nine had hypertension, and all were long-term smokers. Two patients had surgical placement of the stent; in one patient this was part of a combined revascularization procedure. All other stents were placed percutaneously. The transstenotic gradient after injection of vasodilating drugs distal to the lesion decreased from a mean of 32.3 mm Hg +/- 16.7 to 3.1 mm Hg +/- 4.2 after stent placement. Ankle-arm Doppler systolic pressure index increased from a mean of 0.68 +/- 0.22 to 0.96 +/- 0.24 after the procedure. The treatment eliminated intermittent claudication in 14 patients and increased exercise tolerance to 500 m in the patient with a limb at risk for amputation before the procedure. The improved condition persisted in all patients during the follow-up of 6-12 months. Stent placement may be a valuable adjunct in the management of iliac artery disease.     

Erythromycin-induced hepatitis: simulator of malignancy

A 67-year-old patient was admitted with a 2-week history of epigastric discomfort that began after an episode of upper respiratory tract infection treated with erythromycin. Results of liver function tests were abnormal. Abdominal ultrasound (US) and computed tomography showed multiple, poorly demarcated irregular lesions in both hepatic lobes, suggestive of diffuse metastatic invasion. Histologic examination of the biopsy specimen revealed drug-induced hepatitis. Ten weeks after withdrawal of the erythromycin, US showed complete resolution of the hyperechogenic liver lesions.     

Circadian variation of thyrotrophin, determined by ultrasensitive immunoradiometric assay, and the effect of low dose nocturnal dopamine infusion

The effect of low dose dopamine infusion on the circadian rhythm of thyrotrophin (TSH), prolactin and cortisol in a group of six healthy male volunteers is reported. Subjects were infused in random order with either saline (154 mmol/l NaCl solution; control) or dopamine (0.1 and 1 microgram min-1 kg-1) between 21.00 and 01.00 hours, in random order. The serum TSH profile was characterized by a maximal peak occurring at 23.00 hours and higher nocturnal than diurnal values. Superimposed on this are short term oscillations in serum TSH levels, typical of an ultradian rhythm. The maximal peak in TSH, occurring at 23.00 hours, was abolished by dopamine infused at a rate of 1 microgram min-1 kg-1, and was unaffected by the lower rate of dopamine infusion (0.1 microgram min-1 kg-1). The serum prolactin profile was characterized by a peak occurring soon after the onset of sleep (23.30-00.30 hours), which fell during the morning, and began to rise in late evening. Low dose dopamine (0.1 microgram min-1 kg-1) had a slight but insignificant effect with decreased prolactin levels at the end of the infusion whereas the higher dopamine dose was associated with significantly lower prolactin levels during and throughout the infusion. There was a rebound to levels significantly higher than control on cessation of the infusion. Cortisol levels were unaffected by dopamine.     

Natural history and pathogenesis of cervical disk disease.

As the cervical spine ages, degenerative processes occur that involve the intervertebral disk as well as facet joints. Some individuals experience pain as this process evolves. In many instances, it can be difficult to correlate a patient's symptoms with the associated changes. This article reviews the appropriate anatomy and biochemistry of the cervical spine and presents the pathologic entities that are encountered.