Occult Carcinomas of the Lung

In 1974, we reported 26 patients with roentgenographically occult lung carcinomas. In 13 (50%) of them, the tumor was localized and treated by resection while the disease was still early (Stage I). These patients have done well, and the median survival has reached 8 years. We have added 21 patients to the series since our last report. Localization was by fiberoptic bronchoscopy in all 21. Fourteen of these patients had Stage I disease and were treated by resection.Of a total of 27 patients with early disease treated by resection, none has had recurrence after follow-up extending from 2 months to 20 years. However, in 21 of the entire 47 patients (45%) a second carcinoma developed, 15 (71%) of which were second lung carcinomas.     

Extent of agreement between patient and physician ratings of emotional distress

The extent of agreement between subjects’ self-ratings on the Hopkins Symptom Checklist (HSCL) and physicians’ ratings on three other scales for emotional distress was examined in two nonpsychiatric groups–women attending a family-planning service and persons participating in a community health survey. Agreement between patient and physician assessments of depression and anxiety was high, and the HSCL proved to be accurate in identifying symptomatic patients. The findings support the value of the HSCL as a screening instrument for the detection of anxiety and depression in nonpsychiatric medical patients.     

Three-dimensional contrast-enhanced MR angiography of the thoraco-abdominal vessels

With the strategies presented in this article,relevant disease involving the thoraco-abdominal vessels can be well depicted by 3D CEMRA. Aneurysms, dissections, occlusions, congenital lesions, and anatomic anomalies are readily assessed. Time-resolved MRA provides supplemental information in shunts, dissections, aneurysms, and AVMs. Velocity-encoded imaging may help fur-ther characterize lesions and may provide useful functional information to grade and monitor the progression of stenotic disease. 3.0T imaging and recent development in multicoil RF technology will further improve the performance of 3D CEMRAin terms of temporal and spatial resolution.     

Low dose CE-MRA

Over the last decade, three-dimensional contrast-enhanced magnetic resonance angiography (CE-MRA) has emerged as a widely accepted and powerful technique for diagnostic assessment of almost all vascular territories.Its non-invasive nature and lack of ionizing radiation, its potential to cover a large field of view and the safety of gadolinium-based contrast agents make CE-MRA an appealing alternative to digital subtraction angiography (DSA) or computed tomography angiography (CTA). However, recent reports linking high dose gadolinium-based contrast agents to the development of nephrogenic systemic fibrosis [1], [2] and [3] have raised concerns over the safety of CE-MRA. As a result, many investigators have focused attention on gadolinium dose reduction strategies [4] and [5].This article reviews existing state-of-the-art 3D CE-MRA strategies to reduce contrast dose and summarizes current applications and clinical experience to date. It also highlights evolving techniques, which the authors feel are likely to enhance the future impact of CE-MRA.     

Improved Myocardial Strain Measured by Strain-Encoded Magnetic Resonance Imaging in a Patient With Cardiac Sarcoidosis

A woman aged 64 years with cardiac sarcoidosis responded favourably to corticosteroid therapy in terms of recovered longitudinal myocardial strain, as evaluated by strain-encoded magnetic resonance imaging (SENC-MRI). In contrast, circumferential myocardial strain and late gadolinium enhancement demonstrated minimal improvement, suggesting relatively advanced pathology of the myocardial middle layer. We propose SENC-MRI as a marker of disease at an early stage of cardiac sarcoidosis.