Cerebral toxoplasmosis in a patient with Hodgkin's disease

A case is described of a patient presenting with enlarged lymph nodes and in whom a diagnosis of acute toxoplasmosis was made. The patient later developed Hodgkin's disease for which chemotherapy was started. Reactivation of the quiescent toxoplasma infection took place with devastating results. Prophylactic treatment in such cases is discussed.     

Pulmonary histiocytosis X: evaluation with high-resolution CT

Eighteen patients with pulmonary lesions of histiocytosis X were studied with high-resolution computed tomography (CT). Thin-walled cysts were found in all but one patient. The other abnormalities included nodules (n = 14), cavitated nodules (n = 3), thick-walled cysts (n = 7), reticulation (n = 4), ground-glass opacities (n = 4), and irregular interfaces (n = 4). The lesions were most often diffuse (n = 16), with a topographic predominance in the upper or middle lung zones in nine patients. Comparison of CT scans and chest radiographs shows that small and large cysts and micronodules are better detected with CT. Comparison of abnormalities found in patients in the early and late stages of the disease, as well as the evolution observed in one case, suggests that CT patterns progress from nodules to cavitated nodules and thick-walled cysts to cysts to confluent cysts.     

Quantitative renal imaging and its place in urological investigation

Recent developments in renal nuclear medicine enable accurate quantification of useful physiological parameters. These include renal perfusion, total and relative renal function, tracer transit times, and residual urine volume. The intravenous pyelogram (IVP) demonstrates renal excretion and, although both the IVP and renal ultrasound scanning provide excellent structural information, neither is able to assess renal function adequately. In renal medicine, the prime concern is often not structure but function, and quantitative renography provides this essential information.     

Radiation therapy of the elderly

Approximately 50 per cent of cancer patients will receive radiation treatment during the course of their illness. Similar benefits from palliative and curative treatments are seen in the elderly. Considerations for incorporating radiation treatment into the cancer management of older patients are discussed. The basis of and strategies for improved patient tolerance are reviewed.     

Post-synaptic changes and increased dopamine receptor sensitivity in hypothyroid rats

Hypothyroid rats showed increased behavioral sensitivity to both selective and non-selective dopamine agonists. Ligand binding analysis revealed no differences in concentration or affinity of striatal dopamine receptor subtypes in hypothyroid rats. Measurement of striatal cAMP levels however, indicated that hypothyroid rats showed a greater increase in cAMP production in response to stimulation by dopamine. It is concluded that the changes in behavioural sensitivity observed may be associated with alterations in post-synaptic mechanisms.     

CT of muscle necrosis following radiation therapy in a patient with head and neck malignancy.

Radiation-induced changes within skeletal muscle may be seen on follow-up CT or MR scans in patients who have undergone postoperative radiation therapy for head and neck tumors. Because they may mimic recurrent disease, these changes should be borne in mind.     

Preoperative rectal indomethacin for analgesia after laparoscopic sterilisation.

A randomised, double-blind, placebo-controlled study was conducted among 56 day-case patients to determine the effect of the preoperative administration of rectal indomethacin on postoperative pain and opioid requirements after laparoscopic sterilisation. Outcome in women receiving indomethacin did not differ significantly from the placebo group, but there was a trend to lower subjective pain scores, reduction in early postoperative pain assessed objectively and lower parenteral pethidine requirements in the first three hours postoperatively. Indomethacin did not appear either to cause side-effects or to significantly reduce morbidity from the other postoperative sequelae of laparoscopy. Despite evidence for postoperative analgesic effect, the clinical benefits of premedication with rectal indomethacin were minor.