The anatomical basis for ultrasonography of the lateral pterygoid muscle and the infratemporal fossa

Summary The infratemporal fossa and its contents (particularly the pterygoid muscles) is a region difficult to explore, in spite of its importance in odontostomatological pathology. In order to reduce the indications that justify examination by computed tomography and magnetic resonance imaging, for reasons of economy of health, the authors describe by application of orientated anatomical slices the way in which ultrasonography can be performed. Only the posterior approach between the mandible laterally and the mastoid process medially provided consistently adequate exploration of the infratemporal fossa and the pterygoid muscles.Communication presented at the French Section of the European Association of Clinical Anatomy meeting, Bobigny, France, June 20, 1992     

Restricted catch-up growth after cessation of steroid treatment in a growth-hormone-deficient child

The phenomenon of catch-up growth has been known for a long time but its actual stimulus has remained unidentified. Involvement of growth hormone (GH) seems likely, but it is unknown whether normal GH secretion is an absolute prerequisite for catch-up growth. We present insight to this topic by describing a child with GH deficiency who showed a biphasic pattern of catch-up growth. During the first catch-up phase, she showed restricted catch-up growth in the absence of GH therapy, while she achieved nearly complete catch-up with GH therapy. Both periods of catch-up growth are compared separately with the response to GH therapy of age-matched, GH deficient patients with similar height deficit. This observation suggests that the first phase of catch-up growth in a child with severe growth retardation may be partially GH independent, while further catch-up requires normal GH levels.     

Fat suppression by section-select gradient reversal on spin-echo MR imaging. Work in progress

A method to decrease the intensity of fat by reversal of the section-select gradient is demonstrated. This technique takes advantage of the chemical shift in section location.     

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.     

Intracranial hemorrhage: gradient-echo MR imaging at 1.5 T. Comparison with spin-echo imaging and clinical applications

Fifty-seven patients with hemorrhagic intracranial lesions were examined with magnetic resonance (MR) imaging at 1.5 T with use of both spin-echo (SE) and gradient-echo-acquisition (GEA) techniques to assess the clinical applications and limitations of GEA in evaluation of intracranial hemorrhage at high field strength. All GEA images were obtained with a long echo time and short flip angle to emphasize T2*-based contrast. In 30 of 61 cases, GEA images demonstrated more hemorrhagic lesions than SE images. In 14 of 61 cases, GEA images failed to depict the lesion or obscured the specific diagnosis (as depicted by SE MR imaging). The authors believe that GEA imaging in its current form has a limited but definite adjunctive role in the evaluation of intracranial hemorrhage at high field strength.     

Potential hearing loss resulting from MR imaging

To determine if the loud noise generated by magnetic resonance (MR) imaging equipment is capable of inducing hearing loss, the hearing of 24 patients was tested before and after MR imaging. Fourteen patients were imaged without ear protection, and six (43%) suffered a temporary, mild loss of hearing (less than or equal to 15 dB at at least one frequency). Ten patients were imaged with ear protection, and only one experienced any hearing loss. Therefore, the noise generated by MR imagers may cause temporary hearing loss, and earplugs can prevent this loss. All threshold changes had returned to within 10 dB of baseline by 15 minutes after completion of the second audiometric test.     

Relationship of physical activity vs body mass index with type 2 diabetes in women

CONTEXT: Physical inactivity and body mass index (BMI) are established independent risk factors in the development of type 2 diabetes; however, their comparative importance and joint relationship with diabetes are unclear. OBJECTIVE: To examine the relative contributions and joint association of physical activity and BMI with diabetes. DESIGN, SETTING, AND PARTICIPANTS: Prospective cohort study of 37 878 women free of cardiovascular disease, cancer, and diabetes with 6.9 years of mean follow-up. Weight, height, and recreational activities were reported at study entry. Normal weight was defined as a BMI of less than 25; overweight, 25 to less than 30; and obese, 30 or higher. Active was defined as expending more than 1000 kcal on recreational activities per week. MAIN OUTCOME MEASURE: Incident type 2 diabetes, defined as a new self-reported diagnosis of diabetes. RESULTS: During the follow-up, 1361 cases of incident diabetes occurred. Individually, BMI and physical activity were significant predictors of incident diabetes. Compared with normal-weight individuals, the multivariate-adjusted hazard ratio (HR) was 3.22 (95% confidence interval [CI], 2.69-3.87) for overweight individuals and 9.09 (95% CI, 7.62-10.8) for obese individuals. For overall activity (kilocalories expended per week), compared with the least active first quartile, the multivariate-adjusted HRs were 0.91 (95% CI, 0.79-1.06) for the second quartile, 0.86 (95% CI, 0.74-1.01) for the third, and 0.82 (95% CI, 0.70-0.97) for the fourth (P for trend =.01). In the combined analyses, overweight and obese participants, whether active or inactive, had significantly elevated risks, compared with normal-weight active individuals. The multivariate-adjusted HRs were 1.15 (95% CI, 0.83-1.59) for normal-weight inactive, 3.68 (95% CI, 2.63-5.15) for overweight active, 4.16 (95% CI, 3.05-5.66) for overweight inactive, 11.5 (95% CI, 8.34-15.9) for obese active, and 11.8 (95% CI, 8.75-16.0) for obese inactive participants. CONCLUSIONS: Although BMI and physical inactivity are independent predictors of incident diabetes, the magnitude of the association with BMI was greater than with physical activity in combined analyses. These findings underscore the critical importance of adiposity as a determinant of diabetes.