Adrenal magnetic resonance imaging in addison’s disease

Magnetic resonance imaging of the adrenal glands was performed in 9 patients with Addison’s disease to evaluate the role of magnetic resonance (MR) in this entity. All patients had bilateral adrenal masses demonstrated by computed tomography (CT); etiologies included adrenal hemorrhage (2 patients), granulomatous disease (1 patient), adrenal lymphoma (3 patients), and adrenal metastases (3 patients). Spin-echo axial images were obtained at repetition times (TR) 0.5, 2.0 s and TE 28, 56 ms, using a Diasonics superconducting magnet operating at 0.35 T. In the patients with lymphoma, metastases, and granulomatous disease, the adrenal masses appeared hypointense or isointense with liver on the T₁-weighted images (TR 0.5 s, TE 28 ms). In cases of adrenal hemorrhage, areas of hyperintensity were seen on TR 0.5, TE 56 ms sequences, due to shortening of T₁ values. In both groups of patients the masses were hyperintense on T₂ weighted sequences. Mean calculated T₁ of the hemorrhagic glands was 449 ms, compared with a mean of 782 ms for mestastases and lymphoma. While MR is not capable of distinguishing between acute inflammatory and metastatic disases of the adrenal glands, it may be equally efficacious as CT in suggesting the diagnosis of adrenal hemorrhage in patients with Addison’s disease.     

Benign meningioma with a short latency period following irradiation.

Meningiomas have been reported following radiation of the head, usually with a long latent interval between exposure and the diagnosis of the new tumor. We report a benign meningioma resected approximately 3 1/2 years after radiation therapy for a glioma, which represents an unusually short latent interval between radiation and new tumor growth.     

Putting some PEP into pulmonary rehabilitation.

By focusing on quality of life through education and ongoing support, the pulmonary rehabilitation staff at Little Company of Mary Hospital in Torrance, Calif, gives hope to respiratory patients and teaches them to become partners in the management of their disease.     

Determinants of elderly residential mobility in Southern China: Exploration and implications

It is a widely accepted observation that many older Hong Kong residents have lived periodically on the Chinese mainland since the relaxation of restrictions on cross-border mobility and the closer connection between Hong Kong and the mainland. This paper explores and compares the determinants of various modes of residential mobility by Hong Kong retirees to the Pearl River Delta based on the data of two samples—one from Hong Kong and the other from the mainland. The findings support those of studies in Western societies that the decision of elderly residential mobility can be effectively predicted by the personal attributes, place ties, and person ties of the retirees, and that the effects of these factors vary with different modes of retiree mobility. The implications of these findings for the formulation of migration and housing policies for the older population and the economic development of amenity communities are discussed. He is also a Research Associate at the Joint Centre of Excellence for Research on Immigration and Settlement in Toronto, Canada. His research interests are elderly residential mobility, gerontology and geriatrics education, and the help-seeking behavior of older people. Dr. Ma’s latest study concerns the utilization and accessibility of human services for older residents in Hong Kong. He is also a reviewer of several international journals. Dr. Chow’s research interests are social security policies and practice, social policies and services for older people, and family support. The focus of his latest research project is the service needs of new immigrants to Hong Kong.     

Alcohol, education and action: shifting emphases

Over the past 20 years there has not only been a substantialincrease in indicators of alcoholrelated harm, but also an increasein professional and public awareness of alcohol problems andthe need to prevent them. Sadly, however, much of this awarenessof the need for prevention has resulted in little more thanrather desultory calls for more education. From my ‘pointof view’ it is time to shift further some of the emphasesin the debate aboust alcohol, education and action.     

未破裂脑动脉瘤的治疗选择

未破裂脑动脉瘤的处理存在争议。由于其自然史尚未完全明确,因此最佳的治疗策略也不清楚。目前对未破裂脑动脉瘤处理的共识包括观察、显微手术夹闭和血管内治疗。用于随访已知未破裂脑动脉瘤的方法学也有争议,可能取决于经治医生的偏好。大多数动脉瘤由神经外科医师和介入神经放射科医师处理,但未破裂动脉瘤通常是由神经科医师在对患者进行其他神经系统疾病的筛查时首先发现的。因此,关于何时对患者进行筛查和如何对未破裂动脉瘤采取最佳处理的知识将对其日常医疗实践有直接的影响。未破裂动脉瘤经常导致包括缺血事件、癫和头痛在内的其他神经系统症状,这些症状可能促进更积极的干预治疗。由于缺乏设计完善真正基于人群的研究或随机试验,因此目前的最佳处理必须以现有文献和每例患者当时的具体情况为根据。