An evaluation of thallium imaging for detection of carcinoma in clinically palpable solitary, nonfunctioning thyroid nodules.

OBJECTIVE: An evaluation of thallium imaging for differentiating benign from malignant lesions in clinically palpable solitary, nonfunctioning, thyroid nodules. METHODS: Seventy-eight patients presenting with a clinically palpable solitary nonfunctioning thyroid nodule were imaged with 3 mCi thallium-201 with a pinhole acquisition at 20 minutes and 3 hours after injection. Thallium uptake was assessed as grade 1, less than the rest of the gland; grade 2, same as the rest of the gland; and grade 3, more than the rest of the gland. All patients underwent surgery and the histology was compared with the thallium scan results. RESULTS: Of the 78 patients presenting with solitary thyroid nodule, 13 were malignant and 65 were benign. Twenty-four patients with benign disease showed no uptake of thallium at 3 hours (grade 1). Thirty-two patients with benign disease and 2 patients with malignant lesion had grade 2 uptake at 3 hours. Eleven patients with malignant disease and 9 with benign disease had grade 3 uptake at 3 hours. CONCLUSIONS: All malignant lesions had at least grade 2 and most had grade 3 uptake at 3 hours. All lesions with grade 1 uptake at 3 hours were benign, enabling malignancy to be excluded in one-third of cases. Thallium imaging is a useful adjunct to fine-needle cytology in evaluation of solitary thyroid nodules especially when the latter is inconclusive.

Oxytocic drugs and anaesthesia. A controlled clinical trial of ergometrine, syntocinon and normal saline during evacuation of the uterus after spontaneous abortion.

A randomised controlled clinical trial compared ergometrine 0.25 mg, syntocinon 10 mg and normal saline injected intravenously during evacuation of the uterus after spontaneous abortion showed no difference between any drug with respect to uterine contraction, change in blood pressure, blood loss or postoperative vomiting.

Postoperative analgesia for Caesarean section using epidural methadone.

A prospective randomised double blind study was carried out to compare the use of epidural methadone, morphine and bupivacaine for pain relief after Caesarean section. The results indicate that methadone is the most effective agent with few side effects. Subsequently this method was used routinely for postoperative analgesia in all patients undergoing Caesarean section. A retrospective study of 178 patients having this method of analgesia was carried out and indicated that epidural methadone is an effective and safe method of postoperative pain relief.

Behaviour of unsedated children in the anaesthetic room.

The behaviour of 344 unsedated children in the anaesthetic room was assessed using a method similar to that described by Doughty (1959). The influence of the experience of the anaesthetist was found to be unimportant. The influence of the child's age was studied; children aged 7 yr and more behaved in a more satisfactory manner. The frequency of satisfactory behaviour compared favourably with that in published trials of sedative premedication which have used this method of assessment. The results support the view that the inclusion of unsedated children in such behavioural studies is essential.

An assessment of the effects of hormones on short term organ cultures of human breast carcinomata.

Twenty-eight mammary carcinomata were maintained in organ culture in the presence of various hormones. The effects of the hormones have been assessed histologically by estimation of total dehydrogenases activity of the pentose glycolytic pathway and by the incorporation of tritiated thymidine or uridine into DNA or RNA. No significant effects on tumour cell activity due to hormones have been observed.