ABSTRACT
We describe three patients who developed severe endocrine ophthalmopathy at 3, 12 and 18 months after treatment with iodine-131. In two cases with congestive ophthalmopathy steroids alone and plasma exchange alone failed to produce a satisfactory response, but the combination of plasma exchange with steroids or steroids plus cyclophosphamide was followed by resolution of papilloedema and return of visual acuity to normal as well as definite improvement in the other signs of ophthalmopathy. In the remaining case, which did not have papilloedema the signs of ophthalmopathy were progressive despite treatment with steroids. Combined treatment with plasma exchange, steroids and cyclophosphamide resulted in improvement in visual acuity and resolution of periorbital oedema and diplopia. Plasma exchange may be a useful adjunct to immunosuppressive therapy in the treatment of acute progressive endocrine exophthalmos.
Subject(s)
Graves Disease/therapy , Immunosuppressive Agents/therapeutic use , Plasma Exchange , Aged , Cyclophosphamide/therapeutic use , Female , Graves Disease/diagnostic imaging , Graves Disease/drug therapy , Humans , Male , Middle Aged , Prednisolone/therapeutic use , Tomography, X-Ray ComputedABSTRACT
These results indicate that computer assisted tomography of the brain, even when contrast medium enhanced, does not contribute to the detection of occult intracerebral metastases in patients with primary carcinoma of the breast and of malignant melanoma, even if the disease is locally advanced. The number of patients with malignant melanoma is still small, and this part of the study is continuing. However, we have discontinued the use of computer assisted tomography as a staging investigation for patients with carcinoma of the breast. Although the yield of positive scans in those 31 patients with metastatic, or locally recurrent, disease, but no neurologic symptoms, is subsequently found to be 13 per cent at follow-up study, this would not appear to be a profitable investigation in the absence of effective therapy. In our series of patients with neurologic symptoms, abnormal and positive scans were obtained in five of 18 patients. However, even in such patients, a negative computer assisted tomography did not exclude intracerebral metastatic disease. There is no place for routine computer assisted tomography as a staging investigation for patients with early carcinoma of the breast or with malignant melanoma. Its use should be restricted to those patients who have symptoms of cerebral disease.
Subject(s)
Brain Neoplasms/secondary , Brain/diagnostic imaging , Breast Neoplasms , Melanoma , Skin Neoplasms , Tomography, X-Ray Computed , Brain Neoplasms/diagnostic imaging , Breast Neoplasms/pathology , Female , Humans , Melanoma/pathology , Neoplasm Staging , Skin Neoplasms/pathologyABSTRACT
Seventeen schizophrenic patients with tardive dyskinesia (TD) and 33 schizophrenics without tardive dyskinesia were examined by psychological tests of intellectual function and EMI scans were performed. The group as a whole were found to be demented and 31 out of 45 had abnormalities on the scan. On a learning test the tardive dyskinesia group did significantly worse and using a measured parameter of the scan (the Ventricular Index) the tardive dyskinesia group had more abnormality. It is suggested that the higher incidence of pathology in the tardive dyskinesia group may be related to chronic neuroleptic toxicity.
Subject(s)
Dyskinesia, Drug-Induced/psychology , Schizophrenia/drug therapy , Schizophrenic Psychology , Antipsychotic Agents/adverse effects , Atrophy , Cerebral Cortex/pathology , Chronic Disease , Female , Humans , Male , Middle Aged , Psychological Tests , Tomography, X-Ray ComputedABSTRACT
The relationships between the third and fourth ventricles have been studied by examination of the angles formed by third and fourth ventricular projections. These have been subjected to statistical analysis and have proved useful for posterior fossa stereotactic surgery.
Subject(s)
Cerebral Ventricles/anatomy & histology , Adult , Cerebral Aqueduct/anatomy & histology , Child , Humans , Stereotaxic TechniquesSubject(s)
Epilepsy/surgery , Stereotaxic Techniques , Behavior , Cognition , Humans , Intelligence , Motor Skills , PersonalitySubject(s)
Diabetic Retinopathy/radiotherapy , Pituitary Irradiation , Yttrium Isotopes , Adult , Biopsy , Creatinine/metabolism , Diabetic Nephropathies/pathology , Diabetic Retinopathy/drug therapy , Diabetic Retinopathy/pathology , Diabetic Retinopathy/therapy , Female , Follow-Up Studies , Humans , Kidney/pathology , Male , Middle Aged , Proteinuria , Urea/bloodABSTRACT
A total of 76 "high-risk" surgical patients were studied for evidence of venous thromboembolic disease. Episodes of deep vein thrombosis and of pulmonary embolism were related to changes in blood levels of fibrin degradation products (F.D.P.). When diagnosed either by ordinary clinical means or by venography and isotope scanning significantly raised F.D.P. levels were found in all cases. Serum F.D.P. estimations are unlikely to help in detecting deep vein thrombosis, but may prove valuable in diagnosing pulmonary embolism.
