Skin thickness in patients with acromegaly and Cushing's syndrome and response to treatment.

Radiological assessment of skin thickness (ST) was assessed in 22 patients with acromegaly and 17 patients with Cushing's syndrome. The age ranges of the patients studied and the 55 individuals in the control group were comparable. The skin thickness in males was significantly greater than in females (P less than 0.01). Mean skin thickness in patients with acromegaly and Cushing's syndrome was significantly greater and less respectively than the mean skin thickness of the normal controls (P less than 0.02). Following successful treatment of acromegaly (growth hormone less than 5 micrograms/l) there was a significant reduction in skin thickness (P less than 0.02 males: P less than 0.01 females). The skin thickness declined at approximately 0.3 mm/year for the first two years and more slowly thereafter. A highly significant correlation was observed between the logarithm of the pre and post treatment plasma GH concentrations and ST values. With one exception, all patients with growth hormone (GH) levels greater than 5 micrograms/l had ST values above the normal range. At an average of 4.5 years after successful treatment of Cushing's syndrome the average increase in ST was 0.23 mm (P less than 0.01). It is concluded that the measurement of skin thickness is a useful screening test for both acromegaly and Cushing's syndrome and provides an objective assessment of the clinical response to treatment.

Thyroid function following intravenous pyelography.

Thyroid function was assessed by total serum thyroxine, free thyroxine index and serum triiodothyronine immediately prior to intravenous pyelography in 105 female outpatients. The thyroid function tests were repeated two months later. Although all three parameters showed a statistically significant mean rise, the changes were small and not clinically significant. Two patients from the study population with a past history of thyrotoxicosis had a transient elevation in serum triiodothyronine but neither patient developed clinical features of hyperthyroidism.

Infrarenal dissection of the aorta.

Three patients with infrarenal aortic dissection are described and the pathogenesis, investigation and treatment of this condition briefly discussed.

The Motor-Scooter Handlebar Syndrome: Report of a Case.

A case of acute arterial insufficiency of the right leg of a young man is described, following a blow on the inguinal region from the handlebar of a motor-scooter. A review of the literature suggests that this is an uncommon but clear-cut syndrome.