Thyroid echography of subacute thyroiditis

Ultrasound was used to study 10 patients with subacute thyroiditis. With gray-scale technique, a "washed-out" appearance was seen during the active phase of the active phase of the illness. Clinical migration of the inflammation was accompanied by migration of the sonographic abnormality. Ultrasound can be especially helpful in the diagnosis of unilateral subacute thyroiditis and the differentiation of true cysts from hemorrhagic degeneration of goiter.

A spectrum of diseases of the thyroid gland as imaged by gray scale water bath sonography

A method of performing gray scale thyroid echography with a 3.5 MHz focused transducer and an open water bath is described. A preliminary echographic classification of abnormalities and representative echograms illustrating various thyroid disorders are presented.

Serum cystine aminopeptidase and leucine aminopeptidase activity in women with benign and malignant uterine and ovarian tumors

The serum enzymatic activities of cystine aminopeptidase and leucine aminopeptidase were measured in a group of 113 patients of whom 90 had benign uterine or ovarian tumors, and 23 had cancer of the endometrium or ovary. Thirty healthy nonpregnant women and 260 women at different stages of normal pregnancy served as control groups. The presence of pregnancy-specific enzymes in women with uterine or ovarian tumors showed once again that similar processes occur during pregnancy and malignancy. When ovarian or uterine malignancy is suspected on clinical examination, determination of the activities of these enzymes in serum may be of diagnostic value.

Prevention of spontaneous abortion by cervical suture of the malformed uterus

In a group of 82 women with congenital or acquired uterine malformation (such as intrauterine adhesions or uterus myomatosus), cerclage was successfully performed according to the McDonald method. The percentage of term deliveries increased from 29.8% to 69.2% and the percentage of spontaneous abortions decreased from 67.9% to 6.6%. Cerclage should be performed in all cases of uterine malformation, even if the patient previously suffered only one spontaneous abortion, as this is the best way to end the pregnancy with a viable fetus.

Induction of abortion and labor by extraamniotic isotonic saline, with or without addition of oxytocin, in cases of missed abortion, missed labor and antepartum fetal death

In a group of 16 women admitted for missed abortion, missed labor or antepartum fetal death, we induced abortion or labor by means of extraamniotic infusion of isotonic saline solution, using a Foley catheter inserted through the cervix. Eight patients also required parallel intravenous administration of 5-10 U of oxytocin drip. The average time from the onset of treatment until expulsion of the macerated fetus was 9.09 hours. No complications were recorded. This method is suggested in all such cases, especially when the classical methods are contraindicated.

Reversible hypertension. Caused by the hypercalcemia of hyperparathyroidism, vitamin D toxicity, and calcium infusion

Reversible hypertension occurred in a patient during episodes of hypercalcemia caused by hyperparathyroidism, vitamin D toxicity, and an infusion of calcium during an 11-year period of observation. It is suggested that normal renal function may be required for the hypertension of hyperparathyroidism to be reversible and that the hypertension may be directly related to the hypercalcemia in some patients. Early surgery is suggested for otherwise asymptomatic, mildly hypercalcemia hyperparathyroidism that is accompanied by hypertension.

[Indications of choice for extra-amniotic perfusion of physiologic serum]

After a preliminary report on 20 cases, we have used extra-amniotic perfusion of isotonic saline, in association or not with syntocinon, for performing:--56 2nd trimester therapeutic abortions,--16 labor inductions in interrupted 2nd and 3rd trimester pregnancies, with macerated fetus (missed abortion and missed labor). This method, relatively simple, permits the discharge of the conceptus within a reasonable time. Our experience allowed us to draw the indications of choice in the use of this method, which are the following: 1. When the amniotic puncture may be difficult (at the beginning of the 4th month or if the age of pregnancy is uncertain). 2. When there is an increased risk of hemorrhage with coagulation disorder macerated fetus or some systemic diseases). 3. When there are counter-indications for the use of hypertonic saline solution or prostaglandins (some renal, cardiac or respiratory diseases). 4. When one needs a fetus in a relatively good state for embryologic, histologic or genetic studies, which are important in case of abortion for rubella or chromosomic anomaly. In view of the innocuousness of this method, its use for labor induction in evolutive pregnancies is suggested.

[Induction of second trimester abortion by infusion of intraamniotic hypertonic and extraamniotic physiological saline solution (author's transl)]

In a group of 84 women in the second trimester of pregnancy abortion was induced by intramniotic transabdominal instillation of 20 per cent NaCl. In a second group of 91 women the abortion was induced by means of extraamniotic physiological infusion of saline solution. The only complication observed in the first group was an increasing fever. In the second group there were better results. The fetus abortion was complete and in a shorter time. We assume that the new method is the method of choice because it gives no complications and may be easily performed. It may be used also in cases of missed abortion or intrauterine fetal death.

Improved diagnosis of "nondelineated" thyroid nodules by oblique scintillation scanning and echography

The scan of the thyroid gland in oblique projections has enabled us to visualize 11 "cold" thyroid nodules which were not delineated on a traditional anterior view among 825 patients studied in a 2-yr period. Accurate localization of the nodule in the oblique projection facilitated accurate placement of the transducer for echography. The combination of the isotope imaging studies and ultrasound then permitted one to differentiate solid and cystic "cold" nodules. Diagnosis and choice of therapy are therefore enhanced by the addition of oblique views, when needed, and echography.