[The vessels of the retropancreatic space in grey-scale-ultrasound. A contribution to the topography of the pancreas (author's transl)]

Normal pancreatic parenchyma and retropancreatic vessels can be well visualized and differentiated by grey-scale-tomography. The posterior border of the head and body of the pancreas can be defined better with the grey-scale-technique than with other ultra-sound-techniques by visualization of the retropancreatic vessels. For this purpose the venous system (portal vein, splenic vein and superior mesenteric vein) is more important than the arteries because of their closer topographic relationship to head and body of the pancreas. Identification and separation of those veins from other vascular structures is easily possible because of their constantly reliable topography and typical configuration on transverse section. The spleno-porto-vascular bundle--resembling a tadpole--should be demonstrated well enough to avoid the occasional confusion with the pancreas itself.

Relative intelligibility of CID spondees for normal and hearing-impaired listeners

The relative intelligibility of the 36 CID spondees presented via tape recording was found on Ss with normal hearing, and on Ss with flat and with sloping sensorineural losses (N: 15 in each group). The spondees as a group were found not to be homogeneous in intelligibility for each group and across groups. Ss with a sloping loss identified the spondees at a significantly (p less than 0.05) higher sensation level (SL) compared with the other groups. A list of 14 spondees was derived encompassing relative intelligibility within a 5-db range for clinical use with such Ss.

Ultrasonic evaluation of "silent regions" in the thyroid scintiscan

35 patients with scintigraphically silent thyroid regions without palpable cold nodules were further evaluated by ultrasonography. In 33 cases the sonographic diagnosis was confirmed by other examinations or the clinical course. 2 cases were misinterpreted right at the beginning of our series. The use of ultrasonography in evaluating silent thyroid regions in the totally decompensated autonomous adenoma, in unilateral thyroid aplasia, thyroiditis and hyperthyroidism is shown to be a reliable and valuable supplement to the clinical and radioisotopic evaluation procedures. When differentiating the totally decompensated autonomous adenoma from unilateral thyroid aplasia a stimulation test need not be performed in most cases. Suspected thyroiditis can be confirmed in a simple way. Being a non-invasive evaluation procedure, ultrasonography should be used before performing a needle biopsy.

[Ultrasound for differentiated carcinoma of the thyroid, autonomous adenoma and thyroiditis (author's transl)]

The article deals with a number of thyroid abnormalities which produce similar sonographic patterns, characterised by a paucity of echos of low amplitude. It concerns three more or less circumscribed changes (differentiated carcinoma of the thyroid, autonomous adenoma and focal thyroiditis) and two diffuse thyroid conditions (sub-acute and lymphocytic diffuse thyroiditis, hyperthyroidism). Carcinoma of the thyroid is of particular interest. The distinguishing features and differential diagnosis are discussed.

Penicillin-resistant oral streptococci

The tubular handling of gentamicin (G) and its intrarenal distribution were determined to elucidate the mechanism of G accumulation in the kidney. At a serum level of 11.1 ± 0.5 μg/ml (10 animals), as maintained by constant infusion for 5 h, serum Na⁺ and K⁺, arterial pressure, effective renal plasma flow and glomerular filtration rate remained undisturbed. The clearance values in milliliters per minute for G, inulin, and p-aminohippuric acid were 40.3 ± 1.8, 49.9 ± 2.8, and 132 ± 14, respectively. The ratio of clearance of G to clearance of inulin was 0.82 ± 0.04 (P < 0.005), suggesting net reabsorption of G by the renal tubules. The renal cortex/serum ratio for G was 11.9 ± 2.1, and the medulla/serum ratio was 2.7 ± 0.4, indicating greater uptake of G by the cortex. The extraction ratio of p-aminohippuric acid was 0.74 ± 0.03. In contrast, the extraction ratio of G was 0.20 ± 0.03, which was significantly lower than that of inulin (0.30 ± 0.04). It is concluded that the accumulation of G in the cortex was due to tubular reabsorption. Probably some of the reabsorbed G became trapped in the epithelial cells after crossing the luminal membrane, whereas some returned to the circulation.

[The scope of ultra sound in the diagnosis of thyroid disease (author's transl)]

Between 28, 9, 73 and 30, 9, 75, we examined the thyroid glands of 315 patients by means of ultra sound. In 166 patients the ultra sound findings could be compared with other methods of examination, particularly surgery, or with the subsequent clinical course. The value of ultra sould is stressed particularly in the differential diagnosis of solitary "cold" scintigraphic nodules and for wider routine use. The technique and value of this method are described.

Yes-no test for nonorganic hearing loss

The Yes-No Test is a procedure that can be used in the diagnosis of nonorganic hearing loss in children. The test employs a pure tone audiometric technique in which the child is instructed to say "yes" when he hears the tone and "no" when he does not hear the tone. This article describes clinical findings in three cases involving nonorganic hearing loss in which the Yes-No Test was instrumental in determining the true organic hearing thresholds.

Effect of contralateral noise on speech detection and speech reception thresholds

Speech detection thresholds (SDT) and speech reception thresholds (SRT) for spondee words were obtained on 20 normal hearing listeners while white or speech noise making was presented to the contralateral ear. Each masker was presented continously or pulsed simultaneously with the onset of each spondee word. Several masker sensation levels (SL) of 30, 40, 50, 60, 70, and 80 dB were employed, and the amount of masking (threshold shift) was determined for each condition. Small but consistent SDT and SRT shifts were apparent at low masker SLs (30 dB). FOR 60-80 DB masker SLs, the shifts were about 3.5 dB for each 10-dB increase in the masker. The greater threshold shifts at the higher masker SLs may have resulted from transcranial conduction and/or activation of the acoustic reflex. The pulsed masker condition had more of an effected on the SDT than on the SRT; SDT shifts were consistently larger for each masker SL when the masker was pulsed compared to continuous presentation. Overall, the average threshold shifts ranged from about 1 to 11 dB as the masker SL was increased from 30 to 80 dB. These data suggest that central masking is operating for masker SLs below 60 dB; for higher masker SLs, the increased threshold shifts probably result from a combination of central masking, transcranial conduction, and acoustic stapedius reflex action. The clinical implications of central masking are also discussed.