A firm relationship has been established between thymus gland pathology and myasthenia gravis. The most frequent changes observed in this gland consist in simple hyperplasia of germinal centers or thymoma. In order to detect these alterations it is necessary to have a suitable reliable technique, beside routine radiological exams: thymus scan has been proposed as an useful tool. Since 1968 we submitted 52 patients to this procedure; we used as a tracer 75Se-Seleniomethionine in most cases, 57Co-bleomycin and 67Ga-citrate in a few cases. The scan was found positive in 22 cases (42%) showing either localized or diffuse uptake in the region of the sternum. Thymus changes were subsequently examined in 26 cases: 22 cases after thymectomy in 4 cases at autopsy. We found a good correlation between positive scan and pathological changes of the gland such as thymoma or germinal center hyperplasia. However in 4 patients with negative scan that previously received radiation therapy or immunosuppressive therapy such pathology was missed: 3 cases of hyperplasia and 1 residual thymoma. We conclude that thymic scan an useful and highly specific diagnostic procedure and should be done before any kind of treatment which affects thymus.

Adolescent↗

PubMedDate not supplied

[Iopentol in varix radiography. Double blind comparison with iohexol].

This trial was aimed at comparing the tolerance and the safety of Iopentol, a new nonionic monomeric contrast agent, with Iohexol, a reference compound already on the market and commonly used in similar trials. Sixty adult patients (41 women and 19 men, aged 23 to 76 years, mean age: 51.4 years) referred to our Department of Radiology for varicography 24 hours before surgery were examined; the trial was designed as a double-blind, parallel two-group comparison of Iopentol 300 mg/ml and Iohexol 300 mg/ml with 30 patients in each treatment group. No adverse reactions were observed in our series of patients. Only slight and not clinically significant changes were observed in heart rate and blood pressure values. The immunohistochemical parameters were studied for postvaricography anatomopathologic complications of the injected veins (A-Actin ML, Vimentin, Factor VIII, CD31, CD68, CK, Ulex Europaeus I, Lecitin, Desmin, Laminin) and no statistically significant differences were observed between the two groups. The histologic specimens showed only venous wall changes, as diagnosed on admission. All radiographs were classified as technically adequate and contrastographic efficacy was defined as "good" in all patients by two independent radiologists. To conclude, our trial on the efficacy and safety of the two nonionic monomeric radiographic contrast agents Iopentol and Iohexol proved the two contrast agents to be equally effective and well tolerated, which makes Iopentol a good alternative to Iohexol in varicography.

Adult↗