[Phe4]somatostatin: a potent, selective inhibitor of growth hormone release.

[Phe4]Somatostatin was twice as active as somatostatin (SS) in suppressing rat growth hormone release in vitro but had only weak activity toward inhibition of insulin and glucagon release in vivo. The ability of this analogue to inhibit growth hormone release more actively than SS was confirmed in vivo by two separately designed bioassays. Further structure/activity studies of position 4 were carried out with [Glu4]SS, [Thr4]SS, and des-Lys4-SS, all of which had negligible inhibiting activity in the pituitary and pancreas.

Magnification radiography of the temporomandibular joint: technical considerations.

The design, application, and advantages of a temporomandibular joint (TMJ) positioning unit adapted to the RSI microfocus manigification system are described. The reasons for improved TMJ images with this system are discussed and the rationale for film-screen choice presented. The issue of patient radiation exposure is also considered.

Adult hypophosphatasia. Clinical, laboratory, and genetic investigation of a large kindred with review of the literature.

Investigation of the kindred of a 58-year-old woman with all of the features of "adult" hypophosphatasia revealed 12 individuals in 3 generations with subnormal circulating total alkaline phosphatase (AP) activity. The pattern of inheritance suggested autosomal dominant transmission, with incomplete penetrance of the trait particularly in the young males. Hypophosphatasic individuals other than the proposita were clinically well but had loss of permanent teeth, showing that dental abnormalities could be the only clinical manifestation of the disorder.

Brodie abscess: reappraisal.

Upon review, 25 cases of Brodie abscess demonstrated a radiological spectrum not previously appreciated. One third of the lesions were diaphyseal in location, and 50% had associated cortical thickening, while 40% showed a stimulated periosteal reaction, and 20% contained sequestra. The variable radiological appearance was underscored by the fact that the preoperative diagnosis was other than osteomyelitis in half the cases.

Computed tomography of the osseous pelvis.

Computed tomography (CT) was used for study of the osseous pelvis in 43 patients with definitive pathological or clinical follow-up. CT accurately characterized and determined extent of bone and soft-tissue involvement; neoplasms and other disease processes, such as sacroiliac joint disease, were well localized. In cases of trauma, CT was able to identify, localize, and characterize fracture fragments and bone or joint displacement.

Skeletal abnormalities after jejunoileal bypass.

Jejunoileal bypass surgery is fraught with many longterm complications, among which is hypovitaminosis D. The relationship, if any, of hypovitaminosis D to the skeletal disease which may occur following this operation is, however, unknown. Consequently, we studied eight patients with low circulating levels of 25-hydroxyvitamin D who had undergone jejunoileal bypass at least two and one-half years previously.

Computed tomography of long-bone osteosarcoma.

Six cases of osteosarcoma, including medullary, parosteal, periosteal, and intracortical types, were studied by computed tomography (CT). In selected cases, CT provided additional preoperative information as to osseous size and soft-tissue extent. CT helped determine intramedullary involvement and specific sites of cortical destruction and thereby helped to plan the surgical approach to biopsy and the definitive excision.

Intraarticular methyl methacrylate: a complication of hip surgery.

Methyl methacrylate, used as a grout during hip arthroplasty, can inadvertently become lodged between acetabular and femoral components during surgery. After resumption of ambulation, crescentic fragments may extrude into the pseudocapsule. If mobile methyl methacrylate fragments lodge within the joint, late surgical failure may result because of methyl methacrylate's abrasive character.

Shoulder arthrography as a treatment modality.

Some patients undergoing shoulder arthrography with a stiff and painful joint have a small volume capsule or a frozen shoulder. In certain cases when the rotator cuff is intact, the arthrographic procedure has been therapeutic and joint distention has effected a return to normal function. Four such cases are presented.

Isolated clustered microcalcifications in the breast: radiologic-pathologic correlation.

Thirty-one consecutive cases of mammographic isolated, clustered microcalcifications which prompted breast biopsy were studied by radiologic and histopathologic methods. Isolated, clustered microcalcifications were sensitive, but nonspecific cancer markers; 35% of the lesions were malignant and half of these were noninvasive. Radiologic and histopathologic similarities, and overlap between benign and malignant disease, prevented accurate differentiation.

99mTc-pyrophosphate bone imaging in osteopoikilosis, osteopathia striata, and melorheostosis.

Technetium-99m pyrophosphate bone images were contrasted with radiographic findings in two patients with osteopoikilosis, one with osteopathia striata, and one with melorheostosis. Despite the striking radiographic findings, scans were normal in osteopoikilosis and osteopathia striata. In melorheostosis, focal increased radiopharmaceutical accumulation appeared in each radiographically abnormal area.

Idiopathic multicentric osteolysis. Report of an affected father and son.

Genetic, rheumatologic, immunologic, metabolic, and renal studies of a father and son with idiopathic multicentric osteolysis are reported. The disorder appeared through mutation. The father developed symptoms as an infant, his son at age 4 years and 9 months.

Elbow fat pads with new signs and extended differential diagnosis.

Although fat pad signs are classically associated with fracture, there are many nontraumatic disease processes which lead to positive fat pad signs. Any intraarticular fluid or tissue accumulation may result in an abnormal posterior fat pad. A "paradoxical" positive posterior fat pad sign may occur in some instances of extraarticular disease.

Arthrography in the diagnosis of unexplained chronic hip pain with regional osteopenia.

Three cases of chronic hip pain with radiographic periarticular osteopenia and normal joint spaces are reported. The articular nature of symptomatology, periarticular demineralization, and radionuclide localization suggested intraarticular disease. Computed tomography did not disclose the cause of hip pain when utilized in two instances.

Analysis of gas in vacuum lumbar disc.

In three cases in which chemonucleolysis with chymopapain was used for the treatment of back and sciatic pain, gas from the vacuum phenomenon of a degenerated lumbar intervertebral disc was recovered. In one of these, the gas analyzed by gas chromatography contained 90%--92% nitrogen.