The use of magnetic resonance imaging (MRI) provides visual evidence of cerebral deposits of paramagnetic metals. The usefulness of MRI is described in connection with the manganese poisoning of a 44 year old arc welder who had been engaged in the repair and recycling of railroad track made of manganese steel alloy. (British Journal of Industrial Medicine 1993;50:510-513) The diagnosis of manganese (Mn) (fig 1 top). The T, signals were unremarkable (fig 1 bottom).Repeat MRI six months after stopping work ( fig 2) showed almost complete resolution of the high intensity signals in the midbrain. A single photon emission computed tomography scan showed on 27 April 2019 by guest. Protected by copyright.

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We describe a brother and sister with amelogenesis imperfecta, nephrocalcinosis and impaired renal concentrating ability. This is the second sibship reported, further substantiating autosomal recessive inheritance of this condition. There is lack of enamel, lifelong nocturnal enuresis, progressive punctate nephrocalcinosis, and decreased calcium and phosphate excretion over 24 hours and after an acute load. Increased serum osteocalcin and decreased urine delta-carboxyglutamic acid suggest involvement of vitamin K-dependent calcium binding proteins, although this may represent a secondary finding. No other evidence of abnormal calcium metabolism was found. Renal function is stable in the early teens, but the previously reported patients went on to renal failure.

Under the conditions of this study, 2,3-dimercaptosuccinic acid was not effective in producing any clinical or biochemical benefit or any histopathological improvement of skin lesions in patients with chronic arsenicosis.