MRI appears unnecessary as a routine method in the diagnosis of SS; US examination is suitable both for the diagnosis and follow-up of SS. The above combination of the seemingly contradictory US and MRI findings is highly characteristic of lymphoma which has developed in the course of the disease.

The diagnostic potential of technetium-99m hexamethylpropylene amine oxime (HMPAO) following systemic administration of the cerebral vasodilator acetazolamide (acetazolamide test) was evaluated by regional cerebral blood flow (rCBF) single-photon emission tomography (SPET) in patients with Alzheimer's disease (AD) or vascular dementia (VD). An initial, high-resolution SPET study was performed with 99mTc-HMPAO, and after 2 days the patients were re-evaluated with 99mTc-HMPAO following systemic administration of acetazolamide. Reconstructed SPET slices were evaluated visually and semiquantitatively by a semi-automatic rCBF map method. When 99mTc-HMPAO alone was used, bilateral hypoperfusion was found in the temporal and/or parietal regions in 33% (6/18) of the VD patients and in 70% (23/33) of the AD patients. The corresponding data obtained by quantitative evaluation were 41% (7/17) and 71% (15/21), respectively. The vascular reserve capacity, as determined with the acetazolamide test, was preserved visually in 22% (4/18) and quantitatively in 29% (5/17) of the VD patients, but in 73% (24/33) and 76% (16/21) of the AD patients. The differences in the perfusion patterns between the VD and AD patients were statistically significant (P<0.01, Fischer's exact test). Of the VD patients with hypoperfusion (bilateral temporal and/or parietal), 4/6 (67%, visual evaluation) and 4/7 (57%, quantitative evaluation) had a decreased vascular reserve capacity as determined with the acetazolamide test. In the AD group of patients the corresponding results were 3/23 (13%) and 4/15 (27%). It is concluded that the acetazolamide test is promising in rCBF SPET to differentiate VD from AD.

No abstract

Background: An occupation-related susceptibility of professional singers to experience gastroesophageal reflux has been suggested. Aims: To investigate the prevalence of gastroesophageal reflux symptoms in a series of professional opera choristers, wind players, glassblowers and water polo players in comparison with a sample of general population. Subjects and Methods: A total of 202 professional opera choristers from well-known choirs in different Hungarian regions, 71 professional wind players, 43 glassblowers, 54 water polo players were identified and 115 control subjects were compared prospectively. Reflux symptoms together with selected individual characteristics and lifestyle habits were investigated in study groups through a reflux questionnaire. Results:Professional opera choristers reported a statistically significantly higher prevalence of heartburn, regurgitation and hoarseness than control subjects (p < 0.001). Among professional wind players, heartburn and regurgitation were significantly more frequent compared with controls (p < 0.05 and p < 0.01, respectively). Glassblowers reported a significantly higher prevalence of acid regurgitation in comparison with controls (p < 0.01). The prevalence of reflux symptoms in water polo players was similar to that of controls. In opera choristers, wind players and glassblowers, reflux symptoms appeared to be significantly correlated with the cumulative lifetime duration of professional singing, playing and working activity, respectively (p < 0.05). Conclusions: Our results demonstrate that professional opera choristers, professional wind players and glassblowers have a higher prevalence of reflux symptoms compared with control subjects. Gastroesophageal reflux in these professions should be considered as a work-related disorder that may have an impact on quality of life and may negatively interfere with professional performance.

Personal dosimetric survey and limitation of the number of surgical interventions do not appear to be essential.