Hypertension, diabetes mellitus, hypercholesterolemia, and smoking are known coronary risk factors. It has been our impression that premature graying of the hair also predisposes individuals to myocardial infarctions. To test this hypothesis, we evaluated all of the patients under the age of 50 who were admitted to the coronary care unit between 1974 and 1976 with a proven diagnosis of a myocardial infarction. There were 50 patients. Thirty-eight did not have premature graying. Twelve of the male patients (24%) had virtual total graying of the hair which made them appear older than their stated age. The graying in these patients started on the average at 29 years. Five of these patients state that other family members had premature hair graying. The incidence of diabetes, hypertension, and smoking was similar in those with and without premature hair graying. This preliminary study suggests that premature graying of the hair is associated with premature cardiovascular disease. It should probably be regarded as a coronary risk factor and used to identify patients at increased risk.
Summary
Aim: In order to evaluate the diagnostic efficiency of arthroscintigraphy in suspected rotator cuff ruptures this new imaging procedure was performed 20 times in 17 patients with clinical signs of a rotator cuff lesion. The scintigraphic results were compared with sonography (n = 20), contrast arthrography (n = 20) and arthroscopy (n = 10) of the shoulder joint. Methods: After performing a standard bone scintigraphy with intravenous application of 300 MBq 99m-Tc-methylene diphosphonate (MDP) for landmarking of the shoulder region arthroscintigraphy was performed after an intraarticular injection of 99m-Tc microcolloid (ALBURES 400 μCi/5 ml). The application was performed either in direct combination with contrast arthrography (n = 10) or ultrasound conducted mixed with a local anesthetic (n = 10). Findings at arthroscopical surgery (n = 10) were used as the gold standard. Results: In case of complete rotator cuff rupture (n = 5), arthroscintigraphy and radiographic arthrography were identical in 5/5. In one patient with advanced degenerative alterations of the shoulder joint radiographic arthrography incorrectly showed a complete rupture which was not seen by arthroscintigraphy and endoscopy. In 3 patients with incomplete rupture, 2/3 results were consistant. A difference was seen in one patient with a rotator cuff, that has been already revised in the past and that suffered of capsulitis and calcification. Conclusion: Arthroscintigraphy is a sensitive technique for detection of rotator cuff ruptures. Because of the lower viscosity of the active compound, small ruptures can be easily detected, offering additional value over radiographic arthrography and ultrasound, especially for evaluation of incomplete cuff ruptures.
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