Computed tomography and ultrasonography of the adrenal glands in paracoccidioidomycosis. Comparison with cortisol and aldosterone responses to ACTH stimulation.

Fifteen patients with proven disseminated paracoccidioidomycosis (PCM) had computed tomography (CT) and ultrasonography (US) performed to evaluate the form, shape, density and size of their adrenal glands. Plasma and urinary cortisol were determined and adrenal reserve assessed by measuring the cortisol and aldosterone responses to synthetic ACTH. The adrenal CT showed unilateral lesions in two cases and bilateral in another four. The US study showed more frequent alterations, unilateral in seven and bilateral in three subjects. Combining both methods increased the sensitivity to 85% of the cases. All patients had normal plasma cortisol concentrations and normal or increased urinary cortisol excretion. Plasma aldosterone concentration was also normal except in one patient with hypokalemia. Seven patients showed diminished cortisol responses, five had subnormal aldosterone responses and in five plasma aldosterone concentration increased more than normally after stimulation by ACTH. There was an incidence of limited adrenal reserve in 53% of the patients on ACTH stimulation. No correlation was evident between the disorders in adrenal steroid responses to ACTH and changes in morphology revealed by CT and/or US.

Ultra-sonografia do abdome superior: extensao de ultrasonografia (a proposito de 112 exames). / Ultrasonography of the superior abdomen: an extension of the pelvic ultrasonography (an experience of 112 examinations)

Cento e doze pacientes, cuja idade variou entre 17 a 80, com indicacoes para o estudo do abdome superior. Algumas alteracoes foram detectadas, das submetidas, na mesma ocasiao, ao estudo do abdome superior. Algumas alteracoes foram detectadas, dos quais foi o calculo biliar a mais frequente. Houve ainda dois casos de cisto renal e um de hidronefrose com calculo, um cisto hepatico e um aneurisma da aorta abdominal. Ao par da inocuidade do metodo, o deconforto pelvico restante da bexiga cheia e irrelevante, quando comparado a outros tipos de exames. O exame ultra-sonografico pelvico e abdominal, quando se utiliza equipamento dinamico, nao ultrapassa, pelo geral, 25 minutos. Por essas razoes, e face aos achados, julgamos recomendavel, tanto quanto possivel, a observacao sistematica do andar superior do abdome

Regressao espontanea da cistose ovariana na neoplasia trofoblastica gestacional. Acompanhamento ultra-sonografico. / Spontaneous regression of theca lutein cysts in gestacional trophoblastic neoplasms.Ultrasonographic follow-up

Os cistos luteinicos dos ovarios, frequentes na neoplasia trofoblastica gestacional complicam a doenca e prolongam suas manifestacoes clinicas, demais de exigir maior numero de series do agente quimioterapico empregado para lograr a cura.Sendo esperada a regressao espontanea desses cistos, tornou-se a ultra-sonografia o melhor e mais seguro exame para comprovar semelhante evolucao