our
current
diagnostic
suspect.
His
ance-the
ability
others-in
the
panded
and
Myss
imaging
discovery
of
their
internal
organs
Okey
sisters
in 1838
in a scientific
electrical
collaborating
olic
theologian,
fort
to provide
manner
and
those
has
of
been
by Shealy
since
uated
in a blinded
given
only
the
stimulation
1985
with
and
a scientific
basis
In their research
ex-
and
Carolyn
M. Myss,
was
MA, Cathin an
low-tech
the results 50 patients
in New
of the
ef-
“magnetic
they present involving
birthdate
has
England
patients
of a eval-
and
over
was
the
phone by Shealy, who was in Missouri, and was asked to make an intuitive medical diagnosis specifying organ involvement and disease process for comparison with the medical diagnosis known only to Shealy. By using her special abilities, she was able to obtain clairvoyant images of the patients and make a specific and accurate diagnosis In the past few years, Shealy
in 93% of the cases. and Myss have expanded
experience to several hundred There are certainly numerous can be provided by skeptics,
claims be subjected to the same of other clinical studies. However,
rigorous evaluation expected in this era of cost-contain-
ment with ital imaging
be
recent harsh technology,
pensive alternative use of an underutilized
criticism it may
“ magnetic
of overutilized, worthwhile
expensive to evaluate
imaging” techniques resource-our own
priceless
secretion
than more
be considered precipitate
means those
to facilitate predisposed
Use
.
of Furosemide
Inappropriate
in Patients
Antidiuretic
Syndrome
with
Hormone
1.
4.
5.
to 7.
8.
.
Philadelphia,
PA 19107
report
by
September 1991 issue woman who developed syndrome
after
or endorectal
these
provide
the
diuretic
The
sonography
patients.
endorectab sonography, by postmenopausab of patients reported
The
These
furosemide
suggested
as alternative
techniques,
methods
however,
partic-
are somewhat invasive, may be patients who thus far comprise the to develop this complication, and
required
diagnostic
could
information
be used
case
uretics,
cited
by Bhargava
including
furosemide,
Furosemide
not been
is simple
reported
ministration
898
#{149} Radiology
and
(2).
instead.
to cause
of a single
Lewandowski), do
dose
any
major
except
To
our
Furosemide
the loop knowledge,
complications in patients
and
with may
excess be
bladder distension to SIADH.
Matching
Street,
other
free
considered
water.
This
as a safe
in all patients,
Program
including
Ethics
Bridgeport
Bridgeport,
diit has
after who
are
radiology
residency
to suppress
suming program.
CT
Hospital
06610
interviewing
the temptation
task with cynicism For each of the
cably, versity
an
season
to approach
begins,
addehy-
irresponsible agreement,
I do
it is dif-
this
time-con-
at our small, community last 3 years, we have had
hospital candidates
candidate not wish
take an Unopted for theoreti-
could as easily sidestep to dwell on program
a unitype.
One candidate, having reviewed the National Residency Matching Program rules with his attorney, was told that is nothing decisions
not.
to administer.
events
matched to us renege on the match agreement and fibbed position elsewhere. In each case, the candidate a university department program. However, since,
secretion
authors
inhibits reabsorption of free water, may inhibit the effect of antidiuretic hormone on the kidneys, and has been used in the treatment of SIADH. Decaux et al (3) noted that, while thiazides increase sodium excretion, thus worsening SIADH (as in
one
Grant
ficult
in the
hormone
hydration.
for studying
not
Lewandowski
antidiuretic
aggressive
endovaginal
may
and
of Radiology (1) described a 72-year-old water intoxication as a result of the
of inappropriate
(SIADH)
ularly refused group
Bhargava
untoward
in only one patient out of 47 kg who was orally ad-
for patients diuresis,
Residency
As the case
assess-
Editor:
Editor: A recent
in the
Bhargava R, Lewandowski BJ. Water intoxication: a complication of pelvic US in a patient with syndrome of inappropriate antidiuretic hormone secretion. Radiology 1991; 180:723-724. Fleischer AC, Corson AN, Entman 55. Transabdominal and transvaginal sonography of pelvic masses. Ultrasound Med Biol 1989; 15:529-533. Decaux C, Waterlot Y, Cenette F, Mockel J. Treatment of the syndrome of inappropriate secretion of antidiuretic hormone with furosemide. New EnglJ Med 1981; 304:329-330. Davies P. Woods KA, Evans CM, Gray WM, Kulatilake AE. The value of provocative and acute urography in patients with intermittent loin pain. BrJ Urol 1978; 50:227-232. Barrett RJ, Rayburn WF, Barr M Jr. Furosemide (Lasix) challenge test in assessing bilateral fetal hydronephrosis. Am J Obstet Cynecol 1983; 147:846-847. Burnett KR, Handler SJ, Conroy RM, Khonsari F, Nelson C. Percutaneous nephrostomy utilizing B-mode and real-time ultrasound guidance: the lateral approach and puncture facilitation with furosemide. JCU 1982; 10:252-255. Wallach L, Nyarai I, Dawson KG. Stimulated renin: a screening test for hypertension. Ann Intern Med 1975; 82:27-34. Thomas FB, Sinar D, CalswellJH, Mekhjian HS, Falko JM. Stimulation of pancreatic secretion of water and electrolytes by furosemide. Castroenterology 1977; 73:221-225.
267
Street,
significant
From: Donald L. Butler, MD Department of Radiology,
Hospital
11th
use
of
Secretion
From: Ronald H. Wachsberg, MD, and Alfred B. Kurtz, MD Department of Radiology, Thomas Jefferson University 111 South
its
References
6.
2.
(8) without
should
References Mourino MA. From Thales to Lauterbur, or from the lodestone MR imaging: magnetism and medicine. Radiology 1991; 180:593612. Shealy CN, Myss CM. The creation of health: merging traditional medicine with intuitive diagnosis. Walpole, NH: Stillpoint, 1988; 73-78.
during
orthostatic hypotension noted than 200 (a woman weighing
should
puters.
1.
reported
60 mg) (7). In these reports (4-8), up to 60 mg of fuwas administered orally and up to 40 mg was adminintravenously. Therefore, oral administration of 20-40 mg of furosemide
3.
that make biocom-
been
It is adminisand no
ministered rosemide istered
2.
diginex-
have
unstable. scanning,
ment of ureterab obstruction (4) and fetal hydronephrosis (5), or in the guidance of renal puncture (6). Nonradiologic uses for diagnostic purposes include the evaluation of hypertension (7). It has been used experimentally in humans to provoke pancre-
their
patients with similar success. criticisms of this research that and it is important that such
or otherwise hemodynamicably routinely during nuclear renal
complications
atic
device,
diagnostician
for this
Myss
and
neurosurand the
(TENS)
intuitive book, project
fashion. name
a Harvard-trained column stimulator
nerve
publisher,
technique. dramatic
but
drated tered
initially clairvoy-
1988.
transcutaneous
imaging” simple
we would
hysterical
C. Norman Shealy, MD, PhD, geon and inventor of the dorsal been
than
sleep”-induced
to visualize two
researched
(2) in
world
magnetic
“
here made
lieved that these Before making program, I wish specific dents sented
of North American Roentgen
program pass the papers
that you by these
cannot candidates
get
out are
of.” I believe that unethical and am
“there the re-
individuals are not in our residency program. a plea for general fairness in the matching to make a brief case for the legitimacy of our on the basis of results alone. All of our resiboard examinations. Our residents have preat scientific sessions of the Radiological Society
America, Association of University Radiologists, Institute of Ultrasound in Medicine, and American Ray Society, at the International Electronics Imaging
March
1992
Conference,
and
residents
at local
have
idents
and
coauthored
have
gone
or
will
go
didates
and and
Finally,
the
the
takeover there
legitimacy
in obtaining applicants
on
the
shabby
in
at Yale, the
Radi-
by dishonest
can-
point
of a particular
of those
#{149} Number3
RSNA Index to Imaging The cover should read 1989-1991,
to consider
program for matched
that
applicants, operandi
and
even
discounting
the work
program. programs
we reinforce that
surely
involved
By enticing or by accepting
and
is not
to hold by example rules.
the
in their and
sanction ethical hearts obey the
Literature, as follows:
Supplement
1992 January to Radiology
“Three-dimensional Imaging” Radiology Page 325, the last sentence in the Figure as follows:
artists.
is another
modus
Errata
178(I),
Univer-
among others. These legitimacy of our
treatment
lesson we wish these young physicians throughout their careers. Let us teach National Residency Matching Program
Volumel82
Our
published
to fellowships
and Stanford, speak for
suitable residents away from their
enticements
a Machiavellian
condemn
meetings.
articles
Spine, American Journal published Connecticut journals in Acta Cytologica. Finally, our res-
locally articles
sity of Michigan, Columbia, measurable accomplishments
program
medical
first authors for Journal of Rocntgcnology,
Neuroradiologt,
and
Connecticut
been
Anu’rican
t)lO1/,
of
have
(Image
ment of Radiation Arbor.) Page
326, the
as follows:
C
courtesy
Oncology,
first sentence
Screen et al, University
display of North
of Daniel
in the Figure
Volumes
170-
1991; 181 :321-337. 5 legend should read
McShan,
University
from the Carolina,
1992,
DepartAnn
PhD,
of Michigan, 9 legend
should
Virtual Simulator Chapel Hill)
read
(Sherouse .
...
“Esophageal Insufflation and Videofluoroscopy for Evaluation of Esophageal Speech in Laryngectomy Patients: Clinical Implications” Radiology 1991; 181:433-437. Page 433, second author’s name should read James F. Griffin.
Radiology
#{149} 899