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The authors present their preliminary results using intranasal midazolam for claustrophobic MRI patients. This route of administration reduced the necessity for intravenous sedation from 67 to 17% in this select group of patients. The only side effect encountered was a burning sensation of the nasal mucosa. Further investigation is necessary to determine the efficacy of intranasal midazolam in claustrophobic patients scheduled for MR examinations.

LYMPH-node enlargement occurs in approximately half of all patients with systemic lupus erythematosus.1 Although the histologic characteristics were described by Short2 in 1907, until 1943, lymphad...

A case of echinococcal cyst disease of the liver that was evaluated preoperatively by computed tomography is reported, and the findings are described.

Computed tomography was used to evaluate inferior vena caval obstruction due to renal carcinoma.

Idiopathic pulmonary fibrosis is a fatal disorder that starts as an alveolitis and progresses to interstitial fibrosis. Correlative morphologic, physiologic, and biochemical studies in 29 patients have shown that the inflammatory process in best followed by serial bronchoalveolar lavage and 67 Ga citrate scanning, and the fibrotic process is best followed by quantitation of the exercise-induced drop in arterial oxygen tension per unit of oxygen consumed. Although biopsies in idiopathic pulmonary fibrosis seem to show increased amounts of fibrotic tissue, biochemical studies suggest that the disease is probably one of collagen rearrangement rather than collagen increase. Perhaps becasue of this, peripheral lymphocytes of these patients recognize collagen as "non-self" and, when exposed to it in vitro, produce lymphokines and cell lysis. The fibrotic process is probably irreversible, but the inflammatory and immune processes that cause it may be amenable to therapy if diagnosed early.

A computer-based approach for instruction and diagnosis of clinical acidbase disorders has been developed. Its significant features are the following: (1) consideration of a differential diagnosis list (rather than a single diagnosis) for any given blood pH plus either carbon dioxide content, bicarbonate level, or partial pressure of carbon dioxide; (2) use of ancillary clinical and laboratory information about the patient to arrive at the most likely diagnosis from the differential diagnosis list; (3) adaptability to users of widely differing clinical expertise and educational backgrounds; and (4) provision for tabulating the relative frequencies of acid-base disorders presented to the computer. The computer's differential diagnosis is based on an acid-base map. A sample case illustrates the logical process involved. This program demonstrates that the computer can mimic the clinical consultant in its approach to diagnosis and in its ability to teach.