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