Congenital diaphragmatic hernia must be seriously considered in the differential diagnosis of acute respiratory distress in neonates as well as in older infants who present with chronic progressive gastrointestinal and respiratory symptoms. An x-ray film of the chest is mandatory and is almost always diagnostic. Immediate nasogastric decompression of the stomach, with simultaneous fluid and electrolyte replacement and prompt surgical intervention offers the patient the best chance of survival.
Whole body skeletal scintiphotography was carried out in a series of 111 breast cancer patients. The results of scintiphotography were compared with the results of roentgenography and with the diagnostic usefulness of serum alkaline phosphatase levels and the presence or absence of bone pain. In 27 percent of cases, lesions were first identified with the scintiphotos. When lesions were present on both scintiphotos and roentgenograms, involvement generally appeared greater on the scintiphotos. Two false negative studies were recorded. Sixty-seven percent of patients with early metastasis-that is, those with positive scintiphotos and negative roentgenograms-were asymptomatic. Serum alkaline phosphatase levels were normal in 38 percent of those with early skeletal involvement. Skeletal scintiphotography is superior to other commonly employed techniques used to assess bone metastasis in breast carcinoma.
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