Syrup of ipecac (SOI) is a commonly used emetic for toxic ingestions. A preliminary study was undertaken to quantify the efficacy of SOI-induced emesis. Three groups of adult subjects fasted overnight before ingestion of 1 mCi of Tc-99m human serum albumin-sucralfate. Sucralfate is minimally absorbed from the gastrointestinal tract and has a gastric clearance half-time of 90 minutes, approximately equal to that of solid foods. At 5,30, and 60 minutes after ingestion of radiolabeled sucralfate (RSC), subjects were given a standard dose of 30 ml SOI and 240 ml of water. Gastrointestinal tract images were obtained both at the time of ingestion of RSC and 60 minutes after ingestion of SOI. Regions-of-interest were drawn and activity measured over the stomach and small bowel with correction for physical decay. Those subjects (N = 10) treated at 5 minutes after ingestion retained a mean value of 17% of the administered RSC by 60 minutes. The group (N = 5) treated at 30 minutes after ingestion retained a mean value of 41%, while those (N = 5) treated at 60 minutes retained a mean value of 56%. The results tend to confirm the efficacy of SOI-induced emesis when SOI is given promptly (i.e., 5 minutes) following ingestion, and generally support efforts to assure widespread immediate availability of SOI for toxic ingestions.

The most urgent diagnosis addressed by cholescintigraphy is acute cholecystitis. By administering lowdose intravenous morphine sulfate to patients undergoing cholescintigraphy (who demonstrate visualization of both the common bile duct and intestine and nonvisualization of the gallbladder), the time required to complete the study has been reduced to a maximum of 90 minutes. One hundred twenty-eight patients underwent cholescintigraphy for clinically suspected acute cholecystitis. Forty patients received intravenous morphine sulfate during the procedure. In patients who received morphine sulfate during the examination, the sensitivity of cholescintigraphy for the diagnosis of acute cholecystitis was 100%; the specificity was 85%.

A unique case of documented prostatic carcinoma with radiographically evident osteoblastic lesions and a false-negative bone image is presented.