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Previous Volume 352:2355 June 2, 2005 Number 22 Next

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To the Editor: The medical mystery in the April 7 issue¹ involved a radiograph (Figure 1) in a patient who had undergone four lifesaving procedures between 1949 and 2002. The radiograph shows remnants of a therapeutic pneumothorax for pulmonary tuberculosis, a coronary-artery bypass graft, a stent repair of a type B aortic dissection, and a dual-chamber pacemaker for complete atrioventricular block.

View larger version (101K): [in this window] [in a new window]   Figure 1. Radiograph in a Patient Who Underwent Four Lifesaving Procedures between 1949 and 2002.

 

Ralf Ostermaier, M.D.
Asklepios Fachklinikum München-Gauting
D-82131 Gauting, Germany

Marianne Taut, M.D.
Klinik am Tharandter Wald
D-09600 Niederschöna, Germany

Editor's note: We received 729 responses to this medical mystery, from 68 countries. This is an underestimate of the actual number of people participating, since many responses represent a collaborative effort; for example, one response represented the collective effort of the University of Alabama internal-medicine residents, from their morning report.

Thirty-nine percent of the respondents correctly identified the old right-sided lung collapse used as a treatment for tuberculosis, 64 percent identified median sternotomy for a coronary-artery bypass graft, 77 percent identified the placement of a descending aortic stent, and 93 percent identified the placement of a pacemaker. The group from the University of Alabama was among the 25 percent of respondents who correctly identified all four procedures. Another 40 percent identified three of the four procedures correctly. Other suggested procedures included mastectomy, aortoaxillary bifemoral graft, esophageal repair, and lung transplantation.

References

1. Ostermaier R, Taut M. Medical mystery -- 50 years of medical progress. N Engl J Med 2005;352:1473-1473. [Free Full Text]

PDF PDA Full Text Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear Related Article by Ostermaier, R. PubMed Citation