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The abstract in the RSNA guide for Dr. Zagdanski's presentation actually refers to “intense hypotrophy” for the patients with the lowest CD4 lymphocyte counts, and the authors say the “finding is probably due to the reduction of the lymphoid tissue and may reflect the degree of immunodeficiency.” Thus, Dr. Fleckenstein's demonstration that “intense hypertrophy” of the adenoidal tissue is seen in patients with higher CD4 lymphocyte counts, though supportive of a relationship between adenoidal width and CD4 counts, does not “concur” with Zagdanski et al's work on adenoidal “hypertrophy.” Fleckenstein's approach is from the opposite direction; ie, when adenoids are large, not small. I believe that Dr. Fleckenstein may have been misled by the unusual term “hypotrophy,” which the French authors meant to imply a reduction in adenoidal size.

I appreciate Dr. Fleckenstein's clarification on the relationship between CD4 counts and adenoidal width. It makes sense. Nonetheless, I have always been of the belief that someone with the right background can always use data in the appropriate manner to arrive at a statistically significant result. I regret that I have a limited prowess at biostatistics because a number of my “negative” studies (that could never get published) could have used the right “grouping” and sphericity analyses.