Pubalgia is a general term used to describe severe groin and hip pain in the professional athlete. The etiology of this condition can range from adductor tendon injuries, to hip injuries, to abdominal wall injuries. One of the least understood and most perplexing problems is the sports hernia. This diagnosis should be considered in athletes who do not respond to conservative treatment of pubalgia. Only recently has this entity become a known cause of persistent groin pain in the athlete. Some surgeons still do not believe this condition exists. We evaluated 96 professional athletes who underwent surgery for sports hernias. Thirty patients (31%) had adductor pain associated with either lower abdominal or inguinal pain. There were 92 patients (96%) who returned to their preinjury levels of performance. One should not offer surgery unless the groin pain has been present for at least 3 months. The authors describe the laparoscopic preperitoneal approach to repair these injuries. With the proper method of diagnosis and the expertise of an experienced laparoscopic surgeon, the athlete can return to active participation in sports within 3 to 6 weeks after surgery.
Radio-labeled somatostatin analogs have recently gained popularity as agents useful in intraoperative tumor localization, external scintigraphy and in situ radiotherapy. We have synthesized and characterized a series of novel N-terminally extended multiply-tyrosinated somatostatin analogs that possess high binding affinity for somatostatin receptors, exhibit biological activity comparable to the native peptide and retain these characteristics after iodination. These analogs can be radio-iodinated to high specific activities. Following radioiodination, these analogs exhibit minimal radiolysis and may be clinically useful for tumor localization, scanning and therapy.
One of the new, promising areas of nuclear medicine involves radiolabeled low-molecular-weight peptides for the diagnosis and management of cancer. Somatostatin analogous peptides bind to membrane receptors on tumors with high specificity. These analogues, when radiolabeled with 123I, 131I, 99mTc, or (111)In, allow for external scintigraphic imaging or radioguided surgical resection of tumors. Somatostatin analogues with high tumor binding affinity have also been used for high-dose radiotherapy at the Medical Center of Louisiana since 1994. Although we had extensive prior experience with relatively high-dose 131I administration for thyroid ablation, our personnel protection, contamination control, and other safety techniques required significant modification to ensure effective contamination and radiation exposure control. As therapy with radiolabeled peptides becomes more widely utilized, the controls developed at our institution may be implemented by others to maintain exposures ALARA.
The probability and features of memory concerning former head injuries with loss of consciousness was assessed in two formats: a group-test questionnaire and a retest using personal individual interview. Results are given concerning the greater likelihood of reporting short 'permanent' retrograde amnesias in the interview.
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