Technetium-99m sestamibi (MIBI), an alternative radiopharmaceutical for myocardial perfusion imaging, has also been proposed for use as an imaging agent for various tumours, including breast cancer, lung cancer, lymphomas, melanomas and brain tumours. After routine radiation therapy, deteriorating clinical status or treatment failure may be due to either radiation-induced changes or recurrent tumour. Computed tomography and magnetic resonance imaging offer imperfect discrimination of tumour viability and radionecrosis. Against this background we undertook a retrospective study of 35 malignant glioma patients in whom clinical deterioration had occurred, in order to clarify the value of 99mTc-MIBI SPET in identifying tumour recurrence. SPET was performed 15 min after intravenous injection of 1110 MBq with a dual-headed gamma camera using a fan-beam collimator. Transverse, coronal and sagittal views were reconstructed. Intense MIBI uptake was found in 31 patients. This uptake was correlated with tumour recurrence as proved by histology and/or rapid, fatal evolution of these cases. The statistical analysis performed on this population of patients with MIBI uptake revealed a group of patients with a long mean survival and a group with a short mean survival. Two subgroups were found within each of these groups, according to the functional index ratio (tumour uptake/pituitary gland uptake ratio). No MIBI uptake was found in four patients who are still alive and can be considered to be disease-free. In those cases showing MIBI uptake, death occurred an average of 6.69 months following brain SPET. According to our results, the specificity and sensitivity of 99mTc-MIBI brain SPET seem to be high. Moreover, this technique is more accurate than computed tomography or magnetic resonance imaging for discriminating between tumour recurrence and radionecrosis.
This study reviewed 57 hips in 30 children (18 girls and 12 boys) with cerebral palsy who had undergone an adductor tenotomy alone or in combination with an anterior obturator neurectomy (23 hips). Results were evaluated by the Reimers migration percentage (MP). The hips were split into three groups: group A (12 hips) a preoperative MP of less than 20%, group B (25 hips) between 20 and 40%, and group C (20 hips) more than 40%. The mean age at the time of surgery was 6 years and 1 month (range: 2.5-13 years). The mean period of review was 6 years and 3 months (2-20 years). The results were considered as "good" when radiographs at the longest follow-up showed a decrease of > 10% of the MP, as "bad" when they showed an increase of > 10%, and as "stable" when the MPs varied less than 10%. At the latest review of group A, 11 were stable (92%) and 1 was bad. In group B, 12 were stable (48%), 7 were good (28%), and 6 were bad (24%). In group C, 7 were stable (35%), and 13 were bad (65%). The preoperative migration percentage provided to be the only predictor of outcome. Age at the time of surgery had no constant significant effect on the outcome, neither had the addition of an anterior neurectomy.
La luxation tibio-talienne pure est une lésion très rare, causée par un traumatisme toujours violent et de haute vélocité, dont les variétés internes et postéro-internes sont les plus fréquentes. Les auteurs rapportent l'observation d'une luxation tibio-talienne pure fermée chez un patient de 32 ans, suite à un accident du sport (rugby) à déplacement postéro-interne. L'examen vasculo-nerveux était normal après réduction par manoeuvre externe, sous anesthésie générale ; la contention fut assurée par une botte plâtrée pendant huit semaines. L'évolution a été marquée par l'apparition d'une instabilité latérale de la cheville qui était stabilisée par une ligamentoplastie de type Castaing. (hémi-tendon court fibulaire). Après un recul de 14 mois et en se fondant sur des critères cliniques (oedème, douleur, instabilité, boiterie, fléxion-extension) et des critères radiologiques (pincement articulaire calcification, diastasis tibioastragalien), le résultat est bon.Pure talo-tibial dislocation. About one case with medical literature review Abstract: Pure talo-tibial dislocation is a rare injury, and is always a result of a high energy trauma, themedial and posteromedial patterns are the most frequent. Authors report a case of a pure closed talo-tibial dislocation in a posteromedial pattern occurred in a patient of 32 years old following a sport accident (rugby). There was no vascular or nervous disturbance after external manipulation and reduction in a condition of general anaesthesia, setting has been obtained by a plaster after 8 weeks. The course has been characterized by occurrence of a lateral instability of ankle stabilized by ''hemi Castaing''. After a follow up of 14 months, we obtained good result by taking into consideration clinical criterions: edema, pain, instability, limping, flexion and extension, and radiological criterions: articular pinching, calcification, talo-tibial diastasis.
Le lipome intraosseux est une forme rare de lipome, nous en rapportons un cas de localisation intracalcanéenne exceptionnelle, responsable de talalgie et de gonflement de l'arrière-pied à l'appui chez un sujet de 45 ans. L'examen anatomopathologique a permis d'établir le diagnostic et le curetage chirurgical associé à une greffe d'os lyophilisé et de pataos a permis la guérison.
Mots clés Lipome · Intraosseux · CalcanéusAbstract Intraosseous lipoma is an uncommon form of lipoma. We report exceptional calcaneus localization. It was a man aged 45 referred to our institution because of progressive talalgia with swelling of the hindfoot, increasing with prolonged standing. The final diagnosis was established at pathology examination, curettage and bone grafting to pataos provided cure.
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