Imaging of neuroendocrine tumors.

Imaging of Neuroendocrine Tumors

Novel bilayer wound dressing composed of silicone rubber with particular micropores enhanced wound re-epithelialization and contraction.

Human cancer cells overexpress many peptide receptors as molecular targets. Radiolabeled peptides that bind with high affinity and specificity to the receptors on tumor cells hold great potential for both diagnostic imaging and targeted radionuclide therapy. The advantage of solid-phase peptide synthesis, the availability of different chelating agents and prosthetic groups and bioconjugation techniques permit the facile preparation of a wide variety of peptide-based targeting molecules with diverse biological and tumor targeting properties. Some of these peptides, including somatostatin, bombesin, vasoactive intestinal peptide, gastrin, neurotensin, exendin and RGD are currently under investigation. It is anticipated that in the near future many of these peptides may find applications in nuclear oncology. This article presents recent developments in the field of small peptides, and their applications in the diagnosis and treatment of cancer.

/pdf/radiolabeled-peptides-valuable-tools-for-the-detection-and-3zt22ucn15.pdf

Radiolabeled peptides: valuable tools for the detection and treatment of cancer.

https://www.europeanurology.com/article/S0302-2838(04)00466-X/pdf/neuroendocrine-differentiation-in-prostate-cancer-implications-for-new-treatment-modalities

Neuroendocrine Differentiation in Prostate Cancer: Implications for New Treatment Modalities

The commonly used gamma probes are easy to use but also give rough information when employed in radioisotope-guided surgery. When images are required for exact localization, a gamma camera as well as a probe have to be used. Position-sensitive photomultipliers have contemporaneously allowed high-resolution scintigraphy and miniaturization of gamma cameras. We have assembled a miniature gamma camera with a 1-square-inch field of view and an intrinsic resolution of about 1 mm. When the minicamera is collimated with a large-holed, highly sensitive collimator, it acquires a spatial resolution of 3 mm. This prototype has been tested in the detection of difficult-to-image breast cancer sentinel nodes. Five nodes that had not been found with the usual technique of an Anger camera plus conventional probe were checked with the miniature camera that we named imaging probe: it actually is small enough to be used as a probe and large enough to give an image. One of the five nodes was found and imaged. It was small, disease-free, close to the tumor and probably hidden by the Compton halo around the peritumoral injection site. Our pilot study shows that the imaging probe, although still a prototype, has certain advantages over conventional methods when lymph node localization is required during surgery.

Detection of sentinel node in breast cancer: pilot study with the imaging probe.

Background/Aims : It is important to single out the indications for surgery of hydatid disease of the liver at an early stage For this, a fully comprehensive diagnostic work up of the patient is required Surgery represents the most effective therapy and involves resection of the cysts and their outer capsule This must be as complete as possible Material and Methods : Between 1970 and June 1992, 95 patients received this combined treatment for hydatid disease although only those presenting from 1985 were followed up Results : No serious complications were noted apart from pyrexia due to secondary cholangitis or reactive pleuritis This responded quickly to antibiotics and there was no mortality No cases of relapse occurred although one case did show evidence of reappearance of the disease on serological testing alone, all other tests being negative Conclusion : The most effective treatment for echinococcus cystic disease of the liver is radical surgery Results are best when surgery is combined with medical therapy of benzoimidazole drugs given pre- and post-operatively From our experience, we are now confident that surgical treatment must always be preceded and then followed by treatment with benzoimidazole antihelminthics

Hepatic echinococcus disease: our experience over 22 years.

AIMS AND BACKGROUND When removal of osteoid osteoma is performed with open biopsy, the surgeon can be guided by radioactivity of 99mTc-MDP (methylene D- phosphonate) acquired by a probe. MATERIAL AND METHODS We compared the performance of a commercially available ZnCdTe probe (Neoprobe 2000) and a one-square-inch-field-of-view imaging probe (IP) on two patients undergoing open biopsy for osteoid osteoma. Triphasic bone scintigraphy was performed before operation and Neoprobe as well as IP were used in the operating room by two nuclear physicians. When the surgeon asked for guidance, each nuclear physician had to indicate a precise direction. RESULTS The surgeon asked for guidance once in the first operation, on a patient with osteoid osteoma of the femur, and four times in the second operation, for osteoid osteoma of the acetabulum. The indications provided by IP were correct 5/5 times, whereas the commercial probe was correct 3/5 times. Both devices were able to assess the surgical radicality. After biopsy, bone samples were divided into high-count and low-count samples. Pathological examination confirmed the presence of osteoid osteoma in high-count samples. CONCLUSIONS IP has already been used to guide biopsy, but only in breast disease. The present work confirmed its good performance also in orthopedics as a portable mini gamma camera that can be used in the operating room.

Radioguided biopsy of osteoid osteoma: usefulness of imaging probe.

In the microsurgical therapy of facial nerve palsy, the muscles most frequently utilized have been gracilis, latissimus dorsi, and pectoralis minor, this depending upon surgeons' personal experience. However, at the moment no satisfactory comparison studies are available; this work is a comparative study of the three most often used cadaver-derived muscles in surgical therapy of facial nerve palsy. The potential use of gracilis, latissimus dorsi, and pectoralis minor as free flaps has been assessed by analyzing their microsurgical, anatomical and functional parameters. Suitability has been evaluated by scoring each parameter from 0 to 3 (unsatisfactory, satisfactory, good, and excellent respectively). The results may provide the surgeon who undertakes this kind of technique with a useful data comparison.

Facial nerve palsy: which flap? microsurgical, anatomical, and functional considerations

BACKGROUND: Haemorrhoidectomy according to Longo potentially reduces post-operative pain and allows an early return to work. The aim of this study was to evaluate the efficacy of the technique, the early and especially late complications, and recurrences, in 150 patients. METHODS: Between January 2005 and December 2006 we performed 150 consecutive haemorrhoidectomies with the Longo technique: 82 for third degree haemorrhoids and 68 for fourth degree haemorrhoids. The mean age of patients was 42 years. Every patient had a pre-operative proctoscopy and endoscopy. KIT PPH01 (Ethicon Endo Surgery) was used. We evaluated the length of the operation, the post-operative pain, the early and late complications, and the recurrence of the disease. The mean follow up was 52 months (range 36-72). RESULTS: There was no mortality. The mean length of the operation was 25 minutes with a range of 15 to 45 minutes. Pain, evaluated using the V.A.S. scale, was very light in 114 patients (V.A.S. 2,1) and light in 36 (V.A.S. 3,2). Only 11 (7.5%) patients took painkillers, on demand, for a week after discharge from hospital and 2 patients (1,3%) for more than one month. Early complications (6.6%) were: 5 bleeding (2 after seven days), 4 acute urinary retentions, I external haemorrhoid thrombosis and I haematoma of the rectus wall. Mean Hospital stay was 2.1 days. Late complications (10%) were: 5 "faecal urgency" which disappeared after six months, 6 moderate asymptomatic strictures, and 4 persistent skin tags. There were 8 recurrences (5,1 %), 2 for haemorrhoids of grade 3 e 6 for haemorrhoids of grade 4. All the recurrences appeared within the first 24 months. CONCLUSION: The stapled procedure according to Longo is an effective treatment for haemorrhoids. The results for postoperative pain and early return to work are very good. However, special care for haemostasis is essential in order to avoid bleeding. An effective surgical technique prevents late complications, but results after long term follow up show a not insignificant percentage of recurrences that appeared expecially in the fourth degree haemorrhoids. Therefore a careful pre-operative exclusion of those patients with a prominent prolax is necessary.

Effective treatment of haemorrhoids: early complication and late results after 150 consecutive stapled haemorrhoidectomies

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