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Graves' disease is the most common form of hyperthyroidism, accounting for 60-80% of all cases of thyrotoxicosis. If left untreated, it may lead to severe thyrotoxicosis with cardiovascular, ocular, psychiatric complication, and in extreme cases thyrotoxic crisis with a high mortality rate. We present the case of a 50-years-old woman diagnosed in another service with Graves' disease and treated for many years with antithyroid drugs (ATDs), admitted to our service for a relapse due to treatment discontinuation. The surgical treatment was planned and the preoperative preparation with Lugol solution was initiated. Due to a misunderstanding, the administration of iodine solution was extended for a period of about 30 days, thus generating the so-called Jod-Basedow effect, with the exacerbation of the manifestations of thyrotoxicosis and risk of thyroid storm. The patient received treatment with high ATDs doses, glucocorticoids, and beta-blockers, resulting in the progressive improvement of symptoms. She was discharged from hospital and given the risk of thyrotoxic crisis the surgery was postponed. After a month, the patient underwent thyroidectomy without preoperative preparation with iodine solution. The operative and postoperative courses were uneventful.

Adequate antithyroid drug treatment or surgery usually generates remission of myasthenia gravis (MG) in patients with thymus hyperplasia associated with Graves' hyperthyroidism. The case of a 46-year-old woman diagnosed with MG based on the clinical picture, anticholinesterase drug test and positive electromyography (EMG) is presented. The cervico-thoracic computer tomography revealed a compressive nodular goiter and normal antero-superior mediastinum and led to the diagnosis of MG secondary to the hyperthyroidism. An uneventful total thyroidectomy was performed, but postoperatively the MG symptoms worsened. TC99m tetrofosmin scintigraphy revealed an area of hyperfixation in the antero-inferior mediastinum, suggestive for thymoma, as confirmed by a repeated thoracic CT scan. Following a longitudinal sternotomy, a well incapsulated tumor of approximately 6/5 cm located in the antero-inferior mediastinum was found and an extensive thymomectomy was performed. The postoperative course was uneventful and the patient was discharged 9 days later with complete remission of myasthenia. The pathology report of the specimen revealed a mixt thymoma or AB thymoma after Muller-Hermelink and WHO classification, with invasive capsular foci corresponding to Masaoka II stadium. In conclusion, scintigraphy proved to be useful in the diagnosis and decision making of a thymoma.

Background and Aim: It has been known for quite a lot of time that tumours are cellular aggregates of different cells, mainly malignant cells but also immune cells--of which the most well-known are the tumour infiltrating lymphocytes (TIL) and the tumour associated macrophages (TAM). By observing hematoxylin--eosin stained or immunohistochemical stained slides belonging to different areas of the tumour it is clear that there are clusters of malignant cells within the tumour itself that seem to behave differently from the rest of the tumour. Another fact is that different areas of the tumour contain different inflammatory cells which may promote carcinogenesis or may help to confine it. Whereas different immune cells can be recognised by using immunohistochemistry, a satisfactory characterization of the molecular characteristics of the malignant clusters of the tumour cannot be made without further use of different molecular techniques such as different PCR techniques or microarray methods. Laser microdissection thus comes as a valuable aid in choosing exactly which cells will be analyzed further on., Principle of the Method: Laser microdissection is based on using the energy of a focused laser beam to cut through the thickness of the tissue that is placed on a microscope slide in order to obtain cell samples previously selected by the pathologist through special software., Conclusions: To be able to cut the cells that you want and analyze them further without having them contaminated with other cells means that you can get more insight into the progression of the mutations that occur in these malignant cells, mutations that cause them to become more aggressive or multidrug-resistant. This could in time lead to the discovery of new molecular targets for cancer therapy.

Unlabelled: Based on the biochemical composition of erythrocyte membrane and asymmetric distribution of phospholipids, proteins, and cholesterol, FT-IR spectroscopy can monitor the distribution and interaction pattern of membrane constituents., Material and Methods: The study series included 21 clinically healthy subjects aged between 20 and 60 years. Complete blood counts were performed and the serum biochemical compounds (cholesterol, triglycerides, total protein, glucose) were determined., Results and Discussions: The parameters that can be assessed by erythrocyte FT-IR in relation with the biochemical factors that may influence membrane fluidity are: degree of fatty acids unsaturation, saturated fatty acids/unsaturated fatty acids ratio, cholesterol/phospholipids ratio, and phospholipids/protein ratio. Based on the obtained results, in the assessment of membrane status the following vibration modes were selected as spectral parameters: vibration associated valence bond (=CH), asymmetric valence CH2 groups, modes associated with P=O bond and amine bands I and II specific for proteins. Other parameters, such as v(C-O) specific to glucose, may provide additional information on glucose metabolic status., Conclusions: By correlating biochemical markers with these spectral parameters information on red cell membrane status, status that may reflect different pathological processes, can be obtained.

Ectopic ACTH secretion accounts for less that 10% of all causes of endogenous Cushing's syndrome. Carcinoids are rare thymic tumors, and when associated with ACTH hypersecretion display local or distant aggressive behavior. A 32-year-old woman was admitted to the Endocrinology Unit for obesity, moon face, facial hirsutism, hyperpigmentation, and secondary amenorrhea. Laboratory test confirmed the hypercortisolism and excess ACTH, while dexamethasone suppressive test was negative. Thorax computed tomography (CT) showed an antero-superior mediastinal tumor invading the pericardium and left mediastinal pleura. A complete resection through median sternotomy of the tumor, pericardium and left mediastinal pleura was performed. After a one-year symptom-free period, hypercortisolism recurred, confirmed by laboratory findings. Although no signs of local recurrence were seen on thorax CT, left internal mammary lymph nodes involvement and vertebral body metastases at C7 and LI were found. Refractory electrolyte disturbances could not be corrected resulting in severe cardiac arrhythmia and death from cardiac arrest. The reported case draws attention on the aggressiveness of ACTH-secralso due to the refractory electrolyte disturbances with fatal outcome.

The present study examined the safety of the atypical antipsychotic drugs sertindol, olanzapine and quetiapine used in the treatment of schizophrenia. Haloperidol, a typical antipsychotic drug, was used for comparison. These data may account for the different therapeutic effects and side-effect profiles (cardiovascular risk) of typical and atypical antipsychotic drugs in schizophrenia.

Monitoring the evolution of prostate cancer has crucial importance since this tip of neoplasia has a variable biology, ranging from latent cancers to extremely aggressive tumors. At the moment, PSA (prostate specific antigen) values point out to either successful or unsuccessful prostate cancer therapy. Depending on therapeutic strategies, biochemical recurrence (BCR) is differently defined. After radical prostatectomy, the PSA declines to undetectable levels in 3-4 weeks; BCR: PSA = 0.2-0.5 ng/mL for a single measurement or two consecutive values which surpass 0,2-0,4 ng/mL. PSADT < 10 months is a predictor for the progression of the disease. After external beam therapy, PSA is slowly decreasing reaching up the nadir of 0.2-0.5 ng/mL in months or years; BCR: PSA = nadir + 2 ng/mL. In the case of brachytherapy, the nadir is reached in 2-4 years; BCR: nadir + 2 ng/mL. After hormonal therapy, PSA declines in 3-6 months, maintains low values for 18-24 months, then increases, settling for hormone independency. After chemotherapy, PSA is considered normal at values < 2 ng/mL; the response of PSA represents a confirmed decreasing from the second test at 4 or more weeks after the initial decline; the length of the response is the period between first decline with 50 % of PSA to 50 % increase from nadir; the progression of PSA is shown in the increase with 25 % in comparison to the basic level. In the case of active monitoring, a PSADT < 2 years is an indication for radical prostatectomy, but there are cancers which can evoluate despite a stable PSA. The "PSA bounce" phenomenon and the "PSA surge postchimiotherapie" syndrome can complicate the assessment of biochemical recurrence.

Unlabelled: The aim of the study is to compare de results of the bone scintigraphy of prostate cancer patients in different age groups with their total PSA (PSAt) and with their histopathological test results. MATERIALS AND METODS: Of the 180 patients with prostate cancer who were analyzed by Scintiscan in the last five years in our laboratory, 86 have a known PSAt value, and of these, 55 have a known Gleason Score. The 180 patients were divided into three age groups: (1) < or equal 60 years; (2) 60-70 years and (3) >70 years. The 86 patients with a known PSAt were also divided into five groups according to their PSAt value and the 55 patients with a known Gleason Score were divided in three groups. The scintigraphy results included all the patients in 3 groups, according to the presence, the absence or the likelihood of having bone metastasis. The 33 patients with proven bone metastasis were divided, according to their numbers, into the four Soloway groups., Results: Among the patients with PSAt >20 ng/mL, considered high risk for bone metastases, according to the Recomandations of CCAF, 21 (32.81%) of the 64 patients do not show the presence of bone metastases. For PSAt >50 ng/mL, all 5 patients <60 years of age have metastases, while only 15 (62.5%) of the 24 patients over 70 years old have metastases and 1 (4%) has low likelihood. 6 (21.42%) of the 28 patients with PSAt > sau egal 100 ng/mL do not have metastases. 10 (43.4 %) of the 23 patients with a Gleason Score <7, considered low risk, do have metastases (6 patients--26%) or low probability of metastases (4 patients--17.4%)., Conclusions: Our study confirms that the probability of bone metastasis for a high PSAt value is reversely proportional to age. In our study there is no direct correlation between Gleason Score and the bone scan results.

The MDR character is a major factor that influence the effectiveness of cancer chemotherapy. This feature can be noninvasively evaluated through 99mTc isonitrils (MIBI, Tetrofosmin) scintigraphy, because these radiotracers cellular efflux is mediated by the Pgp membranar active transport system, the same that mediate chemotherapy drugs cellular efflux. The Pgp glycoprotein overexpression in the case of the MDR positive tumoral cells will determine both the chemotherapic drug and the isonitrile radiotracer quickly efflux from the cell. This paper present, based both on the literature and personal authors research work, the principle of the method, radiotracers structural characteristics and cellular uptake mechanism, practical protocol details from the acquisition untill the qualitative and quantitative image processing and results interpretation. Quantification indexes are proposed for the radiotracer cellular uptake quantitative evaluation on the scintigraphic image. The results could bring the possibility to make MDR positive patient diagnosis and further selection for the MDR modulators drug therapy.

Unlabelled: Fine needle aspiration biopsy (FNAB) in evaluation of nodular goiter generated a true revolution. It is generally assumed that the use of FNAB reduces the number of surgical procedures by 50%, while doubles the proportion of carcinoma in surgically treated patients. The aim of the study was to demonstrate the utility of FNAB in preoperative diagnosis of thyroid carcinoma., Material and Method: We have investigated 3240 patients with nodular goiter by FNAB (MGG stain and morphometrical analysis), followed by morphological examination in those who underwent surgery., Results: Globally, FNAB had a good sensitivity (77%) and specificity (95%), which made an accuracy of 92%, proving its diagnostic value. In follicular carcinoma (FC), where the cytological diagnostic cannot be certain, morphometry helped the diagnostic: mean cells diameter was significantly higher (p < 0.001) in FC (9.5 mm) vs. thyroid adenoma (8.6 mm)., Conclusion: With good statistical value, FNAB remain a useful preoperative diagnostic method.

Unlabelled: The aim of this experimental work was to assess the uptake of 99mTc MIBI (metoxy-isobutil-isonitril) on Mycobacterium tuberculosis (MT) cultures, and to compare this uptake level with the uptake of two normal cell types in culture (fibroblasts and myocytes), and with MT membrane fluidity., Material and Method: Mycobacterium tuberculosis cultures were realised on Löwenstein Jensen medium by standard methodology. Normal cells were neonatal rat heart myocytes and fibroblasts. Final plating was done to have an almost complete cell monolayer the day of the experiment, in culture dishes. The cells were incubated with a 1.85 kBq/ml concentration of 9mTc MIBI, at 37 degrees C, using three dishes for each cell type. A three point kinetic (15, 60 and 90 minutes) was realised. Static polarization of fluorescence with Diphenylhexatrien (DPH) fluorescent marker of Mycobacterium tuberculosis in suspension (concentration 10(4)/ml NaCl 9 per thousand) was realized., Results: Mycobacterium tuberculosis have high 99mTc MIBI uptake, 106,47% (compared with the known higher normal uptake cells--the myocytes, considered 100%); the highest uptake kinetic point is at 15 minutes radiotracer incubation. The assessment of Mycobacterium tuberculosis wall fluidity has not brought conclusive results., Conclusion: Our results could give informations to understand the Mycobacterium tuberculosis 99mTc MIBI uptake mechanisms in in vivo lesions.

The computer has provided some wonderful opportunities for our children. Although research on the effects of children's use of computer is still ambiguous, some initial indications of positive and negative effects are beginning t emerge. They commonly use computers for playing games, completing school assignments, email, and connecting to the Internet. This may sometimes come at the expense of other activities such as homework or normal social interchange. Although most children seem to naturally correct the problem, parents and educators must monitor the signs of misuse. Studies of general computer users suggest that some children's may experience psychological problems such as social isolation, depression, loneliness, and time mismanagement related to their computer use and failure at school. The purpose of this study is to investigate issues related to computer use by school students from 11 to 18 years old. The survey included a representative sample of 439 school students of ages 11 to 18. All of the students came from 3 gymnasium schools and 5 high schools of Iaşi, Romania. The students answered to a questionnaire comprising 34 questions related to computer activities. The children's parents answered to a second questionnaire with the same subject. Most questions supposed to rate on a scale the frequency of occurrence of a certain event or issue; some questions solicited an open-answer or to choose an answer from a list. These were aimed at highlighting: (1) The frequency of computer use by the students; (2) The interference of excessive use with school performance and social life; (3) The identification of a possible computer addiction. The data was processed using the SPSS statistics software, version 11.0. Results show that the school students prefer to spend a considerable amount of time with their computers, over 3 hours/day. More than 65.7% of the students have a computer at home. More than 70% of the parents admit they do not or only occasionally discuss computer use with their children. This indicates the fact that, although they bought a computer for their children, they do not supervise the way it is used. The family is rather a passive presence, vaguely responsible and lacking involvement. But, the parents consider that, for better school results, their children should use their computers. This study tried to identify aspects of computer addiction in gymnasium and high school students, as well.

Scintigraphic images provide morphologic and functional information referring to pointed human body tissues and organs. Depending on the ability and experience of the nuclear medicine physician and the degree of scintigram complexity, the diagnosis process becomes very difficult sometimes. Image processing might decrease subjectivity and help physicians in decision making in complex cases as bone metastasis diagnosis based on scintigraphic explorations. The aim of this paper is to describe the compulsory steps of a pre-processing method in order to build a database for an automatic final appreciation of pathologic bone scan areas as a percentage of the total bone scintigraphic surface. This may include the scintigraphic result in some metastasis probability category with more accuracy than a simple, subjective appreciation of the scintigram, especially in doubtful cases. This paper points to the steps of the processing method of the database used in the rule-based nuclear medicine aide-decision expert system (NMADES). The objective evaluation of the pathological sites requires image preprocessing operations in a number of steps: histogram transforms, correlated superposition of direct and reversed incidences to reinforce the uptake sites, smoothing by pseudo-cepstrum methods, symmetry axes extraction by robust linear regression and symmetric areas search with fuzzy methods. Some for and against's are underlined in the last section, devoted to conclusions and future work.

Computers continue to play a vital role in today's generation. The need for information about the effects of computers on their users also increases. The purpose of this study is to investigate how children and adolescents use a computer and to explore the beneficial and harmful effects of computer use on children's mental and physical health. The studied group of samples comprised 69 subjects, aged between 13 and 18 years, who answered to a questionnaire. The parents of the children also answered another questionnaire with the same subject. Data have been statistically processed using the program SPSS. The results were obtained about computer use and the pathological use was identified. Some children spend much time on computers, 4% more than five hours/day. 41% of the parents believe that the usage of the computer is favorable to the children's mental and physical health and development, 49% of parents believe that the computer may be harmful. 1.4% of the children had pathological use of the computer.

The measurements of micro-hardness was achieved with a view to studying the influence of chemical composition and fabrication with a view to obtain metal-ceramic dental restorations. The materials used were specimens of metal alloys (Remanium Cs) and specimens of metal alloys-ceramics (Remanium-Biodent ceramic) prepared through polish, lustre and acid attack; the PMT3 machine for microhardness measurements; a 50 grams weight and a length of loading 15 sec. The results of determinations are prove the technological process for cover metal structure of Remanium Cs with ceramics influence significantly the microhardness of metal ingot and Remanium further polish (with and without oxidation).

The occlusal forces have an effect on the dental structure in the longitudinal axis of the tooth, on the one hand, but, on the other hand, in the horizontal plane, they are conducted through interdental contact points. In this paper we try to simulate the stress and the deformations determined by different forces in different directions, over the dental interfaces. We have used the method of finite elements and Fastflo domain for the mathematical calculations of probability. Our conclusions are that the changes in the deformation field appear only for those materials that comply with the rate of elasticity changes in the condition where delta = E1/E2 < 20.

We present the case of a 62 years male subjects, known with liver cirrhosis diagnosed in 2000 during a laparoscopy. The subject presented with important atypical abdominal pain, leucocytosis, thrombocytosis, small ascites; pneumatosis and hydro-aeric images of small intestine at abdominal X Ray, thickened bowel wall at CT-scan. Laparoscopy revealed mesenteric venous thrombosis, intestinal infarction and the standard surgical treatment was enterectomy. Mesenteric thrombosis may rarely occur in liver cirrhosis due to portal hypertension. This rare but severe complication is usually difficult to diagnose..

Autoimmune hepatitis is a self-perpetuating hepatocellular inflammation. The diagnosis is established by a number of diagnostic criteria, defined by the International Autoimmune Hepatitis Group, and the exclusion of other causes of chronic hepatitis. There are two fundamental goals in therapy: induction of remission and maintenance of remission. The standard initial treatment is prednisone monotherapy or combination therapy with prednisone and azathioprine, which induce a clinical, biochemical and histologic remission in 65-87% of patients within 3 years. Other typical treatment endpoints in autoimmune hepatitis are an incomplete response, treatment failure and intolerance of the administrated drugs. If the treatment results are unsatisfactory, liver transplantation and alternative drugs such as Cyclosporin A, tacrolimus, cyclophosphamide, mycophenolate mofetil, budesonide, ursodeoxycholic acid should be considered; however, efficacy in clinical trials has not been shown. Future investigations must focus on the clarification of pathogenic mechanisms, characterization of target autoantigens, identification of host susceptibility factors, and assessment of alternative treatment strategies.

Unlabelled: 420 patients with cancer of breast, prostate, lung and colon were investigated through 99mTc Methylene-diphosphonate whole body scintigraphy. The presence of pathologic radiotracer uptake was qualitatively and quantitatively analyzed in order to establish the metastases distribution. Patient selection was realized over 2455 whole body scintigraphies effectuated between 1998 and 2001 in our Nuclear Medicine Service. All selected cases were metastases with known origin primary cancer., Results: Using the Qui-square Test we have compared the frequency of nine well delimited skeleton regions involved like metastatic site in the different cancer types. We have found a significant statistic difference of the range of frequency only between breast and prostate cancers as well as between pulmonary and prostate cancers. The mean number of the metastatic involved skeletal regions was significantly greater in breast and prostate cancers in comparison with lung and colon cancers (p < 0.0001). The higher metastases site frequency was the rachis, than the pelvis, the ribs and the sternum. The skull metastases localization is more frequent in breast cancer in comparison with all other cancers (7.67% versus less than 4% in other cancer types). The pelvis was more involved for the metastatic process in prostate neoplasm. On the other hand, the highest mean anatomic sites number per patient was found in breast cancer (5.7) and prostate cancer (4.8) related to colon (3.3) and lung (3.0) cancers., Conclusions: Even some particularities were evident, in our study, between the metastases distribution in these four cancer types, the data are not sufficient to sustain the existence of a characteristic pattern related to the primary cancer origin. Metastases localization could be, however, related to the metastazation mechanism.

Image processing for the imagistic medicine domain nuclear medicine have long time being realised through specifical protocols which rarely allowed the intervention of other informatical modalities. Processing depends first of all on the acquisition type. This paper presents the steps of one of the most complex image processing protocols, in the case of myocardial SPECT acquisition (Single Photon Emission Computed Tomography).

AIDS, still present with severe prognosis at the beginning of the 3rd Millennium, may present gastrointestinal and hepatic involvement. Even they have not a fatal prognosis, in order to improve the quality of life of AIDS patients we need a broad knowledge of and to treat the gastrointestinal and hepatic manifestation of the disease.

NASH (Nonalcoholic Steatohepatitis) and ASH (Alcoholic Steatohepatitis) are both diseases with increase frequency which may complicate up to 50% of liver cirrhosis. They are considered as risk factors for liver carcinoma. In order to diminish the incidence of liver cancer, NASH and ASH need a close follow-up. These two entities need to be known not only by gastroenterologist, but also by general practitioners, endocrinologists, nutritionists and cardiologists.

In the first part our intention was, essentially, to present the particularities of glucose tumoral cells metabolism, PET components, the synthesis of 18F FDG and the detection of unknown cancers. This second part makes reference about mainly types of tumors who benefit by FDG-PET indications. Clinical PET has a rapid growth because of its use in cancer diagnosis and management. According with published studies all over the world, the sensibility and specificity of FDG-PET, noninvasive method, is higher than that of the conventional methods like CT, IRM, ultrasonography. PET is en excellent detection method of most of common cancer types and depends not on the histological neoplasm type; the more aggressive is the tumor, more it will uptake the radiotracer. The cost is significant, so the indications must be very precise: evaluating the malignity of solitary pulmonary nodules, evaluating the recurrences of melanoma, colon cancer diagnosis, differentiation between recurrent brain tumor and radiation injury, differential diagnosis of the benign lymph and malign lymph nodes, staging of Hodgkin's and non-Hodgkin's lymphoma, evaluation the response to therapy. Because the PET images are difficult to interpret, appears the necessity of correlation with anatomic images: this was the fusion images beginnings (the PET and CT images combination); now the physiologic information has precise anatomic localization. The growing of this method is very probably, both using 18F FDG -thanks to its highly favorable physical characteristics- and other new radiopharmaceuticals. The clinical cases that illustrate the applications are investigated at CERMEP, Lyon, France.

One of the factors which can explain the scintigraphic Tc-99m MIBI positives images in pulmonary tuberculosis could be the Mycobacterium tuberculosis radiotracer uptake; this can be investigated in vitro, on cell culture, in comparison with normal cell types known to have high (myocites) or low (fibroblasts) uptake. Mycobacterium tuberculosis cultures were realised on Löwenstein Jensen medium, by standard methodology. Myocites and fibroblasts cultures were realized from neonatal rat hearts. Monolayer cells culture were incubated with a same 1.85 kBq/?l Tc-99m MIBI concentration, at 37 degrees C for 15, 60 and 90 minutes. The kinetic was stopped by rapidly washing the cells, with a 4 degrees C physiological saline solution and than scrapped cells were counted for the uptaken radioactivity. The results show that radiotracer cellular uptake (reported at the protein concentration) in myocites was maximum at 60 minutes. Cellular uptake in fibroblasts was very low at all the intervals. In Mycobacterium tuberculosis a peak was observed after 15 minutes, the uptake being similar to that of 60 minutes incubated myocites, considered 100%. After 90 minutes the Mycobacterium tuberculosis uptake was smaller than the 15 minutes value (65.82%). In conclusion, Mycobacterium tuberculosis in vitro uptake results could explain the more positives scintigraphic images in BK positive patients obtain at 15 minutes, in comparison with the delayed images.

The greatest branch of evolution in Nuclear Medicine that appear in the last period of time, also in medical practice, is scintigraphy with 18F FDG-PET. At the beginning, the images with 18F FDG were used especially in the study of functional cerebral metabolism. Now, new data show that the method presents en major role in cancer diagnosis, localize the tumour and metastasis, and monitoring the treatment in oncology because of the peculiars changes in glucose metabolism of the cancer cells. In this two parts of reference synthesis our goal was to present the following subjects: I) first part include the particularities of glucose metabolism of tumour cells, functionality and components of PET, radiopharmaceutical used in PET, the synthesis of 18F FDG, the clinical procedure and the detection of unknown cancers; II) the second part is about the mains types of tumours identified with 18F FDG-PET (lung, breast, lymphoma, melanoma, colorectal cancer and others). The clinical cases that illustrate the applications are investigated at CERMEP, Lyon, France.

It is known that the malignant primary tumor site has a specific lymphatic drainage, all the time intermediate, however, by a first lymph node named sentinel node. This can be situated in some typical or atypical topographic area and can be or not clinically evident. If the sentinel node is not invaded by the metastatic cells there is no metastatic risk for other lymphatic nodes, so the surgical treatment is not necessary to involve the corresponding lymphatic area dissection. An imagine, noninvasive detection of the involvement of the sentinel node in the spread of cancer could be related with the surgical decision to perform (or not) fully regional lymphadenectomy (based on biopsy result of such positive detected nodes) allowing only a tumorectomy in the first stages of neoplasia. For the case of scintigraphic method to detect the sentinel node, the performance depend on the development of radiotracers, the modification of the lymphoscintigraphic mapping techniques protocols, and the development and improvement of detectors.

Unlabelled: We have studied 75 patients, diagnosed with breast cancer, (39 on the right, 36 on the left and 4 on the two breasts), the TNM classification being: stage I--13.3%, stage II--36%, stage III--40% and stage IV--10.6%. Each patient has undergone a whole body scan, 2 hours after a 20-25 mCi 99mTc MDP i.v. dose, using a Siemens Diacam gamma camera. Three parameters where assessed: 1) the distribution of multiple metastasis bone sites; 2) an index, the counts/pixel ratio between the metastatic site interest region and a homologous normal bone interest region (IMDP); 3) a graphic representation of the metastasis heterogeneity radiotracer uptake., Results: Bone metastasis have been found in 23 patients (30.6%), 16 cases having multiple sites; the rate between right and left breast cancer, for these metastases, was 13:10, according with the previous mentioned breast frequency. From all the 23 cases, the most involved site was the ribs (18 cases), followed by the spine (in 17 cases), the iliac bone (9 cases), the femur (7 cases), the skull (3 cases). On the spine, the more frequent involved was the dorsal spine (49.23%), than the lumbosacral (26.13%) and last the cervical spine (12.3%). On the dorsal vertebrae, in 91% the metastasis were localized between D8 and D12. The highest values of I-MDP characterize the femoral metastasis. The heterogeneity was high only for the vertebrae multiple sites. In conclusion, our study show pattern characteristics on the distribution and also on the uptake radiotracer bone metastasis quantification in breast cancer, in respect with others neoplasm's bone metastasis.

Introduction: As the number of medical journals is continuously increasing, their quality becomes a very reliable tool used by the editors in order to increase readership. As a consequence, the structure and the content of submitted papers are carefully revised before publication., Objectives: The purpose of our study is to describe structural aspects and the use of descriptive and inferential statistics methods in papers published by the Medical-Surgical Journal between 1990 and 1997., Methods: Fifteen items were collected for each paper. Ten of them were related to the general structure: type of paper, number of authors, town of authors, professional environment, medical topic covered by the paper, pluridisciplinarity, the existence of a bibliography, the number of titles in the bibliography, language of publication, presence of abstract. The other five were related to data analysis and reporting: description of statistical methods, the existence of significant results without method description, presence of tables and graphics, use of descriptive and inferential statistics., Results: A number of 477 papers were analysed. Original papers represented 57.4%, 71.5% of the authors were involved in medical/non-medical teaching, 58.3% of papers were related to clinical sciences, 29.8% were related to basic medical sciences; pluridisciplinarity was present in 26.8% of papers (significantly increasing trend, p < 0.01), the bibliography was not present in 27.3% of papers (significantly decreasing trend, p < 0.001), romanian was the language of publication in 83% of papers, followed by english (10.9%), french (4.6%) and german (1.5%). Papers without abstract represented 29.9%, the median number of authors is 3(range 1-15) and the mean number of titles in reference list 14.7(SD = 12). Eighteen papers (3.8%) reported significant results without description of methods, 51.4% used tables and graphics, 13.4% used descriptive statistics methods and only 6.9% of the papers have used inferential statistics methods., Conclusion: The structural problems of papers published in Medical Surgical Journal should be avoided using a more restrictive editorial policy. The use of such a policy shows positive results for the last 2 years (1995 and 1996). Statistical methods are poorly used in this Romanian medical journal and much progress is to be made before speaking about statistical assessment of submitted papers.

Scintigraphic imagery was used in breast carcinoma mostly for the bone metastases screening, using 99mTc-MDP. Others radiopharmaceuticals can be used to visualize either the primary tumour or the soft tissues metastases. It's mainly the case of 99mTc-MIBI, and also of some somatostatin analogues, like Octreoscan. This case report of a patient with a T3N1M+ breast adenocarcinoma having different secondary sites represent also a prove of the complementarity of these explorations, which give the possibility of diagnostic and therapeutic evaluation and, in the same time, the possibility of a better understood of the metastasizing mechanism.

99mTc MIBI has been shown to accumulate in different cancer cells types, in vitro and malignant tumours in vivo, making evidence of the scintigraphic diagnostic of them. We report two cases of neurofibromatosis type I, which has realised high levels of 99mTc MIBI uptake, primary to all chemo- or radiotherapy. Only certain zones of tumorous localisation have been seen, but a relation with the lesion histology was not really established. In conclusion, 99mTc MIBI scintigraphy may be usefull in the investigation of type I neurofibromatosis.

Imagery is the only possibility of early glioma diagnosis. Both the gravity of the evolution and the bad prognostic, through all CNS tumors, justify the necessity to asses new techniques in order to improve glioma imagery. From this point of view, cerebral tomoscintigraphy has developed, its usefulness depending highly on the radiotracer tumoral specificity. One of these tracers, 99mTc MIBI, has been found to be uptake in glioma malignant cells, in relation with their viability and even malignity. In our study, -14 cerebral tomoscintigraphies have been realized on patients with glioma (initial or recurrent tumor), after 20 mCi 99mTc MIBI i.v. doses. The results are in correlation with the histologic glioma grade: high grade astrocytoma has positive images, but low grade astrocytoma doesn't. In conclusion 99mTc MIBI glioma tomoscintigraphies can be useful in their initial or recurrent diagnosis; the uptake tracer intensity being correlated with the histologic tumoral pattern, 99mTc MIBI SPECT could make possible a better localization of highest malignity tumoral points, in further biopsies.

The hexakis (2-methoxy isobutyl isonitrile) technetium (I) (99mTc MIBI) is a representative molecule for a class of monocationic lipophile 99mTc compounds, knowing to be initially used like myocardial scintigraphic agents, and now also in oncological scintigraphy. This present study aims to compare the in vitro 99mTc MIBI cellular uptake on some normal and neoplastic cells. Three tumoral cell lines were used: M4Beu (pigmented melanoma), M3Dau (pigmented melanoma), MCF7 (breast cancer), in comparison with newborn rat cardiac myocytes and fibroblasts. Monolayers cultures cell were incubated for 1 hour with 37 kBq of 99mTc MIBI. Our results: (a) confirm a preferentially 99mTc MIBI uptake on the myocytes in comparison of the fibroblasts; (b) show that this uptake is very different on the neoplastic studied cultures cells, depending on the cell type (higher on M3Dau in comparison of the other two malignant cell lines, and also higher than the myocytes. The neoplastic cellular mechanisms to accumulate 99mTc MIBI, are only hypothetically understand; there are thought to be also in relation with the Nernst equations, applied at the plasmatic and mitochondrial membranes level, like in normal cells. A correlation with some phenotypic neoplastic cells characteristics, in relation with the malignancy tumoral potential seems possible. If there is the case, this can be a possible explanation of some in vivo imaging results, obtained with 99mTc MIBI, in oncologic scintigraphy.