Production of scandium radionuclides for theranostic applications: towards standardization of quality requirements.

In the frame of "precision medicine", the scandium radionuclides have recently received considerable interest, providing personalised adjustment of radiation characteristics to optimize the efficiency of medical care or therapeutic benefit for particular groups of patients. Radionuclides of scandium, namely scandium-43 and scandium-44 (43/44Sc) as positron emitters and scandium-47 (47Sc), beta-radiation emitter, seem to fit ideally into the concept of theranostic pair. This paper aims to review the work on scandium isotopes production, coordination chemistry, radiolabeling, preclinical studies and the very first clinical studies. Finally, standardized procedures for scandium-based radiopharmaceuticals have been proposed as a basis to pave the way for elaboration of the Ph.Eur. monographs for perspective scandium radionuclides.

The safety and efficacy of a paclitaxel-eluting wrap for preventing peripheral bypass graft stenosis: a 2-year controlled randomized prospective clinical study.

OBJECTIVES: To compare the safety and efficacy of a bioresorbable paclitaxel-eluting wrap implanted with a synthetic vascular graft (treatment) versus the graft implanted alone (control). DESIGN: Prospective, randomized, controlled, multicentre, 2-year clinical study conducted in adults scheduled to undergo femoropopliteal peripheral bypass surgery with a polytetrafluoroethylene (PTFE) graft. MATERIALS AND METHODS: Hundred and nine subjects were randomized 2:1 to treatment or control. All subjects were implanted with a 6mm expanded PTFE vascular graft; in addition, treated subjects had a 2.5 cm x 4 cm paclitaxel-eluting wrap (1.6 microg/mm(2)) placed around the distal graft anastomosis. RESULTS: The overall incidence of adverse events was similar in both groups. Treated subjects required fewer limb amputations than controls (15.5% vs 18.4%) and time to amputation for those that required amputation was twice as long (153 days vs 76 days). Among diabetics, this effect was pronounced with 13.8% of treated subjects requiring limb amputations compared with 23.5% of controls. Over the course of study, the diameter at the distal graft anastomosis was greater in treated subjects than in controls (difference of 2.1mm at 2 yr, p=0.03). CONCLUSIONS: The paclitaxel-eluting wrap maintained graft patency at the distal anastomosis and was safe to use in patients who had received a peripheral bypass PTFE graft.

[Refertilization after sterilization using surgical micromethods in gynecology]. / Sterilizációt követö refertilizáció nögyógyászati mikrosebészeti módszerekkel.

The authors aquaint the results of refertilization following sterilization in connection eight cases. Four of their patients delivered mature babies in term. The microsurgical methods following different forms of sterilization are described in details. Refertilization can be a real possibility for women who had previously undergone sterilization and would like to be pregnant again.

[CO2 laser in gynecologic microsurgery]. / A CO2 lézer nögyógyászati mikrosebészeti alkalmazása.

Authors report on their gynecological operations performed by CO2 laser. They review the technical solutions done by laser in different types of operations. They discuss the advantages of the administration of CO2 laser in microsurgery and mention the new ways of the evolution of laser surgery.

Candida guilliermondii var. guilliermondii infection in infertile women.

The sera of 263 women--217 infertile and 46 pregnant--were examined by various serological methods (precipitation test, agglutination, indirect immunofluorescence) to detect Candida guilliermondii var. guilliermondii (C.g.) infection. The precipitation reaction was performed with extracellular C. guilliermondii antigen, the agglutination reaction was employed parallel with C. albicans. In the infertile group 122 (56.2%) proved to be C.g. positive, while in the fertile 11 women (23.9%) proved to be so, the level of significance being p less than 0.0001 between the two groups. A one-month ketoconazole treatment (one tablet, 200 mg/day) was adequate for eliminating the C.g. infection. In a few cases hystological examinations were also performed according to Gomori-Grocott and yeast cells could be detected in the stroma of the ovary. IgA, IgG, IgM, Gc-globulin, transferrin and ferritin determinations were carried out before and after the ketoconazole treatment, and there were significant differences in the IgM and transferrin levels between the infected and non-infected groups. The authors achieved 5 pregnancies of 56 treated women in 6 months.

[Conservative solution of tubal pregnancy by microsurgery]. / A kürtterhesség konzervatív megoldása mikrosebészeti módszerekkel.

Possibilities of conservative microsurgical solution of ectopic tubal pregnancy are reported on. The authors present their cases of which a term pregnancy is first reported in the Hungarian literature. The attention is drawn to the expectable complications, the indications and technical realisation of the microsurgical technique are discussed. The importance of conservative microsurgery of tubal pregnancy is emphasized.