Could somatostatin scintigraphy be superior to MIBG scan in the staging of stage IVs neuroblastoma (Pepper's syndrome)?

A 4-month-old infant suffering from Stage IVs neuroblastoma (NB IVs; Pepper's syndrome) was repeatedly examined by I-123 MIBG and somatostatin analog in-111 pentetreotide (SMS) scintigraphy, during a 2-year period. Treatment was restricted to surgery of the primary tumor. I-123 MIBG and SMS scan results were positive in the primary tumor and liver, but I-123 MIBG yielded very poor images and failed to reliably detect bone marrow metastases in the lower limbs and skull, whereas SMS precisely visualized these lesions. Six months after diagnosis, the infant was in complete clinical remission. I-123 MIBG and SMS images had returned to normal at 1 year. The prognostic implication of positive SMS imaging, in combination with positive or negative I-123 MIBG scan results, is not known in NB IVs and requires further investigation.

[beta2-Microglobulin determination's estimation in cerebrospinal fluid (author's transl)]. / Valeurs du dosage de la beta2-microglobuline dans le liquide céphalo-rachidien.

beta2-Microglobulin levels were determined the serum and CSF by radioimmunoassay in various patients from departments of neurology and neurosurgery. Simultaneously a study of CSF protein levels was done. In normal subjects, there is a good correlation between blood and beta2m levels. In patients with pure subarachnoid hemorrhage, the beta2m was always found elevated in the CSF. In tumors of the nervous system, the number of cases studied is yet too small to allow any conclusion.

[Effect of constant rate enteral nutrition on gastrin secretion in children (author's transl)]]. / Effet de la nutrition entérale à débit constant sur la sécrétion de gastrine chez l'enfant.

The aim of this work was to study gastrin secretion in children receiving constant rate enteral nutrition (CREN) then avoiding intermittent stimulation induced by meals. Induced hypergastrinemia was performed in 12 children during CREN and compared with that in 8 children with intermittent oral feeding as a control group. Before stimulation by protein load there was no significant difference between the 2 groups; 20 minutes after stimulation, there was no change in the serum gastrin concentration in the CREN group, but a dramatic increase in the control group. The hypothetic role of gastrin and/or intestinal factors is advanced to explain the inhibition of gastrin secretory response during CREN. A progressive substitution from continuous to discontinuous intakes is suggested to avoid weaning complications of this nutritional technique.

Evaluation of 25-hydroxyvitamin D and vitamin D binding protein losses in thirteen children on continuous ambulatory peritoneal dialysis.

Thirteen children, 6 females, 7 males, aged 2 to 13 years were studied. At the time of study they were on continuous ambulatory peritoneal dialysis (CAPD) for 1 to 22 months. 25-(OH)D loss in daily dialysate fluids represented 2 to 22 micrograms/day. A significant correlation was found between 25-(OH)D plasma concentration and 25-(OH)D dialysate concentration. 25-(OH)D clearance was correlated to 25-(OH)D binding protein clearance (p less than 0.001). These findings of important 25-(OH)D losses in the dialysate fluid of children on CAPD demonstrate the necessity of carefully adapted vitamin D intakes with such a treatment.