RESUMO
In patients affected by unbearable pain secondary to peripheral vascular disorders beyond surgical repair such as thromboangitis obliterans, diabetic microangiopathy, arteriosclerosis obliterans, there is a need to establish the degree of micro-circulation functionality before proceeding with invasive pain therapy, such as Spinal Cord Stimulation (SCS). From our series some cases of refractory ischaemic pain subjected to nuclear medicine techniques assessment before and after SCS implant will be presented; these data suggest that the use of radionuclides for quantifying regional perfusion, in view of the information it offers us both in the dynamic angiographic phase and in the later static phase, constitutes a very valid aid in the diagnosis and treatment of chronic pain conditions of ischaemic origin. Cutaneous, musculoskeletal and bone flow scintiscan is a non-invasive procedure which allowed us to make an objective selection of patients who are candidates for prolonged conservative treatment thus limiting the incidence of ineffective permanent SCS implants.
Assuntos
Terapia por Estimulação Elétrica , Isquemia/diagnóstico por imagem , Isquemia/terapia , Doenças Vasculares Periféricas/diagnóstico por imagem , Doenças Vasculares Periféricas/terapia , Medula Espinal , Medronato de Tecnécio Tc 99m , Adulto , Idoso , Osso e Ossos/irrigação sanguínea , Osso e Ossos/diagnóstico por imagem , Feminino , Humanos , Infusões Intravenosas , Isquemia/fisiopatologia , Masculino , Pessoa de Meia-Idade , Músculos/irrigação sanguínea , Músculos/diagnóstico por imagem , Dor/diagnóstico por imagem , Dor/fisiopatologia , Manejo da Dor , Doenças Vasculares Periféricas/fisiopatologia , Cintilografia , Fluxo Sanguíneo Regional/fisiologia , Pele/irrigação sanguínea , Pele/diagnóstico por imagem , Medronato de Tecnécio Tc 99m/administração & dosagemRESUMO
Sixty-seven patients with malignant melanomas were seen in our institute since 1998. We looked for a sentinel node in 26 (38%) patients with lesions thicker than 1 mm, employing a double technique: staining with methylene blue and gamma probe mapping after injection of 99mTc. Forty-six nodes were retrieved, 25% of them containing tumor cells. This approach enabled us to choose between a wait-and-see policy and radical surgery.
Assuntos
Linfonodos/patologia , Melanoma/patologia , Biópsia de Linfonodo Sentinela/métodos , Neoplasias Cutâneas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Corantes , Feminino , Câmaras gama , Humanos , Excisão de Linfonodo , Linfonodos/diagnóstico por imagem , Linfonodos/cirurgia , Metástase Linfática/diagnóstico por imagem , Masculino , Melanoma/diagnóstico por imagem , Melanoma/cirurgia , Azul de Metileno , Pessoa de Meia-Idade , Cintilografia , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/cirurgia , Agregado de Albumina Marcado com Tecnécio Tc 99mRESUMO
The authors, after a short introduction of physiopathology, report on 17 patients who underwent a total (10 cases) or a subtotal (7 cases) gastrectomy for cancer at various times and then submitted to hemochromocytometric test and Schilling test modified by Katz and Bell. On the bases of information given by the tests, some clinical and therapeutic considerations are made.
Assuntos
Gastrectomia/efeitos adversos , Síndromes de Malabsorção/etiologia , Vitamina B 12/metabolismo , Carcinoma de Células Escamosas/cirurgia , Feminino , Humanos , Masculino , Teste de Schilling/métodos , Neoplasias Gástricas/cirurgiaRESUMO
Certain aspects of OPSI (Overwhelming Post-Splenectomy Infection) are examined, mainly its considerable gravity, its relatively high incidence, especially in children; its difficult prophylaxis with a report on personal experience of ectopic autotransplant of spleen tissue in two young patients after splenectomy for traumatic rupture. The technique was found to be simple and quickly performed. Scintigraphic follow-up for over 4 years after the operation showed satisfactory growth in the transplanted spleen tissue.
Assuntos
Baço/transplante , Esplenectomia , Ruptura Esplênica/cirurgia , Adolescente , Pré-Escolar , Humanos , Masculino , Cintilografia , Baço/diagnóstico por imagem , Transplante AutólogoRESUMO
We used 99mTc HM-PAO SPECT to study 50 patients with partial epilepsy: 47 interictally and 3 during a seizure. All 3 patients studied during a seizure presented an area of increased tracer uptake. Of those in whom recordings were taken during seizure-free intervals 35 (74%) showed perfusion asymmetries: 27 (57%) with decreased and 8 (17%) with increased uptake. We discuss the findings and compare them with those of similar studies using SPECT and positron emission tomography.