unusual presentation, pilomatrixoma in the buttock area - a case report

Pilomatrixoma is benign tumor of skin appendages it is rare tumor mainly involving head, neck face and upper extremities. 1 A 16-year-old male developed a lesion, over a period of 2 year, at the middle of right buttock. The presumed diagnosis was a sebaceous cyst / pyogenic granuloma. An excision biopsy was performed and the histopathologic diagnosis was a pilomatrixoma

Diffuse lung uptake on [99m]Tc-MDP bone scintigraphy-case report

A [99m]Tc-methylene diphosphate [MDP] bone scan of a 35 years old female patient performed for possible skeletal metastasis from carcinoma breast. Diffuse [99m]Tc-MDP uptake was seen in both the lung fields on [99m]Tc-MDP bone scintigraphy. Biochemical and radiological evaluation excluded all the known causes of the diffuse [99m]Tc-MDP lung uptake. Raised serum ferritin levels of 1226ng/ml [normal range for adult female = 13 - 15 ng/ml] was the only abnormal biochemical finding and attributed as the possible cause of lung uptake

Hypospermatogenesis and spermatozoa maturation arrest in rats induced by mobile phone radiation

To determine the morphological changes induced by mobile phone radiation in the testis of Wistar albino rats. Cohort study. Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia, from April 2007 to June 2008. Forty male Wistar albino rats were divided in three groups. First group of eight served as the control. The second group [group B, n=16] was exposed to mobile phone radiation for 30 minutes/ day and the third group [group C, n=16] was exposed to mobile phone radiation for 60 minutes/day for a total period of 3 months. Morphological changes in the testes induced by mobile phone radiation for 60 minutes/day caused 18.75% hypospermatogenesis and 18.75% maturation arrest in the testis of albino rats compared to matched controls. However, no abnormal findings were observed in albino rats that were exposed to mobile phone radiation for 30 minutes/day for a total period of 3 months. Long-term exposure to mobile phone radiation can cause hypospermatogenesis and maturation arrest in the spermatozoa in the testis of Wistar albino rats

Pattern of distribution of metastatic lesions within skeleton in patients with breast carcinoma of Faisalabad and its vicinity

Evaluation of pattern of distribution of skeletal metastases in patients with breast carcinoma. by using [99m]Tc MDP Skeletal Scintigraphy. Retrospective Analysis. Study was conducted at Punjab Institute of Nuclear Medicine [PINUM], Faisalabad Pakistan from January 2006 to June 2009. A retrospective study was performed on 465 consecutive patients having CA Breast irrespective of preoperative/postoperative status, presenting for bone scan at Punjab Institute of Nuclear Medicine. Whole body bone scan was performed, along with additional spot views, where needed. The images were interpreted for metastatic deposits by three independent observers. Where needed, plain X-ray was performed to correlate in favor of benign pathology. Out of 465 patients [453 female and 12 Male], 286 [62%] patients were having either normal bone scan or some benign pathology as correlated with plain x-ray of the suspected area. 179 [38%] patients were positive for metastases within skeleton. Among these, 61.4% patients were having multiple, 14% with two, while 24.6% were diagnosed as having solitary lesions within the skeleton. In patients having multiple skeletal lesions, highest number was noted in spine [84.5%- most common in thoracolumbar], followed by ribs [55.5%], pelvis [37.3%---most frequent in iliac bone], skull [32%], scapula [27.3%], sternum [26.4%], femur [19.1%], humerus [14.5%], clavicle [3.6%] and tibia [0.9%]. In humerus and femur, most lesions were located in their upper ends, followed by shafts. Right side of skeleton was more frequently involved than the left. In patients having lesions in ribs and pelvis, most of the lesions were bilateral. Patients with two lesions showed maximum number of lesions in rib cage [44%], followed by spine [32%-all being in thoracolumbar region], scapula [24%], pelvis and scapula [24% in each], sternum [16%], skull [8%], humerous and femur [4% in each]. In patients having solitary focal lesion, highest number was noted in spine [45.5%-most common in thoracolumbar spine], followed by ribs [22.7%], sternum and pelvis [13.6% each], and skull [6.8%]. No lesion was noted in appendicular skeleton. Multiple skeletal metastases are much more common than solitary or two lesions in cases of known breast carcinoma. Axial skeleton including skull is most commonly involved. Spine [especially thoracolumbar] is the most frequent site of involvement followed by rib cage, pelvis and then skull. In peripheral bones, most frequent site is the upper end of femur followed by humerus

Gated spect myocardial perfusion scintigraphy for identifying septal perfusion artifacts in left bundle branch block

To determine the role of gated Single Photon Emission Computed Tomography [SPECT] for accurate assessment of myocardial perfusion scintigraphy [MPS] of patients with left bundle branch block [LBBB]. Analytical study. Punjab Institute of Nuclear Medicine [PINUM], Faisalabad, Pakistan, from June 2002 to April 2003. MPS data of patients with LBBB was analyzed. Resting gated SPECT MPS was performed after an injection of 740 MBq 99mTc-MIBI in 10 normal and 25 subjects with LBBB [with low probability of coronary artery disease]. Visual and quantitative analyses were done on non-gated [NG], end diastolic [ED], end systolic [ES] images. Calculations included septal to lateral wall ratio [SLR], myocardial thickening [MT=% increase in counts during systole] at end systolic phase and myocardial thickening at peak level [% peak MT]. Septal hypoperfusion was noted in 19 [76%] patients on NG images and in only 1 [4%] patient on gated SPECT ED images. On NG images of LBBB group, SLR was lower than in controls [0.68 +/- 0.07 vs. 0.87 +/- 0.05, p<0.001]. SLR of LBBB patients approached to that of control group in gated SPECT ED data [0.86 +/- 0.06 vs 0.88 +/- 0.06, p=ns]. Myocardial thickening at ES for septum was markedly lower in LBBB group than in controls [21.83% ' 10.86 vs. 66.32% ' 20.15, p<0.001]. In patients with LBBB, reduced septal thickening results in artifactual septal perfusion defects. Gating the perfusion scintigraphy and reporting perfusion status on end diastolic frames in LBBB patients can eliminate these artifacts

Standardization of the techniques evaluating endothelial functions

Besides the well known etiological impact of asbestos, Simian virus 40 has been proposed as an important cofactor in the development of malignant pleural Mesothelioma [MPM]. New diagnostic modalities employed for analysis of serous effusions found a very high immunocytochemical expression of N-cadherin in MPM but not otherwise offering any additional tool in the differential diagnosis among MPM, adenocarcinoma and benign effusion. Pemetrexed and other drugs have shown some promise. Further understanding of the biology of this disease could lead to newer and more targeted treatments. This is an editorial

Diagnosis of coronary artery disease by stress Echocardiography and perfusion scintigraphy

This meta-analysis was performed to compare the diagnostic efficacy of stress echocardiography [SE] and Stress perfusion studies [SPS] in detecting coronary artery disease [CAD]. A meta-analysis of peer reviewed articles, published in English language, reporting head-to-head comparison of vasodilator stress echocardiography [VSE] and SPS for the diagnosis of CAD, was performed. Data of 13 studies comprising of 860 patients from 13 different institutions were analyzed. Algorithms were developed to generate raw data from published papers to calculate statistical parameters with confidence intervals and then compare them at specified significance levels. The overall diagnostic accuracy of the two tests was almost similar, 0.77 for VSE vs 0.8 for SPS [p=ns]. SPS gave higher sensitivity, 0.88 vs 0.70 in cumulative data [p<0.0001] while VSE gave higher specificity, 0.90 vs 0.67 [p<0.0001]. Accuracy of VSE with state-of-the-art protocols became even better than SPS [p<0.05]. In hypertensive patients specificity of SPS was markedly deteriorated. Contrary to this, VSE gave higher specificity [0.90 vs 0.40] in this subgroup of patients as well. VSE might become an effective alternative of SPS where scintigraphy techniques are not available or affordable

99mTc MAG3 and 99mTc DTPA; comparison to evaluate renal functions in renal transplant patients

Renal scintigraphy evaluates the renal function non-invasively. The present study was conducted to compare 99mTc MAG3 and 99mTc DTPA in renal transplant patients for the evaluation of renal functions. Materials and 99mTc MAG3 and 99mTc DTPA studies were performed on 33 renal transplant patients and 10 normal subjects, with 1 day interval in between the two studies. Renal transplant patients were categorized as normal, acute tubular necrosis, rejection, urine outflow obstruction and urinary tract infection groups on the basis of routine clinical investigations and preliminary results of scintigraphic studies. Both radiopharmaceuticals, 99mTc MAG3 and 99mTc DTPA were having equal diagnostic efficacy, however image quality with 99mTc MAG3 was superior to that of 99mTc DTPA. Renograms clearly differentiated various renal groups. Correlation between glomerular filtration rate [GFR] and effective renal plasma flow [ERPF] was good [r=0.89 at P<0.00001]. In terms of perfusion index [PI] our results with both agents were similar [r=0.96 at p<0.00001], clearly differentiating all cases of rejection from acute tubular necrosis. PI was raised in rejection cases, while normal in all other groups. In cases of acute tubular necrosis and rejection, 99mTc MAG3 based parenchymal retention index [R-20/3] was markedly raised, compared to that of 99mTc DTPA [p<0.00001]. 99mTc- MAG3 and 99mTc DTPA have equal diagnostic efficacy in renal transplant patients. However visual delineations of the kidneys is better with 99mTc MAG3, especially in cases with compromised renal functions