Current imaging methods for assessing Graves` orbitopathy activity with particular emphasis on FDG-PET.

The most frequent extrathyroidal Graves' disease manifestation is Graves' orbitopathy (GO). The treatment of GO is determined by its severity and activity. There is currently no reliable, impartial method for assessing it clinically or distinguishing fibrosis from active inflammatory disorders. Today, imaging methods including orbital ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) are frequently employed to show pathological abnormalities in the ocular adnexa of GO patients. In addition, a not widely accepted technique - 99mTc-DTPA SPECT - has some potential to evaluate retrobulbar inflammation in GO patients. However, FDG-PET/CT is possibly superior to other imaging modalities in detecting inflammation in GO and it may be useful in assessing disease activity in case of clinical or serological uncertainty. It might also act as an early indicator of GO development and its aggravation before irreversible tissue alterations take place and may be used in the differential diagnosis of inflammatory disorders of the orbit. However, before FDG-PET/CT could be applied in daily clinical practice, the methodology of GO activity assessment with defined cut-off values for radionuclide concentration - standardized units of value (SUV) have to be established and validated. In addition, the limitations of this technique have to be recognized.

[Assessment of prevalence of intrapulmonary arterio-venous shunt in cirrhotic patients qualified to liver transplantation]. / Czestosc wystepowania plucnego przecieku krwi u chorych z marskoscia watroby kwalifikowanych do leczenia transplantacyjnego.

INTRODUCTION: Hepatopulmonary syndrome (HPS) is the clinical relationship between hepatic dysfunction and the arterial hypoxygenation caused by significant intrapulmonary arteriovenous blood leakage. HPS is responsible for increased peritransplant mortality. Data on prevalence of HPS are contradictory and its clinical risk factors are still unknown. Aim of the study was assessment of prevalence of HPS in cirrhotic patients qualified to liver transplantation and determination of clinical risk factors of this syndrome. MATERIAL AND METHODS: The study involved 30 patients with advanced liver cirrhosis of different etiology, qualified to liver transplantation. In all patients the laboratory hepatic examinations, pulmonary function tests (spirometry, gasometry) and albumin lungs-brain scintigraphy were performed. RESULTS: We did not find symptomatic HPS in the investigated group, but 2 patients (6.6%) with alcoholic cirrhosis showed arterio-venous intrapulmonary shunt. No significant differences in demographic and clinical data were found between patients with and without intrapulmonary shunt. CONCLUSIONS: Symptomatic HPS is rare complication of advanced cirrhosis. Symptom free intrapulmonary shunt occurs in less than 10% of patients, however, significance and clinical risk factors of this phenomenon remain unknown.

[Evaluation of gastric motility in obesity]. / Ocena czynnosci motorycznej zoladka w otylosci.

UNLABELLED: There are conflicting information about differences of gastric emptying rate between lean and obese subjects and lack of information concerning antral motility in both groups. It has been suggested that obesity is associated with an altered rate of gastric emptying, but the results of earlier studies examining gastric emptying rates in obesity have proved inconsistent. AIM: The purpose of this study was to compare gastric emptying rate and antral motility in obese and lean subjects. MATERIALS AND METHODS: Gastric antral motility and gastric emptying were measured after consumption of sweet omelette in 2 groups of patients: 10 obese (BMI mean = 33.18) and 10 lean subjects (BMI mean = 22.16) using a scintigraphic technique. Lag phase was assessed by physiologic and mathematic approach. Gastric area was calculated using a computer programme (Diacam-Siemens). RESULTS: There was no difference in gastric emptying profiles; the mean gastric contents after 2 hours of assessment in obese and lean groups was 69% and 71.6%, respectively. Gastric antral motility parameters such as contraction amplitude and frequency, relaxation and contraction time were not differing between the groups. Only in the 90th minute of the assessment a significant difference in contraction time was found. There were also no differences in gastric area and duration of lag phase. No significant correlation between height, BMI, gastric area and body area was found in both groups. CONCLUSIONS: There are no differences in the rate of gastric emptying and gastric antral motility between lean and obese subjects. No correlation between BMI, height, body area and gastric area was found. This findings deny the common opinion suggesting that obese people have bigger stomach which empties more rapidly than in lean subjects.