Synthesis and characterization of some coordinated metal and charge transfer complexes of isonicotinic acid hydrazide ligand with 2-hydroxyacetophenonylidene.

A new series of coordinated metal (Fe(III), Co(II) and Cu(II)) and charge transfer complexes of Schiff base isonicotinic acid (2-hydroxy acetophenonylidene) hydrazide (L) have been synthesized. The ligand (L), its metals and CT complexes were characterized by UV-Vis spectra, FT-IR, 1HNMR and elemental analysis as well as conductance measurements. The pKa of L was determined in universal buffer solutions (20% v/v EtOH-H2O) with varying pH's values. The molar conductivity measurements prove the non-electrolytic nature of all metal complexes. Furthermore, the thermogravimetry (TG) and differential thermal analysis (DTA) of the synthesized complexes were carried out in the range of 30-1000 °C. In addition, interaction of (L) as an electron donor with 2,3-dichloro-5,6-dicyano-1,4-benzoquinone (DDQ) as π-type electron acceptor has been studied and characterized. The observed new band at 585 nm might be assigned as charge transfer (CT) absorption band. The electronic absorption spectrum of L-DDQ interaction is found to be dependent on time. The IR spectra of L with the coordinated metals and CT-complexes revealed new main IR bands, which strongly support the formation of complexes. The stoichiometry of the complexes was determined from photometric titration methods which are in accordance with the results of elemental analyses. The ratio were found to be 1:2 (metal:L) and 1:1 (L:DDQ). The spectra of L, its coordinated metals and CT complexes are fully discussed.

The Evaluation of Cartilage Regeneration Efficacy of Three-Dimensionally Biofabricated Human-Derived Biomaterials on Knee Osteoarthritis: A Single-Arm, Open Label Study in Egypt.

Full thickness cartilage defects in cases of knee osteoarthritis are challenging in nature and are difficult to treat. The implantation of three-dimensional (3D) biofabricated grafts into the defect site can be a promising biological one-stage solution for such lesions that can avoid different disadvantages of the alternative surgical treatment options. In this study, the short-term clinical outcome of a novel surgical technique that uses a 3D bioprinted micronized adipose tissue (MAT) graft for knee cartilage defects is assessed and the degree of incorporation of such graft types is evaluated via arthroscopic and radiological analyses. Ten patients received 3D bioprinted grafts consisting of MAT with an allogenic hyaline cartilage matrix on a mold of polycaprolactone, with or without adjunct high tibial osteotomy, and they were monitored until 12 months postoperatively. Clinical outcomes were examined with patient-reported scoring instruments that consisted of the Western Ontario and McMaster Universities Arthritis Index (WOMAC) score and the Knee Injury and Osteoarthritis Outcome Score (KOOS). The graft incorporation was assessed using the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score. At 12 months follow-up, cartilage tissue biopsy samples were taken from patients and underwent histopathological examination. In the results, at final follow-up, the WOMAC and KOOS scores were 22.39 ± 7.7 and 79.16 ± 5.49, respectively. All scores were significantly increased at final follow-up (p < 0.0001). MOCART scores were also improved to a mean of 82.85 ± 11.49, 12 months after operation, and we observed a complete incorporation of the grafts with the surrounding cartilage. Together, this study suggests a novel regeneration technique for the treatment of knee osteoarthritis patients, with less rejection response and better efficacy.

Analysis of outcomes of endovascular embolisation: A cross-sectional two-center study on 46 visceral artery pseudoaneurysms.

PURPOSE: Visceral artery pseudoaneurysms (VAPAs) are uncommon in clinical practice but may have serious clinical outcomes up to death. Endovascular management is a safe effective alternative option to traditional surgical procedures. This study assesses the outcome of different embolic materials and techniques used in the endovascular management of VAPAs. MATERIALS AND METHODS: This is a two-center retrospective analysis of endovascular embolisation of 46 VAPAs, with a mean pseudoaneurysm size of 13 ± 11.35 mm, that were urgently managed between July 2018 and March 2020. Patients' presentations were GIT hemorrhage, intrabdominal hemorrhage, hematuria, and abdominal pain in 34.78%, 30.43%, 23.91%, and 10.87% respectively. Management using coils only was done in 28/46 patients (60.87%), NBCA glue only in 16/46 patients (34.78%), combined coils and NBCA glue in 1/46 patient (2.17%), and Amplatzer plugs only in 1 patient (2.17%). The management techniques were sac packing in 9/46 patients (19.57%), inflow occlusion in 28/46 patients (60.87%) and trapping in 9/46 patients (19.57%). All patients were followed-up for 1 year after the procedure. RESULTS: The overall clinical success and periprocedural complication rates were 93.48%, and 15.22% respectively, and 30-day mortality was zero. Clinical success was 92.86% in the coil subgroup (n = 28), and 93.75% in the NBCA glue subgroup (n = 16). The technical success rate was 100%. Effectiveness of the procedures during the follow-up was 97.83%. Target lesion re-intervention rate was 2.17%. CONCLUSION: Transarterial embolisation can provide high technical and clinical success rates with low periprocedural complication and re-intervention rates, as well as satisfactory procedure effectiveness in the management of VAPAs.

Insulin resistance in nondiabetic Egyptian patients with chronic hepatitis C virus. / Resistencia a la insulina en pacientes egipcios no diabéticos infectados con el virus de hepatitis C crónica.

INTRODUCTION AND OBJECTIVE: Insulin resistance and diabetes mellitus are frequently associated with chronic hepatitis C virus (HCV) infection, and it is thought that the presence of insulin resistance aggravates liver disease. We aimed to evaluate insulin resistance in nondiabetic Egyptian patients with chronic HCV infection. MATERIALS AND METHODS: Sixty nondiabetic patients with chronic HCV infection and 30 healthy nondiabetic non-HCV-infected volunteers were enrolled in our study. They were divided into 3 groups: group 1 included 30 patients with chronic HCV infection with no cirrhosis, group 2 included 30 patients with chronic HCV infection and cirrhosis of the liver, and group 3 included 30 healthy volunteers as controls. The entire study population underwent a detailed clinical history and physical examination, weight and height measurement, routine laboratory tests, and viral marker determination that included hepatitis B surface antigen and HCV antibodies. PCR analysis was carried out on the patients with positive HCV antibodies. Fasting blood sugar and fasting insulin levels were measured in all the patients, and insulin resistance was calculated according to the homeostasis model assessment of insulin resistance (HOMA-IR). RESULTS: Patients with cirrhosis of the liver (2 patients with Child class A, 12 patients with Child class B, and 16 patients with Child class C) showed higher insulin resistance levels (2.76±0.97) than the patients with chronic HCV infection and no cirrhosis (2.03±0.743) and the control group (1.22±0.38). The p value was significantly different between the 3 groups. There were direct and significant correlations between insulin resistance, fasting blood sugar, and fasting insulin levels. Patients with chronic HCV infection showed significantly higher fasting insulin and glucose levels than the control group. CONCLUSION: Chronic HCV-infected patients showed significantly higher insulin resistance levels than the normal population, even in the absence of hepatic dysfunction and cirrhosis.

All types of component malrotation affect the early patient-reported outcome measures after total knee arthroplasty.

PURPOSE: Outcomes following total knee arthroplasty (TKA), whether clinical, radiological or survival analysis, have been well-studied. Still, there are some concerns about patient satisfaction with the outcome of the surgery and factors that might contribute to a suboptimal result. This study aims to determine if there is correlation between primary TKA malalignment and early patient-reported outcome measures (PROMs). MATERIALS AND METHODS: Sixty patients, who had primary TKA and a minimum of 2 years of follow up, were recruited for a detailed clinical and radiological examination. Knee alignment was measured in the coronal, sagittal and axial planes. Normal and the outlier measurements of the patients' knees were defined and the clinical results (PROMs) compared to see if there was a statistically significant difference. RESULTS: Correlation between postoperative limb malalignment in the coronal and the sagittal planes and PROMs was not significant. Conversely, there was significant negative correlation between all types of malrotation and PROMs. CONCLUSIONS: Although malalignment has been linked to inferior outcome and implant survival, our results showed that coronal and sagittal limb malalignment has no significant effect on early PROMs. However, all types of component rotational malalignment significantly worsen early PROMs.

All types of component malrotation affect the early patient-reported outcome measures after total knee arthroplasty

PURPOSE@#Outcomes following total knee arthroplasty (TKA), whether clinical, radiological or survival analysis, have been well-studied. Still, there are some concerns about patient satisfaction with the outcome of the surgery and factors that might contribute to a suboptimal result. This study aims to determine if there is correlation between primary TKA malalignment and early patient-reported outcome measures (PROMs).@*MATERIALS AND METHODS@#Sixty patients, who had primary TKA and a minimum of 2 years of follow up, were recruited for a detailed clinical and radiological examination. Knee alignment was measured in the coronal, sagittal and axial planes. Normal and the outlier measurements of the patients' knees were defined and the clinical results (PROMs) compared to see if there was a statistically significant difference.@*RESULTS@#Correlation between postoperative limb malalignment in the coronal and the sagittal planes and PROMs was not significant. Conversely, there was significant negative correlation between all types of malrotation and PROMs.@*CONCLUSIONS@#Although malalignment has been linked to inferior outcome and implant survival, our results showed that coronal and sagittal limb malalignment has no significant effect on early PROMs. However, all types of component rotational malalignment significantly worsen early PROMs.

Transcatheter arterial chemoembolization of hepatocellular carcinoma in patients with celiac axis occlusion using pancreaticoduodenal arcade as a challenging alternative route.

INTRODUCTION: Celiac axis occlusion is a challenging condition when catheterization of the hepatic artery is required for chemoembolization of hepatocellular carcinoma (HCC). As a result, the hepatic artery has to be catheterized through the pancreaticoduodenal arcades (PDA) and the gastroduodenal artery (GDA) from the superior mesenteric artery (SMA) which is a tortuous course with acute angles and small caliber branches. OBJECTIVE: To assess new techniques for facilitating catheterization of the tortuous PDA and the GDA to reach the proper hepatic artery (PHA) and tumor-feeding branches in patients with celiac axis occlusion undergoing chemoembolization of HCC. METHODS AND MATERIALS: The study included eleven patients all admitted to do transcatheter arterial chemoembolization (TACE) for treatment of unresectable HCC. During angiography occlusion of the celiac axis was diagnosed and hypertrophied PDA and GDA was noted in SMA angiography. Catheterization of the PDA was performed by preshaping of the micro-guide wire into a wide curve. Catheterization of the PHA was a challenge and was achieved by reshaping of the micro-guide wire or by looping technique. TACE was done after super selective catheterization of the tumor feeding artery using a mixture of 50 mg of adriamycin, 7cc of lipiodol and gelfoam. RESULTS: In the eleven patients with celiac artery occlusion, DSA showed complete celiac axis occlusion in all patients. Collateral arteries supplying the liver were readily evident via PDA and GDA from SMA. Successful catheterization of the PHA was achieved in all patients. Chemoembolization was performed to all patients after super selective catheterization of the feeding artery. Follow-up triphasic CT was performed in all patients, 9 patients showed good lipiodol trapping with no residual tumor enhancement. Two patients required another session of TACE. CONCLUSION: Chemoembolization of HCC through the PDA and the GDA using micro-guide wire preshaping technique and the microcatheter looping technique in patients with celiac axis occlusion is a challenging but effective treatment for HCC.

Telomeric 1p36.3 deletion and Ki-67 expression in B-Non-Hodgkin's Lymphoma patients associated with chronic hepatitis C virus infection.

The hepatitis C virus (HCV) core protein is able to accumulate genetic p53 mutations and may be considered co-oncogenic. This study investigates 1p36.3 telomere deletion in B-non-Hodgkin's lymphoma (NHL) patients with chronic HCV infection using fluorescence in situ hybridization (FISH) in relation to survival to assess Ki-67 antigen expression. A study group and a control group of 100 patients with B-NHL (50 HCV positive and 50 HCV negative) and 60 control bone marrow biopsies were subjected to FISH for the detection of 1P36.3 deletion and to immunohistochemical staining with Ki-67 antigens. 1p36.3 deletion by FISH was detected in 40% of the study group, and Ki-67 was expressed in approximately 74% of patients. A significant difference was found between positive and negative HCV patients in their overall survival, the qualitative expression of Ki-67 and the quantitative detection of 1p36.3 deletion by FISH. The overall survival was shorter with the presence of an 1p36 deletion by FISH and HCV positive. We concluded that the coexistence of Ki-67 positivity, HCV positivity and 1p36.3 deletion may contribute to infection-related cancers at the 1p36.3 locus.

Repair of fistulae in-ano in children using image guided Histoacryl injection after failure of conservative treatment.

PURPOSE: Our aim is to determine the feasibility and safety of N Butyl Cyanoacrylate (HISTOACRYL), adhesive material in the treatment of fistula in-ano in infants and children. PATIENTS AND METHODS: 30 patients who presented with a perianal fistula (25 males and 5 females) were studied. Their ages ranged from 9 months to 15 years. All patients received medical (conservative) treatment. Six patients improved, 7 patients were subjected to surgical intervention, and the remaining 17 patients were managed by injection of adhesive material through the fistula under fluoroscopic guidance and general anesthesia after failure of medical management. RESULTS: Of the 17 children who underwent injection therapy to the fistula in-ano after failed medical management, 14 patients were males. The procedure time was 10 to 15 min. The mean follow up was 18 months. Two patients had a recurrence after one to two months. They were subjected to reinjection, and one of them had a second recurrence. Overall, 16 (94%) of 17 patients have had successful closure of their fistula, and one of them healed from a second injection. CONCLUSION: Our method of tissue adhesive Cyanoacrylate injection is safe, feasible, and can be used repeatedly in treatment of fistula in-ano in infants and children.

The antimony(III)-bridged heteropolyanion sandwich dimers [Sb(II3(A-α-XW9O34)2]11- (X = SiIV, GeIV and C-shaped double-sandwich [SbIII6O2(PW6O26)(A-α-PW9O34)2]15-.

Interaction of potassium antimony(iii) tartrate hydrate K(2)(SbC(4)H(2)O(6))(2)·3H(2)O with the trilacunary Keggin derivatives [A-α-XW(9)O(34)](10-) (X = Si(IV), Ge(IV)) and [A-α-PW(9)O(34)](9-) in aqueous acidic medium (pH 4.8) resulted in three novel polyanions, [Sb(3)(A-α-XW(9)O(34))(2)](11-) (X = Si(IV) (1), Ge(IV) (2)) and [Sb(6)O(2)(A-PW(6)O(26))(A-α-PW(9)O(34))(2)](15-) (3), which were isolated as the hydrated potassium salts K(11)[Sb(3)(A-α-XW(9)O(34))(2)]·31H(2)O (X = Si(IV) (K-1), Ge(IV) (K-2)) and the mixed potassium-sodium salt K(14)Na[Sb(6)O(2)(A-PW(6)O(26))(A-α-PW(9)O(34))(2)]·61H(2)O (KNa-3) salts, respectively, and characterized by single-crystal X-ray diffraction, IR spectroscopy, as well as elemental and thermogravimetric analyses. The Sb(III)-containing polyanions 1-3 possess unique structural features, as they represent the first examples of sandwich-type POMs with trigonal-pyramidal Sb(III)O(3) linkers. The stability of 1-3 in aqueous media was investigated by multinuclear ((183)W, (31)P) NMR and UV-Vis spectroscopy.

Interaction of thiazolidine-2-thione with 2,3,5,6-tetrabromo-1,4-benzoquinone: a set of sequential interactions involving redox and substitution reactions after an initial charge transfer complexation.

Interaction between thiazolidine-2-thione (T2T) as an electron donor and 2,3,5,6-tetrabromo-1,4-benzoquinone (p-bromanil, BRL) as a π-electron acceptor has been studied by using several spectral techniques, viz. UV/visible, IR, (1)H NMR and Mass spectra. A substitution reaction has been occurred after an initial formation of a CT complex, meanwhile a redox reaction has been occurred, in situ, too in which the interacting donor (T2T) has been oxidized to the corresponding thiazole. Thus, the stoichiometric ratio of this interaction has been found to be 2:1, T2T:BRL. However, the most interesting finding is that unexpectedly neither the SH group of the thiol form nor the NH group of the thione form of the T2T has shared in the substitution reaction with BRL. This finding has been confirmed by the different applied spectral tools, whereas a plausible reaction pathway has been illustrated and discussed.

Preoperative embolization in surgical management of massive thoracic tumors.

BACKGROUND: The surgical excision of a highly vascular giant tumor may be challenging. The aim of this study was to describe our experience with preoperative percutaneous embolization of massive vascular chest tumors before surgical excision. METHODS: From 2009 to 2011, 8 cases of giant vascular thoracic tumor were treated at Assiut University Hospital, Assiut, Egypt, by preoperative embolization of the feeding arteries followed by successful excision after 48 h. RESULTS: The median age of the 8 patients was 39 years. Embolization of their tumors resulted in a reduction of tumor size, and minimal blood loss was observed perioperatively. Perilesional edema and easy differentiation of ischemic tissue facilitated complete surgical removal of the tumors. CONCLUSIONS: Preoperative embolization of giant vascular thoracic tumors is useful to decrease perioperative blood loss and facilitate total excision.

Multiple and sequential charge transfer interactions occurring in situ: A redox reaction of thiazolidine-2-thione with 2,3-dichloro-5,6-dicyano-1,4-benzoquinone.

Interaction of thiazolidine-2-thione (T2T) as an electron donor with 2,3-dichloro-5,6-dicyano-1,4-benzoquinone (DDQ) as an electron π-acceptor has been studied. Electronic absorption spectra of the system T2T-DDQ in several organic solvents of different polarities have been measured. A charge transfer (CT) complexation has occurred between T2T and DDQ. This CT interaction has led to a redox reaction in which T2T has been oxidized to the corresponding dehydrogenated T2T (T2T-2H), meanwhile DDQ has been fully reduced to the corresponding hydroquinone (DDQH2). However, the two new species, resulting in situ, have been interacted, whereas a CT complex having the formula (T2T-2H·DDQH2) has occurred. IR, 1H NMR and mass spectra were used for ascertaining the structural formula of the synthesized CT complex. Formation constants (KCT), molar absorption coefficients (ɛCT) and thermodynamic properties of this CT interaction in various organic solvents were determined and discussed. The obtained KCT and ɛCT values have indicated that T2T-2H is a weak CT donor, whereas the formed CT complex has a low stability and it is classified as a contact-type CT complex.

Supraumbilical pyloromyotomy: a comparative study between intracavitary and extracavitary techniques.

BACKGROUND: Infantile hypertrophic pyloric stenosis (IHPS) is the most common cause of nonbilious vomiting in infancy, with an incidence of 1 to 3 per 1000 live births. Different approaches have been advocated for pyloromyotomy aiming to achieve better cosmetic results with least possible complications. Although many studies have shown that the umbilical pyloromyotomy is as safe as the traditional right upper quadrant approach with superior cosmetic results, still few studies reports high complication rates. The aim of this study was to assess intracavitary pyloromyotomy (ICP) in comparison with extracavitary pyloromyotomy (ECP) regarding the operative time, operative and postoperative complications, time to return to full oral feeding, and duration of hospital stay, as well as the final cosmetic results through supra umbilical skin incision. PATIENTS AND METHODS: Forty patients with IHPS were admitted to Assiut University Children Hospital from January 2008 to June 2010 and operated through supra umbilical incision. They were randomly divided according to the surgical technique into 2 groups: ECP group (20 patients) and ICP group (20 patients). The evaluating parameters were: pyloric muscle thickness, operative time, operative and postoperative complications, time to return to full oral feeding, duration of hospital stay, and final cosmetic results. RESULTS: There was no statistical significant difference between both groups regarding the patient's age, weight, pyloric muscle thickness, and duration of hospital stay. No mortality was encountered among all patients. There was a statistical significant difference between both groups regarding the mean operative time and time to return to full oral feeding. During the follow-up period (ranged from 6 weeks to 8 weeks) all patients were gaining weight satisfactorily and the scar was barely visible. CONCLUSIONS: ICP for pyloromyotomy is safe and can be done in large pyloric masses without wound extension. It gives best cosmetic results with minimal complications.

In vitro simulation of the chemical scenario of the action of an anti-thyroid drug: charge transfer interaction of thiazolidine-2-thione with iodine.

Thiazolidine-2-thione (T2T) has been studied spectrophotometrically by UV-visible and IR spectra. The spectral studies have indicated that T2T has two tautomeric forms, namely thione and thiole forms, in addition to the dimeric thioamide complex existing as a hydrogen-bonded dimer of two thione forms. Interaction of the T2T as an electron donor with iodine as a typical σ-type acceptor has been studied spectrophotometrically. Electronic absorption spectra of the system T2T-I2 in several organic solvents of different polarities have performed a clear charge transfer (CT) band in each spectrum. Formation constants (KCT) and molar absorption coefficients (ɛCT) and thermodynamic properties, ΔH, ΔS, and ΔG, of this system in various organic solvents were determined and discussed. The stoichiometric ratio of the T2T-I2 system in solutions was found to be 1:1 T2T:I2, whereas the elemental analysis of the prepared solid CT complex has illustrated the same stoichiometry. The obtained KCT and ɛCT values have indicated that T2T is a donor of moderately strength capable of interacting with the iodine just to form the corresponding CT complex with an iodine molecule without further reducing of the iodine to either of the corresponding poly-iodide ions viz. I3-, I5-, etc. This action of spongy trapping of iodine simulates in vitro the chemical scenario of the anti-thyroid action of this compound.

Nuclear medicine methods for evaluation of skeletal infection among other diagnostic modalities.

Skeletal infection continues to be a common and difficult condition in clinical practice and early accurate diagnosis is very challenging. Clinical and laboratory features of skeletal infections are not always present, may be confusing, and are nonspecific for bone infection in its early stages, therefore, several imaging modalities are used for early detection of osteomyelitis. Plain films should always be the first step in the imaging assessment of osteomyelitis, however, the sensitivity for X-ray radiography has been reported to range from 43% to 75%, and the specificity from 75% to 83%. Over years, scintigraphic procedures have become an essential part of the diagnostic procedure for osteomyelitis. The standard approach for bone scintigraphy with tech 99mTc labeled methylene diphosphonate to assess for osteomyelitis is to perform a three-phase procedure. The positive uptake on all three phases is highly sensitive for osteomyelitis (sensitivity 73% to 100%). 67Ga citrate gained more attention for the more specific diagnosis of osteomyelitis due to its known capacity to localize in cases of active infection and pus. The reported specificity for 67Ga scintigraphy in osteomyelitis is around 67-70% and the specificity is much higher (92%) when 67Ga single photon emission tomography was obtained. Labeled white blood cell (WBC) imaging has become the procedure of choice to diagnose most cases of skeletal infections except for those of the spine. Labeling of leucocytes can be done either by 111In or 99mTc labeled hexamethylpropylene amineoxime. The sensitivity and specificity for labeled WBCs are in the high range of 80% to 90%. [18F]fluorodeoxyglucose positron emission tomography (PET) has been found to accumulate non-specifically at sites of infection and inflammation. Investigational studies showed that PET is particularly valuable in the evaluation of chronic osteomyelitis and infected prostheses. Other imaging modalities include sonography, computed tomography (CT) and magnetic resonance imaging (MRI). The sensitivity and specificity of CT for the diagnosis of osteomyelitis has not been established clearly and are in the range of 65% to 75%. The sensitivity of MRI for osteomyelitis has been generally reported as being between 82% and 100%, and specificity between 75% and 96%. Cases of osteomyelitis commonly referred to diagnostic imaging departments include chronic osteomyelitis, diabetic foot infections, vertebral osteomyelitis, joint prostheses and patients with suspected reinfection. These specific entities need special attention and careful selection of the correct tracer or combination of imaging modalities that is best suited for the proper therapeutic management protocols.

Imaging bacterial infection with (99m)Tc-ciprofloxacin (Infecton).

AIMS: The diagnosis of deep seated bacterial infections, such as intra-abdominal abscesses, endocarditis, and osteomyelitis, can be difficult and delayed, thereby compromising effective treatment. This study assessed the efficacy of a new radioimaging agent, Tc-99m ciprofloxacin (Infecton), in accurately detecting sites of bacterial infection. METHODS: Eight hundred and seventy nine patients with suspected bacterial infection underwent Infecton imaging and microbiological evaluation. The sensitivity and specificity of Infecton in detecting sites of bacterial infection were determined with respect to Centres of Disease Control, World Health Organisation, and Dukes's criteria. RESULTS: Five hundred and seventy four positive and 295 negative images were produced. These included 528 true positives, 46 false positives, 205 true negatives and 90 false negatives, giving an overall sensitivity of 85.4% and a specificity of 81.7% for detecting infective foci. Sensitivity was higher (87.6%) in microbiologically confirmed infections. CONCLUSIONS: Infecton is a sensitive technique, which aids in the earlier detection and treatment of a wide variety of deep seated bacterial infections. The ability to localise infective foci accurately is also important for surgical intervention, such as drainage of abscesses. In addition, serial imaging with Infecton might be useful in monitoring clinical response and optimising the duration of antimicrobial treatment.

201Tl single photon emission tomography in the evaluation of residual and recurrent astrocytoma.

Twenty-five patients with malignant astrocytoma, either postoperatively (15 cases) or with recurrent tumour versus gliosis (10 cases) were included in this study. 201Tl single photon emission computed tomography (SPECT) was performed with the calculation of early and delayed uptake values and retention index. A high mean value of early and delayed uptake correlated with a low retention index in patients with high-grade astrocytoma in both postoperative residual and recurrent groups, versus a lower mean value of early and delayed uptake with a high retention index in patients with low-grade tumours. All postoperative cases with high-grade astrocytoma had high 201Tl uptake > 1.5, whereas 66.6% of cases with low-grade astrocytoma had low 201Tl uptake < 1.5. There was a correlation between retention index of 201Tl and tumour grade with r = 0.47. Also, recurrent cases showed remarkable differences in early and delayed 201Tl uptake (P < 0.05) and retention index (P < 0.001) compared with postradiation gliosis. There was a higher sensitivity in detection of tumour viability by 201Tl SPECT of 100% versus 80% using computed tomographic scanning and in the differentiation between recurrent tumour and postradiation gliosis.

Tympano-cartilago-stapediopexy: a method to improve hearing in open technique tympanoplasty.

Canal wall-down technique tympanoplasty was indicated in about 41 per cent of our cases with chronic suppurative otitis media. In this series done during the last four years, of 576 tympanoplasties, 240 cases needed type III tympanoplasty. In 145 cases, myringostapediopexy was carried out using temporalis fascia grafting over the head of the stapes. Tympano-cartilago-stapediopexy was performed in the other 95 cases by using tragal cartilage and perichondrium over the stapes. A comparison between the results of both methods of grafting is discussed. Improvement in hearing was achieved after tympano-cartilago-stapediopexy. This method proved to be suitable for those cases which need open technique tympanoplasty.

Crystallographic study of rhinoliths.

Five nasal stones were extracted from five patients. The etiology and clinical picture have been discussed. The stones were analysed by a crystallographic method, using an X-ray diffraction technique. Their composition was identified as calcium phosphate.