A comprehensive overview of radioguided surgery using gamma detection probe technology

The concept of radioguided surgery, which was first developed some 60 years ago, involves the use of a radiation detection probe system for the intraoperative detection of radionuclides. The use of gamma detection probe technology in radioguided surgery has tremendously expanded and has evolved into what is now considered an established discipline within the practice of surgery, revolutionizing the surgical management of many malignancies, including breast cancer, melanoma, and colorectal cancer, as well as the surgical management of parathyroid disease. The impact of radioguided surgery on the surgical management of cancer patients includes providing vital and real-time information to the surgeon regarding the location and extent of disease, as well as regarding the assessment of surgical resection margins. Additionally, it has allowed the surgeon to minimize the surgical invasiveness of many diagnostic and therapeutic procedures, while still maintaining maximum benefit to the cancer patient. In the current review, we have attempted to comprehensively evaluate the history, technical aspects, and clinical applications of radioguided surgery using gamma detection probe technology

The postprandial changes in glucose (a), proinsulin (b), insulin (c), free fatty acid (FFA) (d) and triglyceride (TG) (e) concentrations are shown for 180 min after the ingestion of the standardized test meal (mean ±)

<p><b>Copyright information:</b></p><p>Taken from "Gastric bypass alters the dynamics and metabolic effects of insulin and proinsulin secretion"</p><p></p><p>Diabetic Medicine 2007;24(11):1213-1220.</p><p>Published online Jan 2007</p><p>PMCID:PMC2121126.</p><p>© 2007 The Authors. Journal compilation © 2007 Diabetes UK</p> , Morbidly obese (MO) subjects; , MO subjects treated with gastric bypass (GBP) surgery; , normal weight (NW) control subjects. Glucose: a rapid increase in glucose concentration during the first 30–60 min (early phase) was observed in the GBP-treated group compared with MO subjects (30 min, < 0.001; 60 min, = 0.002) and NW control subjects (30 min, < 0.001; 60 min, = 0.015). In the late phase after ingestion (120–180 min), glucose was significantly lowered in the GBP-treated group compared with MO subjects (120 min, = 0.009; 180 min, = 0.004) and NW control subjects at 180 min ( 0.02). Proinsulin: at all postprandial time points, except at 30 min, proinsulin concentrations were higher in MO than in control subjects ( 0.030–0.008). Early-phase proinsulin concentrations were higher in the GBP-treated group compared with control subjects (30 min, = 0.002; 60 min, = 0.006), but were similar to the MO group. In the late phase, concentrations of plasma proinsulin were significantly lower in the GBP-treated group compared with the MO group (120 min, = 0.048; 180 min, = 0.009), and the GBP-treated group had similar concentrations to control subjects (120 min, = 0.307; 180 min, = 0.814). Insulin: the GBP-treated group had a rapid increase in insulin concentration at 30 min in the early phase that had decreased at 60 min (30 min, = 0.001; 60 min, = 0.026) compared with control subjects. The late-phase insulin response was significantly higher in the MO group compared with the GBP-treated group (120 and 180 min, < 0.001). Insulin concentrations during the late phase in the GBP-treated group did not differ from control subjects (120 min, = 0.072; 180 min, = 0.130). Free fatty acids: no differences were observed regarding postprandial changes between the three groups, except at 180 min, where FFA were higher in the GBP group ( 0.016). Triglycerides: no differences were observed regarding postprandial changes between the three groups, except at 180 min, where TG were higher in the MO group ( 0.001)