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

An unusual movement of the tongue

WOS: 000220063300069PubMed: 1475826

Frontotemporal hypoperfusion detected by Tc-99m HMPAO SPECT in a patient with olfactory reference syndrome

WOS: 000236318300014PubMed: 16516069Olfactory reference syndrome (ORS) is a rare psychiatric condition with an unclear etiology showing great interindividual variance in its course and treatment response. Although the core symptom of the disease is preoccupation with imagined body odor that persists despite reassurance, clinical presentations mimic various psychiatric illnesses. There have been several case reports of underlying general medical conditions related to ORS, such as epilepsy, arteriovenous malformation and substance abuse. However, to our knowledge, there has been no report on regional blood flow changes detected in patients with ORS. In this brief report, we present the case of a patient with ORS who underwent unnecessary surgery and was referred twice by surgeons. The phenomenology, nosological features and differential diagnosis of ORS are also discussed with regard to its relationship with affective disorders. (c) 2006 Elsevier Inc. All rights reserved

Frontotemporal hypoperfusion detected by Tc-99m HMPAO SPECT in a patient with olfactory reference syndrome

Olfactory reference syndrome (ORS) is a rare psychiatric condition with an unclear etiology showing great interindividual variance in its course and treatment response. Although the core symptom of the disease is preoccupation with imagined body odor that persists despite reassurance, clinical presentations mimic various psychiatric illnesses. There have been several case reports of underlying general medical conditions related to ORS, such as epilepsy, arteriovenous malformation and substance abuse. However, to our knowledge, there has been no report on regional blood flow changes detected in patients with ORS. In this brief report, we present the case of a patient with ORS who underwent unnecessary surgery and was referred twice by surgeons. The phenomenology, nosological features and differential diagnosis of ORS are also discussed with regard to its relationship with affective disorders. (c) 2006 Elsevier Inc. All rights reserved

Vasculo-Behcet's disease mimicking a metastatic neck mass

WOS: 000228094200010PubMed: 15802878This article presents a case of Behcet's Disease (BD) with vascular involvement of the neck, which mimicks a metastatic neck mass in the initial presentation. A 58-year-old man presented with dysphagia, weight loss, bulging on the lateral, wall of the left pyriform sinus, and a firm and fixated neck mass suggestive of metastasis. Computed tomography of the neck demonstrated a solid mass, around the bifurcation of the carotid artery together with a pseudoaneurysm of the left external carotid artery. The mass was about four centimeters in diameter and extended to hypopharynx medially. Biopsy from neck mass and hypopharynx revealed no specific pathology. During follow-up the firm and fixated mass changed into a completely pulsatile one in the following three weeks. Reassessment of the patient's past history in detail revealed that he had had recurrent oro-genital ulcers, arthralgia and recurrent skin lesions. The pathergy test was positive. The patient was diagnosed to be BD and treatment consisting of colchicine 1 mg/day, peroral was started. He had a favorable outcome after treatment and was asymptomatic at follow-up of 24 months. It is unusual for BD to present as a neck mass but yet it must be considered in the differential diagnosis of neck masses. The present case report demonstrates how such a mass may mimic metastatic tumoral involvement and cause diagnostic dilemma. (c) 2005 Tohoku University Medical Press

Evaluation of nasal mucociliary functions with rhinoscintigraphy in coal workers' pneumoconiosis

WOS: 000230678900007PubMed: 15983442Objective: To compare nasal mucociliary clearance (NMC) functions in coal workers with pneumoconiosis, coal workers without pneumoconiosis and healthy controls by using technetium-99m-labeled macroaggregated albumin rhinoscintigraphy. Methods: Sixty-five of the 86 coal workers were clinically documented as suffering from coal workers' pneumoconiosis (CWP group). CWP workers were divided into two groups according to smoking status: 44 smokers (CWP-S) and 21 nonsmokers (CWP-NS). Twenty-one workers without pneumoconiosis (NCWP group) were similarly divided into two groups: 12 smokers (NCWP-S) and 9 nonsmokers (NCWP-NS). Thirty-three healthy male volunteers were selected for the control group [ 15 smokers (control-S), 18 nonsmokers (control-NS)]. The half-time (t(1/2)) value for the clearance of the radiopharmaceutical was calculated for each patient. Results: Mean t(1/2) values for CWP-S, CWP-NS, NCWP-S, NCWP-NS, control-S and control-NS were 25.10 +/- 7.75, 10.97 +/- 3.24, 14.68 +/- 4.98, 9.17 +/- 3.71, 19.15 +/- 5.04 and 15.08 +/- 5.11, respectively ( p < 0.001, Kruskal-Wallis variance analysis). Further, mean t(1/2) values of smokers versus nonsmokers in CWP, NCWP and control groups were compared, and it was found that although smoking prolonged nasal transport time in all three groups, the difference was significant only in the CWP group ( p < 0.001, p < 0.023 and p < 0.027, respectively, Bonferroni-adjusted Mann-Whitney test). Conclusion: Our findings demonstrated a synergistic detrimental effect of smoking with coal dust exposure on nasal transport time. Copyright (C) 2005 S. Karger AG, Basel

Prevalence of obstructive sleep apnea syndrome and associated symptoms in 3-11-year-old Turkish children

Our objective was to investigate the prevalence of sleep-disordered breathing (SDB) and obstructive sleep apnea syndrome (OSAS) in 3-11-year-old Turkish children. A cross-sectional study was conducted in Zonguldak, northwestern Turkey Symptomatic children were identified by using a self-administered questionnaire and were classified into three groups: nonsnorers, occasional snorers, and habitual snorers. All habitual snoring children were invited to undergo polysomnography (PSG). Nine hundred fifty-four children (79.5%) were nonsnorers, 205 (17.2%) were occasional snorers, and 39 (3.3%) were habitual snorers. There was no significant relationship between gender and habitual snoring (male, 3.4%; female, 3.1 %; P > 0.05; odds ratio (OR), 1.13; 95% confidence interval (CI), 0.59-2.14). There was a statistically significant relationship between habitual snoring and allergic rhinitis (OR, 4.23; 95% Cl, 2.14-8.35). Fourchildren who snored every night, and who had apnea spells and/or troubled sleep, underwent adenoidectomy and/or tonsillectomy before polysomnographic evaluation because of clinical detoriation. Twenty-eight of 39 children with habitual snoring participated in PSG evaluation. PSG revealed that 11 children (0.9% of the total population) had OSAS. When 4 operated children were added to these 28 children, we found the minimum prevalence of OSAS to be 1.3% in our study group. There was a significant correlation between OSAS and troubled sleeping (P < 0.001; OR, 4.37; 95% Cl, 1.33-14.3). We found the prevalence of habitual snoring to be 3.3% in Turkish children by using self-administered questionnaires. Allergic rhinitis was significantly correlated with habitual snoring. Minimum estimated prevalence of OSAS was found to be 1.3%. (C) 2005 Wiley-Liss,lnc

Classroom use, blended learning

This is a Living reference work entry, first published online in April 2019