Prominent Tc-99m MIBI skeletal uptake in renal osteodystrophy: a possible role for whole-body scanning

Renal osteodystrophy is a process whereby renal failure causes profound bone disease. Effects on bone include osteosclerosis, osteomalacia, osteoporosis, pathologic fractures, aseptic necrosis of the hips, and bone pain. The authors present a case of renal osteodystrophy with intense Tc-99m 2-methoxy isobutyl isonitrile (MIBI) radiotracer uptake in the mandible and propose that Tc-99m MIBI may have a potential role in diagnosing renal osteodystrophy.     

Dietary fish oil increases lipid mobilization but does not decrease lipid storage-related enzyme activities in adipose tissue of insulin-resistant,sucrose-fed rats

Fish oil feeding has been shown to limit visceral fat accumulation in insulin-resistant rats. Our goal was to determine whether this finding is due to increased fat mobilization or decreased lipid storage. Adipocytes were isolated from rats fed for 3 wk a diet containing 57.5 g/100 g sucrose and 14 g/100 g lipids as either fish oil (SF) or a mixture of standard oils (SC); there was also a reference group (R). Substituting fish oil for standard oils protected rats from visceral fat hypertrophy, hypertriglyceridemia and hyperglycemia. The stimulation of lipolysis was greater in adipocytes isolated from SF-fed rats than in those from SC-fed rats. Fatty acid synthase (FAS) activity was markedly lower in the liver but not in the adipose tissues of rats fed SF. Lipoprotein lipase (LPL) activity was 2.2-fold higher in the adipose tissues but not in the muscle in rats fed the SF diet than in those fed the SC diet. The decrease in visceral fat in rats fed fish oil could be attributed to decreased plasma triacylglycerol concentration and/or increased lipid mobilization rather than to reduced lipid storage.     

Precancerous lesions of the buccal mucosa

OBJECTIVES: We analyzed data in the literature in comparison with experience at the Department of Cancer and Oral pathology of the Stomatology and Maxillo-Facial Surgery division of la Salpêtrière Hospital on precancerous lesions of the oral mucosa, in order to establish definitions and describe epidemiological, clinical, histological findings as well as natural history and treatment outcome. MATERIAL AND METHODS: Three literature sources were analyzed: Medline and Current Contents searches, books and references listed in articles. The following key words were used and classed into three groups; 1) oral mucosa, epidemiology, precancerous lesions, malignant transformation, dysplasia, leucoplakia, oral lichen planus, erythroplasia, verrucous, cheilitis, candidosis, immunodepression, 2) oral mucosa, tumor markers, carcinogens, keratin, keratinocytes, gene, nuclear proteins, p53 protein, Ki-67 antigen, 3) oral mucosa, therapy, prevention, nutrients. The period chosen ran from 1980 to 1998. This automatic literature search was completed by systematic manual search of summaries in specialized journals published in 1997-1998. The lists of references in the identified articles were consulted and furnished the principal publications concerning precancerous lesions of the buccal mucosa. In all 383 references were selected and analyzed by level of scientific proof. Among these 135 are cited in the text. If data in the literature were insufficient, the physicians at the Department of Cancer and Oral pathology of the Stomatology and Maxillo-Facial Surgery division of La Salpêtrière Hospital were consulted to provide their experience-based recommendations. RESULTS AND DISCUSSION: Clear and practical definitions drawn from current knowledge were adopted. Precancerous lesions were distinguished from precancerous states. Precancerous lesions included chronic lesions of the oral cavity on which cancer of the oral cavity is known to develop. These were: leucoplakia, oral lichen planus, erythroplasia, papillomatous lesions, actinic cheilitis, submucosal fibrosis, keratotic candidosis, and tertiary syphilis. The precancerous states included cancers occasionally observed in the oral cavity: immunodepression and Plummer Vinson syndrome were analyzed. Epidemiological, clinical, histological, and evolutive data as well as therapeutic strategies were described. A decisional algorithm was elaborated for leucoplakia. The text was enriched with images available in the Department. CONCLUSION: Precancerous lesions of the oral mucosa offer a particularly interesting area of research for understanding the process of cancer formation and its prevention. The level of scientific proof available in the large majority of the published reports is low. Few recent publications provide relevant data. In practice, the experience in the management of cancer and precancerous lesions of the oral mucosa accumulated over the last 40 years at the Department of Cancer and Oral pathology of the Stomatology and Maxillo-Facial Surgery division of la Salpêtrière Hospital provides an invaluable source of information.     

HBA1c: clinical and biological agreement for standardization of assay methods. Report by the experts of ALFEDIAM (Association de Langue Fran?aise pour lEtude du Diabète et des Maladies Métabolique) and SFBC (Société Fran?aise de Biologie Clinique)]

Glycohaemoglobin, and particularly haemoglobin A1c(HbA1c), assays have been used for many years to retrospectively evaluate the glycaemic control of diabetic patients. Cut-off values have been established for deciding treatment modifications. The techniques used in the laboratories however exhibit varying quality, and all of them are not yet standardized. The consequence is an under-utilization of this test, especially in non-hospital practice. In this context, working groups of Société Fran?aise de Biologie Clinique (SFBC), Association de Langue Fran?aise pour l'Etude du Diabète et des Maladies Métaboliques (ALFEDIAM) and Société Fran?aise d'Endocrinologie (SFE) have met together, in order to analyze the national status, and to propose practical recommendations for implementing a standardization process on the basis of international experiences. It is recommended to exclusively express results as HbA1c percentage, using methods standardized and certified by comparison to reference methods such as those using Diabetes Control and Complications Trial (DCCT) values. Simultaneously, contacts have been established with manufacturers, and the realisation of periodic quality control surveys was encouraged.     

Factors affecting the outcome of ureteroscopy in the management of ureteral stones in children

Purpose  

To identify the factors involved in failure and post-operative complications of retrograde rigid ureteroscopy (URS) in the treatment of ureteric stones in children.