The comparison of dual phase Tc-99m MIBI and Tc-99m MDP scintimammography in the evaluation of breast masses: Preliminary report

The aim of this prospective study was to determine the diagnostic value of Tc-99m MDP scintimammography (SMG) for the detection of breast cancer in patients with breast masses and to compare the results with Tc-99m MIBI scintimammography. Twenty patients, categorized as suspicious, positive or benign for breast cancer according to the mammographic findings were included in the study. Dual phase Tc-99m MIBI and Tc-99m MDP SMG were performed in the prone lateral position within 5 days of each other. Although early and late Tc-99m MIBI SMG showed equal (90.4%) sensitivity, the specificity of late Tc-99m MIBI (87.5%) was found superior to early (62.5%) imaging. The overall sensitivity and specificity of early Tc-99m MDP SMG were 71.4% and 62.5%, respectively. Although late Tc-99m MDP imaging showed 100% specificity, its sensitivity was only 23.8%. In the patients with palpable masses, both early Tc-99m MDP and Tc-99m MIBI showed equal sensitivity (100%), but the sensitivity of early Tc-99m MIBI (37.5%) was found slightly higher than Tc-99m MDP (25.0%) for nonpalpable breast lesions. The sensitivity of Tc-99m MIBI and Tc-99m MDP SMG in detecting metastatic axillary involvement was 66.6% and 50%, respectively. High sensitivity and specificity together with its low cost, easy availability and the possibility of detecting bone metastases seems to make Tc-99m MDP a contributive agent in the evaluation of breast lesions as an alternative to Tc-99m MIBI.     

Settlement of Soil Reinforced with Vertical Fiberglass Micro-Piles

This article is dedicated to investigating the properties of soil after its reinforcement with fiberglass elements through large-scale laboratory plate-load tests of various samples that varied in the numbers and lengths of the reinforcing elements. The investigation of the vertical elements considered the diameter increase at the bottom toe by using widening washers. The results were compared relative to each other and to the theoretical calculation results. The theoretical calculations for the settlements were undertaken based on the authors’ proposed method. The method considers the number, shape, area and material of the strengthening elements using a pre-proposed reinforcement area factor µ. This pre-established factor was calculated with reference to the elements’ geometry—the diameter of the vertical elements and the bottom’s washer diameter—which determined the reinforcement area. A comparison between the reinforced and reference soft sandy soil samples indicated a 25% increase in the deformation modulus after the reinforcement process at a pressure of 25 kPa. Samples with µ ranging from 1.20 to 1.43 were 55–65% stiffer than samples with µ equal to 0.69 at a pressure of 100 kPa. The comparative analysis of the calculated results and the actual laboratory PLT test results was adequate for use for further development.     

Primary synovial sarcoma of the kidney: use of PET/CT in diagnosis and follow-up

Primary renal synovial sarcoma is a rarely seen renal neoplasm. An experienced uropathologist is needed to make the pathological diagnosis. A patient, operated on with a prediagnosis of renal cell carcinoma, the pathology of which was reported as synovial sarcoma, is presented in this article. 18F-fluoro-deoxyglucose positron emission tomography and computed tomography were performed preoperatively and in the postoperative follow-up to detect the primary tumor and lymph node metastases.     

Evaluation of the Radiation Shielding Properties of a Tellurite Glass System Modified with Sodium Oxide

In this study, the X-ray and gamma attenuation characteristics and optical properties of a synthesized tellurite–phosphate–sodium oxide glass system with a composition of (85 − x)TeO₂–10P₂O₅–xNa₂O mol% (where x = 15, 20, and 25) were evaluated. The glass systems we re fabricated by our research group using quenching melt fabrication. The shielding parameters of as-synthesized systems, such as the mass attenuation coefficient (MAC), linear attenuation coefficient (LAC), effective atomic number (Z_eff), half-value layer (HVL), tenth value layer (TVL), mean free path (MFP), and effective electron density (N_eff) in a wide energy range between 15 keV and 15 MeV, were estimated using well-known PHY-X/PSD software and recently developed MIKE software. Herein, the optical parameters of prepared glasses, such as molar volume (V_M), oxygen molar volume (V_O), oxygen packing density (OPD), molar polarizability (αm), molar refractivity (R_m), reflection loss (R_L), and metallization (M), were estimated using MIKE software. Furthermore, the shielding performance of the prepared glasses was compared with that of commonly used standard glass shielding materials. The results show that the incorporation of sodium oxide into the matrix TeO₂/P₂O₅ with an optimum concentration can yield a glass system with good shielding performance as well as good optical and physical properties, especially at low photon energy.     

Fragility fractures of the acetabulum

There are limited epidemiological data dedicated to geriatric acetabular fractures. The incidence in individuals older than 60 years of age has more than doubled in the past three decades and expected to double further over the next 20 years. These fractures represent a challenging subset of acetabular trauma patients to treat. Conservative treatment is a valid option in those with minimal displaced fractures and a preserved congruent hip joint. Similarly the frail patient with multiple medical co-morbidities and those unlikely to tolerate surgical intervention should have appropriate analgesia and their fracture managed or ignored by watchful neglect. Surgical treatment options include percutaneous fixation or open reduction and internal fixation techniques. Good outcomes may be expected should a concentric reduction be achieved. Age-related involutional osteoporosis associated with fracture comminution and acetabular dome impaction complicate surgical fixation with higher complication rates and the need for further surgery recognised. Historically described as central fracture dislocations, stoved in hip or burst fracture, acute arthroplasty is advocated in the setting of femoral head damage and in significant acetabular impaction injuries. Controversy remains whether geriatric patients should be treated by open reduction and internal fixation or total hip arthroplasty either acute or delayed and needs to be assessed based on the patient and personality of the fracture.     

Infection of Cranioplasty Seen Twenty Years Later

Cranioplasty is performed using autograft and allograft materials on patients to whom craniectomy was applied previously due to the facts that, this region is open to trauma and the scalp makes irritation and pressure onto the brain paranchyma causing brain atrophy and convulsions. Dramatical improvement of neurological deficits, control of convulsions and partial prevention of cerebral atrophy are achieved after these operations. One of the most important complications of cranioplasty is late infection. Here, we report a 43-year-old male patient admitted with the history of purulant discharge from the right temporal incission site for one year to whom cranioplasty had been performed with allograft material 20 days after craniectomy which had been performed in 1989. Allograft cranioplasty material was removed and cranioplasty was performed using new allograft material with the diagnosis of late cranioplasty infection.     

Factors Affecting Utilization of Family Planning Services in a Post-Conflict Setting,South Sudan: A Qualitative Study

This study aims to explore and examine the conjectures surrounding the utilization of family planning services among currently married couples of childbearing age in Renk County.This study has adopted a qualitative method to collect data on factors affecting the utilization of family planning services through focus group discussions and in-depth interviews, in rural and urban areas of Renk County. It targeted married women, men as well as unmarried men and women. The researchers conducted nine focus group discussions and nine interviews at both Jelhak (rural setting) and Renk (urban setting). The results suggested that the people of Renk County prefer to have large families and therefore choose not to use family planning methods. The data collected was analyzed by means of thematic analysis. This included the construction of a thematic framework, coding, editing and categorization of available data as well as the creation of sub-themes.The result also suggested that perception is a main factor that affects utilization of family planning services with a majority of the people in Renk and Jelhak preferring to have many children in order to increase the family size for some reasons. These are linked to religion, social stigma and taboo that are attached to childless people or users of family planning methods for birth control purposes.The responses revealed some variation in perception between rural (Jelhak) and urban (Renk) areas. Respondents from Renk area reported that some people use family planning services for economic reasons that involve alleviation of financial difficulties and provision of better education when the family size is small. On the other hand, rural people from Jelhak perceive family planning to be socially un-acceptable. Furthermore, men and women of Jelhak reported that after each birth of a child, married couples avoid sexual relationship for a period of two years as means of family planning. Women of both Urban and Rural settings reported intentions to use conventional methods of family planning without the knowledge of their spouses.     

Balloon Retrograde Transvenous Obliteration Versus Endoscopic Cyanoacrylate in Bleeding Gastric Varices: Comparison of Rebleeding and Mortality with Extended Follow-up

Purpose

To assess short- and long-term mortality and rebleeding with endoscopic cyanoacrylate (EC) versus balloon-occluded retrograde transvenous obliteration (BRTO).