BACKGROUND Hallux valgus(HV)is a common foot deformity that manifests with increasing age,especially in women.The associated foot pain causes impaired gait and decreases quality of life.Moderate and severe HV is a def...BACKGROUND Hallux valgus(HV)is a common foot deformity that manifests with increasing age,especially in women.The associated foot pain causes impaired gait and decreases quality of life.Moderate and severe HV is a deformity that is charac-terized by the involvement of lesser rays and requires complex surgical treatment.In this study,we attempted to develop a procedure for this condition.AIM To analyse the treatment results of patients who underwent simultaneous surgical correction of all parts of a static forefoot deformity.METHODS We conducted a prospective clinical trial between 2016 and 2021 in which 30 feet with moderate or severe HV associated with Tailor’s bunion and metatarsalgia were surgically treated via a new method involving surgical correction of all associated problems.This method included a modified Lapidus procedure,M2M3 tarsometatarsal arthrodesis,intermetatarsal fusion of the M4 and M5 bases,and the use of an original external fixation apparatus to enhance correction power.Preoperative,postoperative,and final follow-up radiographic data and American Orthopaedic Foot and Ankle Society(AOFAS)scores were compared,and P values<0.05 were considered to indicate statistical significance.RESULTS The study included 28 females(93.3%)and 2 males feet(6.7%),20(66.7%)of whom had a moderate degree of HV and 10(33.3%)of whom had severe deformity.M2 and M3 metatarsalgia was observed in 21 feet,and 9 feet experienced pain only at M2.The mean follow-up duration was 11 months.All patients had good correction of the HV angle[preoperative median,36.5 degrees,interquartile range(IQR):30-45;postoperative median,10 degrees,IQR:8.8-10;follow-up median,11.5 degrees,IQR:10-14;P<0.01].At follow-up,metatarsalgia was resolved in most patients(30 vs 5).There was a clinically negligible decrease in the corrected angles at the final follow-up,and the overall AOFAS score was significantly better(median,65 points,IQR:53.8-70;vs 80 points,IQR:75-85;P<0.01).CONCLUSION The developed method showed good sustainability of correction power in a small sample of patients at the one-year follow-up.Randomized clinical trials with larger samples,as well as long-term outcome assessments,are needed in the future.展开更多
AIM： To evaluate the clinical usefulness of lSF-fluorodeoxyglucose positron emission and computed tomography QSF-FDG PET/CT） in restaging of esophageal cancer after surgical resection and radiotherapy. METHODS： Bet...AIM： To evaluate the clinical usefulness of lSF-fluorodeoxyglucose positron emission and computed tomography QSF-FDG PET/CT） in restaging of esophageal cancer after surgical resection and radiotherapy. METHODS： Between January 2007 and Aug 2008, twenty histopathologically diagnosed esophageal cancer patients underwent 25 PET/CT scans （three patients had two scans and one patient had three scans） for restaging after surgical resection and radiotherapy. The standard reference for tumor recurrence was histopathologic confirmation or clinical follow-up for at least ten months after ^18F-FDG PET/CT examinations. RESULTS： Tumor recurrence was confirmed histopathologically in seven of the 20 patients （35%） and by clinical and radiological follow-up in 13 （65%）. ^18F-FDG PET/CT was positive in 14 patients （68.4%） and negative in six （31.6%）. ^18F-FDG PET/CT was true positive in 11 patients, false positive in three and true negative in six. Overall, the accuracy of ^18F-FDG PET/CT was 85%, negative predictive value （NPV） was 100%, and positive predictive value （PPV） was 78.6%.The three false positive PET/CT findings comprised chronic inflammation of mediastinal lymph nodes （n = 2） and anastomosis inflammation （n = 1）. PET/ CT demonstrated distant metastasis in 10 patients. ^18F-FDG PET/CT imaging-guided salvage treatment in nine patients was performed. Treatment regimens were changed in 12 （60%） patients after introducing ^18F-FDG PET/CT into their conventional post-treatment follow-up program. CONCLUSION： Whole body ^18F-FDG PET/CT is effective in detecting relapse of esophageal cancer after surgical resection and radiotherapy. It could also have important clinical impact on the management of esophageal cancer, influencing both clinical restaging and salvage treatment of patients.展开更多
A 78-year-old man with a history of mitral valve prolapse underwent echocardiography during his cardiological check-up examination in 2011 in a symptom-free stage. Echocardiography revealed akinesis of the inferior se...A 78-year-old man with a history of mitral valve prolapse underwent echocardiography during his cardiological check-up examination in 2011 in a symptom-free stage. Echocardiography revealed akinesis of the inferior septum and inferobasal free wall as a novel finding suggesting a distal right coronary artery （RCA） lesion （Figure 1）. The systolic left ventricular function was normal. Earlier echocardiographies did not show wall motion abnormalities.展开更多
The aim of this article is to emphasize the importance of nuclear medicine in fungal infection characterization through a case report. Case： patient female, with AML-M2, hospitalized with fever, dyspnea, nausea, myas...The aim of this article is to emphasize the importance of nuclear medicine in fungal infection characterization through a case report. Case： patient female, with AML-M2, hospitalized with fever, dyspnea, nausea, myasthenia, abdominal pain and diarrhea. In the physical examination exacerbated lesion in abdominal wall and subcutaneous nodules in upper and lower limbs. The computed tomography of the chest evinced area of attenuation in ground-glass opacities in the middle lobe, tending to consolidation and bilateral nodular opacities with ground-glass halo which suggested an infiammatory/infectious process of fungal etiology. Immunoscintigraphy with ^99mTc-besilesomab （Scintimun） identified focal infectious processes in activity, scattered over cutaneous and subcutaneous tissues, predominantly in extremities. In blood culture test, there was a growth ofFusarium sp. There is a difficulty in the diagnosis of fungal infections, both in clinical and imaging methods. There is no specific method to reaching the target. In addition, fungal diseases can be divided into focally localized or disseminated infections. There is a greater difficulty in the diagnosis of immunocompromised individuals due to the deficiency of basic defense mechanisms. Scintimun （scintigraphy with besilesomab） is a useful tool of nuclear medicine in the diagnosis of infectious and inflammatory diseases to allow the image of the whole-body and in vivo detection of early pathological and physiological phenomena, even before anatomical alterations occur.展开更多
文摘BACKGROUND Hallux valgus(HV)is a common foot deformity that manifests with increasing age,especially in women.The associated foot pain causes impaired gait and decreases quality of life.Moderate and severe HV is a deformity that is charac-terized by the involvement of lesser rays and requires complex surgical treatment.In this study,we attempted to develop a procedure for this condition.AIM To analyse the treatment results of patients who underwent simultaneous surgical correction of all parts of a static forefoot deformity.METHODS We conducted a prospective clinical trial between 2016 and 2021 in which 30 feet with moderate or severe HV associated with Tailor’s bunion and metatarsalgia were surgically treated via a new method involving surgical correction of all associated problems.This method included a modified Lapidus procedure,M2M3 tarsometatarsal arthrodesis,intermetatarsal fusion of the M4 and M5 bases,and the use of an original external fixation apparatus to enhance correction power.Preoperative,postoperative,and final follow-up radiographic data and American Orthopaedic Foot and Ankle Society(AOFAS)scores were compared,and P values<0.05 were considered to indicate statistical significance.RESULTS The study included 28 females(93.3%)and 2 males feet(6.7%),20(66.7%)of whom had a moderate degree of HV and 10(33.3%)of whom had severe deformity.M2 and M3 metatarsalgia was observed in 21 feet,and 9 feet experienced pain only at M2.The mean follow-up duration was 11 months.All patients had good correction of the HV angle[preoperative median,36.5 degrees,interquartile range(IQR):30-45;postoperative median,10 degrees,IQR:8.8-10;follow-up median,11.5 degrees,IQR:10-14;P<0.01].At follow-up,metatarsalgia was resolved in most patients(30 vs 5).There was a clinically negligible decrease in the corrected angles at the final follow-up,and the overall AOFAS score was significantly better(median,65 points,IQR:53.8-70;vs 80 points,IQR:75-85;P<0.01).CONCLUSION The developed method showed good sustainability of correction power in a small sample of patients at the one-year follow-up.Randomized clinical trials with larger samples,as well as long-term outcome assessments,are needed in the future.
文摘AIM： To evaluate the clinical usefulness of lSF-fluorodeoxyglucose positron emission and computed tomography QSF-FDG PET/CT） in restaging of esophageal cancer after surgical resection and radiotherapy. METHODS： Between January 2007 and Aug 2008, twenty histopathologically diagnosed esophageal cancer patients underwent 25 PET/CT scans （three patients had two scans and one patient had three scans） for restaging after surgical resection and radiotherapy. The standard reference for tumor recurrence was histopathologic confirmation or clinical follow-up for at least ten months after ^18F-FDG PET/CT examinations. RESULTS： Tumor recurrence was confirmed histopathologically in seven of the 20 patients （35%） and by clinical and radiological follow-up in 13 （65%）. ^18F-FDG PET/CT was positive in 14 patients （68.4%） and negative in six （31.6%）. ^18F-FDG PET/CT was true positive in 11 patients, false positive in three and true negative in six. Overall, the accuracy of ^18F-FDG PET/CT was 85%, negative predictive value （NPV） was 100%, and positive predictive value （PPV） was 78.6%.The three false positive PET/CT findings comprised chronic inflammation of mediastinal lymph nodes （n = 2） and anastomosis inflammation （n = 1）. PET/ CT demonstrated distant metastasis in 10 patients. ^18F-FDG PET/CT imaging-guided salvage treatment in nine patients was performed. Treatment regimens were changed in 12 （60%） patients after introducing ^18F-FDG PET/CT into their conventional post-treatment follow-up program. CONCLUSION： Whole body ^18F-FDG PET/CT is effective in detecting relapse of esophageal cancer after surgical resection and radiotherapy. It could also have important clinical impact on the management of esophageal cancer, influencing both clinical restaging and salvage treatment of patients.
文摘A 78-year-old man with a history of mitral valve prolapse underwent echocardiography during his cardiological check-up examination in 2011 in a symptom-free stage. Echocardiography revealed akinesis of the inferior septum and inferobasal free wall as a novel finding suggesting a distal right coronary artery （RCA） lesion （Figure 1）. The systolic left ventricular function was normal. Earlier echocardiographies did not show wall motion abnormalities.
文摘The aim of this article is to emphasize the importance of nuclear medicine in fungal infection characterization through a case report. Case： patient female, with AML-M2, hospitalized with fever, dyspnea, nausea, myasthenia, abdominal pain and diarrhea. In the physical examination exacerbated lesion in abdominal wall and subcutaneous nodules in upper and lower limbs. The computed tomography of the chest evinced area of attenuation in ground-glass opacities in the middle lobe, tending to consolidation and bilateral nodular opacities with ground-glass halo which suggested an infiammatory/infectious process of fungal etiology. Immunoscintigraphy with ^99mTc-besilesomab （Scintimun） identified focal infectious processes in activity, scattered over cutaneous and subcutaneous tissues, predominantly in extremities. In blood culture test, there was a growth ofFusarium sp. There is a difficulty in the diagnosis of fungal infections, both in clinical and imaging methods. There is no specific method to reaching the target. In addition, fungal diseases can be divided into focally localized or disseminated infections. There is a greater difficulty in the diagnosis of immunocompromised individuals due to the deficiency of basic defense mechanisms. Scintimun （scintigraphy with besilesomab） is a useful tool of nuclear medicine in the diagnosis of infectious and inflammatory diseases to allow the image of the whole-body and in vivo detection of early pathological and physiological phenomena, even before anatomical alterations occur.
