Evaluation of preoperative localization of parathyroid adenoma using [99m]tc-sestamibi scintigraphy as a single diagnostic modality for patients with primary hyperparathyroidism

This- study was designed to evaluate the diagnostic yield of Technetium-99m hexakis methoxyisobutylisonitrile [Tc-99m-MIBI] scintigraphy in patients with primary hyperparathyroidism [PHPT] for identification of the site of parathyroid adenoma compared versus operative and histopathological findings. The study included 23 cases with PHPT; 5 nales and 8 females with mean age of 56.5 +/- 10.3; range: 39-69 years. Preoperative scanning using [99m]Tc-sestamibi was done. All patients underwent surgical exploration after methylene blue transfusion. Imaging data were compared with intraoperative finding. All identified and excised glands were sent for histopathological examination. Preoperative sestamibi scan defined a case with mediastinal parathyroid gland and another active cervical gland in 2 patients with persistent and recurrent hypercalcaemia, respectively. Preoperative sestamibi scan defined 6 cases with single parathyroid adenoma in each case, while surgical exploration defined 7 parathyroid adenomata; 5 cases had solitary adenoma and one case had adenoma in 2 parathyroid glands both stained blue after methylene blue infusion. Thus, sestamibi scan defined solitary parathyroid adenomas with an accuracy rate of 83.3%. However, sestamibi scan defined 3 cases with adenoma in 2 parathyroid glands and 2 cases had adenoma in 3 glands. Surgical exploration defined adenoma that confirmed histopathologically in 9 glands of the 12 identified by sestamibi scan; 4 cases had 2 adenomas and one case had one solitary adenoma, the other 3 glands showed only hyperplasia without adenoma formation. Thus, sestamibi scan defined multiple parathyroid adenomos with an accuracy rate of 75%. It could be concluded that preoperative localization of parathyroid gland depending on preoperative sestamibi scan could identify ectopic active glands with accuracy 100% and active cervical glands with an overall accuracy rate of 79.2% and concomitant intraoperative methylene blue localization allowed detection of active glands missed by preoperative sestamibi scan

Evaluation of granulocyte-colony stimulating factor and neutrophil count in term neonates born to mothers with pregnancy induced hypertension

The objective of this study was to estimate the cord blood levels of granulocyte-colony stimulating factor [G-CSF] in term infants born to mothers suffering from pregnancy induced hypertension [PIH] and to study its relation with neonatal neutrophil count and maternal mean arterial blood pressure. G-CSF in the PIH group was significantly lower than the control group, while neutrophil count was not different in the PIH and control groups. Only two infants in the PIH group had marked neutropenia. No definite correlations were found between maternal mean arterial blood pressure and fetal neutrophil count or fetal G-CSF. Also, fetal neutrophil count was not correlated with fetal G-CSF