Effect of calcium hydroxide on inflammatory root resorption and ankylosis in replanted teeth compared with other intracanal materials: a review

Calcium hydroxide (CH) is the gold-standard intracanal dressing for teeth subjected to traumatic avulsion. A common complication after the replantation of avulsed teeth is root resorption (RR). The current review was conducted to compare the effect of CH with that of other intracanal medications and filling materials on inflammatory RR and replacement RR (ankylosis) in replanted teeth. The PubMed and Scopus databases were searched through June 2018 using specific keywords related to the title of the present article. The materials that were compared to CH were in 2 categories: 1) mineral trioxide aggregate (MTA) and endodontic sealers as permanent filling materials for single-visit treatment, and 2) Ledermix, bisphosphonates, acetazolamide, indomethacin, gallium nitrate, and enamel matrix-derived protein (Emdogain) as intracanal medicaments for multiple-visit management of avulsed teeth prior to the final obturation. MTA can be used as a single-visit root filling material; however, there are limited data on its efficacy due to a lack of clinical trials. Ledermix and acetazolamide were comparable to CH in reducing RR. Emdogain seems to be an interesting material, but the data supporting its use as an intracanal medication remain very limited. The conclusions drawn in this study were limited by the insufficiency of clinical trials.

Evaluation of RECIST, PERCIST, EORTC, and MDA Criteria for Assessing Treatment Response with Ga68-PSMA PET-CT in Metastatic Prostate Cancer Patient with Biochemical Progression: a Comparative Study / 대한핵의학회잡지

PURPOSE: The aim of the study was to compare response evaluation criteria in solid tumours 1.1 (RECIST 1.1), positron emission tomography response criteria in solid tumours (PERCIST), European organisation for research and treatment of cancer (EORTC), andMDAnderson (MDA) criteria for response assessment by Gallium 68-prostate-specific membrane antigen positron emission tomography-computed tomography (Ga68-PSMA PET-CT) in metastatic adenocarcinoma prostate cancer (mPCa) patients with biochemical progression.METHODS: Eighty-eight mPCa patients with pre and post treatment Ga68-PSMA PET-CTwere included. A ≥ 25% increase and ≥ 2 ng/ml above the nadir if prostate specific antigen (PSA) drop or ≥ 2 ng/ml above the baseline if PSA does not drop was considered as biochemical progression. RECIST 1.1 and MDA criteria for morphology and PERCIST and EORTC criteria for molecular response were investigated. Percentages of progressive disease (PD), partial response (PR), and stable disease (SD) were calculated. Chi-square test was used for statistical significance.RESULTS: Proportion of PD, SD, and PR by RECIST 1.1 and MDA criteria were 44 (50.57%), 39 (44.83%), 4 (4.6%), and 33 (39.76%), 48 (57.83%), 2 (2.41%) respectively. Proportion of PD, SD, and PR by PERCIST and EORTC criteria were 71 (80.68%), 11 (12.50%), 6 (6.82%), and 74 (84.09%), 8 (9.09%), 6 (6.82%) respectively. Chi-square test showed statistically significant (P < 0.05) higher proportion of progression detected by both molecular criteria as compare to both morphological criteria.CONCLUSION: We concluded that for Ga68-PSMA PET-CT response evaluation, molecular criteria performed better than morphological criteria in mPCa patient with PSA progression.

Effect of Erbium-yttrium, scandium, gallium and garnet [ErYSGG] laser on the bond strength of lithium disilicate ceramics

Objectives: To assess the bond strength of LD ceramics with resin composite material and surface conditioning using Er:YSGG laser and HF acid

Methods: Thirty LD ceramic [Emax, Ivoclar vivadent] discs were prepared using hot pressing technique and treated with hydroflouric acid [Group-1-HF acid] [9%] [n=10] and Er- yttrium, scandium, gallium and garnet laser [Group-2-ER-YSGG laser] [Waterlase iPlus, 10 Hz and power of 0.5 W, pulse duration of 230 micro s] [n=10]. Ten specimens were left untreated to be included as controls [Group-3-Control]. All the specimens were treated with Adper Single Bond adhesive [3MESPE, St. Paul, MN, USA]. Multicore buildups [3mmx3mm] were performed using a rubber mold on the ceramic surfaces and cured using LED light-curing unit for 140 sec. All specimens were tested using shear bond test and failure modes were assessed with a stereomicroscope and scanning electron microscope. Data was analysed using ANOVA and Tukey Kramer multiple comparisons test

Results: The maximum and minimum shear bond strength values were achieved in HF Acid specimens [Group-1] [28.15 +/- 4.72 MPa] and control specimens [13.47 +/- 3.14 MPa] respectively. Specimens treated with HF acid showed significantly higher bond strength in comparison to laser treated and control specimens [p<0.01]. Laser treated specimens had significantly higher bond strength as compared to controls [p<0.01]

Conclusions: Hydrofluoric [HF] acid treatment showed significantly better outcomes than YSGG laser surface treatment

Patologías benignas y variantes que captan 68Ga-DOTATATE en PET/TC / Benign Pathology And Variants With Uptake In 68ga-Dotatate Pet/Ct Studies

Objetivos: Valorar las variantes fisiológicas, anatómicas y lesiones benignas en estudios por tomografía computada por emisión de positrones (PET/TC) con Galio 68 (68Ga)-DOTATATE. Materiales y métodos: Se revisaron en forma retrospectiva los informes de PET/TC con 68Ga-DOTATATE y se seleccionaron aquellos en los cuales se mencionaran palabras en el reporte relacionadas a variantes anatómicas, fisiológicas y tumores benignos. El grado de captación del 68Ga-DOTATATE fue evaluado de forma cualitativa y cuantitativa mediante la medición del valor estandarizado de captación máximo (SUVmax). Se consignó la localización del hallazgo, el valor de SUVmax y la imagen morfológica por tomografía computada (TC). Todos los casos fueron controlados mediante evolución clínica y hallazgos imagenológicos. Resultados: De un total de 772 informes de PET/TC se obtuvo un total de 28 pacientes con 33 variantes o tumores benignos, 14 mujeres y 14 hombres con edad promedio de 63 años. Las captaciones se clasificaron en cuatro grupos: variantes anatómicas y/o fisiológicas (n = 15), dependientes de la actividad osteoblástica (n=4), dependientes de actividad inflamatoria (n = 10) y tumores benignos no neuro-endócrinos (n = 4). Discusión: Los receptores de somatostatina se localizan no sólo en el sistema neuroendócrino sino también en otros tejidos. Las variantes fisiológicas, anatómicas y tumores benignos que expresan estos receptores pueden inducir a un error diagnóstico. Conclusión: Las variantes fisiológicas y lesiones benignas (tumorales e inflamatorias) pueden captar 68Ga-DOTATATE ya que sus tejidos pueden expresar receptores de somatostatina. El análisis semiológico del componente tomográfico de este método de imágenes híbrido, permite la orientación diagnóstica, optimizando el rendimiento del estudio PET/TC.

Purpose: To evaluate the physiological, anatomical variants and benign lesions in positrón emission computed tomography (PET/CT) studies with 68Ga-DOTATATE. Materials and methods: We retrospectively reviewed PET/CT reports scanned with 68Ga-DOTATATE and selected those that contained words in the report related to anatomical, physiological variants and benign tumors. The degree of 68Ga-DOTATATE uptake was evaluated qualitatively and quantitatively by measuring the standarized uptake max value (SUVmax value). The anatomical location, SUVmax value and morphological CT image findings were recorded. All cases had clinical and imaging follow-up. Results: From a total of 772 PET/CT reports, 28 patients were obtained with 33 benign variants or tumors, 14 females and 14 males with a median age of 63 years. Uptake patterns were classified into four groups: anatomic and physiological variants (15), dependent on osteoblastic activity (4), dependent on inflammatory activity (10) and non-neuro-endocrine benign tumors (4). Discussion: Somatostatin receptors are overexpressed not only in the neuroendocrine system but also in other tissues. Physiological, anatomical variants and benign tumors expressing these receptors may be misleading. In the present work the frequency of this finding is 5.1%. Conclusion: Physiological variants and benign lesions (tumor and inflammatory) can accumulate 68Ga-DOTATATE since their tissues can express somatostatin receptors. The semiologic analysis of the tomographic component of this hybrid method enhances the diagnostic efficacy, optimizing PET/CT study performance.

A Pilot Study of Skin Resurfacing Using the 2,790-nm Erbium:YSGG Laser System

BACKGROUND: The erbium:yttrium scandium gallium garnet (Er:YSGG) laser differs from other laser techniques by having a faster and higher cure rate. Since the Er:YSGG laser causes an appropriate proportion of ablation and coagulation, it has advantages over the conventional carbon dioxide (CO2) laser and the erbium-doped yttrium aluminum garnet (Er:YAG) laser, including heating tendencies and explosive vaporization. This research was conducted to explore the effects and safety of the Er:YSGG laser. METHODS: Twenty patients participated in the pilot study of a resurfacing system using a 2,790-nm Er:YSGG laser. All patients received facial treatment by the 2,790-nm Er:YSGG laser system (Cutera) twice with a 4-week interval. Wrinkle reduction, reduction in pigment inhomogeneity, and improvement in tone and texture were measured. RESULTS: Study subjects included 15 women and five men. Re-epithelization occurred in all subjects 3 to 4 days after treatment, and wrinkle reduction, reduction in pigment inhomogeneity, and improvement in tone and texture within 6 months of treatment. CONCLUSIONS: The 2,790-nm YSGG laser technique had fewer complications and was effective in the improvement of scars, pores, wrinkles, and skin tone and color with one or two treatments. We expect this method to be effective for people with acne scars, pore scars, deep wrinkles, and uneven skin texture and color.

[Determination of maximum transmission time of the labeled complex to malignant lymphatic cells using cell culture]

Nowadays, radiotherapy is considered as one of the main methods in cancer treatment, which uses radiation to destroy cancer cells while causing minimal damage to normal tissue and. Another cancer treatment method is photoelectron therapy, which is a new treatment for mass tumors. In this method, high atomic number drugs should be absorbed by tumor cells] while using carriers] so, their atomic number is increased compare to normal cells, which causes more damage to tumor cells when radiation is applied. Thus, applying accurate and effective photoelectron therapy would be possible. The purpose of this study was to identify and analyze the factors affecting uptake of Metrezoate labeled with gallium by lymphatic tumors in cell cultures. Since uptake of Gallium by Malignant lymphatic cells has been reported in numerous researches, Gallium was bonded with a contrast media [metrezoate]. Malignant lymphatic cells [Large Cell Lymphoma, Small cell Lymphoma and Bourkit Lymphoma] in specific colonies were grown in gel culture media. Metrezoate-gallium complex was added to the culture media in concentration of 50%, 60% and 75%. Then, absorbed volume was determined by the SPECT imaging system in 72 hrs post-addition of metrezoate-gallium complex and the cells count and the colonies area were measured. Obtained results in 72 hrs revealed that maximum absorption; count quantity and colonies area occurred 4 hrs post-addition of gallium-metrezoate complex solution. As results show, Gallium-metrezoate complex is significantly accumulated in malignant lymphatic cells. As effective atomic number of malignant lymphatic cells is enhanced, it is expected applying photoelectron therapy in this time leads to more effective treatment

Comparative acute toxicity of gallium(III), antimony(III), indium(III), cadmium(II), and copper(II) on freshwater swamp shrimp (Macrobrachium nipponense)

BACKGROUND: Acute toxicity testing were carried out the freshwater swamp shrimp, Macrobrachium nipponense, as the model animal for the semiconductor applied metals (gallium, antimony, indium, cadmium, and copper) to evaluate if the species is an suitable experimental animal of pollution in aquatic ecosystem. RESULTS: The static renewal test method of acute lethal concentrations determination was used, and water temperature was maintained at 24.0 ± 0.5°C. Data of individual metal obtained from acute toxicity tests were determined using probit analysis method. The median lethal concentration (96-h LC50) of gallium, antimony, indium, cadmium, and copper for M. nipponense were estimated as 2.7742, 1.9626, 6.8938, 0.0539, and 0.0313 mg/L, respectively. CONCLUSIONS: Comparing the toxicity tolerance of M. nipponense with other species which exposed to these metals, it is obviously that the M. nipponense is more sensitive than that of various other aquatic animals.

Pattern Analysis of 67Gallium Scintigraphy in Sarcoidosis / 결핵및호흡기질환

BACKGROUND: 67Ga scintigraphy has been used for years in sarcoidosis for diagnosis and to determine the extent of the disease. The present report is a study of various findings of 67Ga scintigraphy in patients with sarcoidosis. METHODS: Between 1998 and 2007, 16 patients (male:female, 6:10; age, 35.9+/-15.3 years) with histologically proven sarcoidosis underwent clinical evaluation and 67Ga scintigraphy. According to the site of involvement, they were divided into subtypes and analyzed. RESULTS: Sixteen patients with sarcoidosis had involvement of various organs, including lymph nodes (13/16, 81.3%), lung (3/16, 18.8%), muscle (1/16, 6.3%), subcutaneous tissue (1/16, 6.3%), glands (1/16, 6.3%), and bone (1/16, 6.3%). Sites of involved lymph nodes were thorax (12/13, 92.3%), supraclavicular area (5/13, 38.5%), inguinal area (2/13, 15.4%), abdomen (2/13, 15.4%), and pelvis (1/13, 7.7%). CONCLUSION: Because sarcoidosis frequently involves multiple organs, 67Ga scintigraphy is a useful method in for evaluating the whole body. Nuclear medicine physicians should be familiar with the various findings of gallium uptake in sarcoidosis.

Determination of 24 elements in human hair by ICP-MS using microwave digestion / 法医学杂志

OBJECTIVE@#To establish an inductively coupled plasma-mass spectrometry (ICP-MS) method for determination of 24 elements in human hair.@*METHODS@#The samples were digested with microwave digestion instrument. ICP-MS was applied to determine 24 elements in human hair using indium (115In) as an internal standard. The established method was applied to determine element concentration in normal group (56 samples) and heroin abuse group (10 samples).@*RESULTS@#The limits of detection ranged from 0.000 3 microg/g to 10.14 microg/g. Measured value of the standard materials were basically consistent with the standard value. The contents of magnesium, gallium and barium in hair of heroin addicts decreased after rehabilitation treatment.@*CONCLUSION@#The method is sensitive and accurate for determination of 24 elements in human hair.

Preparation and biodistribution study of [67]Ga-gallium calcitonin

In order to develop a radiolabeled calcitonin [CT] derivative for receptor imaging studies, CT was successively labeled with [67]G-gallium chloride. The best results of the conjugation were obtained by the addition of 0.5 ml of a CT nasal pharmaceutical solution [1100 IU] to a glass tube pre-coated with DTPA-dianhydride [0.01 mg] at 25 [degree sign] with continuous mild stirring for 30 min. after solid phase purification of the radiolabeled hormone, instant thin layer chromatography [ITLC] showed radiochemical purity of higher than 95% at optimized conditions [specific activity = 67-134 KBq/IU, labeling efficiency 70%]. [67]Ga-DTPA-CT mainly accumulates in the liver. Preliminary in vivo studies [ID/g%] in male wild-type rats showed significant liver uptake of the tracer after 24 hours. [67]Ga-DTPA-CT can be a suitable probe for biodistribution study of CT receptors in various physiological as well as neoplastic lesions with over-expressed calcitonin receptors

Importância da cintilografia com gálio-67 no linfoma cutâneo primário de células B: relato de dois casos / Importance of gallium-67 scintigraphy in primary cutaneous B-cell lymphoma: report of two cases

Os autores relatam dois casos de linfoma cutâneo de células B, nos quais o correto estadiamento, tratamento e seguimento foram possíveis graças à combinação de exames convencionais e a cintilografia com gálio-67.

The authors describe two cases of cutaneous B-cell lymphoma where correct staging, treatment and follow-up could be achieved through a combination of conventional imaging studies and gallium-67 scintigraphy.

Radiolabeling of NOTA and DOTA with Positron Emitting 68Ga and Investigation of In Vitro Properties / 핵의학분자영상

PURPOSE: We established radiolabeling conditions of NOTA and DOTA with a generator-produced PET radionuclide 68Ga and studied in vitro characteristics such as stability, serum protein binding, octanol/water distribution, and interference with other metal ions. MATERIALS AND METHODS: Various concentrations of NOTA.3HCl and DOTA.4HCl were labeled with 1 mL 68GaCl3 (0.18~5.75 mCi in 0.1 M HCl) in various pH. NOTA.3HCl (0.373 mM) was labeled with 68GaCl3 (0.183~0.232 mCi/0.1 M HCl 1.0 mL) in the presense of CuCl2, FeCl2, InCl3, FeCl3, GaCl3, MgCl2 or CaCl2 (0~6.07 mM) at room temperature. The labeling efficiencies of 68Ga-NOTA and 68Ga-DOTA were checked by ITLC-SG using acetone or saline as mobile phase. Stabilities, protein bindings, and octanol distribution coefficients of the labeled compounds also were investigated. RESULTS: 68Ga-NOTA and 68Ga-DOTA were labeled optimally at pH 6.5 and pH 3.5, respectively, and the chelates were stable for 4 hr either in the reaction mixture at room temperature or in the human serum at 37 degreesC. NOTA was labeled at room temperature while DOTA required heating for labeling. 68Ga-NOTA labeling efficiency was reduced by CuCl2, FeCl2, InCl2, FeCl3 or GaCl3, however, was not influenced by MgCl2 or CaCl2. The protein binding was low (2.04~3.32%). Log P value of 68Ga-NOTA was -3.07 indicating high hydrophilicity. CONCLUSION: We found that NOTA is a better bifunctional chelating agent than DOTA for 68Ga labeling. Although, 68Ga-NOTA labeling is interfered by various metal ions, it shows high stability and low serum protein binding.

Ga-67 Citrate and Tc-99m MDP Uptake in the Lung and Stomach Associated with Hypercalcemia / 핵의학분자영상

Ga-67 scintigraphy demonstrated increased uptake in the lungs and stomach in a 26-year-old man with hypercalcemia. A primitive neuroectodermal tumor was confirmed by bone marrow examination. Tc-99m MDP uptake in the same locations as Ga-67 revealed by bone scintigraphy was consistent with metastatic calcification. Although the mechanism of Ga-67 uptake in metastatic calcification is not understood, the presence of an inflammatory process is suggested.

An experimental study on the effect of LASER on soft tissue healing

Treatment of Infected Hip Arthroplasty with Antibiotic-Loaded Cement Spacers

PURPOSE: This study evaluated the effect of antibiotic-loaded cement spacers on the treatment of infected hip arthroplasty. MATERIALS AND METHODS: Twenty-one patients, twenty-one cases that experienced infection after total hip arthroplasty, were treated with two-stage arthroplasty using antibiotic-loaded cement spacers between July 1995 and March 2005. The average age was 56.3 years (range, 36~84 years). The follow-up period was 7.2 years (range, 3~11.4 years). The period from the first operation to diagnosis of infection was 28 months (range, 1~49 months). Preoperative culture, Tc 99m scan or Gallium scan, intraoperative culture and biopsy were performed for the evaluation of infection. We postoperatively evaluated clinical and radiological outcomes, blood analysis including serologic study, complete blood cell count, differential count, erythrocyte sedimentation rate and C-reactive protein. RESULTS: Of a total of 21cases, acetabular cup, femoral head and femoral stem were substituted in 10 cases (48%). Acetabular cup and femoral head were substituted in 11 cases (52%). Revision arthroplasty was performed in 19 cases, on average 11.9 months (range 2~31 months) after insertion of antibiotic-loaded cement spacers. Infection recurred in 1 case. In 18 cases, excluding the reinfected one, the average Harris hip score, 46.8 points (range, 35~72 points) preoperatively, improved to 89.5 points (range, 78~100 points) at last follow-up in the revision group. In 2 cases in which revision total hip arthroplasty was not performed, the Harris hip score was 53 points (range, 36~70 points) preoperatively, and 86 points (range,72~100 points) at last follow-up. CONCLUSION: The use of antibiotic-loaded cement spacers in two-stage arthroplasty is an effective method for management of infection, preserving joint function until performing revision arthroplasty. Preservation of the femoral stem should be considered in cases in which were fixed firmly and in cases which show no evidence of the spreading of infection to the distal part of the stem on Tc 99m scan or Gallium scan performed preoperatively.

Preparation and biodistribution of [67Ga]-labeledoxytocin for SPECT purposes

Oxytocin [OT] is a paracrine hormone with various biological activities and many sex organs in both sexes, as well as many tumor cells have shown to have related receptors. In this study the development of a receptor imaging tracer for possible tumor imaging has been described. OT was successively labeled with [67Ga]-gallium chloride after conjugation with freshly prepared cyclic DTPA-dianhydride. The best results of the conjugation were obtained by the addition of 1 ml of a OT pharmaceutical solution [2 mg/ml, in phosphate buffer, pH=8] to a glass tube pre-coated with DTPA-dianhydride [0.02 mg] at 25°C with continuous mild stirring for 30 min. Radiochemical purity [RCP] of the labeled compound was determined, using RTLC and ITLC followed by stability tests and animal biodistribution studies. Radiolabeling took about 60 minutes with a RCP higher than 98% at optimized conditions [specific activity = 1000 Ci/mM, labeling efficiency 80%]. The stability of the tracer at room temperature was significant, up to an hour. Preliminary in vivo studies in normal female rat model showed ovary/blood and ovary/muscle ratio uptake of the tracer in 60 minutes to be 4.53 and 9.18, respectively. The result was consistent with the reported OT receptor distribution in normal female mammals. The radiolabeled oxytocin, prepared in this study, was a possible fast acting tracer for OT receptor imaging; studies however, more studies are required to determine the best imaging conditions especially in larger mammal animals

application of unconventional PET tracers in nuclear medicine

The production and application of PET tracers has been a unique step in the progress of nuclear medicine in last two decades. The most important PET tracers include F-18, C-l 1 and N-13 radioisotopes and many nuclear medicine centers throughout the globe are using them. However some new tracers are under their way to the mass administration, currently being in the clinical trials or preliminary studies. Gallium-66 and 68 tracers such as Ga-DOTANOC and Ga-DOTANIC are currently being used in many neuroendocrine tumor studies in human in Europe and North America, and global application of these tracers remain to the cheaper and easier providence of [68]Ge[68]Ga generators. Copper tracers such as[61,62,64]Cu-ATSM and [61,62,64]Cu-PTSM are the most important unconventional tracers used in hypoxia and perfusion studies respectively using PET technology. Copper tracers can easily be produced using a medium cyclotron with simple chemistry. Many other interesting PET radioisotopes such as Tc-94m [HL. 52 min], 1-124 [HL. 100h], Y-86 [HL. 14.7] and rubidium tracers are being studied in some research centers in the world. This review article would describe the properties, mechanisms, production routes and problems of unconventional PET tracers with a look to the future of some important drug candidates

Clinical utility of SPECT-CT co-registration imaging

The interpretation of nuclear medicine studies is largely based on function. However, this interpretation becomes more accurate and reliable when there is a corresponding precise anatomical localization. Hybrid systems are opening up a new era in SPECT imaging. A tertiary hospital in the Philippines has acquired the country's first hybrid imaging device combining a dual-detector, variable angle gamma camera with a low dose X-ray tube attached to the same gantry. This study evaluates the clinical utility of a hybrid imaging system, SPECT/CT for functional mapping with selected radiotracers. SPECT data were first interpreted alone and then re-assessed with the addition of SPECT/CT co-registered images. Patients referred for various nuclear medicine procedures with SPECT components in the first six months of operation studied for various clinical situations were evaluated in the study. Our study included sixty-four (64) patients in the first year of operation of SPECT/CT co-registered imaging systems. This included 23 with I-131, six with sulfur colloid, four with Gallium 67, five with Tc99m Sestamibi and 26 with Tc99m HOP. The pathologic sites in 28 out of 64 (44 percent) patients were noted in both SPECT and SPECT/CT co-registered images. Additionally, SPECT/CT co-registered images provided the precise anatomical localization in 12 (19 percent) patients not clearly evident in SPECT images alone and enabled the exclusion of disease in sites of physiologic tracer deposition in 16 (25 percent) patients found suspicious in SPECT alone leading to a change in the therapeutic approach. SPECT/CT allows a more precise interpretation of scintigraphic studies using selected radiotracers for various clinical situations. It provides additional information that improves diagnostic accuracy of SPECT and impacts on patient management indicating that SPECT/CT co-registered systems are suited for routine use in clinical practice.

Leukoscan [sulesomab-monoclonal antibody] scintigraphy in infectious bone and joint diseases

When clinical data are insufficient to diagnose infrction of bone or joints, nuclear scanning becomes crucial in making an accurate diagnosis. The efficiency of' technetium-99m antigranulocyte monoclonal antibody Fob fragment [leukoscan] was evaluated in 66 patients with suspected muscloskeletal infection and was compared with technetium- 99m methylene diphosphonate bone scan in 54 patients. The overall sensitivity of leukoscan and MDP bone scan was 94.4% and 86.5% respectively Specificity was 91.6% and 50% respectively, and accuracy was 94% and 85% respectively. Leukoscan is more accurate in detecting bone and joint infection with better sensitivity and specificity compared with MDP bone scan

O gálio e a patologia óssea / Gallium and bone pathology

PROPOSTA: Revisão de trabalhos científicos referentes à incorporação do gálio no tecido ósseo, ao mecanismo da atividade terapêutica desse elemento, bem como a formação, crescimento e solubilidade da hidroxiapatita na presença dos sais de gálio. JUSTIFICATIVA: Diferente de outras drogas que impedem a perda de cálcio, os sais de elemento traço gálio são eficazes em hipercalcemia severa. O gálio (geralmente na forma de nitrato) aumenta a concentração de cálcio e fósforo no osso, influindo nos osteoclastos de maneira direta não tóxica, em doses surpreendentemente baixas. Apesar de que os detalhes do mecanismo de ação do gálio não são bem esclarecidos, está comprovado que esse mecanismo envolve a inserção do gálio na matriz de hidroxiapatita, protegendo-a contra a reabsorção e melhorando as propriedades biomecânicas do sistema esquelético. Este fármaco age também nos componentes celulares do osso, impedindo sua absorção ao diminuir a secreção ácida dos osteoclastos. São necessárias mais publicações sobre o uso do gálio no tratamento de várias doenças onde prevalece esta patologia. CONCLUSÕES: Devido as suas características interessantes e promissoras, o gálio merece ser futuramente avaliado do ponto de vista experimental e clínico, como um agente antiabsortivo em ortopedia, traumatologia e doenças relacionadas com o câncer. Maior conhecimento dos mecanismos envolvidos pode fornecer as idéias para estratégia terapêutica, com o objetivo de diminuir hipercalcemia e perda óssea. Espera-se que novos compostos do gálio sejam desenvolvidos e avaliados clinicamente.

PURPOSE: To review the literature concerning the incorporation of gallium into bone tissue, mechanisms of therapeutic activity of this element, as well as the formation, growth and solubility of hydroxiapatite in the presence of gallium salts. JUSTIFICATION: In contrast to other calcium-saving drugs, salts of trace element gallium are effective in severe hypercalcemias. Gallium (most commonly in the form of its nitrate) enhances calcium and phosphorus content of the bone and has direct, noncytotoxic effects on osteoclasts at markedly low doses. Although the details of gallium action on the bone are still uncertain, it is well established that the mechanism involves gallium insertion into the hydroxiapatite matrix protecting it from resorbtion and improving biomechanical properties of the skeletal system. The drug also acts on the cellular components of bone to reduce bone resorbtion by decreasing acid secretion by osteoclasts. More has to be published about the use of gallium in managing a series of clinical conditions in which this pathology is pronounced. CONCLUSIONS: Due to its interesting and promising profile gallium merits further experimental and clinical evaluation as an antiresorbtive agent in orthopaedics, traumatology and cancer-related conditions. Greater knowledge of the mechanisms involved may provide insights for therapeutic strategies aimed at diminishing hypercalcemy and bone loss. New gallium compounds are expected to be developed and tested clinically.