Blood flow of free gingival grafts measured by xenon-133 clearance.

Blood circulation of free gingival grafts by Xe-133 clearance was evaluated in this study with special attention to the relationship between the amount of circulation and graft thickness, surface area and contraction during the initial healing phase. Following baseline clinical examination and initial periodontal therapy, 32 patients received mucogingival surgery with free gingival grafts for treatment of insufficient attached gingiva. Blood flow in recipient and donor areas was measured by injection of Xe-133. Xenon clearance in the free gingival grafts was measured at the first, tenth, twentieth, and fortieth days. Mean blood flow was observed to decrease on the first day and then gradually increased at 10 and 20 days and finally reached the initial value of the recipient area on the fortieth day. It was observed that circulation in the grafted tissue was positively correlated with graft thickness, but negatively correlated with graft contraction during healing.

99Tc(m)-polyclonal IgG scintigraphy in the detection of infected hip and knee prostheses.

We investigated the usefulness of 99Tc(m)-polyclonal human IgG (99Tc[m]-HIG) scintigraphy in the diagnosis of infected hip and knee prostheses. Twenty-nine scintigraphic studies were performed in 27 patients (17 females, 10 males) with a suspected prosthetic infection. As some patients had bilateral prostheses, a total of 35 prostheses were evaluated. There were 25 hip replacements and 10 knee prostheses. The images were analysed both visually and quantitatively. The scintigraphic results were compared with the culture results of surgical specimens and also with clinical follow-up after 3 months. Increased uptake was observed in 22 prostheses, of which 12 were true-positive and 10 were false-positive results. Staphylococci were the agents most commonly isolated. In all false-positive patients, aseptic inflammation was diagnosed. Based on quantitative analysis, no statistically significant difference was found between the true-positive and false-positive cases. For the prostheses as a whole, the sensitivity, specificity, positive predictive value and negative predictive value were 100%, 41%, 54% and 100% respectively. For the hip prostheses alone, these values were 100%, 53%, 57% and 100% respectively. Taking its high sensitivity and predictive value into consideration, 99Tc(m)-HIG scintigraphy can be used as a screening test to help eliminate prosthetic infection.

99Tcm-tetrofosmin scintigraphy in the evaluation of palpable breast masses.

201Tl and 99Tcm-MIBI have been used to evaluate palpable breast masses. The aim of this study was to evaluate the potential of 99Tcm-tetrofosmin as a new tumour localizing agent in patients with palpable breast masses. Nineteen palpable breast masses were evaluated in 18 patients. Each patient received 740 MBq 99Tcm-tetrofosmin intravenously. Ten minutes after the injection, planar breast images in the anterior, right lateral and left lateral views were obtained with the patient in the supine position. Mammography and ultrasonography were performed in all patients. Biopsy or mastectomy with axillary dissection was performed in all patients. Thirteen of 14 primary breast tumours were detected (9 invasive ductal carcinomas, 3 invasive lobular carcinomas, 1 papillary carcinoma). One patient with mucinous carcinoma did not demonstrate 99Tcm-tetrofosmin accumulation. Four of five patients with histopathologically proven benign lesions did not demonstrate 99Tcm-tetrofosmin accumulation (2 fibrocystic diseases, 2 fibroadenomas). 99Tcm-tetrofosmin accumulation was seen in a patient with chronic mastitis. The sensitivity and specificity of 99Tcm-tetrofosmin for malignant breast lesions was 92 and 80% respectively. Four of seven (57%) axillary lymph node metastases showed 99Tcm-tetrofosmin uptake. In conclusion, 99Tcm-tetrofosmin shows real promise for use in evaluating patients with palpable breast masses.