No relationship between 18F-fluorodeoxyglucose positron emission tomography and expression of Glut-1 and -3 and hexokinase I and II in high-grade glioma.

The purpose of this study was to compare glucose metabolism, measured using 18F-fluorodeoxyglucose positron emission tomography ([18F]FDG-PET), with the expression of Glut-1 and -3 and hexokinase I (Hex I) and II in high-grade glioma. The retrospective study involved 27 patients with WHO classification grade III and IV glioma, with either newly diagnosed or recurrent tumours. Patients underwent dynamic and static [18F]FDG-PET to glucose metabolic rate (MRGlu) and standardised uptake value (SUV), respectively. Tumour biopsies were obtained and stained using immunohistochemistry for the expression of Glut-1, -3, Hex I and II. Relationships between variables were studied using Spearman's rank correlation test. Results showed that the expression of Glut-1, Glut-3, Hex I and Hex II varied between and within the tumour samples. The mean of MRGlu was 0.2 (range 0.09-0.25) micromol/min/ml and that of SUV was 4.2 (range 3.2-5.2). There were no significant relationships among the tumour expression of any of the proteins studied with either MRGlu or SUV (p>0.21 for all). In conclusion, the lack of relationship between the immunohistochemical expression of Glut-1, -3, Hex I or II and glucose metabolism measured using [18F]FDG-PET in patients with high-grade glioma may be due to the tissue heterogeneity and presence of necrosis in high-grade tumours.

Transplantation of metanephroi to sites within the abdominal cavity.

A novel approach to circumventing the shortage in transplantable donor organs is the use of embryonic primordia that develop inside the host. Previously published work has shown that transplantation of rat fetal kidney primordia (metanephroi) onto the omentum of adult rat hosts results in growth and development of the metanephroi into functioning kidney units capable of providing a measurable renal function. However, for anatomical and physiological reasons the omentum may not provide the ideal site for transplantation and may limit the maximum renal function that the transplants can achieve. We postulate that it may be possible to increase the renal function of the transplants by transplantation to sites with increased blood flow. To test this we transplanted rat embryonic day 15 metanephroi into the retroperitoneal fat adjacent to major blood vessels in the peritoneum of unilaterally nephrectomized rats; 21 days later the transplants were examined and suitable transplants connected to the host urinary system. Approximately 130 days later the glomerular filtration rate of the connected transplants was analyzed. Our results show that transplantation of metanephroi to the regions highlighted in this study results in an increased presence of urinary cysts, suggesting increased early renal function in the transplants compared to metanephroi transplanted onto the omentum, but most importantly we show that we can increase the renal function of the transplants to a level comparable with other renal therapies such as dialysis. This work suggests life-sustaining renal function could be achieved through transplantation of renal primordia.

MRI in the management of scaphoid fractures in skeletally immature patients.

BACKGROUND: The scaphoid is the commonest fractured carpal bone, but excluding a scaphoid fracture with plain radiographs is difficult. Other imaging modalities are being increasingly evaluated in the management of scaphoid injuries. MRI has been shown to be of considerable value in the adult population but there have been limited studies of its use in children. PURPOSE: To evaluate the role of MRI in the acute management of suspected scaphoid injuries in children. METHODS AND MATERIALS: Fifty-six children (57 injuries) who had a suspected scaphoid injury underwent MRI within 10 days of their initial trauma. The results of MRI were used to dictate management of the injury. RESULTS: In 33 (58%) of the 57 injuries, MRI was normal and the patient was discharged from care. In 16 cases (28%), a fractured scaphoid was diagnosed and appropriate treatment started early. Additionally, other fractures around the wrist joint and ganglion cysts were demonstrated on MRI. CONCLUSIONS: MRI of acute scaphoid injuries in children significantly alters management. Those children with normal scans are discharged earlier. Scaphoid fractures are confirmed earlier and other pathological conditions are also detected.