99mTc-MIBI scintimammography as a complement of the mammography in patients with suspected breast cancer. A multicentre experience.

The aim of this work has been to evaluate the clinical usefulness of 99mTc-MIBI scintimammography, used as a complement to mammography, in the study of patients with suspected breast cancer. We performed prone breast scintigraphy in 253 patients (268 lesions) with suspected breast cancer. The size and degree of the suspected breast cancer was evaluated by mammography.

Assessment of cardiac viability by thallium 201 redistribution and dobutamine echocardiography.

Objective: Dobutamine echocardiography and thalium 201 are useful in the assessment of myocardial viability, but both techniques frequently yield conflicting results. The objective of this study was to determine the minimum mass of viable myocardium that each test could detect and compare the agreement of dobutamine echocardiography and thallium 201 to detect viability.

Methods: Dobutamine echocardiography and thallium 201 were performed in 10 patients scheduled for cardiac transplantation.

[Comparison of dobutamine echocardiography and rest-redistribution 201-thallium SPECT in the assessment of myocardial viability taking PET as gold standard].

Background And Aim: To compare Tl-201 SPECT and dobutamine stress echocardiography for the detection of myocardial viability in patients with severe left ventricular dysfunction using metabolic imaging by positron emission tomography as the standard reference.

Material And Methods: We studied 25 consecutive patients with severe coronary artery disease and left ventricular dysfunction that underwent two different diagnostic modalities for evaluating myocardial viability: stress echocardiography with incremental doses of dobutamine from 5 up to 40 g/kg/min in 3 min stages, and 201 Tl SPECT using a rest-redistribution protocol with delayed images obtained at 4 hours. Fluorodeoxyglucose uptake by PET was used as the gold standard.

[Acute hepatitis E in Spain].

Hepatitis E virus (HEV) is the worldwide leading cause of non-A non-B enterically transmitted hepatitis, and affects most commonly the population in developing countries. Cases outside this area, are nearly always imported, although apparent local acquisition has been occasionally reported. We assisted three patients with acute HEV hepatitis, confirmed by the presence of serum anti-HEV IgM.

[A Spanish multicenter scintigraphic study of the breast using Tc 99m MIBI. Report of results].

Unlabelled: The aim of this work has been to study, with a homogenous method, a wide sample of patients with breast cancer suspicion, in order to evaluate the real clinical usefulness of the scintimammography with MIBI-99mTc.

Methods And Material: We have studied by way of prone scintimammography 388 patients (418 lesions) with breast cancer suspicion. In the mammography the size and degree of breast cancer suspicion was evaluated.

[Elective noninvasive test in the diagnosis of coronary disease in the aged].

Background And Purpose: The purpose of this study was to determine the best noninvasive test to diagnose coronary artery disease in the elderly. PATTERNS AND METHODS: We conducted a study on 56 elderly patients (> 65 years) with chest pain and no previous history of coronary artery disease. They underwent exercise stress test, dipyridamole echocardiography (0.

[A non-invasive test choice for the diagnosis of coronary disease in women].

Background And Purpose: Regarding coronary heart disease, women have often been excluded from clinical trials. Current practical recommendations are thus based on studies in men. To identify the non invasive technique of choice in detecting coronary artery disease in women, a study with different diagnostic tests has been undertaken.

[Management of choledocholithiasis in patients undergoing laparoscopic cholecystectomy].

The development of laparoscopic cholecystectomy has rekindled the issue of management of choledocholithiasis. A number of options exist including pre or postoperative endoscopic sphincterotomy (ERCP-ES), laparoscopic common duct exploration or open common duct exploration. We present here our experience with the management of choledocholithiasis in patients treated with laparoscopic cholecystectomy.

[Pain and jaundice secondary to hemobilia resolved by ERCP and endoscopic sphincterectomy].

We report the case of a patient with hemobilia resulting from a liver biopsy where the performance of the endoscopic sphincterectomy solved the jaundice and the pain of the patient. ERCP has been used previously in the diagnosis of biliary and pancreatic tumors that manifested themselves as an hemobilia. The therapeutic utilization of endoscopic sphincterotomy had been described rarely in this type of bleedings.

[The endoscopic Nd-YAG laser treatment of the "watermelon stomach"].

The watermelon stomach is a vascular malformation at the gastric antrum which is responsible for chronic bleeding. We report here nine patients (5 females and 4 males) referred to our Department from December 1990 to May 1995 with ferropenic anemia resulting from chronic gastrointestinal bleeding and with the diagnosis of watermelon stomach. The mean age at presentation was 52 years (range, 29-80).

[Echocardiography and MIBI-SPECT scintigraphy during dobutamine infusion in the diagnosis of coronary disease].

Background And Purpose: Dobutamine, an adrenergic agonist, has been combined with echocardiography and scintigraphy with MIBI-SPECT to detect coronary artery disease. Our purpose has been to compare echocardiography and MIBI-SPECT scintigraphy during dobutamine infusion for diagnosing coronary artery disease.

Methods: Both tests and coronary angiography have been performed on 72 consecutive patients with chest pain and no previous history of coronary artery disease.

[Training in diagnostic and therapeutic ERCP].

Training in diagnostic and therapeutic endoscopic retrograde cholangiopancreatography procedures is difficult and tedious. Currently, there is no consensus on how to plan and put it into practice. We believe that training in these procedures must be included in the training program of the gastroenterology resident, since the efficiency of these methods (both diagnostic and therapeutic) in biliopancreatic disease including their clinical, social and economic benefits are beyond doubt.

[Adult patients with clinically suspected or known biliopancreatic pathology in whom ERCP is not indicated: the 10 most frequent situations].

Endoscopic retrograde cholangiopancreatography is an invasive endoscopic technique widely used in the diagnosis and eventual therapeutic procedures of many biliopancreatic conditions. While endoscopic retrograde cholangiopancreatography indications are well known, it is not the same in those patients with clinically suspected or known biliopancreatic entities in whom endoscopic retrograde cholangio-pancreatography is not indicated because it will not add valuable information with the potential of changing the previous diagnosis or therapy. Ten very common clinical situations in which this technique is not indicated are presented; among them idiopathic abdominal pain, some pancreatic carcinomas, chronic pancreatitis and pancreatic pseudocyst, and some patients awaiting conventional or laparoscopic cholecystectomy.

[Choledocholithiasis following cholecystectomy: what is the real effectiveness of endoscopic sphincterotomy?].

Aim: To assess real efficacy of endoscopic sphincterotomy in the setting of postcholecistectomy choledocolitiasis (i.e., without excluding for analysis any patient referred for the procedures) traditionally the evaluation has been done after excluding those cases in which the procedure failed or was not attempted.

[The palliative treatment of esophageal tumors with the laser (Nd-YAG). The results of an initial experience].

Palliative treatment of esophagus tumors leads to a remarkable improvement of dysphagia allowing oral feeding, prolonging the survival period and improving patient's quality of life. We have treated 30 patients with such tumors, who had previously been discarded for surgical therapy, with Nd-YAG laser through endoscopy. The procedure could be ended, so the dysphagia improved remarkably, in 23 patients (77.

[False pancreatic pseudocyst during endoscopic retrograde cholangiopancreatography (ERCP) in a gastrectomized patient].

Endoscopic retrograde cholangiopancreatography (ERCP) is a very useful procedure for the diagnosis of biliopancreatic disorders. As a mixed endoscopic and radiologic procedure, its diagnostic yield depends heavily on the quality and skillful interpretation of radiological images. Diagnostic pitfalls must be kept in mind and avoided.

[Treatment of colonic cancer with laser (Nd-YAG). Our initial experience].

Laser-therapy represents an acceptable alternative in the palliative treatment of colon cancer. We have treated 25 patients with this pathology, 10 with obstructive tumor, which impeded the insertion of the endoscope, and 15 non-obstructive tumors. Higher technical difficulties on the former, together with a worse clinical situation, due to the fact that the tumor was more invasive, produce a more discrete result and with a higher risk of complications (one patient had a perforation and other an obstructive stenosis after two months of treatment) in comparison with the group of patients with non-obstructive tumors.

A single technique for polypropylene mesh hernioplasty of inguinal and femoral hernias.

The main factor in the repair of groin hernias is the reinforcement of posterior wall defects of the inguinal canal, including the femoral ring, because the normal insertion of the transversalis fascia and transversus abdominis muscle is on Cooper's ligament and not Poupart's ligament. In approximately one-half of primary femoral hernia repairs in men, a coincidental ipsilateral inguinal hernia existed. Recurrence after inguinal herniorrhaphy is usually femoral.

[Endoscopic retrograde cholangiopancreatography in Mirizzi's syndrome].

Mirizzi's syndrome is characterized by compression and or stenosis of the common duct as a consequence of impaction of a stone in the gallbladder neck, the cystic duct and eventually by a cholecystobiliary fistula. Preoperative diagnosis is important to avoid iatrogenic injury of the biliary tree. We present two cases with Mirizzi's syndrome confirmed at operation in whom ERCP was done prior to the operation.