Determination of systolic thickening index with gated Tc-99m sestamibi SPECT. A new parameter of myocardial viability?

Myocardial perfusion imaging with Tc-99m MIBI SPECT may underestimate the amount of viable myocardium in patients with coronary artery disease and prior infarction. Electrocardiogram gating could potentially better correlate with the presence of jeopardized myocardium, since it allows the evaluation of systolic contractility parameters in addition to the assessment of perfusion. Using the diastolic and systolic bull's eyes of a rest Tc-99m MIBI-gated SPECT study to generate an index of systolic thickening, we clearly observed an impaired contractility in the anterior and septal walls in a patient with multiple vessel disease and a mild mid-left anterior descending stenosis, despite a normal tracer uptake.

Generalized bone marrow metastases. High liver uptake on bone marrow immunoscintigraphy associated with extramedullary hematopoiesis.

Increased hepatic uptake and absent bone marrow uptake on bone marrow immunoscintigraphy has been reported after the formation of human antimurine antibodies. A case of generalized bone marrow metastases is presented, in whom an elevated liver uptake on bone marrow immunoscintigraphy proved to be associated with extramedullary hematopoiesis. Extramedullary hematopoiesis should be included as a possible cause of a disproportionately elevated liver uptake on bone marrow immunoscintigraphy, especially on initial studies, or on repeat studies with low human antimurine antibody titers.

Duodenal diaphragmlike stricture induced by acetylsalicylic acid.

Many reports have mentioned the role of nonsteroidal antiinflammatory drugs in inducing diaphragm-like strictures in the small and large bowel. These lesions are mostly seen in patients with chronic use of nonsteroidal antiinflammatory drugs. We report the case of a 57-year-old man who developed a diaphragmlike stricture in the second part of the duodenum.

Single photon emission computed tomography using perfusion tracers in seizure disorders.

Single photon emission computed tomography (SPECT) using perfusion tracers makes it possible to estimate regional cerebral blood flow (rCBF) and, indirectly, local brain metabolism. It may be possible to detect and follow physiopathological alterations, such as may be seen in seizure disorders. The authors review the principles of and some data on perfusion SPECT in seizure disorders, stress advantages as well as major drawbacks and add their initial experience with Tc-99m hexamethylpropyleneamine oxime (HMPAO) SPECT in febrile convulsions.

Three cases of femoral head fracture in a single car accident.

Three cases of femoral head fractures in a single car accident are described. The outcome of these relatively uncommon fractures after 14 months of followup is fair for the Pipkin Type I and II lesions and good for the Pipkin Type IV one. A review of consulted literature has been added.

Placebo-controlled trial of high-dose Mesterolone treatment of idiopathic male infertility.

The possible effect of Mesterolone (Schering N.V., Brussels, Belgium) (1 alpha-methyl-5-alpha-androstane-17 beta-ol-3-one) on semen quality and fertility of men with idiopathic oligoasthenospermia and/or teratozoospermia has been evaluated in a double-blind trial.