Catálogo de publicaciones - libros

Lymphoscintigraphy plays an important role in the evaluation of lymphedema and several types of tumors, primarily melanoma and breast cancer. Confirmation of a lymphatic etiology for extremity swelling, along with localization of sites of lymphatic obstruction and leakage, can be achieved with lymphoscintigraphy. Its utilization to detect the sentinel node in melanoma patients is well established, while controversy still exists regarding its similar use in patients with breast cancer. In general, isolated removal of the sentinel node is a simpler, more limited surgical procedure that can be performed on an outpatient basis with the patient under local anesthesia and with far fewer complications than more extensive lymph node dissections.

Immunologically derived molecules for use in radioimmunotargeting are rapidly evolving from whole murine-derived antibodies to novel recombinant molecules. In the age of antibody engineering, it is important to understand the various physiologic factors which dictate behavior of these constructs. When evaluating a molecule for immunological targeting, issues of importance include affinity of binding, density and distribution of the antigen, and valence of the molecule, which together affect avidity. Size of the targeting molecule is important in that smaller molecules have potentially increased tissue penetration, reduced immunogenicity, and accelerated clearance from blood and background, but also exhibit decreased bioavailability, and potentially altered excretion pathways which may obscure areas of interest. Incorporation of foreign protein sequences, derived from other species, into the targeting molecule may lead to immunization of the host and altered biodistribution but can potentially be circumvented by recombinant DNA techniques. Identifying extremely high-affinity antibodies, which was once the holy grail of radioimmunotargeting, is now believed to be of more selected benefit, depending on valence, presence and density of antigen on target and background tissues, and the need for homogeneous targeting of the tumor, as in therapy applications.

The field of radioimmunotargeting is evolving from the use of whole or fragmented murine antibodies for antibody imaging to development of novel engineered molecules for therapy and imaging applications. Understanding the physiologic behavior of immunologically derived molecules is therefore of ever-growing importance to the nuclear medicine practitioner.

Several biological effects can result from ionizing radiation. These can be due to direct or indirect mechanisms, and they can be acute or delayed. Acute effects occur with exposure to high-level radiation. Delayed effects may appear after a long time and include cancer, genetic effects, effects on the unborn child, and other effects such as cataracts and hypothyroidism. Based on our current knowledge, no level of exposure to radiation can be described as absolutely safe and no level is uniformly dangerous. Radiation doses have to reach a certain level to produce acute injury but not to cause cancer or genetic damage. No biological effects in individuals have ever been documented as being due to levels of ionizing radiation employed for medical diagnosis. Absorbed doses from nuclear medicine procedures are very low. Fear of radiation must not be permitted to undermine the great value of radiation in clinical practice. However, safe handling of all levels of radiation is important to prevent or minimize possible biological effects.

Hyperthyroidism in pregnancy is generally caused by GTT or Graves’ disease. Management of Graves’ disease remains a challenge, with thionamide treatment as the best option. Patients should be monitored closely because undertreatment, with persistently high maternal TRAB, increases the risk of fetal hyperthyroidism, while overtreatment may cause fetal hypothroidism. Gestational hypothyroidism is usually related to autoimmune thyroid disease, and less frequently to iodine deficiency. The latter may be associated with fetal hypothyroidism as well. Neurological development is influenced by maternal thyroid function, fetal thyroid function, and thyroid horm one levels in the newborn.

Hyperthyroidism in pregnancy is generally caused by GTT or Graves’ disease. Management of Graves’ disease remains a challenge, with thionamide treatment as the best option. Patients should be monitored closely because undertreatment, with persistently high maternal TRAB, increases the risk of fetal hyperthyroidism, while overtreatment may cause fetal hypothroidism. Gestational hypothyroidism is usually related to autoimmune thyroid disease, and less frequently to iodine deficiency. The latter may be associated with fetal hypothyroidism as well. Neurological development is influenced by maternal thyroid function, fetal thyroid function, and thyroid horm one levels in the newborn.

The IP Multimedia Subsystem (IMS) is the latest framework for a seamless conversion of the ordinary Internet with mobile cellular systems. As such it has the backing of all major companies since it aims to offer a unified solution to integrated mobile services, including mechanisms for security, billing, quality of service and so forth. We provide a unique assessment of IMS based on our experimental test-bed, investigating functional and performance capabilities. Our study helps evaluating the level of maturity of state-of-the-art open source technologies in view of the deployment of IMS. We assess the suitability of SIP, IPv6, MIPv6 and IPsec as basic IMS enablers, highlighting crucial shortcomings which need immediate attention.

Cholescintigraphy plays a pivotal role in the evaluation of various biliary tract diseases, particularly when coupled with pharmacological intervention. The physician monitoring the study should be familiar with the most optimal technique for the pharmacological intervention and with conditions and medications that affect gall bladder contraction. It is also important to be aware of the various physiological and pharmacological effects on imaging findings, i.e., not only those findings that are normal but also the undesirable variants [253]. Failure to recognize such effects can lead to incorrect interpretation.

Radionuclide imaging of the liver using the various tracers provides unique functional information, i.e., the functional reserve, presence or absence of hepatocytes/Kupffer’s cells, and RBC pooling. This has been augmented further by the improved resolution with multi-head SPECT systems. Advances in instrumentation such as PET and development of new radiopharmaceuticals, including PET tracers specifically for the evaluation of the liver, will likely expand clinical applications further.

Lymphoscintigraphy plays an important role in the evaluation of lymphedema and several types of tumors, primarily melanoma and breast cancer. Confirmation of a lymphatic etiology for extremity swelling, along with localization of sites of lymphatic obstruction and leakage, can be achieved with lymphoscintigraphy. Its utilization to detect the sentinel node in melanoma patients is well established, while controversy still exists regarding its similar use in patients with breast cancer. In general, isolated removal of the sentinel node is a simpler, more limited surgical procedure that can be performed on an outpatient basis with the patient under local anesthesia and with far fewer complications than more extensive lymph node dissections.

Immunologically derived molecules for use in radioimmunotargeting are rapidly evolving from whole murine-derived antibodies to novel recombinant molecules. In the age of antibody engineering, it is important to understand the various physiologic factors which dictate behavior of these constructs. When evaluating a molecule for immunological targeting, issues of importance include affinity of binding, density and distribution of the antigen, and valence of the molecule, which together affect avidity. Size of the targeting molecule is important in that smaller molecules have potentially increased tissue penetration, reduced immunogenicity, and accelerated clearance from blood and background, but also exhibit decreased bioavailability, and potentially altered excretion pathways which may obscure areas of interest. Incorporation of foreign protein sequences, derived from other species, into the targeting molecule may lead to immunization of the host and altered biodistribution but can potentially be circumvented by recombinant DNA techniques. Identifying extremely high-affinity antibodies, which was once the holy grail of radioimmunotargeting, is now believed to be of more selected benefit, depending on valence, presence and density of antigen on target and background tissues, and the need for homogeneous targeting of the tumor, as in therapy applications.

The field of radioimmunotargeting is evolving from the use of whole or fragmented murine antibodies for antibody imaging to development of novel engineered molecules for therapy and imaging applications. Understanding the physiologic behavior of immunologically derived molecules is therefore of ever-growing importance to the nuclear medicine practitioner.

Lymphoscintigraphy plays an important role in the evaluation of lymphedema and several types of tumors, primarily melanoma and breast cancer. Confirmation of a lymphatic etiology for extremity swelling, along with localization of sites of lymphatic obstruction and leakage, can be achieved with lymphoscintigraphy. Its utilization to detect the sentinel node in melanoma patients is well established, while controversy still exists regarding its similar use in patients with breast cancer. In general, isolated removal of the sentinel node is a simpler, more limited surgical procedure that can be performed on an outpatient basis with the patient under local anesthesia and with far fewer complications than more extensive lymph node dissections.