Catálogo de publicaciones - libros

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.

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.

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.

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.

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.

To understand the various scintigraphic patterns of parathyroid disease, it is important to understand parathyroid embryology and anatomy. Although experienced neck surgeons can achieve a high success rate of parathyroidectomy after bilateral neck exploration without prior localizing study [2, 3], a preoperative localization study would decrease operative time and morbidity and is frequently needed for the minimally invasive surgical approach that is currently practiced with increasing frequency. The most commonly used and most cost effective modality for preoperative localization is Tc-sestamibi and alternatively Tc-Myoview. The technique is being used before the initial surgery but is most clearly indicated for the preoperative evaluation of recurrent or persistent hyperparathyroidism. SPECT and particularly pinhole acquisition are valuable to improve the accuracy of localization. Intraoperative gamma probe localization is increasingly used also along with the minimally invasive surgical approach. The spectrum of parathyroid disease demonstrated with Tc-sestamibi scintigraphy includes eutopic disease, ectopic disease, solitary adenoma, double or multiple adenomas, cystic adenoma, lipoadenoma, multiple endocrine neoplasia, hyperfunctioning parathyroid transplant and others. The diagnosis of parathyroid tumors with Tc-sestamibi scintigraphy is based on the difference in clearance rates between the thyroid and diseased parathyroid glands, and any condition that interferes with radiotracer clearance will limit the effectiveness of the study. Atypical washout is one of the known entities that can limit the accuracy of these stuidies and it is probably related to the mitochondrial contents of the cells of the abnormal glands. Adding thyroid scan and ultrasonography improves results but is not cost effective enough to be a routine practice.

Subtraction Tc-sestamibi, iodine-123 scintigraphy or more recently PET may be helpful in difficult cases.

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.

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.