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Objective: To evaluate and compare the performances of FDG-PET imaging, MRI and clinical examination in the detection of residual tumour 3 months after treatment of patients with head and neck squamous cell carcinoma., Patients: A consecutive sample of 50 patients with squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx or larynx, or a cervical lymph node metastasis from an unknown primary site excluding T1 lip and T1 vocal cord tumours., Methods: Treatment outcome was assessed after 3 months by clinical examination, MRI, and FDG-PET scan. Sensitivity, specificity and accuracy were calculated relative to proven biopsy of residual tumour or a clinical follow-up of 4 months., Results: Residual cancer was confirmed in 8 patients (16%), while the clinical follow-up was unsuspicious in the remaining 42 patients. PET-FDG had a sensitivity of 100% as compared to MRI (88%) and clinical examination (63%). Specificity was higher for clinical examination (90%), intermediate for MRI (83%) and lowest for PET-FDG (74%)., Conclusions: This study finds very high sensitivity for PET-FDG in the detection of residual tumour. However, its lower specificity, lack of anatomical resolution, and high cost, require further studies to determine its role in routine screening.

Peak bone mass, which can be defined as the amount of bony tissue present at the end of the skeletal maturation, is an important determinant of osteoporotic fracture risk in adulthood. The techniques of single or dual energy absorptiometry measure the so-called "areal" or "surface" bone mineral density (BMD), a variable which has been shown to be directly related to bone strength. During puberty the gender difference in bone mass becomes expressed. This difference appears to be essentially due to a more prolonged bone maturation period in males than in females, with a larger increase in bone size and cortical thickness, as there is no significant sex difference in the volumetric trabecular density at the end of pubertal maturation. At the beginning of the 3rd decade, there is a large variability in the normal values of areal BMD in axial and appendicular skeleton. This large variance, which is observed at sites particularly susceptible to osteoporotic fractures in adulthood, such as lumbar spine and femoral neck, is barely reduced after correction for statural height, and does not appear to substantially increase during adult life. It is generally accepted that peak bone mass at any skeletal site is attained in both sexes during the mid-thirties. However, recent studies indicate that in healthy caucasian females, bone mass accumulation can virtually be completed before the end of the second decade, for both lumbar spine and femoral neck. Several variables are supposed to influence bone mass accumulation during growth: heredity, sex, diet components, endocrine factors, mechanical forces, and exposure to risk factors.(ABSTRACT TRUNCATED AT 250 WORDS)

Although reduced gonadal steroid hormone concentration appear to play a major role in lower trabecular bone density (BMD) in female marathon runners, dietary deficiencies and eating behaviors may also affect BMD. To investigate that possibility, dietary patterns and BMD were examined in 27 female regular marathon runners classified as eumenorrheic (8), amenorrheic (10) and under oral contraception (9). The results show a significant lower BMD in amenorrheic athletes but no dietary deficiencies. These results suggest that the eating behavior don't play any role in the lower BMD of our athletes.

Bone mineral density (BMD) was measured by dual photon absorptiometry in the lumbar spine, femoral neck and midfemoral shaft in 209 women and 165 men aged 20 to 98 years recruited among the Geneva population. The prevalence of various factors (life style, calcium intake, body weight) which may be associated with a higher risk of osteoporosis was evaluated. Between the different skeletal sites, BMD was closely correlated. Nevertheless, BMD at one site failed to accurately predict BMD of another site. In each age class, BMD was dispersed over a wide range. Women and men had similar lumbar spine BMD. In women, BMD decreased after the fifth decade by 1.3, 1.0 and 2.6% year in the lumbar spine and femoral neck and shaft, respectively. Daily calcium intake from dairy products was 430 g and 750 g in women and men, respectively. Femoral shaft BMD was positively correlated with calcium intake. These BMD values obtained in a sample of the normal Geneva population should be of major help for the diagnosis of osteoporosis.

Plasma measurement of D-dimers (DD), which are fibrin-specific degradation products, progressively replaces the cumbersome dosage of fibrinogen degradation products (FDP's) in serum for diagnosis and follow-up of consumption coagulopathies, for diagnosis of prethrombotic states and, potentially, for the control of the efficacy of antithrombotic therapies. Moreover, when the ELISA technique is used, this measurement may be very useful in the diagnosis approach of venous thromboembolic disease. In the present review, data are presented which strongly support the view that a low level of plasma D-dimers (less than 500 micrograms/L when using the ELISA from Stago) allows to exclude the diagnosis of deep venous thrombosis or pulmonary embolism with predictive values of 94 % and 100 % respectively. It is suggested that such a diagnostic potential might be very useful in the group of patients with inconclusive perfusion-ventilation scintigraphy (low or indeterminate probability of pulmonary embolism) which represent about 50 % of the patients with suspected pulmonary embolism.

Bleomycin is the term for a group of antibiotics produced by cultures of the fungus Streptomyces verticulus, the anti-tumor cell potential of which was shown by Umezawa. Use of this property as a tumor specific marker radiolabelled with cobalt-57 was recognized by Renault in 1971. Since then there have been numerous publications concerning the good sensitivity of this type of study in the detection of neoplasms. Our department is currently investigating the sensitivity and specificity of this technique for the detection of pulmonary tumors. We describe here two typical cases illustrating the interest of this method in the diagnosis and staging of lung cancer.

57Co-bleomycin scanning dates from the early 1970s, when the first results were presented by Renault et al. Since then there have been numerous publications concerning the high sensitivity of this type of study in the detection of pulmonary or cerebral neoplasms. In the region below the diaphragm, however, sensitivity was poor due to hyperactivity of the kidney, liver and bladder. To eliminate this problem the authors have used single photon emission computerized tomography (SPECT), and their department is currently investigating the sensitivity of this technique for the detection of neoplasms. Two typical cases are described which illustrate the value of this method in the detection of cancer.