The purpose of this study was radiologic assessment of osteoarthritis after arthroscopic partial meniscectomy. At an average followup of 53.5 months, 284 consecutive patients were retrospectively evaluated clinically and radiologically. Two hundred forty-seven patients had been treated for medial (Group I) and 37 for lateral meniscal tears (Group II). Preoperative radiographs were compared with those at followup and were classified. The results were analyzed statistically. Osteoarthritic changes were classified as being worse in 38% of the patients after medial and in 24% of the patients after lateral arthroscopic partial meniscectomy. Further subclassification and comparison of patients with or without already existing articular surface damage at the time of arthroscopy were not found to have significant impact on the prevention of osteoarthritic changes. Patients who were older than 40 years of age and who had undergone arthroscopic partial medial meniscectomy were radiologically classified with a significantly higher rate of osteoarthritis than patients who were younger than 40 years. Partial medial or lateral meniscectomy leads to a significant increase of osteoarthritic changes, even when this intervention is performed arthroscopically.
Molecular imaging and targeted radiotherapy with radiolabeled cholecystokinin-2 receptor (CCK2R) targeting peptide probes holds high promise to improve the clinical management of patients with metastatic medullary thyroid carcinoma and other CCK2Rexpressing malignancies. Low stability and suboptimal targeting of currently available radiolabeled peptide analogs has prompted us to seek new stabilization strategies. In this study, we present a new minigastrin analog with site-specific C-terminal modifications showing a highly optimized targeting profile. Methods: DOTA-D-Glu-Ala-Tyr-Gly-Trp-(N-Me)Nle-Asp-1-Nal-NH 2 (DOTA-MGS5) radiolabeled with 111 In, 68 Ga, and 177 Lu was evaluated in extensive in vitro stability studies. For 177 Lu-DOTA-MGS5, additional metabolic studies were performed on BALB/c mice. Receptor affinity and cell uptake were studied in A431 human epidermoid carcinoma cells transfected with human CCK2R (A431-CCK2R), as well as the same cell line transfected with the empty vector (A431-mock). A431-CCK2R/A431-mock xenografted athymic BALB/c nude mice were used for biodistribution studies and small-animal SPECT/CT. Results: DOTA-MGS5 radiolabeled with 111 In and 177 Lu showed a highly increased stability against enzymatic degradation in different media up to 24 h of incubation. Similar results were observed for 68 Ga-DOTA-MGS5 incubated up to 4 h. In the blood of mice injected with 177 Lu-DOTA-MGS5, at least 70% intact radiopeptide was detected up to 1 h after injection. The unlabeled peptide and the complexes with the natural isotopes showed retained receptor affinity, and the radiopeptides showed unexpectedly high cell uptake in A431-CCK2R cells (.60% at 4 h). Regardless of the radiometal used for labeling, impressively high uptake in A431-CCK2R xenografts was found (∼20% injected activity/g 1-4 h after injection), whereas the uptake in A431-mock xenografts was negligible. Low background activity and favorable tumor-to-kidney ratios (4-6) allowed for high image contrast in small-animal SPECT/CT. Conclusion: The excellent targeting properties of DOTA-MGS5 support future clinical studies evaluating the diagnostic and therapeutic potential in patients with progressive or metastatic medullary thyroid carcinoma, as well as other advanced-stage CCK2R-expressing malignancies.
Development of CCK2 receptor ligands especially for therapeutic purposes in patients with MTC or small cell lung cancer (SCLC) is still ongoing in different laboratories. This comparative study provided valuable insight into the importance of biological stability especially in the context of other results of this comparative trial within the COST Action BM0607.
Intramedullary fixation of midshaft clavicular fractures with a TEN is a safe minimally invasive surgical technique achieving primary stability for practice. It can be seen as an alternative to plate or screw fixation or nonsurgical treatment, as it produces excellent cosmetic and functional results regardless whether patients suffered from isolated clavicular fractures, additional injuries, or multiple traumas.
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