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Biomedical subjects

A Bockisch

Publications and source records attributed to A Bockisch.

At least 73 records · Page 4Linked to original sources
PubMed1996

Value of intracoronary ultrasound and Doppler in the differentiation of angiographically normal coronary arteries: a prospective study in patients with angina pectoris.

BACKGROUND: A substantial proportion of patients undergoing heart catheterization for suspected coronary artery disease have normal angiograms. Coronary morphology and blood flow velocity can be assessed very accurately with intracoronary ultrasound and Doppler. The purpose of this study was to use both methods to classify further patients with suspected coronary artery disease but with coronary angiograms adjudged normal at the time. METHODS AND RESULTS: In forty-four patients with suspected coronary artery disease and normal coronary angiograms, intracoronary ultrasound and intracoronary Doppler were performed in the left anterior descending and left main coronary arteries. Coronary flow reserve was obtained by calculating the ratio of the maximal coronary flow mean velocity after the intracoronary administration of 10 mg papaverine to the coronary flow mean velocity at rest. Of 44 patients, 16 (36%) (group I) were found to have normal coronary morphology by intracoronary ultrasound and normal (> 3.0) coronary flow reserve (5.3 +/- 1.8). In seven patients (16%) (group II) there were normal intracoronary ultrasonic findings but a reduced coronary flow reserve (2.1 +/- 0.4). Plaque formation was found in a total of 21 (48%) of the 44 patients; mean plaque sizes were 3.6 +/- 1.6 mm2 for those in group III (normal coronary flow reserve) and 5.0 +/- 2.3 mm2 for those in group IV (reduced coronary flow reserve). Vessel area in both of these groups (16.3 +/- 8.0 mm2 and 19.2 +/- 6.1 mm2) was significantly larger than that of group I (14.6 +/- 5.7 mm2, P < 0.01). Plaque calcification was found in 25% of those in group III and 44% of those in group IV. Thus, only 36% of the patients with normal angiograms were true normal, 48% exhibited early stage of coronary atherosclerosis, and the other 16% might be considered as syndrome X. CONCLUSION: Intracoronary ultrasound and Doppler can be used to differentiate further heart disease in patients with normal coronary angiograms. Only a minority were true normal. Early signs of atherosclerosis cannot be detected by coronary angiography. This may have important therapeutic and prognostic implications.

Adult↗
PubMed1995

Technetium-99m mercaptoacetyltriglycine clearance: reference values for infants and children.

Six hundred and thirty-nine clearance studies performed in children aged 7 days to 19 years utilizing technetium-99m mercaptoacetyltriglycine (MAG 3) were retrospectively analysed. Standardized conditions for the investigation included: parenteral hydration (60 ml/hxm2 body surface) in addition to normal oral fluid intake, weight-related dose of 99mTc-MAG 3 (1 MBq/kg body weight, minimum 15 MBq) and calculation of clearance according to Bubeck et al. Of the 513 children, 169 included in this analysis could be classified as "normal" with regard to their renal function. Normal kidney function was judged by the following criteria: normal GFR for age, normal tubular function (absence of proteinuria and glucosuria), normal renal parenchyma (on ultrasonography, MAG 3 scan and intravenous pyelography), absence of significant obstruction and gross reflux (>grade I), no single kidney and no difference in split renal function >20%. Results showed increasing MAG 3 clearance values for infants during the first months of life, reaching the normal range for older children and adults between 7 and 12 months.

Adolescent↗
PubMed1995

Gynaecomastia in a patient with a hCG producing giant cell carcinoma of the lung. Case report.

Gynaecomastia, or enlargement of the male breast may result from various endocrine dysfunctions and often reflects ectopic production of substances such as hCG and estradiol. We report on the case of a 30 year old man who presented with gynaecomastia and elevated plasma levels of hCG, estradiol and testosterone. As a result of several diagnostic procedures such as selective venous sampling and magnetic resonance tomography (MRT), a hCG producing tumor of the upper lobe of the left lung was found. This hormonal overproduction induced an enhanced secretion of estradiol and testosterone in the testicular tissue. Histology revealed a giant cell carcinoma with positive immunostaining for hCG. This case report further underlines the necessity of an intensive search for ectopic beta-hCG production due to malignant tumours, in particular in the adult.

Adult↗
PubMed1995

Peripheral osteopenia in adult patients with insulin-dependent diabetes mellitus.

Alterations in bone metabolism in diabetes mellitus is a topic of special interest. Bone blood flow is increased in the distal limb of diabetic patients, which is believed to increase osteoclastic activity. We measure bone mineral density using dual-photon absorptiometry in the distal lower limb, the femoral neck, and the lumbar spine in 41 IDDM patients and in 30 control persons. In the diabetic group there was a 10% reduction of bone mineral density in the femoral neck (p < 0.01) and a 12% reduction in the distal limb (p < 0.001) compared with the control group. No significant difference was found in the lumbar spine (p = 0.22). Our data yield incidence for peripheral osteopenia in IDDM-patients, independent of any systemic bone disease such as osteoporosis. A link between decreased bone mineral density and diabetic neuropathy has been observed for the femoral neck (p < 0.001), but not for the distal limb or axial skeleton. Whether there is a common aetiological link or a casual connection between diabetic neuropathy and bone mineral density has still to be determined.

Absorptiometry, Photon↗
PubMed1995

[Immunoscintigraphy with MAb B72.3 for preoperative detection of lymph node metastases of colorectal carcinoma].

From April 1, 1992 to December 31, 1993 we investigated 30 patients with suspected primary colorectal carcinoma or questionable tumor relapse by immunoscintigraphy prospective with the monoclonal antibody MAb B72.3 in order to detect the tumor and especially regional lymph node metastases. All the patients underwent surgical treatment. The diagnosis was based on surgery and biopsy. The diagnostic sensitivity of immunoscintigraphy in detecting the tumor was 76%, the specificity 94% (predictive value positive [PVP] 95%) and 43%, respectively 85% in detecting lymph node metastases (PVP 60%). The diagnostic sensitivity in detecting rectosigmoid tumors was 79 and 60% in detecting lymph node metastases of rectosigmoid carcinoma (PVP 60%). The specificity was 90%. It could be shown, that the detection of metastases in singularly lymph nodes smaller than 1 cm was not possible and often a final decision could not be done. We conclude, that the benefit of this method in detection of lymph node metastases compared to basic diagnostic, expenses and costs is doubtfully.

Adenocarcinoma↗
PubMed1995

[Imaging of metastases from thyroid carcinomas using 111In-pentetreotide scintigraphy].

There is little experience with imaging of thyroid carcinoma tissue by somatostatin receptor scintigraphy. Our case report describes an acromegalic patient, in whom 111In pentetreotide scintigraphy did not only demonstrate a receptor-positive pituitary tumor but also visualized metastases from a papillary thyroid carcinoma which had no correlate in radioiodine scintigraphy carried out under hypothyroid conditions. The possible role of this radiopharmaceutical in dedifferentiating thyroid carcinoma is discussed for its usefulness in tumor localisation and its predictive value for the outcome of an octreotide therapy.

Female↗
PubMed1995

Indium-111-pentetreotide scintigraphy in Graves' ophthalmopathy.

UNLABELLED: The radiolabeled somatostatin analog 111In-pentetreotide can sensitively demonstrate somatostatin receptor-positive localizations in diseases where activated lymphocytes play a role. Lymphocyte infiltration of retrobulbar tissue in Graves' ophthalmopathy is the rationale of receptor imaging with radionuclide-coupled 111In-pentetreotide. METHODS: Forty patients with Graves' ophthalmopathy, 5 patients with orbital myositis and 10 control subjects were included in this prospective study. Indium-111-pentetreotide (110 MBq) was intravenously injected and SPECT images were obtained at 4 and 24 hr after injection. The scans were analyzed by a region of interest technique. An uptake ratio between the orbits and the brain was determined. RESULTS: Compared to controls (4-hr 111In-pentetreotide uptake: median 6.0 counts/voxel/MBq, orbit-to-brain ratio 5.6), ophthalmopathy patients showed two- to threefold increased uptake (15.8 counts/voxel/MBq versus controls p = 0.0032; ratio 12.6 versus controls p = 0.003). When considering patients with active disease only, even higher uptake was registered (16.8 counts/voxel/MBq versus controls p = 0.0048, ratio 15.6 versus controls p = 0.0006). Untreated patients showed markedly higher uptake (23 counts/voxel/MBq) compared to patients under steroid therapy (12.6, p = 0.001). In myositis, high uptake (20 counts/voxel/MBq) was also registered. CONCLUSION: In contrast to controls, ophthalmopathy patients showed markedly increased orbital accumulation of labeled 111In-pentetreotide. This sensitive nuclear medicine technique could possibly select those patients who might benefit from treatment with immunosuppressive agents and/or octreotide.

Eye↗
PubMed1994

[Changes in the blood picture after radioiodine therapy of thyroid cancer].

AIM: In this study the effect of radioiodine which was administered because of thyroid carcinoma on blood count and various other parameters was examined. PATIENTS AND METHODS: In 567 patients who had been treated because of a thyroid carcinoma between 1980 and 1990 with radioiodine, changes of hemoglobin, RBC, WBC, platelets, potassium, uric acid, gamma GT, GOT, GPT and AP were measured in correlation with the totally administered dose. RESULT: In low doses (< 18.5 GBq [500 mCi]), which are sufficient in most cases with clinical course without complications, relevant changes of blood count (hemoglobin: < or = 9.0/10.5 g/dl, RBC: < or = 3.1/3.5 10(12)/l (female/male), WBC: < or = 2.5 10(9)/l, platelets: < or = 0.5 10(11)/l) were observed in only 5 out of 469 cases. After moderate doses (> or = 18.5 GBq [500 mCi] and < 37 GBq [1000 mCi]) we found in only 1 out of 77 cases relevant changes. After very high doses (> or = 37 GBq [1000 mCi]), which are used to treat metastases and/or recurrences, thrombopoesis is most sensitive to the radiation exposure of the bone marrow. Relevant decrease of RBC and WBC were observed in 2 out of 21 patients. Pancytopenia (hemoglobin: < or = 12.0/13.5 g/dl, RBC: < or = 3.9/4.3 10(12)/l [female/male], WBC: < or = 3.5 10(9)/l, platelets: < or = 1.4 10(11)/l) occurred in 4 cases. CONCLUSION: In high-dose therapy with radioiodine frequent (monthly, but in any cases before each therapy) controls of blood count are necessary. In patients without metastases or recurrence no relevant changes can be expected in most cases.

Adolescent↗
PubMed1994

Decreased benzodiazepine receptor binding in panic disorder measured by IOMAZENIL-SPECT. A preliminary report.

Single photon emission tomography (SPECT) imaging of the central benzodiazepine receptor (BZr) became possible with the newly developed ligand 123I-IOMAZENIL. The BZr binding was investigated in ten patients with panic disorder (PP) compared to ten epileptic patients (EP). Panic patients had lower IOMAZENIL uptake rates in the frontal, occipital and temporal cortex than EP indicating the involvement of the BZr complex in panic disorder.

Adult↗
PubMed1994

[Somatostatin receptor scintigraphy in endocrine orbitopathy].

Somatostatin receptor scintigraphy with 111In-labeled octreotide proves to be a very sensitive diagnostic tool for evaluation of inflammative activity in endocrine ophthalmopathy (EO). The results of somatostatin receptor scintigraphy (SRS) in 40 patients with EO show a high orbital accumulation of 111In-octreotide in clinically active EO (4 h-median/orbit-brain-ratio: 12.6; controls 4 h-median: 5.8) Patients with clinically inactive EO (4 h-median: 7.1) show a similar orbital accumulation of radioactivity compared to controls. 5 patients with active orbital myositis also revealed an even higher orbital accumulation of radioactivity (4 h-median: 42.3). The diagnostic value of SRS lies in its ability to act as a measure of inflammation and can be useful as an activity parameter when planning therapeutic procedure as well as for EO follow-up. The results in patients with orbital myositis nevertheless do not permit a differential diagnosis with this method. The therapeutic value of 111In-octreotide in Graves' disease has yet to be established.

Adult↗
PubMed1994

[Scintigraphic display of an ectopic parathyroid adenoma using 99mTc-MIBI--2 case reports].

Radionuclide imaging of the parathyroid gland is used in the preoperative localization of parathyroid adenoma. Until recently radionuclide imaging of parathyroid tumors was performed using a dual-tracer subtraction technique with 201TI and 99mTcO4-. As an alternative radionuclide imaging with 99mTc-sestamibi (MIBI) has been introduced some years ago. The utility of preoperative parathyroid localization lies in its ability to direct surgical exploration, particularly of ectopic localizations. We present two cases of parathyroid adenoma in which radionuclide imaging with 99mTc-MIBI was successful in detecting atypical locations. In the first case remaining primary hyperparathyroidism was caused by a mediastinal gland. The second case suffered from a recurrence of secondary hyperparathyroidism caused by hyperplasia of the autotransplanted gland after removal of all four parathyroid glands.

Adenoma↗
PubMed1993

[99mTc-MAG3-kidney function scintigraphy without and with captopril in the diagnosis of renovascular hypertension].

In this study, the diagnostic value of renal function scintigraphy performed both without and with ACE inhibition has been evaluated using the new radiopharmaceutical 99mTc-MAG3. In cases of decompensated renal artery stenoses, the typical scan finding with this tubular excreted agent was shown to be a distinct parenchymal nuclide retention in combination with a delayed appearance of the radiotracer in the pelvic system. Using this criterion in 43 patients with suspected renovascular hypertension, sensitivity and specificity were 89 and 88%, respectively. Bilateral positive findings were non-specific; excluding them from the study, specificity increased to 100%. In renal insufficiency, captopril scans seem to be of reduced diagnostic value. Summarising our experiences, renal function scintigraphy using 99mTc-MAG3 without and with captopril was proved to be a reliable non-invasive method to detect or exclude haemodynamically relevant renal artery stenosis.

Captopril↗
PubMed1993

Tc-99m labeled monoclonal antibodies against granulocytes (BW 250/183) in the detection of appendicitis.

Scintigraphy with Tc-99m labeled antigranulocyte antibodies (BW 250/183 MoABs) was performed in 32 patients with suspected appendicitis. Abdominal imaging (planar/SPECT) was performed 2 hours after injection of the tracer. All patients also had surgery and a histologic examination of the resected tissue. Of the patients, 17 suffered from "acute appendicitis" and 12 had right positive scans (sensitivity = 70.6%). In 15 patients, acute appendicitis could have been ruled out, and in 11 of these cases the scan was true negative (specificity = 73.3%). The overall accuracy was 71.8% (23/32 cases). The use of Tc-99m antigranulocyte MoABs may overcome the problems associated with the Tc-99m HMPAO granulocyte and In-111 oxine approaches, which include nonspecific intestinal activity or the lack of timeliness. The use of Tc-99m labeled antigranulocyte antibodies is suitable as an emergency procedure and may play a role in the management of patients with suspected appendicitis.

Adolescent↗
PubMed1993

[Evaluation criteria for captopril-kidney function scintigraphy using 99mTc-MAG3].

Renal function scintigraphy under ACE inhibition has gained an important role in the diagnosis of renovascular hypertension. Using the radiopharmaceutical 99mTc-MAG3, 54 kidneys with angiographically verified renal artery status were evaluated with respect to the following scintigraphic parameters: intraparenchymal tracer transport, urine drainage, kidney size, and functional side-to-side ratio. In cases of decompensated renal artery stenosis, the typical scan finding using MAG3 was shown to be a distinct parenchymal nuclide retention in combination with a delayed appearance of the radiotracer in the pelvic system. In our patients, the visual impression of the renal sequential scans was superior to quantitative evaluation methods. Using these criteria in 43 patients with suspected renovascular hypertension, sensitivity and specificity were 89% and 88%, respectively. Bilateral positive findings were nonspecific; when excluding them from the study, specificity increased to 100%.

Adult↗
PubMed1993

Sperm cell dynamics in the female rabbit genital tract after insemination monitored by radiolabeled spermatozoa.

Dynamic in vivo imaging of spermatozoa radiolabeled with 99mTc-HMPAO in the female genital tract was performed noninvasively. Animal studies were performed under a variety of insemination conditions and their influence on the dynamics and number of spermatozoa in ascent was demonstrated. Spermatozoa motility was not significantly reduced by radiolabeling. In vitro and in vivo labeling stability was > 93% after 18 hr. Female rabbits were inseminated with labeled spermatozoa and dynamic scintigraphic studies were performed up to 12 hr after insemination. The in vivo behavior of labeled spermatozoa was similar to native spermatozoa. Absolute spermatozoa numbers could be determined noninvasively and reliably at different parts in the female genital tract at various timepoints after insemination.

Animals↗
PubMed1993

Optimized dose planning of radioiodine therapy of benign thyroidal diseases.

Thyroid uptake measurements were performed on 246 patients, who underwent radioiodine therapy for benign disease up to 192 hr after oral application of either the test activity (7 MBq) or the therapeutic activity (150-1100 MBq). Using the complete set of uptake values, the cumulated activity in the thyroid was calculated and the dose-to-activity ratio (D/A) deduced. An empiric factor was derived, which allows prediction of the D/A with high precision, using only the late uptake measurement at 96 hr or 192 hr. The correlation between the value calculated from the complete set of uptake values and that of only one at 96 hr or 192 hr was R = 0.99 and 0.97, respectively. The activity required for intended dose can thus reliably be determined by a single, late uptake measurement. In a second analysis, the correlation between the D/A of the test and the therapeutic activity was established. There were two essential findings: For those patients who were without or under stable thyroid-specific medication there was a strong correlation between the two D/A values. The therapeutic value was on the average approximately 15% lower than the test ratio, which is assumed to be due to an enhanced iodine turnover under therapeutic conditions. In patients whose medication changed close to the test study or therapy, the measured test and therapeutic D/A were strongly noncorrelated.

Dose-Response Relationship, Radiation↗