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Biomedical subjects

A Mostbeck

Publications and source records attributed to A Mostbeck.

At least 55 records · Page 3Linked to original sources
PubMed1982

67Ga scanning for assessment of disease activity and therapy decisions in pulmonary sarcoidosis in comparison to chest radiography, serum ACE and blood T-lymphocytes.

In 60 patients with histologically proven sarcoidosis, 67Ga scanning was evaluated in terms of sensitivity and specificity for assessing disease activity and compared with chest radiography, serum ACE and blood T-lymphocytes. While 67Ga scans had the highest sensitivity (94%), the specificity was only 68%. The sensitivity of chest radiography was 80%, of serum ACE and blood T-lymphocytes 77% and 48%, respectively. While in patients with radiographical type I, 67Ga scanning, chest radiography and serum ACE had a sensitivity of 92%-100%, in patients with radiographical type II-III, only 67Ga scans had a sensitivity exceeding 90%. A 67Ga score correlated significantly with serum ACE levels (r = 0.59, P less than 0.001). After effective steroid treatment, 67Ga uptake and serum ACE activities decreased markedly. While in 25% of cases, chest radiography failed to provide reliable information, 67Ga scanning and serum ACE activities always proved useful in evaluating the course of the disease and the patient's response to steroid therapy. A negative 67Ga scan together with normal serum ACE levels seem to have a high predictive value for excluding active sarcoidosis.

Adolescent↗
PubMed1982

Immunoreactive trypsin, alpha-amylase and lipase in serum--is there an age-dependence?

A strong age-dependence of IR trypsin was found in 424 healthy controls suggesting the need for age-matched reference values. A possible relation of other exocrine pancreatic enzymes like alpha-amylase and lipase to age was investigated in 185 apparently healthy persons undergoing a preventive health check. Only alpha-amylase showed a weak correlation with age, but not lipase. Both enzymes correlated with IR trypsin. Whilst alpha-amylase and lipase activities were within the normal range, approximately 25% of IR-trypsin concentrations were above age-matched control values. It is suggested that these apparently healthy persons already have disease of the exocrine pancreas, and IR trypsin is a more sensitive diagnostic tool for screening than alpha-amylase or lipase.

Adolescent↗
PubMed1982

Assessment of activity in Sarcoidosis. Sensitivity and specificity of 67Gallium scintigraphy, serum ACE levels, chest roentgenography, and blood lymphocyte subpopulations.

The value of different factors are examined to assess activity in 60 patients with biopsy-proven sarcoidosis. In patients with active sarcoidosis (n = 35), 67Gallium scans proved to be the most sensitive method (94 percent sensitivity), followed by serum angiotensin I converting enzyme (S-ACE) levels, chest x-ray films, and lymphocyte assays. In patients with peripheral pulmonary lesions, chest x-ray films failed in 32 percent of cases to document activity (68 percent sensitivity) whereas 67Ga scans and S-ACE levels remained to give reliable results. Despite poor specificity, negative 67Ga scans together with normal ACE levels have a high predictive value for exclusion of active sarcoidosis. In patients with peripheral pulmonary lesions, chest roentgenography is of doubtful value for staging lung involvement and assessment of activity including monitoring and control of therapy.

Adolescent↗
PubMed1981

[Nuclear-medical methods in hepatology].

The function of polygonal liver cells can be estimated by using liver specific dyes such as labelled BSP or bengalrosa and labelled X-ray contrast media. Various methods are available: clearance with blood counting or external monitoring, whole body clearance and retention measurement. These tests are of value for following the course of liver diseases. Blood flow measurements either with labelled colloids or 133 Xe are mainly used for scientific purposes. Portosystemic shunts can be detected by injection of labelled microspheres in the spleen and lung monitoring or scanning. With the dynamic scintigraphy portosystemic shunts can be visualized ( radionuclide splenoportography). The measurement of the praecordial appearance time after rectal instillation of 133 Xe permits the functional evaluation of a surgical portosystemic shunt. Dynamic scintigraphy makes possible the estimation of the arterial part of liver blood flow after i.v. injection of 99m Tc and this together with the radionuclide splenoportography allows the assessment of disturbed blood flow in patients with portal hypertension. I. v. applied parathyroid hormone increases the arterial hepatic blood flow. Preliminary results indicate that patients with portal hypertension and a good response to parathyroid hormone seem to have a good prognosis after shunt operation. The determination of red cell survival with 51 Cr is helpful in the differential diagnosis of jaundice. The specificity of liver scanning with labelled colloids for malignant diseases can be reasonably increased by additional 67 Ga-scintigraphy. In the diagnosis of hepatoma with both colloid and Galliumscan and the evaluation of alpha-fetoprotein a 90% accuracy can be achieved. The hepatobiliary transport can easily be visualized with 99m Tc labelled IDA-compounds and also in patients with severe jaundice where the X-ray cholangiopathy is impossible. This examination is indicated in patients with bile duct observations (also intrahepatic), after cholecystectomy, for the differential diagnosis of jaundice, for the demonstration of refluxes etc. The most important radioimmunological in vitro methods for the investigation of liver diseases are only briefly described.

Bile Acids and Salts↗
PubMed1981

[Experimental studies on the efficacy of pressure wave massage (Lymphapress) in lymphedema].

The following effects of a massage by the Lymphapress apparatus could be demonstrated by girth measurements and nuclear medical investigations on the treated extremity: 1. Volume reduction (in lymphedema in average 4,6% of the basic extremity volume after 3 h). 2. Improvement of the lymph kinetics in cases with intact or decreased lymph transport. If isotopic lymphography failed to show any lymphatic transport as in cases with severe, indurated lymphedemas no effect on the lymph kinetics could be demonstrated. 3. Decrease of albumin content in the tissues. However there is an increase of local albumin concentration in lymphedema by overproportional water reduction. Therefore compression bandages should be applied between the Lymphapress massages for maintenance of the effect.

Arm↗
PubMed1980

[Pulmonary embolism in leg and pelvic vein thrombosis. Results of a prospective study - diagnosis, frequency, nuclearmedical and clinical appearance (author's transl)].

In a prospective study 169 patients with clinically suspected leg/pelvic-vein thrombosis were tested by 131 I fibrinogen uptake-test and radionuclide venography for confirmation of this diagnosis and also by a nuclearmedical lung investigation. In all cases of an abnormal perfusion scan a supplementary ventilation scan was performed. The perfusion scan has a sensitivity for pulmonary embolism of near 1.0 but its specificity is only 0.57. An additional ventilation study (133 Xenon, 81m Krypton) improves the specificity to 0.95. A mismatch of regional ventilation and perfusion is the nuclearmedical substrate of pulmonary embolism. The diagnosis of thrombosis was confirmed in 105 of 169 cases (62%). Thrombosis was located in the lower legs in 56%, in the thigh veins in 23% and in the external iliac veins in 21%. From 105 patients with leg/pelvic-vein thrombosis 60 (57.1%) had pulmonary emboli, from 64 patients with negative tests concerning thrombosis only 3 (4.7%) (p < 0.001). Pulmonary emboli were present in 46% when thrombosis was located in the lower legs, in 67% when thigh veins and in 77% when pelvic veins were involved. The average frequency of 57% emboli found in patients with leg and pelvic vein thrombosis agrees with data from pathologic-anatomical studies. An analysis of these patients with embolism showed that 70% of them were over 70 years old, that 52% of the emboli originated from thigh and pelvis and 43% from the lower leg and that 59% had no clinical signs of embolism. 80.4% of the patients had multiple perfusion defects (up to 9) which correlated in size with the severity of the clinical symptoms and which were about equally distributed in both lungs. Larger perfusion defects occure more frequently with thromboses of the thigh and pelvis than in thromboses of the lower leg. According to the chest x-ray pulmonary emboli were suspected to only 6 of 26 patients with clinical evidence of embolism (23%).

Adult↗
PubMed1979

Value of additional lateral scans in renal scintigraphy.

Although it is common to perform scintigrams in multiple projections this technique has not yet been generally accepted for kidney scintigraphy. By performing additional lateral scans using an Anger camera and with patients sitting we found at least three advantages: 1. Better Visualisation of Kidney Lesions: 7 (13,5%) of 52 cases with lesions could be detected in lateral projection only, in all other cases we obtained better information concerning location and size of lesions. 2. Determination of Real Kidney Size: Of 62 patients with kidneys appearing reduced unilaterally in the dorsal projection, additional lateral recordings demonstrated that 24 (39%) seemed diminished because of tilting. 3. Better Interpretation of Renograms: Demonstration of different depths of kidneys facilitates interpretation of renograms with different peak heights. Additional lateral scans thus can provide--at least if dorsal recordings are inconclusive--further information.

Diagnosis, Differential↗