Search PubMed⌕ Search

Biomedical subjects

D Emrich

Publications and source records attributed to D Emrich.

At least 73 records · Page 4Linked to original sources
PubMed1987

Fatty acid metabolism in symptomatic patients with mitral valve prolapse but without coronary artery disease--comparison with 201Tl myocardial perfusion scintigraphy.

Using 123I-omega-heptadecanoic acid (HDA) and 201Tl, respectively, myocardial fatty acid metabolism and perfusion were studied in 51 symptomatic patients with mitral valve prolapse (MVP) as diagnosed by ventriculography, and no evidence of coronary artery disease. Twelve subjects with normal coronary arteries and normal ventriculogram served as a control group for the evaluation of elimination kinetics of HDA. In the control group, the mean elimination half-life was 26.1 +/- 3.6 min, whereas the patients with MVP had a mean value of 25.0 +/- 6.4 min. In patients with MVP, a high incidence concerning abnormalities of accumulation and/or elimination of HDA occurred, namely accumulation defects in 31% and both prolonged and shortened elimination half-lives in 16% and 29%, respectively. Myocardial perfusion scintigraphy using 201Tl showed abnormalities in 76%. Correlations were found between decreased uptake of HDA and prolonged elimination half-life as well as defects by 201Tl, presumably due to ischemia based on small-vessel disease or abnormalities of cellular metabolism.

Adult↗
PubMed1986

[Hyperthyroidism in the thyroid hormone treatment of iodine deficiency goiter].

Standardized assessment of 1973 patients with iodine-deficient goitre, treated on average with 100 micrograms thyroxin, revealed clinical signs of thyroid hyperfunction in 2.4%. But an increased hormone concentration alone was not sufficient for the diagnosis. Probable cause of hyperfunction was autonomy of the goitre, as indicated by a negative TRH test before treatment had begun. It was calculated that in this case the risk of hyperthyroidism from thyroid hormone administration was 10%, but only 0.7% in patients with a primarily positive TRH test. Hyperthyroid symptoms disappeared and hormone concentration became normal in 60% of patients after thyroid-hormone administration had been stopped. It is concluded that patients with primarily negative TRH test must be carefully monitored while receiving thyroid-hormone treatment.

Drug Combinations↗
PubMed1986

Clinical value of dual-isotope fat absorption test system (FATS) using glycerol [125I]trioleate and glycerol [75Se]triether.

In order to delineate the clinical value of a dual-isotope fat absorption test system (FATS) using glycerol [75Se]triether as lipid-phase marker and glycerol [125I]trioleate as the test lipid, fecal isotope ratios from single stools (and a 72-hr stool homogenate) were compared to quantitative fecal fat excretion. The study included 11 patients without and 24 patients with steatorrhea. With a figure of 0.8% as the upper limit of normal, the test was a reliable indicator of steatorrhea with 87.5% sensitivity and 81.8% specificity; efficiency was 85.7%. Related to a prevalence of steatorrhea of 45.9% as the mean value of 1269 consecutive 72-hr specimens investigated for steatorrhea during 1978-1982, the positive (negative) predictive value of the FATS is 80.3% (87.2%). With 2% as the upper limit of normal, no false positive results ensued. It is concluded that a two-step interpretation of the FATS (0.8% limit and 2% limit) may be regarded a valid qualitative index for steatorrhea. The FATS isotope ratio using single stools correlated well with FATS ratios in the 72-hr stool homogenates (r = 0.97). FATS therefore allows a convenient estimate of steatorrhea from measuring single stools. As a quantitative measure of fecal fat excretion, the FATS is unreliable.

Adult↗
PubMed1986

[Cementless implantation of Zweymueller-Endler total endoprosthesis of the hip. Clinical, radiologic and scintigraphic follow-up of 2 years].

Sixty-four patients with cementless Zweymueller-Endler total endoprostheses of the hip underwent follow-up postoperatively for 2 years. In 3 patients loosening or infection occurred. In 61 patients no complications were observed. However, in 74% of these patients increasing activity uptake at the tip of the shaft was found by scintigraphy. This was associated with hypertrophy of the corticalis and/or with a marrow cavity reaction, observed radiologically. The results show that scintigraphic evaluation of cementlessly implanted Zweymueller-Endler endoprostheses of the hip must be interpreted differently compared to isoelastic or to cemented prostheses.

Adult↗
PubMed1985

[Megestrol acetate in various doses in the treatment of metastatic breast carcinoma--clinical and endocrinologic studies].

Both medroxyprogesterone acetate (MPA) and megestrol acetate (MA) are effective in the treatment of metastatic breast cancer. Although the dose-dependent mode of actions of MPA have been extensively clarified, there is still some uncertainty regarding the mode of actions and dosage of MA. Thirty-three patients with metastatic breast cancer were treated with various dosages of MA under a phase-II study. Eight patients were given 200 mg, 9 X 400 mg, 10 X 600 mg and 6 X 800 mg MA daily per os. The LH, FSH, TBI, T3, T4, TSH, ACTH, aldosterone, testosterone, prolactin and cortisol levels were determined regularly during treatment to enable the investigation of the pharmacodynamics of MA. A complete remission was achieved in two patients, a partial remission in seven patients and there was no change in eight patients (total responder rate 51.5%). The clinical and endocrine changes therefore suggest that the dose-dependent mode of actions of MPA and MA are identical. Equivalent dosages of MPA are 1000-1500 mg per os and of MA 160-200 mg. Furthermore, similar relationships between the endocrine changes and remission behaviour of MA and MPA have been observed. Persisting tumour remissions are inevitable under cortisol suppression and normal prolactin, aldosterone and ACTH levels.

Adrenocorticotropic Hormone↗
PubMed1985

Mitral valve prolapse in the ventriculogram: scintigraphic, electrocardiographic, and hemodynamic abnormalities.

Patients with mitral valve prolapse (MVP) frequently have chest pain, which may be difficult to differentiate from angina pectoris in coronary artery disease (CAD). We performed resting and exercise ECGs, pulmonary arterial pressure measurements, radionuclide ventriculography (99mtechnetium), and perfusion scintigrams (201thallium) in 56 patients with angiographically proven MVP and no CAD. Pathological results were obtained in 31% of exercise ECGs, 33% of pulmonary arterial pressure measurements during exercise, 22% of radionuclide ventriculographies, and in 75% of thallium perfusion scintigrams. A significant correlation in pathological results was found only between exercise ECG and both radionuclide ventriculography and pulmonary arterial pressure measurements. Because of the high prevalence of false-positive perfusion scintigrams in patients with typical or atypical chest pain, the use of exercise 201Tl imaging as a screening method to separate patients with MVP from those with CAD will not be appropriate. The variability of cardiac abnormalities in our patients with MVP and angiographically normal coronary arteries suggests that the MVP syndrome may represent a variable combination of metabolic, ischemic, or myopathic disorders.

Coronary Disease↗
PubMed1985

Underestimation of left-ventricular ejection fraction by radionuclide ventriculography in patients with aneurysm.

The left-ventricular ejection fraction (LVEF) of 72 patients with aneurysm of the anterior wall was measured by multiple gated blood pool acquisition (MUGA) in the anterior and left anterior oblique (LAO) positions, and by cineangiography (CA) in right anterior oblique (RAO) and LAO projections of 30 degrees and 60 degrees, respectively. The LVEF was overestimated by CA in the LAO projection and by MUGA in the anterior position, but underestimated by CA in the RAO projection (6.1 percentage points) and by MUGA in the LAO position (6.2 percentage points). In 50 patients without aneurysm, no systematical error occurred using MUGA. The underestimation of the LVEF in patients with aneurysm by MUGA in the LAO position is due to differences of photon attenuation in various parts of the cardiac blood pool. This systematical error can be overcome by biplane MUGA.

Cardiac Output↗
PubMed1985

Detection of occult and intermittent rhinorrhea using 111In-DTPA.

In an attempt to detect occult or intermittent rhinorrhea, 10 patients without and 9 cases with rhinorrhea were investigated after a lumbal injection of 1.3 mCi 111In-DTPA. Significant count rates were detectable in the nasal pledgets of all individuals, so that it was not possible to distinguish those with and those without rhinorrhea. Therefore, the ratio of activity in nasal pledgets and blood normalized for weight recommended by McKusick et al. was used. In the patients without evidence of rhinorrhea, the ratio did not exceed 2.0, whereas in 8 of the 9 cases with rhinorrhea, it was considerably increased. The detectability of rhinorrhea was increased by using more than one measurement and by provocation manoeuvres.

Adult↗
PubMed1985

Improved quality and information in thyroid scintigraphy.

We compared rectilinear scanning, analogous gamma-camera imaging and imaging using a gamma camera interfaced to a computer in order to determine which of these techniques is superior for thyroid scintigraphy. Forty patients with and without goitre and irregular activity distribution were imaged using each of the three techniques. The sets of three scintigrams per patient were rated by seven physicians. These ratings were statistically analysed using a new distribution-free test. Thyroid scintigraphy using a gamma camera interfaced to a computer turned out to be the best method, especially for detecting circumscribed areas of increased uptake. We conclude that this was due to a combination of the following factors: a computer matrix of 128 X 128 pixels in combination with an acquisition zoom of 1.5, the high count density of the scintigrams, computer-controlled documentation after data acquisition and the use of a continuous grey scale for documentation. The improved quality and information content of the scintigrams obtained using a gamma-camera/computer system could improve the diagnostic value of thyroid scintigraphy, especially when the scintigrams are also evaluated quantitatively.

Humans↗
PubMed1985

Hyperthyroidism due to Graves' disease and due to autonomous goiter.

An attempt was made to classify 326 patients with hyperthyroidism due to Graves' disease and due to autonomous goiter in an area of endemic iodine deficient goiter using the following two sets of criteria: Primary criteria: the presence of endocrine ophthalmopathy (Graves' disease) and the absence of endocrine ophthalmopathy and the absence of microsomal antibodies greater than or equal to 1:1600 (autonomous goiter). Sixty-nine percent of the patients could be divided in the two groups with the aid of these criteria. Secondary criteria: age greater than 50 years, presence of a goiter, presence of thyroid nodules, activity distribution in the scan, iodine intake determined by iodine excretion in the urine. These criteria had to be applied in the 31% of the patients who could not be divided into one of the two groups using the primary criteria. The secondary criteria were accumulative. Using these criteria 55% of the 326 patients were classified as having Graves' disease and 45% as having autonomous goiter. The probability of correct grouping when both primary and secondary criteria were applied was estimated to be 90% compared to 54% when we used only the classical terms, i.e. endocrine ophthalmopathy and diffuse goiter on the one hand and multinodular goiter without endocrine ophthalmopathy on the other hand. In a second group of 120 hyperthyroid patients classified in this way, thyrotropin displacing activity was determined independently. Its prevalence was 79% in patients classified as having Graves' disease but only 3% in those classified as having autonomous goiter. The prevalence of TDA observed in patients who presumably had autonomous goiter was in the same range as in the following groups: 45 normal individuals; 126 patients with euthyroid goiter; and in 112 patients with euthyroid and hyperthyroid autonomous adenoma.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1985

Therapy of endemic goitre: controlled study on the effect of iodine and thyroxine.

Two kinds of medical treatment of endemic goitre (400 microgram of iodine, n=11, and 150 microgram of L-thyroxine, n=12) were compared in a double blind study with a placebo group (n=12) during a period of 12 months and an observation time of three months after cessation of therapy. The means of the neck circumference and of the estimated thyroid volume decreased significantly during treatment in both groups, whereas no significant difference was observed in the placebo group. The results in both therapy groups did not differ significantly from each other. No side effects or symptoms of hyperthyroidism were observed. During treatment the index of free thyroxine (FT4I) increased significantly in both the iodine and the thyroxine group and delta TSH after TRH decreased significantly. Total triiodothyronine (TT3) did not show significant alterations. Three months after cessation of therapy in the thyroxine treated group the mean FT4I dropped into the range before treatment, whereas it remained slightly elevated in the iodine group. In the thyroxine treated group the mean delta TSH was higher than its value before therapy. After withdrawal of iodine, however, the mean delta TSH remained decreased for three months. The study indicates that 400 micrograms of iodine per day may be at least as effective as a standard dose of 150 micrograms of thyroxine to treat endemic goitre in an iodine deficient area.

Adolescent↗
PubMed1985

[Follow-up of patients with anterior wall aneurysms using radionuclide ventriculography].

32 patients with a large anterolateral aneurysm were studied by using biplane ventricular angiography and rest and exercise radionuclide ventriculography (gated-blood-pool method). The correlation coefficient of biplane ejection fraction by angiography and radionuclide ventriculography was poor (r = 0.65), but repeated investigations and interobserver comparison showed nearly identical values, therefore we used the gated-blood-pool method (GBP) for follow-up investigations in patients with an aneurysm of the anterolateral wall. 11 patients were studied before and 17 +/- 6 months after left ventricular aneurysmectomy. Resting ejection fraction (LVEF) increased significantly from 28 +/- 8 to 38 +/- 8% (p less than 0.005), but exercise LVEF did not. In 21 patients with medical therapy the second GBP measurement after 16 +/- 6 months showed so significant changes in biplane LVEF (33 +/- 9 and 31 +/- 7%, respectively). During exercise LVEF remained unchanged after aneurysmectomy but increased slightly by 5% (p less than 0.05) in the medically treated group. The regional wall motion was unchanged in patients with medical therapy, but after aneurysmectomy there was a significant increase in local ejection fractions in the anterolateral, apical and posterolateral region. The gated-blood-pool methods is suitable for the determination of left ventricular function in patients with anterolateral aneurysm and may be used for follow-up studies. Left ventricular aneurysmectomy is effective in improving resting ventricular function, whereas in patients with medical therapy LV function remains unchanged.

Cardiac Output↗
PubMed1984

Analysis of left ventricular regional motility: a comparison of different methods.

Multiple gated blood pool (MUGA) and contrast ventriculographic studies were performed within 24 h in 80 patients, 20 with 120 normokinetic wall segments and 60 with wall motion abnormalities in 239 of 360 wall segments. Three methods of evaluation of the radionuclide ventriculograms were compared with the results of the biplane contrast ventriculography which served as a standard: (1) qualitative analysis of the cine mode, (2) analysis of parametric scans (amplitude and phase images) and the phase histogram obtained by Fourier analysis, (3) quantitative determination of regional ejection fraction. Normal values were obtained from 20 patients with normal wall motion in the contrast angiogram. The overall sensitivity for the detection of wall motion abnormalities of high degree was 96% for method 1, 95% for method 2, and 90% for method 3, for those of low degree 72% for method 1, 63% for method 2, and 75% for method 3. Combining methods 2 and 3 the sensitivity was increased to 99% for high grade and to 81% for low grade wall motion abnormalities. The two methods showed a complementary effect because of different sensitivities in dependence of the localization of the wall motion abnormality. Although a high efficiency for the evaluation of left ventricular function was provided by the qualitative analysis of the cine mode the combination of Fourier analysis and the determination of regional ejection fraction should be preferred. It increases the sensitivity for the detection of wall motion abnormalities. Moreover, it offers quantitative data which improve the reproducibility and decrease the observer variability.

Angiography↗
PubMed1984

Role of gastrointestinal transit in the delay of absorption by viscous fibre (guar).

The influence of guar gum on gastric emptying of liquids in healthy volunteers and on mouth-to-caecum transit time in controls and partially gastrectomized patients has been studied. Together with a flattening effect on blood glucose profiles after a liquid glucose load, guar significantly delays mouth-to-caecum transit time both in healthy controls and partially gastrectomized patients. The retardation of transit is not explicable by a delay in gastric emptying, as can be shown by means of an isotope technique. Only in "quick starters' was a delay in initial gastric emptying observed. The exponential phase of gastric emptying remained unaffected. Moreover, it is shown that the prolongation of mouth-to-caecum transit time is not mediated by factors operating at the level of the pyloricantral region. Delayed small-bowel passage by guar might modulate absorption of glucose by increasing the unstirred layer resistance and, in the non-steady state, by limiting the absorptive area initially covered by a bolus.

Adult↗
PubMed1984

[Inhibition of the hemolytic activity of influenza viruses by antibody].

Haemolysis caused by influenza viruses is known to occur below pH 6; the pH-optimum for each virus strain is different. Clear dose-effect correlations were found to prevail between the amount of haemolysis and virus concentration. Antibody-mediated inhibition of haemolysis has been investigated with the strain A/PR/8/34 (H1N1) and the recombinant X-73 (H3N2). Inhibition of haemolysis by antisera against different influenza. A virus subtypes suggests that haemolysis inhibiting antibodies are not identical with haemagglutination inhibiting antibodies. The action of antibodies directed against host-cell specific components was excluded by adsorption procedures. Haemolysis inhibiting antibodies are thought to be directed against antigenic determinants of the haemagglutinin functioning as fusion factor.

Animals↗