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Biomedical subjects

D Emrich

Publications and source records attributed to D Emrich.

At least 127 records · Page 7Linked to original sources
PubMed1977

[Pathophysiology and disgnosis of autonomous adenoma (author's transl)].

From personal experience in 200 patients and after a careful review of the literature autonomous adenoma of the thyroid is discussed under three aspects: 1. Different ways of its pathogenesis are possible. None of them has been sufficiently proven. 2. Differentiation by scintigraphy into a compensated, partially decompensated stage does not correlate sufficiently with the concentration of thyroid hormones in the blood and the overall clinical picture. The TRH test is negative in about 90% of patients independent of the stage evaluated by scintigraphy. 3. The diagnosis of the disease by modern tools is critically reviewed.

Adenoma↗
PubMed1977

[Pathophysiology and diagnosis of autonomous adenoma (author's transl)].

From personal experience in 200 patients and after a careful review of the literature autonomous adenoma of the thyroid is discussed under three aspects: 1. Different ways of its pathogenesis are possible. None of them has been sufficiently proven. 2. Differentiation by scintigraphy into a compensated, partially decompensated and fully decompensated stage does not correlate sufficiently with the concentration of thyroid hormones in the blood and the overall clinical picture. The TRH test is negative in about 90% of patients independent of the stage evaluated by scintigraphy. 3. The diagnosis of the disease by modern tools is critically reviewed.

Adenoma↗
PubMed1977

Alteration of bile acid metabolism and vitamin-B12-absorption in diabetics on biguanides.

Since vitamin B12malabsorption has been described in diabetics on biguanides and inhibition of bile acid absorption found in rat ileum the effect of treatment with different biguanides (phenformin, buformin, metformin) on bile acid metabolism and vitamin B12 absorption was assessed in maturity onset diabetics. Biguanides did not alter faecal weight or faecal fat excretion, but they decreased faecal bile acid excretion. All biguanides tested increased deconjugation of glycocholic acid, as determined by a simple breath test technique. Vitamin B12 malabsorption was most prominent in patients on metformin. Discontinuation of biguanide treatment, or administration of antibiotics, normalized or improved the increased deconjugation of bile acids and the Schilling test. Decreased faecal bile acid excretion, positive 14C-glycocholate breath tests, pathological Schilling tests and the reversal of pathological tests by antibiotic treatment suggest that small intestinal bacterial overgrowth, leading to binding of the intrinsic-factor-vitamin B12-complex to bacteria, is responsible for the previously observed pathological Schilling tests in diabetics on biguanides. Bile acid malabsorption, possibly responsible for the cholesterol-lowering effect of biguanides, does not occur in diabetics on biguanides. Whether qualitative changes in small intestinal bile acid composition might affect cholesterol metabolism remains to be determined.

Biguanides↗
PubMed1977

The thyroidal production of reverse triiodothyronine in autonomous adenoma.

The ratios of reverse triiodothyronine (rT3) to triiodothyronine (T3) concentrations were similar (0.89 +/- 0.09) in twenty-three autonomous thyroid nodules (fourteen decompensated, nine compensated) and paranodular tissues (0.82 +/- 0.08), whereas the serum ratio was significantly lower (0.098 +/- 0.014). This is compatible with the hypothesis that thyroidal rT3 and T3 production from mono- and diiodotyrosine may be a random process in contrast to non-random extrathyroidal rT3 and T3 formation.

Adenoma↗
PubMed1977

[The influence of etiroxat-HCl on iodine metabolism in man (author's transl)].

Investigation of the iodine metabolism in man during and after the ingestion of D,L-methyl-3,5,3,5-tetraiodothyronine-ethylester-hydrochloride (etiroxat-hydrochloride, Skleronorm) exhibited the following results: 1. After 20-40 mg of etiroxat the absolute iodine uptake of the thyroid gland was increased 3-7 times. There was indirect evidence that the incretion rate of thyroid hormones did not change. 2. The concentration of total iodine, T4(D), T4(RIA) and T3(RIA) was artificially increased by etiroxat for 2-3 months after cessation of its application. Therefore these parameters do not offer information on the concentration of thyroid hormones in the blood during this period of time. 3. Like other thyroid hormone analogues 40 mg etiroxat daily for 4 weeks blocks the TSH incretion induced by 200 microng TRH up to 1-2 weeks after cessation.

Humans↗
PubMed1977

Quantitative nuclear angiocardiography in valvular heart disease.

A noninvasive method of quantitative nuclear angiocardiography was developed using a camera system and a computer. The investigation, which can be performed on an out-patient basis within 10-15 min, includes the following steps: injection of 10 mCi 99mTc-labelled human serum albumin into a femoral vein, and external recording of the passage of the bolus through the central circulation by a sequence of scintigraphic frames taken during diastole. From time--activity curves over the right ventricle, the pulmonary artery and the left ventricle, peak-to-peak times and mean circulation times were calculated. The method was applied to 424 patients with valvular heart disease proven by heart catherization. The following results were obtained: (1) The method proved to be highly sensitive in stating whether there was a hemodynamically significant valvular disease or not. But differential diagnosis concerning the different forms of valvular disease was not possible. (2) The prolongation of the circulation times correlated with the hemodynamic severity of the disease. (3) The circulation times were directly related to the cardiac index, the enddiastolic volume of the left ventricle and the pressures in the pulmonary vascular system. (4) The method could be used to evaluate the effect of surgery and for follow-up after operation. Quantitative nuclear cardiography may help to fill the gap between the nonquantitative, rather unspecific and the specific but invasive methods of cardiologic investigation.

Adolescent↗
PubMed1976

Case report: Liver scintigraphy in the follow-up of a patient on cytotoxic therapy.

A 63-year-old male patient with a small cell bronchial carcinoma on cytotoxic therapy was followed up with the use of liver scintigraphy. In the various scintigrams the remission as well as the late reappearance of the liver metastasis was demonstrated. The abnormalities in the liver scintigrams correlated with the biochemical changes throughout the course.

Adenocarcinoma↗
PubMed1976

[The effect of biological factors during functional scintigraphy of the heart (author's transl)].

The parameters relating to functional scintigraphy of the heart (average circulation time, peak time) depend not only on the method (injection technique, radiopharmaceutical), but also on biological factors. Failure to take these into consideration may result in an erroneous interpretation of the findings. Circulation time in normal children aged 6 to 14 years, as determined by isotope methods is significantly shorter than in normal adults. Patients with compensated heart disease, as well trained athletes, show significantly shorter than in normal adults. Patients with compensated heart disease, as well trained athletes, show significant increase in all portions of the circulation time, when compared with normals of similar ages. This indicates that deviation in the haemodynamics of the circulation as shown by functional scintigraphy, can only be interpreted in the light of clinical findings.

Adolescent↗
PubMed1976

[Lateral renal scans (author's transl)].

The value of lateral renal scans was evaluated in 26 patients with a firm diagnosis of space-occupying lesions in the kidneys. In 14 patients the lateral view provided information additional to the usual P.A. scan. In seven of these 14 patients, the abnormality was shown better on the lateral than on the P.A. SCAN. In the other seven patients, the abnormality had been shown on the P.A. view, but the lateral scintigram provided more precise information concerning the position and size of the lesion.

Evaluation Studies as Topic↗
PubMed1975

[Value of radioimmuno-assay of triiodothyronie and thyrotropic hormone in the diagnosis of thyroid disease (author's transl)].

Results of a purely in-vitro test were compared with previously available methods in 425 patients. For triiodthyronie, a normal range must be differentiated from the so-called euthyroid range (0.8-2.0 ng/ml) for patients with euthyroid goitre. The accuracy for triiodothyronine is then more than 95% and in hyperthyroidism 97.5%. It is, therefore, superior to other in-vitro measurements. But a disadvantage is that it is easily influenced by thyroid and extrahyroid factors. Similar accuracy is obtained for the TRH function test (thyrotopine-releasing hormone). Noteable is a negative TRH test in 20% of patients with euthroid goitre. The significance of triiodoathyrone determination is decreased in autonormous adenoma, in which the TRH test has an accuracy of 96.5%. In rare diseases of the thyroid all diagnositc possibilities must be taken into account. In ordinary practice stepwise course is suggested. RT-3U, T-4, T-3 and thyroid scan with 99mTc pertechneate are useful as basic tests. PBI is still thought to be important. The second step involves the TRH test rather than 131I function test. Triiocothyronine determination is best for therapeutic and follow-up perposes, a situation in which TRH test is of limited value.

Adenoma↗
PubMed1975

[May the Schilling test be already repeated the next day using intrinsic factor?].

The effect of previous administration of a dose of 1000 mu-g vitamin B12 on the Schilling test was examined in 18 patients, repeating the test 24 hrs later. On the first day 57-Co was administered, while on the second day 58-Co labeled vitamin B12 was given. The counting error was less than 2.0% at the 95% confidence level. A decrease in urinary excretion of vitamin B12 of 28.7 plus or minus 22.2% (x plus or minus SD) was found. The mean difference between the two subsequent Schilling test series was statistically significant (p less than 0.05). The excretion data of the first and the second test correlate well (r = 0.86; p less than 0.01; y = 0.66 x + 1.09). Thus the repeated Schilling test with intrinsic factor must not be performed the next day.

Anemia, Pernicious↗
PubMed1975

[Methods of functional scintigraphy of the heart: the effect of the radiopharmaceutical agents (author's transl)].

Functional scintigrams of the heart were performed in 63 patients using different injection techniques and two radiopharmaceuticals (99mTc-pertechnitate and 99mTc-human serum albumen). A comparison of the results shows that injection of 99mTc-human serum albumen into the femoral vein gave the best results. Injection of the tracer into the femoral vein causes less dilution of the bolus than the usual injection technique into the cubital vein. There is less recirculation of the indicator resulting in lower co-efficients of variation of the quantitative parameters. The choice of 99mTc-human serum albumen facilitates demarcation of the individual cardiac chambers.

Heart↗