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Biomedical subjects

E G Eising

Publications and source records attributed to E G Eising.

At least 19 recordsLinked to original sources
PubMed2003

Diagnostic value of high-resolution B-mode and power-mode sonography in the follow-up of thyroid cancer.

OBJECTIVE: Ultrasonography is an established diagnostic modality in the follow-up of thyroid cancer. Color flow Doppler has been proposed by some authors as an additional tool for differentiating benign from malignant cervical lesions in various types of head and neck cancer. Over the last few years, a new generation of high-resolution ultrasound platforms with the "power-mode" feature has become available, that also enables the imaging of small vessel blood flow. The objective of our study was to find ways of optimizing the differentiation of benign and malignant cervical tumors in thyroid cancer follow-up by means of sonography. METHODS: Hundred and twelve cervical lesions in 90 patients with thyroid cancer were evaluated by high-end ultrasonography (Sonoline Elegra, Siemens) using a small-part transducer (7.5 L 40, Siemens). B-mode sonography was performed at a frequency of 8 MHz. The Solbiati index (SI= ratio of largest to smallest diameter), configuration, echogenicity, intranodular structures, and margins were assessed. Perinodular and intranodular blood flow was evaluated by color flow Doppler (PRF 1250 Hz for conventional color flow Doppler, 868 Hz for power-mode Doppler). Possible malignancy was validated by histology, cytology, scintigraphy, and follow-up. Thirty five lesions were benign (diameter 0.4-3.0 cm) and 77 were malignant (0.4-5.4 cm). The patients were randomized into a test group and a learning group to determine the diagnostic value of various ultrasound criteria by means of statistical analysis. In the learning group, decision rules based on the dichotomized criteria were developed using a logistic regression model. Sensitivity and specificity of these decision rules were then evaluated in the test group. RESULTS: The presence of an echocomplex pattern or irregular hyperechoic small intranodular structures (criterion A) and the presence of an irregular diffuse intranodular blood flow (criterion B) are the best indicators of malignancy, whereas an SI >>2 is highly indicative of benign changes. Color flow Doppler is a useful addition to B-mode scanning for distinguishing benign and malignant neoplasms in the follow-up of thyroid cancer. Power-mode Doppler sonography significantly improves imaging of perinodular and intranodular blood flow when compared with conventional color flow Doppler. CONCLUSION: We propose the following decision rules based on a combination of the criteria above: (A) and (B) fulfilled: malignant, if SI< or =4; (B) but not (A) fulfilled: malignant, if SI< or =3; (A) but not (B) fulfilled: malignant, if SI< or =2; neither (A) nor (B) fulfilled: malignant, if SI approximately equal to 1 (sensitivity: 90%; specificity: 82%; accuracy 88%).

Adult↗
PubMed2002

Diagnosis of a cardiac angiosarcoma by fluorine-18 fluordeoxyglucose positron emission tomography.

Cardiac angiosarcoma is a rare tumour entity with a poor prognosis. Early detection is difficult but important for the further course of the disease. We report on a young patient with a tumour of unknown origin and dignity of the right atrium. Magnetic resonance imaging, CT and echocardiography were sufficient in localisation, but no statement on the dignity was possible. Furthermore, staging led to ambiguous results. Malignancy could be proved by fluorine-18 fluordeoxyglucose positron emission tomography, leading to early surgery. Histology revealed a poorly differentiated angiosarcoma.

Adolescent↗
PubMed2002

Influence of therapy with iodine-131 on thyroid tissue pattern in colour and power Doppler sonography.

AIM: The aim of this study was to evaluate the influence of radioiodine therapy on sonographic thyroid patterns using power Doppler (PD) and colour Doppler (CD) sonography in hyperthyroid patients with autonomous nodules (AN) and Graves' disease (GD). METHOD: B-mode, colour, and power Doppler sonography, (99m)Tc scintigraphy, and laboratory analyses (free thyronine fT(3), free thyroxine fT(4), thyroid stimulating hormone TSH) were performed in 55 patients (AN = 27, GD = 28) before and 6 months following therapy with (131)I radioiodine therapy (RIT). RESULTS: In patients with an AN (but not in GD), a significant reduction in thyroid vascularization was subjectively noted following radioiodine therapy on both CD and PD ultrasound (Wilcoxon matched pairs, P < 0.05). The pre-therapeutic grade of hypervascularization in the periphery of autonomous nodules correlated closely with the laboratory parameters of hyperthyroidism. As expected, PD indicated a higher grade of vascularization when compared with CD due to its greater sensitivity to flow. CONCLUSIONS: Radioiodine therapy led to a significant reduction in hypervascularization in patients with AN (but not in GD) corresponding to the normalization of serological values. Comparing CD and PD, PD detected a greater number of vessels. CD and PD are not able to replace scintigraphy and/or laboratory analyses in the management of patients with hyperthyroidism.

Adult↗
PubMed2002

Surveillance of TSH-suppressive levothyroxine treatment in thyroid cancer patients: TRH testing versus basal TSH determination by a third generation assay.

OBJECTIVE, DESIGN AND METHODS: Although TRH testing has been eliminated in the diagnosis of most benign thyroid diseases, it is still controversial whether or not it can be replaced by ultrasensitive determination of basal TSH for monitoring optimal TSH suppression in thyroid cancer patients. We compared basal and TRH-stimulated TSH values measured by a 2 nd generation assay (lower detection limit 0.1 mU/l) and by a 3 rd generation assay (lower detection limit 0.005 mU/l) in 209 thyroidectomized thyroid cancer patients under suppressive levothyroxine treatment. RESULTS: In the 2 nd generation assay all patients had basal TSH values < 0.1 mU/l (criterion of admission in the study), and the TRH-stimulated TSH values were above the lower detection limit in 47% of the patients (range < 0.1-1.0 mU/l). In the 3 rd generation assay TSH was above the lower detection limit in 67% under basal conditions (range < 0.005-0.098 mU/l), and in 83% after TRH stimulation (range < 0.005-1.000 mU/l). We observed close correlations (p < 0.001) between basal and TRH-stimulated TSH in the 3 rd generation assay (r = 0.86), between TRH-stimulated TSH in the 2 nd and 3 rd generation assay (r = 0.95), and between TRH-stimulated TSH in the 2 nd generation assay and basal TSH in the 3 rd generation assay (r = 0.73). The ratio between TRH-stimulated and basal TSH values was in the average range 7-9 : 1. Subdividing the patients in three subgroups based on the TRH-stimulated TSH values from the 2 nd generation assay, the corresponding basal TSH values (median and [25.-75. percentile]) from the 3 rd generation assay were < 0.005 [< 0.005-0.010] mU/l in subgroup A (2 nd generation stim. TSH: < 0.15 mU/l), 0.032 [0.021-0.040] mU/l in subgroup B (2 nd generation stim. TSH: 0.15-0.4 mU/l), and 0.066 [0.046-0.085] mU/l in subgroup C (2 nd generation stim. TSH: > or = 0.5 mU/l). CONCLUSIONS: Even in those thyroid cancer patients where a high degree of TSH suppression is the therapeutic goal, 3 rd generation TSH assays enable a reliable adjustment of the levothyroxine dose by basal TSH determinations. In laboratories still using 2 nd generation assays, the monitoring of maximal TSH suppression in patients with high-risk thyroid cancer should be performed by TRH testing.

Adolescent↗
PubMed2001

Parametric oesophageal multiple swallow scintigraphy for validation of dysphageal symptoms during external beam irradiation of mediastinal tumours.

The aim of the study was to evaluate dysphageal symptoms and to measure the effect of local analgesic treatment using parametric oesophageal multiple swallow scintigraphy (PES) during external beam irradiation of the mediastinal region. Fifteen patients (most with lung cancer) with dysphagia grade II underwent PES during external beam radiotherapy of the mediastinum before and after application of local analgesics. Dynamic parametric condensed images were recorded. The intensity of clinical symptoms was correlated with the emptying rate at 10 s (ER-10 s) and the mean transit time (MTT). Visual analysis of the images was performed and the results were correlated with the fields of irradiation portals. Of the 15 patients, 12 showed a correlation between irradiation portals and the region of oesophageal motility disorder. Concordant results of clinical symptoms and PES data were found. In nine patients with a decrease in dysphagia following local analgesia, an increase in mean ER-10 s and a decrease in MTT were observed. In three patients with deterioration in clinical symptoms after analgesic treatment, a similar decrease in mean ER-10 s was found, though MTT remained constant. In three patients with normal values, motility disorders were detected in the dynamic study. In conclusion, PES was found to be a sensitive tool for the validation of dysphageal symptoms in patients during external beam irradiation of mediastinal tumours and for the evaluation and quantification of the efficacy of local analgesic treatment. Additional visual analysis of the dynamic study is helpful in diagnosing minimal disorders.

Adult↗
PubMed2001

Vascular Parkinsonism: a case report and review of the literature.

Vascular Parkinsonism (VP) is characterised by sudden onset and rapid progression of clinical symptoms, absent or poor response to dopamine substitution therapy, and postural instability with shuffling gait and absence of tremor, making it a clinically distinct entity from idiopathic Parkinson's disease (IPD). Furthermore, it displays certain typical findings in neurological investigations. We report on a patient presenting features of VP associated with an intracerebral lesion not ascribed to VP to date, namely an isolated ischaemic focal lesion located in the left cerebral peduncle between the substantia nigra and nucleus ruber as evidenced by magnetic resonance imaging (MRI). The pathophysiological organic correlate for contralateral extrapyramidal symptoms in this patient may be an interruption of nigro-thalamic projection, interrupting the final subcortical station in the cortic-striato-pallido-nigro-thalamico-cortical loop central to the pathophysiology of parkinsonian syndromes. Non-response t o levodopa therapy could be a consequence of disruption of the cortico-basal ganglia-cortical loop on account of ischaemic destruction of subcortico-cortical axons, the underlying pathology, therefore, not being the result of a loss of nigral dopaminergic neurons or striatal dopamine deficiency pathogonomonic of IPD. To our knowledge, this is the first case of clinically manifest VP to be described with a single lesion in the contralateral cerebral peduncle between the substantia nigra and nucleus ruber, and suggests alternative intracerebral patterns for the distribution of disease-causing lesions in VP, and possibly new pathophysiological explanations for the nature of this disease.

Basal Ganglia Diseases↗
PubMed2001

SPECT imaging with [123I]-beta-CIT in Parkinsonism: comparison of SPECT images obtained by a single-headed and a three-headed gamma camera.

Single photon emission computed tomography (SPECT) imaging of dopamine transporters by using the cocaine derivative [123I]-(1R)-2-beta-carbomethoxy-3-beta-(4-iodophenyl)-tropane ([123I]-beta-CIT) has been shown to be useful in patients with Parkinsonism. The aim of this study was to compare beta-CIT imaging with single-headed (SHS) and three-headed gamma camera systems (THS). In 17 patients with Parkinsonism, SPECT imaging with an SHS and a THS was performed 24 h after injection of 180 MBq of [123I]-beta-CIT. The SPECT studies were evaluated by visual assessment of the caudate nucleus (CN) and the putamen (PT) and the calculation of the striatal/cerebellar (S/C) ratios (with additional comparison to clinical symptoms measured by the Unified Parkinson's Disease Rating Scale (UPDRS)). The S/C ratios measured by the SHS and THS showed highly significant correlation (two-tailed P < 0.01) with Spearman correlation coefficients (SCCs) of 0.864 for the right side, 0.676 for the left side, and 0.761 for both sides. By the SHS, a sufficient visual differentiation between the CN and the PT could not be achieved. A significantly better distinction could be achieved by using the THS (Wilcoxon P<0.05). The S/C ratios of the THS only showed a significant (P < 0.05) SCC of -0.514 comparing to the UPDRS. Pathological alterations in the beta-CIT uptake pattern could be identified by using the SHS, but a significantly better differentiation of CN and the PT was possible by using the THS. The significant correlation of the S/C ratios measured by THS only emphasizes the value of THS in beta-CIT imaging.

Aged↗
PubMed2000

Correlation of radionuclide ventriculography with roentgenological findings in chemotherapy patients.

Radionuclide ventriculography (RNV) is a common method to evaluate cardiotoxic effects of drugs applied during chemotherapeutic treatment, whereas thoracic radiographs are used to detect morphologic alterations. Aim of this study was to identify radiographic signs, which correlate with RNV parameters and with RNV image quality. For this study, RNV data of 116 patients receiving chemotherapy acquired during 205 RNV studies (some patients underwent up to 7 follow-up examinations) were correlated to roentgenologic findings assessed by 176 thoracic radiographs. Isolated thoracic radiographic signs of cardiac failure showed only slight correlations to left ventricular ejection fractions measured with radionuclide ventriculography, but the orientation of correlation (positive or negative) could be confirmed well by clinical data. This fact matches clinical experience, that radiographic signs of heart insufficiency can surely predict heart damage only when several of them coincide. By the help of this study it was possible to detect radiographic findings, which are of relevance in patients with suspicion of cardiotoxic damage as side effect of high-dose chemotherapy. The clinical value of several radiologic findings should be reassessed to diagnose cardiac failure in chemotherapy patients.

Adolescent↗
PubMed1999

Non-invasive characterization of cardiac microvascular disease by nuclear medicine using single-photon emission tomography.

In about 10 to 30% of patients with typical angina undergoing coronary angiography for suspicion of stenotic coronary artery disease angiographically normal coronary arteries are found. Kemp et al. in 1973 coined the term syndrome X to describe this entity. In a substantial portion of these patients pathologic findings in myocardial scintigraphy are present. Sensitivity and specificity of thallium-201 exercise imaging by visual analysis of images in the presence of significant coronary stenosis is 84 and 88%, respectively. Several investigators have reported abnormal results in radionuclide exercise tests in patients with angiographically normal coronary arteries. Some of these results can be explained by myocardial bridging, vasospasm, left or right bundle branch block, hypertrophic cardiomyopathy, or absorption artifacts. In the majority of cases, however, these abnormalities are not sufficient to explain the scintigraphic findings. Formerly often claimed "false positive", recent studies suggest that endothelial dysfunction might be the reason for the observed perfusion defects. When comparing patients with angiographically unobstructed coronary arteries with and without perfusion defects in stress myocardial perfusion imaging, patients with pathological results show a significantly lower increase of coronary flow after intracoronary injection of the endothelial-dependent vasodilator acetylcholine. Endothelial-independent vasodilation, however, is not impaired in these patients. In addition, intracoronary Doppler measurements reveal that perfusion defects in myocardial scintigraphy only occur if coronary blood flow in this perfusion area is significantly reduced. These results suggest that regional endothelial dysfunction may cause hypoperfusion in myocardial perfusion imaging and underline the important role of the microcirculation in the distribution of radiotracers. Another striking scintigraphic pattern in patients with microvascular angina is the high incidence of reverse redistribution. These perfusion defects, apparent in images obtained 4 hours after exercise stress testing, often cannot be assigned to the perfusion territory of one of the major epicardial vessels. This results in a marked inhomogeneous radionuclide distribution pattern in resting images. The inhomogeneity is associated with a significant reduced resting coronary flow velocity in these patients. As histologically confirmed microvessel disease is often accompanied by slow-flow phenomenon reflecting decreased resting flow velocity, the results suggest that the inhomogeneous perfusion pattern is caused by microvascular dysfunction. Furthermore, the heterogeneity of nuclide distribution supports the hypothesis that endothelial function is not homogeneous in the entire myocardial microcirculation, but varies considerably. In conclusion, microvascular dysfunction by itself seems to cause regional myocardial hypoperfusion, as documented by myocardial scintigraphy. When interpreting pathological scintigraphic results in patients without significant epicardial stenosis, true blood flow and myocardial perfusion abnormalities must be assumed.

Animals↗
PubMed1998

Influences on evaluability of radionuclide ventriculography in chemotherapy patients.

Radionuclide ventriculography (RNV) is an established method of evaluating cardiotoxic side-effects of chemotherapy. The image quality of RNV depends on labelling yields obtained after red blood cell (RBC) labelling with 99Tc(m)-pertechnetate and has an influence on the evaluation of the left ventricular ejection fraction (LVEF). Several drugs and certain parameters of RBC labelling are known to have a detrimental effect on the labelling yield, but often the reason for poor image quality remains unclear. The aim of this study was to determine the effect of chemotherapeutic agents on LVEF evaluation. The chemotherapeutic medications and RNV data of 116 patients were noted. The patients underwent 205 RNV examinations (up to 7 RNV follow-up examinations) consisting of rest and stress studies. Ten patients with a poor labelling yield after in vivo labelling received an additional RNV study after in vitro labelling. The effects of commonly used anticoagulants and chemotherapeutic drugs on labelling yields were also investigated in experiments on in vitro RBC labelling. In vitro labelling had the advantage of better detection of pathological alterations in left ventricular motility, but often improved evaluability only slightly. The administration of corticosteroids showed an unexpected positive correlation with image quality (Spearman correlation coefficient: prednisone, 0.42403, P = 0.0013; prednisolone, 0.45629, P = 0.0286) and labelling yield (prednisolone, 0.65466, P = 0.0024), whereas idarubicin showed a negative correlation with image quality (-0.53364, P = 0.005). A slight positive correlation of prednisolone with LVEF at rest (0.45425, P = 0.0197) was also noted. Using our evaluation software, the manual contour method was found to be superior to the automatic determination of the left ventricular contour. Cycle ergometry alone caused a significant deterioration in image quality. The in vitro results suggested a negative influence of epirubicine on labelling yields at very high concentrations (10(-3) M). Our main result was that a clinically adequate study is possible in patients with moderate image quality and labelling yields. Furthermore, the administration of corticosteroids had a positive impact on image quality.

Adult↗
PubMed1998

[123I]beta-CIT SPECT visualizes dopamine transporter loss in de novo parkinsonian patients.

Parkinson's disease (PD) is characterized by degeneration of dopaminergic neurons in the basal ganglia, which may be visualized by single photon emission computed tomography (SPECT) in combination with the cocaine analog methyl-3-beta-(4-beta[123I]iodophenyl)tropane-2beta-carboxylate ([123I]beta-CIT). The aim of our study was to correlate findings of SPECT with clinical data of 34 previously untreated, idiopathic parkinsonian patients [age: 59.58+/-10.03 (mean+/-SD) years; Hoehn and Yahr Scale (HYS) mean range: 1.97+/-0.83, ranges I-III; Unified PD Rating Scale 3.0 (UPDRS, 30.64+/-18.68) and 15 healthy controls (age 47.93+/-10.47 years). SPECT scans were performed with a single-head gamma-camera 24 h after intravenous injection of [123I]beta-CIT. Comparison of the striatum/cerebellum (S/C) ratio of [123I]beta-CIT uptake of controls and parkinsonian subjects, subdivided according to their HYS range, was significant. No influence of age or sex was observed. Significant correlations were found between scores of the HYS, UPDRS parts I-III, part II, part III, and the S/C ratio of [123I]-CIT uptake. Moreover, SPECT with the radiotracer [123I]beta-CIT revealed side-to-side differences in parkinsonian patients and significant associations to contralateral clinical extrapyramidal symptomatology. Our data show that SPECT with [123I]beta-CIT is a valuable tool for estimating disease severity in PD.

Adult↗
PubMed1998

Differentiation of prolonged colonic transit using scintigraphy with indium-111-labeled polystyrene pellets.

UNLABELLED: Prolonged colonic transit can be caused either by slow transit constipation or by pelvic outlet obstruction needing different therapeutic regimes. The aim of this study was to prove the value of scintigraphic assessment. METHODS: Colon scintigraphy was performed in 32 patients (28 women, 4 men; age range 8-68 yr) with idiopathic constipation at 8, 24 and 48 hr in ventral and dorsal projection after oral administration of a pH-sensitive, methacrylate-coated capsule of nonresorbable 111In-labeled polystyrene (cathion exchanger) micropellets (3.5 MBq/capsule). The geometric center (GC) as the sum of products of colon segment activity and colon segment number (1 = colon ascendens; 2 = transverse colon; 3 = colon descendens; 4 = rectosigmoid colon; and 5 = stool) dividing by the total counts was used to determine the velocity of colonic transit at least at 24 hr as the proximal colonic emptying (PCE) rates. Stool activity was evaluated indirectly as decay-corrected colon activity loss between two examinations. Results were compared with data obtained from 22 healthy subjects. RESULTS: Twenty-six patients had a significant prolongation of colonic transit after 24 and 48 hr (the 95% confidence interval of the patient's GC showed no overlap to the 95% confidence interval of GC calculated from 22 healthy controls as normal range) revealing slow transit constipation. Six patients had normal or accelerated transit (GCs and PCE rates) up to the rectum but delayed rectal emptying indicating pelvic outlet obstruction. CONCLUSION: By the help of this method it was possible to differentiate the two subtypes of colon transit prolongation by use of the reported scintigraphic technique, which leads to different therapeutic management of the patients. Compared with x-ray methods (Hinton test), this method has the capability of a continuous observation of colonic transit without increasing radiation exposure.

Adolescent↗
PubMed1997

[Carcinoid syndrome. Recurrent upper abdominal pain, diarrhea and flush in a 15-year-old girl].

BACKGROUND: A carcinoid syndrome is typically diagnosed in elderly patients, median age at diagnosis was 60 years in two large series. We describe a patient with the carcinoid syndrome at the young age of 15 years. CASE REPORT: The 15-year-old patient's history and findings on physical examination, clinical chemistry, abdominal ultrasound and liver biopsy were typical for a carcinoid with hepatic metastases. The patient's age, however, was very unusual. Because of her youth, we discussed a potentially curative treatment with resection of the primary tumor in the upper jejunum followed by liver transplantation at a second operation. This concept had to be abandoned, when the first operation revealed a tumor in the mesenterium, close to the primary, 5 cm in diameter and around the superior mesenteric artery. This tumor could not be resected. Liver transplantation therefore did not offer this young patient a chance for cure.

Abdominal Pain↗
PubMed1997

[Comparison of stress echocardiography and radionuclide ventriculography in the diagnosis of cardiomyopathy in patients receiving chemotherapy for malignant diseases].

BACKGROUND AND OBJECTIVE: Early evidence of drug-induced cardiomyopathy (CMP) is of great importance in haematological treatment, especially with anthracyclines. Stress echocardiography (SEC) has proved of value in determining left ventricular function at rest and under stress in patients with heart disease. The study was undertaken to assess the value of SEC in comparison with radionuclide ventriculography (RNV). PATIENTS AND METHODS: 63 unselected patients with malignant tumour (20 women, 43 men; mean age 49 +/- 15 years) underwent SEC and RNV. No chemotherapy had yet been started in 17 of them, 43 had received anthracyclines as main component of the chemotherapy (mean anthracycline dose 339 +/- 251 mg/m2). Left ventricular ejection fraction (LVEF) was measured by both SEC and RNV at rest and during standardized stress (recumbent ergometry). Both methods were applied and results measured independently by two examiners. RESULTS: The time interval between the two tests averaged 1 = 2 days. EC could be performed at rest in 62 of 63 and under stress in 59 of 63 patients (RNV: 63 of 63 and 54 of 63, respectively). Resting LVEF was 61 +/- 8% by SEC and 64 +/- 9% by RNV (P < 0.05). LVEF during stress, measured by SEC, was 71 +/- 11% and 73 +/- 10% by RNV (not significant). Mean LVEF increase between rest and stress was 9 +/- 10% by SEC and 9 +/- 8% by RNV (not significant). CONCLUSION: SEC is a satisfactory alternative to RNV in the assessment of ventricular function in patients receiving chemotherapy. It is less involved and more cost-effective than RNV, avoids radiation exposure and provides additional information on heart size and segmental contraction abnormalities.

Acute Disease↗
PubMed1997

Value of diuresis renography in the post-natal period of assumed physiological renal immaturity.

The aim of this study was to determine if it is possible to exclude renal obstruction using diuresis renography in the first 6 weeks of life (the period of physiological renal immaturity), thus avoiding unnecessary invasive procedures, such as the Whitaker test or surgery. Diuresis renography with 123I-hippuran was performed in 27 patients aged less than 6 weeks and in 50 older children who acted as a reference group (age 6 weeks to 1 year, n = 28; age 1-10 years, n = 22). All 27 patients had significant dilatation of the pelvicalyceal system on ultrasonography. Renal curves were evaluated by mathematical curve characteristics (split renal function, counts, T-max, etc.) as the visual grade of obstruction. Whole-kidney regions of interest were defined on images summed over 30 min; renal parenchyma on images summed over 5 min. The renal curves of 18/27 patients indicated tracer accumulation and led to frusemide administration. Only two patients showed no significant response to frusemide and had to be further investigated by the Whitaker test. The frequency of kidneys with no response to frusemide revealed no significant differences in the three groups. Whole-kidney evaluation resulted in an overestimation of obstruction in 9/150 kidneys, which matches the lower correlation to the DMSA separation values for this method of evaluation. In contrast with the literature, significant post-renal obstruction can be excluded by diuresis renography in most cases in spite of renal immaturity and can help to avoid invasive procedures.

Child↗
PubMed1997

2-[123I]-iodolisuride SPET visualizes dopaminergic loss in de-novo parkinsonian patients: is it a marker of striatal pre-synaptic degeneration?

The aim of this study was to assess the correlation between the functional integrity and density of striatal dopaminergic receptors and clinical data in 15 de-novo patients with idiopathic Parkinson's disease by single photon emission tomography (SPET) using 2-[123I]-iodolisuride (ILIS), a tracer based on the D2-dopamine receptor agonist lisuride. Deficient striatal uptake of ILIS correlated with the severity of the disorder, scored by the Unified Parkinson's Disease Rating Scale (UPDRS) (n = 15; ratio of ILIS uptake: basal ganglia/cerebellum [B/C] & UPDRS I-III, Spearman R = -0.562, P = 0.013), Beck's Depression Inventory (BDI) (n = 12; B/C & BDI, Spearman R = -0.825, P = 0.0009) and the ZUNG Depression Scale (ZDS) (n = 11; B/C & ZDS, Spearman R = -0.7425, P = 0.008). Experimental data indicate that lisuride shows a higher affinity for pre-synaptic dopaminergic autoreceptors than for post-synaptic D2-dopamine receptors under conditions of low applied ILIS concentrations as in this study. From the results of this study and these experimental data, we speculate that ILIS-SPET can visualize pre-synaptic striatal dopaminergic degeneration in Parkinson's disease.

Aged↗
PubMed1997

Does the multidrug-resistance modulator cyclosporin A increase the cardiotoxicity of high-dose anthracycline chemotherapy?

Cyclosporin A has heterogeneous effects on anthracycline-related cardiotoxicity and can prevent multidrug-resistance (MDR). The aim of this study was to explore whether the coadministration of cyclosporin A is accompanied by an increase in cardiotoxicity. Forty-three patients (27 male, 16 female, age: 18-67 yrs [mean: 47.5 yrs, SD: 11.6 yrs]) received 177 radionuclide ventriculography examinations (RNV 177 at rest, 133 at stress) before and during chemotherapy with either doxorubicin (n = 23) or epirubicin (n = 20). RNV studies were applied up to 11 times in the follow-up of the patients. A maximum of 10 courses of chemotherapy was performed. In the doxorubicin group only, the age of the patients and the cumulative dose of the chemotherapeutic agent had a significant negative impact on left ventricular ejection fractions, whereas cyclosporin A had a significant positive influence (multiple analysis of regression, p < 0.05). Cyclosporin A did not cause any significant increase in cardiotoxicity in our patients.

Adolescent↗