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Biomedical subjects

E Moser

Publications and source records attributed to E Moser.

At least 217 records · Page 12Linked to original sources
PubMed1988

[Comparative studies of cerebral blood flow measurements and measurements of the size of the corpus callosum in patients with schizophrenia].

In this study healthy subjects and schizophrenic patients of the so-called Type I and Type II subgroups were examined in each case with a morphological method to determine the size of the corpus callosum and with a method to measure a physiological functional parameter, namely, the regional cerebral blood flow (rCBF). MR and dynamic single photon emission CT were used (in our case as differential method). The study reveals for the first time classified into subgroups of the disease, scientifically measured differences both in the size of the corpus callosum and in the distribution pattern of the blood flow. Whereas the patients of type I had an enlarged corpus callosum and increased blood flow during the task with which they were confronted, these organs were mainly smaller in size with type II patients without an increase in the global blood flow during the relevant task. The statistical data--averaged over patient groups--show these differences clearly, but due to biological scatter it has so far not been possible to arrive at a diagnosis in individual cases.

Adult↗
PubMed1988

Highly sensitive determination of TSH in the follow-up of TSH-suppressive therapy of patients with differentiated thyroid cancer.

Basal and TRH-stimulated TSH levels were determined in 72 patients with differentiated thyroid cancer on hormonal treatment, using a highly sensitive immunoradiometric assay (IRMAclon, Henning). 43 patients were under treatment with levothyroxine (T4), 29 patients with triiodothyronine (T3). In 33/43 patients (77%) under T4- and in 18/29 patients (62%) under T3-treatment basal TSH levels were below 0.1 mU/l and levels stimulated with 200 micrograms TRH i.v. were below 0.5 mU/l. 3 patients showed a significant response (to above 0.5 mU/l) in the TRH test despite basal values of less than 0.1 mU/l. In 2 patients with elevated basal TSH levels (0.23 and 0.60 mU/l, resp.) in the IRMAclon, total suppression of TSH secretion was suggested by a failure of TSH to rise after TRH. By retesting these samples in an own TSH IRMA, basal and stimulated TSH values were below 0.1 mU/l. In conclusion, basal and TRH-stimulated TSH levels are well correlated in most patients with thyroid cancer under hormonal treatment. However, in some cases (5/72) determination of basal TSH could not clearly define the degree of thyrotropic suppression. Thus, TRH testing is still necessary to establish definitely complete TSH suppression in patients with thyroid carcinoma under suppressive treatment.

Adenocarcinoma↗
PubMed1988

Thyroglobulin and 131I uptake of remaining tissue in patients with differentiated carcinoma after thyroidectomy.

In 158 thyroidectomized patients with well-differentiated non-metastatic thyroid cancer the results of serum thyroglobulin (Tg) determination and 131I uptake values established immediately before radioiodine treatment (19 days after surgery) were compared. In 113 patients (72%) Tg was above 6 ng ml-1 (lower limit of detection) and 131I uptake exceeded 2%. In 11 patients (7%) Tg was undetectable and 131I uptake less than 2%. In these cases a radioiodine treatment was not performed; the thyroid ablation was achieved by surgery only. In 34 patients (21%) with undetectable Tg, 131I uptake values, however, varied between 3 and 46% (mean value: 9.6%). Only in 4 of these 34 patients was TSH not maximally (50 microU ml-1) stimulated because of a shorter (9, 10, 11, 13 days) period from thyroidectomy. In conclusion, remaining thyroid tissue, highly stimulated by TSH, can trap a remarkable amount of radioiodine, but may be unable to produce detectable amounts of Tg. Therefore, in contrast to 131I, measuring Tg is insufficient to document the success of thyroid ablation. For the first follow-up study after ablative therapy, the uptake test with radioiodine is mandatory.

Adenocarcinoma↗
PubMed1988

Accuracy of the whole body retention half-life of 75SeHCAT in the diagnosis of ileal dysfunction in patients with Crohn's disease.

The measurement of the whole body retention of the synthetic taurine conjugated trihydroxy bile acid 75SeHCAT has been suggested as a new clinical test for the function of the terminal ileum. Because of the frequent occurrence of ileal dysfunction in Crohn's disease (CD), the accuracy of the SeHCAT test was studied in 64 patients with CD in various clinical conditions. A positive test result (retention half-life less than 1.2 days) was seen in 48.4% of the patients with ileal involvement (true positive tests) whereas a negative test was seen in 33 of the 64 patients. In 21 of the 33 patients (63.6%) the test was false negative since ileal inflammation or resection was confirmed by radiology or endoscopy. In 14 of those 21 patients with false negative test results a stenosis of the intestinal lumen was diagnosed. At a specificity of 100% the sensitivity of the SeHCAT test was 59.6% and the efficiency was 67.2%. If patients with known stenosis were excluded sensitivity improved to 79.4%. In conclusion, calculation of the whole body retention half-life of SeHCAT does not seem to be a valuable screening test for the diagnosis of ileal dysfunction. In CD, a pathologic test result identifies ileal dysfunction with high accuracy.

Adult↗
PubMed1988

[Results of radioiodine treatment of patients with immunogenic and non-immunogenic hyperthyroidism using different focal doses].

The aim of this study was to check the efficacy of radioiodine (131I) therapy (RIT) in a large number of patients (n = 506) suffering from immunogenic or non-immunogenic hyperthyroidism (Graves' disease, Plummer's disease). Since there is no causal cure for immunogenic hyperthyroidism RIT provides, like all other modalities, only a moderate rate of success which is clearly dose-related. Applying 60 Gy, normal thyroid function can be achieved in only 54% of the cases. A dose of 150 Gy succeeds in 86% of the cases. The solitary decompensated autonomous adenoma (DAA) can be eliminated surgically as well as by RIT with a high degree of success (95%). Contrary to surgery, RIT does not have any noticeable early or late morbidity. The high rate of success of RIT in patients with DAA could be confirmed in two groups with different follow-up periods (16 and 65 months). As expected, the rate of hypothyroidism increased from 11% in the early group to 23% in the late group. Multinodular autonomous adenomas can be eliminated successfully using RIT as well. The concept to apply a dose of 400 Gy to the total functional autonomous tissue as determined by ultrasound yields better results (95%) than 150 Gy to the whole thyroid gland as measured by ultrasound (88%). The rate of hypothyroidism as shown by these results (up to a maximum of 62% after RIT of Graves' disease using 150 Gy) is the lesser evil compared to remaining or recurrent hyperthyroidism since these patients can be treated with thyroid hormones without problems.

Adenoma↗
PubMed1987

[Iodine 131: biokinetics, radiation exposure and risk assessment with reference to the reactor accident at Chernobyl].

Following the reactor accident at Chernobyl, this paper describes the biokinetics of radioiodine in man and discusses the radiation exposure resulting from intake of 131I. The risk of radiation-induced thyroid carcinomas and of congenital abnormalities is evaluated. Assuming a linear dose/risk relationship, one can calculate an increase in mortality from thyroid carcinomas amongst children in southern Germany of 100 to 101 per million children. For adults in southern Germany, and for the rest of the population in Germany, the figure is considerably lower. Gonadal dose from the 131I released is so small, compared with the annual natural radiation exposure, that it is not appropriate to discuss genetic effects.

Accidents↗
PubMed1987

[Congenital malposition of the eyelid system: epiblepharon, lower and upper lid entropium. Differential diagnosis, complications and therapy].

Epiblepharon is a relatively common congenital anomaly and has to be distinguished from entropion, a rare congenital condition. Both cause trichiasis and irritation of the globe. Early surgery prevents severe ocular complications. The very rare congenital entropion of the upper lids, in particular, which is based on a tarsal anomaly known as the tarsal kink, requires primary surgical treatment to prevent keratopathy, corneal ulceration, and blindness in newborns. Epiblepharon can usually be treated adequately with a special suture technique; for congenital entropion, however, a skin-muscle resection is often necessary. Congenital entropion in adults can be treated with good results using a modified lid-split technique. In congenital entropion of the upper lid the tarsal kink has to be resected and the anterior lamella transposed upward and tightened. Postoperative treatment with a therapeutic contact lens accelerates healing of the keratopathy. Good results, both functional and cosmetic, can be achieved with the techniques described in this paper.

Child, Preschool↗
PubMed1987

[Evaluation of adriamycin cardiotoxicity using equilibrium radionuclide ventriculography. I. Results at rest].

Results of 606 equilibrium radionuclide ventriculographies performed in 348 non-selected patients receiving Adriamycin (ADM) therapy were stored in a data base system. The aim of the study was to assess the influence of a potential cardiotoxic therapy on left ventricular pump function. Increasing ADM doses yielded a significant (p less than 0.05) decrease of the resting ejection fraction (R-gEF), the peak ejection rate and the peak filling rate. End diastolic and end systolic volumes increased significantly. Stroke volume, heart rate and time to peak filling rate did not change significantly. 368 follow-up studies were performed in 128 patients: 65/128 patients presented a decrease of R-gEF, but only in 45 of these patients R-gEF values fell into the pathologic range. In 44 of these follow-ups, R-gEF remained unchanged. In 19 patients, a R-gEF increase was observed. At the beginning of ADM therapy 14% of the patients had subnormal R-gEF values. With increasing ADM doses pathologic findings increased to 86% in patients with ADM doses higher than 500 mg/m2.

Adult↗
PubMed1987

[Evaluation of adriamycin cardiotoxicity using equilibrium radionuclide ventriculography. II. Results during exercise].

The aim of the study was to evaluate the influence of a cardiotoxic therapy with Adriamycin (ADM) on left ventricular pump function. In 348 patients with malignant tumors, 606 equilibrium radionuclide ventriculographies (ERNV) were performed. In 90 patients, resting studies (R-ERNV) were followed by studies during exercise (E-ERNV). Results were evaluated statistically to determine whether E-ERNV provides more reliable parameters in the early detection of Adriamycin cardiomyopathy (ADM-CMP) than R-ERNV. The following left ventricular parameters were evaluated: global ejection fraction (gEF); end diastolic, end systolic, stroke volume (EDV, ESV, SV); peak filling rate, peak ejection rate (pFR, pER); time to peak filling rate (TpFR) and heart rate. Increasing ADM doses yielded a significant decrease (p less than 0.05) of resting values of gEF, pER, pFR. In contrast, stress-induced increases of gEF, pER, pFR were found independent of accumulative ADM doses and independent of the resting values of these parameters. An increase of gEF resulted from a significant decrease of ESV. In most cases, pathologic results at rest were detected earlier than subnormal changes of exercise values. Therefore, E-ERNV does not have a significantly higher sensitivity in the early detection of ADM-CMP than R-ERNV and is not required for the surveillance of patients under ADM therapy.

Adult↗
PubMed1987

[Radioimmunoscintigraphy with monoclonal antibodies].

Radioimmunoscintigraphy is presented as a new imaging modality in nuclear medicine, using specific antigen-antibody interactions. Monoclonal antibodies to tumor-associated antigens facilitate the characterization of molecular differences between tumors and normal cells. Labelled with gamma-emitting radioisotopes like I-131, I-123, In-111, and Tc99M, these antibodies can be used for in-vivo imaging. Radioimmunoscintigraphy does not compete with morphological modalities like CT and ultrasound, but provides additional information based on its functional principle. Hidden lesions may be detected. Target-to-background ratios, however, are still rather low hampering scintigraphic imaging. The use of Single Photon Emissions Computed Tomography (SPECT) in addition to planar scintigraphy resolves background activities thus providing better visualization and localization of tumors, and increasing sensitivity. The high cost of these time-consuming studies is still a limiting factor to its wider use. Its preliminary indication is founded on the suspicion of tumor progression, based on clinical findings and/or increasing serum tumor markers (CEA, CA 19-9, CA 12-5). This paper provides an overview over possible applications of radioimmunoscintigraphy. Its clinical use is demonstrated by studies of malignant melanoma, colorectal cancer and ovarian cancer.

Antibodies, Monoclonal↗
PubMed1987

[133Xe-DSPECT: normal values of resting cerebral blood flow and reserve capacity].

Using the 133Xe-DSPECT technique, quantitative measurements of regional cerebral blood flow (rCBF) were performed before and after provocation with acetazolamide (Diamox) i.v. in 32 patients without evidence of brain disease (normals). In 6 cases, additional studies were carried out to establish the time of maximal rCBF increase which was found to be approximately 15 min p.i. 1 g of Diamox increases the rCBF from 58 +/- 8 at rest to 73 +/- 5 ml/100 g/min. A Diamox dose of 2 g (9 cases) causes no further rCBF increase. After plotting the rCBF before provocation (rCBFR) and the Diamox-induced rCBF increase (reserve capacity, delta rCBF) the regression line was delta rCBF = -0,6XrCBFR + 50 (correlation coefficient: r = -0,77). In normals with relatively low rCBF values at rest, Diamox increases the reserve capacity much more than in normals with high rCBF values before provocation. It can be expected that this concept of measuring rCBF at rest and the reserve capacity will increase the sensitivity of distinguishing patients with reversible cerebrovascular disease (even bilateral) from normals.

Acetazolamide↗
PubMed1986

Pathological cerebral blood flow during motor function in schizophrenic and endogenous depressed patients.

In this investigation we examined eight Type I (positive symptoms without marked negative symptomatology), eight Type II (marked negative symptoms) schizophrenic patients of the disordered and paranoid diagnostic subgroups (DSM-III 295.1 and 295.3), eight severely (HAMD above 35) and eight less severely (HAMD below 20) endogenous depressed patients, and eight control persons using the 133Xe inhalation method in resting condition and during motor activity of the dominant right hand. In all patient groups we found flow activation patterns that were different from those observed in normal control persons. During motor activation in Type I schizophrenics and in less severely endogenous depressed patients, we found a bilateral hyperflow and a diffuse cortical flow increase, also involving deeper cerebral structures. In Type II schizophrenics and severely endogenous depressed patients, however, we found a widespread nonreactivity of the regional cerebral blood flow (rCBF) to motor activation, with no flow increase in the contralateral primary motor area. In normal control individuals, we reproduced a 25% flow increase that was strictly limited to the contralateral primary motor area, as already reported by other authors. As only the schizophrenic patients were not under antipsychotic medication (4 with a washout of at least 1 week prior to the investigation, 12 never treated with drugs before), contaminating effects of the medication cannot be ruled out for the endogenous depressed patient groups. However, in schizophrenic patients, these results suggest a diffuse disorganization and lack of laterality of motor functional systems. In addition, the change from hyperactivity to hyporeactivity might indicate cerebral functional correlates of the change from Type I to Type II symptomatology in schizophrenic patients, which could possible prove to be of clinical importance.

Adolescent↗
PubMed1986

[Gd-DTPA in magnetic resonance diagnosis of chronic myocardial infarct].

30 patients with myocardial infarction older than three weeks were examined by MRI prior and following intravenous injection of 0.1-0.2 mmol/kg Gd-DTPA, 201TL-SPECT and cineventriculography. Gd-DTPA did not cause any significant change (p less than 0.05) of T2-values for infarcted or non-infarcted myocardium. Compared with this, signal intensity for T1-weighted images increased after the application of the contrast agent both for normal (26 +/- 14%) and infarcted myocardium (33 +/- 16%). The intraindividual signal intensity ratio for infarcted and normal myocardium increased from 1.06 +/- 0.07 to 1.12 +/- 0.09 after the injection of Gd-DTPA. The diagnosis of myocardial infarction by visual analysis of signal intensity was not possible in individual cases. Myocardial infarction could only be visualized indirectly by morphological changes such as wall thinning and aneurysm.

Adult↗