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Biomedical subjects

E Moser

Publications and source records attributed to E Moser.

At least 235 records · Page 13Linked to original sources
PubMed1986

A microsurgical method for reconstruction of interrupted lymphatic pathways: autologous lymph-vessel transplantation for treatment of lymphedemas.

Refinements in microsurgery have made it possible to perform causal therapy on lymphedemas due to a local blockade of lymphatic pathways through transplantation of the patient's lymph collectors. End-to-end anastomoses with lymphatics before and after the blockade or crossing to the opposite side are performed under 40-fold magnification. Between July 1980 and February 1985 32 patients received this treatment. 23 patients had postmastectomy edema, and 9 patients had unilateral edema of the lower limb (2 primary, 7 secondary edemas). The lasting result was that the volume difference between the affected and the healthy limb decreased to about 65%. Lymphatic scintiscans showed improved lymphatic transport capacity with increasing time from surgery and long patency of the grafts.

Adult↗
PubMed1986

[Value of percutaneous sclerotherapy in the treatment of varicocele. Technic and results].

Since December 1983, percutaneous transvenous retrograde sclerotherapy of the internal spermatic vein was performed successfully, without complications in 37 patients. The administration of the sclerosing agent through a coaxially balloon catheter specifically inserted into the spermatic vein caused therapeutic hardening. The effectiveness of the treatment was endorsed by subsequent checks by clinical and radiological examinations.

Adolescent↗
PubMed1986

Influence of long-term injection sclerotherapy on portal venous component of total liver perfusion measured by hepatosplenic radionuclide angiography.

In an attempt to establish whether repeated injection sclerotherapy (ST) has any influence on the portal venous fraction of hepatic blood flow, we investigated 8 patients with liver cirrhosis and esophageal varices immediately prior to and six months after ST, using computerized hepatosplenic radionuclide angiography. The mean values of the portal venous fraction of the hepatic blood flow before and after treatment did not differ (20 +/- SD 9% vs. 20 +/- 11%). Eight cirrhotics with esophageal varices who had received no ST served as controls. Also in these patients, the mean values did not change over a period of six months (17 +/- 10% vs. 17 +/- 14%). The mean portal venous fraction of hepatic blood flow was significantly higher (56 +/- 9%, p less than 0.001) in 10 subjects without hepatobiliary disease. The results show that while the portal venous fraction of hepatic blood flow is significantly reduced in patients with liver cirrhosis and esophageal varices, it is not influenced by ST.

Adult↗
PubMed1985

Evaluation of transport kinetics in lymphoscintigraphy: follow-up study in patients with transplanted lymphatic vessels.

To quantitate visual findings in lymphoscintigraphy with 99mTc-labeled stannous sulfur colloids, a numeric index of transport kinetics was designed by combining visual assessment of five criteria: temporal and spatial distribution of the radionuclide, appearance time of lymph nodes, and graded visualization of lymph nodes and vessels. For assessment, scores were used ranging from 0 to 9. Thus, the resulting transport index (TI) ranged from 0 (normal) to 45 (pathological). TI in healthy extremities was less than 10. Lymphoscintigraphy was performed routinely in healthy lower extremities to ensure normal drainage before transplantation. In 122 investigations of upper and lower extremities, TI was found to be very sensitive (97.4%). Specificity was 90.3%. An interobserver study in 179 investigations revealed a high correlation (r = 0.96). A total of 23 patients underwent autologous lymphatic transplantation. The average decrease of TI was 5.9: 31.1 before and 25.2 after transplantation. This decrease of TI was correlated with a marked decrease of the volumes of the extremities (from 3423 ml to 2580 ml). Changes in TI and volume were significant (p less than 0.05). This method of evaluation has proved to be very sensitive, reproducible, and able to measure the transport capacity of only two or three transplanted lymph collectors.

Adult↗
PubMed1985

[Liver perfusion scintigraphy: method, normal values and results of observations on the course of patients with esophageal varices].

In 26 patients, the hepatic perfusion index (HPI) was determined comparing the slopes of the arterial and portovenous part of hepatic perfusion curves. 10 patients without hepatobiliary disease served as normals. HPI was determined twice with a time interval of 6 months. In normals, HPI was significantly (p less than 0,001) higher (mean value: 56%) than in patients with liver cirrhosis (18%). Despite good "intra- and interobserver"-correlation (r = 0.96 and 0.92, respectively) large intraindividual variations make the detection of minor HPI changes impossible. However, the method permits a clear differentiation between normal and moderately to highly reduced portovenous liver blood flow.

Adult↗
PubMed1984

Time course of thyroglobulin autoantibodies in patients with differentiated thyroid carcinoma after radioiodine therapy.

The time course of thyroglobulin (Tg) was monitored in patients with differentiated thyroid carcinoma after ablative therapy (thyroidectomy + 131I-treatment) with particular respect to endogeneous antibodies (Tg-ABs). In 232 patients (196 without Tg-ABs, 36 with Tg-ABs at the time of treatment) a sensitivity of 88% (accuracy, 93%) was found at the first follow up examination. Twelve months later, 11 of the 36 patients did not present Tg-ABs, therefore, the sensitivity increased to 91% (accuracy, 94%) at that time. It is expected that the determination of Tg can also be employed in patients presenting ABs initially.

Autoantibodies↗
PubMed1984

Thyroglobulin levels to follow-up patients with treated differentiated thyroid carcinoma.

Serum thyroglobulin (hTg) measurements by commercial radioimmunoassay were performed in the follow-up of 118 patients with differentiated thyroid carcinoma undergoing I-131 local and whole-body scans following surgery and I-131 therapy. Patients with positive anti-hTg antibodies (23% of cases) were excluded. In all remaining I-131 accumulating residual, recurrent, or metastatic tumors, hTg levels were elevated (greater than 6.25 ng/ml, minimum detectable value). Twelve patients with neither recurrence nor metastases had elevated hTg levels. Sensitivity and specificity depended on the threshold used for elevate d hTg levels. At an hTg-threshold of 6.25 ng/ml sensitivity has 100%, specificity has 82%. As hTg levels were reported to depend on endogenous TSH stimulation, it is not yet advisable to replace I-131 scans totally by hTg determination. After having determined an hTg "baseline" below detectable values (less than 6.25 ng/ml), we reduced the number of I-131 scans by half. However, elevated hTg levels were an indication for an I-131 scan. Therefore, on the basis of 23% of our patients who had anti-hTg antibodies the need exists to develop a commercial assay which is independent from antibodies.

Adult↗
PubMed1984

[Nuclear medicine diagnosis in intensive care using as example acute and chronic circulatory disorders (brain, lung, heart, kidney)].

The value of nuclear medicine procedures which are noninvasive and impose little burden on the the patient is assessed with respect of intensive care. Firstly, additional data are available to evaluate physiological functions. Secondly, these functions can be monitored under therapy. Thirdly, screening of the contralateral organ or of other organs can be provided. Cerebral procedures yield values of regional cerebral blood flow (ml/100 g /min) in addition to the morphological findings of CT. Cardiovascular procedures are supplementary in describing the regional as well as the global cardiac function. Using myocardium imaging with thallium-201 the extent of infarction can be estimated. In the crucial diagnosis of pulmonary embolism, radionuclide studies provide the necessary information. Renal procedures evaluate single kidney function yielding clearance values (ml/min). Furthermore, radionuclide flow studies are useful to detect early complications of transplanted kidneys. Diagnostic procedures with radionuclides if all instruments were care could be even more efficient if all instruments were available in the intensive care unit or could be transported there instead of transferring the patients to the nuclear medicine department.

Adult↗
PubMed1984

[Secondary resection in primarily omitted thyroidectomy as a prerequisite for multimodal therapy of differentiated thyroid cancers].

From 1.1. 1970 to 31.12. 1982 62 patients underwent secondary thyroidectomy. In 28.3% primary thyroidectomy was omitted due to false negative frozen section. The rate of lesions of the recurrens nerve amounted to 4.8%, the percentage of hypoparathyroidism was 3.2%. The postoperative uptake of radioiodine was 19.4 +/- 16.8%. Uptake of radioiodine and the time interval between the first and second operation were correlated.

Adenocarcinoma↗
PubMed1983

[Results of radioiodine treatment of autonomous thyroid adenomas taking into consideration regional iodine kinetics and paranodular uptake].

In 110 patients with autonomous adenoma of the thyroid, the success rate of therapy with radioiodine using different local dosages (300 and 400 Gy) was monitored. Furthermore the relative paranodular uptake before and after radiotherapy was compared in dependence on the duration of therapy. In a short period of therapy (5-8 d) the paranodular uptake decreases as compared to a long duration (9-20 d) where it increases. This explains the higher rate of hypothyroidism found in the group of patients with a longer period of therapy. The success rate was 93.6% after applying a dosage of 300 Gy and 95% after 400 Gy. However we found a slightly smaller incidence of hypothyroidism (3.2%) after 300 Gy as compared to 400 Gy (8.8%). Nevertheless the higher dosage should be chosen to reduce the failure rate. Because of the increased rate of hypothyroidism with increasing paranodular uptake it is recommended in cases with uptake ratios between 10 and 20% (so-called transitional type) to induce exogenic suppression of the paranodular tissue by means of thyroid hormone.

Adenoma↗
PubMed1983

[Value of posttherapeutic scintigraphy for the demonstration of distant metastases of differentiated carcinomas of the thyroid gland].

The value of posttherapeutic scintigraphy performed at discharge with the remaining radioactivity after an ablative radio-iodine therapy was studied in 190 patients with differentiated carcinomas of the thyroid gland (54% papillary and 46% follicular carcinomas). 163 patients (86%) had no signs of disease. 33 patients had distant metastases. In six out of them, the examination method allowed a first demonstration of metastases. In seven further cases, additional, hitherto unknown foci were found. There was a specificity of 100% and a sensitivity of 82% (no false positive findings, six false negative findings). Further to the usual image-producing examination methods (native X-ray diagnosis, sonography and CT), posttherapeutic scintigraphy furnishes early information about the formation of distant metastases. Therefore it is helpful to indicate a regional percutaneous X-ray therapy and to assess the prognosis.

Adenocarcinoma↗
PubMed1982

[Effect of an aromatic retinoid on human squamous cell carcinomas in vitro].

After in vitro incubation of human squamous cell carcinomas of the head and neck region with aromatic retinoid an increased number of lysosomes can be observed in the tumor cells. It is discussed whether this accumulaion of lysosomes is due to a direct stimulation of lysosomal enzyme synthesis or whether it is consequence of cell damage by the retinoid.

Acid Phosphatase↗
PubMed1982

[Limitations and hazards of palliative renal tumor embolization].

Today the indication for palliative embolization of inoperable renal carcinoma is more restricted than several years ago. Reviewing 31 own palliative occlusions of the renal artery in 29 patients over a period of 5 1/2 years two main reasons for this attitude are presented: 1. Because of collateral or parasitic vascular supply of kidney tumors the occlusion of the renal arteries only results in a retarded tumor growth rate and does not seem to prolong patient survival. 2. the "postembolization syndrome" after tumor occlusion has a relatively high complication rate and lethality (20% serious side effects, 3% deaths directly related to embolization). Therefore embolization of inoperable renal carcinomas is justified only in patients whose remaining lifetime can be alleviated by this measure. Certain indications are: massive hematuria, severe local pain due to the tumor and life endangering endocrine tumor activity, e.g. hypercalcemia. Uncertain indications such as recurring but not perilous hematuria causing progressive anemia and refusal of tumor surgery should be carefully balanced against the hazards of embolization.

Adult↗
PubMed1982

[Results of functional scintigraphy using 131J-hippurate in preoperative diagnosis of patients with kidney tumors: influence on surgical treatment and predictive value for retentional serum levels].

156 patients with renal tumors were studied using 131J-hippurate to assess the validity of functional scintigraphy in preoperative diagnosis and to compare it with the serum levels of Creatinine and Urea before and after tumor nephrectomy. If the contralateral, non tumor bearing kidney had a clearance (RNCL) of more than 200 ml/min, no pathological elevation was found postoperatively. If the RNCL was between 150 and 200 ml/min, the postoperatively elevated serum levels of Creatinine and Urea normalized within 3 weeks after surgery. Elevation persisted for longer than 3 weeks if the RNCL was between 100 and 150 ml/min. In RNCL below 120 ml/min an elevation was found even 6 months after surgery. Only if the RNCL was less than 100 ml/min (2% of all cases), instead of tumornephrectomy, an organ-conserving surgery was performed. In these cases, the results of renal scintigraphy yielded additional information in deciding the type of non-radical surgery. Therefore, renal functional scintigraphy does not need to be performed in patients with renal tumors under the following conditions: 1. no elevation of Creatinine and Urea preoperatively and 2. normal morphological findings (sonography, IVP, angiography, CT) of the contralateral kidney.

Creatinine↗
PubMed1981

[Radionuclide angiography (RNA) with 99mTc-DTPA to follow palliative embolization of renal cell carcinoma (author's transl)].

In 14 patients with renal cell carcinoma, not to be treated by nephrectomy, radionuclide angiography with 99mTc-DTPA (RNA) was employed before and after palliative tumor embolization. If RNA revealed remaining perfusion of the tumor, functional scintigraphy with 131J-hippurate was performed to detect and quantify residual function. Up to 16 months after embolization, 7 patients (50%) revealed neither residual perfusion nor function. In 5 patients (36%) remaining perfusion without functioning renal parenchyma and in 2 patients (14%) residual perfusion with additional function were found. In 4 cases (28%) a nuclear "tumor-halo" was imaged, describing a stripe of high radioactivity caused by capsular arteries surrounding the avascular tumor. RNA has proven to be a suitable non-invasive procedure for to blow-up of embolized renal cell carcinomas.

Adenocarcinoma↗
PubMed1981

[Functional scintigraphy of pulmonary ventilation with 133Xe in juvenile scoliosis (author's transl)].

Twenty children with severe scoliosis underwent spirometry, chest X-ray and 133Xe ventilation studies before surgical correction by the Harrington operation. By means of functional scintigraphy the relative distribution of the functional residual capacity (FRC) and the wash-out curves (3-min-retention without background correction, mean time constant, effectivity index after background correction) were analysed quantitatively. The chest X-ray and the single-breath-phase of the ventilation study remained mostly unchanged, whereas the shifting of the FRC distribution towards the lung of the concave side indicated in all cases a regional ventilation restriction of the convex side. In addition the analysis of the wash-out curves showed a regional impairment of the alveolar ventilation of the convex side which exceeded the shifting of FRC distribution. Even in the cases with normal spirometric values all scintigraphic parameters were slightly pathological, probably due to the decreased lung function caused by the scoliosis. The effectivity index taking into account the respiration frequency, the tidal volume, the FRC and the dead space, was found to be the most accurate and sensitive parameter for the evaluation of regional ventilation impairment.

Adolescent↗