Biomedical subjects

H Bergmann

Publications and source records attributed to H Bergmann.

At least 55 records · Page 3Linked to original sources

PubMed1997

Achalasia. Results of myotomy and antireflux operation after failed dilatations.

OBJECTIVE: To evaluate the outcomes of patients with achalasia who had undergone myotomy and an antireflux operation because dilatations had not yielded satisfactory results. DESIGN: Retrospective analysis. SETTING: University-based tertiary care center. PATIENTS: Of 39 patients who met inclusion criteria, 18 female patients and 18 male patients (age range; 17-85 years; median age, 54 years; range of time elapsed since operation, 1-22 years; median time, 6 years) could be studied. Antireflux operations included 360 degrees fundoplications in 27 patients, anterior hemifundoplications in 5 and other procedures in 4. MAIN OUTCOME MEASURES: Dysphagia for solid foods and liquids, regurgitation, heartburn, retrosternal pain and body weight. RESULTS: Excellent, good, and fair results of myotomy and antireflux operation were encountered in 14, 3, and 6 patients, respectively, and poor or absent results in the remaining 13 patients. The resting pressure of the lower esophageal sphincter was significantly lower at follow-up than preoperatively, and this was associated with reduced dysphagia for solid foods in 14 patients and for liquids in 16 of 17 patients. CONCLUSIONS: Myotomy and antireflux operation yielded excellent to fair results in 23 patients in whom dilatations had not facilitated swallowing. Poor results in the remaining 13 patients seemed to be attributable to the 360 degrees fundoplication performed in 12 of them. In these patients, a further surgical intervention seemed to be indicated.

Adolescent↗

PubMed1997

Radiation doses deriving from patients undergoing 111In-DTPA-D-phe-1-octreotide scintigraphy.

The purpose of this study was to estimate the radiation doses to nursing staff, other patients, accompanying persons and family members deriving from patients undergoing 111In-DTPA-d-Phe-1-octreotide (111In-OCT) scintigraphy. Dose rates were measured from 16 patients who had received an intravenous injection of 140+/-40 MBq 111In-OCT. The measurements were performed at three different distances (0.5, 1 and 2 m) at 10-20 min, 5-7 h and 24 h (and in some cases, up to 48 h) after administration of 111In-OCT. The effective half-lives of the biexponential decrease of the dose rates were estimated to be 2.94+/-0.27 h (T1) and 65.17+/-0. 58 h (T2). The calculated maximum dose to other persons in the waiting area was 27.2 microSv, to family members 61.5 microSv, to nursing staff in a ward 24.1 microSv and to neighbouring patients in the ward 69.5 microSv. Our results clearly demonstrate that the calculated maximum radiation exposure to accompanying persons, personnel, family members and other patients is well below the maximum annual dose limit for non-professionally exposed persons.

Air Pollutants, Radioactive↗

PubMed1997

Gastric emptying of semisolid meal unaltered by 3 days' administration of a sustained-release preparation of the nitric oxide donor, isosorbide dinitrate.

BACKGROUND: Evidence has accumulated that nitric oxide is involved in the regulation of gastrointestinal motor activity. We investigated whether nitric oxide derived from a sustained-release isosorbide dinitrate (Cedocard retard) had an effect on gastric emptying and on subjective feelings. METHODS: Twelve healthy males aged 23-32 years received at weekly intervals, for 3 days twice daily, either 20 mg isosorbide dinitrate, 40 mg isosorbide dinitrate, or placebo, under random double-blind conditions. After a further dose on day 4, subjects ate a 1168 kJ semisolid meal, the emptying of which was recorded scintigraphically for 50 min. RESULTS: Neither dosage of isosorbide dinitrate had an effect on emptying which differed from the effect of placebo and the effects of the two dosages were the same. The radioactivity remaining in the stomach 50 min postprandially was 68.5% +/- 4.5 S.E.M. after placebo, 65.4 +/- 5.6% after 20 mg isosorbide dinitrate and 66.1 +/- 4.4% after 40 mg isosorbide dinitrate. With 40 mg isosorbide dinitrate, all 12 subjects complained of persistent headache, whereas only slight headache was reported by 7 subjects on 20 mg isosorbide dinitrate and by 1 subject on placebo. CONCLUSION: Twenty and 40 mg doses of sustained-release isosorbide dinitrate twice daily had no effect on the gastric emptying of a semisolid meal, but dose-dependently induced headaches.

Adult↗

PubMed1997

The distal colon provides reserve storage capacity during colonic fluid overload.

BACKGROUND: In addition to its absorptive function the capacity of the colon to retain fluid might be relevant in compensating for increased fluid loads and prevention of diarrhoea. The distal colon is considered to be mainly a conduit without extensive storage function. AIMS: To evaluate colonic volume capacity in a model of pure osmotic diarrhoea. METHODS: A non-absorbable, iso-osmotic solution (OS) containing polyethylene glycol (500 ml) was infused into the caecum of nine healthy volunteers; the control group (n = 5) received an equal amount of an easily absorbable electrolyte solution (ES). Fluids were radiolabelled with technetium-99m and gamma camera images were obtained for 48 hours. Counts in the proximal and distal colon were measured and regional and overall colonic transit and stool output were quantified. RESULTS: After OS, in contrast to ES, faecal output was increased significantly (p < 0.05), but colonic transit after OS was not different from transit after ES (p > 0.05). This indicates storage of OS in the colon: after OS infusion, counts in the proximal colon decreased linearly while the distal colon stored approximately 30% of radioactivity for the whole 48 hour study period. After OS, stool output correlated with distal (p < 0.01), but not with proximal (p > 0.05), colonic transit. In contrast, after ES, stool output was determined by proximal colonic transit (p < 0.05) but not by transit through the distal colon (p > 0.05). CONCLUSION: The distal colon retains non-absorbable fluid volumes extensively. In our model transit through the distal colon--but not the proximal colon--determined the time at which diarrhoea occurred.

Adult↗

PubMed1997

Slow gastric emptying in type I diabetes: relation to autonomic and peripheral neuropathy, blood glucose, and glycemic control.

OBJECTIVE: To investigate whether autonomic neuropathy or hyperglycemia plays a crucial etiological role in gastric retention of ingesta frequently found in type I diabetic patients. RESEARCH DESIGN AND METHODS: We investigated the gastric emptying of a radiolabeled semisolid 1,168 kJ meal in 38 female and 45 male patients (age 18-75 years; illness duration 3-46 years). None took drugs affecting gastrointestinal motility. Fasted patients underwent tests of cardiovascular autonomic and peripheral nerve function. Blood glucose levels were determined before and after the scintigraphic recording of gastric emptying. RESULTS: The percentage of meal remaining in the stomach at the end of the 50-min recording time was related significantly to the patients' degree of cardiovascular autonomic neuropathy [r (81) = 0.235, P < 0.028] but not to their degree of peripheral neuropathy, preprandial blood glucose level, HbA1c indicative of glycemic control, diabetes duration, and age. The patients' mean residual percentage of meal was significantly greater than that of 48 healthy subjects, that is, 71.1 +/- 15.1 vs. 53.5 +/- 13.1% [means +/- SD; t (129) = 6.48, P < 0.0001]. The healthy individuals' mean residual percentage + 2 SD was exceeded in 22 patients. CONCLUSIONS: Slow gastric emptying in patients with type I diabetes seems related to the degree of autonomic neuropathy but not to peripheral neuropathy, actual blood glucose, and glycemic control.

Adult↗

PubMed1996

Influence of high-energy photons from cobalt-57 flood sources on scintillation camera uniformity images.

Cobalt-57 flood sources are often used for system flood-field uniformity checks of scintillation camera performance. Such sources are now available in large sizes and with high activities. Uniformity images using new 57Co sources have shown artefacts which are not present in uniformity images obtained from technetium-99m flood sources of the same activity. The high-energy photons emitted by 57Co and cobalt isotope impurities appear to influence the images obtained. This was investigated in three cameras using three 57Co sources of different age. The flood-field images obtained with the 57Co sources showed non-uniformity patterns that were dependent on the age of the cobalt source, the distance of the source to the collimator, and the specific camera type. Quantification of the uniformity images reflected these findings. Energy spectra of a new 57Co source, obtained with an external 1024-channel analyser connected to the camera, showed a broad tail of high-energy photons above the 122-keV photopeak, due to Compton scatter and collimator penetration. This tail diminished with older sources and with increased source to collimator distance, indicating that in both situations fewer high-energy photons were being measured by the camera system. This tail of high-energy photons contributes to the total count rate, but because this is not obvious from the counts observed in the photopeak window, the camera can unsuspectingly be operated at too high a total countrate where pile-up effects become significant. Caution is therefore advised when using 57Co sources. Problems may be minimized by purchasing low-activity sources (certainly no more than 370 MBq), by placing the source at a distance from the collimator, e.g. 50 cm, by allowing a new source to decay, and by manufacturers producing 57Co sources without detectable radioactive contaminants.

Cobalt Radioisotopes↗

PubMed1996

Quantification of intensity variations in functional MR images using rotated principal components.

In functional MRI (fMRI), the changes in cerebral haemodynamics related to stimulated neural brain activity are measured using standard clinical MR equipment. Small intensity variations in fMRI data have to be detected and distinguished from non-neural effects by careful image analysis. Based on multivariate statistics we describe an algorithm involving oblique rotation of the most significant principal components for an estimation of the temporal and spatial distribution of the stimulated neural activity over the whole image matrix. This algorithm takes advantage of strong local signal variations. A mathematical phantom was designed to generate simulated data for the evaluation of the method. In simulation experiments, the potential of the method to quantify small intensity changes, especially when processing data sets containing multiple sources of signal variations, was demonstrated. In vivo fMRI data collected in both visual and motor stimulation experiments were analysed, showing a proper location of the activated cortical regions within well known neural centres and an accurate extraction of the activation time profile. The suggested method yields accurate absolute quantification of in vivo brain activity without the need of extensive prior knowledge and user interaction.

Algorithms↗

PubMed1996

[Collection and utilization of plasma in Austria: on the way to national self-sufficiency].

Self-sufficiency for plasma and plasma products on the basis of voluntary non-remunerated donation is more than guaranteed in Austria. Historically commercial enterprises are co-operating with the non profit sector of the Austrian Red Cross in an ideal way since more than 30 years. Austria needs about 16 millions IE of factor VIII yearly to treat the haemophilia patients as it should be. About 100,000 1 source plasma (FFP) coming from the industry and some 50,000 1 of frozen plasma per year being given for fractionation by the Red Cross Blood Transfusion Services seem to be sufficient for preparing the amount of factor VIII needed. Austria feels furthermore responsible to also fulfill its part as a member of the European Community in order to reach the common European goal of self-sufficiency in due time. As for the term "non remunerated' it is our strong concern that to compensate the plasma donor's time- and work-spending by reinbursement does not mean any sort of "payment'. We agree herewith with the opinion of the "Arbeitskreis Blut' in Germany. To change the successful way of having enough raw material to treat all our haemophilia patients with the necessary amounts of factor VIII by abruptly and artificially pressing for unpaid plasma donations would be a bad decision. By certainly not getting enough plasma by using such an unusual way this idea would not be successful. Austrian Red Cross does not intend to create own plasmapheresis-centres.

Austria↗

PubMed1995

Quality assurance and harmonisation of nuclear medicine investigations in Europe.

A survey of all member societies of the European Association of Nuclear Medicine has shown that a satisfactory degree of harmonisation exists for the quality assurance of the preparation and handling of radiopharmaceuticals and the performance of nuclear medicine instrumentation. However, variations were found in acquisition protocols, data analysis and the interpretation and presentation of clinical results. Harmonisation of these areas of a nuclear medicine investigation would help ensure the overall quality. A European initiative is proposed to collect and collate procedures in these areas in order to produce a reference framework of good practice for the acquisition, analysis and interpretation of nuclear medicine investigations. This would involve collaboration between national societies and exchange of information with and support from European organisations, taking into account relevant international activities. The reference framework should be compatible with quality management guidelines.

Data Collection↗

PubMed1995

[Comparison of postoperative volume therapy in heart surgery patients].

UNLABELLED: Patients who have undergone cardiac surgery with use of extracorporeal circulation frequently reveal marked hypovolaemia in spite of a highly positive fluid balance. This is thought to be due to transient microvascular damage and extravascular fluid shift. Further volume replacement to achieve haemodynamic stability in the postoperative period may cause fluid overload and congestive heart failure. The present study was designed to investigate whether this fluid overload could be avoided by using a hypertonic-hyperoncotic solution (group I: HHL, 10% hydroxyethylstarch 200/0.5 in 7.2% saline) instead of two different standard colloid solutions (group II: HA, 5% albumin; group III: HES, 6% hydroxyethylstarch in 0.9% saline). METHODS: Twenty-one patients meeting our criteria for hypovolaemia immediately after cardiac surgery were randomly assigned to three groups. Patients in group I received HHL in increments of 150 ml, while patients in group II and group III were given HA and HES respectively in increments of 500 ml until hypovolemia was corrected. Haemodynamic assessment was done using a pulmonary artery thermodilution catheter. Intra- and extravascular volumes, including extravascular lung water (EVLW), intrathoracic blood volume (ITBV), and total blood volume (TBV) were measured by the double indicator technique using lung water software (COLD-System, Pulsion, Munich, Germany). RESULTS: Correction of hypovolaemia-related haemodynamic parameters and restoration of normal TBV were achieved by 236 +/- 80 ml of HHL (group I), 857 +/- 244 ml of HA (group II) and 1000 +/- 0 ml of HES (group III) respectively. TBV increased significantly in each group, compared to baseline values. EVLW did not change significantly in any group. We found that the volume-augmenting effect of HHL per millilitre infused solution was more than four times that of HA and HES, primarily as a result of increasing plasma osmolality due to an increase of plasma sodium levels. This pronounced effect on intravascular volume of HHL lasted for only 2 h following infusion, however, and did not lead to any unwanted side effects. In the period between 2 and 20 h after primary volume replacement, further fluid therapy with colloids and crystalloids, guided by clinical signs of hypovolaemia, was necessary in each group of patients. The overall fluid requirements for the first 20 h after operation did not differ among the three resuscitation regimens. CONCLUSION: We found that HHL is a safe and effective solution for acute correction of hypovolaemia after cardiac surgery. The advantages of a smaller initial volume load by HHL cannot be maintained for longer than 2 h.

Adolescent↗

PubMed1995

[Acanthamoeba, naturally intracellularly infected with Pseudomonas aeruginosa, after their isolation from a microbiologically contaminated drinking water system in a hospital].

The drinking water system of a new hospital building that was highly contaminated with bacteria before opening was investigated too for the prevalence of small free living amoebae. Germ counts resulted in > 100 CFU/ml in 100% of the cold water samples, that showed also growth of P. aeruginosa, whereas E. coli and coliforme bacteria could not be identified. The investigation of 37 water samples for protozoa revealed growth of small freeliving amoebae in 20 samples (54%) belonging to 10 species of the genus Acanthamoeba, Naegleria, Hartmannella, Echinamoeba among others. In addition 2 Ciliate- and 2 Microflagellate-species could be observed. While all Naegleria strains isolated belonged to the N. gruberi-complex two of 16 Acanthamoeba-isolates proved to be pathogenic for laboratory mice. From 7 watersamples positive with P. aeruginosa 5 Acanthamoeba- and 2 Echinamoeba strains could be isolated which revealed intracellular multiplication of P. aeruginosa. Because of their well known resistances against chlorine, the amoebae and their cysts are considered to be vectors for these intracellular bacteria. A complete sanitation of the incriminated drinking water system was accomplished by combined chemical and thermic disinfection measures.

Acanthamoeba↗

PubMed1995

[Thallium scintigraphy of the myocardium. Uniform research protocols of the Austrian Society for Nuclear Medicine].

A uniform protocol for thallium scintigraphy of the myocardium has been issued in Austria to avoid difficulties in interpreting results and to avoid repeated examinations to save expenses and radiation burden. From the beginning of 1995 this protocol will be used in the Austrian departments of Nuclear Medicine, differences from this protocol have to be mentioned separately. In this protocol the procedure of examination, bicycle and pharmacological stress testing and vasodilatation, acquisition techniques for planar and SPECT imaging, data processing and quality control of devices are defined.

Adenosine↗

PubMed1994

The use of a high-purity germanium detector for routine measurements of 125I in radiation workers.

A high-purity germanium detector was calibrated for the assessment of 125I uptake in the thyroid gland of radiation workers. A cylindrical water phantom (perspex walls) with high flexibility for position and size of the thyroid was constructed. Within a massive shielding chamber built for a whole-body counter, an activity of 2.2 Bq was detectable (MDA). This is well below the very restrictive limiting value of 20 Bq for inhalation specified by Austrian law. An activity of 128 Bq was measured with a statistical uncertainty of 5% in a counting period of 10 min. Various parameters influencing the result are investigated as well as the performance of two other measurement geometries outside the shielding chamber.

Gamma Rays↗

PubMed1994

Sensitivity of radionuclide bolus transport and videofluoroscopic studies compared with manometry in the detection of achalasia.

OBJECTIVE: The sensitivity of radionuclide bolus transport and videofluoroscopic studies to confirm manometrically revealed achalasia was investigated prospectively in 77 patients with symptoms indicative of disordered esophageal motor function. METHODS: The studies were performed in random order and were analyzed blindly by strict diagnostic criteria. Transport of radiolabeled water was recorded for 2 min with patients supine. Videofluoroscopy assessed three swallows in prone oblique and one in upright position. Manometry employed four pressure sensors in the esophageal body and the Dent sleeve in the lower esophageal sphincter. RESULTS: Radionuclide and videofluoroscopic studies confirmed 25 and 15, respectively, of 37 manometrically diagnosed achalasias and provided indications for the disorder in another 8 and 16 patients. Using information from both studies increased the sensitivity to detect achalasia from 68% and 41%, respectively, to 73%, and increased detection of disordered esophageal motor function from 81% and 74% to 92%. CONCLUSION: Radionuclide and videofluoroscopic studies represent valuable and complementary, although relatively insensitive, procedures to detect achalasia.

Colloids↗

PubMed1993

Scintigraphic evaluation of functional hepatic mass in patients with advanced breast cancer.

Recent studies suggest a high specificity of 99mTc-galactosyl neoglycoalbumin (99mTc-NGA) receptor scanning in vivo by providing both morphological and functional diagnosis of liver disease. In 22 patients with advanced breast cancer 99mTc-NGA (150 MBq; 50 nmol) was exclusively trapped by the liver, the images showing 'cold spots' in areas of liver metastases formation. A two-tailed analysis was performed: the time activity curves recorded for the liver and precordial area were subjected to a kinetic receptor-calculating model allowing an estimation of the NGA-receptor concentration of the liver (i.e. hepatic binding protein, HBP) as well as calculation of the residual functional liver volume (RFLV) via the S.P.E.C.T.-study. In breast cancer patients with liver metastases a significantly (P < 0.01) lower HBP-concentration was estimated (0.65 +/- 0.16 vs 0.82 +/- 0.17 mumol l-1) as evidenced by a lower 99mTc-NGA-accumulation in the liver resulting also in a significantly (P < 0.001) lower RFLV (739 +/- 348 vs 1336 +/- 184 ml). In four amonafide-treated patients (800 mg m-2 intravenous infusion over 3 h) approximately one week after one chemotherapy cycle a significant (P < 0.05) increase in HBP-concentration (0.56 +/- 0.10 vs 0.72 +/- 0.06 mumol l-1) of the liver was found corresponding with an increase in RVLF (546 +/- 297 vs 670 +/- 265 ml). These regulatory mechanisms at the HBP level measured in vivo provide further evidence that 99mTc-NGA should have promise as a clinically useful receptor radiopharmaceutical for both quantification of liver function and assessment of liver morphology.

Aged↗

PubMed1993

Erythromycin effects on gastric emptying, antral motility and plasma motilin and pancreatic polypeptide concentrations in anorexia nervosa.

In primary anorexia nervosa, gastric motility is often impaired and ensuing symptoms further discourage eating. Prokinetic agents have been shown to accelerate gastric emptying in affected patients. This study investigated whether emptying of a radiolabelled semisolid 1168 kJ meal and antral contractility were enhanced by intravenous erythromycin. Eight women and two men with anorexia nervosa (21-46 years, 50-75% of ideal body weight) received 200 mg erythromycin or placebo under crossover double blind conditions. Gastric emptying and antral contractility were recorded scintigraphically for 90 minutes. In addition, plasma motilin and pancreatic polypeptide concentrations were determined. With placebo, antral contractions were of regular 3 cycles/minute frequency. With erythromycin, less frequent and partly arrhythmic long duration contractions set in and emptying was accelerated: after 90 minutes, the activity remaining in the stomach was markedly less than with placebo in all patients (Sign test, p < 0.002). Basal motilin and pancreatic polypeptide concentrations were normal and showed a normal response to the meal in all patients. Motilin concentrations decreased slightly more and pancreatic polypeptide concentrations increased markedly more with erythromycin than with placebo, possibly because the meal reached the intestine earlier. In conclusion, erythromycin accelerated emptying markedly and in most patients induced an antral motor activity characterised by long duration contractions occurring at often irregular intervals.

Adult↗

PubMed1993

Gastric emptying, body weight and symptoms in primary anorexia nervosa. Long-term effects of cisapride.

In a double-blind trial, 12 out-patients with primary anorexia nervosa received, for six weeks, either 10 mg cisapride or placebo, three times a day. Cisapride accelerated gastric emptying of a radiolabelled semisolid meal in all six patients; five gained weight and symptoms of gastric retention ameliorated in four. With placebo, three of six had emptying enhanced, four gained weight, and one's symptoms improved. For another six weeks, all patients received cisapride. In five of the patients who had received cisapride, emptying further accelerated or remained stable; in one it slowed. Of the six patients who received placebo, four had emptying accelerated, five gained weight, and symptoms improved in four. Longer administration of cisapride may, by enhancing gastric motor activity, alleviate symptoms of retention and thus help to change eating behaviour.

Adult↗

PubMed1993

[Production of maedi-visna virus antigen for the immunodiffusion test and its use for field studies].

Using the Maedi-Visna virus strain WLC1 (Weybridge) and different cell lines of sheep plexus chorioideus we were able to establish and improve a production procedure of MV-antigen for use in immunodiffusion assay. Our attention was focused mainly on the efficient virus multiplication in cell cultures and on standardisation of the procedure to find a method keeping the antigen loss as low as possible. Investigations with our antigen in 39 farms of 5 of the former districts in East Germany revealed a seropositive reagent rate between 0 and more than 60%, underlining the need for a complex diagnostic and eradication programme.

Animals↗