Biomedical subjects
Publications and source records attributed to H Bergmann.
Sera from wild ruminants (302 roe, 39 red deer, 17 fallow deer, 1 mouflon) were tested for antibodies against respiratory syncytial virus (RSV). 22 sera (6.1%) were positive: 20 roe, 1 red deer, 1 mouflon. The findings are discussed from the epizootiological point of view.
The non-debatable need for expansion of cardiac surgery beyond the university hospitals was recognized in Austria ten years ago. Such development put an additional strain on the scarce resources of Anesthesia Service and Intensive-Care-Unit (ICU) facilities. To cope with the increase of the ICU patient load the change of ICU admission and discharge criteria was necessary. The economic burden for the hospital was in our case a limiting factor for the number of heart operations, soon the emergency cases and high-risk cardiac patients forced the hospital administration to accept the reality. It took more than five years to change from necessary improvisation to full organization of the Cardiac Service which is presently interwoven into the existing hospital structures. Such interdisciplinary solution (surgery, medical service, anesthesia) is in authors' opinion superior to an isolated cardiac surgical center.
Some 28 nuclear medicine departments out of a total of 40 participated in a nationwide Austrian interlaboratory comparison of the imaging quality of gamma cameras. The participation was voluntary, and confidentiality of the individual results was guaranteed. The survey was completed within 2 months, employing instructors to administrate the tests. An emission phantom simulating a flood field with non-uniformities was imaged by 43 cameras, and 54 images were evaluated. The test images were read by the participants using a graded rating scale to indicate the probability of the presence of a non-uniformity in the various parts of the image. The rating data were used to construct individual ROC curves for each image. The area under the ROC curve was used as the ranking parameter for image quality. The results show a spread of the ROC areas between 0.6 and 0.99, with a median of 0.81. A correlation was found between the year of installation and the ROC area obtained from the gamma camera, indicating improvements of performance in more recent cameras, which accounts for part of the variation of the ROC areas. The remaining variations are due to differences in the performance of the gamma cameras. Feedback was provided to the participants by describing individual performance with respect to the true structure of the phantom and by comparing this performance with that of the group. A questionnaire accompanying the test phantom yielded information about the practice of routine quality control and about details of the acquisition and analysis of images.(ABSTRACT TRUNCATED AT 250 WORDS)
The effectiveness of prophylaxis of thromboembolism either by acetyl-salicylic-acid (ASA) 0.5 g + dihydroergotamin (DHE) 2.5 mg three times a day or by Heparin 5000 IU + 0.5 mg DHE (HDHE) three times a day was compared in 404 patients, elder than 55 years, with fractures close by the hip joint. Effectiveness was proved daily clinical controls, perfusion scintigraphy on the day after admission, the fourth postoperative day and the day before discharge and by autopsy of the died patients. Clinical manifest thrombosis were seen on the operated legs in the HDHE-group in 7.6% of the patients, in ASA-DHE-group in 15.6%, on the not operated leg under prophylaxis by HDHE in 3.8%, by ASA-DHE in 4.1% of the patients. Increased postoperative bleeding could be found under HDHE in 16.1% of the patients, under ASA-DHE in 9.3% of the patients, wound haematoma in 9.5% under HDHE and in 5.7% of the patients of the ASA-DHE-group. Superficial wound infections occurred under HDHE in 8.1%, under ASA-DHE in 5.7% of the patients, deep infections under HDHE in 0.5% and under ASA-DHE in 1.6% of the patients. Gastrointestinal bleeding under HDHE in 0.5% of the cases and under ASA-DHE in 3.1% of the cases. Prophylaxis had to be discharged in 7.6% of the patients of the HDHE-group and of 19.7% of the ASA-DHE-group. Pathologic perfusion scars should be found in 54.0% of the patients of the HDHE-group and in 54.9% of the ASA-DHE-group. Pulmonal perfusion became worse despite of prophylaxis by HDHE in 15.6% of the cases and despite prophylaxis with ASA-DHE in 17.6%. Pulmonal perfusion became better under HDHE in 11.9% and under ASA-DHE in 12.4% of the cases. The mortality was 9.7%. Fatal thromboembolism occurred under HDHE in three patients (1.4%) and under ASA-DHE in three patients too (1.6%), after subcapital fractures in 0.5%, after pertrochanteric fractures in 2.1% and after subtrochanteric fractures in 6.25% of the patients without any significant difference between the two groups of prophylaxis. Fatal gastrointestinal bleeding had to be remarked in 1.0% of the patients of the HDHE-group and in 2.1% of the ASA-DHE-group, fatal infections in 0.5% of the patients of the HDHE-group and in 1.6% of the ASA-DHE-group. Fatal cardinal infarction could be seen under HDHE in 1.9% of the patients, under ASA-DHE no fatal cardial infarction occurred.(ABSTRACT TRUNCATED AT 400 WORDS)
99mTc-galactosylated neoglycoalbumin (99mTc-NGA) is a hepatocyte-specific tracer that, after injection into the blood stream, delivers radioactivity selectively to the liver. This is based upon chemical recognition and binding by the hepatic binding protein (HBP), a receptor specific for galactosylated glycoproteins. Liver tissue samples were obtained intraoperatively from patients undergoing surgery for various cancers. The concentration of specific HBP receptors in the liver (normal liver, hepatoma, liver metastasis) was calculated from the in vitro binding of 99mTc-NGA. One week after surgery, the in vivo HBP density was also measured in some of these patients after injection of 3.5 mg (50 nmol per patient) 99mTc-NGA (150-200 MBq) for simulation of 99mTc-NGA kinetics. Comparison of in vitro and in vivo HBP concentration in the liver showed values in the same concentration range. In patients with hepatoma or liver metastasis a significantly (P less than 0.01) decreased global HBP density was found in vivo compared to controls. The values obtained for in vivo HBP concentration in the liver amounted to 0.38 +/- 0.05 mumol l-1 liver for patients with hepatoma, to 0.4 +/- 0.1 mumol l-1 in patients with liver metastasis and to 94 +/- 0.05 mumol l-1 liver in cancer patients without liver malignancy. In vitro investigation of HBP density revealed the malignant liver tissue to have a significantly (P less than 0.0001) decreased or almost (completely) absent HBP receptor density compared to the normal tissue apart from the cancer area. It is concluded that determination of HBP density in vivo via a specific tracer is a new, simple and reliable approach for the determination of remaining hepatic function in patients with primary or secondary liver cancer.
A shadow shield whole body counter with automated gamma spectrum analysis is used in the division of nuclear medicine for the measurement of whole body radioactivity. After the radioactive fall-out in Austria caused by the Chernobyl accident the instrument has been extensively utilized for the assessment of the radiation level in the general population. In November of 1986 and 1987 the level of internal contamination with 137Cs in high-performance athletes was compared with a group of subjects practicing little or no sports. It was found that significantly higher contents of 137Cs were present in the athletes. Furthermore, it was found that within the groups of athletes male subjects had significantly higher internal 137Cs contamination per kilogram of body mass than the female subjects. An explanation for this is the different nutrition and the higher relative muscle mass of the athletes.
1. The selective 5-HT3 receptor antagonist, ICS 205-930 (Sandoz), has been reported to have potent effects on gastric smooth muscle in vivo and to enhance gastric emptying in animals and in man. 2. This study investigated the effects of ICS 205-930 on fat-delayed gastric emptying of a semisolid meal and antral motor activity in humans. 3. Twelve healthy men participated in each of three studies in which 10 or 20 mg of ICS 205-930 or placebo were infused i.v. in a random double-blind fashion. Gastric emptying and antral motor activity were studied scintigraphically. 4. Gastric emptying was not altered after 10 mg but slower after 20 mg of ICS 205-930 than after placebo. Emptying after 20 mg of ICS 205-930 was significantly slower than after 10 mg of ICS 205-930. 5. Antral contraction amplitude was slightly lower after 20 mg of ICS 205-930 than after placebo, whereas the effects of 10 mg ICS 205-930 did not differ from those of placebo. 6. The results suggest that the investigated doses of ICS 205-930 have only slight effects on gastric motor activity of healthy young men, with 20 mg reducing the rate of emptying.
1. Meals empty more slowly when they contain fat. 2. This study investigated whether an intragastric fat preload in comparison with a water preload affected gastric emptying of a semisolid meal and antral motor activity, and whether cisapride reversed such effects. 3. Twelve healthy subjects were studied under three conditions each: (A), preload of 50 ml water orally; (B) and (C), preload of 50 ml cream (20 g fat). After preloads, subjects reclined right sided for 20 min. Thereafter, placebo in conditions (A) and (B) and 10 mg cisapride in (C) were administered i.v. in a random double-blind fashion and subjects ingested a semisolid radiolabelled 1150 kJ meal. Gastric emptying and antral motor activity were recorded scintigraphically for 50 min using a dual-headed gamma camera. 4. Gastric emptying was significantly slower (P less than 0.005) after fat preload and placebo than after water preload and placebo. Cisapride administered after fat preload abolished the delaying effect of the fat preload (P less than 0.001). 5. Antral contraction amplitudes after fat preload and placebo were higher (P less than 0.01) than after water preload and placebo as well as fat preload and cisapride at the start of recording and decreased slightly thereafter, whereas slight increases occurred in the other conditions. Frequency and propagation velocity of contractions were not differently affected. 6 Gastric emptying is delayed after prior fat ingestion and this effect is abolished by cisapride.
Previous studies showed that symptoms of oesophageal motor disorders can be misinterpreted as indicating anorexia nervosa and that in primary anorexia nervosa gastric motility is frequently impaired. We investigated in 32 women with bulimia nervosa whether symptoms of oesophageal motor disorders could be obscured by or be mistaken as forming part of bulimic behaviour, and whether impaired gastric motility was frequent as well. Oesophageal motility was normal in 18 of 26 patients studied, another four had incomplete lower oesophageal sphincter relaxation. Two patients had vigorous achalasia and each one achalasia and diffuse oesophageal spasm, all of whom experienced two types of vomiting: one self-induced and one involuntary, in which the vomit was non-acidic and tasted as the preceding meal. Gastric emptying of a semisolid meal was studied in all patients except of the eight with oesophageal motor abnormalities. Emptying was significantly slower than in healthy controls and grossly delayed in nine of 24 patients. Antral contraction amplitudes were lower and increased less postcibally than in controls. In conclusion (i) bulimic behaviour can obscure symptoms of oesophageal motor disorders and (ii) gastric emptying is frequently delayed in bulimia nervosa.
Explore the source record for details and available documents.
The prevalence of dental caries in Iceland has been high for many years and the improvements reported from the other Nordic countries in recent years has been slow to appear in Iceland. In this study the prevalence of dental caries among young children in Vopnafjörour, a small community in East Iceland, was investigated in the spring of 1989. Virtually all children in the community born between 1982 and 1985 were examined clinically and with bite-wing radiographs and caries scored as dmfs and DMFS according to standard criteria. The results indicated that children in this community did not have poor dental health, no worse than children from other parts of the country. Sixty-five per cent of four year old children were caries-free which is similar to the proportion reported from other Nordic countries. Children living in the country districts surrounding the town had significantly better dental health than those living in the fishing town itself. It was also apparent that four year old children attended the dentist less regularly than those aged 6 years and this was attributed to the failure of the State Health Insurance Scheme to reimburse the full cost of treatment for children younger than 6 years. Caries was unevenly distributed among the children with 78% of the total amount of caries being found in 21% of children. Clearly the best way to reduce further the prevalence of dental caries would be to concentrate effort on those children most at risk.
The motor activity of the gastric antrum is difficult to record by manometric means and scintigraphic methods have proved unsatisfactory so far as no consistent relationship between antral contractile activity and gastric emptying rate could be detected. We investigated, using data recorded in 16 healthy human subjects after the ingestion of a semisolid standard meal, whether a newly developed method employing factor analysis would yield more meaningful and reproducible results. Factor analysis was applied to sequential scintigraphic images (3-s frame time) of the gastric antrum. The computed factor images and the respective factor curves are representative of distinct dynamic structures of the antrum. From the more or less sinusoidal excursions of the factor curves, which exhibited the 3 cycles per minute frequency characteristic for the stomach, amplitude, frequency and propagation velocity of antral contractions can be calculated. The amplitudes of the factor curves were used to calculate a contraction index. This contraction index was found to be correlated significantly negatively with the gastric half-emptying time of the ingested meal. The employed factor analytical approach thus seems a promising tool to further investigate the role of antral contractility in the process of gastric emptying.
The main task of a central interdisciplinary emergency admission unit (EAU) staffed and administered by the anesthesia department is to provide primary hospital treatment for emergency patients. The EAU serves also as a base for the emergency ambulance and functions as a 24-hour resuscitation unit for the whole hospital. The placement of the unit in the underground floor of the hospital makes it easy accessible for ambulances but excludes walk-in patients. The shock room has a floor area of 152 m2 and is optimally equipped, while two smaller emergency rooms provide reserve accommodation. On the same level are the X-ray department, emergency operating room, trauma team taking care of minor injuries and the medical house officer. The last two and the admissions clerk are responsible for selecting the real emergencies out of 9000 of urgent cases and patients with minor traumas entering the hospital on this level. In the first 40 months of EAU activity 1.2% of total hospital admissions (300-400 patients from a total number of 33,000 a year) were treated in the EAU; 71% of emergencies arrived by our own emergency ambulance or by helicopter, while others were brought by the Red Cross Emergency Service. The majority of acute cases (42.7%) are traumatic; 17.4% have circulatory problems, 10.8% neurological problems, 10.1% are suicidal, 1.5% are dead on arrival and the rest (17.5%) has other origins. From the total number of 1046 living admissions, 99 patients required cardiopulmonary resuscitation (21 = 20.6% were discharged), 25.0% of the total number underwent emergency surgery, and 43% needed intensive care. A general admission unit for pure emergencies is still a unique organizational feature in hospitals. The main objective of the EAU is to increase patient's safety during transition from prehospital to primary hospital acute care. EAU anesthesia staff ensures the competency in acute care and even the continuity of care by the same person from the emergency ambulance to the operating room or ICU.
This study attempted to determine whether the autohemodilution that has repeatedly been shown to be induced by nitrates and other vasodilators is also produced by cilazapril. Fifteen healthy male volunteers were given 2.5 mg oral cilazapril daily for two weeks. Blood rheology was quantified by measuring blood and plasma viscosity, hematocrit count, red blood cell aggregation and deformability, and white blood cell clogging at baseline, four hours after first dose and four and 24 hours after the last dose. No acute or chronic changes were observed except for a significant increase in red blood cell deformability and a decrease in white blood cell clogging. It is concluded that hemodilution secondary to vasodilation may occur but be offset by hemoconcentration induced by aldosterone inhibition and decrease of anti-diuretic hormone levels. The changes in deformability and clogging may benefit microcirculatory function, a hypothesis that would need further investigation in controlled trials.
In order to evaluate the effect of PGI2 on left ventricular ejection fraction (LVEF) an intravenous infusion in 10 patients (3 males, 7 females; 36 to 63 years) with an impaired LVEF (34.7 +/- 14.8%) was performed. LVEF was determined by means of 99mTc-pertechnetate radionuclide ventriculography. An increase of LVEF to 36.2 +/- 13.5% during administration of PGI2 at a rate of 1 ng/kg/min for 15 min and to 43.8 +/- 15.8% during a rate of 5 ng/kg/min (p less than 0.01) for an additional 15 min was observed. Analyzing the data in more detail in 6 patients, an improvement in LVEF became obvious during the administration of 1 ng/kg/min (108, 109, 116, 118, 121, and 123% of pre-infusion value, respectively). In 5 out of these 6 patients a dose-increment to 5 ng/kg/min further increased LVEF (139, 179, 187, 148, and 128% of pre-infusion value, respectively). In contrast, in the other 4 patients no response of LVEF to PGI2 at a rate of 1 ng/kg/min could be observed. However, in 2 out of these 4 patients LVEF increased during the administration of 5 ng/kg/min (111 and 117% of pre-infusion value). Individual changes in hemodynamic parameters showed no correlation to the improvement seen in LVEF in response to PGI2. It is concluded that PGI2 may exert beneficial effects on LVEF, and might be used in certain clinical conditions, such as before heart transplantation, to achieve a temporary improvement in LVEF.
In order to meet an increasing demand for a standard file format which would facilitate the exchange of image files from one computer to another, the protocol initiated by Report #10 of the American Association of Physicists in Medicine has been adopted. This protocol uses the concept of an ASCII file in which key-value pairs are used to describe the various parameters of the image file. Keys specific to nuclear medicine image files have been established and are published here. In addition, the latest version of the keys has been placed on a list server which is accessible by electronic mail. This will facilitate the development of conversion programs which will also be placed on the same list server as they become available.
A department of electron microscopy with specialisation in virus diagnosis evaluates the results concerning retrovirus findings. In the course of research work already classified retroviruses were observed, numerous unexpected retrovirus diagnoses being of special interest. This concerned exclusively to ultra-thin sections of permanent and immune cells. Expounded in this paper are principles by which examiners should abide in any case. Reference is also made to the importance of individual findings.
12 patients with impaired left ventricular function were submitted to left ventricular ejection fraction measurements before and after increasing doses of PGE1 administered by i.v. or i.a. infusion. 6 responders out of the 12 patients showed a significant (p less than 0.01) improvement in LVEF, whereas the LVEF remained unchanged in the remaining 6 patients. 4 of the responders had received intravenous and 2 had received intraarterial PGE 1. Afterload reduction, venous tonisation, increased myocardial contractility and metabolic effects may be causative factors. These results suggest that PGE 1 therapy may be of therapeutic benefit in some patients with impaired LVEF.