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H Creutzig

Publications and source records attributed to H Creutzig.

At least 55 records · Page 3Linked to original sources
PubMed1982

[Demonstration of postgastrectomy bile reflux by hepatobiliary sequential scintigraphy].

After gastrectomy and jejunal interposition by the Longmire technique, symptoms due to alkaline reflux oesophagitis may occur, which are caused by duodeno-jejunal and jejuno-oesophageal bile reflux. Twenty-seven patients who had gastrectomies performed for malignant tumours one to three years previously were examined by hepatobiliary sequential scintigraphy in order to see whether this is able to demonstrate bile reflux. In addition to endoscopies, biopsies and radiological examinations, 45 sequential scintigrams were carried out. Agreement of results during routine use was investigated for five observers. There were considerable variations in results amongst different observers. Nevertheless, in four out of the five observers, there was a significant correlation with the clinical findings (p less than 0.05). Only by using functional scintigraphy with digital data recording is it possible to demonstrate or exclude bile reflux with any degree of certainty. Eight out of twelve patients with marked symptoms, and four out of 28 without symptoms showed reflux into the interposed segment (correlation 0.7, p greater than 0.05). Patients with symptoms showed a high incidence of oesophagitis by the above-mentioned methods (correlation (0.52, p greater than 0.05). Correlation between the results of barium meals and clinical findings was considerably less (0.25) and was not significant. Sequential scintigraphy is therefore better for clarifying reflux symptoms than radiological examination or endoscopy and biopsy.

Esophagitis, Peptic↗
PubMed1981

[Is it necessary to treat the autonomous thyroid adenoma?].

A treatment of the autonomous nodule in an euthyroid patient is still in question. We therefore compared our findings in treated and untreated patients with this disease. Pooling all datas of untreated patients, one got worse in 84 observed years while one got completely normal in 67 years. None of the 16 patients exposed to organic iodine developed a hyperthyroidism. In hyperthyroid patients with an autonomous nodule of the thyroid the disease was controlled by one low-dose Iodine-131 treatment in 82%, while the others needed one further dose to get euthyroid. Because of the high rate of spontaneous remission and the low complication rate were recommend a treatment of the autonomous thyroid nodule in euthyroidism only in selected cases. A careful follow-up should be done in all patients with thyroid disease, treated or untreated; an exacerbation of disease can be controlled by an Iodine-131-treatment.

Adenoma↗
PubMed1981

The "sickle-sign" in bone scintigraphy.

A side-effect of an intensive cytotoxic treatment on bone scanning will be reported: the so called "sickle sign", a diffuse activity around the calvarium seen only in patients at cytotoxic therapy. The differentiation between this harmless side-effect and abnormalities caused by the cancer could be done in our patients by a vertex view. All patients with skull metastases or meningeal carcinosis and this sign in the frontal and lateral view had an inhomogeneous uptake in the vertex view. This view should therefore be added to the standard views in all patients with the sickle sign.

Antineoplastic Agents↗
PubMed1981

[The arterial contribution to total liver perfusion (author's transl)].

Dynamic hepatic scintiangiography is a method of estimating some aspects of liver hemodynamics. Especially in cirrhotics and in liver-grafted patients this method may be clinically useful. We studied some methodological aspects of the differentiation between the arterial and the portal positions of the liver time activity curve. In 16 patients with otherwise proven pure arterial perfusion of the liver there wee three different forms of the curve: in 8 cases the first peak was followed by a second upslope. In 5 cases there was a plateau after the peak, and in 3 cases the peak was followed by a downslope of the curve. No general description of all curves could be found. Therefore all methods using plateau techniques for subtracting the arterial from the portal portion of the curve seem to be doubtful. In these and in other patients five different techniques were compared: the arterial part was much underestimated by the method of George (76 +/- 9%), slightly underestimated by the method of Biersack (91 +/- 8%), and much overestimated by the method of Boyd (123 +/- 11%). The methods of Fajman and our modification estimated always 100% in the patients with pur arterial perfusion. Comparing a set of independent evaluations the mean deviation wa 11% in normals and 23% in cirrhotics of arterial part. Only rough changes of the arterial to portal ratio of hepatic perfusion can be evaluated by dynamic hepatic scintiangiography.

Hemodynamics↗
PubMed1981

[Early changes in acute pulmonary embolism as seen in the scintigram and on x-ray film (author's transl)].

Pulmonary embolism is among the most frequent acute pulmonary diseases. Non-invasive radiological diagnosis can make use of the x-ray film of the chest and of the various forms of scintigraphy of the lungs. The authors compared the non-invasive approaches in 328 patients clinically suspected of acute pulmonary embolism. Compared with computerized ventilation/perfusion scintigraphy, evaluation of perfusion scintigraphy shows an "over-diagnostis" of pulmonary embolism by 60% (148) "detected cases" in 92 patients). 16% of all patients with no abnormal findings in their x-ray film had acute pulmonary embolism, in another 17% we found perfusion defects pointing towards embolism, associated with a disturbance of ventilation. To exclude pulmonary embolism, performance of perfusion scintigraphy will suffice; studies of ventilation will be mandatory to establish proof that embolism is present. Indirect roentgenographic signs are not helpful in arriving at the correct diagnosis.

Acute Disease↗
PubMed1979

[Evaluation of unilateral renal function in urinary obstruction. A comparison of various radioisotope methods (author's transl)].

The catheter-free determination of the unilateral 131I-hippuran clearance correlates well with the unilateral clearance determination with 99mTc-DMSA in patients without obstruction. In patients with unilateral chronic obstruction the clearance of 131I-hippuran on the average is 13% higher than the clearance determined by the DMSA method. After successful correction of the obstruction the two values are identical. 123I-hippuran is foundin the renal pelvis already after 90 seconds in some cases of marked chronic obstruction. The functioning part of the involved kidney is therefore possibly overestimated whereas the DMSA uptake reflects the actual function. Both radioisotope methods should be applied preoperatively in order to evaluate the individual renal function. Functional scintigraphy in patients with obstruction should preferably be carried out with 123I-hippuran.

Humans↗
PubMed1979

[Quantitative sacroiliac joint scintigraphy? (author's transl)].

Methodological aspects and clinical value of digital sacroiliac joint scintigraphy area are described. Preinformation of the observer affects the value of the uptake ratios significantly. A data processing is presented which reduces this effect. Nevertheless there is insufficient discrimination between normal persons and patients with acute inflammation. Routine bone scanning can therefore not be used to exclude "inflammatory changes".

Adult↗
PubMed1979

[Identification of metastases in the infant skeleton--comparison of methods of roentgenology and scintigraphy (author's transl)].

Conventional x-ray examination and a whole body scintigram were performed within four weeks in 40 children with tumours. The findings obtained by both methods were subjected to a comparative analysis. Pathological findings were revealed in eleven children; in eight of these, the findings were partly confirmed as metastases. Of 39 metastases confirmed by x-ray film, 16 were found to be negative according to scintigraphy. On the other hand, 34 of a total of 60 scintigraphically pathological findings could not be confirmed by x-ray examination six months later. The falsely negative scintigraphic findings were mainly localised in the region of the ribs, the pelvis and the long bones near the epiphysis. Our own case material demonstrated these findings.

Adolescent↗
PubMed1978

[Creation of reaction-less pseudoarthrosis on the ulna of the dog (author's transl)].

The model situation of so called "avital, avascular" pseudoarthrosis was surgiclly induced in 25 beagle dogs using defectosteotomy and heat-necrotization of both ulna bones. The clinical evolution was examined weekly using roentgengraphy and each 4th week by scintigraphy. According to roentgen pictures three stages can be identified: 1. Reaction of the bone on surgical trauma (until 4th week). 2. Sequestration or asepticosteolysis (until 18th week). 3. Consolidation of the pseudoarthrosis model-situation (after 18th week). Scintigraphy revealed by the continuing so called "avital" pseudoarthrosis an enhanced metabolism activity at the tips of both bone fragments. The cause for these active metabolic processes evoking enhanced activity on both fragment ends during scintigraphy wich is not demonstrable with roentgen device are the pulling, pushing and tensile strengths originating from a connective-tissue-cord existing between them. The results of scintigraphy lead us to use the term "reaction-less pseudoarthrosis" instead of "avascular" or "avital" for this model of pseudoarthrosis.

Animals↗
PubMed1978

[Staging of patients with carcinoma of the breast by bone scans? [author's transl)].

Bone scans were performed in 170 patients with widespread breast cancer and metastases which were confirmed by the clinical course. In 82% a positive x-ray and in 95% a positive bone scan could be demonstrated. In 43 patients without bone metastases the ratio of false positive scans was 5%. Seventeen out of 50 patients with early cancer had abnormal scans. In 12 cases there were metastases proven by follow-up of at least 18 months. Assuming an incidence of 25% for bone metastases in patients with early breast cancer, bone scans with a sensitivity and specificity of 95% will be valid in staging. To validate this high incidence we investigated a second group of 97 patients with early cancer in a prospective study: in only 3 cases there was an abnormal scan. Using this low incidence bone scanning is calculated to be not valid for staging of breast cancer.

Bone Neoplasms↗
PubMed1977

[Hormone replacement in patients with carcinoma of the thyroid (author's transl)].

82 patients with well-differentiated thyroid carcinoma had been treated by total thyroidectomy and radioiodine destruction of any residual thyroid tissue. They were then given high doses of L-thyroxine (T4), enough to suppress endogenous stimulation by TSH, the recommended dose being at least 300 microgram daily. Six weeks after starting 150 microgram T4 daily there was no significant response to 400 microgram TRH i.v. in 56% of the 82 patients. The T4 dose was then increased until all TRH tests had become negative. There was a significant correlation between the number of negative tests and body surface: at a dose of 40-60 microgram/m2 none of the tests was negative, while at a dose of 80-100 microgram/m2 the test was negative in 83%, the frequency of negative tests increasing up to 94% at higher doses. Mild hyperthyroidism occurred in 17%. It is concluded that after adequate surgical and radioiodine treatment 80-100 microgram/m2 T4 should be given to patients with well-differentiated thyroid carcinoma. The effectiveness of suppressing TSH levels should be checked with the TRH test after six weeks.

Humans↗
PubMed1977

[Thyroid cancer risk from iodine-131-treatment? (author's transl)].

Six of 240 patients with thyroid carcinoma had a history of 131I treatment for a benign disease. All patients had underwent a total thyroidectomy. In this 2.5% of our cancer patients a tumor induction by radiation might be po-sible. The six cases are described in detail and the literature is revieved. A longer observation period than 30 years will be necessary to exclude an increase in prevalence of thyroid carcinomas after 131I treatment in the adult. The clinical importance of this possible increase will dubious; the thyroid carcinoma prevalence in a nonendemic goitre region has been estimated with 5--6%. On the other hand an increase in development of "benign" thyroid nodules has been seen after 131I treatment of thyrotoxicosis. Therefore not every younger hyperthyroid patient should be treated in this manner.

Adenocarcinoma↗
PubMed1977

[Comparative investigations of osteotropic radionucleides. IV. The dynamics of uptake in normal and abnormal bone (author's transl)].

The dynamics of uptake of osteotropic radionucleides in normal and abnormal bone were studied by means of sequential and functional scans. Various phosphate and phosphonate complexes were compared in vivo and in vitro. Only phosphonates were considered as suitable for bone scanning. In normal bones in beagles, radioactivity after HEDP fell to 65% after two hours, but was 105% with 18F. In relation to healing fractures, the curves differ quantitatively and qualitatively. In this situation, functional curves derived from dynamic scans provide a better parallel with histological findings than does static scintigraphy with an uptake quotient. Sequential and functional scanning are able to document the therapeutic effect of irradiation of bone metastases.

Animals↗