Noninvasive imaging of giant hematomas.
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Hemangioma↗
Biomedical subjects
O Eber
Publications and source records attributed to O Eber.
[Tl-201 myocardial SPECT in silent myocardial ischemia and angiographically proven coronary heart disease].
Silent myocardial ischemia is defined as true myocardial ischemia without angina pectoris in patients with angiographically detected coronary artery disease. In this study 52 patients (46 male, 8 female: mean age 53 years) with a pathological exercise test but no symptoms were investigated. They showed stenosis of 75% or more of the diameter in at least one coronary segment on angiography. Prior to or after catheterization (within 14 days) Tl-201 SPECT was done and evaluated independently of angiography. A clear correlation between angiographically confirmed stenosis and reversible perfusion defects with Tl-201 SPECT was established (62 out of 76 lesions). Furthermore, there was a significant relation between angiographically detected subtotal or total occlusions of coronary vessels and irreversible perfusion defects using Tl-201 SPECT (35 in 44 lesions) (p less than 0.001). In patients with ST depression but without angina pectoris during the exercise test, the Tl-201 SPECT is highly suited to determine the hemodynamic effect of coronary stenoses.
Angina Pectoris↗
[Isolated thyroid gland sarcoidosis and hyperthyroidism].
A case of isolated sarcoidosis of the thyroid gland, associated with hyperthyroidism, is reported in a 28-year-old male patient whose thyroid was removed for hyperthyroid multinodular goitre. Histology revealed a regressive adenoma and sarcoidosis in non-adenomatous thyroid residue. Further diagnosis, therapeutic management and a 3-year follow-up did not disclose any specific changes or involvement of other tissues. Isolated thyroidal sarcoidosis with hyperthyroid alterations are extremely rare and mostly chance findings; simultaneous occurrence of thyroid sarcoidosis and hyperthyroidism may be a symptom of gland infiltration for which an adequate explanation is still lacking.
Adult↗
[Metastatic thyroid cancer: sudden death following aclarubicin therapy].
We report on a 62-year-old patient with a metastasising, only poorly differentiated follicular thyroid carcinoma, who was subjected postoperatively to chemotherapy with Aclarubicin. Aclarubicin (Aclaplastin) is a new cytostatic agent, from the group of anthracyclines, with fewer side effects and clearly diminished cardiotoxicity. The patient died suddenly after two treatment cycles with clinical symptoms of cardiac insufficiency; the post-mortem examination, however, revealed that two metastases in the myocardium might have been the cause of death; toxic myocardial damage could be excluded histologically. Upon occurrence of cardial symptoms and signs during therapy with cytostatic agents of thyroid carcinoma with Aclarubicin, whose cardiotoxic side effects are known, the possibility of metastatic spread in the myocardium should, nevertheless, also always be considered in the differential diagnosis.
Aclarubicin↗
[Microcirculation in parenteral Ginkgo biloba extract therapy].
15 patients with arteriosclerotic lesions in the extracranial brain arteries, randomly selected, were treated with an infusion of 250 ml physiological NaCl and 25 ml Ginkgo biloba extract (Tebonin). A second group (n = 15) received 250 ml NaCl without drugs stimulating blood flow. The skin microcirculation was measured in vivo by means of a helium-neon laser at one of the 4 extremities. Perfusion increased significantly (p less than or equal to 0.01) in response to Ginkgo biloba extract als composed with the response in the control group. The results justify the administration of Ginkgo biloba extract in vascular diseases.
Aged↗
[Collagen-induced thrombocyte aggregation in parenteral therapy using Ginkgo biloba].
24 patients suffering from arteriosclerotic disorders were divided into 2 groups. One half received 250 ml NaCl with 25 ml Ginkgo-biloba-extract the other 12 were treated with 250 ml NaCl without this substance. The collagen induced platelet aggregation was determined before, immediately after infusion and on the next day. The platelet aggregation increased in both collectives after infusion. In the group treated with Ginkgo-biloba-extract after 1 day values returned into normal range while the aggregation remained increased in the NaCl-group.
Aged↗
A new measuring design for autonomic dysfunction of skin in neuropathies: hyperthermal laser-Doppler flowmetry.
Twenty patients suffering from diabetic neuropathy, 20 patients suffering from alcoholic neuropathy and 20 healthy volunteers within the same age range were studied for the stimulability of microcirculation with a new measuring design. A laser method (laser-Doppler flowmetry) was used to evaluate the increase of the microvascular blood flow of the skin during the hyperthermal phase. It evaluated the degree of increase of microcirculatory blood flow as well as the time from the beginning of hyperthermy to the onset of change in perfusion (the hyperthermal perfusion latency). This was significantly prolonged in both neuropathy groups; the increase of the microvascular blood flow in the diabetic neuropathies was significantly lower than found in alcoholic neuropathies and in healthy volunteers.
Aged↗
Diagnosis of hepatic hemangioma with 99mTc-labeled red cells: single photon emission computed tomography (SPECT) versus planar imaging.
This paper reports the results of a prospective study carried out to demonstrate the most important advantages of 99mTc-blood pool single emission computed tomography (SPECT) versus the established method of planar scintigraphy (PS) in the non-invasive diagnosis of liver hemangiomas. The study group comprised 40 patients in whom positive evidence of 56 hemangiomas, detected incidentally in the course of screening examinations, was established via SPECT and PS. The sensitivity of SPECT was 51/56 (91%), of PS 22/56 (39.3%); for lesions smaller than 30 mm in diameter, the sensitivity of SPECT was 31/38 (81.6%), of PS 6/38 (15.8%). All lesions with diameters of more than 30 mm were detected by both PS and SPECT. However, the SPECT method proved to be clearly superior in the identification of lesions which were smaller than 30 mm and located in unfavourable topographical sites (dorsal or subphrenic). The study proves that SPECT with 99mTc-labeled erythrocytes is the ideal complement to ultrasonography in the detection of liver hemangionas; its major advantage over TCT (transmission computed tomography) is its safe application in cases with contrast agent intolerance and hyperthyroid patients. Moreover, liver biopsies are dangerous and ill-suited for the verification of diagnosis.
Adult↗
99mTc-labeled monoclonal anti-carcinoembryonic antigen antibody (BW 431/26). Clinical results in the detection of colorectal carcinomas and recurrences.
With the introduction of 99mTc-labeled monoclonal antibodies against carcinoembryonic antigen (CEA) a clinically relevant extension can be expected in the diagnosis of colorectal tumors by immunoscintigraphy (IS). This study comprises a total of 49 patients (primary colorectal tumors, occult neoplasms, and suspicious recurrences), in whom IS with 99mTc monoclonal antibody (MAb) BW 431/26 was performed. After injection of 1100 MBq 99mTc MAb BW 431/26 a whole-body scan was performed in anterior and posterior projection 5 1/2 h later, and SPECT of the abdominal region was done after 6 and 24 h. In the course of primary tumor identification (n = 20) all coloscopically diagnosed and operatively verified carcinomas were confirmed and correctly localized by IS (n = 11). In three patients with positive IS and suspicious coloscopic findings surgery was refused by patients and relatives. In five cases IS was true negative and in 1 case false positive. In the diagnosis of recurrences (n = 29) IS showed an uptake in computer-tomographically and coloscopically suspicious areas in 17 cases. In 12 cases IS was rated negative (11 true-negative findings in scar and granulation tissue, 1 false-negative finding in para-aortal lymph nodes). Elevated serum CEA levels were found only in 17 of 31 patients with true-positive IS. In postoperative cancer care IS with 99mTc-labeled anti-CEA antibody plays a preeminent role in the exclusion or identification of colorectal recurrences.
Adult↗
Intrathyroidal dendritic cells, epitheloid cells, and giant cells in iodine deficient goiter.
Immunohistochemistry and immunofluorescence were performed on thyroid sections of 44 consecutive patients undergoing thyroid surgery for goiter due to iodine deficiency. Sections were compared with specimens from ten individuals without goiters from the same endemic area, with specimens from ten sporadic nontoxic goiter patients, and with specimens from an area with sufficient iodine supply from nine healthy subjects. Cells were characterized using monoclonal antibodies to the CR3 receptor (CD11b) and the p150/95 antigen (CD11c) present on macrophages, to HLA-DR, to antigen presenting cells (RFD1), to T helper (CD4) and to T suppressor/cytotoxic cells (CD8), and with a polyclonal antibody to human cytokeratin. In iodine deficient goiters, focal aggregates were found of RFD1-positive dendritic cells. Furthermore, RFD1-positive epitheloid cells were seen. In 27% of cases, these epitheloid cells completely filled the thyroid follicles. Within the epitheloid cell clusters, multinucleated giant cells could be detected that carried the macrophage markers. Dendritic cells, epitheloid cells, and giant cells were strongly HLA-DR positive. In nongoitrous thyroids from the endemic area such aggregates could also be seen but they were more sparse and were RFD1 negative. Giant cells were absent there. In normal thyroids with sufficient iodine supply, only a few isolated dendritic cells were seen. All except RFD1, which was negative, showed the same marker pattern. In sporadic nontoxic goiters from an area with sufficient iodine supply, dendritic cells occurred in much higher numbers than in the normal thyroids from that area, and they were RFD1 positive. They never aggregated as in iodine deficiency, and giant cells were not observed. These observations on iodine deficient goiter strongly suggest involvement of active antigen-presenting cells in this disorder. However, the immunohistologic difference between this disease and sporadic goiter suggests different underlying mechanisms.
Adult↗
3,5,3'-Triiodothyroacetic acid (TRIAC) effects on pituitary thyroid regulation and on peripheral tissue parameters.
The effects of TRIAC on peripheral thyroid hormones, TSH incretion and peripheral tissue parameters were investigated in 13 mildly obese patients (group I) and 10 volunteers of normal body weight (group II). TRIAC was administered 3 x 1 mg daily over a period of 8 days to both groups. In group I (on a 400 kcal low caloric diet) bTSH and fT4 decreased significantly whereas TT4 decreased only insignificantly. TT3 and fT3 rose significantly due to the cross-reactivity of the employed antibody. The peripheral tissue parameters cholesterol, ankle jerk and systolic time interval did not reveal any changes suggesting an increase in metabolic rate. The increase in heart frequency was not significant either. The significant rise in sex-hormone binding globulin was most probably associated with the weight reduction of 3.1 +/- 1.2 kg per week. In group II (on normal diet) bTSH and fT4 decreased significantly whereas TT4 decreased only insignificantly. As in group I, TT3 and fT3 rose significantly. Also in group II TRIAC did not cause alterations in the peripheral tissue parameters. In contrast to the obese group the volunteers in group II showed no significant rise in sex-hormone binding globulin and no reduction of body weight. Side effects such as nervousness, tremor or palpitations were not observed. Thus, TRIAC does not induce an increase in peripheral metabolic rate, not even under a TSH-suppressive dose as high as 3 x 1 mg per day.
Achilles Tendon↗
[Ginkgo biloba extract and folic acid in the therapy of changes caused by autonomic neuropathy].
10 patients suffering from neuropathies caused by various diseases and with an autonomic disregulation of skin were treated intravenously with a new combination of 87.5 mg Ginkgo-biloba-extract standardized to 21.0 mg Flavonglycosids and 3 mg folic acid during 14 days. The autonomic nerve-function was measured immediately before onset and after the end of therapy with the hyperthermal laser-Doppler-Flowmetry. Additionally pain, superficial and deep sensibility were described. After the end of treatment the autonomic nerve-function was improved in a significant manner (p less than 0.01). An improvement of the described parameters for pain and for perception could be observed too. Therefore this new combination seems to be suited for treatment of polyneuropathies.
Adult↗
[Myocardial damage following lightning injury].
In a 27-year-old woman, struck by lightning behind the left ear, the ECG showed signs of an acute posterior-lateral myocardial infarction after 1 h of unconsciousness and loss of memory. Her serum enzymes were increased as is typical of myocardial infarction, but the patient did not complain of cardiac symptoms. Besides clear signs of lightning injury, the patient showed a hemorrhage throughout the left breast and transient pericardial effusion was observed by echocardiography. In the course of two months, the ECG revealed a regression to unspecific ST-T-deviations and serum enzymes became normal. TI-201-myocardial-scintigraphy (SPECT), done six days and two months after lightning injury, excluded reversible and irreversible perfusion defects.
Adult↗
[Changes in zinc level in the serum, whole blood and erythrocytes in disorders of thyroid function].
The zinc level in serum and whole blood was determined in a series of 121 patients, 20 suffering from overt hyperthyroidism, 34 with manifest hypothyroidism and a control group of 67 euthyroid subjects. The zinc content per deciliter of erythrocytes was calculated from the haematocrit. The hyperthyroid group revealed a highly significantly elevated serum zinc level (p less than 0.01), but a most significantly reduced zinc content in whole blood (p less than 0.001) in comparison with the euthyroid group. On the other hand, the reverse changes were observed in the hypothyroid group, i.e. a most significantly reduced serum zinc content (p less than 0.001) and a highly significantly increased zinc content in whole blood (p less than 0.01). These results suggest that the determination of zinc levels both in serum and in whole blood may be a useful additional parameter of peripheral thyroid hormone effect.
Erythrocytes↗
[The negative TRH test: new differential assessment using a sensitive TSH assay].
Determination of TSH by the IRMA technique shows improved sensitivity and higher accuracy compared to TSH RIA, so that lower detection limits of 0.1 mU TSH/1 can be easily attained. Basal TSH values (bTSH) between 0.4 and 3.5 mU/l clearly define a euthyroid metabolic state. At a bTSH lower than 0.4 mU/l a TRH test should be performed to exclude latent or overt hyperthyroidism. Stimulated TSH values (sTSH) greater than 2.5 mU/l are considered to be a positive test which rules out hyperthyroidism. A negative TRH test (sTSH less than 2.5 mU/l), on the other hand, is an abnormal result which may have several causes and thus does not per se evidence a hyperthyroid state. In a group of thyroid inpatients, a differential new assessment of the so-called negative TRH test for the exclusion of hyperthyroidism was attempted in 355 patients with blunted TSH response (sTSH less than 2.5 mU/l) by means of a methodologically improved TSH assay (IRMA principle). In overt hyperthyroidism the bTSH was lower than 0.1 mU/l in 42 out of 44 cases (95%); sTSH was in all cases below 0.5 mU/l (100%). 78% of the clinically euthyroid patients had a blunted bTSH (0.1-0.4 mU/l) and a significant (p less than 0.001) increase of sTSH up to 0.5-2.5 mU/l. Excluding the patients treated with L-thyroxine, 147 cases had sTSH less than 2.5 mU/l. Among the 65 patients with sTSH ranging between 0.5 and 2.5 mU/l, 66% were euthyroid and 34% borderline cases from a clinical point of view (mostly compensated autonomous adenomas), but there were no hyperthyroid cases.(ABSTRACT TRUNCATED AT 250 WORDS)
Diagnosis, Differential↗
[Blood circulation in diabetic patients and its effects on sports].
Patients with diabetes mellitus should go in for sports. They must reduce all other risk factors. If there is a hyperviscosemia too, additionally a medication seems to be helpful.
Blood Viscosity↗
Hypothyroidism and the influence on human blood rheology.
Viscoelastic properties of human whole blood were measured in 338 subjects: 110 persons (75 F, 35 M) following total thyroidectomy but without substitution therapy over three weeks as well as 228 healthy control subjects (124 F, 104 M) were investigated in this study. Subjects with other variable factors were excluded. The viscous and the elastic portion of apparent whole blood viscosity -the latter subdivided into red cell aggregation and red cell rigidity were determined by using a newly developed oscillating capillary rheometer and densitymeter at the real hematocrit value and at a computed hematocrit of 40%. Serum viscosity, hematocrit (Hct), hemoglobin (Hb), mean corpuscular volume of red blood cells (MCV), free triiodothyronine (fT3), free thyroxine (fT4) and serum-thyrotropin (bTSH) were evaluated as well. In a further subgroup of 80 subjects (40 patients with hypothyroidism, 40 healthy control persons) additional plasma viscosity and sedimentation rate were determined. Red cell aggregation and blood viscosity especially at shear-rates below 10/sec increased significantly in hypothyroid patients. There was no significant difference of red cell rigidity, serum viscosity, plasma viscosity and sedimentation rate as against euthyroids. So new aspects of thyroid dysfunction could be described probably with consequences for therapy and for considerations about the development of atherosclerosis and ischemic disorders.
Adult↗
[Method for the determination of protein binding of thyroid gland hormones and the detection of antibodies to T4 and T3].
More than 99% of circulating thyroid hormones are bound with defined capacity and affinity to transport proteins such as thyroxine binding globulin, albumin and prealbumin. Variants of albumin and/or prealbumin, often familial, will bind T4 and sometimes T3 with increased affinity causing higher TT4 and TT3 values respectively. In determining fT4 and fT3 by analogue tracer its binding to protein variants will also lead to falsely raised free parameters. Thus the possibility of a false diagnosis of hyperthyroidism arises. Also the presence of T4 and T3 autoantibodies will cause misleading findings of increased thyroid hormone parameters as against euthyroid metabolism. For determining the pattern of T4 and T3 protein binding as well as autoantibodies radioactive labelled T4 or T3 is incubated with the patients serum. Transport proteins are separated by means of horizontal agarose gel electrophoresis with water cooling. The gel is sectioned and the activity of individual gel particles is measured in a Gammacounter. The activity graph shows with high precision the binding pattern of T4 and T3 to transport proteins. Moreover, this method also serves to determine any possible T4 and T3 autoantibodies, indicated by a peak in the activity graph in the gamma globulin range.
Autoantibodies↗