Biomedical subjects

T Frank

Publications and source records attributed to T Frank.

At least 19 recordsLinked to original sources

PubMed2002

[Clonidine vs. Midazolam for premedication - comparison of the anxiolytic effect by using the STAI-test].

OBJECTIVE: Many investigations described a positive effect of clonidine for premedication (reduction of perioperative stress response, analgetic effect, anaesthetic-saving effect, prophylaxis of postoperative shivering). The most important objective in premedication is undisputed anxiolysis. The anxiolytic effect of clonidine is differently discussed. Therefore we investigated the anxiolytic effect of clonidine in comparison to midazolam. METHODS: 50 patients (ASA 1 - 3) were included in the present doubleblinded, prospective study. These patients got an oral premedication with 1 mg flunitrazepam in the evening before surgery and 5 microg/kg(-1) clonidine or 100 microg/kg(-1) midazolam 60 - 90 minutes before surgery. By using Spielbergers State-Trait Anxiety Inventory (STAI-G X1) we registered the degree of state-anxiety before and after premedication. RESULTS: Both clonidine as well as midazolam showed a significant reduction of the state-anxiety over time (p < 0,001). Between the groups there were no differences in the STAI-scores at any time (p > 0,05). The degree of reduction in the state-anxiety were comparable between the groups. CONCLUSION: In addition to the higher up listed effects clonidine showed a anxiolytic effect, which is comparable to midazolam. Therefore clonidine is an interesting alternative to benzodiazepines, which are commonly used drugs for premedication.

Adrenergic alpha-Agonists↗

PubMed2001

High-frequency (8 to 16 kHz) reference thresholds and intrasubject threshold variability relative to ototoxicity criteria using a Sennheiser HDA 200 earphone.

OBJECTIVE: The first purpose of this study was to determine high-frequency (8 to 16 kHz) thresholds for standardizing reference equivalent threshold sound pressure levels (RETSPLs) for a Sennheiser HDA 200 earphone. The second and perhaps more important purpose of this study was to determine whether repeated high-frequency thresholds using a Sennheiser HDA 200 earphone had a lower intrasubject threshold variability than the ASHA 1994 significant threshold shift criteria for ototoxicity. DESIGN: High-frequency thresholds (8 to 16 kHz) were obtained for 100 (50 male, 50 female) normally hearing (0.25 to 8 kHz) young adults (mean age of 21.2 yr) in four separate test sessions using a Sennheiser HDA 200 earphone. RESULTS: The mean and median high-frequency thresholds were similar for each test session and increased as frequency increased. At each frequency, the high-frequency thresholds were not significantly (p > 0.05) different for gender, test ear, or test session. The median thresholds at each frequency were similar to the 1998 interim ISO RETSPLs; however, large standard deviations and wide threshold distributions indicated very high intersubject threshold variability, especially at 14 and 16 kHz. Threshold repeatability was determined by finding the threshold differences between each possible test session comparison (N = 6). About 98% of all of the threshold differences were within a clinically acceptable range of +/-10 dB from 8 to 14 kHz. The threshold differences between each subject's second, third, and fourth minus their first test session were also found to determine whether intrasubject threshold variability was less than the ASHA 1994 criteria for determining a significant threshold shift due to ototoxicity. The results indicated a false-positive rate of 0% for a threshold shift > or = 20 dB at any frequency and a false-positive rate of 2% for a threshold shift >10 dB at two consecutive frequencies. CONCLUSIONS: This study verified that the output of high-frequency audiometers at 0 dB HL using Sennheiser HDA 200 earphones should equal the 1998 interim ISO RETSPLs from 8 to 16 kHz. Further, because the differences between repeated thresholds were well within +/-10 dB and had an extremely low false-positive rate in reference to the ASHA 1994 criteria for a significant threshold shift due to ototoxicity, a Sennheiser HDA 200 earphone can be used for serial monitoring to determine whether significant high-frequency threshold shifts have occurred for patients receiving potentially ototoxic drug therapy.

Adult↗

PubMed2000

In vitro colonisation of acrylic resin denture base materials by Streptococcus oralis and Actinomyces viscosus.

AIM: The aim of the study was to compare the attachment of two typical strains of oral bacteria to four denture base materials. DESIGN: In vitro study. METHOD: Discs of acrylic resin denture base materials (Paladon 65, polished and unpolished; Palapress; Microbase, polished and unpolished, and Triad VLC) were placed into Petri dishes with Schaedler's medium, inoculated with Streptococcus oralis 34 or Actinomyces viscosus T14V. MAIN OUTCOME MEASURES: After 24 h or 48 h the numbers of adhering bacteria were measured. RESULTS: The bacteria adhered to all discs in similar numbers: 3-9 x 10(6)/ml (viable cell count) and 9-22 x 10(8)/ml (total cell count) for T14V, and 2-6 x 10(6)/ml (viable cell count) and 1.5-3 x 10(8)/ml (total cell count) for 34. CONCLUSIONS: Polishing had little effect on adherence. Denture base materials are not resistant against adherence and possible surface damage by oral bacteria. Therefore, thorough oral hygiene is important for denture wearers.

Acrylic Resins↗

PubMed2000

High thiamine diphosphate concentrations in erythrocytes can be achieved in dialysis patients by oral administration of benfontiamine.

OBJECTIVE: The influence of either orally administered S-benzoylthiamine-O-monophosphate (benfotiamine) or thiamine nitrate on the thiamine status was tested in a randomised, two-group comparison study in 20 end-stage renal disease (ESRD) patients. Main outcome measures were the pharmacokinetics of thiamine diphosphate (TDP) in blood, the in vitro erythrocyte transketolase activity, its activation coefficient (alpha-ETK) and the TDP concentration in erythrocytes. METHODS: After ingestion of a single dose of either 100 mg thiamine nitrate (corresponding to 305 micromol thiamine) or 100 mg benfotiamine (corresponding to 214 micromol thiamine), the blood levels of thiamine phosphate esters were analysed by means of high-performance liquid chromatography for a 24-h period. The TDP concentration in erythrocytes was calculated using the haematocrit and TDP concentration in blood. Erythrocyte transketolase activity and alpha-ETK were measured before and 10 h after administration. The pharmacokinetics of TDP in blood were compared with healthy subjects of other studies retrieved from database query. RESULTS: Regarding the blood concentrations of TDP, the patients with ESRD had a 4.3 times higher area under the concentration time curve after benfotiamine administration than after thiamine nitrate. After benfotiamine administration, the peak plasma concentration of TDP exceeded that in healthy subjects by 51%. In the ESRD patients, after 24 h, the mean TDP concentration in erythrocytes increased from 158.7+/-30.9 ng/ml initially to 325.8+/-50.9 ng/ml after administration of benfotiamine and from 166.2+/-51.9 ng/ml to 200.5+/-50.0 ng/ml after thiamine nitrate administration. The ratio between the maximum erythrocyte TDP concentration and basal concentration was 2.66+/-0.6 in the benfotiamine group and 1.44+/-0.2 in the group receiving thiamine nitrate (P < 0.001). After 24 h, it was 2.11+/-0.4 and 1.23+/-0.2, respectively. The transketolase activity increased from 3.54+/-0.7 microkat/l initially to 3.84+/-0.6 microkat/l after benfotiamine intake (P = 0.02) and from 3.71+/-0.8 microkat/l to 4.02+/-0.7 microkat/l after thiamine nitrate intake (P = 0.08). Likewise, alpha-ETK decreased from initially 1.10+/-0.07 to 1.04+/-0.04 (P = 0.04) and from 1.12+/-0.05 to 1.08+/-0.06 (P = 0.09). After 24 h, the phosphorylation ratio in whole blood decreased from 12.9+/-6.9 initially to 5.6+/-3.2 after benfotiamine administration (P = 0.02) and from 13.5+/-7.3 to 9.0+/-4.8 (P = 0.03) after administration of thiamine nitrate. No correlation between erythrocyte TDP concentration and transketolase activity and/or alpha-ETK was observed in ESRD patients, either before or 10 h after administration. CONCLUSION: Compared with thiamine nitrate, the oral administration of benfotiamine leads to higher TDP concentrations in erythrocytes accompanied with a significant improvement of the erythrocyte transketolase activity in ESRD patients.

Administration, Oral↗

PubMed2000

Assessment of thiamin status in chronic renal failure patients, transplant recipients and hemodialysis patients receiving a multivitamin supplementation.

The thiamin status of patients with chronic renal failure (CRF, n = 14), dialysis patients (DP, n = 24) and patients after renal transplantation (RT, n = 19) was assessed. Thiamin intake was calculated at mean levels of 1.26 mg/d (CRF), 0.83 mg/d (DP) and 1.42 mg/d (RT). Corresponding mean plasma concentrations were 64.2 nmol/l (CRF), 78.3 nmol/l (DP) and 55.1 nmol/l (RT). Thiamin supplements of 1.5 mg or 8.0 mg orally given to patients of the DP-group after each dialysis session showed slightly higher thiamin concentrations in plasma. Transketolase activity coefficients (ETK-AC) were in the same range (1.11...1.19) except for RT-patients who had a slightly but not significantly higher ETK-AC of 1.22. During dialysis treatment (DT), thiamin plasma concentrations dropped to 75 and/or 82% in patients supplemented with 1.5 and/or 8.0 mg. They both reached initial levels again 44 hours later. Despite large inter-individual differences, thiamin concentrations increased in the non-supplemented DP-group. ETK-AC did not change after a 14-day interruption of supplementation and did not deteriorate after a single dialysis session, both in supplemented and non-supplemented patients. A daily thiamin supplementation which complies with the RDA for healthy subjects is indicated in DP and is sufficient to keep thiamin status within the normal range.

Adult↗

PubMed2000

Does a 100-km walking affect indicators of vitamin status?

The status of thiamin (B1), riboflavin (B2), ascorbic acid (AA), and tocopherol was determined in 60 leisure athletes (age 46 +/- 10 y, BMI 23.7 +/- 2.0 kg.m-2, VO2max 39.4 +/- 6.5 ml.min-1.kg-1), who completed a 100-km walking race. Vitamin plasma levels and activities of erythrocyte transketolase (ETK) and glutathione reductase (EGR) were measured before start, immediately after finishing and 6 hours later. The participators finished the entire distance in 14.25 h (average speed 7 km.h-1). Before start, all participators showed an excellent vitamin status (prevalences of low vitamin status ranged between 1.7 and 1.8%). Plasma tocopherol concentrations correlated significantly with increased age (r = 0.35, p = 0.008). Compared to the values before start, plasma concentrations of B1 and B2 as well as ETK and/or EGR were increased significantly after finishing. The raised levels persisted 6 hours after finishing, whereas AA remained unaltered. The univariate analysis of variance revealed that the change in vitamin status after finish and 6 hours later was in part highly dependent on age, BMI and the level of physical fitness. Despite the long distance, the extensive character of the 100-km walking with its low intensity did not deteriorate the measured indicators of vitamin status.

Adult↗

PubMed2000

Bioavailability of water- and lipid-soluble thiamin compounds in broiler chickens.

The bioavailability of thiamin mononitrate, thiamin chloride-hydrochloride and benfotiamin was compared in broiler chickens. A thiamin-deficient diet was supplemented with either 1.8 and 1.5 mg/kg thiamin equivalent as water-soluble salts, or with 1.5 and 1.2 mg/kg thiamin equivalent as benfotiamin, respectively, and fed to 3 replicate groups/treatment for 21 days. Weight gain, feed consumption and feed conversion rate were not significantly affected by solubility or dietary level of thiamin. Likewise, using biochemical indices of thiamin status (erythrocyte transketolase activation coefficient, and thiamin concentrations in blood and liver), no differences were found between the water-soluble thiamin salts, indicating that they have identical potency. In contrast, biochemical indices of thiamin status showed a significantly higher bioavailability for benfotiamin than for the water-soluble sources.

Animals↗

PubMed2000

ANSI update: maximum permissible ambient noise levels for audiometric test rooms.

The American National Standards Institute (ANSI) specifies maximum permissible ambient noise levels (MPANLs) allowed in an audiometric test room to ensure that hearing thresholds obtained down to 0-dB HL will not be elevated due to masking by ambient noise. MPANLs were originally specified in 1960 and have been revised in 1977, 1991, and most recently in 1999. The purpose of this report is to offer an overview by providing a historical perspective of the MPANLs recently specified by ANSI (ANSI S3.1--1999), the rationale for revising the MPANLs, the new computational method used for determining the 1999 MPANLs, the ANSI S3.1--1999 octave and one-third octave band MPANLs, and information concerning compliance with the new MPANLs.

Audiometry↗

PubMed2000

Clinical rubella reinfection during pregnancy in a previously vaccinated woman.

We report a documented case of clinically apparent rubella reinfection during pregnancy with rubelliform rash and fever followed by lymphodenopathy at the 18th week of gestation, in a previously vaccinated woman with haemagglutination inhibition (HI) antibody titre of 1:32. The serological tests results (including neutralizing antibodies) demonstrated a significant rise in her rubella specific IgG level with strongly positive IgM reactivity. In addition, rubella-specific IgG antibody avidity testing displayed high avidity index (53-88%) typical of rubella reinfection. Umbilical cord blood, drawn by sonographic-guided cordocentesis at 24 weeks' gestation, was found to be negative for rubella-specific IgM antibody. The pregnancy was continued to term, and a healthy infant was born.

Adult↗

PubMed2000

[Premedication in maxillofacial surgery under total intravenous anesthesia . Effects of clonidine compared to midazolam on the perioperative course].

OBJECTIVE: The effects of the currently favoured preanaesthetic drugs (benzodiazepines, alpha 2-adrenoceptor agonists) on the perioperative course are inadequately investigated for new ways of performing anaesthesia with recently introduced drugs (e.g. remifentanil). Therefore clonidine and midazolam were used for premedication in maxillo-facial surgery under total intravenous anesthesia, and the perioperative courses were analyzed. METHODS: Thirty patients (ASA 1-2) were included in the present doubleblinded, prospective study. 60-90 minutes preoperatively these patients got an oral premedication with 5 micrograms kg-1 clonidine or 100 micrograms kg-1 midazolam. For anaesthesia a standardized procedure with propofol, remifentanil and rocuronium was performed. After induction of anaesthesia the infusion of remifentanil was regulated by using spectral edge frequency (target-SEF90, 10-13 Hz). The efficiency of the premedication as well as the emergence and recovery were assessed by using established standardized tests. The perioperative stress response was assessed by recording the effects on haemodynamic parameters (NIBP. heart rate. Holter-ECG). RESULTS: Referring to the effects of premedication (sedation, anxiety) there were no differences between the groups. The clonidine group required a lower remifentanil rate in keeping a steady-target-SEF90 (-24%). The time until emergence and recovery was not significantly different. Even the occurrence of PONV, VAS or the postoperative analgetic requirement did not differ between the two groups. However, the incidence of postoperative shivering was significantly higher in the midazolam group. Intraoperatively the values of MAP were quite equal between the groups. However, heart rate was significantly lower in the clonidine group. Postoperatively both MAP as well as heart rate were lower in the clonidine group. Furthermore, in the midazolam group there was a significantly higher cumulative duration of tachycardia (heart rate > 100 min-1; following descripted as medium with 25% and 75%-percentage; clonidine: 29/0/563 sec.: midazolam: 1058/232/3171 sec.). CONCLUSION: After remifentanil supplemented anesthesia there is, especially in the postoperative period, a benefit in using clonidine compared to the premedication with midazolam.

Adjuvants, Anesthesia↗

PubMed2000

[Clonidine within the scope of balanced inhalation anesthesia with sevoflurane--effects on pEEG parameters].

The anaesthetic-saving property of clonidine has often been reported. In our own prospective, randomized study, in which the depth of anaesthesia was controlled by using spectral edge frequency (target-SEF90 = 10 Hz) and clinical parameters, we confirmed the anaesthetic-saving property only for fentanyl (-20%). On the other hand, there was no difference in MAC-sevoflurane values between the groups in keeping a steady target-SEF. For this reason, we analysed the stored pEEG data with regard to clonidine-specific effects. Twenty-eight patients were included in our study. The patients were randomly treated preoperatively with an infusion of 4 micrograms/kg KG Clonidine (clonidine group) or a placebo (placebo group). For anaesthesia, a standardized procedure with fentanyl, propofol, rocuronium, N2O/O2/sevoflurane was performed. The depth of anaesthesia was controlled by using SEF90 and clinical parameters. SEF90, SEF50 and the EEG power-spectrum were analysed over a five-minute period in the steady state of anaesthesia without surgical manipulation. Both placebo and the clonidine showed comparable values for SEF90 (9.9 +/- 1 vs. 10.7 +/- 0.9 Hz). On the other hand, there were differences in the SEF50 values between the groups (3.3 +/- 0.7 vs. 6.4 +/- 2.2 Hz). In the clonidine group, relative alpha-power was higher than in the placebo group (36.3 +/- 15.8 vs. 16.8 +/- 8.8%). Parallel to this effect, there was a reduction in relative delta-power in the clonidine group (47.6 +/- 15.2 vs. 65.4 +/- 9.1%). The described EEG effects on the power-spectrum inevitably influence SEF50 and SEF90. In our opinion, SEF50 is not a powerful predictor of depth of anaesthesia, when anaesthesia is performed in the way described. By performing this variation of balanced anaesthesia and co-medication with clonidine, higher values of SEF90 (11-14 Hz) seem to be adequate for surgical manipulation.

Adrenergic alpha-Agonists↗

PubMed2000

What the Internet means for the medical device industry.

The Internet is dramatically changing the structure of the industry. For the first time, direct communication between all suppliers and all hospitals is available. The Internet-based electronic market place not only provides the ability to choose products from a standardized catalogue, but also to send orders direct to suppliers' enterprise resource planning systems. One-to-one marketing is also becoming a reality. Medical device manufacturers are advised to test the different electronic sales and marketing initiatives that are now available.

Equipment and Supplies↗

PubMed1999

Cardiodepressant mediators are released after myocardial ischaemia: modulation by catecholamines and adenosine.

The interaction of recently characterized cardiodepressant mediators with catecholamines and adenosine after myocardial ischaemia was investigated using a model of sequential perfusion of two isolated guinea-pig hearts. Sequential perfusion was initiated after 10, 20, and 30 min (group I, II, and III) of global ischaemia in the first heart. At the onset of sequential perfusion LVdP/dtmax and min of Heart II decreased by 46 and 44% in group I, by 28 and 34% in group II, and increased by 60 and 24% in group III. Infusion of the beta1-receptor antagonist metoprolol (2.8 micromol L(-1)) into Heart II did not modulate contractile changes after 10 min of ischaemia in Heart I, prevented the attenuation of the cardiodepressant effect after 20 min of ischaemia, and completely reversed the positive inotropic effect after 30 min of ischaemia. The A1- and A2-receptor antagonists DPCPX (2 micromol L(-1)) and DMPX (20 micromol L(-1)) enhanced the positive inotropic and lusitropic effects in Heart II (LVdP/dtmax +154%, LVdP/dtmin +71%) during sequential perfusion after 30 min of ischaemia in Heart I. It is concluded that the effects of cardiodepressant mediators released after myocardial ischaemia are counteracted by a time-dependent release of catecholamines. Endogenous cardiac adenosine, in turn, attenuates the modulatory effects of catecholamines.

Adenosine↗

PubMed1999

[Preoperative clonidine comedication within the scope of balanced inhalation anesthesia with sevoflurane in oral surgery procedures].

Both clonidine and sevoflurane are interesting drugs for anaesthesia in maxillo-facial surgery. The present study was performed to discover how far it is possible to combine the benefits of sevoflurane (fast modulation of depth of anaesthesia, rapid emergence and recovery) and clonidine (reduction of perioperative stress response, prophylaxis of postoperative shivering, analgetic, antiemetic and anaesthetic-saving effect) without compromising the pharmacokinetic of sevoflurane. Twenty-eight patients were included in the present double-blinded prospective study. These patients were randomly treated with an infusion of 4 micrograms kg-1 clonidine (group 1) or a placebo (group 2) preoperatively. For anaesthesia a standardized procedure with fentanyl, propofol, rocuronium, N2O/O2/sevoflurane and an antiemetic prophylaxis with DHB was performed. The depth of anaesthesia was controlled by using spectral edge frequency (target--SEF90 = 10 Hz). Perioperative stress response was assessed by noting the effects on haemodynamic parameters (MAP, heart rate), and emergence and recovery were assessed by using established standardized tests. We confirmed the anaesthetic-saving property of clonidine only for fentanyl (-20%). On the other hand, there was no difference in MAC-sevoflurane values between the groups in keeping a steady target--SEF90 (1.62 +/- 0.26 versus 1.65 +/- 0.24 vol.%). The time until emergence and recovery was not significantly different. Even the occurrence of PONV, the VAS level or the postoperative analgesic requirement did not differ in the two groups. However, the incidence of postoperative shivering was significantly higher in the placebo group. The stress response to intubation or extubation was lower in the clonidine group. The haemodynamic parameters in the clonidine group were intraoperatively always below the baseline, in some cases by more than 20%, making therapy for hypotension or bradycardia frequently necessary. Postoperatively, the majority of the patients showed similar changes in these parameters, but did not reach the 20% mark. Preoperative clonidine comedication seems to complicate the management of anaesthesia. On the other hand, it is beneficial during the early postoperative period (e.g. stability in haemodynamics, prophylaxis of shivering) without compromising emergence and recovery. Our results show that therapy with clonidine should be better placed at the end of anaesthesia.

Adult↗

PubMed1999

Alteration of thiamine pharmacokinetics by end-stage renal disease (ESRD).

OBJECTIVE: In a comparative study with 20 end-stage renal disease (ESRD) patients the pharmacokinetics of two therapeutically used thiamine (vitamin B1) preparations were assessed. SUBJECTS, MATERIAL AND METHODS: After a single oral dose of either 100 mg benfotiamin (S-benzoylthiamine-o-monophosphate, BTMP) or 100 mg thiamine mononitrate (TN), blood levels of thiamine phosphate esters were analyzed by HPLC after precolumn derivatization to thiochrome phosphate esters for a 24-hour period. RESULTS: The pharmacokinetic parameters AUC0-24h, Cmax and tmax of the benfotiamin group in whole blood and plasma exceeded significantly those in the TN group. Only 1.0 vs. 0.6% of the administered dose were excreted in urine in the BTMP group and TN group, respectively. A high cellular efficacy, as was concluded from the short-term stimulation of the thiamine-dependent transketolase activity in erythrocytes (ETKA), was assessed for BTMP as well as TN. The activation coefficient (ETK-AC) decreased significantly from 1.10 to 1.04 vs. 1.12 to 1.07 in both the BTMP as well as TN groups, respectively. In addition, a high transfer rate to thiamine diphosphate (TDP) was observed in the patients after ingestion of BTMP. The TDP concentration in whole blood increased by 2.6 and 1.4 times from baseline levels to Cmax in the BTMP and TN groups, respectively. The AUC0-24h of TDP in whole blood after BTMP ingestion exceeded those after TN ingestion by 420%. CONCLUSION: These findings justify the therapeutic application of BTMP in ESRD, because a high intracellular concentration of TDP may protect against numerous adverse effects of uremia in the long run.

Chromatography, High Pressure Liquid↗

PubMed1998

Percutaneous endoscopic external ring hernioplasty using Dundee inguinal canal retractor.

The percutaneous endoscopic external ring (PEER) hernioplasty is a novel technique that uses a minimal access approach to the inguinal canal by the anterior route and reproduces the conventional open tension-free mesh repair. The procedure consists of two stages: an open phase through a 2.5-cm incision over the external ring followed by an endoscopic repair of the defect. During the open stage, the spermatic cord is mobilized from the external ring, blunt finger dissection of the inguinal canal is used to create a space beneath the external oblique aponeurosis, and the hernial sac is dissected down to level of the preperitoneal fascia. The second endoscopic stage is performed after insertion of a telescope-mounted retractor through the external ring. The posterior wall of the inguinal canal is visualized and the hernial defect repaired by a tension-free mesh repair (Lichtenstein onlay mesh repair or mesh plug repair). The procedure provides an anatomic approach that is familiar to general surgeons. In a pilot study, the authors have established that the PEER hernioplasty is an easily learned, safe, and cost-effective operation that offers the benefits of minimal access surgery in terms of patient recovery and early return to work, and can be performed as a day case under local or regional anesthesia.

Adult↗

PubMed1998

[Clinical relevance of I-123/I-131-MIBG scintigraphy in intestinal carcinoid tumors].

AIM: Of this retrospective study was to determine the value of MIBG-scintigraphy in patients with intestinal carcinoids dependent on histological, clinical, and biochemical parameters. METHODS: In 15 patients uptake in carcinoid tumors and metastasis was correlated with location of the primary tumor, intra- and extrahepatic tumor masses, histology, immunhistochemistry, neuroendocrinological markers, and clinical symptoms. RESULTS: High uptake was to be seen almost only in tumor masses of primary tumors located in the terminal ileum. There also was a positive correlation with clinical symptoms for carcinoids and urinary 5-HIAA level. No correlation between MIBG uptake and tumor masses, histology, and most of the immunhistochemical and neuroendocrinological markers could be found. CONCLUSION: There is a limited indication for MIBG-scintigraphy in follow up of intestinal carcinoids. In patient with proven uptake MIBG scintigraphy is suitable for long-term follow up and therapy monitoring.

3-Iodobenzylguanidine↗

PubMed1998

[New methods for transurethral electroresection of the prostate from the anesthesiologic viewpoint].

Intravascular absorption of large volumes of solution without electrolytes is a common problem in transurethral resection of the prostate. In the present study we compared two different methods of resection (TURP vs. Vaporization TURP; 20 patients in each group) regarding fluid absorption and loss of blood. In addition, we report on 60 patients who had Vapo-TURP. The operations were performed by different very experienced surgeons. In both groups, spinal anaesthesia and standard regimes of infusion were used. The amount of fluid absorbed was measured by the ethanol method (2 vol.% ethanol; Widmark-formula). Haemoglobin, haematocrit and electrolytes were determined at set times. Ten of the 20 patients in the TURP group showed blood-alcohol levels > 0.1%/1000. In the Vapo-TURP group, only five of 57 patients (three patients with perforation of the prostate capsula were excluded) showed positive levels of blood-alcohol (< 0.05%/1000; fluid absorption < 150 ml). The difference was statistically significant (p = 0.002). Sixty minutes after the beginning of the procedures, the values of haemoglobin and haematocrit were significantly lower in the TURP group (7.68 +/- 0.41 vs. 7.38 +/- 0.64 mmol/l and 0.36 +/- 0.02 vs. 0.34 +/- 0.03). Regarding absorption of fluid and bleeding, Vapo-TURP was superior. From the anaesthesiological point of view, Vapo-TURP should be the method of choice, especially for the elderly.

Aged↗