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W Becker

Publications and source records attributed to W Becker.

At least 163 records · Page 9Linked to original sources

Localisation of epileptic foci with electric, magnetic and combined electromagnetic models.

We compare the localisation of epileptic foci by means of (1) EEG, (2) magnetoencephalography (MEG) and (3) combined EEG/MEG data in a group of patients suffering from pharmaco-resistant focal epilepsy. Individual epileptic events were localised by means of a moving dipole model in a 4-shell spherical head approximation. A patient's epileptic activity was summarised by calculating the spatial density distribution (DD) of all localised events, and the centre of gravity of DD was considered the most likely locus of seizure generation. To verify these loci a subgroup of 6 patients was selected, in which seizures could be related to a clearly identifiable lesion in MRI. On average, the combined EEG/MEG approach resulted in the smallest error (1.8 cm distance between calculated locus and the nearest lesion border); using only MEG yielded the largest error (2.4 cm), while EEG resulted in an intermediate value (2.2 cm). In the individual patients, EEG/MEG would also rank intermediate, but never worst. In summary, combining EEG/MEG appears to be a more robust approach to localisation than using only EEG or only MEG. Finally, we also report on the use of the barbiturate methohexital as a safe method of increasing the number of spike events during an EEG/MEG recording session.

Algorithms↗

Scintigraphic evaluation of functional thyroidal autonomy.

The scintigraphic evaluation of thyroidal autonomy is performed both as a quantitative and qualitative thyroid scintigraphy with 99m-Tc-pertechnetate (99m-TcO4-), using a gamma camera fitted with an on-line computer system. A strong and linear correlation between the global 99m-Tc-pertechnetate thyroid uptake (TCTU) and I-123 clearance has been recognised. Therefore TCTU-values can be used as an reliable equivalent of the iodine clearance in the evaluation of actual thyroid function. The clinical value of the TCTU in the diagnosis of thyroidal autonomy is limited because it represents iodine clearance of both normal and autonomous tissue. As a consequence scintigraphic diagnosis and quantification of autonomy can only be established if the global 99m-Tc-pertechnetate thyroid uptake under suppression (TCTUs) is determined. This method is valuable in risk stratification of spontaneous or iodine induced hyperthyroidism, in the estimation of the target volume prior to radioiodine therapy and in the evaluation of therapeutic success after definitive therapy.

Gamma Cameras↗

[Radiotherapy only in severe, progressive endocrine orbitopathy: long-term results and comparison of various classification systems].

BACKGROUND: Therapeutic results after radiotherapy in thyroid associated orbitopathy (TAO) often are not comparable, because either different therapeutic methods at the same time or different scores were used in the evaluation. This study focuses on radiotherapy alone by means of different evaluation scores. PATIENTS AND METHODS: 60 patients (49 women, 11 men) received standard external beam radiotherapy (20 Gy: 10 fractions of each 2 Gy) as ultima ratio after failing different other therapies of thyroid associated orbitopathy. The mean interval from beginning of the symptoms to the radiotherapy was 17 +/- 36 months (between 6 and 240 months). The follow up was documented--classified by means of 4 different scores--before radiotherapy, 6-12 weeks, 1 year after radiotherapy and at last follow up. The changes of symptom categories or grades of the different scores were analysed. RESULTS: Significant changes of the ophthalmic scores were observed when comparing the endpoints at 6-12 weeks, and at 1-year follow up after radiotherapy. The "classical" Werner score at 12 months follow up did not correlate well with the other TAO scores: American thyroid association (ATA) scoring system, Stanford scoring system, International ophthalmopathy index, while all other TAO scores revealed a high correlation among each other. According to the Orbitopathy Index (OI) of Grussendorf an improvement from 14.2 points to 6.0 points was achieved. Soft tissue involvement and corneal involvement demonstrated the highest response rate (83/87%), extraocular muscle involvement and proptosis a good response rate (69/70%). No long-term complications were observed. CONCLUSION: According to this study there are indications that external beam radiotherapy is a suitable therapy even after pretreatment and a longer course of TAO. The OI, the ATA and the Stanford scoring systems lead to similar results in the assessment of thyroid orbitopathy.

Adolescent↗

Predicting percentage of individuals consuming foods from percentage of households purchasing foods to improve the use of household budget surveys in estimating food chemical intakes.

OBJECTIVE: To examine the hypothesis that there is sufficient agreement between percentage of households purchasing selected foods using household budget surveys and percentage of individuals consuming these foods as determined in individual-based surveys to allow the former to act as a surrogate for the latter when estimating food chemical intakes using household budget data. DESIGN: Database study. SETTING: Databases from Sweden, The Netherlands. Ireland and the UK. SUBJECTS: 319 foods (Sweden n = 60, The Netherlands n = 80, Ireland n = 90, UK n = 89). RESULTS: Pearson correlations demonstrated a high degree of linear association between % households purchasing and % consumers (r = 0.86). Regression analysis defined a close positive relationship between the two datasets (slope 0.95, intercept +2.74). Across countries, using the regression equation, the % households predicted % consumers to within 5% of the true value for between 33 and 48% of foods and to within 10% for between 53 and 78% of foods. CONCLUSIONS: Values for % households can be used as a crude surrogate for % consumers and can thus play a role in improving estimates of food additive intake.

Adult↗

Immunoscintigraphy (BW 250/183) in neonates and infants with fever of unknown origin.

Fever of unknown origin is defined as a temperature above 39.0 degrees C together with a white blood cell count > or = 15,000 mm-3, the duration of fever exceeding 2 weeks and a correct diagnosis not being obtained in the first week of hospitalization. In neonates and infants with fever of unknown origin, the localization of the infectious focus is often difficult and unsatisfactory. In this retrospective study, the clinical value of 99Tcm-labelled antigranulocyte antibodies for this group of patients was investigated. Thirty-two immunoscintigrams were performed using 185-259 MBq 99Tcm-labelled antigranulocyte antibodies (BW 250/183) in 30 neonates and infants (21 boys, 9 girls, mean age 29.4 +/- 2 months), who had fever of unknown origin. Immunoscintigraphy was carried out as whole-body images (n = 7) or single planar images (n = 25) 4 h and 24 h post-injection. In children with known cardiac failure, single photon emission tomography of the thorax was performed to diagnose endocarditis (n = 2). For verification, the results of the immunoscintigrams were compared with radiology (conventional radiography = 14, MRI = 5, CT = 3), biopsy (n = 2), blood culture (n = 10) and clinical follow-up after specific therapy. In 11 of 30 children (36%), the diagnosis of an infective focus was possible with immunoscintigraphy. The sensitivity and specificity of diagnosing infective foci was 72% and 95% respectively (n = 11; colitis = 2, infection of the central permanent catheter tip = 2, middle ear infection = 1, spondylitis/discitis = 3, osteomyelitis = 2, umbilical infection = 1). In vertebral body infections, all lesions were photopenic. In 18 children (60%), no infective focus was found on immunoscintigraphy. In this group of children, the main reason (n = 5) for fever of unknown origin was chronic juvenile rheumatoid arthritis. No uptake was seen in two infants with cardiac failure and suspected endocarditis on SPET. In 3 of the 18 patients (17%), localization of an infective focus was not possible with immunoscintigraphy or on other examinations. In these patients, the fever disappeared spontaneously after a few days of antibiotic therapy. In conclusion, we have shown that 99Tcm-anti-NCA-95 scanning is a safe method with a high sensitivity and specificity for detecting infectious foci in neonates and infants with fever of unknown origin. Furthermore, this method is easy to perform, since no withdrawal of blood is necessary.

Antibodies, Monoclonal↗

Bereitschaftspotential in amyotrophic lateral sclerosis (ALS): lower amplitudes in patients with hyperreflexia (spasticity).

In a pilot study the Bereitschaftspotential (BP) was investigated in 16 patients suffering from amyotrophic lateral sclerosis (mean age 58.6, mean severity of the illness according to Norris ALS score 76.4 points). Comparing the total ALS group (n=16) with matched controls no significant differences in the BP amplitude parameters were found. However, a subgroup of 7 ALS patients with signs of pronounced spasticity (hyperreflexia) differed significantly at the central midline from matched controls and significantly in addition from patients with a lower degree of spasticity. Controls as well as patients with a lower degree of spasticity had significantly higher BP amplitudes at the midline (electrode positions Cz and Pz, P<0.05, H-test). The correlation coefficient between the hyperreflexia Norris score and the various BP parameters for the total ALS sample (n=16) revealed a significant correlation especially over the midline. Stronger signs of spasticity (hyperreflexia) are associated with lower amplitudes of the BP.

Adolescent↗

Hyperleptinemia and leptin receptor variant Asp600Asn in the obese, hyperinsulinemic KK mouse strain.

KK obese mice exhibit a multigenic syndrome of moderate obesity, hyperinsulinemia and hyperglycemia. Here we show that the syndrome is accompanied by a marked elevation of leptin protein in adipose tissue, as well as leptin levels in serum, which corresponds with the degree of obesity. The cDNA sequence of leptin is normal in KK mice, whereas three nucleotide polymorphisms were found in the cDNA of the leptin receptor, one of them resulting in exchange of an aspartate residue for asparagine (Asp600Asn) in a highly conserved part of the second extracellular cytokine-receptor homology module. In female (but not male) F2 mice of a C57BL/6JxKK intercross, the weight of gonadal, retroperitoneal and mesenteric adipose tissue was positively correlated with the number of alleles inherited from the KK parental strain at a microsatellite marker (D4Mit175) which maps close (0.7 centimorgan proximal) to the leptin receptor gene. It is suggested that the Asp600Asn leptin receptor variant contributes to the obesity syndrome in KK female mice, but that its contribution is only a part of the multigenic syndrome.

Adipose Tissue↗

Serum leptin levels in hypo- and hyperthyroidism.

Leptin, the product of the ob gene, is an important circulating signal for the regulation of body weight. In the present study the role of immunoreactive leptin (leptin-IR) was investigated in functional thyroid disease. Serum leptin-IR levels of 23 hypothyroid and 19 hyperthyroid patients were compared with 21 controls. Leptin-IR was quantified by a specific RIA. In hyperthyroid patients, leptin-IR was not different from controls. Serum leptin-IR levels were significantly increased in hypothyroid patients (21.0 +/- 2.7 micrograms/l vs controls 10.8 +/- 2.1 micrograms/l, P = 0.0044). When serum leptin of hypothyroid patients was compared with euthyroid controls of the same body mass index the difference was still significant (P = 0.0333 by paired Student's t-test). This might indicate that elevation of the serum leptin level does not merely reflect changes in body weight secondary to hypothyroidism, but might be increased to overcome the gain of body weight caused by hypothyroidism.

Body Mass Index↗

Histologic findings after implantation and evaluation of different grafting materials and titanium micro screws into extraction sockets: case reports.

The purpose of this study was to compare extraction socket healing in 8 patients after implantation with either xenogenic bovine bone (n=5 sites), demineralized freeze-dried bone (DFDBA) (n=3 sites), autologous bone (n=3 sites), or human bone morphogenetic proteins in an osteocalcein/osteonectin carrier (hBMP/NCP) (n=2 sites). Three of the patients received 6 commercially pure micro screws which were fixed into extraction sockets, after which the sockets were implanted with either bovine bone (n=3 sites), DFDBA (n=2 sites) or intraoral autologous bone (n=1 site). Biopsies of the extraction sockets were taken from 3 to 6 months after treatment (average, 4.6 months). For comparison of healing between the implanted materials, histologic evaluation and bone scores were determined. Bone scores of 0 indicated an absence of new bone, with dead implanted bone particles entrapped within connective tissue, while a score of 3 indicated the entire field consisted of vital bone. Biopsies from bovine bone sockets revealed dead implanted particles surrounded by connective tissue. Isolated sections showed host bone in contact with the bovine bone particles. Bone scores ranged from 0 to 3. Biopsies from DFDBA-implanted sites revealed dead particles entrapped with dense connective tissue. The bone scores ranged from 0 to 1. Biopsies from sites implanted with hBMP/NCP revealed a combination of woven and lamellar bone with bone scores of 3. Five of the 6 micro screws were processed and evaluated. One screw was mobile at the time of removal and was not evaluated. Bone scores were used to compare new bone formation adjacent to the micro screws. Bone scores ranged from 0 to 2. A score of 0 indicated non-vital implant material in contact with host bone and connective tissue in contact with implant; 2 indicated vital bone in contact with the majority of the implant surface. Retrieved sockets with micro screws implanted with bovine bone (n=2) demonstrated a connective tissue interface between the screws and the surrounding tissues (bone score 0). The adjacent tissues showed dead bovine particles entrapped within fibrous tissue. Retrieved screws implanted with DFDBA (n=2) were surrounded by connective tissue, with dead bone particles enmeshed within fibrous tissue (bone score 0). The screw implanted with intra-oral autologous bone was primarily surrounded by vital bone with a connective tissue interface (bone score 1). Three implant threads were in contact with bone. The results of this study indicate that bovine bone, DFDBA, and intraoral autologous bone do not promote extraction socket healing. Sockets implanted with hBMP/NCP contained vital woven and lamellar bone. Xenogenic bovine bone and DFDBA did not contribute to bone to micro screw contacts and are not recommended for enhancement of vital bone to implant contacts. Intraoral autogenous bone also does not appear to significantly contribute to bone to implant contacts. Intraoral autologous bone, xenogenic bone, and DFDBA appear to interfere with normal extraction socket healing.

Aged↗

A prospective clinical trial of endosseous screw-shaped implants placed at the time of tooth extraction without augmentation.

This prospective clinical trial evaluated 134 implants in 81 patients. The implants were placed at the time of tooth extraction and were not augmented with barrier membranes or graft materials. The implants were placed into good jaw bone anatomy and quality and were restored by dentists familiar with the implant system. Forty-seven implants were followed between 4 to 5 years with a cumulative success rate of 93.3%. Marginal bone levels were measured for 61 patients with 108 implants. The average mesial-distal measurements for maxillary implants at abutment connection were 1.02 mm (SD+/-0.59) and 1.36 mm (SD+/-0.78) at an average of 32 months follow-up. These differences were not significant. The average mandibular mesial-distal measurements at abutment connection were 1.05 mm (SD+/-0.92) and 1.54 mm (SD+/-0.91) at follow-up. These differences were statistically significant (P = 0.0027). Removal of one patient (5 implants) with advanced marginal bone loss from the data provided a marginal bone level of 1.20 mm (SD+/-0.94) at abutment connection and 1.30 mm (SD+/-0.87) at follow-up. These differences were not significant. The results of this study indicate that implants placed at the time of extraction without augmentation or grafting have excellent long-term cumulative success rates.

Adult↗

[123I-scintigraphy and perchlorate depletion test in the diagnosis of congenital hypothyroidism].

AIM: Thirty eight children suffering from congenital primary permanent hypothyroidism were studied to determine the diagnostic impact of 123I scintigraphy in comparison to laboratory findings and ultrasonography. METHODS: In all patients 123I scintigraphy was performed after intravenous administration of 3.7 MBq 123I. If accumulation of the radiotracer in thyroid tissue occurred a perchlorate discharge test was performed subsequently. RESULTS: Scintigraphy revealed athyrosis in 7 children. In 9 children a lingual thyroid was observed. Deficiency in iodine organification was diagnosed by a significant discharge of 123I in 15 patients. In four of these children the diagnosis of Pendred's syndrome could be established. Ectopic thyroid tissue could be demonstrated only by scintigraphy where clinical examination and sonography failed in the diagnosis in all cases. Hypoplasia of the thyroid gland as it was diagnosed in 2 cases by ultrasonography appeared to be unlikely because a normal 123I uptake was seen in these patients. In 2 patients with scintigraphic proven athyrosis an orthotopic gland had been falsely considered by ultrasound. In 44% of our patients the final diagnosis could only be established if 123I scintigraphy and perchlorate discharge test were performed. CONCLUSION: This findings suggest that scintigraphy is indispensible in the correct diagnostic work up of congenital hypothyroidism.

Child↗

[Suppressibility of thyroid autonomy in endogenous and additional exogenous TSH suppression in patients with thyroid autonomy].

AIM: The aim of this retrospective study was to examine the effect of an additional exogenous thyroid hormone suppression on the 99m Technetium Thyroid-Uptake (TcTU) in patients with thyroid autonomy and endogenous TSH suppression. METHODS: 21 patients were examined in the years 1992-1996; they had a primary endogenous suppression (end) of the TSH-b and an evaluation of the TcTU. After an additional exogenous suppression (ex) of the thyroid, the first two weeks with 75 micrograms/dl and the following 2 weeks 150 micrograms/d, or depending on the bodyweight 2 micrograms/kg levothyroxin, another evaluation of the TcTU was performed. The whole patients were called group I with a TcTUend of 1.6%-7.4%. The subgroups were selected by thresholds of the TcTUend; group Ia TcTUend > or = 1.6% and < 2.5%, group lb TcTUend > or = 2.5%, group Ic TcTUend > or = 3%. RESULTS: The intraindividual comparison showed a significant decrease of the autonomous "volume" after exogenous suppression with levothyroxin. This is shown by the following values of the TcTU: group I TcTUend = 3.47 +/- 1.65 and TcTUex = 2.91 +/- 1.38, which means a reduction of 20 rel.% (p < or = 0.001); group Ia TcTUend = 2.05 +/- 0.27, TcTUex = 1.85% +/- 0.22, which means 10 rel.% (p < or = 0.001); group Ib TcTUend = 4.18 +/- 1.59, TcTUex = 3.45% +/- 1.34, which means 20 rel.% (p < or = 0.001); group Ic TcTUend = 5.00% +/- 1.43, TcTUex = 4.05% +/- 1.32, which means 20 rel.% (p < or = 0.001). CONCLUSION: Supposing a structural variability of autonomous thyroid tissue with heterogenous TSH receptors our study shows a significant additional exogenous suppression in already endogenous suppressed TSH receptors.

Adult↗

[Effectiveness of goiter treatment with L-thyroxine in patients over 40].

AIM: We examined the effect of levothyroxine on thyroid size in elderly patients (an age > 40 y) with diffuse or nodular goitres. METHODS: 76 patients without relevant autonomy were treated with levothyroxine (2 micrograms/kg BW/d) over a period of 6-12 months. The elderly patients with diffuse goitres (group A, n = 33) and nodular goitres (group B, n = 21) were compared to 18-30 year old respective control groups (group C, n = 13, group D, n = 9). Laboratory parameters and ultrasonic determined goitre volumes were documented before levothyroxine treatment and after 6-12 months, respectively. All measured thyroid volume reductions were referred to the total goitre size. RESULTS: After 6-12 months levothyroxine treatment a significant thyroid reduction was observed in group A (14.8%, p < 0.001), group C (16.0%, p < 0.05) and in group D (19.8%, p < 0.05), whereas in group B thyroid volume was nearly unchanged (4.5%). The result of group B differed from that of group D (p < 0.05). CONCLUSION: These results suggest that levothyroxine can reduce diffuse goitres in elderly patients (group A), whereas in nodular goitres of elderly patients (group B) only a further thyroid growth can be provided.

Adult↗

Crown lengthening: the periodontal-restorative connection.

Crown lengthening procedures are based on biologic principles that can be determinants for successful treatment. These procedures are fixed on an understanding of the biologic width. A few of the indications for crown lengthening are caries beneath the gingival margin, fractured teeth with insufficient clinical crown exposure, and teeth with excessive occlusal or incisal wear. This article describes flap designs, the use of a new bur probe for precise measurement of clinical crown exposure, and suturing methods for flap stabilization. Clinical documentation of patients with various clinical situations requiring crown lengthening is presented.

Crown Lengthening↗

Clinical value of immunoscintigraphy in patients with fever of unknown origin.

UNLABELLED: The aim of our study was to evaluate the clinical value of immunoscintigraphy with the monoclonal antibody 99mTc-BW 250/183 in patients with fever of unknown origin (FUO). The antibody BW 250/183 is an immunoglobulin G1 subtype that binds to the antigen NCA-95, which is expressed on the cell membrane surface of granulocytes. METHODS: We studied 51 patients who were referred with the diagnosis of FUO. Thirty-five percent of the patients suffered from infection, 17% had autoimmune diseases, 14% had neoplasms and 8% had other diseases. The remaining 28% of the patients did not have a diagnosis. Planar imaging was performed in all patients, and 19 patients underwent SPECT. In our analysis, both cold and hot spots were considered diagnostic. RESULTS: Pyogenic infections were visualized correctly in 13 foci. The diagnosis of endocarditis (n = 4) could be determined only by SPECT. False-negative results were found in 4 patients and false-positive uptake was seen in 2 patients. No false-positive uptake or cold spots in the central bone marrow were found in patients with viral, granulomatous and autoimmune diseases or in those patients in whom no FUO cause was found in a 6-mo follow-up. In these patients, a negative scan did not change their diagnostic work-up. Cold spots in the central bone marrow were correctly interpreted in 5 of 6 patients. Sensitivity in detecting pyogenic foci was 73% and specificity was 97%. Positive and negative predictive values were 93% and 87%, respectively. Including areas of decreased uptake in the analysis, sensitivity for detecting an underlying inflammatory or malignant process for FUO was 81 % and specificity was 87%. Positive and negative predictive values were 81% and 87%, respectively. CONCLUSION: Immunoscintigraphy with 99mTc-BW 250/183 in patients with FUO has clinical potential for the diagnosis and exclusion of pyogenic causes of FUO. Metastatic malignant disease and high-grade spondylodiskitis could be diagnosed early in a diagnostic work-up by a characteristic cold spot pattern in the bone marrow. SPECT is indispensible for scintigraphic imaging of endocarditis.

Adult↗

Rat antigen-induced arthritis: cartilage alterations assessed with iodine-123-antileukoproteinase.

UNLABELLED: Imaging of cartilage alterations was attempted in joints of rats with chronic antigen-induced arthritis (AIA) using the cationic 123I-labeled serine proteinase inhibitor antileukoproteinase (123I-ALP; pI > 10), which selectively accumulates in normal cartilage, presumably through interaction with negatively charged proteoglycans. METHODS: Iodine-123-ALP or 123I-myoglobin, a control protein of comparable size but with different isoelectric point (pI=7.3) was injected intravenously into normal or AIA rats. Joint accumulation was followed by scintigraphy for 14 hr. Tissue radioactivity was assessed by well-counter measurements after dissection. The content of charged molecules in articular cartilage was determined by toluidine blue staining; the degree of joint destruction was assessed in parallel by x-ray, ex vivo MRI and histopathology. RESULTS: In intact articular cartilage, ALP accumulated to a significantly higher degree than myoglobin. This preferential accumulation was lost in rats with chronic AIA. The target-to-background ratio for 123I-ALP negatively correlated with the loss of toluidine blue staining in cartilage, which documents depletion of charged matrix molecules (r=-0.92, p < 0.01 at 4 hr; r=-0.97, p < 0.01 at 13 hr). ALP scintigraphy was sensitive in detecting cartilage alterations, even though the degree of joint destruction and inflammatory infiltration was mild, as demonstrated by x-ray, MRI and histopathology. CONCLUSION: In rat AIA, loss of ALP accumulation appears to document proteoglycan depletion in mildly altered arthritic cartilage. ALP scintigraphy may represent a functional assay for early, premorphological cartilage alterations in human arthritis as well.

Animals↗

Arthroscintigraphy in suspected rotator cuff rupture.

AIM: In order to evaluate the diagnostic efficiency of arthroscintigraphy in suspected rotator cuff ruptures this new imaging procedure was performed 20 times in 17 patients with clinical signs of a rotator cuff lesion. The scintigraphic results were compared with sonography (n = 20), contrast arthrography (n = 20) and arthroscopy (n = 10) of the shoulder joint. METHODS: After performing a standard bone scintigraphy with intravenous application of 300 MBq 99m-Tc-methylene diphosphonate (MDP) for landmarking of the shoulder region arthroscintigraphy was performed after an intraarticular injection of 99m-Tc microcolloid (ALBU-RES 400 MicroCi/5 ml). The application was performed either in direct combination with contrast arthrography (n = 10) or ultrasound conducted mixed with a local anesthetic (n = 10). Findings at arthroscopical surgery (n = 10) were used as the gold standard. RESULTS: In case of complete rotator cuff rupture (n = 5), arthroscintigraphy and radiographic arthrography were identical in 5/5. In one patient with advanced degenerative alterations of the shoulder joint radiographic arthrography incorrectly showed a complete rupture which was not seen by arthroscintigraphy and endoscopy. In 3 patients with incomplete rupture, 2/3 results were consistent. A difference was seen in one patient with a rotator cuff, that has been already revised in the past and that suffered of capsulitis and calcification. CONCLUSION: Arthroscintigraphy is a sensitive technique for detection of rotator cuff ruptures. Because of the lower viscosity of the active compound, small ruptures can be easily detected, offering additional value over radiographic arthrography and ultrasound, especially for evaluation of incomplete cuff ruptures.

Adult↗