bluuebunny/crossref_metadata_2025 huggingface dataset:
Bestimmung der renalen clearance anhand der dynamischen Messung der ausgeschiedenen Aktivität
Authors: Hackstein N. , Bauer R.
Published: March 2018

Ziel: In der vorliegenden Arbeit wird ein neues Verfahren vorgestellt, welches durch dynamische szintigraphische Messung der renal ausgeschiedenen Aktivität mit einer Doppelkopfkamera (»Ausscheidungsclearance«) und Messung der Serumaktivität die Berechnung der renalen Clearance ermöglicht. Methoden: Bei 22 Patienten wurde die Tc-99m-MAG-3-Clearance simultan nach dem 2-Kompartiment-Modell nach Sapirstein (»Sapirstein-Clearance«), mit dem virtuellen Verteilungsvolumen nach Bubeck (»Bubeck-Clearance«), nach einem modifizierten Oberhausenverfahren (»Oberhausen-Clearance«) und nach der neuen Ausscheidungsclearance in einer differentiellen und integralen Variante bestimmt. Ergebnisse: Die Sapirstein-Clearance wird als Goldstandard für das Single-shot-Modell angesehen. Die Korrelation der Bubeckund Oberhausen-Clearance lag zwischen r = 0.96 und r = 0.97, die Ausscheidungsclearance (différentielle Variante) bei r = 0.90. Die durchschnittliche Abweichung von der Sapirstein-Clearance betrug bei der Ausscheidungsclearance 21 %, bei der Bubeck-Clearance 11%. Verbesserungen der Genauigkeit der Ausscheidungsclearance ergeben sich möglicherweise durch Verwendung einer Flächenquelle als Testaktivität zur Absorptionsfaktorbestimmung. Diskussion: Die Ausscheidungsclearance ist methodisch aufwendiger als die Bubeck-Clearance, während die Clearancewerte im untersuchten Patientengut weniger gut mit der Sapirstein-Clearance übereinstimmten. Vom theoretischen Ansatz der Verfahren her erwarten wir Vorteile bei der Clearancemessung durch das Ausscheidungsverfahren gegenüber der Bubeck-Clearance bei Patienten mit niedriger Clearance und bei Patienten mit extremen Körpermaßen wie Adipositas permagna oder Kachexie. Diese Annahme soll zusammen mit methodischen Verbesserungen in einer Folgearbeit untersucht werden.
Evaluation of Scatter Correction using a Single Isotope for Simultaneous Emission and Transmission Data
Authors: Kuikka J. T. , Vanninen E. , Kauppinen T. , Länsimies E. , Patomäki L. , Yang J.
Published: March 2018

Photon scatter is one of the most important factors degrading the quantitative accuracy of SPECT images. Many scatter correction methods have been proposed. The single isotope method was proposed by us. Aim: We evaluate the scatter correction method of improving the quality of images by acquiring emission and transmission data simultaneously with single isotope scan. Method: To evaluate the proposed scatter correction method, a contrast and linearity phantom was studied. Four female patients with fibromyalgia (FM) syndrome and four with chronic back pain (BP) were imaged. Grey-to-cerebellum (G/C) and grey-to-white matter (G/W) ratios were determined by one skilled operator for 12 regions of interest (ROIs) in each subject. Results: The linearity of activity response was improved after the scatter correction (r = 0.999). The y-intercept value of the regression line was 0.036 (p <0.0001) after scatter correction and the slope was 0.954. Pairwise correlation indicated the agreement between nonscatter corrected and scatter corrected images. Reconstructed slices before and after scatter correction demonstrate a good correlation in the quantitative accuracy of radionuclide concentration. G/C values have significant correlation coefficients between original and corrected data. Conclusion: The transaxial images of human brain studies show that the scatter correction using single isotope in simultaneous transmission and emission tomography provides a good scatter compensation. The contrasts were increased on all 12 ROIs. The scatter compensation enhanced details of physiological lesions.
Synthese tumoraffiner Yb-169- und Y-90-Porphyrin-Komplexe und tierexperimentelle Untersuchung verschiedener Yb-169-Porphyrine
Authors: Gaidouk M. I. , Rumyantseva V. D. , Fischer T. , Lohr H. , Salditt S. , Liebenhoff S. , Schicha H. , Schomäcker K.
Published: March 2018

Ziel: Es wurde untersucht, ob eine Einführung radioaktiver Isotope von Yb und Y in ausgewählte Porphyrine möglich ist. Außerdem sollten erste Daten zur Bioverteilung von radioaktiven Yb-169-Porphyrin-Komplexen gewonnen werden. Methoden: Die Synthesen der Metall-Porphyrin-Komplexe erfolgten mit geträgerten Radiometallen. Erste Tierversuche wurden an Mammakarzinom-tragenden Mäusen durchgeführt. Die Organe wurden 5 und 24 h nach i.v.-lnjektion im Bohrlochdetektor gemessen. Ergebnisse: Es konnten vier Yb-169-Porphyrin-Komplexe und Y-90-Porphyrin-Komplexe in nicht trägerfreier Form synthetisiert werden. Dies wurde anhand der Absorptionsspektren sowie mittels DC und HPLC bewiesen. Je nach Komplex lagen die Tumor/Untergrund-Verhältnisse im Durchschnitt zwischen 2 und 20. Schlußfolgerung: Die synthetisierten radioaktiven Metall-Porphyrin-Komplexe zeigen eine deutliche Tumoraffinität, die bei weiterer Verbesserung der Synthese (Ziel: Trägerreduzierung, andere Radionuklide) eine Tumorszintigraphie und vielleicht -therapie ermöglichen könnte.
Reliability of Posttherapeutic Dosimetry of Patients with Short-term Hospitalisation after Radioiodine Therapy
Authors: Schneider P. , Hänscheid H. , Köck P. R. , Reiners Chr. , Körber C.
Published: March 2018

Aim: According to the new recommendations of the Federal German Radiation Protection Committee (SSK) for patient discharge, that were published in April 1997, patients can be discharged after radioiodine therapy with a radiation exposure of less than 1 mSv per year in 2 m distance. The aim of this study was to evaluate whether the measurement of the achieved dose was different 48 hours after application of I-131 and after an interval of one week. The study was planned in order to ensure quality management in the follow-up of the patients. Method: In a prospective study 115 patients were followed, that were treated for a benign thyroid disease. The patients were discharged 48 hours after the intake of I-131 after falling short of the exposure limit. All patients were measured at discharge and about 8 days later with the same uptake facility. Results: Because of similar results focal and disseminated forms of benign thyroid diseases could be analysed together. The calculated doses 8 days after the discharge were higher than the values at the time of discharge. The doses were underestimated about 4% with an standard error of 15%. Conclusion: The error in early dosimetric measurements is small in comparison to the overall uncertainty in therapy and uptake dosimetry. A valid dosimetry and sufficient quality management can be guaranteed even for an early discharge.
Comparison of HIG Scintigraphy and Bloodpool Scintigraphy Using HDP in Arthritic Joint Disease
Authors: Grau Kerstin , Puille M. , Matter H.-P. , Lange U. , Steiner Dagmar , Bauer R. , Klett R.
Published: March 2018

Aim: Because of a similar tracer accumulation, we assumed to get the same information about synovitis in arthritic joint disease with HIG scintigraphy and bloodpool scintigraphy using HDP. Therefore, we compared retrospectively 23 patients. Methods: In HIG scintigraphy, synovitis was diagnosed according to increasing activity from early to late image. In bloodpool scintigraphy according to an increased activity in comparison to the surrounding tissues. Results: In 694 joints comparison of both scintigraphic modalities was possible, resulting in a 2 × 2 kappa coefficient of 0.93 or 0.97 by using late-phase bone scintigraphy as an anatomical marker. For intra- and interobserver agreement, 2 × 2 kappa coefficients of 0.93 and 0.88 in HIG scintigraphy, respectively 0.96 and 0.90 in blood-pool scintigraphy were calculated. Conclusion: This study shows an excellent agreement in the visualization of synovitis by HIG and bloodpool scintigraphy. Because of its higher objectivity and lower cost, investigation of synovitis should be performed by bloodpool scintigraphy.
Influence of Blood Viscosity on Circulatory Parameters Determined by First-Pass Radionuclide Angiocardiography in Cor pulmonale
Authors: Tóth K. , Zámbó Katalin
Published: March 2018

First-pass radionuclide angiocardiography (FPRNA) with 99mTc-albumin was performed in 19 patients with cor pulmonale. Pulmonary circulation time (PCT), mean transit time (MTT), pulmonary stagnation index (PSI) were calculated from the time-activity curves for the estimation of cardiopulmonary circulation. Whole blood viscosity (WBV), plasma viscosity (PV) and hematocrit (HTC) were also measured on the same day. Significant prolongation of all parameters was observed (WBW: 5,04 ± 1.19 mPas; PV: 1,36 ± 0,17 mPas; HTC: 47,6 ±2,37%; PCT: 7,10 ± 2,15 s; MTT: 9,33 ±4,11 s; PSI: 1,30 ±0,37) in patients with cor pulmonale. Significant positive correlations were found between PCT and WBV (r = 0,552; 0,001 <P <0.01), MTT and WBV (r = 0,34; P <0,05), furthermore between PCT and HTC (r = 0,356; P <0,05). The results suggest that hemorheological parameters may influence the results of FPRNA, therefore, they should be determined in addition to the radionuclide study.
Beurteilungskriterien für die Captopril-Nierenfunktions- szintigraphie mit 99mTc-MAG3
Authors: Bockisch A. , Maier G. , Düber C. , Kann P. , Hahn K. , Piepenburg R.
Published: March 2018

Im Rahmen der Diagnostik der renovaskulären Hypertonie hat die Nierenfunktionsszintigraphie unter Einfluß eines ACE-Hemmers als nichtinvasives Verfahren erhebliche Bedeutung erlangt. Unter Einsatz des Radiopharmazeutikums 99mTc-MAG3 wurden bei 54 Nieren mit angiographisch, klinisch und endokrinologisch gesicherter Diagnose folgende szintigraphischen Parameter isoliert auf ihre Aussagekraft zum Nachweis bzw. Ausschluß einer relevanten Nierenarterienstenose untersucht: parenchymaler Nuklidtransport, Harnabflußsituation, Nierengröße und seitengetrennte Funktionsanteile. Als typischer Befund einer dekompensierten Nierenarterienstenose erwies sich eine ausgeprägte parenchymale Nuklidretention in Kombination mit einer deutlich verzögerten Harnaktivitätsanflutung im Nierenhohlraumsystem. Im Vergleich zur rein visuellen Beurteilung der Sequenzszintigramme erbrachte die Miteinbeziehung zusätzlicher, quantitativer Kriterien im eigenen Patientenkollektiv keine diagnostischen Vorteile. Bei 43 Patienten mit klinischen Hinweisen auf eine renovaskuläre Hypertonie ergab sich mit diesen Kriterien eine Sensitivität von 89%, die Spezifität betrug 88%. Bilateral positive Befunde erwiesen sich als unspezifisch; blieben diese unberücksichtigt, erhöhte sich die Spezifität der Untersuchung auf 100%.
Zufallsbefund einer progressiven diaphysären Dysplasie (Camurati-Engelmann-Syndrom)
Authors: Grün B. , Bares R. , Büll U. , Altehoefer C.
Published: March 2018

Wir berichten über eine 35jährige Patientin, bei der als Zufallsbefund während einer Phlebographie vor Varizenoperation hyperostotische Veränderungen in Femur- und Tibiadiaphysen im Sinne eines Camurati-Engelmann-Syndroms aufgefallen waren. Bei diesem sehr seltenen Syndrom, welches der Gruppe der Osteochondrodysplasien zugeordnet wird, handelt es sich um eine in der Regel symmetrisch auftretende diaphysäre Dysplasie, die sporadisch aber auch familiär gehäuft vorkommt und progredient verlaufen kann. Die Ursache ist unbekannt, eine autosomal-dominante Vererbung mit variabler Expressivität und Penetranz wird diskutiert. Die Diagnose wurde radiologisch gestellt. Radiologische und skelettszintigraphische Befunde werden vorgestellt.
Erste Ergebnisse der Radioiodtherapie bei multifokaler und disseminierter Autonomie der Schilddrüse unter Verwendung eines TcTUs-adaptierten Dosiskonzepts
Authors: Oexle C. , Moser E. , Reinhardt M.
Published: March 2018

Ziel: Die Studie untersucht prospektiv die Wirksamkeit eines an den prätherapeutischen 99mTc-Pertechnetat Uptake der Schilddrüse unter Suppression (TcTUs) angepaßten Dosiskonzeptes zur Radioiodtherapie (RIT) bei Patienten mit multifokaler (MFA) und disseminierter Autonomie (DISA). Dieses Konzept berücksichtigt die gesamte Schilddrüse als Zielvolumen und verwendet Herddosen von 150 Gy bis 300 Gy entsprechend dem TcTUs als Maß für das »autonome Volumen« der Schilddrüse. Methoden: Es wurden 75 Patienten (54 Frauen, 21 Männer; Alter 71 ± 9 Jahre) mit MFA oder DISA ausgewertet. Die Therapie wurde bei Normalwerten für fT3 und fT4 und bei endogener Suppression des TSH durchgeführt. Als Herddosen wurden appliziert: bei einem TcTUs zwischen 1,5-2,5% 150 Gy, bei 2,51-3,5% 200 Gy, bei 3,51-4,5% 250 Gy und bei >4,5% 300 Gy. Die Abschätzung der zu applizierenden Aktivität erfolgte mit einer modifizierten Marinelli-Formel. Als Therapieerfolg galt ein TSH >0,5 mU/l und ein Verschwinden der autonomen Areale im Szintigramm bzw. ein posttherapeutischer TcTU <1,5%. Die mittlere Nachbeobachtungszeit betrug 8 ± 4 Monate. Ergebnisse: Die Erfolgsraten betragen im Durchschnitt 92%. Nur in einem Fall kam es zu einer konsekutiven subklinischen Hypothyreose und in einem weiteren Fall trat eine immunogene Hyperthyreose auf. Schlußfolgerung: Die vorliegenden Daten sprechen dafür, daß auch Patienten mit ausgeprägter Autonomie (TcTUs >3,5%) bei einzeitiger Therapie mit einer Erfolgsrate von über 90% mit dem hier vorgestellten Dosiskonzept behandelt werden können. Die Frühhypothyreoserate ist insgesamt sehr niedrig.
Gleichzeitiges Auftreten einer endokrinen Orbitopathie und einer Schilddrüsenautonomie
Authors: Smolarz Kamilla , Dederichs Birgit , Schicha H.
Published: March 2018

Das gemeinsame Auftreten einer endokrinen Orbitopathie und einer zweifelsfreien Schilddrüsenautonomie könnte mit einer Häufigkeit von 0,05-0,2% erwartet werden. Entgegen dieser erwarteten Zahlen konnten, innerhalb eines Zeitraumes von 10 Jahren, in einer Schild- drüsenspezialambulanz nur 3 Patienten mit diesen Gemeinsamkeiten identifiziert werden. Der mögliche, jedoch offensichtlich nicht vollkommene Schutz vor einer Manifestation einer Immunhyperthyreose durch eine funktionell relevante Autonomie wird diskutiert.
Intercondylar Notch Width in Dogs With and Without Cranial Cruciate Ligament Injuries
Authors: Kass P. H. , Toombs J. P. , Aiken S. W.
Published: March 2018

This prospective study evaluated the intercondylar notch width in dogs with naturally occurring cranial cruciate ligament (CCL) injuries. The intercondylar notch width was measured in 45 stifles with CCL injuries and 98 normal stifle joints to determine if stifles with CCL injuries have outlet stenosis of the intercondylar notch. A notch width index was calculated in order to compensate for the variety of dog sizes. Stifles with CCL injuries had significantly smaller notch width indices as compared to normal stifles. We concluded that intercondylar notchplasty should be performed if an intra-articular repair of the CCL deficient stifle is planned in order to minimize impingement of the stenotic intercondylar notch on the intra-articular graft.

An intercondylar notch width index was determined in 45 stifles with cranial cruciate ligament (CCL) injuries and 98 normal stifle joints. Stifles with CCL injuries were found to have significantly smaller intercondylar notch width indices as compared to normal stifles.
Dual Energy X-Ray Absorptiometry (DEXA) in Evaluation of the Proximal Femur after Repair of Proximal Femoral Physeal Fractures in Immature Dogs
Authors: Tillson D. M. , McLaughlin R. M. , Toll Ph. W. , Richardson D. C. , Roush J. K.
Published: March 2018

Thin slices of the proximal femora of twelve immature dogs were examined with dual energy x-ray absorptiometry, after surgical creation and repair of proximal femoral physeal fractures. A protocol for the subtraction of microvascular barium sulphate was used to eliminate interference from the barium with the determination of bone mineral content (BMC), bone mineral density (BMD) and volumetric bone mineral density (VBMD). The results showed there was a significant decrease in the BMC (four and eight weeks) and BMD (eight weeks) for the entire proximal femora of the operated side when compared to the non-operated side. Significant decreases were also seen for the BMC of the physeal region at week eight and the VBMD of the metaphyseal area in the two week femora. The findings with DEXA support the clinical findings of femoral neck thinning in proximal femoral physeal fractures that are surgically repaired. The DEXA findings suggest that the quality of the bone of the femoral neck is less as shown by the decreased BMC, BMD and VBMD. Postoperative complications may occur at a higher frequency when such quality changes occur.

Dog proximal femora were examined with DEXA after surgical creation and repair of proximal femoral physeal fractures. DEXA findings support clinical findings of femoral neck thining after fracture repair.
Central Tarsal Bone Fracture in Two Dalmatians
Authors: Hay C. W. , Muir P. , Johnson K. A.
Published: March 2018

Two adult female Dalmatians had type III fractures of the left central tarsal bone. In one the fracture occurred during strenuous exercise, while the cause was not identified in the other dog. Open reduction and internal fixation of a large medial bone fragment was achieved with a medial-lateral directed lag screw into the fourth tarsal bone. A 2.7 mm cortical screw was used in one animal and a 4.0 mm partially threaded cancellous screw in the other. At follow-up examination both dogs were free from lameness.

Central tarsal bone fractures were repaired using lag screw fixation in two Dalmatians. Other than in racing greyhounds, this fracture is rare in dogs.
Geometric Analysis of the Proximal Medullary Cavity of the Femur in the German Shepherd Dog
Authors: Helsen J. A. , Mulier M. , Mattheeuws D. , Jaecques S. V. N.
Published: March 2018

Forty-one cadaver femora of German Shepherd dogs were prepared for implantation of a cementless total hip prosthesis by reaming of the proximal medullary cavity with standard orthopaedic instruments. Silicone paste imprints of the cavity were taken and measured with a 3 D laser reflection system. Data were processed statistically according to a geometric model with these parameters: distal diameter Ø

dist
, medio-frontal radius r, laterofrontal angle α, medio-frontal angle β, helix angle γ and increment eccentricity δ

e

. Correlations between body mass and Ø

disv
body mass and r, body mass and β were moderately significant (p <0.05, p <0.06, p <0.05 resp.). Other correlations between body mass and parameters were not significant. Simple weighing of a German Shepherd is not a useful predictor of the internal dimensions of the proximal femur.

The distribution of the most important parameter Ø

dist
was compared with the range of Ø

dist
sizes of the iso-elastic veterinary hip prosthesis (IVHP). This comparison showed that the test sample of 41 bones could be fitted with four IVHP sizes. However, 25 femora out of 41 do not fit into the available r values of the IVHP assortment. Less than adequate proximal canal fill will be the result if an IVHP is implanted, unless substantial reaming is done proximomedially.

It was shown that measurements on radiographs of intact dog cadaver femora do not yield equivalent results to the imprints. Moreover, comparison of the internal dimensions of the medullary cavity of the human femur showed that a press-fit human prosthesis cannot be geometrically proportional to the IVHP.

Dimensions of reamed cavities of forty-one cadaver femora of German Shepherd dogs were measured with a system of silicone imprinting and 3D laser reflectometry. Data were processed statistically according to a geometric model with seven parameters. Correlations between parameters and body mass were moderately significant for three parameters and not significant for the others. Distributions of the geometric parameters were calculated and implications with respect to prosthesis design are discussed. A comparison with geometric parameters obtained from radiographs was made and the significance of the differences is discussed. Finally, a comparison with the geometric parameters of the medullary cavity of the human femur is made.
Dynamic Analysis of In Vivo Segmental Spinal Motion: An Instrumentation Strategy
Authors: Bertram J. E. A. , Gellman K. , Hermanson J. W. , Haussler K. K.
Published: March 2018

Summary A transducer for measuring threedimensional segmental spinal motion was designed to directly measure dynamic rotations (Rx, Ry and Rz) about three orthogonal axes using an array of liquid metal strain gauges (LMSGs). The configuration of the LMSG array results in differential length changes due to segmental spinal motion. In vitro calibration utilized transducer attachment to Steinmann pins implanted into the dorsal spinous processes of anatomical spinal segments. The response of the LMSGs approximated linearity (R2 ≥0.980) over the calibrated ranges of angular displacement (i.e., ± 5°). On average, artifactual mechanical noise of the LMSGs was <3% of the signal recorded during locomotion. The minimum resolution of the transducer was 0.07 degrees of flexion-extension, 0.46 degrees of lateral bending, and 0.56 degrees of rotation. Average resistive force for all transducers was 0.31 ± 0.05 Nm at the neutral articular position (0°) and 0.51 ± 0.03 Nm at 5° of flexion. Clinically, the modest mechanical resistance of the transducers did not affect spinal mobility nor locomotion. In vivo application of the transducer was demonstrated at thoracolumbar and lumbosacral spinal segments in horses treadmill locomotion. The transducer was designed and tested on an equine model, but may be adapted for other quadrupeds. The dynamic and continuous measure of three-dimensional in vivo segmental spinal motion will provide an important new perspective for evaluating normal and altered spinal motion.

A technique was developed for directly measuring threedimensional segmental spinal motion in the thoracolumbar and lumbosacral spinal segments in horses during treadmill locomotion. The dynamic and continuous measure of three-dimensional in vivo segmental spinal motion will provide an important new perspective for evaluating normal and altered spinal motion associated with back problems.
Intertarsal and Tarsometatarsal Arthrodesis Using a Plantar Approach
Authors: Wilke V. L. , Robinson T. M. , Dueland R. T.
Published: March 2018

The exposure and convenience of a plantar approach combined with the use of various plates for intertarsal and tarso-metatarsal arthrodesis is reported in four limbs. The approach was straight-forward with good exposure and the design of the new carpal arthrodesis plate uniquely accommodated the plantar tarsometatarsal anatomy.

This report in dogs concerns one case of bilateral auto-immune proximal intertarsal subluxation (talocalcaneal-centroquartal), one case of traumatic intertarso-metatarsal luxation and one case of traumatic tarsometatarsal subluxation/fracture. All were treated by arthrodesis using a plantar approach with a plate as primary fixation.
Optimismus auf dem Europäischen Hämatologenkongress (EHA): Fortschritte in allen Bereichen hämatologischer Erkrankungen
Authors: Reich Birgit
Published: March 2018

Während der Amerikanische Krebskongress (ASCO) dieses Jahr auch durch viele negativ verlaufende Studien auf sich aufmerksam machte, gibt es vom Europäischen Hämatologenkongress (EHA) Positives zu berichten. Ein Highlight war die PRIMA-Studie, die die Erhaltungstherapie mit Rituximab bei indolenten Lymphomen als Standard setzte. Daneben zeigten sich Fortschritte bei der Behandlung Multipler Myelome, die sich mittlerweile als chronische Krankheit präsentiert sowie bei der CLL, und neue Strategien führen auch bei Lymphomen zu Erfolgen.
Chronisch myeloische Leukämie (CML): Dasatinib als neue Erstliniensubstanz?
Authors: Reich Bettina
Published: March 2018

Ein Langzeitüberleben ist für Patienten mit einer chronisch myeloischen Leukämie (CML) erst mit der Einführung von Imatinib möglich geworden. Nun scheint allerdings ein Generationenwechsel statt zu finden: Der Tyrosinkinaseinhibitor (TKI) der 2. Generation Dasatinib (Sprycel®) zeigte signifikant bessere komplette zytogenetische Remissionen (CCyR) und gute molekulare Remissionen (MMR) nach einem Jahr als Imatinib bei Patienten mit neu diagnostizierter CML.
Hirntumortherapie
Authors: Fink R. , Link H.
Published: March 2018

Die Therapie der primären Hirntumoren erfährt derzeit einen neuen Schub durch dia-gnostisch und therapeutisch relevante Erkenntnisse im molekularen Bereich. Es werden Defekte der Wachstumsregulation definiert, die in ähnlicher Form auch bei anderen malignen Erkrankungen vorkommen. Gegen diese definierten Defekte werden immer mehr zielgerichtete Therapien mit spezifischen Hemmstoffen verfügbar. Dadurch eröffnen sich neue Perspektiven, die Therapie zu verbessern.
Therapietreue in der Onkologie: Die Sicht des Compliance-Experten: „Bleibt die Therapietreue auf der Strecke, bleiben es die Patientinnen auch“
Authors: Bubenzer von Rainer
Published: March 2018

„Die tägliche Einnahme eines Krebsmedikamentes erinnert Patienten daran, dass sie krank sind und ihr Leben endlich ist“, fasst der Compliance-Experte, Prof. Peyman Hadji, Leiter der klinischen Gynäkologie an der Philipps-Universität Marburg, eine zentrale Reaktion zusammen, die bei vielen chronisch Krebskranken zum Abbruch der bisherigen Medikation führt. Hadji ist Initiator des PACT-Programmes (Patient’s Anastrozol Compliance to Therapy Programme), das multizentrisch und nach Einschluss von 5000 Brustkrebs-Patientinnen die Bedeutung der Compliance bei adjuvanter Antihormontherapie klären soll. Ergebnisse der groß angelegten Studie bereichern die Versorgungsforschung auch in anderen onkologischen Bereichen, wie das folgende Interview zeigt.
Behandlung des triple negativen Mammakarzinoms (TNBC)
Authors: Pohlmann Birgit
Published: March 2018

PARP-Inhibitoren als neue Hoffnungsträger: Die PARP-Inhibitoren (PARP = Poly-adenosin diphosphat ribose-Polymerase) sind eine neue Substanzklasse und Hoffnungsträger für die Behandlung von Patientinnen mit sog. triple negativem“ Mammakarzinom. Letzteres geht in der Regel mit einer sehr ungünstigen Prognose einher und liegt vor, wenn der Tumor weder Östrogen- noch Progesteronrezeptor-positiv ist und keine HER2-Überexpression vorliegt (ER-, PgR-, HER2-). Der klinisch am weitesten fortgeschrittene PARP-Inhibitor ist die Substanz BSI-201 (Iniparib), die sich derzeit in der Phase III-Prüfung befindet.
Protonen-Scanning in der klinischen Praxis: Welche intratumorale Strahlendosis-Konzentration ist erreichbar?
Authors: Herbst Manfred , Rinecker Hans
Published: March 2018

Versuche, klinische Evidenz für eine unterschiedliche intrazelluläre Wirkung der verschiedenen Klassen ionisierender Strahlung – die Photonen elektromagnetischer Wellen bei Röntgenbehandlung und die Partikel Protonen – zu finden, haben keine grundsätzlichen gewebespezifischen Unterschiede gezeigt. Protonen wirken biologisch im Vergleich um einen Faktor 1,1 mehr als Photonen (Röntgen) auf die Tumor Sterilization Probability“, TSP und Healthy Tissue Complication Probability“, HTCP. Dies bezieht sich gleichermaßen auf alle Tumor- und Gewebearten.
Ernährung: Ernährungsempfehlungen begleitend zu einer Tumortherapie
Authors: Hübner Jutta
Published: March 2018

Die Chemo- und Strahlentherapie stellen mit ihren Substanzen bzw. den Abbauprodukten der Zellen, die durch die Therapie zerstört werden, eine starke Belastung für den Körper dar. Durch Entzündungen im Mund- und Schleimhautbereich, Übelkeit, Erbrechen und Durchfälle ist es oft nur schwer möglich, eine gesunde Ernährung einzuhalten, zu der Obst- und Gemüsezubereitungen gehören, aber auch ausreichend Proteine und die richtigen Fette. Eine frühe Beratung durch onkologisch erfahrene Diätassistentinnen hilft vielen Patienten, die für sie geeignete Ernährung zu finden. Wichtig ist auch, eine leichte, verträgliche Kost mit Betonung auf gut resorbierbaren Kohlenhydraten zu sich zu nehmen.
Evaluation of different techniques for percutaneous needle biopsy of synovial membrane in the dog
Authors: Busato A. , Schawalder P. , Rytz U. , Siegfried R.
Published: March 2018

Four different needles were evaluated for percutaneous needle biopsy (PNB) of the synovial membrane (SM) in six different joints (carpus, tarsus, elbow, shoulder, stifle, hip) from eight dog cadavers. Needle biopsies were retrieved with the Parker-Pearson (PP), a novel modified Parker-Pearson (PPM), the Tru-Cut (TC), and the Franklin-Silverman (FS) needles. The success rate of PNB to produce biopsies, of adequate histological quality, was assessed for each needle type and joint. The joints were subsequently surgically opened and standard open SM biopsies were harvested from an adjacent area. The articular cartilage was inspected and graded for damage caused by PNB sampling. The length of the intact synovial lining cell layer (SLCL) and the histological quality of the needle biopsies were compared to the open surgical biopsies. Success rates for the different needles were 49.2% (PPM), 37.5% (PP), 26.7% (TC), and 1.7% (FS). The highest success rates were achieved in the carpus and stifle; the lowest success rate was found in the hip joint. The intact SLCL from the PNB samples was an average of 3.4 times shorter than that of the surgical biopsies. The proportion of the samples with adequate histological quality was 81% for open surgical biopsies and 62% for PNB samples. The FS was found to produce the highest incidence of articular cartilage damage. The application of PNB for SM sampling is a valuable alternative to the open surgical biopsy in dogs. Modifications of the Parker Pearson needle by Arassy and Schumacher and novel modifications introduced by the authors, offer encouraging results, and merit further clinical and research investigations.
The evaluation of extracorporeal shockwave therapy in naturally occurring osteoarthritis of the stifle joint in dogs
Authors: Fitch G. , Evans R. B. , McClure S. R. , Conzemius M. , Dahlberg J.
Published: March 2018

Extracorporeal shockwave therapy (ESWT) has expanded from the original uses of human urinary calculi treatment to veterinary orthopaedic applications. This paper investigates the feasibility and efficacy of treating dogs with osteoarthritis of the stifle joint with ESWT. In this study, dogs with persistent stifle lameness despite previous surgical or medical treatment were either treated with ESWT or served as untreated controls. The more lame rear limb of each dog was determined by force platform analysis. The range of motion (ROM) of the stifle joints was assessed by goniometry. Force platform gait analysis and goniometry were performed on both groups for four visits at threeweek intervals and a final examination four weeks later. Shock wave therapy was performed three times on the treated dogs, once at each of the first three examinations. A placebo treatment consisting of clipping and wetting the hair was performed on the control dogs. The vertical forces were evaluated for objective analysis of treatment response. For peak vertical force (PVF), four of seven treated dogs improved, while only one of five of control dogs improved. The PVF for the within group analysis did not show any significant change for the treated group, however, the control group has a significant decrease (p=0.05) in PVF consistent with an increase in lameness. The range of motion (ROM) of the stifle joint improved in five of seven treated dogs and three of five controls. Dogs in the treated group had a trend toward increased ROM (p=0.07) and a ‘positive slope’ when compared to dogs in the control group which did not have a significant change (p=0.78) and had a negative slope indicating the dogs were developing a decrease in ROM. The subjective data provided by client questionnaire did not show significant difference between groups.
Comparison of tenoscopic and ultrasonographic methods of examination of the digital flexor tendon sheath in horses
Authors: Möbius G. , Ferguson J. , Edinger J.
Published: March 2018

The purpose of this study was to compare sonographic and tenoscopic findings with the purpose of establishing the accuracy and limitations of ultrasonography as a non-invasive diagnostic modality in evaluating the DFTS and its enclosed tendons. The medical records from 22 horses which underwent tenoscopic desmotomy of the palmar/plantar annular ligament were evaluated in a retrospective study. The qualitative assessment of sonographic and tenoscopic findings were documented for the digital flexor tendon sheath (DFTS), the palmar/plantar annular ligament (PAL), the superficial digital flexor tendon (SDFT) and the deep digital flexor tendon (DDFT). The abnormalities diagnosed sonographically within the DFTS were verifiable tenoscopically with a sensitivity of 90.9% and a specificity of 53.8%. The positive predictive value of sonographic examination at the DFTS was 62.5%. The sensitivity of the sonographic examination at the PAL was 68.8%, the specificity was 50% and the positive predictive value 73.3%. Sonographic examination of the SDF tendons revealed abnormal findings in 12 tendons. The tenoscopic examination confirmed these findings on six tendons when they had a pronounced fibrillated or rough tendon surface or tear on the border. Six superficial flexor tendons and seven deep digital flexor tendons had abnormalities seen tenoscopically which were not visible on sonographic examination. Sonographic examination located lesions of the DDFT in four limbs. On tenoscopic examination the lesions could be detected in seven other DDF tendons, including signs of inflammation at the tendon surface that were not seen ultrasonographically (sensitivity 36.4%). Recognition of the limitations of sonographic results should be kept in mind so as not to misinterpret findings, especially if echogenic materials are observed.
Matrix metalloproteinase and tissue inhibitor of metalloproteinase in serum and synovial fluid of osteoarthritic dogs
Authors: Roush J. K. , Schermerhorn T. , Mitchell K. E. , Salinardi B. J.
Published: March 2018

To better understand the mechanisms responsible for the pathological processes of osteoarthritis (OA) and to potentially identify a profile of changes that could be predictive of early OA, matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of matrix metalloproteinase-2 (TIMP-2) in the synovial fluid and serum of normal and osteoarthritic dogs were examined. The concentration of MMP-1 in the synovial fluid of osteoarthritic dogs (0.62 ± 0.16), as measured by densitometry, was significantly higher than that found in control dogs (0.42 ± 0.19) (P = 0.03). The concentration of MMP-1 in the serum of osteoarthritic dogs (0.74 ± 0.16) was significantly less than that found in control dogs (0.87 ± 0.08) (P = 0.05). The concentration of TIMP-2 in the synovial fluid of osteoarthritic dogs (46.2 ± 21.9 ng/ml) was significantly less than that of control dogs (122.0 ± 66.5 ng/ml) (P = 0.009). The concentration of TIMP-2 in the serum of osteoarthritic dogs (116.2 ± 43.1 ng/ml) was not significantly different than that of control dogs (95.1 ± 94.4 ng/ml) (P = 0.554). In addition, a phospho-tyrosine immunoprecipitation and mass spectrometry were used to isolate and identify interferonalpha in canine synovial fluid.
Arthrodesis of the tarsometatarsal joint, using type II ESF with acrylic connecting bars in four dogs
Authors: Yeshurun Y. , Shahar R. , Shani J.
Published: March 2018

Hyperextension injury of the tarsometatarsal joint (TMTJ) is a debilitating injury and arthrodesis of this joint is often the only procedure that can result in full return to function. Most surgical procedures described for arthrodesis of the tarsometatarsal joint necessitate the use of external, splint or cast, to protect the implants used from fatigue failure. This report describes the successful use of type II external fixator that spans the tarsometatarsal joint in four dogs with hyperextension injury of the tarsometatarsal joint. This technique enables the patient to bear weight on the limb immediately after surgery until bony fusion is achieved, without the need for an additional protecting splint.
An in vitro Comparison of Two Replacement Techniques Utilizing Fascia Lata after Cranial Cruciate Ligament Transection in the Dog
Authors: Coetzee G. L.
Published: March 2018

The immediate postoperative biomechanical properties of an “underand-over” cranial cruciate ligament (CCL) replacement technique consisting of fascia lata and the lateral onethird of the patellar ligament, were compared with that of a modified intra- and extracapsular “under-and-over-the-top” (UOTT) method. The right CCL in twelve adult dogs was dissected out and replaced with an autograft. The contralateral, intact CCL served as the control. In group A, the graft was secured to the lateral femoral condyle with a spiked washer and screw. In group B the intracapsular graft was secured to the lateral femoro-fabellar ligament, and the remainder to the patellar tendon. Both CCL replacement techniques exhibited a 2.0 ± 0.5 mm anterior drawer immediately after the operation. After skeletonization of the stifles, the length and cross-sectional area of the intact CCL and CCL substitutes were determined. Each bone-ligament unit was tested in linear tension to failure at a fixed distraction rate of 15 mm/s with the stifle in 120° flexion. Data was processed to obtain the corresponding material parameters (modulus, stress and strain in the linear loading region, and energy absorption to maximum load).

The immediate postoperative structural and material properties of the “under-and-over” cranial cruciate ligament replacement technique with autogenous fascia lata, were compared to that of a modified intra- and extracapsular “under-and-over-the-top” (UOTT) method. The combined UOT T technique was slightly stronger (6%), but allowed 2.8 ± 0.9 mm more cranial tibial displacement at maximum linear force.
Evaluation of Experimental Proximal Femoral Physeal Fractures Repaired with Two Cortical Screws Placed from the Articular Surface
Authors: McLaughlin R. M. , Roush J. K. , Tillson D. M.
Published: March 2018

Proximal femoral physeal fractures were surgically created unilaterally in twelve immature dogs and repaired using two cortical screws placed in lag fashion from the articular surface into the femoral neck. Four dogs were euthanatized at two, four and eight weeks after surgery and evaluated by gross examination, fine detail radiography, fine detail angiography and histology. Mild to severe injury to the articular cartilage of the acetabulum was observed in all operated joints. Narrowing of the femoral neck was evident on fine detail radiographs and was most severe at week four. Metaphyseal vessels crossed the physis and revascularized the epiphysis with greater than 90% of the epiphysis being revascularized by eight weeks. Operated femora showed histological evidence of physeal disruption and premature physeal closure. Osteocyte death in the epiphysis was evident histologically with viable osteocytes following revascularization and proceeding from distal to proximal through the epiphysis over eight weeks.

The healing of proximal fe-moral physeal fractures repaired with two, 2.0 mm cortical screws placed from the articular surface was evaluated by gross evaluation, fine detail radio-graphs and angiographs, and histological examination. Fracture healing and restoration of blood supply was adequate for weight bearing. This technique is acceptable for use in clinical patients.
Unusual Presentation of an Ununited Anconeal Process in a Six-Year-Old Great Dane
Authors: Sikkema Deborah , Roush J. K.
Published: March 2018

An acute weight-bearing, right forelimb lameness developed in a six-year-old Great Dane without any prior history of lameness. Clinical and radiographic findings were consistent with right ununited anconeal process and degenerative joint disease within the elbow, however, radiographically the anconeal process was separated from the ulna and attached to the humerus. Removal of the anconeal process resulted in satisfactory right front limb use for a further 40 months following the operation.
Partial Carpal Arthrodesis in a Warthog (Phacochoerus aethiopicus)
Authors: Spelman Lucy , Spodnick G. , Loomis M. , Roe S. C.
Published: March 2018

A two-year-old male African wart-hog (Phacochoerus aethiopicus) sustained a fracture of the left fourth carpal bone. Initial management consisted of seven weeks of stall rest but moderate lameness continued and fragment displacement was evident on radio-graphs. A partial carpal arthrodesis, involving the intercarpal and carpometacarpal joints, was performed to alleviate discomfort from degenerative joint disease. The joints were stabilized with two bone plates and a cancellous bone graft used to promote arthrodesis. After six weeks of cast support, joint fusion had progressed well. By 24 weeks after surgery, radiographic union was present and the warthog had only mild lameness. Carpal flexion was reduced by approximately 15°. This reduction did not compromise function.

A two-year-old African warthog fractured the left fourth carpal bone in a pen injury. Conservative management was unsuccessful. Partial carpal arthrodesis of the intercarpal and carpometacarpal joints was performed using cartilage debridement, cancellous bone grafting, a T-plate and a dynamic compression plate for stabilization. Forelimb function was maintained in an animal that eats and forages while kneeling on its flexed carpus.
A Comparative Study of the Composition of Discs and of Proteoglycans from Different Spinal Levels of Sheep
Authors: Ghosh P. , Taylor T. K. F. , McAuley Louise , Melrose J.
Published: March 2018

Compositional analyses were undertaken on lumbar (L2L3 - L5L6) and lumbosacral (L6S1) intervertebral disc tissues from young adult (2-year-old) merino wethers. The proteoglycan level in the nucleus pulposus of the lumbosacral disc was significantly lower than that found in the nucleus pulposus of lumbar levels (p<0.05). The annulus fibrosus was richer in collagen compared to the nucleus pulposus in all discs examined, and the lumbosacral disc consistently had both higher annulus fibrosus and nucleus pulposus collagen levels than lumbar discs (p<0.05). Aggregation of the high buoyant density proteoglycans, with hyaluronic acid, was generally higher in annulus fibrosus proteogly-cans than nucleus pulposus proteogly-cans irrespective of the spinal level examined. Examination of the inter-vertebral disc proteoglycans, by composite agarose polyacrylamide gel electrophoresis, demonstrated three proteoglycan subpopulations and that the nucleus pulposus generally contained a greater proportion of higher mobility more polydisperse proteoglycan species than the annulus fibrosus.

Ovine intervertebral disc collagen and proteoglycan composition varies with spinal level. Lumbosacral intervertebral discs contain greater levels of non-aggregatable more polydisperse proteoglycan species than lumbar discs, which may reflect their relative proximities to the pelvis and the variable levels of stress experienced by the respective tissues.
Distal Tibial Articular Fractures in Racing Greyhounds: A Review of Six Cases
Authors: Dee J. F. , Weiss R. , Montavon P. M.
Published: March 2018

Six spontaneously occurring distal tibial fractures extending into the posterior articular margin of young racing greyhounds were reviewed. Concomitant fractures of both malleoli occurred in three cases. Fracture patterns, methods of treatment and functional results were determined. Open anatomical reduction and rigid internal fixation promoted healing with minimal osseous reaction and showed better results than conservative treatment. Complications adversely affecting the outcome were periarticular deformity and osteoarthritis, these were observed as early as five to seven weeks following the operations.

Six spontaneously occurring distal tibial fractures extending into the posterior articular margin of young racing greyhounds were reviewed. Fracture patterns, methods of treatment and functional results were determined.
Reverse Saphenous Conduit Flap: A Case Report in a Cat
Authors: Bauer M. S. , Cozens M. , Degner D. A.
Published: March 2018

This report documents the repair and successful healing of a large metatarsophalangeal skin defect in a cat using a reverse saphenous conduit flap. Recommendations for the use of this flap in the cat cannot be made until a complete study has been conducted. Anatomical reports on the vascular supply to the feline pelvic limb suggest that this type of flap should be viable.

A large metatarsophalangeal skin defect was successfully repaired using a reverse saphenous conduit flap. This technique was originally described in dogs and has not been reported in cats.
Thoracic Injuries in Cats with Traumatic Fractures
Authors: Walter Patricia , Wallace L. J. , Griffon Dominique
Published: March 2018

The medical records of 93 cats with traumatic fractures were examined to study the pattern of thoracic trauma and establish a possible relationship between specific patterns of skeletal trauma and the prevalence of thoracic wall and pulmonary injury. Radiographic evidence of thoracic trauma was identified in 38.7% of these cats. Cats with fractures cranial to T13 were significantly more likely to sustain thoracic trauma (58%) compared to those suffering a fracture caudal to LI (25%). Cats involved in motor vehicle accident were more likely to have radiographic evidence of thoracic trauma (52%) compared to those injured by other means (22%). Forty percent of cats with radio-graphic evidence of thoracic injury did not show any clinical sign.

In a retrospective survey of 93 cats admitted for evaluation of traumatic fractures, 36 cats (38.7%) had radiographic evidence of thoracic trauma. The most common thoracic injuries were lung contusion (66.6%) and pneumothorax (36%). Forty percent of the cats, with radiographic abnormalities, did not show clinical signs suggestive of thoracic injury.
Pelvic Canal Narrowing Caused by Triple Pelvic Osteotomy in the Dog
Authors: Holmberg D. L. , Hurtig M. B. , Sukhiani H. R.
Published: March 2018

During a triple pelvic osteotomy, rotation of the free acetabular segment causes the pubic remnant on the acetabulum to rotate into the pelvic canal. The resulting narrowing may cause complications by impingement on the organs within the pelvic canal. Triple pelvic osteotomies were performed on ten cadaver pelves with pubic remnants equal to 0, 25, and 50% of the hemi-pubic length and angles of acetabular rotation of 20, 30, and 40 degrees. All combinations of pubic remnant lengths and angles of acetabular rotation caused a significant reduction in pelvic canal-width and cross-sectional area, when compared to the inact pelvis. Zero, 25, and 50% pubic remnants result in 15, 35, and 50% reductions in pelvic canal width respectively. Overrotation of the acetabulum should be avoided and the pubic remnant on the acetabular segment should be minimized to reduce postoperative complications due to pelvic canal narrowing.

When performing triple pelvic osteotomies, the length of the pubic remnant on the acetabular segment and the angle of acetabular rotation both significantly narrow the pelvic canal. To reduce post-operative complications, due to narrowing of the pelvic canal, overrotation of the acetabulum should be avoided and the length of the pubic remnant should be minimized.