bluuebunny/crossref_metadata_2025_split huggingface dataset:
The “third“ circulation in human limbs – tissue fluid, lymph and lymphatics
Authors: Olszewski W. L. 
Published: March 2018

ZusammenfassungDer Autor stellt die aktuelle Definition des lymphatischen Systems vor, wie ähnlich und abhängig es vom venösen System ist, was seine Zusammensetzung ist, wie Gewebeflüssigkeit und Lymphe zwischen Zellen und Blutzirkulation ausgetauscht wird, wie sich das in Lymphödemen ändert und im Besonderen, was die Biochemie der Gewebeflüssigkeit bzw. Lymphe ist, deren Druck und Fluss, die Histopathologie und die Lokalisation und schließlich, wie man die häufigsten Komplikationen bei Lymphödemen behandelt, die Dermatolymphangioadentitis.
II. und III. Krossenrezidiv der Vena saphena magna/ Vena saphena parva
Authors: Glowacki P. , Tran P. , Schäfer L. , Frings N. 
Published: March 2018

Zusammenfassung
Ziel: Wir möchten überprüfen, ob die Technik einer modifizierten Re-Krossektomie beim zweiten und dritten Krossenrezidiv der Vena saphena maga/ parva eine nützliche Therapieoption darstellt. Patienten, Material, Methode: Es handelt sich um eine prospektive Studie (05.05.03 bis 31.03.05) mit n = 98 Beinen (91 Magna, 7 Parva) bei 80 Patienten. Aus diesem Kollektiv waren n = 89 Beine (91%) bereits zweimal und n = 9 (9%) bereits dreimal im Krossenbereich der V. saphena magna oder parva voroperiert. Unsere modifizierte OP-Technik bestand darin, dass wir die Hautinzision unterhalb der früheren Narben gewählt haben. Von hier aus wurde in Richtung Rezidivkrosse präpariert. Die tiefe Leitvene (V. femoralis, V. poplitea) wurde – falls möglich (54%) – dargestellt und die Rezidivkrosse hier ligiert oder disseziert. Bei extremen Verwachsungen haben wir jedoch nur leitvenennah ligiert (46 %). Ergebnisse: Drei Monate postoperativ erfolgte bei allen eine Nachuntersuchung mit Farbduplexsonographie: Major-Komplikationen 0; Minorkomplikationen (Lymphocele, Lymphfistel, Lymphödem, Phlebitis, Wundinfektion) je einmal (5/98 = 5%). OP-Erfolg: In 65% (64/98) war die Krosse frei von refluxtragenden Venenästen und in 35% (34/98) bestand weiterhin ein refluxiver Venenast. Dieser Ast hatte jedoch einen geringeren Durchmesser von 3,5 mm als präoperativ (8,5 mm). Unsere Ergebnisse liegen im Niveau von Studien mit erster Re-Krossektomie: Majorkomplikationen ca. 2%, Minorkomplikationen 5-40%, persistierender refluxiver Venenast im Crossenbereich der V. saphena magna oder parva in 5–71%. Studien mit zweiter Re-Krossektomie scheint es nicht zu geben. Schlussfolgerung: Unsere modifizierte OP-Technik stellt eine nützliche Therapieoption dar mit fehlenden Majorkomplikationen, extrem niedriger Minorkomplikationsrate und einer postoperativen Refluxfreiheit im Bereich der Magna-/Parva-Krossenregion, die vergleichbar ist mit den Daten nach erster Re-Krossektomie.
Prilocaine pharmacokinetics and the influence of vitamin C on methaemoglobin concentrations in tumescent anaesthesia
Authors: Teichler A. , Standl T. , Diederich A. , Moll I. , Bruning G. 
Published: March 2018

SummaryIn tumescent local anesthesia high doses of prilocaine are used but valid data on the pharmacokinetics and metabolism of prilocaine during this technique of anesthesia are rare. Patients, methods: In this study plasma prilocaine and methaemoglobin concentrations were measured after subcutaneous injection of prilocaine at doses of 6.69 to 19.21 mg/kg in one hundred patients undergoing varicose vein surgery under tumescent local anesthesia. Half of the patients were randomised to intravenous treatment with 2000 mg ascorbic acid. Glucose-6-phosphate dehydrogenase activity was measured preoperatively. Results: Maximum plasma prilocaine concentrations ranged between 0.14 and 0.86 μg/ml and thus remained below the toxic threshold. Methaemoglobin concentrations ranged between 0.4 and 16.9%. There was no significant effect of vitamin C on the methaemoglobin concentration. Glucose-6-phosphate dehydrogenase activity and methaemoglobin concentrations did not correlate. Conclusions: Tumescent anesthesia with prilocaine at a maximum dose of 20 mg/kg body weight is a safe procedure in varicose vein surgery although the risk of methaemoglobinemia is not reduced by using vitamin C.
Sonographically guided, transcatheter foam sclerotherapy of the great saphenous vein
Authors: Schulz T. , Jünger M. , Hahn M. 
Published: March 2018

Summary
Objective: The goal of the study was to assess the effectiveness and patient tolerability of single-session, sonographically guided, transcatheter foam sclerotherapy and to evaluate its economic impact. Patients, methods: We treated 20 patients with a total of 22 varicoses of the great saphenous vein (GSV) in Hach stage III-IV, clinical stage C2-C5 and a mean GSV diameter of 9 mm (range: 7 to 13 mm). We used 10 ml 3% Aethoxysklerol®. Additional varicoses of the auxiliary veins of the GSV were sclerosed immediately afterwards. Results: The occlusion rate in the treated GSVs was 100% one week after therapy as demonstrated with duplex sonography. The cost of the procedure was 207.91 E including follow-up visit, with an average loss of working time of 0.6 days. After one year one patient showed clinical signs of recurrent varicosis in the GSV; duplex sonography showed reflux in the region of the saphenofemoral junction in a total of seven patients (32% of the treated GSVs). Conclusion: Transcatheter foam sclerotherapy of the GSV is a cost-effective, safe method of treating varicoses of GSV and broadens the spectrum of therapeutic options. Relapses can be re-treated inexpensively with sclerotherapy.
Elastic compression for varicose vein surgery
Authors: Bisacci R. , Bisacci C. , Pagliuca V. , Spinelli G. M. , De Rango P. 
Published: March 2018

SummaryIn daily clinical practice the elastic compression before and after varicose vein surgery is not standardized and there are no clear indications on techniques or materials to use, especially for uncomplicated varicose disease (i.e., absence of ulcers, lymphoedema). Aim of the study was to evaluate the current use of elastic compression for varicose vein in different vein surgical settings in Italy, and to compare Italian practice to the customary approaches used in other European countries. Methods: A national survey exploring pre-, intra and postoperative practice in varicose vein surgery was conducted among surgical departments throughout Italy. Results: The survey, involving practice patterns in 112 Italian venous Surgical departments (26,792 venous operations), showed that a large number of survey respondents ( 57/112), considered use of elastic compression as „non indispensable” in the preparation for varicose vein surgery, but all of them applied compression in the immediate post operative management and at discharge. However, techniques and materials employed for postoperative elastic compression were generally based on personal opinions and thereby, were largely dissimilar among centres. Conclusion: The use of elastic compression for varicose vein surgery is still applied with disparate modalities according with the individual’s experience. Efforts toward more uniformed and wide application of elastic compression need to be implemented. Standardization in the management for varicose venous surgery will reflect in better results also in terms of cost-effectiveness and patient care.
Die Erfahrung zeigt, dass man mit ganz Einfachem recht gut klar kommt.
Authors: Rieger M. , Wilm S. , Wollny A. 
Published: March 2018

Zusammenfassung
Ziel: Mit der Durchführung eines Praxistests der S3-Leitlinie zu Diagnostik und Therapie des Ulcus cruris venosum der DGP sollen Akzeptanz und Praktikabilität der Empfehlungen unter Bedingungen der phlebologischen Praxis untersucht und Erkenntnisse über mögliche Barrieren bei der Implementierung in die Regelversorgung erforscht werden.Methoden: Praxisanwendung bei vertragsärztlich tätigen Phlebologen. Qualitativer Ansatz mit Fokusgruppen und Telefoninterviews, die nach Protokollierung bzw. Transkribierung von zwei Forschern unabhängig inhaltsanalytisch unter der globalen Fragestellung des Projektes systematisch ausgewertet wurden. Ergebnisse: Die Phlebologen betrachten die Leitlinie als theoretischen Goldstandard in Abweichung zur eigenen praktischen Tätigkeit. Hemmende Faktoren bei der Umsetzung im Alltag sehen sie in unzureichenden Vergütungsstrukturen, den Patienten selbst sowie verschiedenen Rahmenbedingungen. Evidenzbasiertes Handeln scheint im Alltag nur eine untergeordnete Rolle zu spielen. Schlussfolgerung: Implementierungshindernisse sowie detaillierte Anregungen der Nutzer könnten für eine Überarbeitung der Leitlinie herangezogen werden.
Schaumverödung: lange Wiederaufschäumbarkeit von Polidocanol-Schäumen
Authors: Gallenkemper G. 
Published: March 2018

ZusammenfassungUnter der Bedingung eines standardisierten Herstellungsverfahrens konnte nachgewiesen werden, dass sowohl 3%ige als auch 1%ige Polidocanol-Schäume nach Verflüssigung mehrfach und über längere Zeiträume ohne Verlust der Schaumqualität wiederaufgeschäumt werden können. Das Aufschäumprinzip entsprach dem DSS-Prinzip. Der 3%ige Schaum wurde über 64 Tage 13-mal wiederaufgeschäumt, der 1%ige Schaum über 78 Tage 12-mal. Am Ende jeder Versuchsreihe konnte ein feinblasiger Schaum gewonnen werden, wobei der 3%ige Schaum etwas feinblasiger war und sich etwas langsamer verflüssigte.
Compression therapy following ambulatory phlebectomy
Authors: Bruins F. G. , Neumann H. A. M. , de Roos K.-P. 
Published: March 2018

Summary
Aim: The study was designed to evaluate the feasibility, results and safety of a very short period of compression after ambulatory phlebectomy. Patients, methods: From September to December 2006 we prospectively studied 49 subsequent patients who underwent ambulatory phlebectomy for branch varicose veins. Post-operatively the treated part of the leg was bandaged for forty-eight hours. Results: No major adverse events occurred. Although 46.9% of treated patients had visible haematomas two days post-operatively, after six weeks this was only visible in one patient. The results of this study show that the clinical outcome of ambulatory phlebectomy in combination with compression for forty-eight hours is at least equal to a conventional (longer) period of compression. Conclusion: Post-operative treatment can be safely reduced without the need of adjuvant compression hosiery. This will reduce patient discomfort after ambulatory phlebectomy without jeopardizing the clinical outcome.
Lymphatic complications following an operation on varicose veins by patients with advanced venous insufficience
Authors: König N. , Miszczak Z. T. , Stark H. J. , Baier P.-M. 
Published: March 2018

SummaryLymphatic complications are minor complications after varicose vein surgery. The frequency of lymphatic complications following an operation on varicose veins is very rarely discussed in literature. Patients, method: We investigated their frequency in a prospective study. Results: Between January 2004 and December 2005 in the cases of 3565 varicose vein operations we found 345 or 9.7% lymphatic complications, i.d. 123 cysts (3.4%), 24 fistulas (0.7%), 7 lymphorrhoe (0.2%) and 5 lymphoedema (0.14%). Conclusion: Lymphoedema is the only longlasting complication of the varicose vein surgery.
Guidelines for diagnosis and therapy of venous ulcers (version 8 2008)
Authors: Gallenkemper Dr. med. Georg 
Published: March 2018

SummaryFour years after the publication of the latest guidelines on diagnosis and therapy of venous ulcer the German Society of Phlebology defines a completely revised and expanded version after the review of the literature published in the meantime. Particular emphasis was laid on international standards, new chapters are related to socio-economic aspects, the physical perception of the patients and the implementation of the guidelines in clinical practice.
Prevalence of iodine- and thyroglobulin negative findings in differentiated thyroid cancer
Authors: Klutmann S. , Jenicke L. , Geiss-Tönshoff M. , Mester J. , Clausen M. , Bohuslavizki K. H. 
Published: March 2018

Summary
Aim: The prevalence of iodine- and thyroglobulin-nega-tive findings was evaluated in all patients with differentiated thyroid cancer (DTC) treated from 1961 until 1998 at the Department of Nuclear Medicine, University Hospital Hamburg-Eppendorf. Methods: A total of 490 patients with papillary thyroid cancer (PCA) and 242 patients with follicular thyroid cancer (FCA) were analyzed retrospectively. Patients were divided into four groups: 1: no recurrence, 2: recurrent disease, 3: primary metas-tatic/progressive disease and 4: inconclusive follow-up. Results of iodine scan, serum-TG, and additional imaging modalities as well as histology were compared in all patients. Results: 21/490 (4,3%) of patients with PCA and 16/242 (6,6%) with FCA suffered from recurrent disease. 62/490 (12,7%) of patients with PCA and 59/242 (24,4%) with FCA had primary metastatic/progressive disease. 12/21 patients with PCA and 12/16 with FCA showing up with recurrent disease had a negative iodinescan. 11/21 of patients with PCA and 4/16 with FCA and tumor recurrence had negative serum-TG levels. 14/62 patients with PCA and 14/59 with FCA presenting with primary metastatic/ progressive disease had negative iodinescan. 14/62 patients with PCA and 6/59 with FCA had negative serum-TG. Conclusion: The prevalence of iodine-negative recurrent"/metastatic disease is in accordance to the literature, whereas the prevalence of TG-negative recurrent/metastatic was noted higher than reported previously. Thus, the commonly used follow-up scheme of DTC is confirmed. However, iodine scan should be regularly performed in patients with high risk of recurrence.
Sentinel node biopsy in breast cancer
Authors: Bembenek A. , Büchels H. , Decker T. , Dunst J. , Müllerleile U. , Munz D. L. , Ostertag H. , Sautter-Bihl M. L. , Schirrmeister H. , Tulusan A. H. , Untch M. , Winzer K. J. , Wittekind C. , Kühn T. 
Published: March 2018

SummaryThe international consensus conference from St. Gallen concerning the treatment of early breast cancer concluded in 2003, that sentinel node biopsy was now accepted as method allowing axillary staging in breast cancer. This procedure may avoid complete lymph node dissection in appropriate cases. Since numerous questions associated with the technique are still not defined and the procedure itself is not yet standardized, the German Society of Senology defined the conditions for the routine clinical use of sentinel node biopsy in an interdisciplinary consensus meeting.
PET in neuroscience
Authors: Bartenstein P. 
Published: March 2018

SummaryThis article gives an overview on radiotracer imaging with positron emission tomography (PET) in measuring various aspects of neurotransmission. The review focusses on the dopaminergic system, the GABA/benzodiazepine system, and the opiate system. Besides dealing with the current clinical applications for brain PET studies with specific radiopharmaceuticals this article outlines an idea on potential future developments for the use of these methods in basic neuroscience.
Guideline on radiation protection in medicine requires documentation of radioiodine therapy and follow-up
Authors: Rosa F. , Knesewitsch P. , Hahn K. , Koch W. 
Published: March 2018

Summary
Aim: The lately updated German guideline on radiation protection in medicine (Richtlinie Strahlenschutz in der Medizin) requires the physician who administers radioactive substances for therapy, to perform and document follow-ups. In order to decrease the administrative burden, an electronic database was developed that interfaces with a word processing software to generate written reports and statistic analysis. Methods: Based on Microsoft® Access and Microsoft® Visual Basic a database was created to monitor patients with benign and malignant thyroid disorders after radioiodine therapy. It permits automatic creation of therapy documents and necessary patient reports in Microsoft® Word. Intuitive handling, third level of normalization in database architecture and automatic plausibility checks guarantee integrity of the data and the efficacy of the database. Results, conclusion: The new software has been a success in over 1500 patients and over 3800 in- and outpatient therapies and visits. The effort of data entry is easily offset by the automatic generation of the necessary patient reports. The required supervision of the follow-up appointments is now also user-friendly and efficient.
Quantitation of neuroreceptors: a need for better SPECT imaging
Authors: Yang J. , Kilpeläinen H. , Kuikka J. T. , Kauppinen T. 
Published: March 2018

Summary
Aim: Existing methods to determine the binding potential in brain receptor and transporter studies with single-photon emission computed tomography (SPECT) show a marked dependence on the physical performance of the scanner and on the regions of interest (ROIs) drawn. We examined the influence of the physical performance on the binding potential. Method: The authors tested three gamma cameras (single-, dual- and triple-head) and two reconstruction techniques (conventional filtered back-projection and iterative reconstruction method) to determine the binding potential in brain receptor studies. Both human and organ-like phantom studies were performed. Results: The binding potential was completely dependent on the imaging resolution, on the reconstruction technique used and on the ROIs drawn. The results of the phantom study revealed that the striatum-to-cerebellum ratio was only 37% of the actual one for the single-head, 63% for the dual-head and 72% for the triple-head gamma camera. Conclusion: The multiple head gamma camera with fan-beam collimators and iterative reconstruction with the attenuation based scatter correction is an imaging system of choice which introduces clinically more relevant images and is able to distinguish smaller differences in radioactivity at early stage of disease. However, for quantitative purposes the improvement without the use of the recovery coefficient is not great enough to restore the binding potentials to those of the true ones.
99mTc-Aprotinin: Comparison with 99mTc-DMSA in Normal and Diseased Kidneys
Authors: Saponaro R. , Villa G. , Lunghi F. , Aprile C. 
Published: March 2018

SummaryAprotinin (A) and DMSA labelled with 99mTc were compared in patients with normal (NK, n = 12) and diseased kidneys (CRF, n = 13) by means of quantitative serial scans and measurements of blood clearance and urinary excretion. Serial scans only were obtained in additional 13 patients. Scan quality in the NK patients was essentially equal: faster blood clearances, reduced urinary excretions and higher fixations of A in the target compensated for the increased liver uptake. On the other hand, the scan quality in the CRF patients was definitely superior with A, allowing detection of residual functioning parenchyma also in severe kidney failure. Correlation between the net kidney uptake 6 hrs p.i. and the separate hippuran clearance rate was better with A than with DMSA, indicating the feasibility of A in evaluating relative renal function.
Synthesis of, and Animal Experiments with, N-Isopropyl-p-123I-Iodo-Amphetamine (IMP) and 18F-3-Deoxy-3Fluoro-D-Glucose (3-FDG) as Tracers in Brain and Heart Diagnostic Studies
Authors: Knust E. J. , Baldwin R. M. , Chen T. , Feinendegen L. E. , Machulla H.-J. 
Published: March 2018

SummaryGermanyFor the investigation of brain functions 18F-3-deoxy-3-fluoro-D-glucose (3-FDG) and N-isopropyl-p-123I-iodoamphetamine (IMP) were synthesized and the course of radioactivity measured in several organs of mice. The results can be summarized as follows:1.IMP is rapidly extracted from the blood and reaches a value of less than 1%/g within the first 15 min;2.123I-radioactivity in the lungs shows a maximum of 76%/g as soon as half a minute after injection and decreases with a concomitant increase in the liver and brain;3. The maximum 123I-uptake in the brain of 11%/g is reached after 30 min and levels off at a constant value of 10%/g;4. 30 min after injection the brain/ blood ratio for IMP is about 14;5. The time course of 3-FDG in the brain has a maximum of 4.8%/g as soon as 5 min after injection and decreases to a constant value of 3%/g within 1 hr; and6. Accumulation of 18F-radioactivity in the heart reaches a maximum of 14%/g after 1 hr and is eliminated with a half-life of 300 min. Comparative clinical studies with 3-FDG and 3-0-11C-methyl-D-glucose (ÇMG) have shown that 3-FDG can be considered as a CMG-analogue and thus can be used for the in-vivo determination of local glucose perfusion and transport rates.
A Radiopharmacological Study without Human Radiation Exposure
Authors: Graul E. H. , Kunkel R. , Loew D. 
Published: March 2018

SummaryThe development, study and control of new drugs today is hardly conceivable without nuclear medicine studies. Nuclear physicians on ethical commissions bear great responsibility in the planning and execution of such studies. In order to protect subjects and patients those nuclear techniques are therefore to be welcome which do not include exposure to radiation. Nuclear techniques used in in-vitro diagnostics (RIA) and the determination of naturally occurring nuclides incorporated in the human body belong to this category. With the aid of a clinico-pharmacological study of a new combination of diuretics it is shown that both methods supply valuable pharmacodynamic evidence.
Freies Thyroxin in der Routinediagnostik
Authors: Thani B. , Kahn P. 
Published: March 2018

ZusammenfassungDie Amerlex FT4-Bestimmung hat sich bei uns als Routinescreening sehr gut bewährt. Mit dieser Methode haben wir gegenüber dem Gesamtthyroxin etwa 30% aller schilddrüsenspezifischen Folgeuntersuchungen einsparen können, wobei diese Reduktion vor allem die TBG-Bestimmungen betrifft. Auch die Frequenz der Trijodthyroninbestimmungen hat gering abgenommen, jene der TSH-Spiegel gering zugenommen, was möglicherweise Ausdruck einer besseren Erkennbarkeit inzipienter Hypothyreosen ist. Die Interpretation von FT4-Werten bei heparinisierten Patienten erfordert besondere Vorsicht. Mit der Umstellung der Bestimmungsmethode von Gesamtthyroxin auf freies Thyroxin ersparen wir unserem Kostenträger jährlich etwa 250000 Schilling an Sachaufwand, ohne dadurch die Treffsicherheit unserer Diagnostik einzuschränken. Spezifität und Treffsicherheit sind gegenüber der früheren Testkombination sogar besser geworden.
Gibt es einen Zusammenhang zwischen Adipositas und Adhärenz für Immunsuppressiva bei Patienten nach Nierentransplantation?
Authors: Pabst S. , Nöhre M. , Bertram A. , Schiffer M. , de Zwaan M. , Albayrak Ö. 
Published: March 2018

ZusammenfassungDie Entwicklung von Adipositas nach einer Organtransplantation erhöht das Risiko für Komplikationen bis hin zum Transplantatverlust. In einer Querschnittsuntersuchung mit 241 nierentransplantierten Patienten wurde der Zusammenhang zwischen Adipositas und verschiedenen Maßen zur Bestimmung der Adhärenz mit Immunsuppressiva (IS) (Selbstbericht, Arzteinschätzung, Biopsie-gestützte Rejektionen, Variationskoeffizient der IS-Talspiegel) untersucht. Zum Zeitpunkt der Transplantation waren 12,9% (n=31) der Patienten adipös und zum Nachuntersuchungszeitpunkt (im Durchschnitt nach 7,2 Jahren) waren 23,7% (n=57) adipös (BM ≥ 30 kg/m2). Wir konnten keinen Unterschied zwischen adipösen und nicht adipösen Patienten in der selbst-beurteilten Adhärenz, der Adhärenzeinschätzung durch die betreuenden Ärzte und dem Vorliegen einer Biopsie-gestützten Rejektion während der letzten 12 Monate finden. Adipöse Patienten wiesen allerdings eine höhere Serumvariabilität der IS-Talspiegel auf im Vergleich zu nicht-adipösen Patienten (p=0,03). Die Serumvariabilität ist allerdings kein reines Adhärenzmaß. Insgesamt gibt es keine überzeugenden Hinweise darauf, dass Adipositas die IS Adhärenz bei Patienten nach Nierentransplantation negativ beeinflusst.