bluuebunny/crossref_metadata_2025_split huggingface dataset:
Der Einfluß von pH auf das freie Serum-Thyroxin und seine physiologische Bedeutung
Authors: Bekier A. 
Published: March 2018

ZusammenfassungDas freie, biochemisch wirksame Serum-Thyroxin bleibt im dynamischen Gleichgewicht mit dem proteingebundenen Thyroxin, welches als Reservoir wirkt. Der Thyroxin-Spiegel im Blut bleibt konstant unabhängig vom Tages/Nacht-Rhythmus, körperlichen und psychischen Belastungen. Meßbare Veränderungen des freien Serum-Thyroxins sowie der thyroxinbindenden Präalbumine konnten dagegen bei verschiedenen Stress-Situationen festgestellt werden.Mittels Gleichgewichts-Dialyse (Equilibrium Dialysis) wird der Einfluß der Wasserstoffionenkonzentration auf die dialysierbare Thyroxin-Fraktion des Serums untersucht. Bei pH Verschiebung der Pufferlösung in saurer Richtung konnte eine Zunahme der dialysierbaren Thyroxin-Fraktion beobachtet werden.Die elektrophoretischen Untersuchungen im Veronal-Natrium-Puffer pH 8,6 und 7,0 zeigten eine nicht signifikante Zunahme der Thyroxin-Bindung durch die Albumin-Fraktion im pH 7,0.Die beobachteten Auswirkungen der Wasserstoffionenkonzentration auf die thyroxinbindenden Proteine des Serums und das freie Serum-Thyroxin stimmen überein mit den Literaturangaben.Die Zusammenhänge zwischen dem pH des Serums, der Bindungskapazität der thyroxinbindenden Proteine sowie dem freien Serum-Thyroxin deuten auf eine physiologisch-regulatorische Rolle der Wasserstoffionenkonzentration.
A Comparison of Serum Thyroxine [T4(D)], RT3U Ratio and T4-RT3 Index with Radioiodine Uptake in the TSH Stimulation Test
Authors: Höschl R. , Gimlette T. M. D. 
Published: March 2018

SummaryA total of 236 TSH stimulation tests were performed using 10 units of TSH intramuscularly. 4 hour uptake of 132I, serum thyroxine [T4(D)], T3 binding coefficient [RT3U ratio] and free thyroxine index [T4-RT3 index] were estimated before and 18 hours after TSH.In 88 tests classified by radioiodine uptake change as positive serum thyroxine increased significantly in only 63.7%, T4-RT3 index in 61.5%.Out of 108 tests classified as negative by radioiodine uptake, serum thyroxine increased significantly in 14.8% and T4-RT3 index in 13.0%.The RT3U ratio procedure used was the least reliable parameter in testing thyroid response to TSH stimulation, T4RT3 index was no better than T4(D) alone.The change in serum thyroxine levels in response to TSH stimulation is in our opinion unreliable for the evaluation of TSH tests, and correlates poorly with changes in radioiodine uptake (r = 0.37), for reasons which are discussed.
Renogram Modification Caused by Furosemide
Authors: Camargo Edwaldo 
Published: March 2018

Parmi 22 individus normaux et 21 individus portant seulement ou à la fois de la nephropatie, de l’uropathie et de l’hypertension arterielle, l’auteur a analysé statistiquement l’action de la furosemide sur le fluxe plasmatique de chaque rein (FPRD et FPRG) et sur les paramètres de temps du rénogramme, ci-dessus: Tmax, T1/2, T5 et Tex.Les résultats montrent que le diurétique réduit fort les paramètres de temp étudiés, sans modifier le fluxe plasmatique de chaque rein. Ils montrent aussi que le médicament ne modifie ni le rythme du fournissement du traceur à la cellule ni le “chemin” parcouru par lui. La montée de la velocitée de transport cellulaire du radiopharmaceutique sous l’action diurétique pourrait être expliquée par le gradient de concentration intra-cellulaire et intraluminal du traceur: il y a des conditions pour le dévelopement du troisième segment du rénogramme quand la valeur minimal de cet gradient est atteinte.La réduction des paramètres de temps, qui peut atteindre des valeurs équivalants ou inférieures a celles que présentent les individus normaux, ne permet pas d’obtenir des rénogrammes chez les malades qui se servent du medicament ou l’on risque d’interpréter comme normal une courbe qui serait pathologique. Cette erreur dévient plus probable si l’involvement cellulaire n’a pas été suffisant pour additioner des altérations morphologiques à celles de la durée de la mesure.L’auteur propose un critérium clinique pour évaluer la gravidité des altérations souffertes par les cellules tubulaires: dans le cas d’un rénogramme anormal, on le repète sous l’action de la furosémide pour vérifier si les altérations disparaissent ou demeurent.
Some Experiences with the Preparation of 99mTc-DTPA
Authors: Tertoolen J. F. W. 
Published: March 2018

SummaryThe behaviour of 99mTc after preparation of Tc-DTPA is studied. Blood incubation tests suggest a good chemical stability of Tc-DTPA. Tc-proteins and a pertechnetate-like compound are formed during in vitro incubation of freshly prepared 99mTc-DTPA with blood by a radiochemical impurity.
Die Myokarddurchblutung bei berufstätigen Koronarkranken
Authors: Heeger H. , Aldor E. , Kahn P. 
Published: March 2018

ZusammenfassungBei 89 Patienten mit koronarer Herzkrankheit wurde im Rahmen der Koronarangiographie die Durchblutung der linken und (oder) der rechten Koronararterie mit der 133Xe-Auswaschmethode bestimmt. Statistisch ergab sich zwischen den Flow-Werten der LCA und der RCA ein hochsignifikanter Unterschied, zwischen den Durchblutungswerten von berufstätigen koronarkranken Arbeitern und Angestellten aber keiner. Interessant ist die signifikant bessere Durchblutung sowohl der rechten als auch der linken Koronararterie von weiblichen gegenüber männlichen Berufstätigen.
Änderung der Durchblutung und Durchblutungsverteilung nach normo und hypothermer Ischämie der Nieren
Authors: Heinze H. G. , Eisenberger F. , Chaussy Ch. , Wirth H. , Pfeifer K. J. 
Published: March 2018

ZusammenfassungEs wurde in Experimenten an 22 Bastard-Hunden der Mechanismus überprüft, der zu einer permanenten bzw. reversiblen Nierenparenchymschädigung nach normo- und hypothermischer Ischämie führt. Zu diesem Zweck wurden die Durchblutung und die Durchblutungs-Verteilung mit 133Xenon, die Gefäßveränderungen angiographisch und die Parenchymfunktion mit 131J-Hippuran untersucht.Nach normothermer Ischämie tritt eine kurzfristige reaktive Hyperämie auf, die allerdings die entstandene Tubuluszellschädigung mit Ausscheidungsinsuffizienz nicht zu kompensieren vermag.Nach hypothermer Ischämie ist zwar die Durchblutung wahrscheinlich als Folge einer kältebedingten Vasokonstriktion vorübergehend eingeschränkt, die Tubuluszellfunktion ist jedoch aufgrund der protektiven Wirkung der Unterkühlung erhalten. Die Bedeutung dieser Befunde für die Entstehung einer sog. Schockniere (akute Tubulusnekrose) und für die konservative Nierenchirurgie in Hypothermie wird diskutiert und die Anwendung durchblutungsfördernder Maßnahmen angeregt.
Evaluation of patients with liver metastases from colorectal cancer for locally ablative treatment with laser induced thermotherapy
Authors: Denecke T. , Hildebrandt B. , Rühl R. , Miersch A. , Nicolaou A. , Ruf J. , Plotkin M. , Hänninen E. L. , Stroszczynski C. , Gutberlet M. , Langrehr J. , Riess H. , Ricke J. , Amthauer H. 
Published: March 2018

SummaryPurpose: Before locally ablative treatment of colorectal liver metastases, patients have to be carefully evaluated to decide whether this is the adequate therapy. In this study we determined the value of FDG-PET in comparison to conventional staging procedures. Patients, methods: In 68 consecutive patients referred for laser induced thermotherapy (LITT) of liver metastases from colorectal cancer, pretherapeutic staging with conventional imaging (thoracic and abdominal CT, liver MRI, chest X-ray) and FDG-PET was performed. The examinations were analysed separately and blinded. Based on the staging information, therapeutic decisions were made by an interdisciplinary review board according to a standardized algorithm. The results were compared between conventional imaging and FDG-PET, and were validated by clinical follow up data and histopathology, respectively. Results: On FDG-PET 210 lesions were interpreted as tumour manifestations. 48 of these were not seen on conventional imaging (true positive, n=46). In contrast, 24 lesions were visualized by conventional imaging only (true positive, n=12). Compared to conventional imaging, discrepant findings on FDG-PET led to treatment modifications in 25 patients (37%); these were correct in 20/25 patients. According to the actual treatment course, the inadequate treatment modifications in the remaining 5 patients were avoided by further diagnostic procedures (i.e. biopsies). Conclusion: In the evaluation of patients with known liver metastases from colorectal cancer before LITT, FDG-PET depicts relevant findings subsidiary to conventional imaging and thus is of high value for therapeutic decision making.
Combined transmission and 99mTc-sestamibi emission tomography for localization of mediastinal parathyroid glands
Authors: Prager G. , Kienast O. , Dobrozemsky G. , Dudczak R. , Niederle B. , Kurtaran A. , Kaczirek K. 
Published: March 2018

Summary:
Aim: Although parathyroid scintigraphy using 99mTc-sestamibi is considered the best preoperative localization method for hyperfunctioning parathyroid tissue it lacks the anatomical details required for successful, minimal invasive surgery of ectopic parathyroid lesions. This study presents the role of combined SPECT/X-ray-CT imaging in a single device for localization of mediastinal parathyroid glands. Methods: 99mTc-sestamibi SPECT/ X-ray-CT was performed by gamma camera-mounted anatomical X-ray tomography (GMAXT; GE Medical systems, Millenium VG with Hawkeye) in four patients with ectopic parathyroid glands (two patients with primary, two with persistent secondary hyperparathyroidism). The device contains an X-ray tube and a set of detectors that rotate around the patient combined with a gamma camera. For comparison with GMAXT additionally high resolution computed tomography images of the neck and mediastinum were performed. Results: Correct preoperative localization was achieved. The parathyroid glands were located in the anterior mediastinum. High resolution computed tomography could not provide further details. Three patients were operated by a minimal invasive open and one patient by a transsternal approach because of concomitant aortic valve replacement. Conclusion: 99mTc-sestamibi/X-ray-CT fusion imaging in a single device can accurately localise ectopic or supernumerary mediastinal parathyroid tumours in primary and secondary hyperparathyroidism. Morbidity, radiation exposure, time, and costs are reduced by avoiding multiple diagnostic examinations and minimal invasive parathyroid surgery becomes possible.
Guideline for radioimmunotherapy of rituximab relapsed or refractory CD20+ follicular B-cell nonHodgkin´s lymphoma
Authors: Behr T. , Grünwald F. , Knapp W. H. , Trümper L. , von Schilling C. , Fischer M. ,   für die Deutsche Gesellschaft für Nuklearmedizin,   Schilling für die Deutsche Gesellschaft für Hämatologie und Onkologie
Published: March 2018

Summary:This guideline is a prerequisite for the quality management in the treatment of non-Hodgkin-lymphomas using radioimmunotherapy. It is based on an interdisciplinary consensus and contains background information and definitions as well as specified indications and detailed contraindications of treatment. Essential topics are the requirements for institutions performing the therapy. For instance, presence of an expert for medical physics, intense cooperation with all colleagues committed to treatment of lymphomas, and a certificate of instruction in radiochemical labelling and quality control are required. Furthermore, it is specified which patient data have to be available prior to performance of therapy and how the treatment has to be carried out technically. Here, quality control and documentation of labelling are of greatest importance. After treatment, clinical quality control is mandatory (work-up of therapy data and follow-up of patients). Essential elements of follow-up are specified in detail. The complete treatment inclusive after-care has to be realised in close cooperation with those colleagues (haematology-oncology) who propose, in general, radioimmunotherapy under consideration of the development of the disease.
Residual kidney function after donor nephrectomy
Authors: Wilhelm A. , Döbert N. , Menzel C. , Gossmann J. , Berner U. , Zaplatnikov K. , Scheuermann E. H. , Grünwald F. , Hamscho N. 
Published: March 2018

Summary:Aim: We evaluated the long-term residual renal function after donor nephrectomy using 99mTc-mercaptoacetyltriglycin (MAG3)-clearance. Donors, methods: Altogether 49 kidney donors were examined using 99mTc-MAG3-clearance after nephrectomy for donation to a relative (m:f = 11:38; age 55±27 years). The donors were examined 16±8 years postoperatively (1.5-26 years). 42 donors (86%) showed normal creatinine values, whereas the other seven (14%) exhibited slightly elevated levels. 20 donors were examined pre- and postoperatively and compared intraindividually. The kidney function was compared to the age adapted normal values of healthy persons with two kidneys (67–133% of age related mean). Results: After nephrectomy all donors showed a normal perfusion, good secretion, merely physiological intrarenal transit and a normal elimination from the kidneys. The 99mTc-MAG3-clearance was 69 ±15% of the normal mean value of healthy carriers of two kidneys regardless of the gender. 20 donors with a preoperative examination showed a significantly reduced total renal function from 84 ± 15% of the mean normal value preoperatively to 60 ± 15% postoperatively (p <0.0005). 15 donors of this group exhibited a significant functional increase of the residual kidney from 40% initially to 60% after nephrectomy (p = 0.003). No correlation was found between the initial 99mTc-MAG3-clearance measured prior to nephrectomy and the clearance levels after nephrectomy. Also, no correlation between the preoperative 99mTc- MAG3-clearance and the postoperative serum creatinine values could be observed. Altogether, 22% of the donors (11/49) developed arterial hypertension 10 ± 8 years after donation (1-23 years). This corresponds to the normal age prevalence of hypertension in the carriers of two kidneys. Three donors suffered from arterial hypertension prior to the operation. Conclusion: Kidney donors with normal or slightly elevated creatinine values postoperatively show a 99mTc- MAG3-clearance value of 69% of the mean value of healthy carriers of two kidneys. This may serve as a reference value for healthy carriers of one kidney. In our study we demonstrated a good compensation of the contralateral kidney via renal scintigraphy by means of 99mTc-MAG3-clearance.
Evil radioactivity
Authors: Beyer T. , Müller S. P. , Görges R. , Hopfenbach A. , Bockisch A. , Freudenberg L. S. 
Published: March 2018

Summary:Aim: We assess the perspective of patients with thyroid disease towards radiation and radioactivity by means of a cultural- anthropological approach based on qualitative measures and quantitative scores. From the interviews with the patients we evaluate as to how much radioactivity is accepted as an abstract term or as a benefit within the medical context. Patients, methods: 68 patients with autonomously functioning thyroid lesions (35 women, 33 men, 32-81 years) were included in this study. All patients were interviewed in an open dialogue with the principal investigator. Patients were asked to describe their attitude towards radioactivity in general and towards radioiodine therapy in particular. Patients were asked to use a scoring system (1 = positive, 5 = negative) to quantify their attitudes. Results: The responses of all patients towards radioactivity in general were heterogeneous with most responses reflecting a negative perception. Many patients expressed their associated fears about atomic energy, malignant diseases and radioactive contamination. The scoring system reflected a mostly negative opinion base. However, patients became more positive once they assumed an immediate benefit of radioactivity for the treatment of their own disease (p = 0.01). Conclusions: Knowing about significant differences in patient’s perception about radioactivity in general or in the clinical context may help to optimise and tailor the initial, pre-therapeutical interview towards the patient.
Guideline for therapy of malignant thyroid tumours
Authors: Wieler H. , Bartenstein P. , Becker H. P. , Bell E. , Decker P. , Jacob R. , Kirsch C.-M. , Musholt T. , Schwab R. , Schwerdtfeger P. , Trampert L. 
Published: March 2018

SummaryTotal (or near total) thyroidectomy (TE) followed by radioiodine (131I) ablation (RIA) of residual thyroid tissue is considered to be the ideal treatment for differentiated thyroid carcinoma. However, the actual guideline of the DGN (German Society of Nuclear Medicine) recommends for the so-called papillary micro-carcinoma of the thyroid (PMC) no further therapeutic strategy (no complete TE, no 131I-ablation of the remaining lobe). PMC has been defined as papillary carcinoma measuring 1 cm (T1) in maximal diameter according to the World Health Organization classification system for thyroid tumours (1988). The new WHO-classification (starting in 2003) defines the T1-tumour measuring 2 cm in maximal diameter. The authors demand a new, modern guideline, following the new WHO classification. This includes, that despite the overall excellent prognosis for patients with PMC, the treatment of patients with T1-tumours of the new WHO-classification (including the “old” PMC) should be no different from the treatment of patients with conventional papillary thyroid carcinoma, i.e. complete surgery (TE and central lymph node dissection) followed by RIA of residual thyroid tissue. The authors argue that it is not appropriate to consider the tumour size as the single most important key factor for therapy and prognosis. Even small tumours may have poor prognostic factors, such as lymph node metastasis, multifocality or molecular characteristics (expression of oncogenes).
Sentinel lymph node diagnostic in prostate carcinoma: Part II: Biokinetics and dosimetry of 99mTc-Nanocolloid after intraprostatic injection
Authors: Kopp J. , Vogt H. , Wawroschek F. , Gröber S. , Dorn R. , Heidenreich P. , Wengenmair H. 
Published: March 2018

Summary
Aim: To visualise the sentinel lymph nodes (SLNs) of the prostate we injected the radiotracer into the parenchyma of the prostate. The activity was deposited in liver, spleen, bone marrow, urinary bladder and regional lymphatic system. The aim of this work is to determine biokinetical data and to estimate radiation doses to the patient. Methods: The patients with prostate cancer received a sonographically controlled, transrectal administration of 99mTc-Nanocoll®, injected directly into both prostate lobes. In 10 randomly selected patients radionuclide distribution and its time course was determined via regions of interest (ROIs) over prostate, urinary bladder, liver, spleen and the lymph nodes. The uptake in the SLNs was estimated from gamma probe measurements at the surgically removed nodes. To compare tumour positive with tumour free lymph nodes according to SLN-uptake and SLNlocalisation we evaluated 108 lymph nodes out of 24 patients with tumour positive SLN. For calculating the effective dose according to ICRP 60 of the patients we used the MIRD-method and the Mirdose 3.1 software. Results: The average uptake of separate organs was: bladder content 24%, liver 25.5%, spleen 2%, sum of SLN 0.5%. An average of 9% of the applied activity remained in the prostate. The residual activity was mainly accumulated in bone marrow and blood. Occasionally a weak activity enrichment in intestinal tract and kidneys could be recognized. The effective dose to the patient was estimated to 7.6 μSv/MBq. The radioactivity uptake of the SLN varied in several orders of magnitude between 0.006% and 0.6%. The probability of SLN-metastasis was found to be independent from tracer uptake in the lymph node. The radioactivity uptake of the SLNs in distinct lymph node regions showed no significant differences. Conclusion: The radiotracer is transferred out of the prostate via blood flow, by direct transfer via the urethra into the bladder and by lymphatic transport. Injecting a total activity of 200 MBq leads to a mean effective dose of 1.5 mSv. It is not recommended to use the tracer uptake in lymph nodes as the only criterion to characterize SLNs.
Die so genannte idiopathische Skoliose
Authors: Stücker Ralf 
Published: March 2018

ZusammenfassungBei der idiopathischen Skoliose unterscheidet man in Abhängigkeit vom Zeitpunkt der Erstmanifestation infantile, juvenile und adoleszente Skoliosen. Die einzig wirksame Maßnahme zur Vermeidung einer Progredienz ist nach wie vor die Korsettbehandlung und bei infantilen Skoliosen die serielle Gipsredression. Zur Vermeidung eines Thorax-Insuffizienz-Syndroms sollten langstreckige Spondylodesen im Kindesalter nicht durchgeführt werden. Bei Progredienz trotz Korsettbehandlung sollten so genannte Non-Fusion-Techniken erwogen werden, die in Einzelfällen ihre Wirksamkeit bereits belegt haben, bei denen jedoch langfristige Resultate noch ausstehen. Die Korrektur und Spondylodese am Ende oder nach Abschluss des Wachstums ist nach wie vor Verfahren der Wahl. Die früher häufig gefürchteten Komplikationen sind aufgrund moderner operativer Verfahren und intraoperativem Monitoring heute in entsprechenden Zentren zu einer Rarität geworden.
Chronische Obstipation im Kindesalter
Authors: Uhlig Holm , Pfeiffer Ulrike , Bühligen Ulf 
Published: March 2018

ZusammenfassungMit Obstipation wird eine unvollständige Stuhlentleerung innerhalb von 3 Tagen oder 3-mal pro Woche definiert. Von einer chronischen Obstipation wird gesprochen, wenn diese Störung mehr als 3 Monate andauert.Das Krankheitsbild ist häufig. Etwa 5% der ambulanten Vorstellungen in Kinderarztsprechstunden erfolgen aufgrund von Obstipation. Das bedeutet, dass der Kinderarzt täglich mit obstipierten Patienten konfrontiert wird. Die geschilderte Symptomatik ist indifferent und führt nicht immer sofort zur Diagnose. Erst die genaue Anamnese mit klinischer und rektaler Untersuchung weist den Weg. Meist bilden funktionelle Störungen die Ursache der Obstipation. Dabei verschlimmert sich die Symptomatik durch die Stuhlretention im Sinne eines Circulus vitiosus. Organische und psychische Komponenten bilden oft gemeinsame Ursachen für eine Darmentleerungsstörung. Therapeutisch ist in mehreren Phasen vorzugehen. Ernährungstherapie, orale Laxanzien, Einläufe und kontrolliertes Stuhltraining bilden die Basis einer erfolgreichen Therapie.