bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ätiologie sekundärer Lymphödeme nicht onkologischer Genese
Authors: Kröll A. , Neuhüttler S. , Brenner E. 
Published: March 2018

Zusammenfassung60% aller Lymphödeme entfallen auf sekundäre Lymphödeme, unter diesen liefern Neoplasien für über die Hälfte die Ursache; ein immer noch beträchtlicher Anteil entfällt damit auf sekundäre Lymphödeme nicht onkologischer Genese. Mit dieser Arbeit wird versucht, einen Überblick über die verschiedenen, in der Literatur erwähnten, Ätiologien dieses Formenkreises zu geben. Prinzipiell kann hier eine Gliederung in zwei Gruppen erfolgen: 1. Ursachen mit immunologischer Aktivität (z. B. Helminthen, Bakterien, Spirochäten, Viren, Pilze, allergische Kontaktdermatitis, Phlebitis, Rheumatoide Arthritis, Morbus Crohn); 2. Ursachen ohne immunologische Aktivität (z. B. Traumata, iatrogene Schäden, Pharmaka, Podokoniose). Hier wird einmal mehr ersichtlich, dass die Erkrankung Lymphödem aufgrund der großen Vielfalt der Ätiologien nicht einer einzelnen klinischen Disziplin untergeordnet werden kann, sondern vielmehr fächerübergreifend gesehen werden muss.
Gastrocnemius- und Poplitealvenendurchmesser bei Patienten mit chronischen Venenkrankheiten
Authors: Lotz M. , Rabe E. , Pannier F. 
Published: March 2018

ZusammenfassungChronische Venenkrankheiten haben in der erwachsenen Durchschnittsbevölkerung eine große Bedeutung. In der Bonner Venenstudie hatten 23% eine Varikose und 15% eine chronische venöse Insuffizienz (CVI) (28). Über die Bedeutung der Gastrocnemiusvenen bei chronischen Venenkrankheiten ist nur wenig bekannt. Patienten, Methoden: In der vorliegenden Untersuchung wurde an insgesamt 135 Patienten ein Venenstatus erhoben und an streng definierten Stellen der unteren Extremität der Durchmesser der medialen Gastrocnemius- und der Poplitealvenen ermittelt. Davon waren: 76 Venengesunde, 34 Patienten mit einer Stammvarikose der Vena saphena magna, 16 Patienten mit einer Stammvarikose der Vena saphena parva, 9 Patienten mit sonstigen Venenerkrankungen: dreimal postthrombotisches Syndrom (PTS), zweimal PTS und Stammvarikose der Vena saphena magna, viermal inkomplette Stammvarikose. In der Gruppe der an der Vena saphena parva Erkrankten (n = 16) konnte in 10 Fällen eine gleichzeitige Insuffizienz einer großen Stammvene diagnostiziert werden. Gemäß den klinischen Stadien nach der CEAP-Klassifikation (5) verteilten sich die Patienten folgendermaßen: C0 und C1: 79 Patienten (C0: 74, C1: 5), C2 und C3: 30 Patienten (C2: 16, C3: 14), C4: 16 Patienten (C4a: 15, C4b: 1), C5 und C6: 10 Patienten (C5: 3, C6: 7). Ergebnisse: Die Durchmesser der Venae gastrocnemiae sowie der Venae popliteae weisen bei Venenkranken durchschnittlich einen höheren Querschnitt auf, als bei Venengesunden. In 9 von 12 untersuchten Parametern der Venae gastrocnemiae konnte ein statistisch signifikanter Unterschied zwischen venengesunden und venenkranken Probanden festgestellt werden. Die Durchmesserunterschiede betrugen teilweise über 2 mm (Vv. gastrocnemiae) im Mittelwert zwischen Stadium C0+1 CEAP und Stadium C5+6 nach CEAP. Schlussfolgerung: Bei der chronischen venösen Insuffizienz kommt es im Rahmen der Varikose neben der Erweiterung der Vena poplitea auch zu einer Dilatation der Muskelvenen im medialen Anteil des Musculus gastrocnemius.
Acute and long term effect of compression stockings in athletes with venous insufficiency
Authors: Kemmler J. , Rauschenbach M. , Venter C. , Niess A. , Häfner H.-M. , Stroelin A. , Moehrle M. 
Published: March 2018

ZusammenfassungVenöse Rezirkulationskreisläufe mit daraus resultierender kapillärer Hypertension beeinflussen möglicherweise den oxidativen Stoffwechsel der Skelettmuskulatur. Ziel dieser Studie war, den Einfluss der chronischen venösen Insuffizienz (CVI) und deren Therapie durch medizinische Kompressionstrümpfe auf Leistung, Laktatspiegel und subjektives Befinden von Langstreckenläufern und Radsportlern zu untersuchen. Studienteilnehmer, Methoden: 24 gesunde Läufer (13 Männer und 11 Frauen) und 20 gesunde Radsportler (18 Männer und 2 Frauen) wurden in einer offenen prospektiven, randomisierten Kohortenstudie über 40 Tage untersucht. Die venöse Insuffiziez der Läufer entsprach Stadium C2–4EC,P,SAS,PPR, die der Radsportler C2–3EPAS,PPR. Die Kompressionstherapie erfolgte mit Unterschenkelkompressionsstrümpfen nach Maß (Venotrain Champion A-D compression class 2, Bauerfeind Germany). Standardisierte Laufbandergometer- bzw. Fahrradergometer-Mehrstufentests mit Bestimmung der kapillären Laktatspiegel wurden durchgeführt und subjektive Beschwerden pro- und retrospektiv mittels Fragebögen erhoben. Ergebnisse: Die medizinische Kompressionstherapie führte zu keinem akuten Effekt auf Leistung, Herzfrequenz und Laktatspiegel, wenn Leistungstests mit und ohne Kompression verglichen wurden. Ebensowenig fand sich kein signifikanter Unterschied zwischen Leistungstests ohne Kompression vor und mit Kompression nach einer vierwöchigen Kompressionstherapie. Die Kompressiontherapie führte jedoch zu einer signifikanten Abnahme von CVI-typischen Beschwerden im Alltag und nach dem Training. Schlussfolgerung: Bei Läufern und Radfahrern mit CVI konnte keine messbare Leistungssteigerung nach einer akuten oder mehrwöchigen Therapie mit Kompressionstrümpfen nachgewiesen werden. Ebensowenig wurde die sportliche Leistungsfähigkeit durch die Kompressionstherapie beeinträchtigt. Subjektiv empfanden die Athleten das Tragen von Kompressionsstrümpfen als sehr vorteilhaft. Kompressionstrümpfe können Athleten mit CVI daher empfohlen werden.
Verbesserung der Kompressionstherapie im retromalleolären Raum durch Pelotten
Authors: Huber C. , Botonakis I. , Hafner J. 
Published: March 2018

ZusammenfassungDer retromalleoläre Raum ist von der chronischen venösen Insuffizienz oft besonders stark betroffen. Aufgrund seiner konkaven Form wird er von der Kompressionstherapie weitgehend ausgespart. Die vorliegende Arbeit hat zum Ziel, den Andruck von Kompressionsverbänden im retromalleolären Raum mit und ohne Pelotte zu untersuchen. ,Methode: Bei zehn gesunden Probanden wurde am rechten Unterschenkel ein Kompressionsverband mit 40 mmHg Ruheandruck angelegt. Zur Messung des Andrucks wurde der Oxford-Pressure-Monitor MK II verwendet. Der Ruheandruck wurde an zwei Messpunkten, nämlich medial und lateral supramalleolär, kontrolliert. Gleichzeitig wurde der Ruhedruck medial und lateral retromalleolär mit und ohne Schaumgummipelotte gemessen. Ergebnisse: Ohne Pelotte wurden retromalleolär medial bzw. lateral Druckwerte von 7 ± 1 bzw. 10 ± 4 mmHg, mit Pelotte solche von 55 ± 9 bzw. 68 ± 20 mmHg gemessen (p = 0,0002; p = 0,00001). Schlussfolgerung: Der retromalleoläre Raum wird von der Kompressionstherapie weitgehend ausgespart. Erst durch die Auspolsterung mit Pelotten entsteht ein effektiver Andruck. Die Verwendung von Pelotten kann sowohl präventiv als auch therapeutisch zur Behandlung der chronischen venösen Insuffizienz im retromalleolären Raum eingesetzt werden.
Failure of low-level laser therapy to boost healing of venous leg ulcers in surgically and conservatively treated patients
Authors: Franek A. , Cierpka L. , Krol P. , Blaszczak E. , Dolibog P. , Kusz D. , Taradaj J. 
Published: March 2018

Summary
Objective: To evaluate in a randomized open-label clinical trial the ability of adjuvant low-level laser therapy (LLLT) to improve healing of venous leg ulcers in surgically and conservatively treated patients. Patients and methods: Eighty three patients with venous leg ulcers were included in this study. Patients in groups 1 and 2 were treated surgically while patients in groups 3 and 4 were treated conservatively. Patients in groups 1 and 3 were additionally treated with the LLLT (GaAlAs laser, 810 nm, 4 J/cm2, 65 mW) once daily, 6 times a week for 7 weeks. Results: After therapy comparison of completely healed wounds, statistically significant differences were seen between groups 1 and 3 (p=0.02), 1 and 4 (p= 0.02), 2 and 3 (p= 0.02), 2 and 4 (p=0.02) in favor of groups 1 and 2. Comparison of the relative change of wound total surface area indicated statistically significant differences between groups 1 and 3 (p=0.002), 1 and 4 (p=0.002), 2 and 3 (p=0.002), 2 and 4 (p=0.002) in favor of groups 1 and 2. Comparison of the other parameters also demonstrated a more efficient therapy effects in groups 1 and 2 than in group 3 and 4. There were no statistical differences in all examined parameters between groups 1 and 2 (p>0.05), 3 and 4 (p>0.05). Conclusion: The application of the LLLT does not enhance healing of venous leg ulcers in surgically and conservatively treated patients. A well conducted surgical operation is much more efficient than conservative pharmacological procedures.
Comparison of standardised lymphoscintigraphic function test and high resolution sonography of the lymphoedema of legs
Authors: Brauer V. S. , Brauer W. J. 
Published: March 2018

SummaryPurpose: Comparison of qualitative and quantitative sonography with the lymphoscintigraphic function test and clinical findings in legs. Patients, methods: In 33 patients a lymphoscintigraphic function test of legs combined with measurement of lymph node uptake was performed and subsequently compared with sonography. Sonographic criteria were: Thickness of cutis, thickness of subcutanean fatty tissue and presence of liquid structures or fine disperse tissue structure of lower limbs, foots and toes. Results: In 51 legs uptake values lie in the pathologic area, in four legs in the grey area and in ten legs in the normal area. The cutis thickness in the lower leg shows no significant correlation with the uptake. The determination of the thickness of the subcutanean fatty tissue of the lower leg and of the cutis thickness of the feet turned out to be an unreliable method. In 47% of the medial lower legs and in 57% of the lateral lower legs with clinical lymphoedema sonography is falsely negative. Conclusion: Early lymphoedema is only detectable with the lymphoscintigraphic function test. In the case of clinical lymphoedema clinical examination is more reliable than sonography.
Varicose vein surgery under anti-platelet therapy
Authors: Baier P.-M. , Miszczak Z. T. 
Published: March 2018

Summary
Background: Platelet function inhibitors (PFI) are used for prophylaxis of atherothrombosis. These drugs cause a prolongation of the bleeding time and should eventually be stopped before an elective operation. However, there is a risk that a perioperative pause of PFI lead to acute atherothrombosis. Objective: Our aim was to study whether a discontinuation of PFI therapy is necessary to avoid bleeding complications in patients undergoing varicose vein surgery. Methods: Selective review of the literature and retrospective analysis of clinical data of our own patients. Results: In the years 2002 to 2007 a total of 10 827 patients have been operated on varicose veins, 673 (6.2%) of these aged 32–86 years (67 ± 7.9) receiving permanent PFI therapy: 256 male patients (38.0%) and 417 female (62.0%), 39.1% categorized as ASA III patients: male 11.6%, female 27.5%. 38 patients who continued PFI therapy did not demonstrate haemorrhagic complications and none of those pausing anti-platelet medication experienced thromboembolic complications. The literature survey confirmed our finding that it is not necessary to suspend PFI medication for varicose vein surgery as the bleeding risk can be controlled for by technical means. Conclusion: Discontinuation of PFI therapy prior to interventions on varicose veins does not seem to be necessary, further studies are essential though.
Radiosynovectomy for the treatment of rheumatoid arthritis of the elbow
Authors: Rozeboom S. , Bihl H. , Dörr U. 
Published: March 2018

SummaryThe Aim of this retrospective study was to evaluate the efficiacy of radiosynovectomy (RSO) in patients with rheumatoid elbow arthritis. Patients and Methods: 40 joints of 31 patients were evaluated. At the time of therapy, patients had been suffering from elbow arthritis for 17.5 months (2-72 months). 95% of the joints (n = 38) had severe dally pain or continuous pain, 97.5% (n = 39) had moderate to severe limitation of the mobility and 10% (n = 4) had severe swelling. RSO was performed by intraarticular injection of 74 MBq colloidal rhenium-l 86 and 15 mg triamcinolonehex-acetonide. Before and six to 26 months after therapy (median follow-up 14.7 months) severity of the patients pain, mobility and swelling (transferred to a scoring system) were determined with a standardised questional. A clinical re-evaluation, along with an ar-throsonographical follow-up was performed in 28 joints. Results: A “good to very good” overall long-term response was achieved in 80% (n = 32) of the treated joints and a temporary response in 10% (n = 4). Only 10% (n = 4) had a non-satisfactory response due to advanced articular destruction. The range of motion for flexion-extension increased from 103.8 ± 20.0 degrees to 144.0 ±12.8 degrees (p <0.001). The respective scores for articular pain, impaired mobility and swelling decreased significantly (pain from 3.15 to 0.82, impaired mobility from 3.15 to 0.82, swelling from 2.40 to 0.65; p <0.00U. No deterioration or complication occurred. The effects lasted throughout the entire follow-up time for 36 joints (90%). Conclusion: For patients with rheumatoid involvement of the elbow joint, radiosynovectomy results in a significant decrease of articular pain and improvement of objective parameter, i.e. joint mobility. Thus, radiosynovectomy represents a feasible and effective therapeutic option for elbow arthritis.
Recovery-test or immunoradiometric measurement of anti-thyroglobulinautoantibodies
Authors: Wunderlich G. , Liepach U. , Koch R. , Bredow J. , Franke W.-G. , Zöphel K. 
Published: March 2018

SummaryThe determination of thyroglobulin (Tg) in the follow-up of differentiated thyroid carcinomas (DTC), is routinely used in nuclear medicine, although some problems, like a disturbed recovery-test (RT) or autoantibodies to thyroglobulin (TgAb), are well known. But it is a controversial issue in literature, whether the determination of TgAb should be performed beside or instead of the RT. Objective: The study compares the clinical value of the determination of both TgAb and RT with sensitive assays. Methods: 356 patients (pts) were investigated. The results were compared to the concentration of Tg in the sera of the pts. 288 pts stayed tumor-free, the remaining 68 pts showed a recurrence (local and/or metastatic) of their DTC. We measured Tg (with RT) using an immunoradiometric assay (Tg-IRMA; SELco® Tg; Fa. Medipan Diagnostica GmbH) and TgAb using a direct assay (CentAK® anti-Tg; also from Fa. Medipan). Results: The prevalence of TgAb, and of disturbed RT respectively, in the whole population of DTC-pts was 7,6%, in the subgroup of tumor-free pts 6,6%, and in the remaining pts with tumor-recurrence 11,8%, respectively 2,0%, 1,7% and 2,9%. In a significantly higher percentage of pts with local/metastatic recurrence, both a positive TgAb (p <0,001) and a disturbed RT (p <0,05) were found. 7/68 pts with tumor-recurrence but Tg <1 ng/ml showed positive TgAb, only 2/7 had a disturbed RT. In this group, no patient with Tg >1 ng/ ml demonstrated either positive TgAb or disturbed RT (p <0,001 and p <0,05). Conclusion: The determination of TgAb in the follow-up of DTC is necessary, because it supports a suspicion to tumor-recurrence in pts with negative Tg. Also the RT is of great value because of a possibly High dose hook-effect.
An approach for comparative quantification of myocardial blood flow (0-15-H2O-PET), perfusion (Tc-99m-tetrofosmin-SPECT), and metabolism (F 18-FDG-PET)
Authors: Nowak B. , Kaiser H.-J. , Block S. , Koch K.-C. , Dahl J. vom , Büll U. , Schäfer W. M. 
Published: March 2018

Summary
Aim: In the present study a new approach has been developed for comparative quantification of absolute myocardial blood flow (MBF), myocardial perfusion, and myocardial metabolism in short-axis slices. Methods: 42 patients with severe CAD, referred for myocardial viability diagnostics, were studied consecutively with 0-15-H2O PET (H2O-PET) (twice), Tc-99m-Tetrofosmin 5PECT (TT-SPECT) and F-18-FDG PET (FDG-PET). All dato sets were reconstructed using attenuation correction and reoriented into short axis slices. Each heart was divided into three representative slices (base, rnidventricular, apex) and 18 ROIs were defined on the FDG PET images and transferred to the corresponding H2O-PET and TT-SPECT slices. TT-SPECT and FDG-PET data were normalized to the ROI showing maximum perfusion. MBF was calculated for all left-ventricular ROIs using a single-compartment-model fitting the dynamic H2O-PET studies. Microsphere equivalent MBF (MBF_micr) was calculated by multiplying MBF and tissue-fraction, a parameter which was obtained by fitting the dynamic H2O-PET studies. To reduce influence of viability only well perfused areas (>70% TT-SPECT) were used for comparative quantification. Results: First and second mean global MBF values were 0.85 ml × min-1 × g-1 and 0.84 ml × min-1 × g1, respectively, with a repeatability coefficient of 0.30 ml ÷ min-1 × gl. After sectorization mean MBF_micr was between 0.58 ml × min1 ÷ ml"1 and 0.68 ml × min-1 × ml"1 in well perfused areas. Corresponding TT-SPECT values ranged from 83 % to 91 %, and FDG-PET values from 91 % to 103%. All procedures yielded higher values for the lateral than the septal regions. Conclusion: Comparative quantification of MBF, MBF_micr, TT-SPECT perfusion and FDG-PET metabolism can be done with the introduced method in short axis slices. The obtained values agree well with experimentally validated values of MBF and MBF_micr.
1-123-Iodo-α-methyl tyrosine SPECT in non-parenchymal brain tumours
Authors: Matheja P. , Weckesser M. , Rickert Ch. , Palkovic St. , Riemann B. , Schober O. , Franzius Ch. 
Published: March 2018

Summary
Purpose: Scintigraphy using I-123-iodo-α-methyl tyrosine (IMT) is useful in the preoperative characterization of gliomas, in detecting recurrent glioma and in the biological re-evaluation of residual or recurrent tumours. A systematic evaluation of non-parenchymal brain tumours has not yet been performed. The aim of the present study was to evaluate IMT SPECT in the management of intracerebral metastases and lymphomas. Patients and methods: IMT uptake was analyzed in 31 patients with 28 metastases of extracerebral solid tumours and 7 cerebral lymphomas. Histology revealed high grade lymphomas, melanomas, and carcinomas of the following origin: lung, unknown primary, breast, colon, renal cell, ovary, vagina, frontal sinus. IMT uptake was quantified as ratio between maximal tumour accumulation and average uptake in the contralateral hemisphere. Results: All tumours except two renal cell and one small cell lung carcinoma metastases accumulated IMT (91%). The highest IMT uptake was found in a metastasis of lung carcinoma. IMT uptake was highly variable and was similar in primary and in recurrent tumours. Conclusion: Significant accumulation of IMT is seen in the majority of tumours, so that this technique might be helpful for the management of cerebral metastases and lymphomas.
Synthesis and biological evaluation of a 99mTc-labelled cyclic RGD peptide for imaging the αvβ3 expression
Authors: Bruchertseifer F. , Bock M. , Kessler H. , Schwaiger M. , Wester H.-J. , Haubner R. 
Published: March 2018

Summary
Aim: The αvβ3 integrin is involved in tumour induced angiogenesis and tumour metastasis. We describe the synthesis and evaluation of a 99mTc-labelled RGD analogue for the visualisation of αvβ3 integrin expression. Methods: The linear peptides were assembled on a solid support. Cyclisation was performed under high dilution conditions. For conjugation with the chelator peptide, a water soluble carbodiimide was used. Radiolabelling was carried out due to standard procedures with high radiochemical yield and radiochemical purity. For in vivo evaluation, nude mice bearing αvβ3-positive human melanoma M21 and αv-negative human melanoma M21-L or Balb/c mice bearing αv-positive murine osteosarcoma were used. Results: Activity accumulation of 99mTc-DKCK-RGD 240 min p. i. was 1.1% ID/g in the αvβ3-positive melanoma and 0.3% ID/g in the negative control tumour. In the osteosarcoma model 2.2% ID/g was found 240 min p. i. Planar gamma camera images allowed contrasting visualisation of αvβ3-positive tumours 240 min p. i. Blocking of the tumour using the αvβ3-selective pentapeptide cyclo(-ArgGly-Asp-D-Phe-Val-) reduces activity accumulation in the tumour to background level. However, 240 min p. i. highest activity concentration was found in kidneys resulting in low tumour/kidney ratios. Metabolite analysis 240 min p. i. showed approximately 60% intact tracer in kidneys and 80% in the tumour. Only 24% intact tracer was found in blood 30 min p. i. Conclusion: 99mTc-DKCK-RGD allows imaging of αvβ3-positive tumours in mice. However, pharmacokinetics as well as metabolic stability of the tracer have to be improved for potential clinical application.
News and Views on Tumor Markers
Authors: Sabine von Kleist 
Published: March 2018

SummaryIt was doubtless due to the phenomenal progress in the field of tumor immunology that took place during the last 20 years, that today we dispose not only of highly sensitive immunological tests like the RIA or EIA, but also of most specific reagents like monospecific polyclonal and monoclonal antibodies. In this context the discovery in human carcinomas of tumor-associated antigens was of prime importance, especially since some of them were found to have clinical relevance as so-called tumor markers. It has been shown that there is a direct correlation between the absolute tumor burden and the blood concentration of these substances. Based on animal models a new technology for tumor and métastasés detection was developed in recent years, that used polyvalent or monoclonal antibodies prepared against tumor-associated antigens. This technique called radioimmuno-detection (RAID), especially in the hands of experts, may be superior in many instances to conventional radiology, radionuclide scanning or ultrasonographic techniques.
Biokinetics and Metabolism of Radiogallium
Authors: Kriegel H. 
Published: March 2018

SummaryThe large number of publications dealing with biokinetics, metabolism and factors influencing tissue uptake of 67Ga-citrate could not clarify the mechanism responsible for the uptake of this compound into tumor tissue. The present paper reviews biokinetic data obtained from clinical investigations and animal experiments and briefly points out some possible pathways of the mechanism for gallium localisation in tumors as well as in abscesses and inflammatory lesions.
Gastrointestinal Scintigraphy Using 99mTc- or 111In-Labelled Polymer Beads
Authors: Jordaan J. H. , Pilloy W. J. , Dormehl Irene 
Published: March 2018

SummaryIn order to establish normal and pathological stomach emptying characteristics by external measurement of a radioactive meal using a gamma camera and computer system, it is necessary for the radioactively labelled substance to have the same behaviour in the stomach as the ingested food. Resins containing chelating groups which enable binding to either reduced 99mTcO4
− or 111In+3 were tested for their suitability as tracers mixed into solid food. The preparation of such styrene-divinylbenzene resins containing either triethylenetetramine substituents or the fully carboxymethylated derivatives is discussed, as well as the procedures of labelling with either 99mTcpertechnetate or 111In-chloride. An evaluation of the resins for gastrointestinal scintigraphy was performed on 3 chacma baboons and a male human volunteer with encouraging results.