bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endovenöse Lasertherapie der Stammvenenvarikose mit dem 980-nm-Diodenlaser
Authors: Rabe E. , Pannier F. 
Published: March 2018

Zusammenfassung
Ziel: In den vergangenen Jahren haben Methoden mit geringem invasivem Vorgehen wie die endovenöse Lasertherapie (ELT) das Therapiespektrum der Varikose ergänzt. Berichte hierzu belegen die hohe Erfolgsrate der ELT, wobei die Definition des Erfolges uneinheitlich ist. Ziel der vorliegenden Arbeit ist es die Therapieergebnisse anhand eines standardisierten Protokolls zu beurteilen. Patienten, Material, Methoden: In der nicht randomisierten, prospektiven Studie schlossen wir insgesamt 67 unselektierte Beine von 65 Patienten ein, die eine duplexsonographisch nachgewiesene Stammvarikose der VSM oder der VSP aufwiesen. Diese wurden im Mittel 2,2 Jahre ( 0,5–3,5 Jahre ) nach ELT klinisch und duplexsonographisch standardisiert nachuntersucht. Die ELT wurde mit einem 980 nm Diodenlaser im gepulsten Modus in Tumeszenzlokalanästhesie durchgeführt. Sämtliche Patienten erhielten eine Thromboembolieprophylaxe mit niedermolekularem Heparin und eine Kompressionstherapie. Ergebnisse: Mit einer Energiedichte von 48 J/cm Vene gelingt eine Refluxausschaltung nach 2,2 Jahren in 88,1 % der Fälle. Liegt kein Reflux mehr vor, so ist bei der Mehrzahl dieser Fälle (69,5%) die behandelte Vene nicht mehr nachweisbar. Ein geringer Teil der verbleibenden Fälle ohne Reflux weist auch weiterhin einen antegraden Flow auf (13,6%). In allen Gruppen mit noch darstellbarer Vene kam es zu einer Durchmesserreduktion von ca. 50%. In allen Gruppen verbesserte sich die klinische Klassifikation (CEAP) in ähnlicher Weise und in allen Gruppen konnte eine sehr hohe Patientenzufriedenheit erreicht werden. Unter klinischen Gesichtspunkten kann 2,2 Jahre nach ELT in über 90% der Fälle von einem Ergebnis mit sehr hoher Patientenzufriedenheit gesprochen werden. Bei keinem der 67 behandelten Fälle trat eine schwerwiegende Komplikation (z. B. tiefe Beinvenenthrombose) auf. Schlussfolgerung: Zusammenfassend lässt sich anhand der hier vorliegenden Studie zeigen, dass die Therapie von VSM und VSP mittels ELT eine sowohl minimalinvasive als auch sichere und effiziente Therapieoption darstellt und eine hohe mittelfristige Erfolgsrate aufweist. Bei der Beurteilung der Ergebnisse sollten nicht nur standardisierte duplexsonographische sondern auch klinische Kriterien verwendet werden.
Therapie der Stammvarikose der Vena saphena magna mittels kathetergestützter Mikroschaum-Sklerosierung ohne Heparinprophylaxe
Authors: Altmeyer P. , Stücker M. , Reich-Schupke S. 
Published: March 2018

ZusammenfassungDie kathetergestützte Sklerosierungstherapie der V. saphena magna (VSM) ist bei entsprechender Indikation eine gute Alternative zur operativen Intervention. Umstritten ist die Notwendigkeit einer postinterventionellen Heparingabe. Ziel unserer Untersuchung war die Bestimmung von Effektivität und Sicherheit der kathetergestützten Sklerosierungstherapie der VSM mit 8 ml Mikroschaum ohne Heparintherapie. Patientinnen, Methoden: Bei 7 Patientinnen mit Insuffizienz der VSM Grad III-IV nach Hach wurde in einer offenen prospektiven Untersuchung eine kathetergestützte Sklerosierungstherapie durchgeführt. Befundkontrollen folgten nach 24 h, 1 Woche und 3 Monaten. Ergebnisse: Bei allen Patientinnen war nach komplikationsloser kathetergestützter Sklerosierungstherapie ein suffizienter VSM-Verschluss festzustellen. Die Nebenwirkungen waren harmlos, passager und selbstlimitierend. Thromboembolische Ereignisse traten nicht auf. Schlussfolgerung: Die kathetergestützte Sklerosierungstherapie stellt in Zusammenschau der Literatur und unseres kleinen Kollektivs ein sicheres und effektives therapeutisches Verfahren der VSM-Stammvarikose dar. Im Gegensatz zur endovenösen Laser- oder Radiowellentherapie ist sie mit geringerem technischen und zeitlichen Aufwand verbunden. Unter Berücksichtigung der Literatur sowie eigener Erfahrungen ist die kathetergestützte Sklerosierungstherapie ohne eine postinterventionelle Heparintherapie möglich, falls keine thromboembolischen Risikofaktoren vorliegen.
The differences in the ankle range of motion in distinct ethnical groups measured by goniometry
Authors: Belczak C. E. Q. , Cavalheri G. , Caffaro R. A. , de Godoy J. M. Pereira 
Published: March 2018

SummaryThe aim of this study was to evaluate if there are any differences in the range of motion of the ankle joint for distinct ethnicities measured by goniometry. A total of 288 ankles of 152 individuals were evaluated and divided into four ethnic groups: 18 male and 20 female Caucasians (75 ankles), 11 male and 26 female Oriental individuals (72 ankles), 25 male and 16 female Black people (70 ankles) and 19 male and 17 female Mulattos (71 ankles). All of the participants were of similar ages and were examined in a single evaluation in the morning by the same examiner using the same goniometric device. Statistical analysis was achieved using means and standard deviation and a comparison of the scores, z-statistics of the normal distribution were calculated with an alpha error of 5% considered acceptable. The total mean obtained from all ethnical groups, considering both left and right legs and both genders, was 60.45°. The averages of the distinct ethnicities were: 63.84° for Caucasians, 66.91° for Orientals, 55.21° for Black people and 55.87° for Mulattos. All groups were significantly different in relation to ankle motion range compared to the other groups, except between Black people and Mulattos. There were statistically significant differences when separately analyzing the means of goniometric measures of the right and left ankles in men and women of the Caucasian and Oriental ethnic groups. Conclusion: There are significant differences in respect to the ankle motion range among the distinct pure ethnic groups and there is a predominance of characteristics of Black people in the Mulatto group in respect to this variable compared to Caucasian traits.
Pathogenesis of chronic venous insufficiency by obesity
Authors: Obermayer A. , Hirschl M. , Göstl K. 
Published: March 2018

SummaryObesity (body mass index: BMI ≥30 kg/m2) is named as a risk factor for chronic venous insufficiency (CVI) in phlebologic studies, even though the mechanisms of effects are still unclear. Therefore we examined literature for current data and hypotheses and described them.On the one hand, the correlation between obesity and CVI is explained by chronically inflammatory processes, affected by the lipometabolism of obese and the metabolic syndrome. On the other hand, this particular correlation is explained by a mechanical approach based on an elevated intraabdominal pressure (IAP), which is transmitted to the venous system of the lower extremities. Recent studies show that the chronically inflammatory processes promote the frequency and manifestation of thrombosis. In regard to the IAP, only the pressure of the elevated abdominal mass (paunch) seems to have a minimal effect in the supine position.Several studies relativised the correlation between obesity and CVI because of the rising prevalence of venous disease with age, which correlates with a higher BMI as well. Furthermore, studies have shown the phenomena of so-called venous hydrostatic ulcerations in obese patients. That means those patients show the typical skin changes of the CVI without any venous reflux. Depending on the study, their proportion is estimated between 21% and 64% of venous leg ulcers. Additionally, it was shown that after weight loss the skin seems to regenerate from the typical signs of CVI. At the moment, the pathomechanism causing hydrostatic ulcers in obese is unclear.
Heparin-induced skin lesions
Authors: Schindewolf M. , Kahle B. , Lindhoff-Last E. , Ludwig R. J. 
Published: March 2018

SummaryCutaneous reactions to subcutaneous heparin injections have been described first in 1952. These reactions may be caused by several mechanisms such as immediate or delayed-type hypersensitivity responses, or by life-threatening immune-mediated heparin-induced thrombocytopenia (HIT). In contrast to bleeding, induction of osteoporosis and hair loss, no data on the incidence and causes of heparin-induced skin lesions had been available until recently. In a large prospective epidemiological study, the incidence of heparin-induced skin lesions was as high as 7.5% in medical patients, far exceeding the expected incidence. As heparin-induced skin lesions may be the sole clinical manifestation of immune HIT, rapid and valid diagnosis of heparin-induced skin lesions is of utmost clinical importance. Therefore, we have reviewed all known causes of heparin-induced skin lesions, and propose diagnostic and therapeutic procedures.
Peritoneo-venous shunt implantation as a therapy for chylous ascites
Authors: Tasnádi G. , Bihari P. , Bihari I. 
Published: March 2018

SummaryWe report a case of primary chylous ascites in a progressively poor condition with proteinlosing enteropathy, pleural and pericardiac effusion. Therapy: Denver peritoneo- venous shunt was implanted. Three years later the patient became septic and the shunt was removed. Clinical course: Soon after implantation the patient’s condition improved, and in two months he lost 51 kg. After three years fibrinous occlusion of the shunt and sepsis developed. The occlusion could be dissolved with streptokinase. Removing the shunt cured the patient’s septic state. The chylous ascites did not recur. Conclusion: In emergency cases implantation of a peritoneo-venous shunt leads to a rapid relief of the state. Usually this is a palliative treatment, but in this case it gave a final result. Fibrin can deposit on or occlude the drain which can be solved without further complications. If the patient is septic the drain must be removed and the septic state ends.
Increased FDG bone marrow uptake after intracoronary progenitor cell therapy
Authors: Menzel C. , Diehl M. , Hamscho N. , Zaplatnikov K. , Grünwald F. , Döbert N. 
Published: March 2018

SummaryPatients with coronary artery disease who undergo FDG PET for therapy monitoring after intracoronary progenitor cell infusion (PCT) show an increased bone marrow up-take in some cases. Aim of the study was to evaluate the systemic bone marrow glucose metabolism in this patient group after PCT. Patients, methods: FDG bone marrow uptake (BMU), measured as standardized uptake value (SUVmax) in the thoracic spine, was retrospectively evaluated in 23 control patients who did not receive PCT and in 75 patients who received PCT 3 ± 2.2 days before PET scanning. Five out of them were pretreated with granulocyte colony-stimulating factor (G-CSF) 5 days prior to PCT and 10 ± 1.2 days before PET scanning. In 39 patients who received only PCT without G-CSF and underwent PET therapy monitoring 4 months later, baseline and follow up bone marrow uptake were measured. Leucocytes, C-reactive protein (CRP) levels and the influence of nicotine consumption were compared with the BMU. Results: In patients (n = 70) who received PCT without G-CSF, BMU median (1.3) was slightly, but significantly higher than in the controls (1.0) (p = 0.02) regardless nicotine consumption. BMU did not change significantly 4 months later (1.2) (p = 0.41, n.s.). After G-CSF pretreatment, patients showed a significantly higher bone marrow uptake (3.7) compared to patients only treated with PCT (1.3) (p = 0.023). Leucocyte blood levels were significantly higher in patients with a BMU ≥ 2.5 compared to patients with a bone marrow SUVmax < 2.5 (p <0.001). CRP values did not correlate with the BMU (rho -0.02, p = 0.38). Conclusion: Monitoring PCT patients, a slightly increased FDG BMU may be observed which remains unchanged for several months. Unspecific bone marrow reactions after PCT may be associated with increased leucocyte blood levels and play a role in the changed systemic glucose BMU.
Microcirculation of the fingers in Raynaud’s syndrome
Authors: Garai I. , Varga J. , Szücs G. , Galajda Z. , András C. , Zeher M. , Galuska L. , Csiki Z. 
Published: March 2018

Summary
Aim: We investigated the circulatory characteristics of patients suffering of primary and secondary Raynaud’s syndrome. Patients, methods: We examined 106 patients presenting with the classical symptoms of Raynaud’s syndrom (47 primary, 59 secondary) by hand perfusion scintigraphy developed by our Department of Nuclear Medicine. After visual evaluation we analyzed the images semiquantitatively, using the finger to palm ratio. We statistically compared the patients with primary and those with secondary Raynaud’s syndrome. Results: By visual evaluation we constated regional perfusion disturbances in 42 from 59 patients with secondary Raynaud’s syndrome. However, this was observed in only 3 from 47 patients with the primary form of this disease. This difference was statistically significant (p <0.001). Semiquantitative analysis showed that the finger/palm ratios (FPR) were significantly lower (p <0.05) for the patients with primary Raynaud’s syndrome. No differences in the FPR values concerning sex or right and left side. Conclusion: The hand perfusion scintigraphy with 99mTc-DTPA is a noninvasive, cost effective diagnostic tool, which objectively reflects the global and regional microcirculatory abnormalities of the hands, and provides quantitative data for follow-up.
Characterization of radioiodine therapy failures in Graves’ disease
Authors: Zimny M. , Schreckenberger M. , Reinartz P. , Nowak B. , Ostwald E. , Schäfer W. , Block S. , Setam K. , Büll U. , Sabri O. 
Published: March 2018

Summary
Aim of this study was a characterization of radioiodine therapy (RIT) failures in Graves’ disease without simultaneous Carbimazole. Method: 226 patients with a confirmed diagnosis of Graves’ disease received 686.8 ± 376.4 MBq of iodine-131 orally for thyroid ablation. Target dose was 250 Gy. All patients were followed up for 6 months. Therapy failures were compared with successes regarding possible influencing variables initial thyroid volume, thyroid function, immune activity (TRAb), 1-131 uptake, effective half-life, absorbed energy dose, age and gender. Results: 212 of 226 patients (93.8%) were treated successfully, 14 (6.2%) showed a hyperthyroidism relapse within 6 months which required a second radioiodine therapy. A success rate of 92.5% (62/67) could also be achieved with 67 patients who were hyperthyroid at the time of RIT. Compared to the therapy successes, the 14 failures achieved significantly lower absorbed doses (223.8 ±76.6 Gyvs. 285.2 ±82.1 Gy, ρ <0.005), but with no significant differences regarding age, thyroid volume, function or TRAb (all ρ >0.2). Of the 14 failures, η = 8 reached an absorbed dose <200 Gy and η = 1 a dose <250 Gy, although 5 of the failures reached an absorbed dose of >250 Gy. Stepwise logistic regression revealed only absorbed energy dose as a variable significantly influencing therapy success (p <0.005), but no influence of initial thyroid volume, function, TRAb value, age (all ρ >0.2) or gender (p = 0.13). Two-tailed Fisher’s exact test showed no significant influence of gender on success rates (failures/successes: male 1 /36, female 13/176, ρ = 0.48). Conclusions: Except for the absorbed energy dose, no other significant variable influencing the outcome of radioiodine therapy in Graves’ disease without simultaneous Carbimazole could be found. It should be noted, though, that 5 therapy failures (2.2%) reached an absorbed energy dose of >250 Gy.
Follow-up of thyroid cancer patients using rhTSH -preliminary results
Authors: Börner A. R. , Weckesser E. , Soudah B. , Otto D. , Widjaja A. , Hofmann M. , Kreipe H. H. , Knapp W.H. , Petrich T. 
Published: March 2018

Summary
Aim: In the follow-up of patients with advanced stage thyroid cancer radioiodine scintigraphy, F-l 8-FDG PET and tumormarker hTg using stimulation with recombinant human TSH (rhTSH) were compared to the results of same diagnostic procedures during TSH-suppression or endogenous TSH-stimulation. Methods: 30 patients were investigated in hypothyroidism and after application of rhTSH regarding the serum hormone concentrations, hTg, radioiodine scans and FGD-PET scans. Results: Radioiodine avidity and FDG uptake were significantly higher in 7/30 and 3/5 patients, respectively, compared to endogenous stimulation or TSH-suppression. In about one third of patients hTg increased more than 30%. Conclusion: Our preliminary results indicate a sufficient feasibility and sensitivity of rhTSH not only in the follow-up by hTg and radioiodine scan but also in FDG-PET.
Exhalation of 1-131 after radioiodine therapy: time dependence and chemical form
Authors: Schomäcker K. , Fischer T. , Eschner W. , Gaidouk M.I. , Schicha H. 
Published: March 2018

Summary
Aim: The change of both amount and chemical forms of radioiodine exhaled in the air of rooms with patients on the therapy ward should be investigated depending on radioactivity applied, time after application, and kind of thyroid disease. Methods: The air of ward-rooms of 62 patients with thyroid carcinoma, Graves’ Disease, and autonomy which received different therapy doses, was investigated with an portable constant air flow sampler. Different chemical iodine species (organic, elemental, aerosol bound) were collected during 8 hr in various filters until 3 days after application of the radioiodine capsule, according to their chemical form. The radioactivity in the filters was measured with a well counter on defined time points after application. Results: The radioactivity exhaled was between 0,008 and 0,03% related to activity of radioiodine applied. The percentage of radioiodine exhaled related to the activity applied, differed significantly depending on disease and changed as follows: Grave’s Disease > autonomy > carcinoma. The exhalation of radioiodine became stronger with increasing applied activities and showed an exponential decrease with time. The most part of radioiodine was present in organic bound form. This organic portion decreased with time in favour of the other iodine species. Conclusion: The degree of accumulation of radioiodine orally applied within thyroid seems to be in direct proportion to the extend of its exhalation. Further measurements directly in the breathing air of RIT-patients are necessary, in order to clarify the relationship between degree of thyroid uptake and quantity as well as chemical form of radioiodine exhaled.
Moyamoya syndrome: Impaired hemodynamics on ECD SPECT after EEG controlled hyperventilation
Authors: Matheja P. , Weckesser M. , Debus O. , Löttgen J. , Schober O. , Kurlemann G. , Franzius Ch. 
Published: March 2018

Summary
Background and purpose: Ischemic symptoms in children with Moyamoya syndrome are typically provoked by hyperventilation (HV) and are accompanied by the “re-build-up” phenomenon in EEG. The value of scintigraphic detection of HV-provoked perfusion deficits remains to be elucidated. Patients and methods: In seven children with Moyamoya syndrome regional cerebral blood flow was assessed by 99mTc-ethyl-cysteine-dimer (ECD) single photon emission computed tomography (SPECT) after HV and under baseline conditions to identify ischemia prone regions. Results: Regional marked hypoperfusion after HV was found in all patients. Predominant perfusion deficits were detected in the frontal lobes. Conclusion: ECD SPECT is a potential tool for the preoperative evaluation of cerebral hemodynamics and for monitoring angiosurgical therapies in Moyamoya disease.
Lithium als Adjuvans in der Radiojodtherapie des Schilddrüsenkarzinoms
Authors: Schraube P. , Winkel K. , Kimmig B. 
Published: March 2018

Zusammenfassung14 Patienten, bei denen nach Thyreoidektomie wegen eines Schilddrüsenkarzinoms eine Elimination der Restschilddrüse mit Radiojod durchgeführt wurde, erhielten eine adjuvante Medikation mit Lithiumkarbonat. Bei 8 Patienten lagen die Lithium-Serumspiegel während der Therapie zwischen 0,3 und 0,9 mmol/1, bei 6 Patienten konstant höher als 0,9 mmoL/1. Die Radiojodkinetik wurde mit den entsprechenden Daten einer 16 Patienten umfassenden Kontrollgruppe ohne Lithium-Medikation verglichen. Weder in niedriger noch in hoher Dosierung bewirkte die Applikation von Lithium eine Erhöhung der Radiojodaufnahme oder eine Verlängerung der intrathyreoidalen Halbwertszeit. Eine signifikante Dosiserhöhung der Therapiedosis konnte somit nicht erreicht werden. Wir führen dieses Ergebnis auf die extreme endogene TSH-Stimulation bei den thyreoidektomierten Patienten zurück, die den Effekt des Lithiums auf das Schilddrüsengewebe kompensiert.
Einfache nuklearmedizinische Nierenclearancemethoden im Vergleich
Authors: Sonntag A. 
Published: March 2018

ZusammenfassungVergleichende Clearancebestimmungen mit Ganzkörpermeßstand, Schultersonde, Gammakamera sowie auch allein mit Hilfe der Plasmaaktivitätskonzentration 45 min p.i. brachten folgende Ergebnisse: Der Ganzkörpermeßstand läßt sich ohne größere Qualitätseinbußen durch eine Schultersonde ersetzen, wenn dies bei der weiteren Auswertung in geeigneter Weise berücksichtigt wird. Hingegen können bei der Clearancebestimmung mittels Kamerauntergrundkurve schon Werte unterhalb von 250 ml/min unter Umständen eindeutig falsch, d.h. zu hoch, sein. Die sehr einfache 45-min-Clearance empfiehlt sich vor allem als Zusatz- oder Reservemethode.
Die quantitative Ruhe-Radionuklid-Ventrikulographie zur multifaktoriellen Analyse der linksventrikulären Funktion
Authors: Kleinhans E. , Seiderer M. , Klepzig M. , Büll U. , Knesewitsch P. 
Published: March 2018

ZusammenfassungMit Hilfe eines Datenbanksystems wurden die Ergebnisse der qÄRNV (in Ruhe) bei 388 Patienten statistisch ausgewertet. Neben den wichtigsten globalen Funktionsparametern [globale Auswurffraktion (gAF), enddiastolisches Volumen (EDV)] wurde das Verhalten der Zeit- und Geschwindigkeitsparameter [Auswurfzeit (ET), Füllungszeit (FT), Zeit ES bis zur maximalen Füllungsgeschwindigkeit (TpFR), mittlere (mER) und maxima’e (pER) Auswurfgeschwindigkeit, maximale Füllungsgeschwindigkeit (pFR)] bei Patienten mit koronaren Herzerkrankungen (KHK, mit und ohne Infarkt-Anamnese) sowie bei Patienten mit dilativer oder kongestiver Kardiomyopathie (KMP) untersucht. Signifikante Unterschiede (p <0,025) gegenüber dem Normalkollektiv zeigten bei KHK I/II die Parameter mER, pER, pFR, ET, bei KHK III gAF, EDV, mER, pER, pFR, ET, bei KHK IV gAF, EDV, mER, pER, pFR, bei Infarktpatienten gAF, EDV, mER, pER, pFR, ET, TpFR und bei Kardiomyopathien gAF, EDV, mER, pER, pFR und TpFR. Die Sensitivität S der RuheqÄRNV bei der Erkennung einer KHK (Schweregrade I—III) war mit den Parametern mER (S: 30-59%), pER (S: 40-65%), pFR (S: 48-60%), ET (58-61%) durchschnittlich höher als die der gAF (S: 19-56%).
The Pyrophosphate Heart Scintigram in Children with Progressive Muscular Dystrophy
Authors: Nesvadba Z. , Ždánský P. , Novák J. , Kubíček J. , Kafka P. , Vižda J. , Mazurová Y. , Duška F. 
Published: March 2018

SummaryA pyrophosphate heart scintigram was obtained in 16 boys with progressive muscular dystrophy Duchenne. All of them showed pathological ECG findings and high plasma levels of CK, AST, ALT and LD. In 4 patients the scintigram was distinctly positive and in further 3 it reached borderline values. The remaining 9 boys had normal scintigraphic findings. Those with a positive heart scintigram had very high plasma levels of the enzymes under study which was suggestive of current progression of the disease. There was, however, no relation between heart scintigraphy and the affliction of the skeletal muscles expressed by means of an index.