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  • 1
    Unknown
    Stuttgart : Thieme
    Call number: WN445:2(2)
    Keywords: Nuclear Medicine ; Radiography
    Notes: 1st ed. entered at NLM under editor with title: Nuklearmedizin, Funktionsdiagnostik.
    Pages: xi, 510 p. : ill.
    Edition: 2., bearb. und erw. Aufl.
    ISBN: 3134619024
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  • 2
    ISSN: 1432-0584
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Evaluation of precision of a commercially available radioabsorbent assay for serum vitamin B12 (Phadebas, Pharmacia) exhibited the following results: Variance in the same assay ±1% (SD); variance between different assays ±3% (SD); recovery at all serum levels of vitamin B12 98±2% (SD); mean in 65 normal patients 527±140 pg/ml (SD). In 86 patients vitamin B12 concentration in the serum was compared with the results of theSchilling test. 12 of 55 patients with a normal55Co urinary excretion exhibited increased values of vitamin B12 in their serum. In 8 of them vitamin B12 premedication could be evaluated. 31 patients had a decreased urinary excretion of57Co (15 by malabsorption and 16 by pernicious anemia). Only in 4 of them vitamin B12 in the serum was also decreased. In 20 of the 27 patients in this group which showed normal or increased values of vitamin B12 in their serum vitamin B12 premedication could be evaluated. In 10 patients theSchilling test was repeated the next day with58Co vitamin B12 using the flushing dose of 1000 μg of vitamin B12 of the first test as premedication for the second one. Although the urinary excretion of58Co was decreased by 9.6±4.7% (SD) the diagnostic reliability was not altered. Normal values stayed in the normal range.
    Notes: Zusammenfassung Bei 86 Patienten wurde mit einem Radioassay der Vitamin-B12-Spiegel im Serum bestimmt und anschließend einSchilling-Test durchgeführt. 55 Patienten mit normalemSchilling-Test zeigten auch normale oder erhöhte Serum-Vitamin-B12-Spiegel, ohne daß Hinweise für myeloproliferative Erkrankungen oder Leberschädigungen bestanden. Von 31 Patienten mit einem Vitamin-B12-Mangel wiesen infolge einer vorherigen Vitamin-B12-Prämedikation in unterschiedlichem Abstand zum Untersuchungstermin 27 Patienten normale oder erhöhte Serumspiegel auf; nur bei 4 Patienten konnte die Diagnose auch durch die Serumspiegel-Bestimmung gesichert werden. Durch einen zweitenSchilling-Test am folgenden Tage konnte gezeigt werden, daß auch derSchilling-Test durch die Vitamin-B12-Prämedikation von 1000 γ für den ersten Test beeinflußt wird. Die beobachtete Verminderung der Urinexkretion erlaubt aber noch die Diagnose eines Vitamin-B12-Mangels, während der Vitamin-B12-Serumspiegel in einen diagnostisch nicht mehr verwertbaren Bereich ansteigt.
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  • 3
    ISSN: 1432-0584
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The effect of previous administration of a dose of 1000 μg vitamin B12 on the Schilling test was examined in 18 patients, repeating the test 24 hrs later. On the first day57Co was administered, while on the second day58Co labeled vitamin B12 was given. The counting error was less than 2.0% at the 95% confidence level. A decrease in urinary excretion of vitamin B12 of 28.7±22.2% (x±SD) was found. The mean difference between the two subsequent Schilling test series was statistically significant (p〈0.05). The excretion data of the first and the second test correlate well (r=0.86; p〈0.01; y=0.66x+1.09). Thus the repeated Schilling test with intrinsic factor must not be performed the next day.
    Notes: Zusammenfassung Bei 18 Patienten wurde der Einfluß einer Vitamin-B12-Prämedikation von 1000 μg auf das Ergebnis des Schilling-Tests geprüft, indem die Untersuchung am folgenden Tage wiederholt wurde. Dabei fand sich eine Verminderung der Vitamin-B12-Ausscheidung im Urin von 28,7±22,2% (x±SD der prozentualen Einzelwert-differenz). Die Unterschiede zwischen den beiden Schilling-Testen waren statisch signifikant (p〈0,05). Die Vitamin-B12-Ausscheidung des ersten und die des zweiten Schilling-Tests waren miteinander korreliert (r=0,86; p〈0,01; y=0,66x+1,09). Somit ist es nicht erlaubt, die Untersuchung bereits am nächsten Tag mit Intrinsic Factor zu wiederholen.
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  • 4
    ISSN: 1619-7089
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The quality of three different labeling methods of visualizing the cardiac blood pool was investigated in 72 patients:99mtechnetium labeling of red blood cells in vivo or in vitro and human serum albumin. By the simplified technique of in vitro labeling of RBC from the view point of (1) labeling efficiency, (2) activity in the blood, (3) count rates in a standard ROI over the left ventricle and the paracardiac background, (4) ratio of these count rates, and (5) evaluation of image quality, the best results were obtained. HSA and in vivo labeled RBC led to satisfactory results for visual assessment of ventricular performance in most cases. In spite of the slightly higher technical investment involved in the in vitro labeling method this technique appears to be preferable for gated cardiac blood pool studies in view of the excellent labeling quality.
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  • 5
    ISSN: 1619-7089
    Keywords: Subacute infective endocarditis ; Immunoscintigraphy ; Monoclonal granulocyte-specific antibody ; Echocardiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Immunoscintigraphy with a technetium-99m murine monoclonal IgG1 antibody directed against non-specific cross-reacting antigen (NCA-95) and carcinoembryonic antigen was performed with 20 patients with suspected subacute infective endocarditis (SIE) and 6 controls with suspected inflammatory/infectious disease elsewhere in the body. Immunoscintigraphy and echocardiography localised SIE in 11 of 15 patients in whom the disease could be confirmed. In 4 patients with validated SIE, the immunoscan was abnormal, and the echocardiogram was normal. In another 4 patients, the result was exactly the opposite. These findings suggest that the combination of immunoscintigraphy and echocardiography improves diagnostic efficacy in patients with suspected SIE.
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  • 6
    ISSN: 1619-7089
    Keywords: Regional chemotherapy ; Probe system ; Leakage
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The objective of this study was to establish a probe system for intraoperative quantitative leakage measurement during selective limb perfusion for adjuvant high-dose chemotherapy in patients with malignant melanomas. We used a portable gamma probe with digital display and investigated the physical properties in a phantom study simulating blood pool activity at different angles of the probe to the surface and different distances. In 20 patients the limb circulation was surgically separated from the systemic blood circulation, and the limb was then selectively perfused (cytostatics added) for 60 min. Initially, 15 MBq technetium-99m labelled autologous red blood cells was injected into the limb circulation, and an equal amount was kept as a standard. Every 10 min, blood samples were drawn from the body circulation and count rates were simultaneously measured by the probe system at the lower end of the sternal body. At the end of perfusion, the circulation of the limb was reconnected, the standard injected into the systemic circulation, and a blood sample drawn after 10 min. All blood samples were counted for calculation of leakage in terms of percent of the injected dose, and the results compared with the intraoperative count rates of the probe system. In the range of leakage observed in this study (0%–86%), the count rate of the probe system (corrected for blood volume, i.e. for body surface) correlated with the results of conventional measurement (r=0.92) according to the equation: %leakage=counts per sx[1.2×body surface (m2)−1.19]. In conclusion, the use of the described probe system is a feasible approach for leakage quantification which continuously yields data during selective limb perfusion.
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  • 7
    ISSN: 1619-7089
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 63-year-old male patient with a small cell bronchial carcinoma on cytotoxic therapy was followed up with the use of liver scintigraphy. In the various scintigrams the remission as well as the late reappearance of the liver metastasis was demonstrated. The abnormalities in the liver scintigrams correlated with the biochemical changes throughout the course.
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  • 8
    ISSN: 1619-7089
    Keywords: Autonomous volume ; Technetium-99m uptake ; Euthyroid and hyperthyroid goitre
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of this work was to determine the autonomously functioning volume in euthyroid and hyperthyroid goitres for prognostic and therapeutic purposes. To this end, various groups of patients were selected: individuals without evidence of thyroid disease, euthyroid patients with diffuse goitre of normal structure and function, euthyroid patients with evidence of autonomy and patients with hyperthyroidism due to autonomy. In all of them the thyroid uptake of technetium-99m was determined under exogenous suppression (TcUs) in the euthyroid state and under endogenous suppression (TcU) in the hyperthyroid state. It was demonstrated that: 1. In patients with unifocal autonomy the TcUs and TcU correlated linearly with the autonomous volume delineated and measured by sonography. 2. A nearly identical result was obtained if the mean autonomous volume in individuals without thyroid disease of 2.2 ± 1.1 ml calculated by TcUs/TcU x total thyroid volume was used as a basis. 3. The critical autonomous volume, i.e. the volume at which hyperthyroidism will occur, was found to be 16 ml at a cumulated sensitivity and specificity of 〉0.9. The method can be used to select patients for definitive treatment before hyperthyroidism occurs and to measure the autonomously functioning volume independent of its distribution within the thyroid for treatment with radioiodine. The method is easy to perform and is also an example of how a relative parameter of a function can be converted into an absolute parameter of a functioning volume.
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  • 9
    ISSN: 1619-7089
    Keywords: Rhinorrhea ; Cerebrospinal-fluid scintigraphy ; 111In-DTPA
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In an attempt to detect occult or intermittent rhinorrhea, 10 patients without and 9 cases with rhinorrhea were investigated after a lumbal injection of 1.3 mCi 111In-DTPA. Significant count rates were detectable in the nasal pledgets of all individuals, so that it was not possible to distinguish those with and those without rhinorrhea. Therefore, the ratio of activity in nasal pledgets and blood normalized for weight recommended by McKusick et al. was used. In the patients without evidence of rhinorrhea, the ratio did not exceed 2.0, whereas in 8 of the 9 cases with rhinorrhea, it was considerably increased. The detectability of rhinorrhea was increased by using more than one measurement and by provocation manoeuvres.
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  • 10
    ISSN: 1619-7089
    Keywords: Thyroid scintigraphy ; Computer-assisted scintigraphy ; Rectilinear scanning ; Image modulation ; Count density
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We compared rectilinear scanning, analogous gamma-camera imaging and imaging using a gamma camera interfaced to a computer in order to determine which of these techniques is superior for thyroid scintigraphy. Forty patients with and without goitre and irregular activity distribution were imaged using each of the three techniques. The sets of three scintigrams per patient were rated by seven physicians. These ratings were statistically analysed using a new distribution-free test. Thyroid scintigraphy using a gamma camera interfaced to a computer turned out to be the best method, especially for detecting circumscribed areas of increased uptake. We conclude that this was due to a combination of the following factors: a computer matrix of 128x128 pixels in combination with an acquisition zoom of 1.5, the high count density of the scintigrams, computer-controlled documentation after data acquisition and the use of a continuous grey scale for documentation. The improved quality and information content of the scintigrams obtained using a gamma-camera/computer system could improve the diagnostic value of thyroid scintigraphy, especially when the scintigrams are also evaluated quantitatively.
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