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  • 1
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    German Medical Science; Düsseldorf, Köln
    In:  56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC); 20050507-20050511; Strasbourg; DOCP044 /20050504/
    Publication Date: 2005-05-05
    Keywords: ddc: 610
    Language: English
    Type: conferenceObject
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  • 2
    ISSN: 1432-0843
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The kinetics of melphalan leakage into the peripheral blood were studied in 21 patients undergoing hyperthermic isolation perfusion of the upper or lower limb as an adjuvant treatment in high-risk melanoma; in 5 patients cisplatin was added. The melphalan concentrations in the peripheral blood rose predominantly during the first 20 min of perfusion and levelled out to an apparent steady state of about 0.28 μg/ml in upper extremity perfusions, and 0.34 (without cisplatin) and 0.37 μg/ml (with cisplatin) in lower extremity perfusions. Erythrocytes labelled with technetium Tc 99m, which were added concomitantly with melphalan to the perfusion medium, appeared in the systemic circulation of the patients at an almost constant rate of 0.32% (lower and upper limb perfusions without cisplatin and 0.37% (with cisplatin) of total tracer/min. This perfusate flow rate indicated by labelled erythrocytes completely explained the leakage of melphalan from the perfusion circuit into the peripheral blood. Peak concentrations of melphalan in the peripheral blood were observed immediately after reconstitution of normal hemodynamic conditions once isolation perfusion had been teminated. This fraction of melphalan might originate from tissue-binding sites, but also from vascular compartments; therefore, a thorough washing-out procedure might minimize this effect.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1434-601X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Physics
    Notes: Abstract Theβ-decay energies of147Eu,147Gd, and151Tb were determined by usingγ-spectroscopical methods. The comparison of experimental with calculatedK-capture probabilities yielded theQ EC values 1.690( −16 +21 )MeV and 2.203( −13 +19 )MeV for147Eu and147Gd, respectively. By measuring the ratio of positron decay to electron capture for two branches in147Eu decay, the decay energiesQ EC=1.702(13) MeV andQ EC=1.709(18)MeV were derived. Also fromEC/β + ratios the valuesQ EC=2.225(75) MeV for147Gd, andQ EC=2.566(12)MeV for151Tb were obtained. Earlier discrepancies in the mass adjustment of these isotopes were removed. In course of the present studiesγ-decay properties of147Eu and147Gd were reinvestigated.
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  • 4
    ISSN: 1434-601X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Physics
    Notes: Abstract The comparison of experimental with calculated K-capture probabilities yielded the decay energies of145Sm and151Gd,Q EC=622(5) and 463(3) keV, respectively. Earlier discrepancies in the mass adjustment of these isotopes were removed and adjusted masses for145Sm,145Pm and151Gd derived. In the decay of151Gd five newγ-rays were found and the half-life remeasured to be 129(4) d.
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  • 5
    ISSN: 1619-7089
    Keywords: Radionuclide ventriculography ; Aortic regurgitation ; Mitral regurgitation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In order to evaluate the significance of gated equilibrium radionuclide ventriculography (RNV) for non invasive quantification of valvular regurgitation and follow up, various approaches were tested concerning accuracy and reproducibility. By using in vitro labeling of red blood cells and extending the acquisition time, a clear reduction of dispersion was obtained in patients without valvular insufficiency. Quantification of regurgitation directly from functional images (ventricular amplitude or stroke volume image) was clearly superior compared to the variable region of interest method. Employing functional images, reproducibility between two observers and between two independent measurements was excellent. Correlation to regurgitation values determined by cardiac catheterization was only moderate with all RNV approaches tested. RNV is limited in the absolute quantification of valvular regurgitation due to the variable overlap of right atrium and right ventricle. However, because of its high reproducibility, RNV is a non invasive technique suitable for intraindividual follow up of patients with valvular insufficiency.
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  • 6
    ISSN: 1432-1459
    Keywords: HMPAO ; SPECT ; Complex partial seizures ; Anticonvulsive therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A patient is described who developed complex partial seizures with secondary generalization 3 years after a severe viral encephalitis with a CT and EEG identified lesion in the left insular cortex and its surrounding structures. When the seizures first occurred CT and MRI as well as repeated interictal conventional EEG recordings were entirely normal. Single photon emission computed tomography (SPECT), however, revealed an area of increased 99mTc-hexamethyl propyleneamine oxime (HMPAO) uptake in the left insular cortex. After anticonvulsive therapy the seizures and the SPECT findings disappeared. 99mTc-HMPAO SPECT is a highly sensitive method for the demonstration of functional alterations in brain tissue. It can improve diagnosis of epilepsy and may provide additional information to monitor anticonvulsive therapy.
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  • 7
    ISSN: 1432-1440
    Keywords: Intracerebral hemorrhage ; Deep-vein thrombosis ; Pulmonary embolism ; Heparin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A prospective randomized pilot study of subcutaneous low-dose heparin in the prevention of deep-vein thrombosis and pulmonary embolism war carried out in patients admitted to hospital after intracerebral hemorrhage. A high incidence of deep-vein thrombosis and lung embolism was detected by phleboscintigraphy and lung perfusion scintigraphy, respectively. There was no significant reduction of deep-vein thrombosis and pulmonary embolism in the therapy group. Heparin did not increase the risk of rebleeding.
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  • 8
    ISSN: 0165-1781
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Medicine
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  • 9
    ISSN: 1432-1459
    Keywords: HMPAO ; SPECT ; Stroke ; Acute cerebral ischaemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Early diagnosis of acute cerebral ischaemia is still unsatisfactory, because X-ray computed tomography (CT) does not reveal the site and extent of hypoperfusion within the first 24h. Single photon emission computed tomography (SPECT) using 99mTc-hexamethylpropylene amine oxime (HMPAO) may offer earlier information, since the distribution of HMPAO follows the actual cerebral perfusion pattern. We therefore investigated 53 patients suffering from acute cerebral ischaemia (10 with transient ischaemic attacks, 9 with prolonged ischaemic reversible neurological deficits, 34 with completed stroke). SPECT and CT examinations were performed on days 1, 3, and 14. On day 1, SPECT revealed hypoperfused areas in 42 patients, whereas CT showed hypodensities only in 5. The sensitivity of SPECT was higher in cortical compared with subcortical ischaemia. In patients suffering from reversible neurological deficits SPECT normalized in the follow-up, corresponding to clinical improvement. In completed stroke, SPECT demonstrated variable perfusion patterns with hypo-, normo-, and hyperperfused areas on day 3 and especially on day 14. In contrast to CT, HMPAO SPECT leads to early diagnosis of cerebral ischaemia, in particular within the cerebral cortex.
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  • 10
    ISSN: 1435-1285
    Keywords: Key words31P‐magnetic resonance spectroscopy – coronary artery disease – nontransmural infarction – myocardial energy metabolism ; Schlüsselwörter31P‐Kernspinspektroskopie – koronare Herzerkrankung – nichttransmuraler Infarkt – myokardialer Energiestoffwechsel
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Um den Energiestoffwechsel in vitalem Restmyokard nach nichttransmuralem Vorderwandinfarkt in vivo zu charakterisieren, wurden Patienten (Gruppe A, n = 19) mit einer Stenose des Ramus interventricularis anterior (RIVA) und lävokardiographisch nachgewiesener Vorderwand‐Hypokinesie nach nichttransmuralem Vorderwandinfarkt phosphor‐spektroskopisch untersucht und mit einem gesunden Probandenkollektiv verglichen. Das Meßvolumen wurde zunächst mittels Kernspin‐Bildgebung in der anterioren Vorderwand positioniert. Die Phosphorspektren wurden dann unter voller antianginöser Medikation aufgezeichnet. Um einen Einfluß der Koronarstenosen ausschließen zu können, wurden zusätzlich Patienten (Gruppe B, n = 4) mit RIVA‐Stenose ohne Vorderwand‐Kontraktionsstörung untersucht. Der Einfluß einer antianginösen Medikation auf den PCr/ATP‐Quotienten wurde bei einem weiteren Patientenkollektiv (Gruppe C, n = 4) mit den gleichen klinischen Kriterien wie Gruppe A zuerst ohne antianginöse Medikation (Auswaschphase 〉 1 Tag) und danach unter laufender i.v. Medikation von Glyceroltrinitrat bestimmt. Im Vergleich zum Normalkollektiv (1,74 ± 0,23) zeigte sich bei Gruppe A (1,4 ± 0,18) eine signifikante Erniedrigung (p 〈 0,01) des mittleren PCr/ATP‐Quotienten. Bei Patienten mit normaler Ventrikelfunktion (Gruppe B) fand sich hingegen keine wesentliche Abweichung des Quotienten gegenüber dem Nornmalkollektiv (PCr/ATP: 1,64 ± 0,22; p = 0,23). Nach i.v. Gabe von Glyceroltrinitrat stieg der PCr/ATP‐Quotient bei der Patientengruppe C von 1,12 ± 0,08 auf 1,32 ± 0,13 (p 〈 0,01). Hypokinetisches Myokard nach nichttransmuralemn Vorderwandinfarkt geht bereits unter Ruhebedingungen mit einer Verminderung des Energiezwischenspeichers PCr im Vergleich zum ATP‐Gehalt des Myokards einher. Als mögliche Ursachen kommen sowohl eine Myozytendegeneration aufgrund gestörter Mikroperfusion als auch Remodelingprozesse von vitalen Myozyten im Infarktgebiet in Frage. Beide Möglichkeiten können dann z.B. über eine Anpassung der zellulären Enzymkonzentrationen zu dem erniedrigten PCr‐Gehalt der Myozyten führen.
    Notes: Summary To characterize energy metabolism in vivo after nontransmural anterior myocardial infarction, patients (group A, n = 19) with a stenosis of left anterior descending artery (LAD) and anterior wall hypokinesia by levocardiography were examined by phosphorus magnetic resonance spectroscopy (MRS). Spectra were compared to those of healthy volunteers (n = 15). The volume of interest was placed into the anterior myocardial wall by magnetic resonance imaging. Phosphorus spectra were recorded under optimal antiischemic medication. To separate the influence of coronary stenosis from that of the ischemic insult, additional patients (group B, n = 4) with LAD‐stenosis but without left ventricular dysfunction were examined. The effect of antiischemic medication on the phosphorus spectra was evaluated in patient group C (n = 4), who had the same clinical features as group A. In these patients, MRS was first performed without antiischemic medication (washout period 〉 one day) and then repeated during intravenous application of glyceroltrinitrate (GTN). Mean PCr/ATP‐ratio was significantly lower in group A patients (1.24 ± 0.18) than in healthy volunteers (1.74 ± 0.23; p 〈 0.01 unpaired t‐test). Patients with normal left ventricular function (group B) showed PCr/ATP‐ratios (1.64 ± 0.22) similar to those of normal controls (p = 0.23). After GTN infusion PCr/ATP‐ratio of group C rose from 1.12 ± 0.08 to 1,32 ± 0.13 (p 〈 0.01 paired t‐test). Thus, hypokinetic myocardium after nontransmural infarction is characterized by a larger decrease of the cellular energy buffer PCr compared to the myocardial ATP‐content. These findings may reflect degenerative changes of myocytes due to disturbed microperfusion in viable areas of the infarct or remodeling processes of viable myocytes in the infarct region. Both mechanisms may lead to adaptive changes of cellular enzyme concentrations resulting in a reduced PCr content of the myocytes.
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