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Biomedical subjects

A Hotze

Publications and source records attributed to A Hotze.

At least 19 recordsLinked to original sources
PubMed2001

Inhalation of [123I]alpha1-protease inhibitor: toward a new therapeutic concept of alpha1-protease inhibitor deficiency?

UNLABELLED: The alpha1-protease inhibitor (alpha1-Pi) is separated from human serum and is therefore extremely expensive. Because only 2%-3% concentrates in the lung after intravenous administration, inhalational therapy for alpha1-Pi deficiency would seem likely to be better. The aims of this study were therefore to determine the pattern of deposition of inhaled alpha1-Pi labeled with 123I and measure the amount deposited in the lungs. METHODS: Eighteen patients with congenital severe alpha1-Pi deficiency were enrolled in the study. The low-specific-activity 123I-labeled alpha1-Pi aerosol (median particle size +/- SD, 3.9 +/- 2.5 microm) was generated by an air pressure-driven nebulizer. The patients inhaled for an average of 23.6 +/- 8.9 min. Static scintigrams in two projections were acquired immediately after (T1) and 1 (T2), 4 (T3), and 24 h (T4) after inhalation. The patients were divided into the following three groups according to their forced expiratory volume in 1 s (FEV1): group I, < or =40% of predicted normal (n = 8); group II, 40% < FEV1 < or = 60% of predicted normal (n = 4); group III, >60% of predicted normal (n = 6). RESULTS: The absolute percentage uptake values of alpha1-Pi in group I were 12.4 for T1, 7.3 for T2, 4.6 for T3, and 1.2 for T4; in group II the values were 13.0, 9.6, 6.2, and 2.0, respectively; and in group III, 14.6, 11.4, 6.5, and 3.6, respectively. Differences between the groups were generally statistically significant. Between T1 and T2, the probability value was <0.05 for group I versus group II, <0.006 for group I versus group III, and <0.39 for group II versus group III. Between T1 and T3, the probability value was <0.29 for group I versus group II, <0.22 for group I versus group III, and <0.94 for group II versus group III. Retention (between T1 and T4) was also dependent on the grade of the disease: P < 0.2 for group I versus group II, P < 0.001 for group I versus group III, and P < 0.02 for group II versus group III. Grading of the uptake pattern by three independent experienced investigators (87% agreement) revealed a peripheral deposition that was group dependent. We found that greater peripheral deposition corresponded with lower lung functional impairment: P < 0.5 for group I versus group II, P < 0.01 for group I versus group III, and P < 0.08 for group II versus group III. Degradation also corresponded with functional impairment: P < 0.05 for group I versus group II, P < 0.006 for group I versus group III, and P < 0.3 for group II versus group III. CONCLUSION: The results of this study show that sufficient amounts of alpha1-Pi can be deposited in the periphery of the lung by inhalation at least in patients with low-grade disease. Inhalation of alpha1-Pi may thus represent a new and more convenient route of drug administration.

Administration, Inhalation↗
PubMed1996

Are serum neopterin concentrations superior to other parameters in the differential diagnosis and prognostic assessment of Graves' disease?

There is a lack (1.) of a single criterion for the definitive differentiation between immunogenic (IH) and non-immunogenic hyperthyroidism (NIH), and (2.) also a lack of an unequivocal prognostic predictor for the individual course of patients with immunogenic hyperthyroidism. In 152 patients scheduled for iodine-131 therapy, serum neopterin concentrations were measured using a commercially available RIA, and the neopterin concentrations of IH (n = 84) and NIH (n = 42) patients were compared. Of these patients, 83 and 26 per cent respectively were treated with antithyroid drugs which did not have a significant impact on neopterin levels. In patients with IH and NIH, the concentrations [mean +/- SD] of neopterin were 1.89 +/- 0.79 milligrams and 1.98 +/- 0.9 milligrams, respectively (p = 0.4). After therapy with iodine-131, 28% of the IH-patients were euthyroid, 32% hyperthyroid, and 40% hypothyroid. In finally euthyroid patients, pretherapeutic neopterin concentrations were higher (3.1 +/- 2.8 milligrams) than in finally hyperthyroid (1.8 +/- 0.7 milligrams), or hypothyroid (1.6 +/- 0.7 milligrams) patients. These results argue against a relevant clinical role of neopterin concentrations for the differential diagnosis of IH versus NIH in these patients. However, a prognostic significance of neopterin concentrations in patients with IH is suggested.

Adult↗
PubMed1993

Analogous effects of serum lipids from patients with nonthyroidal illness and normal subjects on the uptake of thyroxine and its conversion to triiodothyronine by rat hepatocytes in culture.

The low level of triiodothyronine (T3) in nonthyroidal illnesses (NTI) has been attributed to the decreased peripheral conversion of thyroxine (T4) to T3; patient's serum lipids decreased the conversion in a cell-free system. The objective of our study was to determine whether patients' serum lipids, whose content was elevated 2.5-fold above the reference serum value, and oleic acid affected the uptake of T4 and its conversion to T3 by rat hepatocytes in culture, thereby providing information on the cell's response to these processes. Serum ether extracts and oleic acid (0.1 mumol/l) were incubated with cells followed by assessment of T4 uptake and conversion of T4 to T3. The mean T4 uptake in the presence of ether extracts of NTI patients' or normals' sera were similar (112 +/- 15% and 110 +/- 24%, respectively). There was no difference in the T4 to T3 conversion between the patient and normal groups (90 +/- 14%); oleic acid also did not influence the conversion (96.7 +/- 1.6%). Uptake and conversion in the absence of either extracts and oleic acid were controls. These results suggest that serum lipids from NTI patients and normal subjects exercise qualitatively and quantitatively almost similar influences on T4 uptake and its conversion to T3; oleic acid is not an inhibitor of T4 uptake and T4 to T3 conversion in the rat hepatocyte. Since hepatocytes actively process fatty acids, their influence on intracellular conversion of T4 is not equitable with T4 conversion using the cell-free system. Our results do not support the hypothesis that abnormal lipid metabolism in NTI impairs hepatic T4 to T3 conversion.

Animals↗
PubMed1993

Inhalation scintigraphy with an ultrafine aerosol in infants with functional bronchial stenoses.

Evaporation of Tc-99m pertechnetate at about 2500 degrees C on a carbon surface generates an ultrafine aerosol of Tc-99m-labeled carbon clusters (Technegas). The small particle size of about 100 nm enables the aerosol to behave similarly to a gas in its ability to penetrate. After inhalation, the radioactive particles adhere to the walls of the respiratory bronchioles and alveoli, or to the greater bronchial tubes if the airflow is not laminar. The high concentration of radioactivity in the argon carrier gas makes it possible to perform inhalation scintigraphy after only a few breaths. The authors investigated 24 infants with multiple events of bronchitis, most of whom had pneumonia. Seventeen patients had inhalation scintigraphy and bronchoscopy. Of these, 11 had scans diagnostic of bronchial stenosis and 6 had normal scans. Except for two pathologic scans, all scintigraphic findings matched well with the results of bronchoscopy. Seven patients had scintigraphy only, of which four were normal. Inhalation scintigraphy with Technegas is a reliable, nonhazardous procedure to preselect young patients for directed bronchoscopy.

Aerosols↗
PubMed1992

[Current aspects of the pathology, diagnosis and therapy of C-cell carcinoma. A symposium held in Bonn, July 1991].

An essential element in the histological differentiation of medullary thyroid cancer (MTC) from other thyroid tumors is the use of immunohistochemical methods. The detection of calcitonin in the tumor cells is decisive. Factors which impair the prognosis of MTC are age (> 40 y), male sex, elevated DNA-content and mitotic activity of the tumor cells, immunoreactivity against dopa decarboxylase, histaminase and Leu-M1-antigen. Family screening is based mainly on calcitonin-stimulation tests (using pentagastrin or calcium) as a genetic marker for routine screening is not available yet. Scintigraphic methods using 99mTc-(V)-DMSA, 201Tl-chloride or 99mTc-anti-CEA antibodies become more important, especially in the detection of recurrent disease. Selective venous blood sampling is another sensitive method for localizing recurrent disease. Surgical treatment plays the dominant role in the management of MTC. Complete thyroidectomy in conjunction with systematic lymphadenectomy is now the primary treatment of choice.

Carcinoma↗
PubMed1992

[99mTc-anti-granulocyte antibodies (BW 250/183) in the detection of appendicitis].

Scintigraphy with 99mTc-labeled anti-granulocyte antibodies (AGAb) was performed in 50 patients with suspected appendicitis. Sequential and static imaging as well as SPECT of the pelvis and abdomen was performed 2 h p.i. In all patients the diagnosis was confirmed either histologically or by long-term follow-up. 13 patients had histologically proven acute appendicitis. In 11 patients the appendix scan had been positive and in 2 patients the scan had shown no significant tracer uptake in the right lower abdomen. The remaining 37 patients turned out not to have acute appendicitis. 29 out of these patients had negative and 3 had positive scan findings. In 5 patients the scan was equivocal. Out of these patients 2 had pathologic findings on the left side of the abdomen which turned out to be acute diverticulitis in one patient and acute peritonitis in the other. The remaining 3 patients with unclear scintigraphic findings had no acute appendicitis. Scintigraphy with AGAb is fast and easy to perform and thus superior to cell labeling methods for diagnosing acute appendicitis. Sensitivity for the diagnosis of acute appendicitis was 85% with a specificity of 91%. Chronic or scarred non-granulocytic appendicitis--in which there is often no definite indication for surgery--was negative in our study except for two cases.

Acute Disease↗
PubMed1991

The clinician and the thyroid.

The goiter prevalence in iodine-deficient regions is up to 25%-54%. The most frequent disease in these endemic areas is non-toxic goiter, which is, however, oftentimes connected with autonomously functioning thyroid tissue leading to borderline or overt hyperthyroidism. Other thyroid diseases like cancer, thyroiditis and hypothyroidism play only a minor role in a thyroid clinic, while cases of Graves' disease may be observed more frequently. The most cost-effective tools to evaluate thyroid patients are the hand, ear and mouth of the thyroid clinician. The differential diagnosis of thyroid disorders may be evaluated by a battery of diagnostic tools like in-vitro tests and high performance imaging modalities. Once the diagnosis is established, the appropriate therapeutic procedures (drugs, radioiodine, surgery) have to be chosen. This review should be considered as a guideline for the diagnosis and treatment of thyroid diseases. In addition, special problems concerning elderly patients and pregnant women are discussed, including the differential diagnosis of thyroid diseases.

Age Factors↗
PubMed1991

[Nuclear medicine kidney diagnosis in progressive systemic scleroderma].

Kidney involvement is one of the most frequent causes of death in progressive systemic scleroderma (PSS). It is therefore important to detect potential impairment of renal function in PSS very early. In 76 patients referred for nuclear medicine diagnostic procedures, 42 pathologic results were found with 131I-hippurate clearance, while only 14 abnormal results were detected by static 99mTc-DMSA scans. Hippurate clearance is thus a sensitive method of functional renal evaluation in PSS.

Adolescent↗
PubMed1991

[A comparison of 201Tl and 99mTc-MIBI in the follow-up of differentiated thyroid carcinomas].

12 patients with suspected recurrence of differentiated thyroid carcinoma following thyroidectomy, radioiodine therapy and, in some cases, external radiation therapy had 201Tl and 99mTc-MIBI scintigraphy. Except in one case, the findings concerning tumor localization and extension were identical. In all cases, locoregional lymph node metastases as well as osseous metastases were imaged by 201Tl and 99mTc-MIBI scintigraphy. MRI images obtained in all patients with suspected lymph node metastases revealed inoperable situations in 2 cases, whereas there was no correlation in 1 patient with positive 201Tl and 99mTc-MIBI scintigraphy. In contrast, the sensitivity of the two methods was relatively low in the detection of pulmonary metastases which were imaged in 1 out of 3 patients only. Discrepancies between 201Tl and 99mTc-MIBI were observed in a case of axillary lymph node metastasis. Although tumor-/background ratios were slightly higher for 201Tl, 99mTc-MIBI SPECT showed a higher imaging quality compared to 201Tl SPECT, especially in deeply situated tumor lesions. In conclusion, 99mTc-MIBI seems to be a promising alternative imaging agent in the follow-up of differentiated thyroid carcinomas.

Adenocarcinoma↗
PubMed1991

Effect of alpha-lipoic acid on the peripheral conversion of thyroxine to triiodothyronine and on serum lipid-, protein- and glucose levels.

The influence of alpha-lipoic acid (LA, thioctic acid, CAS 62-46-4) on thyroid hormone metabolism and serum lipid-, protein- and glucose levels was investigated. In the first setup of experiments administration of LA together with thyroxine (T4) for 9 days suppressed the T4 induced increase of T3 generation by 56%. This suppression was similar to that affected by 6-propylthiouracil (54%). LA or T4 alone did not affect the cholesterol level, but together they led to a reduction. LA decreased the triglyceride level by 45%; the decrease induced by T4 or LA plus T4 was not significant. Total protein and albumin levels decreased by LA plus T4 treatment when compared to the LA control. The slight increase in glucose level by LA or T4 alone was not observed when they were administered together. In the second setup of experiments the administration of T4 for 22 days increased the serum T3 level 3-fold. When LA was combined with T4 and the treatment continued, the T3 production decreased by 22%. T4 reduced cholesterol level by 30%, and LA plus T4 further reduced it by 47%. The triglycerides were not affected. A moderate decrease in total protein was observed after treatment with T4 plus LA; T4 and LA plus T4 decreased the albumin level. The decrease in serum glucose by T4 recovers by LA treatment. These results demonstrate that LA interferes with the production of T3 from T4 when it is co-administered with T4. The elevated level of T3, after T4 administration, is reduced by treatment with LA.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

Technetium-99m-HMPAO brain SPECT in medically intractable temporal lobe epilepsy: a postoperative evaluation.

The aim of the present study was to evaluate the predictive value of interictal single-photon emission computed tomography (SPECT) using technetium-99m-labeled hexamethyl propyleneamine oxime (HMPAO) for the outcome after temporal lobectomy in patients with complex partial seizures. Out of 40 patients, 21 underwent right-sided and 19 left-sided temporal lobectomy. EEG and CT/MRI were primarily used to select the side of surgery. SPECT results correlated with temporal lobectomy in 68% of the patients. After surgical intervention, memory function was tested for both sides. Following left-sided temporal lobectomy, verbal memory was impaired in 8% of the patients, if SPECT agreed with the side selected for surgery, but in 83%, if it diverged from it. In the present study, there was no relationship between SPECT concordance with the side of temporal lobectomy and outcome as to seizure frequency and non-verbal memory. We conclude that preoperative interictal HMPAO/SPECT can contribute to the prediction of postoperative verbal memory function and that this method should be considered for use prior to temporal lobectomy.

Adolescent↗
PubMed1990

Diagnosis of bone and joint infection by leucocyte scintigraphy. A comparative study with 99mTc-HMPAO-labelled leucocytes, 99mTc-labelled antigranulocyte antibodies and 99mTc-labelled nanocolloid.

Fifty-five patients with 60 suspected infections of bones or joints were studied with 99mTc-hexamethylpropyleneaminooxine- (HMPAO-) labelled leucocytes and 99mTc-labelled antigranulocyte antibodies, in part supplemented with 99mTc-labelled nanocolloid. The findings using the different procedures were in good agreement. Apart from in vertebral lesions, a negative scan--even if the radionuclide bone scan is positive--excludes an infection with high probability (sensitivity 94%). The low specificity (57%) is due to positive imaging of various non-infected lesions. Spondylitis usually shows as non-specific cold lesions. A subtraction technique with computer assisted analysis of HMPAO and nanocolloid scans provides a more precise diagnosis of this condition.

Adolescent↗
PubMed1990

Difference of plasma amino acids following casein or soy protein intake: significance for differences of serum lipid concentrations.

There were significant differences of postprandial plasma concentrations for 8 amino acids (Cys, Val, Met, Leu, Tyr, Lys, Trp, and Arg) depending on whether pigs consumed a meal containing casein or isolated soy protein. The postprandial plasma amino acid pattern conformed with the amino acid composition of the dietary protein (except for Ser). The data, however, do not allow to conclude unambiguously, whether specific amino acids are responsible for the difference of serum cholesterol following casein or soy protein intake. Significant differences between casein- and soy-fed rats were observed regarding total and free plasma thyroxine and triiodothyronine concentrations. This observation can explain the accompanying different serum cholesterol concentrations. The different thyroid hormone concentrations were not paralleled by differences in TSH levels suggesting that dietary proteins affect thyroid function at the thyroid gland.

Amino Acids↗