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Biomedical subjects

A Neumayr

Publications and source records attributed to A Neumayr.

At least 19 recordsLinked to original sources
PubMed1993

[Immunoscintigraphy for detection of inflammatory perioperative foci].

The aim of our study was to evaluate the clinical usefulness of a monoclonal antibody (MAB; BW 250/183; Behringwerke, Germany) in patients with suspected perioperative septic foci. The MAB is directed against the nonspecific crossreacting antigen (NCA 95) which has been found on the surface of human neutrophil granulocytes and which represents a murine immunoglobulin isotype of IgG1. Immunoscintigraphy was performed by labelling the MAB with 740 MBq (20mCi) Tc-99m. Data acquisition followed 4 and 18 to 24 hours after administration by a digital Anger camera (APEX 409A, Elscint). 53 patients were investigated (31 female, 22 male; average age 39 years), 4 patients were twice, 1 patient was 3 times evaluated, which results in a total of 59 studies. 45 patients experienced operation within 12 hours after our investigation, which resulted in 36 true positive, 5 true negative, 3 false negative, and 1 false positive findings. This means a sensitivity of 92%, and specificity of 83%. Immunoscintigraphy with granulocyte antibodies can be performed at any time, the preparation of the radiopharmaceutical is simple, the image quality is high; the obtained information concerning localization and size of perioperative septic infections permits the determination of the optimal point of time for surgical intervention. The accumulation of activity was visible as early as 4 hours post application. SPECT would enhance the diagnostic accuracy, but this technique cannot be applied in all such patients.

Abscess↗
PubMed1990

[Blood-pool-SPECT for imaging portosystemic collaterals in portal hypertension].

In 46 patients, 26 male and 20 female, age from 32 to 71 years (mean 47.4 +/- 11 years) a bloodpool-scintigraphy (BPS) with SPECT (single photon emission computed tomography) was performed. The in-vivo labelling of the erythrocytes with pyrophosphate and Tc-99m was performed in the usual way. The SPECT investigations were performed with a digital Anger-Camera (Elscint; Apex 401). In 14 patients without collaterals BPS was performed to compare the method with patients with liver diseases and collaterals. 29 patients with liver cirrhosis and portal hypertension were investigated with the BPS and additionally a scintisplenoportography (SSP) was performed. In patients with only cephalad collaterals all the results were concordant. In just 1 patient with cephalad and caudad collaterals we found a discordant result. In 8 patients we performed BPS, SSP and a katheterangiography (KA). Taking the KA as the "golden standard" we found a concordant result with the 3 methods in all patients with cephalad collaterals. In patients with cephalad and caudad collaterals we once found a discordant result with the SSP and twice with the BSP. In 2 patients the patency of surgical shunts were proved. 2 patients after sclerosis of the oesophageal varices have been proved by BPS and SSP and both patients showed good therapeutical results.

Adult↗
PubMed1989

[Tumor diagnosis by immunoscintigraphy with anti-CEA antibodies (Tc-99m MAK BW 431/26)].

We evaluated the clinical application of the monoclonal antibody MAb, BW 431/26, which is easy to label with Tc-99m for tumor localization. This is an anti-CEA antibody and a murine immunoglobulin (Ig G1, Isotype). We investigated patients with colorectal carcinoma (n = 14), with colorectal carcinoma recurrences (n = 24), breast carcinoma (n = 2), stomach carcinoma (n = 1), carcinoma of the urinary bladder (n = 3), lung carcinoma (n = 2) and patients with an elevated CEA level. In primary colorectal tumors (n = 14) all carcinomas were correctly localized by IS and ECT technique. In these patients the diagnosis was already known. The planar pictures showed a false negative result in 3 patients. In patients with colorectal recurrences the investigations were performed twice in 2 patients and three times in 1 patient. In these 31 ECT investigations we found 17 true positive results, 12 true negative results, 1 false positive result and 1 false negative result. The lesions were already visualized within 4 to 6 hours, but 24-hour pictures are desirable. SPECT pictures are absolutely necessary because sensitivity is considerably improved thereby. Elevated CEA levels increase the probability of a positive IS low CEA levels do not exclude positive tumor visualization. HAMA was found in only 1 patient, but follow-up investigations are indicated.

Adult↗
PubMed1988

[Syncopes in patients of advanced age].

This review covers the various etiologies and therapeutic possibilities of syncopes in the elderly. The importance of normal blood pressure and the danger of hypotension are stressed: The frequently occurring vascular stenoses may become especially dangerous if pre-stenotic pressure drops as a consequence of orthostatic dysregulation or of inadequate treatment of hypertension. Orthostatic dysregulation--a common phenomenon in old age--is possibly due to a diminished activity of the baroreceptor reflexes or to the pooling of blood in the venous system and/or to the diminution of blood volume by therapeutic procedures (diuretics) or by bed rest. The cautious use of antihypertonics, of diuretics and of psychopharmacological drugs in the correctly adjusted dose is essential in the management of these pathophysiological mechanisms in the elderly. The orthostatic hypotension--a condition that has to be treated in the old aged--can be managed by supportive treatment such as education of baroreceptor reflexes, compression of the lower extremities, and correction of electrolyte and water disturbances. Vasoconstrictors have to be used additionally with great care to adjust the correct dose of the combination of dihydroergotamine and sympathomimetics individually.

Aged↗
PubMed1983

[Epidemiology and basic pathogenetic mechanisms of environmental and iatrogenic diseases].

In the first part environmental diseases by air pollution, water contamination and dietary factors are discussed. The important role of the combustion of coal and petrol and the increasing confrontation with carcinogenic substances, especially with those originated by smoking of tobacco are stressed and underlined by epidemiologic dates. Other epidemiologic evidences are mentioned concerning the development of cardiovascular diseases, neoplastic diseases of the colon or liver diseases by dietetic factors. In the second part epidemiologic facts of drug induced reactions and iatrogenic cases of death in hospitalized and out-patients are reported. The main responsible pathogenetic factors for such events, prevailing in elder persons, are seen in the reduced hepatic metabolic capacity, the decreasing tubular or glomerular function of the kidneys and above all the different and often unpredictable drug interactions. The most important pathogenetic mechanisms for drug interactions are changes of drug binding to albumin or competitive disturbance of renal excretion and particularly alterations of the biotransformation processes as enzyme induction or enzyme inhibition. The clinical relevance of these theoretical considerations is demonstrated by some practical examples referring to the importance of a solid knowledge of the many possible interactions in drug therapy especially in elder patients.

Aged↗
PubMed1982

[The APUD concept and its clinical significance. 2. Effect of gastrointestinal hormones, polypeptides and neurotransmitters on the physiological course and disease processes of the intestinal tract and the nervous system].

The neurally programmed APUD-cells from ectodermal origin are of peculiar significance in two respects: 1. They represent the largest endocrine gland of the whole organism and the peptides, which are secreted by the different APUD-cells, exercise a great influence on most of the motoric and secretory processes within the whole gastrointestinal tract just as on many metabolic processes as demonstrated on the so-called "enteropancreatic axis". Neoplasias of these APUD-cells, the "Apudomes", give rise to peculiar clinical syndromes. Early diagnosis of an apudome can be reached today by radioimmunologic detection of high concentrations of the responsible peptide in the blood enabling us to initiate an effective therapy at least for some of the known apudomes. 2. Beyond that the APUD-cells and their corresponding peptides are representing the so-called "peptidergic" division of the nervous system which acts as third-line effector to modulate not only the actions of the autonomic division but also of each other. The given example of the modulating effect of substance P or of the endorphines on the perception of pain is only one single aspect of the broad functional spectrum of these neuropeptides. The discovery, that the very same peptide can be detected in endocrine cells as well as in neurones, has opened one of the most fascinating and provocative developments in biology of the present time and some surprising new details can be expected in the next future.

APUD Cells↗
PubMed1981

[Clinical experience with occult blood test in 8784 patients (author's transl)].

The faeces of 8784 patients were tested for occult blood, using the "Haemoccult-II" method. 347 (4.0%) gave at least one positive result. Endoscopic examination of the gastrointestinal tract was performed in 301 patients. In 62.8% of cases the lesion responsible for the bleeding was located in the lower gastrointestinal tract, in 17.6% in the upper gastrointestinal tract. In 19.6% no cause was found for the positive test. In 133 out of 301 haemoccult-positive patients (44.2%) tumours were identified as sources of bleeding. Our results were compared with the findings obtained with other screening programmes for colorectal carcinomas. Haemoccult-II test are recommended as a yearly routine procedure for early detection of colorectal tumours.

Adenoma↗
PubMed1981

[Estimation of hepatic blood flow with 133-Xenon (author's transl)].

Regional hepatic blood flow was measured by two methods using 133-Xenon washout technique: 1. "portal method" (injection of 133-Xenon into the spleen), and 2. "arterial method" (direct application of 133-Xenon into the A. hepatica propria by an indwelling catheter after celiacography). The portal method was performed in 38 patients (30 patients with cirrhosis of the liver, 4 patients with chronic hepatitis, 4 controls with normal liver function). The results show that using this method regional liver blood flow can be measured accurately. Patients with cirrhosis of the liver had a highly significantly decreased hepatic blood flow in comparison to the control group. The advantage of this method is that extra- and intrahepatic shunts can be visualized simultaneously. However, using this method in patients with hemodynamically very effective extrahepatic collaterals the tracer does not reach the liver. In these patients regional hepatic blood flow can be estimated by the arterial method (12 patients with cirrhosis of the liver, 2 with normal liver function). However, no information about the morphology of the portal circulation can be obtained using this method. Direct comparison of the quantitative estimation of regional hepatic blood flow was performed in 6 patients. The data obtained by the 2 methods correlated highly significantly (r = 0.91).

Adult↗