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C Reiners

Publications and source records attributed to C Reiners.

At least 109 records · Page 6Linked to original sources
PubMed1995

[Results of the 75selenium homotaurocholic acid retention test (SeHCAT test) in diagnosis of diarrhea].

PATIENTS AND METHOD: For that reason absorption of bile acids was investigated using the 75Se-homotaurocholate (SeHCAT) in 239 patients with diarrhoea. SeHCAT retention time was measured as 7 day retention time in a whole body counter. An intact bile acid absorption (negative SeHCAT test) was confirmed in 23 healthy volunteers within the range of 11 to 50% (mean +/- double standard deviation). RESULTS: In 135 patients with a possible type I bile salt malabsorption the SeHCAT test was positive in 78%, thus indicating bile salt malabsorption. The test is very sensitive detecting bile salt malabsorption in Crohn's disease, identifying ileal disease more precisely than radiology. The SeHCAT test ascertained type II primary bile salt malabsorption in 7 patients, as well as type III bile salt malabsorption in patients (9 out of 28) with cholecystectomy, vagotomy, partial gastrectomy and chronic pancreatitis. In addition, a positive SeHCAT test indicating bile acid malabsorption was found in 5 out of 11 patients with irritable syndrome, diarrhoeic form, and in 4 out of 12 patients with lactose intolerance. CONCLUSION: SeHCAT retention should be measured routinely in patients with chronic diarrhoea for which the cause is not obvious.

Adult↗
PubMed1995

Radioiodine therapy of Graves' hyperthyroidism: standard vs. calculated 131iodine activity. Results from a prospective, randomized, multicentre study.

The present prospective, randomized, multicentre study was performed to directly compare for the first time the effectiveness of a standard activity of 555 MBq 131iodine vs. an activity calculated to deliver 100 Gy for treatment of Graves' thyrotoxicosis. Therapeutic success was defined as the elimination of hyperthyroidism 6 months after radioiodine application (range 4.5-8 months). A success rate of more than 90% in eliminating hyperthyroidism was reported for both approaches, but only in retrospective investigations. Investigated prospectively, hyperthyroidism was eliminated in only 71% of the patients receiving standard activity (70/98) and 58% of those randomized for calculated activity (62/107). In the patients with standard activity, therapeutic success was inversely related to thyroid size. The rate was 100% for thyroid volumes < or = 15 mL, 95% for 16-30 mL, 68% for 31-45 mL, 44% for 46-50 mL, 20% for 61-75 mL and 25% for > or = 75 mL. In those patients with an activity calculated to deliver 100 Gy (except in those with a volume < or = 15 mL) this size/outcome dependency was almost compensated. The rates were 86%, 65%, 45%, 61%, 41% and 45%, respectively. Furthermore, detailed statistical analysis revealed a strong correlation between the success of therapy and the radiation dose actually absorbed by the thyroid. The rate was 11% for a target dose of 50 Gy, 50% for 100 Gy, 67% for 150 Gy, 80% for 200 Gy, 84% for 250 Gy, 88% for 300 Gy, 90% for 350 Gy and 93% for 400 Gy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Bone mineral density in children and adolescents with juvenile diabetes: selective measurement of bone mineral density of trabecular and cortical bone using peripheral quantitative computed tomography.

Bone mineral density (BMD) was studied in 21 children and adolescents with type I diabetes and in age- and sex-matched healthy controls. BMD was selectively measured in trabecular and total bone using peripheral quantitative computed tomography (pQCT). Cortical bone density was calculated. There was a decrease of trabecular bone density (-18.9%, p < 0.01), total bone density (-9.0%, NS) and cortical bone density (-5.1%, NS) in diabetes. Trabecular bone density was inversely correlated with the duration of diabetes and the concentration of glycosylated hemoglobin (HbA1) (r = -0.48, p = 0.027 and r = -0.63, p = 0.002, respectively). Total BMD correlated inversely with HbA1 (r = -0.52, p = 0.017). pQCT allows the selective measurement of metabolically active trabecular bone where changes of mineralization first occur. We conclude that pQCT is a useful method for investigating BMD in diabetes.

Adolescent↗
PubMed1995

[Somatostatin receptor scintigraphy in medullary thyroid carcinomas, GEP and carcinoid tumors].

For this study, 24 patients with medullary thyroid cancer (MTC) and 10 with carcinoid-/GEP-tumours underwent scintigraphy with 123I-Tyr3-octreotide or 111In-DTPA-D-Phe1-octreotide (Octreoscan) or 99mTc-V-DMSA. Calcitonin and CEA were elevated in MTC patients, the other had tumour lesions on CT. Octreoscan-scintigraphy was positive in 68% of all suspicious cases. On the other hand, 123I-Tyr3-octreotide showed only rarely positive results. 99mTc-V-DMSA-scans in MTC patients were positive in 23%. Liver metastases could be seen only with Octreoscan in the non-MTC-group. These results showed better sensitivity of 111In-labelled octreotide.

Adult↗
PubMed1995

[Studies and recommendations on the design ov ROC analyses in nuclear medicine].

ROC analysis is the method of choice for an objective assessment of diagnostic tests; however, it requires large sample sizes. We investigated the influence of study design and data analysis on sampling requirements. A sample size of 123 for the patient as well as the control group, is required to prove a difference in sensitivity of 75% vs 90% (specificity 90%, statistical power 0.8). Analysis with the binormal bivariate ROC model allows > 35% reduction in sample size. If the patient group is increased the control group can be smaller, and vice versa; here the correlated ROC model also allows substantial decreases in sample size. If both diagnostic tests are performed in the same patient and control group and evaluated with the correlated ROC model, an objective, statistically sound assessment of diagnostic performance is possible with relatively small samples.

Analysis of Variance↗
PubMed1995

[Reduction of thyroid volume following radioiodine therapy for functional autonomy].

In a retrospective study we evaluated the data of 112 patients who underwent radioiodine treatment for functional autonomy of the thyroid at Essen University Hospital from 1988 to 1993. Therapeutic activities of radioiodine were administered after individual determination of activity for intended radiation doses (150-300 Gy) taking into consideration autonomously functioning volume, maximum uptake, and effective half-life. The achieved dose was calculated by means of measurement of the radioiodine kinetics during therapy. Depending on the type of autonomous function of the thyroid (solitary autonomously functioning nodule, multiple autonomously functioning nodules, autonomously functioning thyroid tissue) volume reductions between 39 and 46% were found approximately 6 months after treatment.

Aged↗
PubMed1995

[Uptake of DL-3-123I-iodo-alpha-methyltyrosine in recurrent brain tumors].

DL-3-123I-iodo-alpha-methyltyrosine (123I-IMT) is a radiopharmacon which concentrates in brain tumors and can be employed in SPECT. We performed 20 studies in 16 patients after neurosurgery for malignant brain tumors (localization of the primary tumor by CT/MRI). Tumor/non-tumor ratios (T/NT) were calculated in ROI-technique. In 17 cases there was a recurrence or tumor remnant. 14/17 were detectable by increased uptake (T/NT 1.43-2.25). The scans were correlated with CT/MRI studies and validated by biopsy (6/14) or follow-up. All 3 patients without recurrence (neuroradiological follow-up over 6-24 months) had a negative scan. 123I-IMT scintigraphy provides complementary information to CT and MRI. In equivocal neuroradiological or clinical cases it may be valuable in the detection of tumor recurrences and allows an earlier onset of therapy.

Astrocytoma↗
PubMed1994

Radiation doses to those accompanying nuclear medicine department patients: a waiting room survey. EANM Task Group Explaining Risks. European Association of Nuclear Medicine.

In a multi-centre European trial we have assessed the radiation dose to those accompanying patients undergoing nuclear medicine investigations. Dosemeters were first calibrated against each other and then used to measure the radiation dose to the nurse or relative while they were in the waiting room. In departments where there was one waiting room the median radiation dose was 13 microSv, and the corresponding figures for where there were two waiting rooms and where the patients were allowed to leave the department with their nurse or relative were 12 and 11 microSv, respectively. These figures are not significantly different. However, we found that the median radiation dose to relatives was 13 microSv while that to nurses was 3 microSv (P < 0.01), although the waiting times were not significantly different. The reasons for these differences are discussed. Our data do not support the need for a second waiting room for injected patients in a nuclear medicine department.

Calibration↗
PubMed1994

Influence of steroid medication on bone mineral density in children with nephrotic syndrome.

Bone mineral density (BMD) was studied in 26 children with idiopathic nephrotic syndrome and in age- and sex-matched healthy controls. BMD was selectively measured in trabecular (TBD), cortical (CBD) and total bone (BD) using peripheral quantitative computed tomography. Patients showed a decrease in BD, CBD and TBD. BD and CBD were inversely correlated with the cumulative dose of steroid treatment. Of the 26 patients with high cumulative doses of steroid, 16 were also treated with cyclophosphamide. In this group BD and CBD were decreased significantly compared with the children with a low cumulative steroid dose only. Compared with controls for each subgroup, significant decreases in BD, CBD and TBD were found in the group with high cumulative doses of steroids only. The higher cumulative steroid dose and the initial steroid toxicity which made cytotoxic therapy necessary, rather than cyclophosphamide itself, may be responsible for these findings.

Adolescent↗
PubMed1994

[Prophylaxis of radiation-induced thyroid cancers in children after the reactor catastrophy of Chernobyl].

The incidence of thyroid cancer in children living in heavily contaminated regions some 100 km away from the Chernobyl nuclear power plant has increased significantly between 1989 and 1993. On the basis of this observation, preparations for iodine blockage of the thyroid in cases of reactor accidents should be made not only near but also far from nuclear power plants. The WHO recommendations on age-related dosage should be followed; the total iodide dose ranging between 15 and 150 mg daily may be split into several portions. In addition, prophylaxis of iodine-deficient goiters with 50-200 micrograms of iodide daily leads to a significant reduction of the risk of radiation-induced cancers. Consequent elimination of alimentary iodine deficiency should therefore be considered as the basis of precautions against health affects of reactor accidents. Thyroid hormones are indicated only in cases of thyroid enlargement, provided that lesions suspicious for malignancy have been definitely excluded. In the case of thyroid nodules in childhood, the indication for surgery and histological verification of the lesion has to be taken generously.

Adolescent↗
PubMed1994

[Radiation exposure from diagnostic nuclear medicine in Germany 1992 (the former Federal Republic)].

Up to now, exact data on the frequency and collective effective dose of nuclear medicine examinations were missing for Germany. On the basis of official reimbursement statistics for outpatients, compiled by the Kassenärztliche Bundesvereinigung, the total frequency of nuclear medicine examinations is estimated. 2.3 million examinations have been performed in 1992 in the western part of Germany, corresponding to 35 examinations per 1000 inhabitants. 77% of the patients examined were older than 40 years. Thyroid scintigraphy leads the frequency statistics with 51%, followed by bone scintigraphy (28%) and myocardial perfusion scans (7%). The mean effective dose per examination according to ICRP 53, amounts to 3.5 mSv which corresponds to 0.12 mSv per caput. The major contributions to the collective effective dose derive from bone scintigraphy (39%) and myocardial perfusion scintigraphy (35%); the contribution of thyroid scintigraphy to the collective effective dose is only 10%. If the data are corrected for sex and age, the collective effective dose is reduced to 1.4 mSv per examination and to 0.05 mSv per caput, respectively.

Age Factors↗
PubMed1994

Enoximon-echocardiography. A new diagnostic approach for the detection of viable myocardium comparison to dobutamin-echocardiography.

UNLABELLED: Hypo- or akinetic myocardial regions can be identified as viable myocardium through recruitment of inotropic reserve. Both, dobutamine (D) as well as enoximone (E) mediate their inotropic action via an increase in intracellular c-AMP concentration based on a different action. In 10 patients with documented myocardial infarction either D (5 to 40 micrograms/kg/min, increments of 5 micrograms/kg/min every 3 min) or E (1 to 9 micrograms/kg/min, increments of 1 microgram/kg/min every 2 min) was administered intravenously on two consecutive days. Heart rate (HR), systolic and diastolic blood pressure (BP), as well as a wall motion score in 16 segment (WMS) and ejection fraction (EF) with 2D-echocardiography were determined at rest and during each increment. Viability of myocardial regions was assessed with 201thallium-SPECT (Table 1). RESULTS: *p < 0.05 vs. rest, data: mean +/- SD. While E did not cause any side effects, patients complained about rash (n = 10), headache (n = 8), angina pectoris (n = 5), and anxiety (n = 2) during the administration of D. D and E are both able to recruit a potential inotropic reserve in infarcted myocardium, and thus, identify viable myocardium. In contrast to E, D caused an increase in HR and systolic BP. Enoximone-echocardiography seems to be a new, promising tool for the identification of viable myocardium.

Adult↗
PubMed1994

[ROC analysis of tumor identification using 201Tl-(I)-chloride and 99mTc-(I)-hexakis (2-methoxy-2-isobutylisonitrile].

We investigated tumor detectability of bronchial carcinoma using 201Tl and 99mTc-MIBI with planar scintigraphy and SPECT. We studied 30 tumor patients and 7 patients with coronary artery disease in a clinical phase III trial. The lung was partitioned into 6 areas, which were read independently, to provide a sufficiently large sample of tumor-free reference regions. We calculated the statistical power for the comparison of sensitivities at a given specificity of 95% (TPF-test) to demonstrate that the subdivision of the lung and the application of the bivariate bi-normal ROC model allows an objective assessment of diagnostic performance even for the small sample size of our study. There were no significant differences between 201Tl and 99mTc-MIBI for both observers; therefore, no advantage of 99mTc-MIBI over 201Tl for tumor scintigraphy could be demonstrated. SPECT was significantly superior to planar scintigraphy and should be preferred for tumor detection in the thorax.

Adenocarcinoma↗
PubMed1993

Surgical reintervention for differentiated thyroid cancer.

Reoperation was performed in 110 of 185 patients with a differentiated thyroid carcinoma. In 25 patients (23 per cent) the indication for reintervention was a large thyroid remnant and in the other 85 (77 per cent) persistent or recurrent cancer was suspected. In 32 (29 per cent) of the 110 patients undergoing reoperation no evidence of cancer tissue was found. Tumour tissue in 33 patients (30 per cent) was resectable. Of 45 patients (41 per cent) with residual tumour after operation 24 showed only occult thyroid carcinoma with a raised serum thyroglobulin level. Eight of 21 patients with macroscopically persistent tumour died from the disease during a mean follow-up of 2.3 years. In 13 of 38 patients the investigated recurrent tumours were histologically less differentiated than the primary lesions, stressing the importance of total tumour clearance. The treatment of choice for persistent and recurrent differentiated thyroid carcinoma is surgical reintervention, if feasible, before radioiodine and radiation therapy are considered.

Adenocarcinoma, Follicular↗