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Biomedical subjects

D Sandrock

Publications and source records attributed to D Sandrock.

At least 37 records · Page 2Linked to original sources
PubMed1995

99mTc-HMPAO-SPECT in the diagnosis of senile dementia of Alzheimer's type--a study under clinical routine conditions.

This study was designed to evaluate, whether investigations of cerebral blood flow can be a helpful diagnostic tool in the differential diagnosis between (senile) dementia of Alzheimer's type [(S)DAT] and geriatric depression with cognitive impairment. Under clinical routine conditions we performed Single Photon Emission Computed Tomography (SPECT) using 99mTc-Hexamethylpropyleneamine Oxime (HMPAO) in 23 patients with (S)DAT (14f, 9m; mean age 68.9 y), 17 patients with geriatric depression (9 f, 8 m; mean age 66.4 y) and 12 age-matched controls (9 f, 3 m; mean age 69.2 y). Semiquantitative analysis (corticocerebellar ratios) of eight different regions of interest (ROI) revealed a significantly (p < 0.05) reduced perfusion in the (S)DAT patients compared to the control group. The depression group exhibited perfusion values between the (S)DAT and control group. The difference between the depression and (S)DAT group was most prominent in the left parieto-occipital ROI (p = 0.008). We discuss the data with extensive regard to the literature and conclude that 99mTc-HMPAO SPECT is a valuable additional tool in the differential diagnosis of depression and dementia in the elderly.

Aged↗
PubMed1995

Reduced acute thrombus formation results in decreased neointimal proliferation after coronary angioplasty.

OBJECTIVES: We tested the hypothesis that reduced acute platelet deposition after angioplasty results in reduced late neointimal proliferation. BACKGROUND: Platelet-mediated mechanisms contribute to smooth muscle cell proliferation and migration. METHODS: Indium-111-labeled platelets were injected 16 h before coronary stent angioplasty in 10 Göttinger minipigs: group 1 (n = 5) = heparin (100-U/kg bolus) before angioplasty; group 2 (n = 5) = recombinant hirudin (CGP 39393, 1.0-mg/kg body weight bolus intravenously), followed by subcutaneous doses of 6 to 10 mg/kg every 8 h. Furthermore, stent angioplasty was performed in coronary arteries of 16 minipigs: group 3 (n = 5, nine stents) = 100 U/kg heparin only; group 4 (n = 5, 10 stents) = 1-mg/kg bolus hirudin before and 45 min after angioplasty; group 5 (n = 6, 11 stents) = hirudin (1-mg/kg intravenous bolus) before and 45 min after angioplasty, followed by 6 to 10 mg/kg subcutaneously every 8 h. RESULTS: In segments with deep arterial injury, the number of platelets/angioplasty segment in group 2 after 72 h (mean 21, range 9.7 to 39.7 x 10(6)) was significantly less than that in group 1 (mean 375, range 72 to 787 x 10(6)). Morphometric analysis after 4 weeks showed no difference between groups in degree of vessel wall injury. Mean (+/- SD) neointimal thickness was 0.70 +/- 0.06 mm in group 3 and was significantly reduced in both group 4 (0.46 +/- 0.11 mm) and group 5 (0.48 +/- 0.21 mm). CONCLUSIONS: The direct thrombin inhibitor hirudin significantly reduces platelet deposition up to 72 h after coronary stent angioplasty. A hirudin bolus alone as well as continued subcutaneous administration for 14 days substantially reduced neointimal proliferation compared with heparin 4 weeks after coronary stent angioplasty in minipigs.

Angioplasty, Balloon, Coronary↗
PubMed1995

Indium-111-antimyosin Fab imaging to demonstrate myocardial involvement in systemic lupus erythematosus.

Indium-111-antimyosin Fab imaging has been used to indicate myocardial injury. This report describes antimyosin accumulation in two patients with myocardial involvement in systemic lupus erythematosus. Both patients complained of chest pain, and significant stenoses of extramural coronary arteries were ruled out by angiography. The first patient, a 64-yr-old woman, had immunopathologic findings suggestive of systemic lupus. Indium-111-antimyosin Fab imaging showed myocardial tracer uptake. This prompted endomyocardial biopsy providing evidence of systemic lupus. The patient improved under immunosuppressive therapy. The second patient, a 47-yr-old man, had systemic lupus diagnosed by immunopathologic findings and skin biopsy. He had evidence of pericarditis on electrocardiography and echocardiography. Indium-111-antimyosin Fab imaging demonstrated additional myocardial involvement, which supported the initiation of immunosuppressive therapy. Our results suggest that 111In-antimyosin Fab imaging may provide valuable diagnostic information and influence patient management in systemic lupus erythematosus with suspected myocardial involvement.

Antibodies, Monoclonal↗
PubMed1995

[Radioiodine therapy of funcitonal autonomy using the functional autonomous volume].

In order to determine the effective radiation dose to be delivered by 131I in functional autonomy we have used the functional autonomous volume calculated from the global 99mTc thyroid uptake under exogenous or endogenous suppression before and 3 to 7 months after treatment. The radiation dose to the autonomous volume was calculated retrospectively in 131 patients with unifocal, multifocal and disseminated autonomy (75 hyperthyroid, 56 euthyroid) who received 131I treatment of 200-300 Gy to the total volume of the gland. It could be shown that at least 350 Gy to the autonomous volume are required to reach the desired effect of treatment which was dependent only on the radiation dose delivered to the functional autonomous volume.

Follow-Up Studies↗
PubMed1995

Falsely negative 99mTc-antigranulocyte immunoscintigraphy and positive 99mTc-HMPAO-labelled leukocyte scan in active Crohn's disease. Possible effects of immunosuppressive therapy?

A 19-year-old woman with active Crohn's disease under immunosuppressive therapy underwent scintigraphy with 99mTc-anti-NCA-95 antigranulocyte antibodies in order to determine the extent of inflammation. It turned out to be falsely negative whereas a 99mTc-HMPAO-labelled leukocyte scan revealed a marked terminal ileitis and pancolitis. It is assumed that immunosuppressive therapy was the main reason for the falsely negative antibody scan, possibly affecting the red bone marrow where most of the antibodies bind to granulocytes. Peripheral leukocytes labelled in vitro do not seem to be subject to these hypothetical effects on red bone marrow.

Adult↗
PubMed1994

Immunoscintigraphy using technetium-99m-labeled anti-NCA-95 antigranulocyte antibodies as an adjunct to echocardiography in subacute infective endocarditis.

OBJECTIVES: This study was performed to assess the clinical value of immunoscintigraphy in subacute infective endocarditis. BACKGROUND: Radiolabeled granulocytes can reveal inflammatory lesions. METHODS: Using technetium-99m-labeled anti-NCA-95 anti-granulocyte antibodies, planar scintigraphy and single-photon emission computed tomography of the thorax were performed in 72 consecutive patients with suspected endocarditis. Each patient also underwent transthoracic and, if findings were negative, transesophageal echocardiography. RESULTS: Thirty-three patients were found to have endocarditis on the basis of clinical criteria (surgical confirmation in 17 patients), and the remaining 39 served as control subjects. Initial scintigraphy was true positive in 26 patients (sensitivity 79%) and false positive in 7 (specificity 82%). Echocardiography was true positive in 29 patients (sensitivity 88%) and false positive in 1 (specificity 97%). Scintigraphy was positive in the four patients with false negative echocardiography, and echocardiography was positive in the seven patients with false negative scintigraphy. Thus, the combination of scintigraphy and echocardiography yielded a sensitivity of 100% and a specificity of 82%. In 10 of the 11 patients with two to three follow-up studies, scintigraphy became negative parallel to clinical improvement, indicating decreasing floridity of the inflammatory process. CONCLUSIONS: Immunoscintigraphy in patients with subacute infective endocarditis provides valuable diagnostic information in equivocal echocardiographic findings and may be used to monitor antibiotic therapy.

Adolescent↗
PubMed1994

Bone marrow immunoscintigraphy versus conventional bone scintigraphy in the diagnosis of skeletal metastases in urogenital malignancies.

Bone marrow immunoscintigraphy using a 99mTc-labelled anti-NCA-95 monoclonal antibody and conventional bone scintigraphy with 99mTc-methylene-diphosphonate were compared in the diagnosis of skeletal metastases in 58 patients with urogenital tumours. In 13 patients with metastatic disease, bone marrow immunoscintigraphy proved to be superior to bone scintigraphy, detecting 431 metastatic lesions on immunoscans as compared to 261 lesions on bone scans. However, on a patient-by-patient basis bone marrow immunoscintigraphy did not demonstrate a clinical advantage over conventional bone scanning, as in this study no patient was identified with metastatic disease still confined to the marrow space, with bone scintigraphy and bone X-ray being normal.

Adult↗
PubMed1993

[Fibrin agglutination of thyroid gland cysts after fine needle puncture].

Tolerance to and efficacy of a fibrin adhesive injected into thyroid cysts after their evacuation by fine needle puncture was investigated in 60 consecutive patients (52 women, 8 men; mean age 50 [18-82] years) with solitary thyroid cysts. The patients were randomly separated into two groups of 30 each. In group A patients the cysts were completely emptied by fine needle puncture under ultrasound control. In group B patients a fibrin adhesive (0.8-1.4 ml) was subsequently injected. 25 of 30 patients in group A had recurring cysts, twelve of which were larger than the original one. There were 13 recurrences in group B (P < 0.005), but only one was of a larger volume. In each group three patients reported a brief period of pain after the evacuation procedure. The described technique has proven to be reliable and well tolerated. Cysts obliterated by fibrin adhesive recurred less frequently and had a smaller volume than those only evacuated by needle puncture.

Adult↗
PubMed1993

The role of gallium-67 tumour scintigraphy in patients with small, non-cleaved cell lymphoma.

Two hundred and thirty-four scintigraphic studies were performed in 34 patients (27 men, 7 women, age 17.3 +/- 7.7 years) with small, non-cleaved cell lymphoma who had follow-up for 3-96 months (mean 21.6 +/- 21.7 months). Whole-body scintigraphy was performed 48-72 h following i.v. injection of 370 MBq gallium-67 citrate. "Gold standards" for truth determinations were surgery, autopsy, histology, axial x-ray computed tomography, magnetic resonance imaging, ultrasonography and clinical follow-up. Overall, 181 of 234 studies were true negative. Eighty proven sites of disease had true positive 67Ga uptake (in 21 patients/37 studies). Nineteen sites (in 12 patients/15 studies) were false positive. In addition, 31 benign lesions were detected and interpreted correctly in terms of non-malignancy. Ten lymphoma sites (in 6 patients/10 studies) were missed by scintigraphy. Overall, sensitivity of gallium scintigraphy was 89% when calculated by sites and 79% when calculated by studies. Corresponding specificities were 91% and 92%, respectively. Positive predictive values were 81% (sites) and 71% (studies), and negative predictive values 95% (sites and studies). Thus, gallium scintigraphy proved to be a sensitive and specific method for staging and follow-up in patients with small, non-cleaved cell lymphoma.

Adolescent↗
PubMed1993

Platelet and fibrin deposition on coronary stents in minipigs: effect of hirudin versus heparin.

OBJECTIVES: The present study was designed to test the hypothesis that the direct thrombin hirudin is more efficient than heparin in reducing thrombus formation after coronary stenting. BACKGROUND: Despite aggressive anticoagulation, subacute thrombosis of coronary stents is a major complication associated with these new devices. METHODS: In 19 minipigs indium-111-labeled thrombocytes and iodine-125-labeled fibrinogen were injected 14 to 19 h before coronary implantation of tantalum balloon-expandable stents. In group 1 (n = 6, seven stents), a bolus of heparin (100 U/kg body weight) was given before stenting. Group 2 (n = 6, 11 stents) received both dextran (500 ml) and heparin (a 100-U/kg bolus followed by a continuous infusion of 50 U/kg per h). In group 3 (n = 7, 13 stents), hirudin (recombinant desulphatohirudin HV 1 [CGP 39393] [1 mg/kg]) was given before stent implantation, followed by an infusion of 1 mg/kg per h. All animals were pretreated with aspirin (250 mg intravenously). RESULTS: Activated partial thromboplastin time was prolonged to > 1.8 times control values in groups 2 and 3. Histologic examination after perfusion fixation 12 h after stenting showed a variable extent of thrombus on all stents. Medial tear was observed in three stents in group 1, six stents in group 2 and six stents in group 3. The number of platelets on all stents averaged 116.2 (range 22 to 522) x 10(6) in group 1, 64.3 (range 11 to 169) x 10(6) in group 2 and 19.7 (range 9 to 38) x 10(6) in group 3 (p < 0.05 vs. group 1 and vs. group 2). The increase in platelet deposition, associated with medial tear in all groups, was lowest in the hirudin group. Similarly, fibrin deposition was lowest on stents in hirudin-treated animals. CONCLUSIONS: Recombinant hirudin significantly reduces platelet and fibrin deposition on coronary stents compared with the reduction achieved with combined heparin, dextran and aspirin.

Angioplasty, Balloon, Coronary↗
PubMed1993

Long-term follow-up in patients with autonomous thyroid adenoma.

A group of 375 untreated euthyroid patients with solitary autonomous adenoma of the thyroid were studied in a long-term follow-up (observation period 52.8 (mean)/46 (median), range 3-204 months). During the period of observation, 133 (34.2%) of all initially untreated patients underwent treatment (surgery, radioiodine, antithyroid medication) because of hyperthyroidism, mechanical problems, or at the patient's request. Sixty-seven patients developed hyperthyroidism resulting in a mean incidence of 4.1% per year. The incidence of hyperthyroidism increased during follow-up (3% in the first seven years, 10% in the following years). Age, sex, nodule size, initial scintigraphic appearance and the TRH test were of no individual prognostic value in predicting hyperthyroidism. Eleven of 14 patients with untreated hyperthyroidism became euthyroid without treatment during the time of follow-up. After iodine excess (by history or elevated iodine levels in urine, N = 45), 14 patients (31%) developed hyperthyroidism. In conclusion, we recommend a definitive treatment of autonomous adenoma at least in patients with advanced age, concomitant diseases and a higher probability of iodine exposure.

Adenoma↗
PubMed1993

Ultrastructural histology correlates with results of thallium-201/technetium-99m parathyroid subtraction scintigraphy.

Specimens from 15 scintigraphically true-positive adenomas (golden standard: histology), 15 false-negative adenomas, 15 true-positive hyperplasias, 15 false-negative hyperplasias, 15 true-negative normal glands from patients with hyperparathyroidism, and 15 normal glands from patients without hyperparathyroidism, all selected randomly, were studied. After fixation, sectioning and H and E staining, in all 90 tissues the number of oxyphil, chief, and clear cells was counted in five randomly selected squares (103 x 103 microns). In 30 tissues, the number of mitochondria per cell was counted in five randomly selected cells from each lesion in transmission electron photomicrographs. Total cell counts in each group and number of chief cells showed no correlation with lesion detectability by scintigraphy. However, true-positive lesions had a significantly higher number of oxyphil cells than false-negative or normal glands. Twenty-one of 30 true-positive lesions had a oxyphil-to-clear cell ratio > 1; in contrast to only two of 30 false-negative lesions and 0 of 30 normal glands (p < 0.0005). The number of mitochondria per cell was higher in oxyphil cells in true-positive lesions (adenomas: 155 +/- 58, hyperplasias: 55 +/- 18) than in chief or clear cells in false-negative or normal lesions (30 +/- 15, p < 0.001). Our data suggest that the detectability of abnormal parathyroid glands by 201TI/99mTc subtraction scintigraphy is in part dependent upon the presence of mitochondria-rich oxyphil cells.

Adenoma↗
PubMed1991

[201Thallium reinjection after exertion-redistribution myocardial scintigraphy. A new method for distinguishing between scars and vital myocardium].

In a prospective study 38 patients (35 men, 3 women; median age 56 [37-71] years) with known coronary heart disease in whom conventional thallium-201 exercise-redistribution myocardial scintigraphy (ERMS) had demonstrated segments with diminished activity, thallium-201 was again injected ("reinjection scintigraphy"). Its purpose was to test whether in myocardial segments with persisting diminished radioactivity improved activity after reinjection provided evidence for still viable myocardium. Seven myocardial segments were evaluated in each patient, i.e. a total of 266 segments. Activity in the conventional ERMS was diminished in 94 of the 166 abnormal segments, but improved on reinjection in 21 of the 94 segments (22.3%). Nine of the 38 patients (23.7%) benefitted from the reinjection: only scar tissue without any viable myocardium would have been diagnosed by conventional ERMS in four patients, while extent and spread of ischaemic myocardium was better visualized in five.

Adult↗
PubMed1991

Radioimmunoimaging of subacute infective endocarditis using a technetium-99m monoclonal granulocyte-specific antibody.

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.

Adolescent↗
PubMed1991

Positive gallium-67 citrate scintigraphy in Wiskott-Aldrich syndrome with malignant lymphoma.

This case describes the first detection of solid lymphoma lesions by gallium-67 scintigraphy in a 12-year-old patient with Wiskott-Aldrich syndrome. Gallium 67 uptake was found in multiple sites in the patient who had developed an undifferentiated small, non-cleaved cell lymphoma. Response to chemotherapeutic treatment is correlated with findings on the gallium scintigraphy follow-up.

Child↗