Biomedical subjects

E Imhof

Publications and source records attributed to E Imhof.

21 records · Page 2Linked to original sources

PubMed1987

[Differential diagnosis of pneumonia and pulmonary infarct based on lung scintigraphy].

The etiology of radiologic signs of circumscript parenchymatous lesions is multivarious. In some instances infarction of the lung has to be distinguished from pneumonia. The differential diagnosis has important therapeutic consequences for the patient. An important criterion for primary pneumonic infiltration is Xe-trapping within the area lacking perfusion, which can only be demonstrated by perfusion scintigraphy with Xe-133-NaCl. However, infarction of the lung lacks this pathologic feature. Pathophysiologically the various changes may occur as the result of obstruction of the vessel i.e. due to alveolar hypoxia and embolism. In order to improve the diagnostic methods a combination of perfusion scintigraphy using Xe-133-NaCl and Tc-99-macroaggregate and ventilation scintigraphy with Xe-127 was employed. We retrospectively evaluated 20 patients with the nuclear medical diagnosis of either pneumonia (n = 10) or infarction of the lung (n = 10). The following criteria were adopted: history, risk factors, X-ray of the chest, blood chemistry, ECG, phlebography, pulmonary angiography and histopathological diagnosis, as well as the course of the disease. According to our results the specificity of the scintigraphic diagnosis of pneumonia and infarction of the lung was 90%. However these results will have to be verified in a prospective study using pulmonary angiography as the reference method.

Aged↗

PubMed1987

Broxaterol (Z.1170), a new oral beta 2-agonist compared with salbutamol.

The bronchodilating activity and tolerability of a single 0.5-mg oral dose of broxaterol (Z.1170) were evaluated in 18 patients with reversible bronchial obstruction. Salbutamol 4.0 mg and placebo were used as controls. The study design was double-blind within patients. The forced expiratory volume in 1 s (FEV1), pulse rate, and blood pressure were measured immediately before and 0.5, 1, 2, 3, 4, 5, and 6 h after each treatment. At the same time clinical controls were made to detect the possible presence of side effects. Both broxaterol and salbutamol caused significant increases in FEV1 until the 5th hour as compared to baseline values and until the 2nd hour as compared to placebo. No significant difference was reported between the effects of broxaterol and those of salbutamol at all the times considered. The tolerability of broxaterol was good, as was that of salbutamol. The pulse rate and blood pressure did not show any significant clinical variations. The side effect reported most frequently was tremor.

Adrenergic beta-Agonists↗

PubMed1985

Mediastinal staging of bronchial carcinoma: can computed tomography replace mediastinoscopy?

In bronchial carcinoma the assessment of operability requires an accurate evaluation of the regional and mediastinal lymph nodes. For this, both mediastinoscopy and computed tomography are often used on a routine basis today. The present work considers the relative value of these two methods of investigation. Fifty-seven patients with bronchial carcinoma, in whom both investigations were carried out prior to surgery, were included in this prospective study. In the computed tomogram, lymph nodes with a diameter of more than 1 cm were defined as positive (i.e. suspected malignant infiltration). Sixteen of the 57 patients had histologically confirmed lymph node metastases; in 13 cases the metastases were detected by computed tomography, in 12 cases also by mediastinoscopy and in 3 cases only at thoracotomy. In 41 of the thoracotomized patients, no mediastinal metastases were found. As was to be expected, mediastinoscopy also proved negative in these cases. In 9 of these cases, however, the preoperative computed tomography findings were false-positive. For computed tomography the specificity was 78% and the sensitivity 81%; for mediastinoscopy, on the other hand, the specificity was 100% and the sensitivity 75%. The specificity of computed tomography is too low. Also, lymph nodes which are only inflamed may be considerably enlarged and cannot be differentiated in the computed tomogram from those with malignant infiltration. Mediastinal lymph nodes which appear enlarged in the computed tomogram therefore have to be further investigated by mediastinoscopy. However, in this prospective study, mediastinoscopy provided no additional information in those cases in whom the computed tomography findings were negative (lymph node diameter less than or equal to 1 cm); it did not detect the metastases in the 3 patients with false-negative computed tomography findings. Therefore, in the case of a negative computed tomogram, thoracotomy may be performed immediately, without previous mediastinoscopy.

Adult↗