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Biomedical subjects

E M Kirchner

Publications and source records attributed to E M Kirchner.

10 recordsLinked to original sources
PubMed2002

[Observing the density increase curve after intravenous contrast medium administration using a bolus triggering system: a method for detection cardiovascular disorders?].

PURPOSE: Recently bolus tracking systems were developed to improve the timing of intravenous contrast media application in helical computed tomography. We investigated the benefit of this new method as a parameter of the cardiac function. MATERIAL AND METHODS: Retrospective analysis of 64 patients which incidentally underwent bolus triggered contrast enhanced helical CT and invasive investigation of the heart within one week. All examinations were performed on the CT scanner Somatom Plus 4 Volume Zoom (Siemens Corp., Forchheim, Germany) using the C.A.R.E. Bolus software. This performs repetitive low-dose test scans (e.g. for the abdomen: 140 kV, 20 mA, Tl 0.5 s) and measures the Hounsfield attenuation (increase over the baseline) in a preselected region of interest. The displayed increase of vascular density over the time after peripheral contrast media injection (75 ml lopromid (300 mg/ml), 2 ml/s) was categorised to three types: (a) rapid increase, (b) deceleration before a 100 HE threshold was reached and (c) one or more peaks. The findings of the invasive investigation of the heart were correlated to the findings of the bolus-tracking measurements. RESULTS: The examinations were categorized as follows: 19 type A, 34 type B, 11 type C. We found a high significant correlation between the type of the Hounsfield attenuation and systolic pressure in the left ventricle. There was no correlation between the type of the Hounsfield attenuation and the diastolic pressure in the left ventricle, the pressures related to the right ventricle or the ejection fraction. The bolus-tacking system showed a sensitivity of 53, a specificity of 82, an accuracy of 70%, a positive predictive value of 70% and a negative predictive value of 70% in detection of left heart failure. CONCLUSION: The bolus tracking system C.A.R.E.-bolus often shows atypical Hounsfield attenuation in cases of cardiac failure but is not suitable as a screening method of the cardiopulmonary function.

Absorptiometry, Photon↗
PubMed2002

Sequential immunochemotherapy and edrecolomab in the adjuvant therapy of breast cancer: reduction of 17-1A-positive disseminated tumour cells.

BACKGROUND: The aim of our study was to evaluate the efficacy of the monoclonal antibody edrecolomab after chemo- and radiotherapy in the elimination of disseminated tumour cells in bone marrow in the adjuvant therapy of breast cancer. PATIENTS AND METHODS: The bone marrow of 25 patients with breast cancer was tested for the presence of disseminated tumour cells using the pancytoceratine antibody and the alkaline phosphatase-anti-alkaline-phosphatase (APAAP) technique. To characterize tumour cells simultaneously, immunofluorescent double labelling of pancytoceratine and epithelial cell adhesion molecule (antibody 17-1A) was performed on tumour cells after magneto bead enrichment. Patients positive for the 17-1A antigen in bone marrow after chemotherapy were treated with edrecolomab (500 mg Panorex) initially, then 100 mg/month over 4 months) and investigated for the presence of micrometastases 6 weeks after the last treatment. RESULTS: Of the 17 patients showing bone marrow micrometastases (BM-MM), 14 tested 17-1A positive before adjuvant chemotherapy. After chemotherapy, nine patients remained positive for the 17-1A antigen and were treated with edrecolomab. The final investigation after immunotherapy showed a complete elimination of the 17-1A-positive BM-MM in seven patients and a significant reduction of these cells in two patients. CONCLUSIONS: Sequential treatment of breast cancer with edrecolomab after adjuvant chemotherapy can reduce disseminated tumour cells in the bone marrow and eliminate 17-1A-positive micrometastases.

Adult↗
PubMed2001

Transformation of Hodgkin's disease to high-grade B-cell lymphoma: remission after Rituximab monotherapy.

PURPOSE: We demonstrate the usefulness of immunotherapy with the CD20 antibody Rituximab in a case of transformation of Hodgkin's disease (HD) to high-grade non-Hodgkin's lymphoma (NHL). CASE REPORT: A 45-year-old women suffering from lymphocyte predominant HD of paragranuloma type (stage IVb) since 1995 showed mediastinal relapse despite of 6 cycles of chemotherapy following the COPP/ABVD-protocol in 1998. Again complete remission could be achieved after escalated BEA-COPP II therapy in May 1998. Six months later chest radiograph and CT depicted pulmonary nodules. The non-typical resection of the lung revealed pulmonary involvement of a high-grade T-cell rich large B-cell lymphoma with 100% of the tumoral cells CD20 positive. Since the symptoms occurred shortly after the BEA-COPP-escalated protocol chemotherapy resistance had to be assumed. Because of this problems and supported by the refusal of a high-dose chemotherapy with stem-cell transplantation by the patient we decided to perform a mono-immunotherapy with the monoclonal CD20 antibody Rituximab. Today, 14 months later, the patient is still in complete remission including the absence of B symptoms. CONCLUSIONS: Immunotherapy against CD20 positive cells in cases of sequential HD and NHL seems to be an effective therapy in chemotherapy resistant cases because of the suspected clonally relation of both diseases.

Antibodies, Monoclonal↗
PubMed2001

Melanoptysis: findings on CT and MRI.

The purpose of this study was to demonstrate the CT and MRI features of liquefied progressive massive fibrosis (PMF) in coal worker's pneumoconiosis (CWP). A retrospective analysis was made of the CT and MRI features in five patients suffering from severe CWP with the initial clinical finding of melanoptysis ("black phtisis"). CT showed either an air-fluid level or a fluid-precipitate level with high density in the dependent layer. On pre-contrast T(1) weighted images, liquefied PMF showed a fluid level with isointensity relative to soft tissue in the upper layer and a signal loss in the dependent layer of the lesion. The wall of the PMF showed rim enhancement after administration of iv gadolinium. On T(2) weighted images there was a high signal intensity in the upper layer of the lesion. In conclusion, liquefied PMF results in characteristic features on CT and MRI owing to precipitation of silica in the mucous fluid.

Aged↗
PubMed1996

Eating disorder symptoms in former female college gymnasts: relations with body composition.

The purpose of this investigation was to describe eating disorder symptoms in 36.6 +/- 3.8-y-old former college gymnasts as well as relations between body dissatisfaction and body composition. Former college gymnasts (n = 22) and age-(mean +/- SE difference: 0.05 +/- 0.26 y), height-(0.47 +/- 0.75 cm), and weight-matched (2.20 +/- 0.30 kg) control subjects (n = 22) participated. Current and past symptoms were assessed by using the Eating Disorders Inventory-2 (EDI-2) and visual analog scales. EDI-2 body-dissatisfaction scores were correlated with assessments of body composition by dual-energy X-ray absorptiometry. Weight preoccupation was stable across the life span for control subjects but was lower before former gymnasts had begun gymnastics training and higher for former gymnasts when they were participating in college gymnastics (P = 0.03). Current levels of body dissatisfaction were more strongly related to actual minus ideal body-weight discrepancy scores (r = 0.77) than to percentage fat (r = 0.50) for the former gymnasts whereas the opposite was true for the control subjects (r = 0.51 and 0.77, respectively). These results suggest that symptoms of eating disorders abate after retirement from gymnastics and that concerns about achieving an ideal body may be a more important determinant of body dissatisfaction than percentage body fat for gymnasts.

Absorptiometry, Photon↗
PubMed1996

Effect of past gymnastics participation on adult bone mass.

The purposes of this study were to determine bone mineral density (BMD) of former female college gymnasts (FG; n = 18) and controls (FC; n = 15) by using dual-energy X-ray absorptiometry (Hologic QDR 1000W) and to examine the relationships between current and former activity levels, diet, menstrual history and BMD. Current physical activity, dietary intake, and menstrual irregularity were assessed with the use of standardized questionnaires. A study-designed questionnaire was used to assess past physical activity. The BMDs of the FG were significantly higher (P < 0.001) than the BMDs of FC for the lumbar spine, femoral neck, Ward's triangle, and whole body, even when the influences of current and past physical activity levels were statistically controlled via analysis of covariance. FG and FC did not differ in nutrient intakes, and there were no BMD differences between FG who always had regular menstrual cycles vs. those who had an interruption (> or = 3 mo) of their menstrual cycle in the past. The higher BMD in FG compared with FC suggests that past participation in college gymnastics may provide a residual effect on adult BMD.

Adult↗
PubMed1995

Bone mineral density and dietary intake of female college gymnasts.

The purposes of this study were to determine bone mineral density (BMD) of female college gymnasts (N = 26) and age- (+/- 1.0 yr), height- (+/- 5.1 cm), and weight- (+/- 2.3 kg) matched controls (N = 26) using dual energy x-ray absorptiometry and to examine the relationship of physical activity, diet, menstrual history, and BMD in these athletes. Energy expenditure, dietary intake and menstruation were assessed using standardized questionnaires. The BMD of the gymnasts were significantly (all P < 0.0001) higher than controls for the lumbar spine (L1-4), total proximal femur, femoral neck, Ward's triangle, and whole body. Mean calcium and kcal intakes for both groups were lower than the Recommended Dietary Allowances, and gymnasts had significantly lower kcal intakes than controls (P < 0.05). More gymnasts than controls (59% vs 24%) reported that their menstrual cycle had been interrupted at some point since menarche (P < 0.02). The major finding of this investigation is that the BMD of gymnasts were higher than matched controls despite the fact that gymnasts as a group had inadequate dietary calcium and a higher propensity to have an interruption of their menstrual cycle.

Absorptiometry, Photon↗
PubMed1995

Eating disorder symptoms in female college gymnasts.

In study 1, 21 females provided both honest and dishonest answers to the Eating Disorders Inventory-2 (EDI-2). It was found that the EDI-2 can be easily faked. The fake profile was used to screen subjects in a second study, in which 25 gymnasts and 25 matched controls were assessed on symptoms of eating disorders, energy intake, menstrual history, and bone mineral density (BMD). A Hotelling's T2 test (Wilks' lambda = 0.70) revealed that the gymnast and control groups did not differ significantly (P > 0.05) on the EDI-2 subscales; however, both groups exhibited scores on the Drive For Thinness (DFT) subscale of the EDI-2 that were higher than the published average for college women. More gymnasts (61%) than controls (24%) reported an absence of their menstrual cycle of 3 months or more. A higher percentage (8/11, 73%; chi 2 = 4.7, P < 0.05) of the subgroup with elevated DFT scores (i.e., > 14) reported having this disruption of their menstrual cycle compared with those with lower DFT scores (13/33, 39%). DFT scores were negatively (P < 0.05) related to energy intake (r = -0.48) and whole body BMD (r = -0.47). It is concluded that (a) DFT scores may be useful in identifying gymnasts at risk for problems associated with eating disorders, and (b) response distortion must be considered in future research using the EDI-2.

Adult↗