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F T Meisl

Publications and source records attributed to F T Meisl.

7 recordsLinked to original sources

Ultrasound-guided percutaneous ethanol ablation of parathyroid hyperplasia: preliminary experience in patients on chronic dialysis.

OBJECTIVE: We report on a 3-year experience using single-shot, ultrasonography-guided, percutaneous ethanol ablation (PEA) of hyperplastic parathyroid glands in chronic dialysis patients suffering from secondary or tertiary hyperparathyroidism. MATERIALS AND METHODS: Seventeen uraemic patients (mean age 52 +/- 14 years) with hypercalcaemia and elevated serum levels of parathyroid hormone were assessed for ethanol ablation. Ten patients did not fulfil the inclusion criteria and underwent surgical parathyroidectomy. Seven patients were treated using PEA. RESULTS: All patients treated with PEA tolerated the procedure well, and no major complications were observed. Three out of seven patients underwent further ethanol ablation due to recurrent symptomatic hyperparathyroidism. Following the procedures, serum values of total calcium and parathyroid hormone remained within target range with concomitant medical therapy in all patients. CONCLUSION: PEA performed as a single-shot therapy can be used as a minimally invasive and safe supplement to medical therapy in the treatment of secondary or tertiary hyperparathyroidism in selected patients. In case of recurrence, treatment can be repeated without any problems.

Adult↗

Expression of somatostatin receptors in inflammatory lesions and diagnostic value of somatostatin receptor scintigraphy in patients with ANCA-associated small vessel vasculitis.

OBJECTIVE: To assess the usefulness of somatostatin receptor (SSTR) scintigraphy for the evaluation of disease activity in the upper and lower respiratory tract in ANCA-associated vasculitis (AASV). METHODS: Thirty-two consecutive patients with AASV were subjected to SSTR scintigraphy as part of their initial diagnostic evaluation and follow-up. The presence of SSTRs in inflammatory lesions was evaluated with immunohistochemistry in selected cases. RESULTS: In AASV, specificity of SSTR scintigraphy for active vs non-active disease was 96% for pulmonary disease and 100% for ear, nose and throat (ENT) involvement, while sensitivity was 86% and 68%, respectively. Absence of previously present tracer accumulation characterized treatment responders, and treatment resistance was reflected by repeated positive scintigraphy. We could demonstrate the expression of SSTRs in lung and mucosal biopsies obtained from patients with active Wegener's granulomatosis and with microscopic polyangiitis. CONCLUSION: SSTR scintigraphy is useful for the assessment of AASV, indicating disease activity, disease extent and treatment efficacy. SSTRs are expressed in both granulomatous as well as non-granulomatous AASV.

Adult↗

Positive imaging of an inflammatory process at an arteriovenous access site with 111 Indium-labeled platelets.

Complications associated with the vascular access for hemodialysis represent one of the most important causes of morbidity among patients with renal replacement therapy. Early detection of arteriovenous fistula (AVF) dysfunction is of great interest. We present the case of a 70 year old woman who underwent 111In-oxine-labeled-platelet scintigraphy to evaluate thrombogenicity at 3 weeks and 3 months after surgery of a new AVF. In the first post-operative scintigraphy 4 hours after reinjection of autologous 111In-labeled platelets, enhanced focal activity was visible in the AVF projection which could not be detected after 24 hours. Since early platelet accumulation may reflect hyperemia in inflammation, this diagnosis was verified by anti-granulocyte antibody scintigraphy. The platelet scintigraphy performed 3 months later was negative, with persistence of sufficient AVF function. These data show an intense early accumulation of 111In-oxine-labeled-platelets in unspecific inflammation of an AVF.

Aged↗

111In-labelled platelets for assessment of thrombogenicity of new haemodialysis vascular access.

Using platelet scintigraphy to evaluate early thrombogenicity, we examined 39 new vascular accesses 4 weeks and 3 months after surgery. We found a significant association between platelet deposition and Doppler flow (P < 0.01) and blood pressure (P < 0.01). Compared with arteriovenous fistulae, prosthetic grafts showed significantly higher platelet uptake (after 4 h: 2.4 +/- 1.1 vs 1.2 +/- 1.1 eU, P < 0.05; after 24 h: 2.1 +/- 1.0 vs 0.6 +/- 0.8 eU, P < 0.01) and a higher Doppler flow (1184 +/- 202 vs 609 +/- 342 ml.min-1, P < 0.001). In 8 of 39 accesses, a thrombosis occurred. Accumulation of activity was not related to shunt thrombosis (specificity 61%, sensitivity 71%). We conclude that 111In-platelet scintigraphy is not suitable for the early detection of shunt thrombosis or for identifying patients at risk.

Adult↗

Continuous adaptation of the dialysis prescription maintains adequate Kprt/V in CAPD patients.

OBJECTIVE: To analyze the effect of individual adaptation of the dialysis prescription in continuous ambulatory peritoneal dialysis (CAPD), as compensation for the decline of residual renal function (RRF), on peritoneal (Kpt/V) and total (Kprt/V) urea clearance as well as on peritoneal (Kpcr) and total weekly creatinine clearances (CCr). DESIGN: Retrospective analysis of a 2-year period. PATIENTS: We analyzed 18 patients [15 male, 3 female; mean age 58.2 (24 - 80) years]. MAIN OUTCOME MEASURES: Correlations between increased dialysis prescription and Kpt/V, Kprt/V, and Kpcr. Kprt/V and CCr measurements were based on a 24-hour dialysate and urine collection. Measurements were performed over a time period of 3 to 6 months. RESULTS: The results show a linear correlation between Kpt/V and Kpcr and the prescribed volume by kilogram body weight. Kprt/V was increased slightly by increasing the dialysis prescription. Dialysate-to-plasma (D/P) ratios of urea and creatinine remained unchanged. The mean prescribed dialysate volume increased from 7.4+/-1.1 L to 10.6+/-2.5 L. Mean Kprt/V could be maintained on a stable level for a 36-month period. CONCLUSION: By adapting the dialysis prescription on an individual basis to the continuous decline of RRF, and taking the patient's body weight into account in the prescription decision, the increases in Kpt/V offset the decline in RRF. We recommend early individualization of prescription for patients on CAPD.

Adult↗