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Biomedical subjects

H Fill

Publications and source records attributed to H Fill.

32 records · Page 2Linked to original sources
PubMed1976

Osteopathy due to methotrexate.

Two children with ALL receiving long-term therapy with methotrexate (50 mg/week i.v.) developed severe osteoporosis accompanied by swelling of the joints, gait disturbances and fractures after minimal trauma. Bone scans 85Sr disclosed a decreased input and increased turnover of calcium especially in the most used bones. The data of the calcium phosphorus metabolism are within the normal range. The minimal changes in the biopsy material of the iliac crest may be due to little mechanical use so that this part of the skeleton is not much affected by the osteoporosis. Since the controls receiving the same therapy did not have signs of such severe osteoporosis it is assumed that an additional, till unknown factor may play an additional role in this kind of methotrexate side effect.

Calcium↗
PubMed1976

Noninvasive evaluation of regional myocardial perfusion in 112 patients using a mobile scintillation camera and intravenous nitrogen-13 labeled ammonia.

The short half-life positron emitter 13N, as labeled ammonia (13NH4+), was evaluated as a myocardial imaging agent. Regional myocardial uptake of 13NH4 correlated with the distribution of labeled microspheres in experimental myocardial infarction. Using intravenous 13NH4+, myocardial scintigraphy was performed in 85 cardiac patients and 27 normal subjects. Ninety-five scintigrams were suitable for analysis. Eighteen of 24 normal subjects had homogeneous myocardial images; six had inhomogeneous images attributable to early technical problems. Perfusion defects were observed in the scintigrams of 82% (57/65) of patients with coronary artery disease, being most common in patients with myocardial infarction (27/28). Six sequential studies showed changes in perfusion consistent with the clinical course of each patient. Scintigraphic abnormalities were also observed in 4/6 patients with valvular heart disease. 13NH4+ myocardial scintigraphy is a valid and sensitive method of assessing regional myocardial perfusion and is especially useful for sequential imaging at short intervals.

Acute Disease↗
PubMed1975

[Bone scintigraphy with 99mTc-pyrophosphate: pharmokinetics of the substance and clinical experiences with the scintigraphy].

Kinetics and clinical studies of bone scintiscanning with 99mTc-pyrophosphate in 92 patients with certified diagnosis allowed the following conclusions: 1. After i.v. injection 99mTc-pyrophosphate is distributed in 3 compartments, from which it is cleared with biological half-lives of 32.7 minutes, 5.1 hours and 22.54 hours respectively. The relative size of these compartments is 1 : 3 : 6. After application of the substance, an initially high renal excretion with a consecutive exponential drop can be observed. The optimal period for scintigraphic studies seems therefore to be from 3-6 hrs, as at this time there is still an adequate activity in bone structures, while the low background activity yields a good contrast on scintiscans. 2. The clinical results of bone scintigraphy with 99mTc-pyrophosphate with 88.6% correct diagnoses can be considered as "very good". This feature can partly be attributed to an improved correlation of radiographic and scintigraphic images by the use of a specially designed, combined radiographic-photoscanning detector system. 3. Preliminary results concerning the quantitative uptake of 99mTc-pyrophosphate in fractures of the extremities suggest, that the quantitative analyses of the registered data can provide valuable prognostic information in traumatic, inflammatory and neoplastic bone lesions.

Bone Diseases↗
PubMed1975

[Absorption and pharmacokinetics of large doses of 1-thyroxine in man (author's transl)].

In recent years suppression tests with a single dose of 3 mg 1-thyroxine (T4) and weekly doses of 1 mg T 4 in the treatment of hypothyroidism have been put to clinical trial and the lack of side-effects of such high doses (5 to 15 X daily requirements) was stressed. Hence, it was decided to study the absorption of 1-T-4 from the gastrointestinal tract and its metabolism in euthyroid patients. Doses from 250 to 2500 mug T 4, mixed with 250 muCi 131I-thyroxine were given to 10 patients. After the thyroid had been blocked with perchlorate, the excretion was followed in faeces and urine for 4 to 5 days, the thyroid uptake of 131I was checked and serial blood samples were drawn to follow plasma activity curves. Quantitative analyses of T 4, triiodothyronine (T 3), ETR and TSH were also performed on the plasma samples, whilst paper chromatography of urine samples allowed a further separation of iodide and organic iodine compounds. The results showed a definite rise in plasma T 4 levels after administration of large T 4 doses, with a simultaneous increase in T 3 values. Doses of 2500 mug T 4 temporarily produce abnormally elevated plasma T 4 and ETR values, whilst T 3 increases to the upper limit of the normal range. The relatively moderate reaction of the mentioned parameters following the administration of large T 4 doses can be partly explained by the considerably lower faecal excretion of T 4 with doses of 250 mug T 4 than with high T 4 doses. There is also an intensive binding of T 4 to TBG up to single doses of 1000 mug T 4, which provides an adequate metabolic "buffer" and declines only after saturation of the TBG binding capacity at higher dosage. Moreover, larger doses of T 4 are metabolized quicker than smaller ones. The above-mentioned results allow the following conclusions: 1. Very large single doses of T 4 (2500 to 3000 mug) are less easily absorbed from the gastrointestinal tract than "physiological" doses. 2. The degradation of T 4 at high dosage is quicker than at lower dosage. 3. The intensive binding of T 4 to TBG explains the lack of side effects with large doses of orally-administered T 4. 4. On the basis of the present data single doses of 500 to 1000 mug T 4 can be recommended for therapeutic purposes.

Humans↗
PubMed1975

[Comparative studies on the clinical accuracy of two "competitive-binding-assays" for the determination of effective serum thyroxine].

160 sera of patients with normal or disturbed thyroid function was tested by ETR (Byk-Mallinckrodt) and Quantisorb (Abbott) for their metabolically effective thyroxine concentration. In 124 cases the in vitro findings were correlated with extensive clinical data, which had permitted to establish a definite judgement of thyroid function. 5,5--13,5 mug% were considered as normal values with Quantisorb, 0,8--1,18 (see article) with ETR. A critical evaluation of the test results showed a better distinction between normal and abnormal thyroid function with Quantisorb, which explains also the higher diagnostic accuracy of this kit (92,75% : 85,5%). "Grey-zones" between normal and abnormal thyroid function were found with both tests, they were smaller, however, with Quantisorb than with ETR. The Quantisorb kit can therefore be recommended for routine function tests in vitro, although the slightly greater laboratory work should be considered.

Adenoma↗
PubMedDate not supplied

Prognosis of renal transplant function by renography with radioactive hippuran.

The relation of the functional prognosis of a kidney graft to the results of renography with radioactive hippuran (OIH-RG) was assessed in 96 patients after renal allograft transplantation in 1982. By October 1, 1984 26 of these kidneys had lost their function. The curves obtained from the gamma-camera OIH-RG are classified into six different curve patterns (curve types 1 to 6) as published earlier. For the evaluation of the long-term prognosis, the survival times of the kidneys were related to the curve types. The distribution of the curve types obtained in patients with a kidney survival longer than 144 weeks differs significantly from the curve type distribution when the kidney survival is shorter than 144 weeks. The individual survival times in the collective 26 lost kidneys show a relation to the different curve types. All kidneys with curve type 4 in the last examination before hospital discharge are lost within the first 20 weeks while curve types 1 and 2 promise a functional survival up to 144 weeks. Serum creatinine time courses and their relation to the OIH-RG curve patterns are analyzed by analyses of variance and covariance with repeated measurement. These statistical analyses reveal significant differences between the creatinine courses in the single curve types and, in addition, a significant interaction of the curve types with the creatinine courses. In curve type 1, a rapid normalization of an elevated creatinine level can be predicted, while in curve type 4 no improvement of the creatinine level and thus of kidney function can be expected at least within the five days following discharge.(ABSTRACT TRUNCATED AT 250 WORDS)

Creatinine↗