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Biomedical subjects

J Adolph

Publications and source records attributed to J Adolph.

31 records · Page 2Linked to original sources
PubMed1988

Cost-effective management of patients following myocardial infarction: the impact of ischemia on alternative approaches.

Following uncomplicated myocardial infarction patients are at varying risk for cardiovascular morbidity and mortality. In order to identify and treat high risk patients, various management approaches can be employed. We performed a decision analysis to examine the cost-effectiveness of seven alternative strategies under the assumption that prognosis is affected by both the location of anatomic obstruction and the degree of myocardial ischemia. Strategies included combinations of angiography and two theoretical diagnostic tests capable of detecting ischemia with different degrees of accuracy. The strategy associated with the lowest overall six month mortality initiated testing with the diagnostic test most sensitive for ischemia, slightly better than proceeding initially to angiography. Initial use of a test sensitive for ischemia was also considerably more cost-effective than proceeding directly to angiography. Future analyses evaluating the role of diagnostic tests in coronary artery disease should incorporate the dimension of ischemia.

Coronary Disease↗
PubMed1987

[Value of 3-phase skeletal scintigraphy in the diagnosis of bone metastases].

51 patients suffering from 125 bone metastases of various primary tumors were investigated with three-phase skeletal scintigraphy in an attempt to define criteria characteristic for bone metastases with regard to differential diagnosis. During the 3 phases of imaging, the metastases exhibited 5 different patterns of activity concentration. None of these patterns was correlated either to the size and morphological X-ray appearance of the metastases or to the histology of the primary tumors. The intensity of radionuclide concentration was also varying. The most frequent patterns of activity concentration were increased uptake during the blood-pool phase and skeletal phase combined with absence of concentration during the angiographical phase (43%), and increased uptake during all of the 3 phases (34%). In this series, a pattern of scintigraphical findings characteristic for bone metastases or helpful in the differential diagnosis could not be determined. In our experience, three-phase skeletal scintigraphy is not useful in the diagnosis and differential diagnosis of bone metastases.

Bone Neoplasms↗
PubMed1986

[Bone marrow scintigraphy using radiocolloids in bone metastases. Sensitivity, specificity, reliability and indications].

The sensitivity and specificity of bone marrow scintigraphy in demonstrating skeletal metastases was examined in 40 patients with focal metastases. Radiology and MDP scintigraphy were used as reference methods. Sensitivity depends on the region of the skeleton. False negatives are the rule in parts of the skeleton containing little bone marrow. In relation to the entire bone marrow content, sensitivity is 0.64. The high proportion of false negatives (36%) in the presence of confirmed metastases and the incomplete demonstration of the bone marrow makes marrow scintigraphy unsuitable as a screening method. Occasionally lesions confined to the marrow can be demonstrated when radiographs and bone scintigrams are still negative. In advanced cases, marrow scintigraphy can demonstrate the extent of destruction of the bone marrow. Demonstration of displacement or of an 'empty bone' is evidence of invasion of the bone marrow in patients with tumours. In patients with reduced haematopoiesis of unknown origin or unidentified diffuse skeletal uptake, bone marrow scintigraphy may provide valuable information.

Adult↗
PubMed1986

[Functional heterogeneity of liver metastases in 3-phase computerized tomograms].

Ninety patients with liver metastases (68 colorectal carcinomas, 22 breast carcinomas) were examined by triphasic angio-CT. This included demonstration of the entire liver after a bolus-like injection of contrast. Originally, the metastases were hypodense, but showed four patterns of contrast enhancement. Quantitative evaluation of the mammary carcinomas showed a marked increase in density during the bolus phase, with similar contrast values in the liver and at the centre and edge of the metastasis at ten minutes after the injection. Colorectal carcinomas showed only slight increase in density after contrast injection. The difference in density between the centre and the periphery of the metastasis was still present on later images. This finding indicates that there are differences in the vascularisation of these metastases.

Breast Neoplasms↗
PubMed1986

[Intra-arterial dynamic computed tomography in characterizing liver metastases of colorectal cancer].

Locoregional chemotherapy of liver metastases from colorectal tumours is a promising new approach. The results of CT in fifteen patients after intravenous and intra-arterial contrast injection are compared. The liver metastases are supplied mainly by the arterial route and this permits a means of assessing therapy. Contrast injections through a hepatic catheter may result in flow phenomena which limits the value of this investigation. It is unknown whether such flow phenomena may influence the result of intra-arterial chemotherapy. Although the margins of the metastases were more clearly defined, diagnostic accuracy was not increased, as compared with intravenous CT enhancement.

Colonic Neoplasms↗
PubMed1986

[Results of hyposensitization with bee and wasp venom].

The immunotherapy with purified bee and wasp venom is indicated for patients with severe general reactions after insect stings, positive prick test and positive RAST. One hundred seventy four persons were treated for three years with bee venom (SSW Dresden) and 34 patients with wasp venom (Reless). Challenge by a stinging bee after treatment proved in 90 per cent complete protection. There were no general reactions during hyposensitization with wasp venom, but in 46 per cent occurred general reactions during immunotherapy with bee venom. Therefore rush desensitization should be performed in indoor patients till a top dose of 100 micrograms/ml is reached. Booster injections can be given to outdoor patients. All individuals with systemic reactions after insect stings have to get an emergency treatment kit and must be familiar with its application.

Bee Venoms↗
PubMed1985

[Diagnosis and therapy control of neuroblastoma using meta-iodo- benzylguanidine].

Meta-iodine-benzylguanidine (MIBG) scanning provides, for the first time, specific radiological means for diagnosis, treatment follow-up and post-treatment care of patients with neuroblastoma. Of 10 such patients studied by MIBG scanning, 7 had histologically confirmed neuroblastoma. In 6 of them there was markedly increased activity in the primary tumor, in 3 metastases were demonstrated. In at least one patient the intensity of increased activity suggested the possibility of selective therapeutic administration.

3-Iodobenzylguanidine↗
PubMed1985

Pulmonary hyalinizing granulomas.

Little has been written about pulmonary hyalinizing granuloma as a cause of nodules in the lungs. In a patient with a past history of carcinoma of the breast, the diagnosis made a significant difference in the prognosis.

Aged↗
PubMed1984

[Computed tomography and scintigraphy in malignant pheochromocytoma].

Two patients with malignant metastasising phaeochromocytomas are described. Special attention is paid to the findings on computed tomography and scintigraphy with meta-I-benzylguanidine. The scintigraphic findings are not uniform. A review of the literature has shown that the sensitivity of scintigraphy is less for malignant phaeochromocytomas than it is for benign tumours.

3-Iodobenzylguanidine↗
PubMedDate not supplied

[Scintigraphic diagnosis of neuroblastoma using meta-iodobenzylguanidine].

In 1979/80 meta-iodobenzylguanidine (MIBG) was introduced as a radiopharmaceutical agent with high affinity to the adrenal medulla. It could be shown, that scintigraphic imaging with 131J labeled MIBG is a sensitive and highly specific method for localization of pheochromocytoma. In this connection we could demonstrate in 1983 that neuroblastoma can be visualized scintigraphically with MIBG as well. Until now 13 patients were examined with 131J-MIBG by our group: In 10 children with histologically proven neuroblastoma we found a specific enrichment in the tumor area. Besides the primary tumor local recurrence and metastases to bones, bone marrow and brain were detected. There was no neuroblastoma manifestation without MIBG uptake. In 3 patients with tumors other than neuroblastoma no uptake of MIBG was noticed. The results agree with those of other studies: If the physiological pattern of distribution is taken into consideration and if the proper imaging technique is adapted, 131J-MIBG scintigraphy is a highly sensitive and specific method for staging, monitoring of disease and follow-up of neuroblastoma.

3-Iodobenzylguanidine↗