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J Müller-Brand

Publications and source records attributed to J Müller-Brand.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Somatostatin receptor status in non-medullary thyroid carcinoma].

AIM: Recent in-vitro and in-vivo studies demonstrated a somatostatin receptor expression in some non-medullary thyroid carcinomas. In this study we investigated the somatostatin receptor status for this particular tumor entity in a larger patient group. SUBJECT AND METHODS: We compared 131-iodine with 111-In-pentetreotide scans in 24 patients with metastasizing, non-medullary thyroid cancer. The findings were correlated with other imaging modalities. Additionally, we performed receptor autoradiography in one patient, octreotide therapy in another patient and administration of 90-Y- and 111-In-DOTATOC in 2 consecutive patients. RESULTS: In the 15 patients with papillary or follicular carcinoma, 111-In-pentetreotide was inferior to 131-I in 8/15, equal in 1/15, and superior in 6/15 patients. In 8/9 of the patients with Hürthle cell carcinoma, metastases showed a 111-In-pentetreotide accumulation of various intensity, while 131-iodine scans were negative except for one patient. 111-In-pentetreotide was equal or superior compared to 201-Tl or 99m-Tc-sestamibi, but for the most part inferior in comparison with 18-F-FDG-PET. The findings of 111-In-pentetreotide scintigraphy correlated well with the receptor autoradiography and the accumulation of DOTATOC, but not with the therapeutic effect of "cold" octreotide on the thyroid cancer metastases. CONCLUSIONS: Several metastases of papillary and follicular carcinoma, and the majority of Hürthle cell cancer metastases can express somatostatin receptors. 111-In-pentetreotide scintigraphy is a promising tool for localization of metastases especially in Hürthle cell cancer or if PET is not available, and may be useful for selection of possible candidates, if therapeutic effective beta-emitting somatostatin analogues will be available for routine application.

Adenocarcinoma, Follicular↗
PubMed1998

[Bone ultrasound and diagnosis of osteoporosis: correlation of 2 quantitative ultrasound methods with bone density].

In this study, 96 women (mean +/- SD, 65.3 +/- 13.2 years) were investigated by bone mineral densitometry (DXA, Hologic QDR 2000) and quantitative ultrasound (QUS) of the tibia (n = 96; Sound-Scan2000, Myriad) and phalanges (n = 84: DBM Sonic 1200, IGEA). We observed a good correlation of QUS measurement with bone mineral content (BMD) on lumbar spine and both hips (Ward and Neck). Correlation of the two QUS-techniques measuring at different skeletal sites within the same patient was good. QUS instruments measuring at the various skeletal sites and their suitability for screening patients at risk of osteoporosis are discussed. The usefulness of the different QUS methods and the best measuring site for the assessment of fracture risk in osteoporotic patients still have to be established.

Absorptiometry, Photon↗
PubMed1998

Improved myocardial ischemia detection by combined physical and mental stress testing.

The hypothesis that addition of mental stress to physical exercise would modify the circulation response to stress and improve noninvasive detection of myocardial ischemia was tested in a randomized, crossover radionuclide angiocardiographic study. Compared with physical exercise or mental stress alone, combined stress led to higher heart rates and rate-pressure products in early stress stages, to more pronounced symptoms, and to a better discrimination of subjects with and without coronary artery disease by radionuclide angiography.

Adult↗
PubMed1998

Interfemur variation of bone mineral density in patients receiving high-dose thyroxin therapy.

In order to evaluate the interfemoral variability of bone mineral density (BMD) in patients receiving thyroxin (T4) replacement therapy, dual-energy X-ray absorptiometry (DXA) was performed on both hips and the lumbar spine of 114 individuals. BMD was measured in 47 patients under T4 therapy in suppressive doses because of histologically proven thyroid cancer and 67 age-matched controls free of any known local or generalized disorder that would affect the bones and joints. Variation in BMD between both hips was determined for four different regions of interest, i.e., Ward's triangle, intertrochanteric region, trochanter, and femoral neck. No significant difference in hip BMD was found between patients and controls. Even though some individuals had large interfemoral BMD variation, no significant difference in hip BMD variability between the groups was observed. In patients under suppressive T4 replacement therapy, BMD measurement in one hip is suitable to predict BMD of the other hip and therefore unilateral hip measurement may be adequate.

Absorptiometry, Photon↗
PubMed1998

Crossed cerebellar diaschisis and brain tumor biochemistry studied with positron emission tomography, [18F]fluorodeoxyglucose and [11C]methionine.

Cerebral gliomas may cause a reduction of glucose metabolism in the cerebellum contralateral to the tumor side (crossed cerebellar diaschisis, CCD). We investigated whether CCD is related to tumor localization, histological grade, size and tumor biochemistry. Cerebellar glucose metabolism was measured in 44 glioma patients and 15 healthy subjects using positron emission tomography and [18F]fluorodeoxyglucose (FDG). CCD was determined by calculating an asymmetry index of cerebellar glucose metabolism. Further, the tumor uptake of FDG and [11C]methionine (MET) was also assessed, and was expressed as ratio of normalized tracer uptake in tumor over contralateral cortex (T/C). Frontal lobe tumors were associated with highest CCD values. For these tumors, CCD was higher in malignant (-11.8+/-9.9%) than in low-grade (-4.3+/-4.1%) gliomas (P=0.010). In addition, frontal lobe tumors showed increasing CCD values with increasing size. In tumors of the parietal or temporal lobe, CCD was less marked or absent. T/C ratios of tumor tracer uptake were higher in malignant than in low-grade gliomas, but were not correlated with CCD. Our data indicate that the magnitude of CCD is mainly determined by tumor localization and size, the latter being associated with tumor grade. These findings raise the question whether CCD provides a measure of expansion or progression particularly in low-grade tumors of the frontal lobe.

Adult↗
PubMed1997

Noninvasive stress testing of myocardial ischemia: comparison of GRE-MRI perfusion and wall motion analysis to 99 mTc-MIBI-SPECT, relation to coronary angiography.

In the evaluation of ischemic heart disease only MR imaging seems to have the potential to assess myocardial perfusion, function, and coronary morphology on a single instrument. The aim of this study was to assess the feasibility of a stress test with dipyridamole (0. 56 mg/kg) to analyze myocardial perfusion by Gd first-pass enhancement in ultrafast gradient-recalled-echo MRI (perf-MRI), and wall motion by cine gradient-recalled-echo MRI (Cine-MRI) in one imaging session. Twelve patients underwent complete rest and stress studies; satisfactory MR images were acquired in 10 patients. By 99 mTc-MIBI-SPECT sensitivities to detect ischemic segments were 66.7 % with Perf-MRI, 80.0 % with WM-MRI and 86.7 % for Perf-WM-MRI (Perf-MRI vs Perf-WM-MRI; p = 0.03). Scar was equally detected with a sensitivity of 91.6 % with either MRI technique. Thus, Perf-Cine-MRI provides complementary information for the management of ischemic heart disease and has a higher sensitivity than Perf-MRI alone.

Contrast Media↗
PubMed1997

Plasma potassium in patients with terminal renal failure during and after haemodialysis; relationship with dialytic potassium removal and total body potassium.

BACKGROUND: Chronic haemodialysis (HD) patients may present with severe predialysis hyperkalaemia which is improved by dialytic treatment. However, factors influencing the behaviour of postdialysis plasma potassium (plasma K) are not well known. METHODS: In this prospective study 14 patients (7 female, 7 male) on chronic HD were investigated during a standardized 4-h HD with a 2 m2 high-flux dialyser and up to 6 h postdialysis. Dialytic potassium removal was measured by dialysate collection. Total body potassium (TBK) was measured by whole-body counting of 40K. RESULTS: Plasma K declined from 5.65 to 3.62 mmol/l on HD. In spite of a total dialytic removal of 107 mmol of potassium plasma K rose to 5.01 mmol/16 h postdialysis. TBK, as adjusted for age, was 38.2 and 49.0 mmol/kg BW in female and male patients respectively, i.e. in the normal range. Of a total potassium removal of 107 mmol on HD only 42% originated from the extracellular space. Dialytic potassium removal was best correlated with removal of intracellular potassium but also with extracellular potassium content and with the product of plasma K x TBK. The 6-h postdialysis plasma K was correlated with the predialysis value but not with TBK or dialytic potassium removal. CONCLUSION: A rather high dialytic removal of potassium (which is correlated with plasma K x TBK) does not necessarily prevent a rapid postdialysis rebound of plasma K. Therefore patients with marked hyperkalaemia should be monitored closely postdialysis. TBK can be normal in haemodialysis patients who are well nourished.

Adult↗
PubMed1997

[Influence of hormone substitution therapy on postmenopausal uterus].

In a 58-year-old postmenopausal woman blood flow and blood pool images of bone scintigraphy showed a focus of increased activity in the right pelvic region. Computed tomography and ultrasound exhibited no abnormalities in the abdomen; especially the uterus and ovaries were normal. Careful anamnestic evaluation revealed that the patient received a long-term peroral estrogen/gestagen replacement therapy for the prevention of osteoporosis, but did not have menstruation-like bleedings for the last twelve months of therapy. At time of admission, the patient was on day 25 of hormone replacement therapy, and the uterus was, therefore, in a premenstrual stage. Hence, despite cessation of bleedings in postmenopausal women, one should think of hormone replacement therapy as an explanation for vascular pelvic tumors seen by the first two phases of bone scintigraphy, before further diagnostic steps are undertaken.

Estrogen Replacement Therapy↗
PubMed1997

[Effect of thrombus endarterectomy (TEA) on the regional cerebral bloodflow (rCBF) in patients with unilateral internal carotid artery stenosis].

AIM: In a study of patients with unilateral and symptomatic stenosis of the internal carotid artery (ICA), the effect of endarterectomy (EA) on the regional cerebral blood flow (rCBF) was tested over a postoperative interval of 12 months. METHOD: Xenon-133-rCBF was assessed in 74 patients pre- and post-surgery (one week, six weeks, three months and 12 months after EA). This was done at rest and after stimulation with acetazolamide in order to test the perfusion reserve. RESULTS: Before surgery all 74 patients showed a diminished perfusion ipsilaterally-at rest and/or after stimulation. 38/74 (51%) patients had a significant (> 5%) and 36/74 (49%) patients a non-significant (< 5%) interhemispheric perfusion asymmetry. Twelve months after EA, there were only 23/74 (31%) patients with significant interhemispheric perfusion asymmetry. By stimulation, this decreasing effect became more evident: Before surgery 44/74 (60%) patients had a significant interhemispheric perfusion asymmetry, 12 months after surgery there were only 14/74 (19%) patients. CONCLUSION: In regard to the brain hemisphere distal to the ICA stenosis, our study revealed a significant improvement of brain perfusion after EA. Brain perfusion was stable over an interval of 12 months post-surgery. By EA, especially the perfusion reserve increased, as shown by a normal acetazolamide test. Hence, Xenon-133-rCBF could be shown to be an important method in the evaluation of the indication for surgery and of the result of it. In the intra-individual follow-up after EA, rCBF was able to identify hypoperfusion and may help decide, whether re-angiography is necessary or not.

Adult↗
PubMed1996

Bone mineral density in patients receiving suppressive doses of thyroxine for differentiated thyroid carcinoma.

To determine bone mineral density in patients with differentiated thyroid carcinoma receiving thyroxine replacement therapy in suppressive doses, we studied 65 patients (47 women and 18 men; age 25-83 years, mean+/-SD 52.5+/-15.4 years). Patients were free of thyroid cancer in clinical and laboratory examinations at the time of the study. Bone mineral density of the lumbar spine and both hips was measured by dual-energy X-ray absorptiometry. There was no decrease in bone density in either 32 postmenopausal or 15 premenopausal women compared with an age- and sex-matched control group, nor was any decrease in bone density found in men. Our data suggest that thyroxine treatment in suppressive doses in patients with differentiated thyroid carcinoma is not a risk factor for the development of osteoporosis.

Adult↗
PubMed1995

HIV-enteropathy and bile acid malabsorption: response to cholestyramine.

Chronic diarrhea and weight loss are common in patients with AIDS. We report on an AIDS patient with chronic diarrhea, steatorrhea, and marked weight loss. A 75SeHCAT test demonstrated that the diarrhea was mainly due to bile acid malabsorption. Therapy with cholestyramine dramatically reduced bowel movements and led to significant reversal of weight loss.

AIDS-Related Opportunistic Infections↗
PubMed1994

Central nervous system lupus: concomitant occurrence of myelopathy and cognitive dysfunction.

Reported are two cases of patients with central nervous system systemic lupus erythematosus (SLE) with clinical features of a myelopathy confirmed by magnetic resonance imaging (MRI). In one case, further evaluation including Single Photon Emission Computerized Tomography (SPECT) and neuropsychological testing, indicated higher cortical deficits which improved after treatment with monthly pulse intravenous cyclophosphamide. Subsequent cessation of cyclophosphamide was associated with further progression of the neurological disease in this patient.

Adult↗
PubMed1994

Evaluation of high-risk lung resection candidates: pulmonary haemodynamics versus exercise testing. A series of five patients.

We compared the value of exercise testing and measurement of pulmonary haemodynamics (PH) in the pre-operative assessment of 5 patients (mean age: 64 years, 3 men) with clinical stage I or II bronchogenic carcinoma and severe chronic obstructive pulmonary disease. They were considered at high risk due to poor pulmonary function tests (PFT); (one or more of the following): (1) radionuclide calculated postlobectomy FEV1 < 30% predicted, (2) diffusion capacity or transfer factor < 60% predicted, combined with a fall in PaO2 on maximal exercise of > 5 mm Hg, (3) a PaCO2 at rest of > 45 mm Hg. Maximal oxygen uptake (VO2max) during symptom-limited cycle ergometry and PH were measured in these 5 patients. They were considered eligible for lobectomy if they fulfilled at least one of the two criteria: (1) mean pulmonary artery pressure (PAP) of < 35 mm Hg and pulmonary vascular resistance of < 190 dyn.s.cm-5 at moderate exercise (40 W), (2) a VO2max of > or = 15 ml/kg/min. Six months postoperatively PFT and VO2max were measured again. PAP40W was 21, 38, 38, 46 and 52 mm Hg, respectively, which would have excluded 4/5 patients from surgery. VO2max was 21.7, 14.9, 13.4, 19.2 and 18.6 ml/kg/min, respectively, which would have excluded 2/5 patients. Expressed in percent predicted, however, VO2max was > or = 69% in all 5 patients, indicating only mild impairment of exercise capacity in the 2 patients with < 15 ml/kg/min VO2max. Therefore all 5 patients were offered surgery and underwent lobectomy. Apart from 1 prolonged air leak no complications occurred, the mean hospital stay was 16 days (13-21).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗