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Biomedical subjects

J Spitz

Publications and source records attributed to J Spitz.

At least 19 recordsLinked to original sources
PubMed1992

[Clinical relevance of whole body skeletal scintigraphy in multiple injury and polytrauma patients].

The provision of care to polytraumatised patients is a particular diagnostic and therapeutic challenge. The examination data of 162 polytraumatised patients were retrospectively investigated to determine the diagnostic gain provided by skeletal scintigraphy with 99mTc-HMDP. It was found that every fresh fracture (with the exception of fractures to the skull) led to a scintigraphically clearly demonstrable remodelling reaction within ten to 14 days. The timing of the examination was of decisive importance for the information yield. Not until about the tenth to 12th day did also those fractures that showed a delayed uptake show adequately signal-intensive areas of uptake in the scintigram. Typical examples were additional fractures of the spine and pelvis in patients immobilised by fractures of the limbs. At this time, with the aim of skeletal scintigraphy, an additional fracture was found in half of all patients, and was subsequently verified radiologically. Additional diagnostic information is independent of the ability of the patient to cooperate. This was of particular importance in the case of the very severely injured and old patients. Skeletal scintigraphy can be employed with equal efficacy to reliably exclude bone injuries. Thus, skeletal scintigraphy if of particular significance in the determination of the extent of bone injury in polytraumatised patients. This applies in particular to the preparation of an expertise. Thus, as in the case of staging of malignomas, the additional performance of bone scanning twelve to 14 days after traumatisation should form part of routine care offered to polytraumatised patients.

Adolescent↗
PubMed1991

[The age dependence of traumatically induced bone remodeling as studied in the bone scintigram].

Two independent groups of patients were studied by bone scintigraphy to demonstrate age-dependent changes in the appearance time of fractures: 83 patients with 123 fractures of the spine showed neither by multiple regression analysis nor by separation into two subgroups (younger and older than 55 years) a clinically significant difference by scintimetric evaluation. A second group of 162patients with multiple trauma demonstrated no age dependence of the rate of additional bone lesions shown by scintigraphy. Instead a clear dependence on the site of the lesion and the time after trauma was found: fractures of the shafts of long bones and fractures of the pelvis and spine showed up significantly later than fractures in the neighbourhood of the distal joints. 12-14 days after a trauma all fractures may be detected with a high accuracy independently from the fracture site (except for fractures of the skull which did not show up at all in most cases). Thus, the differences in the appearing time of fractures are not age- but site-dependent.

Adolescent↗
PubMed1990

[Comparative measurements of bone mineral content using DPA and DPX--initial clinical experiences].

A technically satisfactory method with adequate precision and reproducibility is necessary for accurate determination of bone mineral content. To the previously described techniques (SPA, DPA, QCT and SQCT) a new method has been added based on the absorption of a filtered x-ray beam (DPX). Comparison of DPA/DPX measurements of the mineral contents of vertebrae and femora in 126 patients showed a high correlation between the results (r = 0.97 for vertebrae and 0.93 for femoral necks). Ten measurements of a vertebral phantom and ten measurements of a normal male showed significantly higher accuracy of the DPX method. Other advantages of the DPX method are increased speed of the procedure by a factor 3-5, lower radiation dose and better spatial resolution. Measurements of the upper and lower extremities are possible in addition to whole body scans. In summary, the DPX technique is a significant improvement on the conventional DPA method, whereas the data obtained from DPA measurements remain valid.

Absorptiometry, Photon↗
PubMed1990

[GnRH-agonists in the therapy of endometriosis].

Repeated application of GnRH agonists causes a reversible suppression of ovarian function. Suppression on estrogen release is the fundamental idea of this hormonal therapy of endometriosis. We treated twelve patients with histologically proved endometriosis with leuprolide acetate depot in a dose of 3.75 mg s.c. every 4 weeks over a period of 6 months. In the first week of therapy the estrogen level decreased to a post-menopausal niveau along with amenorrhoea during the entire period of therapy. Complaints previous to therapy such as dysmenorrhoea, pelvic pain and dyspareunia were relieved or completely disappeared after therapy. The clinical finding on palpation also diminished or disappeared. In addition to this finding pelvis copy showed a shift from severe endometriosis stage III and stage IV to stage I and stage II of the AFS classification 1985. Regular menstruation appeared in 5 to 9 weeks after the last application to all patients. Out of six cases of infertility, four patients became pregnant. Except for one case, typical menopausal symptoms appeared, such as flush, increased perspiration and sleeping disorders. During and after therapy we could not prove any changes in the lipid metabolism under estrogen therapy. Mineralization of the bone decreased under therapy by about 3%. Simultaneously, serum osteocalcin increased. Demineralization occurred with one exception within the normal range for the corresponding age. With identical efficiency but less side effects, we see therapy with GnRH agonists as an alternative to current hormonal therapy of endometriosis.

Adolescent↗
PubMed1990

Coma blisters: report and review.

Coma blisters are self-limited lesions that occur in the setting of coma of various causes, but are most commonly associated with barbiturate overdose. Examination of a skin biopsy specimen demonstrates the characteristic presence of eccrine sweat duct necrosis. Although the exact cause of coma blisters remains unknown, they are not related to underlying infections or rheumatologic disorders, and do not contraindicate the continued therapeutic use of barbiturates.

Adult↗
PubMed1989

[The effect of inactivity-induced osteoporosis on the scintigraphic image of bone lesions of the wrist].

In addition to its established oncological indications the sensitivity of bone scintigraphy is of steadily increasing significance in traumatology. Inactivity-induced osteoporosis plays a major role during the immobilization period in the plaster cast. In the region of the joints remodelling intensity may reach such a high level that the non-injured bone shows a higher rate of accumulation than the fracture. This process already begins between the third and fourth week of immobilization. The highest uptake is found after fracture of the scaphoid bone at the end of twelve weeks of immobilization. Control scintigraphies at intervals of several days are indicated to differentiate between various clinical conditions (pseudoarthrosis, activated osteoarthrosis, algodystrophy in case of doubtful x-ray results).

Carpal Bones↗
PubMed1988

[Nuclear medicine methods for the determination of bone mineral content].

Osteoporosis is becoming recognized as a major social and economical health problem. Bone mineral content (BMC) depends on many hormonal and metabolic factors. The pathophysiological mechanism of the loss of bone mass is still unclear. For preventive diagnosis and treatment of osteoporosis, quantitative technology is required that will measure BMC with high precision and reproducibility. Nuclear medical methods permit the BMC of the appendicular skeleton to be measured by single photon absorptiometry. Whole-body BMC, as well as spine and femur BMC, can be measured by dual photon absorptiometry. The results from both procedures are reasonably precise and correlate well with the ash weight of isolated bone. The radiation exposure level in both SPA and DPA is low. SPA and DPA may be used for cost-effective screening of high-risk patients to predict the likelihood of future fractures and control osteoporosis therapy.

Bone and Bones↗
PubMed1987

[Detection of ischemic muscle necroses using 99mTc perfusion scintigraphy of traumatized extremities].

In the Dr. Horst-Schmidt Kliniken Wiesbaden 19 patients with trauma of the inferior legs have been examined by means of perfusion-scintigraphy with regard to a compartmental syndrome. In the control group there were twelve Patients without trauma. The employed method of computer assisted analysis of function of blood supply of the extremities in connection with the verification of the 99mTC-MDP amassment in the soft tissues seen in follow-up X-rays allows a differentiation between a normal-blood stream raising caused by a traumatic reparation (C = 1.7 +/- 0.6) and the significant higher blood stream as a result of the development of ischemic muscle lesions (C = 3.8 +/- 1.5). This non-invasive method is not very exert for the patient and is practicable with little expense in a nuclear medicine department. It may not be considered as a routine analysis because the clinical signs are sufficient to show the necessity of an immediate operative intervention in order to avoid a compartmental syndrome.

Anterior Compartment Syndrome↗
PubMed1979

[The value of renal phlebography in the differential diagnosis of arteriographically hypo- or avascular lesions in the kidney (author's transl)].

The present paper is an investigation into the diagnostic value of renal phlebography for differentiating between arteriographically hypo- and avascular malignant lesions in the kidney and benign renal masses. In three examinations carried out on eight patients with renal masses, phlebography was of crucial diagnostic importance. In ten renal cysts a presumptive diagnosis made by arteriography was confirmed by phlebography. In another eight renal cysts, a case of haemorrhagic pyelitis and in two cases of unilateral pseudotumerous pyelonephritis, phlebography was of no value.

Adenocarcinoma↗
PubMed1979

[Determination of serum digoxin. A comparison between RIA and EIA (author's transl)].

The results of two radioimmunoassays (RIA, precipitating technique), of a homogenous (EMIT) and a heterogenous (ELISA) enzyme immunoassay (EIA) for ascertaining the amounts of digoxin showed a good correlation in precision and a reasonably satisfying correlation in the recovery. However, there was a clear discrepancy in the amounts of digoxin concentrate in the serum of patients. Only the RIA of Abbott and the EIA of Boehringer showed no significant differences. Particularly noticeable was the tendency towards lower values in the EMIT-technique as well as its liability to unspecific serum changes (lipaemia etc.), which often made the detection of digoxin impossible. The routine use of this technique appears problematic. The need for establishing one's own laboratory and test-specific therapeutical range is pointed out.

Digoxin↗
PubMed1978

[Fibrous cortical defects (author's transl)].

During a period of two and a half years, twelve fibrous cortical defects were discovered as incidental findings. With the exception of two cases, the radiological findings remained unchanged during the period of observation. One large defect extending into the diaphysis was submitted to surgery and verified histologically. The characteristic radiological appearances and the differential diagnosis from similar looking benign and malignant bone abnormalities are discussed and compared with the findings of other authors.

Adolescent↗
PubMed1978

[The effect of iodine-containing radiographic contrast medium on TSH-TRH-tests (author's transl)].

In the course of an investigation of TRH-tests, 340 TSH-tests were performed in 120 patients before and after the administration of various iodine-containing radiographic contrast media in order to determine a possible effect on the TRH-tests. In addition, the peripheral thyroxin level and RIA-T3 content of the serum was determined. Mean TSH rise following TRH (delta-TSH) showed no significant difference before and after the contrast medium. Individual variations were, however, observed. In view of these results, it is concluded that the TRH-test provides reliable information after iodine exposure.

Contrast Media↗