Biomedical subjects

S Eberl

Publications and source records attributed to S Eberl.

46 records · Page 3Linked to original sources

PubMed1987

Determinants of axial bone loss in rheumatoid arthritis.

To assess mechanisms that cause generalized osteoporosis in rheumatoid arthritis (RA), we measured bone mineral density (BMD) by dual photon absorptiometry in the lumbar spine and femoral neck of 111 patients with RA. BMD was significantly reduced at both sites in these patients. Physical activity correlated significantly with BMD in patients with RA, and was found, by multiple regression analysis, to be a significant predictor of femoral bone density in female patients. Multiparity exerted a protective effect on lumbar bone density. Prednisolone (mean dosage 8 mg/day) was not associated with significantly increased bone loss in women, whereas higher dosages in men (mean 10.3 mg/day) were associated with increased lumbar bone loss. Reduced physical activity leading to a form of disuse osteoporosis appears to be an important factor in axial bone loss in RA.

Aged↗

PubMed1987

Genetic determinants of bone mass in adults. A twin study.

The relative importance of genetic factors in determining bone mass in different parts of the skeleton is poorly understood. Lumbar spine and proximal femur bone mineral density and forearm bone mineral content were measured by photon absorptiometry in 38 monozygotic and 27 dizygotic twin pairs. Bone mineral density was significantly more highly correlated in monozygotic than in dizygotic twins for the spine and proximal femur and in the forearm of premenopausal twin pairs, which is consistent with significant genetic contributions to bone mass at all these sites. The lesser genetic contribution to proximal femur and distal forearm bone mass compared with the spine suggests that environmental factors are of greater importance in the aetiology of osteopenia of the hip and wrist. This is the first demonstration of a genetic contribution to bone mass of the spine and proximal femur in adults and confirms similar findings of the forearm. Furthermore, bivariate analysis suggested that a single gene or set of genes determines bone mass at all sites.

Adult↗

PubMed1986

Limitations of forearm bone densitometry as an index of vertebral or femoral neck osteopenia.

Osteoporosis of the spine and femoral neck is a major problem in aging populations, but detection prior to a fracture remains a challenge. Forearm bone mineral content has been advocated as a useful screening test in this situation. We have examined the correlation between distal forearm bone mineral content, by single photon absorptiometry, and lumbar vertebral and femoral neck bone mineral density, by dual photon absorptiometry. Eighty women aged 20 to 76 years were studied and significant correlations (p less than .001) were found between the measurements on the forearm and at the two axial sites (r = 0.66 and 0.69, respectively). However, forearm bone mineral content was an unreliable predictor of axial bone mineral density. For prediction of lumbar spine osteopenia with a sensitivity of 88%, the false positive rate was 91%. Conversely, to achieve a specificity of 82%, the false negative rate was 65%. Similarly, for prediction of femoral neck osteopenia at a sensitivity of 92%, the false positive rate was 87%, and at a specificity of 90%, the false negative rate was 33%. These data demonstrate that forearm bone densitometry cannot be used as a screening procedure for osteopenia of the lumbar spine or femoral neck.

Adult↗

PubMed1986

Osteoporosis in rheumatoid arthritis: safety of low dose corticosteroids.

Fear of inducing generalised osteoporosis is one reason why corticosteroids are withheld in patients with rheumatoid arthritis (RA). No studies, however, have directly measured bone density in such patients at clinically relevant sites. To assess this risk we measured bone mineral density in the lumbar spine and femoral neck by dual photon absorptiometry in 84 patients with RA, 44 of whom had been treated with low dose prednis(ol)one (mean dose +/- SE 8.0 +/- 0.5 mg/day; mean duration of treatment 89.6 +/- 12.0 months). There were significant reductions in bone mineral density in patients treated with corticosteroids (lumbar 9.6%, p less than 0.001; femoral 12.2%, p less than 0.001) and in those who had not received corticosteroids (lumbar 6.9%, p less than 0.01; femoral 8.9%, p less than 0.001), but the differences between the two groups were not significant. We conclude on the basis of these studies that low dose oral corticosteroids do not increase the risk of generalised osteoporosis in patients with rheumatoid arthritis.

Adult↗

PubMed1986

Physical fitness is a major determinant of femoral neck and lumbar spine bone mineral density.

The relationship between physical fitness and bone mass in the femoral neck, lumbar spine, and forearm was studied in 84 normal women. Femoral neck and lumbar spine bone mineral density and forearm bone mineral content were estimated by absorptiometry. Fitness was quantitated from predicted maximal oxygen uptake. Femoral neck and lumbar bone mineral density were significantly correlated with fitness as well as age and weight. In the 46 postmenopausal subjects, fitness was the only significant predictor of femoral neck bone mineral density, and both weight and fitness predicted the lumbar bone mineral density. These data represent the first demonstration of a correlation between physical fitness, and, by implication, habitual physical activity, and bone mass in the femoral neck; they also support the previous reported correlation between lumbar bone mass and physical activity. The data suggest that increased physical fitness may increase bone mass at the sites of clinically important fractures in osteoporosis.

Adult↗

PubMed1985

On surface coils and depth pulses.

A computer program has been developed which calculates the signal response to a generalised depth pulse both on and off resonance. Results are displayed on a grey scale for any plane which includes the axis of the circular surface coil used to apply the pulse. Use of separate (coaxial) transmitter and receiver coils can be accommodated, and both in-phase and out-of-phase signal components can be displayed. Some methods of improving spatial resolution are demonstrated and the off-resonance performance of several depth pulses is compared. Results of the computer simulations are compared with experimental results on phantoms using a simple surface coil.

Animals↗

PubMedDate not supplied

A comparative evaluation of "depth pulses" and related sequences for spatial discrimination in in-vivo NMR spectroscopy with surface coils.

The performance of a range of "depth pulses" and related pulse sequences for achieving enhanced spatial resolution in surface coil magnetic resonance spectroscopy (MRS) has been compared both experimentally and by computer simulation. A detailed analysis of the spatial selectivity of these sequences both on- and off-resonance suggests that the problem of combining good spatial resolution with adequate bandwidth has yet to be fully resolved. These and related problems, such as the shape of the sensitive volume and its dependence on resonance offset, are likely to limit the use of depth pulses, particularly where alternative methods of spatial selection are available.

Animals↗

PubMedDate not supplied

Quantitative assessment of regional myocardial blood flow with thallium-201 and SPECT.

Thallium-201 has been used extensively as a myocardial perfusion agent and to assess myocardial viability. Unlike other 99mTc-labeled agents such as 99mTc-sestamibi and 99mTc-tetrofosmine, the regional concentration of 201Tl varies with time, and its kinetics make it a potential candidate for estimating absolute physiologic parameters with kinetic model analysis. This article outlines a strategy for quantitative assessment of regional myocardial blood flow in man using 201Tl and dynamic single photon emission computed tomography (SPECT). Quantitatively accurate SPECT images that are proportional to the true radioactivity distribution are prerequisites for model-based kinetic analysis. Our technique for quantitative SPECT includes ordered-subset maximum likelihood-expectation maximization (ML-EM) reconstruction with transmission data-based attenuation correction and transmission-dependent convolution subtraction scatter correction. A three-compartment model was found to reproduce the observed regional time-activity curves well, and dog experiments demonstrated that influx rate constant (K1) values estimated from the dynamic SPECT data correlated well with absolute myocardial blood flow determined by in vitro microspheres for a physiologically wide range of flows. Several possible strategies for simplifying the study procedures, without compromising accuracy, are also presented, which should make absolute quantitation of regional myocardial blood flow feasible using 201Tl and a conventional SPECT camera in a clinical setting.

Animals↗

PubMedDate not supplied

Simultaneous emission and transmission (SET) scanning in neurological PET studies.

PURPOSE: We evaluated the impact of simultaneous emission and transmission (SET) measurements of quantification and noise in neurological PET studies. METHOD: Bias in SET was measured as a function of emission count rate and used to predict distortion in simulated FDG tissue curves and its effect on model parameter estimates. Studies were performed on a brain phantom and a patient to verify predicted bias and examine the effect of SET on noise. RESULTS: In static imaging, SET underestimated tracer concentration by approximately 2%. In kinetic studies, tracer concentration was overestimated initially and underestimated during the mid to late part of the study, but bias in measurement of glucose metabolic rate was < 5% by simulation and < 10% in the patient study. SET imaging takes 10% longer than the emission part of a conventional scan to achieve comparable statistics. CONCLUSION: Accurate neurological PET studies can be performed with SET. The relatively small bias can be predicted and potentially corrected.

Adult↗

PubMedDate not supplied

Cerebral perfusion defects, dysautoregulation and carotid stenosis.

Single Photon Emission Computed Tomography (SPECT), imaging of cerebral blood flow was carried out in ten patients with haemodynamically significant carotid stenosis. Before and after carotid endarterectomy each patient was investigated by 3--dimensional SPECT brain scanning using technetium--hexamethyl propyleneamine oxine (99 mTcHMPAO, ceretec). Brain blood flow was normal before and after operation in 3 patients whose autoregulation was kept intact. Seven patients received acetazolamide to limit cerebral vascular reactivity and in four of these, preoperative perfusion defects were visible. After carotid endarterectomy the ipsilateral perfusion defects were abolished and it is concluded that carotid stenosis can reduce perfusion in the dysautoregulation brain and that carotid reconstruction can restore normal flow.

Acetazolamide↗