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Biomedical subjects

U Büll

Publications and source records attributed to U Büll.

At least 127 records · Page 7Linked to original sources
PubMed1983

[Results of radioiodine treatment of autonomous thyroid adenomas taking into consideration regional iodine kinetics and paranodular uptake].

In 110 patients with autonomous adenoma of the thyroid, the success rate of therapy with radioiodine using different local dosages (300 and 400 Gy) was monitored. Furthermore the relative paranodular uptake before and after radiotherapy was compared in dependence on the duration of therapy. In a short period of therapy (5-8 d) the paranodular uptake decreases as compared to a long duration (9-20 d) where it increases. This explains the higher rate of hypothyroidism found in the group of patients with a longer period of therapy. The success rate was 93.6% after applying a dosage of 300 Gy and 95% after 400 Gy. However we found a slightly smaller incidence of hypothyroidism (3.2%) after 300 Gy as compared to 400 Gy (8.8%). Nevertheless the higher dosage should be chosen to reduce the failure rate. Because of the increased rate of hypothyroidism with increasing paranodular uptake it is recommended in cases with uptake ratios between 10 and 20% (so-called transitional type) to induce exogenic suppression of the paranodular tissue by means of thyroid hormone.

Adenoma↗
PubMed1983

[Effect of varied pacemaker stimulation on left ventricular volume data--studies with radionuclide ventriculography].

Left ventricular performance (parameters: EDV, ESV, EF, cardiac output) was studied by gated radionuclide ventriculography in 55 patients with ventricular or AV-sequential pacemakers. 23/55 patients were followed over 4-6 months. EDV and SV decreased significantly (p less than 0.01) and cardiac output increased (p less than 0.01) with changing pacing rate from 70-72 to 100/min. After 4-6 months a reduction of cardiac output was found in 15/23 patients. As compared to ventricular pacing, a significantly higher cardiac output was found during AV-sequential pacing. These nuclear data indicate the dependence of left ventricular performance on pacing mode. From non-invasive methods an individual adapted pacing mode can be derived.

Adult↗
PubMed1983

[Value of posttherapeutic scintigraphy for the demonstration of distant metastases of differentiated carcinomas of the thyroid gland].

The value of posttherapeutic scintigraphy performed at discharge with the remaining radioactivity after an ablative radio-iodine therapy was studied in 190 patients with differentiated carcinomas of the thyroid gland (54% papillary and 46% follicular carcinomas). 163 patients (86%) had no signs of disease. 33 patients had distant metastases. In six out of them, the examination method allowed a first demonstration of metastases. In seven further cases, additional, hitherto unknown foci were found. There was a specificity of 100% and a sensitivity of 82% (no false positive findings, six false negative findings). Further to the usual image-producing examination methods (native X-ray diagnosis, sonography and CT), posttherapeutic scintigraphy furnishes early information about the formation of distant metastases. Therefore it is helpful to indicate a regional percutaneous X-ray therapy and to assess the prognosis.

Adenocarcinoma↗
PubMed1982

[Therapeutic results of malignant goiter 1960-1980. Significance of percutaneous radiotherapy in well differentiated carcinomas].

The therapeutic approach in malignant goitre is fairly uniform, apart from use of percutaneous irradiation. The influence of irradiation on survival rate in differentiated carcinomas transgressing organ boundaries was assessed in the evaluation of treatment results in 621 patients (two patient groups: 1960-1980). Early stages of tumour (T0-T1) were seen in only 18% of cases; 24% of all cases had metastases, mainly of the lungs and skeleton. Males died 1.5 times more frequently due to differentiated tumours than did females The 10-year-survival rate was 90% in patients below the age of 50 years in contrast to 60% in older patients. Papillary carcinomas had such a survival rate in 78% and follicular carcinomas in 66%. Stages T0-T2 had a survival of 87% in contrast to 58% in stage T3. Occurrence of distant metastases diminished survival to 48%. 167 patients with irradiation (I) and 73 without (II), but an otherwise equal treatment, with differentiated carcinoma stage T3 could be compared. Group I showed a 5- and 8-year survival of 88% and 75%, group II 68% and 38% (P less than 0.001). Local recurrence was the same in both groups, however metastases occurred more frequently and earlier in group II.

Adenocarcinoma↗
PubMed1982

Results of oral TRH test in the differentiation of compensated and decompensated autonomous thyroid nodules.

In 17 patients with compensated autonomous adenomas of the thyroid, iv thyrotropin releasing hormone (TRH) tests (200 microgram) and oral TRH tests (40 mg) were performed. In nine of these patients, thyroid-stimulating hormone (TSH) 30 min after iv TRH showed a normal (greater than 2.7 microU/ml) and in eight patients a subnormal (less than 2.7 microU/ml) or negative response. However, after prolonged oral stimulation with 40 mg TRH, after 120-180 min TSH was normal (greater than 2.7 microU/ml) in 15 and subnormal (less than 2.7 microU/ml) in two patients. In 20 patients with decompensated autonomous thyroid nodules. TSH was not detectable (less than 0.8 microU/ml) after iv or oral TRH stimulation. Therefore, the oral TRH stimulation test seemed to be superior to the iv TRH test in the discrimination of compensated and decompensated autonomous adenomas of the thyroid.

Adenoma↗
PubMed1982

[Regional ejection fractions to determine left ventricular function. Comparison of first-radionuclide-pass and equilibrium-radionuclide-ventriculography with the results of cineventriculography].

An analysis of regional left ventricular pump function by regional ejection fractions (rAF) may be done employing First Pass techniques or Equilibrium Radionuclide Ventriculography (MUGA). The ventricle was intersected orthogonally into 5 divisions. This technique was applied to 15 hearts with regular wall motion and to 26 hearts with wall motion abnormalities. The discrimination for wall motion abnormalities of the anterior wall by MUGA was better than using steps of asynergy (normo-, hypo-, dys- and asynergy). With rAF, decrease of regional pump function could be detected (10% of the investigated hearts) even when there was a regular global ejection fraction. Due to the different projection angles for First Pass and MUGA (app. 70 degrees difference), correlation coefficients for anatomically similar divisions of the left ventricle, assessed with both techniques (n = 41) were rather low with the exception of the section belonging to the apex. Assessing the wall motion of the posterior wall, with MUGA isolated wall motion abnormalities could be detected only in 2 out of 6 cases. With First Pass, wall motion abnormalities could be detected in all cases. Therefore, to determine motion and function of the posterior wall, First Pass or even better First Pass and MUGA should be employed since the latter case, the ventricle may be evaluated from two projections in one examination only.

Cardiac Output↗
PubMed1982

Retrograde colonic spread of sulphasalazine enemas.

In five patients with inflammatory bowel disease and in two healthy control subjects retrograde spread and colonic distribution of rectally introduced sulphasalazine (SASP) enema were investigated. The SASP enema was labeled with 99mTc and imaged by a gamma camera. In all patients the SASP enema reached the inflamed portion of the colon. From 73% to 84% of the total SASP enema were fairly homogeneously distributed beyond the patients' rectum. The results suggest that patients with inflammatory bowel disease may benefit from SASP enemas even if the total colon is involved.

Adult↗
PubMed1982

[Results of functional scintigraphy using 131J-hippurate in preoperative diagnosis of patients with kidney tumors: influence on surgical treatment and predictive value for retentional serum levels].

156 patients with renal tumors were studied using 131J-hippurate to assess the validity of functional scintigraphy in preoperative diagnosis and to compare it with the serum levels of Creatinine and Urea before and after tumor nephrectomy. If the contralateral, non tumor bearing kidney had a clearance (RNCL) of more than 200 ml/min, no pathological elevation was found postoperatively. If the RNCL was between 150 and 200 ml/min, the postoperatively elevated serum levels of Creatinine and Urea normalized within 3 weeks after surgery. Elevation persisted for longer than 3 weeks if the RNCL was between 100 and 150 ml/min. In RNCL below 120 ml/min an elevation was found even 6 months after surgery. Only if the RNCL was less than 100 ml/min (2% of all cases), instead of tumornephrectomy, an organ-conserving surgery was performed. In these cases, the results of renal scintigraphy yielded additional information in deciding the type of non-radical surgery. Therefore, renal functional scintigraphy does not need to be performed in patients with renal tumors under the following conditions: 1. no elevation of Creatinine and Urea preoperatively and 2. normal morphological findings (sonography, IVP, angiography, CT) of the contralateral kidney.

Creatinine↗
PubMed1981

[Pancreas grafts. Nuclear medical perfusion to exclude vascular complications and rejection crises (author's transl)].

Perfusion studies with 99m Tc-DTPA, which has hitherto been used routinely to investigate renal grafts, have also proved useful for monitoring the perfusion of pancreas grafts. A total perfusion failure is equally reliably demonstrable as in renal grafts. Quantitatively smaller perfusion alterations can be demonstrated by monitoring the course. It seems possible to differentiate the salivary edema of a rejection reaction, well known from animal experiments, with the help of other parameters (e. g. creatinine). Further clinical studies are however necessary to confirm these results.

Adult↗
PubMed1981

[Significance of ultrasonography in diagnosing complications following renal transplantations (author's transl)].

Routine follow-up examinations by ultrasonography after renal transplantation were performed in 72 patients from December 1978 until March 1980. The aim of these controls was to recognize local complications in the area or surgery in order to differentiate from a rejection reaction in patients with unclear clinical symptoms. 22 out of 72 patients had local complications. 15 out of those 22 were detected by ultrasound in a state without clinical symptoms, which then could be treated by surgical or urological intervention. We therefore believe that routine follow-up examinations after renal transplantation by ultrasound are indicated in order to recognize local complications. Nuclear procedures should be employed if alteration of blood flow or disturbed function of the transplanted kidney are considered.

Graft Rejection↗
PubMed1981

[Radionuclide angiography (RNA) with 99mTc-DTPA to follow palliative embolization of renal cell carcinoma (author's transl)].

In 14 patients with renal cell carcinoma, not to be treated by nephrectomy, radionuclide angiography with 99mTc-DTPA (RNA) was employed before and after palliative tumor embolization. If RNA revealed remaining perfusion of the tumor, functional scintigraphy with 131J-hippurate was performed to detect and quantify residual function. Up to 16 months after embolization, 7 patients (50%) revealed neither residual perfusion nor function. In 5 patients (36%) remaining perfusion without functioning renal parenchyma and in 2 patients (14%) residual perfusion with additional function were found. In 4 cases (28%) a nuclear "tumor-halo" was imaged, describing a stripe of high radioactivity caused by capsular arteries surrounding the avascular tumor. RNA has proven to be a suitable non-invasive procedure for to blow-up of embolized renal cell carcinomas.

Adenocarcinoma↗
PubMed1981

[Value of the "region of interest" technique in the scintigraphic diagnosis of primary bone tumors (author's transl)].

Employing ROI-technique, a ratio Q was obtained from relating accumulation of 99mTc-MDP at the site of the bone lesion (n = 150) with that of contralateral non-involved osseous areas. Values of Q were correlated with histologic tumor diagnosis, its dignity and frequency. Values of Q of greater than 3.0 were found in 95% of all sarcomas, in 100% of the osteosarcomas but in only 3.8% of all benign bone tumors. Values ranging from 1.0 to 1.2 were exclusively measured in benign tumors (e.g., in 52% of juvenile bone cysts and in 67% of non-ossifying fibromas). Since the threshold--separating benign from malignant lesions--at Q = 3.0 was blurred by tumorlike lesions, metastases and especially by Paget's disease, this method does not precisely predict dignity. However, this method may complement radiographic evaluation with low values supporting the diagnosis of a benign lesion. The combined findings of radiography and these rations gained by nuclear imaging may help determine the pathway of a patient through further diagnosis and treatment.

Bone Neoplasms↗
PubMed1981

[Optimized calculation of left ventricular enddiastolic volume by equilibrium radionuclide ventriculography (MUGA)--the influence of background correction and absorption (author's transl)].

Left ventricular (LV) enddiastolic volume (EDV) was calculated in 23 patients from background-corrected enddiastolic count rates (ROI technique). The calculation in volume units (ml) was based on the measurement of a well-defined amount of patients' venous blood (50 ml in a syringe) counted by the gamma camera. Decrease in count rate due to tissue attenuation was corrected for by calculation of soft-tissue absorption in the thoracic and LV wall as well as the blood self-absorption within the LV, applying a rotational ellipsoid with an assumed LV depth of 1.5 times that of the LV width within the LV ROI. Furthermore, the influence of various models of LV background superimposition (homogeneous, parabolic and no background) were tested correlatively for calculations of volume. Best correlation with cineventriculographically measured volumes (r = 0.92) was found with a parabolically weighed background correction, determining an individual value of background superimposition for each LV pixel. This approach was chosen because a homogeneous superimposition is an inadequate model to correct for background due to the geometric extension of the LV. Volumes, parabolically corrected were found to correlate most closely to cineventriculography (CVG) (VMUGA = 0.997 X VCVG - 12.6 ml).

Cardiac Volume↗
PubMed1980

Effects of obstruction on single-kidney function: clinical and experimental results with 131I-hippurate and 99mTc-DMSA.

In 35 patients, renography with 131I-o-hippurate (OIH) and static renal imaging with 99mTc-dimercaptosuccinic acid (DMSA) were used to measure differential renal function (DRF). The results were compared. Depth correction was applied in both methods. In non-obstructed kidneys (19 patients), both methods revealed nearly identical kidney function (r = 0.98). For completely obstructed kidneys (16 patients), OIH gave a significantly better DRF (14 ml/min) than DMSA. This small difference was of no clinical value. Because DMSA is reported to give unreliable results in unilateral obstructed kidneys, the right ureter was ligated in 8 dogs for 10 days and DRF was measured before and after opening an ureteral fistula. The difference in DRF was about 1% and could be accounted for by the amount of urinary radioactivity collected from the pelvic system after the ligature had been opened. Although DMSA appears to give reliable values in determining DRF, even in obstructed kidneys, OIH is preferred since total clearance values and postrenal urinary dynamics can be determined simultaneously.

Animals↗