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Biomedical subjects

U Büll

Publications and source records attributed to U Büll.

At least 163 records · Page 9Linked to original sources

[Embolization of the lung in echinococcosis (author's transl)].

Four months before her death of right heart failure, a 38-year-old woman with a known inoperable echinococcosis of the liver developed fever, increasing eosinophilia and pleuropneumonia. After improvement of the clinical, radiological and laboratory parameters under steroid medication, two months before her death hemoptysis and multifocal perfusion defects in the lung scintigram as a sign of pulmonary embolism occurred, for which heparin therapy was introduced. At autopsy a recurrent embolization due to echinococcus cysts with extensive displacement of the arterial pulmonary blood circulation were found.

Adult↗

[The informative value of diagnostic methods in chronic headache. A study of 112 cases (author's transl)].

A thorough neurological diagnostic investigation was carried out in 112 patients with chronic headache existing for an average of 14 years, using a case history questionnaire we had designed for the purpose. Apart from the history and clinical examination, the program included X-ray negatives, angiography, computer tomography, sequence scanning, electroencephalogram and echoencephalogram. Migraine was the most common diagnosis (54.5%). Three cases in which admission to a ward was necessary for more detailed examination are described and demonstrated with reference to neuroradiological illustrative material.

Adolescent↗

[Cryptogenic liver abscess (author's transl)].

The successful treatment of two patients with cryptogenic liver abscess, a special type of pyogenic abscess, is reported. Quick diagnosis by methods which do not distress the patient, e. g. scintigraphy and echography, leads to a decisive improvement in the prognosis. Opinions are given on the differential diagnosis of cryptogenic, pyogenic and parasitic (amebic) liver abscesses. The good chances for treatment of cryptogenic abscesses compared with the secondary pyogenic liver abscesses are to be found not least in their usually solitary appearance. This is shown particularly clearly in the classification of the patients operated on for pyogenic liver abscess in our hospital in the last ten years into multiple and solitary liver abscess. As in the pyogenic abscess, so in the primary cyptogenic liver abscess is transperitoneal open drainage the method of choice for treatment.

Diagnosis, Differential↗

[The value of serial scintigraphy with 99mTc pertechnetate compared with axial computed tomography in the diagnosis of cerebral tumours (author's transl)].

The increasing use of cranial computed tomography (CT) in the diagnosis of cerebral tumours has suggested that the place of cerebral serial scintigraphy (CSS) with 99mTc pertechnitate needs to be re-assessed. For this purpose 190 patients with 200 intracranial tumours were examined by both methods. Of the 155 histologically confirmed tumours, 87% could be diagnosed by CSS, and 99% with CT. Amongst the total of 190 patients, CSS was correct in 90%, and CT in 99%. Correct tumour diagnosis of meningiomas was 84% for both methods, and for glioblastomas, 83% for both methods. Combining the two methods, however, produced 92% accuracy with meningiomas, and 90% of glioblastomas could be correctly classified. Gliomas of Grade I/II had an accuracy of 39% for CSS (52% for CT), for metastases 50% for CSS (80% for CT) and in the group "various tumours" 19% for CSS (41% for CT). Computed tomography will have to be carried out in future on all patients suspected of having a primary tumour and before any neuro-surgical intervention. The main task of CSS remains as a screening procedure for intracranial space-occupying lesions and to increase the accuracy of diagnosis. CSS is also valuable as an indication for the use of contrast during CT. In some cases this isotope method may increase the type specific diagnosis of CT.

Adolescent↗

A computer assisted comparison of 99Tcm-methylene-diphosphonate and 99Tcm-pyrophosphate bone imaging.

A total of 350 patient studies were carried out using clinical trials' batches of the Technetium (MDP) agent for bone scintigraphy (The Radiochemical Centre), and a commercially available Technetium pyrophosphate agent (CIS). The bone seeking properties of 99Tcm Sn-methylene-diphosphonate (MDP) and 99Tcm Sn-pyrophosphate (PYP) were evaluated by their comparative uptake in compact bone, cancellous bone and soft tissue using a region-of-interest technique. From these data uptake ratios were computed in order to correlate the values with (a) the amount of 99Tcm-MDP injected, (b) the time after injection and (c) the age of patients examined. All ratios derived with 99Tcm-MDP were superior to those using 99Tcm-PYP and were not dependent on the amount of 99Tcm-MDP injected. Uptake ratios determined for 99Tcm-MDP (1.5 h to 2.5 h after injection) were found to be higher than those for 99Tcm-PYP 2.5 to 3.5 h after injection. Soft tissue accumulation of 99Tcm-MDP, visible on scintiphotos, occurred only in 26% of cases but with 99Tcm-PYP, in 75% out of all cases studied. A decrease of cancellous bone/compact bone ratios with increasing age of the patients was found with both radiopharmaceuticals. This is most probably correlated with a diminished mass and/or surface of the cancellous bone in the elderly patient.

Adult↗

Bone-to-bone, joint-to-bone and joint-to-joint ratios in normal and diseased skeletal states using region-of-interest technique and bone-seeking radiopharmaceuticals.

Bone-to-bone, iliosacral joint-to-os sacrum and joint-to-joint ratios were computed using the region-of-interest technique 2 to 3 hrs. after injection of 99mTc Sn-methylene-diphosphonate or 99mTc Sn-pyrophosphate in 139 patients with skeletal diseases (bone tumours, degenerative changes of the spine and joints, inflammatory changes of joints) as well as in 123 patients with normal skeletal states. In the latter group, iliosacral joint-to-os sacrum ratios decreased with increasing age of the patients. In patients with osseous metastases of the spine ratios of 0.80 to 4.0 occurred ( reference area second vertebra below or above the affected vertebra). In degenerative changes of the spine values of 0.80 to 1.69 were computed. These results show, that 74% of the spine metastases could not be differentiated from benign changes of the spine by determining their relative amounts of bone uptake. In bone tumours of the extremities and in rheumatoid or gouty arthritis of the small joints (hands and feet) the highest ratios, i.e. contrasts, occurred referring to a contralateral reference area. Osteoarthritic and inflammatory alterations of the big joints could not be differentiated because of percentual distribution of the increased joint-to-joint ratios turned out to be nearly identical.

Adult↗

Evaluation of myocardial function with the 201thallium scintimetry in various diseases of the heart. A correlative study based on 100 patients.

To assess the validity of the quantitative 201Tl scintimetry in various diseases of the heart (coronary heart disease with and without myocardial infarction, non-coronary cardiomyopathy, scleroderma heart disease and asymmetric septal hypertrophy with IHSS), the 201Tl myocardial uptake values for five standardized projections (a) were correlated with the grade of LAD stenosis, (b) the pattern of myocardial wall motion and (c) were compared with the 201Tl uptake values derived from normal patients. Significant reduction (c) of 201Tl myocardial uptake could in individual cases be evaluated in acute myocardial infarction (95%), in dys- and akinesia (90%), in hypokinesia (71%), in scleroderma heart disease (50%), in non-coronary cardiomyopathy (50%) as well as in normokinesia (28%) when associated with LAD stenosis. The mean values (b) of 201Tl uptake in normo- and hypokinesia significantly differed between these two groups and from those evaluated in dys- and akinesia. The latter group showed the lowest 201Tl uptake values computed which in some cases were very close to the mean mediastinal 201Tl uptake. The correlation (a) of individual 201Tl values demonstrated that 201Tl distribution in the myocardium is not only equivalent to myocardial ""perfusion'' but is corresponding with the myocardial function. In non-coronary cardiomyopathy reduced 201Tl values sometimes could not be separated from values in coronary heart disease (and myocardial infarction). A regional increase of myocardial mass as in septal hypertrophy correlated well with an augmented 201Tl uptake when referred to the 201Tl storage in the mediastinum.

Cardiomegaly↗

[Results of 201thallium myocardial scanning in coronary heart disease (author's transl)].

Quantifiable 201Tl scanning of the myocardium was performed in 23 patients with coronary heart disease and 10 without heart disease. Taking into consideration normal relative minimal storage of 201Tl in different regions of the myocardium (five projections), decreased 201Tl uptake in underperfused myocardium (acute myocardial infarction, coronary artery stenoses with hypo-, dys-, and akinesia) was recognizable according to extent and localisation (iso-impulse rate scan). The lowest relative 201Tl storage was found in dyskinesia or akinesia (37.6-54.1%) in the region of the anterior wall, as well as in acute myocardial infarction (50%). In the period after myocardial infarction persistence and normalisation of underperfusion could both be demonstrated. 201Tl scan as a non-invasive test is an appropriate means for demonstrating relative regional perfusion in the myocardium, with myocardial capacity for active uptake of potassium-like thallium being determined at the same time.

Acute Disease↗

[201Thalium scintimetry of the heart as a new method for functional assessment in coronary heart disease (author's transl)].

201Tl scintimetry of the heart was used for a statistical comparison between normal people (10 individuals) and those with acute anterior wall infarcts (5 patients), anterior wall hypokinesia (5 patients) and dyskinesia (8 patients). Numerical results were obtained by a computer and depended on the relative 201tl storage in the left ventricular myocardium (64 mm2 area) related to mediastinal background uptake. It was found that maximal myocardial uptake, compared with mediastinal activity (about 290%) did not differ between normals and patients with coronary heart disease. Aneurysms of the anterior ventricular wall showed a reduction (with the ventricle perpendicular to the collimator) of 45.8%; in hypokinesia and acute myocardial infarcts, it was 64.2% and 64.6% respectively (normal 82.6%). 201Tl uptake in aneurysms (42.4%) approached background activity (36%) if a projection parallel to the collimator was used. 201Tl scintimetry provides a means of defining functional ability of the myocardium (depdending on myocardial perfusion and mass). Aneurysms and hypokinetic portions of the myocardium can be differentiated statistically from normal 201Tl uptake.

Acute Disease↗

[Concentration of 99mTc-tin-phosphate complexes in soft tissues].

The concentration of 99mTc-pyrophosphate was determined in the lower extremities of rabbits (normal, abacterial and bacterial affected soft tissues), in osteoarthritis of the hip joint (capsule and muscle) as well as in knee joint effusions. Compared with the 85Sr-concentration, reflecting the calcification capacity, concentrations of 99mTc-pyrophosphate in soft tissues were found to be lower 2 hours p.i., but were up to elevenfold higher 24 hours p.i. These findings should be due to a fixation of 99mTc-pyrophosphate in collagen containing tissues as in the soft tissue tumors (myosarcoma, synvialioma, breast cancer) presented. A mechanism of delayed equilibration could explain augmented uptake in lymph-edema, ascites and effusions in florid osteoarthritis of the knee joint. The possible dependence of 99mTc-pyrophosphate concentration in bone and soft tissue on collagenous contents is discussed.

Animals↗