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U Speck

Publications and source records attributed to U Speck.

At least 19 recordsLinked to original sources
PubMed2006

[Non-ionic iodinated dimeric versus monomeric X-ray contrast media: effects on complement factors in vivo].

PURPOSE: To survey contrast media (CM)-induced alterations of complement factors. MATERIAL AND METHODS: In 31 adult patients, who received either an iotrolan (n = 19) or iopromide (n = 12) i. v. injection for CT examination, complement factors C1 q, C3, C4, C5 a, and C1-esterase inhibitor in serum/plasma samples were analyzed. The samples were obtained prior to and 5 min., 30 min., 1 hr., 6 hrs. and 24 hrs. after CM injection. RESULTS: 5 patients (16.1 %) developed a CM reaction. 4 of these were patients who received iotrolan. Other than minimal data, we neither found a significant influence of the CM on complement activation nor a difference between the analyzed CM. In detail, 5 min. after CM administration, we found the tendency to be for the values to decrease and then to return to the basic value. The changes induced by iotrolan were more pronounced than those induced by iopromide; nevertheless the differences were not statistically significant. A more pronounced decrease of C3 and C4 after iotrolan injection indicates the activation of the classic way, while this could not been observed after iopromide injection. One patient who experienced an unwanted reaction towards iotrolan showed shifts of C1 q, C1 INH, C3 and C4. CONCLUSION: The presented data shows different influences of CM injection on the analyzed complement factors after 5 min. that were commonly no longer present 30 min. after CM injection. The dimeric iotrolan induced a significantly increased frequency of unwanted CM reactions than the monomeric iopromide. The question of whether iotrolan is possibly able to activate the classic way of the complement cascade should be analyzed in the future in a greater patient group.

Adult↗
PubMed2004

[Current concepts and recent developments of laser ablation in tumor therapy].

PURPOSE: The purpose of this paper is to present technical innovations and clinical results of percutaneous interventional laser ablation of tumors using new techniques. METHODS; Laser ablation was performed in 182 patients (liver tumors: 131, non hepatic tumors-bone, lung, others: 51) after interdisciplinary consensus was obtained. The procedure was done using a combination of imaging modalities (CT/MRI, CT/US) or only closed high field MRI (1.5 T). All patients received an MRI-scan immediately after laser ablation. RESULTS: In 90.9% of the patients with liver tumors, a complete ablation was achieved. Major events occurred in 5.4%. The technical success rate of laser ablation in non-hepatic tumors was high, clinical results differed depending on the treated organ. CONCLUSIONS: The treatment of tumors of the liver and other organs up to 5 cm by laser ablation was a safe procedure with a low rate of complications and side effects. Image guidance by MRI is advantageous for precise tumor visualization in all dimensions, therapy monitoring, and control of laser ablation results.

Adult↗
PubMed2003

[Laser-induced thermotherapy (LITT) of lung metastases: description of a miniaturized applicator, optimization, and initial treatment of patients].

PURPOSE: A thin-caliber applicator system was developed for introducing a laser fiber under CT guidance into lung metastases with only minimal complications. MATERIALS AND METHODS: A space-saving 5.5 French Teflon cannula with a titanium trocar and connectors for a laser light guide (2 or 3 cm Dornier Diffusor-Tip H-6111-T2 or H-6111-T3 coupled to a Dornier Medilas Fibertom 5100 laser, wavelength of 1064 nm) and a perfusion line for physiologic saline solution were developed. After puncture the laser Diffusor-Tip remains in the cannula and is cooled during its tissue passage by slowly flowing saline solution. The miniaturized applicator system (Monocath) was calibrated in nonperfused bovine liver for maximum energy supply and necessary flow of the cooling saline solution in reference to a commercially available 9 French laser catheter with an 11.5 French inducer sheath (Power-Applicator). The new applicator system was used for treating lung metastases in 10 patients over a period of 21 months. RESULTS: The size of heat coagulation in bovine liver was 24 +/- 2 ml using the miniaturized system with application of 15 W for 20 min and a saline flow of 0.75 ml/min, in comparison to a size of 29 +/- 7 ml for the commercial applicator (30 W, 20 min, 60 ml/min). All metastases could be safely approached with the miniaturized applicator, except for two metastatic lesions at the lung base in two patients. A minor pneumothorax developed in three patients and intrapulmonary bleeding in two. Contrast-enhanced CT demonstrated necrosis of the treated metastatic areas in 6 patients. Follow-up of three patients after 5, 6, and 8 months showed complete tumor regression with minimal scarring in one patient. CONCLUSION: The miniaturized applicator system enables the introduction of a laser fiber into pulmonary metastases with only minor complications. Complete ablation seems to be achievable in suitable patients with the applied laser energy and a slow cooling fluid flow rate.

Adult↗
PubMed2003

Double contrast MRI of thermally ablated liver metastases.

PURPOSE: To investigate the ability of double contrast MRI (enhancement with iron oxide and gadopentetate dimeglumine) to increase the difference in contrast between various tissues after thermal ablation of liver metastases. MATERIALS AND METHODS: 12 patients were imaged after MR-guided laser-induced thermotherapy (LITT). Imaging was performed with a 1.5T MR system. Nonenhanced, iron oxide-enhanced and double contrast images were acquired using T (1)-weighted GRE and T (2)-weighted TSE sequences. Iron oxide imaging was performed 10 min after injection of 1.4 ml ferucarbotran (Resovist(R), Schering AG Berlin, Germany) and double contrast imaging 60 sec after the additional injection of 0.1 mmol/kg body weight gadopentetate dimeglumine (Magnevist(R), Schering AG Berlin, Germany). Qualitative and quantitative assessment was performed on induced necroses, residual or recurrent tumor tissue and metastatic tissue untreated at the time of the study. RESULTS: Iron oxide-enhanced T (1) GRE images demonstrated the highest contrast between ablated hyperintense tissue and iron accumulating and resultant hypointense liver parenchyma. Due to Gd enhancement, double contrast T (1)-weighted GRE images displayed the highest change in signal intensity in vital tumor tissue compared to ablated tissue and iron oxide accumulating liver parenchyma (p < 0.01). CONCLUSIONS: First observations indicate that LITT of hepatic metastases can be better followed with double contrast MRI, which displays increased contrast due to Gd enhancement of perfused tumor tissue and signal intensity loss in iron oxide accumulating hepatic parenchyma. Induced necrosis does not change its signal intensity at all after injection of iron oxide and Gd-containing contrast media.

Aged↗
PubMed1997

[Oral contrast media in CT: improvement by addition of guar?].

PURPOSE: To evaluate the additional effect of guar with iotrolan as an oral contrast medium. METHOD: In a clinical double-blind randomised study a viscous iotrolan (11.2 mg iodine/ml)/guar (4 g/l)-suspension was compared with aqueous solutions of pure iotrolan (11.2 mg iodine/ml) and meglumine ioxithalamate (12 mg iodine/ml). The contrast media were evaluated according to filling, distribution, transit time, artifacts, radiodensity, patient acceptance and side effects. RESULTS: The addition of guar delayed the transit time of the contrast media. Consequently a more homogeneous filling of the bowel with fewer artifacts was observed in comparison to the aqueous contrast media. The results of the pure iotrolan solution were comparable to meglumine ioxithalamate, except for a higher radiodensity in the distal small intestine. The colon showed a better filling with non-viscous contrast media in the given time frame. Pure iotrolan had the best patient acceptance. Two patients considered the iotrolan/guar-solution impossible to drink, the other 18 patients found taste and consistency just about acceptable. CONCLUSION: In spite of the discussed advantages, due to a less subjective acceptance the guar/iotrolan solution is not suitable in routine-diagnosis, unless taste and consistency are greatly improved. Individual use is recommended in selected cases and long-term examinations.

Administration, Oral↗
PubMed1994

Imaging of exocrine pancreatic function. Investigation of the bioavailability of weak organic acids as potential pancreatic contrast agents for computed tomography.

RATIONALE AND OBJECTIVES: The feasibility of targeting iodinated contrast agents to the exocrine pancreas was investigated. Iodinated weak organic acids including succinic acid-mono-3-amino-2,4,6-triiodo- N-ethylanilide (compound I), the ethanolamine salt of N-ethylsuccinic acid-(2,4,6-triiodo-3-methylamino anilide) (compound II), and the sodium salt of 2,4,6-triiodo-3-N-ethylacetylamino-phenylpropionic acid (compound III) were studied as potential contrast agents for computed tomography (CT) of the pancreas. METHODS: An ex vivo perfusion system was used to compare pancreatic uptake of the three compounds. In vivo CT studies were conducted using domestic pigs to study potential enhancement of the pancreas after intravenous injection of the compound. RESULTS: Ex vivo perfusion studies with isolated rat pancreas demonstrated nearly identical extraction ratios of approximately 0.6 for all three compounds tested. Average iodine concentrations measured in pancreas at the end of the perfusion studies was 0.27 mg/g +/- 0.20 for compound I, 0.18 mg/g +/- 0.06 for compound II, and 0.16 mg/g +/- 0.09 for compound III. Differences in iodine concentrations retained were not statistically significant. Computed tomography studies in domestic pigs demonstrated up to 30% enhancement of the pancreas after intravenous injection of 75 and 150 mg/kg of compound II at 45 minutes. Whereas ex vivo perfusion studies indicated increasing extraction of the three compounds with increasing doses/concentrations in the perfusate, no improved contrast enhancement was observed at the higher dose level compared with the lower dose in CT. CONCLUSION: Both ex vivo perfusion studies and dose-independent enhancement levels achieved seem to indicate a transport maximum in the pancreas for the iodinated weak organic acids studied.

Anilides↗
PubMed1992

Preclinical evaluation of Gd-EOB-DTPA as a contrast agent in MR imaging of the hepatobiliary system.

Gadolinium diethylenetriaminepentaacetic acid (DTPA) covalently linked to the lipophilic ethoxybenzyl moiety (Gd-EOB-DTPA) was designed for use as a contrast agent in hepatobiliary magnetic resonance imaging. With T1 relaxivity values of 8.7 L/mmol.second in plasma and 16.6 L/mmol.second in rat liver tissue and a median lethal dose of 10 mmol/kg when administered intravenously in mice and rats, Gd-EOB-DTPA has a fairly high margin of safety. In rats and monkeys, biodistribution studies performed 7 days after administration of 0.25 mmol/kg revealed very little retention of gadolinium (less than 1%) in the tissues, indicating complete elimination via renal and biliary excretion. Biliary excretion was inhibited by coadministration of sulfobromophthalein, indicating the involvement of a carrier-mediated transport system based on the enzyme glutathione-S-transferase. In rats, the biliary transport maximum was 5 mumol gadolinium/min.kg. High T1 relaxivity of Gd-EOB-DTPA in rat liver in vivo can be explained by transient interaction with intracellular components and by increased microviscosity inside the hepatocyte.

Animals↗
PubMed1992

Influence of two guar preparations on glycosylated hemoglobin, total cholesterol and triglycerides in patients with diabetes mellitus.

Guar smoothens postprandial glucose peaks and reduces serum cholesterol. Both properties are advantageous for diabetic patients and can be realized, in part, by adding fiber to the diet. Depending on the blood glucose concentration, a small portion is incorporated into hemoglobin (HbA1), building a largely irreversible complex, making it a long-term indicator of blood glucose status. HbA1 may increase from a normal value of about 5% to as much as 20% of total hemoglobin in diabetics. This study tested the efficacy of two guar preparations in diabetic patients over 3 months by measuring HbA1, cholesterol and triglycerides. Forty diabetic patients with HbA1 > 10% ingested either 3 x 4 g daily of a new guar preparation (GU-052, Steigerwald, Darmstadt, Germany) or 3 x 5 g daily of Glucotard (Boehringer, Mannheim, Germany) for 12 weeks. Before and after 30, 60 and 90 days of treatment, HbA1, cholesterol and triglycerides were determined. After 90 days of treatment, GU-052 caused a reduction in HbA1 from 12.6 +/- 2.6% to 10.5 +/- 1.5% (-15.6 +/- 9.0%) in the GU-052 group and from 12.0 +/- 2.6% to 10.9 +/- 1.82% (-8.6 +/- 7.2%) in the Glucotard group. Cholesterol was reduced from 269 +/- 28 mg/100 ml on day 0 to 227 +/- 18 mg/100 ml on day 90 in the GU-052 group and from 261 +/- 40 to 235 +/- 26 mg/100 ml in the Glucotard group. Both GU-052 and Glucotard had little effect on plasma triglycerides. Fewer unpleasant side effects were reported for the GU-052 preparation than for Glucotard.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

NMR imaging study of the pharmacodynamics of polylysine-gadolinium-DTPA in the rabbit and the rat.

The pharmacodynamics of polylysine-(Gd-DTPA) (Schering, Berlin, Germany), a new blood pooling contrast agent for MRI, were studied in the rabbit and the rat. Polylysine-(Gd-DTPA) is a compound with high LD50. Due to its high molecular weight (50.000) and physico-chemical properties, it remains in the vascular system; during the first hour, the plasma level is three times higher than for Gd-DTPA. MRI was performed at 1.5 T using a SE sequence with TR/TE = 300/15 or 20 msec. Signal intensities of muscle, liver and kidney were measured before and after intravenous injection of the contrast agent (0.1 mmol/kg) during 8 hours in the rat (n = 3) and up to 2 wk in the rabbit (n = 3). A dose response study in three additional rabbits confirmed that the 0.1 mmol/kg dose was optimal. The pharmacodynamics results show that the effects of polylysine-(Gd-DTPA) are similar in both the rabbit and the rat. The liver signal is enhanced by about 60% immediately after injection in both species. This enhanced signal decays to half its maximal value in about one hour, which makes the contrast agent useful for clinical applications at a dose of 0.1 mmol/kg. In the kidney medulla and cortex the signals are enhanced by much larger factors (about 3 to 4); it takes at least one day for the kidney to clear the contrast agent in both species.

Animals↗
PubMed1991

Influence of two guar preparations on glucose and insulin levels during a glucose tolerance test in healthy volunteers.

Dietary fiber deficiency may be alleviated with an increase in fiber-rich foods or fiber in the form of guar. The efficacy of a solid guar preparation and a liquid form on glucose and insulin levels during a glucose tolerance test in 12 healthy volunteers was examined. The first half of the study tested the efficacy of a new guar preparation (GU-052, Steigerwald, Darmstadt, Germany). Six volunteers ingested 75 glucose and 12 g guar mixed in 450 ml water. The other 6 received the same drink without guar. Blood was withdrawn for the determination of glucose and insulin before ingesting the glucose solution and after 15, 30, 45, 60, 90, 120, 180, 210 and 240 min. One week later the groups were crossed over. The second half of the study tested the efficacy of GU-052 against a solid preparation consisting of 5 g guar and 1.13 g additive (Glucotard, Boehringer, Mannheim, Germany). Volunteers receiving GU-052 with the glucose drink showed no increase in plasma glucose. Volunteers without GU-052 reached a maximal plasma glucose value of 6.66 +/- 1.30 mmol/l 30 min after glucose ingestion from an initial value of 5.28 +/- 0.40 mmol/l. A second smaller peak was observed 120 min after glucose ingestion. A 2.5-fold increase from 16.17 +/- 4.30 to 40.10 +/- 19.00 microIU/ml in insulin concentration occurred in the volunteers ingesting GU-052, whereas a 6-fold increase from 19.33 +/- 12.20 to 114 +/- 48.8 microIU/ml insulin occurred in the volunteers without GU-052. A second peak in insulin at 120 min which occurred in the volunteers without GU-052 was not apparent when the volunteers ingested GU-052. The comparison of GU-052 and Glucotard showed that GU-052 maintained the glucose level, whereas Glucotard allowed the plasma glucose to reach 6.67 +/- 0.98 microIU/l. The increase in insulin was not as great with GU-052 as with Glucotard. This study shows that guar suppresses glucose and insulin levels during a glucose tolerance test. The guar form influences the efficacy.

Adult↗
PubMed1990

[Epidemiologic studies of the recognition of the preclinical phase of type I diabetes in school children].

Sera of 4208 schoolchildren in Ulm and surrounding areas (1916 boys, 2292 girls; mean age 13.9 [7-21] years) were analysed for the presence of cytoplasmatic islet-cell antibodies (ICA). ICA were demonstrated in 44 children (1.05%). Complement-fixing ICA (CF-ICA) were found in six of them, insulin autoantibodies (IAA) in seven. The early phase of insulin response in the intravenous glucose tolerance test was below the 1st percentile of normal controls in two of the ICA-positive children. In the course of the subsequent 6-9 months the ICA disappeared in half of the previously positive children. In the two with abnormal glucose tolerance tests ICA, CF-ICA and abnormal insulin secretion persisted during the observation period of 9 months. In another CF-ICA-positive schoolchild insulin response to the glucose tolerance test fell below the 1st percentile after 6 months. These results indicate that, even in an unselected group of children, persisting ICA and CF-ICA are high-risk markers for abnormal insulin secretion, which precedes the onset of type I diabetes.

Adolescent↗
PubMed1990

MR angiography with gadopentetate dimeglumine-polylysine: evaluation in rabbits.

Flow in high-resistance peripheral vessels of the extremities is characterized by a short period of positive flow during systole and almost no flow during diastole. Hence, time-of-flight sequences for MR angiography in high-resistance peripheral vessels are successful only when applied in a plane perpendicular to the vessel course. When applied in a plane parallel to the vessel, the method suffers from the rapid saturation of the inflowing spins. Gadopentetate dimeglumine-polylysine is a new T1 relaxation agent with blood-pooling capability that can be used to prevent blood saturation. In the present study it produced excellent angiograms in rabbits at a dose of 0.01-0.08 mmol/kg injected IV. Time-of-flight angiograms were acquired in a 1.5-T superconducting magnet with a three-dimensional fast imaging with steady precession sequence, 20,40/10/20 degrees (TR/TE/flip angle), with an acquisition volume of 200 x 200 x 60 mm, 64 partitions, and velocity compensation in the slice-selection and frequency-encoding directions. Arteries and veins smaller than 1 mm were visualized over the entire length of the posterior limbs. If ongoing studies confirm the low toxicity of this new agent, gadopentetate dimeglumine-polylysine could offer a totally new approach to MR angiography.

Animals↗
PubMed1989

Influence of guar on serum lipids in patients with hyperlipidaemia.

The antihyperlipidaemic effect of a guar preparation which absorbs a particularly large amount of water has been examined in 13 patients with Type II hyperlipidaemia. A 30-day pre-treatment phase was followed by 60 days of treatment with 4 g guar dissolved in 200-ml liquid at each meal-time (total guar 12 g/day), and a 60-day post-treatment observation period. Routine other clinical blood tests were performed 30, 15 or 0 days before treatment, 15, 30 and 60 days after the start of treatment, and 30 and 60 days after its end. Total cholesterol fell by 0.85 mmol.l-1, from a pre-treatment concentration of 7.4 mmol.l-1 to a treatment value of 6.5 mmol.l-1, and LDL-cholesterol fell by 0.64 mmol.l-1, from 5.5 mmol.l-1 to a treatment value of 4.8 mmol.l-1. There was no significant change in triglyceride and VLDL concentrations during the study. A slight but significant fall in HDL-cholesterol was seen. The sole adverse effect was occasional intestinal discomfort.

Cholesterol↗