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W Börner

Publications and source records attributed to W Börner.

At least 55 records · Page 3Linked to original sources

Hysterosalpingoscintigraphy: a simple and accurate method of evaluating fallopian tube patency.

A prospective study was designed to evaluate the efficacy of radionuclide hysterosalpingoscintigraphy using 99mTc-labelled human serum albumin macroaggregates in 17 patients (34 tubes). In normal females the macroaggregates migrate spontaneously through the female reproductive tract following application into the posterior vaginal fornix. They can be seen in the uterine fornix 20 min p.i. (range: 5-90 min) and as free pelvic activity 120 min p.i. (range 40-180 min). Free pelvic activity could also be demonstrated by culdocentesis. In infertile patients with failure of tubal patency images after 180 min offered no additional information. For the routine diagnosis camera images 5, 60 and 180 min p.i. are recommended. Using 5-10 MBq 99mTc the radiation exposure to the ovaries is about 1/9th of the exposure from a normal radiologic hysterosalpingogram. The reported data show results comparable with those of hysterosalpingography (HSG) in females with patent or with nonpermeable tubes, but in cases of high-pressure by patency by HSG the results of scintigraphy are superior to those of HSG. Moreover, this method provides new insights into sperm motility under various physiological and pathological conditions.

Adult↗

The relationship of peripheral to axial bone density.

Bone measurements were made in young normal women (n = 125) using single-photon absorptiometry (SPA with 125I) of the radius shaft and ultradistal radius, dual-photon absorptiometry (DPA with 153Gd) of the lumbar spine and the proximal femur, and 125I-based quantitative computed tomography (QCT) of the distal radius. Measurements of the appendicular and axial sites also were made in 21 women with spinal osteoporosis. The standard error of estimate in predicting axial densities from peripheral measurements was about 0.11 g/cm2 (10-13%) with all methods. The osteoporotic-normal difference was 21% for SPA of the radius shaft and 125I-QCT of the distal radius, 30% for the lumbar spine and 34% for the femoral neck. Prediction of spine and femur density, and diagnostic sensitivity, with 125I-QCT were equivalent to that obtained with conventional SPA, but the precision of 125I-QCT (0.8%) was 2-3 times better than both SPA and DPA.

Adult↗

Leucocyte elastase in chronic inflammatory bowel diseases: a marker of inflammatory activity?

Leucocyte elastase is a neutral proteinase which plays an important role in the pathogenesis of inflammatory disorders. Infiltration of bowel mucosa by neutrophil and eosinophilic granulocytes is a characteristic feature of chronic inflammatory bowel diseases. We studied plasma elastase in 44 patients suffering from Crohn's disease or ulcerative colitis. Plasma levels were significantly higher in these patients compared to 7 patients with non-inflammatory bowel diseases or 53 healthy controls. Elevated plasma levels were more often found in patients with active inflammation than in those with inactive disease. Elastase did neither correlate with leucocyte counts, serum albumin, ESR, alpha 1-proteinase inhibitor and orosomucoid nor with clinical indices or the faecal excretion of 111In-labelled granulocytes. In serial studies of 15 patients, elastase did not always run parallel to the disease activity. We conclude that plasma elastase does not reliably indicate the inflammatory activity in chronic inflammatory bowel diseases.

Adult↗

[Scintigraphy and sonography in the diagnosis of thyroid autonomy. A retrospective study of 526 patients].

The place of scintigraphy and ultrasonography in diagnosis was analysed retrospectively in a series of 526 patients with confirmed thyroid autonomy. Male:female ratio was 1:4.6; peak age incidence was in the sixth decade. 5.6% of patients were younger than 30 years and in each case had a sonographic focus. A normal thyroid size was found in 6.5% on palpation and in 10% by ultrasound. Normal thyroid function was found in 287 patients (56%), of whom 48% had a positive TRH test, the remainder being hyperthyroid. Unilocular autonomy was present in 57%, multilocular in the remainder. With increasing degree of autonomy there was an increase in echo-density. In 351 patients (74%) the adenoma was echo-poor, in 16% echo-normal and in 10% echo-dense. Focal findings on sonography were noted in 94% of patients. The incidence of thyroid carcinoma was 1.5% (2 of 136 patients with goitre resection), the carcinoma not being located in the autonomous tissue. It is concluded that a thyroid of normal size does not exclude autonomy. Patients younger than 30 years require scintigraphic examination only if there are focal signs. Echogenicity of a thyroid focus does not correlate with function. The incidence of cancer in the presence of autonomy is low. There was no case of thyroid carcinoma in the autonomous region.

Adult↗

111In-oxine-labelled white blood cells in the diagnosis and follow-up of Crohn's disease.

Prospectively, 43 patients with Crohn's disease (41 clinically active, 2 clinically inactive) and 7 patients with irritable bowel syndrome were examined by 111In-oxine-labelled leukocytes ('mixed' leukocyte preparations, n = 8; 'pure' granulocyte preparations, n = 42). The number of scintigraphically diagnosed inflamed bowel segments correlated significantly (r = 0.95, p less than 0.001) with the number of radiologically and endoscopically diagnosed segments. The exact localization of the diseased ileum may be difficult by scintigraphy. One complicating abscess and two fistulas were correctly diagnosed. The percentage of fecal excretion of radiolabelled leukocytes is highly specific for intestinal inflammations. It correlates significantly with the erythrocyte sedimentation rate (r = +0.69, p less than 0.001), serum albumin (r = -0.54, p less than 0.001), orosomucoid (r = +0.65, p less than 0.001), and with the A.I. (van Hees) (r = +0.67, p less than 0.001). In the follow-up of 9 patients, the percentage of fecal excretion decreased or increased more rapidly, but in correlation with the CDAI, A.I., or ESR. The authors conclude that this method is an alternative to common methods and that it is superior in primary diagnosis in patients with severe disease, bowel stenosis, abscesses, and after surgery. After clinical and biopsy-proven diagnosis of Crohn's disease, the special value of the leukocyte scan lies in the noninvasive follow-up of patients and its potential of localizing inflamed bowel segments and assessing disease activity.

Colon↗

[Surgical indications for scintigraphically cold thyroid nodules in relation to clinical, scintigraphic, sonographic and cytologic findings].

The frequency of indication for surgical resection of goitre was retrospectively analysed for 2100 thyroid examinations. During 1974/75 (group I) only scintigraphy was available in addition to clinical examination; in 1979/80 (group II) cytological criteria were added, and in 1983/84 (group III) ultrasound findings were available as well. There were 700 patients in each group. The proportion of scintigraphically negative nodules was largely the same in the three groups (I and II: 21%; III: 22%). Indication for operation was less common after the introduction of ultrasound (I: 56%; II: 55%; III: 44% of patients with scintigraphically cold nodules). In particular, there was a decrease in the proportion of those nodules not definitely considered benign which would have required histological diagnosis (I: 32%; II: 18%; III: 8%). The results underline the special place of small-needle biopsy and, especially, ultrasound examination of the thyroid, in addition to clinical and scintigraphic findings, in providing the indication for and planning of operative nodular goitre resection.

Biopsy, Needle↗

[Indications status and surgical strategy in cold struma nodule].

Scintigraphy, sonography and fine needle cytology have the best accuracy in the evaluation of a cold nodular goitre. In 2,100 investigations on nodular goitre, it could be found that the incidence of the prophylactic operation for histological diagnosis decreased more than half. On the other hand, with the precise diagnosis the surgeon was able to perform thyroidectomy for thyroid cancer in the first operation. Thus complications of thyroidectomy (paralysis of the recurrent laryngeal nerve, tetany, residual thyroid tissue) could be reduced.

Diagnosis, Differential↗

[Scintigraphic diagnosis of inflammatory small bowel stenoses in Crohn disease using 111In oxine-labeled leukocytes].

17 patients with known small bowel involvement in Crohn's disease (clinically active, n = 14; clinically inactive, n = 3) were examined within 8 days via barium enemas of the small bowel (Pansdorf's method or enteroclysis) and by 111In-oxine labelled leucocytes. From 19 radiologically diagnosed small bowel stenoses 14 were classified as inflammatory and 5 as non-inflammatory. The leucocyte scan also showed 14 inflammatory stenoses. The not inflamed stenoses could not be diagnosed scintigraphically. The barium enemas of the small bowel and the leukocyte scans both correctly diagnosed the acute inflamed segments. The inability to show non-inflamed segments (n = 5) and to localise small bowel stenoses exactly is disadvantageous in the scan. The advantage of the leucocyte scan is a non-invasive examination without specific bowel preparation and the possibility to diagnose additionally inflamed large bowel segments (n = 4), fistulas and abscesses (n = 2). The leucocyte scan offers a useful expansion of the diagnostic tools in small bowel diseases, especially in radiological problems in patients with Crohn's disease.

Adult↗

Three-phase white blood cell scan: diagnostic validity in abdominal inflammatory diseases.

Indium-111-oxine saline-labeled "mixed" leukocyte (n = 16) and "pure" granulocyte (n = 66) scans were prospectively performed as "three-phase" white blood cell (WBC) scans (imaging: 30 min, 4 hr, and 24 hr after reinjection of the cells) in 82 patients suspected of having abdominal or retroperitoneal abscesses or inflammatory lesions. Inflammation was verified histologically, endoscopically, radiologically or by autopsy in 51 and excluded in 31 patients. Sensitivity, specificity, and diagnostic accuracy of the 30-min scan (90%, 56%, 72%) were statistically significantly lower than the 4-hr scan (96%, 97%, 98%). Of the 24-hr scan sensitivity, specificity, and diagnostic accuracy were only 84%, 98%, and 89% because many patients with chronic inflammatory bowel diseases had excreted a portion of intestinal 111In activity by 24 hr. The overall sensitivity, specificity, and accuracy of the "three-phase" WBC scan were 98%, 97%, and 98%, respectively. Only one female patient showed a false-positive scan with granulocyte uptake in an ulcerating adenocarcinoma of the colon. The 4-hr scan or the three-phase study are recommended because of their high sensitivity, specificity, and excellent diagnostic accuracy (98%). The 30-min scan is less specific (56%); the 24-hr scan less sensitive (84%). The three-phase study additionally allows the differentiation between inflammatory bowel diseases and abscesses because it allows observation of granulocyte kinetics for 24 hr.

Abdomen↗

Immunoscintigraphy in medullary thyroid cancer using an 123I- or 111In-labelled monoclonal anti-CEA antibody fragment.

The monoclonal anti-CEA F(ab')2 fragment MAb BW 431/31, labelled with 123I or 111In, was used for immunoscintigraphy (IS) in 9 patients with medullary cancer of the thyroid (CCC). The results of 11 studies lead to the following conclusions: When using radioiodine as a label for MAb in IS, potassium iodide is absolutely necessary to block the thyroid which is of special importance in patients with thyroid cancer; Preinjection of "cold" MAb reduces the relatively high unspecific uptake (especially in bone marrow) of MAb BW 431/31, which is of special importance for the antibody labelled with 111In; IS with MAb BW 413/31 in patients with CCC and elevated serum CEA is positive only in cases with large secondaries; and In patients with CCC and several manifestations of secondaries, only a single (large) metastasis may be apparent.

Antibodies, Monoclonal↗

Autologous 111In-oxine-labeled granulocytes in Yersinia infections.

Autologous 111In-oxine-labeled granulocytes have proved to be valuable for the localization of inflammatory bowel diseases, especially Crohn's disease and ulcerative colitis. Other rare inflammatory bowel diseases also yield positive 111In scans. One case of Yersinia infection of the terminal ileum (Yersinia enterocolitica) showing an accumulation of 111In-oxine-labeled granulocytes 0.5, 4, and 24 h after the reinjection of the labeled cells is described. The 4-day fecal excretion of 111In-oxine granulocytes showed a slight inflammatory activity of the terminal ileum. One negative scan is reported in a cotrimoxazole-treated patient with Yersinia infection.

Female↗