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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 152 (1993), S. 674-676 
    ISSN: 1432-1076
    Keywords: Glycogen storage disease type I ; Kidney involvement ; Renal scintigraphy ; Effective renal plasma flow
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To evaluate effective renal plasma flow (ERPF) we performed renal scintigraphies with99mTc-Mercaptoacetyl-triglycine (MAG3) in ninepatients with glycogen storage disease I (GSD I) (age: 16±7 years). Two patients presented with proteinuria, none showed hyperaminoaciduria, disturbed tubular reabsorption of phosphate or hypertension.99mTc-MAG3 clearance values were elevated in eight out of nine patients (865±233 ml/min/1.73 m2 body surface area) and exceeded the agedependent mean values by 21%–145%. ERPF values in patients with poor metabolic control were higher than in patients with long-term good metabolic control (988±186 vs. 619±55 ml/min/1.73 m2;P〈0.05). We conclude that enhanced ERPF is a common finding in GSD I patients, which preceeds clinically overt nephropathy. Renal scientigraphy with99mTc MAG3 is a suitable method for the early detection and monitoring of kidney dysfunction in GSD I.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Alzheimer-Krankheit ; Tau-Protein ; Liquor cerebrospinalis ; Früherkennung ; Key words Alzheimer’s disease ; Protein tau ; Cerebrospinal fluid ; Early recognition
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary In 40 patients with Alzheimer’s disease (AD), in 5 patients with non-AD dementia and in 36 cognitively normal controls the concentration of protein tau was determined in the cerebrospinal fluid (CSF). Of the AD patients, 19 were very mildly demented (MMSE score from 25 to 28). Even in these patients, CSF tau was significantly more elevated than in controls. In the non-AD patients protein tau was less increased. Among the AD patients there was no association between CSF tau and severity of cognitive impairment or deficit in cerebral blood flow, determined by SPECT. Our findings suggest that CSF tau may be elevated even at the predementia stage of AD and be useful as a biological marker for the early recognition of the disease.
    Notes: Zusammenfassung Bei 40 Alzheimer-Patienten, 5 Patienten mit Demenzen anderer Ursache und 36 kognitiv unauffälligen Kontrollpersonen wurde das Tau-Protein im Liquor cerebrospinalis bestimmt. Von den Alzheimer-Patienten befanden sich 19 in einem sehr leichtgradigen Stadium der Krankheit (Summenwert im Mini-Mental-State-Test 25 bis 28 Punkte). Auch bei diesen wurde gegenüber den Kontrollpersonen eine signifikante Erhöhung von Tau gemessen. Eine weniger ausgeprägte Erhöhung von Tau zeigte sich bei den Patienten mit anderen Demenzen. Bei den Alzheimer-Patienten fand sich kein quantitativer Zusammenhang zwischen der Erhöhung von Tau und dem Schweregrad der Demenz oder dem zerebralen Perfusionsdefizit, bestimmt mit SPECT. Die Ergebnisse sind ein Hinweis, daß Tau auch im prädementiellen Stadium der Alzheimer-Krankheit erhöht sein könnte und sich als biologischer Indikator für die Früherkennung eignet.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Epilepsiechirurgie ; Prächirurgische Diagnostik ; Nichtinvasives Protokoll ; Key words Epilepsy surgery ; Presurgical evaluation ; Noninvasive protocol
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary We present a non-invasive epilepsy surgery protocol, which includes EEG-video-monitoring, magnetic resonance imaging (MRI), interictal positron emission tomography (PET) and ictal single photon emission computerized tomography (SPECT). According to this non-invasive protocol 50 of 173 patients with medically intractable focal epilepsy underwent resective surgery. The localization of the epileptogenic zone was based on the congruence of the localizing results of EEG-video-montoring, MRI, interictal PET and ictal SPECT. 46 (92%) of the patients had temporal and 4 (8%) had extratemporal epilepsies. 78% (n=39) of all patients operated according to our non-invasive protocol were postoperatively completely or almost seizure free. Extramesiotemporal resections could be carried out without invasive EEG-recording if the epileptogenic zone was not adjacent to the eloquent cortex. We conclude from our results that in a considerable number of patients with medically intractable particularly temporal focal epilepsies, resective epilepsy surgery can be based on non-invasive EEG-evaluations and the risk of invasive recordings can be avoided.
    Notes: Zusammenfassung Wir stellen ein nichtinvasives Protokoll für die epilepiechirurgische Diagnostik vor, demzufolge bei 50 von 173 Patienten mit pharmakoresistenten fokalen Epilepsien ein resektiver epilepsiechirurgischer Eingriff durchgeführt wurde. Die lokalisatorische Übereinstimmung von Befunden des nichtinvasiven EEG-Video-Monitorings, der Magnet-Resonanz-Tomographie (MRT), der interiktalen Positronen-Emissions-Tomographie (PET) und der iktalen SPECT (Single-Photon-Emissions-Computer-Tomographie) bildete die Grundlage der Fokuslokalisation. Bei 46 (92%) der Patienten lagen temporale und bei 4 (8%) extratemporale Epilepsien vor. 78% (n=39) aller 50 Patienten wurden anfallsfrei oder hatten nur noch sehr selten Anfälle. Extratemporale Resektionen konnten ohne invasive EEG-Untersuchungen erfolgen, wenn umschriebene MRT-Läsionen vorlagen und die Resektionen in ausreichendem Abstand vom eloquenten Kortex durchgeführt werden konnten. Anfallsfreiheit konnte so bei insgesamt 3 der 4 extratemporalen Patienten erreicht werden. Wir folgern aus unseren Ergebnissen, daß bei einer Reihe von ausgewählten Patienten mit pharmakoresistenten fokalen, insbesondere temporalen Epilepsien nichtinvasive EEG-Ableitungen in der prächirurgischen Diagnostik ausreichen und so das Risiko invasiver EEG-Untersuchungen vermieden werden kann.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1619-7089
    Keywords: Key words: Positron emission tomography ; Dual-detector coincidence imaging ; Fluorodeoxyglucose ; Lung cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Dual-head gamma cameras operated in coincidence mode are a new approach for tumour imaging using fluorine-18 fluorodeoxyglucose (FDG). The aim of this study was to assess the diagnostic accuracy of such a camera system in comparison with a full-ring positron emission tomography (PET) system in patients with lung cancer. Twenty-seven patients (1 female, 26 males, age 62±9 years) with lung cancer or indeterminate pulmonary nodules were studied on the same day with a full-ring PET scanner (Siemens ECAT EXACT) and a coincidence gamma camera system (ADAC Vertex MCD). Sixty minutes after injection of 185–370 MBq FDG, a scan of the chest was performed with the full-ring system. Approximately 2 h p.i., the coincidence camera study was performed. Coincidence gamma camera (CGC) and PET images with (PETac) and without attenuation correction (PETnac) were analysed independently by two blinded observers. In addition, FDG uptake in primary tumours and involved lymph nodes was quantified relative to normal contralateral lung (T/L ratios). All primary tumours were histologically proven. The lymph node status was histologically determined in 23 patients. In four patients, no lymph node sampling was performed because of extensive disease or concurrent illnesses. In the 27 patients, 25 primary lung cancers and two metastatic lesions were histologically diagnosed. The number of coincidences per centimetre axial field of view was 3.33±0.93×105 for the CGC and 1.09±0.36×106 for the dedicated PET system. All primary tumours (size: 4.6±2.6 cm) were correctly identified in the CGC and dedicated PET studies. T/L ratios were 4.7±2.5 for CGC and 6.9±2.8 for PETnac (P 〈0.001). Histopathological evaluation revealed lymph node metastases in 11 of 88 sampled lymph node stations (size: 2.3±1.0 cm). All lymph node metastases were identified in the PETac studies, while PETnac detected 10/11 and CGC 8/11. For positive lymph nodes that were visible in CGC and PETnac studies, T/L ratios were 3.7±2.3 for CGC and 6.6±3.1 for PETnac (P=0.02). The diameters of false-negative lymph nodes in the CGC studies were 0.75, 1.5 and 2 cm. False-positive FDG uptake in lymph nodes was found in two patients with all three imaging methods. For all lesions combined, T/L ratios in CGC relative to PETnac studies decreased significantly with decreasing lesion size (r=0.62; P〈0.001). In conclusion, compared with a full-ring PET system the sensitivity of CGC imaging for detection of lung cancer is limited by a lower image contrast which deteriorates with decreasing lesion size. Nevertheless, the ability of CGC imaging to detect pulmonary lesions with a diameter of at least 2 cm appears to be similar to that of a full-ring system. Both systems provide a similar specificity for the evaluation of lymph node involvement.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1619-7089
    Keywords: Iodine-123 metaiodobenzylguanidine single photon emission tomography ; Arrhythmogenic right ventricular disease ; Cardiac sympathetic nerve system
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Arrhythmogenic right ventricular disease (ARVD) is a disease of unknown origin that primarily affects the right ventricle and is characterized by ventricular tachyarrhythmias which may lead to syncope and even, though rarely, sudden cardiac death. In 25 patients with ARVD, sympathetic innervation of the left ventricle was assessed by iodine-123 metaiodobenzylguanidine single photon emission tomography (1231-MIBG SPET). In addition, thallium-201 SPET was performed. The diagnosis of ARVD was made by an electrophysiological study and right and left heart catheterization including right ventricular endomyocardial biopsy. Ischaemic heart disease was excluded by coronary angiography. A group of seven patients without any evidence of heart disease served as a control group. Twenty-two of the 25 patients showed reduced uptake of 123I-MIBG. The abnormal areas were located predominantly in posterior and posteroseptal segments of the heart. No focus of increased 123I-MIBG activity could be demonstrated. No patient had signs of left ventricular involvement on left ventricular angiography. In contrast to the results of the 123I-MIBG SPET, those of 201TI SPET were normal in 16 patients. The remaining nine patients showed areas of slight hypoperfusion not correlated with the reduced 123I-MIBG uptake. 123I-MIBG scintigraphy allows detection of left ventricular adrenergic dysinnervation in ARVD patients without morphological or functional abnormalities of the left ventricle.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Positronen-Emissions-Tomographie (PET) ; Neurologie ; Neurochirurgie ; Psychiatrie ; Key words Positron emission tomography ; Neurology ; Neurosurgery ; Psychiatry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary To date, positron emission tomography (PET) is the most powerful method for the in-vivo investigation of human brain metabolism. Besides extensive application of this technology in the neurosciences, PET is also being increasingly used as a clinical tool. However, despite its acceptance in clinical practice, a major obstacle is its high costs. The present article reviews the literature on the clinical use of PET in neurology, neurosurgery, and psychiatry in order to substantiate the clinical indications for PET in these specialties as established by an interdisciplinary conference.
    Notes: Zusammenfassung Die Positronen-Emissions-Tomographie (PET) ist das derzeit leistungsfähigste Verfahren zur In-vivo-Untersuchung des zerebralen Stoffwechsels. Neben einem breitgefächerten Einsatz von PET in der neuromedizinischen Forschung findet die PET zunehmend auch Eingang in die klinische Diagnostik. Dieser Entwicklung entgegen stehen die relativ hohen Kosten, die mit diesem Verfahren verbunden sind. Die vorliegende Arbeit begründet die, in einer interdisziplinären Konferenz erarbeiteten Konsensusindikationen für den klinischen Einsatz der PET in der Neurologie, Neurochirurgie und Psychiatrie durch Aufarbeitung der einschlägigen Literatur.
    Type of Medium: Electronic Resource
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