99mTc-labelled anti NCA-95 antibodies in prosthetic heart valve endocarditis.

A 54-y old women with earlier replacement of the mitral and aortic valves and clinical signs of localized endocarditis was studied with 99mTc-labelled anti NCA-95 antibody. Whereas echocardiographic findings were negative, increased radionuclide uptake was observed left parasternal over the mitral valve as a sign of prosthetic valve endocarditis. This result could be confirmed by a similar study with leukocytes labelled in vitro with 111In-oxine.

New diagnostic and therapeutic possibilities in manifest idiopathic hemochromatosis.

Up until recently in clinical practice suspected hemochromatosis with a pathological iron-screening test (plasma iron, percentage transferrin saturation, serum ferritin, desferrioxamine-induced urinary iron excretion) made a liver biopsy necessary. Today, as a first step, the density of the liver parenchyma can be measured by means of computed tomography. Normal findings obviate the need for laparoscopy. Since the late forties weekly or twice weekly phlebotomy has been the sole form of treatment for manifest idiopathic hemochromatosis. In the mid-sixties the hopes placed in chelating substances (desferrioxamine) were not fulfilled, because the plasma half-life (only 7-10 minutes) of this drug was too short. Even with several daily injections only a small amount of iron was removed from the body tissue (10-25 mg daily urinary iron excretion). The introduction of portable infusion pumps in the late seventies offered us a new possibility of administering desferrioxamine by subcutaneous injection (Propper et al., 1976). Until that time such treatment was successfully used only in the field of pediatrics to treat secondary transfusion hemochromatosis in thalassemia. In one case of idiopathic hemochromatosis with severe organic involvement (right heart failure, repeated esophageal hemorrhage and bronzed diabetes) we had to achieve rapid iron elimination, and for this purpose we used continuous long-term desferrioxamine administration by means of a portable infusion pump (Autosyringe) in addition to phlebotomy. Since, particularly in the critical initial phase of treatment when heart failure was always threatening, great care had to be exercised in the use of phlebotomy, iron removal was achieved largely by desferrioxamine administration (daily up to 240 mg iron elimination in urine and stools).(ABSTRACT TRUNCATED AT 250 WORDS)

[Weight reduction on a commercially available minimal diet. Results of replacing 1 meal per day]. / Gewichtsreduktion durch eine industriell hergestellte Minimaldiät. Ergebnisse nach 14tägigem Ersatz einer Mahlzeit pro die.

Over a period of 14 days eight female outpatients ingested a new low-calorie formula diet (Enerday Protein) as a substitute for either dinner or lunch. This formula diet contains fructose as carbohydrate. In the two weeks of treatment an average reduction in weight of 2.7 kg (range: 2.0-3.4 kg) was observed, which means a daily weight loss of 193 g. Gastrointestinal disturbances or metabolic changes were not observed. This form of weight reduction was well accepted by the patients. Living and eating habits were not altered, since only one daily meal was replaced.

[Dosage-problems in controlled sodium nitroprusside hypotension in oto-rhino-laryngological surgery (author's transl)]. / Dosisprobleme mit Natriumnitroprussid bei kontrollierter Hypotension in der Hals-, Nasen- und Ohrenchirurgie.

During a study of 130 patients undergoing hypotensive anaesthesia for oto-rhino-laryngological surgery the most important dose problems with sodium nitroprusside (S.N.P.) were characterized. In 14% of the cases more than 15 mcg/kg body weight/min S.N.P. were required. Our data show, that the smallest S.N.P. consumption occurs during neuroleptanalgesia in combination with 0.3--0.8 Vol-% enflurane. On the other hand, during neuroleptanalgesia alone, in several cases toxic amounts of S.N.P. would have been necessary to produce adequate hypotension. In such cases about 0.5 mg/kg body weight dihydralazine must be employed as a supporting agent for hypotension. The influence of this drug on the manoeuvrability of the low pressure state and on the administration of S.N.P. was investigated. Although, the equivalent amount of sodium thiosulfate (S.T.) did not increase the S.N.P. sensibility, its routine use is reconviended, since the combination of S.Th, and even higher doses of S.N.P. were tolerated without metabolic acidosis. As an alternative substance after long-term use of S.N.P. nitroglycerine should be used.