Nitrogen-15 NMR studies of rat liver in vitro and in vivo.

In the present 2.1 T15N NMR study two different kinds of experiments are presented. In one we show that metabolic reactions of 15N-labelled glycine can be followed in the isolated rat liver. In the second we demonstrate that [15N]glycine can be detected using NMR in vivo. For quantification and identification of glycine and metabolites 15N-isotope analysis (emission spectrometry technique) was used. To our knowledge, this is the first demonstration of 15N NMR for study of the metabolism of 15N-labelled compounds in vivo.

[The accuracy of the imaging procedures (sonography, MRT, CT, angio-CT,nuclear medicine) in characterizing liver tumors]. / Treffsicherheit bildgebender Verfahren (Sonographie, MRT, CT, Angio-CT, Nuklearmedizin) bei der Charakterisierung von Lebertumoren.

In a prospective study, an attempt was made to determine the specificity of various imaging methods for defining tumours of the liver rather than their ability to demonstrate them. It was based on 130 patients with histologically confirmed lesions (33 haemangiomas, 17 FNH, 4 hepatocellular adenomas, 28 HCC, 36 adenocarcinoma metastases). The methods were MRT (130 cases), sonography (119), CT (122), dynamic arterial angio-CT (15), 99TC-EHIDA or blood pool scintigraphy (4 FNH, haemangiomas, HCC, 44 cases). MRT showed somewhat better results (accuracy 80%) than CT (73%) and angio-CT (73%) in demonstrating the type of lesion. The results of scintigraphy (53%) and sonography (69%) were rather worse. The range of accuracy for MRT, CT and sonography varied from 94% (haemangiomas with MRT) to 47% (FNH with sonography).

[Results of displacement studies on benzodiazepine receptors (123I-iomazenil and flumazenil)]. / Ergebnisse von Verdrängungsuntersuchungen an Benzodiazepin-Rezeptoren (123J-Jomazenil und Flumazenil).

SPECT studies with 123I-iomazenil were performed in 14 patients with hepatic encephalopathy. The activity concentration in the brain decreases spontaneously by 10 to 20% within 80 min, in the nasal tissue by 35%. After an i.v. injection of 0.1 to 0.5 mg flumazenil a decrease of 29 to 38% is observed within 20 min, with a comparable decrease in white matter and nasal tissue. The application of well-known models of receptor kinetics is therefore impossible.

[The efficacy of therapy using 89Sr-strontium chloride in 200 patients with bone metastases of a prostatic cancer]. / Wirksamkeit der Therapie mit 89Sr-Strontiumchlorid bei 200 Patienten mit Skelettmetastasen eines Prostatakarzinoms.

Since 1976 200 patients with multiple skeletal metastases from prostatic cancer were treated with 89Sr. In the present study the results were evaluated in order to confirm the efficacy of this therapy. Following the application of 3 injections each of 0 (n = 21), 37 (n = 65), 75 (n = 72), 100 (n = 25) or 150 (n = 17) MBq 89Sr subjective pain relief, scintigraphic follow-up observations, survival times and haematological complications were recorded. In comparison to the results of placebo administration the effects of 89Sr on pain were: in the placebo group deterioration 11%, no change 55%, improvement 17% and full pain relief 17% whereas in the Sr groups combined the corresponding figures were 3, 38, 26 and 33%. Pain relief correlated with the activity administered. A dose relationship to scintigraphic regression is probable, the latter correlating with pain relief. Due to a decrease of early deaths the survival rate increased during the first months after start of treatment but later on returned to the level observed in untreated patients. Pain relief and regressive scintigraphic findings were combined with increased marrow involvement which, however, did not by itself influence survival rates. 89Sr therapy is an effective additional treatment of patients with multiple skeletal metastases from prostatic cancer.

[A preclinical study of the organ distribution and radiation dosage of radioiodinated iodolisuride]. / Vorklinische Untersuchung zur Organverteilung und Strahlenbelastung von Radiojod-Jodlisurid.

The distribution in rats of 125I-iodo-lisuride was studied. Three rats each were sacrificed at fixed intervals between 5 min and 24 h p.i., and the radioactivity was measured in isolated organs and parts of the body. The organ distribution and biexponential blood disappearance were similar to values for unlabeled lisuride. The radiation dose was estimated for man assuming a 123I label. The resulting doses were comparable to those from other radiopharmaceuticals in clinical use.

[Determination of kidney circulation with radioxenon]. / Zur Methodik der Bestimmung der Nierendurchblutung mit Radioxenon

On 23 investigations in dogs the 133xenon eluation method was compared with the bloody measurement of the renal blood supply. The most favourable correlation presents the measurement of the initial decrease of the curves with r = 0.827 and y = 0.889x + 53.3, besides the modified hight-surface-method. Possibilities of error exist especially by the recirculation of xenon and the influence on the blood supply by the xenon-injection.

[Kidney circulation in chronic parenchyma diseases and in kidney insufficiency]. / Nierendurchblutung bei chronischen Parenchymerkrankungen und bei Niereninsuffizienz.

In 38 patients with glomerulo- (20 patients) and pyelonephritis the renal blood flow was measured with radioxenon. Despite normal creatinine clearance in chronic diseases the blood flow is already reduced. The correlation to the creatinine clearance is loose. In glomerulonephritis above all a reduction of the blood flow of the cortex appears, in pyelonephritis the participation of the cortex is reduced. Correlations of blood circulation and blood pressure are to be found in no stage of the disease. Concerning the renal insufficienzy there does not exist a disease-specific pattern of blood flow. In renal insufficiency the diuresis is independent of blood flow.

[Calcium metabolism before and during hemodialysis]. / Kalziumumsatz vor und während der Hämodialyse.

Calcium metabolism was studied in the serum of 10 patients before and during haemodialysis with the help of 47-Ca. The patients were in a stabilized condition within a chronic dialysis programme. The measured metabolic rate fell from 0.395 h-1 to 0.208 h-1 during dialysis. This corresponds to a reduction of metabolism by 0.43 mmol L-1 h-1. It is to be assumed that this alteration corresponds to the calcium inflow rate through the dialyser.

[Value of gallium-67 scintigraphy in the diagnosis and assessment of activity in sarcoidosis]. / Zum Stellenwert der Gallium-67-Szintigraphie in der Diagnostik und Aktivitätsbeurteilung der Sarkoidose.

Gallium-67 scan has an increased importance in the examination of activity in sarcoidosis. Compared with other markers of activity only gallium-67 can give an information about the localization of active granulomas in the body. It is profitable to distinguish between the accumulation of 67-gallium in the region of hilus and of lung parenchyma. SACE and gallium-67 scan complement each other. There is a good correlation between SACE and gallium-67 score, especially if there is an involvement of lung parenchyma.

[Diagnosis of absorptive hypercalciuria]. / Zur Diagnostik der absorptiven Hyperkalziurie.

Reference is made to the significance of hypercalciuria in the aetiology of calcium oxalate lithiasis. Differentiation between the various forms of hypercalciuria allows the therapy to be suited to the respective causes. In order to measure intestinal calcium absorption the authors examined serum samples from 22 patients after oral administration of Ca47; in 13 cases absorptive calciuria was diagnosed.

[Assisted circulation. The effect of cardio-synchronous peripheral arterio-arterial counterpulsation on perfusion and metabolism in the area of acute transmural myocardial ischemia]. / Zur assistierten Zirkulation - Die Wirkung der herzsynchronen peripheren arterio-arteriellen Gegenpulsation auf die Perfusions- und Stoffwechselsituation im akuten transmuralen myokardialen Ischämieareal.

After establishing a model of ischemia, perfusion in the ischemic area was considerably disturbed. Examination by means of 133xenon-clearance after intramyocardiac injection showed strongly delayed flowing-off compared with controls. Counterpulsation accelerates the flowing-off (perfusion). Untreated control animals reveal after inducing the model ischemia a crucial decrease of ATP concentration and an excessive increase of lactate concentration in the ischemic area. Counterpulsation may inhibit further decrease of ATP in the ischemic area.

[Suitability of bone scintigraphy for the determination of bone reaction or regeneration following endosseous implantation of alloplastic materials with special reference to bioactive materials]. / Zur Eignung der Knochenszintigraphie bei der Beurteilug der Knochenreaktion bzw. -regeneration nach enossaler Implantation alloplastischer Werkstoffe unter besonderer Berücksichtigung bioaktiver Materialien.

A programme for the investigation of the behaviour of bioactive and bioinactive implant materials by the osseous bed was enlarged by the scanning. This one allows a follow-up of bone processes in vivo. The implants were inserted into the patellar surface of the right and left femur of rabbits. The bone regeneration after defect formation without implant serves as standard of comparison. The scintigrams were taked down with 99m-Tc-EHDP. The bone scanning provides differentiate statements about the temporal process incorporation. Its non-specificity allows no separation between the behaviour of bioactive and bioinactive materials in biologic surroundings. The scintigraphic findings can be interpreted below employment of the results of the other tests and previously known material qualities.

[The LeVeen peritoneovenous shunt--an alternative in therapy-resistant ascites]. / Der peritoneo-venöse Shunt nach Le-Veen--eine Alternative beim therapieresistenten Aszites.

6 patients with therapy resistant ascites underwent implantation of a Le-Veen shunt. The risk of infection in this procedure is low, the surgical technique can easily be handled. In all 6 patients a significant reduction of the ascites could be demonstrated. Postoperatively, a right ventricular insufficiency could be observed in every case and, in addition, there were imbalances of the water and electrolyte metabolism Disseminated intravascular coagulation could not be traced.

[Auxiliary liver transplantation in an animal experiment--a novel surgical model]. / Die auxiliäre Lebertransplantation im Tierexperiment--ein neuartiges Operationsmodell.

At the problem of the auxiliary liver transplantation has been worked for about 30 years. Extensive series of tests with animals with a novel transplantation model justify these promises well of a successful clinical use. Laboratory chemical, histologic, angiographic and nuclearmedical examinations prove the fitness of this method. Basic supposition for a success is the preservation of physiological conditions at the donor liver with sufficient perfusion of the recipient liver.

Results of a double blind study of 89-strontium therapy of skeletal metastases of prostatic carcinoma.

Forty-nine patients were treated with either 3 x 75 MBq 89Sr or saline as placebo. Analysis of results 1 to 3 years after therapy revealed the ineffectiveness of 89Sr to relieve pain from metastases. Unexpectedly, a higher survival rate was found after Sr application (46% vs 4% after 2 years). Covariate analysis underlines the effect of 89Sr therapy on life expectation.

Scintigraphy of lymphatic vessels in malignant melanoma of the skin before operation (en bloc excision).

An injection of 99mTc-labelled antimony sulphide colloid was used to show the lymphatic pathways in patients with malignant melanoma of the trunk skin. Using a gamma camera, optimal visualisation was obtained 15-30 min postinjection. Surprising deviations of the lymphatic pathways were found; therefore, this method makes it possible to plan continuity dissection appropriate to individual cases. Two examples are presented.

[Nuclear medicine diagnosis in auxiliary liver transplantation in the minipig]. / Nuklearmedizinische Diagnostik bei auxiliärer Lebertransplantation beim Minischwein.

Experiences in the blood-flow measurement (133Xe washing out method) and function test (131J-bromsulphthalein, 99mTc-IDA) were reported after auxiliary liver transplantation in miniature swine. Normal values for the global blood-flow [70 (35-144) ml/100 g . min] and the bromsulphthalein half-time (6,5 +/- 2,4 min) were defined pre-operatively. Selective blood-flow measurements were carried out after transplantation invasively. Only insufficient experiences could be received about the liver-cholescintigraphy in consequence of graft insufficiency.

[Splenectomy in sarcoidosis]. / Splenektomie bei Sarkoidose.

It is reported about 6 patients suffering from sarcoidosis with splenomegaly. In these cases indication for splenectomy was given by symptoms of hypersplenism, abdominal pain and ineffective cortisone therapy. In general after operation activity of sarcoidosis is unchanged. Different markers of activity were used after a time interval of 2-11 years. In one case it has to be discussed an overwhelming postsplenectomy infection (OPSI).

89Strontium therapy of bone metastases of carcinoma of the prostatic gland.

Following a firm diagnostic and therapeutic schedule for patients with prostatic carcinoma. 89Strontium therapy was introduced for multiple metastases. Positive skeletal scintigraphy with 99mTc-EHDP induced check for affinity to Sr using 85Sr scintigraphy. Of 80 patients, multiple metastases were found in 26. Therapy with 1 mCi of 89Sr-chloride was started in 20 cases. In 8 patients, relief from severe pain appeared shortly afterward, and a further 8 it was possible to prevent the development of pain. Moderate success in 3 cases and a failure to provide relief in 1 were observed.

Influence of posture on hepatic blood flow.

Hepatic blood flow was measured in 28 patients in supine and prone positions using the 133Xe-inhalation washout method. Even though the reactions in individual patients were considerably different, a mean blood flow of 60.9 ml/100 g/min was unaltered in both positions. This constancy of hepatic blood flow values is valid for patients without liver disease, with chronic hepatitis, and with liver cirrhosis.