The plasma clearance rate of 131I-insulin in diabetic and obese patients and healthy persons.

The plasma clearance rate of 131I-insulin was studied in diabetic and obese patients and healthy persons. The aim of the investigation was to find out whether an accelerated degradation of insulin-probably due to the metabolism of insulin by adipocytes-causes slight forms of the diabetic syndrome. For the evaluation of the data a three-compartment model was used whereby the third compartment reflects the degradation of the intravenously administered 131I-insulin in the tissue. In this compartment 131I-insulin has a half life of 38.7 +/- 7.0 min for control persons (n = 19), 47.4 +/- 27.4 min for patients with a latent diabetes mellitus (n = 7), 34.2 +/- 8.5 min for the group with the subclinical diabetes (n = 5) and 47.6 +/- 16.2 min for the patients with an onset diabetes mellitus (n = 5). No significant difference was observed in the plasma clearance rate between healthy and diabetic persons. There is also no detectable correlation between the grade of obesity and the insulin clearance rate.

Thyroid carcinoma: a follow-up study of 11 years.

During a follow-up of 11 years of thyroid carcinoma 136 patients were repeatedly examined. 43% papillary, 43% follicular, 11% anaplastic and 2% medullary carcinomas was found. The incidence of these types of carcinoma differed considerably; the frequency peak of papillary carcinomas was reached in 45-year-old humans, that of the follicular carcinomas in people aged 60, that of the anaplastic carcinomas in 70-year-old humans. 84% of the patients was female. Classification in pTNM-system: 8% in pT1, 27% in pT2, 12% in pT3 and 49% in pT4. Local and distant metastases were found at a low rate equally in pT1, pT2 and pT3; 26% of patients in pT4 had local metastases and 18% had distant ones in addition. There were 6 patients with metastases of a differentiated adenocarcinoma accumulating no 131-iodine and with no thyroglobulin in serum. 29% of patients had after thyroidectomy an unilateral paresis of the nervus recurrens and 4% a bilateral one. 26% of patients had a permanent hypoparathyroidism after thyroidectomy.

[Scintigraphic diagnosis of multiple pheochromocytomas in childhood with 131I-m-benzylguanidine]. / Szintigraphische Diagnostik multipler Phäochromozytome im Kindesalter mit 131I-m-Benzylguanidin.

Scintigraphy with 131I-m-BG was used in 4 children with a history of multiple pheochromocytomas in order to localize further catecholamine-producing tumors prior to surgery. We overlook 7 scintigraphies without any side effect. Phenoxybenzamine did not interfere with tracer uptake into tumors. Scintigraphic localization of even smallest extra-adrenal tumors was successful in all cases. In most cases we were dealing with benign pheochromocytomas, but also a ganglioneuroma and metastases of a malignant pheochromocytoma could be revealed. Scintigraphy is a reliable technique for tracing pheochromocytomas and catecholamine-producing ganglioneuromas. It seems to be superior to other non-invasive techniques, furthermore, invasive techniques bearing higher risks may be suspended.

Nuclear medical determination of the left ventricular normalized velocity of contraction.

The normalized velocity of contraction (vn) and its maximal value (vnmax) are related to the normalized flow acceleration within the ventricle, to the subendocardial fiber shortening rate, strain rate, and stress. This paper presents the method of the nuclear medical determination of vn and analyzes a typical volume-velocity-time curve. In 60 patients with different stages of coronary artery disease, global vnmax showed good correlation with the minimal ventricular transit time (y = 6.18-1.36 x, P less than 0.001) and global ejection fraction (y = -(2.5 + 356/(x - 104], P less than 0.001). The segmental vnmax showed a highly significant correlation with the regional ejection fraction (y = -(2.5 + 371/(x - 104], P less than 0.001). The mathematical relationships of vn with the mechanical properties of the ventricular wall are described in the appendix.

[Functional scintigraphy of salivary glands of the head during telecobalt radiotherapy]. / Funktionsszintigraphie der Kopfspeicheldrüsen im Verlauf einer Telekobalttherapie.

In order to find out radiogenic lesions to the large salivary glands of the head, the function of parotid and submandibular glands was examined by scintigraphy with 99m-Tc Pertechnetate before, during, and five to eight months after a telecobalt therapy for malignomas of the neck. It was shown that the parotid glands did not function at all immediately after an irradiation with 60 Gy. Five to eight months later, a recovery of about 50% of the secretory function was registered. The function of the submandibular glands was reduced to about 60% of their normal secretion after 30 and 60 Gy. This corresponds to the modification of xerostomia reported by the patients some time after an irradiation of the salivary glands.

Mean transit time image--a new method of analyzing brain perfusion studies.

Point-by-point calculation of the mean transit time based on gamma fit was used to analyze brain perfusion studies in a vertex view. The algorithm and preliminary results in normal brain and in different stages of cerebral perfusion abnormality (ischemia, stroke, migraine, tumor, abscess) are demonstrated. In contrast to the traditional methods using fixed, a priori defined regions of interest this type of mapping of the relative regional cerebral perfusion shows more clearly the irregular outlines of the disturbance. Right to left activity ratios in the arterial part of the time-activity curves showed significant correlation with the mean transit time ratios (Qt = 1.185 - 0.192 Qa, n = 38, r = 0.716, P less than 0.001).

Hypercalcemia in hyperthyroidism. Role of age and goiter type.

Hyperthyroidism is often associated with hypercalcemia which is provoked by osteoclastic activity of the thyroid hormones. These data show that hypercalcemia develops with increasing age and in the presence of a special type of hyperthyroid goiter. Total serum calcium, total protein, and albumin as well as different parameters of thyroid function, namely T3 RIA1, T4 test, ETR and TRH test were determined in a group of 147 patients. The ionized calcium level was estimated from total calcium and albumin. 211 measurements were performed. Hyperthyroidism existed in 92 cases. Total calcium was not significantly elevated in hyperthyroidism. Hyperthyroid patients under 61 years of age showed elevated ionized calcium levels in only 2.3% and patients over 60 years of age in 18.8% of cases. Elevated ionized serum calcium levels were observed in 43.8% of hyperthyroid patients with multinodular goiters. The linear correlation between ionized calcium levels and different parameters of thyroid function is much more pronounced in the older group and it was found to be highly significant. 7 of 9 hyperthyroid patients with elevated ionized calcium levels showed multinodular goiters, though no autonomous adenoma. In the hyperthyroid group of patients of over 60 years of age with multinodular goiters the incidence of hypercalcemia was 43.8%. Direct action of thyroid hormone on calcium turnover as well as increasing age and special goiter type seem to be responsible for disturbances in calcium metabolism. A possible calcitonin deficiency in the above mentioned conditions is discussed.

[Radioisotope angiography in a case of persistent vena cava superior sinistra (author's transl)]. / Radioisotopenangiographie der persistierenden Vena cava superior sinistra.

During insertion of a pacemaker electrode an anomaly of the superior vena cava was suspected. Radioisotope angiography demonstrated a persistent left superior vena cava. The clinical significance, the embryonic development and the incidence of this anomaly is described.

Accumulation of radioiodinated L-alpha-methyltyrosine in pancreas of mice: concise communication.

L-3-iodo-alpha-methyltyrosine, labeled with either I-131 or I-123, has a high pancreatic specificity in mice. A pancreas-to-liver ratio of 8.6 +/- 2.7 is observed during the first hour after i.v. injection. Accumulation is also prominent in the kidneys, but excretion of the radioagent is rapid, 50% of the activity being eliminated during 90 min. Compared with L-[75Se]selenomethionine, the compound currently used for pancreatic imaging, L-3-[123I]or[131I]iodo-alpha-methyltyrosine has a higher pancreas-to-liver ratio, a shorter physical half-life and biological half-time, and better decay characteristics.

[Distribution and excretion of 14c-butylbiguanide in man (author's transl)]. / Verteilung und Ausscheidung von 14C-Butylbiguanid beim Menschen.

Seven patients suffering from maturity on-set diabetes mellitus were given orally 100 mg of 14C-labelled butylbiguanide, specific activity 1.40 or 1.23 muCi/mg, resp. Three days before oral administration, two of the patients had received an i.v. injection of 50 mg butylbiguanide labelled with 120 muCi 14C. The radioactivity in the blood of the patients was followed up during the first 12-h period after administration of the drug. For determination of the radioactivity in the urine aliquots of three 24-h portions were measured. Furthermore, the radioactivity was checked of each individual sample of faeces for the first 72 h after administration. The radioactivity in the exhaled air was also measured. By comparison of the excretion after i.v. and oral application an absorption efficiency of 90% to 92% was calculated. Butylbiguanide is almost exclusively and fast excreted via the kidney. 86.5% of the i.v. administered material was eliminated within 24 h and 88.1% within 3 d in the urine of a person without kidney disease. Elimination through faeces was negligible, 0.2% in a person without kidney disease and 0.7% in a patient with renal insufficiency. The data obtained from the exhaled air show that there is only a negligible break-down of butylbiguanide, if any, to CO2 in man.

Fixation, retention and exhalation of carrier-free 11C-labeled carbon monoxide by man.

Carrier-free 11C-labeled carbon monoxide was produced by proton irradiation of a nitrogen gas flow target via the 14N(p, alpha)11C process followed by on-line reduction of the predominantly formed 11C-carbon dioxide with a yield of 0.4 mCi/muAmin. After appropriate quality control about 2 mCi of carrier-free 11C-carbon monoxide in 500 ml on nitrogen gas were inhaled by test subjects in one breath. The 11C-activity distribution was then followed in vivo by scanning above thorax, head, liver, thigh and os sacrum; simultaneously the 11c-activity of the blood was also followed by batch measurement. The data indicate that part of the 11C-activity migrates from the blood into the intercellular space, while another part is exhaled. The 11C-activity leaves the individual organs with a biological half-life ranging from about 120 to 200 min, a time which is short as compared to the one observed for 51Cr-labeled erythrocytes. A radio gas chromatographic analysis of the exhaled air showed that the 11C-activity leaves the body exculsively in the form of 11C-labeled carbon monoxide. Consequently, metabolism of the 11CO into 11CO2 or other compounds can be excluded.

[Acrodermatitis enteropathica--a disturbance of zinc metabolism with zinc malabsorption (author's transl)]. / Akrodermatitis enteropathica--eine Zinkstoffwechselstörung mit Zinkmalabsorption

The intestinal resorption of zinc using 65ZnCl2 was estimated in 3 patients with acrodermatitis enteropathica, 2 healthy controls, and 3 heterozygotes. After oral application of 65Zn the whole body activity was measured by a whole body counter for 34 days. The 65Zn resorption of the patients amounted to 16, 42 and 30% of the applied dose, whereas the resorption values of the heterozygotes and the controls were in the range of 58 and 77%. The elimination of 65Zn from the body amounted to about 0.7% of the applied dose with no difference between controls and patients with acrodermatitis enteropathica. Before therapy the serum-zinc levels of patients were markedly decreased. After oral application of high doses of zinc aspartate (2 times 400 mg/day) all clinical symptoms disappeared within a week. The results point at a causal connection between zinc and the pathogenesis of acrodermatitis enteropathica. Ultrastructural alterations of the Paneth cells of the intestines are also shown in this disease [12] as have also been seen in Paneth cells of zinc deficient rats [Beitr. Path. 145, 336 (1972)].

[Quantitative determination of enteral calcium resorption with enriched stable 46Ca (author's transl)]. / Quantitative Bestimmung der enteralen Calciumresorption mit angereichertem stabilem 46Ca

The application of a Ca-resportion test without the use of radioisotopes, which can therefore be used for babies, children and pregnant women, was investigated on 14 adult patients. In place of a radioisotope, an enriched form of the stable isotope 46Ca was administered orally, and the proportion of the applied dose of 46Ca appearing in the serum and urine was measured. 46Ca was measured by neutron activation over 47Sc. The clinical picture showed a close correlation with the determined resorption capacities. On the basis of the results, patients were classified into three groups: those with normal, increased, and decreased Ca-resorption.

Primary hypomagnesemia. I. Absorption Studies.

The clinical course of 2 patients with primary hypomagnesemia is reported. In one male patient, 5 months old, measurements of magnesium retention, intestinal absorption, fecal excretion and renal clearance were performed. The retention (2.8%) and absorption (7.8%) of 28-Mg were markedly reduced in comparsion to controls (average retention 25% and average absorption 28%). The retention values of the parents and other realtives did not differ from those of healthy adults. The examined patient was sucessfully treated with trimagnesium dicitrate containing 1.75 g magnesium per day.