[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.

[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.

[Relation between 67-gallium scintigraphy and bronchoalveolar lavage--differential cell count and superoxide anion liberation--in patients with systemic scleroderma and systemic lupus erythematosus]. / Beziehungen zwischen 67-Gallium-Szintigraphie und bronchoalveolärer Lavage--Differentialzellbild und Superoxid-Anion-Freisetzung--bei Patienten mit systemischer Sklerodermie und systemischem Lupus erythematodes.

The aim of the study was to determine the pulmonary 67-gallium uptake, bronchoalveolar lavage (BAL) cell differentiation and the activity of BAL cells, measured as release of superoxide anion (O2-), and to investigate the results whether there are relations. In 11 nonsmoking systemic scleroderma (SS) patients and 11 systemic lupus erythematosus (SLE) patients with lung involvement double-sided BAL were performed, mainly in regions with increased 67-gallium uptake. Release of O2- was measured by INT-assey. BAL cell differentiation was in SS and SLE pathological in 68.2% without side-difference. In contrast to SS, O2(-)-release in SLE depends on BAL cell differentiation and is most increased in normal BAL cell differentiation. There is no correlation between 67-gallium uptake and both BAL cell differentiation and O2(-)-release. The results suggest, that in contrast to SS, BAL cells in SLE with pathological differentiation are less activated than BAL cells with normal differentiation probable due to autoimmunological factors. Pulmonary 67-gallium scan and BAL seem to be independent from each other.

[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.

[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).

[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).

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.

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.

[Oral galactose loading in characterizing the elimination and metabolizing performance of the liver in chronic renal failure]. / Die orale Galaktosebelastung zur Charakterisierung der Eliminations- und Metabolisierungsleistung der Leber bei chronischer Niereninsuffizienz.

For characterising the elimination and metabolisation performance of the liver in chronic renal insufficiency the galactose load test was carried out. 9 children with healthy liver and kidneys, 35 children with chronic renal insufficiency (15 were conservatively treated = group 1, 20 were in the chronic haemodialysis programme = group 2) as well as 5 children after kidney transplantation were examined. In group 1 a normal blood galactose concentration was present. Patients of the 2nd group showed increased concentrations of galactose in the blood which might refer to a decreased redox potential in the liver caused by the uraemic intoxication. In the group of patients who underwent a kidney transplantation in the patients with azathioprine therapy a disturbed use of galactose was present. Children with cyclosporin-A had a normal galactose concentration.

[Value of bronchoalveolar lavage in assessing the activity of sarcoidosis]. / Stellenwert der bronchoalveolären Lavage (BAL) in der Aktivittsbeurteilung der Sarkoidose.

BAL was performed in different courses of sarcoidosis in order to evaluate the importance of this examination. We found a higher degree of lymphocytosis in Löfgren's syndrome and in relapses than in the others. Probably there is a direct connection between high intensity alveolitis and reduction of diffusing capacity. There could not be found any correlation to other markers of activity (lung function, SACE, 67-Gallium-Scan).

[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.

[Allogeneic transplantation of the small intestine--animal experiments and a clinical retrospect]. / Die allogene Dünndarmtransplantation--Tierversuche und klinischer Rückblick.

Allogenic transplantation of small intestine has proved to be an alternative therapy for complex failure of intestinal functions. Attempts in that direction had been made over many years, but impressive were obtained only under conditions of modern immunosuppressive therapy. Hence, wider clinical application is imminent at an international scale. Reference is made in this paper to the authors' own experience obtained from mongrel dogs for an account of indications, surgical technique for collection of intestine and transplantation, perfusion and preservation of the donor organ as well as of various pathophysiological, functional, and immunological aspects. Results obtained at different centres are discussed, with reference being made to individual cases and clinical findings recorded from them. The survival rate of animals which have undergone transplantation of the small intestine provides evidence for the possibility of such organ transplantation and means a challenge to all involved in conventional intestinal surgery and modern medical transplantation.

[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.

[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.