Diagnosis of pancreatic cancer by 2[18F]-fluoro-2-deoxy-D-glucose positron emission tomography.

The detection of pancreatic cancer or the discrimination between pancreatic cancer and chronic pancreatitis remains an important diagnostic problem. The increased glucose metabolism in malignant tumours formed the basis for this investigation, which focused on the role of positron emission tomography (PET) with 2[18F]-fluoro-2-deoxy-D-glucose (FDG) in the detection of pancreatic cancer and its differentiation from chronic pancreatitis. Eighty patients admitted for elective pancreatic surgery received preoperatively 250-350 mBq FDG intravenously and emission scans were recorded 45 minutes later. Intense focal activity in the pancreatic region was taken at the time of scanning as showing the presence of pancreatic cancer. The presence of cancer was later confirmed by histological examination of the surgical specimens and histological findings were compared with the preoperative PET results. Forty one patients with pancreatic cancer (group I: n = 42) had a focally increased FDG uptake in the pancreatic region. Two patients with a periampullary carcinoma (group II: n = 6) failed to develop FDG accumulation. In 28 patients with chronic pancreatitis (group III: n = 32) no FDG accumulation occurred. Overall sensitivity and specificity of PET for malignancy (group I + II) were 94% (45 of 48) and 88% (28 of 32), respectively. The standard uptake value of the patients with pancreatic carcinoma was significantly higher than in patients with chronic pancreatitis (3.09 (2.18) v 0.87 (0.56); p < 0.001; median (interquartile range)). These findings show that FDG-PET represents a new and non-invasive diagnostic procedure for the diagnosis of pancreatic cancer and to differentiate pancreatic cancer from chronic pancreatitis. However, the diagnostic potential of this technique requires further evaluation.

Color Doppler echocardiographic determination of mitral regurgitant flow from the proximal velocity profile of the flow convergence region.

Flow rate across an orifice can be determined from color Doppler echocardiographic maps of the flow convergence region proximal to the orifice. Different methods have been developed in vitro. The proximal velocity profile method was prospectively evaluated in patients with mitral regurgitation. Color Doppler echocardiography was performed in 74 patients before cardiac catheterization. The increasing velocities within the flow convergence region were determined in an apical plane on the straight line from the transducer to the leak; thus the proximal velocity profile was established and plotted on a nomogram. Instantaneous regurgitant flow rate was derived from the position of the resulting curve in relation to the nomogram's reference curves, which were derived from in vitro measurements. Regurgitant stroke volume was calculated as regurgitant flow rate.regurgitant velocity-time integral/regurgitant peak velocity, using additional continuous-wave Doppler. The 55 patients with angiographic regurgitation had a close association between regurgitant flow rate (0 to 600 ml/s) and angiographic grade (Spearman's rank correlation coefficient = 0.91; p < 0.0001). Regurgitant flow rate did not overlap between grades < or = 2+, 3+ and 4+. In 16 patients, regurgitant stroke volume by echocardiography correlated well with that by the angiography/Fick method (r = 0.88; SEE = 17.1 ml), with a regression line close to identity (y = 0.89x + 12.7 ml). The proximal velocity profile method enables determination of mitral regurgitant flow and estimation of regurgitant volume.

[Behavior of back fat thickness, the activity of NADP-dependent dehydrogenases from adipose tissue and adipose tissue constituents fat and protein and their evidence for energy metabolism in dairy cows]. / Verhalten der Rückenfettdicke, der Aktivitäten der NADP-abhängigen Dehydrogenasen des Fettgewebes sowie der Fettgewebsbestandteile Fett und Protein und ihre Aussage zum Energiestoffwechsel der Milchkuh.

Studies were conducted into 60 Friesian dairy cattle in the GDR for determination of dorsal fat thickness (DFT), activities of glucose-6-phosphate dehydrogenase (GPDH) and isocitrate dehydrogenase (ICDH) in adipose tissue, concentrations of fat and protein in adipose tissue, 2 weeks ante partum as well as 0, 2, 4, 6, 8, 12, 16, 20, 28, 36 weeks post partum, and liver fat levels, 2 and 4 weeks post partum. DFT, ICDH, GPDH, ICDH-GPDH ratio, fat level, fat-protein quotient, changes in DFT, GPDH, and fat-protein quotient exhibited significant relations with the weeks of lactation. The above 60 experimental cows were subdivided by 6 groups of half-siblings consisting of 10 animals each. Significant differences were found to exist between these groups of half-siblings with regard to DFT, GPDH, ICDH-GPDH ratio, and fat-protein quotient. Within each of the half-sibling groups, significant differences were found to exist between individuals for DFT, ICDH, GPDH, ICDH-GPDH ratio, and fat-protein quotient. The above parameters can be used to describe the energy metabolism of dairy cow via quantitative and temporal curves of fat mobilisation and fat deposition. In the context of both animal health and breeding, more attention should be given to determination of mobilisation and deposition of fat as well as to the post partum energy deficit.

[The chemotherapeutic treatment with co-trimoxazole i.m. An experience report from 12 established physicians]. / Die chemotherapeutische Anbehandlung mit Co-trimoxazol i.m. Ein Erfahrungsbericht von 12 niedergelassenen Arzten.

The local tolerance of a new mode of application of Cotrimoxazole (Eusaprim i.m.) was tested in 104 patients by 12 general practitioners in the region of Northern Bavaria. The patients received 1--2 injections, after which the assessment of local tolerance of the injection was done.. Parameters were the subjective statements by the patients and the objective findings by the physicians. 102 out of 104 patients reported about a good or acceptable tolerance. The physicians found a good tolerance in 99 cases and an average one in 5 patients.