[Incidence of hepatitis B markers in pregnancy. Comparison with the serological tests legally required for maternal care]. / Hepatitis-B-Marker-Inzidenz in der Schwangerschaft. Vergleich mit den gesetzlich vorgeschriebenen serologischen Untersuchungen im Rahmen der Mutterschaftsvorsorge.

In a prospective study (June 1981 to October 1985) the prevalence of positive hepatitis B findings was recorded for 15957 pregnant women, in addition to the usual legally required serological tests for syphilis, newborn haemolytic disease and rubella immunity. A positive TPHA test was obtained in 69 (0.4%). No rubella antibodies were detected in 1604 (10.1%). Antibodies to neonatal haemolytic disease were found in 65 pregnant women (0.4%) and HBs antigen in 180 (1.1%). Among 13,752 German pregnant women 81 were HBs antigen-positive (0.6%), among 763 pregnant women from southern Europe 29 (3.8%), among 1159 from the Near East the rate was 5.1%, and among 170 from the Far East or other non-European countries it was 6.5%. By extending the required tests during pregnancy to those for HBs antigen, hepatitis B carriers could be identified and maternofetal transmission of the disease prevented by simultaneous passive-active immunization of the newborn.

[Influence of radiotherapy upon tumor accumulation and organ distribution of 57Co-bleomycin in mice with chemically induced squamous cell carcinoma (author's transl)]. / Einfluss der Strahlentherapie auf Speicherung von 57Co-Bleomycin im Tumor und Verteilung in den Organen bei Máusen mit chemisch induziertem Plattenepithelkarzinom.

Squamous cell carcinoma was induced in male 6 to 8-week old NMRI-mice by application of 9,10-dimethyl-1,2-benzanthracene on the skin. 15 weeks later macroscopically visible skin tumors are developed. Then organ distribution and tumor accumulation of 57Co-Bleomycin (spec. activity 1 mCi/3.3 mg) were studied 1 to 48 hours after injection. In squamous cell carcinoma a high uptake of this tumor-seeking agent can be demonstrated (n = 46). After radiotherapy (100 kV; 1.7 mm Al-filter; 18.8 Gy) (n = 26), however, a significantly reduced uptake of 57Co-Bleomycin in tumor tissue is observed. Possible consequences from these animal studies for tumor scintigraphy with this radiopharmaceutical in man are discussed.

Total body water, extracellular water, plasma volume, and total body potassium in cirrhosis of the liver.

Extracellular water (EWC; 82-bromide), total body water (TBW; 3-THO), intracellular water (ICW = TBW-ECW), plasma volume (PV; 51-Cr), and total body potassium (TBK; 40-K) were studied in patients with cirrhosis of the liver (n = 12) and in controls (n = 12). ECW (39%), TBW (28%), ICW (19%), and PV (24%) increased, TBK (28%) however, decreased in cirrhosis. The results indicate that it is less the lean body mass, but rather the intracellular potassium concentration that is lowered (cirrhosis: 84 +/- 21 mmol/l ICW; controls: 115 +/- 23 mmol/l ICW). Decreased potassium per cell (mmol) and increased intracellular water are discussed as possible reasons for this. The correlation between TBK (%) and serum potassium (mmol/l) was found to be r = 0.56 (p less than 0.002). Correlations between the biochemical parameters gamma-globulins, cholin esterase, serum sodium and serum albumin (g/l PV) and characteristic fluid disturbances in cirrhosis are highly significant whereas albumin (g/kg bodyweight) was the same in both groups. We can support the 'overflow theory' of ascites formation.

Evaluation of one dimensional profile scans with a whole body counter--82bromide space in liver cirrhosis: concise communication.

One dimensional profile scans with a whole body counter are refocused with a linear space invariant filter in the frequency domain, 'Hanning' window and inverse system transfer function. Artifacts are eliminated in a way that a clinically applicable method is developed. Topographic information is achieved with the highly energetic nuclide 82bromide. The bromide space (extracellular volume) in patients with liver cirrhosis (n = 9) compared to normal subjects (n = 10) is increased most in the upper abdominal thoracic region.

The influence of chemotherapy on the distribution of 57Co-bleomycin in chemically induced squamous cell carcinoma of mouse skin.

Organ distribution and tumor uptake of 57Co-bleomycin (BLM) were examined in NMRI mice without tumor and with chemically (DMBA-) induced squamous cell carcinoma. In these tumors high accumulation of 57Co-BLM was recorded shortly after injection of 57Co-BLM and low uptake 24--48 h after application. Two groups of tumor-bearing mice received unlabeled bleomycin as a cytostatic in two different doses. Uptake of 57Co-bleomycin was reduced. The study suggests that in patients currently or previously under chemotherapy, 57Co-bleomycin tumor scintigraphy may lead to false negative results.

[Kinetics of whole-body water and bromide space in patients with liver cirrhosis (author's transl)]. / Kinetik des Ganzkörperwassers und des Bromidraumes bei Leberzirrhotikern.

The kinetics of extracellular water (82Br) and total body water (THO) in controls and patients with liver cirrhosis are studied. Analysis of the plasma activity of the radionuclides as a function of time shows that distribution volumes and kinetics can be described by a linear open three-compartment model and that the volumes are of about equal size. Measuring is carried out in the central compartment in which the radionuclides are injected as a bolus. In cirrhotic patients equilibration into a third compartment is attained about four times slower than in controls. Elimination is reduced by about the same factor. Reduced diffusion and effective blood flow in the cirrhotic patients are discussed as possible reasons for the differences.

[Preoperative detection of antrum mucosa in patients with peptic ulcer following gastric secretion -- indication for reintervention?]. / Der präoperative Nachweis von Antrumschleimhaut bei Patienten mit peptischem Ulcus nach Magensekretion -- Indikation zur Nachresektion?

In 6 of 23 patients with marginal ulcer after gastric resection (B II and Roux-Y anastomosis) a retained ("excluded") gastric antrum attached to the duodenal stump was detected by 99mTC pertechnetate scintiphotography; serum gastrin levels were normal in two of those cases. Resection has been abandoned as a treatment method, and transthoracic vagotomy is recommended for this disease.

[Water and potassium metabolism in functional disturbances of the thyroid gland (author's transl)]. / Wasser- und Kalium-Haushalt bei Funktionsstörungen der Schilddrüse.

Total body water, extracellular water (bromide space), plasma volume and total body potassium were evaluated in hypothyroid (n = 24) and hyperthyroid (n = 18) patients and in controls (n = 10). Whereas the relative extracellular water was the same in all groups investigated, the relative intracellular water was found to be reduced in hyperthyroidism and increased in hypothyroidism (p less than 0.05). As to plasma volume there were no significant differences. A negative correlation between total body potassium and functional disturbance of the thyroid (T4) is thought to be attributable to an alteration of the lean body mass.

[Studies of 57-co-bleomycin in patients with carcinoma colli uteri (author's transl)]. / Verteilungsstudien von 57Co-Bleomycin bei Patienten mit Carcinoma colli uteri.

The kinetics of 57Co-Bleomycin was studied in twelve patients with histologically proven carcinoma colli uteri and in ten patients with benign gynaecological conditions. Measurements were carried out on the whole body, on parts of the body and on urine and blood using a whole body counter. Excretion of the tumour-seeking radio-pharmaceutical is predominantly through the kidneys and can be described by a double compartment model. After 48 hours, 2-4% of the applied activity is still present in the body. Radiation exposure to the body, the kidneys and bladder was calculated from the measurements and MIRD tables as 0.02 rad/mci (total body), 0.4 rad/mCi (kidneys) and 0.2 rad/mCi (bladder). In view of the rapid elimination of 57Co-Bleomycin, these figures are lower than data data quoted in the literature. There was no evidence of significantly higher uptake of 57Co-Bleomycin in the carcinomatous epithelium of the collum uteri compared with benign diseases, using the total body counter in the scan node. As possible explanations for this, the authors suggest inadequate geometric resolution of the system and a low tumour/non-tumour distribution ratio.

A whole body counter with an invariant response for whole body analysis.

A scanning 6-detector whole body counter is described. Its characteristics include good sensitivity, high energy resolution, good counting efficiency, geometric uniformity and localisation information of incorporated radioactivity using collimators. Problems such as band-width, calibration for air and phantom and measurements on patients, are discussed. The whole body counter is compared to other systems.

Evaluation of linear profile scans; mathematical treatment of line-spread functions.

The profile measurement capability of a scanning multidetector whole-body counter is described using line spread functions. Measurements in air and water phantoms, as a function of energy, are discussed in relationship to the relevant physical processes. A computer program for evaluating bodyprofile scans and an attempt to improve the resolution are reported.

[Estimation of individual renal function by Tc-DMSA-uptake (author's transl)]. / Abschätzung der seitengetrennten Nierenfunktion mittels der 99mTc-DMSA-Aufnahme.

Hg-Cl2-accumulation and early hippuran uptake are widely used for the estimation of individual renal function, a clinically important procedure in nephrological-urological nuclear medicine. After clinical experience in more than 2500 patients we investigated the assessment of individual renal function by the uptake of Tc-DMSA, a new radiopharmaceutical for renal scintigraphy. Tc-DMSA-uptake was measured after application of 0.8-1.6 mCi Tc-99m-DMSA by a scintillation camera connected to a computer system and by a rectilinear scanner with data storage, additionally hippuran kinetics were registered with a scintillation camera, the total body clearance was performed due to the method of Oberhausen with a modified whole body counter. A good agreement and high correlation between Tc-DMSA-uptake with background corection and the unilateral renal clearance could be established. This easily available and clinically valuable method also can be adjusted to institutions with a rather simple equipment.

[Relationship between digoxin-induced cardiac arrhythmias and serum-digoxin levels (author's transl)]. / Zusammenhang digoxinbedingter kardialer Arrhythmien mit dem Serumdigoxinspiegel

The serum-digoxin level was measured by radio-immunoassay (Immutope) on 245 patients in a coronary care unit. Cardiac arrhythmias were assumed to be digoxin-induced if they disappeared after the drug had been stopped. Patients who had received digitoxin or spironolactone were excluded. The results indicated a normal digoxin range of 1.52 +/- 0.2 ng/ml and a toxic one of 2.78 +/- 0.38 ng/ml. First degree A-V block, atrial ectopic beats and ventricular ectopics with variable coupling intervals were frequently associated with serum-digoxin levels of 1.5-2.5 ng/ml, while higher grade A-V block, atrial tachycardia, bigeminy and atrial tachycardia with block were more frequent with higher serum-digoxin levels (greater than 3.0 ng/ml). Atrial arrhythmias were especially frequent with serum levels above 3.0 ng/ml. This suggests different sensitivities of atrial and ventricular myocardium. Atrial arrhythmias thus in general indicate a higher degree of toxicity at high serum levels, while ventricular ectopic beats occur both with high serum levels and also with increased digoxin sensitivity of the ventricles.

Role of sodium and water in hypertensive patients on maintenance hemodialysis.

In 46 patients of the chronic hemodialysis program blood pressure regulation was studied according to variations of sodium and fluid balance. A strong relationship was observed between blood pressure and the amount of exchangeable sodium. In the hypertensive patients exchangeable sodium was increased depite fulfilled clinical signs of sufficient dehydration. The blood volume was found to be small and the plasma renin activity increased in those hypertensive patients, in which sufficient fluid depletion was inhibited by extreme fluctuations of the blood pressure during dialysis. A diminution of the sodium concentration keeping the fluid balance constant induced an increase of blood pressure and deteriorated the subjective feeling of the patients. By an increase of the sodium concentration up to 155 mEq/l severe blood pressure fluctuations during during dialysis could be prevented, although further fluid was taken off by ultrafiltration. This effect seemed to be mediated--at least partly--by an increase of the low blood volume and a suppression of plasma renin activity. After the patients became normotensive, dialysis procedure could be continued with normal sodium concentration. By a temporary high sodium regimen of the dialysis procedure some patients with renal failure and 'uncontrollable hypertension' can be preserved from bilateral nephrectomy.