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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    European journal of nuclear medicine 23 (1996), S. 568-570 
    ISSN: 1619-7089
    Keywords: Technetium-99m sestamibi ; Multidrug resistance ; P-glycoprotein ; Glutathione
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract An in vitro study was designed to evaluate the uptake of sestamibi (MIBI) in P-glycoprotein (Pgp) and glutathione-associated (GSH) multidrug-resistant (MDR) cell lines. MIBI uptake was studied in various human breast carcinoma cell lines, i.e. in wild-type (MCF7/wt) cells, in adriamycin-resistant (MCF7/adr) cells which express Pgp and in melphalan-resistant (MCF7/mph) cells with increased levels of GSH. The effects of buthiomine sulphoximine (BSO) and verapamil on MIBI uptake were also studied in the MCF7/mph and MCF7/adr cells respectively. The cells were incubated for 1 h with a dose of 0.1 MBq thallium-201 and technetium-99m MIBI. Both MIBI and201Tl uptakes were higher for MCF7/mph cells than for the other cells studied. The mean MIBI uptake in MCF7/adr cells was significantly lower than that in MCF7/wt cells (1.9%±0.5% vs 3.1%.0.6%;P 〈0.01). Verapamil treatment increased the MIBI uptake in MCF7/adr cells (to 2.6%.0.3%;P 〈0.05). Treatment of MCF7/mph cells with BSO resulted in a significant reduction in GSH content (from 243.2±81.1 nmoUmg protein to 17.6±4.4 nmol/mg protein;P 〈0.001). However, MIBI uptake in BSO-treated and untreated MCF7/mph cells was similar (4.43%±0.5% and 5.93%±1.7%, respectively;P 〉0.1). This study suggests that the uptake of MIBI is not diminished by glutathione-associated drug resistance and that MIBI uptake in a tumour sample does not necessarily indicate that a cancer is sensitive to drugs.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    World journal of surgery 10 (1986), S. 579-584 
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé La localisation des tumeurs parathyroïdiennes par les différents procédés d'imagerie et la valeur respective des différentes méthodes prêtent encore à discussion. Les auteurs ont effectué une étude prospective à l'aveugle pour apprécier l'efficacité propre à chaque méthode chez 40 malades atteints d'hyperparathyroïdisme qui furent soumis avant l'intervention à une scintigraphie au Tc99m, à une exploration tomodensitométrique et à une échographie temps réel. Chaque étude fut pratiquée et interprétée de manière indépendante. Les 40 malades furent opérés et soumis à une parathyroïdectomie qui permit de comparer les constatations opératoires et les données de l'imagerie. La sensibilité respective des 3 procédés fut de 72% pour la scintigraphie, de 72% pour la tomodensitométrie et de 57% pour l'échographie avec une spécificité de 93% pour la première, de 92% pour la seconde et de 96% pour la troisième. En ce qui concerne les lésions situées au-dessous de la thyroïde (thymus et médiastin) le taux de sensibilité fut de 86% pour la scintigraphie, de 29% pour la tomodensitométrie et de 20% pour la sonographie cependant que celui de la spécificité était de 100%. Chez les hyperparathyroïdiens qui avaient subi une exploration défaillante les tumeurs parathyroïdiennes furent décelées avec un taux de sensibilité de 88% pour la scintigraphie, de 57% pour la tomodensitométrie et de 67% pour la sonographie, le taux de spécificité étant de 100% pour la première, de 71% pour la seconde et de 100% pour la troisième. La scintigraphie complétée par la tomodensitométrie représente la meilleure stratégie chez les sujets qui présentent une hyperparathyroïdie persistante après une opération négative et pour les lésions qui sont situées audessous de la thyroïde. Si l'on tient compte du fait que les chirurgiens spécialisés dans la chirurgie parathyroïdienne obtiennent la guérison de l'hyperparathyroïdisme dans au moins 93% des cas, ces méthodes d'exploration onéreuses ne paraissent pas indispensables à moins d'un échec de l'intervention initiale.
    Abstract: Resumen Existe controversia en cuanto a las ventajas y adecuación de las modalidades corrientes de imagenología para la localización de tumores paratiroideos. Hemos realizado un estudio prospectivo y ciego para comparar la eficacia de 3 modalidades diferentes de imagenología en 40 pacientes con hiperparatiroidismo primario (HPT). Los pacientes con HPT fueron examinados preoperatoriamente con centelleografía computadorizada con talium 201/tecnecio-99m (CTT), tomografía computadorizada de alta resolución GE 9800 (TC), y sonografía de tiempo real de alta resolución de 7.5 MHz (US). Cada estudio fue realizado e interpretado en forma independiente. Los pacientes fueron sometidos luego a exploración quirúrgica cervical y a paratiroidectomía, lo cual hizo posible la correlación clínica entre los hallazgos patológicos y los resultados de la imagenología. Las sensibilidades globales de las 3 modalidades imagenológicas fueron: CTT-72%, TC-72% y US-57%, con especificidades de: CTT-93%, TC-92% y US-96%. Para lesiones localizadas por debajo de la glándula tiroides (lengüeta tímica y mediastino), las sensibilidades fueron de: CTT-86%, CT-29% y US-20%, todas con especificidades de 100%. En aquellos pacientes con HPT, exhibiendo previas exploraciones fallidas del cuello, los tumores paratiroideos fueron detectados con sensibilidades de: CTT-88%, TC-57% y US-67%, con especificidades de 100%, 71% y 100% respectivamente. La CTT con CT subsiguiente parece ser una estrategia imagenológica óptima para pacientes con HPT con exploración cervical fallida previa o con sospecha de lesiones ubicadas por debajo de la glándula tiroidea. Teniendo en cuenta que los cirujanos experimentados en cirugía paratiroidea exhiben tasas de curación de 93% o más en pacientes con HPT sin exploración cervical previa, estas modalidades de imagenología pueden no ser justificadas desde el punto de vista de costo/beneficio y por consiguiente no estar indicadas en tales pacientes.
    Notes: Abstract Controversy exists concerning the advantages and appropriateness of current imaging modalities of the localization of parathyroid tumors. We conducted a prospective, blinded study to compare the efficacy of 3 different imaging modalities in 40 patients with primary hyperparathyroidism (HPT). Patients with HPT were examined preoperatively by computer-assisted thallium-201/technetium-99m scintigraphy (TTS), high-resolution (GE 9800) computed tomography (CT), and high-resolution (7.5 MHz) real-time sonography (US). Each study was performed and interpreted independently. These patients then had a neck exploration and parathyroidectomy which allowed for clinical correlation of pathologic findings with the imaging results. Overall sensitivities of the 3 imaging modalities were TTS-72%, CT-72%, and US-57%, with specificities of TTS-93%, CT-92%, and US-96%. For lesions located below the thyroid (thymic tongue and mediastinum), sensitivities were TTS-86%, CT-29%, and US-20%, all with specificities of 100%. In those HPT patients presenting with prior failed neck explorations, parathyroid tumors were detected with sensitivities of TTS-88%, CT-57%, and US-67%, with specificities of 100%, 71%, and 100%, respectively. TTS with subsequent CT appears to be an optimal imaging strategy for HPT patients with prior failed neck explorations or suspected lesions below the thyroid. Since surgeons experienced in parathyroid surgery have a cure rate of 93% or greater in HPT patients without prior neck exploration, these imaging modalities may not be cost-effective and thus not indicated for these patients.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Skeletal radiology 16 (1987), S. 136-141 
    ISSN: 1432-2161
    Keywords: Emission computed tomography ; Spine, radionuclide studies ; Pseudarthrosis ; Spine, surgery ; Radionuclide imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Twenty-six adult patients more than 6-months post-lumbar spinal fusion were studied. Flexion and extension radiographs showing motion or bone scintigrams showing focal areas of increased activity within the fusion mass were considered positive for pseudarthrosis. Patients were classified as either symptomatic or asymptomatic. Among the 15 symptomatic patients, scintigraphy had a sensitivity of 0.78 and a specificity of 0.83 which was superior to the 0.43 sensitivity and 0.50 specificity of radiography. Six of the 11 asymptomatic patients had focal areas of increased activity in the bony fusion mass, possibly reflecting painless pseudarthrosis. Planar imaging was substantially enhanced by SPECT in 14 of the 26 cases. It is concluded that for the patient who remains symptomatic after lumbar spinal fusion, bone scintigraphy with SPECT is of significant value in detecting painful pseudarthrosis.
    Type of Medium: Electronic Resource
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