[Integration of PACS and HIS into the workflow of a nuclear medicine department. Experience in Regensburg].

Aim: The development of new diagnostic techniques and the implementation of a modern quality control management system requires the continuous adaptation of existing data processing tools to the nuclear medicine diagnostic workflow. Furthermore, PACS connected to HIS facilitates and enhances the transfer of data and pictures, and satisfies the legal requirements for data retention as regulated by law. Therefore, the aim of this work is to present the architecture, structure and results of such a system newly installed in a department of nuclear medicine.

[The PACS concept of the University of Regensburg].

Aim: Planning a PACS (Picture Archiving and Communication System) with the aim of a filmless hospital. The service for the referring physicians should be optimised.

Methods: Statistical analysis of data from the RIS (Radiological Information System), customer survey, workflow analysis and cost effectiveness analysis was the basis for planning the PACS.

Improved determination of variant erythrocytes at the glycophorin A (GPA) locus and variant frequency in patients treated with radioiodine for thyroid cancer.

Red blood cells from individuals with the blood group MN express each form of the allelic GPA protein (GPAM and GPAN) on their cell surface. Variant cells have lost one form of the protein. Their frequency is about 10(-5) in blood from unexposed persons.

Multicenter German reference data base for peripheral quantitative computer tomography.

The wide spread use of bone densitometers in Germany and other European countries has required the establishment of a validated reference population data base. A semianthropomorphic forearm cross-calibration phantom (EFP), developed during a concerted research action of the European Union's programme in Biomedical Engineering (COMAC-BME), was used to cross-calibrate the peripheral quantitative computer tomography (pQCT) devices at four German centers participating in the multicenter study. In total, 723 women and 208 men were included in the normal data base.

[Radioiodine therapy of autonomously functioning thyroid nodules and Graves' disease].

We studied the effects of radioiodine therapy (RIT) for autonomously functioning thyroid nodules (AFTNs) and Graves' disease on thyroid function and size up to one year after RIT. In 230 patients with AFTNs, a dose of 300 Gy was effective in about 90% of the cases 6 months after RIT. Out of 65 patients suffering from Graves' disease, 5 patients (8%) had persisting hyperthyroidism 6 months after RIT with a dose of 150 Gy.

The impact of degenerative spinal changes on the correlation of peripheral and axial bone density.

Results of bone density measurements by quantitative computed tomography of the peripheral skeleton (pQCT) were compared with those of measurements at the axial skeleton with a view to study the effects of degenerative spinal changes on the validity of bone densitometry of the lumbar spine. 556 consecutive patients were examined by dual-energy x-ray absorptiometry (DXA) of the spine and by peripheral quantitative computed tomography (pQCT) of the distal radius. There were significant differences between the bone mineral values at the distal radius and those at the spine, depending on the degree of spinal degeneration.

Urinary iodide determined by paired-ion reversed-phase HPLC with electrochemical detection.

We propose an automated method for the routine analysis of urinary iodide, using paired-ion reversed-phase HPLC with electrochemical detection and a silver working electrode. Assay conditions include a flow rate of 1.0 mL/min and an operating potential of 0.

Systemic iodine absorption during endoscopic application of radiographic contrast agents for endoscopic retrograde cholangiopancreaticography.

Hyperthyroidism induced by contrast agents in a major problem in patients with pre-existing thyroid disease, particularly in patients with functional thyroid autonomy. The present study was undertaken to evaluate whether contrast media applied during endoscopic retrograde cholangiopancreaticography (ERCP) may result in a significant increase of serum iodine levels and thus may be associated with the risk of iodine-induced hyperthyroidism. The courses of serum concentrations of total iodine and free iodide, as well as of urinary iodine excretion, were measured in 15 patients before and up to 21 days after ERCP.

T cells migrate to tumour sites after extracorporeal interleukin 2 stimulation and reinfusion in a patient with metastatic melanoma.

Peripheral blood mononuclear cells (PBMC) were taken by leukapheresis from a patient with melanoma skin metastases and stimulated in vitro using 1000 IU recombinant interleukin 2 (IL-2)/ml to generate lymphokine-activated killer cells (LAK cells). Two-colour immunofluorescence analysis demonstrated an IL-2-induced up-regulation of CD25 on natural killer cells (CD56+) as well as on T lymphocytes (CD3+). After radiolabelling with indium-111, the cells were reinfused.

Clinical and prognostic effect of a positive granulocyte scan in infective endocarditis.

Thirty patients with clinical signs of infective endocarditis and pathologic echocardiographic findings indicating vegetations underwent scanning with In-111 or Tc-99m hexamethylpropylene amineoxime (HMPAO) labeled granulocytes. Blood cultures were positive in 60% of the patients. The other cases were negative as a result of antibiotic pretreatment.

[Indium-111 or Tc-99m-HMPAO marked granulocytes as specific markers of florid stage endocarditis--results comparing clinical, histological and scintigraphic findings in 30 patients with suspected endocarditis].

Thirty patients with clinically suspected infective endocarditis were scanned with Indium-111- or Tc-99m-HM-PAO-labeled granulocytes. The scans were correlated with the clinical course, and in 20 cases with the results from histologic examination of the valves. In six cases the scintigraphic examination gave correct positive results, in three cases false negative, in one case a false positive, and in 20 cases correct negative results.

[Significance of 2 different bone density measurement methods in the assessment of mineral content of the peripheral and axial skeleton].

Between May 1990 and February 1991 we enrolled 212 patients of 410 referred to our clinic for bone mass evaluation according to different diagnosis or therapeutic procedures. These patients were divided into 7 groups. The question had to be answered, which method of measurement and which skeletal site would give better information about the influence of the diseases of therapeutic procedures.

Effect of calcitonin deficiency on bone density and bone turnover in totally thyroidectomized patients.

To investigate the influence of calcitonin deficiency on bone turnover and density we studied 25 premenopausal female and 12 male patients (age 23 to 49 years) who had undergone total thyroidectomy for differentiated thyroid cancer 1 to 15 years previously. Basal and calcium stimulated extractable calcitonin, representing the monomeric, biologically active form of the hormone, was lacking or markedly decreased in all patients. There was a relative increase of urine hydroxyproline excretion (an index of osteoclastic bone degradation) in relation to serum osteocalcin (an index of osteoblastic bone formation) indicating an imbalance of bone turnover with a tendency to increased degradation in all patients.

[Peripheral quantitative computed tomography for bone mineral measurement using a new special QCT-scanner. Methodology, normal values, comparison with manifest osteoporosis].

Some years ago we designed a special purpose gamma-ray QCT scanner for bone mineral measurements at the forearm. Currently, the first commercially built scanners (Stratec SCT 900) are being tested and clinically evaluated. The scanner uses an 125I photon source with a multidetector translate rotate fan beam geometry and newly developed semiconductor crystals.

Imaging pattern of radiolabelled lymphokine-activated killer cells in patients with metastatic malignant melanoma.

In patients with metastatic malignant melanoma the distribution patterns of radiolabelled lymphokine-activated killer (LAK) cells were investigated. Peripheral mononuclear cells (PMC) were isolated from six patients. LAK cells were generated by culturing PMC in complete medium containing 1000 U interleukin (IL)-2/ml and labelled with indium 111 before retransfer.

[Initial experiences with hysterosalpingoscintigraphy in normal and pathologic fallopian tube passage].

A prospective study in 38 patients was designed to evaluate the efficacy and reliability of radionuclide hysterosalpingoscintigraphy (HSS) using 99mTc labelled human albumin macroaggregates (HAMA). Following application in the posterior vaginal fornix at the time of ovulation, HAMA normally migrate spontaneously through the uterus and tubes and may be identified after 20 min (range 5-90 min) in the uterine cavity and after 2 hrs (range 40 min - 3 hrs) in the free pelvis, using a gamma camera. When correlated with the findings of conventional contrast hysterosalpingography (HSG), the radionuclide procedure yielded comparable results in females with patent or clearly obstructed tubes.