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Biomedical subjects

F Spelsberg

Publications and source records attributed to F Spelsberg.

At least 19 recordsLinked to original sources

[Heterotopic pancreatic cyst of the stomach wall].

A 28 year old female was admitted to the hospital with dolorous postprandial swelling of the left upper epigastrium, occurring since the recent death of her husband. After an asymptomatic interval of eight years pains similar to biliary colics occurred increasing in duration, intensity and frequency during the following year. Sonography and computer-tomography indicated a pseudocyst of the pancreascauda adjacent to the left lobe of the liver, spleen and gastric wall. Laparotomy revealed the diagnosis of a heterotopic cyst of the pancreas of fist-size localized intramurally in the gastric corpus which was totally resected. Histologically a granulomatous partially transformed cyst in a heterotopic pancreas was identified. The patient became symptom-free after the operation.

Adult

[Ultrasound diagnosis of benign teratoma of the thyroid gland].

We report about a six-year old girl who underwent a hemithyroidectomy because of a teratoma in the right thyroid gland. In ultrasonography, the teratoma shows a rather well limited tumor in the right thyroid gland. It shows no signs of infiltration or compression of adjacent structures. The inner structure of the teratoma is characterized by an inhomogeneous and mixtured picture of high density echos, low density echos and areas without echos. Although the localisation of the tumor was possible by ultrasonography, the specific diagnosis of a teratoma remains difficult.

Child

Increased leukotriene B4 synthesis in patients with primary hyperparathyroidism is normalized after parathyroidectomy: a study comparing parathyroidectomy to thyroid adenomectomy.

Synthesis of leukotriene B4 (LTB4) upon stimulation of peripheral blood samples with the calcium ionophore A 23187 was studied in patients with primary hyperparathyroidism who underwent parathyroidectomy. Preoperatively, an increased LTB4 concentration of 1.76 +/- 0.19 ng/ml plasma was found, vs. 0.95 +/- 0.28 ng/ml in healthy individuals. On the fourth day after operation, the LTB4 concentration was almost normalized, reaching 1.25 +/- 0.23 ng/ml plasma. At the same time, mean serum calcium levels were reduced from 6.1 +/- 0.6 meq/liter before operation to 4.53 +/- 0.28 meq/liter after operation. In a control group, euthyroid patients with thyroid adenomas who underwent adenomectomy had normal LTB4 levels before operation (0.84 +/- 0.11 ng/ml) and did not show significant changes in LTB4-synthesizing capacity. The results indicate that synthesis of LTB4 in vivo may depend in part on factors related to serum calcium concentration or calcium metabolism.

Adenoma

Pancreatic B-cell peptides as parameters for diagnosis and localisation of hormone secreting tumours.

Insulin, C-peptide and proinsulin were measured in peripheral blood of 11 patients suffering from different types of hormone-producing pancreatic B-cell tumours. While proinsulin was elevated in 10/11 patients during prolonged fasting, C-peptide and insulin levels were found within the reference range in 5/11 and 3/5 cases respectively. A rapid insulin assay performed during surgery was helpful for localisation and identification of the respective tumours.

Adenoma, Islet Cell

Biliary concentrations of temocillin.

Serum and bile concentrations of temocillin were measured after intravenous administration of 1g twice daily to 16 patients with biliary tract infections. The concentration of temocillin in the bile showed high inter-individual variations; however, in patients drug concentrations were attained which were considerably higher than the minimum inhibitory concentrations of the biliary tract pathogens identified throughout the study period. All the patients admitted to the study were treated successfully by temocillin, with the tolerance of the drug being very good, and no side effects or drug-related deteriorations of laboratory data being reported.

Adolescent

[Carcinoid of the digestive tract. Diagnostic possibilities (author's transl)].

Special features which enable preoperative differential diagnosis are dealt with in detail with reference to 44 patient with carcinoid of the digestive tract. Carcinoid of the appendix becomes noticable early with signs of acute or chronic appendicitis and in 94% of cases is operated on in good time. Angiography of the superior mesenteric artery shows a characteristic stellate figure in the mesenterium in carcinoid of the small intestine. In contrast to the primary tumor, liver metastases show intense vascularization in the angiogram. A rise in urinary excretion of 5-hydroxyindole acetic acid is pathognomonic for carcinoid, its determination permits the checking of operative radicality and shows the appearance of metastases early.

Adult

[Unrecognized traumatic rupture of the diaphragm (author's transl)].

20 cases of rupture of the diaphragm (one due to direct trauma, the other 19 due to indirect trauma) which were not recognized at the time of the accident are described. The reasons for the delay in diagnosing the true nature of the condition and the misleading complaints caused by the unrecognized injury are reviewed. Essential diagnostic measures are discussed and guide-lines are suggested to ensure the early diagnosis of rupture of the diaphragm.

Diagnostic Errors

[Clinical aspects, diagnosis and treatment of organic hyperinsulinism. Experience with 46 operated patients (author's transl)].

The clinical picture of organic hyperinsulinism is presented with reference to experience in 46 operated patients. For the recognition of disease, a careful history is a decisive contribution. The hunger test showed a characteristic hypoglycemic reaction in 100%; the tolbutamide test gave a positive result in 92%. Insulinomas could be localized angiographically in 71%; in one patient this could only be done with an ERCT. The treatment of choice is operation as soon as possible. If possible, enucleation is to be given preference over pancreas resection because of the low complication rate. A search for ectopic (2%) and multiple (12%) adenomas is important. A cure was achieved in 76% of all those operated on. The hospital mortality was about 4%.

Adenoma

[Medullary carcinoma of the thyroid (author's transl)].

The medullary carcinoma of the thyroid plays a special role among the thyroid carcinomas due to his histiogenesis and endocrinologic behaviour. The symptoms like familiar occurrence, simultaneous pheochromocytoma, calcitonin-production, para-neoplastic syndroms with ACTH-production and the commonly associated diarrhea are discussed. The biological behavior of the tumor is presented reviewing the literature.

Adult