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Biomedical subjects

F Spelsberg

Publications and source records attributed to F Spelsberg.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Preventive total thyroidectomy in children with MEN IIa syndrome].

Three children of MEN IIa-families underwent a prophylactic total thyroidectomy (at the age of 4, 7 and 8 years). Pathologic examination showed a bilateral C-cell-hyperplasia in each case. The annual follow-up of the physically and mentally well-developing children so far showed normal calcitonin provocative testing. Members of risk families should undergo a screening program as early as possible.

Carcinoma, Medullary↗
PubMed1993

Complete local tumor remission after therapy with extra-corporeally applied high-energy shock waves (HESW).

High-energy shock waves (HESW) have recently been proposed as a means of non-invasive tumor therapy. Here we report the first successful local treatment of experimental tumors by means of multifocal and reported application of HESW. The experiments were performed on 29 Syrian golden hamsters bearing amelanotic hamster melanomas in the dorsal skin. HESW, generated electrohydraulically, were applied multifocally to the center and to 5 sites on the margin of the tumors. A group of animals undergoing surgical resection and an untreated group served as controls. Complete remission of local tumor was achieved in more than 90% of the HESW-treated hamsters and in the same number of surgically treated animals, while untreated tumors continued to grow. Frequency of metastasis was the same in both groups after HESW treatment or surgery. Tumor therapy with multifocally and repeatedly applied HESW was thus as successful as surgery.

Animals↗
PubMed1993

High-energy shock waves induce blood flow reduction in tumors.

We have studied the effect of extracorporeally applied high-energy shock waves (HESW) on blood flow in amelanotic melanomas (A-Mel-3). Two tumors were implanted in the dorsal skin of 21 Syrian golden hamsters. One of the tumors was treated with 200 HESW, and the other served as an intraindividual control. Mean blood flow in the whole tumor, or the tumor excluding necrotic areas, was quantitatively measured using autoradiography with iodo[14C]antipyrine at 30 min (n = 5), 1 h (n = 5), 3 h (n = 5), and 12 h (n = 6) after HESW treatment. As measured for the whole tumor, blood flow in the controls was 23.4 +/- 7.9 ml/100 g/min (median +/- SE) and thus in the range reported in the literature. Thirty min or 1 h after the application of HESW, tumor perfusion was reduced to 6 +/- 4% or 5 +/- 4% (median +/- SE) of the corresponding controls, respectively. Three h after treatment, perfusion increased slightly to 7 +/- 5% and after 12 h increased significantly to 55 +/- 25% of the corresponding controls. Values measured excluding the necrotic areas were higher in all groups. Temporary reduction of tumor perfusion after treatment with HESW was interpreted as a consequence of HESW-induced damage to tumor microcirculation. These effects should be taken into account for maximizing the therapeutic efficiency of HESW on tumors and for combining HESW treatment with other therapeutical modalities.

Animals↗
PubMed1993

Increased binding capacity of receptors for the epidermal growth factor in benign thyroid nodules and thyroid malignancies.

To determine the role of epidermal growth factor (EGF) receptors in thyroid tumorigenesis, EGF binding was compared in membranes from malignant and from benign thyroid tumors. Surgical specimens were obtained from 28 patients with thyroid carcinomas (3 papillary, 13 follicular, 6 undifferentiated, and 6 medullary carcinomas) and from 30 patients with benign thyroid tumors (15 scintigraphically functional and 15 nonfunctional nodules). In 30 cases normal tissue adjacent to the tumor was also obtained. EGF binding was seen to be increased not only in thyroid carcinomas but also in benign thyroid tumors, particularly in functional thyroid adenomas. The highest EGF binding was found in undifferentiated carcinomas. A direct comparison of the EGF binding characteristics in tumor and adjacent normal thyroid tissue revealed that the increased binding of EGF is due mainly to an increase in the number of binding sites rather than an alteration in receptor affinities. EGF binding capacities were 18.4 +/- 16.7 fmol/mg protein in thyroid carcinomas and 10.5 +/- 5.2 fmol/mg in the corresponding normal tissue (P < 0.05, Kd 0.84 +/- 0.26 nM, n = 11). In autonomously functioning thyroid adenomas binding capacities were 14.2 +/- 8.2 fmol/mg in the nodules and 8.9 +/- 4.8 fmol/mg in normal tissue (P < 0.01, Kd 0.73 +/- 0.62 nM, n = 15). In conclusion, EGF receptor levels are increased not only in malignant thyroid tumors but also in well-differentiated benign thyroid nodules.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

[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↗
PubMed1990

[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↗
PubMed1987

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↗
PubMed1985

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↗
PubMed1985

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↗
PubMed1982

[Islet cell cancer with organic hyperinsulinism. Clinical aspects, diagnosis and therapy].

About 8%-15% of the patients with organic hyperinsulinism have an islet cell carcinoma (13% in our series). In addition to a history of complaints of relatively recent onset, the patients present clinically the typical intermittent neurologic-psychiatric symptoms concurrently associated with hypoglycemia. The diagnosis is established biochemically on the basis of hypoglycemia, with inadequate incrementation of the insulin concentration subsequent to suppression and provocation tests. Elevated serum proinsulin and, in most patients, an increased insulin secretion rate are usually found after administration of agents such as glucose or leucine. Localization of the tumors is achieved by selective coeliacography as well as abdominal computerized axial tomography. The islet cell carcinoma is found most frequently in the tail of the pancreas, less frequently in the body and head of the pancreas. Metastatic spread is seen early into adjacent lymph nodes and especially in the liver. The treatment of choice is surgical resection of the tumor. Even in cases with advanced metastatic involvement, surgical intervention appears indicated. Medical treatment includes the administration of diazoxide, long-acting glucagon as well as the cytostatic agent streptozotocin. The average survival time is 30-40 months after diagnosis (in our series 79 months). Thus, the prognosis of patients with islet cell carcinoma appears relatively favorable, especially when compared with adenocarcinoma of the pancreas.

Adenoma↗
PubMed1982

Intraoperative biochemical localization of insulinomas by quick radioimmunoassay.

In patients with organic hyperinsulinism, intraoperative determination of insulin concentrations in veins draining the pancreas might help localize the tumor. We have developed a radioimmunoassay measuring insulin within 30 minutes. At operation, blood samples are taken at various sites in the splenic, superior mesenteric and portal veins for insulin determinations. In all six patients, the highest insulin concentrations correlated with the site of the tumor. Also, small insulinomas less than 1 cm in diameter could be found. In one patient the tumor appeared to secrete mainly proinsulin. By this procedure we hope to avoid blind distal resection of the pancreas and possibly invasive preoperative diagnostic procedures.

Adenoma, Islet Cell↗
PubMed1982

[Preoperative localization of the parathyroid glands with computerized tomography].

CT was carried out in 50 patients with clinical suspicion of hyperparathyroidism, in order to localise the adenoma. In 45 patients, the diagnosis was confirmed at operation and adenomas or hyperplastic glands were removed. In the remaining five patients the diagnosis was not confirmed at operation, nor by the subsequent clinical course. On four occasions, CT correctly turned out to be negative and in one patient a false positive finding was obtained. Amongst the 45 patients, a total of 59 enlarged glands (adenomas or hyperplastic glands) were found at operation and removed. Pre-operative CT was positive and correct in 78% and negative and incorrect in 22%. Of eight adenomas in the mediastinum, seven could be recognised pre-operatively. Previous operations on the neck did not reduce diagnostic accuracy. The techniques and results are described and discussed.

Adenoma↗
PubMed1982

Computed tomography for localizing enlarged parathyroid glands in primary hyperparathyroidism.

Computed tomography (CT) has been performed in 21 patients with primary hyperparathyroidism (HPT) in an attempt to localize preoperatively the parathyroid tumors. Eighteen of these patients also had ultrasound examinations. The CT examinations included the neck and mediastinum and were performed before and after contrast medium administration. At subsequent surgery, 24 enlarged glands were found, 20 in the neck and 4 in the mediastinum. In the neck, two were locally recurrent carcinomas. The true positive diagnostic rate for ultrasound was 60% with a false positive rate of 15% and a false negative rate of 25%. The CT examinations resulted in 70.9% true positive, 8.3% false positive, and 20.8% false negative diagnoses. The combination of both methods in the 18 patients so studied resulted in 80% true positive, 10% false positive, and 10% false negative findings. The CT examination procedure and its interpretation and limitations in primary HPT are described.

Adenoma↗