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Biomedical subjects

G Baldauf

Publications and source records attributed to G Baldauf.

At least 19 recordsLinked to original sources
PubMed1992

Localization of occult persisting medullary thyroid carcinoma before microsurgical reoperation: high sensitivity of selective venous catheterization.

In 14 patients with occult persisting medullary thyroid carcinoma, tumor tissue was removed by microsurgical reoperation in 13 of 14 patients. This resulted in biochemical improvement in all but 1 patient and biochemical cure in 3 patients (21%). The lateral compartment of the neck or the upper mediastinum was involved in all but 1 patient. Before microsurgical reoperation, selective venous catheterization (SVC) for serum sampling along with serum calcitonin (CT) determination was done and compared to other localization methods. Tumor tissue could be localized correctly by SVC in 89% (CT gradient 1.21-2.02), computed tomography in 38%, and ultrasound in 28%. In patients with an elevated CT level after initial surgery and clinically occult disease, SVC is recommended for localization of tumor tissue. The affected side of the neck should be reoperated on with microdissection of the central and lateral compartment of the neck and the upper mediastinum. With this procedure, the cure rate of reoperation in patients with persistent occult MTC can be improved.

Calcitonin↗
PubMed1992

Sternocostoclavicular hyperostosis: its progression and radiological features. A study of 12 cases.

Twelve cases of sternocostoclavicular hyperostosis were followed up over four to 16 years. The patients underwent repeated radiological examinations of the sternocostoclavicular joints and the sternum, and the extrasternal osseous manifestations of the disease were studied to show changes in the radiological features during long term follow up. Five of 12 (41%) patients had extrasternal manifestations. With the exception of one patient extrasternal manifestations were first detected by scintigraphs because they were asymptomatic. With respect to the sternal manifestations the initial radiological diagnosis was made during an acute phase while painful swelling over the sternum and decreased mobility of the shoulders occurred. The radiological examinations showed the signs of a proliferative destructive arthritis in most patients. In contrast with the frequent occurrences of clinical symptoms, the radiological signs of progression take several years to become detectable. There are no specific bacteriological, serological or histological findings. Usually a permanent increase in the erythrocyte sedimentation rates is found. Sternocostoclavicular hyperostosis is a slowly progressing disease, characterised by a chronic aseptic destructive sternoclavicular arthritis with a reactive low turnover sclerosis that begins in a similar way to an enthesopathy and ends after several decades with total ankylosis. The radiological identification of retrosternal proliferation of soft tissue by computed tomography was found to be a valuable criterion for the differential diagnosis from other benign hyperostotic processes of the sternoclavicular region.

Cervical Vertebrae↗
PubMed1990

Hypertension in rats induced by renal grafts from renovascular hypertensive donors.

Renal transplantations were performed, using microsurgical techniques, with adult male two-kidney, one clip hypertensive rats (n = 9) and sham-operated normotensive Wistar-Kyoto rats (n = 8) as kidney donors and with F1 hybrids, bred from Wistar-Kyoto and stroke-prone spontaneously hypertensive rat parents, as recipients. Systolic blood pressure before surgery was 200 +/- 2.7 mm Hg in hypertensive and 115 +/- 1.7 mm Hg in normotensive donors and 144 +/- 7.1 and 138 +/- 3.5 mm Hg in the two groups of recipients. Renal hypertension in donors was maintained for 14 weeks before surgery was performed and the nonischemic kidneys were transplanted. Bilaterally nephrectomized recipients of renal grafts from hypertensive donors developed sustained hypertension (185 +/- 3.9 mm Hg). In contrast, in recipients of renal grafts from normotensive donors, blood pressure decreased significantly to the level of the donors (111 +/- 3.7 mm Hg). Posttransplantation hypertension in recipients of renal grafts from hypertensive donors was associated with intrarenal vascular hypertrophy, smaller kidneys, a decreased glomerular filtration rate, an increased plasma urea concentration, and polydipsia as compared with normotensive transplanted controls. Renal pyelograms revealed no gross anatomic alterations of transplanted kidneys. Our data indicate that secondary damage to the renal grafts caused by high perfusion pressure before transplantation can induce hypertension in recipients of these kidneys. Furthermore, our data suggest that renal mechanisms may be necessary to maintain borderline hypertension in F1 hybrids.

Animals↗
PubMed1990

[Dilatation treatment of esophageal stenoses in young patients with recessive epidermolysis bullosa dystrophica].

Recessive dystrophic epidermolysis bullosa is a hereditary disorder affecting both skin and esophageal mucosa. The esophagus is frequently affected resulting in almost complete obstruction. We report here the use of inflatable dilatator balloons as a new treatment of esophageal stenosis in three young patients. Dilatation therapy was tolerated well in all three cases and lead to a long standing success. The patients lived without complaints and they did eat normally up to 2.5 years following dilatation.

Adolescent↗
PubMed1989

[Cardiomyopathy in hypocalcemia].

A 48-year-old woman developed a hypocalcaemic cardiomyopathy, the hypocalcaemia being due to hypoparathyroidism after three previous thyroid operations for goitre with tracheal compression. She had signs of severe cardiac failure, but no tetany. She was put on calcium and vitamin D3 medication which raised calcium concentration. The cardiac status improved, as did the radiological and echocardiographic findings, without the patient having received any diuretics, digitalis or afterload lowering drugs.

Calcium↗
PubMed1988

[Extraosseous calcification in juvenile dermatomyositis. The ineffectiveness of EHDP].

A now 20-year-old man was first diagnosed as having dermatomyositis when aged 12 years. At that time he had muscular weakness and heart failure followed a year later by heterotopic calcifications. For over seven years he was treated with corticoids, at times also with azathioprine or methotrexate. Nonetheless the calcifications progressed. Because of the extensive calcifications, predominantly of the extremities, he is severely disabled and has been confined to a wheel-chair. For one year he was treated with EHDP (1-hydroxyethylidenediphosphonate), up to 16 mg/dl per day. In addition he received prednisolone (10 mg/d) and azathioprine (100 mg/d). But radiologically there has been further slight progression of the calcifications, indicating that EHDP has been ineffective in this patient.

Adult↗
PubMed1988

A newly developed spine deformity index (SDI) to quantitate vertebral crush fractures in patients with osteoporosis.

The available methods to quantitate vertebral deformity in osteoporotics are not satisfactory in comparing follow-up measurements in patients. This paper describes a newly developed 'spine deformity index' (SDI) which allows the quantitation of the extent of vertebral fractures. It is based on the observation that, in 110 normal persons, the heights of all vertebral bodies were related to each other in a predictable and constant manner. This relation was independent of the body height of the individual and was preserved despite growth acceleration during the last century. Since in all but one of our osteoporotic patients the 4th thoracic vertebra was unfractured we were able to compare the actual size of their fractured vertebrae to the calculated presumable original heights. The differences between presumable original and actual heights gave a measure of the extent of vertebral compression and allowed to define an index representing the sum of all spinal fractures in osteoporotics. The method was applied retrospectively to X-rays of 39 patients with idiopathic osteoporosis. Thirty-two of them were treated orally with 80 mg sodium fluoride, 1,000 mg calcium and 3000 IE vitamin D daily. Treatment resulted in a reduction of the progression of vertebral deformity. Seven inadequately treated patients had more pronounced progression of vertebral deformity.

Adult↗
PubMed1987

[Value of various radiological study results in the follow-up of Camurati-Engelmann disease].

Camurati-Engelmann disease is a rare progressive bone dysplasia; involvement of the skull base can lead to deafness, vestibular disturbances, facial paralysis and damage to the optic nerves. Treatment with corticosteroids, calcitonin and diphosphonates promises only very limited success. Conservative treatment of compression of the cranial nerves is almost ineffective, but the aim of surgical treatment is decompression of involved nerves. The differential diagnosis depends on radiological findings and clinical symptoms. Follow-up depends on radiographic examination and skeletal scintigraphy for showing the extent of the disease. CT may help in demonstrating compression of cranial nerves and define the indications for surgical decompression.

Adult↗
PubMed1987

[Pulmonary candida manifestation with cavitation in immunosuppressed patients].

The roentgenologic pattern of the pulmonary manifestation of candida species, resulting in a rapid development of pulmonary cavitations with mycetoma-like structures, was described in three patients. All patients, undergoing antineoplastic chemotherapy because of acute leukemia, presented with fever and expectoration, which were resistant to various antibiotic regimes. Cultures of blood and urine were sterile; but Torulopsis glabrata, a candida species, was found in multiple cultures of the sputum of all patients and also in a bronchoscopic lavage obtained from one patient after reconstitution of the granulopoesis. The roentgenologic appearance of the infiltrates was accompanied by a rise of the Ig-M immunoglobulins against candida. Following intravenous treatment with amphotericin B a reduction of the cavitation and of the infiltrates to small residues was observed. Simultaneously the body temperature and the sputum became normal and a fall in the immunoglobulin titers was found. The diagnostic problems of pulmonary cavitation and especially of pulmonary mycosis in immunosuppressed and therapy-induced granulocytopenic and thrombocytopenic patients with acute leukemia were discussed.

Acute Disease↗
PubMed1985

[Therapy of esophageal stenoses in recessive epidermolysis bullosa dystrophica].

Stenosis or complete occlusion of the oesophagus are potentially life-threatening complications of recessive dystrophic epidermolysis bullosa. Consequences are malnutrition, growth retardation, aspiration, or cachexia. Total replacement of the oesophagus by colon interposition has been recommended in such patients. We report on successful conservative management. We applied recently developed knowledge concerning the defective collagenase involved in this disorder and oesophageal dilatation. Phenytoin has been shown to reduce the excessive production of collagenase and thereby to diminish blistering of skin and mucous membranes and stricture formation of the oesophagus. Stepwise dilatation of oesophageal strictures instead of bouginage represents a less traumatic way to restore the oesophageal lumen. The lumen can be maintained by soft nasogastric feeding tubes which may be removed later on after successful dilatation. Oesophageal passage has been maintained for up to 4 years. The management of these severe complications of recessive dystrophic epidermolysis bullosa requires interdisciplinary efforts of dermatologists, internists and otorhinolaryngologists.

Child↗
PubMed1978

[Ossification of the auricle in partial pituitary failure with selective ACTH and STH deficiency (author's transl)].

An acquired partial pituitary insufficiency of unknown origin with selective ACTH and STH deficiency was demonstrated in a 44-year-old patient. The clinical course over many years corresponds to subclinical Addison's disease with occasional acute crises. Ossification of both auricular cartilages and anhidrosis were outstanding signs. There is possibly a connection between the glucocorticoid deficiency over many years with normal mineralocorticoids and the auricular cartilage ossification.

Adrenocorticotropic Hormone↗
PubMed1977

[Eight years of gardner's syndrome in a family (author's transl)].

In all affected members of a family with Gardner's syndrome the complete triad of skin tumours, osteomas and polyps of the colon has developed since 1968 when examination revealed an apparently bisymptomatic variant of Gardner's syndrome. In this family bony changes consisting of circumscript osteomas, diffuse sclerosing zones within certain bones, and ridge-like widening of the corticalis were noted, having developed during puberty but remaining constant thereafter. Similarly, no significant new skin tumours appeared after puberty. Most colonic polyps however, occurred in adolescence or thereafter, with malignant transformation after a variable interval of several years. The necessity of long-term observation of the colon, also in patients presenting with a bi- or monosymptomatic form, is stressed. Coloscopy has proven to be more useful diagnostically than radiological methods.

Adult↗
PubMed1976

[Vitamin D deficiency. Osteopathy after prolonged treatment with anticonvulsents (author's transl)].

Several substances with anticonvulsent activity can lead to hypovitamenosis D after prolonged use through their effect on vitamen D metabolism in the liver. This results in abnormal bone mineralisation and produces rickets or osteomalacia. Radiological examination of the skeleton should be performed on patients receiving prolonged anticonvulsent therapy, in order to arrive at an early diagnosis. This requires an accurate knowledge of the types of bone abnormality and of their most frequent localisation. Pathological findings such as Looser's zones, epiphyseolysis or delayed development must be considered in this context. Radiological examination provides an accurate diagnosis if combined with clinical findings and important biochemical results: reduced calcium and raised alkaline phosphatase. Treatment with vitamen D must then be instituted. Healing may be complete or leave residual changes, depending on the severity of the bone changes.

Adult↗