Search PubMed⌕ Search

Biomedical subjects

G Galvan

Publications and source records attributed to G Galvan.

At least 37 records · Page 2Linked to original sources

Mediastinal tumor and Klinefelter's syndrome.

Klinefelter's syndrome with karyotype 47,XXY in patients with primary extragonadal germ cell tumors rarely occurs. The endocrinology of Klinefelter's syndrome is changed; elevated beta-human choriomic gonadotropin levels are present. Chemotherapy and thoracic surgery brought complete remission in a patient with lung metastases.

Adolescent↗

[Anaphylactic shock after repeated injection of 99mTc-labeled CEA antibody].

In a 64-year old patient with a recurrent rectal carcinoma, immunoscintigraphies with 99mTc-labelled monoclonal antibody against CEA (BW 431/26) were performed in an interval of 14 months. A few minutes after the second injection the patient reacted with anaphylactic shock which could be controlled by epinephrine and cortisone. As far as we know, there is no report in the literature on an anaphylactic reaction to this antibody. An investigation for human anti-mouse antibodies before the second injection was negative with one method and positive with another method.

Anaphylaxis↗

99mTc-DTPA aerosol for same-day post-perfusion ventilation imaging: results of a multicentre study.

A multicentre study was performed in an attempt to evaluate a submicronic technetium-99m diethylene triamine penta-acetic acid aerosol generated by a newly developed delivery system, the aerosol production equipment (APE nebulizer), for same-day post-perfusion ventilation imaging in patients with clinically suspected pulmonary embolism. Quantitative comparison between the DTPA aerosol and krypton gas demonstrated a close correlation with respect to regional pulmonary distribution of activity and peripheral lung penetration (n = 14, r = 0.94, P < 0.001 and r = 0.75, P < 0.0025, respectively). In 169 consecutive patients, DTPA aerosol images performed immediately following perfusion (inhalation scan I) were compared to those carried out on the next day (inhalation scan II) with respect to image quality and assessment of perfusion-ventilation matches or mismatches. Agreement between inhalation scans I and II with respect to perfusion defects matched or mismatched to ventilation was found in 166/169 (98%) studies. The image quality of inhalation scan I was equal to that of scan II in 72%; inhalation scan I was superior in 11% of cases, while scan II was superior in 17%. This submicronic 99mTc-labelled DTPA aerosol is well suited for fast same-day post-perfusion ventilation imaging in patients with clinical suspicion of pulmonary embolism.

Aerosols↗

[Iodine supply and struma in Austria].

Austria is an iodine deficient area as are most parts of Europe. Goiters were always a natural phenomenon. In 1924 goiter prevalence in school children was 45 to 47% and a first attempt was made with iodized salt. This iodized salt (5 mg NaI/kg salt) was not used widely and goiter prevalence remained unchanged for decades. Therefore, in 1963, salt iodized with 10 mg KI/kg was introduced by law in a semi-mandatory way: Non-iodized salt was allowed to be sold only by special request. Consequently, in 1982, 68% of the total salt sold was iodized salt, goiter prevalence dropped to 1.5% in first graders, hypothyroidism in newborns was 1:4,600 and cretinism disappeared. However, in 18 years old females, goiter prevalence was still 13%, and in adults up to 30%. Investigations in various regions of Austria showed that iodine supplementation was insufficient with a mean urinary excretion of 42 to 75 micrograms I/g Cr. Therefore the Austrian Society of Nuclear Medicine (ONG) demanded the raise of the iodine content of salt to 20 mg KI/kg. Finally, in 1990 a new law was issued by the Government following this proposal. In 1992, investigations were done in various regions of Austria demonstrating a normalized iodine excretion of 129 to 177 micrograms I/g Cr. Further prospective and retrospective studies will be done by the ONG.

Adolescent↗

[Value of preoperative fine needle puncture cytology in the diagnosis of highly malignant thyroid tumors].

Highly malignant thyroid tumours are frequently diagnosed only at an advanced stage where radical resection is no longer feasible. By the wide application of fine needle aspiration biopsy as a diagnostic tool in nodular thyroid diseases occasionally early stages of these tumours can be diagnosed. Despite early detection in 23% of our patients with anaplastic carcinomas and sarcomas of the thyroid gland and subsequent radical resection an improvement in the long-term outcome was not achieved. In contrast, thyroidectomy and appropriate oncologial therapy may result in long-term survival of patients with early stages of thyroid lymphomas.

Adult↗

[Therapy of suspicious fine needle puncture from nodular struma with reference to thyroid function and morphology].

A suspicious preoperative cytology (= class "III") may be the result of various disorders of the thyroid presenting with cell atypia. For example hyperthyroidism or thyroiditis can show a cytological aspect, mimicing a differentiated carcinoma. Our study, comprising 231 patients with cytology "III" revealed a low malignancy rate (1%) in cases of concurrent hyperthyroidism or thyreoiditis. In contrast, 26% of the patients presenting with euthyroid nodular goiter and cytology "III" had a malignant histology such patients should be treated by primary lobectomy.

Biopsy, Needle↗

Hyperthyroidism and concurrent thyroid malignancies.

In a 17-year period 1848 patients with hyperthyroidism were operated on. Fourteen (0.76%) had a coexisting thyroid malignancy. Preoperative scintiscan and pathologic diagnoses were compared: 10 malignancies were in cold nodules, two were unidentifiable preoperatively due to small size, and two were in hot areas. Five patients had papillary cancer, four follicular, three anaplastic, and two medullary. Patients with uninodular toxic goiter had a low rate of associated malignancy (0.27%, 3/1108). In contrast, patients with multinodular toxic goiter had an incidence of 1.63% (11/676). No patient with Graves' disease (n = 64) had a carcinoma. Extensive use of fine-needle aspiration biopsy enabled preoperative diagnosis in a majority of the cases (9/14, 64%). We conclude that the incidence of coexisting thyroid malignancy and hyperthyroidism is rare in our endemic iodine-deficiency goiter area.

Adult↗

Pulsatile luteinizing hormone-releasing hormone treatment of male hypogonadotropic hypogonadism.

Luteinizing hormone-releasing hormone (LH-RH) secretion from the hypothalamus follows a rhythmic pattern, inducing pulsatile luteinizing hormone (LH) and follicle-stimulating hormone (FSH) secretion from the pituitary gland. Consideration of this physiologic principle led to the introduction of pulsatile LH-RH therapy via infusion pump for the treatment of different forms of hypogonadotropic hypogonadism. We report on 10 male patients, 16 to 28 years of age, suffering from idiopathic hypogonadotropic hypogonadism (IHH) including Kallman's syndrome (n = 2) and delayed puberty (n = 2). All presented with complete eunuchoidism and had undergone no treatment for their conditions during the previous 2 years. LH-RH was administered in subcutaneous pulses of 4 to 16 micrograms, with a portable infusion pump (ZYKLOMAT, Ferring Corp., Kiel, FRG); treatment periods ranged from 6 to 24 months. With therapy, the subjects improved secretion of LH, FSH and testosterone. Testicular volumes and penis size increased; all patients developed normal secondary sexual characteristics. Spermatogenesis was induced in all patients. The time to onset of spermatogenesis ranged from 3 to 15 months. No major side effects were observed, and no patient dropped out of the study. The results indicate that pulsatile LH-RH therapy is an highly effective treatment for IHH and delayed puberty.

Adolescent↗

Effects of high and low doses of methimazole in patients with Graves' thyrotoxicosis.

In spite of the long-established use of antithyroid drugs, there are many unsettled questions connected with this treatment of Graves' disease. There is a lack of controlled prospective trials studying the results of antithyroid drug therapy while considering the many variables such as disease heterogeneity, regional differences, drug dosage and duration of treatment. Therefore, a multicenter study has been set up in order to compare the effects of two fixed doses of methimazole (10 vs 40 mg) with thyroid hormone supplementation on the clinical, biochemical and immunological course of Graves' disease and on remission rates. Experience accumulated so far suggests that treatment is safe using either 10 or 40 mg of methimazole. While there is a tendency for an advantage of the higher dose within the first weeks (higher effectiveness in controlling hyperthyroidism), this difference is not significant. The impact of dosage on remission rates remains to be shown.

Adult↗

[Chernobyl--practical experiences exemplified by the Salzburg crisis staff].

After Chernobyl the situation in Salzburg was characterized by several particular factors: Here the amount of radiation was higher than in all the other country capitals, there was an exceptionally intensive interest in news, from the very beginning the public was very critical, private initiative groups were organized. Moreover, several mass events took place in this period, as for instance the Pongau-rallye, the international football match with Sweden and the "Dult"-fun-fair. All this and the immediate access to current measurement data was reason for a partly deviating attitude towards the instructions issued by the ministry of health and pollution control. Thus the forbidden grass-feeding of cattle--already turned out to pasture--was not kept, the prohibition of whey fodder was issued very early and whey had to be thickened. For a short period the action "school-milk" was stopped. In order to avoid the unnecessary slaughtering of higher contaminated cattle a screening method was established. The order not to sell salad and vegetable was cancelled but a full week later than in the rest of Austria. An evaluation of the contaminated area could be obtained nation-wide with the project "map square". On the part of the city of Salzburg a register of the radiation amount of the streets was provided. Detailed instructions for the behaviour of the population were made public. The penal responsibility of responsible politicians and representatives of the authorities, according to the opinion of Prof. Dr. O. Triffterer was mentioned.

Accidents↗

[Should the iodination of table salt be increased in Austria?].

Since the main reason of endemic goiter is the avoidable iodine deficiency, this in an unnecessary disease. In Austria an exemplary iodized salt prophylaxis was introduced in 1963. Thanks to this iodized salt prophylaxis endemic cretinism has died out. The incidence of hypothyroidism in newborns is currently 1 : 4600, goiter frequency in the first school year now only 1.1 to 1.5%. In contrast the goiter incidence in girls in the twelfth school year increases to 13.4% and up to one third of adults are afflicted by goiter. Studies of iodine excretion in Feldkirch, Innsbruck, Salzburg, Graz and Vienna on a total of 2627 patients showed an iodine excretion of less than 100 micrograms J/g creatinine in the majority of the patients. This proves that there is still an inadequate iodine supplement. The Austrian Nuclear Medicine Society therefore recommends an increase in the potassium iodide content from the present 10 mg potassium iodide/kg to 20 mg potassium iodide/kg table salt, in keeping with the procedure introduced in Switzerland in 1980. Through this measure a decrease in the goiter frequency to less than 3% is to be expected over a longer period. This will result in a considerable reduction in the costs of diagnosis and therapy for this disease. There might be a temporary increase in hyperthyroidism for a certain period as a result of the increase of the content of iodide in the table salt.

Adolescent↗

[Complete regeneration of the right liver after hemihepatectomy].

Right hemi-hepatectomy was performed in two patients because of metastases in one and a malignant hepatoma in the other. After five and six months, respectively, a right hepatic lobe was again demonstrated, at first by ultrasound, then by isotope scanning. Further studies by coeliacography, 99Tc hepatobida, CT scan and liver-biopsy histology from the regenerated lobe revealed a functionally and morphologically normal picture of a right hepatic lobe, the external form of the regenerated right lobe being identical with the original one. A histologically and functionally unchanged residual liver is considered the prerequisite for satisfactory regeneration after resection. Liver regeneration, as far as regulating factors are concerned, seems to be under similar hormonal control mechanism as external wound healing.

Carcinoembryonic Antigen↗