Search PubMed⌕ Search

Biomedical subjects

H Dralle

Publications and source records attributed to H Dralle.

At least 217 records · Page 12Linked to original sources
PubMed1988

[Pheochromocytoma: blood volume and hemodynamics].

In 12 patients with phaeochromocytoma total blood volume (TBV) prior to and after treatment with phenoxybenzamine and the haemodynamic changes during surgery were determined. Our results were analysed with regard to the standard of our anaesthesiological management. The mean TBV was reduced in 6 of 12 patients. Great individual variations were found after treatment with phenoxybenzamine. In 6 patients alpha-blockade induced an increase of TBV (+ 10%), 2 patients showed no changes and 4 a decrease of TBV (-18%). Haemodynamic measurements prior to induction of anaesthesia revealed a reversal of catecholamine induced cardiovascular changes. During tumour manipulation the supply of vasodilatators not only prevented hypertensive crises but also induced a marked decrease of systemic vascular resistance. All patients received controlled volume loading until tumour removal, leading to progressive increase in pulmonary capillary wedge pressure and cardiac index. Hypotension or left ventricular failure never occurred. Thus, deep anaesthesia and continuous application of vasodilatators during tumour preparation are the main factors to prevent left ventricular failure from increased systemic vascular resistance and oxygen consumption.

Adrenal Gland Neoplasms↗
PubMed1987

Intermediate filaments in cytological specimens of thyroid tumors.

Cytological specimens of thyroid carcinomas and follicular adenomas obtained by fine-needle aspiration biopsies or touch imprints were investigated with antibodies to keratin, vimentin, and neurofilaments. All tumors were keratin positive. In follicular adenomas as well as in papillary thyroid carcinomas, a coexpression of keratin and vimentin was detected; in follicular carcinomas, only some tumors showed coexpression of keratin and vimentin; and in medullary thyroid carcinomas, positive staining of all six tumors studied was seen with the keratin and neurofilament antibodies, with some tumors also showing coexpression of vimentin. The mechanisms of such coexpression is unclear.

Adenocarcinoma↗
PubMed1987

[Prognostic criteria of papillary thyroid cancer. Morphologic clinical analysis of 202 cases of tumor].

A retrospective study of 202 papillary thyroid carcinomas was conducted to determine the prognostic value of different morphological and clinical features. The biological behaviour was primarily influenced by tumor type: Among encapsulated (n = 28) and occult lesions (n = 34), each time recurrence-free survival was seen, whereas 22% of patients with widely invasive tumours (n = 140) died from carcinoma (mean observation period: 9.6 years). In the latter group, dismal prognosis was demonstrated for older patients (greater than 52 years) and oxyphilic or poorly differentiated tumours; the same effect was shown for presence of distant haematogenous spread and tumour invasion of cervical soft tissue. Since lethal outcome was seen even in cases lacking the aforenamed unfavourable criteria, total thyroidectomy should be performed for all widely invasive neoplasms regardless of cellular or histological differentiation, stage of disease and age at diagnosis. The same applies for the two prognostically excellent subtypes in the case of regional metastases. As opposed to this, hemithyroidectomy and life-long TSH-suppressive oral hormone replacement therapy is regarded to be sufficient in encapsulated and occult papillary tumours not accompanied by regional or distant metastases.

Biopsy↗
PubMed1987

[Surgical therapeutic concept of immune thyropathy].

73 patients with Graves' disease, surgically treated from 1975-1986, were investigated retrospectively. 43 patients, treated by subtotal thyroidectomy (Enderlen-Hotz) and a bilateral thyroid remnant of a total of about 8-12 g, were compared with 30 patients, treated by a modified subtotal thyroidectomy leaving a unilateral thyroid remnant of about 4-8 g, with respect to preoperative duration of disease, indications for surgical treatment, weight of resected specimens, operative complications and postoperative thyroid function. Surgical complications were similar in both groups. After subtotal thyroidectomy 14/43 patients (33%) displayed either recurrent hyperthyroidism (9/43, 21%) or local recurrence of Graves' goiter (3/43, 7%) or both (2/43, 5%). The modified subtotal resected group showed no recurrences of the disease. After subtotal thyroidectomy 11 patients were euthyroid without thyroid medication (26%) compared to only two patients (7%) after the modified procedure of subtotal thyroid resection. To prevent recurrences of goiter as well as hyperthyroidism and, on the other hand, to achieve euthyroid function postoperatively without need for thyroid replacement therapy, subtotal thyroidectomy with a small thyroid remnant of about 4-8 g is recommended for all patients with large goiter and a chronic recurrent course of the disease or with iodine induced thyrotoxicosis. Patients with non-recurrent Graves' disease but large goiter probably benefit from subtotal thyroidectomy with a larger thyroid remnant of about 8-12 g.

Adolescent↗
PubMed1986

C-terminal PTH (70-84) after biliary ligation in rats: implications for the diagnostic importance in hepatobiliary disease.

The pathogenesis of hepatic osteodystrophy is still poorly understood. To date, there is no convincing evidence for the involvement of one of the vitamin D metabolites. Recent observations provided evidence for an disturbed hepatic metabolism of intact PTH in patients with primary biliary cirrhosis and children with biliary atresia. To confirm these data experimentally, the extrahepatic bile-duct was ligated and dissected in rats. As expected GOT and AP activity increased in ligated group, calcium and mid-C-PTH remained constant for the first 44 days post-ligation. Similar to the data in the respective groups of patients, C-terminal PTH immunoreactivity increased after biliary ligation. The radioimmunological discrimination between intact PTH and the bone-seaking N-terminal PTH peptide is still impossible without further chromatographic procedures. Therefore, C-PTH may represent an important laboratory parameter for the evaluation of the hepatic metabolism of PTH which seems to be disturbed during severe longstanding cholestasis.

Alkaline Phosphatase↗
PubMed1986

[Medullary thyroid carcinoma. Results of a family screening program].

During a ten-year period (1975-85) 56 patients with medullary carcinoma of the thyroid were under treatment. A family screening programme discovered such a tumour in the offspring of a 47-year-old female patient and her 56-year-old sister. In four of seven offspring from three lines of this family ultrasonography revealed changes in the thyroid. Positive preoperative pentagastrin test with stimulation of calcitonin as tumour marker resulted in the histological diagnosis of thyroid carcinoma.

Calcitonin↗
PubMed1986

[HLA and thyroid cancer].

HLA typing was performed in 51 patients to analyse the pathogenetic background of differentiated and medullary thyroid carcinomas. A higher incidence of Bw62 and DR5 was observed in patients with papillary carcinoma (n = 24), DRw6 antigen in follicular carcinoma (n = 13), and DR3 antigen in patients with medullary carcinoma (n = 11). The DR3 antigen was present in one of two patients with a familial history of medullary thyroid carcinoma. Therefore, HLA typing is not suitable as a screening method for the detection of early thyroid carcinoma.

Adenocarcinoma↗
PubMed1985

[Operative indications and surgical procedure in iodine-induced hyperthyroidism].

Clinical course, indications for surgical treatment, and results of treatment in 8 female patients with iodine induced thyrotoxicosis (IIT) are reported. The diagnosis of IIT could be established in all patients by a) clinical hyperthyroidism, b) increased T3 and T4 serum concentrations, and c) previous iodine contamination. Sources of iodine were radiographic contrast agents for urography (n = 4), oral cholecystography (n = 3), intravenous cholangiography (n = 1), phlebography (n = 1), and cranial computer tomography (n = 1). The onset of hyperthyroidism occurred 1-8 weeks after iodine exposure. Indications for surgical treatment of IIT were: 1. autonomous nodular goiter (n = 6), and 2. iodine exacerbation of preexisting thyrotoxicosis in patients with Graves' disease (n = 2). Corresponding to the different pathogenesis of autonomous and immunogenetic goiter the following surgical treatment is recommended: Enucleation of solitary autonomous adenomas or unilateral lobectomy in case of large adenomas, subtotal bilateral lobectomy in toxic multinodular goiter or, preferentially, unilateral lobectomy combined with subtotal resection of the contralateral thyroid lobe; "Near-total" thyroidectomy in Graves' immunopathy.

Adult↗
PubMed1985

Comparison of histology and immunohistochemistry with thyroglobulin serum levels and radioiodine uptake in recurrences and metastases of differentiated thyroid carcinomas.

The importance of lightmicroscopical and immunohistochemical features of 38 recurrent differentiated thyroid carcinomas (27 papillary carcinomas (PC), 11 follicular carcinomas (FC] for post-operative serum thyroglobulin (TG) concentrations was analysed in regard to pre-operative serum TG levels with tumour type, histological and cytological differentiation, volume fraction of TG synthesizing tumour cells (TG immunohistomorphometry), tumour volume and radioiodine uptake (RIU). Serum TG concentrations increased with tumour size and the number of TG synthesizing tumour cells (r = 0.5). PC and FC did not differ in their volume proportions of TG synthesizing tumour cells, while TG serum levels in FC significantly exceeded those of PC of similar size. The low TG serum levels found in PC might be explained by a specific defect in thyroglobulin secretion. Carcinomas with partial or total cytologic metaplasia (e.g. oxyphilic carcinomas) had low volume proportions of TG synthesizing cells and low serum TG levels. Thirteen of the 38 differentiated carcinomas (34.2%) showed both high TG serum levels and positive RIU, 17 (44.7%) disclosed only elevated TG serum levels and 6 (15.8%) a positive RIU. In two cases (5.3%) TG serum levels were not elevated and RIU's were negative. TG immunostaining was positive in all 38 cases. In summary, TG serum levels depend on the following morphologic factors in differentiated thyroid carcinomas: 1) Number of TG synthesizing tumour cells, 2) Mode of TG secretion and 3) Cytological differentiation of the tumour cells. Serum TG levels did not predict total body iodine scan.

Adolescent↗
PubMed1985

Growth and function of thirty-four human benign and malignant thyroid xenografts in untreated nude mice.

Tissue was taken from 16 patients with benign thyroid lesions (10 nontoxic nodular colloid goiter, two follicular adenoma, one autonomous adenoma, one iodine-induced thyrotoxicosis, 2 Graves' disease) and 18 patients with malignant thyroid tumors [seven papillary, five follicular, five undifferentiated (anaplastic), and one medullalry carcinoma] and was xenotransplanted into the flanks of 124 syngeneic female BALB/c-nu/nu mice 6 weeks of age. Subsequently, without any further treatment, serum levels of thyroglobulin (TG), T3, T4, and thyroid-stimulating hormone were determined by radioimmunoassay at 4 or 5 weeks posttransplantation and at the end of the experimental time period of 4 months. All animals were autopsied. The grafts were examined by light microscopy and TG immunohistochemistry. Morphologically, the grafts of benign and malignant thyroid tumors showed features overall identical to the original tissue. Conversely, nontoxic nodular colloid goiter and Graves' disease grafts revealed a transformation to normofollicular structures. All benign thyroid grafts showed a stationary growth, as did most differentiated thyroid carcinomas. Tumor take rates in differentiated and in medullary carcinoma were 15%, and in undifferentiated carcinomas, 100%. In the cancer grafts, a correlation between resting phase (period until progressive tumor growth) and survival time of the corresponding patients was disclosed. All patients whose tumors were not taken by nude mice are still alive and show no signs of progressive tumor growth at 9 to 34 months after surgery. All but one patient with tumors revealing positive tumor take died within 3 months (resting phase, 3 weeks) or one year (resting phase, 7 to 14 weeks) after surgery. Integrity of hormonal function in benign and malignant xenografts at 4 months posttransplantation could be shown by significantly higher T3 and T4 serum concentrations in animals with benign thyroid tissues (T3, 1.69 +/- 0.13 nmol/liter; T4, 45.69 +/- 2.09 nmol/liter; S.E.) as compared to controls without grafted tissue [T3, 1.29 +/- 0.10 nmol/liter (p less than 0.05); T4, 33.39 +/- 2.71 nmol/liter (p less than 0.05)] and by increased TG serum concentrations in animals receiving benign (TG, 2.70 +/- 1.39 ng/ml) or malignant (e.g., TG in follicular carcinoma, 34.44 +/- 13.83 ng/ml; controls, 0.30 +/- 0.02 ng/ml) thyroid tissue. Thus, we conclude that benign and malignant thyroid xenografts in the nude mouse maintain full morphological and, regarding T3, T4, and TG serum levels, functional integrity for at least 4 months after transplantation.

Animals↗
PubMed1984

The encapsulated papillary carcinoma of the thyroid. A morphologic subtype of the papillary thyroid carcinoma.

Of a total of 182 papillary neoplasms, 25 lesions (average size, 3.1 cm) were classified on cytologic and histologic grounds as being encapsulated carcinomas. In eight of these tumors (32.2%) cervical lymph node metastasis and/or intraglandular lymphatic spread was observed. It was not possible to separate on histologic grounds those that did metastasize from those that did not. The excellent prognosis for the encapsulated variant of papillary thyroid carcinoma was confirmed by a long follow-up period in which no evidence of recurrences or further metastasis was registered as compared with the time of initial diagnosis, whatever the mode of therapy. On the basis of these findings, the encapsulated papillary carcinoma can be regarded as an early or slowly growing form of the papillary thyroid carcinoma.

Adult↗
PubMed1984

The encapsulated follicular carcinoma of the thyroid. A clinicopathologic study of 35 cases.

In a retrospective study of 86 follicular carcinomas of the thyroid gland, 35 lesions were classified as encapsulated carcinomas (40.7%). In two of these, lymph node metastases were detected initially. Another patient presented with distant metastases. The biological behaviour of these 35 tumours was studied over a long-term follow-up period (0.4-19.1 years, mean 10.3 years) which featured three cases of death from thyroid carcinoma 0.4-5.0 years after thyroidectomy. Another patient suffered from local recurrence of a follicular carcinoma 13.9 years later. The morphological and clinical findings of those five patients who initially presented with metastases and/or whose follow-up registered the local recurrence of thyroid cancer or death as a result of it, were compared with the remaining 30 cases which were of a benign clinical course. Statistical analysis showed that the prognosis of encapsulated follicular carcinoma is more serious when tumours occur in patients older than 65 years of age and when the tumour diameter is 5.0 cm or more. There was a tendency towards poorer prognosis in those tumours exclusively composed of oxyphilic epithelium.

Adenocarcinoma↗
PubMed1983

[Appendicitis mortality in the Federal Republic of Germany 1952-1979. Trend analysis and age curves].

Evaluation of age- and sex-specific mortality from 1952 to 1979 shows a decreasing trend in most age groups since the beginning of the observation period. This has become clearly pronounced since the beginning of the seventies. As a percentage reduction of mortality in the youngest group (less than 10 years) is highest and least in the oldest group. Females had a lower mortality from appendicitis at any time of all age groups than males, with the exception of 10- to 19-year-old girls in 1972/73 until 1978/79.

Adolescent↗
PubMed1982

[Thyroglobulin immunohistochemistry: new aspects of pathophysiology and differential diagnosis of benign and malignant goitre (author's transl)].

Thyroglobulin (TG) immunohistochemistry on formalin-fixed, paraffin-embedded thyroid tissue is a functional morphological method to analyse qualitatively and quantitatively benign and malignant lesions of the thyroid. In this article new aspects of pathogenesis, functional morphology and differential diagnosis resulting from the application of this method are reported. According to our immunohistochemical and electron microscopic findings the formal pathogenesis of nontoxic (sporadic) goitre is characterized by the progressive transformation of active small thyroid follicles into inactive macrofollicles. In nodular goitre, the final stage of this process, the macrofollicles are probably irreversibly inactive and not TSH-responsive. Thyroid adenomas can be divided scintigraphically and by TG immunohistochemistry into endocrine active ("hot") and endocrine non-active ("cold") adenomas. The first group consists of autonomous adenomas, second group of other maincell adenomas and adenomas of specific cytological differentiation (e.g. oxyphilic and clear cell adenomas). In metastasizing differentiated thyroid carcinomas TG immunohistochemistry is a reliable method to differentiate primary thyroid carcinomas from other adenocarcinomas, e.g. lymph node metastases of the neck in the case of papillary carcinomas or bone metastases in cases of follicular carcinomas of the thyroid.

Adenocarcinoma↗