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Biomedical subjects

J Kovarik

Publications and source records attributed to J Kovarik.

At least 163 records · Page 9Linked to original sources
PubMed1984

Bladder obstruction--a rare complication after percutaneous renal biopsy.

In the treatment of diffuse renal disease exact histological diagnosis is of great importance. Biopsy, therefore, is an integrated component of patient management. The most common complication following percutaneous renal biopsy (PRB) is bleeding. Gross hematuria can be easily detected; an uncommon complication after PRB, however, is bleeding into the urinary system, with obstruction of the bladder by blood clots. By means of ultrasonic control obstruction of the bladder can easily be diagnosed in a non-invasive way. As far as we know, no cases where bladder obstruction due to blood clots after PRB were diagnosed by ultrasonography have been documented so far.

Adult↗
PubMed1983

Peripheral insulin resistance in primary hyperparathyroidism.

Carbohydrate metabolism was investigated in 9 patients with symptomatic primary hyperparathyroidism. Before and after parathyroidectomy intravenous and oral glucose tolerance test, tolbutamide test, arginine infusion test and insulin tolerance test were performed. During intravenous and oral glucose tolerance tests, patients with primary hyperparathyroidism exhibited hyperinsulinemia and impaired glucose tolerance without normalization after surgery. Tolbutamide-induced induced insulin release did not differ pre- or postoperatively. After restoration of normocalcemia and normocalcemia and normophosphatemia we found significantly lower glucose and insulin levels following arginine infusion and a significantly increased hypoglycemic response to parenterally administered insulin, probably indicating partial improvement of glucose tolerance after surgery. Our findings suggest that biochemical abnormalities associated with primary hyperparathyroidism, like hypercalcemia, hypophosphatemia, and elevated parathyroid hormone levels may cause and sustain a form of endogenous insulin resistance, which consequently leads to hyperinsulinemia and to impaired glucose tolerance. Since hyperinsulinemia as well as impaired glucose tolerance seem to be only slowly and partially reversible in symptomatic primary hyperparathyroidism, these data could be considered as an additional argument for early surgical intervention in this disorder.

Adult↗
PubMed1983

Growth hormone, prolactin and insulin following arginine infusion in primary hyperparathyroidism before and after parathyroidectomy.

The secretion of growth hormone, prolactin and insulin following arginine infusion was studied in 9 patients with primary hyperparathyroidism before and after parathyroidectomy. Growth hormone, insulin and glucose levels after arginine administration were significantly higher before parathyroidectomy compared with the corresponding data obtained in the post-operative state, whereas plasma prolactin concentrations did not differ before and after operation.

Adult↗
PubMed1983

[Human calcitonin in the treatment of symptomatic Paget's disease].

We evaluated the effect of a 6 months trial with synthetic human calcitonin in 10 symptomatic patients with polyosseous Paget's disease of bone. All patients reported a distinct clinical improvement which correlated with a significant decrease of alkaline phosphatase in the plasma and hydroxyproline and calcium excretion in the urine. Though no changes in skeletal x-rays were observed, the bone lesions showed a significant decrease of activity in tho bone scintigrams. Histologically there was a marked decrease of bone turn-over calcitonin therapy. No patient revealed the formation of autoantibodies against exogenous calcitonin after treatment.

Aged↗
PubMed1983

[Tumor-like bursal calcifications due to uncontrollable hyperphosphatemia in chronic hemodialysis. Case report].

The most important factor that appears to be associated with soft-tissue calcifications in uremics is the increase of serum-phosphate levels, especially if the calcium-phosphate product exceeds the value of 75 (concentrations in mg/dl) [6]. In contrast to previous years tumoral paraarticular calcinosis is now rarely seen because much more attention has been paid to the prevention of hyperphosphatemia and because of pharmacological improvement of phosphate binding agents. Therefore, the level of serum phosphate in hemodialysed patients primarily depends on the patients adherence to the low phosphate diet and compliance with the phosphate binding therapy [4, 8]. We want to report of a patient on chronic intermittent hemodialysis who developed tremendous paraarticular soft tissue calcifications during a short period of time due to uncontrolled hyperphosphatemia despite correct intake of phosphate binding compounds.

Bursa, Synovial↗
PubMed1983

[Physiology of parathyroid hormone and calcitonin].

Parathyroid hormone, 1,25-vitamin D3 and calcitonin are the three major hormones in the control of calcium homeostasis. The physiological function of parathyroid hormone and 1,25-vitamin D3 in the short term regulation of calcium homeostasis by varying intestinal absorption and renal excretion are well established. However, there is still an ongoing debate on the physiological relevance of human calcitonin. Calcitonin seems to play an osteoprotective role over a longer period of time or during times in which the skeleton is under stress because large quantities of calcium are required like during pregnancy, lactation or growth. Some important physiological aspects of the two peptide hormones--parathyroid hormone and calcitonin--should be discussed within this article.

Bone and Bones↗
PubMed1983

[The significance of the 5th gland as a cause of primary hyperparathyroidism. Case report and review of the literature].

Of 140 patients surgically treated for primary hyperparathyroidism one patient had persistent hypercalcemia due to an abnormal and ectopic fifth parathyroid gland (0.7%). The possibility of an abnormal fifth gland as the cause of primary hyperparathyroidism should be considered when four glands of normal size and histology have been found in the neck, and of such a gland should be thought in all patients with diffuse hyperplasia after subtotal parathyroidectomy suffering from persistent hyperparathyroidism. The fifth gland is usually found in the lower neck or upper mediastinum, frequently within the thymus. If present, it should be excised by transcervical thymectomy during first operation. In reoperations sternal splitting should be performed.

Adenoma↗
PubMed1982

[Sipple syndrome (bilateral phaeochromocytoma medullary C-cell carcinoma of the thyroid gland) with exceptionally prolonged clinical course].

The sporadic occurrence of the Sipple syndrome with bilateral phaeochromocytoma and medullary thyroid carcinoma is a well-known pathological entity. The present report refers to a patient with medullary thyroid carcinoma, initially misdiagnosed as Hurthle-cell adenoma after partial resection of the thyroid gland. 5 and 8 years later the patient underwent bilateral adrenalectomy for phaeochromocytoma. 4 years after the second phaeochromocytoma a palpable thyroid nodule developed, thyroidectomy was performed and the tumour diagnosed as a medullary thyroid carcinoma. This diagnosis was confirmed by reexamination of the histological specimens obtained during the first surgical intervention. We were prompted to report the current case history, because of the protracted course of the medullary thyroid carcinoma in this patient and to point out the value of the determination of pentagastrin stimulated calcitonin values in patients with medullary thyroid carcinoma for diagnosis, postoperative follow-up and in family screening studies.

Adrenal Gland Neoplasms↗
PubMed1982

Evidence for negative correlation between quantitative histological studies and microradiography of iliac crest bone and forearm osteodensitometry in elderly women with osteoporosis.

Quantitative histomorphometric and microradiographic analysis of iliac crest bone biopsy specimens of 10 unselected and untreated postmenopausal women with osteoporosis was performed and the results were correlated with the values measured by osteodensitometry on the right forearm. No positive correlation between histomorphometry or microradiography and osteodensitometry was observed. Moreover, the data of various histomorphometric parameters and those of the bone mineral content measured by microradiography revealed a significant negative correlation when compared to the values obtained by osteodensitometry. Our results suggest, that evaluation of one skeletal site is not necessarily representative of the entire skeleton in patients with postmenopausal osteoporosis.

Aged↗
PubMed1982

[Phosphorus and calcium metabolism of premature infants fed human milk and formulated milk].

Development of rickets in vitamin-D supplemented very-low-birthweight (VLBW) infants can be associated with low Phosphorus (P) and Calcium (Ca) intake. Therefore, we estimated P and Ca intake of three VLBW-infants who were fed pooled human milk after birth and then switched to an adapted formula. We measured P, Ca, activity of alkaline phosphatase and parathormone in serum and P and Ca excretion in urine. P and Ca intake was below the estimated requirement for prematures with pooled human milk as well as with the adapted formula, on the other hand, Ca and especially P intake increased when infants were switched to the adapted formula. When fed human milk we found evidence for a P deficiency in the body with signs of inadequate bone mineralisation. On the adapted formula infants showed Ca deficiency but bone mineralisation improved. From our findings we conclude that on pooled human milk VLBW-infants do not receive the required amount of P and Ca. The signs of Ca deficiency on the adapted formula might be related to low Ca intake or to the P: Ca ratio of the formula which could be inadequate for VLBW-infants.

Calcium↗
PubMed1982

[Hypercalcemia and primary hyperparathyroidism. Epidemiologic and diagnostic aspects].

In an unselected group of in- and out-patients attending the II. Medizinische Universitätsklinik, Vienna, using multichannel autoanalyzers an incidence of hypercalcemia of 1.1% was found. 20% of the hypercalcemic patients could be diagnosed as primary hyperparathyroidism, in 8% this diagnosis was surgically proven. Thus, an incidence of 200 cases with primary hyperparathyroidism per 100,000 patients as the lower limit can be assumed for the Viennese area. The validity of the determination of parathyroid hormone using four different radioimmunoassay systems differed substantially and varied between clinically useless and 90% efficiency.

Austria↗