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K Baum

Publications and source records attributed to K Baum.

70 records · Page 4Linked to original sources
PubMed1986

[Surgical indications for scintigraphically cold thyroid nodules in relation to clinical, scintigraphic, sonographic and cytologic findings].

The frequency of indication for surgical resection of goitre was retrospectively analysed for 2100 thyroid examinations. During 1974/75 (group I) only scintigraphy was available in addition to clinical examination; in 1979/80 (group II) cytological criteria were added, and in 1983/84 (group III) ultrasound findings were available as well. There were 700 patients in each group. The proportion of scintigraphically negative nodules was largely the same in the three groups (I and II: 21%; III: 22%). Indication for operation was less common after the introduction of ultrasound (I: 56%; II: 55%; III: 44% of patients with scintigraphically cold nodules). In particular, there was a decrease in the proportion of those nodules not definitely considered benign which would have required histological diagnosis (I: 32%; II: 18%; III: 8%). The results underline the special place of small-needle biopsy and, especially, ultrasound examination of the thyroid, in addition to clinical and scintigraphic findings, in providing the indication for and planning of operative nodular goitre resection.

Biopsy, Needle↗
PubMed1986

The influence of furosemide on heart rate and oxygen uptake in exercising man.

We recently observed that heart rate (HR) related methods for assessing physical fitness lead to an overestimation of endurance capacity in subjects treated with furosemide. To gain a more detailed description of this effect, the relationships between work load (WL), oxygen uptake (VO2), and HR were determined in the present study. To this end, nine healthy male subjects performed two incremental exercise tests (10 W increase per 30 s) on a bicycle ergometer. In one test 40 mg furosemide (Lasix) was applied orally 90 min before exercise started. Compared with control conditions, furosemide led to a change in mean blood volume of -4.5% (range: +7.8% to -11.5%). Neither the maximal VO2 (VO2max) nor the maximal work load (WLmax) were significantly altered after furosemide application. Though the WL-VO2 relationship was not significantly affected, the HR-VO2 relationship showed significant alterations which depended on both the loss of blood volume (BV) and work intensity: When the reduction in BV was less than approximately 5%, HR was found to be lowered at all workloads. When the BV reduction was greater than about 5% HR was significantly reduced only in the lower ranges of work load but significantly increased at the higher work intensities. Since BV reductions are known to increase HR during exercise, our findings suggest that, in addition to the blood volume induced changes in HR, furosemide exerts further direct or indirect effects on heart rate adjustment.

Adult↗
PubMed1986

[EEG changes in disseminated encephalomyelitis in comparison with the findings of cerebral magnetic resonance tomography].

The electroencephalograms of 40 patients with acute symptoms of multiple sclerosis, 10 of whom presented with primary manifestation, were compared with the findings in cerebral nuclear magnetic resonance imaging. 32.5% of the patients EEGs showed abnormalities. Considering borderline findings the percentage of remarkable EEGs mounted to 60%. All of the patients presented periventricular lesions in NMR. In addition to the periventricular abnormalities between 1 and 26 district lesions per patient were found (mean = 6.5; Median = 5). In the patients group with five and more non-periventricular lesions, there were significantly more pathologic EEG-findings (p less than 0.05) than in the group with fewer lesions. Statistical correlations between EEG-abnormalities and the extent of functional deficit could not be substantiated. Neither could type and locality of EEG-changes be correlated to non-periventricular lesions in NMR.

Adolescent↗
PubMed1986

[Cortical SEP of early and intermediate latency following stimulation of the median and tibial nerves in disseminated encephalomyelitis--relation to findings in cerebral nuclear magnetic resonance tomography].

Cortical somatosensory evoked potentials following median and tibial nerve stimulation were compared with the findings in nuclear magnetic resonance imaging in 23 patients with multiple sclerosis, 11 of whom presented with their first disease manifestation. Pathological SEP's were found in 55 percent of patients presenting with first manifestation and in 83 percent of those with a longer duration of illness. Except for one patient with spinal cord involvement only, in whom no cerebral lesions were seen, all patients showed periventricular lesions in NMR. Between 1 and 16 (4.7 +/- 3.5) non-periventricular isolated lesions were found per patient. Cortical SEP's are affected differently by lesions within the thalamocortical system: Plaques within the internal capsule may result in SEP-changes as seen in other causes of damage to this region. However, lesions in this strategic area may also remain clinically and electrophysiologically silent. Nevertheless, the size of the lesion seen in NMR is not relevant, as observed in one case of an extensive plaque within the centrum semiovale. Correlations between the lesions near the parietal cortex or within the parietal white matter and SEP-component alterations of intermediate latency (N55, N75) remained insignificant.

Adult↗
PubMed1986

[Initial manifestation of disseminated encephalomyelitis: MRT comparative study with established disseminated encephalomyelitis].

40 patients with a definite diagnosis and 16 patients with an initial manifestation of multiple sclerosis were investigated by cerebral nuclear magnetic resonance imaging (NMR) and compared. The initial manifestation is predominantly characterized in the NMR by significantly less periventricular involvement, especially within the region of the occipital horns, by significantly rarer appearance of confluent, periventricular lesions within the region of the pars centralis and the temporal horns of the lateral ventricles and by significantly rarer appearance of circumscribed non-periventricular lesions. Unlike those in definite multiple sclerosis, the morphology and distribution of the initial lesions do not show a stereotypical and diagnostically characteristic pattern. The importance of the cerebral NMR for the early diagnosis of multiple sclerosis lies primarily in the indication of disseminated lesions.

Adult↗
PubMed1985

[Clinical picture of multiple sclerosis in the magnetic resonance tomogram].

We performed magnetic resonance tomography (MRT) on 22 patients with multiple sclerosis (MS) using varying scan sequences. In 21 patients MRT produced abnormal findings demonstrating multiple lesions, giving varying signals. The MRT appearances of MS have the following characteristics: circular configuration and homogeneous structure of individual lesions, multiple foci, with involvement of all parts of the brain, but with preference for the periventricular region and white matter. This constellation of MRT features is characteristic for MS, but is largely independent of the varying clinical symptoms. The appearance of the individual lesions and the distribution pattern of the foci is sufficiently characteristic to support the clinical diagnosis of MS in younger patients.

Adult↗
PubMed1985

[Significance of magnetic resonance tomography in disseminated encephalomyelitis].

23 out of 24 patients with multiple sclerosis showed multiple, distinct lesions on investigation with cerebral nuclear magnetic resonance imaging (NMR). Arguments for the specific relationship of these lesions to demyelinating foci are: 1. Morphology and pattern of distribution agree to the known pathological observations. 2. Single lesions shown by computerized tomography (CT) were similarly located to lesions shown by NMR. The morphology and distribution of the lesions in the NMR show a common pattern largely independent of the individual neurological deficits. The nuclear magnetic resonance imaging is a method of high sensitivity and specificity for the diagnosis of multiple sclerosis. It offers valuable additional information in particular for early diagnosis and in cases of diagnostic uncertainty.

Adult↗
PubMed1984

[Metastatic differentiated thyroid cancer. Diagnostic accuracy of thyroglobulin-RIA in comparison with 131I-whole body scintigraphy].

In a retrospective analysis in patients with differentiated thyroid carcinoma, the diagnostic validities of 131I whole-body scans and radioimmunologic determinations of thyroglobulin (hTg) are compared with special regard to late metastases. Metastases were found in 83 out of 311 patients with differentiated thyroid carcinoma. In two thirds of the cases, these were primary metastases while in the remaining third of the cases, metastases developed in later follow-up with a mean time of latency of 3.3 years. While about 70% of the early metastases could bei detected by 131I scintigraphy, this percentage amounted to only 40% in late metastases. With a diagnostic sensitivity of 90%, hTg-RIA was clearly superior in the detection of early as well as of late metastases. hTg was measurable, however, only in iatrogenous hypothyroidism in 4 out of 49 cases. Based on these results and an analysis of the literature, a program for follow-up of differentiated thyroid carcinoma is proposed. The hTg-RIA is thereby used as an alternative to 131I scintigraphy in the late phase of follow-up after complete ablation of any thyroid tissue.

Adenocarcinoma↗
PubMed1983

[Differential diagnosis of thyroid nodules. Sonography as a complement to scintigraphy and puncture cytology].

The place of ultrasound in the diagnosis of thyroid nodules was assessed in 384 patients by comparing its findings with those obtained on palpation, scintigraphy, fine-needle cytology and (in 45 cases) histology. Further diagnosis of scintigraphically "cold" nodules is the main indication for ultrasound examination in goitre-endemic areas. In 13 of 69 cases of a cold nodule with complex or echo-poor echo image proved it to be malignant, while in 74 with cold nodules but with a normal or increased echo pattern there was no malignant tumour. Thus, if the echo pattern is "complex" or "echo-poor" urgency of surgical intervention is strengthened, while with echo-normal or echo-rich nodules or cysts indications for operation are relative. In future, a combination of scintigraphy, ultrasound and cytology (ultrasound-guided small-needle biopsy) will give the highest rate of diagnostic accuracy in the differentiation of malignant from benign thyroid lesions.

Biopsy, Needle↗
PubMed1983

[Direct and indirect parameters for free thyroxine. II. Diagnostic accuracy in disorders of thyroid function and binding protein anomalies].

Part II of the study concerning the clinical applicability of direct and indirect parameters for free thyroxine evaluates the diagnostic accuracy of the FT4-RIAs ImmoPhase, GammaCoat, Liquisol, Amerlex and LisoPhase in relation to FT4 index and T4/TBG ratio. This comparison of methods is done on a thoroughly classified collection (n = 640) of patients with normal and impaired thyroid function including patients with binding protein anomalies (pregnancy, estrogen-medication, phenytoin therapy, renal protein loss). FT4 normal ranges of a given kit harmonize well with data of the manufacturers and of the literature. On the other hand, the normal ranges of the various kits are not comparable. The differentiation of euthyroidism from hyper- or hypothyroidism can be made without problems using any of these methods, with the exception of the FT4-RIA GammaCoat. As expected, patients with euthyroid goiter show, on the average, slightly lower parameters for FT4. In pregnancy all direct and indirect parameters for FT4 have a tendency to lower values after the first trimester. This trend is most distinct for the T4/TBG ratio. A weak negative correlation of FT4 parameters with basal TSH, which does not exceed the upper normal range, however, can be interpreted in the sense of a relative hypothyroxinemia. Under contraceptive estrogen medication FT4 parameters do not fall outside the normal range, with the exception of the FT4-RIA ImmoPhase assay which yields a significantly increased frequency of high FT4 levels. On therapy with phenytoin FT4 values are generally lower than in controls. FT4 parameters in patients with renal protein loss of more than 2 g daily do not behave uniformly. While three of the FT4-RIAs tested (ImmoPhase, GammaCoat, Amerlex) show a tendency to lower values, the results of the remaining FT4 parameters do not differ significantly from the distribution of normals. The study leads to the conclusion that indirect FT4 parameters are still useful in the diagnosis of thyroid function; currently available FT4 radioimmunoassays may yield comparable results. With regard to the varying quality of the various commercial test kits, the choice between FT4-RIAs and indirect FT4 parameters does not depend primarily on clinical but on technical viewpoints.

Adult↗
PubMed1982

[Possibilities and limits of thyroid sonography in the diagnosis of thyroid cancer].

The echographic appearance of 19 histologically confirmed malignant thyroid tumours has been analyzed. The value of information by ultrasonography is compared to scintigraphy and fine-needle aspiration biopsy. All patients demonstrated a sonographic pattern of relatively low amplitude, sparse and disordered echoes. Extended thyroid tumours (T2-3) exhibited a serrated marginal border as a sign of the infiltration to the surrounding thyroid tissue. The clinically important separation of solid and cystic nodules can always be made with certainty. Provided that a subtile examination technique is used, ultrasonography can be of great value in choosing the adequate therapy in scintigraphic cold nodules. Diagnostic ultrasound also yields information concerning the reliable and reproducible classification and accurate location of circumscribed thyroid lesions. In all cases, however, the ultrasound pattern did not provide reliable clues as to their histology. A successful differentiation between benign and malignant solid nodules can be obtained only by cytology and histology. Ultrasonography, scintigraphy and aspiration biopsy, therefore, are complementary methods.

Adenocarcinoma↗
PubMed1981

[Bone density and thyroid gland function in adolescents in relation to fluoride content of drinking water].

In 26 adolescents between 13--15 years of age living in a region with increased fluoride concentration in drinking water (3 ppm = 3 mg NaF/l) bone density-measurements by an I-125 profile scanner as well as measurements of thyroid function by means of numerous in vitro tests (T3U, T4, FT4-Index, RIA-T3, rT3, hTg, TSH, thyroglobulin and microsomal thyroid antibodies) have been done. Comparing 19 adolescents of same age from a region with low fluoride concentration in the drinking water (0,1--0,2 ppm) the study showed no influence of fluoride content of drinking water on skeleton mineralization and on thyroid function. There was found only--not depending on fluoride concentration--an increased bone density in females that was interpreted as a physiological difference between males and females.

Adolescent↗
PubMed1976

The bulbar respiratory centre in the rabbit. II. Responses of respiratory neurons to intermittent electrical bulbar stimulation during in- or expiration.

In anesthetized rabbits, spirogram and diaphragmatic activity were examined during electrical stimulation of the bulbar lateral reticular formation. The activity of bulbar respiratory neurons was recorded contra- or ipsilaterally to the stimulation site. One volley of repetitive stimuli per breath was delivered during either inspiration of expiration. 1. Each volley of about 120 ms duration at 100 pulses per second, delivered early in inspiration, caused an immediate and transient inhibition of the diaphragmatic activity. An inspiratory rebound comprising lengthening of inspiration and increase in tidal volume occurred. a) "Inspiratory" and "expiratory-inspiratory" phase-spanning neurons exhibited inhibition during the volley. The burst discharge was lengthened and the spike density increased after stimulus. The same was true of some "inspiratory-expiratory" phase-spanning units. b) The discharge of most of the "inspiratory-expiratory neurons was not inhibited. "Expiratory" units were excited. In both types of cells activation occurred which outlasted the volley. 2. When applied during expiration, the volley caused a short inspiratory twitch. a) "Inspiratory" and "expiratory-inspiratory" neurons exhibited a short post-stimulus firing and the spike density was increased. In some units of the latter type, however, the burst discharge was shortened. b) Most of the "expiratory" and "inspiratory-expiratory" neurons were not inhibited by the volley. Cells of the former type often produced post-stimulus after-discharge; the burst discharge of units belonging to the latter type was shortened. The effects of expiratory stimuli upon neuronal activity, however, were less consistent than those elicited by inspiratory volleys. 3. During spontaneous irregularities of single inspirations (short interruptions), EI and I neurons exhibited comparable burst pattern changes. The changes in pattern of IE and E units were also comparable and differed distinctly from the behaviour of the EI and I cells. No major differences in behaviour were observed between neurons which were inhibited during lung inflation (alpha units) and those which were activated during inflation (beta cells). The findings are in accord with the effects observed during electrical bulbar stimulation, suggesting that EI and I units are inspiratory-activating cells, whereas IE and E neurons may have an inspiratory-inhibitory function. 4. The conclusion is drawn that the effects of bulbar stimulation on the respiratory movements are the result of manipulation on intrinsic rhythmogenesis.

Animals↗
PubMedDate not supplied

Safety and tolerability of a 'refrigeration-free' formulation of interferon beta-1b--results of a double-blind, multicentre, comparative study in patients with relapsing-remitting or secondary progressive multiple sclerosis.

The original glucose-based formulation of Betaferon/Betaseron (interferon beta-1b) requires refrigerated storage. A refrigeration-free formulation of interferon beta-1b, based on mannitol, is stable at room temperature for up to 2 years, and offers a greater degree of flexibility for patients with multiple sclerosis (MS). We compared the safety and tolerability of the two formulations in a 24-week, randomized, double-blind, parallel group, Phase IV clinical study conducted in 303 patients with MS. Patients received the glucose formulation (IFNbeta-1b-G) for 8 weeks, and were then randomized to receive either IFNbeta-1b-G or the refrigeration-free formulation (IFNbeta-1b-M) for a further 8 weeks. On completion of the double-blind phase, all patients received IFNbeta-1b-M for an 8-week follow-up period. The primary outcome measure was the proportion of injection sites that developed reactions per patient during the double-blind period. In addition, a range of secondary outcomes relating to these reactions was also assessed. The difference in the proportion of injection-site reactions between the two groups was not statistically significant (59% IFNbeta-1b-G versus 60% IFNbeta-1b-M). There were no statistically significant differences observed between the two treatment groups in any of the secondary tolerability endpoints. The results from this study demonstrate that the tolerability and safety profiles of both formulations are extremely good, and that the refrigeration-free formulation of interferon beta-1b is comparable with that of the original glucose formulation.

Adjuvants, Immunologic↗