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Biomedical subjects

M Rothmund

Publications and source records attributed to M Rothmund.

At least 289 records · Page 16Linked to original sources
PubMed1983

[CEA determination to differentiate between pheochromocytoma with ectopic calcitonin formation and type-II multiple endocrine neoplasms].

Plasma levels of calcitonin and carcinoembryonic antigen (CEA) were determined pre-operatively and two months postoperatively in ten patients with C-cell carcinoma as part of multiple endocrine neoplasia type II. In addition, CEA was measured in extracts from 20 different phaeochromocytomas (five from patients with multiple endocrine neoplasia type II, 15 from patients with sporadic phaeochromocytoma). In comparison, CEA concentration was determined in extracts from five C-cell carcinomas of patients with multiple endocrine neoplasia type II. When correlating pre- and postoperative calcitonin and CEA levels, there was a significant linear relationship (P less than 0.001). CEA concentration in extracts from phaeochromocytomas was at the lower level of sensitivity (4.7 +/- 12.2 pg/mg tumour wet-weight). In extracts from C-cell carcinomas they were much higher (6402 +/- 4570 pg/mg tumour wet-weight). The results suggest that it is possible, in patients with phaeochromocytoma and high calcitonin levels, to differentiate by additional CEA determination between C-cell carcinoma in the course of multiple endocrine neoplasia type II and sporadic phaeochromocytoma with ectopic calcitonin liberation.

Adrenal Gland Neoplasms↗
PubMed1983

[Secretin versus somatostatin in acute hemorrhage of gastroduodenal ulcers and erosions: a randomized trial].

In a randomized trial the efficiency of synthetic secretin (0,25 clinical units/kg bw/h; 15 patients) was compared with that of synthetic somatostatin (250 micrograms/h, 15 patients) in treatment of severe acute non arterial bleeding from peptic ulcers or stress lesions in the upper digestive tract. In all patients the presence of hemorrhage at beginning of the therapy was established by endoscopic examination. Both test preparations were given as continuous infusions over 48 h and had identical effects on the hemorrhage: in 12 patients (80%) out of each group bleeding stopped during the infusion of secretin or somatostatin, 6 patients (20%) had to be operated on for persistant bleeding or severe recurrence.

Acute Disease↗
PubMed1983

[Correlation of tumor weight and typical pathologic laboratory parameters in primary and secondary hyperparathyroidism].

In a retrospective trial the correlation between tumor weight and typically pathological laboratory findings in serum (parathyroid hormone, calcium, alkaline phosphatase, phosphorous) was investigated in 48 of our patients with primary and 44 with secondary hyperparathyroidism. There was no significant correlation. These laboratory findings therefore do not allow conclusions as to the tumor weight to be drawn.

Alkaline Phosphatase↗
PubMed1983

[Application possibilities of intraoperative sonography].

Preoperative ultrasound, CT-scanning, arteriography and endoscopic retrograde cholangiopancreaticography have improved the diagnostic approach to abdominal and vascular diseases. The correlation between preoperative imaging and intraoperative findings sometimes is difficult. In these cases intraoperative ultrasound can be helpful. The application of B-Scan-Realtime-Ultrasonography during surgery will give additional information on vascular diseases, control of vascular anastomoses, on intraoperative flow-measurement, localization of tumors in the liver and pancreas and on defining margins of resection. Intraoperative sonography is a new device for the surgeon, which should be used to control the site of abdominal tumors as well as vascular anastomoses.

Adult↗
PubMed1983

Computerized tomography of a mediastinal pancreatic pseudocyst.

A pancreatic pseudocyst with mediastinal extension is demonstrated by ultrasound and CT. The value of these examinations compared to conventional radiography is stressed in establishing the correct diagnosis including differential diagnostic considerations.

Adult↗
PubMed1983

[Computed tomography and preoperative staging of esophageal cancers].

Fifty-two patients with proven esophageal carcinoma underwent thoracic and abdominal computed tomography (CT) prior to treatment. The mediastinum, lungs and abdomen were studied for evidence of direct invasion or metastases. Correlation with surgical findings were available in 15 thoracic and 29 abdominal CT-scans. Results indicate that experience of the radiologist is the most important factor in evaluation and in accuracy of CT-scanning. The extent of mediastinal spread in 13 of 15 and intraabdominal metastases in 23 of 29 patients were correctly identified. All errors were caused by false-negative diagnoses. The ability of CT to reliably predict the extent of disease can help the surgeon to plan an optimal therapy.

Esophageal Neoplasms↗
PubMed1983

Total parathyroidectomy and autotransplantation of parathyroid tissue for renal hyperparathyroidism. A one- to six-year follow-up.

From 1975 to 1981 total parathyroidectomy and parathyroid autotransplantation were carried out in 62 patients for renal (secondary) hyperparathyroidism. The paper reports on 46 patients followed for one to six years (mean 2.2 +/- 1.2 years). Forty-one were on chronic hemodialysis, three were predialytic, two had a functioning renal graft. There have been two different groups of indications: one in which hypercalcemia was the main reason for surgery (59%), the other in which severe renal osteopathy (bone pain, radiologic and histologic signs, elevation of alkaline phosphatase, and parathyroid hormone) was observed. Among 45 patients not previously operated on for hyperparathyroidism, five parathyroid glands were removed in three patients, four glands were removed in 36 patients, and three glands were removed in five patients. In one patient previously operated (thyroid surgery), two glands were removed. Tissue was immediately autografted into a forearm muscle. One patient (two glands removed) received a cryopreserved tissue six months after neck exploration. An improvement of bone pain, pruritus, and radiologic signs of renal osteopathy was noted in about 80% of patients. At one to six years no patient was hypercalcemic, in 44 patients the grafted tissue was functioning normally after an average time of 5.8 +/- 1.4 months. One patient is still on low-dose, supplemental therapy for slight hypocalcemia 14 months after autotransplantation. In another patient a part of the grafted tissue was removed for increasing parathyroid hormone levels. Serum concentration of alkaline phosphatase and serum parathyroid hormone decreased after surgery. One- to six-year results after total parathyroidectomy and autotransplantation for renal hyperparathyroidism are considered to be extremely satisfactory.

Adolescent↗
PubMed1983

[Secondary hyperparathyroidism. Modern concepts of its diagnosis and treatment. Apropos of 45 cases].

An analysis of different problems raised by secondary hyperparathyroidism. This condition most often follows chronic renal failure responsible for hyperphosphataemia followed by hypocalcaemia which causes parathyroid stimulation with hyperplasia. Clinical features are dominated by osteopathic manifestations and pruritus. The diagnosis is based upon radiological examination of the skeleton, repeated measurement of serum calcium and phosphate levels and above all iliac crest biopsy. Surgical treatment is based essentially on total parathyroidectomy with autologous transplantation of parathyroid tissue into the muscles of the forearm. This is followed by study of 45 cases undergoing surgery with details concerning surveillance and postoperative care. The results were very satisfactory since amongst these 45 patients undergoing total parathyroidectomy, only two continued to suffer from bone pain.

Humans↗
PubMed1982

[Treatment of jejunal peptic ulcer with cimetidine or an antacid? Results of a long-term study].

The effectiveness of cimetidine or antacid in healing recurrent jejunal peptic ulcers after Billroth II gastric resection without vagotomy was tested in a randomized study of 18 in-patients. Mean stimulated acid secretion of the cimetidine group was 11.2 +/- 4.3 mmol/h, in the antacid group 12.6 +/- 5.6 mmol/h. Serum gastrin levels were within the normal range in all patients. Within four weeks the ulcers had healed completely in eight of the nine patients on cimetidine (1,000 mg/d), but in only three of the nine patients on antacids (magnesium-aluminiumhydroxide, neutralization capacity 564 mmol/d). The difference is statistically significant (P less than 0.025). All 11 patients with healed ulcers were given prophylactically either 800 mg cimetidine daily or magnesium-aluminiumhydroxide (neutralization capacity 564 mmol/d). During a follow-up period of one year recurrences occurred in two of the five patients on antacids, but in none of the six treated with cimetidine. The results indicate that cimetidine also accelerates the healing of recurrent jejunal peptic ulcers. But further studies are required to elucidate whether long-term treatment with histamine-H2-receptor antagonists is as good as surgery in the long-term prevention of ulcer recurrences.

Adult↗
PubMed1982

[Imaging adrenergic tumours with 131J-meta-benzylguanidine].

Pheochromocytoma scanning using 131J-meta-benzylguanidine was done in one patient with metastasizing paraganglioma, one patient with multiple endocrine neoplasia type IIb. No activity of tumour tissue could be demonstrated in the patient with metastasizing paraganglioma, whereas the pheochromocytoma could be clearly defined in the patient with multiple endocrine neoplasia type IIa. The female with multiple endocrine neoplasia type IIb showed a suspect space-occupying lesion of the left adrenal using computed tomography. Pheochromocytoma could be excluded by 131J-benzylguanidine scanning, selective estimation of catecholamines in adrenal venous blood as well as the glucagon stimulation and clonidine suppression.

Adrenal Gland Neoplasms↗
PubMed1982

[Effect of cimetidine and secretin on acute bleedings from gastroduodenal ulcers and erosions: a prospective study (author's transl)].

In a prospective, alternating study 33 patients with ulcer or stress lesions were treated for active nonarterial bleeding with cimetidine (16 subjects) or synthetic secretin (17 subjects). Persistence of bleeding was confirmed endoscopically before onset. Both drugs were given intravenously over 48 hours. The bleeding was stopped in all 16 patients on secretin without requiring operation. Among the cimetidine-treated patients bleeding stopped in 5 after minor recurrences, while in 11 bleeding persisted or there were severe recurrences. The effect of secretin was significantly better than that of cimetidine after both types of bleeding (P less than 0.01).

Cimetidine↗
PubMed1982

[Ectopic hormone formation in multiple endocrine type IIa neoplasia (author's transl)].

A patient with high-grade osteoporosis had elevated levels of ACTH, cortisol and carcinoembryonic antigen (CEA). Computed tomography demonstrated enlarged adrenal glands. Despite intensive search no ACTH-producing tumour was found. A central Cushing's syndrome was thus possible, and a radiologically normal sella turcica made a microadenoma of the hypophysis a possibility. However, a one-time hypertensive crisis with elevated catecholamines raised the suspicion of an additional phaeochromocytoma and thus provided the first pointer to a multiple endocrine neoplasia. Bilateral phaeochromocytomas, discovered at adrenalectomy, as well as raised serum-calcitonin levels, strongly suggested coexistence of a C-cell carcinoma, which previously had not been demonstrated either by thyroid scanning or fine-needle biopsy. A total thyroidectomy revealed a multifocal and metastasizing C-cell carcinoma. On extraction it contained a high concentration of calcitonin, typical for a C-cell carcinoma. An unusual finding was of ACTH in extracts of both the C-cell carcinoma and the phaeochromocytoma. It was immunologically identical with the synthetic ACTH used as a standard.

Adrenal Gland Neoplasms↗
PubMed1982

[Surgical treatment of gastroduodenal ulcers in the elderly (author's transl)].

In the last 12 years, 239 patients over 65 years old with gastroduodenal ulcers have been operated on in the Surgical Clinic of the University of Mainz. The main indication was gastric ulcer (n = 161), followed by duodenal ulcer (n = 78), including an emergency operation in the event of bleeding and perforation. Mortality was 6.5% in patients with uncomplicated ulcers, 27.7% in those with complications. Billroth I or II stomach resection was performed most frequently. The perforation was oversewn, the abdomen washed and drained. Selective proximal vagotomy is a first-choice method only in the treatment of the uncomplicated duodenal ulcer. Operative results can be considerably improved by operating early on uncomplicated gastroduodenal ulcers. After the appearance of complications, the principles for surgery on old people should be closely observed, i.e. an operation as minor, short and safe as possible.

Aged↗
PubMed1982

[Reoperations for persistent and recurrent hyperparathyroidism (author's transl)].

The results of 26 reexplorations in 24 patients with primary hyperparathyroidism are reported. In 20 patients the disease was classified as persistent, in 3 as recurrent. The diagnosis was confirmed by measurement of calcium and phosphate in serum and urine and by serum-PTH. All patients were symptomatic. Localisation of the tumors was possible by following the embryology and topographical anatomy of the parathyroids during surgery; localization was not as successful in the various preoperative investigations used. Postoperatively, no patient was hypercalcemic. The success rate was 100% for 21 patients, with a follow-up time of more than 6 months. Use of cryopreservation and autotransplantation of the endocrine tissue proved very advantageous; this technique was performed successfully in two of ten hypocalcemic patients and still may be considered in another three patients.

Adenoma↗
PubMed1982

[Effect of calcium and magnesium on parathyroid hormone release from human parathyroid tissue in vitro].

The effects of calcium and magnesium on parathyroid hormone release from eight adenomas causing primary hyperparathyroidism and six hyperplastic glands causing hypercalcemic secondary hyperparathyroidism were investigated in vitro using single cell suspensions from the respective tissue. We observed suppression of parathyroid hormone release with increasing concentrations of either cation. The quantitative hormone secretions of both adenomatous and hyperplastic glands was identical.

Adenoma↗
PubMed1982

An in vitro model for the study of human parathyroid gland tissue: single cell suspensions and monolayer cultures.

An in vitro model for studies of parathyroid physiology is described using single cell suspensions and adherent monolayer cultures of human parathyroid tissue. The isolated cells were viable and maintained functional properties tested by calcium and magnesium sensitivity. Parathyroid hormone (PTH) secretion could be suppressed by rising calcium and magnesium concentrations. The secretory behaviour of the cells was not altered by cultivation or cryopreservation. The morphological integrity of the individual cells after mechanical and enzymatic preparation was confirmed by light and electron microscopy.

Adenoma↗