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Biomedical subjects

O Eber

Publications and source records attributed to O Eber.

At least 73 records · Page 4Linked to original sources

Misinterpretation of iodine uptake in papillary thyroid carcinoma and primary lung adenocarcinoma.

This is the first case report of an iodine-storing metastasising carcinoma of extrathyroidal origin and the simultaneous presence of a papillary thyroid carcinoma. In the course of the disease, an increase in pathological iodine uptake was observed after repeated iodine-131 ablation, so that the original tentative diagnosis of a metastasising, differentiated thyroid carcinoma appeared to be confirmed; moreover, the histological work-up of a femur metastasis--without adequate immunohistochemical assessment--was misinterpreted. What is also remarkable about this case report is a pathological iodine-131 uptake both in the extrathyroidal primary tumor and the metastases.

Adenocarcinoma↗

The effect of D- versus L-propranolol in the treatment of hyperthyroidism.

The purpose of this study is to determine whether there is a difference in treatment of hyperthyroidism using either the D- or L-isomer of propranolol. Two groups of 20 patients with overt hyperthyroidism received either 120 mg L- or D-propranolol each for a period of 5 days. In the D-propranolol administered group there was a significant decrease in TT3 and fT3 plasma levels and in the ratio of TT3 to TT4; however, a significant increase occurred in rT3 values up to day 5. On the other hand, L-propranolol treatment resulted in a less pronounced decrease in TT4 and TT3 values, while all other thyroid hormone levels remained unchanged as, above all, did the T3/T4 ratio. The well known effect of D,L-propranolol upon peripheral conversion of T4 to T3 is thus not due to the beta-blocking action of L-propranolol but is mainly conditioned by the D-isomer which has no beta-blocking action itself.

Adult↗

Chromatographically purified immunoglobulin G of endemic and sporadic goiter patients stimulates FRTL5 cell growth in a mitotic arrest assay.

A strain of differentiated rat thyroid cells (FRTL5) in continuous culture was used to study the presence of thyroid growth-promoting immunoglobulins (TGI) in the serum of patients with endemic and sporadic euthyroid goiters. To identify true in vitro cell proliferation a microscopic mitotic arrest assay was used. Immunoglobulins G (IgGs) were prepared with QAE-Sephadex A-50 or protein-A-Sepharose. A positive growth stimulation index was found in IgG preparations of 65 of 71 patients with endemic goiter and in 9 of 14 IgG preparations of patients with sporadic goiter. IgG preparations of 15 control subjects from an area where endemic goiter due to iodine deficiency does not occur and of 18 subjects without iodine deficiency and without thyroid enlargement living in the endemic area did not stimulate FRTL5 cell growth. FRTL5 cell growth stimulation with IgGs of these euthyroid goiter patients could only be detected when IgG was tested in combination with a small dose of TSH. Immunoprecipitation with polyclonal and monoclonal antihuman IgG was able to abolish the growth-promoting effects. In 32 blinded samples the Feulgen cytobiochemical assay, formerly used to detect TGI, was compared with the FRTL5 mitotic arrest assay. The two methods showed similar results. Our observations of chromatographically purified IgG promoting thyroid cell proliferation in vitro provide good evidence that IgG was responsible for thyroid cell growth in vitro and suggest that autoimmune growth mechanisms may be involved in the pathogenesis of both endemic and sporadic goiters.

Adult↗

[Effect of dextran 40,000 on collagen-induced platelet aggregation].

In blood samples of 12 healthy male volunteers under 50 years old the collagen induced platelet aggregation and the influence of a new 10% dextran 40.000 (Dextran Ebewe) was studied. Dextran was added to the samples with a concentration from 10 microliters up to 50 microliters/ml blood. In a concentration of 20 microliters/ml blood a significantly reduced collagen induced platelet aggregation was be observed. Higher dosages did not differ in a significant manner from this effect.

Adult↗

Differentiation of lymph-node metastases by anti-CEA immunoscintigraphy in a patient with follicular thyroid and breast cancer.

Supraclavicular lymph node metastases appeared in a female patient six years after thyroidectomy, radioiodine therapy and external radiation for a follicular thyroid carcinoma and four years after mastectomy and lymphadenectomy for an invasive ductal breast cancer. It was not possible either by conventional imaging methods or by serological methods, to assign the metastases to one of the two primary tumors. Anti-CEA immunoscintigraphy and SPECT of the cervicothoracic region showed a circumscribed pathological uptake of 99mTc-labeled anti-CEA antibodies in the area of the supraclavicular lymph nodes. The preoperative suspicion of lymph-node infiltration by CEA-expressing breast cancer cells was confirmed histologically after surgical removal of the lymph nodes.

Adenocarcinoma↗

Thyroid growth promoting serum-IgG in endemic goiter.

In this study a strain of differentiated rat thyroid cells in continuous culture was used to detect the presence of thyroid growth promoting immunoglobulins (TGI) in IgG preparations of serum of patients with endemic and sporadic euthyroid goiters. TGI was detected when FRTL5 cells were used in a mitotic arrest assay by costimulating the cells with IgG and a suboptimal dose of TSH. TGI was present in 65 of 71 endemic goter cases and in 9 of 14 sporadic goiter cases.

Autoantibodies↗

Transient prealbumin-associated hyperthyroxinemia in TSH-producing pituitary adenoma.

This case report describes a 38-year-old male who was hospitalized for further clarification of clinically mild hyperthyroidism. His increased total hormone levels, the elevated free thyroid hormones and the elevated basal TSH with blunted response to TRH strongly suggested a pituitary adenoma with inappropriate TSH incretion. Transmission computed tomography showed an intrasellar expansion, 16 mm in diameter. The neoplastic TSH production was confirmed by an elevated alpha-subunit and a raised molar alpha-sub/TSH ratio. However, T4 distribution on prealbumin (PA, TTR), albumin (A) and thyroxine binding globulin (TBG) showed a clearly increased binding to PA (39%), indicating additional prealbumin-associated hyperthyroxinemia. The absolute values of PA, A and TBG were within the normal range. After removal of the TSH-producing adenoma, basal TSH, the free thyroid hormones and T4 binding to prealbumin returned to normal. Therefore, the prealbumin-associated hyperthyroxinemia had to be interpreted as a transitory phenomenon related to secondary hyperthyroidism (T4 shift from thyroxine binding globulin to prealbumin) rather than a genetically conditioned anomaly of protein binding.

Adenoma↗

Immunoscintigraphy of inflammatory processes with a technetium-99m-labeled monoclonal antigranulocyte antibody (MAb BW 250/183).

Antigranulocyte immunoscintigraphy with a technetium-99m- (99mTc) labeled monoclonal antigranulocyte antibody (MAb BW 250/183) was performed in 34 in-patients of the departments of accident surgery and internal medicine in order to prove or exclude inflammatory processes. After labeling with 99mTc, 555 MBq, 99mTc-MAb (0.5 mg antibody) were slowly injected intravenously over a period of 5 min. A whole-body scan was done 4-6 hr postinjection, and planar or SPECT images were performed 6, 18, and 24 hr postinjection. Leukocyte immunoscintigraphy proved inflammatory suppurating processes in 20 cases (true-positive) and excluded them in 11 cases (true-negative). The findings were false-positive in two patients (hematoma without signs of infection, pseudoarthrosis) and false-negative in one patient (encapsulated lung abscess with pleural fibrosis). Anti-idiotypic human anti-mouse antibodies (HAMA) were found only in one out of 20 patients. According to our experiences, immunoscintigraphy with 99mTc-MAb BW 250/183 has a sensitivity of 95%, and is, therefore, well suited for the identification of leukocytic inflammations.

Abscess↗

Lipoma of the liver: computed tomographic, ultrasonographic, and cytologic findings.

A hepatic lesion, manifest for several years in a 59-year-old female patient, was diagnosed as lipoma in the pre-contrast scan because of its attenuation value (-87 Hounsfield units (HU)); in addition, diagnosis was confirmed by aspiration cytology. In this case report the great merit of transmission computed tomography (TCT) is demonstrated, and ultrasound patterns and possible histogenetic origin of this neoplasm are discussed. The lipomatous liver tumors described in the literature with attenuation values of less than -60 HU are merely mixed tumors with lipomatous amounts of various sizes, whereas in true lipomas attenuation values from -80 to -120 HU have been measured.

Biopsy↗

Thyroid infiltrating dendritic cells, epitheloid cells and giant cells in iodine deficiency.

This study describes dendritic cells in thyroid sections of iodine deficient goiters. Cells were characterized by monoclonal markers and detected by immunohistochemistry and double labelling immunofluorescence. We observed dendritic cells located in focal aggregates in the interstitium and epitheloid cells as well as multinucleated giant cells filling thyroid follicles. All these cells showed strong positivity for the MHC class II molecules HLA-DR, -DQ, -DP and RFD1, a monoclonal marker for active antigen presenting cells.

Antigen-Presenting Cells↗

201Tl myocardial SPECT and beta-endorphin levels in patients with suspected silent ischemia.

Today silent myocardial ischemia (SMI) is a well-recognized phenomenon. However, in the absence of clinical signs suggesting coronary artery disease (CAD), a streamlined diagnostic approach for precise clarification has proved to be difficult. Sensitivity and specificity of ergometric results are rather poor in symptom-free patients. Thus the question arises, whether the necessity of coronary angiography can be established more precisely by 201Tl myocardial SPECT in these patients. Treadmill exercise according to the Bruce protocol, 201Tl myocardial SPECT and coronary angiography were performed in a total of 106 patients with suspected SMI. In group I (high probability of ischemia; n = 46), reversible defects detected by SPECT correlated well with significant stenoses and irreversible defects with subtotal stenoses or complete occlusions. SPECT sensitivity in the detection of ischemia was 91%, its specificity 96%. In group II (low probability of ischemia; n = 60), SPECT sensitivity was as high as in group I (94%) but due to a high number of false-positive results (e.g. cardiomyopathy) specificity was only 75%. However, SPECT was superior to exercise ECG (sensitivity 70%; specificity 56%) in the detection of SMI. In addition, beta-endorphin levels were determined in 180 healthy subjects, 37 patients with symptomatic CAD and in 34 patients with SMI before and during maximum exercise. Exercise values in patients with SMI were significantly higher than in healthy subjects or in patients with symptomatic CAD.

Adult↗

[Clinical significance of Tl-201/Tc-99m subtraction scintigraphy as a parameter for surgical indication of cold struma nodules].

In a retrospective study Tl-201/Tc-99m subtraction scintigraphy (method acco. to Ferlin et al.) was performed in addition to Tc-99m scintigraphy, sonography and fine needle puncture in 400 patients. Postoperative histological evidence was available of all patients (carcinomas [n = 31], follicular and oncocytic adenomas [n = 235], nodular hyperplasia, Hashimoto's thyroiditis, Riedel's struma and de Quervain's thyroiditis [n = 134]). With regard to possible malignancy the sensitivity, in case of positive Tl-201 uptake was 85%. As however, adenomas also have a high tendency towards isolated Tl-201 uptake, the specificity for malignant growth was 62%. Thus Tl-201/Tc-99m subtraction scintigraphy is well suited as a criterion to exclude thyroid carcinomas; on the other hand, a positive Tl-201 uptake is not a fail-safe indication of malignant processes. At best it suggests the occurrence of autonomous growth and can thus, in addition to sonography and fine needle biopsy, serve as an aid in the decision as to whether surgical intervention is indicated.

Adenocarcinoma↗