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Biomedical subjects

W Langsteger

Publications and source records attributed to W Langsteger.

At least 73 records · Page 4Linked to original sources
PubMed1990

[Iodine supplementation in the province of Styria].

As far back as 1898 the Austrian Nobel price winner Wagner von Jauregg was the first to recommend iodination of salt as prophylaxis against endemic goitre (prevalence 48%) and cretinism (greater than 10%). In 1923 he achieved in a voluntary iodine supplementation of 5 mg KJ/kg table salt, which only lasted for a number of years. It was in 1963 when finally a mandatory iodized salt prophylaxis was introduced at the rate of 10 mg KJ/kg. In this study the effect of 25 years of iodine supplementation is investigated: Endemic cretinism, hypothyroidism, and goitre in newborns disappeared generally and endemic goitre in pupils was significantly reduced. However, due to epidemiological studies at elementary and secondary schools and army recruitment examinations we still found out endemic goitre grade I (according to WHO) mainly in female juveniles. Examinations were done by palpation, ultrasonography and urinary iodine excretion. In the above as well as in the urine of newborns and in mother's milk the iodine content was significantly lower than in iodine rich countries. Consequently a higher iodination of salt at the rate of 20 mg KJ/kg was recommended by the Austrian Society of Nuclear Medicine in 1985. This suggestion was taken up by the Austrian authorities and it will finally be instituted by law in May 1990 for the benefit of coming generations.

Adolescent↗
PubMed1990

Localization of mediastinal parathyroid adenoma by T1-201 scintiscan and SPECT.

A 64-year-old female patient was admitted to our department for fatigue, pain in the right upper abdomen, obstipation, and meteorism. The laboratory findings showed total calcium and ionized calcium elevated, phosphate close to lower limit, and parathyroid hormone increased. T1-201/Tc-99m subtraction scintiscan of the neck and upper mediastinal region did not give any evidence of isolated enhanced uptake suggesting the presence of parathyroid adenoma. After further increases in calcium and parathyroid hormone level T1-201 whole-body scan and single photon emission computed tomography of the thoracic region were performed. These revealed a circumscribed T1-201 uptake in the mediastinum immediately cranial ventral to the heart base. The postcontrast transmission computed tomography of this area confirmed the finding of the T1-201 scintigraphy with a 4 x 3 x 2 cm tumor. After sternotomy and surgical removal of the mediastinal parathyroid adenoma (chief cell adenoma), calcium and parathyroid hormone levels returned to normal values.

Adenoma↗
PubMed1990

[Erythrocyte elongation with 10% dextran 40,000: comparison of 2 substances].

A dosage-effect-study with two 10% dextrans 40,000 was carried out in 12 venous blood samples of healthy men aged from 21 to 45 years. Dextran A (trade name: Dextran 40,000 "Ebewe") and Dextran B (trade name: "Rheomacrodex") were added in dosages of 0.5 to 10 mg/ml whole blood and the elongation-index of erythrocytes at shearrate 50/sec was determined. From 1 mg up to 10 mg/ml the elongation-index in Dextran B showed a stronger decrease than in Dextran A. Under the highest dosage the difference was about 20%. So it was possible to show that in spite of identical molecular weight there are different effects on deformability of erythrocytes. This should be taken into account for parenteral treatment.

Adult↗
PubMed1990

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↗
PubMed1990

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↗
PubMed1990

[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↗
PubMed1990

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↗
PubMed1990

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↗
PubMed1990

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↗
PubMed1990

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↗
PubMed1990

[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↗
PubMed1990

Long term follow-up after enucleation and resection for autonomously functioning thyroid nodules.

The aim of the study was to evaluate the influence of the operative method (i.e. std. resection vs. enucleation) on postoperative function of the thyroid. Uni- or multifocal thyroid autonomy was resected (group I & III) or selectively enucleated (group II & IV). Postoperative function was determined after 6 and 12 months and again after 3-5 years. "Selective" treatment showed minor postoperative hypothyroidism, but goitrous, nodular or functional disorders are more often present compared to resection cases (4.4% vs 12%).

Adenoma↗