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Biomedical subjects

W Langsteger

Publications and source records attributed to W Langsteger.

At least 91 records · Page 5Linked to original sources
PubMed1989

[Tl-201 myocardial SPECT in silent myocardial ischemia and angiographically proven coronary heart disease].

Silent myocardial ischemia is defined as true myocardial ischemia without angina pectoris in patients with angiographically detected coronary artery disease. In this study 52 patients (46 male, 8 female: mean age 53 years) with a pathological exercise test but no symptoms were investigated. They showed stenosis of 75% or more of the diameter in at least one coronary segment on angiography. Prior to or after catheterization (within 14 days) Tl-201 SPECT was done and evaluated independently of angiography. A clear correlation between angiographically confirmed stenosis and reversible perfusion defects with Tl-201 SPECT was established (62 out of 76 lesions). Furthermore, there was a significant relation between angiographically detected subtotal or total occlusions of coronary vessels and irreversible perfusion defects using Tl-201 SPECT (35 in 44 lesions) (p less than 0.001). In patients with ST depression but without angina pectoris during the exercise test, the Tl-201 SPECT is highly suited to determine the hemodynamic effect of coronary stenoses.

Angina Pectoris↗
PubMed1989

[Isolated thyroid gland sarcoidosis and hyperthyroidism].

A case of isolated sarcoidosis of the thyroid gland, associated with hyperthyroidism, is reported in a 28-year-old male patient whose thyroid was removed for hyperthyroid multinodular goitre. Histology revealed a regressive adenoma and sarcoidosis in non-adenomatous thyroid residue. Further diagnosis, therapeutic management and a 3-year follow-up did not disclose any specific changes or involvement of other tissues. Isolated thyroidal sarcoidosis with hyperthyroid alterations are extremely rare and mostly chance findings; simultaneous occurrence of thyroid sarcoidosis and hyperthyroidism may be a symptom of gland infiltration for which an adequate explanation is still lacking.

Adult↗
PubMed1989

[Metastatic thyroid cancer: sudden death following aclarubicin therapy].

We report on a 62-year-old patient with a metastasising, only poorly differentiated follicular thyroid carcinoma, who was subjected postoperatively to chemotherapy with Aclarubicin. Aclarubicin (Aclaplastin) is a new cytostatic agent, from the group of anthracyclines, with fewer side effects and clearly diminished cardiotoxicity. The patient died suddenly after two treatment cycles with clinical symptoms of cardiac insufficiency; the post-mortem examination, however, revealed that two metastases in the myocardium might have been the cause of death; toxic myocardial damage could be excluded histologically. Upon occurrence of cardial symptoms and signs during therapy with cytostatic agents of thyroid carcinoma with Aclarubicin, whose cardiotoxic side effects are known, the possibility of metastatic spread in the myocardium should, nevertheless, also always be considered in the differential diagnosis.

Aclarubicin↗
PubMed1989

[Microcirculation in parenteral Ginkgo biloba extract therapy].

15 patients with arteriosclerotic lesions in the extracranial brain arteries, randomly selected, were treated with an infusion of 250 ml physiological NaCl and 25 ml Ginkgo biloba extract (Tebonin). A second group (n = 15) received 250 ml NaCl without drugs stimulating blood flow. The skin microcirculation was measured in vivo by means of a helium-neon laser at one of the 4 extremities. Perfusion increased significantly (p less than or equal to 0.01) in response to Ginkgo biloba extract als composed with the response in the control group. The results justify the administration of Ginkgo biloba extract in vascular diseases.

Aged↗
PubMed1989

A new measuring design for autonomic dysfunction of skin in neuropathies: hyperthermal laser-Doppler flowmetry.

Twenty patients suffering from diabetic neuropathy, 20 patients suffering from alcoholic neuropathy and 20 healthy volunteers within the same age range were studied for the stimulability of microcirculation with a new measuring design. A laser method (laser-Doppler flowmetry) was used to evaluate the increase of the microvascular blood flow of the skin during the hyperthermal phase. It evaluated the degree of increase of microcirculatory blood flow as well as the time from the beginning of hyperthermy to the onset of change in perfusion (the hyperthermal perfusion latency). This was significantly prolonged in both neuropathy groups; the increase of the microvascular blood flow in the diabetic neuropathies was significantly lower than found in alcoholic neuropathies and in healthy volunteers.

Aged↗
PubMed1989

Diagnosis of hepatic hemangioma with 99mTc-labeled red cells: single photon emission computed tomography (SPECT) versus planar imaging.

This paper reports the results of a prospective study carried out to demonstrate the most important advantages of 99mTc-blood pool single emission computed tomography (SPECT) versus the established method of planar scintigraphy (PS) in the non-invasive diagnosis of liver hemangiomas. The study group comprised 40 patients in whom positive evidence of 56 hemangiomas, detected incidentally in the course of screening examinations, was established via SPECT and PS. The sensitivity of SPECT was 51/56 (91%), of PS 22/56 (39.3%); for lesions smaller than 30 mm in diameter, the sensitivity of SPECT was 31/38 (81.6%), of PS 6/38 (15.8%). All lesions with diameters of more than 30 mm were detected by both PS and SPECT. However, the SPECT method proved to be clearly superior in the identification of lesions which were smaller than 30 mm and located in unfavourable topographical sites (dorsal or subphrenic). The study proves that SPECT with 99mTc-labeled erythrocytes is the ideal complement to ultrasonography in the detection of liver hemangionas; its major advantage over TCT (transmission computed tomography) is its safe application in cases with contrast agent intolerance and hyperthyroid patients. Moreover, liver biopsies are dangerous and ill-suited for the verification of diagnosis.

Adult↗
PubMed1989

99mTc-labeled monoclonal anti-carcinoembryonic antigen antibody (BW 431/26). Clinical results in the detection of colorectal carcinomas and recurrences.

With the introduction of 99mTc-labeled monoclonal antibodies against carcinoembryonic antigen (CEA) a clinically relevant extension can be expected in the diagnosis of colorectal tumors by immunoscintigraphy (IS). This study comprises a total of 49 patients (primary colorectal tumors, occult neoplasms, and suspicious recurrences), in whom IS with 99mTc monoclonal antibody (MAb) BW 431/26 was performed. After injection of 1100 MBq 99mTc MAb BW 431/26 a whole-body scan was performed in anterior and posterior projection 5 1/2 h later, and SPECT of the abdominal region was done after 6 and 24 h. In the course of primary tumor identification (n = 20) all coloscopically diagnosed and operatively verified carcinomas were confirmed and correctly localized by IS (n = 11). In three patients with positive IS and suspicious coloscopic findings surgery was refused by patients and relatives. In five cases IS was true negative and in 1 case false positive. In the diagnosis of recurrences (n = 29) IS showed an uptake in computer-tomographically and coloscopically suspicious areas in 17 cases. In 12 cases IS was rated negative (11 true-negative findings in scar and granulation tissue, 1 false-negative finding in para-aortal lymph nodes). Elevated serum CEA levels were found only in 17 of 31 patients with true-positive IS. In postoperative cancer care IS with 99mTc-labeled anti-CEA antibody plays a preeminent role in the exclusion or identification of colorectal recurrences.

Adult↗
PubMed1989

3,5,3'-Triiodothyroacetic acid (TRIAC) effects on pituitary thyroid regulation and on peripheral tissue parameters.

The effects of TRIAC on peripheral thyroid hormones, TSH incretion and peripheral tissue parameters were investigated in 13 mildly obese patients (group I) and 10 volunteers of normal body weight (group II). TRIAC was administered 3 x 1 mg daily over a period of 8 days to both groups. In group I (on a 400 kcal low caloric diet) bTSH and fT4 decreased significantly whereas TT4 decreased only insignificantly. TT3 and fT3 rose significantly due to the cross-reactivity of the employed antibody. The peripheral tissue parameters cholesterol, ankle jerk and systolic time interval did not reveal any changes suggesting an increase in metabolic rate. The increase in heart frequency was not significant either. The significant rise in sex-hormone binding globulin was most probably associated with the weight reduction of 3.1 +/- 1.2 kg per week. In group II (on normal diet) bTSH and fT4 decreased significantly whereas TT4 decreased only insignificantly. As in group I, TT3 and fT3 rose significantly. Also in group II TRIAC did not cause alterations in the peripheral tissue parameters. In contrast to the obese group the volunteers in group II showed no significant rise in sex-hormone binding globulin and no reduction of body weight. Side effects such as nervousness, tremor or palpitations were not observed. Thus, TRIAC does not induce an increase in peripheral metabolic rate, not even under a TSH-suppressive dose as high as 3 x 1 mg per day.

Achilles Tendon↗
PubMed1989

[Ginkgo biloba extract and folic acid in the therapy of changes caused by autonomic neuropathy].

10 patients suffering from neuropathies caused by various diseases and with an autonomic disregulation of skin were treated intravenously with a new combination of 87.5 mg Ginkgo-biloba-extract standardized to 21.0 mg Flavonglycosids and 3 mg folic acid during 14 days. The autonomic nerve-function was measured immediately before onset and after the end of therapy with the hyperthermal laser-Doppler-Flowmetry. Additionally pain, superficial and deep sensibility were described. After the end of treatment the autonomic nerve-function was improved in a significant manner (p less than 0.01). An improvement of the described parameters for pain and for perception could be observed too. Therefore this new combination seems to be suited for treatment of polyneuropathies.

Adult↗
PubMed1988

[Changes in zinc level in the serum, whole blood and erythrocytes in disorders of thyroid function].

The zinc level in serum and whole blood was determined in a series of 121 patients, 20 suffering from overt hyperthyroidism, 34 with manifest hypothyroidism and a control group of 67 euthyroid subjects. The zinc content per deciliter of erythrocytes was calculated from the haematocrit. The hyperthyroid group revealed a highly significantly elevated serum zinc level (p less than 0.01), but a most significantly reduced zinc content in whole blood (p less than 0.001) in comparison with the euthyroid group. On the other hand, the reverse changes were observed in the hypothyroid group, i.e. a most significantly reduced serum zinc content (p less than 0.001) and a highly significantly increased zinc content in whole blood (p less than 0.01). These results suggest that the determination of zinc levels both in serum and in whole blood may be a useful additional parameter of peripheral thyroid hormone effect.

Erythrocytes↗
PubMed1988

[The negative TRH test: new differential assessment using a sensitive TSH assay].

Determination of TSH by the IRMA technique shows improved sensitivity and higher accuracy compared to TSH RIA, so that lower detection limits of 0.1 mU TSH/1 can be easily attained. Basal TSH values (bTSH) between 0.4 and 3.5 mU/l clearly define a euthyroid metabolic state. At a bTSH lower than 0.4 mU/l a TRH test should be performed to exclude latent or overt hyperthyroidism. Stimulated TSH values (sTSH) greater than 2.5 mU/l are considered to be a positive test which rules out hyperthyroidism. A negative TRH test (sTSH less than 2.5 mU/l), on the other hand, is an abnormal result which may have several causes and thus does not per se evidence a hyperthyroid state. In a group of thyroid inpatients, a differential new assessment of the so-called negative TRH test for the exclusion of hyperthyroidism was attempted in 355 patients with blunted TSH response (sTSH less than 2.5 mU/l) by means of a methodologically improved TSH assay (IRMA principle). In overt hyperthyroidism the bTSH was lower than 0.1 mU/l in 42 out of 44 cases (95%); sTSH was in all cases below 0.5 mU/l (100%). 78% of the clinically euthyroid patients had a blunted bTSH (0.1-0.4 mU/l) and a significant (p less than 0.001) increase of sTSH up to 0.5-2.5 mU/l. Excluding the patients treated with L-thyroxine, 147 cases had sTSH less than 2.5 mU/l. Among the 65 patients with sTSH ranging between 0.5 and 2.5 mU/l, 66% were euthyroid and 34% borderline cases from a clinical point of view (mostly compensated autonomous adenomas), but there were no hyperthyroid cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Diagnosis, Differential↗
PubMed1988

[Chronic invasive fibrous thyroiditis (Riedel struma). Case report with special reference to preoperative diagnosis].

Chronic invasive fibrous thyroiditis (Riedel's struma) is a very rare disease of unknown aetiology mainly affecting middle-aged or old female patients. An aggressive fibrosis partly or totally replaces normal thyroid gland tissue. The gland becomes stony hard, is not displaceable and, characteristically, the fibrous tissue penetrates the capsule and infiltrates into surrounding structures such as muscles, vessels, nerves and even the trachea. Riedel's struma is often associated with fibrotic processes in other parts of the body. The preoperative differential diagnosis includes malignant tumours and fibrosing stages of Hashimoto's disease, as well as subacute thyroiditis de Quervain. This paper reports the case of a 60-year-old woman suffering from Riedel's struma and discusses differential diagnostic aspects with regard to preoperative investigation and pathohistology.

Biopsy, Needle↗
PubMed1988

[Presence of islands of fatty tissue in struma].

We examined 929 surgically obtained thyroid glands derived from 791 female and 138 male patients and found intrathyroidal adipose tissue in 18 cases (1.94%). Only the thyroid glands of middle aged and older women (mean age 51 years) were affected, as well as in the case of follicular adenomas and nodular and diffuse hyperplasia. With respect to localization in the interstitial connective tissue, as well as between thyroid follicles, interstitial, parenchymatous and mixed types are proposed. In addition to sex and age there is a high correlation with obesity, which is suggestive of hormonal influences. Knowledge of the presence of intrathyroidal fat tissue is of interest to the pathologist since it may lead to erroneous interpretations of histological and cytological specimens of the thyroid gland. In conclusion, not one case of hypothyroidism was detected amongst the 18 cases investigated in this study.

Adenoma↗