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  • 1
    Electronic Resource
    Electronic Resource
    Iodine-induced thyrotoxicosis — A case for subtotal thyroidectomy in severely ill patients (1985)
    Springer
    Journal of molecular medicine 63 (1985), S. 1-7 
    Details
    ISSN: 1432-1440
    Keywords: Iodine-induced thyrotoxicosis ; Prognosis ; Therapy ; Subtotal thyroidectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Iodine-induced thyrotoxicosis (IIT), due to iodine application in high amounts in patients with circumscript or disseminated thyroid autonomy, is complicated by a prolonged course, mainly due on the body's resistance to conservative therapy with thiourea derivates. Therefore, we decided to perform subtotal thyroidectomy in 16 thyrotoxic patients. This is in contrast to the common opinion that surgery should only be performed after normalization of thyroid hormones. In all 16 patients with severe IIT, including three patients with thyroid storm, hormone levels decreased within a few days after surgery to normal or subnormal values and the clinical picture of thyrotoxicosis disappeared. In the case of thyroid storm the signs of disorientation normalized within 1–3 days. One patient died 5 weeks after surgery due to severe concomitant diseases. One patient exhibited transitory respiration distress and another had postoperative hypocalcaemia. In nine patients L-thyroxine replacement became necessary because of subclinical or clinical hypothyroidism. Only by this procedure will the high intrathyroidal storage of iodine and preformed hormone be extracted. Surgery as a treatment for thyrotoxicosis should be reserved for patients with severe IIT, where conservative treatment has been shown to be ineffective. Furthermore, in rare selected cases, when a rapid normalization is required, surgery without preoperative treatment seems to be justified. The effect of surgery was impressive in all our cases and there were only minor perioperative complications. Thus, it could be shown that subtotal thyroidectomy may be a rational and effective treatment in severe IIT which should be carefully considered and weighed against other types of therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01537479
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  • 2
    Electronic Resource
    Electronic Resource
    37. Praktische Bedeutung gastrointestinaler Hormone in der Chirurgie (Gastrinome, Antrumrest) (1979)
    Springer
    Langenbeck's archives of surgery 349 (1979), S. 189-194 
    Details
    ISSN: 1435-2451
    Keywords: Gastrointestinal hormones ; Pathophysiology ; Endocrine tumors ; Gastrointestinale Hormone ; Pathophysiologie ; Endokrine Tumoren
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Durch die Entwicklung der radioimmunologischen Bestimmungsmethoden und die Entdeckung zahlreicher Polypeptide im Gastrointestinaltrakt sind die gastrointestinalen Hormone Gegenstand zahlreicher Untersuchungen gewesen. Für den Chirurgen sind gastrointestinale Hormone vor allem als Diagnostica sowie in der Behandlung des paralytischen Ileus (CCK) von Bedeutung. Pathogenetisch spielen die GI-Hormone eine Rolle bei der Entstehung von Recidivulcera nach chirurgischer Therapie. GI-Hormon-produzierende Tumoren sind für das Zollinger-Ellison-, das Verner-Morrison- und das Glucagonom-Syndrom verantwortlich.
    Notes: Summary The development of radioimmunoassays and the detection of numerous polypeptides in the GI-tract mucosa have induced extensive research. In surgery GI hormones are of clinical importance in diagnostic procedures and in the treatment of paralytic ileus (CCK). GI hormones play a role in the pathogenesis of recurrent ulceration after surgical therapy. GI-hormone producing tumors are responsible for the Zollinger-Ellison syndrome, VernerMorrison syndrome and the glucagonoma syndrome.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01729494
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  • 3
    Electronic Resource
    Electronic Resource
    138. Die chirurgische Taktik beim primären Magenstumpfcarcinom (1985)
    Springer
    Langenbeck's archives of surgery 366 (1985), S. 600-600 
    Details
    ISSN: 1435-2451
    Keywords: Primary gastric stump carcinoma ; Total gastrectomy ; Palliative surgery ; Prognosis ; Primäres Magenstumpfcarcinom ; Totale Restgastrektomie ; Palliative Resektion ; Prognose
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Der Vergleich der Zeiträume 1949–1974 und 1975–1983 zeigt einen Wandel in der Therapie und Prognose primärer Magenstumpfcarcinome. Der Anteil der resezierbaren Stumpfcarcinome stieg von 23,4% im ersten Beobachtungszeitraum auf 66,7% im zweiten Zeitraum. Wurde von 1949–1974 in mehr als der Hälfte der resezierbaren Fälle eine subtotale Nachresektion durchgeführt, stieg die Zahl der totalen Restgastrektomien von 1975–1983 auf 85%. Nahezu die Hälfte aller Resektion wurden wegen Lymphknotenmetastasen oder einer Infiltration des Malignoms in die Leber als Palliativeingriffe vorgenommen. Im Gegensatz zum Magencarcinomrezidiv infiltriert das Magenstumpfcarcinom nach Ulcusresektion erst sehr spät das Jejunum, deshalb können auch große Malinome reseziert werden.
    Notes: Summary Comparision of the period 1949–1974 and 1975–1983 shows that treatment of primary gastric stump cancer after ulcer surgery has changed. The number of gastric stump resections increased from 23.4% in the first period to 66.7% in the second period. From 1949 to 1974, subtotal gastrectomy was performed in more than 50% of the resectable cases; in the second period, 85% of the resectable carcinomas were removed by total gastrectomy. Almost 50% of the resected stomachs had lymphnode metastases or infiltration of the liver by the tumor, so that the gastric resection was done as palliative operation. In contrast to recurrent gastric cancer, primary gastric stump cancer infiltrates the jejunum very late; therefore, large stump carcinomas are resectable.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01836737
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  • 4
    Electronic Resource
    Electronic Resource
    105. Operationsstrategie bei gastrointestinalen endokrinen Tumoren (1983)
    Springer
    Langenbeck's archives of surgery 361 (1983), S. 569-569 
    Details
    ISSN: 1435-2451
    Keywords: Gastrointestinal hormones ; Localisation ; Enucleation ; Resection ; Gastrointestinale Hormone ; Lokalisation ; Enucleation ; Resektion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Endokrine Tumoren des Gastrointestinaltraktes sind durch die Entwicklung hochempfindlicher sensibler radioimmunologischer Meßmethoden zur Bestimmung der Hormonkonzentrationen vermehrt in den Blickpunkt des klinischen Interesses getreten. Verschiedene Symptomenkomplexe wie organischer Hyperinsulinismus, Zollinger-Ellison Syndrom, Verner-Morrison-Syndrom, Glucagonom-Syndrom, etc. konnten Hormonproduzierenden Tumoren zugeordnet werden. Durch eine exakte Lokalisationsdiagnostik ist eine Identifizierung kleiner Tumore möglich, die häufig kurativ enucleiert werden können. Beim Gastrinom dagegen sind häufig ausgedehnte Resektionen vorwiegend des Pankreas notwendig.
    Notes: Summary Endocrine tumors of the gastrointestinal tract are of major clinical interest after the development of highly sensitive specific radioimmunological methods for the determination of hormone plasma concentrations. Several diseases can be attributed to hormone-producing tumors such as organic hyperinsulinism, Zollinger-Ellison-syndrome, Verner-Morrisonsyndrome, glucagonoma-syndrome, etc. The identification of even small tumors by an exact localisation procedure is possible which allows to cure the diseases by enucleation of the tumors. Mainly in gastrinoma patients more extended resection procedures, mainly of the pancreas, are indicated.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01275930
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    Paper (German National Licenses)
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