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  • 1
    Electronic Resource
    Electronic Resource
    Calcium- und Knochenstoffwechsel nach Gastrektomie (1997)
    Springer
    Der Chirurg 68 (1997), S. 784-788 
    Details
    ISSN: 1433-0385
    Keywords: Key words: Calcium metabolism ; Bone metabolism ; Gastrectomy ; Therapy ; Review. ; Schlüsselwörter: Calciumstoffwechsel ; Knochenstoffwechsel ; Gastrektomie ; Therapie ; Übersicht.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Nach Magenresektion oder Gastrektomie sind Störungen der Calcium- und Knochenstoffwechsels bekannt. Wahrscheinlich kommt es postoperativ aufgrund einer verminderten Calciumabsorption zu einem Abfall des Serumcalciums. Als Gegenregulation wird Parathormon ausgeschüttet und 1,25-(OH)2-Vitamin D neu gebildet, welche beide Calcium aus dem Knochen mobilisieren. Bei einem Teil der Patienten kommt es in der Folge zu einer Abnahme der Knochenmasse mit einem erhöhten Frakturrisiko. Bisher liegen keine anerkannten Behandlungsempfehlungen dieser Störungen vor, lediglich die Substitution von Vitamin D und Calcium wurde wiederholt empfohlen. Es wird eine Übersicht über die derzeitigen Vorstellungen zur Regulation des Calcium- und Knochenstoffwechsels nach Gastrektomie gegeben.
    Notes: Summary. Disturbances in calcium and bone metabolism after gastrectomy have long been recognized. It has been suggested that due to impaired calcium absorption after gastrectomy, serum calcium is decreased, being counterregulated by parathyroid hormone release and 1,25-(OH)2-vitamin D formation. Both parathyroid hormone and 1,25-(OH)2-vitamin D are known to release calcium from bone, resulting in bone mass loss and increased fracture risk in some of the gastrectomized patients. No therapy is currently generally agreed on, although supplementation of vitamin D and calcium has been suggested repeatedly. A review on the current understanding of calcium and bone metabolism after gastrectomy is given.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001040050270
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  • 2
    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
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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