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C Reiners

Publications and source records attributed to C Reiners.

At least 181 records · Page 10Linked to original sources
PubMed1985

[The suppression test in the control of the course of antithyroid drug therapy: renaissance of an in vivo nuclear medicine procedure?].

Measurements of thyroidal suppressibility by thyroid hormones belong to the diagnostic program in nuclear medicine for more than 30 years. Suppression tests are used in follow-up of antithyroidal treatment to predict remission or relapse of hyperthyroidism. Recently, the number of publications dealing with suppression tests has been increasing. Apparently, non-suppressibility of the thyroid after antithyroidal treatment for about 1 year corresponds to a rate of relapse of about 70% whereas in the case of a positive suppression test, the relapse rate amounts to about 20% only. The diagnostic procedures described in the literature are different with respect to radiopharmaceuticals, activity doses, thyroid hormone suppression and, above all, to the time of uptake measurements. After a critical discussion of the literature, a modern diagnostic procedure for the suppression test is proposed using 123I or 99mTc and a computer-assisted gamma camera.

Antithyroid Agents↗
PubMed1985

The influence of dietary fiber on gastric transit time.

Little is known about the effect of dietary fiber on gastric emptying. At present, we do not know whether any therapeutic effects result from delayed gastric transit time. Functional scintigraphy was used to determine the effect of wheat bran, guar and pectin on the transit time of 200 ml fruit juice and 200 or 400 ml of a liquid test meal in normal healthy subjects. The transit time of fruit juice was significantly delayed by the addition of 4 g guar (viscosity 7079 mPA X s). Neither wheat bran, pectin nor guar resulted in a delay of the test meal transit time despite maximal increases in viscosity of up to 21,500 mPa X s. We therefore conclude that dietary fiber does not significantly delay the gastric transit time of test meals regardless of the increase in viscosity. The reduction in postprandial glucose levels after ingestion of guar or pectin is, therefore, probably not due to delayed gastric emptying.

Beverages↗
PubMed1985

[111In-oxine marked leukocytes: a method for diagnosing the location and evaluating the activity of Crohn disease and ulcerative colitis].

Patients with Crohn's disease (n = 22), ulcerative colitis (n = 5), inactive Whipple's disease (n = 1), irritable bowel syndrome (n = 2), arthritis (n = 1) and Yersinia infections (n = 2) were examined with 111In-oxine labelled "mixed" leukocyte preparations (n = 12) or with 111In-oxine labelled "pure" granulocyte preparations (n = 21). Compared with barium enemas of the gut and colonoscopy, performed within of one week in 31 patients there was a correct location of infiltrated bowel segments in 24 patients (78%). The scan diagnosed more infiltrated segments in 4 patients (13%). In 3 patients it failed to diagnose one inflamed segment. In 24 patients the faecal 111In-excretion was expressed as percentage of the reinjected 111In-activity. All patients with non inflammatory bowel diseases and patients with inactive inflammatory bowel diseases excreted less than 2% of the reinjected 111In-activity. All but one female patient with active bowel disease excreted more than 2%. In 24 patients the correlation of ESR, CDAI and A.I. was available. There was a good correlation between ESR (r = 0.77, P less than 0.001), A.I. (r = 0.61, p less than 0.001) and the %-faecal faecal excretion. The 111In-labelling of white blood cells, especially of granulocytes, seems to be a reliable alternative method to localize infiltrated bowel segments and to assess disease activity in patients with inflammatory bowel diseases, compared to usually performed radiological, endoscopical and clinical methods.

Adult↗
PubMed1984

[Metastatic differentiated thyroid cancer. Diagnostic accuracy of thyroglobulin-RIA in comparison with 131I-whole body scintigraphy].

In a retrospective analysis in patients with differentiated thyroid carcinoma, the diagnostic validities of 131I whole-body scans and radioimmunologic determinations of thyroglobulin (hTg) are compared with special regard to late metastases. Metastases were found in 83 out of 311 patients with differentiated thyroid carcinoma. In two thirds of the cases, these were primary metastases while in the remaining third of the cases, metastases developed in later follow-up with a mean time of latency of 3.3 years. While about 70% of the early metastases could bei detected by 131I scintigraphy, this percentage amounted to only 40% in late metastases. With a diagnostic sensitivity of 90%, hTg-RIA was clearly superior in the detection of early as well as of late metastases. hTg was measurable, however, only in iatrogenous hypothyroidism in 4 out of 49 cases. Based on these results and an analysis of the literature, a program for follow-up of differentiated thyroid carcinoma is proposed. The hTg-RIA is thereby used as an alternative to 131I scintigraphy in the late phase of follow-up after complete ablation of any thyroid tissue.

Adenocarcinoma↗
PubMed1983

[Differential diagnosis of thyroid nodules. Sonography as a complement to scintigraphy and puncture cytology].

The place of ultrasound in the diagnosis of thyroid nodules was assessed in 384 patients by comparing its findings with those obtained on palpation, scintigraphy, fine-needle cytology and (in 45 cases) histology. Further diagnosis of scintigraphically "cold" nodules is the main indication for ultrasound examination in goitre-endemic areas. In 13 of 69 cases of a cold nodule with complex or echo-poor echo image proved it to be malignant, while in 74 with cold nodules but with a normal or increased echo pattern there was no malignant tumour. Thus, if the echo pattern is "complex" or "echo-poor" urgency of surgical intervention is strengthened, while with echo-normal or echo-rich nodules or cysts indications for operation are relative. In future, a combination of scintigraphy, ultrasound and cytology (ultrasound-guided small-needle biopsy) will give the highest rate of diagnostic accuracy in the differentiation of malignant from benign thyroid lesions.

Biopsy, Needle↗
PubMed1983

[Direct and indirect parameters for free thyroxine. II. Diagnostic accuracy in disorders of thyroid function and binding protein anomalies].

Part II of the study concerning the clinical applicability of direct and indirect parameters for free thyroxine evaluates the diagnostic accuracy of the FT4-RIAs ImmoPhase, GammaCoat, Liquisol, Amerlex and LisoPhase in relation to FT4 index and T4/TBG ratio. This comparison of methods is done on a thoroughly classified collection (n = 640) of patients with normal and impaired thyroid function including patients with binding protein anomalies (pregnancy, estrogen-medication, phenytoin therapy, renal protein loss). FT4 normal ranges of a given kit harmonize well with data of the manufacturers and of the literature. On the other hand, the normal ranges of the various kits are not comparable. The differentiation of euthyroidism from hyper- or hypothyroidism can be made without problems using any of these methods, with the exception of the FT4-RIA GammaCoat. As expected, patients with euthyroid goiter show, on the average, slightly lower parameters for FT4. In pregnancy all direct and indirect parameters for FT4 have a tendency to lower values after the first trimester. This trend is most distinct for the T4/TBG ratio. A weak negative correlation of FT4 parameters with basal TSH, which does not exceed the upper normal range, however, can be interpreted in the sense of a relative hypothyroxinemia. Under contraceptive estrogen medication FT4 parameters do not fall outside the normal range, with the exception of the FT4-RIA ImmoPhase assay which yields a significantly increased frequency of high FT4 levels. On therapy with phenytoin FT4 values are generally lower than in controls. FT4 parameters in patients with renal protein loss of more than 2 g daily do not behave uniformly. While three of the FT4-RIAs tested (ImmoPhase, GammaCoat, Amerlex) show a tendency to lower values, the results of the remaining FT4 parameters do not differ significantly from the distribution of normals. The study leads to the conclusion that indirect FT4 parameters are still useful in the diagnosis of thyroid function; currently available FT4 radioimmunoassays may yield comparable results. With regard to the varying quality of the various commercial test kits, the choice between FT4-RIAs and indirect FT4 parameters does not depend primarily on clinical but on technical viewpoints.

Adult↗
PubMed1983

[Direct and indirect parameters of free thyroxine. I. Method, quality control and in vitro experiments on storage of samples and effect of drugs].

The clinical applicability of direct FT4 determinations by the radioimmunoassays ImmoPhase, GammaCoat, Liquisol, Amerlex and LisoPhase is tested in comparison to the FT4 index and the T4/TBG ratio. Part I of this study deals with technical aspects concerning quality control as well as with in-vitro experiments concerning storage of samples and interference of drugs. The precision of FT4-RIAs is satisfactory; inter-assay coefficients of variation are generally lower than 10% for medium hormone concentrations. Because of a change of the standard curve calibration by the manufacturer of the Liquisol kit, the inter-assay variability (17%) of this assay is unacceptably high. The comparison of working ranges shows that the sensitivity of all FT4 assays is sufficient. However, the upper limits of working ranges of the Liquisol and LisoPhase kits are too low. Storing the samples in form of serum yields lower values for any FT4 parameter than storing as whole blood. This unexpected observation is true for room temperature as well as for refrigeration at 4 degrees C. To be sure, the values of indirect FT4 parameters from serum and whole blood coincide somewhat better especially when the samples are stored in the refrigerator. Repeated thawing and refreezing does not influence the results of FT4-RIAs significantly. In vitro testing of drug interferences by addition of therapeutic doses of primidone, phenobarbital, phenytoin and acetylsalicylic acid yields significant effects only for the last quoted pharmaceutical. While the FT4 levels of the Liquisol and LisoPhase assays rise with the acetylsalicylic acid dose according to expectations, the values of the Amerlex and GammaCoat assays decrease. With regard to handling of the tests, there are no special technical problems for all FT4-RIAs tested.

Aspirin↗
PubMed1982

[Possibilities and limits of thyroid sonography in the diagnosis of thyroid cancer].

The echographic appearance of 19 histologically confirmed malignant thyroid tumours has been analyzed. The value of information by ultrasonography is compared to scintigraphy and fine-needle aspiration biopsy. All patients demonstrated a sonographic pattern of relatively low amplitude, sparse and disordered echoes. Extended thyroid tumours (T2-3) exhibited a serrated marginal border as a sign of the infiltration to the surrounding thyroid tissue. The clinically important separation of solid and cystic nodules can always be made with certainty. Provided that a subtile examination technique is used, ultrasonography can be of great value in choosing the adequate therapy in scintigraphic cold nodules. Diagnostic ultrasound also yields information concerning the reliable and reproducible classification and accurate location of circumscribed thyroid lesions. In all cases, however, the ultrasound pattern did not provide reliable clues as to their histology. A successful differentiation between benign and malignant solid nodules can be obtained only by cytology and histology. Ultrasonography, scintigraphy and aspiration biopsy, therefore, are complementary methods.

Adenocarcinoma↗
PubMed1981

[Bone density and thyroid gland function in adolescents in relation to fluoride content of drinking water].

In 26 adolescents between 13--15 years of age living in a region with increased fluoride concentration in drinking water (3 ppm = 3 mg NaF/l) bone density-measurements by an I-125 profile scanner as well as measurements of thyroid function by means of numerous in vitro tests (T3U, T4, FT4-Index, RIA-T3, rT3, hTg, TSH, thyroglobulin and microsomal thyroid antibodies) have been done. Comparing 19 adolescents of same age from a region with low fluoride concentration in the drinking water (0,1--0,2 ppm) the study showed no influence of fluoride content of drinking water on skeleton mineralization and on thyroid function. There was found only--not depending on fluoride concentration--an increased bone density in females that was interpreted as a physiological difference between males and females.

Adolescent↗
PubMed1981

Thyroid hormone changes in obese subjects during fasting and a very-low-calorie diet.

Total fasting was compared with VLCD (1.28 MJ, 300 kcal/day; 56 g protein, 12 g CHO) in 14 euthyroid obese patients, selected as matched pairs, over a period of 28 days. The weight loss was significantly greater during fasting than during the VLCD (16.5 kg vs. 12.7 kg). The basal metabolic rate of (BMR) showed a significant decrease (25 per cent) during total fasting, but was unchanged with the VLCD. With both diets there was a transient increase in T4, FT4 and FT4I, and a tendency for TSH to decrease. There was a decrease in T3 and a transient increase in rT3. Nitrogen balance was attained in five of seven patients on the VLCD after four weeks.

Adult↗
PubMed1980

[Evaluation of functional scintigraphy of gastric emptying by the principal component method (author's transl)].

Gastric emptying of a standard semifluid test-meal, labeled with 99mTc-DTPA, was studied by functional scintigraphy in 88 subjects (normals, patients with duodenal and gastric ulcer before and after selective proximal vagotomy with and without pyloroplasty). Gastric emptying curves were analysed by the method of principal components. Patients after selective proximal vagotomy with pyloroplasty showed an rapid initial emptying, whereas this was a rare finding in patients after selective proximal vagotomy without pyloroplasty. The method of principal components is well suited for mathematical analysis of gastric emptying; nevertheless the results are difficult to interpret. The method has advantages when looking at larger collectives and allows a separation into groups with different gastric emptying.

Evaluation Studies as Topic↗