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Biomedical subjects

G Görtz

Publications and source records attributed to G Görtz.

12 recordsLinked to original sources
PubMed1998

Prophylactic thyroidectomy in 75 children and adolescents with hereditary medullary thyroid carcinoma: German and Austrian experience.

When mutations of the RETproto-oncogene were found in 1993 to account for hereditary medullary thyroid carcinoma (MTC), surgeons obtained the opportunity to operate on patients prophylactically (i. e., at a clinically asymptomatic stage). Whether this approach is justified, and, if so, when and to which extent surgery should be performed remained to be clarified. A questionnaire was sent to all surgical departments in Germany and Austria. All of the patients who fulfilled the following criteria were enrolled: (1) preoperatively proved RET mutation; (2) age </= 20 years, (3) clinically asymptomatic thyroid C cell disease; and (4) TNM classification pT0-1/pNX/pN0-1/M0. Seventy-five patients were identified, and fifteen mutations were detected in six codons. Two adolescents had unilateral pheochromocytomas as part of the multiple endocrine neoplasia II (MEN-II) syndrome. No hyperparathyroidism was noted. All patients underwent total thyroidectomy, and 57 patients went on to have lymph node dissection. Parathyroid glands were removed in 34 patients and autografted in 11. Histopathology revealed MTC in 46 patients (61%, youngest 4 years); C cell hyperplasia (CCH) only was detected in the other 29 patients. Three patients had lymph node metastases (LNMs) the youngest being age 14 years. Calcitonin levels were not useful for differentiating between CCH and MTC, but in all patients with LNMs at least the stimulated calcitonin levels were assayed. After surgery, five patients (6.7%) sustained permanent hypoparathyroidism, and one patient (1.3%) had a permanent unilateral recurrent nerve palsy. All but three patients (96%) were biochemically cured. In conclusion, prophylactic total thyroidectomy can be performed safely in experienced centers. We recommend prophylactic total thyroidectomy at age 6. Cervicocentral lymph node dissection should be included when calcitonin levels are elevated or if patients are older than 10 years. Bilateral lymph node dissection should be performed if LNMs are suspected or when patients with elevated calcitonin are older than 15 years.

Adolescent↗
PubMed1997

[Local antiseptic and anti-endotoxin measures in intra-abdominal infections].

With standardized operating strategies, a lethality rate of 10.2% was achieved following intra-abdominal administration of taurolidine in 352 cases of severe intra-abdominal infection. The extent and type of antibacterial therapy were determined on the basis of the clinical severity, the patient's age, and the original site of the infection. Local antisepsis includes tactical surgery and the use of locally and systemically acting taurolidine. Antibiotics were used for systemic antibacterial therapy. After laparoscopical clearance of the focus of infection (appendix, gall bladder) the operating time was significantly extended compared with that required for open surgery, while the postoperative complication rate and the length of stay in hospital were significantly reduced.

Adult↗
PubMed1996

[Preventive thyroidectomy in hereditary medullary thyroid gland carcinoma].

Screening for hereditary medullary thyroid carcinoma (MTC) includes both calcitonin stimulation tests and DNA analysis. Positive results of these diagnostic procedures are indicators for the presence of neoplastic C-cell hyperplasia or an asymptomatic MTC. Thyroidectomy and lymphadenectomy of the first compartment are mandatory in both conditions even in young children.

Adolescent↗
PubMed1990

[Differentiated cancers].

A total of 119 papillary and 67 follicular thyroid carcinomas were subdivided according to the WHO classification of 1988 in the morphological subtypes of occult, encapsulated and invasive carcinomas. The patients were monitored over a followup period of 16 years postoperatively. Initially 10.6% of all patients with early follicular carcinoma had distant metastases and 2 of 19 died of carcinoma. In cases of early papillary carcinoma there were no distant metastases and no deaths. Limited thyroid surgery is recommended as curative surgery only for such patients.

Adenocarcinoma↗
PubMed1986

[Systemic antibiotic prophylaxis with metronidazole in elective colonic and rectal surgery. Results of a clinical controlled study and a critical literature review].

The pathogen spectrum of wound infections in colon surgery is composed almost exclusively of facultatively aerobic and obligatorily anaerobic intestinal flora. A study was performed in which a one-shot prophylaxis was carried out by applying metronidazole, 500 mg i.v., or latamoxef (lamoxactam) 2 g i.v., on induction of anesthesia. The metronidazole group evidenced a 26.3% incidence of infections due exclusively to aerobic pathogens. In the latamoxef (lamoxactam) group, it was possible to achieve a reduction of the postoperative rate of wound infections to 11.1%. The study was prematurely terminated because of the high rate of wound infections in the metronidazole group and the exclusive selecting of aerobic pathogens.

Colon↗
PubMed1984

[Thyroid function after peritoneal lavage with polivinylpyrrolidone-iodine solution in diffuse peritonitis].

In 36 patients, intraoperative peritoneal lavage with PVP-iodine solution (26 patients) or with the iodine free chemotherapeutic agent Taurolin (10 patients) was performed because of peritonitis. Total iodine serum levels increased considerably after peritoneal lavage with PVP-iodine. In the early postoperative phase, the resorbed iodine was mostly present as iodide in serum. Iodine serum values returned to normal after 30 days. A decrease in T4 and T3 could be observed with a concomitant reciprocal increase of rT3 in the acute phase of peritonitis. Normalization of the thyroid hormone took place after 8 days. A stronger increase in T4 occurred temporarily in 2 of 5 patients known to have thyroid function disorders. These changes in thyroid hormone may also be considered as the consequence of the severe primary disease. Normalization of hormone values was clearly delayed after PVP iodine lavage. The possible risk of an iodine-induced thyrotoxicosis after intraperitoneal application of PVP-iodine is pointed out, and objections are made to using this therapy.

Adult↗
PubMed1980

Deletions and DNA rearrangements within the transposable DNA element IS2. A model for the creation of palindromic DNA by DNA repair synthesis.

Three derivatives of mutant ga10P-308::IS2-I of Escherichia coli were characterized by DNA sequence analysis. Deletions and DNA sequence rearrangements were observed which apparently were initiated at short A-T rich inverted repeats within IS2. Two of the mutants carried newly synthesized DNA sequences which were inverted copies of already existing IS2 sequences. Thus long stretches with twofold symmetry were formed. It is discussed whether these inverted repeats were formed by DNA repair synthesis which was initiated at the A-T rich palindromes of IS2.

Base Sequence↗
PubMedDate not supplied

Identification and susceptibility patterns of anaerobic bacteria isolated from clinical specimens during a one-year period.

During the whole of 1983, all anaerobes cultured from clinical specimens were identified using both the Minitek system and gas chromatography. Antimicrobial susceptibility patterns were established using a broth microdilution test. The results show isolation rates for the individual species to be in good agreement with previous studies. Despite widespread use (even for prophylactic purposes), mezlocillin, latamoxef, cefoxitin, metronidazole and clindamycin retained their high activity against anaerobic bacteria and no clusters of resistance were observed. Augmentan also showed excellent in vitro activity. Penicillin was found to be inactive against most gram-negative anaerobic rods while tetracycline showed a rather high degree of resistance.

Anti-Bacterial Agents↗