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Biomedical subjects

G Knappe

Publications and source records attributed to G Knappe.

At least 19 recordsLinked to original sources
PubMed1990

[Cushing's syndrome in CRF-producing mediastinal carcinoid].

A 36-year-old patient developed marked pigmentation, marked myopathy and severe hypokalaemic alkalosis which at first pointed towards an ectopic ACTH syndrome. The dexamethasone test at a high dose indicated cortisol suppression. A mediastinal tumour was seen radiologically, but the sella was of normal size. Computed tomography provided indirect signs of a sellar space-occupying lesion which suggested an ectopic production of corticotropin-releasing factor (CRF) as cause of the Cushing's syndrome. CRF concentration in antecubital venous blood was markedly elevated to 280 ng/l. The mediastinal tumour was excised and proved to be a carcinoid histologically. Postoperatively the CRF concentration fell to 70 ng/l. An extract of the carcinoid contained 15.5 ng/g wet-weight of CRF and 254 ng/g wet-weight of beta-endorphin. The patient died 5 weeks postoperatively of sepsis with bilateral pneumonia. At autopsy the hypophysis was of normal size but showed nodular ACTH-cell hyperplasia. This was thus a case of Cushing's syndrome resulting from ectopic CRF production in a mediastinal carcinoid tumour.

Adult↗
PubMed1990

A 5 year interdisciplinary control of iodine deficiency in the GDR.

The interdisciplinary iodine prophylaxis in the GDR is a successful measure for control of ID. The iodization of nearly all the salt is planed perhaps with reduction of the iodine concentration. However, next further steps may be done in cooperation of the Interdisciplinary Iodine Commission with the "Arbeitskreis: Jodmangel" in the FRG.

Germany, East↗
PubMed1989

Paradoxical response of plasma beta-endorphin to combined administration of TRH and GnRH in adrenal disorders.

The combined intravenous injection of TRH and GnRH elicited paradoxical responses of plasma beta-endorphin in active and successfully treated pituitary dependent Cushing's disease as well as in ectopic ACTH syndrome and in congenital adrenal hyperplasia. No response was observed in Cushing's syndrome due to adrenal tumours. It is concluded that an abnormal response to inappropriate releasing hormones cannot verify the existence of a pituitary corticotrophic microadenoma.

Adenoma↗
PubMed1989

[The immunohistochemistry of pituitary adenomas].

A great deal of progress has been achieved in recent years in the field of immunohistochemistry of pituitary adenoma. Continued use of more new antisera and monoclonal antibodies against numerous hormones in the adenohypophysis have resulted in new approaches to classification of pituitary adenoma. However, new problems have been discovered, on the other hand, by large-scale studies in recent years. The great number of multihormonal pituitary adenomas and possible change of the immunohistochemically detectable hormone status in cases of recurrent tumours have particularly re-emphasised the need for new thinking about patterns of classification. It would appear somewhat problematic, in this context, to uncritically accept terms, such as ACTH cellular adenoma or GH cellular adenoma. Reference is also made to the distribution pattern of cell and tissue markers in pituitary adenomas. The paper is based on thorough literature screening as well as on experience obtained by the authors from 450 cases of pituitary adenoma of which 260 had been analysed by immunohistochemistry, 131 by morphometry, and 80 by electron microscopy.

Adenoma↗
PubMed1989

Interdisciplinary aspects of iodine prophylaxis in German Democratic Republic.

Endemic goiter still occurs in several European countries. Alimentary iodine deficiency could be proved as the main cause of endemic prevalence. Extensive epidemiologic surveys showed the great medical and economical impact of this matter for the GDR. Over 200 million Marks might be spent for diagnosis and treatment of thyroid patients per year. Also in the field of veterinary medicine and animal production iodine deficiency plays an important role. Under the conditions of iodine deficiency the fodder containing nitrate and glucosinolates (e.g. bruised rape extraction) results in additional goitrogenic effects (so-called indirect or relative iodine deficiency). Due to iodine deficiency disorders considerable losses of yields in cattle, pigs and sheep occurred. The content of iodine in animal products used for human nutrition was subsequently low. Considering the ecological implication of these problems an Interdisciplinary Iodine Commission within the Society for Endocrinology and Diseases of Metabolism of the GDR was established. Together with the governement authorities it worked out corresponding recommendations for the prophylaxis and control of its efficiency. In 1986 the iodination of most of the packed salt (32 mg KIO3/kg = = 19 mg I/kg) and the administration of iodinated mineral mixtures for the animal production were started for pigs in the whole territory of GDR and for cattle in the southern counties of the GDR only. These activities have been accompanied by information of TV as well as in the newspapers and medical journals. Thus, an improved supply of iodine to the population through iodinated table salt and animal products can be taken into account. The efficiency of these prophylactic measures is controlled interdisciplinarily.(ABSTRACT TRUNCATED AT 250 WORDS)

Animal Husbandry↗
PubMed1988

Somatomedin-C in active and successfully treated acromegaly.

Sm-C concentrations in serum were found significantly different in either active acromegaly or following successful treatment with pituitary adenomectomy. Although after normalization of serum GH the Sm-C levels sometimes exceeded the normal range no overlap was found between both groups. Exceptionally two acromegalic patients showed elevated Sm-C levels in spite of normal GH values. Likewise, a high Sm-C concentration was found in one patient suspective of ectopic GH secretion with only moderately elevated serum GH. Sm-C determinations are judged as a good adjunct to usual diagnostic methods which in special cases of acromegaly can be even superior to measurements of serum GH.

Acromegaly↗
PubMed1987

[Development and effectiveness of struma prevention in East Germany].

For the control of iodine deficiency disorders in man and animal since 1985/1986 measures have been introduced which were interdisciplinary attuned: 84% of the paketed salt are iodized (32 mg KIO3/kg) and iodized mixtures of mineral substances are used in the animal production of agricultural useful animals. The effectiveness of the iodine prevention becomes visible by an increase of the renal iodine excretion, regression of the frequency of connatal goitre and iodine deficiency disorders in the animal production. Increased manifestations of cases of hyperthyroidism as sequelae are of transient importance.

Goiter, Endemic↗
PubMed1986

[Status of goiter prevention in East Germany from an interdisciplinary viewpoint].

The endemic goiter occurs still in many countries of Europe. Alimentary iodine deficiency could be proved as essential cause of the increased prevalence. Comprehensive epidemiological investigations refer to the medical importance of this appearance for the GDR. 200 million marks might have to be spent annually for diagnostics and therapy. Also in the production of animals sequelae of iodine deficiency play a great part. Nitrate containing and glucosinolate containing feeding stuffs (e. g. rape extraction groats) here under the conditions of the iodine deficiency additionally develop goitrogenous effects (so-called indirect or relative iodine deficiency), which lead to decrease in vitality and clinical symptoms in the agricultural useful animals cattle, pig and sheep. The iodine content of animal products was frequently low. In view of the ecological connection of these problems an interdisciplinary iodine commission was founded which in accordance with the responsible state organs elaborates adequate recommendations for the prophylaxis and control of efficiency. From 1986 was begun with the iodisation of the largest part of packet salt (32 mg KJO3/kg) und the delivery of iodized mineral mixtures for the production of animals. Thus is to be reckoned with an improved direct supply of iodine for the population by iodized table salt or an indirect one over animal product. The iodisation of the entire common salt with modified iodine concentration is striven for. Measures for the control of efficiency are introduced.

Animals↗
PubMed1986

[Postoperative therapy of epithelial ovarian cancer at the Göttingen University Gynecologic Clinic. A retrospective analysis of 82 patients 1981-1984].

An epithelial ovarial carcinoma was diagnosed and treated during 1981 to 1984 in 82 patients of the Department of Gynaecology of the University of Göttingen. The diagnostic approach and therapy are described in the paper by Grospietsch et al. [Geburtsh. u. Frauenheilk. 46 (1986), 588]. The present paper deals with the results of postoperative treatment, with particular emphasis on those factors presently considered to be prognostically relevant, such as postoperative tumour residue, age of the patient and stage of tumour spread. The results are classified according to rate of response, progression-free interval and survival time or survival rate. Analysis of the results shows that on the one hand an improvement of long-term results (survival time) has been very unsatisfactory with present-day methods--and moreover, that partly such long-term results are obtained only on the basis of an accurate diagnosis--whereas on the other hand the short-term results (tumour-free interval) together with a clear improvement of the quantity and quality of life do justify the considerable effort required by the treatment concept. Improvement of the overall result is more likely to be achieved by clinical and preclinical research towards consolidation of the primary therapy effect than by employing "trial-and-error" methods within the framework of primary therapy.

Adult↗
PubMed1986

[Current aspects of therapy of ovarian cancer. Surgical therapy of epithelial ovarian cancer at the Göttingen University Gynecologic Clinic. A retrospective analysis of 82 patients 1981-1984].

The most important step in the treatment of epithelial ovarian carcinoma is radical surgery which should be as radical as possible, since this can exercise a decisive influence on the effectiveness of subsequent chemotherapy or radiotherapy. During 1981-1984 98 patients with an ovarian carcinoma were operated upon. 82 of these patients had epithelial tumours that will be discussed in the article. The mean age was 59.9 years. 88% of the patients were additionally at risk by one or several risk factors. Surgical approach was standardised: longitudinal incision, hysterectomy, adenectomy, resection of omentum and, if necessary, maximum possible removal of the peritoneum of the pelvis. In 28 cases additional surgery became necessary at the intestine. 77% of the patients (n = 63) were in the advanced stages FIGO III and IV. In 50 patients the operation lasted for up to 4 hours, in 24 up to 6 hours and in 8 for more than 6 hours. Intraoperative complications occurred in 37% (twice lesion of the ureter, in 5 cases intestinal lesion, in 23 cases anaesthesiological problems due to preexisting risks). In stages I and II reduction of tumour size below 2 cm was achieved in 100% of the cases, in stage III in 87.5%, in stage IV in 45%. Two patients died postoperatively. The postoperative complication rate was 48%. Almost 30% of these were represented by cardiopulmonary disturbances. Although the percentage appears high, most of the problems were well manageable, so that the patients could be transferred to follow-up therapy within 2-3 weeks. For type of follow-up therapy, tumour response.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1986

[New aspects of the pathogenesis of acromegaly-somatoliberinomas].

According to modern knowledge, acromegaly can develop in at least three ways. A pituitary adenoma with growth hormone overproduction is the most frequent. Much rarer is ectopic growth hormone secretion by extra-hypophyseal tumors. A further possibility is the production of growth hormone releasing factor (GRF) by hypothalamic or ectopic tumors. This involves the secretion of a substance which selectively stimulates the GH producing cells of the pituitary. Special features of the clinical and morphological picture of this condition are described, based on the authors own observations. Two patients developed acromegaly: one had a retroperitoneal paraganglioma and the other a bronchial carcinoid. Ectopic GRF secretion could be confirmed radioimmunologically and immunohistologically in both cases. As a result of the on-going, tumor related GRF stimulation the patients developed nodular or diffuse GH-cell hyperplasia in the adenohypophysis. Since ectopic GH secretion does not cause hyperplasia of the adenohypophyseal cells, morphologic examination of the hypophysis can contribute to the differential diagnosis in such cases.

Acromegaly↗
PubMed1986

Iodine deficiency disease in the GDR.

In the last decade several epidemiologic surveys were carried out in the GDR. The findings of all studies indicate consistently that the goiter is existing in the whole country increasing from the north to the south. Inhabitants of all ages are involved. The main cause appears to be an iodine deficiency of grade II. In the south of the GDR more than 90% of the groups examined are subjected to it. The introduction of iodinated salt prophylaxis is going on. An Interdisciplinary Iodine Commission has been established to control and coordinate these measures.

Adolescent↗
PubMed1985

[Unusual abdominal apudomas. I. Cushing syndrome in association with Zollinger-Ellison syndrome in an endocrine pancreas tumor].

Ectopic production of ACTH is observed in 6% of patients with Cushing syndrome. Ten percent of these cases are related to endocrine pancreatic tumors. In a few cases a multiplicity of hormones are produced. The combination with a Zollinger-Ellison syndrome is very infrequent. In the present case, a female patient aged 54, there was an interval between the onset of Zollinger-Ellison and Cushing syndrome. The combination of bilaterally enlarged adrenals in the absence of an adrenal adenoma and the presence of Crooke-cells in the adenohypophysis in a patient with Cushing syndrome are of diagnostic significance. This trias should always alert the physician to the possibility of extrahypophyseal ACTH production.

Adrenocorticotropic Hormone↗
PubMed1985

[Immunohistological determination of beta-endorphin in chromophobe, clinically hormone-nonproducing hypophyseal adenomas].

Pituitary adenomas are usually classified according to the nature of their proper hormonal production. Silent adenomas of the pituitary are tumors without clinical and biochemical evidence of overproduction of any known adenohypophyseal hormones. The proportion of such seemingly nonfunctioning tumors is 20 to 30%. Silent corticotropic adenomas are able to synthesize some normal or abnormal sequences of proopiomelanocortin precursor without any signs of hypercorticism. These tumors were divided into basophilic adenomas with strong periodic acid-Schiff (PAS) positivity and chromophobic adenomas with moderate or no PAS positivity. All of our cases were chromophobic adenomas. Two of the cases were positive for beta-endorphin by immunofluorescence. ACTH immunoreactivity was not present in the cells. Electron microscopic study of the adenoma cells showed small secretory granules with a halo. The diameter of these granules varied from 50 to 250 nm. Automated morphometric and densitometric investigations of silent corticotropic adenomas and adenomas from patients with Cushing's disease gave different karyometric results. The most important practical problem arising from the present investigation was the high frequency of recurrence of silent corticotropic tumors.

Adenoma, Chromophobe↗