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Biomedical subjects

J Brändle

Publications and source records attributed to J Brändle.

11 recordsLinked to original sources
PubMed1986

[A so-called atypical adenoma of the thyroid in an endemic struma area].

In view of the benign clinical course of the atypical adenoma and the high diagnostic accuracy of our frozen sections we feel that subtotal strumectomy with in toto removal of the adenoma and closely spaced follow-ups constitutes an adequate treatment of this thyroid neoplasm. In our opinion primary lobectomy means unnecessarily exposing a disproportionately high percentage of patients to the higher complication risk of this more radical surgery. From 1977 to 1982 there were 47 cases of atypical adenoma among our patients. The ratio men: women was 1:3.7, the mean age of the patients was 44 years. The patients underwent subtotal strumectomy. In the period under review "atypical adenoma" diagnosed on the basis of frozen sections turned out to be carcinoma in 5 instances. The follow-up period of the 47 patients that underwent surgery ranges from 1 1/2 to 7 years. None of the patients has had tumor regrowth so far.

Adenoma↗
PubMed1985

[Sonographic findings in autonomous adenoma of the thyroid gland in a goiter-endemic region].

Ultrasound scanning was carried out in 84 patients with autonomous nodules and 67 patients with inactive nodules. The echo pattern was correlated to the macro- and microscopic findings as well as to the function of the nodules. The autonomous nodules showed a low echogenicity in 57%, a normal parenchyma-identical echogenicity in 10% and a high echogenicity in 33%. In comparison the echo pattern of the inactive nodules showed low level echoes in 31%, normal in 36% and a high level echoes in 31%. Only one third of the nodules showed a homogeneous echo pattern, one third showed liquid degeneration and one third a mixed echo pattern. There is no correlation between the echo pattern of the autonomous nodules and the metabolic function of the nodules. 65 patients have been operated (37 autonomous and 28 inactive nodules). The macroscopic findings showed bleeding and cysts in most of the echo-poor nodules, also those with homogeneous structures. In the histological findings microfollicular structures were found in both high- and low-echogenicity nodules (18/16%). Macrofollicular changes and mixed forms were found mainly in nodules with parenchyma-identical and high echogenicity (58/48%). Ultrasound is very helpful in the morphological diagnosis of thyroid nodules, but there is no significant correlation to metabolic activity or to microscopic structures of the nodules in the thyroid gland.

Adenoma↗
PubMed1983

[Antibiotic prevention in gynecology. Concentrations of ceftizoxime in the serum, myometrium, endometrium and fallopian tubes].

34 patients received an intravenous bolus injection of 2 g ceftizoxime over 5 min at various times before abdominal or vaginal hysterectomy. Ceftizoxime concentrations in myometrium were substantially higher than in salpinges and endometrium. Tissue concentrations of 4 micrograms/g could be maintained for at least 3 hours. The ceftizoxime tissue concentrations attained in myometrium, endometrium and salpinges justify therapeutic studies and controlled prospective clinical trials on the prevention of postoperative wound infections with this antibiotic.

Adult↗
PubMed1983

Concentrations of ceftriaxone in serum and gynecological tissues.

31 patients received an intravenous 15-min injection of 2 g ceftriaxone at various times before abdominal or vaginal hysterectomy. Ceftriaxone concentrations in salpinges were significantly higher than in myometrium and endometrium. Tissue concentrations of 20 micrograms/g could be maintained for at least 5 h. Due to its high tissue concentrations maintained for the whole operative procedure, ceftriaxone does seem to be one of the antibiotics of choice for single-dose prophylaxis of postoperative infections in gynecology.

Adult↗
PubMed1983

[Clinical value of sonography in the diagnosis of thyroid diseases].

In 63 patients echography of thyroid was performed additionally to case history, palpation, scintigraphy and hormone tests for evaluating clinical significance of this method. The benefit of this technique is rapid measurement of thyroid size, demonstration of nodules in palpable diffuse goiters and differentiating of solid or cystic nodules of the thyroid. For diagnosis of autonomous areas in the thyroid scintigraphy remains the method of choice. Also there is no correlation of ultrasound findings and thyroid function. In routine diagnostic procedure of thyroid disease echography may replace scintigraphy only in diffuse goiter and if radionuclide imaging is not possible. Nevertheless ultrasonic evaluation of the thyroid is an important additional method in diagnosis of thyroid diseases.

Adenoma↗
PubMed1979

[Comparison of glibenclamide, gliquidone, glisoxepide and placebo in maturity onset diabetics of differing degrees of severity (author's transl)].

The purpose of the study was to investigate whether the potency of effect on the beta cell differs with type of sulfonylurea (SU) and with degree of severity of diabetes. 12 maturity onset diabetics were classed according to fasting blood glucose (FBG) in three groups of 4 patients each. Each patient served as his own control. Glibenclamide, Gliquidone, Glusoxepide and placebo were administered in random order with degree dosage adjusted according to degree of severity of diabetes. All patients were given a standardized diet with 150 g carbohydrates per day. Fullday profiles of blood glucose, insulin, C-peptide and sulfonylurea level in serum were made on the third day under each preparation. Results showed that with proper nutrition and sufficient weight reduction, patients in group I (FBG 80--130 mg/dl) needed no oral medication and in fact showed a tendency towards hypoglycaemic episodes under oral therapy. In group II (FBG 130--200 mg/dl) the effect of nutrients on beta cell secretion appeared to be both enhanced and accelerated by SU administration. Satisfactory metabolic control was achieved with SU, but not with placebo. This group seems to represent the type of patient most likely to benefit from SU therapy. In spite of high dosage levels, satisfactory control was not achieved with SU in any patient in group III (FBG greater than 200 mg/dl). Depending on individual factors such as ketosis-proneness, vascular complications, age and psycho-social aspects, insulin administration should be considered for these patients. There were not differences between the individual SU preparations in the parameters studied. There was insufficient evidence for a pharmacokinetic differential diagnosis.

Blood Glucose↗
PubMed1979

Preprogrammed insulin infusion with a portable pump system.

A glucose-controlled insulin infusion system (Biostator) was used to determine patient insulin requirement for clinical evaluation of a portable pump system (technical development by Siemens AG). Results from 6 insulin-dependent diabetics with respect to quality of control, carbohydrate/insulin ratio, and insulin requirement are shown. Preprogrammed insulin infusion with the portable system was carried out for up to 117 days.

Adolescent↗
PubMed1979

Use of glucose-controlled insulin infusion system for improvement of subcutaneous insulin regimen.

The use of an artificial pancreas for blood glucose monitoring and feedback correction for evaluation and improvement of subcutaneous insulin therapy facilitates the process of finding an optimal therapy regime for the individual patient. The frequency of hypoglycemic episodes can be reduced while maintaining good control, and hospital stays can be considerably shortened. This procedure is particularly useful in achieving tight control in pregnant diabetics.

Adolescent↗
PubMed1979

Treament of biguanide-induced lactic acidosis with dichloroacetate. 3 case histories.

The administration of dichloroacetate (DCA) in cases of biguanide-induced lactic acidosis (LA) improves pyruvate oxidation and therefore increases energy production from glucose. Preliminary results of treatment of LA in humans are reported. A continuous fall in pyruvate was observed in all 3 cases after administration of at least 20 g of DCA (4 g i.v. bolus, then continuously 12 g/h). In Case 1, in which no supplementary measures for controlling the acidosis were applied, the acidosis did not improve and the patient died. In Case 2, despite administration of tris-buffer and dialysis, pH-values could not be raised sufficiently. The production of hydrogen ions persisted and lactate continued to rise. This patient also died. Case 3 was admitted in the beginning stages of a phenformin-induced LA, and in this case therapy was successful. The decline in pyruvate was accompanied by a slow fall in lactate, and a further fall in pH was averted. The clinical condition of the patient improved markedly after i.v. administration of a total of 34 g of DCA.

Acetates↗
PubMed1977

[Investigations of the effect of midodrine on carbohydrate and fat metabolism with particular reference to the diabetic metabolic state (author's transl)].

Midodrine, which is used in the treatment of hypotensive circulatory distrubances was investigated with respect to possible effects on carbohydrate and fat metabolism in 5 healthy subjects and 7 patients with disturbed glocuse tolerance. An i.v. glucose tolerance test was carried out on both groups and was repeated a few days subsequently with simultaneous administration of midodrine (5mg i.v.). Midodrine had no significant effect on glucose tolerance in either group, nor was there any significant effect of midodrine on FFA, serum insulin, triglyceride or cholesterol levels. 15 diabetic patients controlled by different therapeutic regimens (5 by diet only, 5 by oral preparations and 5 by insulin treatment) were given 3x5mg midodrine orally over a 5-day period and the effects on diabetic control and metabolic parameters compared with a 5-day pretreatment period without midodrine. Midodrine did not cause any change in the quality of diabetic control nor any significant alteration in serum lipid or uric acid levels.

Adolescent↗