PubMed Health⌕ Search

Biomedical subjects

J Kinser

Publications and source records attributed to J Kinser.

At least 19 recordsLinked to original sources
PubMed1996

[Long-term course of medullary thyroid gland carcinoma].

UNLABELLED: To obtain information on the outcome of medullary thyroid carcinoma (MTC) in the Berne area, a retrospective analysis of the 28 MTCs diagnosed by the Institute of Pathology of the University of Berne in the 25-year period between 1969 and 1994 was done. These 28 MTCs represented 2.4% of all thyroid malignancies diagnosed at the Bernese Institute of Pathology in the 25-year period mentioned above. 25 MTCs were sporadic and 3 associated with a multiple endocrine neoplasia (MEN) syndrome. Follow-up data were available from 27 of the 28 MTC patients. After a follow-up period of between 2 and 275 months 7 of these 27 patients had died form the MTC (among them all 4 patients with T4 tumors) and two were alive with tumor. 18 patients, including all 14 patients with T1 or T2 tumors without lymph node or distant metastases at the time of diagnosis, were alive and without evidence of tumor at the end of the follow-up period. CONCLUSIONS: MTCs are rare malignant tumors and comprise only a small fraction of all thyroid carcinomas in the Berne area. Most MTCs were sporadic, only a small minority was associated with a MEN syndrome. The TNM stage was the most important prognostic factor for patient survival. These data are in accordance with the results of similar MTC surveys done in other areas.

Adult↗
PubMed1993

[Risk factors in papillary thyroid cancer].

270 patients with papillary thyroid carcinoma were retrospectively analyzed. The mean age at initial diagnosis was 43.5 years. 74% of the patients were females. 15 patients (6%) had residual tumor after initial surgery and 61 patients (24%) showed recurrent disease. The recurrence was discovered clinically, radiologically and by increasing thyroglobulin levels in 72%, 23% and 5% of the patients, respectively. Recurrent disease was located in the tumor bed, locally and metastatic and only metastatic in 61%, 23% and 16% of the patients, respectively. After a mean follow-up of 9.4 years (range 3-20 years) the overall mortality was 13%. 6% of the patients died from tumor, 3% with tumor and 4% without tumor. 46% of patients with residual tumor died from tumor progression, in contrast to 18% of patients with early recurrence (< 5 years) and 6% of patients with late recurrence (> 5 years). We conclude that papillary thyroid carcinoma has a low mortality (6%) even in an endemic area. Patients with residual tumor after initial surgery and patients with early recurrence have an increased cancer mortality.

Adult↗
PubMed1992

[Long-term course in differentiated thyroid gland carcinoma].

545 patients with differentiated thyroid carcinoma were followed up for periods ranging up to 25 years after first treatment (mean 8.1 years, 65% for over 5 years). 72% of patients with papillary carcinoma (n = 270), but only 52% with follicular carcinoma (n = 275) remained tumor-free during the further course. Residual malignancies persisted for more than the first year in 6% and 17% of patients respectively; there were tumor recurrences after an apparently tumor-free interval in 22% and 31% respectively, the latest after 12 and 27 years respectively. 6% and 19% of patients respectively died as a direct result of the tumor (and a group of equal size from other causes), half due to residual and half due to recurrent carcinoma. With regard to residual tumors, few significant risk factors were found preoperatively, comprising distant metastases (factor = 34 and 20 for papillary and follicular tumors respectively), age over 50 years (F = 6.4 and 5), infiltrating growth of primary tumor (F = 4 and 4.3), and regional lymph node involvement (F = 1.2 and 2). However, these factors were of little use in predicting the risk of the more frequently observed tumor recurrence, with maximum factors of 2 (for T4 and N+ stage) for papillary thyroid cancers and 1.5 for follicular cancers. At risk for recurrence were patients in whom total thyroidectomy was not performed (F = 2.3 and 2) and those who did not receive postoperative radioiodine treatment (F = 3), irrespective of age and tumor stage. Therefore, any individualizing regimen beginning with the first treatment has a bearing not only on residual tumor's 50% contribution to mortality. The equally large contribution of recurrences to tumor death can be influenced only by thyroidectomy or, more realistically, by strumectomy combined with early ablation of thyroid remnants with radioiodine. Postoperative radiotherapy of the neck region did not prevent tumor recurrence, and although hormonal suppression was never given the results compared well with the best of published long-term follow-up studies. There were no acute or late complications that could be ascribed to radioiodine treatment. However, a strict strategy of the reducing the administered doses was adopted: the ablation dose was half that used previously (1.5 GBq, i.e. 45 mCi on average), tumor treatment was halted even where residual uptake was observed scintigraphically (in 44% of patients treated) and radioiodine was no longer used for follow-up investigations.(ABSTRACT TRUNCATED AT 400 WORDS)

Adenocarcinoma↗
PubMed1985

[Surgical treatment of hyperthyroid struma: surgery results, postoperative long-term course and study of a factor connected with recurrences].

None of the 335 patients thyroidectomized for hyperthyroidism in our department of surgery between 1972 and 1982 died as a consequence of the operation. Reassessment of 226 of these patients by questionnaire 68 +/- 25 (SD) months after thyroidectomy revealed the following complications: postoperative paresis of the recurrent nerve (9%), persistent change of voice (2%), and persistent hypoparathyroidism (3.5%). 91 patients underwent a follow-up investigation 74 +/- 33 months after thyroidectomy. Only one had recurrent hyperthyroidism but 6 had a recurrence of the goiter. Patients with recurrent goiters had a significantly higher frequency of increased serum thyroglobulin levels than patients without goiters. These results emphasize the effectiveness of surgical therapy in hyperthyroidism, and suggest that serum thyroglobulin might be a useful predictor for goiter recurrence.

Adult↗
PubMed1985

A modification of the 133Xe inhalation method for the measurement of liver blood flow in man.

The 133Xe inhalation technique for liver blood flow measurements was modified by using a gamma camera for data acquisition. Desaturation curves were derived from regions of interest (ROIs) over different parts of the liver, the lung and that lung area overlapping the liver, the liver hilus, and the splanchnic area. An additional liver scan with 99mTc-sulfur colloid facilitated the choice of these regions and allowed the estimation of the total liver volume. Thirteen healthy volunteers were examined under baseline conditions. Uncorrected blood flow values derived from the 133Xe-washout curves over the liver (40 +/- 10 ml/min/100 g liver) were lower than those found with other methods. A multicompartment model, based on the input functions calculated from the lung and splanchnic curves, gave values in accordance with those reported in the literature (94 +/- 20 ml/min/100 g or 1,356 +/- 382 ml/min/liver; mean liver volume: 1,475 +/- 227 g). Some methodologic limitations are shared with other invasive or noninvasive techniques.

Adult↗
PubMed1985

A diagnostic approach to lytic lesions of the mandible.

Fifty seven patients with histologically proven cyst-like lesions of the mandible are reviewed. The importance of combining radiographic with scintigraphic imaging is stressed. These two imaging modalities are complementary in demonstrating both the biological activity and the extent of the lesion. In osteomyelitis the bone scan, which is more sensitive than the radiograph, is also the method of choice in assessing the result of treatment.

Adolescent↗
PubMed1984

[Hyperthyroidism in thyroid cancer. Retrospective study of 53 cases].

Hyperthyroidism was diagnosed in 53 of 273 thyroid carcinoma patients at the time of their first examination (between 1971 and 1983). This corresponds to 19.5% of these mainly well-differentiated thyroid cancers. In 24 (45%) patients the hyperthyroidism and the thyroid carcinoma were two separate distinct illnesses: of 4 patients with Graves' disease (1.5% of 273), 2 had been operated because of an additional solitary cold nodule, and in the other 2 an occult carcinoma was found intraoperatively. Twenty patients of this group had Plummer's disease: there was a malignant cold nodule within a multinodular goiter with multifocal functional autonomy (MFA)(n = 14) or a carcinoma located near the solitary hot nodule of the toxic adenoma (TA)(n = 6). In these patients the distribution of the different histologies was about the same as in other thyroid cancer patients from this region. The remaining 29 patients (55%) had Plummer's disease, 28 with the classical finding of a solitary toxic adenoma, in which the hot nodule and the malignant tumor were identical. It was possible to confirm this identity histologically in 10 out of 24 cases, retrospectively. Eight of these patients had metastases with radioiodine uptake at the time of the first examination. Of the tumors in this group, 24 were follicular and 5 papillary carcinomas. As a rough estimate, one malignant, scintigraphically hot tumor is found for every 50 benign toxic adenomas. Criteria for the differentiation are: recent growth of the nodule, tumor size of greater than 5 cm diameter or greater than 35 g and an elevated T3-level of less than 0.06 nmol/l/g tumor.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1983

Tomoscintigraphic assessment of myocardial metabolic heterogenity.

I-123-omega-heptadecanoic acid (HDA) was evaluated for myocardial scanning in 59 healthy volunteers and 133 patients, using a 7-pinhole collimator. Early (uptake) and late (retention) images were compared visually. Regional HDA elimination was also followed semiquantitatively based on the calculation of a retention-over-uptake ratio, R(phi), derived from the maximal counts/pixel in 60 midventricular slice sectors. The healthy heart concentrated HDA homogeneously in all segments with no difference between early and late images. The minimal R(phi), taken as representative of that myocardium with the best function, was unchanged after maximal ergometer stress and with dipyramidole-induced hyperperfusion. A circumscribed decreased HDA uptake is the clear-cut criterion for an abnormal finding. HDA tomography of the myocardium had an 86% sensitivity for myocardial infarcts (MIs) up to 4 wk old, and 83% for myocardial scars (MSs). Comparing early and late tomograms, we find a cool-warm sequence more often with acute and subacute MIs. A cool-cool or a cold-cold sequence dominated with MSs. HDA tomoscintigraphy cannot replace TI-201 for the evaluation of regional coronary reserve in coronary heart disease.

Adult↗
PubMed1980

[The effectiveness of recurrence prophylaxis four to five years after struma surgery].

Four to five years after the operation of an endemic goiter, 63% of the patients regularly take thyroxin prophylactically and 85% as substitution. The effect of this hormone therapy was checked using the radioiodine uptake of the thyroid. In those patients with an increase in the size of the thyroid in the scintigram, there was usually a pathological TRH-TSH test with elevated basal and very elevated late values for TSH. While the prophylactic benefit of thyroxin after unilateral thyroidectomy must be further evaluated with other parameters, there is no doubt that thyroxin is necessary for those patients in whom a bilateral thyroidectomy has been performed.

Goiter, Endemic↗
PubMed1977

Enzyme induction and renal function in man.

1. In a previous study in rats, an increased PAH clearance was found following chronic phenobarbitone administration. These results formed the basis for the present study in which fifteen healthy male volunteers were investigated and the parameters of liver microsomal enzyme activity and renal function were measured. 2. As parameters of liver microsomal enzyme activity, the antipyrine elimination in the plasma, the gamma-glutamyl-transpeptidase and the D-glucaric excretion in the urine were measured. Endogenous creatinine clearance, 51Cr-EDTA and 125I-Hippuran clearance were determined as measurements of renal function. 3. No correlation was found between any of the parameters of microsomal enzyme activity and renal function. 4. Of the fifteen volunteers, seven having a mean antipyrine half-life of 13.3 h were given antipyrine (500 mg) daily for 3 weeks. Afterwards all measurements of liver microsomal enzyme activity and renal function were repeated. The antipyrine half-life decreased to 8.5 h, while the antipyrine clearance was increased by about 56%. gamma-glutamyl-transpeptidase and D-glucaric acid were also significantly increased, while renal function remained unchanged. 5. Therefore, an increased PAH-clearance, as found in the rat, is not obtained in man following induction of liver microsomal enzyme activity.

Adult↗