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Biomedical subjects

K Reschke

Publications and source records attributed to K Reschke.

12 recordsLinked to original sources
PubMed2006

[CranioNet -- an interdisciplinary strategy for craniopharyngioma].

In patients with craniopharyngioma, pituitary failure and often lifelong hormone replacement therapy, persisting ophthalmological problems with impaired vision, cranial nerve palsies, and psychoneurological deficits will lead to a persisting impairment in quality of life and social competence. Some patients completely depend on assistance. To prevent this, a major goal is an early diagnosis and limitation of operative radicality to minimize postoperative complications. Surgery in centers with special expertise is mandatory. Radiotherapeutical strategies are relatively safe and improve the outcome and recurrence-free survival after incomplete surgical resection or after local recurrence. Multidisciplinary concepts and prospective data acquisition are desirable with regard to therapy and outcome in patients with craniopharyngioma. Problems in the follow-up period are the development of atherosclerotic complications and metabolic syndrome as a consequence of occasionally excessive obesity, which may impair the long-term survival of the patients. Cause and progression of these complications are not fully understood, therapeutical strategies for the morbid obesity are not available. Only interdisciplinary co-operation will help to develop and evaluate therapeutical concepts for the management of this rare disease.

Combined Modality Therapy↗
PubMed2006

Diabetes insipidus due to herpes encephalitis in a patient with diffuse large cell lymphoma. A case report.

The major causes of central diabetes insipidus are neoplastic or infiltrative lesions of the hypothalamus or pituitary, severe head injuries and pituitary or hypothalamic surgery. Central diabetes insipidus caused by viral infections has been rarely reported in immunosuppressed patients, such as those with acquired immunodeficiency syndrome or Cushing's syndrome. We report the case of a 48-year-old woman suffering from diffuse large cell lymphoma, who developed hypotonic polyuria, hypernatriaemia and somnolence after the first course of chemotherapy with CHOEP and rituximab. Diabetes insipidus was diagnosed by low urine osmolarity and an undetectable vasopressin concentration. MRI revealed no pituitary abnormalities but encephalitis, and lumbar punction confirmed herpes zoster infection. To the best of our knowledge this is the first description of central diabetes insipidus in a lymphoma patient caused by an opportunistic CNS-infection.

Brain↗
PubMed2003

[Thyrotoxic crisis].

Besides the typical and in this case severe signs of hyperthyroidism the thyrotoxic crisis is characterized by additional signs and symptoms such as fever, cardiac involvement (tachycardia, arrhythmia, heart failure) and central nervous impairment eventually leading to coma. Additional diseases and comorbidities impair the diagnostic process and may mask the symptoms of thyrotoxicosis. If undiagnosed, this situation harbors a mortality of approximately 90%. The precise knowledge of typical (and atypical) symptoms is mandatory in order to rapidly recognize this situation and to initiate pharmacological treatment and/or surgery. An experienced endocrinologist should always be involved in this decision process.

Antithyroid Agents↗
PubMed2001

Playing games in promoting childhood dental health.

Oral health behaviour is a result of a life-long learning process, this process can best be achieved by an interdisciplinary collaboration among dentists and professionals in other areas, e.g. psychologists, teachers and kindergarten teachers. The basis of our research is a childhood dental health promotion programme which consists of a tool of games for children in the age of 3-5 years. After development by an interdisciplinary research group, the effectiveness of this teaching and behaviour modification technique should be proved. This study describes a controlled field study, in which two forms of game play activities were compared to a control groups. The results showed that the use of games and shows aimed at a child's developmental level can be more efficacious than the presentation of didactic information alone.

Age Factors↗
PubMed2001

Carney complex--an unexpected finding during puerperium.

Carney complex is an extremely rare, autosomal dominant, multi-system disorder characterized by multiple neoplasias and lentiginosis. The genetic defect responsible for this complex has been localized to the short arm of chromosome 2 (2p16). The most prevalent clinical manifestations in patients with Carney complex are spotty skin pigmentation, skin and cardiac myxomas, Cushing's syndrome and acromegaly. Here we report the case of a 31-year-old woman with a spontaneous pregnancy. At 32 weeks of gestation, she was admitted to our Department of Obstetrics with hypertension and severe back pain. In addition, she had unusual pigmentation and typical cushingoid features. One day after admission, the pregnancy was terminated by emergency cesarian section because of preeclampsia and pathological CTG. During the postoperative period the severe back pain persisted, and radiographic evaluation revealed a collapse of L(2)/L(3) with severe osteopenia. A CT scan showed a mass in the right suprarenal area. Histopathological examination revealed a primary pigmented nodular adrenocortical disease. After biochemical confirmation of the diagnosis of Cushing's syndrome, it was recognized that the patient met the diagnostic criteria for Carney complex.

Acromegaly↗
PubMed1998

Role of ultrasound in the diagnosis of thyroid autonomy.

The role and the different technical modes of ultrasound in thyroid autonomy are discussed. B-mode sonography is routinely employed to e.g. calculate thyroid and nodule volume, describe the echo pattern of both the thyroid gland and focal lesions and to visualize neighboring organs such as lymph nodes. Sonography thus possesses a complementary role to scintigraphy, since it may further aid in the localization of toxic adenomas, in particular when they are dorsally located or it may change the therapeutic decision. An example for the latter would be the preference of a surgical approach in case of cystic degeneration of an autonomously functioning nodule. Recently, color-coded doppler sonography using color flow mapping has been employed. With the advent of this technique it has become possible to describe the pattern of vascularization in thyroid focal lesions such as rim perfusion or internal hypervascularization. This technique harbors a high sensitivity for toxic adenoma exhibiting high internal blood flow, but does not appear to reliably discriminate between benign and malignant lesions. Nevertheless, further improvement of this technique may be promising in further characterizing the functional status of sonographically detected lesions and in the prognostic assessment of post-treatment outcome.

Adenoma↗
PubMed1997

[Hyperthyroidism in TSH-producing hypophyseal adenoma].

HISTORY AND CLINICAL FINDINGS: For 5 years a 59-year-old man had been treated with thyrostatic drugs for hyperthyroidism of unknown aetiology. As he had been losing weight, computed tomography had been performed in the search for a malignancy. It revealed a hypophyseal space-occupying lesion. INVESTIGATIONS: Peripheral thyroid hormone activities were raised, while thyroid-stimulating hormone (TSH) was also raised to 12.4 mU/l and there was evidence of partial hypophyseal insufficiency. Octreotide scintigraphy demonstrated increased activity in the area of the hypophysis. TREATMENT AND COURSE: The transsphenoidal surgery and immunohistochemical tests confirmed the diagnosis of TSH-producing hypophyseal adenoma. The patient became euthyroid after the operation. CONCLUSION: TSH-producing hypophyseal adenoma should be considered as a rare cause of hyperthyroidism when it is combined with non-suppressed TSH.

Adenoma↗
PubMed1997

Healthy dietary practices among European students.

Predictors of 5 healthy dietary habits were examined in data from the European Health and Behaviour Survey (A. Steptoe & J. Wardle, 1996), a study of over 16,000 students from 21 European countries. The level of practice of these healthy dietary habits was low. Significant univariate associations with healthy dietary habits were identified for gender, weight, dieting status, dietary health beliefs, nutrition knowledge, and health locus of control. In multivariate analyses, only gender, dieting status, and dietary health beliefs were significant predictors of healthy dietary habits. The practical implications of these results for dietary health promotion are discussed.

Adult↗
PubMed1995

Circadian variation of insulin requirement in insulin dependent diabetes mellitus the relationship between circadian change in insulin demand and diurnal patterns of growth hormone, cortisol and glucagon during euglycemia.

In 13 subjects with type 1 (insulin dependent) diabetes mellitus the 24 hour insulin requirements to maintain euglycemia were assessed by means of feed back controlled insulin infusion. For the study steady state conditions, i.e. bed rest and fasting were required. Venous blood samples were collected, at 2 hour intervals, for the measurement of glucagon, growth hormone and cortisol. During the day, the insulin demand showed small changes. However, the early morning requirement for insulin was twice as much as the daytime demand (dawn phenomenon). There was a significant difference (p < 0.05) in the insulin requirement between 6.00 to 8.00 hours in the morning and 12.00 to 16.00 hours in the afternoon. The plasma glucagon levels showed no significant changes during the euglycemic period (median range from 28.7 to 30.1 ng/ml) (p < 0.05). The median of the growth hormone level decreased throughout the night from a peak of 4.41 ng/ml at midnight to a nadir of 1.05 ng/ml at 4.00 hours. There was a significant difference (p < 0.05) between the growth hormone concentration between midnight and the early morning. The cortisol concentration indicated a circadian variation. The median was significantly higher from 4.00 to 8.00 hours in comparison with the median at 20.00 to 24.00 hours (p < 0.05). The results of the study showed that the early morning rise in the insulin demand is related to the increased early morning cortisol secretion and to the nocturnal peaks of growth hormone concentration (p < 0.05).

Adolescent↗