Biomedical subjects

P Rezek

Publications and source records attributed to P Rezek.

13 recordsLinked to original sources

PubMed1998

[Treatment of endocrine orbital disease by elimination of the thyroid gland. The effect of unsuccessful elimination, severe pretibial myxedema and persistence of hypothyroidism after removal in long-term results].

The reason why soon after elimination of the thyroid gland protrusion of the bulbi does not recede and adequate regression of soft orbital tissue infiltration does not occur is at first the short time which has elapsed after elimination. The result usually is recorded only later. The long-term cause of minor improvement is the impossibility to combine surgery of the thyroid gland and radioiodine with corticoids, as well as incomplete thyroid elimination and presence of residues and finally pretibial myxoedema associated with a persisting high level of antibodies against the receptor for TSH. Hypothyroidism after the eliminating dose must not be left too long, so far a period of 3-4 weeks seems adequate.

Glucocorticoids↗

PubMed1994

[Significance of determination of antibodies to TSH receptors (using TRAK) in the diagnosis and monitoring of therapy in endocrine orbital disease].

The elevated antibody level against receptors for TSH assessed by the commercial set TRAK (Henning Berlin) supports the diagnosis of endocrine orbitopathy (EO) which is important in more complicated cases with unilateral EO or EO in euthyroid or hypothyroid patients. During treatment of EO by elimination of the thyroid with radioiodine 131I (with or without previous thyroidectomy) a decline of originally high TRAK values to normal suggests successful elimination. Persistence of high TRAK values is associated with a poorer therapeutic effect of elimination and reasons for this should be sought. In four of 26 such patients the authors found radioiodine accumulation in the residual thyroid tissue, in 8 patients they found a non-accumulating residue by means of sonography. In 14 patients within two years after administration of the radioiodine elimination dose a residue of the thyroid gland was not found by scintigraphy nor by sonography. Improvement of the therapeutic effect occurred in one of these subjects with a drop of the TRAK value after the 30th month following elimination, in another female patient after a high diagnostic radioiodine dose. Improvement of the protrusion after radioiodine treatment with or without previous incomplete thyroidectomy and was recorded in 33 subjects where a drop of the originally high level of TRAK antibodies occurred was significantly greater than in subjects where the TRAK values did not decline.

Autoantibodies↗

PubMed1993

[A multidisciplinary approach in the treatment of endocrine orbitopathy].

Despite the knowledge of immunological mechanisms of Graves-Basedow's disease the pathogenesis of endocrine orbitopathy remains obscure. Apart from the most frequent association with GB disease it may occur also in patients with primary hypothyroidism, Hashimoto's thyroiditis or in rare instances in euthyroid patients not suffering from thyroid disease. Endocrine orbitopathy is a typical example of a disease with a multidisciplinary approach to its diagnosis and treatment. In the submitted paper the authors demonstrate the collaboration of four clinics of the Faculty Hospital when dealing with this problem. Complete or almost complete removal of the thyroid gland leads within 1-4 years to regression of the protrusion of the bulbus by 1 mm. In combination with decompression of the orbit by a modification of Ogura's and Walsh's method improvement of visual acuity by 50% was achieved and the mean value of the exophthalmus diminished by 3.5 mm.

Exophthalmos↗

PubMed1992

[Surgical treatment of endocrine orbital disease. Indications, methods,results].

Surgical removal of the thyroid gland in Graves-Basedow's disease has, beyond doubt, also a major effect on endocrine orbitopathy. After total or near-total removal of the thyroid gland after three months a slighter deterioration or even ameloriation of ocular protrusion is found, contrary to the effect of subtotal thyroidectomy. There exists a significant correlation between the volume of the residual gland evaluated according to 24 h-uptake of 131I, and between the regression of the protrusion (r = 0.385, p < 0.01). Total or near-total thyroidectomy alone even in the absence of other therapeutic methods leads after 1 to 4 years to an average regression of the protrusion by 1 mm which matches the results of prednisone treatment, if the latter is used as the sole treatment. Orbital decompression by the modified method of Ogura and Walsh led in patients treated concurrently with prednisone and thyroidectomy to improvement of the visual acuity on average by 50% (from the range of 0.008 to 0.33 to values from 0.4 to 1.0) and to regression of the protrusion on average by 3.3 mm. When determining the time of operation of the oculomotor muscles, in addition to the unchanged ocular finding also the echographic picture in sectorial visualization proves useful.

Exophthalmos↗

PubMed1991

[Personal experience with reconstruction of the lacrimal tract].

The authors present their initial experience with the microsurgical reconstruction of lacrimatory pathways damaged by injury or inflammation. They describe complications which differ in different types of silicon cannulas used for implantation into the lacrimal canals. The achieved results indicate quite clearly the advantages of microsurgical reconstruction, in particular primary reconstruction, in case of discontinuity of the lacrimatory pathways.

Humans↗

PubMed1987