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R Gutekunst

Publications and source records attributed to R Gutekunst.

7 recordsLinked to original sources

[Relationship between thyroid size and urinary concentration of iodine in the population of Bialystok].

The survey carried out in May 1991 in the city of Białystok comprised 308 children of age between 8 and 14 years and 116 young adults. In each of the studied subjects the size of the thyroid was measured by ultrasonography and iodine concentration determined in a randomly voided sample of urine. Body weight and height of the subjects have also been measured. In about 50% of the subjects studied (58.4% of children, 38.5% of men and 58.4% of women) the presence of goiter accompanied by a low urinary iodine concentration (median--2.0 micrograms/ml) was found. A significant negative correlation between the thyroid size and urinary iodine concentration, and lack of relation between the former and TSH concentration, have been found. No relation was observed between the presence of goiter and the inadequate physical development in the children studied. Insignificantly elevated TSH levels without accompanying clinical symptoms of hypothyreosis were observed in 8.7% of children, 3.8% of women and 5.1% of men studied. Higher prevalence of goiter found as compared to the results previously obtained in the same area can be related on the one to the use of more precise methods and on the other to real worsening of the situation due to discontinuation of obligatory iodine prophylaxis in the country more than 10 years ago.

Adolescent

Epidemiological surveillance of iodine deficiency in Romania by urinary iodine determinations in children aged 6-16 years from 30 counties.

Epidemiologic studies on school-children aged 6-16 years along 1978-1980 and in 1986, according to the WHO classification revealed the persistence of endemic goiter even in high incidence in some areas. Following UNICEF WHO recommendations, a new epidemiologic study was initiated in 30 counties for assessing urinary iodine through the spot urine sample method, which has widely been accepted as a satisfactory index of iodine intake. The urine samples were collected from lots of 100-200 children aged 6-16 years within each district. The results showed low iodine values, i.e., 2.4-5.5 micrograms/dl urine in 12 areas and 6-12.1 microgram/dl urine in the rest of the country. Comparison of the data on goiter endemic and iodine values in various counties shows lack of correlation in some areas. This prompted an extension of the study of urinary iodine over to larger groups of children in some counties.

Adolescent

Ultrasonography related to clinical and laboratory findings in lymphocytic thyroiditis.

The value of ultrasonography compared with established diagnostic procedures was investigated by reviewing medical records of 92 patients (88 women and 4 men, age 11-81 years, mean age 47) with lymphocytic thyroiditis. Clinical manifestations of the disease and serum antimicrosomal antibodies and TSH were determined in all patients. The thyroid was examined by ultrasound. Both lobes were aspirated by a fine needle under sonographic control and smears examined cytologically. A total of 27 (29.3%) patients had no clinical symptoms. Antimicrosomal antibodies were undetable in 12 (13%) patients, 16 (17.4%) had low titres 1:32-) 1:100, and 64 (69.6%) greater than or equal to 1:320. TSH (reference values 0.3-3.9 mU/1) was les than 0.3 in 4 (4.3%) 0.3-3.9 in 4) (44.6%) , 4-20 in 26 (28.3%), and greater than 20 in 21 (22.8%) patients. Ultrasound revealed a scattered sonolucent echo in 87 (94.6%) patients, and in 45 (48.9%) a normal thyroid volume (women less than 18, men less than 25 ml). Cytology alone was diagnostic in 84 (91.3%) patients, In conclusion, ultrasound can suggest lymphocytic thyroiditis. If antimicrosomal antibodies are undetectable or titres are not significant and/or clinical symptoms are uncertain, fine-needle aspiration can confirm the sonographic finding. Epidemiological studies including ultrasonography are necessary to obtain reliable data on the prevalence of lymphocytic thyroiditis.

Adolescent

Parathyroid localization.

Twenty-nine consecutive patients with suspected primary hyperparathyroidism were examined preoperatively using ultrasound, sonographically guided fine needle aspiration, and aspirate immunostaining for PTH. In 25 patients, localization of enlarged parathyroid glands was successful. In 2 patients, the tumors were located retrosternally and, thus, could not be detected by ultrasound. One patient had a multinodular goiter which impeded localization. In 1 patient with renal osteodystrophy, 2 enlarged parathyroid glands in the neck were not visualized preoperatively. Cytology was not diagnostic, although some cytological features were suggestive of parathyroid cells. Immunostaining of the aspirated smears for PTH, however, correctly diagnosed all preoperatively localized lesions. Ultrasound should be the routine procedure of choice for preoperative localization of abnormal parathyroid glands in primary hyperparathyroidism. Fine needle aspiration and immunocytochemistry can supply confirmation, if necessary.

Adolescent

[Diagnosis and control of therapy of thyroid disorders by TRH-test (author's transl)].

TSH-measurement before and after stimulation with TRH proved to be of good value in the diagnosis of thyroid dysfunctions, better than other parameters including J-131-test. During treatment of hypothyroid disorder TRH-test, often repeatable, allows estimation of T4 substitution dosis. In Graves disease therapy, furthermore, should be judged by in-vitro or clinical parameters.

Aged

[Comparison of the data of palpation and ultrasonic examination in assessing the dimensions of the thyroid gland].

Comparison of the thyroid-sizes estimated by palpation and ultrasonic scanning in 282 women and 178 men has shown that if the thyroid is small (from 0 to 2nd degree, according to O. V. Nikolayev's classification), its size cannot be estimated by palpation and this method fails to assess the endemic goiter in epidemiologic surveys. Correlation between the thyroid size estimated by palpation and its ultrasonically assessed volume has made up 0.346 (p < 0.001) in women and 0.193 (p < 0.01) in men. Ultrasonic assessment of the thyroid volume appears useful both for clinical and epidemiologic studies.

Female