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Biomedical subjects

S Röhling

Publications and source records attributed to S Röhling.

At least 19 recordsLinked to original sources
PubMed1986

Some factors influencing the survival of patients with less advanced stages of differentiated thyroid cancer.

Two groups of patients with less advanced stages of differentiated thyroid cancer were followed from 2 to more than 25 years: 1. 326 patients with preventive thyroid ablation (PTA) in cases of a tumor without lymphatic and remote metastases; 2. 471 patients with lymph node syndrome. It was found that the survival of patients with lymph node syndrome was less including the group below 40 years of age. Within the first group (with PTA) the survival was less in cases with the invasion of tumor through the thyroid capsula (stage T3 according to WHO classification). In both groups neither any significant effect of sex nor histological characteristics of the tumor (i.e. papillary v.s. follicular) was found. However, the effect of age was found to be remarkable in both groups, the prognosis being worse in patients after 40 years of age. Finally, the prognosis of less advanced stages of differentiated cancer was much better than than in patients with remote metastases.

Adenocarcinoma↗
PubMed1984

The rational use of 201Tl scintigraphy in the evaluation of differentiated thyroid cancer.

Fifteen patients with differentiated thyroid cancer were examined following 131I thyroid ablation, of these seven were examined after radio-iodine therapy to disseminated neck cancer. They had no further radio-iodine uptake and were evaluated using a 201Tl scan. In thirteen patients there was a good correlation between the results and the clinical diagnosis, showing no uptake in seven subjects with negative clinical findings, and positive delineation of tumour tissue in the neck region in six patients. The remaining two patients with lymph node metastases after previous radio-iodine irradiation showed marked clinical regression of the metastases with absent uptake of both 131I and 201Tl, probably due to radiation-induced changes. The comparison of thallium scans with plasma thyroglobulin levels showed certain differences (high plasma thyroglobulin without any proof of remaining thyroid tissue in one patient and normal/low plasma thyroglobulin in the presence of a tumour in two patients) but both measurements could give additional information. It is believed that while in the differential diagnosis of a thyroid nodule no important information could be expected of scanning (compared with the high value of aspiration biopsy), the evaluation of patients without 131I uptake by 201Tl scans could provide important information for further therapy.

Adenocarcinoma↗
PubMed1983

Serum thyroglobulin determinations in patients with differentiated thyroid carcinoma.

Serum thyroglobulin levels were measured in 636 patients with differentiated thyroid carcinoma, in whom altogether 1240 determinations were performed in different phases of disease and treatment. A modified sensitive radioimmunoassay was employed using an own high-specific thyroglobulin antibody. The results showed that both the majority of patients with functioning metastases accumulating radioiodine and with non-functioning metastases which could not be detected by scanning had higher serum TG levels, compared with a group of healthy subjects. However, "normal" TG values in patients with metastases, especially non-functioning, were found too. Thus, these findings decrease the diagnostic value of the TG determination. The highest TG values were found in patients with distant metastases of differentiated thyroid carcinoma (in lungs and bones); on the other hand, the proportion of patients with lymph-node(s) metastases and "normal" TG levels was relatively high. We suggest that the serum TG determination cannot generally replace scanning with 131I and cannot serve as the only test, while being a helpful indicator in the long-term follow-up of differentiated thyroid cancer patients.

False Negative Reactions↗
PubMed1982

TSH stimulation and other ways to increase the uptake in normal and tumorous thyroidal tissue.

The use of bovine TSH is still the most important means for increasing the radioiodine uptake in functionally active tissue. The increase is more marked in normal thyroid tissue (where 2.5 fold increase of the initial value can be expected); but the tumorous tissue reacts to the stimulation, though less substantially (mean increase to 1.5). In intact thyroid gland the increase of uptake is more pronounced with lower uptake in the remaining thyroid tissue; in functionally active tumor this relation cannot be proved. With very low uptake in the tumorous tissue (below 2.5%/24 h) the chance to achieve practically significant increase is negligible. The complications with TSH administration appear especially with repeated application, the proportion of more serious side effects being low. The use of diuretic regime with the iodine depletion simultaneously with TSH stimulation is rather pretentious for the patient; it substantially increases the uptake in the tumorous tissue (again to 2.6 times), although more markedly decreases the iodine excretion in the urine what leads to higher danger of complications caused by radioiodine therapy. The use of TSH stimulation to increase the uptake in the tumorous tissue had not yet been shown to be useful.

Humans↗
PubMed1980

Thyroidectomy as a pathogenic factor in the evolution of thyroid cancer.

In a group fo 860 patients with thyroid cancers (TC), 66 were found having had thyroid surgery for benign disorder more than 5 years before the diagnosis of TC. More than 70% of these patients were operated upon 10 or more years ago. The incidence of cancers developing in thyroid postsurgical remnants could thus be estimated to 5.5-7.7% of all thyroid cancers. These patients had predominantly follicular cancers and usually were older than 40 years at the age of diagnosis of TC. Unusually high incidence of distant metastases (pulmonary or osseous) was proved compared to other patients with TC, while the increase of patients having both pulmonary and osseous metastases was not found. It seems that the risk of developing TC late after thyroid surgery is somehow connected with endemic goitre areas, as all such reports arise from the central European area. Whichever the pathogenic mechanism may be, all patients following surgery for benign eumetabolic goitres should be checked up in regular intervals with regard to the possible benign or malignant recurrence. Patients operated upon because of hyperthyroidism do not seem to carry any similar risk.

Adenocarcinoma↗
PubMed1979

Mode of spread of thyroid cancer.

Metastatic dissemination of differentiated cancer was studied in a personal group with the following results. Invasion of cancer to adjacent structures can be encountered even in children with typical increase with age. The lymphatic spread to regional lymph nodes is typical of papillary cancers and in young patients. The same type of spread without the age-dependent decrease can also be proved, with lower incidence, in follicular cancers. Pulmonary metastases are frequently the only type of distant metastases and may originate from previous spread to lymph nodes. The isolated bone metastases a;e probably brought about through the vertebral venous system. Patients having multiple bone metastases or both bone and lung lesions are probably the only typical examples of metastasizing through the systemic blood flow. As the above types of distant metastases carry different prognosis they should also be recognized by the TNM system.

Adult↗
PubMed1979

[Roentgenological characteristic of pulmonary metastases in thyroid cancer in respect of its biological behaviour (author's transl)].

In metastases of the lung which must be considered as typical in cancer of the thyroid, it is possible to differentiate roentgenologically between fine and coarse nodules, the limit being approximately 10 mm. Metastases consisting of fine nodules are by no means to be considered as representing a fatal generalisation, whereas metastases with coarse nodules are frequently accompanied by other metastases distant from the primary tumour.

Adenocarcinoma↗
PubMed1979

Labelled amino acids in plasma of patients with thyrotoxicosis and thyroid cancer after radioiodine treatment.

The levels of total organically bound 131I, per cent of labelled iodoproteins, total labelled iodinated amino acids and a percentage of individual iodinated amino acids (thin-layer chromatography) were measured in serum of 84 patients with thyroid cancer and of 16 patients with thyrotoxicosis at 48 h after the administration of therapeutic dose of 131I. In thyrotoxic patients treated with therapeutic doses of 131I (2 to 39.6mCi; 74 to 1500 MBq) the findings were similar to normal subjects. In patients with thyroid cancer a significant increase of iodotyrosines was found after thyroid radioiodide ablation (100 to 200 mCi; 3.7 to 7.4 GBq). No remarkable differences were found between two groups of patients with thyroid cancer, the first one being treated with thyroid eliminating dose in attempt to activate the metastases of functionally differentiated tumour, while the second one was treated with similar doses (i. e. 100 to 200 mCi) to suppressor destroy a functionally active tumour or its metastases. Even though the hormonogenesis in tumours was hardly distinguishable from the products of its radiation damage, it was suggested that the hormonogenesis in neoplastic tissue differs from that in normal thyroid only quantitatively, being less in patients with thyroid cancer than in these with thyrotoxicosis.

Amino Acids↗