PubMed Health⌕ Search

Biomedical subjects

Thomas Leitha

Publications and source records attributed to Thomas Leitha.

9 recordsLinked to original sources
PubMed2005

Insulin-like growth factor 1, chromogranin A and prostate specific antigen serum levels in prostate cancer patients and controls.

OBJECTIVE: Insulin-like growth factor 1 (IGF-1) and chromogranin A (CGA) are currently discussed as supplemental serum markers for prostate cancer (PC) diagnosis. To address this issue we determined serum levels of IGF-1, CGA and PSA in men with newly diagnosed PC and controls. METHODS: A consecutive series of 156 men (median age: 67 yrs) with newly diagnosed, untreated PC and 271 controls (69 yrs) were recruited. The diagnosis of PC was made by transrectal ultrasound guided biopsies only. In controls, the presence of PC was excluded by digito-rectal examination, serum prostate specific antigen (PSA) levels by using age-specific reference values and-if indicated-by transrectal ultrasound guided 12-core biopsies. Serum levels of IGF-1, CGA and PSA were compared between cases and controls and correlated to histopathological findings and age. RESULTS: Serum PSA-levels were significantly higher in men with PC (49.6+/-13.9 ng/ml, mean+/-standard error of the mean; median: 7.0 ng/ml) than in controls (2.6+/-0.2 ng/ml; median: 1.3 ng/ml) (p<0.001). In contrast, serum levels of IGF-1 (PC: 166+/-6.1 ng/ml, median: 155 ng/ml; controls: 159+/-4.5 ng/ml, 153 ng/ml) and CGA (PC: 92+/-7.4 U/l, median: 67 U/l; controls: 117+/-12.0 U/l; median: 74 U/l) were identical in both groups (p>0.05). Serum levels of IGF-1 and CGA revealed no correlation to serum PSA, Gleason score and number of positive biopsy cores. In the PC-cohort all three serum markers did not correlate with age. In controls, PSA (p=0.018) and CGA (p<0.001) correlated positively and IGF-1 (p<0.001) negatively with age. CONCLUSION: Our data suggest that quantification of IGF-1 and CGA-serum levels provides no useful information in the diagnosis of PC.

Adult↗
PubMed2004

Elevated levels of serum type I collagen C-telopeptide in patients with rapidly destructive osteoarthritis of the hip.

We compared type I collagen degradation using serum cross-linking C-terminal telopeptide (ICTP) in 18 patients with rapidly destructive osteoarthrosis and in 20 patients with slowly progressive osteoarthrosis of the hip. The diagnosis was established by clinical examination and radiographic evaluation. Total hip arthroplasty was performed in all patients. Serum levels of ICTP, bone-specific alkaline phosphatase, osteocalcin and N-terminal propeptide were studied. Patients with rapidly destructive osteoarthrosis had higher mean (SD) serum ICTP levels than patients with slowly progressive osteoarthrosis [13.2 (5.6) versus 3.7 ng/ml (1.4), p=0.001] whereas no significant difference of all other markers was seen between the groups. Elevation of ICTP levels correlated significantly with decreased joint-space width assessed by radiographs of the hip (p=0.01). Our data suggest that rapidly destructive hip osteoarthrosis is associated with elevated serum ICTP levels, reflecting increased collagen type I degradation.

Aged↗
PubMed2004

Frequency and risk factors for meningioma in clinically healthy 75-year-old patients: results of the Transdanube Ageing Study (VITA).

BACKGROUND: The prevalence of clinically silent intracranial tumors in specific populations is poorly researched. It is known that, in advanced age groups, the number of clinically manifest meningiomas constitute a small proportion of the actual number of cases. The goals of the current study were to determine the frequency of asymptomatic patients with meningioma in advanced age and to identify risk factors for meningiomas in this population. METHODS: Between May 2000 and November 2002, 532 probands from a specifically defined geographic area of Vienna who were age 75 years underwent a magnetic resonance imaging scan of the brain and were evaluated for the presence of a space-occupying mass. All probands were examined clinically and neurologically as well as by a neuropsychiatrist. The patients' medical histories were carefully documented with regard to previous diseases, medication, and lifestyle, as were their laboratory reports. The collected data were correlated and similarities among subjects with meningioma were determined. RESULTS: Nine meningiomas that were unknown until the time of investigation were observed among the 318 women included in the trial (corresponding to a calculated prevalence of 2800/100,000 clinically silent meningiomas in 75-year-old women). No tumors were found among men. Associated clinical changes or deficits were not observed in any subject. Apart from advanced age and female gender, no other accepted or well known risk factors were observed in the tumor patients. CONCLUSIONS: Clinically quiescent meningiomas in the elderly female population were more common than was believed to be the case to date. Known and influenceable risk factors were found to be less important than age and gender. The high frequency of this lesion should be considered when deciding on the treatment of patients with incidentally discovered, clinically quiescent meningiomas.

Aged↗
PubMed2004

SPECT-CT for topographic mapping of sentinel lymph nodes prior to gamma probe-guided biopsy in head and neck squamous cell carcinoma.

INTRODUCTION: Lymphoscintigraphic planar imaging is a common procedure for sentinel lymph node imaging prior to lymph node biopsy, but fails to elucidate the specific lymphatic drainage. Composite functional/anatomical imaging (SPECT-CT) has the potential to enhance topographic orientation and diagnostic sensitivity of sentinel lymph node imaging, but has not yet been applied in the head and neck region. STUDY DESIGN: A total of 30 patients were investigated. Planar imaging was 5 min, 265 x 265, right and left lateral; 500 kilocounts (Kcts) and SPECT (GE Millenium VG Hawk Eye 6 degrees/30s. step, 128 x 128, slice thickness 4.42 mm). Scans were performed 60 min after intra-mucodermal injection of 0.1 ml of 20 MBq 99mTc nanocolloid in patients with squamous cell cancer of the head and neck. SPECT studies were analysed by filtered back projection (FBP: Hann (0.7) prefiltering, Butterworth (0.5) postfiltering) and reconstruction (OSEM: Post Filter Hamming (0.85), 2 Iterations) and independently viewed with the co-registered CT image (eNTEGRA Functional Anatomical Fusion Vers 2.0216). The results were validated by comparing the results of each method employed in all 30 cases and intraoperative gamma probe-guided sentinel lymph node biopsy with histological examination in 13 of these patients. RESULTS: The majority of patients had more than one sentinel node (mean 1.63, min. 0, max. 4). Seven out of the 30 studies demonstrated lymphatic flow to the contralateral side of the neck. Forty-nine sentinel nodes were identified by iteratively reconstructed SPECT-CT. Thirty-eight out of these 49 could be located in lymphoscintigraphic planar imaging, whereas only 24/49 were detected in filtered back projection, respectively. In 11 of the 30 cases, a clinically unpredictable pattern of lymphatic drainage was observed. No correlation was found between T stage or tumour location and the number of sentinel nodes detected. In one out of the 13 cases, in whom imaging was followed by intraoperative gamma probe-guided biopsy, no sentinel node could be detected with the probe in the proximity of the primary tumour, although the node was clearly discernible in the reconstructed SPECT-CT. CONCLUSION: Composite functional/anatomical imaging (SPECT-CT) is feasible for sentinel lymph node detection. It enhances topographic orientation and diagnostic sensitivity with more sentinel nodes being detectable than by planar lymphoscintigraphy alone. Planar imaging should be accompanied by iterative reconstructed SPECT-CT to identify lymph nodes adjacent to the primary lesion. Such nodes are easily overlooked by planar lymphoscintigraphy and intraoperative gamma probes, as the high activity at the injection site can obscure their detection.

Adult↗
PubMed2004

Microvessel density is not crucial for scintigraphic visualization of brain tumors using 99mTc-MIBI.

Functional imaging of brain tumors assists biopsy localization, therapy monitoring, and differentiating tumor recurrence from radiation necrosis. Tumor vascularization is a strong prognostic predictor in solid tumors and also a key factor of tracer uptake. However, the relationship of brain tumor vascularization and functional imaging has not yet been investigated sufficiently so far. In the present study, we correlated histologically assessed microvessel density as an objective parameter for brain tumor vascularization with imaging data. Four male patients were studied. After 99mTc-MIBI scintigraphy, all patients had a MRI within 2 weeks. Histology showed microcystic astrocytoma, glioblastoma (n = 2), and anaplastic oligodendroglioma, respectively. Microvessel density was lowest in the microcystic astrocytoma, medium in the glioblastomas, and highest in the anaplastic oligodendroglioma. Scintigraphy visualized only the glioblastomas, but not the microcystic astrocytoma or oligodendroglioma. Our data showed no correlation between tumor microvessel density and 99mTc-MIBI scintigraphy. Thus, we conclude that scintigraphic visualization of brain tumors is not strictly dependent on tumor vascularization.

Adult↗
PubMed2003

Concomitant hyperparathyroidism and nonmedullary thyroid cancer, with a review of the literature.

PURPOSE: Primary hyperparathyroidism and concomitant thyroid cancer is a rare and complicated setting for diagnostic imaging. MATERIALS AND METHODS: The authors report the accidental finding of primary hyperparathyroidism in a patient with rapid enlargement of a thyroid nodule and the results of a literature review. RESULTS: Tl-201-Tc-99m subtraction scintigraphy correctly revealed the malignant nature of a large cold thyroid nodule and mediastinal parathyroid hyperplasia. In contrast, high-resolution ultrasound indicated a retrothyroidal hyperplastic parathyroid gland. Surgery followed the findings of the preoperative ultrasound and intraoperative biopsy, yet hyperparathyroid disease persisted. Repeated scintigraphy confirmed an ectopic parathyroid gland, which was resected from a paraesophageal location. Subsequently, hormone and calcium levels returned to normal and remained normal during a follow-up period of 3 years. A literature review revealed a prevalence of approximately 3% of nonmedullary thyroid cancer, which was found in patients operated on for primary hyperparathyroidism. Previous neck irradiation, especially in childhood, appears to be a risk factor for the development of both nonmedullary thyroid carcinoma and for primary hyperparathyroid disease. CONCLUSIONS: This case illustrates the need for clinical awareness of concomitant hyperparathyroidism and nonmedullary thyroid cancer and is substantiated with published case reviews. The preoperative scintigraphic localization of hyperfunctioning parathyroid tissue, although not advised as a routine procedure, may provide diagnostic information in addition to high-resolution ultrasound and intraoperative biopsy. In addition, scintigraphy can be useful even in the technically difficult setting of concomitant thyroid cancer.

Adenoma↗
PubMed2002

Hypertrophic osteoarthropathy caused by PGE1 in a patient with congestive heart failure during cardiac rehabilitation.

Continuous chronic drug infusion with PGE1 via a portable pump and neuromuscular electrical stimulation (NMES) help to improve the quality of life in patients with severe chronic heart failure waiting for a donor heart, as both treatments can be performed at home. We report a 56-year-old woman suffering from severe chronic heart failure, who was referred for a cardiac rehabilitation program because of progressive muscle weakness and weight loss. Due to her underlying heart disease she was unable to perform voluntary exercise. NMES of both knee extensor muscles was started. Under simultaneous chronic drug infusion with PGE1 via a portable pump the patient developed clinical signs of hypertrophic osteoarthropathy, which prevented her from continuing the rehabilitation program. X-ray examinations and bone scans concurred with the diagnosis of secondary hypertrophic osteoarthropathy. After the PGE1 dose had been reduced, the clinical signs of the osteoarthropathy resolved and the patient was able to continue the rehabilitation program with no difficulty. This case report underlines the importance of being aware of the potential side effects of modern cardiac drugs in the complex treatment of patients waiting for a donor heart.

Alprostadil↗