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Biomedical subjects

W Horst

Publications and source records attributed to W Horst.

At least 55 records · Page 3Linked to original sources
PubMed1976

The risk of chronic progressive radiation myelopathy.

Five cases of chronic radiation myelopathy (four of the thoracic and one of the cervical cord) are presented together with a short summary of cases already published. The important influence of the fractionation scheme is stressed. A dose not exceeding 4400 rd in the thoracic myelon (20 X 2000 rd, 5 times per week, plus 10 X 40 rd - or 15 X 200 rd plus 15 X 90 rd, 5 times per week, - or 8 X 330 rd, three times per week, plus 15 X 80 rd 5 times per week) is considered to be a safe limit. In view of the scarcity of adequately documented cases of cervical myelopathy, it is recommended to keep dose limits about 10% lower than in the thoracic region and to avoid high single doses in curative treatments. Hypertension may increase the risk of radiation myelopathy (case nr. 5).

Adult↗
PubMed1976

[Radiotherapy of salivary gland carcinomas (results from 80 patients)].

Of 102 patients irradiated because of a tumor of the salivary glands between 1952 and 1973, 80 cases are evaluated in this paper. 67 tumors were localized in the parotid gland. We found 12 tumors in the submandibular gland, one tumor in the sublingual gland. The tumors turned out to be benign in 17 cases, whereas the remaining 63 tumors evidently proved to be malignant. 28 patients underwent either sole irradiation, or radiation therapy was performed after a subtotal operation the number of the patients only irradiated being very small. In 29 cases radiation therapy followed a radical operation; the remaining 23 patients were sent to us for radiation therapy not earlier than after a single or repeated recurrences following surgical treatment. In 23 patients a local recurrence developed after irradiation. Metastases to the lymph nodes were observed in 24 patients, in 17 cases being already manifest at the beginning of the irradiation. Distant metastases were found in 30 patients, six of these existing already at the beginning of the radiation therapy. Till now, thirty patients died because of their cancerous disease, 13 patients because of intercurrent diseases. The five-year survival recovery rate amounted to 50%, the rate of seven-year survival to 42%. The results of surgery for malignant tumors of the salivary glands are distinctly improved by radiation therapy. Especially the high percentage of recurrences after sole surgical treatment reveals the necessity of postsurgical radiation therapy. For the prevention of local recurrences, however, very high doses have to be delivered to the tumor generally. We recommend 6500 rd as a minimal dose to be applied within five to six weeks. In certain cases, with particularly radioresistant tumors, a local dose of up to 7500 rd may be delivered to a small volume. Irradiation of the highly malignant tumors of salivary glands should encompass the regionary lymph nodes too, even if they are not affected metastatically.

Adolescent↗
PubMed1975

[Results of treatment of hyperthyroidism with 125-iodine].

About 100 patients with hyperthyroidism and diffuse goiter (gland weight not more than 60 g) were treated with an individually calculated dose of 125-Iodine. After a follow-up time between 1.5 and 2 years there are the following results: 82% of the patients are euthyroid and 18% are still hyperthyroid. Relapse rate was 10%. More than 30% of the residual or relapse hyperfunctions were T3 toxicosis. The status of 125-Iodine in the treatment of thyrotoxicosis is discussed with regard to the necessity of a "destructive" therapy in the major part of the patients. Published results of 125-Iodine therapy are summarized.

Adult↗
PubMed1975

[Radio-iodine treatment of hyperthyroidism. Experience in more than 2000 patients (author's transl)].

Results of radioiodine therapy (131/125) of hyperthyroidism are reported. The individually calculated doses of 131-iodine were: 6000 rad in cases of small (not more than 60 g) diffuse goiters, 8000-10000 rad in large diffuse goiters, 10000-12000 rad in nodular goiter and 30000-40000 rad in autonomous adenoma. In about 75% of the patients a single application of 131-iodine was sufficient to control the hyperfunction. The cumulative risk of myxedema ten years after therapy was: 31% in small diffe goiters, 12% in large diffuse goiters and 6% in nodular goiter. All cases considered together, the cumulative myxedema risk was about 12%. This figure compares favourably with the results of surgical treatment and they document the necessity of individual calculation of the dose in order to get optimal results. 125-iodine was applied since October 1972 in cases of small diffuse goiters. The dose was standardized according to the gland weight, uptake and effective half value time (dose at the colloid-cell interface 12000-15000 rad). 5-12 months thereafter, there were about 60% of the patients euthyroid. The genetic and somatic risk of radiation is considered quantitatively and we conclude that there is no real argument aginst radioiodine therapy of hyperthyroidism except in children and in youth. Risks and efficiency of other treatments (surgical, antithyroid drugs) are compared with the radioiodine treatment and it is concluded that radioiodine is to be preferred in the major part of the hyperthyroid patients.

Humans↗
PubMed1975

[Exhalation diagnosis with C14 tagged compounds, methods and results].

The method and results of the 14C exhalation test for metabolic studies are presented. In patients under radiotherapy for malignant diseases (we consider radiotherapy to be a well defined metabolic disturbance), studies with 14C-carboxyl triglycerides, with 14C-glycincholate, with 14C-histidine and with 14C-uridyl reveal the extent of the metabolic changes and also how long it would take to return to the normal state. It is not yet well understood why a disturbace of glycincholate absorption persists for years after radiotherapy of the pelvis. The method can also be employed in gastroenterology (absorption of bile salts) and in assessing an anabolic or catabolic state as af function of thyroid hormone. Further metabolic tests for radiobiologic evaluations are in progress.

Bile Acids and Salts↗
PubMed1975

[Results of primary and combined radiotherapy of mouth carcinomas (tongue, tonsil, maxilla, mandible, palate, floor of the mouth cheek mucosa)].

Responses to highvoltage radiotherapy of 320 patients with carcinomas of the oral cavity are discussed. Five year survival rate according to the stage of the, disease were the following ones: in carcinoma of the anterior 2/3 of the tongue and floor of the mouth 20-60%, buccal mucosa, upper and lower jaw 30-50%, base of the tongue 26% and tonsil 30-100%. After simultaneous irradiation of the efferent lymphatics in parimary N0 patients, whose primary tumor subsequently was under control, a significantly lower frequency of metastases to the lymph nodes was found than without coirradiation of the lymph flow. Clinically verifiable metastases of the lymph nodes are also controllable to a high percentage by radiotherapy alone: Only in a little more than five per cent of the primary N1-3 patients with the parimary tumor being under control, additional metastases of the lymph nodes developed later on. The complication rate was 6.8 per cent. Most frequently, osteonecrosis was involved, indeed occurring chiefly in cases, where a primary skeletal manifestation of the tumor already was existing.

Bone Neoplasms↗
PubMed1975

Results of radioiodine (131/125I) therapy of hyperthyroidism.

One individually calculated dose of 131I was sufficient to control the hyperfunction in 75% of the patients with Graves' disease and 85% of the patients with autonomous adenoma. The cumulative myxedema risk 10 years after therapy was: 15% in the patients with Graves' disease and nearly zero in patients with autonomous adenoma. Early results of 125I therapy of Graves' disease are presented. Peculiar aspects of thyroid function after destructive therapy of Graves' disease are discussed.

Adenoma↗
PubMed1975

Simultaneous estimation of tubular and glomerular renal clearance with separate estimation of each side using a self-constructed whole-body measuring set.

A measuring device for simultaneous determination of glomerular and tubular clearance with separation of both sides is described. The patient lies on a table. Two detectors mounted on the ceiling count the residual radioactivity in the body except in the kidneys which are shielded by a lead block. Two other detectors count the renal radioactivity. The total renal clearance is calculated by the whole-body clearance curve and plasma activity. The fraction cleared by each side is calculated by the renal activity time curve. Radiopharmaceuticals were: 99Tcm-EDTA and 131I-hippuran. Values for normal patients are given.

Glomerular Filtration Rate↗
PubMed1975

[Mobile therapy with electrons in breast cancer (author's transl)].

Our intention in breast cancer is to reduce the local recurrency by optimal radiotherapy. The use of electrons with their ideal depth dose distribution was limited by several problems (e.g., field homogeneity, constancy of dose rate). Taking constructive measures, we now have an easy to handle, mobile electron therapy.

Breast Neoplasms↗