Endokrine Orbitopathie 1998

Die haufigste extrathyreoidale Manifestation der autoimmunen Thyreopathie ist die endokrine Orbitopathie. Das Charakteristikum dieser Autoimmunerkrankung ist die entzundliche Volumenzunahme des peri- und retrobulbaren Gewebes, die zur klinischen Symptomatik nichtinfiltrativer Lidaffektionen, Protrusio bulbi, Augenmuskelparesen und bis hin zum Visusverlust fuhren kann. Die pathologischen Veranderungen der endokrinen Orbitopathie sind gekennzeichnet durch immunologisch vermittelte Entzundungsreaktionen im Retrobulbarraum, in deren Verlaufes zur lymphozytaren Infiltration und Einlagerung von Glykosaminoglykanen in das orbitale Muskel-, Binde- und Fettgewebe kommt. Trotz verschiedener neuer dia…

Aktuelle interdisziplinäre Diagnostik und Therapie der endokrinen Orbitopathie*

Radiation response non-invasively imaged by [18F]FDG-PET predicts local tumor control and survival in advanced oral squamous cell carcinoma

It is a major challenge to preoperatively identify patients who will profit from surgery of advanced oral cancer. In multimodality therapy, response to neoadjuvant radiation correlates to treatment success. Hence, for preoperative decisions, assessment of treatment response is required. Therefore, we analysed the prognostic significance of glucose metabolism after preoperative radiotherapy. [(18)F]FDG-PET investigations were performed for re-staging 35 patients after neoadjuvant radiotherapy (36Gy) immediately prior to tumor resection. Emission and transmission measurements were obtained and SUV's were calculated for the sites of maximum [(18)F]FDG-uptake. Subpopulations of "low" (SUV4) and…

Somatostatin-receptor scintigraphy in Graves' disease: reproducibility and variance of orbital activity.

Somatostatin-receptor (SSTR) scintigraphy using the single photon emission computed tomography (SPECT) technique allows the assessment of orbital inflammation in patients with Graves' disease. Previous studies showed differences in orbital octreotide uptake already 4 hr after injection. In this study, analysis of inter-/intra-observer variance and reproducibility in the evaluation of orbital SPECT images was performed. First, SPECT data of one representative female patient with clinically active Graves' ophthalmopathy (GO), obtained 4 hr after intravenous injection of 110 MBq 111In-pentetreotide and processed by filtered backprojection, were analyzed. Transverse SPECT images were reconstruc…

Individuell dosiertes Levothyroxin mit 150 µg Jodid versus 100 µg Levothyroxin kombiniert mit 100 µg Jodid: Eine randomisierte Doppelblindstudie

BASIC PROBLEM AND OBJECTIVE Intrathyroid deficiency and the influence of thyroid stimulating hormone (TSH) are the main pathogenetic factors in the development of endemic euthyroid goitre. Goitre reduction is achieved with either administration of levothyroxine, which diminishes hypophyseal TSG production, or of iodide. Aim of this study was to compare the efficacy of treatment with a dose-fixed combination of levothyroxine plus iodide with that of an individualized dosage of levothyroxine plus iodide. PATIENTS AND METHODS After randomization 49 patients with euthyroid goitre (24 women, 25 men, aged 20-43 years) were treated for 12 weeks in a double-blind trial. Patients in group A received…

Das polyglanduläre Autoimmunsyndrom Typ II: Epidemiologie und Manifestationsformen

Background and objective Polyglandular autoimmune syndrome (PAS), is characterized by the coexistence of several autoimmune diseases, affecting predominantly the endocrine glands. The juvenile form (PAS type I) is distinguished from the adult type II in which autoimmune thyroiditis, adrenal cortical insufficiency and diabetes mellitus type I predominate. The connections between epidemiological, clinical and immunological aspects were analysed and described in this study of patients with PAS type II. Patients and methods Among a total patient population of over 15,000 seen in our endocrinological university policlinic from 1992 through 1996, the clinical data of all 151 patients with PAS typ…

SPET/CT image co-registration in the abdomen with a simple and cost-effective tool

Fusion of morphology and function has been shown to improve diagnostic accuracy in many clinical circumstances. Taking this into account, a number of instruments combining computed tomography (CT) with positron emission tomography (PET) or single-photon emission tomography (SPET) are appearing on the market. The aim of this study was to evaluate a simple and cost-effective approach to generate fusion images of similar quality. For the evaluation of the proposed approach, patients with neuroendocrine abdominal tumours with liver metastases were chosen, since the exact superimposition in the abdomen is more difficult than in other regions. Five hours following the injection of 110 MBq (111)In…

Therapiemonitoring mittels 2-[18F]-FDG-Positronenemissionstomographie nach neoadjuvanter Strahlenbehandlung des Mundhöhlenkarzinoms

Die Kombination strahlentherapeutischer und chirurgischer Behandlungsschritte beim Mundhohlenkarzinom erfordert eine fruhe, objektive Bewertung des Bestrahlungserfolgs. Schlechtes radiotherapeutisches Ansprechverhalten verlangt die moglichst umgehende chirurgische Sanierung auch bei hohem Operations- und Narkoserisiko. Eine deutliche Remission unter Strahlentherapie kann dagegen die Fortsetzung der Bestrahlungsbehandlung begrunden. Die vorliegende Studie untersucht daher die Bewertung des Bestrahlungserfolgs anhand der durch Positronenemissionstomographie (PET) bestimmten Glukosestoffwechselaktivitat.

Synthesis of C1-[18F]fluoroethylamnino asparagine for imaging cancer

C1-[18F]fluoroethylamino asparagine was synthesised from N1-t-boc C1-p-nitrophenol asparagine and the radiolabelled precursor [18F]flouroethylamine in a one-pot-synthesis. The yield of this synthesis was 22% referring to [18F]fluoride, including the removal of the protection groups. The in vivo tests are in progress.