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  • 1
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    Konjunktivale Neurome und prominente korneale Nervenfasern als diagnostischer Hinweis auf endokrinologische Multiorganerkrankungen1
    Georg Thieme Verlag KG ; 2001
    In:  Klinische Monatsblätter für Augenheilkunde Vol. 218, No. 6 ( 2001-6), p. 463-465
    Details
    In: Klinische Monatsblätter für Augenheilkunde, Georg Thieme Verlag KG, Vol. 218, No. 6 ( 2001-6), p. 463-465
    Type of Medium: Online Resource
    ISSN: 0023-2165 , 1439-3999
    URL: Article
    DOI: 10.1055/s-2001-16264
    RVK:
    XA 10000
    Language: Unknown
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2001
    detail.hit.zdb_id: 2039754-9
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  • 2
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    Online Resource
    Parathyroid Hormone Levels Predict Long-Term Outcome After Operative Management of Parathyroid Cancer
    Georg Thieme Verlag KG ; 2017
    In:  Hormone and Metabolic Research Vol. 49, No. 07 ( 2017-07), p. 485-492
    Details
    In: Hormone and Metabolic Research, Georg Thieme Verlag KG, Vol. 49, No. 07 ( 2017-07), p. 485-492
    Abstract: The role of parathyroid hormone (PTH) serum levels for prediction of outcome is ill defined for parathyroid cancer, which is a very rare disease. This investigation of 17 consecutive patients with parathyroid cancer, (re-)operated on at a tertiary referral center between 1994 and July 2016, with a mean follow-up of 179.6 months (15 years) aimed to clarify the suitability of PTH serum levels for prediction of clinical outcome after comprehensive operative management of parathyroid cancer. Cancer-specific mortality occurred significantly more often with the performance of sternotomy before or at first operation at this institution (80 vs. 0%; p=0.002); mean PTH serum levels before first operation (1 105 vs. 357 pg/ml; p=0.008; r=0.77) and at most recent follow-up (3 167 vs. 101 pg/ml; p=0.019; r=0.60); and normalization of PTH serum levels at most recent follow-up (0 vs. 64%; p=0.034). For cancer-specific survival, receiver-operating characteristics analysis identified as optimum cut-off point an initial PTH serum level of 700 pg/ml. For local recurrence, no significant associations were found. Kaplan-Meier analysis confirmed that the patients with initial PTH serum levels 〉 700 pg/ml (plog-rank=0.011) and sternotomy (plog-rank 〈 0.001), but not node or lung metastases, had worse cancer-specific survival. Parathyroid cancer is much more an endocrine disease with oncological features than an oncological disease with endocrine features. Operative intervention(s) should be comprehensive and directed at clearing all metabolically active parathyroid tumor deposits early. If surgical cure cannot be reached, it is pivotal to achieve metabolic control, obviating the need for, or facilitating, medical therapy of hypercalcemia, and preserve renal function.
    Type of Medium: Online Resource
    ISSN: 0018-5043 , 1439-4286
    URL: Article
    DOI: 10.1055/s-0043-109562
    RVK:
    XA 46918
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2017
    detail.hit.zdb_id: 2056576-8
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  • 3
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    Axillary Node Metastases of Medullary Thyroid Cancer: A Hallmark of Terminal Disease
    Georg Thieme Verlag KG ; 2023
    In:  Hormone and Metabolic Research
    Details
    In: Hormone and Metabolic Research, Georg Thieme Verlag KG
    Abstract: Little is known about axillary node metastasis of medullary thyroid cancer (MTC). To address this, a comparative study of patients with and without axillary node metastases of MTC was conducted. Among 1215 consecutive patients with MTC, 482 patients had node-negative MTC and 733 patients node-positive MTC. Among the 733 patients with node-positive MTC, 4 patients (0.5%) had axillary node metastases, all of which were ipsilateral. Patients with axillary node metastases had 5.7–6.9-fold more node metastases removed, both at the authors’ institution (medians of 34.5 vs. 5 metastases; p=0.011) and in total (medians of 57 vs. 10 metastases; p=0.013), developed more frequently distant metastases (3 of 4 vs. 178 of 729 patients, or 75 vs. 24%; p=0.049), specifically to bone (2 of 4 vs. 67 of 729 patients, or 50 vs. 9%; p=0.046) and brain (1 of 4 vs. 4 of 729 patients, or 25 vs. 0.5%; p=0.027), and more often succumbed to cancer-specific death (3 of 4 vs. 52 of 729 patients, or 75 vs. 14%; p=0.005). Altogether, patients with axillary node metastases revealed 4–8-fold more node metastases in the ipsilateral lateral neck (medians of 11 vs. 3 metastases; p=0.021) and in the ipsilateral central neck (medians of 8 vs. 1 metastases; p=0.079) patients without axillary node metastases. Cancer-specific survival of patients with vs. patients without axillary node metastases of MTC was significantly shorter (means of 41 vs. 224 months; plog-rank 〈 0.001). These findings show that patients with axillary node metastases of MTC have massive metastatic dissemination with poor survival.
    Type of Medium: Online Resource
    ISSN: 0018-5043 , 1439-4286
    URL: Article
    DOI: 10.1055/a-2172-9263
    RVK:
    XA 46918
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2023
    detail.hit.zdb_id: 2056576-8
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  • 4
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    Online Resource
    Distinct Late-Night Salivary Cortisol Cut-Off Values for the Diagnosis of Hypercortisolism
    Georg Thieme Verlag KG ; 2021
    In:  Hormone and Metabolic Research Vol. 53, No. 10 ( 2021-10), p. 662-671
    Details
    In: Hormone and Metabolic Research, Georg Thieme Verlag KG, Vol. 53, No. 10 ( 2021-10), p. 662-671
    Abstract: Due to high morbidity and mortality of untreated hypercortisolism, a prompt diagnosis is essential. Measurement of late-night salivary cortisol provides a simple and non-invasive method. However, thresholds and reference ranges differ among studies. The goal of this study was to define a threshold of late-night salivary cortisol for the diagnosis of hypercortisolism based on the used assay. Moreover, the influence of different aetiologies of hypercortisolism and individual comorbidities were investigated. Prospective analyses of 217 patients, including 36 patients with proven hypercortisolism were carried out. A sum of 149 patients with suspicion of hypercortisolism but negative endocrine testing and 32 patients with hypercortisolism in remission served as control group. Late-night salivary cortisol was measured using an automated chemiluminescence immunoassay. Cut-off values were calculated by ROC analysis. The calculated cut-off value for the diagnosis of hypercortisolism was 10.1 nmol/l (sensitivity 94%; specificity 84%). Only slightly lower thresholds were obtained in patients with suspected hypercortisolism due to weight gain/obesity (9.1 nmol/l), hypertension or adrenal tumours (both 9.8 nmol/l) or pituitary adenomas (9.5 nmol/l). The late-night salivary cortisol threshold to distinguish between Cushing’s disease and Cushing’s disease in remission was 9.2 nmol/l. The cut-off value for the diagnosis of ectopic ACTH-production was 109.0 nmol/l (sensitivity 50%, specificity 92%). Late-night salivary cortisol is a convenient and reliable parameter for the diagnosis of hypercortisolism. Except for ectopic ACTH-production, thresholds considering different indications for evaluation of hypercortisolism were only slightly different. Therefore, they might only be useful if late-night salivary cortisol results near the established cut-off value are present.
    Type of Medium: Online Resource
    ISSN: 0018-5043 , 1439-4286
    URL: Article
    DOI: 10.1055/a-1608-1720
    RVK:
    XA 46918
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2021
    detail.hit.zdb_id: 2056576-8
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  • 5
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    Online Resource
    Pro - Vorteile des intraoperativen Neuromonitorings bei Schilddrüsenoperationen
    Georg Thieme Verlag KG ; 2008
    In:  DMW - Deutsche Medizinische Wochenschrift Vol. 125, No. 24 ( 2008-3-25), p. 774-774
    Details
    In: DMW - Deutsche Medizinische Wochenschrift, Georg Thieme Verlag KG, Vol. 125, No. 24 ( 2008-3-25), p. 774-774
    Type of Medium: Online Resource
    ISSN: 0012-0472 , 1439-4413
    URL: Article
    DOI: 10.1055/s-2007-1024495
    RVK:
    XA 39100
    RVK:
    XA 10000
    Language: German
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2008
    detail.hit.zdb_id: 2035474-5
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  • 6
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    Online Resource
    Metastatic Risk Profile of Microscopic Lymphatic and Venous Invasion in Medullary Thyroid Cancer
    Georg Thieme Verlag KG ; 2021
    In:  Hormone and Metabolic Research Vol. 53, No. 09 ( 2021-09), p. 588-593
    Details
    In: Hormone and Metabolic Research, Georg Thieme Verlag KG, Vol. 53, No. 09 ( 2021-09), p. 588-593
    Abstract: The metastatic risk profile of microscopic lymphatic and venous invasion in medullary thyroid cancer is ill-defined. This evidence gap calls for evaluation of the suitability of microscopic lymphatic and venous invasion at thyroidectomy for prediction of lymph node and distant metastases in medullary thyroid cancer. In this study of 484 patients with medullary thyroid cancer who had≥5 lymph nodes removed at initial thyroidectomy, microscopic lymphatic and venous invasion were significantly associated with greater primary tumor size (27.6 vs. 14.5 mm, and 30.8 vs. 16.2 mm) and mo re frequent lymph node metastasis (97.0 vs. 25.9%, and 85.2 vs. 39.5%) and distant metastasis (25.0 vs. 5.1%, and 32.8 vs. 7.3%). Prediction of lymph node metastases by microscopic lymphatic invasion was better than prediction of distant metastases by microscopic venous invasion regarding sensitivity (97.0 vs. 32.8%) and positive predictive value (58.4 vs. 39.2%); comparable regarding negative predictive value (98.5 vs. 90.5%) and accuracy (80.4 vs. 85.1%); and worse regarding specificity (74.1 vs. 92.7%). On multivariable logistic regression, microscopic lymphatic invasion predicted lymph node metastasis better (odds ratio [OR] 65.6) than primary tumor size (OR 4.6 for tumors 〉 40 mm and OR 2.7 for tumors 21–40 mm, relative to tumors≤20 mm), whereas primary tumor size was better in predicting distant metastasis (OR 8.3 for tumors 〉 40 mm and OR 3.9 for tumors 21–40 mm, relative to tumors≤20 mm) than microscopic venous invasion (OR 3.2). These data show that lymphatic invasion predicts lymph node metastases better in medullary thyroid cancer than venous invasion heralds distant metastases.
    Type of Medium: Online Resource
    ISSN: 0018-5043 , 1439-4286
    URL: Article
    DOI: 10.1055/a-1559-3424
    RVK:
    XA 46918
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2021
    detail.hit.zdb_id: 2056576-8
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  • 7
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    Online Resource
    Register der schwierigen chirurgischen Situationen : Datenbank individueller Erfahrungen für operierende Chirurgen
    Georg Thieme Verlag KG ; 2018
    In:  Der Klinikarzt Vol. 47, No. 07 ( 2018-07), p. 327-331
    Details
    In: Der Klinikarzt, Georg Thieme Verlag KG, Vol. 47, No. 07 ( 2018-07), p. 327-331
    Abstract: Als schwierige chirurgische Situation wird jedes Problem, das zu einem erhöhten Risiko für intra- oder postoperative Komplikationen führen kann, bezeichnet. Bezogen auf diese Definition wurde von Korenkov et al. eine präoperative Klassifikation erweiterter intraoperativer Schwierigkeiten entwickelt. Diese Klassifikation bezieht sich auf das Ausmaß der chirurgisch-technischen Schwierigkeiten von Schweregrad 1 – technisch einfach zu operieren, bis Schweregrad 4 – jede operationstechnische Handlung ist sehr schwierig. Für die Evaluierung des Schweregrads der intraoperativen Komplikationen schlug die Arbeitsgruppe um Kaafarani die Klassifikation der intraoperativen negativen Ereignisse vor. In Abhängigkeit vom Schweregrad wurden die intraoperativen Komplikationen auf 6 Klassen von der 1. (unproblematisch beseitigte Komplikationen) bis zur 6. Klasse (intraoperativer Exitus letalis) aufgeteilt. Für eine Systematisierung des Schweregrads der postoperativen Komplikationen hat sich weltweit die Klassifikation von Clavien-Dindo etabliert. In dieser Klassifikation sind die postoperativen Komplikationen von Schweregrad 1 (jede Abweichung vom normalen postoperativen Verlauf mit „minimaler“ Behandlung) bis zum Schweregrad 5 (Tod des Patienten) aufgeteilt. Gestützt auf die vorgeschlagenen Klassifikationen und auf die Problematik der individuellen Entscheidungen in der Chirurgie entstand die Grundidee, ein Register (SCS-Register) zu etablieren. Das Hauptprinzip solcher Studien ist die Ansammlung der individuellen Erfahrungen von operierenden Chirurgen. Die wissenschaftliche Analyse fokussiert sich auf die Sondersituationen, bei denen das Behandlungskonzept an die individuelle Patientensituation adaptiert war und manchmal von den gängigen Standards abwich. Die Registrierung und Bearbeitung der angemeldeten Fälle wird auf der Basis der entsprechenden IT-Plattform anonym geführt. Das Ziel dieses Registers ist, die schwierigen chirurgischen Fälle bundesweit zu sammeln, zu registrieren und zu analysieren, um für die operierenden Chirurgen eine zugängliche Datenbank zu gestalten. Dabei wird für jeden Chirurgen die Möglichkeit bestehen, nachzulesen, wie der eine oder andere Kollege in ähnlich schwierigen Situationen gehandelt hat.
    Type of Medium: Online Resource
    ISSN: 0341-2350 , 1439-3859
    URL: Article
    DOI: 10.1055/a-0647-6241
    RVK:
    XA 10000
    Language: German
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2018
    detail.hit.zdb_id: 2106610-3
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  • 8
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    Online Resource
    Clinical Significance of Coexistence of Hashimoto Thyroiditis and Graves’ Disease with Differentiated and Medullary Thyroid Cancer
    Georg Thieme Verlag KG ; 2022
    In:  Experimental and Clinical Endocrinology & Diabetes Vol. 130, No. 06 ( 2022-06), p. 381-385
    Details
    In: Experimental and Clinical Endocrinology & Diabetes, Georg Thieme Verlag KG, Vol. 130, No. 06 ( 2022-06), p. 381-385
    Abstract: The association of Hashimoto thyroiditis and Graves’ disease with papillary, follicular, and medullary thyroid cancer has not been comprehensively investigated until now. This comparative clinicopathological study of consecutive patients thyroidectomized at a surgical referral center aimed to explore interdependencies between chronic autoimmune thyroiditis and thyroid cancer. Altogether, there were 852 (58.4%) patients with papillary thyroid cancer, 181 (12.4%) patients with follicular thyroid cancer, and 426 (29.2%) patients with sporadic medullary thyroid cancer, of whom 75 (5.1%) patients also had Hashimoto thyroiditis and 40 (2.7%) patients also had Graves’ disease. Patients with papillary (medians of 42 vs. 48 years; P =0.008) and follicular (medians of 33 vs. 63 years; P=0.022) thyroid cancer, unlike patients with medullary thyroid cancer (medians of 57.5 vs. 57 years; P=0.989), were younger at thyroidectomy when they had Hashimoto thyroiditis concomitantly. No such associations were seen with Graves’ disease. Primary thyroid cancers tended to be more localized in conjunction with Hashimoto thyroiditis, and less so with Graves’ disease, although patterns were not consistent across tumor types. In conclusion, Hashimoto thyroiditis, but not Graves’ disease, may be associated with differentiated (papillary and follicular) thyroid cancer but not with medullary thyroid cancer.
    Type of Medium: Online Resource
    ISSN: 0947-7349 , 1439-3646
    URL: Article
    DOI: 10.1055/a-1562-3455
    RVK:
    XA 42403
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2022
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  • 9
    Online Resource
    Online Resource
    Register der schwierigen chirurgischen Situationen
    Georg Thieme Verlag KG ; 2018
    In:  Zentralblatt für Chirurgie - Zeitschrift für Allgemeine, Viszeral-, Thorax- und Gefäßchirurgie Vol. 143, No. 01 ( 2018-02), p. 55-59
    Details
    In: Zentralblatt für Chirurgie - Zeitschrift für Allgemeine, Viszeral-, Thorax- und Gefäßchirurgie, Georg Thieme Verlag KG, Vol. 143, No. 01 ( 2018-02), p. 55-59
    Abstract: Als schwierige chirurgische Situation wird jedes Problem, das zu einem erhöhten Risiko für intra- oder postoperative Komplikationen führen kann, bezeichnet. Bezogen auf diese Definition wurde von Korenkov et al. eine präoperative Klassifikation erweiterter intraoperativer Schwierigkeiten entwickelt. Diese Klassifikation bezieht sich auf das Ausmaß der chirurgisch-technischen Schwierigkeiten von Schweregrad 1 – technisch einfach zu operieren, bis Schweregrad 4 – jede operationstechnische Handlung ist sehr schwierig. Für die Evaluierung des Schweregrads der intraoperativen Komplikationen schlug die Arbeitsgruppe um Kaafarani die Klassifikation der intraoperativen negativen Ereignisse vor. In Abhängigkeit vom Schweregrad wurden die intraoperativen Komplikationen auf 6 Klassen von der 1. (unproblematisch beseitigte Komplikationen) bis zur 6. Klasse (intraoperativer Exitus letalis) aufgeteilt. Für eine Systematisierung des Schweregrads der postoperativen Komplikationen hat sich weltweit die Klassifikation von Clavien-Dindo etabliert. In dieser Klassifikation sind die postoperativen Komplikationen von Schweregrad 1 (jede Abweichung vom normalen postoperativen Verlauf mit „minimaler“ Behandlung) bis zum Schweregrad 5 (Tod des Patienten) aufgeteilt. Gestützt auf die vorgeschlagenen Klassifikationen und auf die Problematik der individuellen Entscheidungen in der Chirurgie entstand die Grundidee, ein Register (SCS-Register) zu etablieren. Das Hauptprinzip solcher Studien ist die Ansammlung der individuellen Erfahrungen von operierenden Chirurgen. Die wissenschaftliche Analyse fokussiert sich auf die Sondersituationen, bei denen das Behandlungskonzept an die individuelle Patientensituation adaptiert war und manchmal von den gängigen Standards abwich. Die Registrierung und Bearbeitung der angemeldeten Fälle wird auf der Basis der entsprechenden IT-Plattform anonym geführt. Das Ziel dieses Registers ist, die schwierigen chirurgischen Fälle bundesweit zu sammeln, zu registrieren und zu analysieren, um für die operierenden Chirurgen eine zugängliche Datenbank zu gestalten. Dabei wird für jeden Chirurgen die Möglichkeit bestehen, nachzulesen, wie der eine oder andere Kollege in ähnlich schwierigen Situationen gehandelt hat.
    Type of Medium: Online Resource
    ISSN: 0044-409X , 1438-9592
    URL: Article
    DOI: 10.1055/s-0043-104769
    Language: German
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2018
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  • 10
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    Online Resource
    Risk Patterns of Distant Metastases in Follicular, Papillary and Medullary Thyroid Cancer
    Georg Thieme Verlag KG ; 2022
    In:  Hormone and Metabolic Research Vol. 54, No. 01 ( 2022-01), p. 7-11
    Details
    In: Hormone and Metabolic Research, Georg Thieme Verlag KG, Vol. 54, No. 01 ( 2022-01), p. 7-11
    Abstract: This study of 542 patients with follicular thyroid cancer, 366 patients with the follicular variant and 1452 patients with the classical variant of papillary thyroid cancer, and 819 patients with sporadic medullary thyroid cancer operated at a tertiary referral center aimed to determine risk patterns of distant metastasis for each tumor entity, which are ill-defined. On multivariable logistic regression analyses, lymph node metastasis consistently emerged as an independent risk factor of distant metastasis, yielding odds ratios (ORs) of 2.4 and 2.8 for follicular thyroid cancer and the follicular variant of papillary thyroid cancer, and ORs of 5.9 and 6.4 for the classical variant of papillary thyroid cancer and sporadic medullary thyroid cancer. Another independent risk factor consistently associated with distant metastasis, most strongly in follicular thyroid cancer and the follicular variant of papillary thyroid cancer (OR 3.5 and 4.0), was patient age 〉 60 years. Altogether, 2 distinct risk patterns of distant metastasis were identified, which were modulated by other cancer type-dependent risk factors: one with lymph node metastasis as leading component (classical variant of papillary thyroid cancer and sporadic medullary thyroid cancer), and another one with age as leading component (follicular thyroid cancer and the follicular variant of papillary thyroid cancer). Distant metastasis was exceptional in node-negative patients with sporadic medullary thyroid cancer (1.7%) and the classical variant of papillary thyroid cancer (1.4%), and infrequent in node-negative patients with the follicular variant of papillary thyroid cancer (4.4%). These findings delineate windows of opportunity for early surgical intervention before distant metastasis has occurred.
    Type of Medium: Online Resource
    ISSN: 0018-5043 , 1439-4286
    URL: Article
    DOI: 10.1055/a-1668-0094
    RVK:
    XA 46918
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2022
    detail.hit.zdb_id: 2056576-8
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