Pathologic-anatomic diagnosis of endocrine neoplasms: new trends and applications

The pathologic-anatomical diagnosis of endocrine diseases mainly relies on established techniques of histology and cytology. Additional immunhistochemical tests an the expression analysis may lead to a higher specificity of the morphological diagnosis. For thyroid tumours so-called high-throughput methods have been established in clinical routine successfully. Calcitonin screening tests can be performed routinely in patients with or without an increased risk of familiar dominance. For the neuroendocrine neoplasms of the pancreas and the gastrointestinal tract a new WHO classification has been established.     

Hybrid imaging for endocrine diseases: new perspectives

Hybrid Imaging, also termed dual modality imaging, is the technique of fusionizing and interpreting images, that are gained from two different modalities constructed in one unit. Therefore, hybrid imaging may be regarded as a form of image fusion. Clinical applications in the field of endocrinology are the localization of neuroendocrine tumors and of lesions of the adrenal or the parathyroid glands. Significant diagnostic impact can be gained with this technique influencing the certainty of radiological reports.     

内分泌代谢罕见病的诊断和治疗

内分泌代谢系统包括内分泌腺体和内分泌组织,通过分泌激素调节人体机能。内分泌罕见病发病隐匿,临床表现与常见病有重叠,其中不少疾病属于遗传病,诊断依赖基因检测,常规治疗效果欠佳。根据2018年我国发布的第一批罕见病目录中疾病主要累及的内分泌器官,选择卡尔曼综合征、B型胰岛素抵抗、低磷性佝偻病等典型的内分泌罕见病,从垂体、胰腺、骨代谢3个方面对内分泌罕见病的致病机制、临床特点、治疗方法做一系统阐述。     

Diagnosis and therapy of gynecologic diseases in girls

Problems arising the examination and treatment of children with gynaecological disorders are described. Over a period of 8 years 1300 newborn to 15 year-old girls were given a gynaecological check-up at the outpatient department for infants and juveniles at the 1st Department of Obstetrics and Gynaecology of the University of Vienna. The average age of the young patients was 7.6 years. The most frequent condition diagnosed was vulvovaginitis (43%), followed by pathological vaginal bleeding (13%), vulval disorders (7%) and suspicion of intravaginal foreign body (5%); about twenty additional disorders were diagnosed. Absolute and extended indications for Gynaecological and vaginoscopic examination, as well as therapeutic recommendations are enumerated.     

Clinical use of nuclear medicine in the management of thyroid diseases

Radionuclides are widely used for the diagnosis and therapy of many diseases. Among them, 131I has the longest history of more than 60 years of clinical use, and has been still used for the therapy of Graves' disease, Plummer disease (hyperfunctional adenoma) and thyroid cancer. Radiodine is specifically taken into thyroid cells and organized. Recently PET using 18F-FDG(glucose analogue) is applied to know the extent of thyroid cancer. New tumor specific drugs, such as 131I- or 90Y labeled antibodies, have been discovered and succeeded in the therapy of lymphoma.     

核医学在中国的发展和医学物理师制度

本文论述了核医学在中国的发展及其临床应用价值,指出了日常核医学诊疗中医学物理工程人员参与的必要性和重要性.大力培养和建立一支高素质的医学物理工程人员或医学物理师,为推动我国医学事业发展,建立医学物理师制度具有重要意义.     

Edema in endocrine and metabolic diseases

Edema develops as one of symptoms and signs in several endocrine disorders, and sometimes can be important clue in detecting the basal endocrine disorder. In patients with long-standing hypothyroidism, characteristic edematous skin changes develop and be called myxedema. In hyperthyroid patients with Graves' disease, peripheral edema sometimes develop with or without heart failure. Severe eyelid puffiness composing Graves' ophthalmopathy and 'circumscribing myxedema', mostly in the pretibial regions, are also highly disease-specific disorders. In Cushing's syndrome, both adrenal and ACTH-dependent, peripheral edema is sometimes important sign leading suspicion of this syndrome. In diabetic patients, attention should be paid to edema constantly especially with nephropathy and hypertension. In diabetic nephropathy stage 3B, aggravation of renal function is often progressive. Recently the range of therapeutic options of glycemic controls has been extended with introduction of thiazolidinediones (TZDs). Weight gain and peripheral edema are recognized side effects of these drugs, particularly when used in combination with insulin. The potential risk of worsened heart failure should be taken into consideration when TZDs are used in patients with diabetes and heart diseases.     

Assessment of metabolic bone disease: review of new nuclear medicine procedures

In the management of patients with metabolic bone disease, nuclear medicine laboratories offer two nontraumatic procedures of potential clinical importance: bone mineral measurements and bone scintigraphy. Bone mineral measurements from the radius, lumbar spine, and hip obtained with use of absorptiometry or computed tomography can be used to predict the risk of fracture at these skeletal sites, can determine the severity of bone loss for the assessment of a benefit-versus-risk ratio on which appropriate therapy can be based, and can substantiate the effectiveness of therapy over time. Bone scintigraphy with use of labeled diphosphonate allows assessment of focal and, in defined circumstances, of total skeletal bone turnover in patients with normal kidney function. Both of these techniques have been used successfully in studies of population groups for the evaluation of trends. Their application to the management of individual patients is currently being evaluated.     

Embryonic stem cells: new possible therapy of degenerative diseases

The capacity of embryonic stem (ES) cells for virtually unlimited self-renewal and differentiation has opened up the prospect of widespread applications in biomedical research and regenerative medicine. The use of these cells would allow to overcome the problems of donor tissue shortage and also implant rejection if the cells are made immunocompatible with the recipient. Since the derivation in 1998 of human ES cell lines from pre-implantation embryos, considerable research is centered on their biology, on how differentiation can be encouraged towards particular cell lineages and also on means to enrich and purify derivative cell types. In addition, ES cells may be used as an in vitro system not only to study cell differentiation but also to evaluate the effects of new drugs and the identification of genes as potential therapeutic targets. This review will summarize what is known about animal and human ES cells with particular emphasis on their application in four animal models of human diseases. Present studies of mouse ES cell transplantation reveal encouraging results but also technical barriers that have to be overcome before clinical trials can be considered.     

Hormones and tumor therapy: the rational basis of endocrine therapy in breast cancer

Since endocrine therapy has gained great importance in curative and palliative radiotherapy, the hormone-therapy of breast cancer owing to the relevance of the receptor contents in the tumour, has had to be reconsidered over the past decade. Accordingly, this paper deals with endocrine pathophysiology both in relation to the central and cellular mechanisms of hormone action; in addition it presents recent findings on biosynthesis of the different hormones. Furthermore, important treatment criteria with regard to patient selection will be listed. The discussion of these criteria is based both on clinical findings ("empirical criteria") and on the receptor status ("objective criteria") with a view to a better assessment of risk and prognosis at the time of surgery.     

Diagnosis of the multiglandular endocrine neoplasias

Multiglandular endocrine neoplasia syndromes are disorders characterized by autosomal dominant inheritance patterns and by the striking patterns of clinical presentation of these endocrine tumors, which are often hormonally active. Not every patient with adenomas of more than one endocrine gland has one of these classical familial syndromes. This paper will deal with the specific diseases known as multiglandular endocrine neoplasia Types 1, 2A, and 2B. Types 2A and 2B are also known as Types II and III.