Are In-Bed Electronic Weights Recorded in the Medical Record Accurate?

This study found large discrepancies between in-bed weights recorded in the medical record and carefully obtained standing weights with a calibrated, electronic bedside scale. This discrepancy appears to be related to inadequate bed calibration before patient admission and having excessive linen, clothing, and/or equipment on the bed during weighing by caregivers.

Developing effective screening strategies in multiple endocrine neoplasia type 1 (MEN 1) on the basis of clinical and sequencing data of German patients with MEN 1.

Background: Multiple-endocrine-neoplasia-type-1 (MEN1) is an autosomal-dominant inherited disorder characterized by the combined occurrence of primary hyperparathyroidism (pHPT), gastroenteropancreatic neuroendocrine tumors (GEP), adenomas of the pituitary gland (APA), adrenal cortical tumors (ADR) and other tumors. As the tumors appear in an unpredictable schedule, uncertainty about screening programs is persisting.

Objective: To optimize screening and to analyze possible differences in sporadic versus familial cases.

Assessment of suspected insulinoma by 48-hour fasting test: a retrospective monocentric study of 23 cases.

Objective: Insulinoma causes fasting hypoglycaemia due to inappropriate insulin secretion. The diagnosis of insulinoma is based on Whipple's triad during a supervised fasting test. The aim of our study was to evaluate retrospectively the percentage of positive 48-hour fasting tests in a large series of patients with insulinoma.

[Endovascular therapy of non-aneurysmatic infrarenal aortic rupture].

Introduction: Endovascular therapy is being used increasingly also to treat ruptured infrarenal aortic aneurysms. Non-traumatic rupture of non-aneurysmatic infrarenal aorta is an absolute rarity.

Methods: The feasibility of endovascular repair of infrarenal aortic rupture is demonstrated with a case history and a literature review.

Manifestation of thyrotoxic periodic paralysis in two patients with adrenal adenomas and hyperandrogenaemia.

Hypokalaemic periodic paralysis is a fairly common complication of hyperthyroidism in Asian populations, but a rare event in Caucasians. In the present work we describe 2 male Caucasian patients with thyrotoxic periodic paralysis (TPP) as initial clinical manifestation of Graves' disease. Further diagnostic procedures demonstrated unilateral adrenal adenoma and hyperandrogenaemia in both patients.

Improved assessment of body cell mass by segmental bioimpedance analysis in malnourished subjects and acromegaly.

Background: Estimation of body cell mass (BCM) has been regarded valuable for the assessment of malnutrition.

Aim: To investigate the value of segmental bioelectrical impedance analysis (BIA) for BCM estimation in malnourished subjects and acromegaly.

Methods: Nineteen controls and 63 patients with either reduced (liver cirrhosis without and with ascites, Cushing's disease) or increased BCM (acromegaly) were included.

A homozygous HFE gene splice site mutation (IVS5+1 G/A) in a hereditary hemochromatosis patient of Vietnamese origin.

The vast majority of Caucasian patients presenting with hereditary hemochromatosis demonstrate a single homozygous missense mutation in the HFE gene (C282Y). The underlying genetic defects in hemochromatosis patients of non-Caucasian origin are largely unknown. A 48-year-old man of Vietnamese origin presented with insulin-dependent diabetes mellitus, tertiary adrenocortical insufficiency, and laboratory results highly indicative of hereditary hemochromatosis.

[Food-dependent Cushing syndrome of long standing with mild clinical features].

History And Clinical Findings: A 40-year-old woman complained of weight gain for 10 years. Because of this, she yearly went on a excessive weight reduction diet with weight loss of up to 12 kg. Nevertheless, a total weight gain of 15 kg as well as changing degrees of hypertension, muscular weakness and severe depression were registered during this long period.

[Gastric polyps in pernicious anemia: indications for polypectomy].

History And Clinical Findings: A 54-year-old man was admitted to hospital with dyspnoea, giddiness, lack of appetite and burning sensation in the tongue for 3 years. Gastritis was known from his history. Clinical examination showed jaundice, glossitis, systolic murmur and pallhypesthesia of both legs.

[Unusual localization in primary hyperparathyroidism].

Background: Cystic degenerations of parathyroid adenoma appear in 4 to 5% of all cases. These tumors might be localized in the mediastinum. Until now very few cases of cystic parathyroid adenoma have been published.

[Prevalence of diabetes in acromegaly and Cushing syndrome].

In a retrospective study glucose metabolism was investigated in 206 patients with acromegaly and 131 patients with Cushing's disease. 40.5% of the patients with hypersomatotropism and 32.

Diagnosis of Cushing's syndrome: re-evaluation of midnight plasma cortisol vs urinary free cortisol and low-dose dexamethasone suppression test in a large patient group.

We studied plasma cortisol levels at 00:00 h and 08:00 h in 103 patients with Cushing's syndrome and 144 patients in whom this diagnosis had been excluded. These patients were hospitalized in our department from 1975 to 1996. Additionally, we measured these parameters in 20 healthy volunteers and in 5 patients with nonendocrine disease.

McCune-Albright syndrome: clinical and molecular evidence of mosaicism in an unusual giant patient.

Molecular genetics recently uncovered the mystery of the protean picture of McCune-Albright syndrome by identification of the somatic gain of function mutations in the GNAS1 gene. Here we present an adult patient with fibrous dysplasia and an endocrinopathy resulting in unusual giant height. The clinical diagnosis in the patient could be confirmed by molecular investigations in tissues involved in the process of fibrous dysplasia.

[Improvement of diabetes mellitus after excision of a parathyroid adenoma].

Disturbances of glucose metabolism with hyperinsulinism and peripheral insulin resistance are frequently observed in patients with hyperparathyroidism. The mechanism of how hyperparathyroidism affects glucose metabolism is not known. Hypercalcemia, hypophosphatemia and the parathyroid hormone itself seem to be involved.

[The long-term therapy of hypothalamic-hypophyseal Cushing's syndrome with mitotane (o,p'-DDD)].

Background And Objective: Drug treatment of hypothalamic-pituitary Cushing's syndrome is indicated if standard surgical intervention is not possible or has failed. The question arises whether, after unsatisfactory treatment with various adrenostatic drugs, mitotane (o,p'-DDD), used against adrenal cortical cancer, is efficacious and free of significant side effects when used long-term.

Patients And Methods: The results of long-term administration of mitotane to six patients, including one pregnant woman, were analysed retrospectively.

[Pregnancy in hyperprolactinemic patients].

In a retrospective study we analysed the outcome of 27 pregnancies in 17 hyperprolactinaemic patients. Cranial CT or MRI scans showed a microadenoma in 9, a macroadenoma in 7 and no change in 1 case. In 5 patients macroadenomas were surgically removed but a residual hyperprolactinaemia remained.

[Sellar germinoma with lung metastases].

Reported in this paper is the case of a boy aged 15 years with sellar germinoma which led to one singular pulmonary metastasis, three years after subtotal surgical removal and subsequent successful irradiation of the tumor rest. The primary tumor together with the lung metastasis were characterised as germinoma with trophoblastic giant cells as additional elements. Interpretation of the pulmonary tumour was somewhat difficult, since diagnosis of the primary tumor had encouraged assumption of a chromophobic hypophyseal adenoma with polymorphic manifestation, with no relationship between the intracranial and pulmonary tumors being presumed by the surgeon.

[Cushing's syndrome in CRF-producing mediastinal carcinoid].

A 36-year-old patient developed marked pigmentation, marked myopathy and severe hypokalaemic alkalosis which at first pointed towards an ectopic ACTH syndrome. The dexamethasone test at a high dose indicated cortisol suppression. A mediastinal tumour was seen radiologically, but the sella was of normal size.

Fabry-Perot interferometer with personal computer control.

To record weak light scattering spectra with a Fabry-Perot interferometer, long measuring times are often necessary. For long term stability of the parallel alignment of the mirrors, a microcomputer controlled interferometer system has been developed for both single and multipass operation. The three piezo stacks, which are responsible for the alignment of the mirrors, are supplied from three digital-to-analog converters controlled by a personal computer.

Paradoxical response of plasma beta-endorphin to combined administration of TRH and GnRH in adrenal disorders.

The combined intravenous injection of TRH and GnRH elicited paradoxical responses of plasma beta-endorphin in active and successfully treated pituitary dependent Cushing's disease as well as in ectopic ACTH syndrome and in congenital adrenal hyperplasia. No response was observed in Cushing's syndrome due to adrenal tumours. It is concluded that an abnormal response to inappropriate releasing hormones cannot verify the existence of a pituitary corticotrophic microadenoma.