W Buchinger

Krankenhaus Barmherzige Brüder Wien, Wien, Vienna, Austria

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Publications (28)34.79 Total impact

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    ABSTRACT: Since multiple sclerosis (MS) and autoimmune thyroiditis (AIT) are presumed to be of autoimmune origin the correlation of these two diseases is of special interest. The aim of this study was to determine whether there are differences in the prevalence of thyroid disease with special emphasis on AIT compared with MS and normal subjects and whether the presence of thyroid disease correlates with disability, disease course, age, and disease duration. 353 consecutive patients with clinically definite MS, without interferon-beta treatment and 308 patients with low back pain or headache were extensively examined for the presence of non-immune or autoimmune thyroid disease. We found a significantly higher prevalence of AIT in male MS patients (9.4 %) than in male controls (1.9 %; p = 0.03). The prevalence of AIT in female MS patients (8.7 %) did not differ from female controls (9.2 %). Hypothyroidism, caused by AIT in almost all cases, showed a tendency to be more severe and more often present in patients with MS. There was no association between relapsing-remitting and secondary progressive disease course of MS and the prevalence of AIT. MS patients with AIT were significantly older but did not differ in disease duration and expanded disability status scale (EDSS). Further studies are warranted, to see if there is a difference in sex-hormone levels between MS patients with and without AIT and healthy controls. Longitudinal studies comparing MS patients with or without AIT could show whether there is an influence of AIT on the disease course or progression.
    Journal of Neurology 07/2003; 250(6):672-5. · 3.58 Impact Factor
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    ABSTRACT: Zusammenfassung: Das gehäufte gemeinsame Auftreten von chronischer Polyarthritis (cP) und Immunthyreoiditis wird seit langem beschrieben und führt zu teilweise widersprüchlichen Ergebnissen. Wir untersuchten 792 Patienten (383 cP-, 409 Osteoarthrose-Patienten) auf das Vorliegen von pathologisch erhöhten Thyreoglobulin-Antikörpern und/oder Antikörpern gegen Schilddrüsenperoxidase. Die cP-Patienten wiesen signifikant häufiger positive Schilddrüsenantikörper auf als die Osteoarthrose-(OA)-Patienten (9,1 % versus 3,7 %, p = 0,0016). Daraus schließen wir, dass eine gehäufte Koinzidenz der beiden ­Erkrankungen vorliegt und deshalb cP-Patienten auf das Vorliegen von Schilddrüsenerkrankungen, insbesondere von Immun­thyreoiditiden, routinemässig untersucht werden sollen.Summary:Increased occurrence of autoimmune thyroiditis in patients with rheumatoid arthritisThe frequent occurrence of both rheumatoid arthritis and autoimmune thyroiditis was already investigated with in part many conflicting results. We investigated a number of 792 patients (383 of them suffering from rheumatoid arthritis and 409 with osteoarthritis). In all patients antithyroid peroxidase and antithyroglobulin antibodies were determinated. Patients with rheumatoid arthritis showed a significantly higher occurrence of circulating thyroid antibodies than those with osteoarthritis (9.1 % versus 3.7 %, p = 0.0016). We conclude that there exists a cumulate coincidence of both diseases. Patients suffering from rheumatoid arthritis should undergo a thyroid examination especially for the presence of autoimmune thyroiditis.
    Acta Medica Austriaca 12/2002; 27(2):58 - 60.
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    ABSTRACT: Zusammenfassung: Schilddrüsenhormonautoantikörper können über eine Interferenz mit den Radioimmunoassays (RIA) für die Bestimmung der Schilddrüsenhormone zu einer Diskrepanz zwischen gemessenen Werten und der Klinik der Patienten führen. Wir haben bei sechs Patienten mit bekannten Trijodthyronin-Autoantikörpern (T3-Ak) FT3 mittels RIA und Elektrochemilumineszenz-Immunoassay (ECLIA) bestimmt. Whrend mittels RIA falsch hohe Werte für FT3 gemessen wurden, ergab die FT3 Bestimmung mittels ECLIA korrekte Werte. Aus unseren Ergebnissen schließen wir, dass bei Patienten mit T3-Ak die Bestimmung von FT3 mit ECLIA der Bestimmung mittels RIA überlegen ist.Summary:Free triiodothyronine (FT3) measurement using an electrochemiluminescence immunoassay in patients with autoantibodies to triiodothyronineThyroid hormone autoantibodies may lead to abnormal values of free triiodothyronine (FT3) and free thyroxine (FT4) by interference with the radio immunoassay (RIA). We examined thyroid function in six patients with known triiodothyronine-binding autoantibodies using a RIA and an electrochemiluminescence immunoassay (ECLIA). FT3 values measured by RIA were spuriously high, ECLIA measurement of FT3 led to correct values according to the patients' thyroid status. We conclude from these results that in patients with triiodothyronine-binding autoantibodies FT3 measurement by ECLIA is more useful than measurement by RIA.
    Acta Medica Austriaca 12/2002; 27(2):54 - 55.
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    ABSTRACT: Zusammenfassung: Einflüsse von nicht-steroidalen Antirheumatika (NSAR) auf die Schilddrüsenhormonspiegel sind seit langem bekannt und werden auf Interferenzen der NSAR mit der Schilddrüsenhormonbindung zurückgeführt. Wir untersuchten die Auswirkungen einer Einmaldosis von Aceclofenac auf die Schilddrüsenfunktion und die Schilddrüsenhormonbindung bei 18 gesunden Probanden. Die Serumkonzentration der freien Schilddrüsenhormone (FT3, FT4) und des Thyreotropins (TSH) wurden mit handelsüblichen Methoden bestimmt, die Schilddrüsenhormonbindung wurde mit einer speziell modifizierten Agarose-Gel-Elektrophorese vor und 2 Stunden nach Aceclofenac-Einnahme ermittelt. Es zeigte sich eine signifiknate Abnahme der T3-Bindung an TBG und eine signifikante Zunahme des Albumin-gebundenen T3. Die übrigen Parameter der Schilddrüsenhormonbindung und die FT3- und FT4-Spiegel zeigten keine signifikanten Veränderungen. Aus diesen Ergebnissen schließen wir, daß Aceclofenac zu einer signifikanten Umverteilung von T3 an den Transportproteinen führt. Dies ist am ehesten durch eine Aceclofenac-induzierte T3-Verdrängung vom TBG zu erklären.Summary:Influences of aceclofenac on thyroid hormone binding and thyroid functionInfluences of non-steroidal anti-inflammatory drugs (NSAID)on concentrations of thyroid hormones are known for a long time. These effects could be explained with interference between NSAIDs and thyroid hormone binding. We investigated the effects of a single dose of aceclofenac on thyroid function and thyroid hormone binding in 18 healthy volunteers. Serum levels of free thyroid hormones (FT3, FT4) and thyrotropin (TSH) were measured with commercial available kids and thyroid hormone binding was estimated with a specially modified horizontal argarose-gel-electrophoresis prior to and 2 hours after receiving a single dose of aceclo­fenac. We found a significant decrease in T3 binding on TBG and a significant increase of albumine-bound T3. All other investigated thyroid hormone binding parameters, FT3 and FT4, showed no significant changes. We conclude that aceclofenac leads to a significant redistribution of T3 protein binding. These effects seem to be explained by T3 displacement from TBG induced by aceclofenac.
    Acta Medica Austriaca 12/2002; 27(2):56 - 57.
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    ABSTRACT: Zusammenfassung: Saisonale Schwankungen in der Häufigkeit von Hyperthyreose-Erstdiagnosen sind seit langem bekannt. Sowohl Temperaturunterschiede als auch Schwankungen der alimentären Jodzufuhr werden als mögliche Ursache dafür angegeben. Die saisonale Varianz im Auftreten der Hyperthyreosen wurde vor und nach Erhöhung der Speisesalzjodierung 1990/1991 untersucht. Im Zeitraum von Jänner 1987 bis Dezember 1995 wurde an unserer Abteilung bei 4711 Patienten die Erstdiagnose einer Hyperthyreose gestellt. Das Kollektiv wurde nach Ätiologie (Immunhyperthyreose, funktionelle Autonomie, andere Hyperthyreoseformen), Ausprägung der Hyperthyreose (latente oder manifeste Funktionsstörung) und dem Jahr der Diagnosestellung (vor oder nach Erhöhung der Speisesalzjodierung) unterteilt. Die daraus entstandenen Gruppen wurden in der Folge nach dem jeweiligen Monat der Erstdiagnose in weitere 12 Gruppen unterteilt. Signifikante monatliche Schwankungen der Hyperthyreoseinzidenz mit einem Maximum zwischen Juni und August konnten in der Gruppe der manifesten Immunhyperthyreosen und der funktionellen Autonomien mit latenter Hyperthyreose nach Erhöhung der Speisesalzjodierung festgestellt werden. Unsere Ergebnisse zeigen, dass die Erhöhung der alimentären Jodzufuhr bei Patienten mit manifester Immunhyperthyreose und latenter funktioneller Autonomie eine wichtige Ursache für das Auftreten von jahreszeitlichen Schwankungen der Hyperthyreosehäufigkeit ist.Summary: Seasonal variations in the diagnosis of ­hyperthyroidismSeasonal variations in the frequency of thyrotoxicosis are known for a long time. Both, variations in the temperature and in the iodine supplementation are believed to affect the incidence of the diagnosis of hyperthyroidism. Seasonal variation of the incidence of hyperthyroidism was investigated before and after increase of salt iodination in 1990/1991. In the period from January 1987 to December 1995 ­hyperthyroidism was diagnosed for the first time on 4 711 ­patients in our department. This population was subdivided according to etiology (Graves'disease, autonomous nodular goiter) and grade of hyperthyroidism (preclinical or clinical form). The so formed groups were divided according to the month of diagnosis into further 12 subgroups. Significant differences in month to month variation were found in the patients suffering from Graves' disease and autonomous nodular goiter with preclinical hyperthyroidism after increased iodine supplementation. The peak incidence of the diagnosis occurred in June, July, and August. Our results indicate that improved iodine supplementation may be the main cause of seasonal variations in the incidence of thyrotoxicosis.
    Acta Medica Austriaca 12/2002; 27(2):51 - 53.
  • Clinical Chemistry 02/2001; 47(1):144. · 7.15 Impact Factor
  • Journal of Neurology 01/2001; 248(11):988-989. · 3.58 Impact Factor
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    ABSTRACT: Seasonal variations in the frequency of thyrotoxicosis are known for a long time. Both, variations in the temperature and in the iodine supplementation are believed to affect the incidence of the diagnosis of hyperthyroidism. Seasonal variation of the incidence of hyperthyroidism was investigated before and after increase of salt iodination in 1990/1991. In the period from January 1987 to December 1995 hyperthyroidism was diagnosed for the first time on 4711 patients in our department. This population was subdivided according to etiology (Graves' disease, autonomous nodular goiter) and grade of hyperthyroidism (preclinical or clinical form). The so formed groups were divided according to the month of diagnosis into further 12 subgroups. Significant differences in month to month variation were found in the patients suffering from Graves' disease and autonomous nodular goiter with preclinical hyperthyroidism after increased iodine supplementation. The peak incidence of the diagnosis occurred in June, July, and August. Our results indicate that improved iodine supplementation may be the main cause of seasonal variations in the incidence of thyrotoxicosis.
    Acta Medica Austriaca 02/2000; 27(2):51-3.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Influences of non-steroidal anti-inflammatory drugs (NSAID) on concentrations of thyroid hormones are known for a long time. These effects could be explained with interference between NSAIDs and thyroid hormone binding. We investigated the effects of a single dose of aceclofenac on thyroid function and thyroid hormone binding in 18 healthy volunteers. Serum levels of free thyroid hormones (FT3, FT4) and thyrotropin (TSH) were measured with commercial available kids and thyroid hormone binding was estimated with a specially modified horizontal argarose-gel-electrophoresis prior to and 2 hours after receiving a single dose of aceclofenac. We found a significant decrease in T3 binding on TBG and a significant increase of albumin-bound T3. All other investigated thyroid hormone binding parameters, FT3 and FT4, showed no significant changes. We conclude that aceclofenac leads to a significant redistribution of T3 protein binding. These effects seem to be explained by T3 displacement from TBG induced by aceclofenac.
    Acta Medica Austriaca 02/2000; 27(2):56-7.
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    ABSTRACT: Thyroid hormone autoantibodies may lead to abnormal values of free triiodothyronine (FT3) and free thyroxine (FT4) by interference with the radio immunoassay (RIA). We examined thyroid function in six patients with known triiodothyronine-binding autoantibodies using a RIA and an electro-chemiluminescence immunoassay (ECLIA). FT3 values measured by RIA were spuriously high, ECLIA measurement of FT3 led to correct values according to the patients' thyroid status. We conclude from these results that in patients with triiodothyronine-binding autoantibodies FT3 measurement by ECLIA is more useful than measurement by RIA.
    Acta Medica Austriaca 02/2000; 27(2):54-5.
  • [Show abstract] [Hide abstract]
    ABSTRACT: The frequent occurrence of both rheumatoid arthritis and autoimmune thyroiditis was already investigated with in part many conflicting results. We investigated a number of 792 patients (383 of them suffering from rheumatoid arthritis and 409 with osteoarthritis). In all patients antithyroid peroxidase and antithyroglobulin antibodies were determined. Patients with rheumatoid arthritis showed a significantly higher occurrence of circulating thyroid antibodies than those with osteoarthritis (9.1% versus 3.7%, p = 0.0016). We conclude that there exists a cumulate coincidence of both diseases. Patients suffering from rheumatoid arthritis should undergo a thyroid examination especially for the presence of autoimmune thyroiditis.
    Acta Medica Austriaca 02/2000; 27(2):58-60.
  • Acta Medica Austriaca - ACTA MED AUST. 01/2000; 27(2):56-57.
  • W Buchinger, G Niederwieser, F Rainer
    DMW - Deutsche Medizinische Wochenschrift 12/1999; 124(48):1473. · 0.65 Impact Factor
  • W Buchinger, R Pongratz, K Nadler, F Rainer
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    ABSTRACT: Effects of gender and age on quantitative sacroiliac joint imaging are discussed controversially. In most investigations the number of controls has been small and might not exactly reflect the change of sacroiliac/sacral (SI/S) ratios related to different age and gender. The aim of our study was to evaluate the changes SI/S ratios according to age and gender. In 125 patients without any history of either diseases or complaints of the sacroiliac joints a bone scintigraphy was obtained and the SI/S ratios were calculated. We observed a significant negative correlation of SI/S index with age. After separation into 4 different age groups a significant decline of the ratios could be shown. There were no significant differences between male and female patients. We conclude that the influence of age on SI/S ratios is substantial. But also many other factors like patient position, algorithm of SI/S ratio calculation, the time interval between application of the radiopharmaceutical and data acquisition may exert effects on SI/S ratios. It seems necessary for each department to evaluate their own age related reference values of SI/S ratios.
    Wiener Medizinische Wochenschrift 02/1999; 149(19-20):569-71.
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    ABSTRACT: The recommendations for the dietary allowance of iodine are 150 micrograms per day for adolescents and adults. Thyrotropin (TSH) and thyroglobulin (Tg) can be used as surveillance indicators for assessing iodine deficiency disorders. We compared the relation between TSH and Tg, free triiodothyronine, and thyroxine serum levels with urinary iodine excretion in 2311 untreated euthyroid patients using our modified cericarsenite method. An adequate iodine intake may be assumed when TSH and Tg values are at the lower end of the normal range. Patients were grouped according to urinary iodine excretion and goiter size. In the group with an iodine excretion between 201 and 300 micrograms of iodine per gram of creatinine, the lowest TSH values and even low Tg levels could be shown. We conclude that an iodine intake of approximately 250 micrograms/day is associated with the lowest TSH stimulation to thyrocytes. In the groups separated according to thyroid size, significantly higher Tg levels were found in the patients with uninodular and multinodular goiter as a result of longstanding iodine deficiency, whereas actual urinary iodine excretion did not differ significantly. Additionally, iodine excretion of 39,913 euthyroid patients between 1984 was 1996 was examined. In Austria iodized salt (10 mg KI/kg) was introduced by law in 1963 and increased to 20 mg KI/kg salt in 1990. An initial increase of iodine excretion until 1993 was followed by a decrease in 1994 and 1995 without further changes in 1996. These results show that iodine intake has improved since 1984; however, in 1996 iodine excretion in one-third of the investigated patients was under 100 micrograms per gram of creatinine and more than 80% had less than 200 micrograms per gram of creatinine.
    Thyroid 09/1997; 7(4):593-7. · 3.54 Impact Factor
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    ABSTRACT: The electrophysiological effects of intravenously administered pure (S)- and (R)-propafenone hydrochloride has been determined for the first time in humans-12 patients with supraventricular tachycardia. Measurements were performed before and during drug therapy. (S)- and (R)-propafenone prolonged the AH interval from 82 to 107 ms and 75 to 84 ms, respectively, and significantly increased the V nodal Wenckebach cycle length by 58 ms and 37 ms, respectively. The AV nodal effective refractory period in both groups was increased significantly to the same extent (45 vs 42 ms). Sinus node recovery times were not significantly influenced by either enantiomers. Both (S)- and (R)-propafenone significantly prolonged the HV interval to the same extent (from 41 to 51 ms, and 42 to 53 ms). Changes in the electrophysiological characteristics of the myocardium were more pronounced in the atria than in the ventricles. Only (S)-propafenone significantly increased the atrial effective refractory period from 204 to 230 ms, and the ventricular effective refractory period from 225 to 241 ms compared to (R)-propafenone (from 221 to 239 ms, and from 219 to 222 ms, respectively). There was a more pronounced electrophysiological effect on AV nodal conduction of (S)- than (R)-propafenone, probably as a result of its beta-blocking activity. The electrophysiological effects of (S)-compared to (R)-propafenone were not very pronounced, so it still remains questionable whether one of the enantiomers might be clinically superior to the other, or to the racemic mixture.
    European Journal of Clinical Pharmacology 02/1996; 50(3):185-90. · 2.74 Impact Factor
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    ABSTRACT: In this study we examined 278 patients as to the effect of thyroidal dysfunctions upon late-potential parameters in high-resolution ECG (HR-ECG). It could be demonstrated that both hyper- and hypothyroidism tend to produce late potentials. It is remarkable that even "subclinical" dysfunctions reveal significant alterations in HR-ECG. As late potentials represent a risk factor for ventricular arrhythmias these results are an additional indication that already "subclinical" dysfunctions of thyroid gland call for an appropriate therapy. In hyperthyroidism late potentials may be eliminated rapidly by propranolol even in low dosages.
    Acta Medica Austriaca 02/1995; 22(4):73-74.
  • W Buchinger, R Pongratz, G Binter, O Eber
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    ABSTRACT: Elevated serum levels of lipoprotein(a) [Lp(a)] represent an independent risk factor in the development of arteriosclerosis and coronary heart disease. In overt but also in subclinical hypothyroidism a reversible increase of Lp(a) occurs. We compared Lp(a) serum levels, cholesterol, triglyceride, HDL- and LDL-cholesterol in 19 hypothyroid patients prior to and following the state of euthyroidism (group 1). On the other hand in group 2 we investigated 20 euthyroid patients having elevated thyroid antibodies as against 50 euthyroid normolipemic control subjects without detectable thyroid antibodies. Group 1: The elevated Lp(a) serum levels of the hypothyroid patients decreased significantly in the euthyroid state (37.9 +/- 8.24 vs. 28.1 +/- 6.13 mg/dl, mean +/- SEM). Group 2: The mean Lp(a) serum levels of the patients with increased thyroid antibodies were significantly higher than those of the control group (24.8 +- 5.78 vs. 9.6 +/- 1.56 mg/dl, mean +/- SEM). In other parameters of lipid metabolism and thyroidal function no significant differences between both groups could be seen. The question arises whether such isolated Lp(a) elevation will lead to an increased arteriosclerotic risk. To minimize this possible risk regular controls of thyroid function should be carried out in euthyroid patients with elevated thyroid antibodies. In this way hypothyroidism may be detected and treated at an early stage.
    Acta Medica Austriaca 02/1995; 22(4):78-1.
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    ABSTRACT: The differential regulation of free and bound plasma magnesium was studied in healthy volunteers exposed to various forms of stress, and patients screened for thyroid disorder. Both ergometric (7 min) and psychological (45 min) stress had no effect on free plasma magnesium, but increased the bound fraction. Before combined physical and psychological stress (45 min aerobatics) there was no correlation between the plasma fractions of magnesium; thereafter, there was a strong negative correlation between increased free and decreased bound magnesium. Three days of training in ground combat increased significantly the plasma levels of both magnesium fractions. Patients screened for thyroid disorder had a significant, positive correlation between both plasma fractions of magnesium, and a highly significant negative correlation between plasma T3 and the two magnesium fractions. No clear correlation between plasma catecholamines and magnesium levels was seen under any of the above conditions. Overall, the data show that the evaluation of the functions of circulating magnesium requires the specific measurement of the free and bound fractions.
    Life Sciences 02/1994; 55(17):PL327-32. · 2.56 Impact Factor
  • Source
    B Tiran, O Lorenz, A Tiran, W Buchinger, O Eber
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    ABSTRACT: Zinc concentration in erythrocytes is a suitable marker of peripheral tissue response to thyroid hormones. Therefore, the determination of erythrocyte zinc concentration has become an important marker for duration of preexisting hyperthyroidism in the clinical laboratory. We compared a new indirect erythrocyte zinc determination method with a commonly used direct method in 42 euthyroid and 14 hyperthyroid subjects. Zinc concentrations (median and range) obtained by direct and indirect methods were 172.8 (134.4-241.1) and 176.8 (143-243.9) mumol/l erythrocytes in the euthyroid group and 117.1 (71-141.9) and 118.5 (73-137) mumol/l erythrocytes in the hyperthyroid group. Values measured by the indirect method were slightly higher in both groups. Regression analysis showed a good correlation (r = 0.967, p = 0.0001). The influence of the anticoagulants, potassium EDTA and heparin, on erythrocyte and plasma zinc values was studied, and zinc concentrations in serum and plasma were compared. No statistically significant differences were found. Thus, the indirect determination of erythrocyte zinc concentration is a simple and rapid technique well suited for use in clinical laboratory work, yielding accurate and reliable results. For the indirect method reference concentrations were established in a collective of 102 thyroid healthy subjects. An erythrocyte zinc concentration of 176.3 +/- 23.9 mumol/l (mean +/- SD) was found with a cut-off limit of 138 mumol/l to hyperthyroidism.
    European journal of clinical chemistry and clinical biochemistry: journal of the Forum of European Clinical Chemistry Societies 05/1993; 31(4):239-44.

Publication Stats

127 Citations
34.79 Total Impact Points

Institutions

  • 2001–2003
    • Krankenhaus Barmherzige Brüder Wien
      Wien, Vienna, Austria
  • 1988–2002
    • Krankenhaus der Barmherzigen Brüder Graz
      Gratz, Styria, Austria
  • 1997
    • St. John of God Hospital, Vienna
      Wien, Vienna, Austria
  • 1990–1996
    • Karl-Franzens-Universität Graz
      • • Department of Pharmaceutical Chemistry
      • • Institute of Psychology
      Gratz, Styria, Austria