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Biomedical subjects

A Juul

Publications and source records attributed to A Juul.

At least 91 records · Page 5Linked to original sources
PubMed1994

Growth hormone (GH) treatment increases serum insulin-like growth factor binding protein-3, bone isoenzyme alkaline phosphatase and forearm bone mineral content in young adults with GH deficiency of childhood onset.

Recent studies have demonstrated that growth hormone (GH)-deficient adults have a markedly decreased bone mineral content compared to healthy adults. However, there are conflicting results regarding the effects of GH treatment on bone mineral content in GH-deficient adults. Therefore, we evaluated the effect of GH treatment on a marker of bone formation (bone alkaline phosphatase), hepatic excretory function and distal forearm bone mineral content in GH-deficient adults. Growth hormone was administered subcutaneously in 21 adults (13 males and 8 females) with GH deficiency of childhood onset for 4 months in a double-blind, placebo-controlled GH trial, while 13 of the patients then received further GH for an additional 14 months. Serum insulin-like growth factor I (IGF-I) increased significantly from 100 to 279 micrograms/l and IGF binding protein-3 (IGFBP-3) from 1930 to 3355 micrograms/l after 4 months of GH treatment (p < 0.0001). In addition, the molar ratio between IGF-I and IGFBP-3 increased significantly from 0.22 to 0.33 after GH treatment (p < 0.0001). Bone alkaline phosphatase increased significantly from 38.6 to 92.9 U/l during GH therapy in male patients (p < 0.0001), whereas liver-derived alkaline phosphatase was unaltered by GH. In the females, the increase in bone alkaline phosphatase did not reach statistical significance (19.1 vs 40.0 U/l, p = 0.06). The GH-induced increase in bone alkaline phosphatase correlated significantly with the increase in serum IGFBP-3 (r = 0.46, p = 0.04) but not with the increase in serum IGF-I (p = 0.16).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Impaired thermoregulation in adults with growth hormone deficiency during heat exposure and exercise.

OBJECTIVE: It has recently been shown that patients with growth hormone deficiency have a reduced sweating capacity. We hypothesize that reduced sweating might affect thermoregulation in growth hormone deficiency patients. In the present study we have examined thermoregulation in growth hormone deficiency patients. DESIGN AND PATIENTS: Six adult growth hormone deficiency patients and six matched controls were exposed to a 90-minute heat period (40 degrees C). On a second day the subjects exercised for 30 minutes under standardized conditions. MEASUREMENTS: On both occasions changes in GH secretion, sweating and temperature were registered. Heat storage and evaporation were calculated from these data. RESULTS: We found that during the moderate heat exposure, evaporation was less (56.7 vs 115.6 W, P = 0.0037) and heat storage greater (60.7 vs 37.0 W, P = 0.025) in growth hormone deficiency patients compared to their matched controls. Two of the six patients reacted with severe clinical symptoms of heat exhaustion, whereas the controls were unaffected. After exercise the patients reached significantly higher core temperatures than their matched controls (38.1 vs 37.8 degrees C, P = 0.0097). CONCLUSIONS: Thus, our findings are indicative of a reduced thermoregulatory function in some patients with GH deficiency.

Adult↗
PubMed1993

Serum concentrations of type I and III procollagen propeptides in healthy children and girls with central precocious puberty during treatment with gonadotropin-releasing hormone analog and cyproterone acetate.

Serum levels of type I and III procollagen propeptides (s-PICP and s-PIIINP) were measured in 466 healthy school children and in 23 girls with central precocious puberty (CPP) during GnRH analog and cyproterone acetate therapy, using two commercially available RIAs. In normal children, s-PICP and s-PIIINP changed significantly with age and pubertal development stages. For s-PIIINP, a peak was seen at 12 yr for girls and 13 yr for boys; no peak could be discerned for s-PICP. The prepubertal (Tanner stage 1) s-PICP value (mean +/- SD) for girls was 374 +/- 132 micrograms/L, the midpubertal value (stage 3) was 442 +/- 135 micrograms/L, and the postpubertal value (stage 5) was 203 +/- 103 micrograms/L. The mean s-PIIINP levels for girls were 9.1 +/- 2.4, 15.0 +/- 4.3, and 6.8 +/- 3.1 micrograms/L, respectively. For boys, levels were 362 +/- 119, 544 +/- 138, and 359 +/- 256 micrograms/L for s-PICP and 8.5 +/- 2.2, 14.5 +/- 5.0, and 8.6 +/- 3.8 micrograms/L for s-PIIINP (P < 0.001 for both propeptides in both boys and girls). There was, however, a large variation in normal values for both propeptides within the age groups and pubertal stages. There was a significant correlation of s-PICP and s-PIIINP levels to height velocity in girls (r = 0.35; P < 0.001 and r = 0.33; P < 0.001, respectively), while in boys, only s-PIIINP showed significant correlation to height velocity (r = 0.40; P < 0.001). In untreated girls with CPP, serum levels of s-PIIINP were elevated [PIIINP SD score (SDS), 2.13]. Levels of s-PICP were normal (PICP SDS, 0.39). Levels of both propeptides decreased within 2 months after initiation of therapy and remained below initial values (P < 0.01). The decrease in s-PIIINP after 2 months of therapy showed a significant correlation with the fall in height velocity SDS for chronological age after 6 months of therapy (r = 0.64; P < 0.01). We conclude that s-PIIINP and, to a lesser degree, s-PICP reflect growth in normal children, but due to the large variation, both propeptides seem unsuitable as markers for screening of growth disorders in children.

Adolescent↗
PubMed1993

Clinical studies of IGFBP-2 by radioimmunoassay.

A specific radioimmunoassay for human IGFBP-2 was developed using a polyclonal antiserum directed against a partial sequence (hIGFBP-2(176-190)). The tracer was prepared by radioiodination of a [Tyr]o-hIGFBP-2(176-190) derivative. The assay was used to study IGFBP-2 levels in numerous clinical and experimental situations. There was little circadian fluctuations of serum level which showed a marked age-dependence with high levels at birth and senescence and low levels during puberty. Decreased IGFBP-2 levels were present in untreated insulin-dependent diabetes mellitus (IDDM), in acromegaly and during dexamethasone suppression test. GH deficiency, fasting, IGF-I administration to patients with GH receptor deficiency, hepatic failure and insulinomas caused a moderate increase of serum IGFBP-2. Markedly elevated levels were found in chronic renal failure, non-islet cell tumour induced hypoglycemia and leukaemias. The fact that all possible relationships between insulin secretion and IGFBP-2 levels could be identified suggests that insulin is not a major regulator. In general, there was an inverse relationship with serum IGFBP-3 (except IDDM) and IGFBP-2 levels were high in situations where free IGF-II should be expected to be high. The tentative conclusion would therefore be that free IGF-II is a major regulator of circulating IGFBP-2.

Animals↗
PubMed1992

Nasal packing and nocturnal oxygen desaturation.

Nasal obstruction influences respiration during sleep, and nasal packing may be the cause of obstructive sleep apnoea. In order to investigate this phenomenon, perioperative nocturnal oxygen saturation was monitored for 3 nights with continuous, non-invasive pulse oximetry in 12 patients who had total nasal packs after septoplasty. Significant extension of nocturnal accumulated time of oxygen saturation less than 90% was demonstrated both during the first and second postoperative nights. The clinical significance of these results is as yet unknown, but the use of partial nasal packing in association with septoplasty is advocated and further investigations on nocturnal oxygen saturation are called for.

Adolescent↗
PubMed1991

Episodic nocturnal hypoxia and nasal packs.

Nasal obstruction influences respiration during sleep and nasal packs may cause obstructive sleep apnoea. In order to investigate this, the perioperative oxygen saturation was monitored for 3 nights with continuous pulse oximetry in 12 patients, who had bilateral nasal packs after septoplasty. A significant increase in the number of nocturnal episodes of hypoxia and a significant prolongation of the mean duration of the individual hypoxic periods were demonstrated during the first and the second post-operative nights. The clinical significance of these results is as yet unknown, but the use of partial nasal packing in septoplasty is advocated. Further investigations of nocturnal oxygen desaturation and design of nasal packs, securing the post-operative nasal airway, are needed.

Adolescent↗
PubMed1990

[Treatment of unstable angina pectoris. A questionnaire study].

Questionnaires about therapy in unstable angina pectoris were sent to 63 Danish medical departments and were answered by 52 departments (82.5%). Nitroglycerin is commonly used but only in half of the departments is Nitroglycerin administered intravenously. Calcium-receptor-blockers are used in more departments (65%) than beta-receptor-blockers (35%) (p less than 0.05). Five departments use thrombolytic therapy along local guidelines. All recommend aspirin as prophylaxis against thrombosis and 63% recommend the therapy to be continued for life. An exercise test is always performed during hospital stay in 1/3 of the departments while the rest of the departments often wait till after the patient has been discharged. The estimate of frequency of coronary angiography varied considerably: from less than 5% to 100%. The frequency of coronary angiography was stated to be higher in Copenhagen and Aarhus (median 50%, interval 10-100%) than in the rest of the country (median 15%, interval less than 5-75%) (p less than 0.01).

Adrenergic beta-Antagonists↗
PubMed1990

[Use of fibrinolytics in the treatment of acute myocardial infarction in Denmark. A questionnaire study].

Questionnaires were sent to all Danish departments admitting patients with acute myocardial infarction (AMI) in order to investigate the attitudes of the departments to thrombolytic therapy in AMI. Two questionnaires were used: one with few questions which was answered by all 68 departments, and a more comprehensive questionnaire which was answered by 51 departments. The study shows that thrombolytic therapy now is use in all departments as opposed to 25% two years ago. In connection with introduction of thrombolytic therapy scientific studies are performed in 75% of the departments. In all departments, streptokinase (SK) is the drug of first choice and recombinant tissue plasminogen activator (rt-PA) is used in 2/3 of the departments in cases where SK-antibodies are suspected.

Denmark↗
PubMed1990

[Endogenous opioids and their therapeutic use in the treatment of pain].

Cancer patients with chronic pain and obstetric patients have participated in clinical trials of the analgesic effects of endogenous opioids. It is possible to achieve adequate relief of pain in these patients following epidural or intrathecal administration of endogenous opioids. Further investigations are required.

Endorphins↗
PubMed1989

Guanethidine-induced sympathectomy in the nude rat.

Guanethidine sulphate 40 mg/kg was administered intraperitoneally daily for 14 days to normal Lewis rats and athymic nude rats of a Lewis background (rnu/rnu). Histological examination of the superior cervical ganglia demonstrated a pronounced chromatolysis of the neurones and a loss of the major part of the nerve cells accompanied by an increased number of small mononuclear inflammatory cells. The extent of chromatolysis and nerve cell death induced by guanethidine did not differ between normal and nude rats, whereas the increase of the number of mononuclear cells was lower in the nude rats than in the normal rats (163 and 268 per cent respectively of the saline treated controls, P less than 0.01). Since guanethidine induced nerve cell death in the T-cell deficient nude rat to the same extent as in normal rats, it is concluded, that the effect is caused by either a thymus-independent immune-response or by a direct toxic effect.

Animals↗
PubMed1989

Traumatic tympanic membrane perforations: complications and management.

There is great diversity in the methods of treating traumatic perforations of the tympanic membrane. To elucidate the controversy, we present a long-term follow-up study of 37 patients. On the basis of our present study and available relevant data in the literature, we emphasize that early surgical intervention of a traumatic myringeal perforation is not indicated, as most of these perforations (an average of 88%) do heal spontaneously without complications. However, we stress the importance of performing a meticulous auditory and vestibular examination with close follow-up and repeat audiograms in all patients with acute traumatic myringoruptures to provide enough information for diagnosis of a major perilymph leak that would warrant operation. Myringeal perforations or major conductive hearing losses persisting 3 months after injury warrant tympanotomy and appropriate reconstruction.

Adolescent↗
PubMed1986

Efficacy of perioperative ceftazidime in the surgical treatment of chronic otitis media due to Pseudomonas aeruginosa. Preliminary report of a prospective, controlled study.

A prospective open and controlled study of perioperative antibiotics was conducted in patients with chronic otitis media (COM). Drug efficacy was found in a subgroup of 26 patients, who were characterized by preoperative aural drainage culturing Pseudomonas aeruginosa. Fourteen of these patients were randomized to receive ceftazidime (cephalosporin) for 5 days at the operation, while 12 had no antibiotic treatment. The occurrence of subsequent aural drainage was compared with the actual clinical and microbiological conditions of the ears 2 months after the operation; statistically significant differences were found in favor of the group treated with ceftazidime. Further studies must define the role of ceftazidime and other antibiotics in the management of patients with COM.

Adult↗
PubMed1985

Quinsy: a bilateral presentation.

Bilateral peritonsillar abscesses are rare and often not diagnosed until tonsillectomy. As the condition may create diagnostic problems and serious complications, a case history is presented. The importance of rapid otorhinolaryngological examination and treatment is stressed.

Adult↗