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Biomedical subjects

A M Ermans

Publications and source records attributed to A M Ermans.

At least 37 records · Page 2Linked to original sources
PubMed1981

[Use of plasmapheresis in a case of Graves' disease with malignant ophthalmopathy (author's transl)].

A short trial with high doses of prednisolone to treat a 62 year-old woman with malignant ophthalmopathy due to Graves disease yielded an unsatisfactory improvement after 5-6 days. The authors decided therefore to use plasmapheresis, 4 plasma exchanges of 2.5 liters each associated with prednisolone (80 ng/day) and azathioprine (100 mg/day). This therapeutic approach resulted in a spectacular improvement obtained after less than 2 weeks: normalization of thyroid function, improvement of all ophthalmological indices confirmed by radiology (C.A.T.) of the retroocular region. The rapid and important improvement obtained after such a short period of time is in favor or the major role of plasmapheresis in this combined therapy of malignant Graves' ophthalmopathy.

Azathioprine↗
PubMed1980

Bacterial meningitis complicated by spinal arachnoiditis: diagnostic contribution of Tc-99m-inulin myeloscintigraphy.

Six cases of bacterial meningitis with myeloscintigraphic evidence of medullary arachnoiditis are reported. Four patients has tuberculous meningitis, another showed severe myelopathy, and the last was suspected to have hydrocephalus. Arachnoiditis is suspected when the earliest images show a sharp decrease of tracer concentration. Scintigraphy began 2 hours after lumbar injection of Tc-99m-Polyfructosan and imaging was performed at intervals of 2, 4, and 6 hours. This method has proved easy, innoculous, reproducible, and, owing to the small amount of irradiation, studies may be repeated during and after therapy. Scintigraphy is superior to the Queckenstedt test becaise it detects partial blocks and localizes lesions.

Adolescent↗
PubMed1978

A chemical method for the labeling of fibrinogen with 99mTc.

A new method allowing the labelling of fibrinogen with 99mTcO4- is described. The 99mTcO4- is reduced by stannous chloride in an alkaline medium. After 1 h incubation with fibrinogen, the pH was brought down to 7.1. The study of (1) the pH of the solution, (2) the quantity of the reducer, and (3) the time of incubation allowed us to specify optimal conditions for labeling. The labeling yield varied from 91.68% plus or minus 6.05% to 95.18% plus or minus 2.13% according to the method of control used: the precipitation of fibrinogen by (NH4)2SO4 25% or thin-layer chromatography with methylethylketone as solvent. Clottable radioactivity averaged 72% plus or minus 4.43%. Column chromatography separated the tracer into two radioactive peaks. The first peak corresponded to the fibrinogen and carried 73.36% plus or minus 5.8% of the total radioactivity. The total recovered radioactivity amounted to 89.86% plus or minus 8.07%. Spectroscopic clottability was 88.23% plus or minus 2.42%. The in vivo stability of the labeling and the molecule was followed for 24 h after intravenous injection. If the radioactivity measured in the 5 min sample was considered to equal 100%, the 24 h sample averaged 32.71% plus or minus 3.25%, of which 85.68% plus or minus 2.92% was recovered in the clot. In conclusion, this method enabled us to obtain a stable tracer that we used for routine investigations in man.

Fibrinogen↗
PubMed1978

Fetal hypothyroidism and maternal thyroid status in severe endemic goiter.

The relationship between maternal thyroid function and newborn thyroid function was studied in a region of very severe endemic goiter (Ubangi, Republic of Zaïre). T4, T3, and TSH concentrations were measured in the sera of 56 mothers (at the time of delivery) and 60 newborns (in the cord). The results obtained in these groups (untreated) were compared with those obtained in two control groups, comprising 53 mothers whose iodine deficiency had been corrected by the injection of iodized oil and 68 neonates born to such mothers. The results show that the mean (+/- SEM) T4 serum concentration (micrograms per dl) was 11.5 +/- 0.7 in the untreated mothers compared with 15.7 +/- 0.7 in the treated mothers (P less than 0.001), and 9.4 +/- 0.8 in the untreated newborns compared with 12.4 +/- 0.5 in the newborns of treated mothers (P less than 0.01). The values observed for the mean T3 serum concentrations (nanograms per dl) in the same groups were 171 +/- 10 and 154 +/- 9 (mothers; P greater than 0.05) and 68 +/- 6 and 55 +/- 6 (newborns; P greater than 0.05); the mean TSH serum concentrations (microunits per ml) were 8.7 (7.6 - 9.9) and 5.4 (4.9 - 5.9; mothers; P less than 0.001) and 19.6 (16.6 - 23.2) and 6.4 (5.8 - 7.0; newborns; P less than 0.001). The proportion of untreated newborns, i.e. 40%, with individual TSH values deviating by more than 2 SDS above the mean of the treated newborns is much greater than the corresponding proportion, i.e. 15%, of untreated mothers in relation to the treated ones. In 6 out of 34 untreated newborns, definite biochemical signs of congenital hypothyroidism were observed. Correlation coefficients were calculated between the untreated subjects. A positive correlation coefficient of 0.80 (P less than 0.001) was observed between the serum T4 concentrations of the mothers and those of the newborns, and one of 0.61 (P less than 0.001) was observed between their respective serum TSH values. Significant inverse correlations were observed between maternal serum T4 and cord serum TSH (-0.79; P less than 0.001) and between cord T4 concentrations and maternal TSH concentrations (-0.57; P less than 0.01). No definite trend is observed between the variations of serum T3 on one hand, and those of serum T4 or serum TSH on the other hand. Out of 51 mothers in whom serum T4 was determined, 11 showed values below 8 micrograms /dl; the newborns of those mothers showed very low serum T4 values (5.5 +/- 1.6 micrograms/100 ml) and extremely high serum TSH levels [144 (98-210) microU/ml]. It is concluded that, contrary to the situation observed in physiological conditions, maternal thyroid function in regions of severe endemic goiter is a good indicator of newborn thyroid function. The reasons for this probably lie in the influence of environmental factors acting simultaneously on the mother and the fetus.

Congenital Hypothyroidism↗
PubMed1978

[Adverse effect of amniofetography on fetal thyroid function (author's transl)].

Amniofetography is a valuable tool for the diagnosis of fetal malformations. We have studied the effect of radiopaques dyes, containing large amounts of iodide, on fetal thyroid function. We have performed serial determinations of serum thyrotropin and thyroxine in seven newborn infants submitted to amniofetography. This work demonstrates that amniofetography induces a transient impairment of fetal thyroid function.

Contrast Media↗
PubMed1978

[Pathogenesis of endemic goiter: evidence of a dietary factor different from iodine deficiency (author's transl)].

The role of cassava was investigated in particularly severe endemic goiter area (Ubangi). Dietary intake of cassava induces an increase of plasma thiocyanate concentration and an increase of urinary excretion of stable iodine. Generalized iodine deficiency induces very high thyroid uptakes; the other parameters of thyroid function are more or less affected according to the dietary intake of thiocyanate. When thiocyanate intake is high an adaptation is obtained only at the expense of a drop of plasma T4 level and very high increase of plasma TSH.

Democratic Republic of the Congo↗
PubMed1977

Strategy of goitre and cretinism control in Central Africa.

Goitre prevalence in Ubangi Mongala (north-western Zaïre) ranges from 27 to 60 per cent in the male population and from 48 to 78 per cent in the female population; the prevalence of cretinism ranges between 0.7 and 7.6 per cent. This severe endemia affects 1.5 million inhabitants and constitutes a major public health problem. If administered to an entire population, single injections of slowly resorbable iodized oil can reduce goitre prevalence substantially, correct the iodine deficiency and restore normal thyroid function for a period of 3 to 7 years, depending on the parameter considered. The cost of programme of endemic goitre prevention based on this method can be estimated at 0.07 US dollars per person and per year of protection. A strategy of goitre and cretinism control in Central Africa, using iodized oil in an attack phase and iodized salt in a follow-up phase, is proposed. The organization of this programme will be dovetailed into other public health activities and will strengthen the basic health service framework.

Adolescent↗
PubMed1977

Serum thyrotrophin determination on day 5 of life as screening procedure for congenital hypothyroidism.

In 327 newborns cord blood thyroxine (T4) was 11.8 +/- 0.4 mug/100 ml (SEM) (151.9 +/- 5.1 nmol/l), and serum thyrotrophin (TSH) 6.7+/-1.0 muU/ml. Variability was marked for both T4 and TSH. Remeasured in the same patients on the fifth day of life, the TSH level was 3.7 +/- 1.0 muU/ml, lower than at birth (P less than 0.001), while scattering of TSH values was much smaller, with 99.4 % of values less than 12 muU/ml...

Congenital Hypothyroidism↗
PubMed1976

Adverse effect of amniofetography on fetal thyroid function.

Amniofetography is a valuable tool for the diagnosis of fetal malformations. This technique is being used routinely in pregnancies carrying a high risk of external fetal malformations. There are very few published data concerning the effect of radiopaque dyes, containing large amounts of iodide, on fetal thyroid function. We have performed serial determinations of serum thyrotropin and thyroxine in seven newborn infants to assess the effect of amniofetogrpahy on fetal thyroid function. This work demonstrates that amniofetography induces a transient impairment of fetal thyroid function.

Amnion↗