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Biomedical subjects

C Chapman

Publications and source records attributed to C Chapman.

At least 181 records · Page 10Linked to original sources

Effect of bromocriptine on maturity onset diabetes.

The effect of the dopamine agonist, bromocriptine, and the dopamine antagonist, metoclopramide, on glucose tolerance was examined in maturity onset diabetics and normal subjects. After bromocriptine there was a lowered fasting blood glucose and improved glucose tolerance in the diabetics. The controls showed an initial improvement in glucose tolerance. A reduction in insulin levels and a marked fall in plasma prolactin was observed in all subjects. Growth hormone concentrations were low and unaffected in the diabetics, and there was an inconsistent rise in the normals. After metoclopramide there was some impairment in glucose tolerance in the normal subjects, but this was not significant in the diabetics. There was also a marked prolactin release in all subjects, but no significant effect on insulin or growth hormone. It is concluded that bromocriptine lowers the blood glucose and improves glucose tolerance in maturity onset diabetics. This action may be the result of the lowered prolactin which occurred without a concomitant rise in growth hormone.

Blood Glucose↗

Thyroid function tests during carbimazole therapy.

Changes in plasma thyroxine (T4), triiodothyronine (T3), free thyroxine index (FT4I) and thyroid stimulating hormone were studied in 100 patients with Graves' disease treated with carbimazole. During therapy plasma T3 concentrations were disproportionately high compared to those of T4, the T4 : T3 ratio was low, and many patients were clinically euthyroid with a normal plasma T3 but low T4 concentration. Although there was considerable individual variation in response, the order of response was always the same with plasma T4 falling to normal or low levels before T3. Plasma T3 was the best indicator of clinical status and the best predictor of the impending change; additional information of changes in thyroid status was obtained from plasma T4 and FT4I estimation, especially when these were followed sequentially. Single measurements of T4 or FT4I only are not recommended for assessing thyroid function during carbimazole therapy.

Adolescent↗

Precocious puberty associated with primary hypothyroidism in a mongol girl.

A mongol child suffereing from hypothyroidism who presented with precocious puberty is described. A presumptive diagnosis of idiopathic precocious puberty was first made and she was treated initially with medroxyprogesterone acetate, and later, with cyproterone acetate. The diagnosis of primary hypothyroidism was made late because of misleading results of protein bound iodine estimations. Subsequently, thyroid medication resulted in a prompt return to the normal range of the previously elevated levels of plasma gonadotrophins, thyroid stimulating hormone and plasma and urinary oestrogens, but the serum prolactin remained elevated for several months after therapy was begun.

Child↗

Legionnaires' disease in Kingport, Tennessee.

In August and September 1977 a discrete cluster of 27 serologically or pathologically confirmed cases of Legionnaires' disease, plus six highly presumptive cases were identified in the area of Kingsport, Tennessee. Three patients died. Most patients manifested severe pneumonia and fever; no mild or asymptomatic disease forms were recognized despite intensive case-finding efforts. Illness was epidemiologically associated with residing, visiting, or working in one geographic area of Kingsport, residence there being the factor most strongly associated. Although the attack rate for area residents was 0.64%, the randomly determined prevalence of serologic reactors was 5.2%, which is not significantly different from that in a nonimplicated control neighborhood. The epidemic did not correlate temporally with any identified environmental or demographic event. No source of the bacterium was found either by a detailed case-control study of area associations or by bacterial isolation from sentinel guinea pigs or environmental specimens. There was no evidence of person-to-person spread.

Disease Outbreaks↗

Interpretation of laboratory tests of thyroid function in chronic active hepatitis.

Because the incidence of thyroid disorder is much greater than expected in chronic active hepatitis we have evaluated routine in vivo and in vitro tests of thyroid function in forty one clinically euthryoid patients with chronic active hepatitis and in five patients with chronic active hepatitis and concomitant or previous clinical thyroid disease. Serum thyroxine, thyroid hormone binding, triiodothyronine, thyrotrophin releasing hormone tests and thyroidal uptake of radio-iodine all gave misleading information in some clinically euthyroid patients with chronic active hepatitis. However, the free thyroxine index calculated from the serum thyroxine and thyroid hormone binding level gave results that accorded with the clinical impression in all but two of the euthyroid patients whose results were borderline and subsequently normal and in all but one of those with past or current thyroid disorder. This suggests that anomalies of protein binding accounted for abnormal results in thyroxine and thyroid hormone binding levels.

Adolescent↗

Effects of exercise, altitude, and food on blood hormone and metabolite levels.

Measurements of blood glucose and plasma free fatty acids (FFA), thyroxine (T4), free thyroxine (FT4), triiodothyronine (T3), and thyroid-stimulating hormone (TSH) were made on samples taken from fed and fasted human subjects while at rest and immediately after 20 min moderate exercise. Six subjects were studied on successive weeks before (LA1), during (HA1, HA2, HA3), and after (LA2) a 3-wk sojourn at high altitude (3,650 m). The subjects and location were the same as those used for the energy expenditure measurements described in the preceding paper (J. Appl. Physiol.: Respirat. Environ. Exercise Physiol. 45:345--349, 1978). The most marked effect of altitude was to potentiate the rise in FFA due to exercise. This effect was most noticeable in fed subjects during HA1 and HA2. Changes in the plasma levels of the thyroid hormones correlated with the FFA changes and, once again, exercise at altitude caused the greatest increase in circulating levels. Possible causes of the parallel changes in FFA and thyroid hormone levels and their relationship to changes in energy metabolism are discussed.

Acclimatization↗

The effect of altering thyroid hormone concentrations on plasma gonadotrophins in postmenopausal women.

Plasma gonadotrophin levels were measured at frequent intervals in six postmenopausal thyrotoxic women treated with carbimazole. All patients showed an increasing follicle stimulating hormone/luteinizing hormone (FSH/LH) ratio as the thyroid hormone concentrations fell to normal and then into the hypothyroid range. Although the increased FSH/LH ratio was primarily due to a rise of FSH, two patients had a rise of both gonadotrophins. It is suggested that menstrual irregularities occurring in premenopausal women with disorders of thyroid metabolism may be related to similar changes.

Aged↗

Red-blood-cell composition in thyroid disease.

Eight red-blood-cell (R.B.C.) consitituents were measured in ten patients with hyperthyroidism and in ten healthy subjects. Only R.B.C. sodium ([Na]) and zinc ([Zn]) differed much between the groups. Therefore, only these variables were measured in a larger group of untreated hyperthyroid patients. The increase in. R.B.C. [Na] and decrease in R.B.C. [Zn] were confirmed. The R.B.C. [Na] and [Zn] were related to each other and to the plasma-thyroid-hormone concentration. However, more patients had low R.B.C. [Zn] (91%) than had raised R.B.C. [Na] (50%). Further studies suggest that the R.B.C. [Zn] lags behind the clinical response when these patients are treated. These results suggest that the measurement of R.B.C. [Zn] may have a role in the diagnosis of hyperthyroidism.

Adult↗

Circular Dichroism Studies of Cyanate-Induced Conformational Changes in Hemoglobins A and S.

Circular dichroism and difference spectroscopy have been used to study dilute aqueous solutions of oxygenated, deoxygenated, and carbamoylated deoxygenated hemoglobins A and S (HbA and HbS, respectively). The spectra of HbA and HbS, in comparable state of oxygenation or carbamoylation, are identical, strongly implying identical conformations about the heme groups of the respective proteins. The spectra of the oxygenated forms change little upon addition of KCNO, which is known to carbamoylate the NH2 terminals of the individual chains (Cerami and Manning, 1971). The spectra of the deoxygenated forms, on the other hand, are markedly altered. The decreased magnitude of the 430-nm extremum with increased cyanate concentration can be used to calculate an addition curve which becomes asymptotic at a cyanate:heme molar ratio of approximately 10(3). This conformational change occurs in the absence of O2 and has been predicted (Njikam et al.,1973); it can also be demonstrated by difference spectroscopy techniques, whereby a comparable addition curve can be constructed from changes in the 555-nm absorption, while the 541-nm absorption remains invariant. The change described corresponds to the formation of a new conformation, corresponding to carbamoyldeoxyhemoglobin, carrying one carbamoyl group per chain. In the presence of a small quantity of oxygen, however, the above reported changes in CD are accompanied by a concomitant rise in the 415-nm peak-corresponding to the formation of oxyhemoglobin-while those in the difference spectra reflect not only a change in the 555-nm band but also a parallel one at 541 nm, confirming the formation of oxyhemoglobin. Thus the conformation achieved upon carbamoylation of deoxyhemoglobin has the higher oxygen affinity predicted by Nigen et al. (1974) for carbamoyldeoxyhemoglobin. Cyanate has been used (Cerami and Manning, 1971) as an antisickling reagent in vivo and in vitro, but, although it has been shown that it binds covalently to the NH2-terminal residues of hemoglobin (Lee and Manning, 1973), its effect on hemoglobin conformation has not been previously shown nor has its mechanism of action been fully clarified. The results presented here show that the effect of cyanate on hemoglobin is the formation of a new conformation with heightened oxygen affinity. Since oxyHbS does not aggregate while deoxyHbS does, in a temperature-dependent fashion, the formation of carbamoyldeoxyHbS interferes with such aggregation in vitro in deoxygenated samples. In vivo, where there are generally low residual concentrations of O2, the formation of oxyHb is favored by the higher O2 affinity of carbamoyldeoxyHbS, and aggregation with concomitant red cell sickling is therefore disfavored.

Binding Sites↗