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Biomedical subjects

D A Koutras

Publications and source records attributed to D A Koutras.

At least 91 records · Page 5Linked to original sources
PubMed1978

Free-thyroxine index in psychotic and neurotic depression.

The mean free-thyroxine index value of a group of 25 psychotic depressive patients was found to be significantly lower than that of an age- and sex-matched group of 20 neurotic depressives (P less than 0.01). These findings support the view that psychotic and neurotic depression are differentiated not only with respect to their clinical expression, but also on account of their biological substrate. Comparison of free-thyroxine index values of each group of patients with a group of 240 euthyroid subjects hospitalized for various somatic illnesses revealed a lower mean free-thyroxine index value in the group of psychotic depressives (P less than 0.001). The neurotic depressives were not differentiated from the group of euthyroid subjects. The decreased thyroid activity in psychotic depression might be interpreted in the light of recent findings implicating catecholamines in both the release of hypothalamic hormones and the neurochemical mechanism of the affective disorders.

Adjustment Disorders↗
PubMed1978

Lack of influence of povidone-iodine on tests of thyroid function.

The external application of povidone-iodine, an antiseptic agent, was tested for its influence on thyroid function. Previous workers have described some in vitro changes in thyroid function tests following its use. In the present study topical application of povidone-iodine did not affect thyroid function as measured some days later using both in vivo and radio-active iodine in vitro test methods, despite the fact that the latter are notorious for being influenced by exogenous iodine.

Administration, Topical↗
PubMed1978

Iodide organification defect in iodine deficiency endemic goiter.

In 17 goitrous persons in an iodine-deficient area, in 23 nongoitrous inhabitants of the same village, in 10 goitrous persons in Athens, and 8 normal controls the perchlorate discharge test was performed, either in the simple standard form or after pretreatment with either 0.5 or 2.0 mg potassium iodide or 2.5 mg carbimazole. With the simple test or with 0.5 mg potassium iodide, there was no significant discharge in any group studied. With 2.5 mg carbimazole, there was a profound discharge of the trapped iodide in both groups in the iodine-deficient area. With 2.0 mg potassium iodide, however, there was a clear discharge in the two goitrous groups (i.e. the one in the endemic area and the second in Athens), a less pronounced discharge in the controls studied in Athens, and no discharge at all in the nongoitrous inhabitants of the iodine-deficient endemic area. These findings provide evidence for an abnormality present in the patients with endemic goiter, most probably faulty iodine utilization due to impaired organic binding. The nongoitrous persons in the endemic areas, on the other hand, seem to be even more efficient in handling the trapped iodide than the controls studied in Athens. These findings may provide an explanation for previous observations that in endemic areas only part of the population develop a goiter, whereas the others adapt successfully to iodine deficiency without significantly enlarging their glands.

Child↗
PubMed1977

The toxic effect of small iodine supplements in patients with autonomous thyroid nodules.

In sixteen cases of toxic adenoma of the thyroid (autonomous hot nodule with complete suppression of the surrounding normal parenchyma) potassium iodide was given in doses of 100 microgram/day for one week, 200 microgram/day for another and 400 microgram/day for a third week. There was a progressive increase in the serum T4 level. Serum T3 also increased, although this was significant only after the first week. Serum TSH was undetectable throughout the entire period of the study. This metabolic pattern is different from the response seen in cases of nontoxic endemic goitre, where small iodine supplements induce an increase in serum T4 but a decrease in serum T3. Furthermore, the present results may explain the phenomenon of iodine-induced or iodine-precipitated hyperthyroidism (Jod-Basedow) when patients with autonomous thyroid are presented with a high iodine intake. In contrast to the results obtained with small iodide doses, two other cases treated with large pharmacological doses of iodide showed a decrease in both serum T4 and serum T3. It is concluded that the physician should be aware of the possibility of precipitating or aggravating thyrotoxicosis in patients with an autonomous hot nodule by increasing their intake of iodine.

Goiter, Nodular↗
PubMed1977

Carcinoembryonic antigen in thyroid disease.

Plasma carcinoembryonic antigen (CEA) levels were measured by the Z-Gel technique in 138 patients with benign thyroidopathies, 25 patients with thyroid cancer, and 141 normal persons. Levels were raised (above 5 ng/ml) in 2% of the normal subjects, in none of the patients with benign thyroidopathies, and in 20% of the patients with thyroid cancer. They were considerably raised in all cases of medullary carcinoma of the thyroid but they were also high in other histological types of thyroid cancer. Measurement of plasma CEA may be of value in the preoperative diagnosis and follow-up of patients with thyroid cancer.

Carcinoembryonic Antigen↗
PubMed1977

Electrocardiographic abnormalities in hypothyroidism before and after exercise.

Eleven men and 50 women with severe hypothyroidism were studied. All patients had a serum PBI less than 3.0 mug/100 ml, 131I 24 hours uptake less than 13% and a a photomotogram contraction and half relaxation time of 380 msec or more. Before exercise the mean +/- SE heart rate was 68.39 +/- 3.26/min, the PR interval 17.08 +/- 0.37 csec, the QRS voltage (sum of the QRS amplitude in leads I, II and III) 16.44 +/- 0.89 mm (10mm = 1.0 mV) and the T wave amplitude 0.06 +/- 0.15 mm. A significant correlation (p less than 0.05) existed between the PBI values and the QRS voltage. Following exercise there was a significant acceleration of the heart rate (+ 23.39/min, p less than 0.001), shortening of the PR interval (-0.66 csec, p less than 0.02) and T wave elevation (+ 0.40 mm, p less than 0.001). ST segment changes were not observed in any case. Replacement treatment in 7 cases resulted in a significant change in the resting heart rate (+ 11.86/min. p less than 0.025), PR interval (-3.28 mm, p less than 0.025) and T wave height (+ 2.50 mm, p less than 0.01). These findings suggest that exercise may be used in the differentiation between hypothyroidism and coronary heart disease. The theoretical importance of these findings is also discussed. An increase in cardiac energy demands during exercise may be the cause for some of the ECG changes observed on exertion.

Adult↗
PubMed1976

The TRH stimulation test in endemic goitre in Greece.

The serum T4=T4(D), T3 in vitro uptake=RT3U and TSH were measured before and 30 min after the injection of 200 mug of TRH in 30 subjects from an iodine deficient area of Central Greece. These persons were divided in two groups of 16 goitrous and 14 nongoitrous patients and the results from each group compared to each other and also with the same parameters obtained from 14 controls subjects, all nongoitrous and from a nonendemic area. It has been found that in this area with a mild iodine deficiency serum T4 is the only hormone decreased whereas RT3U and TSH both before and 30 min after TRH injection are normal. There existed however a negative correlation between serum T4 and TSH in the goitrous group. Why the nongoitrous iodine deficient persons achieve the same compensation without thyroid gland enlargement remains unsolved but it may be stated from the present results that goitre development should be regarded as a maladaptation rather than a compensatory process.

Adult↗
PubMed1976

Malignant cold thyroid nodules in hyperthyroidism.

In 65 hyperthyroid patients with a cold nodule a carcinoma was found at operation in 14 cases, i.e. a malignancy incidence of 21-5 per cent. In 859 euthyroid cases with a cold thyroid nodule 104 malignant lesions (12-1 per cent) were found. The difference is statistically significant. Surgery in cases with a cold thyroid nodule is strongly indicated if this occurs in a hyperthyroid gland.

Adult↗
PubMed1976

Similar serum IgM concentrations in Greek endemic goiter and control populations: failure to confirm previous experience.

Circulating immunoglobulin M (IgM) concentrations were determined in 47 nontoxic goiter patients from four Greek endemic goiter areas, and in 13 patients from Athens, a non-goitrous area; and compared with 38 control non-goitrous subjects from the same goiter regions, and 23 more controls from Athens. The values in both goitrous and non-goitrous groups were indistinguishable. Current techniques for single radial immunodiffusion were employed. The results are expressed in standardized international units/ml serum, instead of the formerly used mg/dl. The present findings are in disagreement with the earlier observation from this laboratory that 40 per cent of goitrous patients had elevated IgM values compared with 10 per cent of control subjects.

Adolescent↗
PubMed1976

Thyroid scanning with gallium-67 and cesium-131.

The roles of 131Cs and 67Ga in the evaluation of solitary thyroid nodules were investigated. Radionuclide scans were performed with 67Ga and 131I in 27 patients and with 131Cs and 131I in 43 patients. Gallium-67 detected only two of eight malignant nonfunctioning nodules and 131Cs detected one of three such nodules. The contribution of 131Cs and 67Ga to the preoperative identification of malignant thyroid lesions is of doubtful value.

Adenocarcinoma↗
PubMed1975

Comparison of various treatment schedules for accelerating the elimination of radioiodine from the thyroid and the human body.

In 68 euthyroid patients undergoing 131I thyroid function tests the thyroidal, urinary and plasma protein-bound radioactivity has been serially measured for 14 days. The patients were subdivided in controls and 9 groups treated with potassium iodide, carbimazole, potassium perchlorate and TSH, singly or in combination. The aim was to devise a treatment scheme for accelerating the release of iodine from the thyroid and the elimination from the body in cases of accidental radioiodine poisoning if the patient is seen after the radioiodine has already been taken up by the gland. All treatment schedules were effective, but TSH injections gave the best results, especially if combined with carbimazole and potassium perchlorate. This combination is the treatment of choice under these circumstances.

Blood Proteins↗