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Biomedical subjects

D Reinwein

Publications and source records attributed to D Reinwein.

At least 181 records · Page 10Linked to original sources
PubMed1976

The thyroidal T4/T3 ratio and its regulation in non-toxic goitre.

In 35 patients with non-toxic goitre, surgically resected thyroid tissue was hydrolyzed with Pronase under anaerobic conditions in the presence of methylmercaptoimidazole. Total iodine, PBI, L-thyroxine (T4-RIA and T4 (D)) as well as triiodothyronine (T3-RIA) were determined in the tissue hydrolysates. The data obtained were compared with T4/T3 ratios in the serum, TRH test and thyroidal 131I uptake before operation. The total iodine, amounted to 112.6 +/- 14.6 ug/g tissue. The T4/T3 ratio was 11.37 +/- 1.80. Using this procedure of tissue hydrolysis and RIA assays for iodothyronines, the yield for T4 and T3 is considerably higher than the one obtained with previous methods. As in animal experiments, evidence was given for human goitre that T3 is predominantly produced first in the case of decreased T4 production. Second in the case of iodine deficiency, and third in cases of increased TSH response after TRH. Patients with a large amount of iodine and T4 in their thyroids have a much smaller increase in serum TSH after TRH than do subjects with a much lower thyroidal T4 concentration. This occurs even though the thyroid hormone levels in serum in these groups are not different. No correlation between thyroidal T4/T3 ratio and serum T4/T3 ration could be demonstrated even under extreme conditions. This finding favors the assumption of a predominant extrathyroidal regulation for T4/T3 ratio in serum.

Adult↗
PubMed1976

Long-term treatment of acromegaly with bromocryptine: postprandial HGH levels and response to TRH and glucose administration.

Fourteen patients with acromegaly were treated with bromocryptine (CB 154, Sandoz), 4 X 2.5 mg, for periods of up to eleven months. One patient did not tolerate the drug, ten of the remaining thirteen experienced considerable clinical improvement. There was a dose-dependent suppression of plasma growth hormone levels, but growth hormone response to TRH injection and to glucose administration was still present during therapy although reduced. TSH response to TRH was not significantly altered. The suppressive power of bromocryptine on growth hormone appears to be related to the mechanism by which TRH stimulates growth hormone secretion in acromegaly, but long-term administration of this drug may be successful in spite of an absent response to TRH in some cases. Bromocryptine appears to be a safe and effective drug for the treatment of acromegaly.

Acromegaly↗
PubMed1976

Effects of growth hormone release-inhibiting hormone and bromocryptine (CB 154) in states of abnormal pituitary-adrenal function.

Growth hormone release-inhibiting hormone (GHR-IH) was administered to five patients with abnormal pituitary-adrenal function. There was immediate suppression by about 50% of ACTH levels in two patients who had undergone bilateral adrenalectomy because of Cushing's disease; one of them had Nelson's syndrome. Bromocryptine (2-5 mg) suppressed ACTH levels by 62-67% for more than 6 h in these patients. GHR-IH did not significantly influence cortisol secretion by an adrenal carcinoma and only slight changes were seen in two patients with Addison's disease. The possible therapeutic implications are discussed.

Adrenal Gland Diseases↗
PubMed1975

[Abnormal hypothalamic-hypophyseal regulation as a new endocrine sign in the testicular feminisation syndrome (author's transl)].

In a 38-year-old woman with the testicular feminisation syndrome (TFS) there were increased serum levels of LH and FSH, despite normal testosterone levels, ranging from 808 to 1330 ng/dl. The patient exhibited complete end-organ resistance to androgens, as well as decreased free testosterone fraction of 1.5 percent. On stimulation with LH-RH there was enhanced LH reaction to 15 ng/ml, while FSH levels remained unchanged. Fluoxymesterone did not suppress LH and testosterone, as it did in normal controls. But the functional Leydig-cell reserve could be normally stimulated with HCG. Our results apparently confirm the suspected reduction in sensitivity of the hypothalamic-pituitary axis to androgens and suggest that this plays an important part in the pathogenesis of TES.

Adult↗
PubMed1975

[Fatal vitamin D intoxication].

A 43-year-old man with alopecia maligna was treated for 4 weeks with a total of 130 mg vitamin D3. Two weeks later, after intensive exposure to the sun, he developed a hypercalcaemic crisis and died 5 weeks later of acute cardiac failure. The hypercalcaemia proved treatment-resistant despite good diuresis. Causes other than vitamin D intoxication were excluded clinically and on histopathological investigations. It is suggested that vitamin D should be administered only on the strictest indications and with regular control of the patient.

Adult↗
PubMed1975

Serum triiodothyronine 7-15 years after fractionated low dose radioiodine therapy of thyrotoxicosis.

In 189 of 334 patients, who had been treated with fractionated doses of radioiodine for Graves' disease 7-15 years ago, the serum concentrations of triiodothyronine have been estimated in additition to the following parameters: Protein bound 127-iodine (PB-127-I), free thyroxine index, cholesterol- and TSH-level in serum, tendon reflex time and clinical index according to Billewitz et al. (1969). In forty-one of the 189 sera the free T4 (AFT4) and free T3 (AFT3) concentrations were measured as well. The following hormonal and clinical patterns were observed: (1) Euthyroidism, with all parameters within the normal range in 148 patients (equals 78-4%). (2) Hypothyroidism with low serum T3, PBI, AFT4, AFT3 and elevated TSH six subjects (equals 3-2%). (3) Persistent hyperthyroidism with increased thyroid hormone concentrations and low TSH in seven cases (equals 3-7%). (4) In twenty-eight clinically euthyroid patients (equals 14-8%) TSH was elevated with normal PBI and AFT4. Twenty of these subjects had a low normal T3 and in nine the T3 was clearly in the hypothyroid range (40 plus or minus 12 mug/dl). (5) The constellation of normal T3, low T4 and elevated TSH, which has been frequently found after radioiodine therapy, has been seen in only moderate form in ten cases.

Adult↗