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Biomedical subjects

G Kallner

Publications and source records attributed to G Kallner.

At least 19 recordsLinked to original sources
PubMed2001

Dual-energy X-ray absorptiometry registers bone mineral in the liver.

OBJECTIVE: To analyse the difference in bone mineral content (BMC) between the left and right trunk generally obtained by dual-energy X-ray absorptiometry (DXA) by creating identical images over the liver region and the contralateral side. PATIENTS AND DESIGN: Fifty-four patients were selected at random from 1,722 subjects examined by DXA because of osteoporosis. Another five patients were selected who had been followed for osteoporosis by repeated DXA two to five times at intervals from 2 to 36 months. One healthy volunteer was followed for one day by means of DXA total body measurements. All protocols were analysed with respect to BMC, fat mass (FM) and lean tissue mass (LTM) of the imaged trunk and liver. RESULTS: BMC of the right trunk exceeded that of the left trunk in 78% of the investigated subjects. The right (liver) image dominated in all 81 investigations calculated from 60 subjects. There were intraindividual short- and longterm variations between repeated DXA examinations. The amounts of FM and LTM were distributed symmetrically between the right and left trunk. CONCLUSIONS: DXA registers BMC in the liver, which explains the general dominance of the right trunk. The absorption over the liver region varies in the same individual in repeated measurements at intervals of hours to months.

Absorptiometry, Photon↗
PubMed2000

Mortality in 497 patients with affective disorders attending a lithium clinic or after having left it.

The impact of lithium prophylaxis on mortality has been studied in 497 patients, 405 bipolars and 92 unipolars, who attended the same out-patient lithium clinic for up to 30 years. In order to avoid preselection, no minimum period of lithium treatment was required in our study. Of a total of 6014 patient-years, 4330 were spent in regular contact with the study clinic. General mortality due to natural causes was not significantly increased; among cardiovascular diseases, only pulmonary embolism showed an excess mortality. No patients died of lithium intoxication or chronic renal insufficiency. Patients were divided into three groups: Group A, 277 patients, attended the study clinic until death or the end of the study, Group B, 86 patients, left the clinic but continued to take lithium, and Group C, 134 patients, both left the clinic and stopped taking lithium. Among bipolars, the suicide rate compared to the general population was in excess in all three groups. Among unipolars, suicides occurred only after the patients had left the study clinic and stopped taking lithium. A special analytical method was used for intergroup comparisons of suicide rates. Bipolars in Group A attending the study clinic regularly had a suicide rate of 3.5 per 1000 patient-years. The rate increased to 6.3 or by 80 % if patients had left the clinic and did not take lithium any longer as in Group C. The suicide rate in Group C increased by 45% compared to Group B, patients who left the clinic but continued to take lithium. Our results support the hypothesis that lithium has a significant antisuicidal effect in bipolars as well as in unipolars. The suicide mortality can be further reduced by regular attendance in a specialised mood disorder clinic.

Adolescent↗
PubMed1996

Comparison of standardized initial doses of two antithyroid drugs in the treatment of Graves' disease.

OBJECTIVES: To obtain a simple standard regimen, suitable for general practice, and based upon the addition of antithyroid drug plus thyroxine for attaining euthyroidism in patients with Graves' disease. DESIGN: Prospective, randomized trial of patients with Graves' disease followed for 3 months after the initiation of therapy with an antithyroid drug and combined with the later addition of triiodothyronine to keep the patient euthyroid. The patients were randomized, according to birth date, between methimazole and propylthiouracil. Three dose schemes were tested for each antithyroid drug. SETTING: The study was performed at the thyroid outpatient units of two general hospitals, with the patients having been referred from primary care. SUBJECTS: Ninety-four patients with Graves' disease who were suitable for treatment with antithyroid drugs. INTERVENTIONS: The patients were allocated into six groups. Three groups received methimazole (10 mg every 6th, 8th or 12th h) and three received propylthiouracil (100 mg every 6th, 8th or 12th h). Twenty micrograms of triiodothyronine was added when the patients were euthyroid to avoid hypothyroidism. MAIN OUTCOME MEASURES: The lowest serum free thyroxine level within 3 months of the initiation of the antithyroid treatment. RESULTS: Fourteen per cent of the patients on methimazole 10 mg every 12th h and 29% on propylthiouracil 100 mg every 12th h did not achieve euthyroidism within the 3-month observation period. All but one patient on methimazole 10 mg every 8th h or propylthiouracil 100 mg every 8th h reduced the free serum thyroxine levels to the normal or hypothyroid range within the observation period. All of the patients on methimazole 10 mg every 6th h and 56% on propylthiouracil 100 mg every 6th h reduced the serum T4 values into the hypothyroid range within the period. CONCLUSION: A standard regimen, based upon the addition of methimazole 10 mg every 8th or 6th h or propylthiouracil 100 mg every 8th or 6th h and followed by the addition of thyroxine or triiodothyronine when euthyroid to avoid hypothyroidism, seems to be suitable for attaining euthyroidism within 3 months in patients with Graves' disease. A dose scheme based on methimazole 10 mg every 12th h or propylthiouracil 100 mg every 12th h were found to be unsuitable due to an unacceptably high incidence of failure to attain euthyroidism or hypothyroidism within 3 months.

Adolescent↗
PubMed1995

Renal, thyroid and parathyroid function during lithium treatment: laboratory tests in 207 people treated for 1-30 years.

A total of 207 patients (diagnoses revised according to DSM-III-R) attended our outpatient clinic and were treated with lithium for 1-30 years. They were subjected to conventional renal, thyroid and parathyroid function tests. With increasing treatment duration, the renal tests showed only moderate deviations from expected reference values. No patient developed renal insufficiency. Oversubstitution (thyrotropin < or = 0.1 mU/l) was suspected in 25% of the patients on thyroxine. Cross-sectionally unrecognized hypothyroidism was found in 6% of the patients. Elevated ionized serum calcium was found in 25% and elevated serum intact parathyroid hormone in 23% of the patients.

Adult↗
PubMed1988

Hypothalamic-pituitary-testicular axis in patients with hyperthyroidism.

To test whether chronic thyroid hormone excess influences the hypothalamic-pituitary-testicular axis, 8 hyperthyroid men were given two identical intravenous GnRH tests. The first test was performed before any treatment had been instituted, the second 6-13 months later, when medical treatment had made the patients euthyroid. Although basal serum luteinizing hormone (LH), follicle-stimulating hormone (FSH) and testosterone (T) levels were of similar magnitudes before and after the medical treatment, LH and FSH responsiveness to gonadotropin-releasing hormone (GnRH), as reflected by the hormone incremental areas (U/l X min), were significantly larger in the thyrotoxic state compared with the euthyroid state (LH incremental areas: 3,999 +/- 665 vs. 2,640 +/- 430, p less than 0.02; FSH incremental areas: 825 +/- 193 vs. 542 +/- 98, p less than 0.05). Furthermore, serum T increased significantly in response to GnRH when the patients were hyperthyroid (T incremental area: 162 +/- 51, p less than 0.02), but failed to do so when they were euthyroid (T incremental area: 92 +/- 53, NS). These results imply that chronic thyroid hormone excess makes the pituitary gonadotrophs 'hypersensitive' to exogenous GnRH. This may in turn explain why human Leydig cells respond more powerful to exogenous GnRH in thyrotoxic patients than in euthyroid subjects.

Blood Glucose↗
PubMed1987

Recurrent factitious hypercalcemia.

Severe hypercalcemia recurred three times during an observation period of 15 years in a woman with anorexia nervosa. The patient displayed a factitious cheese-alkalosis syndrome similar to the iatrogenic milk-alkali syndrome.

Adult↗
PubMed1987

Highly sensitive assays of serum-thyrotropin in the diagnosis of hyperthyroidism: assessment of performance and reference values.

The performance of three different highly sensitive immuno-assays for thyrotropin in serum (S-TSH) was compared. Specimens from 803 patients with suspected hyperthroidism or other thyroid disease were used. Hyperthyroid patients were identified and characterized by determining serum thyroid hormones and by clinical observation. The performance of the methods in discriminating between hyperthyroidism and euthyroidism was described in terms of diagnostic sensitivity and specificity. The performance was also assessed by systematically varying the reference values. If patients with treated hyperthroidism were eliminated, the three S-TSH assays performed equally well at a suggested lower reference value of 0.4 mU/l. A diagnostic efficiency of more than 0.95 was achieved at the observed prevalence of disease (0.12). A graphical model which allows an adjustment of reference values to favour sensitivity or specificity is presented. Reference values were also calculated from the euthyroid subjects using parametric and non-parametric approaches. The specificity, when using the recommended discrimination level, suggests that patients with low S-TSH values should be subjected to further investigation by biochemical or other methods.

Adolescent↗
PubMed1986

Immunoreactive somatomedin B (RIA-B) in the circulation of healthy adults and patients with endocrine disorders.

The serum and cerebrospinal fluid (CSF) levels of immunoreactive somatomedin B (RIA-B) were examined throughout life in healthy adult humans. A significant decline in serum RIA-B was observed in subjects over 60 years of age. No significant diurnal, daily, or monthly serum variation was observed in healthy subjects aged 20-60 years. However, women taking oral contraceptives had elevated RIA-B values. No significant decline in CSF RIA-B was observed in subjects over 60 years of age. A significantly lower level of RIA-B in CSF was observed in subjects sampled at 20.00 h compared to subjects sampled in the morning. A significant decline in serum RIA-B was observed in patients with hypopituitarism and diabetes mellitus and a significant elevation of serum RIA-B levels was observed in patients with hyperthyroidism. CSF RIA-B was significantly elevated in patients with Cushing's syndrome.

Adult↗
PubMed1985

Hypoglycemia and low S-T3--an experimental study.

Ethanol-induced hypoglycemia after 44 hours of complete fasting was allowed to last for four hours. S-T3 decreased significantly (p less than 0.05), by 16.5%, S-rT3 remained unchanged and S-cortisol increased significantly (p less than 0.01). No correlation was found between S-T3 and S-cortisol. An association was found between S-T3 and blood glucose (p less than 0.05). An acute low S-T3 was achieved by depressing the peripheral availability and utilization of glucose. No association to a simultaneous increase in S-cortisol was found. An increase in S-rT3 failed to appear, probably also due to glucopenia.

Adult↗
PubMed1985

An incident of bilateral mastodynia after the menopause.

A 54-year-old postmenopausal woman is described who quite suddenly experienced intense tenderness and tension in both breasts lasting for about 3 weeks. Subsequently she had a uterine bleeding. Excessively increased levels of estradiol (peak value 2325 pmol/l) were found during the period of mastodynia. Seven months previous to this event, hyperthyroidism had been diagnosed. She had, however, been treated with propylthiouracil and was euthyroid long before and during the period of mastodynia.

Breast↗
PubMed1981

Assessment of thyroid function in chronic alcoholics.

The clinical manifestations in chronic alcoholics may sometimes mimic those of hyperthyroidism. However, diagnostic aids are somewhat contradictory in many cases. Ten chronic alcoholics with symptoms from the sympathoadrenal system were investigated. A significant increase (p less than 0.01) of T3 at 120 min after TRH stimulation was found despite a blunted TSH response (increment less than 3 mU/l) in some cases. This increase in T3 indicates a preserved thyroid function in chronic alcoholics despite generally low basal T3 levels. It is concluded that T3 determinations at 120 min in connection with TRH test may be an essential parameter in evaluating euthyroid function in chronic alcoholics.

Adult↗
PubMed1980

Serum reverse-T3 determinations in the laboratory diagnosis of hyperthyroidism.

The relative discriminatory value of the estimation of the serum reverse-T3 levels for the laboratory diagnosis of hyperthyroidism was investigated in 47 patients with clinical signs or symptoms of hyperthyroidism. The results were compared with those from the determination of the total serum levels of T3 and T4 prior and after correction for the binding proteins. Twenty-three of the patients had normal thyroid function and 24 had hyperthyroidism. The estimation of the total serum T3 level was superior to both the determination of the total serum T4 and reverse-T3 levels even subsequent to correction for the binding proteins.

Humans↗
PubMed1979

Serum T3 and T4 determinations during the TRH test as a complement to improved discriminatory power in suspect hyperthyroidism.

The aim of the study was to determine whether the addition of T3 and T4 determination in connection with a routine TRH-test could increase the discriminatory power of the test. Thus, forty-one patients with suspect hyperthyroidism were examined and samples for T3 and T4 and TSH determinations were drawn prior to the administration of TRH and at 20 and 60 min thereafter. The results showed that the addition of these thyroid hormone estimations did not increase the clinical value of the TRH-test.

Adult↗