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Biomedical subjects

H Bliddal

Publications and source records attributed to H Bliddal.

105 records · Page 6Linked to original sources
PubMed1982

The relationship between plasma concentration and plasma disappearance rate of immunoreactive insulin in normal subjects.

To investigate the mechanism of insulin degradation in normal subjects, a kinetic model of insulin disappearance was constructed: insulin was assumed to be extracted from plasma by two independent processes, one saturable and one non-saturable. On the basis of these assumptions, a linear (non-proportional) relationship between steady-state plasma insulin concentration and steady-state plasma disappearance rate was predicted over the concentration range studied. Constant infusion experiments were performed on eight healthy normal subjects, normoglycaemia and fasting plasma C-peptide concentrations being maintained during the experiments. Agreement was found between the predictions of the model and the experimental results, and it is concluded that insulin degradation in normal subjects may be described in terms of two processes: one that is saturated at physiological plasma insulin concentrations and one that is apparently non-saturable over a wide concentration range.

Antigens↗
PubMed1982

Thyroid-stimulating immunoglobulins in Hashimoto's thyroiditis measured by radioreceptor assay and adenylate cyclase stimulation and their relationship to HLA-D alleles.

The relationship between thyroid-stimulating immunoglobulins, measured by both radioreceptor assay and adenylate cyclase stimulation, and the HLA alleles was studied in 41 patients with Hashimoto's thyroiditis. TSH binding-inhibiting immunoglobulins (TBII) were detected in 9 (22%) patients, and human thyroid adenylate cyclase-stimulating immunoglobulins (HTACS) were found in 21 (51%) patients. Only 2 patients were positive in both assays, and an inverse relationship was observed between TBII and HTACS. In the 21 HTACS-positive patients, HLA-Dw5 was only found in 1 subject, compared to 8 of the 20 HTACs-negative patients (P less than 0.01), while 4 of the 9 TBII-positive patients had HLA-Dw5 compared to 5 of the 32 TBII-negative subjects (P = -0.09). No significant relations were observed between the presence of HTACS or TBII and HLA-Dw3 or HLA-B8. It is concluded, that TBII and HTACS are produced independently in Hashimoto's thyroiditis, and that the production of these autoantibodies seems to be related to the HLA-D region in this disease.

Adenylyl Cyclases↗
PubMed1982

131I treatment of diffuse and nodular toxic goitre with or without antithyroid agents.

The results of 131I treatment in combination with pre- and post-treatment with carbimazole (n = 122) were compared to the results of 131I used as the only antithyroid treatment (n = 203). The two groups of patients were fully comparable in regard to age, size of goitre and time of observation, and the same diagnostic criteria and dosage regimen of 131I were used. The incidence of early myxoedema in patients with diffuse goitre was significantly reduced after combination therapy, 5 per cent, compared to 16 per cent after 131I as the only antithyroid therapy (P less than 0.05). The incidence of late myxoedema was 6 per cent in both groups 3 years after the last treatment, and fully compensated myxoedema was found in 13 and 22 per cent (n.s.). No severe acute side effects were observed after 131I therapy in any of the two groups. It is concluded that--in diffuse toxic goitre--a lower early incidence of myxoedema was obtained on the combined regimen because of either a possibly lower absorbed radiation dose or a more fractionate therapy. A major advantage of the combination therapy is also, that the patients are rendered euthyroid shortly after the diagnosis and remain so during the prolonged period of treatment. 131I treatment in combination with carbimazole is advocated in all patients with diffuse and nodular toxic goitre if the patient is above fertile age and thyroidectomy is not indicated.

Adenoma↗
PubMed1982

Evidence of a correlation between thyrotrophin receptor binding inhibition and thyroid adenylate cyclase activation by immunoglobulins in Graves' disease before and during long-term antithyroid treatment.

In the present study we have measured in parallel thyrotrophin binding inhibiting immunoglobulins (TBII) and thyroid adenylate cylase stimulating immunoglobulins (TACSI) in patients with Graves' disease (GD) both before and during long-term antithyroid treatment. A statistical model based on the calculation of the differences (TACSI-TBII) is presented, comparing the changes in this parameter to the analytical variation. The correlation between TBII and TACSI in 52 patients with GD before treatment was: r = 0.58, P less than 0.0001. During long-term antithyroid treatment of GD the 2 activities changed in parallel in 39 of 45 patients followed. In a few patients discrepancies were observed, and 1 patient, initially TACSI positive, developed adenylate cyclase inhibiting IgG during treatment but without detectable TBII. In conclusion, 1) TBII and TACSI are significantly correlated in patients with GD both before and during long-term antithyroid treatment, 2) in some patients discrepancies between TBII and TACSI suggest, that these IgGs are heterogeneous with varying capacity for stimulation of the adenylate cyclase and receptor binding, and 3) adenylate cyclase inhibitory IgG without TBII activity was demonstrated in GD.

Adenylyl Cyclases↗
PubMed1981

Prognostic value of thyrotrophin binding inhibiting immunoglobulins (TBII) in longterm antithyroid treatment, 131I therapy given in combination with carbimazole and in euthyroid ophthalmopathy.

Thyrotrophin binding inhibiting immunoglobulins (TBII) were measured in 27 patients with Graves' disease during and after longterm antithyroid treatment. The median observation period after treatment was 24 months. During the first 6 months of treatment the TBII index increased significantly in both the relapse and the remission group, but during the rest of the treatment and the observation no further change was observed. Patients with a TBII index below 0.35 at drug withdrawal (n = 8) all relapsed and patients with values above 1.00 (n = 5) all stayed in remission. There was a significant correlation between the TBII index at drug withdrawal and the time elapsed before a relapse. Graves' disease was treated with 131I in combination with carbimazole in 22 patients. The TBII index of these patients decreased after 131I and increased towards normal values during longterm observation of median 33 months. Of 4 patients with euthyroid ophthalmopathy one was TBII positive. This patient became overt hyperthyroid after an observation period of two years of prednisone treatment. It is concluded, that the TBII index is of some prognostic value after longterm antithyroid treatment, but is of no clinical importance following 131I treatment.

Adult↗
PubMed1981

A stable, reproducible radioreceptorassay for thyrotropin binding inhibiting immunoglobulins (TBII).

A radioreceptorassay for thyrotropin binding inhibiting immunoglobulins (TBII) is presented. A stable reproducible method was established based on the use of thyroid glands obtained by autopsy for the preparation of a highly purified plasma membrane from human thyroid homogenate. Lower detection limit for TSH was below 5 miu/l. The TBII activity was measured in a crude IgG precipitate from serum and the results were calculated as an index value compared to normal controls, the mean of which was defined as 1.00. The binding of [125I] TSH to this membrane preparation was stable for more than 6 months. Interassay variations of the TBII index in three ranges were 1.30 +/- 0.19, 0.37 +/- 0.08 and 0.04 +/- 0.07 (mean +/- SD) over a period of 6 months. The intra-assay variations of the TBII index in three ranges were 1.30 +/- 0.08, 0.46 +/- 0.03 and 0.09 +/- 0.03 (mean +/- SD). Seventy-six of 116 patients with untreated Graves' disease had index values below the reference interval and TBII was also detected in 4 of 14 patients with multinodular goitre. The value of the TBII index in patients with untreated Graves' disease was significantly correlated to S-T3, the 4 h [131I] uptake and the 20 min [99mTc] uptake. No significant correlation between the TBII index and long-acting thyroid stimulator (LATS) measured in a bioassay was found. However, the LATS-positive patients also had positive TBII index.

Goiter↗
PubMedDate not supplied

A randomized, controlled study of a single intra-articular injection of etanercept or glucocorticosteroids in patients with rheumatoid arthritis.

OBJECTIVE: Glucocorticosteroids are used successfully for both systemic and intra-articular treatment of arthritis. Inhibitors of tumour necrosis factor alpha (TNF-alpha) are effective when administered systemically and this study was performed to compare the effect of intra-articular injection of these two substances. DESIGN: A randomized, parallel-group, double-blind study with an independent observer. Thirty-eight patients with flare of arthritis in a single joint (wrist, elbow, or knee) were given intra-articular 25 mg etanercept or 40 mg methylprednisolone guided by ultrasound. The primary end-point was the 4-week change in pain in the target joint. The study complied with Good Clinical Practice (GCP) and the Consolidated Standards for Reporting of Trials (CONSORT) statement. RESULTS: At 4 weeks no difference in pain outcome between treatment groups was demonstrated by analysis of covariance (ANCOVA). Pain on the Visual Analogue Scale (VAS) for etanercept was baseline mean 40.9 (SD 19.6) mm, follow-up 32.7 (29.1) mm (p = 0.29), methylprednisolone baseline mean 47.1 (29.6) mm, follow-up 25.3 (24.7) mm (p<0.001). The investigator's evaluation was for etanercept baseline 30.6 (21.2) mm, follow-up 17.1 (15.5) mm (p = 0.054) and for methylprednisolone baseline 35.4 (26.4) mm, follow-up 11.9 (14.6) mm (p = 0.012). Joint swelling was for etanercept baseline 1.78 (0.73), follow-up 1.25 (0.77) (p = 0.015) and for methylprednisolone baseline 1.74 (0.73), follow-up 0.71 (0.77) (p<0.001). One serious adverse event was seen in a patient treated with methylprednisolone injection. CONCLUSION: Although no difference between groups was demonstrated, the within-group effect of methylprednisolone was more marked than that of etanercept. Injections with 25 mg etanercept were well tolerated. However, the cost of etanercept will presumably limit its use to patients with adverse reactions to steroid.

Adult↗
PubMedDate not supplied

Antipolymer antibodies in Danish fibromyalgia patients.

OBJECTIVE: To use a new immunologic assay to investigate antipolymer antibody (APA) levels in women with fibromyalgia (FM). METHODS: The study population consisted of 35 patients with FM and 129 controls. The controls were selected based on a prior history of breast surgery and the presence or absence of a prior hospital diagnosis of soft tissue rheumatism. Study subjects underwent blood sampling, including tests for antinuclear antibodies (ANA) and APA, a clinical examination, and an interview focusing on rheumatic complaints and self-reported disability. The severity of rheumatic symptoms/signs was scored from 1 (= none) to 5 (= severe) based on the clinical examination and the interview. RESULTS: FM patients in this study represented a broad spectrum of disease severity, with the majority having mild symptoms. FM patients had a higher symptom severity and myalgic scores than controls (p < 0.001 for both variables). Adjusting for symptom severity, a weak positive association between APA levels and FM was observed (p = 0.08). The APA level was inversely associated with age, i.e., decreasing APA levels were seen with increasing age (p = 0.008). CONCLUSION: FM patients tended to have slightly higher APA levels than controls when adjusted for symptom severity. APA levels declined with age, a finding that has not been reported previously. The APA test and its clinical relevance should be evaluated in future studies.

Adult↗
PubMedDate not supplied

Imaging of intratendinous distribution of glucocorticosteroid in the treatment of Achilles tendinopathy. Pilot study of low-field magnetic resonance imaging correlated with ultrasound.

OBJECTIVE: Recently, a positive treatment effect of intratendinous injections of steroid in Achilles tendonitis (AT) has been described. Our aim was to test the localization and distribution of the injected steroid in both healthy (animal) tendons and in diseased human Achilles tendons. MATERIAL AND METHODS: Four pig tendons were injected in vivo and harvested. The harvested tendons were placed in 0.2 Tesla MRI scanner, in order to select the optimal MRI sequences for tracking and localizing the bolus injection. Three patients with AT were treated with intratendinous steroid injection. Injections were placed in the pathologic areas of the tendon guided by ultrasound (US). MRI and US were performed at baseline and again immediately and 60 minutes after injection. A final follow-up MRI was performed 1 month after the injection. RESULTS: In the animal model, significant recoil of the injected substance was seen in all cases. In all three patients the injection was readily distributed within the tendon and no recoil through the injection channel was found. One-month follow-up showed a total regression of hyperaemia on US as well as regression of intratendinous oedema on MRI in all 3 patients. CONCLUSION: It is possible to demonstrate the distribution pattern of injected steroid in diseased Achilles tendons by MR-imaging. In contrast to the recoil experienced in the healthy tendon of the animal, the lack of recoil of the injected volume through the injection channel in the sick human tendon may be caused by a derangement of the fibre structure, which allows the extra volume to be distributed within the lesion. This indicates that the effect on AT of intra-tendinous injections of steroid is due to a local intra-tendinous action of the drug.

Achilles Tendon↗