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Biomedical subjects

H J Heberling

Publications and source records attributed to H J Heberling.

36 records · Page 2Linked to original sources
PubMed1984

[Results of lithium treatment in severe hyperthyroidism].

Up to the present time lithium therapy is under discussion in patients with severe, particularly of contrast remedy induced hyperthyroidism. The aim of our presentation was to investigate if the short term combined methimazole-lithium therapy in the initial phase will be advantageous in contrast to the monotherapy of methimazole. The examination in our material showed a good effectiveness and tolerance of the combined therapy. At present the precise mechanism of action of lithium has not been elucidated. There is evidence that lithium inhibits the thyreoglobulin hydrolysis and the peripheral conversion of thyroxin to triiodothyronin. Other actions are under discussion. In our opinion only the combined methimazole-lithium therapy will be advantageous. Through this procedure an earlier drug effect could be expected and the increase of thyroid hormones after finishing lithium therapy will be suppressed. In the own material severe side effects are not demonstrable.

Contrast Media↗
PubMed1983

[Thyrostatic therapy of hyperthyroidism with special reference to drug side effects].

In discussing undesirable therapy effects by thyrostatics one must issue from the fact that the possible side effects have a different genesis and appear in different frequency. While pharmacodynamically caused therapy effects are generally to be avoided, when considering the pathophysiology of the regulation of the thyroid gland, this is not the case as to allergic side effects and only to a limited extent with regard to toxic side effects. Allergic side effects abruptly and suddenly appear and do not show any dependence on dosage. But for the greater part these side effects are harmless. Severe side effects are nearly without exception of toxic genesis. The decrease of the initial dose and the early transition to a still effective maintenance dose reduce the possibility of toxic complications. In case that side effects lead to a discontinuation of the corresponding thyrostatic, a change to a thyrostatic of another chemical group is possible and necessary.

Antithyroid Agents↗
PubMed1981

[First experiences with short-term lithium therapy in severe thyrotoxicosis].

Even nowadays the therapy of severe, particularly of contrast remedy-induced hyperthyroidism is not without any problems. According to reports in literature the application of lithium salts seems to be an expedient from this dilemma. We controlled the effect of a short-term lithium therapy of 7 days in combination with methimazole in comparison to a group with methimazole monotherapy. The examination showed a good effectiveness and tolerability of the lithium methimazole therapy. While the decrease of the thyroxin concentration in the two groups was not different, in the group with combined therapy a more rapid per cent decrease of the triiodothyronine concentration appeared. In primarily strict selection of the therapy severe side-effects are not to be expected. According to the results yielded up to now the described form of therapy is an actual enrichment for selected forms of hyperthyreosis.

Adult↗
PubMed1981

[Peripheral thyroid function and TRH-TSH test in patients with acromegaly].

In 11 patients with acromegaly the peripheral thyroid hormones were determined and a TRH-TSH-test was carried out. Depending on the result of the determination of the growth hormone the patients were classified into two groups (active and inactive acromegaly). The serum thyroxin level and the T3-binding capacity were normal. Only in a few patients decreased triiodotyronine levels were found. Independent of the degree of activity of the acromegaly positive as well as negative TRH-TSH-tests were found. The struma in patients with acromegaly which is frequently to be observed seems to be in a causal connection with this disease. The examination show altogether that the control of the function of the thyroid gland and the TRH-TSH-test do not deliver an essential contribution for the diagnostics of acromegaly itself.

Acromegaly↗
PubMed1981

[Understanding disorders in the regulatory cycle of the thyroid. Significance for diagnosis and therapy].

In the regulating circle for the regulation of the functions of the thyroid gland interactions exist between hypothalamus, anterior lobe of the pituitary gland, thyroid gland and the concentrations of the thyroid hormone at the periphery. By means of the TRH-test the secretory work of the thyrotropic function of the hypophysis depending on the activity of the thyroid hormone can be judged. On the other hand, the T3-suppression test (radioiodine test before and after application of T3) allows a statement on the hypophyseal-thyroidal regulation. In contrast to the exclusive determination of the peripheral thyroid hormones by means of the TRH-test an etiologic differentiation of hypothyreoses and an essential improvement in the diagnosis and conduction of the therapy of thyroidal diseases and functional disturbances is made possible, as it is demonstrated at instances. By means of the T3-suppression test it is possible to establish, still under the treatment of a diffuse hyperthyreosis, whether the function of the thyroid gland is again regulated by the hypophysis or is still autonomous. Together with the result of the TRH-test decisions may be rendered on the end of the treatment or on the further course of the therapy.

Adenoma↗
PubMed1980

[Personal experiences in the diagnosis and treatment of primary hyperparathyroidism].

It is reported on an interdisciplinary team consisting of internists, radiologists and urologists which treated twelve patients with suspicion of primary hyperparathyroidism. The diagnostics is performed in form of a three-step progamme. A great importance is still ascribed to hypercalcaemia and therefore it serves as leading symptom. By means of the selective determination of parathormones no clear side classification could be achieved. In ten patients the operation could successfully be finished with the exstirpation of one or more adenomas of the parathyroid glands. A special importance deserves the intensive postoperative control with regular determinations of serum calcium in order to encounter in time a hypocalcaemia with tetanies by applications of calcium. It is referred to the necessity to search for an adenoma of the parathyroid gland at the slightest suspicion of the presence of a primary hyperparathyroidism.

Adenoma↗
PubMed1977

[Control of therapy for hyperthyroidism. Comparison of in-vitro and in-vivo methods].

55 patients with treated hyperthyroidism (thyreostatics) underwent a T3 suppression test and a TRH stimulation test. 60% of the patients had a positive and 40% a negative T3 suppression test. While patients with a positive T3 suppression test always showed a positive TRH test, the behaviour of the TRH test in negative suppression test was different (68.2% positive, 31.8% negative). These discrepant findings are to be explained from the establishment of different phases of regulation. In negative TRH test the concentrations of hormones were significantly higher. Increased basal TSH values are an expression of an overtreatment with thyreostatics. In positive suppression test and TRH test after a therapy lasting at least one year the medication can be stopped. In negative suppression test, however, the therapy should be changed. The TRH test allows only evidence about the quality of the regulation of therapy. Finally it can be established that the two tests on account of their different working points in the regulatory system are necessary and not changeable between each other.

Antithyroid Agents↗
PubMed1976

[Drug therapy of hyperthyroidism].

The possibilities of the treatment of hyperthyroidism are mentioned, in which cases the author especially deals with the medicamentous therapy, taking into consideration the different chemical groups (imidazol derivations, thiourazil derivations, perchlorates) and their therapeutic mechanisms. The indications and contraindications of this treatment and the possible side effects are compiled in form of a table. The in-vitro-parameters which are necessary for the observation of the course are estimated in their significance. The author deals with the problems of the additional treatment. Taking into consideration indications and contraindications as well as controls of the course of functional parameters the medicamentous therapy concerned is a treatment with a good prognosis. It is promising particularly in such cases, when suitable parameters are used for the solution of the question concerning the end of the therapy. For this purpose nowadays two tests are at our disposal: 1. modified Alexander's test (radioiodine-test and suppression test under thyreostatic therapy) and 2. TRH-test with radioimmunological determination of TSH. The treatment should be carried out in adequate endocrinological dispensaries, as there are certain risks in not optimal therapy.

Conjunctivitis↗
PubMed1975

[Diagnostic staged program in thyroid diseases].

After some physiological principal remarks the modern possibilities of the in-vitro-diagnostics specific for the thyroid gland are briefly explained. The essential factors of disturbance which are necessary for the avoidance of false interpretations are mentioned. From the sequence of the description (BEJ, T4-test, T3-test, FT4-index, RIA-T3 and RIA-TSH) results the diagnostic step programme proposed by us, by means of which the majority of the functional disturbances of the thyroid gland existing may certainly be classified. Only after exhaustion of the in-vitro-diagnostics the radio-iodine-test should be performed.

Female↗