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H Studer

Publications and source records attributed to H Studer.

At least 55 records · Page 3Linked to original sources
PubMed1988

Can serum thyroglobulin predict the effect of thyroid hormone therapy on goitre growth?

Serum thyroglobulin and goitre size were followed in 22 patients with simple goitre or single thyroid nodules during 9 months of thyroxine therapy, to see whether alterations in serum thyroglobulin correlated with changes in goitre size. In the case of such a correlation serum thyroglobulin could be used to predict which goitres respond to thyroxine therapy and which require surgery. Pretreatment serum thyroglobulin was elevated in 11 patients. It normalized in one of 7 patients whose goitre did not shrink and in none of the 4 patients whose goitre shrank during thyroxine treatment. Thus no simple correlation exists between alterations in serum thyroglobulin and goitre size during short-term thyroxine therapy. Since other studies suggest that increased serum thyroglobulin indicates ongoing goitre growth, thyroxine treatment might have been unsuccessful in all patients with persistently elevated serum thyroglobulin with a longer follow-up. The presence of predominantly thyroxine responsive tissue together with some autonomously growing, thyroglobulin-releasing areas in the same goitre could explain the failure of serum thyroglobulin to normalize in patients whose goitre shrank during therapy. The study shows that after eradication of iodine deficiency, thyroxine treatment is rarely successful in the Swiss goitre population and that surgical treatment is usually required.

Adult↗
PubMed1988

[Histopathogenesis of goiters].

The basic mechanisms acting in the transformation of a normal thyroid gland into a toxic or nontoxic goiter are summarized: 1) Any goiter arises from multiplication of follicular epithelial cells forming new follicles. 2) In the follicular epithelium there are cell families with much higher than average growth potential. 3) Cells of an individual follicle are not identical but heterogeneous. 4) Each follicular cell has a certain level of autonomy of growth and of function.

Cell Division↗
PubMed1988

Pathogenesis of nodular goiter and its implications for surgical management.

Despite sufficient iodine supply, goiter continues to be of considerable surgical significance in formerly endemic countries. It now appears that iodine deficiency and increased thyrotropin stimulation are not the only causes of goiter. Xenotransplantation of human thyroid tissue onto nude mice allowed study of the regulation of growth and function in human goiter tissue. Grafts of human thyroid tissue growing in nude mice could be shown to react to endogenous mouse thyrotropic stimulation and suppression. 131I autoradiographs of xenotransplanted goiter tissue showed as marked a heterogeneity as did the original goitrous tissue prior to transplantation. There was no firm correlation between the morphologic appearance of a follicle and its iodine metabolism. Scintigraphically "cold" and "hot" goiter tissue differed from each other quantitatively but not qualitatively; i.e., both "hot" and "cold" tissue were composed of metabolically active and nonactive follicles. Iodine organification was not completely suppressible by thyroxine treatment; this indicates autonomous functional activity. The distribution of proliferating tissue labeled by 3-H-thymidine did not parallel the distribution of functionally active tissue labelled by 131I. Thyroxine treatment did not completely inhibit 3-H-thymidine incorporation, indicating autonomous growth. Thus, our pathogenetic concept of goiter formation is based on three mainstays: (1) goiter heterogeneity, (2) autonomy of growth and function, and (3) dissociation of growth and function in human goiter tissue. Thus, the surgeon dealing with goiter ought to remove all pathologically altered tissue, i.e., nodular tissue, irrespective of its appearance on scintiscans.

Animals↗
PubMed1987

Naturally occurring clones of cells with high intrinsic proliferation potential within the follicular epithelium of mouse thyroids.

The proliferation pattern of some scattered clones of naturally occurring follicular cells with an exceedingly high intrinsic growth potential was investigated in the mouse thyroid gland. In particular, evidence was sought to demonstrate that the high propensity to replicate is a stable trait transmitted from the progenitor cells to their offspring. We hypothesize that these cell clones are at the origin of the multiple adenomas that invariably arise in chronically stimulated thyroid. Growth stimulation was induced either by hemithyroidectomy or by methimazole feeding. In a first series of experiments, involving hemithyroidectomized animals, [3H]thymidine was administered continuously for 3 weeks by means of osmotic minipumps, so that all cells entering the mitotic cycle during that time were labeled. Hemithyroidectomy led to a 3-fold increase of the fraction of labeled cells in the remaining lobe. The increase was prevented by thyroxine treatment in thyroid-stimulating hormone-suppressing doses. Autoradiographs of contiguous serial sections across whole follicles showed that roughly 75% of the labeled cells were clustered in groups of 3 or more, rather than being randomly distributed. In a second set of experiments, glands stimulated by methimazole-induced thyroid-stimulating hormone hypersecretion were pulse-labeled by a single i.p. injection of [3H]thymidine. Animals were sacrificed either 2 h or 3 weeks after the administration of the label. The thyroids were excised and the fate of labeled thyroid cells was analyzed autoradiographically. In the 2-h exposure, about 95% of all labeled follicular cells were single and the remaining 5% were in pairs. In contrast, about 50% of all labeled cells were clustered in groups of 3 to 12 cells 3 weeks after the pulse labeling. The number of silver grains per nucleus was compared to that of the identically exposed controls. The intensity of label per cell appeared to be decreased in proportion to the size of the labeled clusters, indicating that clusters had generated several subsequent generations of cells. The results support previously produced evidence that highly growth-prone cells naturally occur within the normal thyroid and demonstrate, in addition, that their high intrinsic growth rate is a stable, inheritable trait. Cells which replicate at a rate faster than that of the average epithelial cell have a tendency to overgrow during goitrogenesis. They may be at the very origin of the nodules and adenomas commonly found in experimentally produced and naturally occurring goiters.

Animals↗
PubMed1987

Interactions of amiodarone with digoxin in rats.

1. The influence of oral amiodarone treatment on the blood and tissue concentrations of digoxin was investigated in the anaesthetized rat by use of unlabelled and [3H]-digoxin. 2. Amiodarone diminished the total body clearance and the apparent volume of digoxin distribution by 60%. This reduction was due to a 50% reduction of the hepatobiliary clearance, whereas the renal clearance did not change. 3. Amiodarone treatment increased blood, myocardial and skeletal muscle [3H]-digoxin concentrations by 200% indicating passive equilibration between blood and these tissues, and resulting in unaltered tissue to blood ratios. In contrast, the liver concentration increased by 70% only and the liver to blood ratio therefore decreased under amiodarone treatment. 4. It is concluded that the hepatobiliary elimination of digoxin is decreased in amiodarone-treated rats compared to controls and is responsible for the increased levels of blood and tissue glycoside.

Amiodarone↗
PubMed1987

Autonomy of growth and of iodine metabolism in hyperthyroid feline goiters transplanted onto nude mice.

Hyperthyroidism caused by nodular goiters is a common disease of aging cats. Growth and iodine metabolism were studied by autoradiography in normal and hyperfunctioning thyroid tissue obtained from cats injected with 125I before surgery, and in xenografts, grown in nude mice, after double-labeling with 131I and [3H]thymidine. Hyperthyroid cat goiters contain single or multiple hyperplastic nodules, consisting of highly cellular tissue with an iodine metabolism exceeding that of the surrounding normal tissue. Xenografts of hyperplastic hot tissue in thyroxine-treated nude mice retain their original histologic pattern and continue to accumulate radioiodine intensely. Autoradiographs assessed for [3H]thymidine incorporation reveal autonomously proliferating follicular cells within the hyperplastic foci but not within the normal tissue. Administration of sera from donor cats into host mice fails to stimulate the xenografts. Neither hyperfunction nor growth of toxic cat goiters depends on extrathyroidal stimulators. The basic lesion appears to be an excessive intrinsic growth capacity of some thyroid cells.

Animals↗
PubMed1987

Progressive recruitment of follicular cells with graded secretory responsiveness during stimulation of the thyroid gland by thyrotropin.

One of the earliest responses of the thyroid cells to TSH is macropinocytosis with formation of intracellular colloid droplets. We demonstrate here that increasing stimulation with TSH not only elicits a highly individual macropinocytotic response among different follicular cells but that the fraction of TSH-responsive cells is also a function of the TSH dose. After pretreatment with T4, mice and rats were injected ip with bovine TSH and killed 2 h later. The macropinocytotic response to TSH was evaluated on periodic acid-Schiff-stained 3-microns sections of the thyroids in terms of droplet number per 25 follicles and, in addition, by assessing recruitment, i.e. percentage of droplet-containing cells. Both variables increased with increasing TSH stimulation until they reached a plateau at about 9 mU TSH in mice and at about 300 mU TSH in rats: the percentage of droplet-containing cells gradually increased in mice from 2% (no TSH) to 67% (9 mU TSH) and in rats from 11% (no TSH) to 54% (300 mU TSH). Overall pinocytotic response as well as thyrocyte recruitment could be modified by extra- and intrathyroidal factors: for example, pretreatment of the mice with an iodine-deficient diet increased the maximal percentage of droplet containing cells to nearly 90%. Obviously, two separate components of the macropinocytotic response of the thyroid gland to TSH can be distinguished: the first is the gradually increasing fraction of droplet-containing cells, the second is the well known increase of the number of colloid droplets in each TSH-responsive cell with progressive TSH stimulation. Recruitment of thyrocytes with a gradually increasing natural threshold to a hormonal stimulus appears to be a fundamental mechanism in the thyroid gland and possibly in other organs.

Animals↗
PubMed1987

Age-related failure of endocytosis may be the pathogenetic mechanism responsible for "cold" follicle formation in the aging mouse thyroid.

With advancing age, 60-80% of the follicles of the mouse thyroid gland turn "cold", i.e. they lose their normal capacity to iodinate thyroglobulin (Tgb). Cold follicles are morphologically characterized by their large size, by deeply periodic acid-Schiff-stained colloid and by flat epithelial cells. We investigated the hypothesis that a progressive, age-related failure of endocytosis, leading to a gradually increasing mismatch between production of new Tgb and resorption of stored Tgb, could lead to overfilling of colloid stores with consecutive impediment of diffusion. To this purpose, labeling of the thyroids was started when mice were 3 months old, and 125I was continuously administered thereafter for 2-6 months. After this time, all follicles were homogeneously labeled in autoradiographs. Tracer application was then discontinued. Autoradiographs obtained at intervals during the washout of the tracer yielded a mirror image of that observed after acute labeling. The large follicles which were cold after acute labeling in old animals now still retained labeled iodoproteins even after 7 weeks of washout, i.e. at a time when morphologically normal follicles had long lost their labeled Tgb stores. Thus, the cold follicles of the old thyroid must have been functioning normally during equilibration of young thyroids, but have then gradually lost their capacity to iodinate and to remove stored Tgb from the colloid. The observation supports the thesis that aging primarily affects the cytoskeleton and, thus, the cell's endocytotic machinery. This effect of aging on the thyroid can be prevented by life-long stimulation of the gland by TSH.

Aging↗
PubMed1987

A disproportionate accumulation of fibrous tissue is not a causal factor in human goitre growth.

Histological preparations from human nodular goitres reveal the presence of variable and sometimes considerable amounts of acellular material separating the individual follicles. Part of this interstitial tissue consists histologically of fibrous strands. However, quantitative data on the fibrous tissue content of goitres are scarce. In the present study the proportion of fibrous tissue in normal human thyroids and human goitres was determined biochemically by measuring their content of collagen, the predominant component of fibrous tissue. Total collagen content increased in parallel to thyroid weight. The relative collagen content, however, decreased slightly but significantly with increasing thyroid weight. The collagen/DNA ratio (= fibrous tissue/cell number ratio) was not higher in goitres than in normal human thyroids. These results indicate that in goitre growth, there is no disproportionate accumulation of fibrous tissue accompanying the multiplication of thyroid follicular cells. They are in line with the earlier findings that despite histological heterogeneity, the main component of nodular goitres is newly generated follicles.

Age Factors↗
PubMed1986

[Goiter].

Studies in Switzerland (1979), in Austria (1982) and in Germany (1975) revealed that greater than 10% of the population has a goiter. Simple guidelines are offered to the practising physician for the work-up and therapy of this fairly common pathological condition. In the work-up one investigates firstly whether the goiter in question could be malignant, and, secondly, whether it could be due to thyroiditis. If this is not the case the goiter is probably benign (Graves' goiter or "simple" goiter). Malignant goiters are referred to the endocrinologist/surgeon for further work-up and therapy. Subacute thyroiditis is treated with salicylates or steroids. The hyperthyroid phase of thyroiditis is treated with beta-blockers and possibly steroids and the hypothyroid phase with thyroxine. The hypo- and euthyroid variants of "simple" goiter are treated with thyroxine. Goiters which grow during this therapy are removed surgically. The hyperthyroid variant of "simple" goiter should preferably be treated surgically.

Austria↗
PubMed1986

Inactivation of peroxidase and glucose oxidase by H2O2 and iodide during in vitro thyroglobulin iodination.

Thyroglobulin iodination and thyroxine synthesis in vitro require the presence of peroxidase, H2O2 and iodide. H2O2 is usually continuously generated by glucose oxidase (GO) and glucose. The aim of this study was to investigate whether the two enzymes could possibly be inactivated by a particular concentration of H2O2 or iodide present during incubation. The results revealed that both enzymes were indeed inactivated under two distinct conditions: Lactoperoxidase and thyroid peroxidase were inactivated by modest concentrations of H2O2 accumulating during incubation. Glucose oxidase was inactivated by an oxidized species of iodine or singlet oxygen produced in the catalytic cycle. The results may explain some hitherto unsolved discrepancies between different iodination procedures. Moreover they may have an impact on the regulation of in vivo thyroglobulin iodination and hormone synthesis.

Glucose Oxidase↗
PubMed1986

Iodination of thyroglobulin molecules depends on their diffusion velocity in follicular colloid.

We have studied in vitro the effects of altered physicochemical properties of thyroglobulin molecules in solution and of the solution itself on iodination kinetics and hormone synthesis. Any change in hydrodynamic properties had a far greater effect in compartmentalized systems, obtained by coating the test tubes with peroxidase, than in conventional homogeneously mixed systems. Increasing thyroglobulin concentration in a range still far below that existing in vivo greatly retarded iodination and hormone synthesis. In contrast, a number of physiological and non-physiological changes of thyroglobulin structure, such as desialylation, preiodination, oxidation and denaturation, strikingly accelerated iodination. The highly variable physical-chemical state of thyroglobulin molecules appears to be a main determinant of protein diffusion within the colloid and, thereby, of iodination kinetics and rate of hormone synthesis. Moreover, alterations of the physicochemical state of thyroglobulin molecules may explain some hitherto ill-understood diffusion phenomena in live follicles.

Chemical Phenomena↗
PubMed1986

The effects of amiodarone on the electrocardiogram of the guinea-pig are not explained by interaction with thyroid hormone metabolism alone.

The iodine-containing contrast medium iopanoic acid induces alterations of thyroid hormone metabolism comparable to those observed with the iodine-containing antiarrhythmic drug amiodarone. Both compounds inhibit the intracellular conversion of thyroxine (T4) to triiodothyronine (T3). Using iopanoic acid, the question was investigated, in guinea-pigs, whether inhibition of T4----T3 conversion is by itself associated with the same changes in the electrocardiogram, i.e. QT prolongation and bradycardia, as those observed during amiodarone treatment. At a dose of 4 g kg-1, iopanoic acid induced maximal inhibition of the T4----T3 conversion. Although these changes were even more pronounced than those in a control group of animals treated with 2.12 g amiodarone kg-1, neither prolongation of the QT nor a slowing of the heart rate was observed. QT prolongation and bradycardia were induced only by amiodarone treatment but not by iopanoic acid. Iopanoic acid at the high toxic dose of 12 g kg-1 induced the same degree of inhibition of T4----T3 conversion as the 4 g kg-1 dose. QT prolongation and slowing of the heart rate were apparent at this dose in parallel with a loss of weight. It is concluded that even a maximal inhibition of the T4----T3 conversion has no effect on the ECG of guinea-pigs. The inhibition of the T4----T3 conversion alone does not explain the QT prolongation and bradycardia observed with amiodarone treatment. The amiodarone effects on the ECG may represent a combination of interactions with thyroid hormones and antiadrenergic activity.

Amiodarone↗
PubMed1986

Diffusion of thyroglobulin in the follicular colloid. (Minireview).

Methods used for estimating in vivo diffusion velocity of thyroglobulin (Tgb), the factors affecting hydrodynamic properties of thyroidal colloid and the effects of changing diffusion properties on follicular function are briefly reviewed. The principal methods, besides pure in vitro techniques, are autoradiography of thyroid sections after in vivo labelling of Tgb and freezing autoradiography for examining colloidal diffusion of ions or other small molecules. The main factors known to affect diffusion of Tgb in the colloid space are concentration and actual physico-chemical properties of the Tgb molecule itself, the latter parameter depending on several factors such as sugar content, iodination degree, etc. Additional factors are thyrotropin which speeds up and drugs such as pentobarbital or verapamil which slow down the velocity of Tgb diffusion. High iodine supply has a retarding effect on Tgb diffusion in the colloid of mice thyroids. Any change of Tgb diffusion in the colloid may have a striking effect on follicular function. The hydrodynamic properties of the colloid components are increasingly recognized as a potentially important factor in regulating kinetics of hormone synthesis.

Animals↗
PubMed1985

Amiodarone-treated patients with suppressed TSH test are at risk of thyrotoxicosis.

Therapeutic use of the potent antiarrhythmic drug amiodarone requires early detection of impending hyperthyroidism, a potentially life-threatening adverse reaction in cardiac patients. Since amiodarone inhibits peripheral conversion of thyroxine (T4) to triiodothyronine (T3), serum T4 and T3 levels become unreliable parameters of thyroid function. In 44 patients treated with amiodarone for a median period of 7.3 months, up to seven TRH-TSH tests were performed. The TSH response to TRH was normal in 23 patients, partially suppressed in eight, totally suppressed in eight and overshooting in five patients. Two of the eight patients with suppressed TRH-TSH tests were clinically hyperthyroid, in four others thyrotoxicosis developed within 1 to 2 1/2 months after the first observation of a suppressed TSH response, while two patients remained euthyroid. In all patients with negative TRH-TSH tests. TSH response to TRH returned to normal between 2 and 29 months after withdrawal of amiodarone. We conclude that the TRH-TSH test, repeated at intervals, is a reliable tool for assessing thyroid function in patients on long-term treatment with amiodarone. Patients with a suppressed response under amiodarone therapy are at risk of developing thyrotoxicosis. Normalization of the TSH response indicates that this risk is over.

Adolescent↗
PubMed1985

Pharmacokinetics of amiodarone, desethylamiodarone and other iodine-containing amiodarone metabolites.

In 23 patients treated with the iodine-containing antiarrhythmic drug amiodarone, the plasma concentrations of amiodarone, desethylamiodarone and iodine have been studied. Besides amiodarone and desethylamiodarone, a pool of iodine-containing substances, NANDAI (non-amiodarone-, non-desethylamiodarone-iodine), was present. At steady state the iodine content of NANDAI amounted to 64% and the iodine content of amiodarone plus desethylamiodarone to 36% of total serum iodine. At steady state 26% of the NANDAI fraction was made up of inorganic iodide, the average plasma concentration of which was at least 40 times above the upper limit of the normal range. The serum elimination half-life of NANDAI of 57-160 days exceeded that of amiodarone (35-68 days) and of desethylamiodarone (31-110 days). At steady state the serum concentration of desethylamiodarone appears to be related to the concentration of amiodarone by a Michaelis-Menten type function, yielding a Km of amiodarone of 2.45 mumol/l and a maximal desethylamiodarone concentration of 3.61 mumol/l.

Adolescent↗
PubMed1985

[Operative strategy in thyroid autonomy and Basedow hyperthyroidism].

The different extra- and intrathyroid origin of hyperthyroidism, the advantages of the surgical procedure and the criteria for the extent of thyroid resection determine the operative tactics. For both forms of hyperthyroidism we recommend a rather extended resection of the diseased thyroid gland in order to prevent recurrent hyperthyroidism and recurrent thyroid growth as well. These recurrences require subtotal thyroidectomy for Graves' disease, monolateral partial lobectomy for a so-called toxic adenoma and bilateral partial lobectomy for toxic multi-nodular goiters. With these procedures lesions of the recurrent nerves and parathyroid glands can be prevented.

Adenoma↗