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Biomedical subjects

H Studer

Publications and source records attributed to H Studer.

At least 109 records · Page 6Linked to original sources
PubMed1980

[The problem of hemoperfusion in poisonings: ineffectiveness in maprotiline poisoning].

A case of self-poisoning with maprotiline presenting with coma stage III was treated by resin hemoperfusion for 9 hours using an XAD-4 resin cartridge. Plasma levels of about 800 ng/ml maprotilin were initially found. After 5 hours of hemoperfusion progredient clinical improvement was noticed without decreasing tendency of the blood drug levels. The theoretical extraction efficiency calculated from the maprotiline blood levels and the perfusion rate yielded 50 mg for maprotiline and 16 mg for desmethylmaprotiline and was in good agreement with 60.5 mg of maprotiline and 17.3 mg of desmethylmaprotiline recovered from the resin cartridge at the end of the hemoperfusion. The in vitro binding capacity for maprotiline was estimated to be 230 mg per g of resin. These results demonstrate that XAD-4 resin efficiently binds maprotiline. However, because of the very low blood concentrations due to the large volume of distribution, whole body concentrations are minimally affected by resin hemoperfusion. Main complications consisted in thrombocytopenia extending over 24 hours after stopping hemoperfusion, anemia, a short initial decrease of blood pressure and an episode of premature ventricular beats.

Anthracenes↗
PubMed1979

Low molecular weight intracellular iodocompounds with long intrathyroidal half-life: remnants of thyroglobulin hydrolysis?

In this paper additional information on low molecular weight, soluble, intrathyroidal iodocompounds with slow metabolic rate is provided. These compounds have previously been localized autoradiographically within the follicular cells. Radioiodide was administered to rats on a normal iodine intake (6--7 microgram/day) for 80 days to approach isotopic equilibration of the intrathyroidal iodine with the dietary radioiodide. When the isotope was omitted from the diet the intrathyroidal radioiodine was released with an apparent half-life of approximately 12 days. When the individual soluble components carrying radioiodine were analyzed after separation on Sephadex G-200, different apparent half-lives were found, the half-life of thyroglobulin (Tgb) being roughly 10 days and that of the low molecular weight iodocomounds being in the order of 60 to 100 days or more. In addition to the soluble low molecular weight iodocompounds, the radioactivity in the particulate fraction increased by 100% during the tracer washout when compared to Tgb and the total soluble fraction. The soluble slow turnover iodocompounds contained a higher percentage of carbohydrate and total iodine than Tgb, while the relative amounts of each sugar analyzed (hexoses, fucose, hexosamine and sialic acid) were close to those in Tgb. Sephadex G-25 chromatography of the low molecular weight iodocompounds obtained after Sephadex G-200 separation resulted in the separation of 4 peaks. Two peaks identified as iodopeptides could be further analyzed. The carbohydrate composition of these peptides was similar to that of 2 glycopeptides obtained after in vitro enzymatic hydrolysis of purified Tgb with pronase. Slow equilibration with radioiodine, long apparent intrathyroidal half-life and carbohydrate content similar to that of Tgb, taken together with previously published data on intracellular localization of soluble intrathyroidal iodocompounds, suggest that the low molecular weight iodocompounds are products of in vivo hydrolysis of engulfed Tgb droplets.

Animals↗
PubMed1978

[Unrecognized hyperthyroidism in hospital patients. Analysis of clinical symptoms compared to aged euthyroid goiter patients].

During a 14-month period hyperthyroidism has been diagnosed in 39 of 2916 inpatients of a general medical service. Graves' disease was present in only 8 cases. 21 patients had solitary autonomous nodules or multiple autonomous nodules (toxic multinodular goiter). In 10 patients the type of hyperthyroidism could not be established. The referring practitioner suspected hyperthyroidism in all 8 patients with Graves' disease, but in only 5 of the 31 remaining cases. The relative rarity of Graves' disease in inpatients reflects the fact that this form of hyperthyroidism is easily recognized by the practitioner and treated on an out-patient basis. Graves' disease patients and those with autonomous solitary or multiple nodules were of comparable age and had an identical serum free-thyroxin. Thus, neither higher age nor lower thyroxin is responsible for the atypical clinical presentation of autonomous nodules. A comparison with age- and sex-matched carriers of euthyroid goiters identified weight loss, resting pulse rate over 90 and auricular fibrillation as reliable clinical features. A thyroid function test is therefore indicated in every patient with a goiter and one of the three above clinical findings.

Adenoma↗
PubMed1978

[Importance of thyroid diseases in internal medical hospital].

Retrospective analysis of 2627 and prospective analysis of 289 inpatients (mean age: 57 years) of the Department of Internal Medicine, University of Berne, disclosed euthyroid goiter in 33.9%. 65% of the patients had urinary iodine excretion below 100 microgram per gram creatinine. Thus, iodination of salt (raised to 10 mg potassium iodide per kg in 1962) is still inadequate. 1.4% of the inpatients had hyperthyroidism. Hypothyroidism was diagnosed in 0.5% of the inpatients, which is about three times less than in comparable prospective English studies. The finding raises the possibility that cases of hypothyroidism have been frequently missed. Antibodies against thyroglobulin and/or microsomal antigen were present in 8.5% of 105 goiter patients and 4.0% of 124 patients without goiter. This is a definitely lower incidence than has been reported in comparable English populations and confirms reports from other Alpine endemic goiter areas. Among the 2916 patients of the entire study only 3 cases (0.1%) of clear-cut chronic lymphocytic (Hashimoto) thyroiditis were found.

Autoantibodies↗
PubMed1978

[The little observed ions: magnesium and phosphorus].

Signs and symptoms of phosphorus and magnesium deficiency are recognized with increasing frequency. More and more clinical settings are known to favor P and Mg depletion. The clinical aspects of the P and the Mg depletion syndrome and are briefly summarized and a list is provided of papers describing the pathophysiologic mechanisms which may lead to clinically relevant loss of phosphorus and magnesium.

Deficiency Diseases↗
PubMed1978

[Hyperthyroidism (author's transl)].

Surgical cure of hyperthyroidism aims at removing enough functioning follicles to prevent hyperthyroidism while leaving sufficient tissue to maintain euthyroidism. In the case of Graves' disease the surgeon is faced with a goiter consisting of uniformly hyperstimulated follicles that are but one of the multiple targets of an immunologic attack. In contrast, autonomous follicles with an intrinsic functional abnormality are the hallmark of multinodular toxic goiter. These follicles may be clustered (toxic adenoma) or spread in different patterns throughout the gland. Partial thyroidectomy provides definite cure. While operating, the surgeon is unable to appreciate the functional quality of the tissue left behind. Thus, both postoperative hypo- and hyperthyroidism may occur independently of the surgical technique.

Goiter, Nodular↗
PubMed1978

Morphologic and functional substrate of thyrotoxicosis caused by nodular goiters.

The pathogenesis of nonimmunogenic thyrotoxicosis caused by nodular goiters--with the exception of true toxic adenoma--was investigated in 11 patients by means of scintigraphic, morphologic and autoradiographic technics. The basic event is the appearance, for unknown reasons, of autonomously functioning follicles which are morphologically indistinguishable from normal follicles. Four basic patterns of intrathyroidal distribution of autonomously functioning follicles are individualized: Type I = multiple individual autonomously functioning follicles scattered throughout the goiter. Type II = clustered autonomous follicles without demarcation from less active parenchyma. Type III = multiple microadenomas. Type IV = autonomous function of the majority of all follicles. In all four types, the autonomous follicles occur without recognizable relation to nodule boundaries. Scintiscans cannot predict the microstructure of these types of goiters. More than one pattern of distribution of autonomously functioning follicles may occur within a single goiter. The growth of thyroid nodules is independent of, and certainly not a prerequisite to, thyrotoxicosis. Rather, the appearance of thyrotoxicosis in this type of multinodular goiter depends on (1) the number of autonomous follicles throughout the gland and (2) their mean hormone-producing capacity per unit of time.

Autoradiography↗
PubMed1978

Transformation of normal follicles into thyrotropin-refractory "cold" follicles in the aging mouse thyroid gland.

Autoradiographs of thyroid glands of aging mice demonstrate the gradual appearance of "cold" follicles which fail to iodinate the intraluminar iodoproteins even after intense exogeneous or endogeneous TSH stimulation. "Cold" follicles first appear at the age of 5 months. They may account for 80% of all thyroid follicles in 13-month-old mice. Morphologically, the "cold" follicles are characterized by a larger than normal colloid volume and a comparatively flat epithelium for any given follicle size. Old thyroids are twice as large as young ones. They contain twice as much normally iodinated thyroglobulin/mg wet weight. The total number of cells per gland remains constant throughout the life time. This is probably also true for the total number of follicles. The iodide pump, as judged by the tissue to serum ratio, remains normal and TSH-responsive. Yet, it is not established whether this is due to a higher activity of the pump in normal follicles or to preservation of inorganic iodide transport in "cold" follicles. Pinocytosis is defective in "cold" follicles and is poorly responsive to TSH stimulation. Furthermore, diffusion of iodocompounds is severely impaired in the colloid of "cold" follicles. It is suggested that the primary defect in the pathogenesis of "cold" follicles in old mice is the gradual failure of endocytosis to respond to normal TSH stimulation. Because exocytosis and iodination would first proceed normally, the follicular lumina would become overdistended up to a point where the apical membrane is functionally impaired. With this sequence of events, "cold" follicles would have impaired iodination while being metabolically as active as hot ones. Thus, several puzzling reports on high metabolic activity of "cold" tissue could possibly be interpreted.

Aging↗
PubMed1977

[Cushing's syndrome and adrenal suppression by means of intranasal use of dexamethasone preparations].

In two 15-year-old boys with bronchial asthma and allergic rhinitis, bronchospasm disappeared with prolonged use of intranasal dexamethasone ointment and drops respectively. Both showed cushingoid features and total or partial suppression of adrenocortical function. The first patient died during a sudden and unexpected asthma crisis one week after withdrawal of the 0.25% dexamethasone ointment he had been taking at the rate of 1.8 mg/day for one year. The second boy recovered near-normal adrenocortical function 3 months after gradual withdrawal of the 0.01% dexamethasone nose drops he had been on at an average daily dose of 0.5 mg, for the past 6 years. An acute trial in 10 normal volunteers showed marked short-term suppression of endogenous cortisol production after a single intranasal ointment application containing 0.9 mg dexamethasone. Long-term use of dexamethasone preparations on the nasal mucosa may be dangerous by inhibiting hypophyseal-adrenocortical function. Abrupt withdrawal may lead to sudden relapse of a potentially life-threatening accompanying disease such as bronchial asthma.

Adolescent↗