Search PubMed⌕ Search

Biomedical subjects

J M Hansen

Publications and source records attributed to J M Hansen.

At least 91 records · Page 5Linked to original sources
PubMed1990

Observer variation in the scintigraphic diagnosis of solitary cold thyroid lesions.

In order to evaluate the reproducibility of the diagnosis of solitary cold thyroid lesions, two specialists in nuclear medicine and two specialists in endocrinology independently twice read 240 thyroid 99mTc pertechnetate scintigrams. No significant difference or interaction between the results obtained from the right and the left lobe was found. A solitary cold lesion was diagnosed in 100 of the 480 lobes; however, in only 30 did all four observers agree upon the diagnosis. Interobserver variation was determined by pairwise comparison of observers. The observed agreement was between 0.91 and 0.94. After adjusting for expected chance agreement, kappa values between 0.57 and 0.70 were found. Intraobserver variation was smaller than interobserver variation, revealing agreement rates of 0.93-0.96 and kappa values between 0.71 and 0.77. Agreement was related to large lesions, lesions located centrally in the lobe, and ovoid-shaped lesions. Clinicians should be aware to what extent they can rely on the information they use in their decisions. The considerable inconsistency in the evaluation of cold lesions on thyroid scintigrams should be taken into consideration, and calls in question the value of using thyroid scintigrams for deciding whether a patient should be referred for operation or biopsy.

Adolescent↗
PubMed1990

Observer variation in the assessment of scintigraphy of the thyroid gland.

In order to determine observer variation in the assessment of thyroid scintigrams two specialists in nuclear medicine and two specialists in endocrinology independently evaluated 240 thyroid pertechnetate scintigrams twice, and assessed a number of variables concerning size and isotope uptake. The observed agreement between pairs of observers for the variables ranged from 0.70 to 0.98. By the use of the kappa coefficient the observed agreement was adjusted for change agreement. Kappa can variate from -1 (total disagreement) to +1 (perfect agreement). Kappa values between 0.29 and 0.86 were found. In the intraobserver study the observed agreement ranged from 0.83 to 0.99 resulting in kappa coefficients between 0.53 and 0.96. Thus the level of agreement in the present study was "fair to substantial" for agreement in the interobserver part and "substantial to almost perfect" for agreement in the intraobserver part. No difference was found in the level of agreement between the nuclear specialists and the endocrinologists. Although the treatment of patients is based on knowledge of the case histories and clinical and laboratory findings the high degree of observer variation may lead to misclassification of a number of patients with thyroid disease and subsequently a less optimal choice of treatment.

Adolescent↗
PubMed1990

Effect of oral glucose feeding on thyroid hormone action in human mononuclear blood cells.

The effect of glucose feeding on serum concentrations of thyroid hormones, nuclear T3 binding and thyroid hormone stimulated oxygen consumption and glucose uptake was evaluated. Six persons without thyroid diseases were fed exclusively glucose (2500 kcal/day) for two days. Glucose feeding resulted in the following serum hormone levels (before vs after glucose feeding) T3: 1.07 vs 1.16 nmol/l (p less than 0.05); FT4I: 76 vs 102 a.u. (p less than 0.05) and TSH: 1.48 vs 1.14 mU/l (n.s.). Nuclear T3 binding decreased after glucose feeding; before: maximal binding capacity (MBC) 1.3 +/- 0.5 fmol/100 ug DNA, MBC after glucose feeding: 0.8 +/- 0.2 fmol/100 ug DNA (p less than 0.05). The Ka's were identical in both groups before glucose, Ka: 4.2 +/- 1.2 x 10A10 l/mol, after glucose, Ka: 3.5 +/- 1.2 x 10(10) l/mol. Conversely did glucose feeding increase thyroid hormone stimulated oxygen consumption by approximately 100% and thyroid hormone stimulated glucose uptake by approximately 200%. In conclusion, our results show that glucose feeding 1) increases serum T3 levels, 2) decreases nuclear T3 binding, 3) enhances thyroid hormone stimulated oxygen consumption and glucose uptake.

Administration, Oral↗
PubMed1989

[Use of helium spirometric pulmonary function tests by general practitioners at a hospital outpatient department].

The case records of 94 helium spirometric pulmonary function investigations on patients referred by their general practitioners to the clinical-physiological department, Svendborg Hospital during 1985 and 1986 are reviewed. In 35% of the cases, the diagnosis on referral was "dyspnoea of unknown origen". Half of the results of the investigation were abnormal and it is concluded that this investigation is suitable for differentiating the patients who have reduced ventilatory capacity as the reason for the dyspnoea. 11% of the material consists of patients with bronchial asthma. According to the literature, these patients could be monitored advantageously instead with current peak-flow measurements. 18% of the investigations were carried out on patients with chronic bronchitis. The authors consider that a single spirometric measurement should be replaced by current monitoring of the forced expiration in litres and the forced vital capacity. Investigations undertaken as part of assessment for pensioning constotuted 18%. It was apparent from a questionnaire investigation that the general practitioners obtained considerable information from the result of the investigation. This information was independent of the result of the investigation. The profits were greatest when the investigation resulted in alteration of medication than when this was not the case.

Adolescent↗
PubMed1989

Differential effect of continuous administration of beta-adrenoceptor antagonists on antipyrine and phenytoin clearance.

1. Antipyrine (1000 mg orally) clearance was studied 3 days before treatment with either atenolol (50 mg twice daily), metoprolol (100 mg twice daily), propranolol (80 mg twice daily) or placebo, and at day 5 and 18 during treatment. Phenytoin (100 mg intravenously) clearance was measured on days 0, 7 and 21 during treatment. 2. Antipyrine clearance was decreased by about 20% after 5 days of treatment with either propranolol or atenolol and this decrease persisted after 18 days of treatment. Antipyrine clearance did not change during treatment with either metoprolol or placebo. Phenytoin clearance did not change during any of the treatments.

Adrenergic beta-Antagonists↗
PubMed1989

Influence of rifampicin on thyroid gland volume, thyroid hormones, and antipyrine metabolism.

The influence of rifampicin (450 mg/day for 28 days) on the hepatic microsomal enzymes and thyroid function variables were investigated in 13 healthy male volunteers. After 14 and 28 days of treatment a significant increase in median thyroid volume (determined ultrasonically) was demonstrated (20 ml, range 13-28 before; 26 ml, range 18-48 at day 14, and 24 ml, range 17-40 at day 28) (p less than 0.01). A significant decrease in median serum free T4 index levels was seen (94.1 arbitrary units, range 80.1-123.4 before treatment; 86.8, range 71.7-102.0 at day 14, and 85.3, range 65.5-131.3 at day 28) (p less than 0.01). Serum T4, T3, T3 resin uptake, free T3 index and TSH levels were not significantly altered. Hepatic microsomal enzyme activity assessed by antipyrine clearance was significantly increased (approximately by 85%) at day 14 and 28, whereafter it normalized. The study supports the hypothesis that the increase in thyroid volume after treatment with rifampicin and other hepatic enzyme system inducers (e.g. phenytoin and carbamazepine) is a compensatory mechanism caused by an increased hepatic degradation of thyroid hormones.

Adult↗
PubMed1989

Suppressed natural killer cell activity in patients with euthyroid Graves' ophthalmopathy.

The purpose of the present study was to determine whether patients with euthyroid Graves' exophthalmopathy have an impaired NK cell function compared to patients with Graves' hyperthyroidism and healthy controls. The NK cell activity measured against K562 target cells was significantly suppressed (p less than 0.01) in patients with euthyroid Graves' ophthalmopathy, whereas the NK cell activity of patients with Graves' hyperthyroidism was not. Although interferon-alpha, interleukin-2 and indomethacin significantly enhanced (p less than 0.01) the NK cell activity in all three groups, none of these agents fully restored the defective NK cell activity in euthyroid Graves' ophthalmopathy. The concentrations in the blood of large granular lymphocytes and CD16 positive cells did not differ between the three groups, furthermore an immunosuppressive serum factor was not detected. The number of effector/target cell conjugates did not differ between patients and controls, whereas the interferon-alpha induced production of a soluble natural killer cytotoxic factor (NKCF) with specificity for NK sensitive target cells was suppressed in patients with Graves' euthyroid ophthalmopathy. We conclude that one of the mechanisms underlying the defective NK cell activity in patients with euthyroid ophthalmopathy may be an impairment of the release of NKCF from the NK cells.

Adolescent↗
PubMed1989

Pituitary-cell autoantibody diversity in sera from patients with untreated Graves' disease.

Sera from 22 untreated patients with recently diagnosed Graves' disease (GD) were screened in an immunocytochemical tissue assay for presumptive pituitary IgG autoantibodies, as defined by the presence of immunoreaction with rat and swine pituitary cell types. Forty four patients with Hashimoto's thyroiditis (HT) and 97 healthy subjects were also studied. Anti-pituitary antibodies were found in 14 of the 22 GD sera (64%). Of these, 6 sera reacted with cytoplasmic components of growth hormone (GH) cells, 3 with prolactin (PRL) cells, and 5 with both GH and PRL cells. Yet, none of the immunoreactive sera reacted with human GH, bovine PRL or TSH in dot-blot assays and absorption studies. Anti-pituitary antibodies also occurred in 4 of the 44 HT patients (9.1%) and in 9 of the 97 healthy subjects (9.2%). The frequency of sera revealing anti-pituitary antibodies was significantly higher in patients with GD compared to the groups of HT patients (P less than 0.00005), and healthy subjects (P less than 0.00005). Healthy subjects and patients with HT had a similar frequency of anti-pituitary antibodies (P = 1.0000). These data demonstrate that in thyroid autoimmune conditions antibodies reactive with cytoplasmic components of pituitary GH/PRL cells, may be present in sera from patients with GD. The pathological importance of this observation is at present unknown.

Adolescent↗
PubMed1989

Crossover comparison of cibenzoline and quinidine in ambulatory patients with chronic ventricular arrhythmias.

This study was designed to compare the efficacy and safety of cibenzoline and quinidine in ambulatory patients with ventricular arrhythmias. Following washout of previous antiarrhythmic treatment, a 48-h ambulatory electrocardiographic (ECG) recording was obtained. Twenty-seven patients were screened, of whom 20 met the entry criteria of greater than or equal to 30 ventricular premature beats (VPBs)/h. Cibenzoline was started at 130 mg every 12 h and was increased to 160 mg every 12 h if necessary. Quinidine was started at 300 mg every 6 h and was increased to 400 mg every 6 h if necessary. Treatment was assessed by 24-h ambulatory ECG recording. Efficacy was defined as greater than 75% reduction in single VPBs, greater than 90% reduction in paired VPBs, and total abolition of ventricular tachycardia events. A 7-day washout with repeat 24-h ambulatory ECG recording to document return of ventricular arrhythmias was required prior to crossover. Efficacy was documented in 9 of 20 (45%) patients receiving cibenzoline and in 9 of 20 (45%) patients receiving quinidine. Response to cibenzoline 130 mg every 12 h was documented in 8 of 20 (40%) patients and in 1 of 11 (9%) patients receiving cibenzoline 160 mg every 12 h. Response to quinidine 300 mg every 6 h was documented in 8 of 20 (40%) patients and in 2 of 6 (33%) patients receiving 400 mg every 6 h. Dose-limiting side effects occurred in 1 of 20 (5%) patients receiving cibenzoline and in 7 of 20 (35%) patients receiving quinidine. Cibenzoline and quinidine are equal in efficacy, but cibenzoline is significantly better tolerated.

Adult↗
PubMed1989

Relationship between serum thyroglobulin, thyroid volume and serum TSH in healthy non-goitrous subjects and the relationship to seasonal variations in iodine intake.

In order to investigate the interrelationship between serum thyroglobulin (Tg), thyroid volume and serum TSH by a sensitive method, 176 healthy euthyroid non-goitrous subjects were studied. Furthermore the seasonal influence, assuming seasonal differences in iodine intake in Denmark, was studied in 13 healthy male volunteers. A weak correlation between serum Tg and thyroid volume was found only in female non-goitrous subjects. No correlations between serum Tg, thyroid volume, free T4 and free T3 indices, T3/T4 ratio, serum TSH by sensitive method or age were seen. Thyroid volume was increased (P less than 0.01) during the winter without any change in thyroid function or TSH level, whereas serum Tg level in these subjects was significantly lower (P less than 0.02) during the winter compared with the summer. In conclusion, serum Tg showed no correlation with either thyroid volume, super-sensitive TSH or thyroid function in a population of non-goitrous subjects in Denmark. The lack of correlation between increased thyroid volume and decreased serum Tg during the winter compared with the summer is unexplained. It might be hypothesised that short-term changes in iodine intake induce only colloid accumulation (i.e. increased thyroid volume) without changes in the glandular secretion of Tg or thyroid hormones.

Adolescent↗
PubMed1989

Frequency of thyroiditis and postpartum thyroiditis in a 10-year consecutive hyperthyroid Danish population.

In a retrospective study 716 consecutive newly diagnosed and untreated hyperthyroid patients were examined in regard to the frequency of silent thyroiditis and postpartum thyroiditis. Six patients (0.8%) had possible silent thyroiditis (24-hour radioiodine uptake less than or equal to 5% and hyperthyroidism without anterior neck pain). None occurred within one year postpartum. We conclude that silent thyroiditis is a rare cause of hyperthyroidism in our thyroid clinic. The fact that none occurred postpartum suggests that postpartum thyroiditis is oligosymptomatic and that screening programmes are needed if one wants to diagnose the earliest phases of this condition.

Adolescent↗
PubMed1988

Tetracycline for sclerosis of thyroid cysts. A randomized study.

In a prospective study, 53 consecutive patients with solitary thyroid cysts were randomized to ultrasonically guided cyst aspiration and subsequent flushing with isotonic saline (n = 30) or tetracycline hydrochloride (n = 23). The patients were followed up clinically and ultrasonically 1, 3, 6, and 12 months after treatment. If the cyst recurred, a repeated treatment was offered. Cure was defined as the absence of any residual nodule and an ultrasonic cyst volume of less than 1 mL 12 months after the last treatment. During follow-up, two patients without recurrence after saline treatment and six patients without recurrence after tetracycline treatment developed solid cold nodules. Fourteen (47%) of 30 patients in the saline group and ten (43%) of 23 patients in the tetracycline group were cured (not statistically significant). Tetracycline does not seem to offer any advantage over isotonic saline in the treatment of thyroid cysts, and some of these patients still need thyroid surgery.

Cysts↗
PubMed1988

Stroke in thyrotoxicosis with atrial fibrillation.

Chronic atrial fibrillation is associated with an increased risk of stroke. In elderly patients with thyrotoxicosis, atrial fibrillation is frequently encountered, and the true risk of cerebrovascular events in these patients is controversial. We retrospectively studied 610 patients with initially untreated thyrotoxicosis, 91 (14.9%) of whom had atrial fibrillation, with the highest frequency in the elderly patients. The risk of cerebrovascular events, with special attention to the first year after the diagnosis of thyrotoxicosis, was calculated using logistic regression methods with age, sex, and atrial fibrillation as independent variables. Only age was an important risk factor (p less than 0.005), whereas sex and atrial fibrillation were not significant (p = 0.09 and p = 0.17, respectively) as independent risk factors. This is contrary to other studies of patients with thyrotoxic atrial fibrillation, and the need for further clarification of this issue is clear. From our study the indication for prophylactic treatment with anticoagulants for prevention of stroke in thyrotoxic atrial fibrillation seems doubtful, especially as no controlled studies of such treatment in patients with atrial fibrillation are currently available.

Adolescent↗
PubMed1987

Does prophylactic thyroxine treatment after operation for non-toxic goitre influence thyroid size?

In order to evaluate the influence of thyroxine treatment on thyroid volume after thyroidectomy for non-toxic goitre 110 consecutive patients were randomised to receive thyroxine (150 micrograms daily) or no treatment three months after operation. Thyroid volume determined by ultrasonography did not differ significantly between the two groups one year after operation. Nevertheless, a similar decrease in volume was seen from three to 12 months postoperatively in the thyroxine treated and no treatment groups (median 18 (range 8-70) ml to 16 (range 7-57) ml, and median 20 (range 9-72) ml to 17 (range 8-58) ml, respectively). Three patients (two given thyroxine) had recurrence of goitre within the observation period of one year. In this series thyroid volume decreased during the first postoperative year independently of thyroxine treatment. Hence it seems questionable whether postoperative thyroid function studies can identify patients at risk of recurrence of goitre after operation for non-toxic goitre and whether routine postoperative treatment with thyroxine is justifiable.

Adolescent↗
PubMed1987

Micturition pattern in hyperthyroidism and hypothyroidism.

Micturition pattern was investigated in 61 consecutive patients with thyroid disease. The patients were divided into three groups: hyperthyroid, hypothyroid, and euthyroid. Micturition pattern was examined after the first visit to the hospital and again six months later, when thyroid function had been restored to normal. Hyperthyroid patients had significantly increased micturition frequency as well as nocturia compared with their own control group when euthyroid (p less than 0.01). Hypothyroid patients had reduced micturition frequency compared with their own control group (p = 0.05). No significant changes were found in the euthyroid group. Which mechanisms might be responsible for the relationship between thyroid function and micturition pattern is debatable, and calls for further urodynamic and electrophysiologic studies. One conclusion is that thyroid disease should be borne in mind when patients present with unexplained urinary frequency or retention.

Female↗
PubMed1987

Serum thyroglobulin in chronic renal failure--effects of haemodialysis.

The influence of chronic renal failure (CRF) on serum thyroglobulin concentration (Tg) was investigated in 37 patients (29 on haemodialysis) and compared with results obtained from matched controls. Serum Tg did not differ significantly between CRF patients not on haemodialysis: median 24.1 micrograms/l, (range 2.5-47.0) and controls: median 23.6 micrograms/l, (range 2.1-53.0). Patients on haemodialysis had a significantly lower serum Tg level: median 11.4 micrograms/l (range 2.1-54.0) compared to controls (p less than 0.01) but no change in serum Tg level could be demonstrated after a single haemodialysis. A possible explanation for the low serum Tg level in patients with CRF on haemodialysis is decreased production parallelling the decreased production rate of T4 and T3. Since CRF patients not on haemodialysis had an unchanged serum Tg level compared to controls, haemodialysis was associated with small changes in serum Tg level, and since none of the patients had a serum Tg value above the upper reference limit we conclude that these changes were not of a magnitude likely to cause misinterpretation of results in routine clinical situations.

Adolescent↗