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Biomedical subjects

J Nerup

Publications and source records attributed to J Nerup.

At least 253 records · Page 14Linked to original sources

Long-term treatment of acromegaly with bromocriptine.

Treatment with bromocriptine, 30-55 mg daily, in 13 acromegalics for 1-15 months, resulted in a 60% decrease in growth hormone secretion, as judged from the excretion of growth hormone in 24-h urine. Normal excretion was obtained in 10 patients, while 1 patient showed no response. The plasma growth hormone response to O-GTT was improved, but not normalized, in 4 of 7 patients treated for more than 6 months, and marked glucosuria disappeared in two diabetics. While the secretion of TSH, LH and FSH was unchanged, the prolactin secretion was inhibited. The urine excretion of free cortisol showed a 30% decrease, possibly due to a direct effect of bromocriptine on the ACTH-secretion. Hypercalcaemia was never seen, but the initial hypercalcuria showed a modest decrease without measurable changes in the creatinine clearance. The subjective relief during long-term treatment was marked in 10 of 11 patients and the dominating symptoms disappeared in 40-67%, whereas heal-pad thickness, enlarged sellae, and visual fields remained unchanged. No serious side effects were observed. Treatment with bromocriptine seems effective and should be considered as a remedy amongst others, in suitable cases of acromegaly.

Acromegaly↗

HLA, islet cell antibodies, and types of diabetes mellitus.

Insulin-dependent diabetes mellitus, in contrast to non-insulin-dependent diabetes mellitus, is associated with HLA factors B8, BW15, and B18. Recent studies have shown the association to be even stronger with HLA, DW3, and DW4 and have produced evidence for the existence of two "diabetogenic" genes predisposing to insulin-dependent diabetes in different ways. Evidence to suggest the existence of a gene--associated with DW2--that protects against the disease is accumulating. Islet cell antibodies are a feature of insulin-dependent diabetes mellitus and can be seen, in most cases, at the time of diagnosis.

Adult↗

Incidence, seasonal and geographical patterns of juvenile-onset insulin-dependent diabetes mellitus in Denmark.

The incidence, sex, seasonal and geographical patterns of juvenile-onset insulin-dependent diabetes mellitus (j.i.d.m.) were studied retrospectively on one third of the Danish population 1970-1974. The j.i.d.m. incidence remained fairly constant during the study period, the average being 13.2 per 100000 per year. The total number of boys exceeded the number of girls by 27%. A marked peak of incidence was found at 12-14 years, earlier for females than for males. A seasonal variation in onset (diagnosis) of j.i.d.m. was observed with the lowest number of new cases in May-July. The j.i.d.m. incidence seemed to show socioeconomic differences, being highest in those parts of the survey area with lower status.

Adolescent↗

Low-dose insulin treatment of diabetic ketoacidosis.

Twenty-four consecutively admitted episodes of acute diabetic dysregulation in 22 patients were treated with a low-dose insulin regimen, given as hourly i.m. injections of 5 IU insulin. The fall in blood glucose was almost linear during the first 8 hours of treatment, on an average 10 percent per hour of the initial value. The hyperglycemia and acidosis were corrected by 2-12 hours of treatment. The deficiency of water and electrolytes, especially potassium, was treated with infusion from the beginnning, and the fluid balance was corrected within 12-16 hours. A severe fall in plasma potassium was never seen, but hypokalemia (less than 3.6mEg/I) was still present in some cases after 24 hours of treatment. One patient died on account of a large myocardial infarction, but otherwise the patients were restored to habitual condition in 1-4 days. The regimen was found to be simple, safe and effective in all cases, without risk of late hypoglycemia or severe hypokalemia. The study indicates, however, that the parenteral supply of potassium advocated previously, 12.5 mEq/hour, is not sufficient when the plasma potassium on admission is below 5.0mEq/I. In such cases it is recommended that the rate of potassium infusion is increased.

Acute Disease↗

HLA antigens in Graves' disease.

HLA typing of 86 patients with Graves' disease was performed for the A, B, C and D series antigens. An increased frequency of HLA-B8 (47 per cent) and Dw3 (51 per cent) compared with controls (23.7 and 21 per cent, respectively) was observed. The increase of B8 and Dw3 was almost exclusively found in a group of 48 patients with relapse of disease, whereas the frequency of B8 and Dw3 in patients without relapse did not differ significantly from that of the control group. No association with the presence of exophthalmos, thyroid antibodies, or antibodies to Yersinia enterocolitica serotype 3 could be found.

Epitopes↗

Effects of somatostatin on basal levels of plasma growth hormone and insulin in acromegalics: dose-response studies and attempted total growth hormone suppression.

Somatostatin 5, 10, and 25 mug and saline were given as a 2 min bolus injection to 6 acromegalic patients in basal conditions. A significant dose-response relationship could be demonstrated between somatostatin and the suppressions of plasma growth hormone and insulin. The lowest somatostatin dose tested exerted a significant suppression of both hormones. Insulin suppression after the bolus injection lasted for 15 minutes, while the suppression of growth hormone was maintained for 30-50 minutes. In order to obtain total suppression of the elevated plasma growth hormone levels in acromegalics, 3 patients received 50, 250, and 500 mug of somatostatin as bolus injections at time 0, 90, and 180 minutes, 2 patients received 50 mug of somatostatin as bolus injections 4 times with an interval of 20 minutes between each injection, and finally 3 patients received a large dose of somatostatin, 3000 mug given as an infusion over 2 hours. The single injections of somatostatin were not followed by a satisfactory growth hormone suppression. In the infusion experiments, the average plasma growth hormone level was suppressed only 65%, resulting in individual plasma growth hormone plateaus of 20, 14, and 3.6 ng/ml. Only the lowest of these plateaus would be acceptable from a clinical point of view.

Acromegaly↗

Thyroid hormone response to varying doses of TSH.

Fifty-five normal subjects were studied following intravenous injection of increasing doses of bovine thyrotropin (b-TSH) from 0.5 to 250 mU/kg. Serum triiodothyronine (T3) and thyroxine (T4) were measured 1, 2, 3 and 4 h after the TSH injection. Dose-related increments in serum T3 and T4 were demonstrated with doses of b-TSH = 2.5 mU/kg and a maximum response was obtained after approximately 100 mU/kg. The fractional increase in serum T3 was greater than in serum T4, but the ratio between the increase in serum T4 and serum T4 and serum T3 (21.3/l ng/ng) was independent of the dose of b-TSH and time after TSH stimulation. The T3 response was reproducible and unaffected by sex and age.

Adolescent↗

Autoimmune insulitis. Pathological findings in experimental animal models and juvenile diabetes mellitus.

Organ-specific, species non-specific anti-pancreatic cellular immunity has been reported as a feature associated with juvenile diabetes of short duration. In order to further elucidate a possible causal relation between autoimmunity and juvenile diabetes morphological studies were made on an autopsy material from 12 juvenile onset diabetics, dying within 1 year after the onset of the disease. Each patient was compared with 2 age and sex matched controls. In the group of patients the islets of Langerhans showed the following characteristics: 1. The B cells were degranulated and present in reduced number, 2. The A cells appeared normal, 3. A lymphocytic, non-cicatricial insulitis was detected in 50% of the patients. Those findings were correlated with animal experiments, in which rats and mice were immunized with A: heterologous and homologous preparations of endocrine pancreas, in complete Freunds' adjuvant, B: heterologous and homologous insulin in complete Freunds' adjuvant, and C: complete Freunds' adjuvant. Only animals of group A developed spleen cell migration tests positive to the pancreatic preparations, lymphocytic infiltrations of the islets and degranulation of the B cells. In addition, the B cells showed ultrastructural signs of degeneration. The morphological changes were reversible and were accompanied by a transient reduction in glucose tolerance.

Adolescent↗