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Biomedical subjects

L Wide

Publications and source records attributed to L Wide.

At least 181 records · Page 10Linked to original sources
PubMed1983

Pulsatile subcutaneous low-dose gonadotropin-releasing hormone treatment of anovulatory infertility.

Subcutaneous pulsatile long-term administration of low doses of gonadotropin-releasing hormone (GnRH) was given for induction of ovulation to 14 infertile amenorrheic women who did not respond to clomiphene citrate. A small peristaltic pump was used to deliver 1, 5, or 20 micrograms of GnRH every 90 minutes. Nineteen treatment courses with a duration of 26 to 187 days were given. Thirty-six ovulatory cycles were induced in 12 of the 14 women; 8 of the women conceived. Five healthy children have been born. Three early spontaneous abortions occurred. The subcutaneous GnRH therapy was given with the same pulse frequency until menstruation or pregnancy occurred. The treatment could be given without interruption to induce repeated ovulatory menstrual cycles. No serious adverse effects occurred. Subcutaneous pulsatile administration of low doses of GnRH is a promising new treatment of women with anovulatory infertility.

Adult↗
PubMed1983

Diabetes mellitus, glucose tolerance and insulin response to glucose in patients with primary hyperparathyroidism before and after parathyroidectomy.

In a retrospectively analyzed series of 441 patients operated for primary hyperparathyroidism (HPT), the prevalence of diabetes mellitus was 8.2%, which was three times higher than in the unselected age-matched population. Following parathyroid surgery, the need for antidiabetic treatment was unchanged. The insulin response to an intravenous glucose load was enhanced preoperatively [95 mU/1 +/- 41 (SD)] in twenty-six prospectively studied patients compared to postoperative (65 +/- 41 mU/1) investigations (P less than 0.01). This response was inversely correlated (r = 2, P less than 0.01) to the serum phosphate concentrations but not related to calcium or parathyroid hormone levels. Postoperatively, most HPT patients experienced a deterioration of their glucose tolerance (t 1/2 for i.v. glucose 54 +/- 12 and 64 +/- 21 min, respectively, P less than 0.05), and one-third of them had pathological values at follow-up. Despite this, neither the fasting blood glucose levels nor the values for haemoglobin A1c were significantly affected.

Adult↗
PubMed1983

Qualitative difference in follicle-stimulating hormone activity in the pituitaries of young women compared to that of men and elderly women.

The possible existence of qualitative differences between FSH in pituitaries from men and women of different ages was investigated with the use of an in vitro bioassay, an in vitro bioassay, and a RIA. Aqueous extracts were made from pituitaries obtained at autopsy and frozen until extracted. The FSH activities per pituitary and the ratios of FSH activities as obtained with the three assay methods were similar for young and elderly men. The ratios of in vivo biological to in vitro biological FSH activities were similar for men and postmenopausal women and significantly higher than the corresponding ratio for FSH from young women. With the in vivo bioassay the activity in the extracts of pituitaries from men and young women were similar, whereas extracts from postmenopausal women had significantly higher activity. With the in vitro bioassay the extracts from young women and elderly women had a similar content of FSH activity, whereas the FSH level in the extracts of male pituitaries was significantly lower. The results of the RIA correlated well with those of the in vitro bioassay. In conclusion, the results show that FSH in pituitaries from young women has a biological activity that is qualitatively different from FSH of men and elderly women. The relatively low in vivo biological activity of FSH from young women compared to FSH from men and elderly women was most likely due to a more rapid clearance of the hormone from the circulation of the test animal.

Adolescent↗
PubMed1983

Parathyroid autotransplantation. An investigation of parathyroid autograft function.

During a four-year period, 27 patients underwent total parathyroidectomy with autotransplantation of parathyroid tissue to the forearm. In order to minimize the risk of persistent or recurrent hyperparathyroidism (HPT), a routine thymic resection and a wide excision of fat tissue around the parathyroids was performed to ensure excision of possible supernumerary glands or rudimentary parathyroid tissue. The indications for operation were HPT secondary to chronic renal failure in 24 patients (22 of whom had hypercalcaemia) and persistent or recurrent primary HPT in 2 cases. One further patient, who had a multiple endocrine neoplasia syndrome type I, underwent this procedure at the primary parathyroid operation. Preoperative hypercalcaemia was reversed in all patients but three during the first postoperative days, concomitantly with a fall in the parathyroid hormone (PTH) level. Fourteen patients showed marked hypocalcaemia postoperatively, necessitating calcium or vitamin D supplementation. This medication could later be discontinued in all of them. Thirteen patients, including two of those with primary HPT, never required any supplemental therapy. Survival of the grafts was documented by several observations. In all patients normal serum calcium values were being maintained without supplemental therapy at follow-up. During induced hypocalcaemia a PTH secretory response was demonstrated in all eight studied patients with a gradient between the grafted and non-grafted arm. In two patients in whom the grafts were examined histologically 19 and 28 months after the transplantation, viable parathyroid tissue was observed. In the initial part of the study excised tissue was cryopreserved. Since persistent hypocalcaemia did not occur in our patients, we have now abandoned this safety precaution. Thus, total parathyroidectomy with autotransplantation of parathyroid tissue is a valuable method for restoring long-term parathyroid function in patients with secondary HPT and uraemia. It also appears of value in selected cases of primary HPT.

Adolescent↗
PubMed1982

Intranasal LHRH agonist treatment for inhibition of ovulation in women: clinical aspects.

Daily intranasal administration of the potent stimulatory LHRH analogue D-Ser(TBU)6-EA10-LHRH was given to fifty healthy women for 3 months. Twenty-six women received 400 micrograms LHRH agonist/day and twenty-four women received 600 microgram/day. Inhibition of ovulation occurred during 147 of the 150 treatment months. The three presumptively ovulatory cycles were probably the result of initial technical problems with the nasal spray. No pregnancies occurred. Reactivation of corpus luteum with slightly raised progesterone levels in serum at initiation of treatment was observed in six women. During 20 month treatment the serum progesterone levels were slightly raised, indicating luteinization of follicles or defect luteal phases. Most of the women had menstrual-like bleeding during treatment. Seventeen volunteers had regular bleeding and twenty-three women had oligomenorrhoea. No dysfunctional uterine bleeding occurred, but three women reported spotting. The remaining ten women had amenorrhoea during treatment without any symptoms of oestrogen deficiency. After discontinuation of treatment the women regained ovulatory menstrual cycles after 31 days on average. The treatment was very well accepted by all the women.

Administration, Intranasal↗
PubMed1982

Spontaneous variations in renal vein renin activity in man.

The spontaneous variations in renal vein renin activity (RVRA) and in peripheral vein renin activity (PVRA) were studied in one normotensive and nine hypertensive patients. Eight of the hypertensive patients had renal artery stenosis on one or both sides. Blood samples were drawn simultaneously from the two renal veins and from a peripheral vein every fifth or tenth minute for one hour. Plasma renin activity (PRA) was measured by radioimmunoassay. The precision of the PRA assay, expressed as coefficient of variation, was related to the PRA level. A large intra-individual variations was found in RVRA, the RVRA ratio and PVRA even in patients with unilateral renovascular hypertension. The intra-individual variation could not be explained by specimen collection error or by error of the assay procedure. The variation seems to be reflect a biological fluctuation. The clinical implication of these findings is that repeated, simultaneous collection from the two renal veins, avoidance of factors known to decrease renin secretion. and consideration of the relation between the RVRA ratio and RVRA level are of importance in the preoperative evaluation of patients with renal artery stenosis.

Adult↗
PubMed1982

Peptide hormone markers in screening for endocrine tumors in multiple endocrine adenomatosis type I.

In three families with the multiple endocrine adenomatosis type I (MEA I) trait, 51 members were investigated by measurement of circulating peptide hormones as tumor markers. Twenty-five of 51 members (49 percent) were considered to be affected by MEA I disorders. The incidence rose with age (75 percent in generation II). Both sexes were affected equally. Hyperparathyroidism was present in 20 of 25 affected members (80 percent), and pituitary tumors (prolactinomas) were found in four of 25 (16 percent). Endocrine pancreatic tumors were found in nine of 25 affected members (36 percent), but when "probable" tumors (seven) are included the frequency rises to 72 percent. Hyperparathyroidism was found in all except one member with proved lesions in other organs. Among patients with proved and possible endocrine pancreatic tumors, elevated serum levels of gastrin and pancreatic polypeptide were frequently found, 78 percent and 67 percent, respectively, and we suggest that serum gastrin and pancreatic polypeptide levels are the most useful screening markers at present for pancreatic lesions in MEA I.

Adenoma↗
PubMed1982

Early follicular phase luteinizing hormone-releasing hormone agonist administration - effects on follicular maturation and corpus luteum function in women.

The potent luteinizing hormone-releasing hormone (LRH) agonist D-Ser(TBU)6-EA10-LRH was administered in a daily subcutaneous dose of 5 or 25 microgram for 1, 3 or 5 consecutive days to twelve regularly menstruating women in the early follicular phase of the menstrual cycle in an attempt to disturb follicular maturation and induce luteolysis. The treatment was monitored by clinical examinations, basal body temperature recordings, bleeding patterns and frequently taken peripheral venous blood samples for analyses of gonadotropins and ovarian steroids. The luteal phase during the LRH agonist treatment cycles did not differ in length from that of the control cycles before and after the treatment (p greater than 0.05). The maximal progesterone concentration during the luteal phase exceeded 32 nmol/l in all but one of the treatment cycles. The follicular phase of the treatment cycle was prolonged in comparison with that of the control cycles (p less than 0.01). Thus, administration of high doses of a superactive LRH agonist during the early follicular phase of the menstrual cycle prolonged the follicular phase and postponed ovulation but did not interfere with corpus luteum function in normally ovulating women.

Adult↗
PubMed1982

Failure to induce early abortion by huge doses of a superactive LRH agonist in women.

The possible abortifacient effect of the potent stimulatory luteinizing hormone-releasing hormone analogue D-Ser(TBU)6-EA10-LRH was studied in five women in early pregnancy. Four of them were treated by intravenous injections of the superactive LRH agonist in a dose of 50-125 micrograms t.i.d. for four days (total dose 600-1500 micrograms). The fifth woman discontinued treatment after the first 50 micrograms dose. The treatment was instituted on gestational day 37, 38, 40, 42 and 46. Clinical examinations and frequently taken peripheral venous blood samples for analyses of human chorionic gonadotropin and ovarian steroids were used for monitoring the treatment. No abortifacient effects of these large doses of the superactive LRH agonist were observed and the pregnancies had to be terminated by suction curettage after 10-13 days. Thus, previously described luteolytic effects by superactive LRH agonist are overcome probably by endogenous chorionic gonadotropin in early human pregnancy.

Abortion, Induced↗
PubMed1982

Effects of beta-adrenergic blockade on serum parathyroid hormone in normal subjects and patients with primary hyperparathyroidism.

Recent experimental studies suggest that the autonomous nervous system can effect the secretion of parathyroid hormone (PTH) and that these effects could be of physiological importance. The short-term effects of propranolol were investigated in 13 patients with primary hyperparathyroidism (HPT) and 6 normal subjects. During a 2-hour infusion there were no changes in serum PTH or calcium concentrations in any of the individuals studied. During long-term treatment of HPT patients with beta-blocking agents for 2-6 months no reduction or raised PTH levels was detected and the hypercalcaemia was unaffected. These findings question the importance of the adrenergic system for the normal regulation of serum PTH levels and its role for hormone hypersecretion in primary HPT. Our experience does not support the use of propranolol as an alternative to surgery in patients with primary HPT.

Adrenergic beta-Antagonists↗
PubMed1982

Clinical studies on phosphate handling in hypercalcaemia.

Phosphate indices (serum phosphate, tubular reabsorption of phosphate, renal threshold phosphate concentration (TmP/GFR) and index of phosphate excretion) were studied in 88 hypercalcaemic subjects: 64 with primary hyperparathyroidism (HPT) and 24 with hypercalcaemia from other causes, predominantly malignant disease. HPT patients as a group could easily be separated from normal subjects (n = 16) and patients with functional hypoparathyroidism (n = 7) by use of the phosphate variables but these indices were of little discriminating value for the differential diagnosis between HPT and hypercalcaemia from other causes. There was no difference in the urinary cyclic adenosine monophosphate (cAMP) excretion between the two hypercalcaemic patient groups, but HPT patients had clearly elevated serum parathyroid hormone (PTH) levels compared with normal PTH concentrations in patients with other causes of hypercalcaemia. A positive correlation between cAMP and serum calcium and an inverse relationship between cAMP and TmP/GFR were found in patients with hypercalcaemic malignant disease. These findings suggest the existence of a humoral factor with PTH-like effects in malignant disease. Since PTH levels were low, the physiological actions were apparently not mediated by circulating PTH. No difference in the values for phosphate variables, PTH, cAMP or serum calcium was found between renal stone-forming and stone-free patients with HPT.

Adolescent↗
PubMed1982

Bromocriptine-induced pregnancies in women with large prolactinomas.

Fourteen women with large prolactinomas experienced a total of nineteen bromocriptine-induced term pregnancies. None of the women had received prior pituitary tumour therapy. Post-partum sellar X-ray examinations showed signs of tumour enlargement in two women. Only one of them had clinical symptoms of tumour expansion with visual field defects during the pregnancy. The visual impairment improved when bromocriptine treatment was reinstituted and the pregnancy continued to term. The other twelve women had a total of seventeen uneventful pregnancies without symptoms or signs of pituitary tumour expansion. Thus, medical therapy with dopamine receptor agonists is the primary treatment for most infertile women with prolactinomas. The risk of serious pregnancy-induced tumour expansion is very small in properly investigated and carefully supervised patients with large PRL-secreting pituitary adenomas.

Adult↗
PubMed1982

Failure of positive feedback of oestradiol during chronic intranasal luteinizing hormone-releasing hormone agonist treatment.

An oestrogen provocation test was performed in five healthy women during chronic intranasal treatment with 400 or 600 micrograms of the superactive LHRH agonist D-Ser(TBU)6-EA10-LHRH daily. Oestradiol benzoate 2.5 mg was administered intramuscularly after at least 3 months of LHRH agonist treatment. The serum levels of FSH and LH were not affected by the oestrogen injection. Failure of positive feedback of oestradiol may be one explanation for the inhibition of ovulation which occurs during chronic LHRH agonist treatment.

Adult↗
PubMed1982

Menstrual function and serum prolactin levels after long-term bromocriptine treatment of hyperprolactinaemic amenorrhoea.

Long-term bromocriptine treatment was discontinued in thirty-seven women with hyperprolactinaemic amenorrhoea. After cessation of therapy thirty of the thirty-seven women became hyperprolactinaemic again with amenorrhoea or anovulatory bleeding. Seven of the women continued to have regular ovulatory menstruation but only three were normoprolactinaemic 3 months after stopping treatment. Two of the seven women had evidence of pituitary tumour regression. After the discontinuation they had nearly normal prolactin levels but during 2 years of follow up the serum prolactin levels slowly increased. In the twenty-seven women with pre treatment prolactin levels below 100 micrograms/I there was no difference between the prolactin levels before starting and 1 month after stopping treatment, while the women with pretreatment prolactin levels above 100 micrograms/l had lower levels after therapy. Bromocriptine treatment seldom results in permanent cure of hyperprolactinaemic amenorrhoea.

Adult↗
PubMed1982

Cerebrospinal fluid ferritin in newborn infants. Elevated levels in cerebral infection or bleeding.

One hundred and four infants with neurological symptoms or suspected infection during the neonatal period were consecutively investigated with respect to ferritin and albumin concentrations in the cerebrospinal fluid (CSF). In some cases serial determinations of CSF ferritin were performed during the period in the neonatal unit. CSF ferritin was significantly higher in infants that recovered very soon from a transient neonatal disorder (TND) than in apparently healthy adults. No difference in CSF ferritin was found between full-term infants with TND and pre-term infants with TND or asphyxiated infants. Three out of five infants with septicaemia or meninigitis showed a marked increase in CSF ferritin during the observation period, and the same finding was made in three infants with intracranial bleeding, in whom CSF ferritin values 100 times the upper reference limit for infants with TND were recorded. In two infants with neonatal convulsions secondary to asphyxia moderate CSF elevations were observed. No correlation was found between ferritin and albumin in CSF, suggesting that other mechanisms than passive penetration from blood into CSF must have been responsible for the raised levels of CSF ferritin. More likely the observed ferritin increments reflect ferritin release from macrophages undergoing phagocytosis either induced by cerebral bleeding or due to infectious agents.

Adult↗
PubMed1982

Comparison between serum levels of oestriol in venous and capillary blood from pregnant women.

The concentration of unconjugated oestriol in serum was measured in venous and capillary blood from 41 pregnant women. 22 women had uncomplicated pregnancies. The others had different kinds of complications including severe oedema and pre-eclampsia. The correlation between values of unconjugated oestriol in venous and capillary blood was high. In 77 out of 78 samples the conclusions drawn about the feto-placental function from venous and capillary blood were similar. The day-to-day variability was of the same order for capillary as for venous samples. A few samples were analysed for total oestriol and also in this case a high correlation was found between capillary and venous blood. It is concluded that capillary blood samples may well be used for estimation of total and unconjugated oestriol. Capillary blood could replace venous blood for estimation of unconjugated oestriol in the management of high risk pregnancies.

Capillaries↗