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Biomedical subjects

R Goebel

Publications and source records attributed to R Goebel.

At least 73 records · Page 4Linked to original sources
PubMed1982

[Wegener's granulomatosis causing diabetes insipidus].

Very few cases of Wegener's granulomatosis which were associated with diabetes insipidus have hitherto been described. Our patient was a young man with severe (also histological) changes in the nose and paranasal sinuses. Typical pulmonal involvement developed. The hypothalamus seemed not to be affected; hyperprolactinemia, as described by other authors, did not exist. A computerized tomography was normal with regard to the hypothalamus. Typically the disease responded well to cyclophosphamide. An affection of the anterior lobe of the hypophysis was not demonstrable; likewise the kidneys were unaffected.

Adolescent↗
PubMed1982

[Two generations of FT4-radioimmunoassays--results in euthyroid patients and in patients on thyroid hormone therapy].

In accordance with the TRH-test two generations of FT4-immunoassays were checked in order to find a substitute for the free thyroxine index. The euthyroid reference range of FT4 was between 0.69-1.91 ng/dl using GammaCoat (Clinical Assays) and 0.94-2.29 ng/dl using Amerlex (Amersham), respectively. In the euthyroid range, FT4 as measured by Amerlex was, on the average, 47% higher than the value obtained by using GammaCoat. During treatment by thyroid hormones and TSH-suppression following TRH application, Amerlex FT4 values were up to 59% higher than the GammaCoat FT4 values. During replacement therapy, the FT4 values obtained by Amerlex were within the euthyroid reference range so that a differentiation between substitution and suppression appears to be possible by means of determining FT4. An overdose was assessed by simultaneous determination of T3 and FT4. According to our results Amerlex FT4 meets the requirements of a modern radioimmunoassay and is suitable as a substitute for the free thyroxine index. For this purpose the earlier method of determining FT4 (GammaCoat) does not seem suitable.

Adolescent↗
PubMed1982

The comparison scanning electron microscope within the field of forensic science.

A brief historical view of the origin, development, and application of the light comparison microscope is given. Problems emanating from restricted depth of focus in light-microscopical techniques are eliminated by utilizing the scanning electron microscope. Various attempts have been made to use the scanning electron microscope suitable for comparison microscopy: videotape, image storage tube, split field scan. In 1980 another way of performing scanning electron comparison microscopy was contrived: the coupling of two instruments. Both instruments are equipped with several electron detection systems, which produce special contrast effects. For applications with the comparison scanning electron microscope in forensic science a number of interchangeable specimen holders, were designed.

Forensic Medicine↗
PubMed1981

Stereospecific determination of D-thyroxin and L-thyroxin in serum.

A new method for separate determination of D-thyroxin and L-thyroxin in the serum was applied to study the response of serum levels of these isomers and of radioimmunologically determined total T3, total T4, free T4 and TSH upon administration of 2, 4 and 6 mg of a highly purified D-thyroxin preparation in six male patients with diffuse nontoxic goiter. D- and L-thyroxin are determined separately following extraction of the hormone from the serum and formation of diastereomeric dipeptides. The separation and final determination are accomplished by means of ion-pair chromatography on reversed-phase columns using an iodine-selective catalytic detector. A significant decrease in TSH takes place during the 3-days observation period. The values of D-T4, total T3 and free T4 are highest 4 hours after administration of the tablets and get to be to initial values after 24 hours. L-T4 shows no significant change. A direct suppressive effect of D-T4 on the pituitary gland may therefore be assumed as the cause of the suppression of TSH secretion.

Adult↗
PubMed1981

[Determination of serum free thyroxine: normal range, relation to the free thyroxine ratio and total thyroxine (author's transl)].

The validity of a commercially available f-T4 radioimmunoassay was investigated in 122 patients with different thyroid status. The normal range of f-T4 was 0.60-2.20 ng/dl in euthyroid patients from an endemic goiter area. No significant difference was found between normals and a group taking oral contraceptives (mean = 1.37 ng/dl vs. 1.45 nd/dl). In patients on thyroid hormone or antithyroid drug therapy, f-T4-values showed a better correlation with the results of an oral TRH-test than total T4 or the free thyroxine ratio (ETR). Specificity of ETR was better than that of f-T4. Sensitivity of f-T4 was higher in the group with negative TRH-test, but lower in hypothyroidism as compared to ETR. Determination of f-T4 by radioimmunoassay is a simple diagnostic procedure. Since f-T4 RIA is not influenced by changes in TBG-levels its use is particularly recommended in cases where such changes are to be expected such as estrogen application or gravidity.

Antithyroid Agents↗
PubMed1981

[Serum levels od D-thyroxine in euthyroidism and hypothyroidism (author's transl)].

Serum levels of D-thyroxine (D-T4) and L-thyroxine (L-T4) were determined by use of a newly developed method for the stereospecific determination of these isomers in 8 patients with diffuse non-toxic goiter and 2 hypothyroid patients following administration of increasing doses of D-thyroxine. During the 3-day observation period a significant decrease of serum-TSH takes place. D-T4 levels are highest 4 hours after administration of the tablets and approach basal values within 24 hours in euthyroid as well as hypothyroid patients. Serum half life of D-T4 was 5.7 hours on the average in the euthyroid group and was markedly prolonged in hypothyroidism. L-T4 levels show no significant changes. Since the D-T4 preparation used, contained only very little amounts of the L-isomer, it may be assumed that D-T4 exerts a direct suppressive effect on the pituitary TSH secretion, as evidenced by the observed significant decrease in basal and TRH-stimulated TSH serum levels.

Adult↗
PubMed1981

[The current status of scintigraphy in oncology (author's transl)].

The clinical usefulness of tumor scanning methods is discussed under the practical considerations of tumor screening, determination of tumor size and noninvasive tumor staging as well as diagnostic follow-up after therapy. Scintigraphy as a primary diagnostic tool is mainly restricted to suspicious enlargements of the thyroid gland whereas scintigraphy with 67Ga-citrate in Hodgkin's disease and bone scintigraphy with 99mTc-phosphates in tumors with tendencies to early bone metastases are widely used non-invasive diagnostic means for the evaluation of tumor propagation. Post therapy conversion of positive findings is of less predictive value than than persistence of a positive scan. Some results of the literature are discussed with our own experiences.

Antineoplastic Agents↗
PubMed1980

[Influence of a highly purified D-thyroxine medication on thyroid iodine uptake and in vitro tests of thyroid function (author's transl)].

25 euthyroidal patients with elevated serum cholesterol levels were treated with 4 mg of D-thyroxine daily for 4 weeks; controls were made after this period and after a withdrawal period of another 4 weeks. At the end of the treatment period there was a significant decrease of the serum cholesterol level, of the basal and TRH-stimulated serum TSH and of the thyroidal radioiodine uptake. The radioimmunologically determined values of total T 3 and Free Thyroxine index and of the serum iodine level rose significantly without being accompanied by clinical hyperthyroid symptoms. These changes can be explained on one hand by the well known cholesterol lowering effect of D T-4 and by the inclusion of D-isomeres of thyroid hormones in the radioimmunoassay, and, on the other hand, by the fact that the above-mentioned medication causes an uptake of iodine, and, possibly, by a direct inhibitory effect of D T-4 on the pituitary gland.

Adult↗
PubMed1980

[Oral TRH test: normal range and comparison with intravenous TRH test (author's transl)].

TRH (40 mg) was given orally to 122 patients with divers thyroid status. In euthyroidism, TRH induced TSH response ranged from 2.5 microU to 45 microU TSH, measured three hours after oral administration. TSH values were threefold higher following oral TRH (mean 24.5 microU) as compared to intravenous TRH-test using 200 microgram TRH (mean 7.05 microU). No exaggerated TSH response were found in patients on oral contraceptives and in euthyroid nodular goiter. Preclinical hypothyroidism was present in 50% in patients with previous partial thyroidectomy and only 15% of patients with blunted TSH response on an thyroid hormone regimen of 70 microgram thyroxine daily. Oral TRH test was negative in every patient with normal serum hormone levels under antithyroid drug therapy.

Administration, Oral↗
PubMed1979

[Progress in the therapy of acute and chronic cardiac insufficiency by means of systemic vasodilators. Studies with prazosin and nitroglycerin].

In acute and chronic left heart failure peripheral resistance is elevated due to increased sympathetic tone. This should compensate the decrease in stroke volume. In the diseased left ventricle however the augmentation of afterload leads to further reduction of stroke volume and to increase of heart size and myocardial oxygen consumption. This vitious cycle may be interrupted by vasodilators. Drugs like nitroglycerin, mainly acting on the venous system, reduce preload and thereby relieve symptoms of pulmonary congestion (backward failure). Phentholamin on the other hand primarily reduces afterload by an action on the resistance vessels and thereby increases cardiac output (forward failure). Nitroprusside has effects on both, the capacity and resistance vessels. So nigroglycerin is the remedy of choice in acute pulmonary edema. Nitroprusside in leftf heart failure in acute myocardial infarction and Phentolamin in acute left ventricular failure due to critical rise in blood pressure. For long term treatment of chronic left heart failure (coronary heart disease, cardiomyopathy, rheumatic heart disease) hydralazin or prazosin may be used as well as long acting nitrates.

Blood Pressure↗
PubMed1979

[Effect of biguanids on the lactate metabolism. Studies in diabetics under submaximal ergometric exercise (author's transl)].

24 diabetics without any complications were subjected to an exercise test before and after biguanid therapy. The schedule of the physical strain was a modification of the Kaltenbach diagram. Changes of lactate, pyruvate, pH-standard bicarbonate and base excess values were analysed. Additionally to antidiabetical therapy each of the 8 patients was given either metformin or buformin or phenformin now. Each one of the biguanid derivates induced a rise of the lactate level before and after the exercise test. Phenformin showed the greatest influence on the lactate metabolism, metformin the smallest. Reasons causing the lactogene effect and the quantitative differences of the biguanides are discussed.

Biguanides↗
PubMed1979

New chromosomal dysmorphic syndromes. 3. Partial trisomy 3q.

Chromosome analysis in a newborn, the daughter of diabetic parents, who showed multiple dysmorphic signs and malformations revealed direct duplication of a long arm segment of chromosome 3(3q2100 leads to 3q2700). Both parents have normal karyotypes. Compilation of the phenotype stigmata with those of 7 other patients and 1 fetus with partial trisomy 3q confirmed that clinical recognition of this syndrome is possible. It is characterized by hypertrichosis, typical craniofacial dysmorphia, frequent organ malformations and skeletal anomalies, as well as a peculiar dermatoglyphic pattern. It is a severe genetic disturbance, leading to death in the first months of life in many cases and only symptomatic care is advised.

Bone Diseases, Developmental↗