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Biomedical subjects

S Ljunghall

Publications and source records attributed to S Ljunghall.

At least 307 records · Page 17Linked to original sources
PubMed1985

Evaluation by integrated thermography of the beneficial effect of cyclofenil in severe subcutaneous arterial insufficiency.

Integrated thermographic measurements were made in a patient suffering from a complex syndrome which included scleroderma, Osler-Weber-Rendu disease and a marked atherosclerotic circulatory insufficiency. A new anti-estrogenic drug, cyclofenil, elicited a rapid and prolonged curative effect against the entire syndrome. The circulatory amelioration was registered periodically by integrated thermography of the face and both hands. This method enables temperature distribution functions to be calculated and seems to hold considerable promise for the evaluation of circulatory changes and in particular those changes evoked by therapeutic agents.

Aged↗
PubMed1985

Lipid-lowering effects of two synthetic oestrogen derivatives with weak genital oestrogen properties.

The effects on serum lipids of two weak synthetic oestrogens were examined in 23 patients, 17 of whom were given cyclofenil and 6 methallenestril for a period of 10 weeks. These compounds have previously been demonstrated to have a much lower effect on the genital organs than on connective tissue compared with natural oestrogens. With both substances there were during treatment significant reductions of serum triglycerides (mean average reduction 25%) and cholesterol (20%). No side effects were noted. Previous studies have shown that the net effects of oestrogens on serum lipids depend on their formulation. This study indicates that weak synthetic oestrogens, primarily designed to influence bone and connective tissue, also have lipid-lowering properties which are unrelated to their feminizing capacity.

Adult↗
PubMed1984

Neuromuscular involvement in primary hyperparathyroidism.

Sixteen consecutive patients with primary hyperparathyroidism (HPT) were examined by a combination of electrophysiological, morphological and biochemical measurements. Six patients had, preoperatively, subjective impairment of neuromuscular function. Three of them were improved by the normalization of parathyroid function after surgery. In the other patients, who either had vague symptoms or appeared to be asymptomatic, the operation did not cause subjective changes in their neuromuscular function during a 3-month follow-up period. Altogether seven patients, three of whom had symptoms, had impairment of the neuromuscular transmission as evaluated by the single-fibre EMG technique. The changes were of slight degree and unlikely to be of clinical importance. Two patients had a slightly reduced nerve conduction velocity and in two cases moderate abnormalities were found in muscle biopsy specimens. In conclusion, the muscular weakness reported by HPT patients did not seem to be caused by disturbance of neuromuscular transmission. HPT patients who preoperatively were apparently asymptomatic did not have defects of their neuromuscular transmission that were of clinical significance.

Aged↗
PubMed1984

Defective regulation of the cytosolic Ca2+ activity in parathyroid cells from patients with hyperparathyroidism.

The parathyroid hormone (PTH) release and cytosolic Ca2+ activity were determined in normal bovine parathyroid cells and parathyroid cells obtained from patients with hyperparathyroidism (HPT). There was a sigmoid relation between the cytosolic Ca2+ activity and the extracellular calcium concentration between 0.5 and 6.0 mmol/l. The PTH release was inhibited in parallel with the rise in the cytosolic Ca2+ activity. Both the hormone release and the cytosolic Ca2+ activity were lower in cells from human adenomas and hyperplastic glands, and in comparison with the bovine preparations these cells had higher set points for the cytosolic Ca2+ activity and PTH release. There was a close correlation between the individual set points for the cytosolic Ca2+ activity and PTH release in a material containing both normal and pathological cells. The results indicate that the abnormal PTH release characteristic of HPT is due to a defective regulation of the cytosolic Ca2+ activity.

Adenoma↗
PubMed1984

Insulin-induced hypoglycaemia stimulates secretion of parathyroid hormone.

In-vitro and in-vivo studies have suggested a role for the adrenergic system in the regulation of secretion of parathyroid hormone (PTH). In the present study the effects of insulin induced hypoglycaemia on serum concentrations of PTH, cortisol, calcium and phosphate were evaluated in ten healthy subjects. Maximum hypoglycaemia occurred 25 to 35 min after administration of insulin at a standard dose of 0.15 U/kg body weight. All this time there was a slight and transient increase of the serum calcium concentrations whereas there was a marked drop in the serum phosphate levels with a nadir 15 min after maximum hypoglycaemia. Cortisol levels were below baseline when blood glucose was as lowest but increased to a maximum level of 200% 60 minutes after maximum hypoglycaemia. Serum PTH levels increased significantly and reached a maximum of 130% of baseline values concomitant with maximum hypoglycaemia, whereafter they returned to pre-insulin-injection levels within 15 minutes. These findings indicate that during stress endogenous catecholamines affect the secretion of PTH which could be of physiologic importance. In five patients with primary hyperparathyroidism there was, however, no increase in the PTH levels, although they displayed the same response to hypoglycaemia for cortisol and phosphate. This supports previous suggestions that these patients have an impaired capacity to respond to circulating catecholamines.

Adult↗
PubMed1984

Treatment of primary hyperparathyroidism with cyclofenil--a synthetic stilbestrol derivative with minimal feminizing effects.

In eight patients with primary hyperparathyroidism (HPT) the laboratory effects of cyclofenil, which is a synthetic stilbestrol derivative with weak feminizing effects, were studied over a period of 5-13 weeks. In all the patients there were during treatment clear reductions of the serum calcium levels as well as the urinary excretions of calcium and hydroxyproline. These findings are in accordance with earlier reports that oestrogens reduce bone resorption mediated by parathyroid hormone. It has previously been demonstrated that cyclofenil can be given, on other indications, for several years to both male and female patients without oestrogenic side-effects. This pilot study, therefore, indicates that treatment with cyclofenil might be of value in some cases of primary HPT where surgery is not considered.

Aged↗
PubMed1984

Screening for multiple endocrine neoplasia syndrome (type 1) in patients with primary hyperparathyroidism.

In 63 consecutive patients with primary hyperparathyroidism (HPT) a prospective screening study was undertaken for coexistent multiple endocrine neoplasma-(MEN)-syndrome type 1. The screening consisted of a clinical examination, a radiological examination of the sella turcica with skeletal tomography (and in equivocal cases computed tomography), visual field examination by perimetry and a hormonal evaluation including measurements of the serum levels of prolactin, gastrin, pancreatic polypeptide (PP) and subunits of human chorionic gonadotrophin (HCG-alpha and -beta). Clinical examination did not reveal any signs of endocrine disease suggestive of a MEN-1 syndrome. In only one case there was a radiological abnormality of the sella turcica; this patient had an empty sella syndrome and a raised serum prolactin value. All other prolactin values were within the normal range. In 41% of the patients raised serum gastrin levels were found; these tended to normalize after parathyroidectomy. As a group, patients with raised gastrin values were older than the others and generally they had hypo- or achlorhydria. The serum PP levels were raised in 28% of the patients but there was no clinical evidence of a pancreatic tumour in any of these cases, and the serum HCG-alpha and -beta levels were within the normal range in all patients but two. We conclude that the incidence of MEN-1 syndrome in unselected patients with primary HPT must be low, and that investigations for this syndrome are justified only in HPT patients with specific symptoms or with a positive family history.

Adult↗
PubMed1984

Effects of physical exercise on serum calcium and parathyroid hormone.

The effects of physical exercise on plasma ionized calcium, total serum calcium and parathyroid hormone (PTH) concentrations were evaluated in healthy subjects submitted to work on an ergometer bicycle. When the workload was increased stepwise there was a significant increase (P less than 0.001) in the calcium concentrations (ionized calcium from 1.13 +/- 0.03 (SD) to 1.24 +/- 0.03 mmol 1(-1) and total calcium from 2.35 +/- 0.07 to 2.48 +/- 0.07 mmol 1(-1] when the workload exceeded approximately 65% of the estimated maximum--i.e. a load that caused accumulation in blood of lactic acid. The rise in plasma ionized calcium was, therefore, presumably largely attributed to the acidosis but reduction of plasma volume and influx from extracellular sources might also have contributed. Beta blockade (with oral intake of propranolol) reduced physical capacity, shortened the duration of work and caused less acidosis. These factors were probably responsible for a smaller rise in ionized calcium during beta blockade (7 +/- 4%) than in control studies (21 +/- 5%) without medication in subjects examined during short-term maximal exercise. Long-term (1 h) steady-state work which caused fatigue without producing lactic acidosis did not affect the calcium concentrations. Despite the effects of work on calcium levels there was no discernible suppression of the PTH concentrations. This might have been due to a concomitant stimulation of PTH secretion by work.

Adult↗
PubMed1984

A prospective study of renal stone recurrences.

A simple metabolic investigation was carried out in 54 patients presenting with their first attack of renal stones. In three cases a probable cause for stone formation was found. During the following 8 years 53% of the patients developed recurrences, the risk of which was highest during the first years after the initial attack. Recurrences were more common in males than in females. As a group, patients who were to have recurrences had higher urinary calcium levels but there was a considerable overlap between the two groups. This prospective study confirms the opinion from retrospective evaluation of the natural history of renal stones that recurrences are common. However, they cannot be predicted from standard laboratory findings in individual patients.

Adult↗
PubMed1984

Effects of high intake of dietary animal protein on mineral metabolism and urinary supersaturation of calcium oxalate in renal stone formers.

The metabolic effects of a high protein diet (HPD) were studied in eight patients with idiopathic recurrent calcium oxalate stones. On the HPD there was a 35% increase in urinary calcium concomitant with increased excretion of cyclic AMP and hydroxyproline. These findings point to an enhanced resorption of bone, possibly secondary to increased renal loss of calcium. The urinary citrate decreased by 25% along with reduced serum standard bicarbonate and urinary pH. The high formation of acid metabolites might also have adverse effects on calcium balance and bone. Urinary oxalate excretion was not affected nor were there any significant changes in the calculated urinary supersaturation of calcium oxalate, if changes in urinary citrate, pH, sulphate, sodium, phosphate and volume were also considered. This study suggests that the possible negative influence on the propensity to form renal stones of a diet rich in animal protein is probably due to reduced urinary inhibitory activity.

Adult↗
PubMed1984

Ultrasonic appearance of adenomatous and hyperplastic parathyroid glands.

An investigation was made of the sonographic and histopathologic characteristics of 27 parathyroid adenomas and 11 primary and secondary hyperplastic parathyroid glands demonstrated by ultrasound before surgical confirmation. All the hyperplastic glands and 21 of the adenomas had a homogeneously sonolucent interior structure and a smooth periphery. The adenomas and hyperplastic glands were sonographically indistinguishable except for 5 large adenomas which had areas of varying echodensity and an irregularly nodulated periphery. The ultrasonically inhomogeneous adenomas were histopathologically more heterogeneous with asymmetric, nodular enlargement. One patient had a cystic adenoma. The results are discussed in relation to the ultrasonic appearance of thyroid noduli and lymph nodes being the main source of errors in parathyroid ultrasonography.

Adenoma↗
PubMed1984

Effects of 1,25- and 24,25-dihydroxycholecalciferol on parathyroid hormone release from human parathyroid cells in vitro.

The effects of 1,25-dihydroxycholecalciferol (1,25-(OH)2D3) and 24,25-dihydroxycholecalciferol (24,25-(OH)2D3) on parathyroid hormone (PTH) release from human parathyroid cells were investigated using an in vitro system of dispersed cells. The cells were obtained from 7 patients with primary hyperparathyroidism (HPT) and adenoma, 4 patients with primary HPT due to hyperplasia and 2 patients with parathyroid hyperplasia secondary to chronic renal failure. The dispersed cells were incubated in tissue culture medium at low, normal and high external calcium concentrations for 2-16 h. There was a gradual suppression of PTH release (5-55%) when the calcium concentration in the medium was increased from 0.5 to 3.0 mM, thus indicating retained regulation of hormone release. The addition of 1,25-(OH)2D3 in concentrations of 0.1 and 1 ng/ml and of 24,25-(OH)2D3 in concentrations of 1.0 and 10 ng/ml during the incubations did not further affect the amount of PTH released by the cells. The concentrations of the different vitamin D metabolites tested closely correspond to levels observed under normal physiological conditions and during treatment with high doses of vitamin D in vivo. Thus, the findings contradict the idea of any direct short-term regulatory effect of either 1,25-(OH)2D3 or 24,25-(OH)2D3 on the secretion of PTH from hyperfunctioning human parathyroid tissue.

24,25-Dihydroxyvitamin D 3↗
PubMed1984

A stimulation test with calcitonin for differential diagnosis of hypercalcaemia.

Experimental studies have suggested that in primary hyperparathyroidism (HPT) the cells of the hyperfunctioning parathyroid tissue retain some capacity for stimulation and that an increase in secretion of parathyroid hormone (PTH) can occur when the extracellular calcium concentration is lowered within the hypercalcaemic range. We have tested this hypothesis in 23 patients with HPT, 10 patients with hypercalcaemia of other origin (7 of whom had disseminated malignant disease) and 17 normal subjects. In all three groups a single injection of 100 MRC units of salmon calcitonin caused a reduction in serum calcium of approximately 3 to 5%. In the hypercalcaemic patients this reduction was correlated to the basal calcium level (r = -0.57, P less than 0.01). In the patients with HPT, although they all remained hypercalcaemic, the decrease in serum calcium was associated with a mean increase in serum PTH of 10%. Only in 2 patients did such an increase fail to occur despite an adequate decrease in serum calcium. These 2 patients had high basal PTH levels and the lack of response might have been due to a high degree of autonomous parathyroid function. Calcitonin also reduced serum calcium and increased serum PTH in normal subjects. None of the patients with hypercalcaemia of other origin than primary HPT displayed a secretory PTH response to serum calcium reduction. Thus, this test could be of practical clinical value, particularly in patients with borderline PTH values. A calcitonin-induced rise in PTH while serum calcium is lowered within the hypercalcaemic range strongly suggests primary HPT.

Adult↗
PubMed1984

Histological changes in parathyroid glands in subclinical and clinical renal disease. An autopsy investigation.

In an autopsy material of patients with varying degrees of renal impairment, the parathyroid glands were examined regarding glandular and parenchymal cell weights and cellular types and arrangement. The findings were related to the different stages of renal disease. The study comprised 69 cases--29 females and 40 males. Their mean age was 74 years (range 33-98 years). There was a positive relation between serum creatinine level and total parathyroid parenchymal cell weight (r=0.37, p less than 0.01) and an inverse correlation between kidney weights and parathyroid parenchymal cell weight (r=-0.24, p less than 0.05). The patients with the most advanced renal impairment had significantly higher mean total glandular and mean total parenchymal weights than those with less pronounced renal disease. Nodular arrangement and an increased number of oxyphil and transitional oxyphil cells were noted in cases with advanced histological kidney changes but normal serum creatinine levels. This nodularity as well as the frequency of oxyphil cells increased in parallel with deterioration of renal function. The two most important factors that influenced the proportion of oxyphil cells were the parenchymal cell weights and the age of the patient. It is concluded that signs of stimulation of the parathyroids are present already in early stages of renal disease, in some cases before renal dysfunction is clinically manifested.

Adipose Tissue↗