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Biomedical subjects

S Reichlin

Publications and source records attributed to S Reichlin.

At least 163 records · Page 9Linked to original sources

Natural history of familial medullary thyroid carcinoma: effect of a program for early diagnosis.

To detect familial medullary thyroid carcinoma in a premetastatic stage, we administered tests provocative of calcitonin secretion (infusion of calcium or pentagastrin or both) each year for seven years to members of a pedigree now numbering 107. Since 1970, 21 patients converted from normal to abnormal secretory responses (two separate tests in which calcitonin levels exceeded 0.58 ng per milliliter). Twenty of 21 glands removed showed C-cell hyperplasia, and eight of the 20 also showed foci of carcinoma. As compared to the 12 patients with tumors detected during the first year of screening, all of whom had bilateral carcinoma (seven of 12 with local metastases), later carcinomas were smaller (mean diameter of 0.2 vs. 0.8 cm), were unilateral (in all but two cases) and occurred in younger patients (mean age of 14.9 vs. 36.4 years), and none had detectable metastases.

Adolescent↗

Do thyroid-stimulating immunoglobulins cause non-toxic and toxic multinodular goitre?

The prevalence of serum thyroid-stimulating immunoglobulins (T.S.I.) in a variety of thyroid diseases was determined in 96 patients and 35 normal controls. Significantly elevated levels of T.S.I. were found not only in patients with Graves' disease and Hashimoto's thyroiditis but also in those with non-toxic and toxic multinodular goitre, whereas patients with a single autonomously functioning thyroid nodule, with subacute thyroiditis, and with "hyperthyroiditis" had levels which did not differ from those in the controls. We postulate that non-toxic multinodular goitre, like Graves' disease, may result from increased circulating T.S.I., which in some cases may be present in sufficient concentration to cause thyrotoxicosis.

Adolescent↗

Thyroid hormones in the adult rat lung.

Thyroid hormones have been postulated to be involved in lung development and the regulation of the surfactant system. This study was designed to determine the concentration of thyroxine and of triiodothyronine in adult rat lung. Tissue-to-plasma ratios of thyroxine and triiodothyronine were determined in adult rats by the equilibrium distribution of radiolabeled hormones. Extracellular thyroid hormone space was estimated by equilibrium distribution of radiolabeled bovine serum albumin. The mean +/- SE ratio of lung triiodothyronine to plasma triiodothyronine, corrected for extracellular space, as 2.57 +/- 0.40, indicating appreciable concentration of this hormone. In contrast, lung thyroxine ratios indicate that this hormone is virtually excluded from adult lung parenchyma. Such results support the hypothesis that thyroid hormone may have a significant role in the regulation of the surfactant system.

Animals↗

Abnormal gonadotropin secretory responses to LRH in transsexual women after diethylstilbestrol priming.

To determine whether female transsexuals have abnormal hypothalamic-pituitary feedback control, pituitary LH and FSH secretory responses to synthetic LRH (100 micrograms iv) were measured in nine female transsexuals with normal menstrual cycles before and after a 7-day course of treatment with diethylstilbestrol (DES; 2 mg/day). Control groups included five heterosexual women and seven heterosexual men. Pituitary responses to LHR in heterosexual women studied in the early follicular phase increased markedly after DES administration and were clearly different from responses in men, which were all inhibited by DES. Responses to LRH in nine transsexual women studied in the early follicular phase differed strikingly from normal women in that gonadotropin responses were not enhanced by DES. The finding that the responses of female transsexuals to DES and LRH were intermediate between the female and the male patterns suggests that a biological abnormality accompanies the psychological abnormality in such patients.

Adult↗

Neurogenic galactorrhea-amenorrhea.

Neuroendocrine function in two women with galactorrhea-amenorrhea arising from abnormalities in the PRL reflex arc was compared to that of normal women. Basal gonadotropins were lower than normal, and one patient lacked episodic secretion of LH; however, the serum gonadotropin rise after iv LRH was in the normal range in both patients. Mean basal PRL levels were slightly elevated in one patient and were normal in the other, and the PRL levels after TRH, chlorpromazine, and levodopa testing were similar to those seen in normal women. Breast stimulation did not increase PRL levels in either patient. PRL levels fell with bromergocryptine therapy, galactorrhea ceased, and normal menses resumed. These studies indicate that chronic afferent impulses originating in the PRL reflex arc can result in galactorrhea and amenorrhea and that bromergocryptine therapy in such patients can restore normal menses.

Adult↗

Neurogenic diabetes insipidus: management with dDAVP (1-desamino-8-D arginine vasopressin).

We used dDAVP, the 1-desamino-8-D arginine analogue of arginine vasopressin with high antidiuretic and low vasopressor potency, to treat 29 patients with neurogenic diabetes insipidus for up to 22 months. Intranasal dDAVP, 2.5 to 15 microgram twice daily, provided excellent control in most patients. Individual responses were independent of age, weight, and severity of diabetes insipidus. Resistance to dDAVP may be a rare complication of prolonged therapy. Two patients with acute postoperative diabetes insipidus were effectively treated with 5 microgram of dDAVP every 14 to 18 h. Compared to previous therapy, side effects of dDAVP were minimal (headaches in two patients), and control of symptoms and urine volume was as good as with vasopressin tannate in oil or better than chlorpropamide and lysine vasopressin nasal spray. We conclude that intranasal dDAVP, because of efficacy, long duration of action, and infrequent side effects, is the preferred treatment of neurogenic diabetes insipidus in children and adults.

Adolescent↗