Syndrome of persisting thyroid stimulating immunoglobulins and growth promotion of goiter combined with low thyroxine and high triiodothyronine serum levels in drug treated Graves' disease.

Among 48 Graves' patients treated with antithyroid drugs there were 8 patients with a further growth of an already enlarged goiter and a persistence of thyroid stimulating immunoglobulins (TSI). TSI activity did not persist in a comparison group of patients with less severe initial symptoms and an uncomplicated course during a similar regimen of drug treatment. Thyrotoxicosis was difficult to control in this subgroup of patients as low serum T4 was accompanied by borderline high T3 levels although TSH in serum remained undetectable.

HLA-DR3 and HLA-DR5 associated thyrotoxicosis--two different types of toxic diffuse goiter.

One hundred fifty patients with toxic and scintigraphically diffuse goiter were HLA typed (A, B, C, DR). One group consisted of 101 patients with concomitant Graves' ophthalmopathy and/or TSH-binding inhibiting antibodies (TBIAb). Forty nine patients had neither ophthalmopathy nor TBIAb.

Lack of influence of the antidopaminergic drug domperidone on basal and TRH-stimulated TSH-serum levels after oral administration.

Since antidopaminergic drugs are known to elevate basal and TRH-stimulated TSH-serum levels and since this effect was also shown after iv administration of the novel dopamine antagonistic agent domperidone, it was investigated, whether this antiemetic drug could interfere after oral intake with the evaluation of thyroid function. Oral domperidone caused a marked TSH-enhancement of TRH-induced TSH increments in 6 out of 14 euthyroid subjects, with no statistical significance, however. The difference between oral and parenteral influence as well as inter-individual changes are probably due to the varying first pass effect of the drug after oral absorption.

[Mechanical resistance of methanal preserved bioprostheses].

Methanal (formaldehyde) preserved and ethane acid peroxide finally sterilised aortic segments showed in vitro and in vivo a significant decrease of the material characteristics in case of watering for 180 days. Intraperitoneal incorporation in a xenogeneous animal species during 60 days reduced the mechanical stability of the substitutes without long-term watering and also with long-term watering, but with an additionally greater negative effect.

[Detoxication of methanal preserved bioprostheses].

The substitutes could be decontaminated by means of six to eight times soaking into sterile sodium chloride solution (154 mmol/l = 9 g/l) in each case half an hour if a short preparation time for the implantation of protein cross-linked and methanal storaged bioprotheses is existent. This procedure must be carried out under strict aseptic conditions. A microbial recontamination of the preparations threats moreover.

[Stability of acetate buffered methanal solutions].

The determination of the concentration in acetate puffered methanol solutions (formaldehyde solutions) with pH = 5.60 during 14 months disproved the opinion of the limited durability of these solutions. Neither a significant decrease of the methanal mass concentration nor a noticeable change of the pH value could be proved during the period of the examination under different influences of light and temperature.

[Mechanical stability of vascular grafts for chronic hemodialysis, preserved with methanal or peroxyethanic acid].

Vessels implants as possible vessel connections for chronic haemodialysis have to meet certain requirements concerning resistance to cutting and kinking and ability to be sewn under tolerable intraoperative damage risk. Preservation in peroxyethanic acid significant reduces the mechanical resistance of the biological primary material; by contrast, preservation in methanal clearly raises the mechanical stability of the preparations.

Circulating diiodotyrosine: studies of its serum concentration, source, and turnover using radioimmunoassay after immunoextraction.

This report describes the application of a sensitive, specific, and reproducible RIA for diiodotyrosine (DIT) in human serum and metabolic studies on the source and kinetics of circulating DIT. Interference by cross-reactivity of T4 and other analogs was completely eliminated by isolation of DIT from serum with an efficient preparative immunoprecipitation technique. Mean (+/- SD) serum DIT levels were 161 +/- 133 pmol/liter (7.

[Misdiagnoses and mismanagement in thyroid diseases (author's transl)].

Measures prior to diagnosis and treatment already installed were assessed retrospectively in 8501 patients with suspect thyroid disease between the years 1976 and 1979. In 10.5% of these patients there were 11.

Pharmacological interference with in vitro tests of thyroid function.

Numerous drugs may cause changes in the serum concentrations of T4 and of T3. If such alterations are not recognized an incorrect diagnosis may result. In moderate degrees of hypo- and hyperthyroidism thyroid hormone levels may be spuriously normal, or the influence of pharmacological substances may lead to false diagnosis of thyroid disease in euthyroid patients.

Binding of solubilized human TSH-receptor protein by peripheral blood lymphocytes of patients with Graves' disease.

Peripheral blood lymphocytes (PBL) from patients with hyperthyroidism due to Graves' disease (GD) were investigated for the ability to bind radioiodinated TSH receptor protein as hypothetical autoantigen (ABL). Thyrotropin-displacing antibody (TDA)-positive patients, who relapsed and were investigated shortly after starting antithyroid drug therapy, as well as TDA-positive patients with a first diagnosis of GD, who were investigated before starting therapy, showed significantly increased numbers of ABLs (0.2 +/- 0.

Mitogenic response of peripheral blood lymphocytes from patients with Graves' disease incubated with solubilized thyroid cell membranes containing TSH receptor and with thyroglobulin.

Transformation of peripheral blood lymphocytes (PBL) in response to solubilized TSH receptor and to human thyroglobulin (hTG) was carried out in patients with Graves' disease (GD). Mean stimulation index (SI) in response to solubilized TSH receptor was significantly increased only in hyperthyroid GD patients (SI = 3.0 +/- 1.

Relations between serum levels of TSH, TBG, T4, T3, rT3 and various histologically classified chronic liver diseases.

Serum levels of TSH, thyroxine-binding globulin (TBG), T4, T3 and reverse T3 (rT3) were measured in 36 patients with fatty liver disease, 11 patients wih chronic persistent hepatitis, 17 patients with chronic active hepatitis, and 29 patients with liver cirrhosis. TBG was significantly above normal levels in both groups of chronic hepatitis, the slight concomitant T4 and T3 increase was significant only for T4 in chronic persistent hepatitis. A significant decrease in T4 and T3 concentration was found in fatty liver disease and in hepatic cirrhosis.

[Permeation of formaldehyde (methanal) through supravital and preserved tissue].

Allogenic and xenogenic tissues can be preserved with acetate buffered formaldehyde solution 1,332 mol/l and pH 5,60. The permeation of methanol molecules through the tissue was analysed with a double chamber research arrangement with a rotating set-up. The coefficient of diffusion of the formaldehyde (methanal) through the wall of the aorta descendens of pigs was calculated by means of the first Fick principle from the obtained measured particulars.

[The HPLC determination of elemental sulfur in foodstuffs (author's transl)].

A simple HPLC method for the determination of sulfur is described. Sulfur is extracted from foodstuffs with petroleum ether, separated by means of HPLC and measured at 263 or 254 nm.

Amniotic fluid concentrations of 3,3',5'-tri-iodothyronine (reverse T3), 3,3'-di-iodothyronine, 3,5,3'-tri-iodothyronine (T3) and thyroxine (T4) in normal and complicated pregnancy.

Amniotic fluid concentrations of 3,3',5'-tri-iodothyronine (rT3), 3,3'-Di-iodothyronine (3,3'-T2), 3,5,3'-tri-iodothyronine (T3) and T4 were studied in 384 women during normal and complicated pregnancy. An inverse correlation was observed between decreasing rT3 and increasing 3,3'-T2 concentrations in amniotic fluid with gestational age. The mean rT3 level in normal pregnancy was 2.

Relationship between thyroid status and Graves' disease-specific immunoglobulins.

The prevalence of TSI in Graves' disease was investigated with a radioligand receptor assay using human thyroid membranes and highly purified labeled porcine TSH or bovine TSH in 110 patients before treatment and in 39 patients after successful treatment with antithyroid drugs. In 11 patients, the assay was performed before, during, and after therapy. The results in the radioligand receptor assay were compared to thyroid function tests (TRH test, free T4 index, serum %3 level, and thyroid suppression test).

A low T3 syndrome in diabetic ketoacidosis.

The pituitary-thyroid axis was investigated in nineteen euthyroid patients with severe diabetic ketoacidosis. A 'low T3 syndrome' was found, with the following characteristics: lowered serum concentrations of triiodothyronine (T3), increased reverse triiodothyronine (rT3), slightly low thyroxine (T4), normal thyrotrophin (TSH), slightly increased triiodothyronine uptake (RT3U) values, and a blunted TSH response to thyrotrophin-releasing hormone (TRH). These disturbances in thyroid-function tests required several days good control of the diabetes to be corrected, at least partially.